Saturday, December 1, 2018

I Hate This Even More












I hate both the original world-class homicidal level of dumbfuckery described in the following story, and even more, the level of jackassery drawn to burp out their collective "wisdom", like moths drawn to a flame, in response.

This was the story at Kenny's Knuckledraggin My Life Away site, "where bad choices make good stories".
(Charlotte Observer) A nurse at Nashville’s Vanderbilt University Medical Center thought they were giving a frightened patient “something to help (them) relax.” Instead, the nurse mistakenly administered a fatal dose of a drug sometimes used to execute condemned prisoners, WTVF reported.

Read more here: https://www.charlotteobserver.com/news/nation-world/national/article222422170.html#storylink=cpy
The nurse intended to order the anti-anxiety drug Versed but instead ordered Vecuronium, a general anesthesia drug used to sedate patients for surgery. It is also part of the drug cocktail used to execute some prisoners through lethal injection, WTVF reported.

Read more here: https://www.charlotteobserver.com/news/nation-world/national/article222422170.html#storylink=cpy
According to the report, a nurse couldn’t find the medication in the patient’s profile, and so did an “override” to find other medicines. Then nurse typed two letters, “ve” and selected the first one without checking the name on the vial. The medication dispensed was Vecuronium, not Versed.
A hospital spokesperson said the error occurred “because a staff member had bypassed multiple safety mechanisms that were in place to prevent such errors” and that the hospital would “continue to work closely with representatives of Tennessee Department of Health and Centers for Medicare and Medicaid Services to assure that any remaining concerns are fully resolved within the specified time frame,” WTVF reported.
The incident put the hospital under review from Medicare, forcing the hospital to make a plan to prevent such an event from happening again, The Nashville Tennessean reported. Without corrective action, the hospital could have been cut off from reimbursements. About a fifth of the hospital’s income comes from Medicare, according to the paper.
A commenter posted essentially the same information here yesterday, leading to this comment from me, here, before it was even posted at Knuckledraggin , and with the additional information that Medicare was threatening to cut the hospital off completely from participating in Medicare and associated government programs, because they had attempted to cover up the original incident:

"1) Medicare isn't going to terminate Vanderbilt's Medicare contract:
They want changes, and they'll get them. They may even financially punish them, but they won't go to contract termination. That's just saber-rattling. It would ruin the hospital, possibly all the way to financial failure, and punish the Medicare recipients who lost that resource far more harshly than necessary, even more than the hospital.
2) Vanderbilt personnel should be terminated:
a) the person(s) who was/were responsible for making a report to state medical oversight, and tried to hide the incident
b) the nurse who screwed the original order/med administration up

BTW, vecuronium is a paralytic, used for intubation, while Versed is an anti-anxiety med/sedative; how someone not insane could switch one for the other and not notice is something that should be investigated, under oath, at a hearing to suspend or revoke nursing licensure at inquest, and probably at criminal arraignment.
That's an admin error that resulted in a fatality, and requires that whoever did it was at minimum a total moron, or else trying to kill someone. That level of negligence, if that's indeed what it was, or worse, should be answered at an inquest and probably a criminal trial as well. At a minimum, we're talking involuntary manslaughter by gross professional negligence.

As a single incident, it would be difficult, and gross stupidity, to punish an entire hospital system for a single medication error, even one that lead to a death. That's swatting a fly with artillery. But the failure to mandatorily report the mistake is conspiracy to cover up after the fact, and the person(s) who did that should be fired, if not prosecuted as well. That's something for the state's attorney general to look into, along with what lawyers are going to turn into a lotto payday for next-of-kin.
QED

As these are slam-dunk cases based on that article, I'm wondering why they aren't already referred for prosecution at every level.

If I were the member at large for the state nursing licensure board, that nurse's license would either be suspended for 10 years at minimum, or revoked outright.
That level of screw-up is inexcusably and unexplainably outrageous.
If I were on the civil jury for the family, the payout would be in the low 8 figures: $2-5M for the death, and treble that in punitive damages for the cover-up.
Along with criminal charges and fines, that's the only way they learn not to do that." -Aesop
And then the fun started at Kenny's site, as the lunatic fringe chimed in on the original story:

Walpurgis says:

This shit happens ALL the time. You practice medicine. Wrong surgery, wrong amputation, all sorts of crap.
He could have left it there, and I'd have walked on by, because he'd have been right, to that point. But hubris and stupidity never knows when to quit while ahead:
It’s a fun fact to look up, but 1 in 3 patients admitted to the hospital die there.

