Cardiologist Arrested For Murder After Cathing Patient to Death.

Tallahassee, FL -- The Tallahassee medical community was stunned Friday after state prosecutors charged local Cardiologist Stan Wellington with first degree murder for the cathing death of James Binkmann.   Prosecutors claim the 79 year-old patient was killed by a four hour cathing rampage that ended with cardiac arrest just as a left pinky artery stent was being deployed.

Cardiologist arrested for murder after cathing patient to death.
Prosecutors released a transcript of the frantic 911 call they received from a float nurse in the cath lab the morning of the patient's death.  "This is damning evidence," said State Prosecutor Denny Fleming.
911:  911.  What is your emergency?
Nurse:  I'm at the hospital watching a doctor cath a patient to death. He's been here four hours and says he won't stop until he finds something to stent.  I don't know what to do!
911:  We're sending officers now.  Tell the doctor food just arrived in the doctor's lounge and get out of there now, before he tries to cath you next.
Dr. Wellington's defense attorney claims he was just doing what his patient requested.  "Mr Binkmann told my client not to quit until he was sure nothing was wrong - that he didn't want to come back next week and do this all over again."

"While Mr Binkmann's death is unfortunate, Dr. Wellington was directed by the deceased not to repeat the failures of the Hospitalist doctors who had released him 'too early' his last seven admissions this year.  He said he wanted everything done, so my client did everything."

After finding crystal clear coronary arteries, prosecutors claim the doctor went too far by cathing his eyes, tongue, neck, lungs, kidneys, spleen, gallbladder,  colon, and even his scrotum before finally finding a clearly stentable lesion in the victim's left pinky.

"He was out of control.  Like a vampire in search of blood.   For God's sake, he cathed the poor man's testicles in search of stentable lesion", said a nurse who witnessed the scene unfold.

Dr Wellington has another theory on why his patient died on the cath table.  "Those damn nephrologists  canceled my Lasofloxalbuterol order and gave him fluid instead."




Joint Commission Mandates Armband to Identify Patients With Too Many Armbands.

Oakbrook Terrace, IL --  Hospitals are up in arms again after The Joint Commission (TJC) on Monday started requiring all patients with too many armbands  to be flagged with an armband for having too many armbands. Mark Chassin, President and Chief Executive Officer of TJC, applauded his organization for taking  action against his organization's failed policies.

Too many armbands?  There's an armband for that!
"I'm proud The Joint Commission is finally  taking a stand against The Joint Commission for continuing to ignore all the unintended consequences of their regulations," said Dr. Chassin.

Doctors and nurses have been telling authorities for years that too many patient armbands are a safety hazard, but those complaints had fallen on deaf ears until last week when 87 year old ICU patient Pat Swanson of Denver, Colorado  underwent emergent bilateral upper extremity amputations at Great Scotts Medical Center shortly after 52 armbands cut off circulation during an anasarca storm.

"After a root cause analysis, we  determined the PROBABLY A PALLIATIVE CARE CANDIDATE  armband placed an hour before the event finally took her arms over the edge," said Dr. Steven Johnson, the Hospitalist on duty when this tragic but totally foreseeable event occurred.

"When she was admitted 24 days ago, she only had three arm bands, but if you do the math, she gained just over 2 armbands per day in the ICU that nobody noticed. In retrospect, the patient telling us 'My arms are too heavy with armbands to lift a spoon and eat' should have clued us into an emerging problem, but we were too busy filling out FMLA papers for multiple family members everyday to head her cry for help," said Dr. Johnson.

In the last four years, The Joint Commission says the average number of patient armbands has skyrocketed from 3 to over 17, as more and more patient characteristics demand armband worthy status, adversely affecting everyone in the hospital.  Nursing students are constantly pulling the code blue cord in an abundance of caution after being unable to palpate a radial pulse.  Medical students have no idea what  pronator drift is anymore.  Phlebotomists are being  retrained to perform bedside  carotid cut-downs for routine blood draws.  Even administrators are overwhelmed with committees trying to solve the excessive armband problem.

"At one point we had 17 committees - all working independently and without communication - each trying to come up with a solution that nobody else liked, resulting in 17 other committees to sort it all out," said Dr Johnson.

What came out of these painful meetings was nothing short of genius at Great Scotts Medical Center. "We hired a hospital seamstress to convert  all those armbands into one giant sash for the women and a handsome fashion belt for the men.  Patients love it and it's a great conversation piece for family.  Plus, as an added bonus, we have the highest satisfaction scores in the universe! Thank you Joint Commission for being so helpful," said Dr Johnson.


Complete list of 52 armbands removed from Pat Swanson.

