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| No. 20 | 
Jul 31, 2007, 01:28 PM
 Re: Transplant surgeon kills donor? Originally Posted by Bluehair  How do you even draw up 80 mg of Ativan? That would be 40 vials of the 2 mg/vial stuff. It probably comes in bigger vials, but I haven't seen much bigger. The stuff is like drawing up glue. Morphine doesn't usually come in the 100 mg vial size either. This really sounds strange. It comes in 10 cc multi-dose vials, too. However, it is still 2mg/cc, so while it is fewer vials to draw from, it still is a pretty huge volume of ativan. I'm going to venture a guess that the kid was benzo/narc tolerant. If he was sz prone his whole life (not a "reach" for a cp kid with other problems), then he was probably used to ativan. Just the fact that it took him so long to die after they gave the drugs supports that. It makes me wonder how that hospital determines brain death. I used to work in a truama center that produced quite a few organ donors. We always had to take the patient to nuc med for a brain flow scan before we could have them declared brain dead. Our docs weren't allowed to declare it based off clinical exam alone. For the record, I've seen plenty of patients declared brain dead that still took a while to cease cardiac function once off the vent. If, after the prouncement of "brain death," the family did not choose to consent to organ donation, then we would remove the ventialtor and any pressor support, and put the patient on a T piece. I can remember one girl, in her mid 20s, that took over 6 hours to go asystole once on the tpiece. While I can imagine how frustrating that would be for a transplant surgeon waiting to harvest organs (and probably having a recipient waiting in another OR), it certainly doesn't make what he did right. I'm not certain, though, that I understand why the patient had to cease cardiac function before proceding with harvesting organs. Brain death is a form of death. You would think that you would want the heart to continue to perfuse the organs. The second article makes it sound as though the patient hadn't been delcared brain dead yet. If that is the case, then what was he doing in the OR???? Were they hoping that cardiac death would happen first, and then they could harvest the kidneys? If that is the case, wouldn't the mother have to consent? Families always have to consent to organ/tissue donation. This just really doesn't make sense.  | | Advertisement Sponsored Links | | | | No. 21 |
Jul 31, 2007, 02:14 PM
Re: Transplant surgeon kills donor? Originally Posted by gentlegiver I'm sorry, this article makes me sick. He gave the order, a nurse obeyed it w/o questioning, and the rest of the staff stood by and watched then complained after the man passed. It is wrong on so many levels I don't know where to begin!
This nurse is just what the doctors want her to be, a non thinking, abuse accepting automaton. Then there are the back stabbers, the other nurses who saw what was happening and waited to pounce on the non thinking nurse. Then there is the self appointed god, the doctor.
The patient a gonner-
These are the players in this case, and I hope they all get hung from the highest tree-
| | No. 22 |
Jul 31, 2007, 02:20 PM
Re: Transplant surgeon kills donor?
I'm wondering if there isn't more we're not hearing.
| | No. 23 |
Jul 31, 2007, 02:55 PM
Re: Transplant surgeon kills donor? Originally Posted by CritterLover For the record, I've seen plenty of patients declared brain dead that still took a while to cease cardiac function once off the vent.
If, after the prouncement of "brain death," the family did not choose to consent to organ donation, then we would remove the ventialtor and any pressor support, and put the patient on a T piece.
I can remember one girl, in her mid 20s, that took over 6 hours to go asystole once on the tpiece.
While I can imagine how frustrating that would be for a transplant surgeon waiting to harvest organs (and probably having a recipient waiting in another OR), it certainly doesn't make what he did right.
I'm not certain, though, that I understand why the patient had to cease cardiac function before proceding with harvesting organs. Brain death is a form of death. You would think that you would want the heart to continue to perfuse the organs.
The second article makes it sound as though the patient hadn't been delcared brain dead yet. If that is the case, then what was he doing in the OR????
Were they hoping that cardiac death would happen first, and then they could harvest the kidneys?
If that is the case, wouldn't the mother have to consent? Families always have to consent to organ/tissue donation.
This just really doesn't make sense.
Brain death had not been declared. This type of situation is called "donation after cardiac death" or DCD. Here's a better example:
A patient suffers a devastating neurological injury (MVC, SAH, etc) and requires mechanical ventilation/life support. They're not brain dead, but certainly could become so. Life support is removed (after family consent) with the understanding that some organs & tissue will be recovered. It's done in the OR because of time...kidney viability begins to diminish as soon as blood flow stops. Typically the patient is medicated for comfort prior to life support removal. If cardiac function doesn't cease in 30-60 minutes, the patient is returned to a room for comfort care measures.
