This is beyond freaking crazy !

[Ayesha]

This is outrageous ! Please after you read this artical if you find it as
horrid as I do please take the time to write the people at the email
addresses at the end of the page .

A man's life hangs in the balance, a man who is the sole custodian of his
2 young children.

Thanks,

Ayesha


By Carla McClain
ARIZONA DAILY STAR

A Tucson father who faces certain death without a new liver has been
kicked off the UA transplant list.

University of Arizona transplant officials confirm that David Rasmussen,
41, had been accepted for a lifesaving liver transplant but was taken off
the list for what they call "abusive" behavior to nurses.

The incident occurred while Rasmussen was hospitalized at University
Medical Center, after he tried futilely for 40 minutes to summon a nurse
to unhook him from tubes during an attack of diarrhea, he said.

Only words were exchanged during the incident, Rasmussen said, when a
nurse "yelled" at him for unhooking his own tubes so he could go to the
bathroom.

"I said something wrong when I was very sick, and now it's a death
sentence," said Rasmussen, who has sole custody of his two young children,
5 and 7.

"I had only one chance, and now I have no chance. It seems so strange to
me. I don't know how one bad night can be enough to kill you."

Nursing charts at the time of the incident confirm that Rasmussen was
plagued with diarrhea during his weeklong hospitalization for an extremely
serious liver condition known as hepatic encephalopathy.

The condition, which can be life threatening, is caused by hepatitis C,
the disease that has destroyed Rasmussen's liver. He said he thinks he
contracted hepatitis C when he got a tattoo as a teen-ager.

The liver condition is known to cause disturbances of consciousness and
psychiatric changes in the patient.

Defending the decision to deny Rasmussen a transplant, UA officials point
to the extreme scarcity of donor livers.

"Livers are certainly scarce, and we have to make sure they go to people
who will benefit from this gift," said Constance Glasby, UMC's director of
transplant services.

"Success of a transplant depends on a patient's willingness and ability to
comply with medical directions and on having a support system to help him
through the entire process.

"During this process, the patient develops a relationship with our team, a
relationship that is permanent. You just don't get a transplant and then
go off fancy-free. They're with us for life. It's a serious commitment -
it's a marriage.

"So the patient must refrain from causing any adverse relationship with
the team and must refrain from destructive behavior.

"I said something wrong when I was very sick, and now it's a death
sentence."

David Rasmussen
Liver transplant patient

"Mr. Rasmussen has demonstrated through specific actions or inactions that
he cannot make this commitment."

Glasby added: "This is not just a single incident."

But she declined to elaborate further, saying "UMC is not comfortable
discussing patients publicly."

An examination of Rasmussen's UMC medical records show only one
hospitalization, for seven days in February, since he was accepted for
transplant there in August 1999.

While he was in the hospital - both before and after the diarrhea incident
- nursing charts repeatedly describe Rasmussen as "pleasant,"
"cooperative," "appropriate," "social" and "agreeable." His psychological
evaluation on the day he was discharged from UMC is marked "WNL" - "within
normal limits."

It was only during one time period in the middle of his hospital stay that
nursing charts note "agitation" and "impatience," as well as "grieving"
and "scared."

Rasmussen said he was severely bloated - a symptom of the encephalopathy -
suffered severe diarrhea, was scared he might die and was worried about
his children.

It was that night that he could find no nurse to help him untangle his
lines and sheets and go to the bathroom.

"It seemed the nurses never had the time to be around. I could never get
help, when I was bleeding or vomiting, or with the diarrhea," he said.

"This time, I pushed the button for 40 minutes, and no one came. I knew it
was going to be a real mess. I had to go very badly. So I unhooked the
heart monitor and broke one of the little plugs while I was doing it."

When he got back to his bed, the nurse came in and berated him for
unhooking himself and breaking one of the lines, he said.

"She got very upset. She said I should never do that, no matter what was
going on. I don't know what I said. I think I said she should have been
there to help. I was cranky. I admit it. I felt terrible, and I told her
she should have been there."