Srsly? "1 in 3"? Like you figure no one has a mouse, or Google??
My response to that load of horseshit:
 Aesop says:

And that’s absolute bullshit, but thanks for playing.
FTR, there were +/- 37,000,000 hospital admissions in most any year you’d care to look up.
https://www.statista.com/statistics/459718/total-hospital-admission-number-in-the-us/
I’m pretty sure we’d notice more deaths than WWII, including the Holocaust, every freaking year.
The actual number of deaths is about 800K/yr. <800k p="" yr.="">And the vast majority of those deaths are people >85 y.o., so it isn’t like the ones who die are shocking anyone.
https://www.cdc.gov/nchs/products/databriefs/db118.htm
So maybe actually look that shit up before you tell us how “fun” it is, when you biff the actual number of deaths by 4600%. (I even rounded that down to go easier on you.)
No excuse, man, that took me 4 mouseclicks to run down in about a minute.
Math: still actually a thing.
As far as the original story: that’s a nurse who needs a criminal trial for manslaughter, after they yank their license for from 10 years to life, and he/she and the people at Vanderbilt who failed to report that to the state need firing and prosecuting.
I expect the civil suit will come to something in the low 8 figures.
Especially as the death could have been avoided by, y’know, looking at the frickin’ label on the vial.
That should be prison time, right there.
The host:
 Wirecutter says:

Let’s see, when I went to moderate just now there were 2 comments from you to 2 different readers, both of them insulting which seems to be the way all your comments roll.
I bet you’re a real joy to live with.

The other post in question:
GregN says:

Fun fact. Check out CDC mortality stats for “medical misadventure” (i.e. f#$k ups). Something around 75K to 80K die every year in clinics, hospitals and MD offices because of incompetence.
On the other hand, gotta get rid of those guns because 8 or 9K are murdered and around 10K off themselves by guns every year. Oh and it’s normal to dispose of 1.5 million lumps of tissue every year /sarc
Amazing the lack of perspective isn’t it?

My response to that turd in the punchbowl:
           Aesop says:  
11/30/2018 at 16:18    
  • Funner fact: there is no support for that imaginary number anywhere on the planet, inclusive.
    It’s brought to you by the same pseudo-science that gave you anthropogenic globull warming, the hazards of second-hand smoke, and spousal abuse claims during Superbowl halftime: i.e. pulled entirely from some SJW’s nether parts. still steaming, and smelling exactly like you’d expect from way up between their butt cheeks.
Nota bene, if you please, the complete lack of pejorative aimed at said second poster, rather the surgical precision of language that noted that it's the "data" cited that's absolute codswallop.
I won't apologize for pointing out someone's foundation is quicksand. Anything rude or condescending is the fault of the poster for choosing that, not mine.

The peanut gallery response to that reply:
Padawan says:

Wow. You’re just a bright ray of fucking sunshine, ain’tcha cupcake?
Yeah, you got me. It's all me. The person who claims we whack one out of three patients routinely isn't Debbie Downer for pulling "facts" out of their ass. The person who knee-jerk swallows pseudo-science and passes it off as Truth is Good Time Charlie. All I did was try to wrangle in a couple of facts and some logic at the party, and I'm the bad guy.
Well-played.

Then there's the next buttnugget:
WestcoastDeplorable says:

Moral to the story? Stay away from the hospital. Especially near holidays. I friend of mine went to the ER on Labor day complaining of a pain in his leg. Since it was a holiday and they were short-staffed, instead of doing a scan they sent him home with aspirin and painkillers.
You guessed it…..the problem was a blood clot and they amputated his leg the next day.
I don't recall my full reply to that one, and it's currently sitting in moderation limbo, but it won't endear me to the commentor, nor likely the host, either, but it went something like this:

"The next day?" That would have required a blood clot the size of his head. They wouldn't have needed to scan him, they could have just held him up to the light to see that.