  1. Swanson With an O
  2. Already Outlived Life Expectancy
  3. Don't Code Her, She Won't Know The Difference
  4. Allow Natural Life Support
  5. Risk of Talking Alot
  6. Risk of Family Filling Out Poor Patient Satisfaction Survey
  7. Looks Older Than Her Stated Age
  8. Ambiguous Name Alert
  9. Suspected  Female
  10. Hard of Understanding
  11. Hits On Young Male Doctors
  12. Likes To Talks About Her Bowels
  13. POA Is A Physician
  14. Doesn't Believe In Flu Shots
  15. Family Googles Everything
  16. Thinks Most Doctors and Nurses Are Too Young
  17. Risk of Asking Lots of Questions
  18. Reads Every Consent Word-For-Word
  19. Family Wants Lawyer To Review All Documents
  20. Wants a Comfortable Death With Everything Done
  21. No Known Drug Allergies
  22. Allergic to All Antibiotics - Anaphylaxis
  23. Allergic To  Wasps, But Not Bumble Bees
  24. Has Two Daughters Who Never Leave The Room
  25. Thinks She's The Only Patient In the Hospital
  26. OK To Go Outside and Smoke
  27. Has Lots of Great Stories If You Have a Free Moment
  28. Wants Everything Taken Care Of While She's Here
  29. Found Cheating at Crossword Puzzles
  30. Should Be In a Nursing Home
  31. Can't Remember If She Has Dementia Or Not
  32. When She Yells 'Bill', Just Say 'Yes,'
  33. Doesn't Like To Be Called Honey
  34. It's Fakeasia, Not a Stroke
  35. Frail like a Babby Bunny
  36. That's Not a Wig You See
  37. Was Perfectly Healthy Until A Week Before Getting Sick
  38. Has Appointment at Mayo Clinic After Discharge To Figure This Out
  39. Disappoints Easily
  40. Not Really a Fighter
  41. Loves a Good Foley
  42. QHS = 4 PM
  43. Rides Call Light Like a Rodeo Champ
  44. 12/10 On The Pain In My Ass Scale
  45. Direct Eye Contact Should Be Avoided
  46. OK To Incubate 
  47. Gown and Glove Encouraged
  48. On Family Meal Plan
  49. Dilaudid 2 MG IV Push Preferred
  50. Dysphagia 7 Diet
  51. Probably a Palliative Care Candidate
  52. Too Many Armbands



Memorial Day Also Remembers Veterans Who Lost Their Life In a VA Hospital.

VA Hospitals -  Memorial Day is a time to remember our service men and women who died while serving in the armed forces, but it's also a time to pay respect to the thousands of veterans who die every day in our VA hospitals all across the country.

Memorial Day honors veterans who lost their lives in a VA hospital
Billy Smith and his family are using today to remember World War II Veteran Granpa Jim, shot 17 times in war, who passed away three years ago at their local VA hospital after undergoing routine bunyan surgery and never making it out alive.  "We dropped him off for a routine surgery and we never heard from him again," said Billy, who says the VA still has no record of him ever getting admitted in the first place.

The Smith Family is not alone.  Hundreds of thousands of families use Memorial Day to remember their fallen VA hospital heroes who went in to get routine medical care and ended up paying the price with their lives.

For many families, Memorial Day is a painful reminder of the lack of accountability in the VA system, were employees can't be fired even in the most egregious of circumstances.

"When I was a resident, I was trying to save the life of my ICU patient crashing on the ventilator, and the x-ray technologist said he wasn't going to come in on a Friday night to do a stat chest x-ray because he lived 30 minutes a way and it was snowing outside," said Dr. Stanley Franklin, an internist who knows how hard it is to get anyone fired from the VA for gross incompetence.  "That place breeds death."

"Then there's the time my MI patient waited six days for a cardiac echo because the echo tech was on vacation for a week.  Oh and then there's that one time my patient bled to death after a nurse stuck him 87 times trying to get an IV started. The list goes on and on."

For many veterans the real war is not on foreign grounds with bombs and bullets, it's fighting for their lives every time they enter a VA hospital.  Please remember to honor your fallen VA patients who gave their lives so some VA employee could instead enjoy a fine potluck lunch.






Staying Against Medical Advice: Top 15 Reasons!

Much has been said about patients who leave against medical advice, but little has been described  about patients who stay against medical advice.  When a hospital setting is no longer appropriate for a patient, a physician will recommend discharge to the next appropriate level of care.  For most well adjusted patients, the hospital is the last place in the world they want to be, but for a select subset of customers,  the hospital is the only place they would like to be.

Staying Against Medical Advice is your right!
The average adult probably finds it hard to believe some patients actually want to stay in the hospital longer than necessary, but it's true.

