Grandma got ran over by the John Deere..

[SunsetBengal]

Yeah, the title is a humorous spoof, but the story is real. Last Thursday, my wife calls me at work, and we never call each other at work unless it's something truly significant. She informs me that her mother rolled the riding lawn mower over herself several times. She lives in the country, a few miles North of Marietta, it's pretty hilly around there.

Anyway, I leave work to see my wife off to Ohio to be with her mother. The hospital in Marietta checks her over, does a couple X-rays, and sends her on her way. My wife and one of her brothers have spent the entire time since the accident with her. This lady has gotten progressively worse, day by day. Finally, they get her to her primary care provider today, across the river in Parkersburg WV, and she get's some legit testing.

Turns out that she has a compression fracture in her T-10 vertabrae, a hematoma to her liver, fractured ribs, a rather large lesion on her leg from a puncture wound; Not to mention severe bruising and general muscle injuries all over her body.

My question is; How does the hospital in Marietta simply "look her over" and send her home, without noticing any or all of those serious injuries? I know that we have at least a couple of members with medical credentials on here. Can you offer any advice as to why the ER would examine her, and then send her home without admitting her?

[HarleyDog]

Is it possible she refused further testing while at the hospital? Sometimes we just don’t know right away the extent of our injuries because of the excitement and wish to avoid enormous hospital bills.

[SunsetBengal]

(08-26-2020, 07:31 AM)HarleyDog Wrote: Is it possible she refused further testing while at the hospital? Sometimes we just don’t know right away the extent of our injuries because of the excitement and wish to avoid enormous hospital bills.

I don't think that was the case.  Brother in law was at the hospital with her, he was in disbelief that they sent her home.  Her primary care physician was astonished that they didn't at least keep her overnight for observation.

[jfkbengals]

Not saying this was the case, but I recently read that there are some ERs where, due to the focus on trying to keep in front of Covid, they are limiting admission to the hospital. The description was basically what you describe, a quick check of the patient and a diagnosis and treatment that gets them back out the door.

[*bengalfan74*]

This has been like 25 years ago but my then father in law got to feeling bad, and he had been for several weeks. Bad stomach pain, gray stool lots of times. They finally talked him into going to the DR. He ordered tests including MRI or CT scan ? of stomach, liver, gall bladder and whatever ? The doctors at a Southern Ohio hospital said it all looked good.

Couple weeks later he was dead. We had some Dr's in Columbus look at the results/film a few weeks later and they were astonished ! They said "they told you he was clear"???? They showed us, here's a 4cm gall stone, here's a 3cm gall stone, there's a blockage here like 5cm and on and on. They were like "WOW"

The Radiology Dept/Dr's at that hospital were ummm not good.

Hope she's ok.

[SunsetBengal]

(08-26-2020, 10:08 PM)bengalfan74 Wrote: This has been like 25 years ago but my then father in law got to feeling bad, and he had been for several weeks. Bad stomach pain, gray stool lots of times. They finally talked him into going to the DR. He ordered tests including MRI or CT scan ? of stomach, liver, gall bladder and whatever ? The doctors at a Southern Ohio hospital said it all looked good.

Couple weeks later he was dead. We had some Dr's in Columbus look at the results/film a few weeks later and they were astonished ! They said "they told you he was clear"???? They showed us, here's a 4cm gall stone, here's a 3cm gall stone, there's a blockage here like 5cm and on and on. They were like "WOW"

The Radiology Dept/Dr's at that hospital were ummm not good.

Hope she's ok.

She's in better hands, now.  The hospital in Parkersburg ran some tests and showed several things that the one in Marietta either failed to acknowledge or failed to diagnose.  She has a compression fracture in her T-10 vertabrae, in addition to the things that I listed previously.  My wife and her brothers are going to try to rotate time, so that someone is always with her.  However, at age 70, they also realize that this is likely the beginning of the end for Mama Brenda.

[*bengalfan74*]

(08-26-2020, 10:22 PM)SunsetBengal Wrote: She's in better hands, now.  The hospital in Parkersburg ran some tests and showed several things that the one in Marietta either failed to acknowledge or failed to diagnose.  She has a compression fracture in her T-10 vertabrae, in addition to the things that I listed previously.  My wife and her brothers are going to try to rotate time, so that someone is always with her.  However, at age 70, they also realize that this is likely the beginning of the end for Mama Brenda.

Yes you've got to be careful. Some hospitals just don't have quality people/DR's in all areas. Lack of experience, knowledge, or just hurry up and get em out here ? I dunno. 

And unfortunately you see that a lot in the elderly. A fall, accident or something starts the downhill slide they never recover from. My dad however had a very bad face plant when he was like 75 ? Broke his collar bone, face and head was so swollen and bruised. I figured it was gonna be the end of him. He's 83 and still going.

[*Synric*]

Marietta Hospital is nothing more than a bandaid station. Camden Clark in Parkersburg is one of the better medical facilities in the area.

[oncemoreuntothejimbreech]

I don’t think I’ll be able to offer a satisfactory explanation because that sounds like poor work, but I’ll try.

As far as missed injuries:

Xrays aren’t recommended for rib fractures in most cases because 50% of simple rib fractures are missed by X-rays. And even if you see the rib fracture the treatment is the same; pain management. If your mother in law is 70, I probably would have ordered the xrays or a CT. Over age 65 it is recommended they be admitted for pain management and respiratory therapy to reduce the chance of developing pneumonia. Imaging is more geared toward other underlying injuries, like pneumothorax or free air in the abdomen from a rib fracture puncturing other structures.

Compression fracture of T10 could be missed on X-ray and could also be pre-existing. Additional testing such as CT, MRI, or bone scan can help determine if the compression fracture is new or old. Usually the radiologist will advise you on additional testing in his report. The treatment would be pain management, again, with ortho referral. Surgery for a T10 compression fracture would be cases by case, but probably unlikely. Just let it heal.

A liver hematoma may not be present initially, but could develop over the next few days. I’ve seen cases like that monitored on an outpatient basis and they healed on their own.

As to why she wasn’t admitted, I don’t know. They may not have had the beds. If they didn’t have a bed, but thought she needed to be admitted then they should have arranged a transfer.

It’s difficult to speculate knowing so little.