We don't even amputate black, gangrenous body parts within 24 hours.

Seriously, guys, let's just sit around telling 3rd grade campfire horror stories.
Like the amputated hand that wouldn't die.
Or the Chicken heart That Ate New York.
https://www.youtube.com/watch?v=fE0hHEtkkQA

In a follow-up, I told the host I sincerely apologize for any trouble to which I put him, and I meant it. I'll also be skipping Kenny's site for the foreseeable future, without further discussion or decision. He'll do fine with or without my commentary contributions. It's absolutely his site, and any host can cultivate the commentariat he or she values. I have no desire to make his day harder, and Kenny's actual postings run from interesting to cringeworthy to hilarious, and ten days out of nine, Knuckledraggin' is a better news outlet than anything in the MSM, on any level. You should go there, regularly.

Look, I get these two facts:

























(And notice, please, the typical Internet meme on that second one - that I corrected there - gets it wrong by noting incorrectly "Even if you win, you're still a retard". Comedy is hard, Internet Minions of Stupidity. If you can't do the joke without bungling the punchline, stay on the porch with the small dogs. Just me, being a fucking ray of sunshine again.)

Like all other informational media (magazines, newspapers, TV, etc.) there are two groups of people who post on the Internet:
A) Those who know what they're talking about, and
B) Those who don't.
Group B is further divided:
1) Those who don't know what they don't know. Those are the Ignorant.
2) Those who don't care what they don't know. Those are the Stupid.

It's not a crime to be ignorant. It's even curable, if you wish, with minimal effort.
But the only check on stupidity is fastballs, thrown up high near the chin.

And those groups are not represented by proportional quantities. Signal to noise on the 'net is about 1:10, on a good day, and 1:100 from some places. So if you're Ignorant, unf*ck yourself. If you're Stupid, STFU.















There's a corollary to those undeniable truths, boys and girls:
If you put on your feathered hat, and wing suit, and stick pinfeathers up your ass, then wander onto the grounds of the Turkey Shoot, hide in the bushes, and say "Gobble! gobble!", like any other total jackass, you don't get to piss, whine, and moan when you're awarded an ass-full of shotgun pellets for your efforts.

In fact, there's only one proper response to getting flamed for stupidity on the internet, from victim, witness, or sitehost:
























So if anything I wrote, here, or anywhere else, has your sphincter aflame, I urge you to fill one of those out, in haste, and send it to someone who cares.
Your mommy, your congressweasel, Bill Gates, or whomever.
And then carefully untwist your panties.

Then put on your footie pajamas, and go have some hot cocoa. Like you do.

 
So as a public service, this reminder to those who live at the left side of the intelligence bell curve (If you're not sure whether that's you, ask your friends. If you have no friends, consider that a "Yes".):
 
 
And if you don't think before you post, I'm sure someone will remind you.
Kinetically.
 
You can try facts and logic, and avoid a lot of butthurt on the 'net.
Or, you can learn to treat for shock from bleeding out your shredded ass, after being target practice for people who enjoy your plight, and buy electrons by the metric fuckton.
Your call.
 
Have a nice weekend. Even if you're a dumbass.

26 comments:

15Fixer said...

I had a college professor in honors English that was a joy to listen to. His use of language, vocabulary, and structure was eloquent. His logic was legendary. You're alot like him. I love reading your stuff. Keep up the good work, not everyone out here is an asshole.

Aesop said...

Most people aren't assholes, and most assholes aren't assholes 100% of the time.
But the ones who are abuse the privilege, and screw it up for everyone.

I am constantly reminded of the truth of the benediction delivered by Hognose' father at his son's memorial service:

"Being dead is a lot like being stupid. Everybody else, especially your friends and family, all know it; but you don't."

Truer words...

MMinLamesa said...

It'd be a darker world without fuckin' rays of sunshine like yourself.

Having had the oppo for about a year to work security with DOC sitting on inmates receiving medical care, I was able to regularly see up close how damn hard CNAs & RNs work. Tough job dealing with a bunch like these guys. Especially repeats who would intentionally harm themselves to GTFO of prison-a lot of swallowers, weird.

