Child's appendix bursts after 20 hour ER wait


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A nine-year-old boy with appendicitis was made to wait more than 20 hours for surgery at the emergency ward of a Stockholm-area children's hospital before his appendix finally burst.

"The only treatment he received was morphine and paracetamol tablets so he didn't die from the pain," Jesper, the father of nine-year-old William Str?mgren, told the Dagens Nyheter (DN) newspaper.

William arrived at Astrid Lindgren Children's Hospital in Stockholm last Thursday after suffering stomach pains for days. He was immediately diagnosed with appendicitis, but then nothing happened.

After having his operation repeatedly pushed back by doctors, William's desperate parents were told by the chief surgeon that an operation would only be possible if it was carried out "the old-fashioned way", rather than using a procedure which resulted in less scarring.

"There was only one overnight operating room to handle all of Stockholm's children," William's father told DN.

"I'm convinced that if we hadn't demanded to speak with the chief surgeon we would have had to wait yet another night."

But by the time doctors operated on the nine-year-old, his appendix had already burst, resulting in an extended hospital stay, two weeks of missed school, and no ice hockey for young William until after Christmas.

"If they had operated sooner, I'd be home now," the nine-year-old told the paper.

Employees at the hospital acknowledged that patient safety is in jeopardy.

"Tough budget cuts, staff shortages, and recruitment difficulties have unfortunately put more pressure on surgeries and meant that children and parents have had to wait longer as a result," a hospital employee told DN.

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20 hours? How can a hospital make a patient wait that long, when they are in obvious need of immediate surgery. That seems like a no-brainer...

At least the kid didn't die.

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Why on earth didn't they transport him if they knew he had appendicitis and they knew he would have to wait for that long? To put someone through the agony of a burst appendix (which can be fatal just because of the pain, regardless of the risk of infection in the days after) just because you can't organise properly should be enough to land someone in jail for neglect.

They can blame budget cuts all they want, but did they also cut common sense too?

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20 hours? How can a hospital make a patient wait that long, when they are in obvious need of immediate surgery. That seems like a no-brainer...

At least the kid didn't die.

Back in the 1990s, I went to the hospital with chronic appendicitis, which basically means it would go away and come back, so my appendix was rotting. I went in on a Monday evening, and had my appendix taken out Wednesday morning.

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The funny part...even though everyone talks about how awesome the US healthcare system is in comparison to the rest of the world...I assumed this WAS about the US healthcare system when I read the title before I came in.

I almost died sitting in an ER once due to a SEVERE case of food poisoning from a restaurant. By the time they got me in the back some of my veins had started collapsing due to extreme dehydration.

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20 hours? How can a hospital make a patient wait that long, when they are in obvious need of immediate surgery. That seems like a no-brainer...

At least the kid didn't die.

Seeing as there was only the one operating room, my guess is there were other kids queued up for urgent surgery with journalists ready and waiting to write the story about one of them instead.

The only relevant question in the moment is whether there was another location they could've gone to for the procedure. I don't know the region, and can't comment on that, though.

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I almost died sitting in an ER once due to a SEVERE case of food poisoning from a restaurant. By the time they got me in the back some of my veins had started collapsing due to extreme dehydration.

I was not aware this could happen... :o

Part of the problem is that everyone wants a scarless, 0% error rate surgery these days. Go back to pulling these out with a pen knife and accepting that some kids might not make it and the wait time will go down.

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This is what happens when the government pays for your medical, Canada has same type of problems, Emergency room doctors don't care, because they're so busy.

Due to budget cuts and short staffing, So with Government paid health care (Obamacare) being implemented in the USA, this is what will happen.

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This is what happens when the government pays for your medical, Canada has same type of problems, Emergency room doctors don't care, because they're so busy.

Due to budget cuts and short staffing, So with Government paid health care (Obamacare) being implemented in the USA, this is what will happen.

You can't say for sure that the doctors do not care. There are many factors. If the surgery room is being used then what are they suppose to do. Do the surgery in the hallway. If there are no available surgeons then what is suppose to happen. Are they going to grab a nurse or janitor and have them do the surgery. There are also laws in place and hospital rules. If there is a surgeon available and the room is not they might not be allowed by law or rules to operate in another location. If they do not follow the law or rules they can loose their license and get sued. It is not the doctors fault the hospital will not build another surgery room or hire more doctors.

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This is what happens when the government pays for your medical, Canada has same type of problems, Emergency room doctors don't care, because they're so busy.

Due to budget cuts and short staffing, So with Government paid health care (Obamacare) being implemented in the USA, this is what will happen.

