Patient awoke to doctors preparing to remove her organs

[Yreka]

At least she still had the guts to speak up about it..

 

[SirStev0]

The hospital and doctors make millions on the organs they harvest. They don't actually "sell" them, but the procedures they perform to use them make them wealthy.

Transplant surgeons live terrible lives. They don't make more than the average general surgeon. They are on call constantly. Have to be ready to be flown at a second's notice.

It isn't some glamorous life where they sit in mansions counting the pennies they took out of granny's guts when they were harvesting her organs.

It actually blows. And the recipient are usually very sickly people who need constant post op care...

Oh and let's not forget they have to watch people slowly die and deteriorate before their eyes waiting for the small chance they are lucky enough that another HUMAN BEING loses their life so they can live theirs...
Most people die waiting on a transplant list...

So shut the fuck up.



To answer Nate's question by someone who isn't just talking out of their ass about something they have no fucking idea about:
They usually do wait. It takes 12-48 hours usually to run all the HLA and genetic tests as well as other lab to determine if the organs are healthy enough to be transplanted and to find matches.

They don't run in trying to harvest organs without matches for everything they can. Every non-matched organ is a wasted organ. So even if that "financial gain" thing everyone in this thread was talking about was a major thing... they wouldn't run in trying to hawk out organs.

The only time they will go in like that is when there is high likelyhood that the body will physically die and render everything unusable. They will often then take them back then with out matches to take pieces that don't need matches like eye lenses, etc.


Which is why this story is probably bullshit. Typical Medical witchhunting for sensational headlines.

I have declared people brain dead. It isn't a ten minute checklist. It is a complex series of criteria. Just for instance to be brain dead in WV you have to be normal body temperature and have no alcohol or other sedating or illegal drugs detectable in your system.

Try getting someone to normal body temperature when they herniate their central temperature regulators with the rest their brain... It isn't easy.

 

[Mark R]

Why the rush to harvest her organs 10 minutes after they declare her brain dead? They can't give her a few days on life support to confirm their diagnosis?

That's normally what happens. Laws vary, but a common legal requirement is 2 separate tests for brain death, performed by at least 2 independent doctors, at 2 different times at least 12, preferably 24, hours apart.

 

[monovillage]

Tell it to the 90,000+ dead patients from medical misadventures every year.

 

[JEDIYoda]

One question..if the story is BS why is it being reported as fact??

 

[OverVolt]

The hospital and doctors make millions on the organs they harvest. They don't actually "sell" them, but the procedures they perform to use them make them wealthy.

bingo

 

[monovillage]

Transplant surgeons live terrible lives. They don't make more than the average general surgeon. They are on call constantly. Have to be ready to be flown at a second's notice.

It isn't some glamorous life where they sit in mansions counting the pennies they took out of granny's guts when they were harvesting her organs.

It actually blows. And the recipient are usually very sickly people who need constant post op care...

Oh and let's not forget they have to watch people slowly die and deteriorate before their eyes waiting for the small chance they are lucky enough that another HUMAN BEING loses their life so they can live theirs...
Most people die waiting on a transplant list...

So shut the fuck up.

The poor babies don't even make as much as some general surgeons! *gasp* those poor millionaires, i'm crying for them. Then after the organs are harvested the recipients are still sickly (ka-ching!) and need constant care (ka-ching!)

Frankly the medical industrial complex puts the military industrial complex to shame, it has the same level of greed, but with less compassion.

 

[Exterous]

Tell it to the 90,000+ dead patients from medical misadventures every year.

Why do people love to throw out big numbers without context? Is it because you want attention or do you not understand percentages?

Number of emergency department visits: 129.8 million
Inpatient care discharges: 35.1 million
Outpatient care visits 100.7 million

http://www.cdc.gov/nchs/fastats/hospital.htm

This is just for non-federal, short stay hospitals. Just using these numbers your chances of being killed by a 'medical misadventure' is absolutely tiny. If ALL of those misadventures happened in these institutions (which definatley is not the case) your chances of a death by medical misadventure is less than 0.0001%

 

[Strk]

The poor babies don't even make as much as some general surgeons! *gasp* those poor millionaires, i'm crying for them. Then after the organs are harvested the recipients are still sickly (ka-ching!) and need constant care (ka-ching!)