And anecdotally, my healthy 37 year old daughter went into a hospital 2 1/2 years ago complaining of pain in her neck and some swelling. Despite warnings from her and her husband that she had one kidney and with large cysts breaking out on her body, they continued to intravenously feed ? in numerous(?) saline solutions, had kidney failure, went into cardiac arrest and died. There's a lawsuit her husband is now immersed in.

Stats don't mean much when you're the numerator.

Anonymous said...

hmm, no excuses my ass would be in sling if i did not call medical control and 7Rs. shit #1 is right medication, ugh. I always think how much better the medical employees would be if the illegals and drug addicts were no part of the number of PTs seen daily. both of the last time at the ER seemed like the providers from triage to doc were happy to have a real injury and a PT (ME) that did not want to be there. like the old days.

Aldo Cella said...

Eh.
I can be a real @$$hole, and sometimes you are too, Aesop.

Doesn't mean you're wrong.

I kinda like your acerbic, take-no-prisoners writing style, and I've only ever seen you deliver a good spanking to those who need one. Perhaps what has them so butthurt is that you do it so well, as Karl can testify.

And our fellow sphincter Ken's been around long enough to know that.

SiGraybeard said...

I want to shift the direction here, even if I'm the only one to go down this road, to: The incident put the hospital under review from Medicare, forcing the hospital to make a plan to prevent such an event from happening again, The Nashville Tennessean reported.

They already had a plan to prevent this from happening. The idiot/soon to be felon deliberately worked around the plan. Which underlines another old saying, "you can't make things fool proof because they keep making better fools".

What more can they possibly do as a system? The only thing I see from the description of what happened is to have that drug choice signed off by a committee. My bias is, like trying to make high-reliability electronics, you can't prevent a recurrence, you can only make it less likely.

Anonymous said...

Wircutter's site seems to attract some real maroons.
I'm surprised he hasn't banned you, he banned me years ago.
All I did was point out his stupidity a few times and he couldn't handle it. I may have told him to fuck off or something like that.
He's like an old hippy dead head sometimes; can't handle reality.

Ned2

Tactless Wookie said...

I'll continue to read Wirecutter's site. I rarely read the comments and even more rarely post a comment there.

Of all the blogs I read daily This is my first stop. I actually enjoy reading A's rebuttals to jackassery whether posted here, WRSA, Wirecutter's etc.

Keep up the good work Sir.

Phil said...

Aesop, feel free to drop by and kick my ass verbally any time the need arises.
Every once in a while I fuck up real good.
I'm man enough to admit it though.

Lord of the Fleas said...

Almost off-topic, but I have to say that I appreciate seeing you use Daniel Patrick Moynihan as a source of wisdom in that one graphic about opinions and facts. There may be things about him that I don't know, but from what I DO know, to my mind he was the last decent, honourable Democrat to serve in Congress.

Wayne said...

Much inconsistency in the media reports, and some on your part, Aesop.

Versed is brand name for midazolam, vecuronuim is generic drug name.
If the nurse couldn’t find “Versed” in the patient’s profile, that should have been a huge red flag.
Seems maybe nurse was unaware of generic name for the med.
Was this an inexperienced nurse still under orientation?


Where I worked, Versed (midazolam) was never ordered outside of surgery/ICU.
Typically docs would order Ativan (lorazepam) or Haldol (haloperidol) for patients needing sedation.

Doing an override of the Pyxis was strongly discouraged outside of immediate emergent situation and only allowed if their was at least a verbal order from the provider (MD, NP, PA). Otherwise the nurse is outside scope of practice and liable fo practicing medicine without a license.

The nurse will most likely lose their license, but I don’t see where this is a CRIMINAL action on the nurse’s part.
The hospital cover up, on the other hand, is a different story.

Your reference to “retards” in the meme in this post was rude, offensive, and completely inappropriate.
You owe an apology to people with developing disability.


Anonymous said...

He doesn't owe an apology to anyone. That's the point. Did you even read the sidebar on his blog?

