Cosmetic Surgery Leaves Thornton Teen Brain Damaged

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This was likely Versed and Fentanyl toxicity. Makes the most sense. She was left alone for quite a while right?

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Highly unlikely LAST. Even a smaller than toxic dose of bulk injected intravascularly could do it though.

still highly like ti be an airway issue.
 
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Thought I read they left her alone ‘under anesthesia’ for 10-15 min. I imagine she had an airway event (likely easily treatable) in that time.

However, one can easily assume if it was LAST there was no intralipid available. And if she had had MH there was no dantrolene around.

Beyond abandonment, they sadly kept her there 6 hours clueless and twiddling their thumbs before transport. And the surgeon appeared to at first tell the mother nothing, and then lied to her.

Meeker and the surgeon should have all licenses yanked. Neither of them should be allowed to ever touch a patient again. You couldn’t pay me Conrad Murray money to step foot in his office.
 
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Thought I read they left her alone ‘under anesthesia’ for 10-15 min. I imagine she had an airway event (likely easily treatable) in that time.

However, one can easily assume if it was LAST there was no intralipid available. And if she had had MH there was no dantrolene around.

Beyond abandonment, they sadly kept here there 6 hours clueless and twiddling their thumbs before transport. And the surgeon appeared to at first tell the mother nothing, and then lied to her.

Meeker and the surgeon should have all licenses yanked. Neither of them should be allowed to ever touch a patient again. You couldn’t pay me Conrad Murray money to step foot in his office.
How much was Dr. Murray making?
But seriously, I think we all question why the severe delay in seeking a higher level of care.
 
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How much was Dr. Murray making?
But seriously, I think we all question why the severe delay in seeking a higher level of care.
Well, how much is conrad murray money?


$150k/month

 
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You couldn’t pay me Conrad Murray money to step foot in his office.
$150k/month


For $150k/ month i would just take money out of my own pocket to make sure he has all the equipment and staffing. I'm not THAT greedy.

This is a problem that can easily be solved with money.
 
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$150k/month

I totally would do it. I would purchase my own Dantrolene and MH cart if needed.
The work there cannot be that hard. And if you have any kind of brain, call for help when needed as you continue resuscitation.
 
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This medical team's performance is so abysmal that i wouldn't believe anything in their medical record.
Five hours is time enough to cook the books, or doctor the documents.
BTW .....the proceeding made it sound like the CRNA did the local anesthetic injections ....in 30+ plus years of doing breast augmentations
I have never seen or had an anesthesiologist do the local injections....are there anesthesiologists injecting local on BA's?
 
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This medical team's performance is so abysmal that i wouldn't believe anything in their medical record.
Five hours is time enough to cook the books, or doctor the documents.
BTW .....the proceeding made it sound like the CRNA did the local anesthetic injections ....in 30+ plus years of doing breast augmentations
I have never seen or had an anesthesiologist do the local injections....are there anesthesiologists injecting local on BA's?

Yes it absolutely sounds like BS
 
This medical team's performance is so abysmal that i wouldn't believe anything in their medical record.
Five hours is time enough to cook the books, or doctor the documents.
BTW .....the proceeding made it sound like the CRNA did the local anesthetic injections ....in 30+ plus years of doing breast augmentations
I have never seen or had an anesthesiologist do the local injections....are there anesthesiologists injecting local on BA's?

I briefly did some moonlighting in a surgicenter where some clown of an ophthalmologist kept trying to get me to do his retrobulbar blocks in preop to save him time. One of a dozen reasons I quit after 4 days.
 
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Don't laugh boys and girls - this is EXACTLY what the Dr. Nurses will claim.

You can call them nurse whenever addressing them. Even if they have a phd in what was it again...NURSING.

nothing compels me to call them Dr. regardless of degree they hold. Not personal or stigmatizing their degree. I would not refer to someone with a phd in english, arts, music, dance or engineering as Dr in every encounter I have with them.

Redundant

Pedantic
 
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I briefly did some moonlighting in a surgicenter where some clown of an ophthalmologist kept trying to get me to do his retrobulbar blocks in preop to save him time. One of a dozen reasons I quit after 4 days.


I think this is an aside from the topic but was your issue with doing the block or the fact you thought he was trying to pull a fast one?

It is common in certain areas for anesthesia to do the eye blocks.
 
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Now that the plastic surgeon can only perform surgery with anesthesiologists, I know an anesthesiologist that will get off probation the same time he does.


Discounted plastic surgeries..... by convicted felon and suspended surgeon.
 
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anyone legal savvy has the dockets?? they seem to be taken down.
 
Legal pot.

That also explains why Taco Bell is now serving fries and Burger King has tacos.

“Do you smoke?”
“Not cigarettes....”

“Do you use drugs?”
“Marijuana, but I have a card for it.....”

Two of my most hated answers from patients.....
 
