Florida surgeon charged with killing man after removing liver instead of spleen
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See: Cultist Roots, Osteopathic Education, Osteopathic Hype, Questionable Practices, Cranial Therapy, and "Objections to This Article", etc. at the below link:
https://quackwatch.org/consumer-education/qa/osteo/
And there are other objections:
https://www.ipl.org/essay/Osteopathy-Vs-Quackery-F3W2C3PBG5FV
And for general medical quackery exposure, there is always this website:
https://sciencebasedmedicine.org/
https://sciencebasedmedicine.org/nopandemicrevisionism/ <== concerning COVID quackery
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My prior PCP was a DO, and a perfectly nice man. I don't think he was a quack and he never discussed osteopathic medicine. However, he was stupid and lazy, and it seemed very obvious he became a DO because he wasn't able to get into any MD programs.
It seems that the entire osteopathic medical system is indefensible. At best, you get a med school reject. At worst, you get a fancy feelgood chiropractor whose ideology was considered quackery 100 years ago.
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Surely the fact that the victim had only consented to the laparoscopic surgery means that everyone in that OR was party to a crime even even before things went wrong.
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The anesthesiologist would have been sitting behind the curtain at the head of the patient, no where near the surgical site, almost certainly scrambling to start lines, carry out transfusions and push pressors to keep the patient alive. The anesthesiologist has their own job and duties which were in full emergency mode during this incident and they do not have the time, responsibility, capacity to both carry out their attempted life saving protocols as well as move around the table to look over the surgeon's shoulder to see what organ the surgeons hands which are elbow deep in a bloody abdominal cavity are manipulating. The anesthesiologist must have suspected a major vein or artery was cut but from that moment on they would have been in full crisis mode attempting to maintain the patient's homeostasis and would have been in no position to oversee a surgeon.
All to say you are way too quick to throw others under a bus when you clearly have no idea what you're talking about
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This particular example is extreme but examples of surgeons killing patients by removing their only working kidney are pretty common place. A quick google will find you examples from UK, Italy, France etc.
Here's a story of a German surgeon removing a kidney instead of a spleen
https://www.aa.com.tr/en/europe/german-clinic-mistakenly-removes-young-mans-kidney/934712
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Let’s not be overly dramatic. You just need to learn this if you’re going to travel to (or already reside in) Florida.
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You would be late too if the hooker had extra lines of blow. What is a poor punter to do? I walked around with various purple dots on one side or the other of my head last year after cataract surgery, as the surgeon told me he likes to measure three times before he cuts. Score one for academic medical centers over places occupying the old restroom block of a long departed Hooters.
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How many examples can you find of the same surgeon doing it twice ?
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Insomnomaniac
Wise, Aged Ars Veteran
This is hilarious to me, because I am aware of a Hooters location that closed down, with the building remodeled and reopened some years later as an eye clinic.
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And since when has the spleen been on the right side of the body? They would know there's something wrong before blood started spurting.
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This would make me seriously question the qualifications of any other "Doctor" from his alma mater, Midwestern University. The website for the medical school focuses on the potential salaries of doctors right on the front page. Looks like a diploma mill for medical professionals. Ugh.
https://www.midwestern.edu/academics/degrees-programs/doctor-osteopathic-medicine-program
https://www.midwestern.edu/academics/degrees-programs/doctor-osteopathic-medicine-program
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Results may vary; I've limped into my Osteopath's practise with a severely spasming back from a snowboarding fall right onto my coccyx, that had spread sympathetic muscle pain and cramping/spasming almost up to my shoulders. Technically I probably shouldn't have driven there, if I'm being honest and it was getting worse each day despite my attempts to stretch it out with yoga positions. I walked out standing straight, and no spasms significantly reduced pain.
He practised Osteopathy that uses no Chiropractic manipulation, as I'm not a fan of sudden manipulations and wouldn't try it.
He also said it wouldn't take any more than 3-4 visits, and sure enough, after four visits I had no pain at all, and what I though was going to be one of those injuries you carry for life was gone. He was like you don't need another visit. I only ever had to go back when I had new injuries, and he was never interested in getting me into regular visits.
Have sent a lot of friends to him with similar injuries and everyone I sent had good results and also commented on the fact he would only treat them until their pain was gone, for some that was only 2 treatments.
