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To: retMD
“If they annoy me, work them up twice as carefully”

Good for you. The article says this lady had been there 3 times in 3 days. It sounds as if she had a history of gallstones. If she ever got past the triage nurse in any of her three visits the ER doctor should have at minimum checked out her gallbladder and appendix. I'm very curious about her treatment on her prior two visits. A perforated bowel would have shown free fluid on a CT and if treated emergently she might still be alive.

58 posted on 05/20/2007 11:48:57 AM PDT by McLynnan
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To: McLynnan

Thanks. There could be various causes for the perforated bowel, and some patients just don’t do what the textbooks say - no fever, normal white blood cell count, or no free air on Xray, etc.

I’d bet she was seen by an ER doc on earlier visits; the triage nurse could delay the care, but not send her home without exam. (Unless things are much worse at that hospital than even the reports say.) So I’d be very curious to see the initial work up. It’s been known for years that a patient returning to the ER unexpectedly can mean an initially missed diagnosis. Three times would definitely make most docs look carefully. I agree, if she was diagnosed and treated promptly, she might be alive today.


70 posted on 05/20/2007 12:08:20 PM PDT by retMD
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