Wrong-procedure Surgery - Like participation trophies, a slap on the wrist sends the wrong message to bad medicine and to children.

We were to begin Part IV of the wrong-site surgery yesterday, but trial took me away and then I was sent a story that is directly related to what we are talking about and I think it’s worth discussing. So assuming we aren’t provided with more wrong-site or wrong-patient or wrong-procedure surgery cases that warrant discussion I’ll be back on track on Monday.

The headline reads, “Doctor reprimanded for secret sterilization” by Sandy Maple.

"Last year, when a woman in Berryville, Arkansas went into the hospital to deliver her baby by Cesarean section, she did not request or authorize her doctor to also perform a tubal ligation. But that minor detail didn't stop Dr. Shirolyn Ruth Moffett from doing just that. Dr. Moffett claims that she surgically ensured that this woman would never have another child because she feared that the patient's uterus would burst if she ever got pregnant again.

Not only did Dr. Moffett perform this procedure without permission, she failed to inform the woman after the fact and made no notation of what she had done on her medical chart. "I know now that was a mistake," she told the Arkansas State Medical Board. "I had not made this kind of error my whole medical career. I was appalled.""

A mistake is what the doctor is reported to have called what she did. A mistake. A simple mistake. Unfortunately mistakes aren’t purposefully done followed by what can be described as actions that point towards a cover-up.

"She was appalled? I imagine the woman who underwent this forced sterilization was even more appalled. Officials at St. John's hospital, where the procedure took place, clearly understood the gravity of the situation and stopped Dr. Moffett from seeing any more patients. But regulators at the Medical Board feel a reprimand is more appropriate to the offense and voted last week to allow Dr. Moffett to keep her medical license.

How is this possible? I don't get it and neither do officials at St. Johns, who released a statement expressing surprise at the decision. If performing an unauthorized and secret tubal ligation is not an offense worthy of losing a medical license, what is?"

Go back to my last post with the medical student who says, its nobody's fault when these mistakes happen, and you’ll have the answer to why a woman can be secretly sterilized and the offender gets a slap on the wrist. (Wrong-Site Surgery - Does anyone see the bigger picture of what is wrong with the system?) The Board of Medicine doesn’t fear the general public’s reaction and probably can predict that any reaction will be muted by a press that turns the other way when moneyed interests are the news. (Surgery Gone Wrong, by Beth Janicek, San Antonio, Texas.)

Society (the jury) has elevated, excused, looked the other way, ignored and pandered to the few bad doctors whose methods of practicing medicine hurt the medical system we are trying to preserve. It starts in medical school where they are taught that as doctors they owe legal responsibility to no patient. Then just out of medical school when jobs are offered that essentially buy-back the recent grads school loans and pay the income taxes they would be legally liable to pay, and begin to realize just how far America will go with relieving them of normal responsibility. They are in their minds, America’s royal family. As a profession we are excusing them without regard to responsibility they owe to society. I think we are doing this out of fear. And when fear is the key ingredient in the decision-making process the decision is most always skewed away for the norm.

Then when a few bad doctors make mistakes we expect the board of medicine to protect us, but the board of medicine can’t or won’t and the bad doctor takes the geographic cure and moves on to another unsuspecting community to repeat his/her mistakes.

In my office we have a very similar case out of northern Iowa; too similar to call it a coincidence. This appears in every respect to be unauthorized, unconsented surgery. How that can ever be just a mistake is beyond explanation. Why the offender was discussing their actions in the third-person while claiming to be appalled, is at best a mystery.

Or is it a mystery? Is this a simple case of a system that is failing to protect the patients because society fears not having enough doctors? Are not having enough doctors a reasonable excuse for looking the other way when unauthorized medical procedures are performed? Is it easier to look the other way because this patient we know of only in the abstract? Describing it another way how would you feel if this woman were your mother and you’d not yet been born? Or if the patient were your only daughter who had yet to conceive a grandchild? Then would it matter more? Would it then be of more interest to you or your neighbor, your mother and father and all those who sit on juries in this country?

The tort reformers will tell you that trial lawyer’s act appalled over cases like this because we make money. We do just like the doctor who treats cancer and the plumber who fixes a leaky pipe and the accountant who prepares your tax returns. Clients who suffer secret sterilization injuries and the emotional damage it causes them are known as real people by their attorneys; they aren’t stories read in the abstract. They are real people with real problems who have suffered real damage to their lives. That is why we are appalled.

We’ve been handing out participation trophies for so long that responsibility has become something the other guy needs to worry about. We started handing out participation trophies to our children so they could feel good about themselves and we could feel better about not taking responsibility for staying home and guiding their upbringing.

A participation trophy in youth sports is a parent's diseased thinking.

One in a jury box is a juror problem.

“Let’s all give Johnny a round of applause for just showing up today. Even though he didn’t practice as he should have, didn’t practice with the team or on his own, didn’t work hard, didn’t learn to juggle the ball, was late for games, forgot his jersey, didn’t bring his water bottle and had a poor team attitude; I his parent, want him (me) to feel good about himself (myself) so we’ve (I) have arranged to have this (loser) trophy all shiny and nice, made with his name on it, the year (he acted like a loser) and the team (that accepted and trophied) his (loser) participation. So stand up Johnny and take a bow.”

Only losers want or accept a participation trophy. Winners want to earn one.

Each instance when we hand out a participation trophy we send the wrong message. Whether it’s to Little Johnny or doctors who perform secret sterilizations it sends the wrong message by promoting and encouraging loser behavior.

So ask yourself do you really want to protect society and patients? Or do you want to promote losers? Because what you do in the jury box does send a message and does have an affect on how this system works. In the old Soviet Union injured people had no right to sue. The wrong doer had no legal responsibility to atone with compensation. So they feared no one and were never discouraged from putting into the marketplace poor products or shoddy workmanship. Under Lenin everyone was handed a participation trophy. As a result their system runs poorly and is in bad shape. I know this for a fact because I’ve visited there for the past two years. Are we heading in the same direction? Is this what we want to encourage? Or do we want to encourage taking responsibility for our actions? We are not fooling our children with this mixed-message. They see it, hear it and act on it.

Keep handing out reprimands, participation trophies, and sending the wrong message. We think we fool them, but the few bad doctors are hearing you loud and clear. Our children hear this mixed-message as well and don’t think you’re fooling them. In ten years of coaching soccer no child every asked for a participation trophy. It was the parents with guilty consciences that did. ©

Labels:medical negligence malpractice wrong site procedure patient

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