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Rodney Knoepfle, 67, suffered from significant health problems. He had a history of stroke and orthopedic and cardiac problems. Before all this took place, he executed an advance directive, which designated his wife to make healthcare decisions and stated his desire to forego life-sustaining healthcare treatment should that become necessary. In other words, he signed this directive stating that he did not wish to be resuscitated in case of a deteriorating medical condition.

When Knoepfle began feeling poorly, he was admitted to St. Peter’s Hospital. He provided his advanced directive to the nurses and staff who entered a do-not-resuscitate (DNR) order into the hospital computer system.

However, two days later, Knoepfle became non-responsive, prompting a nurse to call for help. When no one responded to the call, the nurse called a code. The on-duty hospitalist, Dr. Lee Harrison, came to Knoepfle’s bedside and performed chest compressions for 10 to 15 minutes. Knoepfle was resuscitated; however, he then coded the following day. Dr. Harrison then gave Knoepfle adrenaline.
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Johnny Terrell Sledge, 24, suffered a gunshot wound to his back. He was taken to the DCH Regional Medical Center emergency room where an emergency room physician recognized the need for surgery.

On-call trauma surgeon Dr. Bradley Bilton was paged repeatedly but responded that he was in surgery and that someone else should be called to assist Sledge. The hospital staff could not locate another surgeon; Dr. Bolton was paged again.

Instead of coming to the emergency room after completing the surgical procedure that he was involved in, Dr. Bilton started a second elective surgery instead of coming to the aid of Sledge.
Unfortunately, Sledge died while waiting for an emergency laparotomy. He is survived by his family.
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Christine Coffey was diagnosed as having a “berry aneurysm.” The vascular surgeon assigned to Coffey was Dr. Henry Woo who reviewed Coffey’s images and advised her that an untreated aneurysm could cause sudden death.

Dr. Woo performed an Onyx brain aneurysm procedure. During the procedure, Coffey suffered brain damage that has left her with permanent hemiparesis. Hemiparesis, or unilateral paresis, is the weakness of one side of the body. Hemiparesis can be caused by different medical conditions, including stroke.
Coffey had worked at a hospital, but she is now unable to work. She also has an impaired ability to take care of her young child.

Coffey sued Dr. Woo alleging negligence in that he chose not to obtain an informed consent. The lawsuit claimed that Dr. Woo had forced the liquid Onyx embolic agent into Coffey’s small aneurysm, causing the Onyx particles to escape the aneurysm and cause a stroke. Coffey also asserted that Dr. Woo decided not to advise her of the dangers of the surgery and safer available alternatives.
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Questions about nursing home facilities’ staffing are always important to know whenever there is a report of an injury, neglect or abuse in any nursing home setting. A study from the Center for Retirement Research at Boston College concluded that when the economy is strong, death rates at nursing homes rise. This research shows that when general employment levels rise, staffing at nursing homes drop. It turns out that the reason is that many nursing home staff prefer to work elsewhere. Therefore, the loss of caregiving for the elderly is linked with higher death rates, particularly in older women who outlive their male partners.

As Americans live longer, the need for nursing home facilities and care-giving resources are being stretched to their limits. Those living into their 80s are among the fastest growing age groups in the United States.

Because the federal and state governments have reduced Medicare funding for nursing home facility reimbursement rates, the elderly face much greater financial pressure. There is continued pressure to reduce healthcare spending, particularly on caregivers. The study found a precipitous rise in deaths at nursing facilities as the economy expands and workers find jobs in other work places.
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Many people are considering careers in the medical field, particularly in nursing. According to one study, the state of Michigan faces a critical shortage of nurses.

In order to meet this estimated job shortage, many workers are changing from their current volatile careers to what they see as a more stable career choice. A recent New York Times article showcased some Michigan natives making the shift to nursing, many of which were male. Examples are the 49-year-old grocery warehouse employee who now works at a nursing home, or the 59-year-old nursing student who used to work as an automotive vibration engineer. These men represent the growing trend of keeping their options open and finding work where it’s available.

