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(KSTP St. Paul)   Doctor doesn't work quickly enough to make sure a man's airway is unobstructed, leading the man to have permanent brain damage and need long-term medical care. Oh you bet that's a lawsuit   (kstp.com) divider line 36
    More: Sad, permanent brain, Pakistanis, Pakistani students, radiation damages, health cares  
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4699 clicks; posted to Main » on 29 Mar 2014 at 2:16 AM (22 weeks ago)   |  Favorite    |   share:  Share on Twitter share via Email Share on Facebook   more»



36 Comments   (+0 »)
   
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2014-03-29 12:48:58 AM
Is the reporter in this article limited by his editor to twitter-length stories?

For the record, the town where this incident occurred has 12,000 people in it. This is a small, 76 TOTAL bed hospital in rural community. This isn't a trauma center, or a major regional hospital. It's a level IV bandaid center. 

It's very likely the doctor did the best he could depending on the level of injury this man presented with. If he took a deer through the windshield to the face or neck, he might have had what is known as a difficult or failed airway. In that case, these small hospitals do not have very many resources to call to their aid - many of them don't even have a CRNA or Anesthesiologist in house after hours.

Sadly, there's more to this story than we're being told in TFA. Until it gets to a courtroom, the hospital or the doctor cannot defend himself to the media thanks to Federal laws.
 
2014-03-29 01:10:28 AM

hardinparamedic: the doctor cannot defend himself to the media thanks to Federal laws.


It's not just doctors.

Pretty much anyone can be taken down by a media hatchet job and you have no recourse, no way to fight it. That's why you need a cult of personality around yourself.
 
2014-03-29 01:16:34 AM
This is why being a First Responder Instructor / First Responder scares the shiat out of me in the US.  Good Samaritan laws are helpful but the cost of defending a civil lawsuit cannot be avoided if someone wants to go for it anyway.

I took over for someone attempting CPR on a boy who drowned in a pool recently.  It wasnt clear that they had training but they were trying.  I cleared the airway of a big wad of spaghetti, but if I'd just taken over and assumed they'd done everything it would have been my fault when the boy died.  Fortunately he lived and recovered nicely.

Good Samaritan laws need to be stronger and first responders, nurses and doctors need to be protected better unless gross negligence is obvious.
 
2014-03-29 02:06:44 AM

me texan: I cleared the airway of a big wad of spaghetti


Uh oh, looks like someone didn't wait an hour before getting in the water...
 
2014-03-29 02:28:31 AM
I'm really glad I have no first aid/emergency training whatsoever, sometimes.
 
2014-03-29 02:33:46 AM

doglover: hardinparamedic: the doctor cannot defend himself to the media thanks to Federal laws.

It's not just doctors.

Pretty much anyone can be taken down by a media hatchet job and you have no recourse, no way to fight it.


I thought they had these things called "libel lawsuits" in the USA, that prevented anyone from saying anything speculative and damaging about people on TV?
 
2014-03-29 02:44:14 AM

hardinparamedic: Is the reporter in this article limited by his editor to twitter-length stories?

For the record, the town where this incident occurred has 12,000 people in it. This is a small, 76 TOTAL bed hospital in rural community. This isn't a trauma center, or a major regional hospital. It's a level IV bandaid center. 

It's very likely the doctor did the best he could depending on the level of injury this man presented with. If he took a deer through the windshield to the face or neck, he might have had what is known as a difficult or failed airway. In that case, these small hospitals do not have very many resources to call to their aid - many of them don't even have a CRNA or Anesthesiologist in house after hours.


More than likely his airway was damaged upon impact, and by the time for first responders to got to the scene and then got the man to the hospital, the damage had already been done.  But, go ahead and sue.  Can't hurt at this point.
 
2014-03-29 02:46:50 AM

moeburn: doglover: hardinparamedic: the doctor cannot defend himself to the media thanks to Federal laws.

It's not just doctors.

Pretty much anyone can be taken down by a media hatchet job and you have no recourse, no way to fight it.

I thought they had these things called "libel lawsuits" in the USA, that prevented anyone from saying anything speculative and damaging about people on TV?


Isn't that pretty much all Nancy Grace does?
 
2014-03-29 02:51:31 AM

Yes this is dog: moeburn: doglover: hardinparamedic: the doctor cannot defend himself to the media thanks to Federal laws.

It's not just doctors.

Pretty much anyone can be taken down by a media hatchet job and you have no recourse, no way to fight it.

I thought they had these things called "libel lawsuits" in the USA, that prevented anyone from saying anything speculative and damaging about people on TV?

Isn't that pretty much all Nancy Grace does?


I thought all she did was biatch and say the word, "porn" repeatedly like a derped parrot.
 
