TerryJ2
Well-Known Member
Arrgh!
Cousin P was bitten and scratched by her cat in early Dec.
It got infected.
The nurses were alerted by S, from Visiting Angels.
They put antibiotic cream on it and bandaged it.
It quicky got out of control, turning red and spreading and hot to the touch.
She told the nurses to call the dr.
I called after she went home and asked the nurses to call the dr.
They left a msg and he blew them off.
We took her to the pain mgmt dr last Monday for her chronic tailbone pain. He pretty much ignored the tailbone and looked at her leg and told us to get her to a surgeon and get an xray asap.
After she rec'd emergency antibiotics at the ER, I told the asst living dir of nursing that I wanted them to pay the bill.
The rest is in the correspondence below.
*****
Good Afternoon Terry,
I wanted to touch base with you as I promised regarding the investigation with Ms. Ls cat bite and its subsequent treatment.
We have documentation that the bite was reported the evening of 12/18. T immediately treated it and notified Dr. L asking for an antibiotic and treatment order. He responded and provided an order for a topical antibiotic daily. Documentation from the 18[SUP]th[/SUP] and 19[SUP]th[/SUP] reveal that the bandage was changed and antibiotic applied per order, with only slight redness and no fever. On the 20[SUP]th[/SUP], it was not changed as she was documented out of facility. (this was the day of the pain management visit and subsequent ER visit) Worsening seems to have occurred quickly between the 19[SUP]th[/SUP] and the morning of the 20th as is a potential complication with a cat bite. I spoke with Dr. L at great length on the 24[SUP]th[/SUP] regarding his treatment plan. It was not appropriate to place Ms. L on a systemic (oral) antibiotic due to the risk of progressive insensitivities (MRSA etc) on the 18[SUP]th[/SUP] and thus he placed her on a topical antibiotic as was completely appropriate at the time.
Dr. L acted quickly and prescribed the appropriate treatment on the 18[SUP]th[/SUP]. The nursing staff performed the ordered treatment appropriately on the 18[SUP]th[/SUP] and 19[SUP]th[/SUP], documenting on the condition of the bite. On the 19[SUP]th[/SUP] it was documented with redness but no drainage or fever suspicious of possible systemic infection.
On the 20[SUP]th[/SUP], she was seen at the urgent care and the ER.
Based on the above, there was no delay in service or inappropriate treatment regarding the cat bite in the 1.5 days of its treatment here. Per the documentation, the facility staff acted appropriately and followed all MD orders. The MD did prescribe a topical antibiotic. I did notify Dr. L that you had some questions regarding his choice of treatment and he asks that you call him with any specific questions you may have.
The bite is showing signs of healing and continues to improve. Dr. Ls number is ...
Thank you and have a great evening!
***
Terry,
In addition to the previous email, I spoke with Q and we recommend that if Nipper is proving to bite you may want to consider a different home for him. I know that Ms. L loves him and he provides companionship for her, however I would hate for one of his bites to cause serious health complications to her or another resident/staff member should he get out inadvertently.
Ive not known Nipper to bite before now, and maybe it was just a one-time occurrence. I will certainly let you be the judge of that, but we, as oversight at the facility level are just concerned that if it does happen again and we have knowledge that he has done it before; we certainly could be held responsible. If you would like Ms. L to keep Nipper, it is very important that she does not let him out even inadvertently. Certainly you can understand this.
We just want all of our residents safe and happy. Your thoughts on this?
Thanks!
*****
Dear C:
Thank you for your investigation into Mrs. L's cat bite infection.
1) Dr. B, pain management specialist for H, looked at the infection and said that Mrs. L should be immediately seen by a surgeon or specialist. He asked whether M had nurses and doctors and why they hadn't done something other than topical antibiotics.
This was the same question asked by Dr. MB atPatient First, and asked by the ER physician at M.
In addition, Dr. MB said that it was "Too late" for oral antibiotics.
Clearly, the fact that Mrs. L was out of the building that morning was of little consequence because the infection had gotten out of control before then. The point is that Mrs. L should have been given oral antibiotics over the weekend, if not earlier.
If you would like to talk to Dr. B, his number is .
If you would like to talk to Dr. M at Patient First, the number is .
2) I agree that something should be done about the cat. I had already begun investigating new homes for Mrs. L's cat, Nipper, and also the option for declawing him. I have an appointment for blood work at C Animal Hospital next week, and a consultation with the veterinarian in regard to either declawing or re-homing Nipper.
Sincerely,
*****
Terry,
I will make sure to pass the below info and contact numbers to Dr. L and have him call you. Perhaps you speaking with him may help to answer the additional questions you have.