Frankly the medical industrial complex puts the military industrial complex to shame, it has the same level of greed, but with less compassion.

I'm thinking you need to do a bit more research. Big pharma will make quite a bit, but besides them, not so much for the doctors and hospitals.

 

[brycejones]

Frankly the medical industrial complex puts the military industrial complex to shame, it has the same level of greed, but with less compassion.

Please feel free to never visit a medical facility. No one is forcing you to.

 

[Hayabusa Rider]

Transplant surgeons live terrible lives. They don't make more than the average general surgeon. They are on call constantly. Have to be ready to be flown at a second's notice.

It isn't some glamorous life where they sit in mansions counting the pennies they took out of granny's guts when they were harvesting her organs.

It actually blows. And the recipient are usually very sickly people who need constant post op care...

Oh and let's not forget they have to watch people slowly die and deteriorate before their eyes waiting for the small chance they are lucky enough that another HUMAN BEING loses their life so they can live theirs...
Most people die waiting on a transplant list...

So shut the fuck up.



To answer Nate's question by someone who isn't just talking out of their ass about something they have no fucking idea about:
They usually do wait. It takes 12-48 hours usually to run all the HLA and genetic tests as well as other lab to determine if the organs are healthy enough to be transplanted and to find matches.

They don't run in trying to harvest organs without matches for everything they can. Every non-matched organ is a wasted organ. So even if that "financial gain" thing everyone in this thread was talking about was a major thing... they wouldn't run in trying to hawk out organs.

The only time they will go in like that is when there is high likelyhood that the body will physically die and render everything unusable. They will often then take them back then with out matches to take pieces that don't need matches like eye lenses, etc.


Which is why this story is probably bullshit. Typical Medical witchhunting for sensational headlines.

I have declared people brain dead. It isn't a ten minute checklist. It is a complex series of criteria. Just for instance to be brain dead in WV you have to be normal body temperature and have no alcohol or other sedating or illegal drugs detectable in your system.

Try getting someone to normal body temperature when they herniate their central temperature regulators with the rest their brain... It isn't easy.

Remember the old saying "no one knows your job better than someone who has never done it."

 

[bononos]

......
Which is why this story is probably bullshit. Typical Medical witchhunting for sensational headlines.
......

The state fined the hospital for the mishap.

You can try to sweep the scandal under the rug and deny it ever happened. The sad fact is that people like you see patients as profitable biological containers to be harvested. The hospital and transplant team messed up and very nearly killed someone despite signs that the patient was alive.

 

[bononos]

That's normally what happens. Laws vary, but a common legal requirement is 2 separate tests for brain death, performed by at least 2 independent doctors, at 2 different times at least 12, preferably 24, hours apart.

It might be different now. Brain death is now too much of a hassle because of the demand for more organs. The rules could've been changed to non-heart beating death.
http://en.wikipedia.org/wiki/Non-heart-beating_donation
http://www.dailymail.co.uk/news/art...rgeons-wont-wait-make-sure-heart-stopped.html

Its odd that the patient in the OP was going to be given a powerful sedative despite being 'dead'.

 

[CottonRabbit]

It might be different now. Brain death is now too much of a hassle because of the demand for more organs. The rules could've been changed to non-heart beating death.
http://en.wikipedia.org/wiki/Non-heart-beating_donation
http://www.dailymail.co.uk/news/art...rgeons-wont-wait-make-sure-heart-stopped.html

Its odd that the patient in the OP was going to be given a powerful sedative despite being 'dead'.

Donation after cardiac death (DCD) is much more of a hassle than normal donation. It's come back because there are too many people on the transplant list.

From looking at the source report, it appears that the patient in this case was being prepared for DCD, which involves taking a patient with irreversible brain injury but not brain death off the ventilator and waiting up to an hour for the patient's heart to stop beating on its own. If they patient does not die on his own during this time off the vent, they'll put the patient back on the vent and not attempt DCD again. Sedatives are given because the patient is not dead during this, thus whatever hypothetical suffering the comatose patient may feel needs to be addressed. Sedatives are not given to make sure the patient doesn't wake up so they can gleefully cut her up. Because the patient should be irrecoverably brain injured, the patient should not wake up regardless and would have to remain on life support until death.

