Anesthesiologist behaving badly

[BLADEMDA]

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How far does that logic go? Did you personally synthesize the drug? Did you personally sterilize the needle? Did you draw back on the IV and waste it to ensure there was no in line contamination? Thinking that a bag of saline that is not expired or spiked is contaminated by virtue of it not being in a sealed box is insane. This level of paranoia is not practiced anywhere else in the hospital and if it is considered the standard then why wouldn't it be?

There are places where if an IV bag is "open" but not used that bag is dated. This is the normal practice at some institutions. I expect there will be changes to how open, unwrapped IV bags are viewed in the near future.

 

[BLADEMDA]

Stability of IV Fluids
IV fluid bags come packaged in different sizes, and with an outer plastic wrapping. If the bags are stored with
this outer wrapping intact the fluids are considered stable until the expiration date that is imprinted on the bag
by the manufacturer. Depending on the size of the IV fluid bag, once the IV fluid bag is removed from its outer
wrapper the fluids are considered stable for: 15 days, if the IV bag is 50ml or smaller and 30 days, if the IV
fluid bags are 100ml or larger. This is only if the bags are being stored without being used and they have been removed from their outer wrappers. According to CDC (Center for Disease Control) guidelines, once any IV fluid bag is spiked (an IV drip set inserted into the bag for fluid delivery), or if a needle has been inserted into the injection port for any reason, the fluids are considered stable for only 24 hours. Any IV fluid bag that has been infiltrated should be labeled with the date and time of initial use and discarded after 24 hours. Do not write directly on the bag of fluids with any type of pen as some inks have been known to leach through the plastic and into the fluids. Write any needed information on labels or tape first, then affix to the bag

 

[coffeebythelake]

Again, if he did inject the bags he did it with the wrapper completely off. If the wrapper is still on, it is likely safe. If someone hands you a bag of fluid w/o the wrapper, throw that **** away

He couldn't inject through the wrapper?

 

[BLADEMDA]

He couldn't inject through the wrapper?

Maybe the next psycho, killer anesthesiologist will inject through the wrapper itself, but this guy injected directly into the IV bag.

 

[pro-propofol]

I wonder what actions if any the ABA did regarding his previous domestic violence history.

He’s not board certified the ABA has no jurisdiction.

 

[pro-propofol]

Maybe the next psycho, killer anesthesiologist will inject through the wrapper itself, but this guy injected directly into the IV bag.

If you read the findings from the board it clearly says there were holes in the wrapper.

 

[deleted641888]

If you read the findings from the board it clearly says there were holes in the wrapper.

Did the board say which tech stocks he bought?

 

[amyl]

Maybe the next psycho, killer anesthesiologist will inject through the wrapper itself, but this guy injected directly into the IV bag.

He injected through the outer wrapper and into the rubber stopper… thus depositing drugs into the iv fluids. On closer inspection, there were tiny poke holes visible through the outer wrapper. These were not unwrapped bags.

 

[Outrigger]

I don't get why everyone is acting shocked at people getting IV fluids at home. While I have never done so nor plan on it, I've known everyone from anesthesiologists to RNs admit to this practice.

 

[deleted1130227]

Did the board say which tech stocks he bought?

I actually did laugh out loud.

 

[ethilo]

I don't get why everyone is acting shocked at people getting IV fluids at home. While I have never done so nor plan on it, I've known everyone from anesthesiologists to RNs admit to this practice.

My cat was having kidney stones and I gave subQ fluids to flush the kidneys. Worked amazingly 👍

 

[pro-propofol]

When folks take IV supplies and fluids home it is theft plain and simple.
You can quite legally walk into a IV therapy shop and pay for it.
Or just drink Gatorade/ tap water!
Hospitals loose money from theft and it makes healthcare more expensive.
Videolaryngoscopes are walking at alarming rates.

 

[teacher2md]

When folks take IV supplies and fluids home it is theft plain and simple.
You can quite legally walk into a IV therapy shop and pay for it.
Or just drink Gatorade/ tap water!
Hospitals loose money from theft and it makes healthcare more expensive.
Videolaryngoscopes are walking at alarming rates.

