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OOPS!

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Topic: OOPS!

Posted By: Mack
Subject: OOPS!
Date Posted: 26 July 2009 at 12:27am

It's no secret, since I mention it repeatedly, that my experiences with the military medical establishment are a the primary reason I am very skeptical about further government involvement in health care. I stumbled across this http://www.foxnews.com/story/0,2933,534050,00.html - article (quoted below) and decided to provide it as an example of the reason for my distrust. I thought about sticking this in the on-going thread on this topic, but chose not to muddy the waters of what is actually a fairly civil and informed discussion with what is essentially an anecdote about a doctor's mistake. (I would like to point out that my distrust of the government running health care is based on more than a single incident; I saw quite a few mistakes, some at least as serious than this, while I was in.)

Article wrote:

A Texas Airman stationed at an Air Force Base near Sacramento, Calif. has lost both legs after surgeons reportedly botched a routine surgery to remove his gallbladder.

Colton Read, 20, underwent laproscopic surgery last week at David Grant Medical Center at Travis Air Force Base near Sacramento. Laproscopic surgery is a minimally invasive procedure that involves making a tiny incision to minimize pain and speed recovery time.

About an hour into the surgery, something went wrong. Read's wife Jessica told CBS11TV.com.

"A nurse runs out, 'we need blood now' and she rounds the corner and my gut feelings is 'oh my God, is that my husband?'" Jessica Read said. Read's wife said an Air Force general surgeon mistakenly cut her husband's aortic valve, which supplies blood to the heart, but waited hours to transport Colton Read to a state hospital with a vascular surgeon.

Read, who is still in intensive care, lost both legs as a result of the blood loss. Meanwhile, his http://www.foxnews.com/story/0,2933,534050,00.html#">gallbladder still has not been removed. Jessica Read said the doctor admitted his mistake, but under federal law the Reads cannot sue.

The future of Colton Read's career is now uncertain, http://www.fox40.com/news/headlines/ktxl-news-airman,0,4446243.story - FOX 40 in Sacramento reported .

Jessica Read told FOX 40 she is appalled that the Air Force is even considering medical retirement or medical discharge while Airman Read is incapable of making any type of decision. She said he is not 100 percent lucid and is still heavily medicated.

The Air Force is conducting a review of the case using outside experts.

Please note the reference to having no legal recourse in the quoted article.

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Replies:

Posted By: *Stealth*
Date Posted: 26 July 2009 at 12:36am

Firstly,

The surgeon didn't cut the Aortic Valve - he would have had to literally been operating on the heart in order to accomplish that.

Secondly,

The Aorta is the primary artery that carries blood away from the heart.

and even then - lets say the surgeon DID actually crack the mans ribs, open his heart, and sever a valve inside the heart, which would mean he completely disregarded the fact that the gallbladder is located on the opposite lower quadrant of the body. It's even more far fetched for me to believe they managed to keep this man ALIVE, let alone to just lose his legs, for "hours" with such a major heart related mishap - transfusion or no.

Those are just some major facts that really obscure the validity of this article for me.

I call shens.

Also,

There are major medical errors all of the time in the private sector. Some people are good at their job, some people are bad - and there are allot of bad doctors/surgeons out there, it's not a government exclusive anomaly.

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WHO says eating pork is safe, but Mexicans have even cut back on their beloved greasy pork tacos. - MSNBC on the Swine Flu

Posted By: Linus
Date Posted: 26 July 2009 at 1:02am

Actually, Stealth, the Aorta goes all the way down the abdomen, and splits off into both femoral arteries. There's something called an abdominal aortic aneurysm. If that burst and you're not ready for it, a person will bleed out in seconds.

The gallbladder is also in the upper right quadrant of the abdomen, not the lower, tucked beneath the liver, which is just below the diaphragm, which is just below the heart.

Also, with the man in the hospital, with a ready supply of blood for transfusion, him surviving an aortic cut is not that hard to believe, as it happens. Rare, but it happens.

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Posted By: Peter Parker
Date Posted: 26 July 2009 at 1:09am

Article wrote:

[Awful stuff]

That's awful. I absolutely hate reading stuff like that.

