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Interviews with survivors, victims' families, policy makers, and health care workers. What went wrong? How can we make health care safer? Host Scott Simpson, uses his counselling skills to evoke the secrets, stories and solutions. https://www.patreon.com/rss/MedicalErrorInterviews?auth=2eY8hVY9bd5o78a8cmpNSURYZ2VrqXrq
Episodes
Monday Jan 13, 2020
Monday Jan 13, 2020
In part 2 of my interview with David Moore, he tells us about being a caregiver to his friend and mentor college professor Patti as her health declines and the medical intervenes. When Patti goes in for what she thinks will be a routine 45 minute operation, David waits patiently.
When the surgeon comes out after 3 hours and says there were complications, David begins to worry. When Patti survives and gets to the ICU, the surgeons want to do more surgeries to fix what they broke, but David is named in Patti’s medical directive, and he follows her wishes and tries to protect her from what he calls the profiteering of Nazi-esque eugenics programs.
SHOW NOTES
Aortic valve stenosis for Patti
0:05:15
David's touched on 3 medical errors: his experience with the dental industry; the food we grow and eat and its impact on our microbiome; and the over-treatment of the elderly for profit - David was also taking care of an elderly friend who recently died
0:06:15
David was caretaker for the last 15 years of a friend who was his Department Chair when David was an adjunct professor at UNLV (University Nevada Las Vegas) - about 3 years ago she was diagnosed with aortic stenosis, that means there is valve in the heart that has become over-calcified and is reducing blood flow - this is no big deal unless under high exertion, then it can cause a special kind of fainting spell
0:07:15
She / Patti was 78 years old, they did an echocardiogram and they recommend a surgery called a TAVR (transcatheter aortic valve replacement) - a medical device they stick up through the groin arteries and cut out the valve and this device is a cage that is supposed to expand and seal - if it doesn't seal, it is called a leaky valve or heart failure
0:08:15
Instead, Patti went on a marijuana regime, and in 3 years cleaned out her arteries so she didn't require a stent - she did diet changes - a new study just came out saying stents are less effective then diet changes - but during these 3 years she lost 30 pounds and in the pool more often - sure, she wasn't feeling as sprightly as when she was younger, but she was aging well
0:09:15
For those 3 years doctors told her she could drop dead at any moment - she would walk up at night with panic attacks and afraid she was going to die - David explained that it was her sleep apnea, where she stops breathing, and that was causing her panic - the doctors convinced her to get an angiogram - the echocardiogram showed her aortic valve opening at .36 cm - anything below .7 or .8 is consider critical
0:10:15
She lived a sedentary lifestyle, never left the house, David did all of her shopping, she was always on the computer teaching courses online - the angiogram, 9 months after the echocardiogram, showed she a .56 cm opening - according to modern science that is impossible - David attributes this to marijuana and her diet
0:11:15
Her surgeon doesn't have Patti's case history, he wouldn't speak to David in front of a nurse - the cardiologist said they found biomarkers for heart disease, but David pointed out how she had improved
0:12:15
The statistics show there is a 6% chance she'll die during, and a 25% chance she'll die within 12 months of surgery - Patti ends up going for the surgery, she's convinced it will be a 45 minute procedure and she'll be home the next day - TAVR surgery is highly risky, no efficacy, and unproven beyond 3 years
0:13:15
The actual surgery lasted 3 hours - the surgeon came out and told David to 'go home and get some rest and come back in a few hours and Patti will be in ICU, don't worry, the 1st one we put in didn't work, so we're trying a 2nd one' - we haven't put in a pacemaker yet
Surgery gone awry
0:14:15
Patti / David did not know this risk factor: that since Patti's aorta was only .36 cm, very calcified, it was obvious a stent would not seal because calcium has jagged edges - it is impossible
0:15:15
The 1st didn't seal, and they played around with it, and then it slipped down and that reduces her blood flow and blood pressure, essentially making her heart die - in that moment her heart is dead - they gave her a bunch of chemicals and put in a 2nd valve up through the 1st and get it to open and seal to the calcified walls - David thinks that once the 1st valve failed they should have gone to open heart surgery
0:16:15
So there is a gap between the valves, they are both leaking, her heart is being mechanically pumped, she's on a breathing tube and they are pumping her full of chemicals / medications - her body is moving as her heart is pounding - Patti's medical directive said she did not want heroic efforts, feeding tubes, etc
0:17:15