2014-03-29 02:51:37 AM
This video will give you permanent brain damage...

https://www.youtube.com/watch?v=Uo-nS9yB-Ow
 
2014-03-29 02:52:56 AM

moeburn: I thought they had these things called "libel lawsuits" in the USA, that prevented anyone from saying anything speculative and damaging about people on TV?


You're thinking of the United Kingdom, where their absolutely draconian Libel and Slander laws are used regularly to stifle political and scientific critics of hacks and quacks.

In the United States, it's exceedingly difficult to prove libel or slander without outright evidence of their intent, and even more difficult to prove it as a countersuit in a medical malpractice case. Thanks to the HIPAA and it's various related laws, the physician and the facility involved - unless the family has granted them a waiver to do so - cannot use any detail of the case to defend themselves in the eye of the public or media.
 
2014-03-29 03:11:16 AM
Call him a potential terrorist and ship him to Gitmo. PROBLEM SOLVED!
 
2014-03-29 03:11:23 AM

indy_kid: More than likely his airway was damaged upon impact, and by the time for first responders to got to the scene and then got the man to the hospital, the damage had already been done


Baring a decent article with details to the contrary this is what I would assume.
 
2014-03-29 03:15:40 AM
I'm going to go out on a limb here and guess that the dude's throat was already FUBAR long before he got to the hospital. But this is 'murcia so grab for that brass ring. The hospital could be completely on the clear of any negligence but if you can get enough members on tge jury to start shedding tears...ca-ching.
 
2014-03-29 03:17:54 AM
Seems like a fairly normal insurance company protocol thing, no? Tragic, yes, but it's not an article.
 
2014-03-29 03:42:58 AM
Yep.  Come to America and sue the shiat out of somebody.  4. Get rich ;)
 
2014-03-29 04:22:05 AM
Entubating a crushed tube....oh yea.....I can do that.......joke......
4 minutes to reestablish 02  to the brain..........God have mercy on the physician who gets that running thru their door.  I have nightmares enough as it is.......
 
2014-03-29 04:24:02 AM
Boy that article was just rich with complete lack of information and details.
 
2014-03-29 06:02:24 AM

moeburn: doglover: hardinparamedic: the doctor cannot defend himself to the media thanks to Federal laws.

It's not just doctors.

Pretty much anyone can be taken down by a media hatchet job and you have no recourse, no way to fight it.

I thought they had these things called "libel lawsuits" in the USA, that prevented anyone from saying anything speculative and damaging about people on TV?


False.

Libel lawsuits don't mean jack. Once the accusation's leveled, that genie's out of the bottle.
 
2014-03-29 06:41:29 AM

me texan: This is why being a First Responder Instructor / First Responder scares the shiat out of me in the US.  Good Samaritan laws are helpful but the cost of defending a civil lawsuit cannot be avoided if someone wants to go for it anyway.

I took over for someone attempting CPR on a boy who drowned in a pool recently.  It wasnt clear that they had training but they were trying.  I cleared the airway of a big wad of spaghetti, but if I'd just taken over and assumed they'd done everything it would have been my fault when the boy died.  Fortunately he lived and recovered nicely.

Good Samaritan laws need to be stronger and first responders, nurses and doctors need to be protected better unless gross negligence is obvious.


I think I read somewhere, that if you don't have cpr training, and try to give it anyway and fail to save a life, or do and cause damage (broken ribs and such) you don't get in trouble, but if you do have training, try, and fail it's entirely your fault they died
 
2014-03-29 08:16:03 AM

Gyrfalcon: Boy that article was just rich with complete lack of information and details.


Yes, but we know the status of his student visa, which is nice.
 
2014-03-29 09:29:06 AM
Now we can send him back to Pakistan!
 
2014-03-29 09:29:47 AM

indy_kid: hardinparamedic: Is the reporter in this article limited by his editor to twitter-length stories?

For the record, the town where this incident occurred has 12,000 people in it. This is a small, 76 TOTAL bed hospital in rural community. This isn't a trauma center, or a major regional hospital. It's a level IV bandaid center. 

It's very likely the doctor did the best he could depending on the level of injury this man presented with. If he took a deer through the windshield to the face or neck, he might have had what is known as a difficult or failed airway. In that case, these small hospitals do not have very many resources to call to their aid - many of them don't even have a CRNA or Anesthesiologist in house after hours.

More than likely his airway was damaged upon impact, and by the time for first responders to got to the scene and then got the man to the hospital, the damage had already been done.  But, go ahead and sue.  Can't hurt at this point.


My first thought is this is more of a means to keep him in the country than it is to actually seek justice for malpractice.  Which I'm now wondering, does Pakistan keep injured folks like him alive the way the US does, or do they cut him loose and let nature takes its course?
 
