A Funny Thing Happened on the Way to the Morgue

[BloodNGuts]

Today in OR where I work a patient was brought in urgently from the ER in need of a bowel resection. After the patient was opened, she coded. After the necessary attempts to revive her the code was called. The weird thing is that the surgeon continued to do the bowel resection. Isn't this a criminal activity?? Due to the fact that the patient had been in the hospital less than 24 hours, she is automatically a coroner's case. Any organs taken from her body after the code was called would go to the pathology department not to the coroner. When the coroner receives the body he/she would assume that the code happened after the bowel resection occurred instead of before as it actually happened. If not down right criminal activity it seems to me that this was ethically wrong. Is there any valid reason why a surgeon would continue to perform any procedure, especially one where organs are removed (except for organ procurement, obviously) after a code is called?

[DutchgirlRN, ASN, RN]

Ok I admit it, I missed it....what's funny about this story???

Today in OR where I work a patient was brought in urgently from the ER in need of a bowel resection. After the patient was opened, she coded. After the necessary attempts to revive her the code was called. The weird thing is that the surgeon continued to do the bowel resection. Isn't this a criminal activity??

I've never worked in surgery so I'm certainly no expert but I don't see this as criminal activity. The surgeon probably thinking or hoping that she would survive would still urgently need the resection. Surgeons do not respond to codes and wouldn't have been any help anyway. May as well continue with the surgery.

Is there any valid reason why a surgeon would continue to perform any procedure, especially one where organs are removed (except for organ procurement, obviously) after a code is called?

I doubt anything removed during a colon resection would be used for an organ transplant. Had the surgeon been removing the heart, kidneys, liver etc...that would have been majorly obvious to everyone present. Not likely the doctor was dealing in selling organs for money.

Interested in hearing more responses because I just don't get it. If I'm wrong I'd like to learn why...

[bifurcated]

Today in OR where I work a patient was brought in urgently from the ER in need of a bowel resection. After the patient was opened, she coded. After the necessary attempts to revive her the code was called. The weird thing is that the surgeon continued to do the bowel resection. Isn't this a criminal activity?? Due to the fact that the patient had been in the hospital less than 24 hours, she is automatically a coroner's case. Any organs taken from her body after the code was called would go to the pathology department not to the coroner. When the coroner receives the body he/she would assume that the code happened after the bowel resection occurred instead of before as it actually happened. If not down right criminal activity it seems to me that this was ethically wrong. Is there any valid reason why a surgeon would continue to perform any procedure, especially one where organs are removed (except for organ procurement, obviously) after a code is called?

I have unfortunatly been in on many OR deaths..... I have NEVER seen a surgeon continue on with any operation when the patient has expired! I do not know the legalities of the action, but I think that perhaps the director of your department and the cheif of surgery might want to know about it. Ask them the question and let's see what they say

[justme1972]

As a layperson reading this...I wonder if the patient's family was billed for the procedure? Wouldn't that be insurance fraud?

[DutchgirlRN, ASN, RN]

I have unfortunatly been in on many OR deaths..... I have NEVER seen a surgeon continue on with any operation when the patient has expired! I do not know the legalities of the action, but I think that perhaps the director of your department and the cheif of surgery might want to know about it. Ask them the question and let's see what they say

I agree no surgeon would continue an operation when the patient has expired but as I am reading it the surgeon continued to operate while the patient was coding not yet pronounced dead.

[DutchgirlRN, ASN, RN]

As a layperson reading this...I wonder if the patient's family was billed for the procedure? Wouldn't that be insurance fraud?

No.

Operations are charged no matter the outcome.

[BloodNGuts]

I don't think you are understanding the situation. It was the operative patient that coded, she was pronounced during the procedure. The resection had not yet taken place. Once a code is called the patient is deceased and all rescussitative measures are to be stopped. Why would a surgeon continue to perform the resection, ie, removing body parts? Any parts removed during the course of a procedure must be sent to pathology. The body will be sent for autopsy. Why would a surgeon remove parts from a body that requires an autopsy unless he was trying to hide something from the coroner? These parts are in no way for harvesting. There is no valid reason that I know for continuing with the procedure once the code has been called.

[BloodNGuts]

No, the surgeon continued to work after the code was called. The patient began coding before the actual resection had occurred. That's why I'm so confused. Even for teaching purposes, it doesn't seem ethical to continue a procedure on a corpse.

[DutchgirlRN, ASN, RN]

I don't think you are understanding the situation. It was the operative patient that coded, she was pronounced during the procedure. The resection had not yet taken place. Once a code is called the patient is deceased and all rescussitative measures are to be stopped. Why would a surgeon continue to perform the resection, ie, removing body parts? Any parts removed during the course of a procedure must be sent to pathology. The body will be sent for autopsy. Why would a surgeon remove parts from a body that requires an autopsy unless he was trying to hide something from the coroner? These parts are in no way for harvesting. There is no valid reason that I know for continuing with the procedure once the code has been called.

Thanks for clarifying. I just wasn't getting it but now I do. This surgeon must be nuts or as you say trying to hide something. Gees, that's scary!!

[BloodNGuts]

Not funny ha ha, funny queer, as in very weird. I just can't comprehend why you would perform a resection on a corpse

[BloodNGuts]

All procedures are billed but in a sense it is fraud. The procedure should have been ATTEMPTED colon resection. Since the patient coded and was pronounced before the resection portion of the procedure began, all the necessary staplers, etc had to be opened and charged. Just can't wrap my head around why this happened.

[BloodNGuts]

It's very scary. There is so much going on these days, I'm afraid to be involved in direct patient care anymore.