A prime lawsuit

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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! :banghead:

Specializes in OB, M/S, HH, Medical Imaging RN.
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

gastrograpfin can also be given as a rectal contrast to allow visualization of the appendix. patients with acute abdomens generally cannot tolerate any po contrast.

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Specializes in OB, M/S, HH, Medical Imaging RN.

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.

nothing personal...honest...but i'm glad your brother didn't listen to you. i may have said it doesn't fit classic appendicitis but go to the er.

we had an 89 y/o woman with abdominal pain that we scanned. she had been having a bm when she experienced a sudden sharp pain in her lower right abdomen. turned out to be a ruptured appendix.

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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.

i am not sure i agree. the op went so far as to name the thread "a prime lawsuit." so, at this point i can only guess that the op feels differently. however, the op may post additional information that will make me think otherwise. i will reserve judgment at this time.

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Specializes in OB, M/S, HH, Medical Imaging RN.
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! :banghead:

the post makes no sense.

why would a urologist find it odd that a post op appy would still have a stone? many patients have kidney stones and don't know it, it is a very common incidental finding.

the er doc assumes it is his appendix. no. i feel quite sure it was an educated decision on both the part of the er doc and the surgeon. we're obviously not getting the whole story.

the title of the thread is only the opinion of the op.

no one is critizing the doctor or the surgeon. did the op even consider that the patient signed a surgical permit. it would seem that this surgery was forced upon this patient. i doubt it.

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Specializes in Emergency & Trauma/Adult ICU.

1. None of us were there, so we do not have all the facts.

2. As several posters pointed out, if the patient went to surgery without any imaging being performed, this is an unusual situation. Some of you are quick to state that that is evidence of substandard care, without considering the possibility that the condition of the patient may have dictated a deviation from standard protocols.

3. As another poster stated, an ER MD does not "send a patient to surgery." Surgery is not an assembly line performing procedures on whatever comes down the conveyor belt. In this case, a surgeon was consulted, and agreed to perform the procedure.

Instead of the blame game, this case would make interesting and informative reading as a case study.

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Specializes in LTC, office.

I guess I couldn't judge without knowing more about the situation. I am an office nurse for a general surgeon. Diagnostic imaging is certainly the norm, but not unheard of to take a patient to the OR for an appy if the labs and patient presentation are consistent with acute appendicitis.

Several other conditions can present as a possible appy; kidney stone, ovarian cyst and even gastroenteritis and severe constipation can sure seem like an acute appy.

A shame for anyone to have to go through surgery twice in such a short time.

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nothing personal...honest...but i'm glad your brother didn't listen to you. i may have said it doesn't fit classic appendicitis but go to the er.

we had an 89 y/o woman with abdominal pain that we scanned. she had been having a bm when she experienced a sudden sharp pain in her lower right abdomen. turned out to be a ruptured appendix.

i'm glad he didn't listen, too. :coollook:

all of us, every day, have things that -- if the worst were true -- could be something traumatic. but 99% of the time it's not. if we all went to the er every time we had abdominal pain, the ers would have nothing else to do.

the point i was trying to make is that everyone makes mistakes. it's just humbling personally to know about this one.

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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! :banghead:

Just curious.....but could it have been the app was more of an issue than the stone at the time. Maybe tests were done and the ER doc did see the stone and that could have been the justification for the consult. Many times people go to the hospital or surgery for one thing and find many other ailments are present, but ultimately healthcare professionals will deal with the more severe first.

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Specializes in Oncology, Research.

Out of curiosity, say the OP has the facts straight. How is insurance billed for this? You know how they are so keen to skirt a bill. If the hospital/doc did not follow the standard protocol (per the insurance company), did surgery and found they misdiagnosed the patient then they might use that as grounds for not covering the charges. That would then be grounds for a patient lawsuit. Anyone familiar with insurance and billing?

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Specializes in OB, M/S, HH, Medical Imaging RN.
out of curiosity, say the op has the facts straight. how is insurance billed for this? you know how they are so keen to skirt a bill. if the hospital/doc did not follow the standard protocol (per the insurance company), did surgery and found they misdiagnosed the patient then they might use that as grounds for not covering the charges. that would then be grounds for a patient lawsuit. anyone familiar with insurance and billing?

i don't think there would be a problem. it's not totally uncommon to have an appendectomy only to find out it wasn't necessary. the surgeon is educated to know what is appropriate. a ct scan is not mandatory or part of a pre-op protocol.

also we do not know whether this patient actually did have appendicitis or not only that he did have a large kidney stone.

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

Bingo.........that statement says volumes about our profession.

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I never said I agreed with the lawsuit, but in today's world people sue over much less and win. I was just posting this because I thought it was an interesting case. I wasn't critical of the ER Doc I was just suprised that a quick KUB or non-contrast ct wasn't done. I never intended for this to be such a hot topic.

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