tag:blogger.com,1999:blog-8395646.post4164597896525424316..comments2024-03-06T19:21:15.708-05:00Comments on RealChoice: Two dead patients and a lot of lame excusesChristina Duniganhttp://www.blogger.com/profile/04785550737493692252noreply@blogger.comBlogger24125tag:blogger.com,1999:blog-8395646.post-85551601910043255642010-07-18T19:48:54.577-04:002010-07-18T19:48:54.577-04:00If the staff had done everything perfectly, these ...If the staff had done everything perfectly, these two patients would still have died.OperationCounterstrikehttps://www.blogger.com/profile/11877707857942926743noreply@blogger.comtag:blogger.com,1999:blog-8395646.post-92063505844748702752010-07-18T19:46:49.170-04:002010-07-18T19:46:49.170-04:00Rachel, the staff may well have been keeping inade...Rachel, the staff may well have been keeping inadequate records. They may even have been monitoring the patient less intensely than they should, strictly speaking. But they did not cause these deaths.<br /><br />There is no way to predict who will suffer a rare bad response to anaesthesia, and there is very little you can do for a patient once the response is in progress.<br /><br />It's just one of the risks you assume when you go in for ANY procedure requiring anaesthesia. Just as you assume a certain risk of having a car accident when you drive.OperationCounterstrikehttps://www.blogger.com/profile/11877707857942926743noreply@blogger.comtag:blogger.com,1999:blog-8395646.post-10847697203448896102010-07-18T19:24:41.680-04:002010-07-18T19:24:41.680-04:00*Correction
However, in cases such as these, where...*Correction<br />However, in cases such as these, where the staff was keeping inadequite records, including ommiting the dosage of the anesthesic medication administered, it <i>would</i> of been difficult...Ladybughttps://www.blogger.com/profile/09101347971678139917noreply@blogger.comtag:blogger.com,1999:blog-8395646.post-73491712340793429292010-07-18T19:22:19.753-04:002010-07-18T19:22:19.753-04:00Yes, I am aware there are 4 levels of twilight ane...Yes, I am aware there are 4 levels of twilight anesthesia. In standard practice, physicians may use a minimal level. However, in cases such as these, where the staff was keeping inadequite records, including ommiting the dosage of the anesthesic medication administered, it was of been difficult if not impossible to know how deep of sedation of the patient was in.Ladybughttps://www.blogger.com/profile/09101347971678139917noreply@blogger.comtag:blogger.com,1999:blog-8395646.post-16634638175170932602010-07-18T19:19:23.043-04:002010-07-18T19:19:23.043-04:00Rachel, RE: "OC, so physicians shouldn't ...Rachel, RE: "OC, so physicians shouldn't preform a basic physical screening (blood pressure and heart/respirations) in addition to taking a medical history before preforming a elective surgery and administering anesthesia?"<br /><br />Yes, of course they should. But "basic physical screening" is different from "physical exam to determine whether this type of anaesthesia is appropriate" which is what GG said.<br /><br />Bah. You are not interested in serious discussion, only in word games.OperationCounterstrikehttps://www.blogger.com/profile/11877707857942926743noreply@blogger.comtag:blogger.com,1999:blog-8395646.post-38659680612315940802010-07-18T19:17:37.185-04:002010-07-18T19:17:37.185-04:00Providing abortion is no different from any other ...Providing abortion is no different from any other surgical specialty in that regard.OperationCounterstrikehttps://www.blogger.com/profile/11877707857942926743noreply@blogger.comtag:blogger.com,1999:blog-8395646.post-36463912211033893412010-07-18T19:16:48.749-04:002010-07-18T19:16:48.749-04:00RE: "And a botched abortion now is purely a c...RE: "And a botched abortion now is purely a civil matter, not a criminal matter. Nobody gives a rat's ass any more how many women these quacks injure or kill."<br /><br />That's your stupid fantasy. If you malpractice and kill someone you face a strong liklihood of prison time, IF THE DEATH IS REALLY YOUR FAULT (unlike these two cases, which were NOT the doc's fault.)OperationCounterstrikehttps://www.blogger.com/profile/11877707857942926743noreply@blogger.comtag:blogger.com,1999:blog-8395646.post-23116211984715903852010-07-18T19:14:57.304-04:002010-07-18T19:14:57.304-04:00OC, so physicians shouldn't preform a basic ph...OC, so physicians shouldn't preform a basic physical screening (blood pressure and heart/respirations) in addition to taking a medical history before preforming a elective surgery and administering anesthesia?Ladybughttps://www.blogger.com/profile/09101347971678139917noreply@blogger.comtag:blogger.com,1999:blog-8395646.post-72946632069007249912010-07-18T19:12:29.450-04:002010-07-18T19:12:29.450-04:00There are FOUR different levels of twighlight anae...There are FOUR different levels of twighlight anaesthesia, which require different levels of monitoring. For early abortion, the minimal level is used.