Worst thing you've done to a patient

[waterski232002]

So... I'm bored at work and need something to do. I figured I'd start a thread on the worst thing we've done to a patient iatrogenically. We've all messed up--it's part of residency, part of life, and part of learning. How about we pull out those old skeletons and share some stories of what we have inadvertently done in the past.

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[waterski232002]

I'll start... When I was a 3rd year medical student, I ruptured an umbilical cord on a pregnant lady while delivering her placenta. It was a bit of a mess for awhile until the OB resident manually removed the placenta.

I also fluid overloaded a lady s/p pneumonectomy with a large malignant pleural effusion on her remaining good lung, put her into pulmonary edema, and she coded. We got her back thank god.

 

[southerndoc]

Uh, with all the lawyers lurking on the board, I don't think we should be posting things like this.

 

[JackBauERfan]

Uh, with all the lawyers lurking on the board, I don't think we should be posting things like this.

haha

 

[toxic-megacolon]

I unplugged a patient's ventilator to recharge my cellphone.








Just kidding...

 

[njbmd]

I had a drunk and unruly patient in the ED. He was in four-point leathers. He kept swearing and spitting so I put a surgical mask over his face (loosely of course). He kept spitting and ended up covered in his own saliva. That did make him happier but it kept the poor police officer that was with the drunk from getting covered.

njbmd

 

[beyond all hope]

A friend of mine told me this story

There was a patient who was a royal pain in the *ss in the ED with a chin lac. He had a thick beard and didn't want the lac sewn. He kept cursing me out and telling me what a bad doc I was. While I was interviewing other patients he would take away my chair or move my stuff around, still bitching at me.
He wasn't even drunk, he was just a nightmare. I couldn't DC him because the attending wouldn't see him.

During rounds in the morning, the attending asked me why I hadn't sewn his lac. Now the guy says, "Yeah, why didn't you sew it up?" I had plenty of time overnight to sew it but now it's the end of a 12 hour shift and I'm exhausted and now I have to stay late to sew this guy's lac.

So then I did the worst thing I've ever done. I took the lido syringe, filled it full of saline, injected the wound, and sewed him up.

I still feel guilty about this. This is the only time in my life I've ever deliberately done something bad to a patient.

The funny thing is that he complained less during the lac than he did when I was trimming his beard to get to the lac. I think it hurt me more than it hurt him.

That's what my friend told me. (and by the way, I never inhaled...

 

[pedidoc]

Okay, I'm on call and I leaned over to look at this baby's retractions and the stethoscope fell and hit the baby on the head (with the bell!!) and it thunked really loud. The parents were really cool, but this is going to make me cringe for the rest of my life!!

 

[Boopieness]

I was living in this run down apartment off-campus that did not allow pets and I reeeeeeeeeeeeeally wanted a puppy. On the other side of town was this low-priced cooperative. Let's call it "Happy Village" They were town houses. 8K to buy in. Rent thereafter was like 400/month with maintenance & utilities included for a two bedroom. It was awesome, pool, workout area, club house, free upscale laundry facilities, excellent security. And they allowed pets. Problem was, there was a 42-person wait list. I couldn't get in.

Anyway, I was on my psych rotation and there was this unbelievable frequent flyer - beyond help. Let's say her name is "Sam". This was Sam's 20th hospitalization. I actually thought she just lived at the hospital. Everyday she kept talking about throwing herself in front of a train. So I was on call one weekend with my attending and told not to discharge her no matter that she had expressed no suicidal ideation and was now acting halfway sane. I said okay, come Monday her psychiatrist says thanks to us for not discharging her. Alright. He assesses the situation and he discharges her that day. Tuesday during morning report one of the social workers says she just heard on the radio coming into work that "a body had just been found at the railroad tracks." And the conductor swears 'that somebody' walked intentionally onto the tracks. Another social worker adds, I bet it was "Sam." Then another and another all nodding in agreement. I said why do you think that it was her. That's way across town. Answer came back "Sam" lives just two blocks away from the tracks at "Happy Village." I was like, NO WAY!

I couldn't wait for morning report to be finished. I made sure everyone cleared out of the room then called "Happy Village" and asked for the umpteenth time if "Happy Village" had an immediate opening right now in the middle-of-the-month. 'No.' So I asked. "Are you sure." Yes, the business office says. I add, "I can move in tomorrow if there's an opening, really I can." She insists, there is no opening. "But how do you know there won't be an opening tomorrow." We don't get openings in the middle-of-the-month. "But what if say, there was an opening, could I move in?" She says "look, let me make it perfectly clear, there are no openings. There are NEVER any openings. Everyone is happy at 'Happy Village' "I add, well what if say someone wasn't happy.