There's good and bad in any profession.
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When I had my foot amputated, it was pretty obvious which one needed the work as the infected area was large and obvious and my other foot was wearing a yellow grippy sock. But for my fistula installations and vein graft, the surgeons specifically marked the arm the procedure was to be performed on. They also wrote 'gallbladder' on my belly for my gallbladder removal.
My list of working parts keeps getting smaller and smaller.
My list of working parts keeps getting smaller and smaller.
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jonbob_newcastle
Ars Praetorian
Public healthcare isn't immune either, although in this case the surgeon merely signed his work...
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"Once is happenstance. Twice is coincidence. The third time it’s enemy action" - Ian Fleming
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In seriousness, yes, I would expect he was under the influence of drugs or alcohol. Likely drugs. If alcohol, he was a, generally, highly functional alcoholic or staff would have been a lot more likely to have noticed his impairment/smell of alcohol.
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I'm sure the people downvoting you think they have a good reason for doing so, but have they all forgotten who Florida's currently appointed surgeon general is?
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When I went in for an orchiectomy (cancer) a nurse came in marked a large X on the back of my hand. I jokingly asked "Is that to make sure you get the right one?" "Actually, Yes."
I was 22 at the time and hadn't really contemplated that a surgeon could screw something like that up. Thankfully I had a professional team.
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As a physician I honestly do not understand how you could possibly 1) decide to fucking staple the IVC ever for any reason it would be as good as shooting someone in the forehead with a shotgun 2) mistake a LIVER for a SPLEEN. As a SURGEON. They look completely different and are in completely different places! A PSYCHIATRIST wouldn't make that mistake! It's so unbelievable I literally don't believe it. Only intentional malice or psychotic episode are plausible explanations. And him going back 3 times to insist the organ was a spleen leans towards psychotic crash out.
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Yeah, that is one of the major problems overall - unqualified bozos in positions like this are much better protected than the patients. I'm all for shielding qualified surgeons from frivolous lawsuits, but this guy should have been facing real consequences years ago.
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This is untrue. Perhaps this is the case on plain film xrays but this man would have had at least one CT abdomen/pelvis, probably with at least IV if not oral contrast. Basically every patient who gets admitted to the hospital with abdominal pain is gonna get a CT in the ED for CYA trust and believe, even and especially at the worst hospitals. The radiologist gets a 3d cross sectional image of the entire abdomen and has no trouble telling the spleen apart from the bowels.
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My wife got fired years ago from a hospital because she refused the doctor's orders. She was a bedside nurse, and could plainly see that the doctor's orders were counter to proper care. She attempted to discuss it with the doctor privately and the doctor reported her for refusing orders and was "allowed to resign" and be black listed from the largest hospital system in our area the next week.
The doctor in question was fired 2 months later for screaming at a nurse in front of patients (no, the hospital system didn't bother to go back and review anything). Only because it happened in front of patients was anything done. In my wife's case, a review of the orders and medical file would have plainly shown that the doctor in question was wrong and my wife was correct in counseling the doctor to change the orders. But nurses follow doctor's orders. Period. It doesn't matter what hospital policy says. It doesn't matter what national standards of care says. The doctor is right. Full stop.
And most doctors operate that way. It doesn't matter if they are fresh out of residency and they are dealing with a nurse with 30 years of experience. They know better, because they are the doctor. Not too dissimilar from your average butter bar lieutenant dealing with a 30 year-service first sergeant.
As to the anesthesiologist and OR nurses (and PA if there was one). Well a lot of possibilities.
The anesthesiologist, yes, does have authority in the OR as well. But it is possible they were a nurse anesthetist. It doesn't matter if he/she has the same authority that a doctor of anesthesiology has, the surgeon isn't going to listen to them the same. A PA does not have the same authority as their attending physician does (though I doubt there was a PA if they were on a skeleton crew). The nurses do not have the same authority that the surgeon does. That being said, the very start of this operation sounds like a somewhat standard deviation. Laparoscopic had to be abandoned and invasive surgery was required. That happens frequently enough. After that, things went off the rails fast. Short of a nurse or anesthesiologist tackling the surgeon, even if they told him to stop, reconsider, etc. if he wasn't listening, there isn't much they can do. Despite THEIR experience, they aren't the surgeon and they also aren't in the same surgical field of view. So that aren't going to visualize things nearly as well as the surgeon is. Mix in a blood filled cavity and it sounding like he quickly just started stapling like he was trying to pin down roofing underlayment in a windstorm, it was likely too late for staff TO do anything to correct or stop things.
