Surgical Mistakes
 

http://more.abcnews.go.com/sections/...al_errors.html

Hurshell Ralls discovered that his penis and testicles had been removed during surgery.

(ABCNEWS.com) ‘Total Disbelief’
Penis Removal Just Latest In Series of Surgical Mistakes, But Patients Can Protect Themselves

Aug. 11 — After 67-year-old Hurshell Ralls went into surgery for bladder cancer, he came out of surgery missing more than he ever expected. His penis and testicles were gone.

"My wife had to hold my hand in the bed there. And she said 'Honey it's over. They got all the cancer.' And she waited a few minutes and then said 'But they had to remove your penis.' And I was one mad dude, you know," Ralls said on ABCNEWS' Good Morning America.

Ralls, a mechanic, says doctors never warned him or his wife that amputation of the penis and testicles might have been part of surgery before he went in for the procedure in November 1999. Ralls filed a negligence lawsuit against the Clinics of North Texas in Wichita Falls, and the doctors who operated on him. The civil case is set for trial Aug. 25.

"It was never even discussed. And I felt like he ought to have at least told us that this might be a possibility so that we could have talked it over even before he was admitted to the hospital," said Thelma Ralls, his wife. In a February deposition, Ralls' doctor said that he determined the cancer had spread to the penis while he was removing Ralls' bladder. Doctors did not send a tissue sample to the lab until after the surgery. A Dallas doctor who examined cell slides later found that Ralls did not have penile cancer.

The Ralls' case may sound outrageous, but for cancer patients across the country, medical errors are something they — and many other hospital patients — face with alarming frequency.

The Robert Wood Johnson Foundation reported in 2001 that 95 percent of doctors have witnessed a major medical mistake, and that many of them involved cancer. When Johns Hopkins reviewed tissue samples from thousands of cancer patients around the country, they found one out of every 71 cases was misdiagnosed.

Both Breasts Removed, No Cancer
Frank Barerra is another cancer patient who was the victim of an error. He was actually in surgery, about to have his prostate removed, when a call came from the pathology department — there had been a mistake. His slides showed no cancer.

"You can imagine — it was like waking up from a bad dream," Barerra said. "It never occurred to me that a pathology lab could just bungle a decision like that."

Last January, Good Morning America interviewed Linda McDougal, who was misdiagnosed with breast cancer. McDougal was given a double mastectomy at the United Hospital of St. Paul, Minn., in May 2002. After the surgery, McDougal was told that she actually had no signs of cancer.

"My surgeon walked in and said that she had bad news, and she had no other way of telling us other than to put it on the table. And that I didn't have cancer," McDougal said. "And my immediate reaction was, great, you got it all. And then she said, you don't understand. You never had cancer. And it was instant shock. I couldn't even react to it."

When McDougal appeared on Good Morning America, the hospital that did the operation offered an apology. Dr. Laurel Krause, a senior pathologist at the hospital said that two patient slides at the hospital were inadvertently switched.

"We deeply regret what happened, and wish we had made that clear at the time," Krause said. "At the time, Linda was very angry, and justifiably so."

But to victims of medical errors, sometimes an apology can't make up for what they've lost.

"I really felt like they played God and took it in their hands and decided to do it," Thelma Ralls said. "This is Hurshell's life, and my life. And to me they destroyed our sexual life."

Understand Your Doctor

Dr. Rache Simmons, a breast cancer surgeon with Weill Cornell Medical Center in New York, said that there are steps that patients can take to protect themselves. First of all, patients should listen carefully to their doctors, and all of their options and recommendations. If you don't understand your doctor, get a new one, she advises.

"Part of being a good doctor is being able to communicate with your patients," Simmons said. "If you don't understand your doctor, and you've asked him or her to explain it again and your still don't get it, find another physician."

Patients who are told they need surgery should also seek out a second opinion. It makes good sense, and almost all health plans will pay for it. If the opinions disagree, call your health plan and ask if they will pay for a third. If they won't go with your gut on whether to proceed with the surgery, Simmons said.

Once the decision is made, all patients should bring a family member or friend to a pre-surgical appointment to write down information and ask questions.

"I give out hand-outs and videos at my practice because, as a breast cancer surgeon, it's hard for anyone to be calm enough to take in all the information at the appointment," Simmons said.

Ready for the Worst

It is also important for patients to designate someone as their health care proxy before surgery, Simmons said. The patient-appointed proxy can carry out the patient's wishes while the patient is under anesthesia.

Before going into surgery, patients sign a consent form, which they should read very carefully before signing. The form will describe exactly what the doctor is allowed to do, and whether a doctor will be allowed to proceed if more serious conditions are found.

"It really boils down to a consent issue. So we as doctors can only do what's in the consent form," Simmons said.

Another important document that patients should consider is a living will, which can protect a patient's rights and wishes while they are under anesthesia, in case the unexpected happens. Doctors need to know what they should do in terms of extraordinary life-saving measures.

Oh. My. God.

What do you do when your husband comes home without a penis? Above what do you do when you find out it was a mistake? :eek: How can you just diagnose someone with cancer without EXTENSIVE testing? That is CRAZY!!