Finally, I gave up and thought if I say one more word, the HIPAA Police are going to come get me. I would have slept on her old bed sheets. I wanted that place sooooooooo bad.

And Yeah, they did have an opening the next day. It was Sam.


I couldn't believe who I turned into on that rotation. I was just as crazy as the rest.
So, the worst thing I ever did, ...was not care.

 

[JackBauERfan]

I was living in this run down apartment off-campus that did not allow pets and I reeeeeeeeeeeeeally wanted a puppy. On the other side of town was this low-priced cooperative. Let's call it "Happy Village" They were town houses. 8K to buy in. Rent thereafter was like 400/month with maintenance & utilities included for a two bedroom. It was awesome, pool, workout area, club house, free upscale laundry facilities, excellent security. And they allowed pets. Problem was, there was a 42-person wait list. I couldn't get in.

Anyway, I was on my psych rotation and there was this unbelievable frequent flyer - beyond help. Let's say her name is "Sam". This was Sam's 20th hospitalization. I actually thought she just lived at the hospital. Everyday she kept talking about throwing herself in front of a train. So I was on call one weekend with my attending and told not to discharge her no matter that she had expressed no suicidal ideation and was now acting halfway sane. I said okay, come Monday her psychiatrist says thanks to us for not discharging her. Alright. He assesses the situation and he discharges her that day. Tuesday during morning report one of the social workers says she just heard on the radio coming into work that "a body had just been found at the railroad tracks." And the conductor swears 'that somebody' walked intentionally onto the tracks. Another social worker adds, I bet it was "Sam." Then another and another all nodding in agreement. I said why do you think that it was her. That's way across town. Answer came back "Sam" lives just two blocks away from the tracks at "Happy Village." I was like, NO WAY!

I couldn't wait for morning report to be finished. I made sure everyone cleared out of the room then called "Happy Village" and asked for the umpteenth time if "Happy Village" had an immediate opening right now in the middle-of-the-month. 'No.' So I asked. "Are you sure." Yes, the business office says. I add, "I can move in tomorrow if there's an opening, really I can." She insists, there is no opening. "But how do you know there won't be an opening tomorrow." We don't get openings in the middle-of-the-month. "But what if say, there was an opening, could I move in?" She says "look, let me make it perfectly clear, there are no openings. There are NEVER any openings. Everyone is happy at 'Happy Village' "I add, well what if say someone wasn't happy.

Finally, I gave up and thought if I say one more word, the HIPAA Police are going to come get me. I would have slept on her old bed sheets. I wanted that place sooooooooo bad.

And Yeah, they did have an opening the next day. It was Sam.


I couldn't believe who I turned into on that rotation. I was just as crazy as the rest.

thats pretty creepy.

 

[mayostand]

my FM preceptor was telling me about his first year in practice when he was flushing out the wax from an older guy's ear with the big metal "syringe" full of lukewarm water. He didn't put his left hand in place to guard against the syringe slipping and the plunger wasn't quite screwed in right. It jabbed forward into the guy's TM and ruptured it. He said the guy was literally crying in pain as blood poured out of his ear.

 

[littlepurplepil]

Pt came in with change in mental status, so he orderd a CT head which was normal, and a chest x-ray which showed an effusion. So he then ordered a CT chest for loculated effusion and went home for the day. The patient was taken for the CT at midnight. The next day he went in and his resident, who was reviewing the chart, said "hey, why did you order a CT head for a loculated effusion?" Turns out that he had written the order for "CT head - loculated effusion" and the pt got a head CT. He then had to go & explain to the pt that they did not get the necessary test last night. Needless to say the pt wasn't happy and he was very embarrassed.

 

[deleted4401]

Had a brittle diabetic patient admitted for other reasons. The husband and family already contacted patient relations and were likely to litigate already, prior to our team accepting the transfer. I couldn't control her sugars. Asked for help from resident, and didn't really get any advice. I told the attending that I couldn't control sugars and I needed an endocrine consult. He said that we should try to handle it ourselves. Ended up bottoming out the patient to a glucose of 16 (probably underestimated, as extremes aren't read accurately on an accuchek). I ended up sending the patient unit. Felt horrible about it ... the rest of the year, I was so conservative and allowed patients to be hyperglycemic, even though I know outcomes are worse ... strange thing, after the fact, is that nurses swore that the husband was up to something, and all of them told me that they suspected surreptitious insulin administration (someone saw a syringe). Nobody had been able to control the patient's sugar during the entire admission. I don't know if I believe it, I think that specific event was my fault. I went over the orders after the fact with endocrine, and they were suspicious of foul play, but still my management was less than perfect. I still think about that situation ...

