Duke

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.

dumbest premed

Membership Revoked
Removed
15+ Year Member
20+ Year Member
Joined
Jan 11, 2003
Messages
434
Reaction score
0
One program that isn't going to be on my match list a few years down the road when I'm ready to match into a general surgery and then CT fellowship slot...after recent events.

Members don't see this ad.
 
The 17 year old girl whose heart-lung transplant at Duke was of the wrong blood type and is now rejecting the organs...flip on the news.
 
Members don't see this ad :)
He/she is referring to the transplant mistake made at Duke. Story.

Not that I think it's a reason not to go to Duke. It, unfortunatley, is not that simple.
 
I find it hard to believe that one would not apply to Duke's residency based on this.

Errors occur at all hospitals and surgery residencies. Most do not get published.

I'm glad that the surgeon took responsibility and didn't try to cover up the situation or just blame it on someone else. That makes me think MORE of Duke's surgeons.
 
Originally posted by Geek Medic
I'm glad that the surgeon took responsibility and didn't try to cover up the situation or just blame it on someone else.

Totally agree with you GM. Despite the fact that when a transplant team gets "the call" that a heart is available and everything goes into rush mode, this guy still had it in him to take responsibility for this unfortunate outcome.

I'm just wondering, blood typing has to go through several checks before the patient gets to receive the organ. How much blame do you guys think the rest of the people along the way that were responsible for checking blood type would have received if the surgeon hadn't taken responsibility? Or would most of the blame had fallen on the transplant team itself regardless, specifically on the surgeon(s) involved?

BTW, since this guy has now admitted he was responsible, I can't even begin to imagine how fast the lawyers are lining up to take him and the hospital to the cleaners:rolleyes:
 
I agree with the other replies. I never applied to Duke, but I know they have a good name in the surgical world. This mistake should not tarnish that. Furthermore, they took public accountablity for their mistake. It's a f*^$up, for sure. However, wait until you start residency and you'll be amazed at your mistakes, most of which will go unnoticed because luck is on your side. This is what separates surgery from most other careers. If you are a lawyer, banker, teacher, garbage collecter etc - you're mistakes don't directly kill people. In surgery, they do. We should learn from their mistake, but not chastise those who made it without knowing all the facts.
 
An error like this is pretty shocking for a transplant program. There were clearly multiple levels of failures there for what is the simplest antigen match that you have for those organs. I assume heads will roll in the North Carolina transplant office that coordinates the intra & interstate transport of organs. This is not actually the first error of this type of transplant, I read its happened twice before, both @ OHSU in Portland.

I would not read too much into the training program there based on this episode. Duke is a fine & well-endowed place with a lot to offer. It has the reputation as an academic breeding ground ("the decade with Dave (Sabiston)") rather then an "in the trenches" program to get clinically trained at. If you wish to pursue academic CTVS or ironically cardiopulmonary transplant, it really has a great brand name for those fields.
 
Duke might as well just shut down their program if they dont have a chance of matching dumbestpremed
 
Maybe dumbest premed has not entered his/her clinical training yet. But fyi, docs make mistakes and big ones. Just attend an M&M conference. or talk with nurses who double-checked an erroneous medication orders. As said in previous posts, we should learn from each others mistakes. The surg as well as the hospital will likely pay financially as well as mentally. Last I heard, she now has irreversible brain damage.

he can change his name to mis-informed premed.
 
What happened to the girl is tragic. However, I do feel sorry for the doctor whose career is now ruined. I feel even more sorry for him cuz the Chief of Surgery is publicly blaming the surgeon who performed the operation. I feel that due to pr, they decided which surgeon would take the fall and are now slashing him to pieces...just an speculation though...
 
I am a student at UNC, thus, to say I loathe Duke would be an understatement. However, I can't help but feel this whole situation is tragic and undeserved, on both sides. In a recent news conference, the "family spokesman" was practically in the face of the Duke CEO, accusing him of making mistakes. Yes, a horrific mistake was made, but everyone, even the Dookies, makes mistakes. And, for the family to now blame Duke and accuse them of being malicious is reprehensible.

On another note, I don't understand how Jesica was able to have a heart-lung block designated as hers. I thought it was illegal for individuals to specify to whom their or their family's organs would go. Furthermore, in my isolationist, Republican mindset, why is a citizen of another country getting two much needed organs (twice) while 197 US citizens sit on the UNOS list?
 
As a surgeon, I find it hard to understand how this error occurred. Not saying that in an accusatory way, but rather in a puzzled way.

It sounds as though, since normally a compatible cross match is an absolute requirement for a recipient to be in consideration for an organ, when the recipient team was offered the organs, they assumed that a correct type and screen was already in place. After that no one checked until too late.

But there are normally so MANY checks which occur - like when blood is administered. How did they all get bypassed? It's hard to imagine...
 
Originally posted by womansurg
It sounds as though, since normally a compatible cross match is an absolute requirement for a recipient to be in consideration for an organ, when the recipient team was offered the organs, they assumed that a correct type and screen was already in place. After that no one checked until too late.

