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Re: [infoguys-list] eyes have it: infection

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  • suesarkis@aol.com
    Amy - It appears you have a lot of smoke and mirrors here. I will try to make my response a lot briefer than your outline. I see a series of no-nos mostly
    Message 1 of 2 , Oct 4, 2006
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      Amy -

      It appears you have a lot of smoke and mirrors here. I will try to make my
      response a lot briefer than your outline. I see a series of no-nos mostly
      stemming from the surgeon.

      For starters, the sterilization of the instruments has no bearing at all on
      whether the water was tap or distilled. Distilled is used to protect the
      integrity of the lens since tap water contains abrasive salts. The fact that
      the ink was gone is probably irrelevant if the written notes indicate that the
      proper temp was set. However, that is definitely an issue to be raised with
      the Joint Commission on Accreditation of Healthcare Organizations who will
      not be very happy little campers.

      Was the doctor aware that she had taken Motrin pre-op? If not, why not? He
      should have asked.

      Why did she, an MD and her husband, an MD, allow her to take the Motrin
      pre-op?

      What antibiotics were used prophylactically either pre or during surgery?
      Hopefully 1 gm Ancef or something similar which is the norm in most facilities.

      What did they clean her hair with post-op? The norm would be peroxide and
      distilled water. Did they use tap water?

      Implants are much more subjective to infections because of the introduction
      of foreign matter. This is a unique situation. However, I believe the
      plaintiff does have a hard row to hoe since both she and her husband have MD after
      their names and a jury is not going to be as sympathetic as it would be
      toward a normal lay person..

      Since the surgery lasted more than twice as long as it should have, I would
      bet that there was cross-contamination on the surgical tray between the chin
      and eyelid instruments. Regardless, because of the excessive bleeding, it
      would be my guess that they did not get all of the blood out of all of the
      pockets as well.

      There are many, many species of mycobacteria. Most are environmental
      organisms and are ubiquitous in that they are everywhere. However, they are only
      responsible for opportunistic infections which is almost non-occurring in
      immunocompetent individuals. The Prednisone, I believe, is as guilty and
      responsible as the contamination itself.

      They thrive in wet environments (bloody instruments/used gauzes, etc) and
      they have an insatiable appetite for oxygen. The longer the bloody surgical
      instruments are exposed to the environment, the more apt they are to become
      contaminated. No folks, medical facilities are not aseptic contrary to what one
      would think and that is why so many people contract infections in the
      hospital.

      1) Excessive bleeding
      2) Extended exposure due to lengthier procedure caused by the surgeon’s error
      3) Prednisone as a steroid is KNOWN to delay wound healing AND suppress the
      immune system.
      4) No immediate post-op culture and sensitivity when prolonged swelling
      first realized.

      In closing I will say that I do not believe it was the endoscope. Although
      there might have been improper cleansing of the surgical incisions post-op
      coupled with a cross contamination of the actual surgical instruments, I
      believe it was a combination of many factors. However, the Prednisone was the
      biggest mistake in my opinion. Also, remember that even though the endoscope
      was sterilized, it still had instruments inserted in it during surgery. I
      would say that the liability is on the surgeon and that the bleeding was a very
      significant factor. Delayed surgery results in longer exposure to aerobic
      pathogens. Hello, it is a medical facility with sick people.

      I would suggest you back off the improperly sterilized endoscope and
      emphasize more on the cross-contamination due to the overall surgical procedure and
      the lack of ordinary care and treatment under the circumstances presented.

      Sincerely yours,
      Sue
      ________________________
      Sue Sarkis
      Sarkis Detective Agency


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