NEW: RI Doctor Guilty of Malpractice in Fatima Emergency Room
Tuesday, December 18, 2012
Rita S. Kurl, MD, whose specialty is internal medicine, has a business address at Roger Williams Medical Center in Providence and was involved in a case at Our Lady of Fatima Hospital emergency department on March 23, 2008. On that date, Dr. Kurl inserted a silicone gastronomy catheter into the abdomen of an 89-year-old female patient who had twice pulled out her own G-tube prior to arriving at the ER.
Improper insertion of G-tube
Kurl confirmed the tube placement with auscultation (using sound), according to a report issued by HEALTH, "but when tube was flushed, patient cried out in pain." Kurl "appropriately" ordered a fistulogram x-ray to check the tube's placement, but Fatima had changed its imaging software and Kurl had not been trained on it. Because of her unfamiliarity with the system, Kurl selected an x-ray from earlier the same day which showed proper placement of the tube.
The patient was discharged and returned to her nursing home. The next morning she returned to Fatima's ER. A radiologist who then viewed the correct x-rays that had been ordered by Kurl the night before noticed that they showed that the G-tube "projected over the patient's upper abdomen and that the contrast material was located outside the lumen (cavity of the stomach), suggesting that the tube's end was outside of it."
The patient had surgery that day to repair the perforation caused by the misplaced tube, which the surgeon found "lying in the subcutaneous tissues." The surgical team evacuated 700 milliliters of tube feedings from the patient's abdomen and the tube was reinserted. But the patient later developed "a massive infection" and died 13 days after the improper G-tube placement.
Based on the following, HEALTH found that Kurl was in violation of two RI laws and for malpractice. Kurl, officially reprimanded by the Board, has agreed to a 5-year probation.
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