David was Patti's power of attorney for medical - they'd been friends for 25 years, and he was her caretaker the last 15 years - then the surgeons put her in ICU and asked for her consent to try to put in a balloon to try to seal - David says they lied to him that a valve was restricting the blood flow, but they actually know the valve implants are leaking
0:18:15
They tried the balloon in a 3 hour surgery, and that didn't work - then another 3 hour surgery to put in a pacemaker - Patti was conscious between the surgeries - after the 1st surgery, instead of following Patti's medical directive, the hospital called her next of kin and they gave permission to keep her alive
0:19:15
The surgeon said that he'd been keeping Patti alive for 5 hours because that's what her sister said - David told him he'd already given him Patti's medical directive, and the surgeon is freaking out - he's worked so hard to keep Patti alive with chemicals - David thinks they should have let Patti die, but the doctors follow the next of kin and do the other surgeries
0:20:15
Then they wanted to do another surgery called 'a cuff' that would force open the slip valve - they had told David the ballon was the last ditch effort, and now they're saying a cuff is the last ditch effort - they had said that if things went wrong in the 1st surgery they would do an open heart surgery - David later found out that there is only a 2% survival rate after failed TAVR surgery - they declined the open heart surgery - David also wanted to decline the cuff because it was torturing Patti
0:21:15
David had a meeting with all the doctors and nurses - he had to threaten to call in the administrators and lawyers - they decide to bring Patti out of sedation to ask if she wants to consent to a cuff surgery, and she does - they wanted David to sign the consent but he refused and left the hospital - David says anyone on death's door would consent to anything
David refuses consent for more surgeries
0:22:15
They told David that if he wouldn't sign the consent, they would take Patti off pain medications for 4 hours to get her direct consent - David didn't want her to experience that pain so agreed to sign the consent - however, they were doing exactly what Patti didn't want and had expressed in her medical directive
0:23:15
But somehow the hospital had lost her directive - so they kept Patti in ICU for 48 hours and as they're wheeling her into the operating room for surgery, her heart gave out and she died - the surgeon told David 'her heart is dead, we're not going to do the surgery', a weird mechanical response
0:24:15
This hospital is building a new cardiac wing but they ran out of money - this surgeon sits of the board of the hospital and they sent out a donation form to hospital staff with their pay cheque, basically saying that if they wanted to keep their job, make a donation - David suspects they were trying to increase Patti's insurance pay out
0:25:15
Patti had great insurance, and David feels they were running up the bill - one angiogram cost Patti's insurance $150,000 - the more procedures, the more profit - unnecessary procedures is one of the health care system's biggest expenses
0:26:15
Turning back to the dental board - David was filing complaints and a lot of other people contacted him because he did an public statement - in Nevada the 'open meeting law' - so all licensing boards are required to have public meetings and allow public members to speak, and they can speak for 3 minutes
0:27:15
David was encouraged to make the public statement, his supporters said they would record it - as soon as David starts talking about doctors, David was cut off and not allowed to speak about the corruption - drama unfolds, police arrive, and David is kicked out of the meeting - the dental board applied for an extended restraining order against David so that he can never go back and speak - they claim David threatened their lives - but David had video evidence
0:28:15
David played the video for the judge and she reprimanded the dental board - but the judge also took the dental board's side about the restraining order - David was told by the judge that if he didn't like her decision, he could leave the state of Nevada
0:29:15
The judge was rude to David and tried to get him riled up so she could justify the restraining order - David says Clark County is a small place and all the professionals look out for each other - then Governor Sisolak, a democrat, is elected, ousting the republican - Sisolak has been on a lot of boards
0:30:15
Sisolak started going after the dental board saying 'he'd never seen a more egregious audit in my life' - David sees his chance and starts making public statements at Sisolak's Board of Examiner meetings with District Attorney, Treasurer - David made 3 public statements, and Sisolak liked them
Disciplinary Hearing
0:31:15An investigative journalist for the Las Vegas Review Journal writes a multiple part expose, and exposes all the nastiness with the dental board - David submits 3 new dental board complaints against 3 other dentists, totalling 6 complaints (with his other 3) - the dental board assigns one investigator for all 3 new complaints, in violation of the Governor and audits orders
0:32:15