By the time they probably knew he was F-ing up big time, they are elbow deep in emergency procedures to keep him alive, ordering emergency blood to be brought up from the blood bank and starting rapid transfusion. At that point, it is hoping the surgeon can correct the situation. He removed the liver AFTER death and tried to call it a spleen. He likely stapled, and tore the wrong blood vessel (well, duh, it mentions he stapled the vena cava). Staplers are not one size fits all. If he stapled a too large blood vessel with a small stapler, it would tear it apart, not clamp it. He was likely going in with the proper sized stapler for the vessels of the spleen.
Nurses DO sometimes act to protect a patient when they see a doctor doing the wrong thing, but this isn't just an authority thing. In many cases, once staff becomes aware something is wrong, there is literally nothing to do but HOFDL. Unless you can call in a different surgeon fast, there is nothing to do except hope the one there can fix things. You severe a major blood vessel and the person is dead in a minute or two, even with emergency rapid transfusion. You can transfer about a unit of blood per 15 minutes if you are pushing it to a central vein.
Of note, the inferior vena cava carries between .9-2.2 liters of blood per minute at rest. Which means the average adult would bleed out in about 2 minutes with no replacement blood, and you'd be losing blood at a rate approximately 60x faster than you can push it. So it would be effectively seconds for the surgeon to repair the damage.
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Yes they are. "everyone knows" but hospital administration isn't likely to do anything about it until it gets to something patient facing, impossible to ignore, or multiple malpractice suits (multiple).
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You're assuming the person he might ask would know the correct answer. Remember, this was in Florida.
I want to know what medical school let this butcher graduate...we already know he was licensed by Florida.
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As a non-medical person, I’m amazed that the first thing they saw after cutting into the patient, a massively distended colon, was completely ignored. Surely that should have been cause to reconsider the original diagnosis based only on a scan? Intestinal blockages are not uncommon, especially in older people.
In another field altogether we know that as “target fixation,” ignoring the obvious in favor of some preconceived idea.
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I absolutely can. Heck, I could in high school. These days, I do internal anatomy of a few deer every year. It isn't hard to tell the difference between a liver and a spleen, and maybe I couldn't do lifesaving SURGERY with a blood-filled cavity, but I can still easily identify the difference between a liver and spleen in a blood-filled cavity working with a head lamp in the dark. And I can find and identify the vena cava and femoral arteries in the chest cavity too, even filled with blood (in case it isn't clear, I am a hunter).
Let alone years of medical practice and training in a well lit ER with suction.
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In defense of DOs. My physician is a DO, working for an academic medical institute, and is a graduate of the other big in state university to boot. He is also a fine physician, and one would not know he is a DO rather than an MD from professional interactions.
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There’s another thing that strikes me about this surgeon: he was credentialed at this hospital, but not on its staff. He performed surgeries at other hospitals as well. That may account for his 1 hour late arrival for the botched surgery, and for his apparent lack of focus. His incompetence may also have been less visible by the errors being spread thinly around.
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I agree with your point that the distended colon should have been a red flag that the whole diagnosis was likely wrong. But this goes way beyond "target fixation".
As somebody with almost no medical training, I barely recall ever hearing of the inferior vena cava, and certainly didn't identify it from the description, but "hey, that's funny, I wasn't expecting this blood vessel to have a pulse, maybe I should staple it anyway" was where I had to stop reading. I don't know what the surgeon's underlying issue was, but he was clearly in no condition to practice medicine.
When you can't hold the gun steady, "target fixation" is irrelevant.
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It truly is horrible. Also worth noting to anyone knocking the surgical staff, that they immediately called the Chief Medical Officer of the hospital into the OR to see what had happened, even while doing chest compressions to save that poor man:
They already knew the surgeon had fucked it all up:
Absolutely horrendous.