He admitted he spoke "harshly" to the nurse, "as she had done to me."

Rasmussen was also cited for throwing a small carton of milk across the
room the next morning. He said he was trying to throw it onto his food
tray. The nurses accused him of throwing it at a technician.

"That's just not true. There was no one in the room when I threw it," he
said.

Rasmussen also was cited for taking an over-the-counter antacid without
permission.

Nursing notes at this time say Rasmussen was "tired of waiting for his
milk," "threw milk across the room" and "had concerns about plans for his
children after his death."

Later that day, a UMC social worker told Rasmussen all of this "might be
enough to get you off the list," he said.

"That shocked me. I had tears down my face. I said, 'You can't do that. It
took me two years to get here, and I've got to be there for my kids. I
don't want to die.'

"I said, 'Please, maybe I'm not acting my best, but I don't want to die.'
"

A month later, UMC's liver transplant surgeon, Dr. Paul Nakazato, wrote a
letter to Rasmussen's primary-care physician saying Rasmussen was off the
UMC transplant list.

In the letter, Nakazato cited the February hospitalization that produced
"two major problems."

"First, he does not have the standard support systems available for him to
be able to arrange clinic vis ...[Message truncated]

azgov@azgov.state.az.us
mcweb@mail.ci.tucson.az.us
jibarra1@mail.ci.tucson.az.us
cwest1@mail.ci.tucson.az.us
scarbaj1@mail.ci.tucson.az.us
ward4@azstarnet.com
ward5@azstarnet.com
ward6@mail.ci.tucson.az.us


Mods, if I am out of line posting this let me know, I will apologise.

[evilbeth]

This is outrageous!

"We don't like your attitude so it's death for you."--WTF?

This post really should be in the Pit for me to say what I want to say but here it will get more notice.

The man is DYING AND TERRIFIED!!!!! I can see why he might be a tiny bit cranky!

I work in a hospital and I know the attitudes of some nurses. They don't always answer the call buttons for patients who need periodic care. Whenever those patients need help, it either tends to be messy or just time consuming and they don't want to do it--I see it happen everyday.

I am too upset about this to say anything else right now. I'll have to come back.

[Kricket]

All I can say is Oh my goddess! What in the hell is wrong with these people?
Beth, I think I will meet you in the pit when ever you are ready.

[Initial Entry]

Oh my god. Thats insane.

[Eo Echo]

It is at that. The sad thing is I'm not shocked. I think I should be.

[Typo Negative]

I'm sure there are lawyers lining up around the block to sue these basterds. Rightfully so!

If I had to wait 40 minutes for a nurse during an attack of diarrhea, I would be more than just a bit abusive.

[Lux Fiat]

When the hell did "First, do no harm" become "Shut up and toe the line or we let you die"? Christ, that's some arrogance.

[evilbeth]

I have posted a Pit thread if anyone feels their response cannot possibly be held in check to MPSIMS standards.

[Grimhacker]

I'm sure you are not getting the whole story. I bet the guy is a real prick and had it coming to him.

[tatertot]

OMG! Who made that Lindsay chick in charge of the transplant system?

(Y'all do remember Lindsay, right? I'm not just making her up, am I?)

[Zenster]

Hopefully, everybody who is reading this thread is already an organ donor. If you are not, do something about it today! I have been for many years, and it is one of the best things that you can do for the world around you.

[wring]

I have a friend in a similar circumstance. He's been on dialysis for about 4 years now, 3 times a week, he's hooked up for several hours. Well, he showed up to the clinic for his scheduled time, and the clinic wasn't open. He waited and they finally opened, and started frantically hooking people up. He was hooked up (according to them on time, since he was in the process within 20 minutes of his orginal appointment time, but he'd wated nearly an hour). He tried to ascertain what the problem was.

Keep in mind that being hooked up to these machines is what keeps him alive, and no one made any announcement about what had happened or appologized in any fashion for the delay.

