U.S. Rep. John Murtha died after surgical mistake

You know how some people say that Americans deserve the same health care that Congress provides for itself? Maybe we should rethink that.

The Pittsburgh Post-Gazette reports the following on the death of U.S. Rep. John Murtha:

Mr. Murtha was first hospitalized with gallbladder problems in December. He had surgery Jan. 28 at the National Naval Hospital in Bethesda, Md. He went home, but was hospitalized two days later when complications developed.

According to a source close to Mr. Murtha — confirming a report in Politico — doctors inadvertently cut Mr. Murtha’s intestine during the laparoscopic surgery, causing an infection.

On the other hand, neither does it appear to be the proper time to debate limits on malpractice lawsuits.

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53 comments Add your comment

Road Scholar

February 9th, 2010
9:18 am

Was the surgeon a demo or repub?

That was a joke for the paranoids on each side!

Nancy from Pittsburgh

February 9th, 2010
9:33 am

Pittsburgh is spelled with an “h” at the end!

BigAppleGeorgiaPeach

February 9th, 2010
9:40 am

I think I’d be afraid to have any doctor who works for the government lay his/her hands on me!

Edwin A. Bowman M.D.

February 9th, 2010
9:45 am

Having practiced military medicine, I know that when a celebrity patient enters a military facility, it is likely that his or her care will be assumed by a ranking physician. In the case of surgery, this is not always a good situation for the patient. Being occupied by administrative details, the higher ranked surgeon may not in the operating room daily honing his skills. If you have a choice, always pick a surgeon who does a lot of surgery and does it every day, regardless of his rank.. Endoscopic removal of the gall bladder is an operation that requires constant practice to be perfected.

Elizabeth C.

February 9th, 2010
9:54 am

My 91 year old grandmother had laparoscopic gallbladder surgery in September and also had complications. The surgeon in her case pinched off her common bile duct during the surgery. As a result, bile was not able to drain from her liver properly. She had to have a second surgery to repair the common bile duct. During this surgery, the surgeon placed a feeding tube in her stomach because he felt that she may have issues eating after the two surgeries. A few days later she was out of ICU and eating normally. During an examination by the doctor, it was noticed that her stomach was distended and hard as a rock. Further investigation revealed that the feeding tube had become dislodged and that stomach contents were leaking into her abdomen. This led to her third surgery in one week. During this surgery, the stomach tube was removed. They eventually placed a feeding tube through her nose. I could continue with the list of incompetecies that hindered my grandmother’s recovery. It is a miracle that she is alive today. I think the problem here seems to be that there is a high incident of secondary complications as a result of laparoscopic procedures especially in elderly patients and that doctors should be required to undergo more training for these procedures as they require more skill to perform.

Just A Grunt

February 9th, 2010
9:55 am

What makes you think it was an accident?

The headlines today all proclaim Murtha as a defender of or spokesman of the military. I think at least 8 soldiers and their families (Haditha) would disagree with that and a large part of the military who he regularly criticism in the Global War On Terrorism.

No, Mr Murtha was no friend of the military. He was the friend of military contractors in his district. You want to talk about somebody who could create jobs, mostly for his extended family, then Jack was your man.

Edwin A. Bowman M.D.

February 9th, 2010
10:14 am

To Elizabeth C.: Pinching off the common bile duct is an inexcusable, but unfortunately not uncommon, surgical mistake. These endoscopic procedures do require more training and experience, and not all surgeons have the inate ability to master it. Unfortunately, some surgeons refuse to accept their limitations. Always question your surgeon about his, or her, training and number of operations they have performed. Don’t take vagueness for an answer. No surgeon, being human, is perfect. But you want as close to it as you can get.

Wounded Warrior

February 9th, 2010
10:58 am

Most active duty military can’t wait to use the private health care instead of the Army hospitals. A soldier can’t sue them for medical malpractice and mistakes happen more there than in a private hospital. My experience stinks at the VA, but pay for great private health care. Even a private knows not to use the military hospitals if given 1/2 a chance.

