Utah: Victim's Family States 3 negative tests for H1N1 before death

[Skatman]

Flu Victim Family's Statement

Staff Writer

7:40 PM MDT, June 14, 2009
Our family would like to express thanks to the Shock and Trauma unit at IMCH. And to those who have prayed and supported our family over the past 2 weeks.

Francine and her mother became ill with the flu two weeks ago today. Her mother tested positive and was treated for the flu and has since recovered. Francine tested negative and was sent home. Her health continued to decline, and three days later she was taken to Jordan Valley Hospital. For the second time she tested negative, was sent home, and told to increase fluids and rest.

We begged the doctors to treat her with Tama flu because it had helped her mother, but they refused because her test had come back negative. After another three days she became incapacitated, and was again taken to Jordan Valley where she was admitted and found to have pneumonia, plus all of the symptoms associated with the flu, but once again tested negative. At this point she had had the flu for approximately eight days, untreated. Her condition continued to decline, and on Tuesday was transferred to IMC Hospital. By this time her body was so ravaged from the virus that her kidneys and lungs started to fail and brain activity had diminished. On Wednesday, June 10 we received a positive Type-A flu test, and on Thursday we received, from the CDC, a positive test for H1N1, Swine Flu.

After fighting a valiant battle she succumbed to this illness. It has been reported that she had underlying illnesses that contributed to her death, but according to her doctors she died from lung damage, kidney failure, and brain damage which were all strong and healthy prior to contracting the virus

[Laidback Al]

Re: Utah: Victim's Family States 3 negative tests for H1N1 before death

Also: see this thread: http://www.flutrackers.com/forum/sho...d.php?t=110341

[the doctor]

Re: Victims Family States 3 negative tests before death

Another case of muti-organ failure.

What's more another instance where the doctors treating the patient relied upon the now notoriously uninformative rapid flu test (high false negative rate) rather than the patient's symptoms to decide whether to treat her with Tamiflu or not.

If I was a malpractice attorney, I would have a field day with this and the many other cases of US deaths that contain the same basic facts. Press reports abound with similar stories. (If you are a plaintiffs attorney, don't bother contacting me. I am too busy getting ready for the pandemic to bother with being a hired gun for you.)

These doctors will state in court that they were only following the CDC's guidelines for who to treat with Tamiflu and they would be correct. The problem is the CDC's guidelines are wrong and the doctors remain responsible for their decisions irrespective of the guidelines they followed.

OK, they followed the CDC guidelines but the patient died. Admittedly she may have died even if given Tamiflu early in her course but for some inane reason, these doctors when faced with a patient with an ILI and a negative rapid test for flu decided not to treat her. This is despite the fact that 90%+ of all LILs seen in the US today are due to Swine Flu and it remains 100% sensitive to Tamiflu. What were they thinking? The retail cost of Tamiflu is $100 for a 5 day course. What is the cost of a life? Maybe they didn't want to go through the hassle of getting the Tamiflu pre-authorized by the patient's insurance company, a diabolical insurance company policy that was introduced in mid-May and is now widespread. And guess what? The insurance companies are only approving payment for Tamiflu prescriptions where the patient meets the CDC guidelines.

Oops! I think that constitutes Catch 22.

Doctors must rely upon their own judgment not guidelines when treating individual patients. This is what the jury will decide in this and the other cases when they come to court. Guidelines are provided from the prospective of the health of the public as a whole rather than for the health of the individual patient. Doctors that forget this will pay a great price. Not the malpractice award, that is the small price. The big price is the death of the patient which will stay with the doctor through eternity.

As a doctor, I have made mistakes that has harmed my patients and like the doctors I fillet above, did not intend to do so. These doctors are not to blame as they did their best for the patient. What I am upset about is how this pandemic has been handled since mid-May by TPTB. It is they who I blame for the death of this and many others in the US not these or the other doctors. I know they did their best and share the sorrow they feel for their failure to help these people. God bless and protect them (from guilt but especially from malpractice attorneys ;~) )

Grattan Woodson, MD

[somebodyoutthere]

Re: Utah: Victim's Family States 3 negative tests for H1N1 before death

I am absolutely horrified that she was refused Tamiflu.

[UtahApoc]

Re: Utah: Victim's Family States 3 negative tests for H1N1 before death

After fighting a valiant battle she succumbed to this illness. It has been reported that she had underlying illnesses that contributed to her death, but according to her doctors she died from lung damage, kidney failure, and brain damage which were all strong and healthy prior to contracting the virus.

