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medical-malpractice-on-law-amp-order-ft-legal-eagle

Medical Malpractice On Law &amp; Order Ft. Legal Eagle

it's about time we react to the very first episode of Law and Order there's actually a lot of medicine in this of which I know a lot law on the other hand I don't that's why I brought in my good friend the legal eagle I'm back baby it's time to talk about medical malpractice uh I'm scared of that but the eagle has landed so let's get started beep been here 40 minutes I just need to know where she is holy crap it's Leo McGary from The West Wing don't mess with that guy like that that guy I have no idea who that is or what we're talking you've never seen The West Wing no dude she can't breathe get the amboo back no pulse call a code come on let's go move I need a line in chest compressions chest compressions chest compression if someone's pulseless you don't go get tools you start chest compression get the defibrillator you knew that wasn't right also these chest compressions are absolutely poo what what is this you have to put your whole body weight into it in order to push 2 in deep it has to be to the rhythm of staying alive even even I know that Taylor Swift's clean just for my swifties out there I just read that from the American Art Association ah now now there's some privacy no more privacy no more no response get me adrenaline excuse us please please wait we're doing everything we can what's going on excuse us my daughter please you can't come in here this don't even try what's going on let Leo McGary see his they're letting the entire ER see this poor woman get coated but they won't let the father into the room once you violated Hippa once you might as well just just keep it going keep it going and that monitor is clearly saying she's flatlining so the purpose of getting the defibrillator is really useless they did call for epinephrine which is the medication that you do give in Flatline to hopefully restart the heart okay yeah so at least that was correct let's call it 237 they went like 1 minute please try a little harder how long would it normally take so there are there's no there's no rule but each round of CPR is 2 minutes because you're supposed to do chest compressions for 2 minutes and in between that time give medications find out history things that are reversible causes there's patients that I brought back after 15 minutes 20 minutes and they come back and they're great we we get them back in in fighting shape and I'm not saying that they're instantly great it takes time and they recover but just to say after a few minutes now we're calling it that's not right yeah so more like Ed Harris in the abyss then law order I don't know these references give me like a SpongeBob reference I'm so old we're like 2 years apart how many years apart Are we more than that I'm 89 more than that okay what the hell happened the doctor had Cardiac Arrest well resuscitate her def her please please def her no you can't shock flatlines so the the the right course of action is not defibrillation when there's when a flatline uh it's chest compression yeah so the purpose of the defibrillator is to stop the the heart and have it automatically restart the heart has its own natural pacemaker if that pacemaker is beating in a rhythm that is not viable with having a healthy heart sometimes it does something called ventricular fibrillation where it's beating but it's beating in a non-effective way then the defibrillator comes in shocks the heart it stops and then hopefully it restarts with a normal Rhythm but what's happening here is you have a heart that has no rhythm shocking it doesn't actually help the situation here you want to give medications to hopefully get the natural paker to start up there's no such thing as jump starting a heart in fact the defibrillator stops the heart and it restarts on its own got it your daughter was killed at the hospital yeah in the emergency room and I want to swear out a murder complaint against the resident in charge of it oh wow but she was at the hospital for treatment yeah a sore throat muscle aches she only went in to get a prescription for some antibiotics bro can you repeat what he just said she only went to the hospital for some antibiotic ICS does he also call them diabetics just had my first day off in two weeks there is a world out there you're the intern who treated a young girl named that's one cocky intern I know right for an intern I thought he was the head of the hospital for a second I just I want to punch that intern so bad oh yeah she's the last patient I admitted before I took off bronchitis she dramatized symptoms a bit so Law and Order is famous for like having random actors pick up crates and like load them and I feel like putting on the white lab coat while you're talking to police in a murder investigation that's the doctor equivalent of yeah I remember that guy right now we're doing a routine investigation of her death D here here's my acting you sound surprised why else would the police be there here every day well she wasn't that sick I you don't die from bronchitis well you Canan she had pneumonia the sputum examination in blood culture we're indicative so sputum culture and blood culture check for bacteria growing in both of those sources the way we see it is we actually grow the bacteria and then we put different antibiotics on that bacteria to see which of those antibiotics it's resistant to to make sure that if I give an antibiotic I don't give one that the bacteria will be like safe from would you also check to see if antibiotics worked against the culture especially antibiotics okay Suzanne Morton yes uh if you see Mr Morton please extend my condolences Dr Raza were you on rounds when they reached her yes yes