Sam Hill

February 9th, 2010
11:04 am

Murtha was a scum and a crook. Three cheers for his surgeon!

Ole Guy

February 9th, 2010
11:21 am

Doctor Bowman, It was always difficult for that 20 year old WO-1 pilot to understand that, as aircraft commander, his decisions, as far as flying the aircraft, took precedence over the demands of that ranking, though non-rated guy in back. That, of course, was 40-odd years ago. I find it incredulous that not a whole lot has changed in that regard. A surgeon with rusty, possibly antiquated skills is preferable to a doctor, junior in rank, whose skills are both current and functionally up to date. Perhaps this protocol should be reviewed.

Dr. Feelgood

February 9th, 2010
11:38 am

Laparoscopic GB surgery is not benign. Bile ducts are commonly injured resulting in bile leaks, infection, and death. Traditional open GB surgery allows easier identification and avoidance of the bile ducts.

Bowel injury is less common but any time you poke an instrument into the abdomen you can injure the bowel which may result in death.

Dr. Feelgood

February 9th, 2010
11:42 am

People often mistake the number of years a physician has worked for “experience”. Some of the most “experienced” physicans I know make the most mistakes. Being a physician requires lifelong learning. You can’t just walk out of residency and never open another book. Unfortunately many physicans do exactly that.

Bobby

February 9th, 2010
11:46 am

John Murtha was a fine American soldier. Sean Hannity, Rush Limbaugh and Neal Boortz aren’t worthy enough to do so much as polish his shoes. None of them served in the U.S. Military.

Ole Guy

February 9th, 2010
11:47 am

OK, so Doc Feelgood, are you suggesting that, given a preop consult, it would be wiser to opt for open surg as opposed to lapro? Other than scar mitigation, does lapro hold any advantages over traditional cuttin?

mike

February 9th, 2010
11:47 am

To Sam Hill one thing about your post Mr Hill. It is obvious that you have benefited from Murtha’s long outstanding military service to this country. Likewise for all his so-called opponents who never put those boots on like this man did. Even in death, folks of your ilk still are ate up with hate. Must be a really sad and miserable life to get up everyday and feel like you do towards someone you don’t know or ever hope to be in Murtha’s class.

J. Luft

February 9th, 2010
11:50 am

Life guarantees eventual death, and somewhere truth be known if it be hastened.

Edwin A. Bowman M.D.

February 9th, 2010
11:53 am

Dr. Feelgood…A good surgeon is careful where and when he pokes an instrument into the abdomen. I did this over a thousand times, often teaching other surgeons the procedure, and never had an injury. Whether you are comfortable with the idea or not, endoscopic surgery is here to stay. In most cases, it has many advantages over traditional open surgery.

Road Scholar

February 9th, 2010
11:59 am

Hate to break it to you two, but Sam and Fred YOU ARE the scum!

Winfield J. Abbe

February 9th, 2010
12:04 pm

The duped public should be grateful to this newspaper and the Pittsburgh Post Gazette for honestly reporting another medical failure that would normally be covered up “sorry we did our best”. Cancer treatment is another area where this kind of medical malpractice is common. All approved cancer treatments are life threatening. My wife was nearly killed not from breast cancer but treatment. The chemotherapy kills cells good and bad alike like a machine gun. It affects rapidly dividing cells in the colon. If too many cells are killed it literally makes a hole there for life threatening bacteria normally found in the bowel to enter the bloodstream. My wife had clostridium septicum in her blood from which most patients die in 24 hours. She was placed in intensive care for about 11 days in a vegetative state. To add insult to injury the local Athens hospital then charged about $77K to keep her alive after they nearly killed her. Luckily she did not die. But if she had they would have said “sorry, we did our best”. The doctor would not immediately admit this is what happened to her.
Over a half million cancer patients die each year either from cancer, treatment or both, mostly treatment. In any other situation one would be offered their money back. But with doctors not even an apology is offered. Years ago professor Hardin Jones, Ph.D., professor of medical physics and physiology at UC Berkeley and expert in medical statistics, proved that cancer patients who refused the orthodox treatments lived up to 4 times longer than those who accepted them. Little has changed today. The war on cancer is a dismal failure. Read “The Cancer Industry” by Ralph W. Moss Ph.D. and “The Truth About Hydrazine Sulfate-Dr. Gold Speaks” by Joseph Gold M.D. at http://www.hydrazeinsulfate.org. Americans love to be fooled. Too much advertising.
Winfield J. Abbe, Ph.D., Physics
Athens, GA

