California – Interventional Radiology – Radiologist Uses Profanity And Hits Patient’s Hand In Anger During Procedure

On 5/4/2015, between 6:00 p.m. and 6:45 p.m., an interventional radiologist entered the hospital’s Room 9 to perform a cerebral angiogram.  The interventional radiologist intended to perform a procedure on the patient, a 99-year-old patient who had just suffered a stroke.  The cerebral angiogram procedure involves the practitioner gaining access to the patient’s femoral artery, near the patient’s groin, by inserting and threading a catheter from the patient’s femoral artery to the brain.  The catheter absorbs and/or extracts any blood clots and can control bleeding in the patient’s brain.

Previously, between 5:30 p.m. and 5:50 p.m., three female ancillary staff, namely Registered Nurse (RN) A, Technician A, and Registered Nurse B, prepared both Room 9 and the equipment in Room 9 for the medical procedure.  In addition, ancillary staff prepared the patient by restraining the patient’s head and hands to the surgical table, as well as covering portions of her body with drapes.  When the interventional radiologist entered the room, he was immediately upset that the ultrasound machine was not fully ready and had not been placed by the patient’s head.  The interventional radiologist yelled, using profanity, at Technician A, regarding the fact that the ultrasound machine was not ready.

As the procedure began, the interventional radiologist started to gain access to the femoral artery to insert a guide wire into the femoral artery, near the patient’s groin, while the patient was lying on a table with her head taped to the table and her right arm was restrained to a board.  At that time, the patient managed to move or wriggle her hand toward her groin, a sterile field where the interventional radiologist was trying to insert the guide wire.  The interventional radiologist immediately grabbed the patient’s right arm with his hands and yelled at the patient, “God Damn It!  Don’t F—— Move!  I Said Don’t Move.”  The interventional radiologist was standing to the side of the patient when he then took the patient’s right hand and hit it with his closed fist hard.  The patient was not yet sedated and she cried out in pain.  The interventional radiologist then yelled at Technician A, “Look at what you made me do!  This is all your fault.”

After the hitting incident occurred, but during the procedure, a charge nurse came into the room to make her observations.  As the charge nurse was Technician A’s supervisor, Technician A wrote on a piece of paper, “He hit the patient” and gave the note to the charge nurse.  The charge nurse then left the room.  This note exchange occurred approximately between 6:45 p.m. and 6:55 p.m.

Once the procedure was completed, the interventional radiologist requested to look at the patient’s right hand.  Staff removed the drape over the hand and observed that the hand was bleeding and bruised.  The interventional radiologist ordered that the hand be x-rayed.  Later, the interventional radiologist returned to the room and told staff that he had informed the son how his mother had received the injury.  However, the interventional radiologist’s version as told to the son was that he had grabbed the patient’s hand and not that he hit her hand with a fist.  The interventional radiologist never documented in the patient’s chart that the bruising and bleeding of the hand occurred at all nor how it occurred.

The interventional radiologist’s conduct of swearing at the patient when she moved her hand constituted an extreme departure from the standard of care.  The interventional radiologist’s act of hitting the patient’s right hand with his closed fist also constituted an extreme departure from the standard of care.

The Board issued a public reprimand against the interventional radiologist.  Stipulations included enrolling in a course on anger management and a course on professionalism.

State: California

Date: February 2017

Specialty: Interventional Radiology

Symptom: N/A

Diagnosis: Ischemic Stroke

Medical Error: Ethics violation, Failure of communication with patient or patient relations

Significant Outcome: N/A

Case Rating: 3

Link to Original Case File: Download PDF

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