Monday, February 11, 2008

Vermont Vet Paeplow Found to Have Committed Unprofessional Conduct when Cat Left Without Monitoring Dies After Dental

This story is a cautionary tale about what you as a pet owner need to be concerned about when you take your otherwise healthy pet to the vet for a routine procedure like a dental.

Here are excerpts from the Vet Board's Findings in the case of the unnamed cat:

"On or about May 3, 2004 Dr. [John] Paeplow performed a routine dental cleaning on a cat belonging to the complainant, E.H. He began the procedure at around 10:00 am.

The procedure was performed under a general anesthetic. Dr. Paeplow used an injectible anesthetic, Ketamine. One of the effects of this type of drug is hypothermia.

The drug is measured according to the weight of the animal.

He testified that he did not remember where he got the information about the dosage he used. He said it was so long ago he could not remember the origin of information. The Board finds that Dr. Paeplow relied on old information."

[Comment: The Board's focus on the dosage used cannot be for no reason. Where there is smoke, suspect fire. Does the Board infer here that they believe too high a dose may have been given????]

"The recovery room was heated. Dr. Paeoplow could not say if he used a heater for the cat or not.

Dr. Paeplow did monitor the cat until 12:00 noon. At that time the cat appeared to be well on its way to recovering from anesthesia. It had awakened, its eyes were open and its head bobbed. It moved in its cage. It appeared to be recovering normally."

[Comment: Clearly, that is the vet's account. As we will soon see, he then left the office and the cat was not monitored, and the cat died. As a consumer, I have to question whether or not his account of seeing the cat start to recover before he left is true. If he needed excuses for leaving, if there were no witnesses to the contrary, and if he was willing to lie -- he could simply claim that he saw the cat recovering to minimize the appearance of negligence.]

"Dr. Paeplow testified that in his 38 years of practice including thousands of anesthesia administrations, he had not ever seen a cat that had reached the point of recovery he saw in this cat and then fail to fully recover from the anesthesia."

"Dr. Paeplow left his office for lunch with Ms. Marcotte, another employee at the practice.

D.B., a recent hire at the office, was left at the practice."

[Comment: As we will later learn, D.B. is a receptionist -- NOT a veterinary technician.]

"D.B. was not trained in anesthesia monitoring and post procedure monitoring.

While Dr. Paeplow was out of the office, D.B. left the office for an hour and a half, leaving the cat unattended."

"At some time between noon and 2:40 the cat died. The cause of death was not clear. No post mortem was conducted."

"At approximately 2:40 p.m. that day, E.H. [the owner] called Dr. Paeplow's office. The receptionist, D.B., told E.H. that she could come pick up the cat.

E.H. arrived at 2:55 p.m.

D.B. took E.H. back to where the cat was and found it dead.

[Comment: Please note the time. This cat has gone without competent veterinary monitoring for 3 whole hours. Do you think it would have made a difference if someone had given a damn, to check on this cat, to help this cat, to make sure this cat had competent and capable people there to help it???? They might have been able to save it's life, instead it was left without veterinary monitoring and died.]

"This was extremely upsetting for E.H. [owner]. Dr. Paeplow described it as a "horrendous scene."

[Um, are we supposed to feel sorry for these people that the client made a "scene" when the receptionist takes her back to get her cold, dead cat?]

"Dr. Paeplow showed up moments later."

[Comment: What exactly was Dr. Paeplow doing on his lunch with Ms. Marcotte that took 3 hours?????]

"Dr. Paeplow felt the cat and described it as 'cold' and 'stiffening.'

"After this incident Dr. Paeplow consulted with another veterinarian who advised that one should monitor an animal until it is able to stand on it's feet."

[Um, this guy had been practising for 38 years and he didn't know that? How many dead pets haven't we heard about?]

"At the hearing Dr. Paeplow demonstrated remorse for the incident. He took the initiative to reevaluate his office procedures. He took full responsibility for the course of events."

[Well, that's something.]

The Board concluded:

"By leaving the practice before the cat was able to stand on its feet, Dr. Paeplow failed to properly monitor the cat's recovery from anesthetics. He relied on information and used procedures which he admitted were old. This is a failure to conform to the essential standards of acceptable prevailing practice."

"By leaving D.B. [the receptionist] at the practice, when D.B. was not qualified to monitor the cat and its recovery, Dr. Paeplow delegated responsibilities to a person who was not qualified . . . failure to conform to the essential standards of acceptable and prevailing practice.

"This is unprofessional conduct."

Let this story serve as a warning to all pet owners: Even when you think the procedure is routine, otherwise healthy pets die during routine veterinary procedures all the time. If anesthesia is involved, the risk is greater. Please make sure you KNOW EXACTLY WHO will be at the practice when your pet gets a dental or another routine procedure. If needed, physically stay there to make sure they are on top of it. Ask questions about their anesthetic protocol -- who will be monitoring the anesthesia and recovery, what drugs will be used. Get online and ask in veterinary communities if these protocols are standard.

I can tell you that when my cats have dentals, they are given isoflourane and they are intubated to keep their airways open, and are on an IV drip in case something goes wrong and they need to be given some drugs. The veterinary technicians at the place I now use are all licensed. The vet calls me the minute the procedure is done. This is all because I had to learn the hard way. Don't let a story like the one above happen to you or your pet.

Links:

http://vtprofessionals.org/opr1/oprdocs/all/VE12-0504.pdf