What a patient thinks isn't important enough to bring up may be the cause of an untimely demise. These patients thought they could get away with secret habits or behaviors that they didn't want their doctor aware of. Well that completely backfired for them, prompting all sorts of mayhem in these hospitals to ensue. The hospital bills after these commotions must have been outrageous. Content has been edited for clarity.
Medicine Room Break-In
“I was admitting patients to the psychiatric ward. It was a busy night, and I was too far behind. An older man with schizo-affective disorder was admitted with a caretaker. A nurse asks them a few questions, including if the patient has taken any medicine and/or narcotics. The caretaker says no. I get to see the patient four hours later. He seems delirious, which often is caused by a somatic problem (which includes medicine, so you know where this is going).
He can’t maintain eye contact and can only sit in his chair and talk nonsense. He drools and yells every word, but somehow he seems very tired. I ask the caretaker if the patient has taken any medication. This caretaker says that the patient broke into a medicine room at the institution where he lives, and he just started eating random pills. Apparently this all added up to somewhere around eighty pills. She couldn’t be more precise, because she did not bother gathering the empty pill boxes. The only information I could get was that he definitely ate over forty lithium pills (which is just great, if you really hate your kidneys).
Now, after calling the emergency department to quickly prep an ambulance with an anesthesiologist for transport, I talked with the caretaker. I tried to be calm and talk through my teeth, trying not to be more than just slightly angry. Apparently the nurse ‘wouldn’t understand’ because it wasn’t his own medicine, and this caretaker didn’t want to ‘make a fuss’. I screamed into my pillow that night in pure frustration. I later found out he lived after intensive care and almost losing his entire kidney function.”
Small Lie, Big Consequences
“One surprisingly common instance is when older guys are having chest pain, and we want to give them nitroglycerin paste or pills in order to help their chest pain. One thing that doesn’t mix well is nitroglycerin and male enhancement pills. The mixture causes a blood pressure drop that can be really dangerous. We always ask and make it really clear that if we give the nitroglyverin and they are taking male enhancement pills or similar meds, that they could die. It usually takes three or four warnings in a row before the guy will finally admit it. Early on, I made the mistake of trusting a guy after just a couple mentions of how dangerous it would be. I sprayed the nitroglycerin paste under his tongue, and he said, ‘Does generic version of these pills count?’
At one point, his blood pressure wasn’t even registering on the box cuff, it was insanely bad. I thought I was going to get screamed at by another doctor, but he just laughed and said it was so common that he wasn’t upset. Thankfully, this guy gave me a couple ideas on how to make it more clear to male patients how dangerous it was to their safety.”
“I work in outpatient surgical center. Important fact: lying to a doctor before being administered anesthesia can be really, really dangerous. I’ve had a person lie about not taking prior substances, and then reacting badly when given the anesthesia meds. The anesthesia and mysterious substances reacted adversely to one another. Fortunately for that patient, the reaction wasn’t intense enough to kill him. I will forever have this image ingrained in my head of the anesthetist leaning over his head screaming, ‘What did you take?!’
Another experience that I have unfortunately come across includes people eating or drinking food before the anesthesia, and then quickly denying that they did so. Luckily for my patients, they’ve only thrown up after waking up from the procedures, so we immediately knew they didn’t follow our directions. Thankfully, they made it through intact. The danger during this procedure includes puking during sedation and getting the substance trapped in your lungs. This is called ‘aspirating’, and you can die from that. Thankfully, I haven’t encountered that in a patient yet, but I’ve heard far too many stories about it.”
Is Survival Possible?
“I worked in the army with the Combat Medic team. We had been in a small firefight, and a soldier was hit in the leg. It was very easy to see the wound, as the desert camo outfits don’t blend in well with blood. The part of this event that actually almost killed him was being hit in the chest. He never told us this, only mentioning the hit in the leg.
I knew he was lying because he was also gripping his chest. I didn’t want to make a dire situation even worse, so I didn’t say anything at first. When I asked him again, he still tried to deny the wound. Of course, I didn’t want him to die, so I pulled off his plate carrier and examined the entire wound. He was definitely knocking on death’s door, as the bullet punctured his lung and he was having trouble breathing. We immediately called for a MEDEVAC, and this guy managed to survive with only one lung. I never saw him after that day, so I never knew if he resumed his position after his hospitalization. I really hope he stayed out.”
“I wasn’t the lead on this case, but I was certainly assisting. Back when I was in dental school, this patient came in and was really hyped up. My buddy asked him if he has been on any particular substances and the guy just said he had a lot of caffeine to drink. That seemed fine, so we moved forward. From what my friend told me, this man’s blood pressure was high, but it wasn’t too high for an elective procedure.
Part of the local numbing we give patients has epinephrine in it, and sometimes this gets into the bloodstream with certain types of nerve blocks. This sort of thing is not uncommon. However, if you’ve snorted a couple lines and then get epinephrine in your bloodstream, that’s a horrible combination. We ended up calling the ambulance, because his blood pressure was so high that he was at risk for a stroke. So yeah, even stuff the dentist performs can kill you if you lie.”
Time Runs Out
“My cousin is an Emergency Room doctor and sees this issue quite a bit in his practice. He’ll come across people lying about having done narcotics and underage drinking because they don’t want to get in trouble. These young people don’t understand that these doctors are less concerned with getting some teens in trouble than they are making sure these teens will live.
