The hostess died after infusion in a tertiary hospital, and the parents announced the autopsy complaint: the doctor changed the medicine without authorization, did not do the skin test and electrocardiogram

Introduction

Posting on Weibo to “discuss what to say” is to seek justice. Or cyberbullying?

Source: YimaitongAuthor: Running Emergency Old LiuThis article is edited and written by Yimaitong, please do not reprint without authorization. Pneumonia died after infusion. The cause of death was related to drugs. How to ensure the safety of drugs? Review of the caseOn June 6, the parents of a hostess posted on Weibo, detailing how their daughter was in the hospital. The process of seeking medical treatment and eventually death. And uploaded CT reports, pathology reports, autopsy reports, chat records, transfer records, photos and other content on Weibo. After that, the incident attracted the attention of the media, who interviewed and reported the identity of the hostess and the detailed diagnosis and treatment process. Female host’s family Weibo Source: Weibo screenshotaccording to Weibo News reports show the patient’s diagnosis and treatment process: 1. The patient, a 27-year-old female, was admitted to a local large-scale comprehensive teaching school due to fever on April 14 Outpatient department of respiratory and critical care medicine in the hospital (4990 open beds). Chest CT showed: consolidation shadow in the right middle lobe, cloud flocculent density increase shadow in the right lower lobe, small nodules in the left lower lobe about 5.1mm long, impression “inflammation in the middle and lower lobe of the right lung, anti-inflammatory treatment is recommended” Re-examination afterward; small nodule in the lower lobe of the left lung, follow-up.”2. On April 15, the patient was admitted to the emergency department 2 for hospitalization. On April 18, bronchoscopy was performed, and mycoplasma pneumonia was diagnosed after surgery. No tumor cells were found by bronchoscopy. 3. On April 20, the patient felt discomfort in the stomach/chest area during the infusion of the antibacterial drug moxifloxacin. At 15:12, the infusion was over, and the patient still reported chest tightness. At about 20 o’clock in the evening, the patient died suddenly, and the rescue failed and eventually died. 4. The autopsy appraisal opinion is “sudden cardiac death caused by arrhythmia caused by the use of moxifloxacin in mycoplasma pneumonia”. The photo shows that the analysis of some autopsy reports showed that the patient suffered from mycoplasma pneumonia, and the cough improved after adjusting the antibiotic moxifloxacin. 5. On June 7, the staff of the medical publicity department told reporters that they are currently communicating with their families and the incident is still under investigation. The patient’s boyfriend and parents questioned the diagnosis and treatment process including: 1. Improper operation of the bronchoscope, resulting in massive bleeding from the nose and mouth; 2. The doctor’s personal WeChat 3,500 examination fees were charged, and receipts and invoices were not given; 3. The patients were changed without authorization without necessary procedures such as skin tests and electrocardiograms; 4. There was no monitoring during the treatment process;5. The adverse reaction occurred during the infusion process, which was reported to the medical staff, and no monitoring and response measures were taken in time;6. The patient had convulsions Afterwards, there were only practice nurses at the scene, and lack of experience led to confusion;7. The rescue only had simple cardiac compressions, not even a defibrillator;8. The doctor asked to sign informed consent Only books can be used for ventilator rescue, and intubation is delayed. Posting on Weibo to “discuss opinions”, is it justice or cyber violence? Because the current reports on the incident on the Internet are only one-sided words of the patient, no medical records have been published, and the examination report and autopsy report given are only part of the content. False to be verified. Therefore, the truth of the incident still needs an authoritative investigation conclusion. As far as I have seen the content announced by the patient, I have not seen any obvious fault of the doctor. In response to the various doubts raised by the patient, people who are not in the medical industry may feel that the doctor is heinous, but those in the industry may not agree with it very much. 1. For the problem of nose and mouth bleeding caused by bronchoscopy. Nasal mucosal bleeding is the most common complication of bronchoscopy, and some patients may experience severe epistaxis, with blood from the nose and mouth appearing to be serious. However, nasal mucosal bleeding cannot be completely avoided, and nasal mucosal damage generally recovers quickly without causing serious effects. 2.For the personal collection of 3500 yuan. But seeing the replies from the netizens on the family’s Weibo, you can clearly understand that the money was not charged by the doctor, but was sent for examination. Image source: Comment screenshot3. and EKG problems. This is not a routine diagnosis and treatment, nor is it required by the drug insert. This is not a necessary procedure as stated by the patient. All drugs may cause allergic reactions. The skin test of drugs is mainly used to predict the probability of type I (immediate) allergic reactions, but not all allergic reactions. In addition, when the skin test result is negative, there is still a 3%-30% chance of allergy. Therefore, the Pharmacopoeia only stipulates that some drugs require a skin test, and most drugs do not require a skin test. As for the ECG, although these drugs may cause QT prolongation and lead to arrhythmia risk, the risk of death is extremely low, and premedication ECG is not routine. 4. For questions without any guardianship. The infusion of anti-inflammatory drugs requires continuous monitoring. This is not a routine diagnosis and treatment, and there is no such requirement in the drug insert. Although continuous monitoring will provide better observation, it wastes medical resources and is difficult to achieve in reality. 5. For chest tightness and stomach discomfort, untreated problems. The screenshot of WeChat did not reflect the sudden chest tightness during the infusion, nor did it reflect the evidence that the doctor was informed and ignored by the doctor. Chest tightness and stomach discomfort are common in patients with pneumonia, especially after infusions of anti-inflammatory drugs, and repeated tests are usually not performed. 6. Questions about the rescue process. The number of night shift nurses in the general ward is limited, and there will not be only two trainee nurses on duty. Unexpected sudden death in an ordinary ward will inevitably lead to confusion at the rescue scene. Cardiopulmonary resuscitation is the main rescue method for cardiac arrest, and defibrillation is not necessarily required. Tracheal intubation and ventilator-assisted breathing require the informed consent of the family members. Signing now will reduce delays. I don’t know when it started, posting Weibo, raising public opinion, blogging sympathy, and discussing compensation have become the remedy for the patient. The content announced by the patient is one-sided, sharply accusing the hospital, and publishing a large number of patient information and photos. The news media took the rhythm. Although the title stated “suspected medical malpractice”, it pointed out that “the death of an innocent person was ultimately caused”, and called on “the hospital to face up to the mistake and make corresponding compensation to the victim’s family”. Before there is no authoritative appraisal agency or investigation agency to analyze and judge the incident, the conclusion that the doctor is at fault is given. Netizens in the industry do not approve of the family’s request for justice.