patient DIED yesterday at MVP.... warnnnnnnnning

[elijahspk]

MissOrange said: ↑

The latest update is MVP has been declared officially innocent and the patient's family accepts this unfortunate event. A press statement to come but off the record, the patient was found to have an unknown heart condition. This reminds me of one tonsillectomy adolescent patient I had who kept bleeding and would not clot. Turned out he had an undiagnosed bleeding disorder! Luckily he survived the op but it took an hour to control the bleeding. In the US, PTT and APTT are tested routinely for bleeding problems preop but in the NHS they do not test this preop and he had an unknown rare bleeding factor deficiency. Maybe if you have never had GA, getting an ecg might be wise to ensure your heart is sound but often only questions are asked about any family history of heart disorders or any health problems and young adults don't get ecgs until they are middle aged.

It still does not excuse the conduct of the staff on cctv but hopefully they will learn to behave professionally at all times in the operating room. I still like the idea of a separate charge for the anaesthetist to ensure you get an anaesthetist doctor for GA which is standard in the UK and US for private plastic surgery.

Click to expand...

WTF??? Each and every patient is tested before any surgery in Korea and how can his supposedly 'unknown' heart condition go unnoticed after all the necessary tests??? This shows CLEAR NEGLIGENCE of MVP and how MONEY HUNGRY they are that they proceeded with the surgery despite tests showing that something is wrong with that boy's heart.

Also, the boy's condition cannot be used as an excuse to prove MVP's innocence. The CCTV recording is proof that the doctor did NOTHING to mitigate the emergency situation, and this is very VERY appalling and indigestible. Also, the bizarre fact that nurses present there were literally laughing and one of them tying her pony (sic)....

This is unpardonable and disgusting act ,and the doctor along with those nurses should be banned from practicing any further and their licenses should be canceled ASAP. PERIOD !!!!!!!!!

 

[lemontea1234]

Actually. You can have undiagonsed cardiac conditions. It happens. Only way you can truly detect is through cardio echocardiogram or even angiogram. Its not unheard of for someone fit and healthy, just suddenly go into cardiac arrest with no warning.

Also sometimes your usual blood test will not look for specifically heart muscle functionality. You need specific tests that are a) expensive to run and take ages to run b) are so rare that its not considered worth running as a standard set of tests unless otherwise indicated.

How the medical staff conduct themselves is appalling. To be honest, i hope they do learn from it and improve greater patient safety in general.

 

[coppermind]

One of my worst fears is having a surgeon who cares more about being paid than the welfare of the patient. This poor woman; I hope there is justice for her.

 

[krod2017]

This is horrible, omg, thanks for sharing

 

[jphuoc]

MissOrange said: ↑

My understanding is rhino is done under GA. I had all my rhinos under GA and all the septoplasties I did in ENT were done under GA. Imagine with all the blood in the nose the surgeon would not want the patient to aspirate it into the lungs so intubation protects the airway. I got laryngeal mask intubation.

Click to expand...

All septoplasties and rhinoplasties should be done under GA for the reason you mentioned. However, an LMA is not considered a protected airway. If there is an increased risk for aspiration, an endotracheal tube should be used.

MissOrange said: ↑

In the US, PTT and APTT are tested routinely for bleeding problems preop but in the NHS they do not test this preop and he had an unknown rare bleeding factor deficiency.

Click to expand...

In the US, coagulation panels are not routinely sent for outpatient procedures.

lemontea1234 said: ↑

Actually. You can have undiagonsed cardiac conditions. It happens. Only way you can truly detect is through cardio echocardiogram or even angiogram.

Click to expand...

Truth.

Extensive lab work and physical evaluations are not performed on young patients with no prior medical history even at the most renowned medical centers. This unfortunate incident should highlight the risks we all are accepting when having procedures done at an outpatient center. Outpatient centers are not equipped like major hospitals, and the staff are not as prepared to handle emergent events.

 

[elijahspk]

lemontea1234 said: ↑

Actually. You can have undiagonsed cardiac conditions. It happens. Only way you can truly detect is through cardio echocardiogram or even angiogram. Its not unheard of for someone fit and healthy, just suddenly go into cardiac arrest with no warning.

Also sometimes your usual blood test will not look for specifically heart muscle functionality. You need specific tests that are a) expensive to run and take ages to run b) are so rare that its not considered worth running as a standard set of tests unless otherwise indicated.

How the medical staff conduct themselves is appalling. To be honest, i hope they do learn from it and improve greater patient safety in general.

Click to expand...