During one particularly nasty incident, the person had drank quite a bit and done several kinds of narcotics at the same time, but he wouldn’t admit to it. He came in alone, so there was no one to verify what had happened exactly. This person wouldn’t admit to anyone the substances they had taken, not even to multiple doctors. The doctors had no way to help, and could do little except watch as this person slowly passed away from the substance interactions. Without knowing what was already in their system, giving them any sort of medication could have only sped up the deadly process. This person was a minor and passed away from massive organ failure, because they were more worried about getting in trouble than saving their own life, until it was far too late to admit the truth.”
Not The Grandma!
“Here’s a supremely messed-up family story. We had an eighty-one-year-old frail grandmother, who was brought in by family for ‘failure to thrive’ in the family’s home. She had an incurable stage IV colon cancer. This patient was admitted while being awake and conversational, but she was a poor historian, who was complaining of pain. She proceeded to gradually get more sick. She shut down like she was dying, becoming gradually nonverbal, unresponsive, and dropping vitals. She was DNR, so we did supportive care and looked for causes such as a Urinary Tract Infection, Spontaneous Bacterial Peritonitis, sepsis, and even liver failure. This family was around us the whole time, acting very involved and caring. Thirty-six hours later, she gradually started coming out if it, before recovering back to baseline. We were amazed.
It turns out she was given her home dose of morphine in the ER prior to admission, which was 100 mg of extended release morphine twice daily, as she had been complaining of pain. Her family had failed to mention that they been diverting all her pain medications. That nearly got their grandmother killed, as we had no reason to suspect an opiate as the cause. That definitely reminded me to always consider opiates. We discharged her to a long term care facility.”
Won’t Take No For An Answer
“I’m a nurse on an orthopedic unit. This particular patient just made it through a fresh post-operation joint replacement. They woke up in the middle of the night going completely insane. This man was insisting that he had to leave immediately. He was seeing things. We were on the sixth floor, and he tried going down the back stairwell. There was no reasoning with this dude. He was straight up determined to leave, no matter who objected.
Well, it turns out that he was detoxing from substance abuse. He had lied to both his doctor and the nurse that admitted him about his terrible addiction. When you’re a heavy user like he was, quitting cold turkey can kill you. We were lucky he didn’t start seizing up completely before we got another medical team on board to help him detox safely. I was very thankful that I caught him trying to get down the stairs before he went and fell over the railings and completely cracked his head open.
A few months later, he was back on the surgery schedule to fix an injury on his operative leg from falling over. Luckily, his doctor knew to plan for detox this time around. But unfortunately, the patient also planned ahead. After this sad man was discharged, we found a bottle of bubbly hidden within his bedside table.”
“I work in an STD clinic, so the stuff I deal with isn’t usually deadly, or at least not immediately deadly. However, I am constantly surprised by the percentage of patients who test positive and refuse to tell their partners.
A guy came in a few years ago who for something relatively simple like gonorrhea, but he somehow seemed to have trouble walking. Long story short, a nurse called an ambulance for him, and we sent him to the ER for a spinal tap. Turns out an ex-boyfriend refused to tell him about his own syphilis diagnosis after they had a rough break up, like fifteen to twenty years earlier. So not only was our guy possibly spreading syphilis unknowingly, he now had untreatable neurosyphilis. He had to work with our Disease Intervention Specialists to track down as many partners as they could, but I think he died from related complications like a year after his initial visit.”
Error In Surgery
“When we do our pre-operational check before a surgery, our office prints out a list of medications that we have in file that the patient is taking. We tell the patients to please look at this list and sign it to indicate this is the current and up to date list of the medications that you take. This one patient signed off, and we planned for surgery to take place next week. I get a call from anesthesiologist the day before the patient’s scheduled surgery.
Apparently, she ‘forgot’ to mention she had started taking a weight loss pill. If you are taking this particular pill, it can cause severe hypotension when you go under anesthesia, and in extreme cases, you can even die from that. You have to have stopped the pill for at least four days to be safe, in order to have anesthesia. So her surgery got pushed back a week. We didn’t have it canceled, just pushed back enough to be safe. She called our office fuming and demanding a refund for the time she took off work. Seriously lady? Sorry, but we have a signed document saying you told us all your medications. Exactly who should be mad at whom? You put us at liability, and now the surgeon and our office doesn’t get paid for that day, when we could have subbed in someone else in that slot.”
“My work focused on Labor and Delivery. My coworker had a patient show up in labor, and this woman was 6 centimeters dilated. I was helping to get the room set up for delivery, and the patient’s mom started to ask my coworker, ‘So does that mean the baby-‘ but the patient violently shushes her.
Her doctor wasn’t on that night, and that office didn’t have electronic records we could access at night. All we can do is to just go ahead with prepping for this delivery. When her doctor happened to come into the nurse’s station, it was because she had to come in for a medical patient on another unit. She just stopped by to chat, but noticed that patient on the board and asks, ‘Oh, so her baby actually flipped?’
It turns out the kid had been breech all pregnancy, and was still breech. The woman didn’t want a c-section, so she figured she’d just try to come in so far dilated that she could just deliver. That would have been okay if she was frank breech (butt down) since it wasn’t her first baby, but she was footling breech (crossed legs with feet down). That’s super dangerous, because it’s super easy for the umbilical cord to come out first instead of the baby, which cuts off baby’s oxygen. Her baby was immensely lucky that her water hadn’t broken yet, especially if she’d been at home still.
She still kept refusing the c-section, and my coworker finally snapped. We had another patient who was in for a stillbirth, and this person had a lot of family down in our waiting room trying to process what had happened. My coworker asks if her patient had noticed all the crying people at the end of the hall, as they were mourning their dead baby, and would she rather have a c-section, or deal with the grief that this other family had?
She finally got the stupid c-section. My coworker caught a lot of flak for checking in on that patient and not noticing she wasn’t feeling a head.”