Entries in Surgeons (5)


Trauma Surgeons Call for 'War on Ammunition'

iStockphoto/Thinkstock(MIAMI) -- Skyla Davis was shot before she was even born.

Her mother, Tiffany Davis, 27 and eight months pregnant, was leaving a convenience store Dec. 9 in Miami when gang members started shooting in her neighborhood.

One bullet struck her in the brain; another hit her in the abdomen, piercing her womb and shattering her 4-pound baby girl's arm and elbow.

Skyla was delivered by emergency Caesarean section. Her arm is now swaddled in a makeshift sling.

Her mother, unable to speak, was told by doctors about the shooting Monday. Because the bullet shattered in her frontal lobe, which controls much of a person's cognitive function, doctors doubt she'll fully recover.

The bullets were from a Glock 10, the same kind of handgun carried by Adam Lanza, the 20-year-old who fatally shot his mother and then 26 children and staff members at a Newtown, Conn., school Friday before killing himself.

"This epidemic of gun violence is affecting unborn children," said Dr. Tanya Zakrison, who treated Skyla. Zakrison attended an impromptu town hall meeting of trauma surgeons at Ryder Trauma Center at Jackson Memorial Hospital in Miami.

Her hospital, where trauma surgeons bound for Iraq and Afghanistan are trained, is a kind of ground zero in a national crisis.

Last year, 600 gunshot victims -- more than in all of England in a 10-year period -- were treated at Ryder. But Ryder's emergency room is just one piece of a nationwide puzzle.

In 2010, 31,000 Americans were killed by guns -- 60 times more than the number of troops killed in Iraq and Afghanistan in the same year.

About a dozen surgeons who spoke to ABC News -- some of whom said they owned guns themselves for protection -- agreed that they'd like to see guns taken off the streets across the United States, but conceded that it was an impossibility.

"Have all the guns you want," said Dr. Nicholas Namias, medical director of Ryder Trauma Center. "We need a war on ammunition."

Zakrison said she could tell immediately when a victim entered the emergency room whether they'd been hit by an assault weapon or a handgun.

"Absolutely," she said. "[It] looks like a bomb has gone off on the inside."

She said she wants the bullets used today in many semiautomatic weapons to be banned.

Not only do assault rifle bullets travel about three times as fast through the rifle's longer barrel, but they are designed not just to strike but to explode or fragment, causing extensive damage.

Zakrison also said that victims of gun violence needed to be counseled. She said that when drunken drivers caused accidents, they were given counseling with the hope that they don't endanger people again.

She said that patients she saw who'd been wounded by gunfire were often caught in a cycle of violence and were not given that same help.

Copyright 2012 ABC News Radio


Open Heart Surgery of the Future

Jupiterimages/Thinkstock(SAN DIEGO) -- More than half a million people in the U.S. undergo heart surgery every year. It has become a common and mostly successful surgery, where surgeons open the chest wall to get to your heart, cutting through the upper part of a patient’s breastbone to get there.

For the past 75 years these surgeons -- many who now do more than one surgery a day -- have been using an ancient-looking hand crank that winds open the chest, bit by bit -- a tool that requires some muscle by the surgeon.

Chuck Pell, the chief scientist at Physcient, a new surgical device company based in Research Triangle Park, N.C., talked to ABC News while at the 2011 TEDMed Conference on innovation in science and medicine. He explained that not only is the hand crank technology just plain old, but the cranking can really damage the tissue in the chest wall. A surgeon can break the sternum or ribs, damage cartilage or cause long term back pain.  

So Pell’s company set out to solve this problem.  Physcient has created a motorized retractor, i.e., a robot, to open the chest wall that a surgeon operates from a hand-held battery-powered controller. The device creates a smooth movement so that it is a lot less damaging to the chest tissue.  Pell describes it as “anti-lock brakes” for chest retraction.

As the chest opens, the smart device senses when the tissue is tearing and stops until the tissue settles. The prototype is currently on an iPhone interface and seems very simple to use (meaning it won’t require surgeons hours of training like many other robotic- surgery-assist tools). But that’s not the way the product will be presented in operating rooms. Pell says that Apple actually discourages the medical community from using the iPhone during surgery because it doesn’t believe the phone is precise enough for something so important.  

As for the cost, Pell said it would run a hospital about $500 per use, but he anticipates a huge cost savings by not having to treat other problems that arise from potential tissue damage in the long-term. The device still has a way to go -- it has only been tested on pigs. Sheep are next, and then, finally, humans. It will be about 18 months before the robot is submitted to the Food and Drug Administration for approval.

Copyright 2011 ABC News Radio


Buyer Beware: Uncertified Doc Botches Surgery

ABC News(NEW YORK) -- After going into surgery for a simple repair of her breast implants, Dinora Rodriguez, 40, awoke from the procedure to find that her plastic surgeon had left her with conjoined breasts. Without her knowledge or permission, the surgeon had also nip/tucked her eyelids, leaving Rodriguez with eyes that to this day cannot close all the way.

Rodriguez learned the hard way -- you always have to vet your plastic surgeon.

"A friend had recommended the doctor to me. My biggest mistake is that I didn't check any of her credentials. I found out later that she had done really bad surgeries on some other people too," Rodriguez told ABC News.

The doctor in question was licensed to practice as a plastic surgeon in California, where Rodriguez lives, but she was not board certified by the American Board of Plastic Surgery.

