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Misadventurous Melissa

Everyday is an adventure, or misadventure as the case may be. It is the latter that makes for the best stories, inspiring the name of my blog. I'm a nurse and an attorney (and way too silly sometimes). I am retired now. WELCOME to my blog! This is a work of fiction inspired by true events. The patients I refer to are a patchwork quilt of various patient's problems mixed together. If you think you recognize someone, you are wrong. These people do not really exist.

Saturday, September 09, 2006

The Wrong Hip

And I thought that I was having a bad day. One of our surgeons operated on the wrong hip. With all of the safeguards in place you wouldn't think that could happen, but it did.

The patient several years ago had bilateral hip replacements. There is a lifetime risk of infection with artificial components inside the body, and unfortunately this guy got unlucky and his left hip became infected. Antibiotics don't work well in situations like this, so there was no choice but to remove the infected hardware. After months of IV antibiotics, the hardware can then be replaced.

On the day of surgery, the guy arrived at the hospital and his right hip was also red and swollen. The doctor got an additional consent to do an incision and drainage on the right hip.

At some point, the surgeon and everyone else in the OR got confused. After he removed the pus from the right hip, he forgot that the consent was to remove the hardware in the left hip and the pus in the right hip. He went ahead and removed the hardware in the right hip and totally forgot about the left hip.

Fortunately for the surgeon, the right hip was also infected and the hardware did need to be removed, so the patient doesn't have much in the way of damages. It is, however, battery because there was no consent for the procedure that the doctor did. At some future date, the patient has to go back to OR and have the hardware from the remaining hip removed.

The doctor's OR report is kind of interesting. He makes it sound like he did what he was supposed to do. A consultant in the case also wrote in the chart as though everything went as planned. We all know the truth, though.

I don't know what the patient knows. The patient doesn't speak much English and isn't well educated, so nothing will likely come of this.

I bet the surgeon doesn't feel like coming to work on Monday. The administrators will be waiting for him.


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13 Comments:

At 9/09/2006 05:00:00 PM, Blogger Michelle said...

On the bright side he could have amputated a wrong leg!
Seriously though, can you explain how how artifical hips etc get infected? I can understand a wound on the outside, but how does the inside of someone get infected?
Sorry, i just have no clue how this can happen....i do dye my hair blonde if that helps explain :o)

 
At 9/09/2006 08:38:00 PM, Blogger Gary said...

That is both funny and sad at the same time.The patient should have written a note on his hip with a marking pen and hoped the doctor could read his language.

 
At 9/09/2006 08:57:00 PM, Blogger Terri said...

I've known people going to surgery to take a BIG RED Sharpie and mark their body HERE with an arrow. Pointing to which kidney, breast, elbow, hand, etc. that was to be operated on. I always thought "how ridiculous!" Um, next time I have surgery I'm getting my red pen Sharpie out!

 
At 9/09/2006 09:31:00 PM, Blogger dkgoodman said...

I'd take a fat, red Sharpie and write in big letters, "Not me! Operate on THAT guy over THERE! ====>"

 
At 9/10/2006 09:54:00 AM, Blogger Sarah said...

If the patient had already consented to, and had, bilateral hip replacements, which we know in fact not only have the risk of infection, but only last approximately 10 or so years...it seems to me there is an expectation, unless the person is 90 yrs old, that both joints will need to be replaced in the patients lifetime. If I was the patient and I was already under and open and it was determined that the joint needed to be replaced I would be PISSED if they didn't do it, causing me to have an additional surgery and 2 recovery periods, not to mention the additional copays. I would consider my consent to be implied.

 
At 9/10/2006 05:35:00 PM, Blogger Melissa said...

Michelle, I didn't know that you were a fellow blondo.

It doesn't take much, a paper cut or scrape and bacteria can enter into the bloodstream. The immune system can usually handle minor assaults like that, except when there is hardware inside the body. If bacteria latches onto the hardware, the immune system has trouble fighting it and the bacteria keeps growing.

Gary, normally the wrong side is marked so that it can't accidently be operated on, but both hips needed surgery.

Terri, I would do that also, just in case.

Dave, that other guy would probably be the anesthesiologist. He might object. :)

Sarah, in this case, the doctor forgot to do the surgery on the original bad hip. The patient still needs a second surgery.

 
At 9/10/2006 08:09:00 PM, Blogger Alan said...

If my time ever comes, I'm definitely going the Sharpie route.

 
At 9/10/2006 10:46:00 PM, Blogger Sarah said...

Was the patient healthy enough with a good support system and full time caregivers to have them both done at the same time?

 
At 9/10/2006 10:53:00 PM, Blogger Tati said...

Your posts are increasingly feeding my fear of hospitals ;-)

 
At 9/10/2006 11:17:00 PM, Blogger Michelle said...

Thanks for the explanation :o)
Yes, i found it easier to manage my hair blonde than medium brown....the grey shows up too easy!

 
At 9/11/2006 12:40:00 PM, Blogger Melissa said...

Alan, me too.

Sarah, it doesn't matter. All of the infected hardware needs to come out. He's just going to keep getting sicker with it in place. He'll probably end up in a SNF.

Karen, there is good reason to be afraid.

Michelle, I keep my hair a light blonde mainly because white roots don't show so much. I would prefer a little darker blonde.

 
At 9/11/2006 05:44:00 PM, Blogger Alan said...

All professions have their acronyms. SNF? I'm guessing "facility" of some kind.

My word verification was "zzbabuj". People seem excited about the verification words lately. I guess it's a respectful term for South Asians who play in Texas rock bands.

 
At 9/12/2006 12:31:00 AM, Blogger Melissa said...

Alan, SNF, pronounced sniff, is a skilled nursing facility. Is there really a term for South Asians who play in Texas rock bands?

 

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