Morphine did not cause post-op death

As suspected, such a low dose of morphine was not responsible for a post-op death, discussed here recently. (via a reader tip)

Comments

WilliamManginoMd
What posseses doctors and hospitals to think that this kids condition wasn’t a set-up to get in trouble?
What part of their decision-making overlooked the fact that this type of procedure, even if properly conducted, wasn’t frought with inherent danger?
I’m sorry – this was a violation of a simple standard owed to this patient. It doesn’t require a lot of imagination to foresee potential disaster in scheduling any procedure-much less one that takes place in and around the glottic aperture – as an outpatient. Not to mention the obesity and retardation. Cut me a break !!!
Was this because the insurance company wouldn’t give pre-approval for an overnight stay? Or was it the hospital who overlooked their obligation to protect this child.
This is first-year resident ENT and anesthesia decision making “Stuff.” This was ‘red flag city.’ Only no-one was home in the whole town.
This was poor decision making that cost a kid his life. Plain and simple.
WilliamManginoMd
And, by the way, while we’re on the subject– don’t give us that bullshit that this kid ‘fell asleep on the sofa,” causing apnea.
What the fuck would they expect from a short fat kid post op, less than one day, with a freshly instrumented airway region – given Valium or other medications – some of which just love fat to hang around in in a patient who was probably unable to articulate his fears.
Who the fuck did they think this kid was –Winston Churchill ?
The more I read about this the more pissed off I get.
UNCONSCIONABLE
NoAcuteDistress
As I posted early on in the original discussion of this case, no one learned anything from it. The defendants must have thanked their stars that they got a med-mal attorney so stupid as to focus on a very narrow issue of drug administration in the recovery room. By those narrow standards, the jury was absolutely correct in aquitting the anesthesiologist (who did nothing wrong in the much disputed administration fo the two doses of morphine) and the surgeon (who had nothing to do with the administration of the much contested doses of morphine).
THIS is the sytem which the med-mal attorneys have given us. It truly IS a lottery: in this case the plaintiff’s attorney was out of his league. He’s baffled that the case didn’t go his way? Jeeez Louise. The guy builds a castle of sand and then wonders why the tide washes it away?? If he’d have had the insight to really understand the issues at hand he would have constructed his case along the lines that Dr Mangino outlines above- sentiments with which I am in agreement 100%. If the plaintiff’s attorney had obtained REAL expert testimony on the big picture, he’d have won in spades. Any anesthesiologist or otolaryngologist worth his/her salt would have given him the low down just like Dr. M above.
Sad, sad, sad case.
Anonymous
“Any anesthesiologist or otolaryngologist worth his/her salt would have given him the low down just like Dr. M above.”
After reading Dr M’s rant above I doubt he would have the balls to do such a risky case. Now he hands out pain pills. God bless him for that.
WilliamManginoMd
I don’t “Hand out” pain pills. You and I need to meet face to face.Give me some time, and I’ll work it out.
I take that type of insult very personally. It’s a genetic thing with Italians.
WilliamManginoMD
I just got off the phone with several anesthesia and ENT specialists who are concerned about this case in California.
Two of the people, with whom I spoke, are university hospital department chairpersons.
As a result of these conference calls – they are considering having The Attorney General, in California, look into the possibility of filing manslaughter charges against the hospital and physicians.
Kevin-md is supposed to be a place where commentary is exchanged about medical issues. I can see from the level of personal attack launched against me that fair-play is not part of the equation.
Someone accused me of “Handing out pain pills.”
That accusation has made me very angry. It is not true-and, furthermore, those types of accusations border on accusing me of criminal activity.
So i’ve decided to make war – I sincerely hope that personal attacks will cease.
When I expressed my dismay at the handling of the medical decisions in this case I was not trying to ruin the lives of the doctors.
I changed my mind
NoAcuteDistress
It’s not a matter of having the BALLS to do this risky case Anonymous 7:38PM, it’s a matter of having the BRAINS to know that given the bloody OBVIOUS co-morbidities of the patient in this case, one should not have done it in the outpatient arena. I believe that is what Dr M is referring to, and it is certainly what I am referring to in my own “rant.” Had a reasonably intelligent med-mal attorney asked ME for my two cents on this, I would have gladly given it to them (as I suspect Dr M would -but I don’t wish to speak for him). In a Grand Rounds setting to which I referred in my initial post, any number of us would have been glad to give such an assessment for FREE. For you med-mal attorneys lurking out there I’ll explain it to you: we do such forums because we all learn from them, not because we’re trying to make a buck or crucify anyone. I’m sick of you guys coming into these sites and tossing about aspertions about doctors’ integrity with respect to our willingness to testify in such matters.
One last question in case any med-mal attorneys are out there: Why is the manner in which this plaintiff’s attorney brought this case not a glaring example of LEGAL malpractice??

Morphine did not cause post-op death

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