Coroner Cause of Death: “Physical Therapy Note Missing Date and Time”

reports on a hospital death that could have been saved if the physical therapy note was dated and timed appropriately.  Beau Thorsgood, Albuquerque’s coroner, told reporters this morning that Denise Goodwell’s life could have “easily been saved if her physical therapy note was dated and timed.

 

Sources close to the matter say the Denise Goodwell was admitted for the Unhappy Triad: anterior cruciate ligament (ACL), medial collateral ligament (MCL), and meniscus tears. Dr.  Mathew O’Conner operated on her right knee Thursday and had her stay 2 days for “pain control and physical therapy.”

Physical therapist Jen Tripton rounded on her Friday morning and early reports claim that Ms. Goodwell “had great range of motion on post-op day one.”  When questioned, the physical therapist said she was impressed with her pain control and her ability to complete exercises that were normally done on post-op day 2.  Dr. O’Conner told reporters, “I was going to send her home that day since her pain was controlled by the peripheral nerve blocks that the anesthesiologist placed.”

 

Sources can pinpoint where things went wrong when Tripton put her note in the paper chart, omitting the date and time, and then went two rooms down to see her next patient.  As she was walking the hall toward room 838, she saw the “Code Blue” lights flashing over Ms. Goodwell’s room.  “Everyone was rushing in there, nurses, medical students, and a few doctors.  I thought, ‘She is 27, I’m sure she just bumped her code button.’”

Image result for Physical Therapy death

Tripton couldn’t have been more wrong, it was a full code.  Chest-compressions were performed for 30 minutes without success.  “It wasn’t until the code was called and time of death was noted, that we finally checked her chart,” hospitalist Dr. Douglas Moore said.  “I’m kicking myself because if I would have just seen the missing date and time, I could have saved her life.”

 

Tripton refused to comment further, but sources close to her say that she was in “such a hurry she forgot something so vital like the date and time.”  Colleague Kimberly Ashton said, “I don’t know what she was thinking, they will probably drug screen her, put her on administration leave, and perhaps take her license.”

 

The whole Albuquerque community will be having a candlelight vigil in Goodwell’s honor. The Facebook announcement clearly pointed out the DATE and TIME.  GomerBlog was denied access to the records because it is now a Joint Commission investigation.