Currently, Michigan’s unemployment rate is at 4.3 percent. In order to not become a number in that statistic, many former automotive employees are turning to nursing as a way to jumpstart a new career. In fact, the trend is so common that Oakland University in Rochester, Mich., established a program specifically geared toward training former autoworkers in nursing careers.
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Hospital-borne infections have been a problem for years, and drug-resistant bacteria like MRSA (Methicillin-resistant Staphylococcus aureus) have become household names. However, a New York Times article highlights another virus that is causing a high rate of death among children and the elderly. The article provides some insight into how the medical community could help decrease the number of deaths.

Norovirus is an extremely contagious virus and in recent years has become the leading cause of acute gastroenteritis. And while many of the symptoms caused by norovirus mimic that of the flu or a severe cold, e.g. nausea, vomiting, diarrhea, and stomach pain; epidemiologist Aron Hall warns, “I think there is perhaps a misperception that norovirus causes a mild illness; . . . [it is] a major problem that requires some attention.”

According to the Centers for Disease Control and Prevention (CDC), each year norovirus causes over 20 million illnesses, leads to 70,000 hospitalizations, and results in 800 deaths. In addition, norovirus is the most common cause of food disease outbreaks in the U.S. Because norovirus has much in common with C. difficile, a bacterial infection, medical officials are examining the ways hospitals and nursing homes have tried to combat the spread of C. diff to try and help reduce the spread of norovirus.
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A New York Times article described a family that encountered a common family problem: What to do with our aging mother, living alone, who doesn’t want to move into a nearby nursing home?

Dr. Socorrito Baez-Page, a general practitioner in Alexandria, Va., moved her parents first into a nursing home. She converted a dining room and TV nook on the main floor into a bedroom. But the problem was that the bathroom was down four steps, which were difficult and dangerous for her mother to navigate. It was embarrassing for her mom to use a commode next to her bed.

As an alternative, the Page family found that they could buy a high-tech MedCottage, which is a pre-fabricated 12×24 bedroom-bathroom-kitchenette set up as a free standing structure in the backyard.

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Connie Lockhart was hospitalized after overdosing on medication. She was 58 years old at the time of this incident. An emergency room physician inserted a central line femoral catheter in her right leg. However, this was misplaced into her femoral artery instead of her femoral vein.

Lockhart was transferred to the facility’s ICU where she received care from critical care pulmonologist Dr. Sachin Lavania.

Nurses informed Dr. Lavania that Lockhart’s leg had become cold, mottled, and pulseless.
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Rickie Lee Hewitt consulted a urologist at The Iowa Clinic after receiving his prostate cancer screening results. He was 65 years old at the time. The urologist ordered a biopsy, which was sent to the clinic’s anatomical laboratory for interpretation.

Pathologist Dr. Joy Trueblood, the laboratory’s director, examined Hewitt’s slides and reported that she had found cancer in both sides of his prostate.

Hewitt then met with the urologist, who told him that he required a radical prostatectomy in order to survive his cancer. The surgery left Hewitt with erectile dysfunction and incontinence.
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Melina Greer, 25, went to a hospital emergency room complaining of a severe headache, neck pain and decreased and blurred vision. She received a neurological consultation from neurology resident, Dr. Basad Essa, who noted that she was having difficulty performing an optic fundus examination.

An emergency physician later discharged Greer with a diagnosis of a complex migraine.
Two days later, she returned to the hospital with complete vision loss. A lumbar puncture led to a diagnosis of idiopathic intracranial hypertension.

Greer sued neurologist Dr. Ruggero Serafini, whom she claimed had consulted on her case during the first hospital visit, alleging he chose not to timely diagnose intracranial hypertension. It was alleged had she undergone a simple fundus examination and lumbar puncture, Greer asserted she could have been timely treated with acetazolamide and an LP (lumbar peritoneal) shunt and avoided additional vision loss.
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