Comments on: Anna Brown And Appropriate Emergency Medical Care

By: usa

usa — Thu, 28 Mar 2013 04:29:42 +0000

All is assumptions I believe a lot could have been done don’t matter how many ultrasounds ,x rays etc needed she wasn’t satisfied and she wasn’t well so she shouldn’t have been discharged she should have been admitted with more test. It doesn’t matter if her background wasn’t perfect no ones background is,but because of her background she was treated like a animal. That’s just not right she deserved better treatment and what about medical treatment in the jail why wasn’t she seen by a nurse there. To me she was discriminated against and its not fair to her children , parents and friends.

By: Latoria Cypress

Latoria Cypress — Thu, 28 Mar 2013 01:47:21 +0000

Im not a Doctor or a Nurse but I will say this before anything were all Human and it seems to me that if nothing else the Medical staff and the Police department neglected to treat her like a Human I always thought that most people in the medical and law enforcement profession cared about people these day its all about a dollar pretty it up all you like they could have ran whatever test they wanted to what it all boils down tois that noone cared about Ann and because she didnt have insurance they were not going the extra mile nomatter what Ann complained about they did all they were going to do Does anyone care that someone died that didnt have to

By: ER Nurses Blog: Curious Case of Anna Brown

ER Nurses Blog: Curious Case of Anna Brown — Wed, 29 Aug 2012 22:40:50 +0000

[...] and found dead on the floor of a jail cell. Report. And some reaction thru the blogosphere: Sad outcome, proper treatment. Limited press for sad case. Labelling patients. Your thoughts? Could the doctors have done [...]

By: Rich

Rich — Fri, 03 Aug 2012 13:14:49 +0000

Stephanie, just keep adding details to your massively complicated narrative and at some point perhaps someone will grasp the relevance.

By: JustADoc

JustADoc — Fri, 03 Aug 2012 01:02:12 +0000

My apologies, I do see how a complaint of lower back pain and diaphragm pain(the next time I hear that complaint will be the first time in person) versus a complaint of leg pain and swelling should lead to an identical work up. The next time I see someone with ankle pain after a fall I will order a D-dimer and CT chest with contrast.

By: Stephanie Lewis

Stephanie Lewis — Thu, 02 Aug 2012 17:56:00 +0000

Actually, I only had pain in my lower back and diaphragm which was misdiagnosed by four physicians as pleurisy. Breathing was fine until the pneumonia I was getting took hold in the hospital – that was after all of the tests I had in this order: chest x-ray (negative), d-dimer (positive), CT Scan (showed “suspicion” of clots, and positive for pneumonia), ultrasound of legs and arms (negative), a VQ Scan (confirmed clots), and finally another chest xray to see my progress while being an admitted patient in the hospital (which is what showed my pneumonia getting worse and then the breathing problems started). A month prior (with my doctor and I looking through the “retrospectascope”), I had had a pulmonary embolism that I survived, but another doctor at the time interpreted my coughing up blood as throat irritation from my “seasonal allergies”. I believe doctors are human and usually treat them as such; for instance, I am not litigious at all and would only sue one if they committed some egregious infraction like operating on me drunk. Since they are human and flawed, they also make excuses for themselves and their colleagues (for fear of the truly litigious). I’m my own patient advocate and had my husband with me at all times while I was heavily medicated to make sure these humans didn’t make mistakes.

By: Stephanie Lewis

Stephanie Lewis — Thu, 02 Aug 2012 17:40:05 +0000

I couldn’t agree more with your detailed response, including the sarcasm.

By: JustADoc

JustADoc — Thu, 02 Aug 2012 17:33:47 +0000

My mistake. I misread part of your comment. You had the D-dimer before the CT and VQ.
However, I still stand by the fact that leg swelling and leg pain and ‘no history of leg swelling or pain or clots in my legs – ever.’ are very different chief complaints.

By: JustADoc

JustADoc — Thu, 02 Aug 2012 17:32:03 +0000

By your own admission your presentation was completely different than this patient(leg swelling and pain verus your ‘no history of leg swelling or pain or clots in my legs – ever.’
So the comparison is pretty much invalid to begin with.
However, with leg swelling and a 3-4 day hospital stay it is unlikely she did not have a D-dimer. However, even if she did not, the follow up test for that would be an ultrasound, which she did in fact have.
There is no mention in this article of her complaining of shortness of breath or chest pain that would prompt one to consider a PE.

Your story is in fact almost the exact opposite. You had a CT and a VQ of your chest that showed clots. I presume you had either chest pain or shortness of breath or some similar complaint that led to such studies. Honestly, in your case, the D-dimer being done after a positive CT scan and positive VQ scan added nothing to your case except cost.
They then looked for a clot in your legs as the most likely source of the clot and didn’t find it. They then did a work up for clotting disorders, which it turns out you have.
Other than you and Ms Brown both having a clot, I do not see any similarities in your cases at all.

By: Stephanie Lewis

Stephanie Lewis — Thu, 02 Aug 2012 14:45:53 +0000

My D-Dimer led my hospitalist to order a CT Scan, a VQ Scan, and Ultrasound on my legs and arms. The first two showed clots in my lungs. The ultrasound showed nothing and I had had no history of leg swelling or pain or clots in my legs – ever. They ran genetic tests because of having no apparent cause for my PE and found out I am both Factor V Leiden and have the Lupus Anticoagulant. This all happened two days after my 40th birthday. Now I am on lifetime anticoagulants. To me, if the article is at all accurate about how well she was treated in the hospital, she did NOT receive the thorough care that I did and now she is dead. I sincerely doubt she received a d-dimer screening since they weren’t initially going to do it for me. Luckily, I had an excellent hospitalist who was a creative and critical thinker.