-S

 

[Apollyon]

Remember in neuroscience in preclinical when you learned about "cold calorics"? And now, in clinical medicine, the only people who do them are the neurologists, as part of the "brain death" protocol.

Well...if a patient has impacted wax in their ear, and you are going to lavage it out with water or saline...make sure it's warm, or else you WILL get a patient with nystagmus, and vomiting like crazy!

 

[Anasazi23]

Has anyone ever given a 'placebo?' i.e. shot of B12 or something? Perhaps for constant and unrelenting psychogenic "pain" which secondarily keeps both the resident and neighbors up with complaining and screaming for the sake of being demanding?

I never did anything like that.

 

[Hurricane]

Has anyone ever given a 'placebo?' i.e. shot of B12 or something? Perhaps for constant and unrelenting psychogenic "pain" which secondarily keeps both the resident and neighbors up with complaining and screaming for the sake of being demanding?

I never did anything like that.

Today I gave a guy with CHF a little D5 1/2 NS at a ridiculously slow rate to placate the family, because they can't understand that someone can be NPO for a day without requiring "some kind of IV nutrition." This is the same family who constantly calls the nurse because the patient it is pain/nauseated/itching, and then the nurse comes to find the patient soundly asleep. So I admit I did it more to keep my crosscover from being smothered in calls rather than to benefit the patient. I heard last night's crosscover had a really rough time with this family. Despite my placebo fluids, I bet my crosscover is talking to the family this very moment. I'm glad I'm here in my jammies instead of in there with him.

 

[MiesVanDerMom]

I was living in this run down apartment off-campus that did not allow pets and I reeeeeeeeeeeeeally wanted a puppy. On the other side of town was this low-priced cooperative. Let's call it "Happy Village" They were town houses. 8K to buy in. Rent thereafter was like 400/month with maintenance & utilities included for a two bedroom. It was awesome, pool, workout area, club house, free upscale laundry facilities, excellent security. And they allowed pets. Problem was, there was a 42-person wait list. I couldn't get in.

Anyway, I was on my psych rotation and there was this unbelievable frequent flyer - beyond help. Let's say her name is "Sam". This was Sam's 20th hospitalization. I actually thought she just lived at the hospital. Everyday she kept talking about throwing herself in front of a train. So I was on call one weekend with my attending and told not to discharge her no matter that she had expressed no suicidal ideation and was now acting halfway sane. I said okay, come Monday her psychiatrist says thanks to us for not discharging her. Alright. He assesses the situation and he discharges her that day. Tuesday during morning report one of the social workers says she just heard on the radio coming into work that "a body had just been found at the railroad tracks." And the conductor swears 'that somebody' walked intentionally onto the tracks. Another social worker adds, I bet it was "Sam." Then another and another all nodding in agreement. I said why do you think that it was her. That's way across town. Answer came back "Sam" lives just two blocks away from the tracks at "Happy Village." I was like, NO WAY!

I couldn't wait for morning report to be finished. I made sure everyone cleared out of the room then called "Happy Village" and asked for the umpteenth time if "Happy Village" had an immediate opening right now in the middle-of-the-month. 'No.' So I asked. "Are you sure." Yes, the business office says. I add, "I can move in tomorrow if there's an opening, really I can." She insists, there is no opening. "But how do you know there won't be an opening tomorrow." We don't get openings in the middle-of-the-month. "But what if say, there was an opening, could I move in?" She says "look, let me make it perfectly clear, there are no openings. There are NEVER any openings. Everyone is happy at 'Happy Village' "I add, well what if say someone wasn't happy.

Finally, I gave up and thought if I say one more word, the HIPAA Police are going to come get me. I would have slept on her old bed sheets. I wanted that place sooooooooo bad.

And Yeah, they did have an opening the next day. It was Sam.


I couldn't believe who I turned into on that rotation. I was just as crazy as the rest.
So, the worst thing I ever did, ...was not care.

Didn't that happen on Seinfeld once?