***
Cousin P was bitten and scratched by her cat in early Dec.
It got infected.
The nurses were alerted by S, from Visiting Angels.
They put antibiotic cream on it and bandaged it.
It quicky got out of control, turning red and spreading and hot to the touch.
She told the nurses to call the dr.
I called after she went home and asked the nurses to call the dr.
They left a msg and he blew them off.
We took her to the pain mgmt dr last Monday for her chronic tailbone pain. He pretty much ignored the tailbone and looked at her leg and told us to get her to a surgeon and get an xray asap.
After she rec'd emergency antibiotics at the ER, I told the asst living dir of nursing that I wanted them to pay the bill.
The rest is in the correspondence below.
*****
Good Afternoon Terry,
I wanted to touch base with you as I promised regarding the investigation with Ms. Ls cat bite and its subsequent treatment.
We have documentation that the bite was reported the evening of 12/18. T immediately treated it and notified Dr. L asking for an antibiotic and treatment order. He responded and provided an order for a topical antibiotic daily. Documentation from the 18[SUP]th[/SUP] and 19[SUP]th[/SUP] reveal that the bandage was changed and antibiotic applied per order, with only slight redness and no fever. On the 20[SUP]th[/SUP], it was not changed as she was documented out of facility. (this was the day of the pain management visit and subsequent ER visit) Worsening seems to have occurred quickly between the 19[SUP]th[/SUP] and the morning of the 20th as is a potential complication with a cat bite. I spoke with Dr. L at great length on the 24[SUP]th[/SUP] regarding his treatment plan. It was not appropriate to place Ms. L on a systemic (oral) antibiotic due to the risk of progressive insensitivities (MRSA etc) on the 18[SUP]th[/SUP] and thus he placed her on a topical antibiotic as was completely appropriate at the time.
Dr. L acted quickly and prescribed the appropriate treatment on the 18[SUP]th[/SUP]. The nursing staff performed the ordered treatment appropriately on the 18[SUP]th[/SUP] and 19[SUP]th[/SUP], documenting on the condition of the bite. On the 19[SUP]th[/SUP] it was documented with redness but no drainage or fever suspicious of possible systemic infection.
On the 20[SUP]th[/SUP], she was seen at the urgent care and the ER.
Based on the above, there was no delay in service or inappropriate treatment regarding the cat bite in the 1.5 days of its treatment here. Per the documentation, the facility staff acted appropriately and followed all MD orders. The MD did prescribe a topical antibiotic. I did notify Dr. L that you had some questions regarding his choice of treatment and he asks that you call him with any specific questions you may have.
The bite is showing signs of healing and continues to improve. Dr. Ls number is ...
Thank you and have a great evening!
***
Terry,
In addition to the previous email, I spoke with Q and we recommend that if Nipper is proving to bite you may want to consider a different home for him. I know that Ms. L loves him and he provides companionship for her, however I would hate for one of his bites to cause serious health complications to her or another resident/staff member should he get out inadvertently.
Ive not known Nipper to bite before now, and maybe it was just a one-time occurrence. I will certainly let you be the judge of that, but we, as oversight at the facility level are just concerned that if it does happen again and we have knowledge that he has done it before; we certainly could be held responsible. If you would like Ms. L to keep Nipper, it is very important that she does not let him out even inadvertently. Certainly you can understand this.
We just want all of our residents safe and happy. Your thoughts on this?
Thanks!
*****
Dear C:
Thank you for your investigation into Mrs. L's cat bite infection.
1) Dr. B, pain management specialist for H, looked at the infection and said that Mrs. L should be immediately seen by a surgeon or specialist. He asked whether M had nurses and doctors and why they hadn't done something other than topical antibiotics.
This was the same question asked by Dr. MB atPatient First, and asked by the ER physician at M.
In addition, Dr. MB said that it was "Too late" for oral antibiotics.
Clearly, the fact that Mrs. L was out of the building that morning was of little consequence because the infection had gotten out of control before then. The point is that Mrs. L should have been given oral antibiotics over the weekend, if not earlier.
If you would like to talk to Dr. B, his number is .
If you would like to talk to Dr. M at Patient First, the number is .
2) I agree that something should be done about the cat. I had already begun investigating new homes for Mrs. L's cat, Nipper, and also the option for declawing him. I have an appointment for blood work at C Animal Hospital next week, and a consultation with the veterinarian in regard to either declawing or re-homing Nipper.
Sincerely,
*****
Terry,
I will make sure to pass the below info and contact numbers to Dr. L and have him call you. Perhaps you speaking with him may help to answer the additional questions you have.
***