Yes, those 50 cent bags of saline and zofran vials are definitely the reason for $2k/month premiums.

 

[ethilo]

When folks take IV supplies and fluids home it is theft plain and simple.
You can quite legally walk into a IV therapy shop and pay for it.
Or just drink Gatorade/ tap water!
Hospitals loose money from theft and it makes healthcare more expensive.
Videolaryngoscopes are walking at alarming rates.

...And JAHCO requiring we use one syringe for each and every medication we administer is simply wasteful and harmful to the environment. Same goes with 2 Lpm flow rates for sevo. I think they can afford to give me a bag of saline and an IV set so I don't have to take my cat to the vet.

 

[pro-propofol]

So it’s ok to steal as long as you don’t steal too much!
When does it become to much ?
When it’s yours of course!

 

[IMGASMD]

So it’s ok to steal as long as you don’t steal too much!
When does it become to much ?
When it’s yours of course!

Can we actually buy iv fluid, tubing and IV catheter in the open market? I don’t know the answer…. If it’s easily obtainable with same day shipping, (Amazon health, did I hear you?!) be even better.

All I know was during COVID, there were a few people who were fired on the spot when they took some masks from a state affiliated hospital home. That punishment also don’t seem to be quite right either.

I’ve received fluid from my co-residents. I’ve asked pharmacist in hospital to tube me some Tylenol or naproxen, I suppose both parties should be fired? One of my pain attending took a vial of decadron from Pyxis to give another colleague trigger point injection, is that also so very wrong?!

Regardless how you feel about all these situations. I’ve learned two pieces of advice from my PDs.

From internal medicine PD: never be your own doctor. You should have someone else to take care of your health and worry about you.
From anesthesia PD: never give yourself any injections. (IV and/or IM). It’s a gateway to no good.

I still hold both of these as axioms whenever I want to take care of something for myself.

 

[kidthor]

Can we actually buy iv fluid, tubing and IV catheter in the open market? I don’t know the answer…. If it’s easily obtainable with same day shipping, (Amazon health, did I hear you?!) be even better.

All I know was during COVID, there were a few people who were fired on the spot when they took some masks from a state affiliated hospital home. That punishment also don’t seem to be quite right either.

And yet finance douchebags can engage in insider trading, nurses can host botox & wine parties, and marijuana is legalized in much of the country. It seem outright stupid that these little things with doctors end in suspicion and termination.

 

[IMGASMD]

And yet finance douchebags can engage in insider trading, nurses can host botox & wine parties, and marijuana is legalized in much of the country. It seem outright stupid that these little things with doctors end in suspicion and termination.

I suppose there’s some self grandiosity going on for us….. we should be above it and operate on a higher standard.

However, when we ask for be respected as the physicians, suddenly we are the a-holes who cannot play in the sandbox.

 

[marr65]

Can we actually buy iv fluid, tubing and IV catheter in the open market? I don’t know the answer…. If it’s easily obtainable with same day shipping, (Amazon health, did I hear you?!) be even better.

All I know was during COVID, there were a few people who were fired on the spot when they took some masks from a state affiliated hospital home. That punishment also don’t seem to be quite right either.

I’ve received fluid from my co-residents. I’ve asked pharmacist in hospital to tube me some Tylenol or naproxen, I suppose both parties should be fired? One of my pain attending took a vial of decadron from Pyxis to give another colleague trigger point injection, is that also so very wrong?!

Regardless how you feel about all these situations. I’ve learned two pieces of advice from my PDs.

From internal medicine PD: never be your own doctor. You should have someone else to take care of your health and worry about you.
From anesthesia PD: never give yourself any injections. (IV and/or IM). It’s a gateway to no good.

I still hold both of these as axioms whenever I want to take care of something for myself.

I know for a fact that you can buy fluids, iv medications, needles, and tubings all online. As long as you have your DEA and a medical license, any medical supplies wholesaler will work with you. If you want to try go to McGuff.com, there are other wholesalers too.

