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Tue Apr 22 21:06:05 BST 2008

Once again someone taking incomplete and possibly incorrect information
and making judgments. You weren't there, don't know the extent of the
patients injuries or the reasoning of the physician for insisting. If we
accept a refusal we are sued for not convincing them refusal is a bad
thing, if we don't accept a refusal we are criticized, sued or arrested
for assault. 

-----Original Message-----
From: trauma-list-bounces at trauma.org
[mailto:trauma-list-bounces at trauma.org] On Behalf Of
bowwow49 at bellsouth.net
Sent: Tuesday, April 22, 2008 2:39 PM
To: Trauma &amp; Critical Care mailing list
Subject: Re: Rectal Exam Lawsuit DENIED

And in the same frame as when a women says no, it means NO, not maybe,
correct ! What is the difference when a man says no, and it makes no
difference in this world what the Dr's opinion was, if this man did
indeed say not only no, but begged for this not to be done, this is
still , at least as of right now ,The United States of America people
and it is his right and any one on this list that feels there MD
overrules the free choice of a adult that is Awake Alert and oriented ,
should not only be found liable, but further more there should have been
charges filed against this doctor, not the pt that was being assaulted
just because this ER doctor was pissed because someone lacking the
proper information of why this might have needed to be done had the
ignorance to refuse his judgment ! This kind of situation is just as
responsible for lawsuits as the BS crap that comes up ! Come on folks !
Bowser
-------------- Original message from "Charlene M Morris"
<cvmmorris at gmail.com>: -------------- 

> Apart from the ramifications of an exam the clinician feels is 
> necessary, I am STILL of the mind that patients have rights and 
> responsibilities. In this instance, I would have documented in bold 
> letters: "PATIENT DECLINES [OR REFUSES] RECTAL EXAM DESPITE STATING 
> ITS IMPORTANCE IN HIS CASE FOR DETECTING NEUROLOGICAL DEFICIT". 
> Whether that holds up in a COURT OF LAW is yet another issue.
> 
> I once worked with a Dr. who wanted to do a breast exam on ALL women. 
> His nurse defended his committment to detecting breast cancer, but to 
> my mind-- if a woman (PATIENT) says no, she should NOT be subjected to
what the Dr.
> *felt* necessary.. 
> 
> JMO--
> 
> Charlene Morris
> 
> 
> On 4/22/08, Jeffery Hammond wrote: 
> > 
> > I guess it's time to agree to disagree. :)
> > 
> > JSH
> > 
> > -----Original Message-----
> > From: trauma-list-bounces at trauma.org [mailto: 
> > trauma-list-bounces at trauma.org]
> > On Behalf Of Moore, Rick
> > Sent: Tuesday, April 22, 2008 1:30 PM
> > To: Trauma & Critical Care mailing list
> > Subject: RE: [ccm-l] RE: Rectal Exam Lawsuit DENIED
> > 
> > 
> > Gee, I didn't hear any indignation about "passing judgment in a 
> > situation where we have very limited information" directed towards 
> > the other comments that were uniformly condemning lawyers and 
> > praising the "good guys."
> > 
> > That's because until your comments nobody had been indignant calling

> > the procedure unwarranted, unnecessary and hogwash, again based on 
> > only one limited side of the story. All conclusions that no one 
> > other than those close to the case with all the information should
make.
> > 
> > -----Original Message-----
> > From: trauma-list-bounces at trauma.org 
> > [mailto:trauma-list-bounces at trauma.org] On Behalf Of Jeffery Hammond
> > Sent: Tuesday, April 22, 2008 12:01 PM
> > To: 'Trauma & Critical Care mailing list' 
> > Cc: 'CCML' 
> > Subject: RE: [ccm-l] RE: Rectal Exam Lawsuit DENIED
> > 
> > Replies below to Dr Myers comments... 
> > 
> > -----Original Message-----
> > From: Jeff Myers, D.O., Ed.M. [mailto:myersj at alum.rpi.edu]
> > Sent: Tuesday, April 22, 2008 12:38 PM
> > To: Jeffery Hammond
> > Cc: 'Trauma & Critical Care mailing list'; 'CCML' 
> > Subject: Re: [ccm-l] RE: Rectal Exam Lawsuit DENIED
> > 
> > Remember all, we are getting the lay press' report of the events and

> > armchair quarterbacking the incident.
> > 
> > -->>Agreed
> > 
> > All I glen was that this patient was struck in the head at a 
> > construction site. Was the treating team concerned about a head and
c-spine injury?
> > 
> > -->> You don't need a rectal exam for an injury limited to the head
> > in a patient moving all 4 extremities. 
> > 
> > Were they concerned the patient was combative / ? altered from the 
> > head injury?
> > 
> > -->> He was apparently talking to them. He didn't become
> > combative
> > until they tried to bugger him. 
> > 
> > The patient was not only sedated but intubated (according to the
> > description) - doesn't this scenario occur across the country when 
> > we are taking care of altered trauma patients so we can obtain 
> > timely imaging and intervene rapidly?
> > 
> > -->> Yes, in heavily intoxicated patients or those with major
> > TBI. 
> > But, in this case (agreeing that we have only part of the data) I 
> > would counsel any trauma team member who intubated a patient just to

> > do a rectal exam.
> > 
> > I just ask you all to reflect on situations where you may have done 
> > the same thing as reported because you were doing the right thing 
> > for the patient before passing judgment in a situation where we have

> > very limited information.
> > 
> > -->> Gee, I didn't hear any indignation about "passing judgment
> > in a situation where we have very limited information" directed 
> > towards the other comments that were uniformly condeming lawyers and

> > praising the "good guys."
> > 
> > Jeffrey Hammond MD, MNPH
> > New Brunswick, NJ
> > 
> > 
> > 
> > 
> > 
> > --
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> > 
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Rectal Exam Lawsuit DENIED