I would like to clarify a few important things here :

1. Firstly, I don't think that there's anything like "undiagnosed heart condition", why I say this because a person having even a slightest of an issue with their heart will always feel some or the other kind of symptoms which further lets them visit their GP. Also, as far as accurate tests are concerned then, yes, EKG and other such test methods are used to detect any abnormal heart rhythm.

2. I do personally think that every hospital should have this set standard pre-surgery procedures where heart abnormalities are also ruled out before moving on to the surgery, along with other necessary tests. As a matter of fact, we all know that the most affected organ inside the human body due to general anesthesia is brain & heart. And how ironic it is that no hospital carries extensive tests of brain and heart pre-surgery, as what shall be an essential pre-surgery protocol and safety measures standards in each and every hospital.

3. I strictly disagree with the last paragraph of yours. What do you mean by " learn from it and improve....." ???? That's ********. What I inferred from your last para thus far is that if somebody is dying in front of me and I know for the fact that I CAN save that soul but I still peacefully watch him die and that's ok if I did not do anything this time to save their life but next time I should definitely not leave anyone dying and try to save their life.

That careless doctor and those demonic nurses deserve a life sentence and their respective licenses being canceled immediately!!!!

 

[lemontea1234]

ElijahSpk said: ↑

I would like to clarify a few important things here :

1. Firstly, I don't think that there's anything like "undiagnosed heart condition", why I say this because a person having even a slightest of an issue with their heart will always feel some or the other kind of symptoms which further lets them visit their GP. Also, as far as accurate tests are concerned then, yes, EKG and other such test methods are used to detect any abnormal heart rhythm.

2. I do personally think that every hospital should have this set standard pre-surgery procedures where heart abnormalities are also ruled out before moving on to the surgery, along with other necessary tests. As a matter of fact, we all know that the most affected organ inside the human body due to general anesthesia is brain & heart. And how ironic it is that no hospital carries extensive tests of brain and heart pre-surgery, as what shall be an essential pre-surgery protocol and safety measures standards in each and every hospital.

3. I strictly disagree with the last paragraph of yours. What do you mean by " learn from it and improve....." ???? That's ********. What I inferred from your last para thus far is that if somebody is dying in front of me and I know for the fact that I CAN save that soul but I still peacefully watch him die and that's ok if I did not do anything this time to save their life but next time I should definitely not leave anyone dying and try to save their life.

That careless doctor and those demonic nurses deserve a life sentence and their respective licenses being canceled immediately!!!!

Click to expand...

Oh boy. I think you need to calm down first

1. There is such a thing as undiagonsed heart condition. Like missorange said, if it was a leaky valve there will be no symptoms as per say. Mitral/aortic valve regurgitation often doesnt have many noticeable symptoms.
Heck, there was a case that was shown on TV where a woman had her aorta randomly ruptured. She did not even know she had this condition. Sometimes people dont even think much and put it down as been working too hard. And they dont want to persue it further. Also sometimes, something may be mild that its not even noticable. It can progress if no one knew about it.

2. Standard blood tests are ordered because it is fast to run and have a quick turn over to give you a person's general health. But for cardiac specific testing such as myocarditis or cardiac myopathy is extremely expensive and takes time. To run as a general standard set will cost you heaps. If there is no reason for those tests, why take up more hospital resources and put more pressure on a pathology lab? There are more pressing and critical tests for sicker patients that needs to be run. Also what you want is assuming in ideal world. Everything that is run as diagnostic are often interpreted by a human being. So even then theres a chance something can be missed.

3. Have you ever been in a medical emergency?no? You sound extremely young.
In a medical emergency, if you do you dont experience it every day. Your body panics and you don't know how to manage the situation at hand. Look, its an unfortunate event, and i feel bad for the the patient's family. Do you think a loss does not weigh a lot on a person's mind? Even for me, if we lose a patient it effects all of the people involved. How often when you're in a stressful situation, do you just panic and your brain doesnt function?

All i am saying is, training is key. And implementing policy and procedures in place. As humans we learn better from experience. If we train more, and learn from this event. We reduce the swiss cheese effect.

Im not saying this should be taken lightly. Yes, we all have the right to be mad at loss of a human life. Instead of focusing all of your negative energy being angry at the dr and the team. It should be what can we learn from this incident and improve? Being angry isn't helpful. It just clouds your judgement further.

Eh thats my two cents.

