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I am placing a story on this blog that represents an unfortunate sequela of surgery but nevertheless happens weekly in this country, if not daily. When a Senator, Congress member, noted singer or actor has a negative outcome during or after a surgical procedure it catches the attention of the media and then the entire country. We lose over 100,000 lives each year because of iatrogenic errors. Some of these are the result of a poor H&P, sometimes because of a sleepy or non-vigilant anesthesia provider, sometimes because of lack of proper post-operative follow-up or horrible handwriting that cannot be deciphered by other members of the health care team. My father-in-law died three years ago because residents and a surgeon had no idea that he had been on steroids for the past three years, and 1 week post-op he had a major evisceration, vomited, aspirated his stomach contents and died of septic shock and multi-organ failure. Case in point is that in this country there are needless deaths because many, if not all of these problems, could have been prevented with strict, focused medical care and responsible dictating, careful dissection of tissues and notes and orders that cannot be misinterpreted. Here is the story of a preventable death with a few comments after. Perhaps you can add your comments to mine, and we can discern how we can improve our delivery of care.
Source: Surgical Error May Be To Blame For Murtha’s Death
A Pennsylvania congressman and longtime friend of the late Rep. John Murtha says the congressman's large intestine was damaged during gallbladder surgery and an infection developed.
February 9, 2010
The sudden death Monday of Rep. John Murtha could be attributed to a surgical error, according to a source close to a congressman.
Murtha, a Democratic Congressman for Pennsylvania who was a longtime fixture on the House subcommittee that oversees Pentagon spending, died after complications from gallbladder surgery, according to his office.
According to Rep. Bob Brady, a Pennsylvania congressman and longtime friend of Murtha, the congressman's large intestine was damaged during gallbladder surgery and the complications led him to be hospitalized, the Associated Press reports.
The gallbladder surgery was performed days earlier at the National Naval Medical Center in Bethesda, Md.
Murtha died Monday at Virginia Hospital Center in Arlington, VA, where he was admitted on Jan. 31. He was 77.
Rep. Brady says an infection developed following the procedure, and that Murtha had a fever when he was admitted to the Virginia hospital.
According to CNN, the Democratic congressman had undergone scheduled laparoscopic surgery to remove his gallbladder. The procedure was "routine minimally invasive surgery," but doctors "hit his intestines," a source close to the late congressman told CNN.
"This should have been a really simple surgery. Laparoscopic gallbladder surgery usually is no big deal," reported CNN's senior medical correspondent Elizabeth Cohen. "Many times people don't even get admitted to the hospital."
However, a source told CNN that the congressman may have died after his intestines were nicked during the procedure.
Murtha was initially hospitalized in December and had to postpone a hearing with Defense Secretary Robert Gates on the administration's strategy in Afghanistan. The congressman returned to work after a few days in the hospital and helped oversee final passage of the 2010 defense appropriations bill.
According to Raw Story, it's not unusual for complications to arise during routine surgery. In a recent survey at the Mayo Clinic, 9 percent of doctors admitted making a major error during the last 3 months. Seventy percent of those doctors say that they
were at fault for the error.
Sources: The Associated Press, CNN, www.rawstory.com
- Patients, in their informed consent, need to know all of the potential complications.
- Minimally invasive does not mean that the problems can be minimal. Choleycystectomy is fraught with many potential complications that can alter the patient’s life and cause death. Among the many problems are perforation of the liver or the gall bladder, with leakage of bile and stones into the peritoneal cavity, or perforation of both large and small intestines as well as other organs and vessels.
- They didn’t hit his intestines, but perforated them with a trocar or a grasper.
- Post-operative fevers may have six different etiologies, but when accompanied by distention and abdominal pain that increases, then peritonitis should be suspected, the proper studies should be performed to rule in or out immediate surgery, and there still remains the possibility of multi-organ failure.
- The senior medical correspondent has made a reprehensible statement by calling the Lap Cholecystectomy a “simple surgery”, “usually no big deal “and stating that “many times people are not even admitted to the hospital.” I would hope that the American College of Surgeons takes her to task for these remarks. Obviously she is not a surgeon because the word “simple” is not a part of the vocabulary of most surgeons in this country.
When we see irresponsible reporting such as this, we need to address it among ourselves and with the news agency that has issued the statement. Any comments?
Robert M. Blumm has received national recognition as a distinguished fellow of the American Academy of Physician Assistants (AAPA). He is the past president of the Association of Plastic Surgery Physician Assistants, and was past-president of the American Association of Surgical Physician Assistants, past president of the American College of Clinicians and NYSSPA, as well as Chairman of the Surgical Congress of the AAPA. In addition, Bob received the John Kirklin MD Award for Professional Excellence from the American Association of Surgical Physician Assistants. Along with his associate, Dr. Acker, Bob was the first recipient of the AAPA PAragon Physician-PA Partnership Award. He has been a contributing author of three textbooks, written 150 plus articles and is a sought out conference speaker throughout the United States.
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