2014-03-29 09:56:44 AM
Ugh, this family again. I dislike them. They were all like "The US Govt is deporting our poor injured son." and when the govt agencies who deal with that were asked about it, they had no idea who the vegetable was because there were months left on the student visa.
 
2014-03-29 10:08:23 AM
Did the doctor do harm, or are they unsatisfied with the results of the care?
 
2014-03-29 10:32:53 AM

hardinparamedic: Is the reporter in this article limited by his editor to twitter-length stories?

For the record, the town where this incident occurred has 12,000 people in it. This is a small, 76 TOTAL bed hospital in rural community. This isn't a trauma center, or a major regional hospital. It's a level IV bandaid center.

It's very likely the doctor did the best he could depending on the level of injury this man presented with. If he took a deer through the windshield to the face or neck, he might have had what is known as a difficult or failed airway. In that case, these small hospitals do not have very many resources to call to their aid - many of them don't even have a CRNA or Anesthesiologist in house after hours.

Sadly, there's more to this story than we're being told in TFA. Until it gets to a courtroom, the hospital or the doctor cannot defend himself to the media thanks to Federal laws.


This.  Just because the doctor didn't open the airway in time doesn't mean he did anything wrong.  What evidence do we have that he could have done better??

zarker: I think I read somewhere, that if you don't have cpr training, and try to give it anyway and fail to save a life, or do and cause damage (broken ribs and such) you don't get in trouble, but if you do have training, try, and fail it's entirely your fault they died


No way.  Most CPR will fail even when performed correctly.  Furthermore, broken ribs are to be expected from CPR and are not evidence of wrongdoing.

What you are thinking of is the untrained person won't be liable for doing it wrong, the trained person can be held liable for doing it wrong.
 
2014-03-29 11:45:37 AM
If he'd have been intubated in the field and flown to a trauma center like he should have been, problem solved.
 
2014-03-29 12:07:59 PM

cretinbob: If he'd have been intubated in the field and flown to a trauma center like he should have been, problem solved.


A response as short and pointless as the article is short and thin on facts.
 
2014-03-29 12:46:51 PM

cretinbob: If he'd have been intubated in the field and flown to a trauma center like he should have been, problem solved.


Are EMTs authorized to intubate a patient?  If the airway is so damaged that intubation isn't possible (I'm reminded of that pic of the guy being intubated directly through his shredded trachea), does the EMT perform a tracheotomy?

Somehow, I suspect most EMTs are forbidden from such procedures.
 
2014-03-29 01:03:36 PM

indy_kid: Are EMTs authorized to intubate a patient?  If the airway is so damaged that intubation isn't possible (I'm reminded of that pic of the guy being intubated directly through his shredded trachea), does the EMT perform a tracheotomy?

Somehow, I suspect most EMTs are forbidden from such procedures.


EMT-Basics are allowed by three or four states to intubate IF they have been through a special class and have the endorsement on their license. Otherwise they're only allowed to, in many states, place an oral or nasal airway and bag-valve-mask ventilate them. EMT-Intermediate/99 used to be able to intubate without drug assistance, but the AEMT curriculum which they went to only allows placement of a supraglottic blind airway adjunct, such as a King-LT or Combitube - no direct laryngoscopy. If they had a Paramedic or Critical Care/flight Paramedic on scene, absolutely they could tracheally intubate - and in some services are even allowed to use special drugs typically used by MDs and Anesthesiology to facilitate that.

Of course, it's entirely possible that the man had too deformed or damaged of an airway to place an oral or nasal ET tube. In that case, an emergent crichothyrotomy - either needle, seldinger-kit guided (like the Cook Kit), or outright surgical trach is performed. (Surgical tends to be avoided - it requires regular drill and skills practice to be competent to do, and if a kit-crich is available its safer for the patient)

Then again, we don't really know what the situation was. If you can't identify landmarks on the neck, you can't do a needle or surgical cric in the field. This patient might have very well been maintained with bag-valve ventilation, and the Paramedics on scene not been able to give drugs to facilitate oral intubation and made the decision to transport to the local hospital to get an airway.

cretinbob: f he'd have been intubated in the field and flown to a trauma center like he should have been, problem solved.


Unfortunately, we don't know that would be true, either. If a flight service cannot establish an airway, their SOP is usually to land at the closest hospital for a physician to do so.

zarker: I think I read somewhere, that if you don't have cpr training, and try to give it anyway and fail to save a life, or do and cause damage (broken ribs and such) you don't get in trouble, but if you do have training, try, and fail it's entirely your fault they died


Absolutely false. They would have to prove A) You are the proximal cause of their death, B) You intended to cause their death or were negligent in performing CPR beyond what you were expected to do as an off-duty provider, and that C) This is part of a continuing pattern.
 