Why is it in every case I read about they claim "Underlying conditions" yet the famlies ALL have refuted such claims. Is the CDC putting a coverup or gag order to dispell panic that this is affecting you-mid age persons not typical of the seasonal flu

[HenryN]

Re: Utah: Victim's Family States 3 negative tests for H1N1 before death

Hospital defends actions in care of Utah flu victim

<!--subtitle--><!--byline-->By Brooke Adams
The Salt Lake Tribune

<!--date-->Updated: 06/15/2009 01:05:35 PM MDT
<!--secondary date-->


<SCRIPT language=JavaScript> var requestedWidth = 0; </SCRIPT><SCRIPT language=JavaScript> if(requestedWidth < 200){ requestedWidth = 200; } </SCRIPT> Francine Rushton (Courtesy of Craig Whitehead)



Related

• <LI class=packageTitle>Swine flu <LI class=packageDate>Jun 14: <LI class=packageItem>Two more deaths in Utah tied to new flu <LI class=packageDate>Jun 12: <LI class=packageItem>Drugmakers rush to produce a swine flu vaccine <LI class=packageItem>New flu formally a pandemic <LI class=packageDate>Jun 11: <LI class=packageItem>H1N1 pandemic and Utah <LI class=packageItem>Salt Lake Valley E.R.s overrun with patients reporting flulike symptoms <LI class=packageItem>Swine flu: World Health Organization says it's now pandemic <LI class=packageDate>Jun 8: <LI class=packageItem>Utah's summer camps fighting H1N1 swine flu <LI class=packageDate>Jun 4:
• Utah child's death tied to swine flu virus

<SCRIPT language=JavaScript> if(requestedWidth < 200){ requestedWidth = 200; } </SCRIPT>
<SCRIPT language=JavaScript> if(requestedWidth > 0){ document.getElementById('articleViewerGroup').styl e.width = requestedWidth + "px"; document.getElementById('articleViewerGroup').styl e.margin = "0px 0px 10px 10px"; } </SCRIPT>A hospital visited twice by a Utah woman who died Saturday of H1N1 swine flu complications said Monday it acted properly in caring for her.
In a statement, Jordan Valley Medical Center said it cannot comment on the specifics of the case but "in respect to the treatment of any patient with suspected Novel Influenza A H1N1 virus, we can confirm that all established CDC guidelines are followed during their course of treatment."
Francine Rushton, 47, who died Saturday, became ill a day after her mother was positively diagnosed with the flu on May 30 at an outpatient clinic. Rushton, who was living with her mother, visited the same facility but was told her flu test was negative, said her brother Craig Whitehead.
"They got sick at the same time, within 24 hours," he said.
Three days later, Rushton went to Jordan Valley Medical Center but a second test came back negative. She was sent home and told to drink fluids and rest, her brother said.
"We begged the doctors to treat her with Tamiflu because it had helped her mother, but they refused because her test had come back negative," Whitehead said in a statement. He said Monday that physicians there "didn't think them living together, eating together was big enough factor to treat her."
Rushton continued to deteriorate and three days later returned to Jordan Valley, where she was admitted. A third test for the flu again was negative.
She was transferred to Intermountain
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Medical Center in Murray on June 9 in critical condition; a day later, a test for Type-A flu finally registered positive and a day later the Centers for Disease Control and Prevention [CDC] confirmed Rushton had H1N1 flu, Whitehead said.
"IMC hospital -- we want to thank them, they did a great job," he said. "We love the effort put out to help her. The shock and trauma unit was unbelievable in trying to save her life."
So far, four Utahns who have contracted the H1N1 flu have died. The state had registered 688 confirmed cases as of June 12.
The rapid influenza antigen test used to make an initial flu diagnosis has a sensitivity rate of 50 percent to 70 percent compared to viral tests, according to the CDC.
"However, much lower sensitivities have been reported," said Tim Uyeki, a physician with the CDC's influenza division. "False negative results clearly occur. This means that a fair amount of infections are missed by this test."
False negative results are more likely when disease prevalence is high, the CDC said.
"Clinicians may consider using rapid diagnostic tests as part of their evaluation of patients with signs and symptoms compatible with influenza, but results should be interpreted with caution," the CDC said in a May 2 report.
The brief said the H1N1 flu cannot be excluded based on a negative rapid antigen test, and that in patients who have had contact with someone with a confirmed case of the flu additional testing and treatment may be warranted.
"Transmission of this new virus is not completely understood," Uyeki said in an e-mail. "There are many unanswered questions about this virus that CDC scientists and others are working to address."

http://www.sltrib.com/news/ci_12594446

[tropical]

Re: Utah: Victim's Family States 3 negative tests for H1N1 before death

My condolences.