The major error here looks like incorrect diagnosis of irreversible brain injury, leading to the attempt at DCD. However, since this patient was not dead and did not have irreversible brain injury, her heart would have kept beating when they took her off life support. Thus, even if she did not happen to wake up immediately, they would have seen that she was still alive during the DCD attempt and wheeled her back to the floor.

In other words, this patient was never at risk of being cut open while alive to harvest her organs, which is probably why the hospital was only fined $6000 for this. To put this into context, the same hospital was fined $16,000 because they let a different patient fall and hit her head. The OP is sensational journalism at its worst. Articles like this can literally lead to the death of sick people on the transplant list.

 

[bononos]

Donation after cardiac death (DCD) is much more of a hassle than normal donation. It's come back because there are too many people on the transplant list.

From looking at the source report, it appears that the patient in this case was being prepared for DCD, which involves taking a patient with irreversible brain injury but not brain death off the ventilator and waiting up to an hour for the patient's heart to stop beating on its own. If they patient does not die on his own during this time off the vent, they'll put the patient back on the vent and not attempt DCD again. Sedatives are given because the patient is not dead during this, thus whatever hypothetical suffering the comatose patient may feel needs to be addressed. Sedatives are not given to make sure the patient doesn't wake up so they can gleefully cut her up. Because the patient should be irrecoverably brain injured, the patient should not wake up regardless and would have to remain on life support until death.

The major error here looks like incorrect diagnosis of irreversible brain injury, leading to the attempt at DCD. However, since this patient was not dead and did not have irreversible brain injury, her heart would have kept beating when they took her off life support. Thus, even if she did not happen to wake up immediately, they would have seen that she was still alive during the DCD attempt and wheeled her back to the floor.

In other words, this patient was never at risk of being cut open while alive to harvest her organs, which is probably why the hospital was only fined $6000 for this. To put this into context, the same hospital was fined $16,000 because they let a different patient fall and hit her head. The OP is sensational journalism at its worst. Articles like this can literally lead to the death of sick people on the transplant list.

Is brain death or non-heart beating death a higher standard of 'death'? Or is the only sure way of certifying death is waiting until they are stone cold dead? Isn't the main concern here that a potential donor might still be alive rather than the problem of 'too many people on the transplant list'? This reminded me of the Dunlap case which was another slipup.

Link to the source report?

There are other problems with the organ harvesting procedure like the apnea test which could be harmful to the patient, especially so when they are already in bad shape and the unreliability of the test. Do they get consent from the next of kin before cannulation and administration of heparin?

 

[CottonRabbit]

Is brain death or non-heart beating death a higher standard of 'death'? Or is the only sure way of certifying death is waiting until they are stone cold dead? Isn't the main concern here that a potential donor might still be alive rather than the problem of 'too many people on the transplant list'? This reminded me of the Dunlap case which was another slipup.

Brain death is legal death. There's nothing more to say about it. DCD is attempted usually only attempted when 1) The patient is not dead but will never make any recovery from their catastrophic injury 2) The patient's family is very interested in organ donation. Nobody likes DCD. The organs are lower quality, the logistics are much more challenging and often it's a waste of everyone's time because the DCD attempt doesn't work. The only reason its being done is because there are not enough brain dead donors.

Link to the source report?

http://www.scribd.com/doc/148583905...care-and-Medicaid-Services-report-on-St-Joe-s

There are other problems with the organ harvesting procedure like the apnea test which could be harmful to the patient, especially so when they are already in bad shape and the unreliability of the test. Do they get consent from the next of kin before cannulation and administration of heparin?

What are you even talking about? The apnea test isn't part of the "organ harvesting procedure". It's a test for brain death. If we stopped all organ donations, apnea tests would still be done. Also, managing organ donation is the responsibility of donation coordinators, not doctors. The doctors who do the apnea test take no part in the organ donation process. By protocol, they aren't even supposed to broach the subject with the patient's family. Your last sentence is completely irrelevant to anything.