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“Do you smoke?”
“Not cigarettes....”

“Do you use drugs?”
“Marijuana, but I have a card for it.....”

Two of my most hated answers from patients.....
You can't fix stupid.

"Anything to eat or drink this morning?"
"Just a small yogurt. My stomach felt empty." (EGD patient)
 
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“Do you smoke?”
“Not cigarettes....”

“Do you use drugs?”
“Marijuana, but I have a card for it.....”

Two of my most hated answers from patients.....

Haha try almost every pain patient in clinic ..

Patient: "its for pain"

"Does it help?"

Patient: "yes"

Whats your level of pain?

Patient: "10/10 pain and you have to fix it"

Most longstanding pain docs have enormous cognitive dissonance.
 
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When I had plastic surgery, it was only the surgeon there, no medical nurses to back him up or anything. Lucky everything was fine.

Shame what happened here.
 
When I had plastic surgery, it was only the surgeon there, no medical nurses to back him up or anything. Lucky everything was fine.

Shame what happened here.
The nursing profession is not here to assist us taking care of patients anymore, they are there to denigrate you, and 1 up you, instigate , spread rumors etc etc..
 
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Just an update, the teen just passed away.


Such a sad story. Did not look like she had any chance to recover and just would continue suffering for a while. Family can at least start to heal and hopefully got a very hefty settlement.
 
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Just an update, the teen just passed away.


Thanks for sharing.
I wonder what the restrictions on Dr. Kim are while they continue to practice medicine.
 
Thanks for sharing.
I wonder what the restrictions on Dr. Kim are while they continue to practice medicine.

I do know he is required to use an anesthesiologist for his surgeries now.
 
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The AANA did nothing to protect the surgeon for what amounted to a CRNA abandoning the patient. It wouldn't be above them to sue the board of medicine for restricting CRNA trade by mandating the surgeon work only with an anesthesiologist.

While they might consider it, such a suit would focus attention and publicity on this case.

Also from the AANA code of ethics:

2. Responsibility as a Professional
As an independently licensed professional, the CRNA is responsible and accountable for judgments made and actions taken in his or her professional practice. Requests or orders by physicians, other healthcare professionals, or institutions do not relieve the CRNA of responsibility for judgments made or actions taken.
 
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Another fraud perpetrated on Anesthesiologist. No one is bothered about fixing systemic problems such as fcked up machine alarms that beep during induction , intubation . No one addresses why there is anger between all the clip board nurses and doctors. The hospital administration will pay their bonuses instead of fixing the defective or archaic machines.
The anesthesiologist is correct, it does cause alarm fatigue and decreases your ability to concentrate and take care of patient. But I would not touch another health care worker. How can we assert the control without becoming violent. Is empowering nurses with cliche like patient advocate gone too far that nurses refuse to follow doctors orders and direction ?
These nurses are arrogant b**c###. Trying to provoke and then claim they are innocent. Most of them are lazy and could not get into Med school and have an ax to grind
 
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Another fraud perpetrated on Anesthesiologist. No one is bothered about fixing systemic problems such as fcked up machine alarms that beep during induction , intubation . No one addresses why there is anger between all the clip board nurses and doctors. The hospital administration will pay their bonuses instead of fixing the defective or archaic machines.
The anesthesiologist is correct, it does cause alarm fatigue and decreases your ability to concentrate and take care of patient. But I would not touch another health care worker. How can we assert the control without becoming violent. Is empowering nurses with cliche like patient advocate gone too far that nurses refuse to follow doctors orders and direction ?
These nurses are arrogant b**c###. Trying to provoke and then claim they are innocent. Most of them are lazy and could not get into Med school and have an ax to grind

Thats what you got from the article? Unless you have some insider knowledge, it seems like thr anesthesiologist in question snapped and had a mental breakdown. Should have had a psych eval IMO.
 
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These nurses are arrogant b**c###. Trying to provoke and then claim they are innocent. Most of them are lazy and could not get into Med school and have an ax to grind

Wow. You are going to have some very, very long days at work ahead of you.
 
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The 911 call is available online. It’s disturbing.
The CRNA called. No urgency in his voice. Minimal detail. Said she had a “brief asystole” and didn’t wake up. It’s good that he can’t practice. There’s something wrong with him.
 
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The 911 call is available online. It’s disturbing.
The CRNA called. No urgency in his voice. Minimal detail. Said she had a “brief asystole” and didn’t wake up. It’s good that he can’t practice. There’s something wrong with him.

Link? I tried searching but couldn't find it
 
Link? I tried searching but couldn't find it


You can find it in this article. Definitely disturbing.
 
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do you have any information to support that?

from the 6th ed. of Big Miller (vol. 2, Chap. 46, p.1794-5):

The Patient Undergoing Liposuction
...

