Getting Sued: A Doctor’s Experience

It was a cold winter day in 2009 when my life changed forever; however, it would be months before I figured that out.  On that fateful day, a drug-addicted surgical scrub tech assigned to my operating room allegedly stole syringes of fentanyl, a potent intravenous narcotic, from my anesthesia cart.  According to news reports, investigative summaries, and the scrub tech’s confession, once she took the syringes, she used them on herself.

It’s hard to fathom, but that’s not even the really sick and twisted part to this tale.  The scrub tech had hepatitis C, a blood-borne virus that attacks and, sometimes, destroys the liver.  Based on her own testimony, she knew she was positive for the virus.

Yet, after supposedly injecting herself with a drug intended for a vulnerable and innocent patient, she then allegedly chose to refill the syringe with saline.  Theoretically, the syringe was contaminated with her infected blood.

She then allegedly replaced the syringe in my cart.  If these allegations are true, and there is no way of knowing, there was no way I could have known that she had tampered with my drugs.  The syringes purportedly would have been in the same place where I left them, and both fentanyl and saline look identical.  So, on that unfortunate day, it is alleged that I injected a mixture of saline and hepatitis C into my patient’s bloodstream, instead of a painkiller. 

The following summer, the story made local and national headlines.  At least 5,000 patients were at risk for having been exposed to the virus.  Every anesthesiologist in my group secretly prayed that they weren’t involved.  The hospital went into extreme damage-control mode.  Tight restrictions and policies regarding the handling and securing of narcotics were strictly enforced.  Panicked patients were tested en masse for the potentially lethal virus.

A few months later, I received notice that I was being sued, along with the hospital.  Receiving the summons and the two-year ordeal that followed was, by far, the most painful, mortifying, demoralizing, and caustic event of my life.  Of course I grieved for the patient, but I had to do so in silence because any discussion of the event was forbidden, on the advice of my attorneys.  Never before would I have imagined the depths of shame, guilt, and self-doubt that I was capable of inflicting upon myself.

As the lawsuit evolved, the lawyers and the patient grew nastier and greedier.  My initial feelings of compassion and empathy dissolved into rage and betrayal.  I suffered through an eight-hour deposition with hostile attorneys where I was belittled, ridiculed, verbally abused, and intimidated.   Months later, I was emotionally beaten down, and I made the painful decision to settle.

At that point, it was no longer about right vs. wrong.

I just wanted the nightmare to end.  It was at that time, in the middle of settlement negotiations, that I was featured on the local television news station, only to be followed a week later by a front-page headline in the local paper.  Statements I made during my deposition were taken out of context.  The public commenters on the stories cried for my crucifixion.  I will never know this for certain, but the timing of the stories and their prejudicial slant reeked of a couple of reporters on the take.  I was made to look like a cold, heartless, reckless villain, whose patient was the innocent victim of my blatant negligence. 

I never got my day in court or the opportunity to explain that I’m not a monster.  I wish I could have explained that, before this happened I was a caring, compassionate, skilled, and highly qualified physician.  The manner in which I secured and stored my narcotics was identical to the manner in which most of my colleagues handled theirs.  We were all taught during residency that the operating room was a secure environment.  Furthermore, we were taught to have our drugs drawn up in advance of our cases, so as to be able to handle emergent and unforeseen events more expeditiously.

Now I am a shadow of my former self.  I’m bitter, defensive, cynical, and wounded.  I want to stress that in no way is this article intended to take away from the fact that a patient was hurt.  I was as much of a victim of the scrub tech’s crime as was my patient.  We just endured different kinds of injuries.  Mine were of the heart and soul and will never heal.

Note: I would greatly appreciate any feedback.  Also, if you have any questions or would like to schedule an interview regarding this or any other facet of life in the operating room, please contact me by email @ kateoreilley@gmail.com or visit my website@ http://www.kateoreilley.com.

