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Tue Apr 22 21:40:09 BST 2008

What do you think CYA stands for? Cover your *ss?! How about "call your
attorney"?.

And as one lawyer once told me: anyone can you for ANYthing. And ER is a
high risk place for just that.

Still, to forcibly perform an invasive exam on someone...I just do not know.
And you are correct: I was not there. I have been in many other similar
situations and do the best I can with what I have at hand.

CMM

On 4/22/08, Moore, Rick <Rick.Moore at triadhospitals.com> wrote:
>
> 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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