7.02.2007

The Rodriguez Medical Examiners Report

They've made Ms. Edith Isabel Rodriguez's autopsy available on the internet.

The medical examiner reports that...it was an accident. That her abdominal pain, and ultimate bowel perforation, was partially secondary to her chronic drug abuse. It seems like the medical evaluation and treatment involved multiple radiologic examinations, hospital admission, evaluation by specialists...the whole deal.

It's difficult to determine if a drug abuser is 'for real this time' . And I do have sympathy for the medical staff as this was a very complicated, and difficult case. It seems as if this woman did, in fact, receive great, comprehensive (expensive) medical care. Actually, it's the fact that she died in the waiting room that makes the case newsworthy...not the fact that she died.

I've read lots of comments on various message boards ranging from:

"She deserves a Darwin Award...she was an illegal immigrant, criminal, homeless, drug-addicted prostitute..who cried wolf one too many times."

to "the entire medical staff should be brought up on premeditated murder."

Both are outrageous, and completely inappropriate points of view. But, in the middle lies the answer.

Edith wasn't an innocent victim absolved of any responsibility, and her family doesn't deserve millions just because she happened to die in the waiting room rather than the ED hallway/chair/floor. She apparently had lots of things going on (diabetes, HTN, cholelithiasis, obesity, drug addiction with sequelae, social issues, and was a frequent flier with inappropriate follow-up). What she died from possibly developed after her hospital evaluation and discharge earlier that same day. It's an unusual diagnosis in a woman her age. And, it sounds like she was appropriately worked up.

But, how horrible is it to see someone die in the ER, begging for help? Perhaps if she would have been reevaluated by an MD, she would have received IV fluids, antibiotics, pressors, and possibly even a surgical evaluation revealing an acute abdomen. This intervention *may* have saved her life if it were possible to clinically recognize the emergency (but it seems like this was no easy task).

Like most of you, my sole source of information regarding this case is via internet, and news media. I am well aware that I don't have enough information to make an informed decision one way or another. It's unfortunate that many of the people who are talking out of their asses don't have this same realization.

The truth, whatever it is, will probably not be revealed in the local paper. And without knowing the truth, thoughts/opinions are a product of media persuasion...

...I'd like to think of myself as an independent, critical thinker.

16 comments:

Petri said...

From just my volunteerism in the Er I have seen so much more drama present at the greet desk.

People yelling, screaming for help, having seizures, pleading to be seen because of the pain. When I started I couldn't believe the callousness of the staff at letting so many of these people wait out here. What if they died in the waiting room?

The fact is though, the people in the back were always worse. And for all the antics no one ever died in the waiting room. Sadly enough, many of these people are frequent visitors, and they have perfected getting into the ER fast by faking seizures, chest pain, blinding pain, etc.

The triage staff have such a difficult job already, and it is made far worse by people trying deliberately to deceive them. They do an incredible job and have been forced to grow a seemingly cold thick skin. But they are not sadists, and their compassion is shown in the fact that they endure the abuse day after day because they want to help those in need.

This woman represents the small fraction that the triage staff judges incorrectly. Yes, it's the fault of the Triage nurse for not believing, but it is also the woman's fault for not helping herself be taken seriously. Healthcare staff cannot force people to take care of themselves, and cannot be expected to miraculously save the day with a patient who has been chronically killing herself for years. I'm sure the triage nurse feels extreme guilt, but criminal culpability? Nurses and Doctors are just as human as the rest of us.

24HourNurse said...

Love this comment. Glad you were able to see through the coldness some have to portray.

Vitum Medicinus said...

I won't pretend that I have any experience in surgery, but I wonder how much help exploratory surgery would have done. We can assume that they, like the individual who performed the autopsy, would have seen "free stool in the abdominal cavity," but if the "perforation [was] not grossly seen at autopsy" I wonder if it could have been found (and therefore fixed) by a surgeon?

ERnursey said...

This woman died from self neglect and a lack or self responsibility. It i unfortunate that she and her family are being portrayed as helpless victims. Since I assume they all arrived at the hospital via some mode of transportation why didn't they employ that same mode to leave and go to another hospital? That is what happens when you cry wolf too many times, people tend not to believe you when something is really wrong.

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tci said...

Love this comment. Glad you were able to see through the coldness some have to portray.

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