that is right I came right away why I didn't think she was that sick we heard bronchitis maybe pneumonia no no no no no she was very sick oh snap that's a real why did you uh order the Santiago off the island if your orders are always followed right there like why did you come quickly if she was in perfect health yeah that's a good question sneaky you solve every case you work on we can tell a felony from a traffic ticket like a patient walks in with a headache she have a subarachnoid hemorrhage a berry aneurysm a retroorbital tumor or does she just have a headache it's a valid question you have to distinguish between the levels of Acuity based on signs and symptoms that the patient's showing subarachnoid hemorrhage is one of those conditions where we call it as a thunder clap headache where patients come in they say I'm having the worst headache of my life and that's bleeding into the brain basically I saw that girl in the emergency room on rounds she was in the hands of competent staff the girl is dead well people like to believe that medicine is pure science medicine is a science but doctors know it's also a lottery I heard the art component of that statement before I've never heard of Lottery wow is every patient that walks into your office just like pulling a lottery ticket whether they're going to walk out that just shows you have no regard for human life proceed Sherlock back in the day of paper handwritten notes some hospitals that I trained in as a student I still wrote handwritten notes like this but now everything's on the computer everything's electronic for good and bad electronic health records add a lot of Secretarial work to what we do day in and day out so that we end up spending more time on administrative tasks rather than taking care of patients so hey what do you do when you make a mistake use white out uh-uh you cross it out and initial it this ain't no letter to Dear Abby these charts got to show everything well there could be serious legal repercussions if you didn't document it it didn't happen is everyone's very famous medical saying and if you make a mistake you always cross it out in initial yeah and if you're using white out to hide something before that's just laying a literal paper trail of the crimes that you have committed no on top of the white out it says a set Ament ofan a common everyday painkiller but t underneath the white out it said madine that's a very strong opioid medication so very big difference Tylenol M perody uh is that the kind of medication that would stop someone's heart so opioids one of their nasty side effects is that they slow breathing down and you could slow it so much so that the person stops breathing then there's in cases where you're giving someone Comfort Care at end of life and they're struggling because they have air hunger we actually give morphee not for pain in that situation but for that air h sensation so they don't feel like they're struggling and we could naturally slow their breathing down even though that's not quote unquote extending their life but at that moment it's about Comfort rather than prolonging the few hours that they have interesting medical use there she had a headache and a low-grade fever nothing more I gave her an antibiotic and an antihistamine no doctor would have done anything more her psychiatrist had her un fenel and sulfate this is a monoamine oxidase inhibitor very unique medication a lot of interactions with not just foods but also medicines so we've kind of straighted away from it but there are instances where we still do prescribe it so okay the talk screen shows a setam minen it shows aspirin and it shows an antihistamine so there's no sign of madine we were in the standard gas and chromatography oh we know the girl was on something called fenine not a trace madine fenine recreational drugs do another talk screen I think you're wasting your nickel this guy's Act is hilarious too but can they do that can they order more tests yeah sure nobody takes madine and fenel unless they want to risk ending up here it going be a fatal combination yeah why do you think the police are asking you to run that screen I don't know specifically the interactions between those two medications but giving a an opioid medication plus an MA aoi medication could create respiratory depression cardiac issues neurotoxicity and most importantly there's a condition called serotonin syndrome where by taking both of those medications you could have so much serotonin that it creates your uh like an overheating of your body and that breaks everything down and that's why when uh I started a patient on an anti-depressant and we start adding other meds or they're already on meds that's when we say we need a psychiatrist on board to manage these interactions yeah all these have evening rounds at 6 6:30 and the night that Suzanne Morton do rounds were after nine if you hear hoof beats it's probably a horse not a zebra that's a very common saying and I wish we'd stop saying it's good in one sense because frequently what happens when you have Med students they study all these obscure diseases for test and then they come into you know a patient's exam room and the patient says they have a headache and they start naming all of the rarest conditions that cause headaches so as an attendant you have to remind them that if you see a headache it's probably just a headache not some rare condition of zebra which is really funny because in the prior scene this doctor was like it could have been like this other life-threatening tumor and now he's like oh just just a stop looking for zebras where would you even get that notion you gentlemen are on a zebra hunt again that guy is so either a zebra or a horse using white out well maybe Dr RZA made a mistake in the chart maybe he made