Sophie Tyler

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epidural man said:
Anyone know more about the sophie tyler case? The details in the media make the story seem confusing.

I'd like to know the details it.
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I read a article a couple weeks ago that left me a little :eyebrow: ... some things don't really add up, but it's not like you can trust reporters to get facts correct. That article said a spinal needle was left in place and forgotten for two days.

Useless reporters seem to be plagiarizing, er, reporting facts obtained from other reporters:

http://www.telegraph.co.uk/health/h...al-admits-error-that-left-girl-paralysed.html
The next day she underwent an MRI scan which revealed the anaesthetic had entered her spinal cord and damaged the membranes, paralysing her from the waist down.
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http://www.dailymail.co.uk/news/art...on-remove-gallstones-went-horribly-wrong.html
The following day she had an MRI scan which revealed that the anaesthetic had entered the spinal cord and damaged the cells surrounding it.
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I haven't been able to find any information other than she underwent a chole, got an epidural for postop pain control, and wound up with a spinal injury. The hospital promptly admitted error, but it's not at all clear to me what the error was.
 
pgg said:
I read a article a couple weeks ago that left me a little :eyebrow: ... some things don't really add up, but it's not like you can trust reporters to get facts correct. That article said a spinal needle was left in place and forgotten for two days.

Useless reporters seem to be plagiarizing, er, reporting facts obtained from other reporters:

http://www.telegraph.co.uk/health/h...al-admits-error-that-left-girl-paralysed.html


http://www.dailymail.co.uk/news/art...on-remove-gallstones-went-horribly-wrong.html



I haven't been able to find any information other than she underwent a chole, got an epidural for postop pain control, and wound up with a spinal injury. The hospital promptly admitted error, but it's not at all clear to me what the error was.
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PGG
Sounds like she got a syrinx?
NP
 
I'd bet

1) hematoma - symptoms not recognized because she's "supposed" to be numb and in pain

2) med error - someone accidentally injected something neurotoxic through the epidural


But the whole thing is kind of weird. An epidural for a chole? Must've been a hell of a whack. There's got to be more to this story.
 
I like how they refer to the law firm as "solicitors". Very appropriate definition in other settings. This story, however unclear, is very sad for any teenager.
 
pgg said:
I'd bet

1) hematoma - symptoms not recognized because she's "supposed" to be numb and in pain

2) med error - someone accidentally injected something neurotoxic through the epidural


But the whole thing is kind of weird. An epidural for a chole? Must've been a hell of a whack. There's got to be more to this story.
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I just found an interview with the girl (she has pink hair....). It sounds like she had a hematoma. That makes MUCH more sense then what the press was saying....stupid press.
 
Know nothing about the case, but the story would make sense if it occurred as follows:
-Technically difficult lap chole that led to open chole
-difficult pain mgmt afterwards leading to pain consult
-epidural placed for patient comfort
-poor communication between surgical and pain team
-surgeon begins LMWH without consulting with pain service
-pain service pulls epidural a few days later without knowledge of the patient being therapeutic on LMWH

I am surprised that the above scenario does not happen more often due to silo behavior on the anesth and surgical sides. The surgeons frequently don't consider how their actions can impact the epidural and the pain team fails to be vigilant about their patient selection and the epidural orders. Pharmacy can play a big role in being a safety net to avoid the above. In our hospital, a big red flag halts LMWH doses in epidural patients.
 
TrustMe said:
I like how they refer to the law firm as "solicitors". Very appropriate definition in other settings. This story, however unclear, is very sad for any teenager.
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In Britain, lawyers are known as either "solicitors" (if they work outside courtrooms) or "barristers" (if they work inside).
 
I hear and understand everything that you are saying but if we are going to be placing/manipulating/pulling catheters I feel we are obligated without exception to be 100% aware of anticoagulation status and make no assumptions.

Gern Blansten said:
-surgeon begins LMWH without consulting with pain service
-pain service pulls epidural a few days later without knowledge of the patient being therapeutic on LMWH

I am surprised that the above scenario does not happen more often due to silo behavior on the anesth and surgical sides. The surgeons frequently don't consider how their actions can impact the epidural and the pain team fails to be vigilant about their patient selection and the epidural orders. Pharmacy can play a big role in being a safety net to avoid the above. In our hospital, a big red flag halts LMWH doses in epidural patients.
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We try to do preop thoracic epidurals for postop pain for open choles. But those are usually older patients who have had multiple previous abdominal operations and lots of adhesions. Or, they might have chronic cholecystitis or a complicating hernia to fix. Or they're super septic and can't tolerate laparoscopic insufflation. All very unlikely conditions for a 16 year old.

I can't imagine an epidural being justifiable for a lap chole, no matter the age. Maybe they put the thoracic epidural in under general anesthesia? Or maybe those crazy Brits were crazy enough to do the entire case under epidural anesthesia, with a heavy PPF gtt for referred shoulder pain and 16yo anxiety?
 
Poor follow-up care.

http://www.metro.co.uk/news/873980-...alysed-by-birmingham-childrens-hospital-error

"The day after the operation she complained that her right leg was numb, but the epidural infusion was not removed, and by day two, the numbness had spread to both legs and Sophie could hardly move her feet.

"An MRI scan revealed that the anaesthetic had got into the spinal cord, damaging membranes and causing the paralysis."

It's unclear if the epidural was placed under general, which could've happened as this was done in a pediatric hospital. Nor is it clear if this was for an open chole, which is a lot more painful than one done laparoscopically.
 
Oggg said:
I can't imagine an epidural being justifiable for a lap chole, no matter the age.
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Maybe she looked like this?
jabba.jpg
 
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