Dr. Feelgood

February 9th, 2010
12:06 pm

Dr. Bowman, I’m sure Murtha’s surgeon was being careful too. Maybe he had done it a thousand times too.

Ole Guy, as with anything in life there are pros and cons to each approach. Open surgery has a lnger ecovery time but does allow easier identification and avoidance of the bile ducts and bowel. Laparoscopic surgery has a shorter hospital stay and fastery recovery time but makes things like bile duct injury or bowel injury potentially an issue. Surgeons often don’t explain this during their informed consent. I’ve have seen numerous patients languishing in the ICU from bile duct injuries from GB surgery.

Vince Culpepper, MD

February 9th, 2010
12:09 pm

As a surgeon who performs this operation on a regular basis, it bothers me to read the comments regarding supposed incompetence and negligence. These complications occur despite excellent training, experience, and care. Without knowing the whole story it is difficult to pass blame. There are at least a dozen things that can go wrong in any operation – people are not all people are created exactly the same. The worst part of this is that no one recognized the injury at the time of operation, not that the injury occurred. I compare it to a competent, well experienced driver who hits an unmarked road hazard – the accident is not necessarily his fault even though he is driving the car. He may be able to recover control of the car and prevent a catastrophe, but a smaller collision is still going to occur. In this case the catastrophe was not avoided probably because it was recognized too late in an elderly man who can’t recover as a younger person would.

Dr. Feelgood

February 9th, 2010
12:11 pm

Agree with Dr. Culpepper.

Winfield J. Abbe

February 9th, 2010
12:11 pm

The like above should be corrected to read http://www.hydrazinesulfate.org,

VA Defender

February 9th, 2010
12:26 pm

My grandfather who is 92 years old is a VA patient and has been for years. After 3 separate bouts of cancer (prostate, colon and throat) and being hospitalized with an extreme case of gout, my grandfather has found the doctors and nurses at the VA hospital to be top notch professionals and very caring. With his age he naturally has many ailments which make his life difficult. However not a week goes by in which he receives a phone call from his primary care physician at the VA to inquire about his status. It may be government healthcare…but he would not be alive today if it were not for the professionals at the VA.

Ole Guy

February 9th, 2010
12:35 pm

Thanks for the insight, doctors.

Randall

February 9th, 2010
12:51 pm

@Bobby

You forgot, Obama and Clinton did not serve in the Military. I’m sure this was just an oversight on your part.

Elizabeth C.

February 9th, 2010
1:23 pm

Dr. Culpepper,

Why should it bother you? Yes, there are many things that can go wrong in an operation. Some of these things are pure accidents. Some of these things are caused by negligence and incompetence. The incompetence being that some surgeons don’t realize their limitations and continue to move forward despite situations that indicate they should not.

Billy boy

February 9th, 2010
1:41 pm

Murtha had an A+ rating from the NRA, always voted Pro Gun.

He was Anti War, a former Marine Combat vet and Neo CONS hated him as he denounced their illegal Occupations.

Glenn

February 9th, 2010
1:48 pm

Why is it that the chuckleheads that scream tort reform the loudest never mention the idea of getting the lousy doctors out of medicine .

Ronnie

February 9th, 2010
2:35 pm

Is it known how many people die per year from legal malpractice?