<br /><br />You are getting your info off a web site. I am getting mine from real-world experience in a world-class hospital.OperationCounterstrikehttps://www.blogger.com/profile/11877707857942926743noreply@blogger.comtag:blogger.com,1999:blog-8395646.post-68657987341975377692010-07-18T18:11:30.790-04:002010-07-18T18:11:30.790-04:00There are different levels of monitoring. You put ...<i>There are different levels of monitoring. You put an infra-red sensor on the patient's finger and keep someone in the recovery room with all the patients, and that's enough. You DON'T have an individual doc or nurse monitoring each patient individually; that would be way overkill.</i><br /><br />Yes, I know what a pulse oximeter and oxygen saturation is. <br />Really? Not according to the consenses of medical professionals. <br /><i>"Patient monitoring during conscious sedation must be performed by a trained and licensed health care professional. This clinician must not be involved in the procedure, but should have primary responsibility of monitoring and attending to the patient.</i><br />and<br /><i>Vital signs and other pertinent recordings must be monitored before the start of the administration of medications, and then at a minimum of every five minutes thereafter until the procedure is completed.</i><br /><br />Why are you being dishonest here and why are you advocating neglegence and riskier practice, rather than prudence during the use of anesthesia? We're not talking about cadaviers here, we're talking about living, breathing human beings!Ladybughttps://www.blogger.com/profile/09101347971678139917noreply@blogger.comtag:blogger.com,1999:blog-8395646.post-49105958517532816682010-07-18T17:46:30.252-04:002010-07-18T17:46:30.252-04:00RE: Monitoring the patient
There are different le...RE: Monitoring the patient<br /><br />There are different levels of monitoring. You put an infra-red sensor on the patient's finger and keep someone in the recovery room with all the patients, and that's enough. You DON'T have an individual doc or nurse monitoring each patient individually; that would be way overkill.OperationCounterstrikehttps://www.blogger.com/profile/11877707857942926743noreply@blogger.comtag:blogger.com,1999:blog-8395646.post-87928959489087178602010-07-18T17:44:59.646-04:002010-07-18T17:44:59.646-04:00Rachel, RE: ""If the patient is to under...Rachel, RE: ""If the patient is to undergo a minor surgical procedure, screening and assessment of medical conditions that may interfere with conscious sedation must be explored. These potential risk factors include advanced age, history of adverse reactions to the proposed medications and a past medical history of severe cardiopulmonary (heart/lung) disease.""<br /><br />That's not a physical exam, that's taking a medical history and screening for counterindications. There is no evidence that anyone failed to take a medical history in these two cases.OperationCounterstrikehttps://www.blogger.com/profile/11877707857942926743noreply@blogger.comtag:blogger.com,1999:blog-8395646.post-45466745737858160872010-07-18T17:38:48.300-04:002010-07-18T17:38:48.300-04:00This comment has been removed by the author.OperationCounterstrikehttps://www.blogger.com/profile/11877707857942926743noreply@blogger.comtag:blogger.com,1999:blog-8395646.post-87496714333745528262010-07-18T13:11:13.148-04:002010-07-18T13:11:13.148-04:00There is no such thing as--how did you put it-- &q...<i>There is no such thing as--how did you put it-- "a physical exam or any exam to determine if Debra was an appropriate candidate for this type of anesthesia."</i><br /><br />Bzzt! Wrong again!!<br /><br />According to the Encyclopedia of Surgery, in an article, entitled, "Conscious Sedation," written by<br />Laith Farid Gulli, M.D.,M.S. Alfredo Mori, MBBS:<br />"If the patient is to undergo a minor surgical procedure, screening and assessment of medical conditions that may interfere with conscious sedation must be explored. These potential risk factors include advanced age, history of adverse reactions to the proposed medications and a past medical history of severe cardiopulmonary (heart/lung) disease."