 

[sethco]

Dallas anesthesiologist Dr. Raynaldo Ortiz Jr. to remain in custody until trial - NewsBreak

DALLAS (CBSDFW.COM) - A federal judge has denied a request from Dallas anesthesiologist Dr. Raynaldo Rivera Ortiz Jr. for his release while he awaits trial

www.newsbreak.com

Being held until trial. Probable flight risk. Also shows good video in the link of the questionable action

 

[IMGASMD]

I know for a fact that you can buy fluids, iv medications, needles, and tubings all online. As long as you have your DEA and a medical license, any medical supplies wholesaler will work with you. If you want to try go to McGuff.com, there are other wholesalers too.

Thanks!
They even offer free shipping for order more than $50.
I will stock up!

 

[deleted875186]

Dallas anesthesiologist Dr. Raynaldo Ortiz Jr. to remain in custody until trial - NewsBreak

DALLAS (CBSDFW.COM) - A federal judge has denied a request from Dallas anesthesiologist Dr. Raynaldo Rivera Ortiz Jr. for his release while he awaits trial

www.newsbreak.com

Being held until trial. Probable flight risk. Also shows good video in the link of the questionable action

Wow, that video is pretty damning.

No logical reason why you would exchange an IV bag from the warmer, or even drop off an individual IV bag. Would be interesting to see how the defense tried to defend it.

 

[OptionOffense]

IF this is true it sounds like the person in question was taking justice into his own hands. He felt he was "done wrong" by whomever and was seeking his method of revenge.

You gotta wonder how much crime out there that is attributed to this kinda revenge since our justice system is made up of coward judges.

 

[Twiggidy]

When folks take IV supplies and fluids home it is theft plain and simple.
You can quite legally walk into a IV therapy shop and pay for it.

No matter how cynical people want to be, this correct. They jumped on us at our place because people were taking home AA batteries and Band-Aids.

 

[Twiggidy]

I love how people without board certification can just run around like loose cannons and get jobs, meanwhile, I'm jumping through every hoop so someone doesn't throw my CV in the trash......but I digress.

 

[deleted87051]

IF this is true it sounds like the person in question was taking justice into his own hands. He felt he was "done wrong" by whomever and was seeking his method of revenge.

You gotta wonder how much crime out there that is attributed to this kinda revenge since our justice system is made up of coward judges.

Yep. A lot of road rage, revenge, street justice, etc nowadays.

 

[deleted87051]

I love how people without board certification can just run around like loose cannons and get jobs, meanwhile, I'm jumping through every hoop so someone doesn't throw my CV in the trash......but I digress.

You don’t even have to be a doctor. Any warm body…..

 

[vector2]

I love how people without board certification can just run around like loose cannons and get jobs, meanwhile, I'm jumping through every hoop so someone doesn't throw my CV in the trash......but I digress.

I've got a clean medmal record, double board certified, been at the same primary job for 5 yrs, but my credentialing at this prn gig is getting held up cause - despite already having 3 current references - they can't get in touch with someone from a prn gig I did for a week 2 years ago.

And they wonder why people omit things on applications/CVs even though their records are clean.

 

[IMGASMD]

I've got a clean medmal record, double board certified, been at the same primary job for 5 yrs, but my credentialing at this prn gig is getting held up cause - despite already having 3 current references - they can't get in touch with someone from a prn gig I did for a week 2 years ago.

And they wonder why people omit things on applications/CVs even though their records are clean.

There is one place I haven’t put on my CV/Resume for years now. There was one hospital, I literally was there for one weekend.
I was applying for a license recently, took 9 months. Because they wanted/needed to verify and explanation for every little thing on your CV.