There are two separate pieces to DCD: Removal of life support and then organ recovery. Our OPO emphasizes that the two sides are kept separately. One group treats the patient & removes the life support. The other recovers the organs. Like the 2nd article pointed out, Under state law, transplant doctors cannot direct the care of organ donors before they are declared dead.
Once again, we don't have the entire story. But what a black eye for organ donation and those waiting on transplant lists.
| | No. 24 |
Jul 31, 2007, 03:11 PM
Re: Transplant surgeon kills donor? Originally Posted by traumaRUs Sorry don't believe this. Ativan 80mg and Morphine 200mg would have depressed his respirations and killed him - he only weighed 80#.
Curious? Doesn't pharmacy get involved at all anymore? My pharmacy would be on the phone with me lickity split with me once that order came across. In my small ICU, we don't have enough vials in the Pyxis to get 200mg of MS OR 80 of Ativan. We don't keep MS gtts in the pyxis either. How'd they get so much of the meds, without pharmacy getting involved? Originally Posted by Noryn With giving that much Ativan that quickly I would also be concerned about the propylene glycol he received.
The propylene glycol would just put him in lactic acidosis. I would venture to say he was in all kinds of that just being off of the vent for so many hours.
The inadvertant administration of the propylene glycol was the least of his concerns.
This case is pretty odd, and disgusting if true.
| | No. 25 |
Jul 31, 2007, 09:00 PM
Re: Transplant surgeon kills donor?
In an interview with CBS News, the surgeon's attorney alleges the charges stem from racism because of the doctor's Iranian background. http://www.cbsnews.com/sections/i_vi...ml?id=3120476n
If this is the best defense this attorney can provide - he's in trouble. A few other details as well.
| | No. 26 |
Jul 31, 2007, 11:30 PM
Re: Transplant surgeon kills donor? Originally Posted by multicollinarity In an interview with CBS News, the surgeon's attorney alleges the charges stem from racism because of the doctor's Iranian background. http://www.cbsnews.com/sections/i_vi...ml?id=3120476n
If this is the best defense this attorney can provide - he's in trouble. A few other details as well.
We had a local restaurant owner who was (coincidentally) Iranian and when the health department closed his restaurant due to violations he made the same ridiculous accusation. I hate it when people resort to tactics like this. I hope this case brings some much stronger scrutiny over the organ business. This is scary.
| | No. 27 |
Aug 03, 2007, 04:16 AM
Updated
Aug 03, 2007 at 04:20 AM by SNJess
Re: Transplant surgeon kills donor?
I dont know much about organ donation, but...this part of the article kind of disturbs me:
"Experts said the case is likely to raise uneasiness among potential organ donors and could prompt doctors to shy away from a somewhat controversial practice of retrieving organs before a patient is brain dead." from http://www.latimes.com/news/local/la...=la-home-local
Can they take organs away from someone who has some brain function (i.e. besides people understanding and consenting to donate part of their liver or a kidney), or was that a sarcastic remark? I dont understand.
| | No. 28 |
Aug 03, 2007, 04:38 AM
Updated
Aug 03, 2007 at 04:38 AM by Diary/Dairy
Re: Transplant surgeon kills donor?
First, I am curious as to how long a period of time the morphine and ativan were administered over.....Second, I have to agree, there is probably more to this story than we have heard.....Third, I have been opposed to organ transplantation for myself for a long time on the grounds that people should not be used for replacement parts.... I know a lot of people who have benefited from transplants and have gone on to live happy lives. Good for them, I wish them well...just for me for myself, in my heart, I cannot see this system being a good thing.
Also, that charge of racism is a scream! I cannot believe he went there!
| | No. 29 |
Aug 03, 2007, 09:33 AM
Re: Transplant surgeon kills donor? Originally Posted by jlsRN We had a local restaurant owner who was (coincidentally) Iranian and when the health department closed his restaurant due to violations he made the same ridiculous accusation. I hate it when people resort to tactics like this. I hope this case brings some much stronger scrutiny over the organ business. This is scary.
Off topic -
Had a doctor once who played the race card with admin. so he could (attempt) to get his way on something. Didn't work. A few of us found out about it, and we all completely lost respect for the man. Still stuck working with him.  |
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