This sounds like an error that starts with the Duke transplant coordinators (non-physicians) & the UNOS agents involved. The surgeons usually have little to do with these things pre-transplant other then a phone call from the coordinator or Carolina Organ Bank saying that you've been offered a matching organ by UNOS for patient X, do you want it?. The harvesting of these organs is coordinated closely with the explantation of the heart & both of these are performed simulaneously to minimize ischemia time. I've done ~ 15 harvests & ironically done at least 3 that I can think of where surgeons from Duke were also there retrieving the heart.

I'm just shocked @ how this slipped past the UNOS system safeguards. This should have set off multiple alarms on their little computer algorithm that matches organs to patients
 
Agree with droliver.

There's more going on here that we know. Do people really think a surgeon is gonna sit there doing a crossmatch and typing in the OR? That's what the media is making it sound like. Like droliver said, that's just not reality, and somewhere either UNOS or a transplant coordinator screwed up. I'm assuming Duke is like my hospital, where the surgical team gets a phone call saying that a compatible set of organs is available, and we go about the operation. I think this Jaggers is being burned at the stake without adequate proof.

Furthermore, more media attention needs to be focused on this family spokesperson Mahoney. From his comments only, it seems like at the very least there is some sort of personality disorder running rampant and creating soundbytes left and right. "I'm here saving this little girl," "The doctors murdered her." And on and on. This guy is not all there, but our media takes whatever he says at face value because that's all the reading public can understand. At some level this guy means well, but this is a bad example of what happens when people of below-average education become wealthy.
 
I'm just a flea from the land of IM, but I have a great amount of respect for surgeons and what they do. Having been in the OR 3rd and 4th year, it's pretty obvious that surgeons have to be able to have some degree of trust in their support staff, or else their lives would be absolute pure hell if they had to supervise 100% of the aspects of any and every surgery. This surgeon's career will probably be ruined, but it's likely not his fault - he trusted a system that let him down.
 
Originally posted by Behcet
This surgeon's career will probably be ruined
Oh no. I agree with the rest of what you wrote, but I don't think this surgeon's career will be ruined. Surgeons make mistakes, as do all humans, and - god forbid - one or more of the times that we do, there may be a bad outcome, or even a death. Decades of hard work and integrity are not negated with a single error. If this physician has a pattern of irresponsible behavior, then that would be one thing. But it seems as though the institution and the medical community are standing firmly behind him - something they would not do unless he had an established reputation as a good and careful surgeon.

This surgeon has paid and will continue to pay for this error in deeper tolls than financial retributions or public censure could ever exact. All of you - I mean this - ALL of you will find yourself at some point in your career, alone in your bed at night, knowing that a momentary lapse of judgment or attention on your part has caused harm to a patient. This is necessarily true, because no person and no system is perfect. Mistakes will happen, despite our very greatest efforts to minimize them. The most important step in reducing error is acknowledging that it exists. Duke university and this physician have done an exemplary job in sticking to this very difficult principle under these most difficult of circumstances.
 
I agree that this is a tragedy that everyone involved would probably do anything to repair. I definitely do not think this is reflective of an error that can be blamed on just one person; as tragic as it is, mistakes happen, this should be a sign to re-evaluate the system to find where this error was able to slip through to improve things in the future. Surgeons don't run out of the OR to type and cross; that's not the way the system works, so I think the media is being unjust in their implications that this is solely the fault of the surgeon.

I realize this may be a horrible and sinister thing to think, but if she really has been declared brain-dead (assuming that was secondary to the bleed and that the current organs are not being rejected,) could the organs be re-harvested for another waiting patient? Again, don't mean to offend anyone by that; hopefully the word on the news that she is "brain-dead" is just a rumor and that this whole issue may not end in a tragedy.
 
she's not brain dead...she is dead-dead now. Yeah, it was a terrible mistake, but no more terrible than the thousands of mistakes that are made daily in the medical profession. The media frenzy will die off now until the law suit starts and no one will care. Maybe it will help push in some changes to prevent future mistakes, but I am not going to let CNN turn me into a bleeding heart.
 
Glad someone else spoke up about this Mahoney guy; he seems to be on an ego-trip. Have you all been to his website? Forget the address, but it's on CNN or WashPost, or somewhere out there...One of his arguments against Duke is that by not going public, they somehow decreased this girl's chance of getting a 2nd transplant in the first couple of days post-op. HOW?????

What about everyone else on the UNOS list; should the media run a story on each of them as well?

After this long on ECMO (I'm assuming this is the "heart-lung machine" the media refers to), I don't think the organs would be in good enough shape for retransplant.

Like almost all errors in medicine (and in the airline industry and in other complex systems), this was a multi-factorial error. The more I learn about how many safeguards failed, the more respect I have for the surgeon for stepping up and taking responsibility; in my book, this is a true sign of a great leader.
 
Top