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?

[EricG]

With all of that being said, there is conflicting information now about the whole scenario. It appears that the bowel may have already been open so merely closing it would not have been the wrong thing to do. The scrub involved did not really want to talk about it and the circulator was just not sure but felt that something was wrong when the surgeon asked for a stapler after the code was called. I still seems that there was perhaps something not quite right about the situation but since I was not directly involved I have done all that I can do.

I think the above sums up the entire situation. Sure, it makes for a great controversial post, but let's have the whole picture and not what you heard from a few rooms away. There are too many variables and unknowns to even utter the words "criminal activity", IMO.

[DutchgirlRN, ASN, RN]

I think the above sums up the entire situation. Sure, it makes for a great controversial post, but let's have the whole picture and not what you heard from a few rooms away. There are too many variables and unknowns to even utter the words "criminal activity", IMO.

I totally understand the OP's frustration. I can feel it by reading his/her posts. I have been in a job situation where I was so burned by a multitude of errors (not mine) that I thought I would lose it. However, I have to agree that the OP has no business reporting this just on hearsay. If I were an investigator I wouldn't even take a phone call from someone who wasn't actually present when the incident occured. Everyone knows once a story goes from person to person, even 2 or 3 people, the story gets larger each time it's told. I would be afraid of losing my job with 10 years experience for sticking my nose in somewhere that it didn't belong. As frustrating as it is it doesn't change the fact that the patient is dead and that whatever happened, if it was criminal, the surgeon and the others involved will have to live with it on their conscious. The OP has no involvement and no related guilt. She/he has no dog in this particular fight and should stay out before he/she gets fired.

Sorry, OP, Just IMO

[CRNAGAL]

The surgeon probably cut out the dead bowel to get the abdomen closed. Dead bowel stinks, it would be nice to close up and have a presentable body so the family can say their last goodbyes. I don't understand all the suspicion out there, I think folks are watching too much CSI. I also don't think its right to get involved when you weren't in that room and if the surgeon would get wind of this thread accusing him of criminal or suspicious activity you could open yourself up to legal action.

[CritterLover, BSN, RN]

the surgeon probably cut out the dead bowel to get the abdomen closed. dead bowel stinks, it would be nice to close up and have a presentable body so the family can say their last goodbyes.

sounds pretty reasonable to me.

when i first read the op, i couldn't figure out what the surgeon would have to hide.

patients with dead bowel die sometimes; they don't always make it to the or in time.

unless the surgeon had really dragged his feet getting to the or, what would he have to cover up?

and even if he had some culpability in the death, the coroner would more than likely be able to tell. cutting out the dead bowel and throwing it out wouldn't do anything to hide what had happened. the coroner has full access to the patient's medical record, ct scans, xrays, etc. the cause of death would still be evident.

[Kymmi]

I agree that the OP really has no business reporting hearsay to anyone. Sounds to me like they are attempting to find trouble when trouble doesnt exist because they are upset about the way they have been treated. You know the old rule that everytime a story gets told and passed on one more untruth is added to it.....I agree why cause trouble for this surgeon when the OP really has no clue on the real facts.

I think it makes perfect sense to finish the surgery if the belly was opened......what did you want him to do...send the patient to the morgue with a dead smelly gut and open wound?

[DutchgirlRN, ASN, RN]

The surgeon probably cut out the dead bowel to get the abdomen closed. Dead bowel stinks, it would be nice to close up and have a presentable body so the family can say their last goodbyes. I don't understand all the suspicion out there, I think folks are watching too much CSI. I also don't think its right to get involved when you weren't in that room and if the surgeon would get wind of this thread accusing him of criminal or suspicious activity you could open yourself up to legal action.

Bingo!