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Dr. Atul Gawande wrote about this in The Checklist Manifesto. In a 2001 experiment at Johns Hopkins Hospital in Baltimore, Dr. Peter Pronovost implemented a 5-step checklist for running a central line (insertion of a catheter into a large vein for providing medicine). For a month, he asked nurses to track how often doctors skipped or missed at least one step, with the result being at least a third of the time. With this information in hand, Pronovost convinced the hospital to allow nurses to stop doctors when they skipped a step and force them to do it right. They also authorized nurses to ask daily if a central line should be removed or changed.
The result was immediate and strong. The 10-day line infection rate dropped from 11% to 0%. The hospital estimated that it prevented 43 infections and two deaths, and saved $2 million. Various other checklists were started around the hospital, and the fraction of patients missing some recommended care dropped from 70% to 4%, pneumonia rates dropped by a quarter, and 21 fewer patients died than the year before. Similar experiments at other hospitals saw similar stunning results, and after the New England Journal of Medicine fast-tracked publication of a wider study by Gawande, et al., it picked up a lot of traction. Now, checklists are a common practice at many if not most hospitals in the US and in many other countries.
Before that, nurses were afraid to speak up, or they thought it was not their role to correct a doctor. There are still cases where this happens, and it may have happened in this operating room. Nurses see all manner of mistakes on the part of doctors, but they either silently fix them or they let them slide because usually things turn out OK. But when you apply "usually" across thousands of patients, you inevitably get avoidable outcomes.
At this point, if the culture of the hospital is such that the rest of the OR staff were afraid to speak up when they saw the surgeon working on the wrong area, that is on the hospital itself, and any settlement with the hospital should include a requirement to adopt modern hospital culture. It's been established in dozens of studies over the last 30 years that God complexes among physicians kill patients. There's a reason that newer doctors tend to be much more open to listening to the rest of the staff: it saves lives, reduces costs, and keeps practitioners out of jail.
Are you differentiating between private health insurance and private health care? Because the two are not the same. There are many private health care resources that do excellent work. Physician-owned practices, clinics, and hospitals generally provide superior care, but they're still private health care.
If you want to see examples of how bad things can get, the VA is a perfect example. They led the way in developing electronic medical records, which really helped to improve the care from the abysmal depths of the early 1980s, but good grief, do they hire some bad doctors, and the treatment my wife has gotten through them is proof. Part of it is that they don't pay all that well compared to even county hospitals, so they tend to get the people who can't find work elsewhere, who often move on when they have a more stable resume. Part is that the turnover is high, which makes it difficult for even competent medical professionals to work there. The ones who do stay are typically those who are dedicated to the mission.
My wife has a nurse practitioner as her primary VA care interface, and she's one of the latter. We've met some others who do wonders within the system. But I've been in the room with her with some of the bad ones at a time when she used the VA because that's what she (before marriage) or we (after) could afford. I've been with her in the ER when she was begging for something to help her migraine, and the ER staff was literally making fun of her when they thought they were out of earshot -- I could hear them talking about her like she was a junkie, and she wasn't even asking for anything that strong, just the same thing she had gotten the last time she was in a year before.
It's not about public vs. private health care. It's about the culture within the facility.
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I'm no doctor or even in the medical field, but you'd have to be even worse than The Simpsons' Dr. Nick to confuse a liver with a spleen.
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To be clear I don't think osteopathy is itself all that bad. It's basically like American acupuncture - it's not scientific but it seems to help people without doing too much harm.
I didn't say all DOs were bad, and my DO was indistinguishable from a crappy MD. There are legitimate reasons to choose a DO program. But DO programs have much worse standards than MD programs (and almost no research); it seems that the net effect is filling gaps in the US medical system with a second tier of doctors.
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I'm so very glad this horrible activity has been rooted out of "any even halfway sane society"! But wait, where did you say that society was?
"System Failure: How Banned Doctors Move Across Europe, Leaving Patients Vulnerable" (OCCRP)
Is it even remotely possible this problem isn't restricted to America? No, no, that can't be it, I'm sure the article is wrong and the doctors mentioned in the article are just American grifters, incompetents, and frauds who've grifted, incompetented, or frauded their way into the halfway (or more) sane societies.
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