"Comments are appreciated. They require neither prior ID nor screening for content. Anonymous abusive or rude comments will be either mocked mercilessly, or simply deleted into the internet ether, solely at the blog owner's discretion. (That would be me.) If you somehow labor under the misapprehension that free speech applies everywhere, try this experiment: put on a ski mask, go to your next door neighbor's house, urinate and defecate on his living room floor in front of him, and call him a m*****f****** @$$hole, then see whether you receive an award from the ACLU, or an ambulance and police car, who stop momentarily to help collect your teeth. If you don't get this, you're too stupid to be on the Internet, let alone posting comments on my blog. Disagreement is one thing, even ignorance can be understandable, but rude @$$holery will not be tolerated here. I have neither the time nor inclination to imbue what a public K-12 failed to instill in those folks bereft of the ability to reason intelligently or behave like well-adapted human beings in polite society.That's why for you there's a Skid Row."

That pretty much covers it. If you find something offensive, don't read here.

Aesop, you keep kicking ass out there. You're a relief from the waffling simpletons everywhere on this planet. Everyone else wants to mince around, fine, but I get tired of it and come here for a refreshing brain wax. Though I do drink cocoa while being refreshed, so there ;)

J J said...

“You owe an apology to people with developing disability”

Wow, he owes an apology to the 53 million or so who voted for Felonia Von Pantsuit?

My experience is that those people with developmental disabilities have a better sense of humor than 99% of the people who are offended on their behalf.

If Aesop offends you, too f*ing bad. The truth is pretty offensive but most people don’t understand that simple fact.

James said...

I enjoy this site a lot,for laughs at times and actual knowledge,same with Kenny's,so,will follow your advice and keep visiting both(along with others,I am a site whore).

I will say the phrase"Being dead is a lot like being stupid. Everybody else, especially your friends and family, all know it; but you don't." brought a twinge of sadness and a smile also.Last time I heard that was 6/11/17,you were also there.I think will go visit site and take a trip down memory lane and some of the inane yet funny comments there

Aesop said...

@Wayne

1) I "owe" an apology to no one. Be very clear on that point.
If the 100% accurate characterization I made hurt your feelings, IIRC, there's a .jpg of the form you can fill out in the post immediately above, which I urge you to use. Instructions for that are in ¶42-43, above.

2) Most medication dispensing machines in use (Pyxis is the Xerox of those) will pull up drugs both by brand and generic, automatically.

3) Overriding is so commonplace as to be completely unremarkable; doctors are usually doing ten things at once, and their orders - once they get around to entering them in the EMR - then wait for confirmation by pharmacy, whereas patients need the medication ordered ASAP. At that point, the onus is on the nurse to be circumspect, rather than a fucking moron.

4) Versed is routinely used in the E.D. as well as OR/ICU. And clearly, the nurse was able to readily obtain it on their own. Were that not the case in this incident, Nurse Shitforbrains would have had to get it from the Pharmacy, who would have saved the nurse from a fatal error, and Mr. Spazzypants would be alive now. At any rate, he wouldn't have died that day in the MRI.

5) An experienced nurse still under orientation means two nurses should be fired, lose their licenses, and go to jail: the orienting nurse, and the preceptor.

6) Killing someone, even accidentally, is always a criminal matter. That's why it's called "homicide". There is no medical immunity from criminal prosecution. If you accidentally run over a pedestrian because you were texting, you don't just lose your driver's license. If this was simply gross and easily preventable error, which is the most lipstick a defense attorney could put on that pig, the nurse only deserves a charge of manslaughter via reckless negligence, which should get them 1-6 years or so in the slammer as a Class E felony, and eligible for parole in about 3. That sounds about right for this.

From the Tennessee Code §39-13-212:
TN Code § 39-13-212 (2017)
(a) Criminally negligent conduct that results in death constitutes criminally negligent homicide.
(b) Criminally negligent homicide is a Class E felony.

Were the nurse's actions grossly negligent? Absolutely yes.
Did someone die? Yes.
QED

Book 'em, Dano.
If the nurse pleads guilty up front, and avoids the expense of a trial, I'd say knock two years off their sentence. So four years, out in two, maybe.
And a felony would be a bar to ever working in the health care industry again, except as a billing clerk.

Idiots like this, no profession needs.

Aesop said...