It happens in the US too. Shane Nokes already mentioned one incident, my wife has had two incidents at the ER where nobody was available to check on her (one was for a migraine and the other a severely swollen ear). America has a shortage of medical staff even though the government doesn't pay for it.

In Hong Kong the government pays for your medical too (but there are private hospitals as well) and the longest I've known anyone (friends, family etc) to wait at the ER was just under two hours.

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This is what happens when the government pays for your medical, Canada has same type of problems, Emergency room doctors don't care, because they're so busy.

Due to budget cuts and short staffing, So with Government paid health care (Obamacare) being implemented in the USA, this is what will happen.

My case that I posted about happened back in 1999, and was in the US. So try again.

I could bring up multiple other cases of things like this happening with family members all in US hospitals...all in the 70's 80's, 90's, and early 00's.

I could even bring up the one time that I had a fast onset ear infection...not sure of the cause. Within 4 hours my ear & jaw had swollen...I had to walk to the hospital (can't afford the ambulance without insurance) which was several miles. When I got there they had me waiting for hours, even after I had some minor bleeding from the ear. I got very lucky that they got to me in time to drain it down a bit, and give me some pretty hefty antibiotics in order to get rid of it. I almost had the eardrum actually rupture...which I thought had happened when the bleeding occured. They claim it didn't happen, but I'm wondering since I've had tinnitus ever since.

So, government has nothing to do with it in those cases...but I don't expect folks to do anything but bash it, even though the same thing will happen either way.

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I had appendicitis when I was a kid and my surgery was also delayed by an emergency. My appendix was gangrenous and burst during surgery, requiring excessive handling of my bowels which resulted in a subsequent re-hospitalisation. In an ideal world you'd have the resources and staff to cope with these situations but the reality is that having large numbers of doctors and operating rooms on standby is hugely inefficient and very expensive.

Hopefully the hospital will take steps to prevent situations like this from being repeated.

PS - This has nothing to do with socialised healthcare.

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This is what happens when the government pays for your medical, Canada has same type of problems, Emergency room doctors don't care, because they're so busy.

Due to budget cuts and short staffing, So with Government paid health care (Obamacare) being implemented in the USA, this is what will happen.

Yes.. because Obamacare suddenly made the medical system worse.

Look, healthcare costs have always been spiraling out of control, and only until recently has the AMA allowed for more medical schools to be built to meet the growing demand for healthcare because of all the aging baby boomers. Another problem is the bottleneck of available residency positions in the United States. Not all medical school graduates are able to get placed in residency positions, many just go directly into healthcare administration or research instead.

Medical residents are paid by teaching hospitals, who are reimbursed via Medicare. We have a huge shortage of primary care physicians/general practitioners because they aren't paid well. If you are graduating college and medical school with six figures in debt, why would you choose a position that pays $80,000 or so? After taxes, that's even less, and is definitely not a viable option when you consider the long hours you will be working, on call away from family, paying taxes, and dealing with debt. It's clear why the most growth is being seen in specialized fields where $150-200,000 is guaranteed.

Obamacare is one part of the solution: everyone is required to get health insurance. No more free loaders on the system! As a conservative, you should be happy about the individual mandate, after all it came from the conservative think tank the Heritage Foundation. Aren't you supposed to be the party of personal responsibility? Ensuring everyone buys health insurance is forcing people to take responsibility. Had McCain won and "McCainCare" passed, I'm sure you wouldn't be as butthurt.

Right now, we need to address the costs associated with tuition for medical school, and the availability of more residency positions in order to prepare for the future. Personally I think physicians assistants and primary care nurses should be able to qualify for a MD in a general-practitioner program of sorts, there's no reason they shouldn't. After all, they take the same courses as most first year med students do anyway!

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This is what happens with social medicine and is why a lot of Canadians come to the US for major operations.

So care to explain my posts...since I'm from the US, and socialized medicine didn't play into any of my points...

As regards Canadians coming here for operations...when is that old bit of half-truth going to die?

The interesting part...is I usually hear that Canadians flooding the US for healthcare thing...from folks who live in Red States.

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So care to explain my posts...since I'm from the US, and socialized medicine didn't play into any of my points...

As regards Canadians coming here for operations...when is that old bit of half-truth going to die?

The interesting part...is I usually hear that Canadians flooding the US for healthcare thing...from folks who live in Red States.

Ship happens regardless of when and where but this sort of thing seems to happen a lot with socialized medicine.

Well I know Canadians and a lot of them say the same thing. And by the way, I'm also from Austin which is a Blue city.

