{"id":102,"date":"2008-03-21T00:11:15","date_gmt":"2008-03-21T05:11:15","guid":{"rendered":"http:\/\/72.9.147.40\/archives\/2008\/03\/minnesota-wrong-kidney-tragedy-part-ii.html"},"modified":"2008-03-21T00:11:15","modified_gmt":"2008-03-21T05:11:15","slug":"minnesota-wrong-kidney-tragedy-part-ii","status":"publish","type":"post","link":"https:\/\/participatorymedicine.org\/epatients\/2008\/03\/minnesota-wrong-kidney-tragedy-part-ii.html","title":{"rendered":"Minnesota wrong kidney tragedy, part II"},"content":{"rendered":"

Important update: before reading, please see correction 3\/23\/08 to Tuesday’s original post. The basic issue is unchanged but in any sensitive case like this accuracy is vital.<\/i><\/p><\/blockquote>\n

I received a comment<\/a> on Tuesday\u2019s post<\/a> from a doctor in the Twin Cities, Dr. Bill Utz.<\/p>\n

Dr. Utz’s message evoked so much thought and feeling that rather than replying in a further comment, I\u2019m replying in a second post.<\/p>\n

Dr. Utz, first, I wish this weren\u2019t email-like faceless blogging, because I\u2019d welcome a chance to talk as live individuals. If you\u2019d like to do that, let me know how to contact you, at epatientdave at comcast.net. I want to be sure both my respect and my intensity come across. …<\/p>\n


\nSecond, my apologies for the delay in responding. My notifications of comments didn\u2019t arrive.<\/p>\n

Third, thank you sincerely for contributing to this discussion. As someone who had his kidney removed 12 months ago (Stage IV Grade 4 RCC), I take this whole episode very personally, and I want people to be looking at this and asking \u201cWhat can we do that will make a difference<\/i>?\u201d<\/p>\n

I understand the discipline of designing processes which, if followed, will absolutely prevent an error. At the same time, I have to ask you \u2013 what good does it do, now, to identify where culpability rests?<\/p>\n

If it were me, it would do me no good to identify who did something wrong. To the contrary, as I faced my own diagnosis and approached treatment, my question was \u201cWhat is everything I can possibly do<\/i> to improve my odds?\u201d I had a clear experience that I didn\u2019t know what would make a difference, but that I was going to do everything in my power.<\/p>\n

To put it differently: I was going to do everything in my power to take responsibility for influencing my outcome.<\/p>\n

Don\u2019t anyone, anywhere, anyhow dare try to discourage empowered patients from doing that!<\/p>\n

But I don\u2019t think that\u2019s your intention \u2013 as you said, you support the basic premise.<\/p>\n

As it happens, I did everything recommended in the subject hospital\u2019s home page\u2019s<\/a> own \u201cGet involved with your health care<\/a>\u201d Flash video.<\/p>\n

I assert that it does absolutely no good to say \u201cIt shouldn\u2019t have happened.\u201d And in fact, if I can say this with respect, it seems to carry a certain unintended arrogance, or misplaced priorities, to imply that \u201cwe shouldn\u2019t need\u201d to be reading our own charts because the problem should never happen.<\/p>\n

btw, one of us misread something \u2013 your comment mentions \u201chaving access to your records with the belief that the dictated report is, in fact accurate, will not completely eradicate the chance for a mistake.\u201d The point is that we could have seen that they\u2019re NOT accurate, had it said \u201cleft kidney\u201d – especially since on the way out of my hospital, we could stop and get a copy of my scan images on CD.<\/p>\n

Please understand, that falls squarely into \u201ceverything I can possibly do to improve my odds.\u201d<\/p>\n

Look \u2026 I just went onto PatientSite (isn’t that cool?) and looked up the report for my ultrasound 1\/11\/07, which says \u201cThe right<\/b> kidney shows a solid mass at its lower pole, which appears to be somewhat bilobed and measures approximately 5.0 x 3.4 x 3.5 cm. \u2026 the most likely explanation is a renal cell carcinoma. Abdominal CT is recommended.\u201d<\/p>\n

A CT report that night said <\/p>\n

A 2.1 x 1.0 cm nodule is seen within the right<\/b> adrenal gland. Two large, heterogeneously enhancing, lobular masses are identified within the right<\/b> kidney. The mass at the mid pole of the right<\/b> kidney measures approximately 3.4 x 3.3 cm in axial dimensions (series 3, image 35). The mass at the lower pole of the right<\/b> kidney measures 5.4 x 3.2 cm in axial dimensions (series 3, image 29), and demonstrates multiple small calcifications. Smaller 1.1-cm rounded hypodensity within the mid pole of the right<\/b> kidney possibly represents a simple cyst, although it is too small to characterize by CT.<\/p><\/blockquote>\n

(Btw, there\u2019s fun in them thar radiology reports, too. My family also got a hoot out of reading that my bowel was \u201cgrossly unremarkable.\u201d)<\/p>\n

Please, please look from the patient\u2019s point of view. Apologies for not tracing down the original cite but it\u2019s 1 a.m. and I have work in the morning\u2026 this<\/a> Time<\/i> article says \u201cMore than 1 in 3 doctors in a 2002 survey by the Harvard School of Public Health reported errors in their own or a family member’s medical care. \u2026 Not all the errors are due to ignorance or incompetence; even the best doctors can make mistakes.\u201d<\/p>\n

Unlike many people I know, I have no interest in berating \u201cthe system\u201d nor ranting about \u201cbad doctors.\u201d That does nobody any good.<\/i> My whole point is that we, the patients, ought to be aware of everything we can do to participate in our care, and ought to be supported in that by regulations requiring transparent access to our records.<\/p>\n

In this particular instance, from what I\u2019ve read, that one factor might have outwitted all the other breakdowns that happened. How can we say no to that? As I said at the beginning, the transformative question is, what can we do that will make a difference?<\/p>\n

Thank you again for contributing. Do contact me if you\u2019d like to talk live. This is too important to be left to impersonal bytes, or to appear to be a personality clash. It\u2019s not.<\/p>\n

 <\/p>\n","protected":false},"excerpt":{"rendered":"

Important update: before reading, please see correction 3\/23\/08 to Tuesday’s original post. The basic issue is unchanged but in any sensitive case like this accuracy is vital. 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