A prime lawsuit

[xoemmylouox, ASN, RN]

I work in a urology office, and often are doctors are called to do consult on admitted hospital patients. I know everyone makes mistakes and boy have we seen plenty from the hospitals, but what happened this week really takes the cake! We get a call saying Dr needed to do a consult on a post op 20 something male who had a very large kidney stone. Dr finds it odd that he would be post op and still have the stone so he calls the hospital to get the full story. The kid shows up to the ER with flank pain. The ER doc assumes it is his appendix and sends him for surgery without any pre op imaging. Turns out it wasn't the appendix, but his kidney stone that was the cause of pain. Poor kid lost an organ for nothing. Not to mention had to have 2 surgeries in 2 days!

[CuttingEdgeRN]

Kidney stones hurt

Ruptured appendix can KILL

Which would you treat first?

You really can't play judge and jury without knowing more facts.

[traumaRUs, MSN, APRN]

I'm an APN and would not question what other providers do. I feel bad that this young man had to undergo two surgeries in two days but wouldn't second guess the other providers' assessment.

[GilaRRT]

Agreed. I cannot speak for the ER Doc; however, he must appreciated some pretty significant evidence from the history and exam to suspect a hot appy. I would want a doc to error on the side of caution if I were the patient. Medicine is not exact and we all error, at least it looks like the ER Doc thought he/she was looking out for this kid. Not another blow the patient off and find them dead in the waiting room story.

[Wendy_RN]

My husband is a 5 year cancer survivor. During the course of his surgeries, treatments, etc., he had a surgery that ended up being termed "exploratory." This was because his surgeon was wrong about something. I got so tired of people saying "I would sue." Why? Because the surgeon did what he thought was right. My husband had 38 staples aftwards, an uncomfortable recovery, and a major surgery 2 months later. As much as he hated going through it only to have another surgery to face, he was not upset or bitter. He still sees that physician, as do I. If I had surgery today I would want him to be the surgeon. It is unfortunate that the ER patient had 2 surgeries, but I would not begin to question the ER doc. He had valid reasons for his dx. I am not sure why you are ranting about it. Like in the situation with my husband, it did not concern anyone but us. I just wanted everyone to back off and mind their own business. Sorry, but I think it just adds fuel to the fire when you criticize/rant in these situations.

[Tweety, BSN, RN]

I wouldn't let anyone cut me or my family member without diagnostic imaging. Maybe if I was having the severe pain of a kidney stone I would let them do anything for relief, but still......

I know it's easy to play armchair judge, but I'm not as supportive as the above people. I realize we don't know all the facts. A simple CT scan, ultrasound or a KUB would have been in order in my opinion. I realize there were other signs and symptoms and presumably some lab work that supported a diagnosis of appendicitis. I'm not saying they should sue the doc, but I'm not like the above and I am arm chair judging. :)

[mscsrjhm]

Pre-op imaging is pretty important. I think this was the OPs concern.

Imaging for flank pain would be SOP.

[Tweety, BSN, RN]

I'm an APN and would not question what other providers do. I feel bad that this young man had to undergo two surgeries in two days but wouldn't second guess the other providers' assessment.

Interesting. We nurses do it to each other daily, but practioners blindly support one another's actions?

[BeachBayNurse]

Do you have 110% confidence that no scans were done? Are you sure the patient didn't refuse the scans, that the patient was not crashing and the doctor thought he was going septic and the patient needed the surgery ASAP? I would not become a doctor for anything this day and age, they are expected to take people who have abused their bodies for years and are expected to cure everyone. I am not saying this young man did anything wrong, I feel horrible he suffered through an extra medical procedure. However, if medicine was so simple, we could diagnose ourselves at home with an interactive CD-Rom, you click through your symptoms, you print out your diagnosis.

[jnrsmommy]

Please correct me if I'm wrong, but isn't there protocols in place for various ailments in the ER (chest pain, MI, stroke, etc)? Also, I thought an ER doc doesn't just send a pt to surgery. Doesn't the surgeon have a say in this? Obviously, he felt there was something that warrented him to go to surgery.

[GilaRRT]

We have two docs who thought this was a hot appy. A surgeon and an ER doc. There is more to the story than we know at this point and callng poopoo on the docs involved at this point is simply going off half cocked.

As far as practitioners supporting each other, we can only hope that nurses get to this point one day. I am not talking about blindly supporting somebody; however, many nurses are so petty and involved in work politics, I swear they would hang their mothers out to dry. I know I work much better in the rare setting where another nurse has my back.

[Wendy_RN]

We have two docs who thought this was a hot appy. A surgeon and an ER doc. There is more to the story than we know at this point and callng poopoo on the docs involved at this point is simply going off half cocked.

As far as practitioners supporting each other, we can only hope that nurses get to this point one day. I am not talking about blindly supporting somebody; however, many nurses are so petty and involved in work politics, I swear they would hang their mothers out to dry. I know I work much better in the rare setting where another nurse has my back.

Well said. There is nothing to be gained by criticizing the decisions made. I am sure the patient did not walk in the door and the ER doc decide it was a slow day in surgery so he would send them another case.

I hope that more nurses will begin to support each other. I think too many times some people just look for things to make another person look bad and stir up controversy. It is such a waste of resources when we are already spread thin enough.