<br /><br />And again, <br />"Patient monitoring during conscious sedation must be performed by a trained and licensed health care professional. This clinician must not be involved in the procedure, but should have primary responsibility of monitoring and attending to the patient. Equipment must be in place and organized for monitoring the patient's blood pressure, pulse, respiratory rate, level of consciousness, and, most important, the oxygen saturation (the measure of oxygen perfusion inside the body) with a pulse oximeter (a machine that provides a continuous real-time recording of oxygenation). The oxygen saturation is the most sensitive parameter affected during increased levels of conscious sedation. Vital signs and other pertinent recordings must be monitored before the start of the administration of medications, and then at a minimum of every five minutes thereafter until the procedure is completed. After the procedure has been completed, monitoring should continue every 15 minutes for the first hour after the last dose of medication(s) was administered. After the first hour, monitoring can continue as needed."<br />http://www.surgeryencyclopedia.com/Pa-St/Sedation-Conscious.html<br /><br />OC, you ought to learn to be more honest, it's starting to make you look unreliable and dishonest.Ladybughttps://www.blogger.com/profile/09101347971678139917noreply@blogger.comtag:blogger.com,1999:blog-8395646.post-8821027189185882692010-07-18T13:02:04.922-04:002010-07-18T13:02:04.922-04:00D&C with twighlight anaesthesia does not requi...<i>D&C with twighlight anaesthesia does not require individual monitoring. Just as you don't need individual monitoring when you recover from having a wart removed. Emergencies are so rare that individual monitoring would be a waste of someone's time. Like posting a traffic cop at the entrance to a mine.</i><br /><br />Bzzt!! Wrong! It is not dependent on the type of the procedure, but rather the anesthesia and according to the American Association of Nurse Anesthetists (AANA):<br />"Because patients can slip into a deep sleep, proper monitoring of conscious sedation (also known as twlight anesthesia) is necessary. Healthcare providers monitor patient heart rate, blood pressure, breathing, oxygen level and alertness throughout and after the procedure." <br />http://www.aana.com/ForPatients.aspx?id=298<br /><br />Also, it was not just "bad luck" but neglect on the part of the clinic staff to not document the dosage or concentration, nor Debra's weight or the amount of fluid given, nor obtain whether the patient has any medical allergies or history substance abuse.Ladybughttps://www.blogger.com/profile/09101347971678139917noreply@blogger.comtag:blogger.com,1999:blog-8395646.post-82109942609519318622010-07-18T02:55:35.448-04:002010-07-18T02:55:35.448-04:00Your "paper trail" for legal abortions i...Your "paper trail" for legal abortions isn't all that great. You should see the lawsuits when they're filed. The woman has to sue every doctor in any way affiliated with the facility because she doesn't even know who was poking around her insides.<br /><br />And a botched abortion now is purely a civil matter, not a criminal matter. Nobody gives a rat's ass any more how many women these quacks injure or kill. Or at least nobody who is ostensibly in it (with proper catch in the voice) "for the women!"Christina Duniganhttps://www.blogger.com/profile/04785550737493692252noreply@blogger.comtag:blogger.com,1999:blog-8395646.post-7735527025198733502010-07-17T23:34:35.631-04:002010-07-17T23:34:35.631-04:00"Anonymous tips" Sure, in some tiny fra..."Anonymous tips" Sure, in some tiny fraction of cases.OperationCounterstrikehttps://www.blogger.com/profile/11877707857942926743noreply@blogger.comtag:blogger.com,1999:blog-8395646.post-9522035205992014122010-07-17T23:28:35.382-04:002010-07-17T23:28:35.382-04:00Christina, the large majority of illegal abortions...Christina, the large majority of illegal abortions were done anonymously, with the patient never learning the name of her doctor, or even seeing his face, and the doctor not keeping any records, except in a few rare cases. <br /><br />Today, there's always a paper trail. You can FIND OUT who did the abortion, and hold them responsible. This was not true for illegal abortions, except in rare cases they were entirely anonymous. This is again the problem with your method of research, focusing on individual cases and passing over the general picture.<br /><br />D&C with twighlight anaesthesia does not require individual monitoring. Just as you don't need individual monitoring when you recover from having a wart removed. Emergencies are so rare that individual monitoring would be a waste of someone's time. Like posting a traffic cop at the entrance to a mine.