2014-03-29 01:39:39 PM

zarker: me texan: This is why being a First Responder Instructor / First Responder scares the shiat out of me in the US.  Good Samaritan laws are helpful but the cost of defending a civil lawsuit cannot be avoided if someone wants to go for it anyway.

I took over for someone attempting CPR on a boy who drowned in a pool recently.  It wasnt clear that they had training but they were trying.  I cleared the airway of a big wad of spaghetti, but if I'd just taken over and assumed they'd done everything it would have been my fault when the boy died.  Fortunately he lived and recovered nicely.

Good Samaritan laws need to be stronger and first responders, nurses and doctors need to be protected better unless gross negligence is obvious.

I think I read somewhere, that if you don't have cpr training, and try to give it anyway and fail to save a life, or do and cause damage (broken ribs and such) you don't get in trouble, but if you do have training, try, and fail it's entirely your fault they died


Bullshiat.  CPR rarely works.  In fact, the vast majority of people who arrest don't make it, and the ones that do often end up with some disability.  TV way distorts survivability from cardiac arrest.  You pretty much have to be lucky enough to arrest in a healthcare facility or in the presence of EMS.
 
2014-03-29 01:44:39 PM

CreativeFarkHandle: zarker: me texan: This is why being a First Responder Instructor / First Responder scares the shiat out of me in the US.  Good Samaritan laws are helpful but the cost of defending a civil lawsuit cannot be avoided if someone wants to go for it anyway.

I took over for someone attempting CPR on a boy who drowned in a pool recently.  It wasnt clear that they had training but they were trying.  I cleared the airway of a big wad of spaghetti, but if I'd just taken over and assumed they'd done everything it would have been my fault when the boy died.  Fortunately he lived and recovered nicely.

Good Samaritan laws need to be stronger and first responders, nurses and doctors need to be protected better unless gross negligence is obvious.

I think I read somewhere, that if you don't have cpr training, and try to give it anyway and fail to save a life, or do and cause damage (broken ribs and such) you don't get in trouble, but if you do have training, try, and fail it's entirely your fault they died

Bullshiat.  CPR rarely works.  In fact, the vast majority of people who arrest don't make it, and the ones that do often end up with some disability.  TV way distorts survivability from cardiac arrest.  You pretty much have to be lucky enough to arrest in a healthcare facility or in the presence of EMS.


I meant when it comes to being held legally responsible
 
2014-03-29 01:52:45 PM
From the Wikipedia page on the good Samaritan law: "In [some] jurisdictions, a person who is neither trained in first aid nor certified, and who performs first aid incorrectly, can be held legally liable for errors made."
I had it backwards
 
2014-03-29 03:21:55 PM

CreativeFarkHandle: Bullshiat.  CPR rarely works.  In fact, the vast majority of people who arrest don't make it, and the ones that do often end up with some disability.  TV way distorts survivability from cardiac arrest.  You pretty much have to be lucky enough to arrest in a healthcare facility or in the presence of EMS.


Question: Is the growing prominence of Automatic Defibrillator Units changing that? (That is, allow for defib before EMS can arrive?)
 
2014-03-29 03:28:38 PM

Felgraf: CreativeFarkHandle: Bullshiat.  CPR rarely works.  In fact, the vast majority of people who arrest don't make it, and the ones that do often end up with some disability.  TV way distorts survivability from cardiac arrest.  You pretty much have to be lucky enough to arrest in a healthcare facility or in the presence of EMS.

Question: Is the growing prominence of Automatic Defibrillator Units changing that? (That is, allow for defib before EMS can arrive?)


Absolutely. And the placement of AEDs in areas of large public conveyance, such as a stadium or airport, is a class I evidence based public health intervention. Many large plants and offices have their own emergency response teams in house now with CPR/AED trained people.
 
2014-03-30 01:19:15 AM

hardinparamedic: Felgraf: CreativeFarkHandle: Bullshiat.  CPR rarely works.  In fact, the vast majority of people who arrest don't make it, and the ones that do often end up with some disability.  TV way distorts survivability from cardiac arrest.  You pretty much have to be lucky enough to arrest in a healthcare facility or in the presence of EMS.

Question: Is the growing prominence of Automatic Defibrillator Units changing that? (That is, allow for defib before EMS can arrive?)

Absolutely. And the placement of AEDs in areas of large public conveyance, such as a stadium or airport, is a class I evidence based public health intervention. Many large plants and offices have their own emergency response teams in house now with CPR/AED trained people.


Not all cardiac events are caused by fibrillation.
 
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