@SiG:
Concur.
Vanderbilt's stated policy to satisfy Medicare should be "to beat senseless with metal pipes the next moron in their employ who violates standard procedure by"
1) ordering the wrong drug
2) self-dispensing the wrong drug via override
3) not using their Mk I Eyeball and reading the goddam label like was pounded into him/her probably no less that 73 times in nursing school, and semi-annually after that
4) administering the wrong drug
5) killing the patient by inducing cardio-respiratory failure due to respiratory paralysis
or any combination of 1-5."

If they also voluntarily agreed to also administer vecuronium to the culprit, and watch the offending recipient do the fish-out-of-water gasping without being able to inhale, until just short of passing out, then bagging them with oxygen for a couple of minutes, and then repeating that cycle 5-8 times until the vecuronium wore off, I would not raise a stink about it.

On a more serious note, it should be mandatory to apply a pulse oximetry device to all patients in MRI, as the procedure typically takes a half an hour or more, during which time no vital signs nor pulse check is possible, especially after administering sedatives.

Had that been done in this case, when the O2 saturation and pulse declined, alarms would have gone off, and it would have been possible to call a Code Blue, and save the patient's life with minimal trouble before they went into full cardiac arrest.

As it is, after being in respiratory paralysis and then the inevitable cardiac arrest from being paralytically suffocated, when the MRI tech probably discovered them cold, blue, and lifeless half an hour later, their first words were probably something like "O $#!^!!!", but far too late to effect a reversal of the problem.

That was eminently fixable and preventable, even after Nurse Shitforbrains performed his/her homicidal ministrations.
But at least the patient laid very still for that MRI.

Anonymous said...

I do not want to start a fight, but I do have a question.

Is there a good source on the number of people that are killed each year by medical errors or malpractice? I have heard 80,000 people and 250,000 people numbers.

Brenda said...

I really enjoy your "ray of sunshine" posts! Keep it up. I always learn something. eleven years ago my sister went to the hospital on Thanksgiving day because of severe headache and vision problems. They did testing, determined she had a brain tumor, told them they were short handed and recommended surgery the following day when they had a larger staff. My sister and husband agreed. During surgery they discovered it was a brain infection, not a tumor. She ended up having three more surgeries to remove the infection. They were told she couldn't have any more surgeries after that and the IV antibiotics would have to do the rest. A year later she had her last surgery to replace all the skull bone that had been removed. She had the largest kevlar (I think that is what they used) replacement to date. It was made by a company in LA and was a perfect fit. She is doing well with some residual after effects of the infection and surgeries. The only thing my sister says is that she wishes she had opted for surgery on Thanksgiving day. I wonder how much of a difference it would have made.

Aesop said...

@Anonymous 6:53
There is a source, it's the CDC, but the methodology was to pull that number out of their @$$. That's my point.
There's no actual data, because no one collects it.

There's 700-800K in-hospital deaths@yr, so they arbitrarily decided 10% of them must be from "medical misadventure". It's probably closer to 1%, but even that lacks any data whatsoever.

If they asked, everyone on both sides would be embarrassed, and some would lie, or under-report.
And when the tally was as low as it probably really is, they'd toss the results in the round file, and go back to made-up numbers.

I gave Wingnut his rhetorical spanking and gave him credit for all 700-800K hospital deaths @ yr, which makes deaths:admissions 1:46.xxxx.
If I used the CDC imaginary "misadventure" deaths:admissions, it would be 1:460+, i.e. his recockulous claim would be ten times worse that it already is.

Anonymous said...

1) I used to work in a place that made investment castings. There were a lot of ladies cutting, scraping, etc. on the wax patterns with sharp little knives. One would cut herself now and then, which involved filling out forms.
One of the questions on the form was "What steps have been taken to prevent recurrence of this injury?" The answer: "Addt'l instruction in use of knives." Real World: "Be more careful in future." Obviously, there was no way to prevent this from happening again, but you had to say something.
The hospital has to say something. They already had the procedures in place, but apathy and/or incompetence can thwart nearly any system.

2) When I see pictures of Pajama Boy: I just know the smug, effeminate, little shit we all know as "Pajama Boy" must have been pissed on in the showers after gym and subjected to the various and sundry other indignities that have been visited upon twerps since time immemorial, and I smile inside.
_revjen45

Wayne said...