Another human failure sourced from wrong preparedness, health decisions and on the field triage makers.

All the previous pandemic plans highlighted the importance of giving preventive Tamiflu doses to the family in the same living place of an illnessed, without previously proving their's infection by tests.

To not mention the cruelty of not prescripting to the victim her share package of antivirals trumpeted to be stocked for treatments.

And more ..., is the fact that seems they even not suggest to the family to try to get privately the antivirals and treat at home her.

Such folks seems to forget the value of human life when they conduct lacked money shaped previously determined triages (worldwide).

[the doctor]

Re: Utah: Victim's Family States 3 negative tests for H1N1 before death

One lesson from this and the other potentially preventable cases of death from flu is that patients and their families must become proactive regarding their health. Do not count on the doctors trying to follow guidelines when treatment is concerned.

The Utah doctors might have agreed to give this patient a prescription for Tamiflu or not. I do not know but if they did and the insurance company refused to pay for it, don't let that stop you from getting the prescription filled at your own expense (about $100).

If you follow this course and your loved one lives, you will not be able to recover the $100 from the greedy insurance company but so what? The important thing is your loved one survived.

What I recommend is those of you who find yourself in this situation sit down with the doctor and calmly but firmly tell them that in your opinion your loved one has Swine Flu and is at risk of death and if the doctor does not give the patient a prescription for Tamilfu and the patient dies or has a poor medical outcome due to flu that you will sue them for malpractice. Furthermore, I would record the conversation, with the doctor's knowledge.

I think under these circumstances most doctors will write the prescription.

This is an absurd situation we find ourselves in today. It stems initially from those within the PH and medical community concerned about the misuse of antivirals by patients given these drugs for stockpiling prior to the advent of pandemic. Now the refusal seems based upon knee-jerk adherence to the misguided CDC guidelines. What a mess.

GW

[wotan]

Re: Utah: Victim's Family States 3 negative tests for H1N1 before death

One lesion from this

One lesion? Interesting typo.

[rikkitikkitavi]

Re: Utah: Victim's Family States 3 negative tests for H1N1 before death

The Salt Lake Tribune seems to have updated the story here: http://www.sltrib.com/news/ci_12594446. The remarks by Robert Rolfs, the Utah state epidemiologist, are some of the more reasonable words to come from a public health official.

The comments on the Salt Lake Tribune website following the article are also illuminating: at least one reader mentions a similar experience of initially being denied Tamiflu based on false negative tests - even though she was exposed to known flu cases and even though she had asthma and an autoimmune condition!

Hospital defends actions in care of Utah flu victim
By Brooke Adams

The Salt Lake Tribune

Updated: 06/15/2009 08:37:39 PM MDT

A hospital visited twice by a Utah woman who died Saturday of H1N1 swine flu complications said Monday it acted properly in caring for her.

In a statement, Jordan Valley Medical Center said it cannot comment on the specific case but added that for any patient with the virus, "we can confirm that all established CDC guidelines are followed during their course of treatment."

Two rapid diagnostic tests conducted by the hospital indicated Francine Rushton, 47, did not have the flu. So she did not qualify for antiviral medication under state and federal guidelines -- despite the rapid test's high false-negative rate, her flu-like symptoms and her contact with her mother, who did have a confirmed case.

The Utah state epidemiologist, while not commenting specifically on the woman's case, said Monday doctors need to exercise their own clinical judgment rather than relying strictly on the test or treatment guidelines.

The H1N1 flu is now so widespread in Utah that a person with a fever, cough and sore throat can be presumed to have the flu unless there is some other obvious explanation, said Robert Rolfs, of the Utah Department of Health.

"If that person also was exposed to somebody who has influenza it makes it even more likely they have influenza," said Rolfs. "At this point, it's common enough I think it is quite reasonable to treat them [as a flu patient] whether or not that rapid laboratory test tells them they have influenza."

Rolfs also said that anyone who tests positive for Type A influenza, "it really tells you they have the H1N1 virus because that is all that is circulating right now."

And someone sick enough to be hospitalized should be treated, he said.

Rolfs said that "depending on the test, depending on the situation, [the test] may miss half of the people who have it. So those tests are not perfect."

[edited for length]

Rolfs said health care officials don't know what to expect from the virus next flu season.

"Some of the past pandemics have started out like this -- relatively mild -- and become much more serious," he said. "But there have also been times when it started out like this and didn't get much more serious. We are preparing in case it does get worse. I hope it doesn't."

[HenryN]

Re: Utah: Victim's Family States 3 negative tests for H1N1 before death

Actually, there were three deaths reported yesterday from the Salt Lake region in UT.