The nurse told him "we're all inconvenienced." gee whiz. you had to hustle for a few minutes, my friend got to sit and wonder if he was going to die. yep, seems equal to me

He got so irate that he nearly had a stroke.

And the clinic was going to refuse to treat him.

I interceded on his behalf, talked at length with the social worker. all these places have social workers. they came up with an "action plan" where my friend was able to keep up with his treatment, they were able to save face, things proceded.

[Dragwyr]

This appears to have some elements of an urban legend. Can anyone confirm this story? I'm not necessarily saying that it hasn't happened, but it sounds almost too sensational to me.

[OpalCat]

(Reposted from the PIT)

Well *I* can verify that UMC is a bunch of bastards. I was born there, and that is where I had Nicky... and I've been in their emergency room, ICU, and Psych wards... To give you an example of their caring nursing staff, when I woke up after my seizure, not knowing where I was, the nurses made fun of me. I had a severe pain down by my vagina all day, and finally when the nursing staff changed shifts, a FRIENDLY nurse agreed to look and see what was wrong. They'd catheterized me but didn't tie the catheter line to my leg, like you're supposed to. So the entire weight of that was just tugging at my urethra. OW.

In the psych ward, where I was recuperating from what they insist on calling a suicide attempt (but which I claim was an attempt to put myself in a coma) the nurses yelled at me for crying at night.

This is also the hospital that kept Nicky an extra day after he was born, forcing me and my husband to sleep in the waiting room (24 hours after a 52 hour labor, I'm sleeping on chairs) and who also gave him a bottle against my instructions and effectively RUINED my chances of breastfeeding, which was probably the cause of him being failure to thrive for the first 3 months of his life. *sigh*

So all in all I would not be surprised in the least to find this was true. It's a crappy hospital.

[OpalCat]

As an aside, if the nurses were being that slow to come when I had diarrhea, I'd just shit the bed and see if they preferred cleaning THAT up.

[Shaky Jake]

(also posted in the Pit)

The surgeon and reporter in the story are real people. I emailed the reporter to confirm the story.

Opal
I worked with xplant patients. The hospital started a new "linen policy": only change the sheets every 3 days unless soiled (not as outrageous as it sounds: the hosp. found it was using 18 lbs of lined per pt per day). One guy waiting for a transplant loved his fresh sheets every day. When he heard of the new policy, he told me "Well, when I get up every day, instead of dragging myself to the bathroom, I'll just take a shit in my bed". I told him "lets pretend you did, and I'll change your sheets". Problem solved.

Shaky Jake

[Mojo]

I can back Opal up- when I went to UMC, it was a 2+ hour wait before someone examined me in a hallway. The gunshot victim next to me got a room after an hour. From everyone I talked to who had been to UMC, all said that their bedside manner is lacking.

[Ayesha]

The artiacal I posted at first was cut short, here is the rest, along with the e-mail address of the reporter.

"First, he does not have the standard support systems available for him to be able to arrange clinic visits and emergency hospitalizations," Nakazato wrote.

"Second, we were not able to work with him on a friendly basis. Mr. Rasmussen was abusive to the nursing staff as well as broke some hospital equipment."

Nakazato then recommended that Rasmussen move out of state and try to get on the list at another transplant program.

"I just felt numb all over my body - I was nauseated, sick," said Rasmussen on getting that letter. "I was just asking, 'Why and how did this happen?' It seemed blown so way out of proportion."

Requests for an interview with Nakazato were declined.

Rasmussen, who is low income and covered for the transplant by AHCCCS, has contacted the the Arizona Center for Disability Law, which is now investigating his plight.

"We simply want this man to live," said Stephen Palevitz, an attorney with the center. "To me, it is unbelievable. Does what happened on one night - what is documented in his records - justify allowing him to die? He had no idea that, if he got mad, it was a death sentence."

Nakazato's charge that Rasmussen lacks a sufficient support system was especially surprising, both Rasmussen and Palevitz said.

