[HSF] More Bad News About Trasylol

[Ramaiah, Chandrashekar]

Hal,
Thank you for your advise regarding the Lawyers (I do not like them
either and I hope I don't see them any time soon).
I don't think I am doing something illegal by using a drug that is still
approved by FDA for this purpose. I do counsel the patient pre-op in
elective surgeries since the last NEJM articles (our anesthesiologist's
request). I understand your concerns about the drug but the fact is
there is no free ride here. Every thing we do comes with risk. It is all
about balancing the risk and benefit. I used it today on a patient that
received 2 drug eluting stents few months ago and remains on Plavix (you
don't want to know the details!)

I think it is a very useful drug. The company has been pushing it too
hard for all cases and may come back to haunt them in the long run.
Chand

-----Original Message-----
From: openheart-l-bounces at lists.hsforum.com
[mailto:openheart-l-bounces at lists.hsforum.com] On Behalf Of
Hgrmd at aol.com
Sent: Saturday, September 30, 2006 1:41 PM
To: OpenHeart-L at lists.hsforum.com
Subject: Re: [HSF] More Bad News About Trasylol

Chand,
  How can you still persist in using the product when you know that it
has a 
distinctly higher risk of complications, particularly ATN?  The  last
time I 
used it was in an 85 yo lady with an aneurysmal ascending and arch
aorta.  
Using circ arrest, I sewed the graft to the arch, just before the  left
common 
carotid.  I then sewed the innominate to the side of the  graft.  Circ
arrest 
time was 37 minutes.  She woke up and did well  hemodynamically, but she
never 
made another drop of urine.  Two months  later, last I heard she was
still on 
dialysis.  
  I would rather just deal with the bleeding rather than deal with the
ATN 
and the lawsuits.  With this latest salvo of bad news in the press, I'm
sure 
the scum sucking bottom feeders (lawyers, not catfish) will be trolling
for  
cases with renewed vigor.  Chand, suppose you do get a lawsuit for use
of  
Trasylol and ultimately prevail.  You still lose after you consider the
mental 
stress, time lost going over discovery and depositions, etc associated
with 
getting sued.  Believe me, back in the days when I had malpractice
insurance, I 
used to get B.S. frivolous suits that were ultimately  dropped.  The
mental 
anguish is excruciating.  You are a young guy who  is probably
unfamiliar with 
these hassles.  Believe me, it's not worth  it.
Hal
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