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Hot on the heels of my malpractice insurance fiasco comes this timely post. Here I detail the top ten mistakes seen in vet practice (yeah, we vets do stupid stuff sometimes):
1-Forgetting to take out the IV catheter when pets go home: This is common (three or four times a year for us), though not so much since we started including CATH OUT! checkboxes on our patient’s cage cards.
For the record, I know firsthand this happens in human medicine, too. I remember distinctly after bringing my 85 year-old great aunt home from the hospital that I’d had to remove the IV the hospital left in. The most memorable bit of this story is that before I extracted it, she’d been calling her doctor claiming they’d left her “VCR” in. I got a kick out of that one.
2-Leaving the thermometer in: Yes, really. Though I’ve never been known to do this, almost everyone has at least one story about broken thermometers in backsides, clients threatening to sue over mercury poisoning, surprise thermometer-laden stools and other decidedly un-funny rectal temp occurrences. Other than a slew of broken digital thermometers lost to racehorse hooves during my stint in school at Penn’s New Bolton Center (you try taking the rectal temp of a spoiled, 1,200 pound two year-old) I have no great stories for you on this front.
3-Close-cropping toenails: OK, so this one’s boring, but the bloodbath that can result from an overtrimmed claw means possible head trauma for our squeamish, faint-prone clients. Such a tiny transgression is not without its ripple-effect.
4-Cutting the patient while removing bandages: Again, one disaster I’ve never managed but which one bifocal-sporting colleague admits to frequently stressing over—especially when it comes to cats (even when using bandage scissors!). Tissue glue works wonders for this, by the way—as does honesty. No client wants to be surprised by evidence of your accidental slice before you tell them about it.
5-Too-tight bandages: Now, this is an understandable one. In many cases, we’re stuck bandaging swollen spots. We sometimes make it a tad tighter in places with the judicious understanding that the swelling will subside over the next 24 hours. But not all estimates work out. And then there’s the vagary of limb movement and bandage sliding and chewing to consider.
6-Mis-labeling the meds: Wow, now that’s a killer—potentially, anyway. Though we typically train everyone in our hospitals to learn how to check standard drug dosages, it still happens.
7-Just plain forgetting to do something while the pet was under anesthesia: Just today, I realized I’d committed this sin (which occasioned this post, of course). I hadn’t removed a retained puppy tooth from a one year-old dog’s mouth during her spay. Oops!
Sure, it’s in the chart. Sure, it’s ultimately my responsibility if someone’s ears didn’t get a thorough flushing. But an extra tooth? Sheesh! That needs to come out! And this one’ll be on my dime for sure—as it should be.
I know ya’ll hate declaws but I couldn’t resist telling you about one who’s left dewclaw got left behind. That’s an asymmetrical double-oops!
8-Whose poop is whose?: On a busy day it’s all over the place. (The stool, that is.) The last thing you want is to try figuring out who had the hookworms…after the fact.
9-Forgetting to place the e-collar immediately after surgery: Murphy’s Law dictates that these are the pets most likely to tear out their sutures.
And finally…
10-The dreaded syringe malfunction: I actually read about a lawsuit currently pending on this issue. The aggrieved owner is suing the vet for pain, suffering and an emergency room visit after the euthanasia solution got into her eye after a syringe malfunction during the procedure. For the record, something like this has happened to me exactly twice in twelve years of practice.
One time, the thickness of the solution, the slipperiness of the needle tip and too much pressure on my part made for a barbiturate shower. Luckily the owner wasn’t present and the only one personally affected by the solution was me (and it didn’t hurt my eyes a bit but it sure tasted awful nasty). I now use luer lock syringes for all euthanasias.
The second time, my syringe actually came apart during a sizable blood draw, spilling what appeared to be buckets of blood on the tile floor below. The owner didn’t faint but she didn’t wit around for another blood draw, either.
Got more? Give ‘em up!
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Here are some ACTUAL mistakes that have been made in veterinary practices in the past 5 years, the first one -- made on MY cat.
1. Leaving your patients with an UNLICENSED UNSUPERVISED person who happens to be your son, who is NOT a vet tech, and who "hasn't given an insulin shot" in years, and who subsequently uses a TUBERCULIN syringe instead of an insulin syringe, resulting in a MASSIVE 30 unit overdose.
2. Letting unlicensed unsupervised assistants give insulin (different case), and they end up using a U-40 syringe to give U-100 insulin. (this was done to someone else's cat).
3. Ligating both ureters during a spay (this has been done MANY times by MANY vets)
4. Allowing an unlicensed, unsupervised "assistant" to compound medication, resulting in a fatal overdose (real story).
5. Giving a cat who has pleuresy from fluid overload and is "recumbant" a dose of lasix and then leaving her unattended overnight.
6. Keeping an elderly dog under anesthesia for 3-4 hours to pull every tooth in his mouth without informing the owners you were going to do that. (he died).
7. Leaving the drug cabinet unlocked.
8. Persisting in a diagnosis of toxicity due to ingestion of shampoo YOU prescribed when the owners told you no shampoo was ingested and the dog is a Shetland Sheepdog who came in with a visible tick bite and unexplained limping followed by increasingly severe symptoms.
9. Giving an injection of pentobarbitol (diluted) directly into the abdominal cavity for "sedation" or pain (not for euth). This destroyed this animals internal organs.