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Ship happens regardless of when and where but this sort of thing seems to happen a lot with socialized medicine.

Well I know Canadians and a lot of them say the same thing. And by the way, I'm also from Austin which is a Blue city.

I wasn't commenting on your particular affiliation. I was noting an interesting correlation based on state. :)

I know Canadians too...and most of the folks I know think our healthcare system is a joke. :p

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I hope I never get appendicitis, although I don't think I will. I've been fine so far and next year I will be 30. Thankfully this kid is lucky as appendicitis is very serious from what I've heard.

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"Tough budget cuts, staff shortages, and recruitment difficulties have unfortunately put more pressure on surgeries and meant that children and parents have had to wait longer as a result," a hospital employee told DN.

So much for that supposedly better healthcare.

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********, this is what happens in busy hospitals that are poorly organised.

A quick google search finds thousands of similar incidents in the USA. It's pathetic how some people will try and use this and say "the American system is fine!" It isn't, it's one of the worst in the developed world.

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As a Canadian, I can confidently say that claiming Canadians flock to the U.S. for health care is completely bogus. The only time Canadians go to the U.S. for health care is if they need some silly surgery that no doctor here believes is necessary. Is there a wait time on some surgeries and or certain medical treatments? Of course. But it doesn't make anyone run to the U.S. And the ones who do go, for the reason I mentioned above, it's only because they have the ridiculous amount of money that's required to even have the surgery.

This whole health care debate between the U.S. vs The World is utterly retarded. The rest of the world works just fine with this type of health care, what makes the U.S. so special that it would automatically fail? Barring ignorance and tediousness from it's people. This was definitely unfortunate, but it had EVERYTHING to do with idiotic doctors/nurses and NOTHING really to do with the system itself. There is absolutely 0 reason the nurses or doctors couldn't determine he was close to bursting, unless they were flat out ignoring the kid. In which case, how is the system at fault? LOL *shakes head*

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This thing stinks!

First of all, appendicitis is hard to diagnose properly as several other conditions can be identified with the same symptoms.

"he didn't die from the pain" - It hurts like hell, but you won't die from the pain, especially after morphine and paracetamol!

"after suffering stomach pains for days. He was immediately diagnosed with appendicitis" - Wait... Stomach pains for days... appendicitis... immediate diagnosis? You have to go through several different examinations to properly diagnose appendicitis as I sad earlier. Physical examination, blood test, X-ray, ultrasound, kidney functions (check for kidney stones).

It is true that the infection can spread rapidly in case of a 9-year-old child, but this is common in children and by the time of the surgery they have to be cut open to solve the problem. The worst thing with appendicitis is its spreading. It can create a periappendicular or diffuse peritonitis and in extremely rare cases it can result in the patients death. Older patients show a tendency to have a slower progressing disease and they can even develop a periappendicular abscess. This kid complained of pain for several days by the time he was admitted to the hospital. I think there wasn't any chance to this procedure laparoscopically.

"There was only one overnight operating room to handle all of Stockholm's children" I can't believe there was only ONE active hospital in the capital of Sweden! If his case was so severe and all of the operating rooms were full in this one, he would have been transferred already!

"I'm convinced that if we hadn't demanded to speak with the chief surgeon we would have had to wait yet another night." - I don't think so.

"But by the time doctors operated on the nine-year-old, his appendix had already burst, resulting in an extended hospital stay, two weeks of missed school, and no ice hockey for young William until after Christmas." - Oh no! He is missing school for two weeks instead of one or one and a half and he can't play ice hockey for a month. I won't let my son play ice hockey for a month even after a laparoscopic surgery!

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"If they had operated sooner, I'd be home now," told the nine-year-old or his father told him to tell this or the newspaper thought it would be great to have the boy to say this.

"Tough budget cuts, staff shortages, and recruitment difficulties have unfortunately put more pressure on surgeries and meant that children and parents have had to wait longer as a result," This is the only thing I have to agree with!

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20 hours? How can a hospital make a patient wait that long, when they are in obvious need of immediate surgery. That seems like a no-brainer...

At least the kid didn't die.

I waited 24 hours in a local hospital with a broken jaw [it broke in 2 different places, and found out its hard for them to wire your jaw if your already missing teeth]. It was the weekend and the plastic surgeon, the only guy trained they had to do the surgery wasn't in till Monday afternoon. I guess I had enough blood lost in that period to trigger oversleeping and dehydration only AFTER I was released from the hospital a few days later, So another week in the hospital. Sigh, I have more details but I won't go into it.

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