tag:blogger.com,1999:blog-4968787219619380438.post3378069488263945067..comments2023-09-21T04:02:29.457-04:00Comments on Skeptical Scalpel: Pregnant woman dies after ovary removed instead of appendixSkeptical Scalpelhttp://www.blogger.com/profile/13206922456661320751noreply@blogger.comBlogger11125tag:blogger.com,1999:blog-4968787219619380438.post-32724123716629887302013-07-07T10:23:49.166-04:002013-07-07T10:23:49.166-04:00I review all of my pathology reports and most of t...I review all of my pathology reports and most of the pathology slides of all tissues removed from my patients. Besides having a great relationship with every pathologist at my hospital, reviewing reports and tissues is a good learning tool for me. <br /><br />Under no circumstances was I, as a resident, allowed to operate without an attending physician in the OR. He/She might have been reading a journal or watching what I was doing over my shoulder but he/she was there. I never allow any trainee to do anything except close skin without my presence in the OR. Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-55550849654756867042013-07-03T19:00:49.152-04:002013-07-03T19:00:49.152-04:00Anon, thanks for the explanation.
As I said in th...Anon, thanks for the explanation.<br /><br />As I said in the post, the level of training of the two surgeon trainees was not stated. The story implied that supervision was in order for them but not provided. If the details are true, they could have used some help, regardless of their level of experience.Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-57903666660268632282013-07-03T15:50:23.427-04:002013-07-03T15:50:23.427-04:00Surgical “residency” in the UK consists of 2 years...Surgical “residency” in the UK consists of 2 years of internship (Foundation 1 and 2), three years of core surgical training, two to three years of specialty surgical training, and then a year or two as a Surgical Registrar. Each step is competitive. A Registrar is commonly a PGY-8 or 9 grade. One does not get to be a “consultant” (attending) until a post opens up, one can stay a Registrar or staff grade forever until this happens. It even takes five post grad years in the UK for someone to be a GP. Trainee does not mean the same there as here in the US.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-77968097477563477542013-06-27T17:35:43.809-04:002013-06-27T17:35:43.809-04:00So far robots don't operate by themselves. It ...So far robots don't operate by themselves. It should really be called "robot-assisted" surgery. I'm not sure what protocol was in effect for this case.Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-79929330531420343952013-06-27T17:08:49.723-04:002013-06-27T17:08:49.723-04:00Bottom line: systems and protocols don't oper...Bottom line: systems and protocols don't operate (although now that robots do, who knows?) I'm becoming a dinosaur, but I believe that clinical judgment is being suspended by "protocols". Hard to figure out how this situation, even as outlined, is justifiable anywhere, thoughAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-90859918399733185032013-06-13T12:57:38.243-04:002013-06-13T12:57:38.243-04:00I agree. Sometimes it really is someone's faul...I agree. Sometimes it really is someone's fault.Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-75267985192866958372013-06-13T11:33:29.523-04:002013-06-13T11:33:29.523-04:00I believe as an industry we have gotten to used to...I believe as an industry we have gotten to used to chalking things up to "systems failure" that we too often fail to hold individuals accountable for their actions and decisions. Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-52962244548390417252013-06-12T14:08:58.038-04:002013-06-12T14:08:58.038-04:00I agree heavily pregnant is a bit vague. There is ...I agree heavily pregnant is a bit vague. There is a photo of the poor woman and she looks pretty far along to me.<br /><br />Good question as to what else they might ignore.Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-88554195120185224882013-06-12T14:02:14.428-04:002013-06-12T14:02:14.428-04:00Just what is "heavily" pregnant? I did ...Just what is "heavily" pregnant? I did an open appendectomy on a lady who was about 6 months pregnant just this past weekend. She weighed about 370...is that "heavily" pregnant? <br /><br />It wasn't that difficult to expose the pericecal region, perhaps the enlarge uterus pushed it toward the surface. I certainly didn't have to operate by feel. I could have done a lap, but my op time was only 39 minutes. I dare say I could have handled it without too much problem when I was a mid level resident, but there is no way I would let trainees operate on a pregnant patient without supervision. <br /><br />No excuse imaginable for not following up on a path report. Do they order labs and x rays and ignore them as well? artigerhttps://www.blogger.com/profile/13361655152970244221noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-22564039474475522072013-06-12T09:18:18.798-04:002013-06-12T09:18:18.798-04:00Thanks for commenting. We see pathologists and rad...Thanks for commenting. We see pathologists and radiologists calling us all the time with questions. It's a good trend.Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-42445278548302026062013-06-12T08:53:55.103-04:002013-06-12T08:53:55.103-04:00A colleague of mine sent a "hernia sac" ...A colleague of mine sent a "hernia sac" as specimen. The pathologist called the next day to say that the sac contained bladder. He said he even read the operative note to make sure that it wasn't part of the case. I was impressed and am forever more appreciative of all specialties. We can't do it alone. <br /><br />That being said...no attending I know, myself included, would leave any trainee alone to operate on a pregnant woman. We'd even have OB there to monitor the fetus. Anonymousnoreply@blogger.com