Rasmussen has arranged with several of his brothers and sisters to fly to Tucson for rotating weeks to care for him after the transplant. The mother of his children lives here and is helping him with them. He said he has arranged with neighbors and friends to help out when necessary. He said he has never had any trouble getting to the hospital for his appointments and has never missed any.

All of this was relayed to UA transplant officials when he underwent the psychosocial evaluation a year ago. Passing that evaluation is required of all patients before they are accepted for a transplant.

"At the time, the transplant coordinators were convinced I had good support, and I do," Rasmussen said. "Nothing's changed. I don't know why they are saying that now it's not good enough."

Asked about that judgment, Glasby said only, "We did list him, that is true."

Glasby also said Rasmussen has "other options" and named the liver transplant program at the Mayo Clinic in Scottsdale. Acknowledging that Rasmussen has a limited income, she said AHCCCS would pay for his housing there.

But AHCCCS officials indicated that is not a certainty.

"Housing for him and his children and a caretaker? Wow. I don't know if that would be covered in our contract with Mayo," said AHCCCS spokesman Frank Lopez.

"For transplants, we contract with the facilities to get the best deal we can. It would obviously not be the best deal for a Tucson patient to go to Phoenix when there is a facility in Tucson. That would have to come under review."

At the very least, Rasmussen should have gotten a strong warning about compliance and behavior after the one incident before he was thrown off the list, said one of the country's leading medical ethicists.

"Most transplant centers do that," said Dr. Arthur Caplan, head of the University of Pennsylvania Center for Bioethics.

"If it's true this is a single incident and that's it, then I think it's going to be very tough to justify taking someone off the list.

"Yes, there is a short supply of organs, and they have to be used in the best way possible. But one strike and you're out?

"You do that with everyone who's ever had an angry outburst in the hospital, and you'd have an empty hospital."

* Contact Carla McClain at cmcclain@azstarnet.com

[Tzel]

Originally posted by Dragwyr
This appears to have some elements of an urban legend. Can anyone confirm this story? I'm not necessarily saying that it hasn't happened, but it sounds almost too sensational to me.

If this was the pit, I'd do some ranting about the tendency of some Straight Dopers to cry Urban Legend whenever they hear a story that's even a little bit unusual. C'mon, this was an article from an Arizona newspaper about an event that is or was current at the time, about an individual within their own state. This is not an e-mail forward. This is not an Ann Landers column. I personally don't see any evidence whatsoever that this might be an UL.

[dewt]

Please keep us up to date on this. I hope he sues them for enough to buy the hospital and fire all the abusive staff.
grrr.

[Ayesha]

JFTR, Ms McClain's email addy was at the end of the newspaper story, so I doubt posting it was an invasion of her privacy.

[jb_farley]

I just emailed Dr. Art Caplan, Bioethicist quoted in the article, to verify the veracity of the article. He's the ethics ombudsman for the philadelphia area, so I don't know how readily he responds to missives from a dorko on a message boards. But I did give him the thread address. I'll keep y'all posted.

jb

[Ayesha]

Guys, our own Germ Boy called the reported who wrote the story, if you will check evilbeth's post here http://boards.straightdope.com/sdmb/...threadid=38987 you will see what he learned.

Thanks Germy, I am already married, but if I weren't ohhhh baby !

[Germ Boy]

Ayesha,
If the simple fact that I could track down a reporter gave you the urge to create a union with me then, by gawd, you're my kind of woman! You should see me ferret out an intermittent short in my car's electrical system. Make ya' wet!

[Spider Woman]

Ayesha, I was referred to this thread from evilbeth's pit thread (didn't see yours at first). I e-mailed all those addresses asking for them to look into the matter and take action, and I gave the web addresses of SDMBs and of this thread. I requested that they keep us apprised of their progress, which they may or may not do (maybe depending on who is up for re-election).

Thank you for bringing this to our attention. It makes me feel proud to be a member, because of people like you who make the efforts you make.