 

[chocomorsel]

The wrapper is pretty thick, it is not easy poking a hole there without seeing it and if they do the needle has to go through the bag which will cause the bag to spring a leak in which case when you unwrap it there will be the tell tale sign of tampering... wetness upon ripping the wrapper. In order to not get fluid, you would have to somehow get your needle into the stopper where you inject medicine into the bag and that stopper is covered with a rip-away thingy which you can really only rip away by unwrapping the bag. It is not easy tampering with iv bags, unless you do what most preops do which is have a tech unwrap 60 bags the night before to save the lazy day of surgery nurses the trouble of unwrapping the iv bags. This practice(poor) gives the dr death types full opportunity to tamper with Iv fluid. This is really a basic safety thing. I am not saying anything new here.

He went thru bag to stopper. Maybe he used a frigging small needle. In any case, before all this, who really thoroughly inspected bags before using them? I know I didn’t. Never occurred to me till now that they could be tampered with.

 

[Twiggidy]

I've got a clean medmal record, double board certified, been at the same primary job for 5 yrs, but my credentialing at this prn gig is getting held up cause - despite already having 3 current references - they can't get in touch with someone from a prn gig I did for a week 2 years ago.

And they wonder why people omit things on applications/CVs even though their records are clean.

I applied for privileges at a hospital then that group lost the contract months later. I never did a single anesthetic there. I’m wondering how much of a hassle this is going to be in the future

 

[chocomorsel]

What “tainted IV bag” could kill someone?

I could see that happening if the bag contained ethylene glycol or something lethal

Do people really jump on threads and not even read the first damn post? Like really? It’s like opening a book to page 97 and it not making sense.
WTH is wrong with you?

 

[chocomorsel]

So it’s ok to steal as long as you don’t steal too much!
When does it become to much ?
When it’s yours of course!

Where did you come from? Welcome moral police! We have been missing you. We have been behaving so badly. We were really in need of your services. Help us!!!

 

[pro-propofol]

You’re very welcome!
Why don’t you follow your own advice and not post stuff already posted.

 

[nopain1234]

Do people really jump on threads and not even read the first damn post? Like really? It’s like opening a book to page 97 and it not making sense.
WTH is wrong with you?

Wowzers lol

 

[chocomorsel]

You’re very welcome!
Why don’t you follow your own advice and not post stuff already posted.

Because you clearly can't read or comprehend the English language. Would you like me to help you? Because English is my third language and I used to tutor the subject in Junior High.
I read the first page.
I didn't say anything about stuff already posted now did I?

This is the Anesthesia Forum on SDN. It's like the Wild Wild West of SDN, hence why it's the most popular. So no.... we don't need to moral police policing us.

 

[pro-propofol]

Now aren’t you entitled and offensive at the same time.
You get on here and slam this country and talk about the prejudice you face.
Perhaps you need some anger management counseling that is probably better accessed in this country rather than some place that you’re planning to go to.
Have a very nice day!

 

[Straight2eight]

 

[pgg]

I wonder what actions if any the ABA did regarding his previous domestic violence history.

the board alleged Ortiz had a “history of violence against women.”

That's ominous, but vague. Perhaps substantiated? Perhaps just an allegation? Do we really want the ABA or any other professional organization to become an enforcing and punishing arm for alleged criminal acts?

I barely trust the ABA to keep my MOCA Minutes in order.

If my crazy neighbor hears me yelling at my dog (drop the dead squirrel, you idiot!) and reports me to PETA for animal abuse, does the ABA need to get involved?

 

[pgg]

Can we actually buy iv fluid, tubing and IV catheter in the open market? I don’t know the answer…. If it’s easily obtainable with same day shipping, (Amazon health, did I hear you?!) be even better.

Yes

If you've got a medical license there are a handful (at least) of suppliers with web sites you can order bulk rx drugs, IV fluids, basically any medical supply you want.

I've ordered such things in the past and UPS or FedEx just leave them on my doorstep like any other package. Many physicians who travel to remote areas acquire supplies and pharmaceuticals this way. Obviously if you can get to an ER, that's usually the right choice. But it's stupid for a group with a licensed physician to be unequipped, unsupplied, unprepared ...

If there's international travel involved, there are some potential pitfalls, but within the USA, no worries. I've purchased from these guys before -

Henry Schein, Inc.

