A prime lawsuit

DutchgirlRN, ASN, RN · Apr 12, 2008

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. :)

i agree. a ct of the abdomen takes maybe 3 minutes at best and would have revealed the stone as the problem.

GilaRRT · Apr 12, 2008

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.

I agree. I remember when I was a new grad RN in the ER. Thr rumor mill was out of control. First, my fellow nurses started talking about how my pay was several dollars an hour more than the most senior nurses in the department. Then, I had to deal with a situation where people reported me to the manager because "I looked too young to adminiser scheduled substances." Not a single nurse lifted a finger to help me out and I had to deal with crap patients and critical patients with no experience and little help. In fact, some of the nurses started a betting pool on me. They bet that I would be gone by this day or that day. I remember a fellow nurse yelling at me because I had difficulty discharging a patient who did not speak english.

The only people who cared to help me out were a couple of ER techs and the paramedics. At one point, the situation was so bad an ER doc (an ER doc not known for his kindness to nurses) intervened and told the nurses they needed to back off and let me be.

So, I disagree with anybody who pulls out the docs look out for docs card. Good for them. Nurses have no reason to complain, and perhaps we should learn a lesson from the docs?

DutchgirlRN, ASN, RN · Apr 12, 2008

i agree. i remember when i was a new grad rn in the er. the rumor mill was out of control. first, my fellow nurses started talking about how my pay was several dollars an hour more than the most senior nurses in the department. then, i had to deal with a situation where people reported me to the manager because "i looked too young to adminiser scheduled substances." not a single nurse lifted a finger to help me out and i had to deal with crap patients and critical patients with no experience and little help. in fact, some of the nurses started a betting pool on me. they bet that i would be gone by this day or that day. i remember a fellow nurse yelling at me because i had difficulty discharging a patient who did not speak english.
the only people who cared to help me out were a couple of er techs and the paramedics. at one point, the situation was so bad an er doc (an er doc not known for his kindness to nurses) intervened and told the nurses they needed to back off and let me be.
so, i disagree with anybody who pulls out the docs look out for docs card. good for them. nurses have no reason to complain, and perhaps we should learn a lesson from the docs?

um...okay...and this applies how??? :uhoh3:

GilaRRT · Apr 12, 2008

Talking about nurses and doctors supporting each other. Yeah, the off topic police are on the way to lock me up.

I simply want people to stop for a moment and consider the thought that we may not have all of the facts. Some of us are jumping onto the doc was wrong, a ct should have been done, etc wagon.

UM Review RN, ASN, RN · Apr 12, 2008

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!

OK, to me, these words were the key. "Without any preop imaging." I find that very hard to believe and I agree that films would've supported the kidney stone over the hot appy.

.....Unless......

The patient had both a hot appy and a large kidney stone.

GilaRRT · Apr 12, 2008

In addition, the surgeon had to at least agree with the ER assessment. Nearly every surgical case I have seen in the ER, had the surgeon come in and look at the patient, in some cases perform tests, and then decide the course of action. The exception would be a scenario where a patient was dissecting and on the way to the OR.

At this point things do not seem to add up.

DutchgirlRN, ASN, RN · Apr 12, 2008

at this point things do not seem to add up.

agreed. :yeah:

emsboss · Apr 12, 2008

"without imaging" seems to be a key phrase here... What about labs? WBC elevated maybe? Yeah...somethin' not said by the OP? As for we nurses supporting one another...THAT is a topic for another thread...

Trauma Columnist · Apr 12, 2008

Tweety - my point is that I would not second guess another provider's assessment unless I had more to go on then what is here. I will say that my opinion has changed dramatically since becoming an APN. In this lawsuit-threatening world in which we live, I do not say anything in public against another provider. What's the point?

TazziRN, RN · Apr 12, 2008

The ER doc may not have gotten any imaging but what about the surgeon?

As for a belly scan taking only 3 minutes, I wonder if this is standard practice: at my last facility any belly scans were done with, at minimum, PO contrast to light up problems. Yes, a stone would have shown up like a light bulb, but a hot appy would be hard to see without contrast. The actual scan only takes minutes but it takes a while to get the contrast in and circulated.

Appys are misdiagnosed all the time, and it's not because of negligence or ineptitude, even with the advent of scans.

James Huffman · Apr 12, 2008

My favorite story regarding appendectomies happened a few Christmases ago.

We had had everyone over for a big meal and get together. My brother and his wife and 2 sons were there.

Brother's concerned about my nephew's abdominal pain. Thinks it's an appendix issue. Wants me to look and see if I think so.

So I did. The pain's "not right." (Most of you know what I mean). No nausea, no vomiting, no fever. Just nothing that quite looked like an appendix issue.

After I had done my assessment, they headed back home. And when they got in the car, my brother tells his wife, "The heck with him. I think we need to go to the ER."

So they did. And an hour later, my nephew is minus one vital organ.

Those of you who have been nurses more than 20 minutes know how long it takes to live something like this down. :bowingpur

DutchgirlRN, ASN, RN · Apr 12, 2008

tweety - my point is that i would not second guess another provider's assessment unless i had more to go on then what is here. i will say that my opinion has changed dramatically since becoming an apn. in this lawsuit-threatening world in which we live, i do not say anything in public against another provider. what's the point?

respectfully, i think the intention of the op is going by the wayside. i don't think any of us would say anything in public against a provider. nor, do i think this has anything to do with nurses not supporting each other.

the point is that the child had to endure two surgeries because the er doc "may have been" too quick to judge. as outsiders we can easily say a ct scan should have been done. with the information that we have yes a ct scan should have been done. does that make the doc guilty of malpractice. no. do we really know any of the facts? no. we're simply making observations, not critizing the er doc.