Tuesday, March 10, 2009

Reconsider taking your elderly patients to Duke University Hospital

The original title was "Don't take your elderly patients to DUH." My mom requested that I just suggest that families "reconsider."

Does Duke Risk Management (or anyone else at DUH) care about elderly and sick patients?

. . . I can answer my own question after leaving (1) my first message with Duke Risk Management at 11:00 am, (2) my second message at 2:42 pm and then (3) my third message at 4:42 pm.

No one would have ever called me back? Why? Dad is a Stage 4 cancer patient with a foot infection caused by a DUH Hospitalists negligence. Of I had not kept calling, I would have been ignored (like my dad).

Duke Risk Management is a post event "cover our ass" office. Duke Risk Management does not care in any way, shape or form about preventing risks from evolving into a harm to patients.

I have warned, pleaded, written to Duke Risk Management (and even its accrediting organization, Joint Commission) about the inherent problems if Duke Hospitalists refuse to cooperate, communicate or coordinate patients care with the Duke Clinic physicians.

It would be so much more productive if the Risk Management personnel actually acknowledged a risk and then tried to manage it! And, by "risk," I mean a problem that we can see in advance may cause harm (or God forbid dollars) to the Duke System.

Instead, Duke Health Systems apparently waits for a problem to actually happen and then manages the "risk" of being sued!

All I wanted to know today is whether anyone at Duke Medical intended to care for my dad. I thought maybe my advocacy had caused Duke Risk Management to "no care" my dad.

The answer from a lady with Duke Risk Management "if your father is having an acute problem, he should go to the ED."

As I explained to the Risk Management lady (who claimed that she did not even know what being "no cared" meant) there was no coordination of care for my dad after he was discharged from Duke University Hospital in November 2008.

1. No wound management.
2. No infectious disease control.

Now my dad is in horrible pain, his foot is infected and the pins (placed by the Duke orthopedic surgeon) are almost out.

I have tried for weeks (and I literally mean weeks) to get the Duke Clinic orthopedic clinic to help me or give me some guidance on wound care and determining whether dad is going to lose his foot or life.

What do I get from Duke Clinic orthopedics? SILENCE.

I am scared that nothing will change at Duke Medical.

I beg you to avoid (opps, I mean reconsider) taking your elderly patients to Duke University Hospital. Period.

And if you are a hospitalists (for whatever reason) looking for a job, I recommend avoiding employment with Duke University Hospital.

Even the creator of the "Hospitalist Program Model" has expressed to me disappointment in the Duke University Hospital hospitalist program since the Duke Hospitalists flatly refuse to cooperate, communicate and coordinate patient care with clinic doctors.

Hospitalists (for whatever reason), you can do better (I hope) than working at DUH.

I personally know a woman whose elderly (but active) husband dies last Fall 2008 while a patient at DUH. The man had an extremely successful liver cancer surgery. In fact, the Duke surgeon was so thrilled with the results of the liver surgery that she expected to write a paper on it.

After the surgery the elderly man was in bed with his wife watching on. The patient had not eaten in a few days. His blood glucose level was down. But the man was not a diabetic.

A DUH nurse entered the room and announced that she was going to inject the elderly man with insulin. The wife was confused and asked to speak with a doctor. The pic line had already been removed from the patient and so it seemed odd that the surgeon would have expected to inject more medication.

The DUH nurse injected insulin into a perfectly healthy man (who probably needed a meal). Forty-five minutes later a man who (pre-insulin injection) who was planning a walk around the hallways with his wife . . . was DEAD.

The wife reported that the Duke Clinic surgeon entered the room in tears. The Duke surgeon certainly never expected the surgical patient to die.

The family asked Duke for a copy of the medical records and specially asked for copies of the nurses notes. Not surprisingly, Duke did not provide the nursing notes for that DUH hospitalization.

IMHO, Duke killed that elderly surgical patient. It was unnecessary. But Duke knows the "risk" to Duke is low because the man was old. And, even if the family sued Duke, how much could they really be awarded?

I mean, the guy had no lost income. Just a widow.
I pray no one else dies needlessly.

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