[...] This post was mentioned on Twitter by ajc dot com, politicalinsidr, ajcpolitics, Chloé, Tim Alborg and others. Tim Alborg said: RT @politicalinsidr: U.S. Rep. John Murtha died after surgical mistake http://bit.ly/cCQabo [...]

Base

February 9th, 2010
4:25 pm

How about pay for performance for doctors!

Chuck

February 9th, 2010
4:32 pm

Well, Maybe he did the same care that everyone else gets. I am sure that Sister Nancy will be closing that loophole.

Marty McFly

February 9th, 2010
4:37 pm

Bet ole Murtha is hanging with Teddy K right now in hades. Hope they are having fun!

Vince Culpepper,MD

February 9th, 2010
4:42 pm

Elizabeth C., What bothers me is the attitude of the public such as Glenn. That this was a lousy doctor. Yes there are lousy doctors, just as their are lousy airline pilots, lawyers, etc. If a plane crashes, we don’t assume it is the pilot until an invesigation by qualified people (pilots) is performed. Lawyer’s lose a case, malpractice is not assumed. Yes, this guy nicked the bowel, but the question is would it have occurred if someone else were doing the case, due to perhaps internal scars or other anatomy that increased his risk. No one should graduate from residency in this country without completing about a thousand operations. For most of us it was many more. It is a very demanding 5 years of about 100 hours per week of work. this has now been reduced to 88 hours per week over concern for fatigue contributing to medical errors. I have done over 900 laparoscopic gallbladder operations, I have had one injury to the bowel, which I repaired at the time and the patient did well. I have never injured or clipped the common bile duct as happened to your grandmother. I say this not to brag, I am not arrogant about it. I say this to tell you that it is only by the grace of God that has not happened to me. I am very careful, but sooner or later I too will have a complication such as this no matter how careful I am. And doing the open operation may decrease the risk in some ways, but many older patients die from pneumonia or other complications after open gallbladder surgery. These are the things we learn to weigh out in training. sometimes you are d’d if you do and d’d if you don’t. there is an old saying among surgeons – if you haven’t had a major complication you haven’t operated enough. The numbers will eventually catch up with you. Bad doctors don’t need to practice, but the public should not decide who is a bad doctor and neither should the court, any more than we should decide why the plane crashed.

Parkerized

February 9th, 2010
9:24 pm

The biggest problem I have with medical malpractice is that the medical profession is self regulating but does not seem to hold its members to a high standard. The medical boards are made up of medical professionals who continue to give incompetent doctors many chances. One local doctor in my area has been to drug rehab multiple times but is allowed to continue practicing. As a Professional Engineer I understand my professional responsibilities and would not attempt to practice outside my areas of specialty. If I make a fatal professional mistake through incompetence, arrogance, or corruption I expect to lose my license. Which is as it should be! If the medical boards were stricter I believe many people would be more interested in malpractice lawsuit limits.

Joseph J. Neuschatz M.D.

February 9th, 2010
9:38 pm

BASE asks: “How about pay for performance for doctors ?” You mean contingency fees like the lawyers have ? No cure….no pay. If cure takes place….33.33% of the value of your possessions ? Could be interesting.
Statistically speaking a hospital bed is a very dangerous location. More people die in a hospital bed than in any other location. I had my bed at home for 42 years and, so far, nobody died in it. Should I stay home if I get sick ?
By the way: not every death on the O.R. table is due to malpractice. I wrote a book about it.

Joseph J. Neuschatz M.D.

February 9th, 2010
9:44 pm

PARKERIZED: The biggest problem I have with medical malpractice is that when a physician gets sued, the lawyers make sure that there is not one medical professional in the “jury of your peers.”

Wounded Warrior

February 9th, 2010
10:17 pm

The Ft. Hood Army Dr. that shot up the base is a great example of lame Dr. He did awful on his tests, and constantly tried to get others involved in his cause. He should have been a soldier first…Equal Opportunity failed at Ft. Hood.