The Governor swoops in and cancels the dental board's meeting and says they all need to come in for a disciplinary hearing for what their doing - instead, they send a republican lobbyist that represents a certain faction of the board, to tender their resignations
0:33:15
So none of the dental board shows up, they all resign - but before they resigned they fired the executive director and the attorney for the dental board - they didn't do that because they were scared of discipline, they did that because David threatened them with a lawsuit that would make them personally liable - there was a Supreme Court decision in 2015 against the dental board in North Carolina - they were trying to block the ability of consumers to access cheaper commercial dental devices
0:34:15
The North Carolina board wanted to make money - but the Supreme Court said that if the board continued to act in an antitrust manner, they would be held personally responsible
0:36:15
Making the board personally responsible was the key into opening the door to make change - the governor passed a bill to set up a patient protection commission, appointed in 2020
0:37:15
Health and Human Services deals with public health, they are not concerned with other aspects of health - David says they need to focus on human success by creating a system that gets the holistic person gets on the health care record
0:38:15
Right now it is very siloed and that increases costs and medical errors - so the solution is to make the members of the medical boards personally responsible and ensure patients are informed about all risk factors - a health record would be a bunch of 'if...then' statements
0:39:15
That patients sign off on on these 'if...then' statements - David says it is all about personal responsibility and tracking everything
Health care for profit per procedure
0:40:15
Artificial intelligence would help doctors make decisions - right now the health care system is built on a for-profit per procedure, David would make the system for-profit per success - this would force doctors to look at the whole patient
0:41:15
David hoped to be appointed as a public member on the Governor's commission - David thinks he is a bit confrontational for the doctors taste, but thinks that's what the Governor wants - conflict creates change
0:42:15
David thinks that eventually each state will have protected patient advocacy groups that are situated in every hospital and speak with every patient - there is tons of research evidence that patients should be aware
0:43:15
David says the control mechanism has to be the insurance companies, but if their colluding with the medical industry to maximize profits, we're in trouble, and that's what's happening - the number of medical devices is sky rocketing
0:44:15
David thinks the Governor needs to dictate a vision, and the Commission should fulfill that vision
0:45:15
David will speak again at the Governor's next meeting - David finds patient advocacy very rewarding - David Harold Moore on Linkedin is the best way to connect him - David's website about marijuana neutriceutal is MyLifeBak.com
0:47:15
David says that only by sharing our nightmare stories will change come - regular media is not covering our stories because the whole system has been corrupted by money - David says the solution for the dental industry is simple: minimally invasive, one tooth at a time
Connect with David Moore:
Website: https://www.mylifebak.com
Linkedin: https://www.linkedin.com/in/davidharoldmoore
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Scott Simpson: Counsellor + Patient Advocate + (former) Triathlete
I am a counsellor, patient advocate, and - before I became sick and disabled - a passionate triathlete. Work hard. Train hard. Rest hard.
I have been living with HIV since 1998. I was the first person living with HIV to compete at the triathlon world championships.Thanks to research and access to medications, HIV is not a problem in my life.
I have been living with ME (myalgic encephalomyelitis) since 2012, and thanks in part to medical error, it is a big problem in my life.
Counseling / Research
I first became aware of the ubiquitousness of medical error during a decade of community based research working with the HIV Prevention Lab at Ryerson University, where I co-authored two research papers on a counseling intervention for people living with HIV, here and here.
Patient participants would often report varying degrees of medical neglect, error and harms as part of their counseling sessions.
Patient Advocacy
I am co-founder of the ME patient advocacy non-profit Millions Missing Canada, and on the Executive Committee of the Interdisciplinary Canadian Collaborative Myalgic Encephalomyelitis Research Network.
I am also a patient advisor for Health Quality Ontario’s Patient and Family Advisory Council, and member of Patients for Patient Safety Canada.
Medical Error Interviews podcast and vidcast emerged to give voice to victims, witnesses and participants in this hidden epidemic so we can create change toward a safer health care system.
My golden retriever Gladys is a constant source of love and joy.
I hope to be well enough again one day to race triathlons again. Or even shovel the snow off the sidewalk.
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