 

[amali9099]

lemontea1234 said: ↑

Oh boy. I think you need to calm down first

3. Have you ever been in a medical emergency?no? You sound extremely young.
In a medical emergency, if you do you dont experience it every day. Your body panics and you don't know how to manage the situation at hand. Look, its an unfortunate event, and i feel bad for the the patient's family. Do you think a loss does not weigh a lot on a person's mind? Even for me, if we lose a patient it effects all of the people involved. How often when you're in a stressful situation, do you just panic and your brain doesnt function?

All i am saying is, training is key. And implementing policy and procedures in place. As humans we learn better from experience. If we train more, and learn from this event. We reduce the swiss cheese effect.

Im not saying this should be taken lightly. Yes, we all have the right to be mad at loss of a human life. Instead of focusing all of your negative energy being angry at the dr and the team. It should be what can we learn from this incident and improve? Being angry isn't helpful. It just clouds your judgement further.

Eh thats my two cents.

Click to expand...

I am only jumping in just to say that panic doesn't usually involve fixing one's hair and that a trained doctor or nurse should be well past the point of any kind of meltdown. In other countries, medical students are subjected to enough emergencies that by the time they graduate, they are trained to react adequately.

My guess is the anger is coming from the lackadaisical manner in which the staff conducted themselves while a kid's life slipped away on the table. It is a horrifying thing to envision and the anger is augmented when one wonders, heart issue or not, if his life would have been saved had he received proper emergency treatment. Today, it was him. Tomorrow it is you, me, or anyone else here.

While I do think this case (and others like it) should engender change in the forms of better policies, procedures, and even laws requiring better emergent care, the conduct here suggests something more than "poor training" and points a bit more to negligence. So I can understand those who are calling for criminal charges.

If a clinic can't manage itself during an emergency during which a patient's life hangs in the balance, then they shouldn't be taking patients' money and offering to do surgery.

 

[jphuoc]

lemontea1234 said: ↑

1. There is such a thing as undiagonsed heart condition. Like missorange said, if it was a leaky valve there will be no symptoms as per say. Mitral/aortic valve regurgitation often doesnt have many noticeable symptoms.

Click to expand...

Thank you lemontea for correcting that statement. MissOrange gave a perfect example of an asymptomatic cardiac condition that can prove fatal: hypertrophic obstructive cardiomyopathy.

lemontea1234 said: ↑

2. Standard blood tests are ordered because it is fast to run and have a quick turn over to give you a person's general health. But for cardiac specific testing such as myocarditis or cardiac myopathy is extremely expensive and takes time.

Click to expand...

More truth. Cost effectiveness is always factored into patient care. OF COURSE all medical practitioners wish they had a 12-lead electrocardiogram, metabolic panel, blood count, coagulation panel... an echocardiogram, a stress test, and a pulmonary function test would be amazing too.

BUT that's over doing it for standard outpatient procedures on young healthy adults because who's going to end up paying for it? The patient. And guess what? The patient will soon be calling a few months later complaining of all the extra costs.

EDIT -- These outpatient surgery centers will always exist if there is a demand from the public. So everyone please understand that although general anesthesia is performed routinely, it does have associated risks.

"The medications we give you can cause possible memory problems, organ problems, and in the most severe cases, death. The breathing device we place in your mouth can cause possible damage to your lips, your teeth, your mouth, and your throat, and possibly your eyes."

 

[versehg]

I agree with Miss Orange. Although their behaviour on the CCTV could not be excused but death by undiagnosed heart condition is unlucky situation.
Deep condolences for the boy and his family.

 

[pear-orange]

MissOrange said: ↑

Having read most of the 3000 naver comments using google translate, @ElijahSpk 's intense anger is echoed by many who watched the cctv footage and by the deceased's mother at interview, and I think we all agree it is appalling to see a nurse groom her hair nonchalantly, a nurse appear to be laughing, one handed cpr which may suggest lack of serious effort and a surgeon standing aside with arms crossed as their patient lies dying. In a code situation in the NHS everyone rushes to the patient and surrounds the bed to help. It is as if to say we all want to do everything to save your life, as it is in peril, a life or death situation. The observed behaviour on cctv contradicts this and may suggest character flaws in these individuals that make us worried to have them treat us or other patients. We all know the phrase arrogance kills. So I can understand the many on naver and @ElijahSpk who wish to have the staff struck off based on their observed behaviours on cctv. However appalling character flaws is not enough to be struck off or imprisoned which is why we can only hope the public humiliation will make the staff improve and change their behaviour. I know what some are thinking, that this type of cruel behaviour is not befitting medical staff and a potential red flag and may not be changed but may be inherent in these particular individuals. I feel deep sadness that the boy's mother has to live with these images of how her son died. When a patient dies in hospital, we tell the family we did everything we could but this poor mother has these heartless images to live with for the rest of her life unless the surgeon and clinic can meet with the family and show genuine remorse and ask for her forgiveness for the observed behaviours.

