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Thread: ICU case

  1. #41

    Default Re: ICU case

    Quote Originally Posted by d2xpeter View Post
    That is enlightening...thkq

    "Yet despite these numbers, the American public remains unaware of just how pervasive the problem is...."

    There could be the similar situation here. And yet people still think that patients are over-reacting.
    Uncle Fai is right. Must sue
    suing isn't the problem. you take the American approach to suing just about anyone who just ticks you off a little, and soon no one wants to be a doctor or nurse here in Singapore. that's why we have laws to make sure that frivolous cases are thrown out...

    and you have to look at the statistics. 98,000 is an estimated number. also Singapore has a smaller amount of cases.

    there are people who even sue because they are given a wrong diagnosis, that they will live instead of die from cancer. while i count it a blessing to be alive, those people count it a blessing to be able to sue and make money, while giving ridiculous excuses that "my life was taken away from me".

  2. #42
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    Default Re: ICU case

    Quote Originally Posted by kei1309 View Post
    there are people who even sue because they are given a wrong diagnosis, that they will live instead of die from cancer. while i count it a blessing to be alive, those people count it a blessing to be able to sue and make money, while giving ridiculous excuses that "my life was taken away from me".
    this, of course, is the extreme/unreasonable one.

  3. #43

    Default Re: ICU case

    Quote Originally Posted by d2xpeter View Post
    this, of course, is the extreme/unreasonable one.
    but do you think starting a lawsuit is the right way to do things? it's nothing about unreasonable/extreme. you open the floodgates, and knowing Singaporeans' unreasonable attitudes, i guarantee you that this will become the norm.

  4. #44

    Default Re: ICU case

    the law of unintended consequences:
    1. medical bills become higher -> insurance to cover the doctor/hospital's ass should they get sued
    2. doctors become less willing to take on difficult cases -> if i try to save u, and u die, i get sued

    i'm not giving a free pass to medical professionals who are negligent in their duty, but lawsuits rarely, if ever have the intended consequences.

  5. #45
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    Default Re: ICU case

    Quote Originally Posted by kei1309 View Post
    but do you think starting a lawsuit is the right way to do things? it's nothing about unreasonable/extreme. you open the floodgates, and knowing Singaporeans' unreasonable attitudes, i guarantee you that this will become the norm.
    it is already a norm. LOL. Our leaders have already set very good examples. LOLLLL.
    didn't you see there were many lawyers letters flying around in the recent past?

  6. #46
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    Default Re: ICU case

    but seriously, the article quoted by An drew is very informative.
    the quote below could hv answered kei1309 and cks doubts: lawsuits does not seem to be rampant [even with American preference to use it] and cost is not from lawsuits but rather from the amount of malpractices.

    quote
    "People have been led to believe that there are hundreds of thousands of medical negligence lawsuits every year and only a handful of genuine medical errors. In reality, the reverse is true. There are very few medical negligence lawsuits, and hundreds of thousands dying from preventable medical errors. As University of Pennsylvania law professor Tom Baker puts it, “We have an epidemic of medical malpractice, not of malpractice lawsuits.”

    Much of the discussion surrounding medical negligence revolves around costs, whether it be the cost of physicians’ insurance or the cost to health care. While these are the subject of much debate and acrimony, the potential savings from the elimination of medical errors are undeniable."

  7. #47

    Default Re: ICU case

    Gordon Moore, if you're from an EE background would know him as Intel's co-founder, one of the richest men in the world and a noted philanthropist.
    When his wife almost died from a medical error, he asked the nurse that almost killed his wife - why did you make that mistake?
    The nurse said - training issue.
    So instead of suing (I doubt he needs the $), he donated $$$ to fund increase in nurse training - setting up the Betty Irene Moore School of Nursing at UC Davis.

    The Betty Irene Moore Nursing Initiative, the Foundation’s first major investment in healthcare, was born from Betty’s vision and leadership.

    Having served as a caregiver for multiple generations of her own family, she has always understood the important influence nurses have on their patients and the role they play in providing safe, high quality care. After suffering adverse consequences from a medical error, Betty made improving healthcare for adults in her community a priority, for which she placed a strong emphasis on nursing. As a result, the Gordon and Betty Moore Foundation established the Betty Irene Moore Nursing Initiative in 2003.

