Wow, the lay people scare me!

[DeepDermis]

http://www.nydailynews.com/ny_local...anplant_patient_vincent_liew_donor_kidne.html

If you havent heard about this, take a moment to read up about this case from New York. In short, an ESRD patient had a renal transplant from a brain-dead patient who was later found to have undetected uterine cancer on autopsy. The transplant surgeon informed the patient, who allegedly refused explantation based on discussion with and recommendations from the surgeons. The patient was eventually explanted 2 months after that discussion, but unfortunately died from metastic uterine cancer soon after.

Well, the jury dismissed the suit against NYU and the transplant surgeon. Clearly, this case prompts some very interesting disucssions that try our ethics and intellectual limitations.

Most concerning, take a moment to read the comment board below the article and how the general public views this case. Take a look at some of the postings for earlier articles as well!!!

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[45408]

I'm sure the donor had a high white count that should have tipped them off she had cancer! They're liable!

Ugh, this is what happens when someone has a little bit of knowledge. The ddx on leukocytosis is enormous, and the NPV for cancer in the presence of a leukocytosis s/p CVA has also got to be enormous.

The failure does seem to have been with the organ donor network, who settled with the other families affected.

 

[glade]

I like how the article is like "but the widow of Vincent Liew won't get a dime because the first lawyer she hired didn't sue the organ donor network and went after NYU Medical Center instead." LOL. Like, no offense, but you have some guy who has ESRD and is on dialysis, so by definition he's racking up hundreds of thousands of dollars of bills on taxpayer credit, then he gets a transplant, which is also hundreds of thousands of dollars of bills on taxpayer credit, all for free. And, while it's certainly unfortunate that he died, it was by his own stupidity. And yet people are running around like "who can we sue?? Who can we sue??" Yeah, sue the Organ Donor Network. Good job, *****s, you just sued the only organization that gives a s**t about promoting organ donations and keeping you alive. That's a smooth move. Hey, why don't you sue them out of existence so that all the other 99.999% of organ recipients who never had a problem with their transplants can go without donations? Hooray! You won some cash!

Nothing like these people who come into the hospital at like 95 years of age, their family neglecting them, they have 50 comorbidities and twenty allergies and God forbid something goes wrong or else it's like "I SUE YOU, I SUE YOU, I SUE YOU ...WHO MOVED OVER THERE?? I SUE THEM, TOO!!" Someone needs to sucker punch these people in the back of the head.

 

[JackADeli]

Ugh, this is what happens when someone has a little bit of knowledge. The ddx on leukocytosis is enormous, and the NPV for cancer in the presence of a leukocytosis s/p CVA has also got to be enormous...

I must agree. In a classroom, speaking ethics and informed consent, you hear things of fully informed and un-coerced. These are almost impossible when speaking about variably educated patients and families with terminal and/or emergent conditions. Much of medicine, especially at the terminal and emergent end are Vegas crap shoots. We are trading a hope for extending life vs do nothing with almost certainty of death. Yes, I fully support every effort to fully inform. I do not support a cavalier attitude that the almost certainty of death excuses rank experimentation. But, we need some realistic understanding... there really may be some things worse then death.

Some anecdotes:
1. had a patient that received kidney transplant for poly cystic kidney. she was young, married and appeared otherwise healthy to her family, husband, and healthcare providers. Following renal transplant, she ended up with painfully deformed perineum. She had unrecognized HPV. This had a tragic impact on her self image and intimate relations with her husband. It required almost weekly ablation/resections for tumor surveillance and debulking. She was depressed, crying..... she "wished [she] was dead".
2. similar tale involving a patient with genital herpes.
3. similar tale with oral herpies/cold sores

Transplant truely is trading one disease for another... hopefully with a longer life expectancy. You can have resurgence of occult infectious disease or cancers and/or donor transmission of occult infectious or malignant diseases. And, you are NOT getting a new organ, it is used and will undergo plenty of medical abuse to remain in your body.