Mack wrote:

Please note the reference to having no legal recourse in the quoted article.

I think the phrase you are looking for is "tort reform."

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"E Pluribus Unum" does not mean "Every man for himself".

Pop Quiz: What do all the Framers of the Constitution have in common?

Posted By: Linus
Date Posted: 26 July 2009 at 1:12am

I remember a JAG episode where a similar thing happened, where a Naval doctor could not be sued for malpractice.

Tis gotta be true, it's endorsed by the DoD!

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Posted By: slackerr26
Date Posted: 26 July 2009 at 1:13am

Linus wrote:

, a person will bleed out in seconds.

.

which he obviously didnt. they would have exhausted a huge amount of blood if he was emptying out in seconds. they would have had to keep supplying him every few seconds for several hours. which leads me to agree with stealth on the calling of shens.

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Posted By: *Stealth*
Date Posted: 26 July 2009 at 1:14am

Linus wrote:

Actually, Stealth, the Aorta goes all the way down the abdomen, and splits off into both femoral arteries. There's something called an abdominal aortic aneurysm. If that burst and you're not ready for it, a person will bleed out in seconds.

The gallbladder is also in the upper right quadrant of the abdomen, not the lower, tucked beneath the liver, which is just below the diaphragm, which is just below the heart.

Also, with the man in the hospital, with a ready supply of blood for transfusion, him surviving an aortic cut is not that hard to believe, as it happens. Rare, but it happens.

I'm well aware of the arteries, and aneurysms. I'm pre-med - I've taken my anatomy classes Linus.

The article states: Aortic Valve, and unless you know something I don't - there is only one such place for that, and it happens to be a semi-lunar valve located just above the left ventricle of the heart.

Also, you're right about the quads - it is on the opposing as I said - but upper is correct and my mistake - i meant to try to convey the gross sense of misdirection one would have to posses to be at the heart as the gallbladder is as you know, sub-cardiac, or deep to the heart - if you'd rather. Thanks for the brush up on the basics though - I appreciate it. Either way - when surgeons operate within millimeter specifications - the distance between the heart and gallbladder may as well be kilometers apart from one another,

and a valve cut of that magnitude, ready supply or not, would be impressive, especially given the skill of the doctors discussed. And we won't even get started on the nerve damage that such and error would imply, and how the would impact the heart itself. Your talking Bundle of Hiss damage in order to hit the Aortic valve.

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WHO says eating pork is safe, but Mexicans have even cut back on their beloved greasy pork tacos. - MSNBC on the Swine Flu

Posted By: Linus
Date Posted: 26 July 2009 at 1:25am

slackerr26 wrote:

Linus wrote:

, a person will bleed out in seconds.
.

You seem to have missed where I said "aneuyrsm" as opposed to cut, and "not expecting it" as opposed to being inside of surgery room that's stocked with a ton of blood.

You also missed the "surgeon" part... surgeons are used to sealing up arterial bleeds.

*Stealth* wrote:

.The article states: Aortic Valve, and unless you know something I don't - there is only one such place for that, and it happens to be a semi-lunar valve located just above the left ventricle of the heart.

Oh that I know... I was just closing in on the fact that the aorta is more then superior to the heart, like many people thing, and that it actually goes inferior as well, and is pretty chunky. Chunky, it's a medical term... look it up

Also, you're right about the quads - it is on the opposing as I said - but upper is correct and my mistake - i meant to try to convey the gross sense of misdirection one would have to posses to be at the heart as the gallbladder is as you know, sub-cardiac, or deep to the heart - if you'd rather.and a valve cut of that magnitude, ready supply or not, would be impressive, especially given the skill of the doctors discussed.

Ah ok, I thought you were trying to say that the gallbladder was in the RLQ. Misread the intention.

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Posted By: Monk
Date Posted: 26 July 2009 at 1:29am

Yeah, I call shens too. There is no way that they would have hit any valve, and had they hit a large artery, there is no way they could have stopped the bleeding in time.

Also, why would they have to take his legs?

Its stuff like this that makes me glad I'm in the medical field so I dont get duped.