<br /><br />These deaths were not the doc's fault. If they had been his fault, the board would have found more severely against him.<br /><br />You don't know enough about abortion to make these judgements. You need to spend six months or so volunteering at an abortion clinic, see how it's done. Except of course they wouldn't let you in. Well, enroll in med school, and do a rotation at a clinic. THEN you'll be on the road to qualification for making these judgements.OperationCounterstrikehttps://www.blogger.com/profile/11877707857942926743noreply@blogger.comtag:blogger.com,1999:blog-8395646.post-8471300723109537112010-07-17T23:23:51.838-04:002010-07-17T23:23:51.838-04:00This comment has been removed by the author.OperationCounterstrikehttps://www.blogger.com/profile/11877707857942926743noreply@blogger.comtag:blogger.com,1999:blog-8395646.post-86687082364282884232010-07-17T17:18:00.638-04:002010-07-17T17:18:00.638-04:00OC, NOBODY WAS MONITORING THEM! They were improper...OC, NOBODY WAS MONITORING THEM! They were improperly resuscitated when people finally noticed that they weren't breathing. If you consider this just "bad luck" -- well, bad luck in that they walked into a nasty abortion mill. <br /><br />And illegal abortion meaning no paper trail? You've not done any research, have you? Dr. Timanus and Dr. Spencer kept perfectly ordinary medical records on their abortion patients. Timanus even reported to the 1955 PP conference on abortion. And you don't need a "paper trail" to nail the guy who did it. Read some of the illegal abortion deaths I post. There are cases where the cops got an anonymous tip after the funeral and they caught the perp. You seem to think that if you do something illegal, somehow you can't get caught because you're not reporting it. I'd like to know who are in our prisons, then.Christina Duniganhttps://www.blogger.com/profile/04785550737493692252noreply@blogger.comtag:blogger.com,1999:blog-8395646.post-83154383750548572422010-07-17T00:02:39.530-04:002010-07-17T00:02:39.530-04:00Illegal abortion means no paper-trail.Illegal abortion means no paper-trail.OperationCounterstrikehttps://www.blogger.com/profile/11877707857942926743noreply@blogger.comtag:blogger.com,1999:blog-8395646.post-58637677417682408502010-07-16T23:59:32.165-04:002010-07-16T23:59:32.165-04:00From your description of the cases, it doesn't...From your description of the cases, it doesn't sound as if anyone SHOULD have gone to prison. These two cases sound like individual surprise reactions to anaesthesia, which can happen to anyone. There is no way to predict who will react badly to anaesthesia. There is no such thing as--how did you put it-- "a physical exam or any exam to determine if Debra was an appropriate candidate for this type of anesthesia."<br /><br />Two cases of bad luck, that's all.<br /><br />I agree that Dr. Kioko was wrong to deny his responsibility for everything--he's the doc, so he's responsible--but these two cases are not good grounds even for yanking his licence, let alone prison.<br /><br />Regarding your other comment, about holding people responsible, in most cases where women died from illegal abortions, no one ever found out who had done the abortion.OperationCounterstrikehttps://www.blogger.com/profile/11877707857942926743noreply@blogger.comtag:blogger.com,1999:blog-8395646.post-58571532617578934932010-07-16T22:29:20.305-04:002010-07-16T22:29:20.305-04:00"If this had been an illegal abortion, there ..."If this had been an illegal abortion, there would have been no investigation, no way to hold the doc accountable if the deaths had been his fault."<br /><br />WHAT? Haven't you noticed that before legalization came along to protect women, the quacks who killed them were PROSECUTED? They'd get sent to freaking SING SING instead of just letting their insurance take care of it.<br /><br />What makes this case unusual for a legal abortion death is that people actually paid attention. But NOBODY went to prison.Christina Duniganhttps://www.blogger.com/profile/04785550737493692252noreply@blogger.comtag:blogger.com,1999:blog-8395646.post-35215012797340655592010-07-16T00:32:58.887-04:002010-07-16T00:32:58.887-04:00The patient's sister was wrong. This was not ...The patient's sister was wrong. This was not "like a back-alley abortion".<br /><br />If this had been an illegal abortion, there would have been no investigation, no way to hold the doc accountable if the deaths had been his fault.<br /><br />Cases like this show why we need to keep abortion legal. So there can be professional oversight.OperationCounterstrikehttps://www.blogger.com/profile/11877707857942926743noreply@blogger.com