Chris Mathews is covered in his own spittle because he is drinking, again and becacuse he is a racist

February 10th, 2010
1:07 am

RealityCheck

February 10th, 2010
1:42 am

Looking for advice. A close friend had a similar experience a month ago, but he did not die. His two-day hospital stay for laparoscopic surgery on a pelvic ligament problem turned into a one-month stay and two additional surgeries, including one to investigate the infection (10 hours after symptoms began), and another one a few days later — from sternum to mid-abdomen — to further investigate the infection when fever, white blood count double the normal level, and discomfort continued. The family had insurance, but will still need to pay a percentage of the $500,000 in medical bills, which they cannot afford. And, six weeks after he entered the hospital, he still needs assistance because of the major surgeries. What are the options the family can take to pay for this, get the fees reduced, or get the doctor to take some responsibility? Is a malpractice suit advisable? The family is not sophisticated in terms of health care rights and responsibilities.

RealityCheck

February 10th, 2010
1:53 am

Looking for advice for a similar situation that occurred a month ago on a close friend in Philadelphia. His one-night hospital stay for laparoscopic repair of a pelvic ligament turned into a month-long stay, including two additional surgeries (the last one from sternum to abdomen) to investigate the infection from a perforated colon. This was followed by three weeks of drainage tubes and high doses of antibiotics. Medical bills so far — $500,000. The parents of this young man have insurance, but will be responsible for that which the insurance doesn’t cover. What options do they have for payment? Should they consider a malpractice suit? Is there precedence a suit of this nature? The father is a gardener. This would “break” them financially.

Joseph J. Neuschatz M.D.

February 10th, 2010
8:00 am

DR. BOWMAN: Celebrity patients having their surgery performed by ranking physicians who are usually busier administrating than operating ? WOW ! You hit the scalpel on the head.

Joseph J. Neuschatz M.D.

February 10th, 2010
8:32 am

DR. CULPEPPER: You are absolutely right. American citizens are innocent until proven guilty. The exception ? The American physicians. They are guilty until proven innocent.

The inspiration for my novel “terrO.R.” came from an old (never explained) incident, when I discovered that the estate of an O.R. fatality was allowed to forbid the diagnosis making post-mortem examination (for religious reasons), but maintained the right to sue for “Anesthetic Death,”

28th Amendment « Chamblee54

February 10th, 2010
11:45 am

[...] may not)… is a bit ironic. Sometimes too much privilege can be a problem. US Representative John Murtha died recently, from complications after gall bladder surgery. Mr. Murtha, a Vietnam Veteran, had been a [...]

Dr.G

February 10th, 2010
2:16 pm

Last night’s ediition of the NY Daily news states that Murtha’s death “triggered second hand allegations the infection may have been caused when a surgeon nicked the large intestine”.”Rep Bob Brady (D-Pa.) who was mentored by by Murtha, said he had no personal knowledge of operating room errors and I only know I heard someone on Murtha’s staff said that”. Elizabeth C., Glenn and Parkerized should be ashamed of themselves for commenting on an event based on rumor for which the facts are unknown. In addition they have no medical training as I have no training in engineering, Parkerized. Here is what we know and don’t know. Murtha had the misfortune of developping gallstones, they weren’t placed there by the surgeon. The surgeon decided that if they weren’t removed they could eventually kill him, so in fact he was trying to save him from that possibility. Second, nothing is routine in medicine, there are statistics for complications and death even from gallbladder surgery just as there statistics for plane crashes even in the best of hands. Captain Sully a good pilot was lucky he was flying over the Hudson the outcome may have been different in Atlanta. Third we know nothing of Murtha’s overall health, the same complication occuring in one patient may not be fatal in another patient depending on his or her medical conditions. Fourth we know nothing about what transpired in the Virginia hospital where he was admitted. There is a lot of that medical information missing. Finally we know nothing about the surgeon. Often times the best surgeons are the ones who will operate on patients no other surgeons will operate on and in saving many of these patients will lose some. I can tell you this because as an Anesthesiologist I see this everyday. And to choose or not to choose a surgeon by whether or not and how many times he’s been sued is a mistake. Good surgeons operate a lot, do difficult cases, often have high risk patients, and have overwhelmingly good results but will have the rare poor outcome despite good care that results in a lawsuit. The most common topic in todays ORs is litigation, fear of litigation, how to avoid it, rising malpractice premiums, overtesting patients etc. We’ve done a great job chasing experienced highly competent obstetricians out of practice because of litigation and astronomical malpractice premiums leaving their place to inexperienced “never been sued” recent graduates. We’re in the process of doing the same to our surgeons by what we’re doing to them in the newspapers and courtrooms.