@Aesop. Request to “revise and extend” as the Congress critters say.
I went back, reread your post and comments, the Becker’s hospital review article and comments.

I haven’t worked in ER environment. I defer to your experience regarding use of Versed.

My experience with computerized med dispensers is with the Pyxis brand. Ours was set up to default to generic med names, in this case that would be midazolam. Easy peasy, you could change to display the brand name, Versed in this case, but that wasn’t automatic. Other systems or implementations may be different, I don’t know.

I disagree that ALL cases of causing another person’s death are criminal. Besides the obvious case of self defense, I can think of instances where a driver is fully alert, attentive, in compliance with speed limits, and a person jaywalks such that the driver cannot stop in time. A tragedy, not a crime.

That obviously is not the case here. Among other things, as you replied to SiG, read the phucking label.

Wow, this isn’t Versed! Oh sh!t! I nearly killed someone!

The nurse appears to be guilty of criminal negligence, and should face the consequences.

Also agree that pulse ox monitoring should be standard for a patient undergoing MRI/CT.

Regarding the Special Olympics meme. I stand by what I said. Other than not catching my “autocorrect” changing “developmental” to “developing.” The e-card “Cancel all my meetings” was funny. The Pajama Boy meme was both fair and accurate as Pajama Boy is an adult and has put himself out there.

The cheap ass joke about Special Olympics was frankly beneath you. I’ve read a lot of your stuff, you’re better than that.

Obviously, I can’t make you apologize. It’s your blog. You can delete my comment, banhammer me, whatever. It won’t change that you went for a cheap laugh by making fun of a group of people who can’t even defend themselves.

Aesop said...

@Wayne:

Causing another person's death is ALWAYS a criminal matter. That doesn't make it a criminal offense. That's what prosecutors, judges, and juries decide.

A quote I have used in a widespread manner is the excellent one from Ambrose Bierce in The Devil's Dictionary:
"There are four types of homicide: felonious, excusable, justifiable, and praiseworthy."

IANAL, but in my humble but expert opinion, this case clearly meets the fundamental criteria for felony criminal negligence under the TN statute, and the nurse in question deserves a long time in a quiet prison cell to contemplate that. The converse of "no harm, no foul" is that when there is harm, it probably is a foul.
The patient did nothing to cause this, unlike a jaywalker.
This case is all about the driver: i.e. watch what you're effing doing.
That makes it criminal homicide, not justifiable homicide.
When the only defense, as in this case, is "Oops, my bad", the state and people of TN have passed law that says you deserve 1-6 years in the Big House to consider your sins. I hope that is exactly what happens, and were I an expert witness called to testify, would opine under oath that there is no excuse in mitigation for this nurse's deliberate, inexcusably dreadful negligent and harmful behavior.
The profession will lose nothing from seeing this individual example hammered as it ought to be. That's one of the differences between an actual profession and a street gang.

If you'd like to attempt to mount a Devil's Advocate defense of the conduct, either from facts in evidence, or on any theoretical grounds, go ahead on.

This was, based on everything known, definitely criminally negligent homicide, i.e. manslaughter, caused solely and entirely by the nurse's egregiously negligent behavior, and mitigated by absolutely nothing. Not to prosecute that as exactly that is an injustice to the entire state of TN, not to mention the deceased, their next-of-kin, and the nursing profession.

In fact, an overzealous prosecutor, based on the lack of any affirmative mitigating defense, could make a reasonable case that might even secure a guilty verdict that such deranged indifference was deliberate, and roll this into a far worse crime, and the only question based on what is known a year later is how compellingly they could make that case to the jury. Probably only a tearful and sorrowful show of sincere remorse at trial would likely mitigate the verdict from deliberate to merely negligent, but nothing in the realm of ordinary imagination (...the nurse had a seizure? ...temporary insanity? ...mind control by malicious extraterrestrials? Nope, nothing.) could remove the criminal culpability sufficient to gain acquittal. Tennessee needs to send Nurse Shitforbrains to prison, with all the trimmings, and in haste. Please. Revoking their licensure and suing them out of all worldly assets is just relatively inconsequential icing on that cake, in comparison to doing justice for the criminal conduct involved.
(cont.)