10. Putting two dogs together in one cage when the owner has told you not to.
11. Prescribing NSAIDS to a pet who is in kidney failure.
I could go on, but you get the drift.
Your previous post from yesterday makes it sound like there is so much UNWARRANTED claim of vet mal going on, but I can tell you, that there are SCORES of completely WARRANTED claims of vet mal -- and nothing is done about it. These vets typically are fined VERY little and given "stayed" suspensions.
Problem is that from the POV of one vet who knows lots of super vets it's harder to imagine malfeasance among my friends. And I've seen them suffer after being sued for *no good reason.* They won their cases handily after the judges looked at things clearly but they still spent months of stress and loads of money defending themselves.
It's not that I'm making excuses for the many truly indefensible offenders. I know they're out there and I assure you that *all vets* have a vested interest in getting them gone from this profession.
When I have a vet I've worked with for a while and trust I'd be happy to sign such a thing to keep litigation costs (and consequently my costs) under control.
Our vets have a dogs on leash, cats in carriers policy to keep everyone safe and happy. My dogs' vet doesn't handle exotics, but restraining our friendly neighborhood predators seems like it should keep everyone safe in a mixed practice. Dogs with aggression problems (human or animal) can also be muzzled as an extra precaution.
I wasn't particularly upset - it happens, it's not fatal, the vet was very apologetic and by the end of the visit, the dog had already forgotten that it happened.
Mixing up fecal samples has happened a few times w/me, too. We've been using a centrifuge for quite some time, though, and the samples go into a clear tube that's a little less ambiguous than a fecalyzer container - you can at least tell what color the feces was, how much was put in there, etc.
Putting blood samples in the wrong tube: sometimes you forget that you need to run a heartworm test with that blood too - after you put it into a serum separator tube, etc.
I did work for a veterinarian who once removed the thyroid from the wrong cat. There was an almost identical cat in the kennel next to the hyperthyroid kitty and the tech forgot to double-check the charts. Then I guess the vet didn't notice she was cutting on the wrong cat. Pretty crazy. Lucky for the vet, the owner of the de-thyroided kitty didn't sue...but she could have, and it would have been warranted. I think that's the most serious transgression I've witnessed.
My own confession? I frequently forget to snap Snap tests. Even though the directions say to put the test on a flat, level surface, I've taken to carrying them with me (as parallel to the ground as possible) as I go on w/my tasks so I don't forget to snap the darn thing!
I've never really understood why anyone would let their dog go say hello to another without permission. ESPECIALLY in a vet waiting area where the dogs might be contagious.
As for vet's, we used to take our poodle to one that did grooming as well. During the grooming, as he was working on her face, he shaved out her eye!! Then, said that he would put her to sleep and reimburse (sp?) for a new dog.
-.-
we don't use that vet anymore...
I had an elderly cat who I had to give frequent sub-q fluids to.... more than once I realized I'd poked too far when the fluid came spurting out the other side of her scruff! ;/
At least the fix is easy: just pull the needle back a little so it's still under the skin and doesn't poke out.
I have difficulty trying to think *how* he managed to actually do it, I can only imagine he stuck the corner of the blade into the eye somehow. Terrible, I shudder to think about it. Did you end up having her PTS, or did she survive (minus the eye ?), what was the outcome ?
Alison
Everyone cuts toenails too short once and a while; it comes with the territory.
I have witnessed the euthanasia-solution shower that occurs with non-leur lock syringes. At my work the only non-leur lock syringes we have are tuberculin syringes or catheter tips; the rest all lock!
And I can totally relate with Anna about SNAP tests; I will usually forget to snap one about every two months; it's always on the patients that were hard to draw blood from! Augh!
Ones I recall:
A Dr. meant to give a Centrine injection, and was puzzled when the dog became very sedate. He had picked up the Telazol bottle by accident! Fortunately the dose was within a safe range.
Another: a tech asked her assistant to give a patient an ampicillin IV injection. The assistant, not knowing the difference (and not taking the initiative to ask), gave an amoxicillin white suspension meant for subcutaneous injection IV. Fortunately, the patient did not have any reaction.
And once a tech gave a cat a canine DHPP. Again no reaction occurred, thankfully.
Little did I know, he had Parkinsons. It wasn't terribly obvious until he went to insert the syringe, and she struggled, and he almost landed the shot in me! Awful experience. I am still sad that my girl's last memory was one of her owner totally terrified of being euthanized. (My dog and I weighed about the same amount - I guessed that it would have been as effective on me as it was on her)
Needless to say, when we brought a new puppy home, we also found a new vet. While I loved our old vet and his common sense approach to veterinary medicine, I am also happy that he retired.
****this is not applicable to FRAUD, cruelty, & financial scams. Where are all these malpractice cases??? Most states consider a pet no more than a "toaster", legal fees for the client to bring suit, would more than likely not be recouped by any damage awards---not too mention "non-economic" is not even allowable for a broken or dead toaster.
Anyways,I digressed. A younger sibling of mine also had a much needed life-saving surgery back in '06. After a week or so, a distinct white piece of plastic partially protruded through an unhealed wound. Our family, including my sibling had lots of yucks, proclaiming the surgeon lost his "coffee spoon" ----it wasn't, of course, but added some humour to a stressful time. Drs. ----anyone have an item accounted for, after an open surgery???