Patients Lie

[igcgnerd]

Yeah newsflash!
Whats the worst or most dangerous lie your patients have told you?
Mine was a well known prostitute "swearing to God she never does drugs"
Well her track marks and the 4 or 5 times I had to pick her up for an OD beg to differ

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[docB]

The most dangerous lie in the ED was the 80 yo F with pneumonia who kept insisteing she was deathly allergic to "all antibiotics." Her daughter eventually showed up and said that she actually wasn't allergic to any abx but that doxy had made her vomit. The patient just couldn't understand that there wasn't "something else" to give her besides an antibiotic.

The most dangerous lie in the field was the 33 yo M called 911 for SOB. On scene patient in walking around living room in moderate distress wearing a big, black down coat. Replied "no" to all questions about other health problems, etc. Got patient seated on gurney. Got him to take off coat to assess lungs. GSW in lat right chest now obvious. So now EMS crew and patient are sitting in the middle of the crime scene without PD backup and no idea where the shooter is. Could have been bad. Fortunately patient was shot off scene and went home to call 911.

 

[rn29306]

Patients tell anesthesia that "I haven't eaten in 18 hours." Induce them, slide down an OG for a long case and up comes couple hundred mls of goo with food chunks.

Aspiration pneumonitis anyone? Anyone?

What's worst is when parents lie for their children going for PEDS anesthesia. Yeah, I know that little ones can get into the fridge and some parents might not know, but it is a sad day when you can bust mom and dad in the PreOp area concerning the child's NPO status. They usually get a posterior chewing from the anesthesia MD in charge that day. One MD even told the parents they were "sorry and ignorant".

 

[Empress]

20 year old female with abdominal pain. I asked her if she was pregnant, "No," very nastily. Asked her again when Mom was not present, "I already told you, bitch, I'm NOT pregnant." Wouldn't let me examine her, not even a blood pressure. Fine. Drop her off at the ER, give report to RN and emphasized the adamant denial of pregnancy, refusal for examination, etc.

20 min later the RN calls to chew me out because the patient just delivered a full-term baby and I didn't tell tell them in my report. What part of deny and refuse did she not understand? Later I found out that during the birth the patient was still denying being pregnant and accused ER staff of trying to trick her when they showed her the baby.

 

[jbar]

20 min later the RN calls to chew me out because the patient just delivered a full-term baby and I didn't tell tell them in my report. What part of deny and refuse did she not understand? Later I found out that during the birth the patient was still denying being pregnant and accused ER staff of trying to trick her when they showed her the baby.

I had the same patient, though later in the call. I was called to take mom and baby to the woman's/children's hospital. Same deal though, she walked into the ER and had back pain, was in labor, denying the whole time even as she gave birth.

She wouldn't look at the baby or hold it. It was one of the sadest things I've ever seen. Here is this kid that has no one to take care of it, who it totally dependent on others and mom won't take responsibility. I was ready to name the kid James myself. He looked like a James, and he damn well deserved to have a name.

Oh, and the boyfriend showed up. Nice guy, but shocked. It's one thing if you are mom in denial, but can you imagine getting a call at 7am to come to the hospital cuz you are now a dad? No nine months to get used to the idea, just bam, instant family. Scary (personally, as a former boyfriend myself.)

 

[Empress]

Yes, it was sad, but I didn't know her full story to really get a good gauge on the situation. I did know that she had 2 other children and she seemed to genuinely care for them.

A couple months later, I was called to a 30-ish morbidly obese woman for back pain. She was quite nice, maybe a little below average intelligence, and walked to the ambulance. While doing assesment she told me she couldn't remember her LMP, and then with some gentle prodding told me she had never known she was pregnant with her son and had him the ER for back pains just like the ones she was having now. This time I did flat out tell the RN that I thought there was a possibility of her giving birth soon, and she had a healthy baby an hour later in OB.

Drug seeking lies I understand more easily than pregnancy ones. I just don't get it.