  8. #48
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    Default Re: ICU case

    Quote Originally Posted by cks2k2 View Post
    Gordon Moore, if you're from an EE background would know him as Intel's co-founder, one of the richest men in the world and a noted philanthropist.
    When his wife almost died from a medical error, he asked the nurse that almost killed his wife - why did you make that mistake?
    The nurse said - training issue.
    So instead of suing (I doubt he needs the $), he donated $$$ to fund increase in nurse training - setting up the Betty Irene Moore School of Nursing at UC Davis.
    ya, this is one of the best way to help to reduce medical errors, which is on the rise [surprisingly] despite our advance in medical technology.
    Definitely need to focus on the training aspect. The right type of training, to be specific.
    IMHO, the way a hospital is managed is also crucial.

  9. #49
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    Default Re: ICU case

    Quote Originally Posted by cks2k2 View Post
    So instead of suing (I doubt he needs the $),
    btw, the objective of suing may not be only for $.
    It is also to send a message to the other party that what they did is wrong and to deter them from repeating.
    As an example again, do our leaders need $? They hv been so well paid. But they still sue. LOL. Precisely for what objective, i dont know. Could be the above.

  10. #50

    Default Re: ICU case

    Quote Originally Posted by d2xpeter View Post
    btw, the objective of suing may not be only for $.
    It is also to send a message to the other party that what they did is wrong and to deter them from repeating.
    As an example again, do our leaders need $? They hv been so well paid. But they still sue. LOL. Precisely for what objective, i dont know. Could be the above.
    i thought they donate away whatever they won?
    the problem with the americans is they too often use litigation to enrich themselves.

  11. #51

    Default Re: ICU case

    Quote Originally Posted by d2xpeter View Post
    ya, this is one of the best way to help to reduce medical errors, which is on the rise [surprisingly] despite our advance in medical technology.
    Definitely need to focus on the training aspect. The right type of training, to be specific.
    IMHO, the way a hospital is managed is also crucial.
    I was actually reading superfreackonomics and they covered the issue of high death rates in US hospitals.
    turns out doctors themselves hardly practice personal hygiene i.e. washing hands!

  12. #52
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    Default Re: ICU case

    went back to re-read the case and check out on the possible complications of colostomy.



    "Complications of Colostomy

    Colostomy is a surgical procedure in which an opening on the front wall of the abdomen is made to ease the removal of feces after extensive operations of the large intestine.

    There are several possible complications connected to the very procedure. The infection is the leading one. This can be easily explained by the proximity of the bacteria that normally live in colon. These bacteria can contaminate the operated area. The best way to prevent possible infection after colostomy is timely application of antibiotics.

    Prolonged and excessive bleeding can be another complication of colostomy. In some patients who are already suffering from problems with coagulation there is even a chance of thrombophlebitis. The inflammation and clod clots most commonly affect veins in the legs. Thrombophlebitis may consequently lead to pulmonary embolism which is rather serious and potentially life threatening condition. And some patients may develop pneumonia after the surgical procedure.

    Additional complication is slow closure of the wound. Namely, in some patients the opening on the front wall of the abdomen is only temporary and it will be closed once the surgeon decides it is time for that. The wound may need longer time to heal properly. Still it eventually heals completely.
    And finally, it may take some time for a patient to recover completely. General health of the patients is what determines the recovery."

  13. #53
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    Default Re: ICU case

    further check on the danger of Pulmonary embolism
    Pulmonary artery is the artery that transfer blood from the right ventricle to the lungs to oxygenate the blood.
    And take particular note of the last sentence.


    "Symptoms of pulmonary embolism


    Pulmonary embolism is a blockage of the pulmonary artery or its smaller branches due to dislocation of a blood clot (thrombus) or other bodies from the periphery, through which they enter in the pulmonary blood circulation. Embolism can cause blood clots, fat droplets, gases, foreign bodies, bacteria, parasites and the body cells.

    The most common cause of pulmonary embolism is a thromboembolism in the deep veins of the lower extremities and pelvis. Thrombi can rarely come from the heart, if it is expanded or from superior vena cava.

