** This follows from the previous blog post**
A week later a 10 pound package came for me in the mail – it was a copy of the patient’s entire medical record. It took me almost an hour to find the part that had to do with the paralysis event, but as I read through the chart I saw my note and then gasped.
My note was simple: it documented my physical exam findings, the time I first found him paralyzed, the time I called the surgical team, the time it took them to get to the patient’s room. It was all clearly written and nicely documented. But the entry just above mine was from a nurse who had apparently turned the patient earlier that morning to wash his posterior. She noted that the patient was having some neck pain afterwards and that she had given him some Tylenol.
Then came my note.
And then came another note from the nurse, dated 3 months after the incident, and labeled “addendum:”
“Paged Dr. Jones to evaluate patient with complaint of inability to move lower extremities. Dr. Jones responded that she would examine him after rounds. I told Dr. Jones that it was an emergency but she said the patient would need to wait.”
I was horrified. That’s not at all what happened – the nurse was clearly afraid that she would be held responsible since she was the one who had moved the patient earlier that morning, possibly displacing his (recently operated upon) spine and causing a bleed. She obviously wrote the note to make it look as if the irreversible paralysis was due to the slowness of my response.
And so I felt helpless and very afraid – is this what will end my medical career? I thought about all my years of training, how careful I always tried to be, how much I cared for my patients – and would it all end with this insanity?
As it turned out, I had to prepare for a deposition. I studied every angle of the case, read every piece of the chart, sweated it out for many weeks. And then I got another call from the lawyer one day: “They’re settling out of court. You don’t have to come in. Just forget about it.”
I was relieved, but angry. I also felt very sorry for the patient. But most of all I wondered about the legalities of practicing medicine – how vulnerable we docs are, how a complication can be seen as malpractice… and how another healthcare professional can be so damaging. Sometimes practicing medicine scares me – lives are at stake, and even the best intentions can lead to life-altering events.
This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.