 

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Kate O’Reilley, M.D. is a practicing anesthesiologist in the Rocky Mountain region. In addition to being a physician, she has also written two books, both of which are medical thrillers. She plans on releasing her first book, “It’s Nothing Personal” in the near future. When not writing, blogging or passing gas, Kate spends her time with her daughter and husband. Together, they enjoy their trips to Hawaii and staying active. Please visit her at her website, http://www.kateoreilley.com/ , and her blog www.katevsworld.com.

 

Put me to Sleep: Anesthesiology

I’m so pleased to host a new guest blogger, Dr. Kate O’Reilley, anesthesiologist extraordinaire. Today, she’s talking about an anesthesiologist’s main job– putting you to sleep– in a good way!
 
Welcome, Kate!
 

Anesthesia is all about passing gas (no pun intended!)  The most common anesthesia gases administered in operating rooms today include Sevoflurane, Desflurane, Isoflurane, and Halothane.  The gases, which are also referred to as volatile anesthetics, can be given to a patient in one of two ways. The first method involves the anesthesiologist simply holding a mask over the patient’s face and having the patient spontaneously breathe in a mixture of gas and oxygen. The second method employs the use of a ventilator that is attached to a breathing tube inserted into a patient’s airway.  Similar to the first method, the ventilator delivers a mixture of volatile anesthetic and oxygen to the patient’s lungs.

All of the anesthetic gases have similar effects. They cause sedation, muscle relaxation and amnesia – the three components to an ideal general anesthetic. The gases have slight differences in how they are metabolized, toxicities, dosages, and degree of cardiovascular depression.

Induction of anesthesia is simply the process of taking a patient from an awake, conscious state to a state of unconsciousness. With adults, this process is usually achieved through the intravenous administration of a series of drugs. Once the patient is unconscious and a breathing tube is placed, the anesthesiologist turns on one of the gases to an appropriate concentration, and uses the gas to maintain anesthesia during the operation.

With children, we rarely have the luxury of a preoperative intravenous line. It’s simply too difficult and traumatizing to place an IV in the little rascals while they’re awake. As a result, anesthesia in children is often induced with gas instead of drugs. Once the child is asleep, an OR nurse places and IV and surgery commences.

Watching a patient being anesthetized by gas alone is an interesting process. It’s the only time one is able to see the distinct stages of anesthesia. The first stage of anesthesia is a state of voluntary excitation and euphoria. It lasts from when the patient is awake until they are rendered unconscious.  Until the patient is unconscious, their movements are purposeful and they can follow commands.  Stage 2 of anesthesia is a stage of involuntary excitation. In this stage, patients my flail their arms and legs, giving the appearance of being combative or agitated. However, they are completely unaware of their actions. When parents accompany their children to the operating room for induction, this stage is usually unsettling for them to witness. The third stage of anesthesia is the stage of surgical anesthesia. In this stage, the patient has reduced muscle tone and will not respond to surgical stimulation. This is the stage where we want patients to be during the operation.  Stage 4 of anesthesia is where we aim not to be. It is the stage where there is severe cardiovascular and respiratory depression. If allowed to persist, this stage could result in death.

So once the patient’s surgery is done, how do we get rid of the gases? We simply turn the gas off.  Over time, the patient breathes off the gas and eliminates it from their bloodstream. Often times, as patients wake up, we will see the stages of anesthesia in reverse. As patients pass through the second stage, they often need to be restrained in order to protect them and the operating room staff from injury. Once a patient returns to stage 1, they may continue to be groggy and somewhat disoriented, but they should be able to follow simple commands. Only once a patient has returned to stage 1 is it safe to remove a breathing tube.

I hope that helps explain a little about anesthesia gases and how they work.  If there are any questions, always feel free to email me at kateoreilley@gmail.com.
 
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Kate O’Reilley, M.D. is a practicing anesthesiologist in the Rocky Mountain region.  In addition to being a physician, she has also written two books, both of which are medical thrillers.  She plans on releasing her first book, “It’s Nothing Personal” in the near future. When not writing, blogging or passing gas, Kate spends her time with her daughter and husband. Together, they enjoy their trips to Hawaii and staying active. Please visit her at her website, http://www.kateoreilley.com/ , and her blog www.katevsworld.com.