    Risk factors for a venous thrombosis of lower extremities are usually prolonged sitting and lying after surgery, tumors, blood coagulation disorders etc. Thrombi which are separated from their primary position carried by the blood may block pulmonary artery. Obturation of pulmonary artery causes a sudden increase of resistance and pressure in the pulmonary circulation leading to loading the right ventricle of the heart. If the load is large, the heart can not deflate enough blood which is known as cardiogenic shock.

    Most pulmonary embolisms pass without symptoms, because small arteries are mostly closed. Obstruction of small branches of pulmonary arteries leads to infarction of the lungs, or the extinction of small segments of the lungs. However, if the affected area receives an additional circulation from the surrounding arteries it does not cause pulmonary infarction, but appears pulmonary hemorrhage.

    If there is a blockage of the main pulmonary artery it performs immediate death. If the patient survives massive embolism, develops the heavy shock. Later appears difficult dyspnea (difficulties with breathing), the patient is very frightened, he/she has pain behind the sternum and cold sweating. Also develops pale cyanosis, blood pressure decreases, pulse is rapid, veins in the neck are swollen and liver gradually increases. If pulmonary embolism is less, the patient has a mild and short-term dyspnea, he/she is anxious, suddenly sweating, has tachycardia, has a moderate fever and primary disease worsens. Symptoms of pulmonary infarction occur 12-48 hours after pulmonary embolism. Suddenly appears pleural pain localized in the lower parts of the lungs. Pain can be projected to the neck or upper part of abdomen. Other symptoms include persistent cough, coughing up ichor, shortness of breath (dyspnea), tachycardia, fever, sometimes mild jaundice. Laboratory test show increased white blood cell count, sedimentation, bilirubin, and lactic acid dehydrogenase levels in the blood. The x-ray shows a characteristic triangular shadow and irregular or round shadow like at bronchopneumonia.

    With early diagnosis and aggressive treatment, most patients will survive pulmonary embolism with low rate of recurrence."
    Last edited by d2xpeter; 18th April 2013 at 11:19 PM.

  14. #54
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    Default Re: ICU case

    Pulmonary embolism seems to be the most probable occurrence judging from the symptoms described.
    And according to Ms Ho, patient was not attended to till 2 hours later.
    Last edited by d2xpeter; 18th April 2013 at 11:28 PM.

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    Default Re: ICU case

    Quote Originally Posted by cks2k2 View Post
    i was in c ward (the 6 bed ward, c1 or c2?), had 3-4 nurses at all time.
    In C ward you will have much more nurses around you: those young ones on professional training. C ward patients seem to be used as guinea pigs and exercise objects.
    Actually, I missed them in B1 ..
    EOS

  16. #56

    Default Re: ICU case

    Quote Originally Posted by d2xpeter View Post
    Pulmonary embolism seems to be the most probable occurrence judging from the symptoms described.
    And according to Ms Ho, patient was not attended to till 2 hours later.
    PE / DVT can also occur in a long haul flight.. sue the airline also ?

  17. #57

    Default Re: ICU case

    Quote Originally Posted by d2xpeter View Post
    Pulmonary embolism seems to be the most probable occurrence judging from the symptoms described.
    And according to Ms Ho, patient was not attended to till 2 hours later.
    1. you're not a doctor/expert
    2. we don't have all the facts, only some bits and pieces from newspaper
    3. my uncle died from pulmonary embolism

  18. #58

    Default Re: ICU case

    Quote Originally Posted by Octarine View Post
    In C ward you will have much more nurses around you: those young ones on professional training. C ward patients seem to be used as guinea pigs and exercise objects.
    Actually, I missed them in B1 ..
    i guess i forgot to mention i got attended to by some chio trainee doctors?

  19. #59

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    Quote Originally Posted by d2xpeter View Post

    it is already a norm. LOL. Our leaders have already set very good examples. LOLLLL.
    didn't you see there were many lawyers letters flying around in the recent past?
    How would you like it if someone insinuated that you, as a leader, was corrupt? If u had studied law, your argument would have held little water in court, simply because of the irrelevance to the case in question

  20. #60

    Default Re: ICU case

    Quote Originally Posted by cks2k2 View Post
    i guess i forgot to mention i got attended to by some chio trainee doctors?
    Don't get heart attack

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