 

[pgg]

Unfortunately, we HAVE to trust our co-workers. We just have to.

Yeah, agreed.

The surgeon could carve his initials in someone's liver. Someone at the factory could deliberately (or accidentally) compromise any drug or fluid we use. An anesthesia tech could flush my a-line setup with bleach. The HVAC guy could toss mushrooms from the hospital lawn into the OR ventilation system. There are a million ways a psychopath could randomly kill any of us or any of our patients.

 

[chocomorsel]

Now aren’t you entitled and offensive at the same time.
You get on here and slam this country and talk about the prejudice you face.
Perhaps you need some anger management counseling that is probably better accessed in this country rather than some place that you’re planning to go to.
Have a very nice day!

I can’t seem to get anyone to keep me as a patient. The last few ended up in the hospital. I have a tendency to punch them in the face when they tell me I have anger issues.
SMH

 

[pro-propofol]

Bless your heart!

 

[pocafx]

Or spike your abg with d5 NS and taint all your abgs

 

[OptionOffense]

That's ominous, but vague. Perhaps substantiated? Perhaps just an allegation? Do we really want the ABA or any other professional organization to become an enforcing and punishing arm for alleged criminal acts?

I barely trust the ABA to keep my MOCA Minutes in order.

If my crazy neighbor hears me yelling at my dog (drop the dead squirrel, you idiot!) and reports me to PETA for animal abuse, does the ABA need to get involved?

He is not bd certified. As much as the ABA is licking their chops, they aint got jurisdiction. Stick with grading multiple choice exams and threatening to revoke people for not answering fast enough

 

[Ashers]

Can we actually buy iv fluid, tubing and IV catheter in the open market? I don’t know the answer…. If it’s easily obtainable with same day shipping, (Amazon health, did I hear you?!) be even better.

Yes, you can very easily. I buy IV tubing and needles for my cat since the vet supplies cost about 10x as much (depending on where/when you can find/buy it). I buy it through my LLC and pay myself back. I use an Rx from the vet for the fluids and get those at Sam's Club or Costco. My cat is on Plasma-Lyte right now for renal disease. The tuxedo, Chaucer, is getting fluids. His sister just has bad IBD vs gut lymphoma.

If you look at IV bags, they all say Rx only. I haven't tried to get those w/o an Rx for my cat.

 

[anbuitachi]

...And JAHCO requiring we use one syringe for each and every medication we administer is simply wasteful and harmful to the environment. Same goes with 2 Lpm flow rates for sevo. I think they can afford to give me a bag of saline and an IV set so I don't have to take my cat to the vet.

jhaco should be destroyed

 

[anbuitachi]

Yes, you can very easily. I buy IV tubing and needles for my cat since the vet supplies cost about 10x as much (depending on where/when you can find/buy it). I buy it through my LLC and pay myself back. I use an Rx from the vet for the fluids and get those at Sam's Club or Costco. My cat is on Plasma-Lyte right now for renal disease. The tuxedo, Chaucer, is getting fluids. His sister just has bad IBD vs gut lymphoma.

If you look at IV bags, they all say Rx only. I haven't tried to get those w/o an Rx for my cat.

View attachment 359879

is cat supply same as human supply? or are they different standards

 

[pgg]

is cat supply same as human supply? or are they different standards

Sometimes. Probably.

Lots of drugs are labeled for vet use only but it seems likely that they come off the same production lines as human use drugs. Preppers and survivalists have a long and glorious tradition of stocking up on Fish-Mox (amoxicillin for aquariums) so they can treat their diabetic foot ulcers and other fat sedentary diseases when Armageddon comes.

Years ago my wife worked as a vet tech. They had bottles of propofol and sevoflurane that were the same as I saw in the hospital.

I did some work with military working dogs in Afghanistan. We just used our regular supplies.

 

[Ashers]

is cat supply same as human supply? or are they different standards

It's exactly the same. The stuff my mom was buying from chewy was Baxter. (The vet tech seemed to think vet standards are higher, I looked at the packaging, it's the same.)