The US is Officially Nuts: Judges now telling hospitals how to treat COVID patients

[Anonymous865]

Judges are now telling hospitals how to treat covid patients.

TLDR; A man was in the ICU for COVID.  The wife asked the physicians to prescribe Ivermectin.  They refused saying it wouldn't help and could interfere with treatment that does work.  Wife went to a Dr associated with Front Line Covid-19 Critical Care Alliance who gave her a prescription for her husband.  Hospital refused to administer it.  She went to court and got a judge to force the hospital to administer it.

Quote

Butler County Common Pleas Judge Gregory Howard ordered West Chester Hospital, part of the University of Cincinnati network, to treat Jeffrey Smith, 51, with Ivermectin. The order, filed Aug. 23, compels the hospital to provide Smith with 30mg of Ivermectin daily for three weeks.

Read in entirety: Judge orders Cinci hospital to treat COVID-19 patient with Ivermectin, despite CDC warnings

[JKL33]

Never mind Muno. This post is being edited!!

I thought you wrote "where's your problem"

Sorry!

[guest1163268]

29 minutes ago, MunoRN said:

I understand when family feels a loss of control in these situations, and that they may be blinded to the fact that their desperation to exert control can manifest as actions that actually cause their loved one harm.  This is why we have doctors and nurses, and why hospitals don't allow just any provider to prescribe medications to be given to hospitalized patients.

So in requiring the hospital to administer the medication the Judge effected ordered a provider with hospital privileges to enter the order, or for a nurse to enter the order as essentially a verbal order from a Judge, who holds no medical license.  

I'm not sure how the Judge is not now guilty of practicing medicine without a license.

Excellent, excellent point! 

[JKL33]

6 minutes ago, MunoRN said:

the Defendant allowed the sedation drug to completely run out, causing Jeffrey to awaken, rip the air tube out of his esophagus,

Oh my. ??‍♀️

[MunoRN, RN]

7 minutes ago, JKL33 said:

Never mind Muno. This post is being edited!!

I thought you wrote "where's your problem"

Sorry!

I fixed it, sorry, I see how the first version didn't come across right.

[MunoRN, RN]

I find it odd that even the fringe doctors who push ivermectin do so based on the claim that it interferes with virus at the point when it is actually triggering the initial infection.  This guy is 6 weeks out from his initial infection, and has now transitioned into ARDS and apparently an aspiration pneumonia.  There is likely little if any Covid actually left in his system.  I'm curious how the Judge then determined ivermectin would be useful even if you didn't question the unsubstantiated claims of it's effectiveness against Covid.

[toomuchbaloney]

16 minutes ago, JKL33 said:

Oh my. ??‍♀️

The downside of overwhelmed ICUs and not enough nurses to adequately monitor patients during code blue events.  

In this case the judge has ordered the defendant give the drug.  The defendant is the hospital. No nurse or MD is compelled by that order to administer anything, the hospital is, right?  Making the hospital give that med will be like sending Purdue pharmaceutical to prison for the crimes of the owners, right?

[Horseshoe, BSN, RN]

18 minutes ago, MunoRN said:

I find it odd that even the fringe doctors who push ivermectin do so based on the claim that it interferes with virus at the point when it is actually triggering the initial infection.  This guy is 6 weeks out from his initial infection, and has now transitioned into ARDS and apparently an aspiration pneumonia.  There is likely little if any Covid actually left in his system.  I'm curious how the Judge then determined ivermectin would be useful even if you didn't question the unsubstantiated claims of it's effectiveness against Covid.

Details, details.  

[JKL33]

8 minutes ago, toomuchbaloney said:

The downside of overwhelmed ICUs and not enough nurses to adequately monitor patients during code blue events.  

I think Muno's comment and my reaction were about the complaint stating that the ET tube was supposedly yanked out of the esophagus.

?

I do certainly agree about things that happen when everyone is overwhelmed.

[JKL33]

Not the least of the problems here is that as far as I can tell this order was made based on reports from the wife (who appears to believe that ETT goes in the esophagus). There is nothing stating that the ordering physician examined the patient or performed the other prudent tenets of medical practice such as detailed review of records when purposing to participate in a complicated case, etc. And, I don't mean this comment to be petty but I had to chuckle when I saw the copy of the written RX at the very end, as....I guess that is not the handwriting I would have expected. I'm not a handwriting expert but there are some features of the signature that suggest it was written by the person who wrote the RX. And yet....well, I didn't expect the style.

[verene, MSN]

On 9/1/2021 at 12:38 PM, macawake said:

That was I was wondering. What would actually happen if the ICU doc simply refuses to follow the judge’s ruling? Is it actually in a judge’s power to order medications that aren’t approved as treatment for a specific disease be administered?

I don't know and I imagine whatever legal case would result would be complicated (I believe I read in another article that the judge essentially ignored the testimony of expert witnesses in this case who said it was unreasonable to prescribe, but I can't find that article again). 

I've been in the position of having a court order for medications  where I found the order unsafe (in this case appropriate medications but wildly inappropriate dosing).  Judge was horrified when he realized that what was actually in the court order was horribly mangled from original recommendations and if the medications were prescribed as in the strict parameters of the the court order they would likely kill the patient. End result of this hearing was him telling me to rewrite the order with reasonable prescribing parameters and he'd copy my language verbatim into a new order that would be reasonable and safe and would not leave me in the position of violating court order vs killing patient in prescribing.  Fortunately this was a case where there was limited patient harm in not prescribing anything for a few days while the legal process ran and all parties were in agreement that amending the order for safety was a reasonable plan. 

In this ICU case though I really don't know who holds the liability, particularly as it seems that the court order is for a specific dose for a specific length of time which really doesn't seem to allow for lowering/stopping for adverse effects (though I haven't read the actual language of the order, maybe it does) and thus could potentially lead to horrible harm if it can't be stopped/adjusted for side effects or ineffectiveness or to allow safe administration of alternate treatments.  I would hope the Judge (and potentially even the wife?) is at least partially liable if something adverse dose occur since he is apparently ordering this over the objections of treating team.  While there are human formulations of Ivermectin which are potentially safer than formulations for livestock - it seems likely that there are still safety concerns, particularly since the hospital/treating team's assertion is that the risk/benefit ratio is not favorable for use in this case.  

I would not want to be on that ICU team right now, and I really don't like the legal precedent this case potentially sets. 

[verene, MSN]

2 hours ago, toomuchbaloney said:

The downside of overwhelmed ICUs and not enough nurses to adequately monitor patients during code blue events.  

In this case the judge has ordered the defendant give the drug.  The defendant is the hospital. No nurse or MD is compelled by that order to administer anything, the hospital is, right?  Making the hospital give that med will be like sending Purdue pharmaceutical to prison for the crimes of the owners, right?

Whoever is the agent for the hospital I would think is potentially liable (Hospital Superintendent? CMO?) If it isn't administered (Like CEO of a major corp may have to answer for legal accusations against that corp).   It seems like a nightmare case for all involved. 

[Kerivara]

Judge gets sued for medical malpractice.  Welcome to 2021.