[HSF] "Easier to let pts suffer than to do what is right"

Wed Feb 6 18:19:16 EST 2008

"Oh, by the way - what is the peer review process for "medical errors" and
how are they defined?   and by whom?"

Good Question

NFA

On Feb 6, 2008 5:52 PM, Michael Firstenberg <msfirst at gmail.com> wrote:

> But if the purpose of these "peer reviews" is to make sure that your re-op
> for bleeding is not 2x the STS average, is that a bad thing?  Oh my, I am
> starting to sound like an administator - Hal, quick, shoot me......
>
> Oh, by the way - what is the peer review process for "medical errors" and
> how are they defined?   and by whom?
>
> -michael
>
>
> On 2/6/08, John Schor <johnschor at mac.com> wrote:
> >
> > I have worked with people who would not admit their own errors. I have
> > seen many pt's "buried" due to surgeons not doing the right thing, ie
> > reoperating on a pt like Hal's while under close scrutiny. I no longer
> > work with those people.
> >
> > I am now alone in practice in a rural area of Northern Arizona. When a
> > pt has any complication, the whole medical staff immediately knows
> > about it. If a surgeon reoperates, read "unplanned procedure", a flag
> > is raised on the chart and it is automatically reviewed by a member of
> > the "peer review committee".
> >
> > It's usually a primary care doc, pediatrician, radiologist, or other
> > "peer" who has to figure out whether the Board Certified CT Surgeon
> > knows what he's doing and has provided standard of care.
> >
> > I have had a couple of "unplanned procedures" because I am very
> > conservative and will reexplore pt's if things "just don't look
> > right". Any one on the HSF would understand and even commend such
> > behavior, but small town medical politics are very interesting.
> >
> > On the other hand, I do have a monopoly for a 60 mile (100km) radius.
> >
> > John
> >
> >
> > John Schor, MD
> > Verde Valley Medical Center
> > Cottonwood, AZ 86326
> > Tel: 928-649-2584
> >
> > On Feb 6, 2008, at 2:20 PM, Nasser F. Abou'Seada wrote:
> >
> > > "a place that keeps tabs on which pt's go back to the
> > > OR; then secret tribunals are held in order to "educate" the medical
> > > staff. It takes guts to take on cases like that. It's a lot easier to
> > > let pt's suffer than to do what is right."
> > >
> > > Dear John
> > > please elaborate more ....
> > > sounds the same everywhere !!!!
> > >
> > > NFA
> > >
> > >
> > >
> > > On Feb 6, 2008 3:06 PM, John Schor <johnschor at mac.com> wrote:
> > >
> > >> Hal:
> > >> Great job!
> > >> You prove the point that we can only know so much without operating.
> > >> Pontificating is the worst place to be. It is clear you are a Jedi
> > >> Master; "May the force be with you".
> > >>
> > >> I am currently at a place that keeps tabs on which pt's go back to
> > >> the
> > >> OR; then secret tribunals are held in order to "educate" the medical
> > >> staff. It takes guts to take on cases like that. It's a lot easier to
> > >> let pt's suffer than to do what is right.
> > >> I admire your efforts.
> > >> John
> > >>
> > >>
> > >> John Schor, MD
> > >> Verde Valley Medical Center
> > >> Cottonwood, AZ 86326
> > >>
> > >>
> > >> On Feb 6, 2008, at 10:03 AM, Hgrmd at aol.com wrote:
> > >>
> > >>>
> > >>> Prasanna,
> > >>>
> > >>> ? Thanks.
> > >>>
> > >>>
> > >>>
> > >>> Hal
> > >>>
> > >>>
> > >>> -----Original Message-----
> > >>> From: Prasanna Simha M <prasannasimha at gmail.com>
> > >>> To: OpenHeart-L at lists.hsforum.com
> > >>> Sent: Wed, 6 Feb 2008 11:55 am
> > >>> Subject: Re: [HSF] (no subject)
> > >>>
> > >>>
> > >>>
> > >>>
> > >>> Gut instinct pays.
> > >>> Prasanna
> > >>>
> > >>> On Feb 6, 2008 10:17 PM, <hgrmd at aol.com> wrote:
> > >>>
> > >>>>
> > >>>> Ahmed,
> > >>>>
> > >>>> ? Thanks for your words.? Parenthetically, all of my partners
> > >>>> advised me
> > >>>> not to operate.
> > >>>>
> > >>>>
> > >>>>
> > >>>> Hal
> > >>>>
> > >>>>
> > >>>> -----Original Message-----
> > >>>> From: alsadd <alsadd at ksu.edu.sa>
> > >>>> To: OpenHeart-L at lists.hsforum.com
> > >>>> Sent: Wed, 6 Feb 2008 5:33 pm
> > >>>> Subject: RE: [HSF] (no subject)
> > >>>>
> > >>>>
> > >>>>
> > >>>>
> > >>>> Congratulations Hal a job well done. It is the thing to do bite the
> > >>>> bullet.
> > >>>>
> > >>>>
> > >>>> Ahmed
> > >>>>
> > >>>> -----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: Wednesday, February 06, 2008 3:21 AM
> > >>>> To: OpenHeart-L at lists.hsforum.com
> > >>>> Subject: [HSF] (no subject)
> > >>>>
> > >>>> Dear Members,
> > >>>> ? Two days ago, I reoperated on the gentleman with the stenotic and
> > >>>> thrombosed SVC.? I'm glad I did.? I femorally cannulated and went
> > >>>> on pump
> > >>>> prior to splitting the chest (he was 3 weeks postop).? I only
> > >>>> dissected
> > >>>> the
> > >>>> right atrium.? The adhesions were torture.? The tip of the femoral
> > >>>> cannula
> > >>>> was advanced only into the IVC.? No effort was made to control
> > >>>> either
> > >>>> cava.?
> > >>>> The heart stayed warm and beating.? A right atriotomy was made and
> > >>>> extended
> > >>>> across the RA-SVC junction.? It was tightly stenotic.? A large
> > >>>> amount of
> > >>>> clot was retrieved with a 6mm Fogarty.? A large patch of bovine
> > >>>> pericardium
> > >>>> was placed.? The whole operation took less than 3 hours.?
> > >>>> Yesterday, it
> > >>>> was
> > >>>> evident that his facial and forearm edema were markedly improved.?
> > >>>> He's
> > >>>> already on Lovenox and Coumadin.
> > >>>>
> > >>>> Hal
> > >>>>
> > >>
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> > >>>
> > >>> --
> > >>> Prasanna Simha M
> > >>> _______________________________________________
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> > >>
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