Further complicating the management of liposuction patients are the large doses of lidocaine administered. During this procedure, patients receive up to 70 to 80 mg/kg of lidocaine. Vasoconstriction and removal of most of the infused solution is thought to prevent lidocaine toxicity.[141] However, one report suggested that lidocaine might impair alveolar epithelial fluid clearance. This impaired clearance of pulmonary fluid in conjunction with increased intravascular volume from the absorbed solution may explain some of the adverse occurrences, including death, reported after liposuction. There are significant data to support the increase in the maximum dose of lidocaine from the standard 7 mg/kg, but the maximum safe dosage of lidocaine for tumescent liposuction is still an area of controversy.

The American Academy of Dermatology has published guidelines for liposuction. The use of significant amounts of intravenous sedation or analgesic administration was considered to be potentially dangerous, particularly when conducted in an office-based setting. The recommended maximum dose of lidocaine was 55 mg/kg. This increased dosage mandates proper preoperative evaluation of patients' medications to determine whether they are using any drugs that inhibit the cytochrome 3A4 or 1A2 system. These are the major pathways by which lidocaine is metabolized, and even mild inhibition of these enzyme systems can lead to potentially lethal serum lidocaine levels.

Controlled trials regarding the best method for performing liposuction are lacking. However, a large body of practical knowledge suggests that liposuction can be performed safely using large doses of lidocaine and large volumes of infused solution. Vigilance regarding potential volume overload and pulmonary edema is required to safely perform this procedure.
 
The doses and manner of injections i described follow current guidelines practiced by specialty boards.....as I previously stated lidocaine was developed by a Swedish anesthiologist in the 1940's, it went on sale in the USA in 1948, the anesthesiologist who "discovered" it felt 1 gram was acceptable....
the FDA's recommendation in 1948 was based on epidural injection case reports....in the last 70 years there has been a plethora of information regarding blood serum levels, dilutions and injection sites.....this info is not my opinion (in fact i practice well below the guidelines), guidelines of specialty boards and surgical organizations recognize injections of up to 55mg/kg... you may want to reflect that this is not based on thousands of cases, but millions (over 250,000 liposuction cases are performed yearly just in the USA) .

The 55mg/kg comes from dermatology literature.

From my previous post reference 141

141. Dermatol Surg. 1996 Nov;22(11):921-7. Tumescent anesthesia with a lidocaine dose of 55 mg/kg is safe for liposuction. Ostad A, Kageyama N, Moy RL. Department of Dermatology, New York University School of Medicine, New York, USA.
 
Why do you all not think this death was LAST? Intercostal are basically giving it IV.

Regarding tumulscent lidocaine,

I quit working at a plastic surgeons office because of this issue. I just wasn’t comfortable with the levels.

I don’t care what Derm literature says because in the end, the FDA says - you better not use
More than 7mg/kg. I feel like that is pretty clear by a powerful regulating body.

One of my wonderful mentors, Red Howard, had this to say to me some years ago on the subject.

“ Despite all the published self-serving "safety studies" now in the dermatologic literature, I remain unpersuaded that patient safety is the underlying motive behind the increasing popularity of using mega-dose lidocaine in liposuction. This situation seems all too similar to the recent attempts by gastroenterologists when they ask that we allow nurses without adequate training in anesthesia to push propofol during colonoscopies. And when a "dermatologic surgeon" asks me to provide MAC while he administers tumescent local, I get a sense, albeit a bit different, akin to being asked to provide anesthesia for chiropractic manipulation -- it is something that has probably been done profitably thousands of times, but doing so just seems contrary to the high expectation I have of the anesthesiologist as the physician who protects the patient from those rare demons of injury that still lurk in the surgical theater. The simplistic horrors of pre-anesthetic surgery have been banished for over 150 years, so the the sophisticated anesthesiologist worth his seasoned salt now confronts rarer, subtler dangers as surgeons today push the few limits we have empirically, even if unscientifically, set for ourselves. “
 

Attachments

  • ASA Abstract - liposuction 2015.pdf
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  • As Liposuction Deaths Mount Study Exposes Cracks in Safety - Anesthesiology News.pdf
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  • AM News 1999 - Lidocaine dose questioned in liposuction deaths.doc
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How is Rex Meeker still allowed to practice as a nurse. It says a lot about the BON. Never about patient care.
I guess it’s common for nurses to leave their non critical patients for a significant amount of time, so he should be good.
If that was my kid, at some point they’d be searching for a body that would never be found. If you care so little for the lives of the people that you are caring for that you’d abandon them to have lunch while under anesthesia, don’t expect their loved ones to value your life.
 
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Anecdotally, I have had orthopedic surgeons tell me they used to inject up to 300 mL of ropi 0.2% for decades without problems on their joints.
 
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I just listened to the 911 call. WTF is wrong with this guy? Is he mentally slow or impaired?
 
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