They get it right! ICD-10 Code W5609XS Other contact with dolphin, sequela

The ongoing saga of the new International Classification of Diseases, 10^th revision [ICD-10] continues. ICD-10 is what every physician and hospital must use when submitting bills to various third parties. The list of codes has been expanded from 18,000 to 140,000 and some of them defy description. See other posts about getting sucked into a jet engine and drowning having fallen off burning water-skis.

In today’s episode, we investigate W5609XS Other contact with dolphin, sequela. Since this is listed as “other contact,” you may be wondering what the specific codes might be. They are as follows

W5601XA Bitten by dolphin, initial encounter

W5601XD Bitten by dolphin, subsequent encounter

W5601XS Bitten by dolphin, sequela

W5602XA Struck by dolphin, initial encounter

W5602XD Struck by dolphin, subsequent encounter

W5602XS Struck by dolphin, sequela

Having eliminated bitten or struck, I thought I was left with only my imagination to envision what “other contact with dolphin” might be. What other contact with dolphin could there be? Why would the folks at ICD-10 headquarters have put in such a code? Well, apparently they did their homework on this one.

In 2002, CNN reported that a dolphin was attempting to sexually assault female bathers on the south coast of England. A noted dolphin wrangler was unsuccessful in to trying to lure the dolphin to France. [It's unclear why France was the destination. It be related to the fact that's it's also the home of Dominique Strauss-Kahn, another alleged sexual predator.]

But the other side of the story is the recent news that a man named Malcolm Brenner has written a book about his 9-month long sexual relationship with a dolphin. The book, entitled Wet Goddess: Recollections of a dolphin lover, tells the story of his affair with “Dolly,” who interestingly is portrayed as the aggressor in the relationship. There is also a website devoted to this story. T-shirts and posters are available should you be so inclined.

Somewhat off point, but nonetheless amusing, is the unfortunate juxtaposition of an ad on Amazon.com’s page describing Wet Goddess. Just above the details about how to purchase the book is information on how you can buy a case of Chicken of the Sea Tuna, new or used [sic] for only $39.84.

You may recall that dolphins are known to swim with tuna and are often caught by commercial fishermen. There is controversy about the fate of dolphins ensnared in this way. Ironically, Amazon purchasers of both the book and the bargain tuna might be reading about Dolly and eating her at the same time.

You cannot make this stuff up.

Retractor Left in Patient’s Abdomen after Hemorrhoid Surgery [Not Likely]

NBC News in San Diego reports that five hospitals have been fined a total of $300,000 by the California Department of Public Safety for “dangerous errors.” One of the errors is described as follows:

Scripps Memorial Hospital in Encinitas, April 16, 2010: A malleable retractor was left inside a 66-year-old woman's stomach during a hemorrhoidectomy (removal of hemorrhoids).The flexible metal instrument was described as being approximately 12 inches long and 1 inch wide. Surgeons performed a second operation to remove the instrument.

I have some real news for you. Unless this was the mother of all hemorrhoids, it is very unlikely that a 12 inch long retractor was left in the stomach [obviously, they meant to say abdomen] of a patient. Hemorrhoids are located in the anorectal area. One does not need a 12 inch long retractor nor does one need to open the abdomen to perform a hemorrhoidectomy. So if this retractor was left in the abdomen during hemorrhoid surgery, it is a bigger problem than simply leaving a retractor in a patient. The surgeon had to have been completely lost or temporarily insane to have done what this report claims.

I think there is something else going on here. It could not have been a hemorrhoidectomy that resulted in this complication.

Oh well, let’s not let the facts get in the way of a sensational story.