 

[StrangerGuy]

Tell it to the 90,000+ dead patients from medical misadventures every year.

This is the dumbest post I ever seen for a long time.

Yeah, why not just stop living now because everything you and other people do has a chance of killing you no matter small.

 

[WelshBloke]

How does organ donation work in the US?
There's a debate here in the UK about how to up the numbers. One of the solutions is to make donation an opt out thing rather than an opt in thing. Obviously this relies on a national data base to track permissions but we have that with the NHS anyway.

Personally I like the idea of the opt out option with the addition that if you opt out you don't get to go on a list to get an organ if you need one. If you have great moral issues with donation you get the option to not donate and if you're against donation then the same moral issues would probably be there for accepting an organ.

 

[bononos]

.....
http://www.scribd.com/doc/148583905...care-and-Medicaid-Services-report-on-St-Joe-s

What are you even talking about? The apnea test isn't part of the "organ harvesting procedure". It's a test for brain death. If we stopped all organ donations, apnea tests would still be done. Also, managing organ donation is the responsibility of donation coordinators, not doctors. The doctors who do the apnea test take no part in the organ donation process. By protocol, they aren't even supposed to broach the subject with the patient's family. Your last sentence is completely irrelevant to anything.

Ok. Thanks for the report.

Here what I gathered from the report:-
- the patient was declared (brain) dead after the hospital messed up the apnea test
- nurse #1 noted the patient moving (ie not dead) when stimulated and administered the sedative ativan
- 2 doctors (resident#2, neurologist#2) dismissed nurse #1 notes that patient was moving
- patient was wheeled into the OR but she opened her eyes there

So it was a narrow miss for the patient to wake up right in the OR.

The apnea test puts some strain on the patient it is not a benign test, there are some harmful side effects. And furthurmore the test is not reliable as there is no proper standardized apnea test and slipups could occur.

At what point do potential organ donors get their veins cannulated and receive heparin? Before or after receiving consent from the next of kin?

 

[CottonRabbit]

Ok. Thanks for the report.

Here what I gathered from the report:-
- the patient was declared (brain) dead after the hospital messed up the apnea test
- nurse #1 noted the patient moving (ie not dead) when stimulated and administered the sedative ativan
- 2 doctors (resident#2, neurologist#2) dismissed nurse #1 notes that patient was moving
- patient was wheeled into the OR but she opened her eyes there

So it was a narrow miss for the patient to wake up right in the OR.

The apnea test puts some strain on the patient it is not a benign test, there are some harmful side effects. And furthurmore the test is not reliable as there is no proper standardized apnea test and slipups could occur.

At what point do potential organ donors get their veins cannulated and receive heparin? Before or after receiving consent from the next of kin?

My previous posts already explain most of this.

The patient was never declared brain dead. This incident has nothing to do with donation after brain death. The patient was taken to the OR not to have her organs removed but to be extubated for a DCD attempt. See my previous posts on what a DCD attempt is. Even if she had not woken up at that moment, she would not have been operated upon because she did not have irreversible brain injury requiring life support.

The apnea test or any other test for brain death has nothing to do with organ donation. In a world without organ donation, you would still want to do tests to determine whether your patient is dead or not.

Organ donation coordinators, not doctors, start managing the cadaver after the patient is dead. None of the medical management a patient receives before death has anything to do with organ donation. Almost everyone in the hospital gets an IV. Heparin is one of the most commonly used drugs in the hospital. A physician doesn't need special consent to do either of these two things.

 

[bononos]

I get that you are saying that the patient wasn't brain dead so the plan was for her to be a non heart beating donor instead. And that her heart was going to keep beating anyway so she was going to be fine.

What I was trying to discuss about the apnea test is that there is some controversy over how reliable the test is and some hospitals may have a less stringent protocol.

http://www.onelegacy.org/site/docs/...ologists_OrganDonationSamplePolicy_061407.pdf
From what I gather from the above doc about the dcd organ harvesting procedure, procedures like cannulation and other drugs like heparin could be carried out and administered before the patient dies (after consent) but is expected to when they take them off the ventilator. Wouldn't those drugs be harmful to an already severely injured patient?