Aesop said...

(cont.)
And the Special Olympics joke has been around for literally decades, is beneath no one, and the people in question have nothing to "defend" themselves against.
They haven't been attacked, and are, in fact, retarded, exactly as described.
They are and have been neither being mocked nor ridiculed for that condition by me, or Comedy as an actual entity.

And if anything, they, unlike certain internet commenters from the original post, have the relative luxury of blaming unfortunate life circumstance for being so.

People who post retarded comments on the internet have no such defense, and deserve the full mocking they obtain for their efforts.

If that still hurts your feelings, that's a shame.

But the original commenters posting such utter nonsense, and accusing the entire medical community of levels of negligent homicide higher than the body count of WWII, hurts my sense of decent behavior in public, and sets my Jackassery Detector to peg over on the right side, beyond maximum reading.

Likening them to someone actually mocking retarded people, by them acting mock-retarded on the internet, is actually as bad as running in the Special Olympics and pretending to be retarded too. That's where your ire belongs: that behavior.

If there were some useful word or phrase to insult their lack of basic intelligence and decency that was more scathing and pejorative than calling the offenders mock retards (when likely they are no such thing in fact), rest assured I would use that instead, but even as resilient and flexible as it is, the English language has some limitations.

The Gray Man said...

These idiots who make claims like the "one in three" guy still continue to show up though. Funny that.

You'd think if you knew you had a 33.3% chance of dying when you went to the hospital, you'd stop after your second trip.

Hey "one in three" guy... When your appey blows or you come down with cholelithiasis, let me know how your alternative treatments work out for you.

Mike_C said...

Just tossing this anecdote out here. So when I was an intern we had an adult Down Syndrome patient admitted to cardiology. When formally presenting* the patient the other intern on our team said, "Mr Smith is a developmentally-delayed 50-year old gentleman who was brought to ER with chest pain, 12-lead EKG showed ..."

The attending cardiologist cut her off with, "He's not 'delayed', he has Down Syndrome, so just call it that. It's a solid medical diagnosis and description." The intern started to protest about being sensitive, to which the attending said, "This guy is 50 and has Down's. I talked with him already before rounds. He's a really nice fellow, but he's not bright and is not going to get brighter with age. Are you somehow suggesting that next year he'll be doing partial differential equations in his head, and the year after that winning a Nobel Prize in theoretical physics? Because that's what you're implying by insisting on 'developmentally-delayed'. He's not delayed, he's where he is and will continue to be."

I got along GREAT with that attending. (And for the record, that attending was great with patients and an expert and dedicated clinician. But he had zero tolerance for bullshit.)

As to the original nonsense at Kenny's, I started to type out a response/comment, and amusingly it had the "not entitled to your own facts" quote as well. I had also written "it does not strengthen your assertion if you pull something out of your ass then wave it around, but it does make you look like a poo-flinging monkey" then decided not to post because I couldn't see an upside to doing that. Personally what gets MY goat is people who refuse to believe guidelines and recommendations based on multiple clinical trials, and/or good population studies, (because Big Pharma! Joooos! Illuminati!) but are all in on some bullshit pronouncement about brain tumors -- or something -- spouted off by a disbarred Albanian podiatrist and two hippies living under a pyramid-shaped cabin near Mt Shasta, and published on a "UFOs are piloted by Bigfoots" website. [...] not that I have strong feelings about that.

*presenting: for you non-medical folks, this is not some bedside introduction: Dr Jones, this is Mr Smith. Mr Smith, your attending physician Dr Jones. Presenting the patient means telling the team (and the team boss or "attending") briefly about why the patient is in hospital, and pertinent medical history. Presentation CAN be done at bedside, but in this case we were sitting in a team room (no patients, family or random visitors around to overhear anything).

Unknown said...

Bad news, statistitards. EVERYONE who EVER checks into a hospital dies, eventually. Hell, even folks who've NEVER been in a hospital die, eventually... Now that I've pointed out the obvious, ya'll can feel free to return to your regularly scheduled purse-swinging. This shit is better than cartoons!