After a year of pain and disfigurement, Rodriguez sued her doctor for malpractice and says she found out that the corrective surgery on her breasts was not even necessary in the first place.

"She told me that she needed to replace the implants because they were leaking and I believed her. She gave me a good price on the surgery and I said yes," she said.

Now Rodriguez has become the poster child for a new safety campaign spearheaded by the new president of the American Society of Plastic Surgeons (ASPS), Dr. Malcolm Roth. The campaign, announced Monday at the annual ASPS conference, warns against "white coat deception" – basically, just because a doctor has a white coat, and even an M.D., doesn't mean they are qualified to perform plastic surgery.

In 48 states it is currently legal in the United States for doctors who are not certified by the board of plastic surgeons to practice cosmetic and plastic surgery.

"This means that we have other physicians creeping in who have taken a course and think they can do plastic surgery," said Roth. "It's not the same as going through six years in training specifically in plastic surgery, plus the continual training and code of ethics that are required for those who are board certified," he said.

"People spend months or years making a decision on which care they're going to purchase – it's no different when having a procedure performed. Plastic surgery is elective, there's plenty of time to do your homework and that's really all we're asking: do your homework," Roth said.

Rodriguez ended up settling her malpractice suit out of court. She says the compensation she received barely covered her reconstructive surgery she needed. Because the surgeon had cut across the two separate "pockets" that normally hold breast tissue, the implants were able to touch in the middle, said Dr. Steven Teitelbaum, a plastic surgeon in Los Angeles who did Rodriguez's reconstructive surgery.

Unfortunately, because the first surgeon had removed too much skin from Rodriguez's eyelids during the procedure she says she had never asked to have done, there is nothing that can be done to reconstruct her lids -- she will never again be able to fully close her lids and must take medication for the rest of her life to moisten her eyes. Because the first surgeon cut through nerves and muscle, she also has shooting pains in her ribs surrounding her breasts.

The number of non-board certified plastic surgeons practicing is on the rise, Teitelbaum said, because the public is demanding more plastic surgery and with insurance reimbursements so low, many non-plastic surgeons are offering cosmetic procedures in an attempt to maintain their income.

And with the rising number of unqualified plastic surgeons practicing, he says the number of patients suffering from less-than-ideal surgeries is also increasing.

So what can a patient do to check out their doctors before going under the knife?

First and foremost, make sure the doctor is board certified in plastic surgery specifically, which you can do by searching the doctor's name on the ASPS website, Roth said.

In order to be board certified, doctors who do their residency in plastic surgery must pass a rigorous set of written and oral examinations. While they can legally practice plastic surgery even if they don't pass these tests, they will not get board certification.

Another important question to ask of your surgeon is whether they have hospital privileges if needed to perform their procedures, Roth says.

"If the nearby hospital won't let them practice under their roof, then something might be up," he says. "Probably, the physicians at the hospitals don't believe that this physician has adequate training."

Copyright 2011 ABC News Radio


Doctors Face High Risk of Malpractice Claims

Jupiterimages/Thinkstock(BOSTON) -- Almost every physician in the U.S. will face a malpractice claim during his or her career, according to a new study published in the New England Journal of Medicine.

Researchers led by Dr. Anupam Jena, a physician at Massachusetts General Hospital and Harvard Medical School, analyzed malpractice data over a 14-year period for all physicians covered by a large malpractice insurance provider.  They estimated more than 75 percent of doctors in specialties with a low risk of malpractice and 99 percent of doctors in high-risk practices will be sued.

"If you consider a doctor who is 30 years old and just starting a career and in a high-risk specialty, there is about a 100 percent chance that by the age of 65 he will have faced a claim," said Jena.  "We find that across all specialities, the annual risk of a claim is substantial -- 7.4 percent of all physicians had a malpractice claim every year during the study period."

The study also found that while the risk of a malpractice claim is high, about 80 percent of claims never result in any payment to plaintiffs.  Average payments ranged from $117,832 for dermatologists to $520,923 for pediatrics.

Neurosurgeons, thoracic/cardiovascular surgeons and general surgeons face the highest risk of a malpractice claim, while general practitioners, pediatricians, and psychiatrists face the lowest risk.

While the monetary costs of claims are low compared to risks, Jena said doctors pay an extremely high price in other ways.

"There are substantial costs associated with those claims," Jena said.  "There are the costs of defending the claim [and] the losses in productivity while doctors spend time with their defense.  Patients may suffer by not being able to see their doctors, and there also [are] the effects of stress and potential damage to reputations."

Copyright 2011 ABC News Radio


Study: Surgeons More Prone than Most to Thoughts of Suicide

Photo Courtesy - Getty Images(CHICAGO) -- Six percent of U.S. surgeons have had suicidal thoughts during the past year -- a percentage 1.5 to three times higher than the general population -- according to a new report in the Archives of Surgery.

Pressures of the job often weigh heavily on doctors' minds, as well as guilt over mistakes they might have made.

To make matters worse, only about one in four have sought assistance from a mental health professional to help them deal with their issues.  Generally speaking, most of the surgeons who didn't go for therapy were concerned that they would put their medical licenses in jeopardy by opening up about their problems.

The majority of surgeons who think about killing themselves are male and over age 45.  Divorced doctors are also at a greater risk than their married counterparts.

Overall, it's estimated that between 300 and 400 physicians commit suicide annually, which is also more than the general population.

Copyright 2011 ABC News Radio

ABC News Radio