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Mon Jan 8 05:33:05 GMT 2007

Fascinating! I'm an emergency physician in Richmond, Virginia, and I'm 
pretty sure I saw this gentleman when I was working at a small community 
hospital here, a hospital that had a contract to see prison inmates with 
potential emergencies requiring hospitalization. Because he was coming from 
jail, I was a little suspicious of malingering, then all the more so given 
his normal appearance and vital signs (yes, normal, equal BP's in both 
arms), extensive allergies precluding a rapid contrast CT of the chest among 
other things, and his flat, apparently unconcerned affect. He reported the 
CLASSIC TEXTBOOK description of dissection, but overtly looked fine, not at 
ALL like the few dissections I have seen. He did have a sternotomy scar, 
however, and reported a history of Ehlers-Danlos syndrome, although I didn't 
find any hypermobile joints (for whatever that's worth). Because we didn't 
have CT surgery, I put a call in to the nearby academic medical center 
(Medical College of Virginia of Virginia Commonwealth University), and 
wasn't I surprised when the ED doc on the other end of the line could tell 
me the guy's NAME as I was describing the patient! Turns out the guy was in 
jail because this fellow had been at MCV/VCU as a patient with the same 
complaint, ultimately requiring sedation and premedication for an angiogram, 
if I remember correctly, before medical records obtained from other 
institutions (in North Carolina, perhaps) revealed he was fraudulently using 
the medical records of someone else or using someone else's identity, and 
was arrested because of this. I sent him back to jail -- he didn't say a 
word! -- and I haven't heard anything since until now. This was a couple 
year ago, maybe.

If word gets out to hospitals across the U.S., is he going to move on to 
other countries?

Jason Cillo, MD
Richmond, VA
USA

> Message: 5
> Date: Sat, 6 Jan 2007 21:41:20 -0500
> From: "Doug Condit Jr" <thoracicsurgpa at msn.com>
> Subject: M?nchhausen Syndrome
> To: "Trauma &amp; Critical Care mailing list" <trauma-list at trauma.org>
> Message-ID: <BAY106-DAV1097342D0B92C0BBBC1154CEBD0 at phx.gbl>
> Content-Type: text/plain; charset="iso-8859-1"
>
> While I admit that Münchhausen Syndrome is not trauma, there are numerous 
> ED & CVT folks on this list.
>
> I would like to refer you to a recent article in the Annals of Thoracic 
> Surgery:  Münchhausen Syndrome Simulating Aortic Dissection (Ann Thorac 
> Surg 2006;81:1497-9) with the follow-up letters AnnThoracac Surg 
> 2006;82:1948-54, as I believe that I could have recently had the 
> opportunity to see this patient.  According to the article and letters, he 
> has at the very least visited ED's in RI, VA, TX, CT, NJ, CA, MI, and NC. 
> May I add that the individual I saw presented with typed results of an MRI 
> obtained in PA, and presented with history similar as reported in the 
> Annals here in NY.
>
>
> ~doug~

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