They say that patients should read the consent forms thoroughly, but they are very vague, to say the least. I read those forms thoroughly and they only say something along the lines of "You give consent to the hospital to perform any service that may be deemed necessary for your diagnosis." :confused: If, at the time, they deem a service necessary, then what? You just find out about it in the end. They need to lay out SPECIFIC steps that will be taken during surgery. If they find something else that isn't life-threatening, then they should wait and allow that patient to decide if they want to have another procedure.

I wish a mo-fo would try to send me home without mines and not tell me about it first. But that's why incidents like that one and the one at Duke University are happening. Too many people trying to take too many short cuts and are not thinking about the consequences.

I think they need to write these forms in layman's terms so that an eighth grader (because I think the average adult can read on the eighth grade level) can understand exactly what is going one. I would like to think that this would take the confusion out of everything.

Unfortunately, technological advances are slow to come to healthcare for a variety of reasons. Shoot, my hospitals JUST got the automated perscription system which eliminates any medication error that may result from trying to read the doctor's handwritting.

Surgical procedures like the "penis incident" could be avoided with simple technology PATENT PENDING :D , like scanning the bar code on the patient's ID bracelet (with a device similiar to what is used in Wal-mart for price checks). Once scanned, on the screen it should indicate what surgical procedure that the patient is scheduled to have. This would eliminate any errors due to mis-filed/labeled patient files.

You're right. At my hospital (M. D. Anderson) we're required to write consent forms at the sixth-grade level. Things are different here because we're a specialized cancer center. Most of these mistakes occur at general hospitals where you have a l ittle bit of everything going on, w/ a couple of hot-shots on the side who call themselves oncologists. We've also got online charting started, and a digital prescription system, w/ a robotic dispensation process for inpatient care. 100% accurate in the past 5 years it's been running and a dream-come-true for those of us who don't want to read Dr Cantwrite's scribbles.

A couple of hospitals across the street from us (coughStLukescoughMethodistcough) sprint through the consent process. Then if their patients come to us for another opinion, we have to start all over again educating them, because there was NO way they got it the first time. :mad:

The point in the article about slides being misdiagnosed is absolutely true. Our pathology dept reports 25% of the diagnoses that accompany slides is wrong. Wrong to the point of changing the treatment plan: 17%.

A lot of us in medicine are equally PO'd and appalled at these kinds of mistakes. They are totally inexcusable and make the patient's life hell and any other doctor's job harder.

Adrienne

The labs are one of the biggest holes in the process. I was diagnosed with hyppthyroidism even though I had vert few of the symptoms and actually demonstrated the exact opposite behaviors of other symptoms. After my PCP referred me to a specialist and I received all of these nuclear tests, the specialist reviews the lab results and indicates that they were impossible! Of the 3 numbers *don't quote me*, two should have been high and the third low...well there were TWO that were low, a physical impossibility based on actual blood chemistry. Fortunately, all that resulted was exposure to some nuclear agents and a missed day's work...:mad:

My husband was diagnosed at the same office w/ diabetes. His only risk factor was that he is AA, thats it! I beleive it was incorrect lab results in this instance as well. Fortunately, the doc did a retest and found no signs of the disease.

I am in total shock! He didn't even have penile cancer, and she didn't have breast cancer. I feel so sorry for them. :(

Scissors Are Left in Woman After Surgery
Tue Apr 20, 5:23 PM ET Add Strange News - AP to My Yahoo!


SYDNEY, Australia - A Sydney woman demanded an explanation Tuesday from a hospital where a pair of scissors were left in her abdomen after surgery and said she planned to sue.


Pat Skinner, 69, had part of her colon removed at Sydney's St. George Hospital in May 2001. But she said that she continued to suffer intense pain in her abdomen for months after the operation.


Eventually, she demanded doctors x-ray her abdomen. They did and discovered the 6.7-inch pair of scissors, which were removed in October 2002.



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http://story.news.yahoo.com/news?tmp...ralia_scissors

Are those two different people because one photo looks like the scissors were left in her abdominal area and the other looks like it was left somewhere in the thoracic area? Photo 1 is the pelvic area and the other...those are ribs! Either way, it shows that some physicians are smoking that $hit!

I was thinking the same thing cause the second set of scissors aren't as big either. Nor are they open. But like you said it STILL shows someone was acting a damn fool.

Maybe it's a hoax.:confused:

That's a big ass pair of scissors! :eek:

Oh MAN, talk about a lawsuit!!! :eek: :eek: I would definately be...:mad: :mad: :mad:

They have to be different pictures/people - - the abdominal cavity doesn't include ribs, sternum, collarbone(s), and shoulder blades!

This woman has an unbelievable lawsuit to file.

IMHO, the top pic is the correct one - unless someone got scalpel-happy and cut all the way into the thorax for a colon resection. :eek:

For a mistake of this magnitude (it wasn't a dropped needle, an extra lap sponge, etc) you have to have an ENTIRE TEAM of people being incompetent and covering for each other. When instruments, sponges, etc are brought into the field in surgery, they are counted 3 times, by three nurses (not the doctor, he's operating) from 3 vantage points. Then they're counted again, the same way, when they're taken out. The counts have to match or either the patient doesn't get closed, or if they're unstable and they have to close, they go *straight* to Xray to find whatever was left.

"Human error" my butt. A single sponge left behind the liver or something is an error that you could possibly see happening. Scissors or a snap clamp? Forget it.

I hope heads roll and licenses get pulled. It's crap like this that gives all of medicine a bad name.

:mad:

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