Sunday, September 09, 2007

Cardiologist Gone Wild

Imagine a cardiologist striking a patient during a catheterization procedure.


Well, apparently not.

And given the 54 comments so far, many have plenty to say about it.

Now I have no clue what transpired during the procedure described. Certainly witnesses were disturbed enough to report the doctor. After all, striking a patient is never appropriate. But it would not be a far stretch to see how the means of forceful restraint might be perceived as abuse, since the patient is usually in no condition to cooperate at such times. Occasionally, patients respond paradoxically to the sedative medications we administer during procedures and become combative and some even try to leave the table in the middle of their procedure. I have experienced patients becoming markedly agitated during pacemaker implants and have had to quickly call on my technicians and nurses to hold a patient so they would not contaminate the sterile surgical field. Often, we have had to physically restrain patients while calling for our anesthesia colleagues to safely sedate (and if necessary, paralyze them) with more powerful drugs to assure patient safety.

Now add to that scenario full anticoagulation and a wire structure in their coronary artery and one can see how tense such moments can become.

And where to most patients have the most strength?

Their legs.

And where do interventional cardiologists usually work?

From the patient's leg(s).

So when the two individuals do not cooperate during a procedure, it can be very intense, indeed.

I guess I'd let this one play out in the courts, since this is assuredly where this situation will end up. It's just a shame for all involved.


h/t: Kevin, MD.


Ed said...

Waking Up Costs briefly touched this, GruntDoc thought perhaps unwisely.

DrWes said...


Thanks for the links. I think that the original report did little to explain what really happens in cath lab settings when a patient gets aggitated and hence the purpose of my post. I would never want to step into my impressions about behavior upon which I have no basis to form an opinion. I have to agree w/Allen (GruntDoc) on this one - some things in those circumstances are best left unsaid.