a mistake in the emergency room how can you just brush it off if you were there and you watch to make the mistake and you say no I saw him he did it but he's just assuming again he's completely nonchalant and while talking to the uh the the New York Police Department homicide detectives and he's completely dismissive of the possibility that anyone on his staff possibly done anything wrong so what happened that night why we around so late we waited for the chief of Medicine Dr roster got on high descending well he descended late he was there he' been delayed at some uh retirement party for one of the service Chiefs seemed like Dr uster had a good time was he drunk oh snap it smelled like he had been drinking criminal negligence yeah that that seems really bad that you don't want an attending physician if he's drunk from a party that seems less than ideal not less than ideal I mean that's illegal and a crime and wrong and you should be fired and not practice medicine there's a lot of things that should happen there don't drink and conduct rounds kids will perform surgery you guys just apply bartenders crates just just moving crates even in the first episode they had to shoehorn in a guy moving crates y was there two waitresses and Rory another bartend remember this guy yeah Jim in a party with like dozens or hundreds of people yeah I remember that old white guy at a doctor's party I mean good for him that guy has a great memory yeah Edward auster no no Jim green the bourbon that's what he drank on the Rocks one every five minutes does Jim Beam come in green I think he means Johnny Walker Green did he say Jim Beam green Jim Jim green Jim green I think they can't say the brand so he made up a fake Jim Bean Jim Breen green whatever he said I'm begging you don't make me torpedo in my career we need a second Witness do they really need a second witness it would definitely help for sure really but also if this guy failed to do anything because the chief of medicine was completely blackout drunk I assume his career is probably over he's going to get sued to death this guy is not worried about the right things at this point my question is how can they prove that he was drunk delivering care when you can't retroactively go back and test him is it enough to get witnesses to say that he drank that he smelled that he acted weird that's enough oh 100% And that's one of those reasons why uh circumstantial evidence is often the strongest evidence you have if you have the testimony of the bartender who says I serve this guy a dozen drinks well that's not direct evidence it's not a a you know a blood test of their blood alcohol level but that's pretty strong evidence that a guy that's like 170 lb is probably pretty drunk true I came to New York because of him do you know what do you know what it means to be able to say I studied under Dr Edward Austin he could destroy the rest of my career what career he was drunk oh that's not that much stronger of evidence than the bartender saying I personally served him this many drinks it takes more of a link to be able to say that this doctor has the expertise to know when someone is drunk and how drunk they are the girl had muscle pains doctor ordered M paradine and the resident said something about Pine I I I don't I don't think he even heard he took the M paradine he injected it himself try to stop them what are we going to do wrestle Dr Edward AER to the floor I mean yeah probably right yeah if you're watching someone get murdered what are we going to wrestle him if he took a knife out and started stabbing the patient yeah I mean so this is tricky because I'm trying to figure out what crime this guy might be responsible for I think that the act of not stopping a doctor from doing a clearly wrong medical treatment that would 100% kill someone is probably negligence he clearly didn't have the intent to join a conspiracy so it would be hard to convict this person of anything criminal but I think it would you'd have a much better chance uh suing this guy civil yeah I I think he's probably on the hook the David's kid already made the turn once said flat out auster was drunk I going to go in with more than a nervous resident H the bartender says to drank La a fish at the party you need more than that that sounds pretty solid to me well okay so there is a wrinkle here that they haven't gotten to because I think you and I had the same reaction that okay this guy is really really drunk and he's administering care but this guy is I guess a generalist of some kind he's not a surgeon certainly if you drink before conducting surgery almost certainly Reckless homicide so imagine for example if a radiologist gets drunk before reading scans reading scans that's not the kind of medicine where you're going to actively end up causing their Dem exactly you might miss something and it might lead to exactly and that's certainly negligence this doctor is somewhere in between he can prescribe medicine that might have a really adverse effect but he's also not you know cutting someone open and Performing heart surgery and so it's possible that this guy is a I hate to say it but a really high functioning alcoholic and therefore is able to offer a high level of medical treatment even under that kind of condition interesting that would be cool to argue in a court of law hey I'm really good when I'm drunk yeah boy I would not want to make that argument or have to make that argument on behalf of a client but yeah I think that's the argument you'd have to make Edward ler he looks drunk right now we have a warrant for your arrest the arrest has been made this is where the legalities kick in continue by watching the rest of our reaction right here part two on Legal Eagles yeah w

Dr.

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