Staying longer than necessary does come with risk, including hospital acquired infections, medication errors and other unspecified iatrogenic badness.  But, try explaining that to the clientele refusing to leave and many doctors risk getting a 4 instead of a 5 on their patient satisfaction experience scorecard.

Remember, an unsatisfied patient is a hazard to a hospital's health.  With Medicare paying hospitals these days partly based on the patient experience, hospitals and their healthcare providers must walk an often impossible line between doing what's good for the patient and what's good for the patient experience.

In fact, Medicare believes so strongly in a patient's right to refuse discharge and stay against medical advice, they have a form that allows the patient to stay against medical advice and have their discharge decision appealed by some unknown entity with an unknown degree deep within the Medicare Fort.

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So why do some patients want to stay against medical advice and risk all the complications of continued hospital care?  Here is a Top 15 List of real quotes from patients who were allowed to stay against medical advice by hospitals fearful of not getting 5/5 on their patient satisfaction scores.

  1. "You have the best Dilaudid of any hospital I've ever been to."
  2. "My daughter ain't going anywhere  until you have her pseudoseizures under control."
  3. "My ride is out of town until Tuesday of next week."
  4. "Someone stole my Oxycotton script and I'm not leaving until you write me another one."
  5. "My husband got admitted to the hospital yesterday and I want to stay here until he goes home too.  Can he stay in my room too?"
  6. "I'm lonely at home and my kids never call."
  7. "The chicken cordon bleu here is amazing."
  8. "I have a call button.  Why would I want to go home?"
  9. "I've been having abdominal pain for 20 years and I'm not leaving until you figure it out."
  10. "My team is playing tonight and I don't have cable at home."
  11. "I'm not going to rehab until I'm strong enough for rehab."
  12. "I'm a squatter.  Get over it."
  13. "My kids don't get back from vacation until next week."
  14. "My water got shut off and I have no way to take a bath."
  15. "You all make me feel so good."
Prepare yourself. Patient is staying against medical advice!

 Prepare Yourself.  Patient is Staying Against Medical Advice!


UPDATE:  Patient #9 is still in the hospital after 423 days.



Universal Ortho H&P Rescues Surgeons From Pain and Suffering.

Rosemont, IL -  David Teuscher, President of the American Academy of Orthopaedic Surgeons (AAOS), confirmed yesterday a universal H&P that just needs to be signed by the surgeon is the best selling product offered by the society.

"The H&P is by far the best selling product our society has ever had!" said Dr. Teuscher.  "As an ortho doc myself, I have personally struggled through H&Ps my entire professional life.  I wish I had these twenty years ago."

Ortho is thrilled with their new universal H&P template!
With Hospitalists increasingly refusing to do 'Need pre-op H&P' consults, ortho doctors have increasingly found themselves in the uncomfortable position of having to complete an  H&P, especially ones on patients with no actual medical problems.

Dr.  Stitch Ansaw,  a prominent orthopaedic surgeon who admits he doesn't know what H&P actually stands for,  says the AAOA template has already saved at least one of his patients from needless suffering.

"I hadn't done an H&P for at least 10 years.  Last week a Hospitalist said they couldn't get to my stat 5 a.m. pre-op H&P consult for least 30 minutes because of  three code blues they were running simultaneously at three different hospitals.  That's just ridiculous.  Here my 48 year old patient with no medical problems and stable ring-finger OA is suffering needlessly and they're too busy to help me do paperwork for surgery.  Because of the AAOA template, I  was able to get this H&P thing done without delay and my lady is now on the road to recovery."

Contrarily, Hospitalists were thrilled to learn of the society's plan to help surgeons complete required pre-operative work.   Dr. Burke Kealey, President of the Society of Hospital Medicine, commended AAOS officials for their proactive approach to helping their members not look so helpless in the eyes of everyone around them.

"I'm actually quite surprised orthopaedic surgeons need help completing an H&P.  Most of them completed four years of medical school and at least five years of residency training, which is two years more than even the brightest internist.   You'd think they would have picked up a few H&P pointers from the medicine guys in those nine years," said Dr. Kealey.

Dr. Kealey admits he has little compassion for his poor ortho colleagues.  "I watched an ortho colleague the other day struggle for two hours trying to complete the universal H&P form while mumbling 'H&Ps are for little people' the whole time.  All he had to do was sign the form and be done."

For a scant $1,799 annual fee, ortho doctors  have been promised unlimited access to this copy write protected level 3 ortho H&P.  "Our members will never have to worry about doing an H&P ever again," said Dr. Teuscher from his 4 million dollar condo in Maui, paid for by AAOS H&P proceeds.

"I think we can probably charge 10X that amount and still not lose any sales."


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