This post from an atrial fibrillation support group:
“I had an ablation at Johns Hopkins this past week and am very upset at the outcome. I haven’t had any [afib] symptoms but experienced severe shortness of breath. After xrays and tests it was discovered that the phrenic nerve was damaged and I now have parylasis of the right diaphragm. I have a continuous dry cough and such SOB I can’t lay down to sleep. I can’t even sniffle.
“I’m told if it doesn’t resolve in 24-48 hrs [which it didn't] that it may take 3 months to a year to recover and that is not guaranteed.. I’m very dissappointed and confused. I’m also on amiodarone and worry about lung involvement with a weakened respiratory system. I was released after 4 days and an appointment for 3 months from now. I don’t know where to start to figure out what I need to do now to make this better.”
That’s what happens when you get clipped at a teaching hospital—the bum’s rush. This was supposed to be a safe and minimally invasive outpatient sort of procedure, and here you are at home after an unexpected 4 day stay at the hospital; wounded, scared and confused, with more questions than answers and hardly able to breath.
The person who caused this situation is Dr. Hugh Grosvenor Calkins, who is, according to the victim of this story, the best doctor at the best facility in the land. That is what they would have you believe, and that is what most of us do believe. People want to believe it, and once you’ve put your life into the doc’s hands, you have got to believe it.
As for the complication, Dr. Calkins has reassured you that he himself did the procedure and that it was a very rare thing that happened in your case, so rare that he didn’t think it worth mentioning. And actually, when you think about it, it’s sort of your fault because your anatomy is different than everyone else’s. Your atrium is smaller than a normal person’s, or the walls of your heart are thinner.
“I was informed of many side effects but not that one. When I asked why I wasn’t informed I was told it is rare.
“Also talking to the radiologist and Drs. and looking at the ct scans and TEE results I have an abnormal heart anatomy. Things are not where they are supposed to be.
It makes you feel bad somehow, that America’s Best Hospital has deemed that you have odd body organs.
Maybe Hugh Calkins is behind in his journal reading, otherwise he would have seen that phrenic nerve injury is “a well-described complication of AF,” and he would have read about “currently available tools to avoid the complication.” Or maybe a doctor who was training for his fellowship in electrophysiology did the job. After all, that’s what they do at a teaching hospital, and the head of the EP lab at Johns Hopkins is on record as saying that for ablation procedures at Hopkins, “the attending shows up to be there during the burn.”
What did you expect?
Don’t ever get a cardiac ablation!!!!! They tell you the lab director will do it then they have their fellow and he pokes a hole in your ventricle and causes a cardiac tamponade. He caught me with the echocardio camera that was on one of the catheters. After all he had three catheters in my one leg. The thing about this is it is considered the normal risk for this type of procedure, therefore it falls back on you taking the risk. Wish to heavens never did it and would never have done it!!!!! Forget cardiac ablations if anything goes wrong it all falls back on you!!!! Thank you for the venting now that I have ruined my life!!!!!
I have a bad case of pericarditis from the cardiac tamponade they created when they punctured my ventricle and A Fib that I have never had. I have been told it will take months on bed rest with heavy drugs anti- arrthymics and other cardiac drugs to keep my heart at rest to heal. Hopefully at the end of all this my heart will heal and the AFib will go away without damage. My days are spent lying around keeping my heart calm until it heals.
sandra
please get well
never helps to plan your suit from the hospital room. there will be plenty of time for that
What about malpractice is reached because fellow using echocardiogram camera on catheter is not schooled in inserting catheter at the right angle and in doing so in his learning experience nick my ventricle. Not malpractice?
Sounds like malpractice to me. I the director of the lab told you he was going to do the job and then he handed it off to a trainee without your informed consent…
I am damaged and lawyers telling me I should have stopped the procedure.
I didn’t know. Boy would I have!!!
I was told by the lab director he would do my ablation for me to my face. There was no question of a fellow doing it!
I think why I am so upset and disappointed is that I really believed the doctor who was the lab director was truly going to do my ablation. I was assured by the head that he would let the lab director do his family instead I got his fellow and only the second time in five year poke in the heart! Very disappointed in docs.
Current guidelines dictate that informed consent consists of informing the patient of COMMON and SEVERE complications. Of which phrenic nerve injury is neither (in relative terms). Current incidence is 0.11 – .048% with 81% obtaining complete recovery.
I encourage Dan Walters to look at the data and see that teaching hospitals have lower complication rates than private hospitals.
Earl, malpractice is not defined as a bad outcome. Malpractice only occurs when the standard of care is breached. Example: Patient goes in for colon surgery and the aorta is accidentally nicked. Patients dies. Not malpractice. On the other hand, patient goes in for colon surgery and surgeon uses wrong stapler resulting in sepsis. Malpractice.
What data are you talking about Mark? The self-reported numbers in which patient injuries are routinely under reported?
You are probably completely correct that adverse outcomes are under reported, however, what makes you believe that teaching hospitals under report more than private hospitals? Under reporting is likely the same, and may be increased at private hospitals due to less supervision, less care providers, who can each report a negative outcome, and less reporting by private attending physicians tending to private patients.
By the way, here is one study comparing the two: http://journals.lww.com/academicmedicine/Abstract/2005/05000/Quality_of_Care_in_Teaching_Hospitals__A.12.aspx
“…adverse outcomes are under reported, however, what makes you believe that teaching hospitals under report more than private hospitals?”
The question proves my point. You are asking us to believe that your dishonest data is not as bad as everyone else’s?
To reply to your comment that “Current guidelines dictate that informed consent consists of informing the patient of COMMON and SEVERE complications. Of which phrenic nerve injury is neither (in relative terms).”
Tell that to the terrified patient person who was sent home with difficulty in breathing, no information, and a follow-up in three weeks. What explanation do you offer for that?
And then there is this:
“Maybe Hugh Calkins is behind in his journal reading, otherwise he would have seen that phrenic nerve injury is “a well-described complication of AF,” and he would have read about “currently available tools to avoid the complication.”
The “current guidelines” on informed consent may be handy technical legalese which allow doctors to cover their mistakes, but I believe that a physician has a moral duty not only to inform the patient of a “well described complication,” but to also employ available tools to help avoid it.
In the case above, neither was done, and if you read my book you will see plenty of proof that at this particular teaching hospital, at least, patient safety and informed consent take a back seat to corporate interests and the personal career ambitions of high-profile doctors.
The point here is that the injured patient was not told of a recognized risk of the procedure, and that this is how they routinely conduct business at teaching hospitals.
If you have complaints about the procedure why not sue Dr. Hugh in court and let justice prevail? why are you writing articles and stating names? How sure are we that what you wrote here are true?
Well, Earl, here’s how you can tell that what I write is true: http://collateral-damage.net/source-notes/