I ask this question mainly because there WAS an ENT who WAS sued (and settled) for
NOT abandoning his patient in the operating room. [
link]
Imagine this hypothetical scenario...
You are an ENT surgeon in a rural community hospital performing a fairly difficult but elective
sinus surgery on a 12 years old child with cystic fibrosis with extensive pan-sinus
nasal polypoid disease. Given the extensive nasal polypoid disease, a fair amount of bleeding is occurring which was not unanticipated.
Suddenly, you get a phone call from the emergency room regarding a patient with progressive difficulty breathing suspected to have epiglottitis.
What do you do if you are the only ENT in the hospital?
Do you "abandon" the 12 years old child in the operating room, still bleeding, still under general anesthesia and attend to the ER patient who himself might die without an emergency
tracheostomy? Doing an evaluation to determine how critical the ER patient may take anywhere from 15 - 60 minutes including the
tracheostomy itself.
What if you are the only ENT available in the region let alone the hospital? No fellow ENT colleagues to call upon for help. General surgery is "unavailable" or not comfortable with performing tracheostomies especially given ENT performs all tracheostomies in the hospital?
Patient abandonment is defined as:
- Failing to transfer a patient to an appropriate level of care
- Failing to respond to calls from a hospital regarding a patient
- Refusing to care for a patient after arranging the patient's admission
- Failing to treat a patient until new coverage is arranged
Proving patient abandonment includes:
- Your doctor had a duty to treat you - a duty was created when the physician-patient relationship was established
- You had a reasonable expectation that your doctor would treat you
- Your doctor failed to treat you although he or she was obligated to do so
- You suffered injury as a result
Well, according to
one lawsuit, it seems that the ENT was required to abandon his patient in the operating room and attend to the ER patient. The lawsuit stemmed from the fact that the ENT did not abandon his patient in the operating room and the ER patient did die as a result of not being attended to quickly and a tracheostomy performed. Of course, the settled lawsuit also blamed the hospital, general surgery, and anesthesiology.
However, abandoning a patient on the operating room table is also tantamount to medical malpractice according to the very definition of patient abandonment.
And, I would not be surprised if the patient on the operating room table would have sued the ENT if he DID leave the operating room in the middle of surgery to attend to another patient.
What to do?
I have no answer...
Doing an emergency tracheostomy is HARD, even for someone who has performed hundreds of elective tracheostomies. I know... I've done perhaps a half-dozen emergency trachs in my career so far. In this
particular lawsuit, I found it incredible that a hospitalist (not a surgeon) was the one who finally attempted the emergency tracheostomy (albeit unsuccessfully).
Do you consider the patient you are CURRENTLY caring for has a higher priority than a patient you have never met, even if possible life-threatening illness is involved? (Keep in mind that when called for an airway problem, that 99% of the time, an emergency tracheostomy is not needed.)
OR, do you prioritize the patient you have never met given the possible life-and-death circumstances involved, even if 99% of the time, no surgical airway is required.
What would YOU do? What should you do? Feel free to comment below!
Source:
He not only won one Olympic Gold Medal, but two in men's platform diving in 1948 and 1952.