In the US and UK, the names of the clinic and doctors are often printed by press even before the official verdict. This is good and bad. We have seen named individuals pilloried in public only to find they were innocent of, for instance rape, but their lives destroyed because they were publicly named and shamed and once in print seems to stay forever on the www unless one can afford an expensive lawyer to remove but papers also with expensive lawyers may argue it was disclosed in the public interest. Yet conversely we the public want to know for our own safety the name of the clinic that hires such seemingly uncaring theatre staff which is why some on naver have disclosed the name and here too.

As I said before there are only 2 surgeons at this clinic who do rhinoplasties and it is not Dr Seo. Through a process of elimination you are forewarned. I would rather not mention his name without official confirmation but do know from my experience and that of 2 other pf members with him, that his seemingly aloof behaviour watching as others he employs attend to his patient and a seemingly jovial operating theatre atmosphere, fits the character profile of the particular surgeon I met there and I have posted in the past not recommending him but not everyone out there reads pf and therein lies the dilemma. I suppose if you do book surgery at this clinic, you as a patient may have the right to ask for a different surgeon or ask not to be booked with the surgeon with the crossed arms?

For me, I wish I had not seen how their theatre staff behave as it leaves me torn as the clinic employs the best plastic surgeon in my opinion Dr Seo and if he ever changes clinics, I would stalk him to ensure I stay young forever.

If I were the boy's mother I would want to know he did not die so young in vain and that some change for the better has happened because he lived. Maybe korean anaesthetists will now meet and examine their patients before surgery or maybe patients will ask their families if there is any history of heart problems in relatives etc. I don't know what change but it would bring her much comfort to know something positive happened because her son had lived and died in such unfortunate circumstances. It will be harder for her to just accept he died because he was unlucky from an undiagnosed heart condition after witnessing the footage. She would have been comforted had the cctv shown all the staff attend diligently to her dying son. We as a society expect that respect is shown to the patient especially during emergency resuscitation.

I know firsthand how it affects a family when a son dies on the operating table. It tore my family apart when my baby brother died of missed intussusception. My Korean parents separated. My mother mourned, wept, sang hymns, kneeled, prayed and we children just took care of ourselves. We never met with any hospital staff. I watched as my mother was dragged home in the arms of 2 tall Bobby policemen when the news was broken to her in hospital. Our family received no explanation and it was only as a medical student that I requested a death certificate to find out why my brother had died. No apology, no counselling, just silence from the hospital and GP who had failed to diagnose the condition despite numerous visits with a sick baby. Sadly cases like mine still happen in Nhs hospitals where a code of silence keeps families in the dark.

I think a news channel broadcasting the cctv coverage seized by police is a good move and public disclosure is so important as the last thing a grieving family want is to be met with silence and secrecy.

Hopefully an official statement will be announced by the clinic soon.

Click to expand...

Hi @MissOrange ,

This news is deeply shocking to me as I have considered doing rhinoplasty at MVP before. My deepest condolences to the young boy’s family.

May I ask your opinion on how to make sure we don’t die during GA? Aside from having our weight taken to get the proper dose, making sure that the anaesthetist doctor will monitor us for the whole surgery, the Clinic muat have the properti Emergentisme equipment, getting ecg, what else must we remember?

I’m not even sure if the clinic will want to perform ecg test for a young patient like me

 

[sheonlylooks25]

MissOrange said: ↑

My understanding is rhino is done under GA. I had all my rhinos under GA and all the septoplasties I did in ENT were done under GA. Imagine with all the blood in the nose the surgeon would not want the patient to aspirate it into the lungs so intubation protects the airway. I got laryngeal mask intubation.

Click to expand...

Thanks for info MissO. I guess there would be bleeding.
I don't get it, why would an OR in these clinics have a basic crash cart with a defibrillator at the very least so that incompetent doctors who don't know CPR 1O1 can resuscitate patients or try to before the ambos arrive. Heck I would even hire a defibrillator if there was one.

 

[pear-orange]

pear orange said: ↑

Hi @MissOrange ,

This news is deeply shocking to me as I have considered doing rhinoplasty at MVP before. My deepest condolences to the young boy’s family.

May I ask your opinion on how to make sure we don’t die during GA? Aside from having our weight taken to get the proper dose, making sure that the anaesthetist doctor will monitor us for the whole surgery, the Clinic muat have the properti Emergentisme equipment, getting ecg, what else must we remember?

