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Killed By TPN: A “Never-Ever” Hospital Event?

Recently, nine patients died in Alabama when they received intravenous nutrition that was contaminated with deadly bacteria. This type of nutrition is called total parenteral nutrition, or TPN, and is used to nourish patients by vein when their digestive systems are not functioning properly. It is a milestone achievement in medicine and saves and maintains lives every day.

What went wrong? How did an instrument of healing become death by lethal injection? What is the lesson that can emerge from this unimaginable horror?

This tragedy represents that most feared ‘never event’ that can ever occur – death by friendly fire. No survivors. Contrast this with many other medical ‘never events’ as defined by the Centers for Medicare and Medicaid Services, such as post-operative infections, development of bed sores in the hospital or wrong-site surgery. Under the ‘never events’ program, hospitals will be financially penalized if a listed event occurs. Many physicians and hospitals are concerned that there will be a ‘never events’ mission creep with new outcomes added to the list that don’t belong there. Medical complications, which are unavoidable, may soon be defined as ‘never events’.

Do we need a new category of ‘never ever ever events’ to include those that lead to fatal outcomes? Read more »

*This blog post was originally published at MD Whistleblower*

Computer Error: 25 Blood Tests Ordered On Same Patient

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It’s going to take a while to draw all those labs. And the patient will probably need a transfusion at the end of it.

(Reportedly the printer engaged itself in a loop and printed out blood culture label sets 25 times, so don’t panic).

*This blog post was originally published at GruntDoc*

When Your iPhone Finishes Your Sentences

I personally find the word-completion tool kind of annoying on the iPhone – especially as a doc. The software is geared towards choosing the most common word after a few letters, and you can bet that physicians are not typing out common words. Like “emycin” is not “empty” – I’m just sayin’.

A couple of awkward ones recently – my friend was texting me about a tragic and unexpected event and I responded with “Geeze!” which (as I pressed send) turned into “Geese!” That one was hard to explain, and quite insensitive at the time. Err…

Another friend of mine was dealing with a sick kitty at home. She had taken the cat to the vet because she’d stopped eating/going to the litter box. The kitty was diagnosed with an infection and was on the road to recovery, when a couple days later she had her first bowel movement. So my friend decided to text her husband the good news via her iPhone. She typed “the cat went poo,” but alas, the iPhone had the last word. Her husband received this alarming, if not perplexing text message:

“the cat went pop”

Have you had similar iPhone drama? Do share…

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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