 

[docB]

One of my classmates from residency delivered a baby for a 14 yo non-pregnant girl who wouldn’t believe it was hers. The 14 yo’s dad also denied it was her and accused my friend of trying to “plant” the baby on her. Security had to bounce him so the doc could get the placenta out. Social services got involved and then they called the cops because it started to seem more and more like the dad was the father of the baby too. I’m sure those three have gone on to lead happy and productive lives.

 

[Taaki]

One of my classmates from residency delivered a baby for a 14 yo non-pregnant girl who wouldn’t believe it was hers. The 14 yo’s dad also denied it was her and accused my friend of trying to “plant” the baby on her. Security had to bounce him so the doc could get the placenta out. Social services got involved and then they called the cops because it started to seem more and more like the dad was the father of the baby too. I’m sure those three have gone on to lead happy and productive lives.

EEEEK!!

 

[McPoyle]

Two years ago I had a female patient who called us for Abdominal pain. We found her in the fetal position on the bathroom floor. Focusing our assessment on the abdomen, she repeatedly denied any recent abdomen problems, states there is no possible way she could be pregnant, her last period was last week, has not seen a physician in quite some time, no meds no allergies. However, something wasn't adding up...the pain was very severe with no trauma, no reported bleeding etc...and she was also having some pretty severe pain in the shoulder/neck which started recently and was also non-traumatic. So anyways, we get going to the hospital.
I begin giving report and get to the OB/Gyn part:

Me: patient states no possibility of pregnancy, last period ended last week as is normal per her cycle. No abnormal bleeding etc...

and I leave the room to finish writing and can hear the nurse interviewing the patient:

patient: Yes, I was seen last week at Hennepin for an ectopic pregnancy....


hmmmmm.....don't lie....I still had suspected it, but still this would've helped.

 

[docB]

Two years ago I had a female patient who called us for Abdominal pain. We found her in the fetal position on the bathroom floor. Focusing our assessment on the abdomen, she repeatedly denied any recent abdomen problems, states there is no possible way she could be pregnant, her last period was last week, has not seen a physician in quite some time, no meds no allergies. However, something wasn't adding up...the pain was very severe with no trauma, no reported bleeding etc...and she was also having some pretty severe pain in the shoulder/neck which started recently and was also non-traumatic. So anyways, we get going to the hospital.
I begin giving report and get to the OB/Gyn part:

Me: patient states no possibility of pregnancy, last period ended last week as is normal per her cycle. No abnormal bleeding etc...

and I leave the room to finish writing and can hear the nurse interviewing the patient:

patient: Yes, I was seen last week at Hennepin for an ectopic pregnancy....


hmmmmm.....don't lie....I still had suspected it, but still this would've helped.

I've seen this a lot, where the patient "knows" what's going on but won't tell certain members of the team because they are saving it for who ever they perceive as the "important" person. I get all kinds of info that the triage nurse doesn't get and it's not because triage didn't ask. I did have a patient who knew she had a ~14 wk fetal demise because it had been worked up 2 days prior at another ED. She didn't say anything about any of this to any of us. I started working her up for an appy (she was vary obese and denied VB and DC). Over th course of the next few hours rads called to dc the CT scan because the preg was positive so I changed it to an ultrasound. The US showed the fetal demise. I went in to tell her and she was annoyed and said that she already knew that. I asked her why she didn't tell me and she said she was waiting to talk to the OB/GYN. I asked how I was suppose to know she even needed an OB/GYN and she said that she assumed that when she checked in all of her records from the other ER would "come up on the computer." She then accused me of not checking the computer on her. People have no clue.

 

[McPoyle]

I should've mentioned this in my original post, but this patient was Somali, I imagine this wasn't so much of her lying as it was her not being comfortable talking to a male about her problems (me, my partner and the two officers are all male). I had forgotten this peice until today, it was probably more of a cultural thing than anything. Ah well, no harm done.