I’m not even sure if the clinic will want to perform ecg test for a young patient like me

Click to expand...

*proper emergency

 

[jphuoc]

pear orange said: ↑

May I ask your opinion on how to make sure we don’t die during GA? Aside from having our weight taken to get the proper dose, making sure that the anaesthetist doctor will monitor us for the whole surgery, the Clinic muat have the properti Emergentisme equipment, getting ecg, what else must we remember?

I’m not even sure if the clinic will want to perform ecg test for a young patient like me

Click to expand...

I know this was directed to MissOrange, but I thought I would give some input. My biggest advice? Be honest. Notify the clinic of any preexisting health conditions and all medications you are taking, including herbal supplements. In the US, young, healthy adults generally do not undergo extensive workups prior to outpatient surgery. Even an ECG is usually not obtained for a 20-something year old with no significant medical history.

Here's some questions that a standard evaluation should include:

Do you have any drug allergies? Have you had GA before? Have you or any family members ever experienced problems with GA, such as fever or death? Do you have a history of seizures or stroke? Any lung conditions, such as asthma or shortness of breath? Do you smoke? Do you drink? Any recreational drug use? Any cardiac conditions such as high blood pressure or an abnormal heart rhythm? Are you able to climb at least 2 flights of stairs without stopping? Any stomach issues, such as acid reflux when you lay flat? Thyroid problems? Diabetes? Have you noticed any easy bleeding or bruising?

Just some questions to think about.

And PLEASE, for the love of God, no food 8 hours prior to surgery, no water 2 hours prior to surgery.

 

[elijahspk]

lemontea1234 said: ↑

Oh boy. I think you need to calm down first

1. There is such a thing as undiagonsed heart condition. Like missorange said, if it was a leaky valve there will be no symptoms as per say. Mitral/aortic valve regurgitation often doesnt have many noticeable symptoms.
Heck, there was a case that was shown on TV where a woman had her aorta randomly ruptured. She did not even know she had this condition. Sometimes people dont even think much and put it down as been working too hard. And they dont want to persue it further. Also sometimes, something may be mild that its not even noticable. It can progress if no one knew about it.

2. Standard blood tests are ordered because it is fast to run and have a quick turn over to give you a person's general health. But for cardiac specific testing such as myocarditis or cardiac myopathy is extremely expensive and takes time. To run as a general standard set will cost you heaps. If there is no reason for those tests, why take up more hospital resources and put more pressure on a pathology lab? There are more pressing and critical tests for sicker patients that needs to be run. Also what you want is assuming in ideal world. Everything that is run as diagnostic are often interpreted by a human being. So even then theres a chance something can be missed.

3. Have you ever been in a medical emergency?no? You sound extremely young.
In a medical emergency, if you do you dont experience it every day. Your body panics and you don't know how to manage the situation at hand. Look, its an unfortunate event, and i feel bad for the the patient's family. Do you think a loss does not weigh a lot on a person's mind? Even for me, if we lose a patient it effects all of the people involved. How often when you're in a stressful situation, do you just panic and your brain doesnt function?

All i am saying is, training is key. And implementing policy and procedures in place. As humans we learn better from experience. If we train more, and learn from this event. We reduce the swiss cheese effect.

Im not saying this should be taken lightly. Yes, we all have the right to be mad at loss of a human life. Instead of focusing all of your negative energy being angry at the dr and the team. It should be what can we learn from this incident and improve? Being angry isn't helpful. It just clouds your judgement further.

Eh thats my two cents.

Click to expand...

I agree with everything you said except the "panic" issue. As far as my knowledge goes, doctors and nurses are all well trained to handle medical emergencies without getting panicked. So there's no question of them getting panicky in such unforeseen circumstances.

No f**king training and experience can teach any doctor or nurse to not laugh, engross oneself in making ponytails and crossing arms when a patient is dying. You know why, right? Because this is a serious character flaw(as stated by MissOrange) and that too shockingly coming from a doctor and nurses at whom people trust completely & have faith in them for their lives.

There would have been completely no issues at all only if for the doctor and nurses extreme efforts to save that dying soul, but, very shockingly the scenario in this tragic incident was just completely opposite and actually very heartbreaking and gut-wrenching.

The problem is not the boy's "unknown heart condition" but the attitude of those nurses and, of course, the doctor who did literally NOTHING to save that dying soul. I don't seem to understand that how can you attribute this bizarre behavior with training and experience???

P.S: Don't you think that it's a bit rude to judge anybody's age from their opinion?