Edit: http://www.fox40.com/news/headlines/gallbladderairman,0,7707031.story - http://www.fox40.com/news/headlines/gallbladderairman,0,7707031.story

Atleast it explains the amputation. But that doctor must really really blow!

Posted By: oreomann33
Date Posted: 26 July 2009 at 1:32am

I've always wondered where a gallbladder was.

If that pipey thing behind it is the vein i could see it happening.

What do surgeons do if they have to sneeze while their inside someone?

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Posted By: *Stealth*
Date Posted: 26 July 2009 at 1:33am

In all fairness - it is likely, given an aortic cut, that the legs would be amongst the first to go. - legs are amongst the least efficiently circulated areas of the body, due to distance from the heart, and gravity forces.

Which is why you ought to stop and walk around during longs drives, to "get the blood moving" :)

So I can at least see that part of the article as realistic.

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WHO says eating pork is safe, but Mexicans have even cut back on their beloved greasy pork tacos. - MSNBC on the Swine Flu

Posted By: *Stealth*
Date Posted: 26 July 2009 at 1:36am

oreomann33 wrote:

If that pipey thing behind it is the vein i could see it happening.
?

Inferior Vena-Cava...

... It brings all the blood from your lower half of your body back to your heart - or more specifically right atria.

Extremely important - but not what the article states.

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WHO says eating pork is safe, but Mexicans have even cut back on their beloved greasy pork tacos. - MSNBC on the Swine Flu

Posted By: Monk
Date Posted: 26 July 2009 at 1:37am

Well in the other article it sights removing the legs to stop the risk on infection.

Posted By: Linus
Date Posted: 26 July 2009 at 1:37am

Monk wrote:

Yeah, I call shens too. There is no way that they would have hit any valve, and had they hit a large artery, there is no way they could have stopped the bleeding in time.Also, why would they have to take his legs?

Answer 1 to the artery-- Large vessels are severed fairly often. Not a great survival rate, but it's not unheard of, and does happen a bit. So yes, they could have stopped the bleeding in time.

Again, already in surgery, already have an open body, and already have the necessary tools.

As for the legs---

Long story short, when blood loss happens, the body attempts to compensate. Part of this compensation is the shunting of blood from extremities to the core, and this is handled by constriction of peripheral vessels. The more blood is lost, the less there is to go to the legs to give them nutrients.

Since nutrients aren't being brought, and waste isn't being taken away, the cells die. When blood does finally return, dead cells get carried away, which can cause a clot in the brain leading to a stroke, or in the lungs leading to a pulmonary embolism.

Also with the dead cells is toxins, which end up killing more cells, which again, leads to more cell death.

This is why diabetics sometimes get their feet chopped off.

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Posted By: *Stealth*
Date Posted: 26 July 2009 at 1:44am

Monk wrote:

Well in the other article it sights removing the legs to stop the risk on infection.

Linus touched on the details I didn't want to.

I thought "legs would be amongst the first to go' would suffice.

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WHO says eating pork is safe, but Mexicans have even cut back on their beloved greasy pork tacos. - MSNBC on the Swine Flu

Posted By: Linus
Date Posted: 26 July 2009 at 1:47am

Can you believe people trust me with drugs, needles, and their lives?

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Posted By: IMPULS3.
Date Posted: 26 July 2009 at 4:28am

Linus wrote:

Can you believe people trust me with drugs, needles, and their lives?

No.

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Posted By: brihard
Date Posted: 26 July 2009 at 3:46pm

Regarding the control of bleeding, I expect a military hospital would probably have some sort of hemostatic agents or dressings handy- Quickclot, HemCon, something along those lines. I know Quickclot can literally stop and femoral artery bleed. If they had any of thse on hand (I don't know where in the U.S. they are and are not medically licensed for use), him surviving an aortal cut is completely believable.

The rest of the article is out of my area of expertise. Suffice to say, really sucks for him, and I hope he's properly taken care of.

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"Abortion is not "choice" in America. It is forced and the democrats are behind it, with the goal of eugenics at its foundation."

-FreeEnterprise, 21 April 2011.

Yup, he actually said that.