From the Sun Sentinel:
The Coral Springs mother went to the emergency room feeling sick after running out of medicine. But instead of just getting a refill, she died when a nurse gave her a massive overdose of a seizure drug, according to hospital officials and state records.The nurse at Broward General Medical Center injected Michelene Plass, 44, with 10 times the dose the doctor ordered, officials said. To get that much, nurse Dionne Cooper had to round up 32 vials of the drug. Plass died in minutes.
Plass’ death in April is getting fresh scrutiny, as an outgrowth of a lawsuit filed by her ER doctor, Paul Rohart, who contends he was unfairly dismissed. The nurse also was fired. After Rohart contacted them last week, Broward County prosecutors asked Fort Lauderdale police to begin a criminal review of the case and the nation’s hospital accrediting group agreed to examine Broward General’s response to the death.Rohart and Plass’ mother said that they were stunned that Cooper would give such a high dosage without double-checking the script and that the hospital’s safety system did not catch the error.
On April 23, Plass had a seizure and was rushed to the hospital, her mother said. She was discharged with a refill of her medicine, but before she could leave, she had another seizure in a bathroom, records show.
Rohart, an ER specialist for eight years and a doctor since 1989, said he ran tests and prescribed 800 milligrams of the anti-seizure drug Dilantin. “She and I were laughing when I left for the day,” Rohart said.But Cooper instead administered 8000 mg (eight grams), quickly stopping Plass’ heart, hospital officials said. T
he fatal dosage is two to five grams.”Her husband called me to say they were releasing her from the hospital,” Peggy Plass said. “Then 10 minutes later he called to say she was dead.”The correct dose required 3.2 vials of the drug. Cooper gave Plass 32 vials, hospital administrator Joe Scott said. To get that many, she had to search the halls and take every vial from three computerized drug-dispensing machines, he said. “That would be a big red flag,” Scott said.
Welcome to Gardner’s Gate. I am the first ever official American College of Emergency Physicians (ACEP) blogger. I am a practicing emergency physician and I currently serve as the Secretary/Treasurer of the Board of Directors of ACEP. I plan to use this space to talk about the business of the college, the state of medical care in America, interesting events in the news, the ethics of healthcare, my family, my friends, and my fellow colleagues on the Board of Directors.
Here’s a link: http://gardnersgate.blogspot.com/
CPR Glove A Potential Lifesaver
Two engineering students from McMaster University have invented what they believe is the solution: the CPR Glove. They have entered a prototype of their innovative device in this year’s Ontario Engineering Competition for university students being held in Ottawa from Feb. 9 to Feb. 11. They are part of a 17-member team competing from McMaster.
The black, one-size-fits-all CPR Glove features a series of sensors and chips that measure the frequency and depth of compressions being administered during CPR and outputs the data to a digital display.
To be effective, compressions must be given at the rate of 100 per minute and at a depth of four to five centimeters.
A study measuring retention of CPR training published in the Journal of the American Medical Association showed that 59 per cent of the time, compressions were applied at the rate of only 80 per minute. Thirty-seven per cent of the time, the compressions were too shallow. CPR administered at these levels is not likely to save a person in cardiac arrest.
“We were brainstorming about what we could create for our final-year design project that would provide a real contribution,” said Corey Centen, a fourth-year student in electrical and biomedical engineering at McMaster, whose family lives in Ottawa. “We came across this study and recognized the importance of finding a solution.”
From the Asbury Park Press:
Race, gender and health insurance status strongly influence how U.S. hospital emergency departments evaluate patients with chest pain, says a new study.
Researchers at the Medical College of Wisconsin and Johns Hopkins University analyzed data on 7,068 patients, 30 years or older, who had chest pain and went to an emergency department from 1995 to 2000.
Overall, black males were 25 percent to 30 percent less likely than non-black men to receive any diagnostic or monitoring tests, such as electrocardiography, chest radiography, oxygen saturation monitoring and cardiac monitoring.
Over the six-year study period, there was a decrease in the use of all forms of diagnostic testing and monitoring (with the exception of oxygen saturation monitoring) among black men. From 1995 to 2000, the use of electrocardiography decreased more than 16 percent among black men, while the use of cardiac monitoring declined 26 percent.
The study also found that black women were about 5 percent less likely to have electrocardiography than non-black males, and 17 percent less likely to have cardiac monitoring, 14 percent less likely to have oxygen saturation monitoring, and 6 percent less likely to have chest radiography. Non-black women were also less likely than non-black men to have these
Insurance was another important factor. Compared to patients with commercial insurance, those with other types of insurance were 13 percent less likely to have electrocardiography, 21 percent less likely to have cardiac monitoring, 23 percent less likely to have oxygen saturation monitoring, and more than 13 percent less likely to have chest radiography.
From the AP wire:
The most common method of diagnosing a stroke in the emergency rooms catches only about one out of every four cases, far fewer than an MRI scan, which also was better at spotting the type of stroke, a U.S. government funded study showed.
The study led some experts, writing in the medical journal The Lancet, to declare that MRI scans should replace CT X-rays as the standard of care. The journal published the stroke study in Friday’s issue.