Falling five storeys from a New York rooftop changed my life • Hacker News Board

Re: Falling five storeys from a New York rooftop changed my life

#151

Post by gnopgnip » Tue, Oct 27, 2020, 6:48 AM UTC

xmprt wrote: post #120

ghufran_syed wrote: post #110

Earlier quoted context omitted.

This is just bad medical care, assuming the description is correct. Even if they had been given the pain meds, you move the shoulder slightly to see how well the pain medicine is working, if it’s not working well enough (= patient shows evidence of significant pain), you give more pain medicine. But it’s hard to get to some level of analgesia that can control the peak of the pain that will happen during joint reducti…

What happens to the doctor in cases like this? Seems like a slam dunk medical malpractice lawsuit but then again it's just one word against another and damages are hard to prove since pain is only experienced in the moment.

In most cases like this, nothing for medical malpractice.

Calculating damages for pain and suffering is usually based on a multiplier of the "economic" damages, the medical bills or lost income from missed work. So in a case where the pain does not result in a longer recovery(or permanent disfigurement or worse) there are no, or nearly no damages. Because of the way tort reform has worked out, it would be impractical for an attorney to represent you unless you can show $25k+ in medical damages, even if it is clear the provider violated the standard of care and it caused you a great deal of pain. Also even in a straightforward case like this, showing that the standard of care was violated is not clear

You could complain to the hospital ombudsman and your insurance co, both to prevent this from happening to others, and because it could reduce your bill.

Re: Falling five storeys from a New York rooftop changed my life

#152

Post by curryst » Tue, Oct 27, 2020, 10:13 AM UTC

srtjstjsj wrote: post #148

thaumasiotes wrote: post #123

Earlier quoted context omitted.

> Basically, an addict wants to look genuine, so a lot of genuine patients have to put up with stuff designed to cut off addicts. It's much stupider than that. Addicts want the drug. So all of the indicators of addiction are actually indicators of wanting the drug. So anyone who wants the drug is, ipso facto , an addict. There's no element of addicts trying to look more genuine. Look at that list of red flags: - Comp…

Let's not go too far to one-sided cherry picking. https://intervention911.com/common-signs-of-drug-seeking-beh... - laiming they need more drugs to replace a lost or stolen prescription - Misrepresenting their symptoms - Frequent visits to multiple doctors, including a willingness to travel to a different city or state to see a new physician – a phenomenon called “doctor shopping” - Unwillingness or inability to prov…

Many of these things are uncommon, but not particularly rare among non-addicts.

> Claiming they need more drugs to replace a lost or stolen prescription

Have you really never lost a prescription? I've lost portions of mine once or twice (i.e. I had a week left and lost the bottle). Luckily not having mine is more of an annoyance than anything, but I can empathize for someone in pain who lost theirs. Stealing medications is common in addicts as well, and for every addict that steals a prescription, there's someone that legitimately did have their prescription stolen.

> Misrepresenting their symptoms

If this can be shown objectively, I can't see any way a non-addict would do this. I fear that it sows distrust between the patient and the doctor, though. The doctor is always looking for signs of the patient misrepresenting symptoms, and the patient is always worried that the doctor is going to think that they're misrepresenting their symptoms.

> Frequent visits to multiple doctors, including a willingness to travel to a different city or state to see a new physician – a phenomenon called “doctor shopping”

Uncommon, but it wouldn't be entirely shocking for someone to travel for access to a better doctor. This wouldn't be that out there for someone who has cancer, for example.

> Unwillingness or inability to provide a complete health history or contact information for previous physicians

I've moved a few times in my life. My complete health history probably involves 30 or so doctors if we go back to childhood. I don't think I could even name all of them, much less have contact info for them.

The statistics do matter, but we're talking about subjecting people to pain here. The evidentiary bar should probably be higher than "you did a thing that addicts are statistically more likely to do". I think especially so when the worst case scenario is that we give an addict a fix. I'm not advocating drug use, but the harm caused seems pretty minimal, beyond the cost of administering that dose in a hospital.

Re: Falling five storeys from a New York rooftop changed my life

#153

Post by curryst » Tue, Oct 27, 2020, 10:33 AM UTC

ReactiveJelly wrote: post #44

arkitaip wrote: post #36

Earlier quoted context omitted.

This is why checklists have become are a huge thing in the medical field. In your scenario, imagine if the first nurse had it drilled into her that she must tick a box on the patient checklist, which lies very visible next to the patient and is almost impossible to not notice, and you have a physical system that makes it difficult to commit mistakes

That sure would be nice. I haven't had any problems of this scale, but my doctor can't even schedule a follow-up appointment 3 months in advance. They can't even use a calendar, much less a checklist. My pills are prescribed for 3 months and they always manage to hem and haw and almost miss the window as if the passage of time was a recent concept that their practice was unequipped to deal with. On the other hand, ev…

A lot of medical software is severely lacking, and general practitioners often operate solo practices where they operate by the doctor's preferences (which might make everyone else's life very difficult, such as the people who have to handle recurring appointments). I've been around some doctors that will do things like ban using the recurring appointments because when they double click the appointment it takes them to the "edit recurring appointment" page, not the "take patient notes page". So yes, their office may be literally unequipped to handle the passage of time because either their EHR system sucks, or the doctor is making everyone else's life hard.

Psychiatrists seem to operate out of groups more often (I see far fewer solo psychiatrists). Groups mean that you have to have EHR software that works well enough to transfer patients between doctors, and you have to have standards set up to where doctors can read patient histories from other doctors. Basically your EHR system needs to be functional, which has nice side effects like making scheduling and prescription refills work correctly.

Re: Falling five storeys from a New York rooftop changed my life

#154

Post by curryst » Tue, Oct 27, 2020, 11:06 AM UTC

hzay wrote: post #146

delfinom wrote: post #142

Earlier quoted context omitted.

Babies don't magically change weight. It's just when they are fighting being picked you are probably being forced into a position with less mechanical advantage.

It doesn't seem to make sense logically, if you think of weight as mass * gravity. But hypothetically speaking, if the baby can do this -- https://www.youtube.com/watch?v=f5Wks63Ng0Y -- don't you think the weight will be different to whoever is picking the baby up? We don't pick up the baby as a single movement. If we did, then yes there can be no magical weight change. But in reality, there's a bit of a choreography…

You're right, just using the wrong terms. The baby's weight is fixed at mass * gravity, it doesn't change. What changes is the force required to accelerate the baby upwards, which is the delta between the force of gravity (the baby's weight) and any upward forces opposing that gravity. So if the baby pushes upward with it's feet to help you, you have to exert less force to lift the baby.

Scientifically speaking, the weight of an object cannot change unless gravity changes or it's mass changes. The forces required to accelerate that object in a particular direction vary wildly based on all kinds of things that exert a force on the object.

Off topic, but that does make me curious how "weight" works in an environment where you're exposed to more than one gravitational field. Like if you're close enough to two black holes to be affected by the gravity from both.