Gringo

February 10th, 2010
3:09 pm

How about pay for performance for government workers?

Joseph J. Neuschatz M.D.

February 10th, 2010
3:19 pm

Dr. G (and to whom it may concern): here are a couple of letters to the NY Times, written almost a quarter century ago:

http://www.nytimes.com/1987/02/18/opinion/l-white-house-tries-to-shortchange-research-imperfect-results-545987.html

http://www.nytimes.com/1986/08/16/opinion/l-pay-as-you-went-631586.html

Despite political pre-election slogans…..NOTHING CHANGES !

I would love to learn the opinion of fellow Anesthesiologists on my novel “terrO.R.” (fiction ?)

Dr.G

February 10th, 2010
6:11 pm

What about pay for performance? What about pay for performance for all physicians?What does it mean?Does it mean that if a patient dies, or has a heart attack or stroke or loss of some vital function you don’t get paid? If so you won’t find many orthopedic surgeons rushing to fix hip fractures as they do now in 90 year old patients who may still have a good 5-10 years left.Patients at high risk will suffer. Those at high risk needing total joint replacements will be given medical therapy for their painful condition, the same for some coronary patients needing coronary bypass and the list goes on and on. Even surgery for some forms of cancer such as brain tumors might disappear given their high rates of poor outcome, too bad for those rare cases of survival. The use of money to influence decision making is what brought medicine to the miserable state it is in.What the public needs to allow is to allow the physician to determine what’s best for the patient based on medical knowledge not on financial considerations and for medical decisions to be made by physicians not by individuals and institutions with no medical training. Medicine is not cookbook, each patient undergoing some type of therapy or procedure is unique, some with similar conditions may even have different therapies based on numerous factors least of which should be financial. As such, outcomes cannot be reliably compared nor guaranteed.

Ole Guy

February 11th, 2010
6:35 pm

Bobby, and many more out there, I should point out a very important consideration relative to the publics’ “deitization” of military people, particularly high profile personalities. Many of these fine folks, despite rank, ribbons, and blaring bands are/were horrible humans. This is neither an indictment against the military nor a smear on any individual, but merely a reality-based observation that the very nature of military service, particularly the participation in mans’ inhumanity to man, while an unfortunate ingredient of humanity, does terrible things to many. I speak, not of PTSD, but simply of the military members’ relationships with the world about.

During the 21 years I wore the uniform, people would, during overseas movements, shower accolades upon my brothers and me. While certainly appreciated, I would often wonder, “Why us…why me”? You, the public, don’t know who I am or what I am. I could be a flaming ars, on my 6th wife at the age of 30, an alcoholic with kids whom I regard with disdain (I’ve seen all this), but because I wear a uniform, in the public eye, I’m an All American Hero.

Don’t get me wrong…public support is highly appreciated. I have, hanging in my den, the Christmas stocking that a family sent, anonamously, during my last tour. I look at this stocking, every day, and I am reminded, every day, that the American people place great trust and esteem in the American Fighting Man (gender neutral). Just don’t forget the folks who deserve at least the same degree…if not more so…of praise: educators, public servants (except for a lot of politicians).