Tonight's bad vet comes from Wisconsin.
The owner brought in a 10-year old boy kitty, who was gagging, "pawing at the throat," and vomiting phlegm.
Vet Carey Johnson did a chest x-ray. The x-ray showed that the cat's stomach was "air filled and displaced behind the diaphragm." The cat also had a "slightly elevated trachea."
Johnson then "administered hydrogen peroxide to induce vomiting which produced only foam." Johnson "then injected ketamine/xylazine and acepromazine to induce vomiting and only a small amount of clear fluid was obtained."
Johnson "did not record the dosage amounts of the drugs administered to the cat in either the controlled substances log or the patient record."
Then, Johnson decided to put an "endotracheal" tube down the cats throat while she did an oral examination.
"During placement of the endotracheal tube, [Johnson] inflated the balloon cuff to the point that rupture of the trachea may have occurred. . . . Subseqent radiographs [xrays] taken by [Johnson] reveal an over inflated balloon cuff. [Johnson] did not recognize the over inflation upon review of the radiograph [xray]."
The cat deveoped a "pneumothorax" and died the next morning.
OK, so you might be wondering: What is a pneumothorax, and did the vet cause this with the overinflation of the tracheal tube, thus perhaps causing the cats death?
PNEUMOTHORAX: WHEN AIR ACCUMULATES BETWEEN THE LUNG AND THE CHEST WALL, CAUSING THE LUNG TO BE COMPRESSED (COLLAPSED), AND CAN COMPROMISE THE HEART FUNCTION LEADING TO POSSIBLE RESPIRATORY OR CARDIAC ARREST. http://www.ctshearts.com/Terminology.asp
What can cause "pneumothorax?"
Check out this abstract in the Annals of Thoracic Surgery:
http://ats.ctsnetjournals.org/cgi/content/abstract/60/5/1367
It says:
"Tracheobronchial rupture after tracheal intubation has been infrequently reported . . . Overinflation of the tracheal cuff was speculated to be a frequent cause of the tracheal damage because the lesion was always a linear laceration of the posterior membranous wall. The diagnosis was suspected on the basis of common signs such as subcutaneous emphysema, respiratory distress, pneumomediastnum and pneumothorax. . . . Tracheal intubation–related airways ruptures are rare but probably underestimated. Early recognition and emergent repair are essential because failure to do so could result in potentially lethal events."
Can you imagine being this poor cat? You are brought into the vet sick, the give you medicine (who knows how much!) to make you puke, then the shove a tube down your throat and inflate it until it "may have" ruptured your bronchial airway? Air leaks around your lungs until your lungs collapse, you can't breathe, and you die?
The Board found that Johnson's "conduct constituted a violation of Wis. Adm. Code Sec. VE 7.06 (1) in that she failed to properly manage the patient’s airway by failing to properly inflate the balloon cuff on the endotracheal tube and that she failed to recognize on subsequent radiograph the over inflation which may have resulted in rupture of the trachea."
They keep saying "may have." But the cat died with pneumothorax, a known complication of overinflating the tracheal tube ballon and thus causing "tracheobronchial rupture." What do you thinkk -- do you think the vet board really knows that this vets actions caused this cat to die? What does it sound like to YOU?
So what punishment did the vet board give this vet? They made her take 7 hours of classes and pay them the investigation costs (only $550). Do you think that's enough?
Links: http://drl.wi.gov/dept/decisions/docs/1204120.htm
http://ats.ctsnetjournals.org/cgi/content/abstract/60/5/1367
http://www.ctshearts.com/Terminology.asp
