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Good news: Ebola to the rescue. Now that Ebola has reached the states, hospitals may need to hire some unemployed pathologists to do work on the autopsy side.

but oh wait... s*** insurance companies /government don't reimburse for autopsies
 

WEBB PINKERTON

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There is money to be made on Ebola. Claim you have devoloped an LDT for Ebola with 30 minute turnaround time. It's an LDT so you can do a pathetic validation study and no one will get in your way. Then pump people full of fear and market it to physicians in Texas. Make a boatload of money and then disappear.
 

pathstudent

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You would be crazy to accept an autopsy on an Ebola patient. And what would be the point. What else could you conclude except he died of Ebola?

What I don't get is why wasn't he transferred to one of those top Texas hopitals. You know. MD Anderson. They could change their trademarked motto to "Making cancer and Ebola history".
 
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BlondeDocteur

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We were expecting to get him, as you might imagine. I think he wasn't transferred for two reasons: 1) the hospital had already greatly erred, and their public reputation has been irreparably damaged, by discharging from the ER two days prior with antibiotics and no travel/social history taken, and they wanted to try to remedy that by treating him; 2) the city & county public heath department didn't want more people exposed and possibly quarantined. Presbyterian shut down an entire floor just for him, and his care was costing them $1000/hr. They were really invested, but quite possibly they just didn't have the resources or staff to handle him.

I do think it's interesting that of the four people repatriated to "the West" from Africa who have died of Ebola, all four were in less specialized community-type hospitals, not the major academic medical centers. The two in Spain were at a small regional hospital, not the only one in Madrid which is equipped for this kind of care; the Texas patient was at a suburban community place; and the last one went to Macedonia. The other 12 are being treated at higher-level facilities and have recovered.
 

mlw03

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While it's not necessary to autopsy this man from a cause or manner of death perspective, I wonder if the CDC pushed for one nonetheless. Not too many westerners have died of Ebola this time, and I wonder if they would want the post for research and/or public health purposes. No one in Canada has been diagnosed yet, and if we get one in our province I'm not sure what'll happen.
 

Poeppel

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Would you, personally, perform an autopsy on someone who died from Ebola? If yes, what are the necessary precautions and/or facility modifications to do so safely?
 

mlw03

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No, I would not autopsy an Ebola patient unless absolutely forced to do so by my superiors. Cause and manner of death are very clear. If Health Canada ordered me to do so, I would insist on one of their doctors also being present and assisting, and to provide guidance for how to do so safely.
 
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BlondeDocteur

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Because they closed their entire critical care floor, just for him. And of course they still didn't have the expertise to take care of him properly. The second nurse who tested positive has requested to be transferred to Emory, and rightly so.
 

pathstudent

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Because they closed their entire critical care floor, just for him. And of course they still didn't have the expertise to take care of him properly. The second nurse who tested positive has requested to be transferred to Emory, and rightly so.
Proper care is supportive treatment. There is nothing sophisticated about it. That is really insulting to imply they couldn't take care of it. That first Texas patient would have died at Emory or your hospital too.
 

WEBB PINKERTON

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Proper care is supportive treatment. There is nothing sophisticated about it. That is really insulting to imply they couldn't take care of it. That first Texas patient would have died at Emory or your hospital too.
I think that BlondeDocteur is getting ready for when she is a hyperspecialized pathologist. Implying that the community pathologist is incompetent runs rampant in our field. Hell, CAP even does it quite often.

One question I would like answered is why didnt that guy received donor plasma? Mismatched plasma transfusion is no biggie.
 
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I think that BlondeDocteur is getting ready for when she is a hyperspecialized pathologist. Implying that the community pathologist is incompetent runs rampant in our field. Hell, CAP even does it quite often.
This kind of attitude burns me. If the ivory-tower types think us community peons are incompetent, I would suggest that they decimate residency recruitment to 5% of current so that the only places that pathologists work are those same ivory towers. Why train a bunch of us if only a few of us will be "competent", nevermind not having access to cutting edge ancillary tests?
 
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pathstudent

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There is an obvious reason that the Ebola patients weren't transferred to another hospital in Texas.

As much as anything else all hospitals are concerned about their bottom lines. . Had one accepted the Ebola patients it would have hurt its brand. Would you want your baby delivered at the Ebola hospital? Would you want you lumpectomy done at the Ebola hospital? Would you want you new hip at the ebola hospital? Maybe you would but the general pop would not. i think all hospitals are getting prepped to take on any patients that might present at the hospital but few are interested in taking transfers from other hospitals.

Emory with its cdc connection would be an exception of course.
 
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