Regarding reported injury or death from spider bites

The following is a synopsis of several months of correspondence with colleagues in the medical field. Let's start with a pair of now retired physicians, one an ER doc with 38 years practice and one a pathologist with over 40 years practice, paraphrased:

"Assume none of the reports read in newspapers, heard on TV, or otherwise broadcast publicly, regarding medically significant spider bites, are valid or credible."

To explain. A person goes to a medical provider with a suspicious injury and we end up reading about it in a tabloid or even a reputable news outlet. Consider the source. The patient, and what the patient has gleaned from what the physicians have told them. Hearsay information.
You will probably NEVER read or hear a physicians actual words. If you do actually get the info from the 'horses mouth' it will be in clinical terminology and will be immediately obvious as such..

Have you ever read a direct quote from a physician? Seen a physician interviewed in the news?

Why not? If you need to ask this, you need to read up in doctor-patient confidentiality and doctor and care facility liability. To be precise,
A physician or care facility that releases the actual clinical findings is deliberately placing themselves in severe jeopardy from law suits. The patient may request a verbal summation of their condition. They can request a copy of the clinical findings which normally requires a release of liability form that should only be signed with an attorney present. Then once they have the clinical findings in hand, it would ordinarily take another physician or other medical expert to translate and explain what the findings are.

"The doctor said it was a spider bite." Possible. If the doctor is mentally deficient and likes being dragged before a peer review and jeopardizing his or her license to practice. Otherwise the doctor will always couch their words with terms like 'indicative of' 'reminiscent' and similar. The doctor will let the clinical findings speak for him. Why? No liability.

In doc V's words, "I don't care if the patient and 20 bystanders saw the spider gnawing on the patient. That is suspicious, yes, but not a diagnosis. It's plain and simple jumping to a conclusion and is unsupported until lab and other diagnostic work has been performed. UNSUPPORTED. Very crucial word. Unsupported is an assumption without having all the facts. The spider bite, the venom, may have certain effects, but to assume those effects are the primary ailment of the patient is asinine. It's conclusion jumping. So a patient has an injury indicative of a bite. We have cardiac issues. Pulmonary issues. Shall we assume the spider bite is the cause and ignore advanced cardiovascular disease? Infectious pneumonia? We work in facts and only in facts, derived from proper diagnosis using established and proven medical procedures."

The bottom line. If you read or hear about a spider bite and there is no nearly incomprehensible technical jargon attached, it is at best a persons impressions, not facts as ascertained by proper medical procedures. As example, Child dies from recluse bite is complete (bull****) unless a pathologists report is cited.

So say the information in that news piece came from some other source. A clinical assistant, a nurse, a therapist. No reputable hospital has any employees down to the janitorial staff that hasn't signed the form that includes the general wording, "Releasing of any patient information except through proper channels is a cause for immediate employment termination".
The person who is cited in that news piece is no longer an employee of that facility and has lost his/her job because they engaged in .........?

All of the above is directly from the medical profession.

+1 I think more of us need to realize the reality behind medical science and the scientific method that still applies to medicine. I think most of the problem boils down to our internet culture where laymen (dumbasses) read one sentence that appears very shocking on a buzzfeed type of website and immediately deems it as credible and tells 5 people that this "fact" is definitely the truth. The people he tells are often also uneducated enough to demand cites for clinical studies, etc and tell another 5 people.

It's a trend that will only get worse, at least in the US.

problemchildx said:

+1 I think more of us need to realize the reality behind medical science and the scientific method that still applies to medicine. I think most of the problem boils down to our internet culture where laymen (dumbasses) read one sentence that appears very shocking on a buzzfeed type of website and immediately deems it as credible and tells 5 people that this "fact" is definitely the truth. The people he tells are often also uneducated enough to demand cites for clinical studies, etc and tell another 5 people.

It's a trend that will only get worse, at least in the US.

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Pretty much sums it up. The problem sets in when they tell their stories that involve real life. Specifically, exacting sciences like medical or laboratory procedures. To the educated, no matter how much research or watching TV shows, they just sound foolish. How many grains? or How many moles? and so on. The boring stuff, the 90% of what is going on, isn't dramatized and is missing.

I'd like them to do just one episode of Real Life Emergency Room. 02:00. Filling out reports to stay awake. Playing with the radio and wondering if you screwed up the settings and should you admit that to the entire county by calling for a radio check? Re re re re inventory the CS supplies list. You know one of the nurses has sacked out in the office. Hearing a call on the radio of a passed out drunk at the other end of the county seems like it's going to be the major excitement that night. Then a mom brings in a kid who is vomiting all over the room. It takes us 20 minutes to wade through her BS before she admits to leaving that bottle of Coffee liqueur out and had been calling it cough syrup. Well, at least we will get to watch housekeeping help us stay awake. One of the guys from housekeeping has been sleeping on the ironing table. His hair is all flattened on one side. Who's working RT? Ah, a buddy of mine. Think I'll stop by there for a couple of minutes on their O2 to help wake up a little. 04:30. Half hour before the cafeteria opens. I put dibs in on going first and get orders for coffee and any kind of roll they might have. A sleepy voice from the office seconds that order. Ah, the excitement of a weekday graveyard shift!

This is precisely what is so disturbing about news reports of alleged "spider bites". HOW did the doctor arrive at the conclusion in the first place? What clinical tests were performed to confirm specific spider venom? Take the incident with the five-year-old boy, for instance; no mention is made of how anyone proved that his death was caused by a Brown Recluse, other than the family saw one. Perhaps it did actually bite the child, perhaps it was just in the vicinity, and even still, was that spider even a Brown Recluse? No arachnologist/entomologist got to examine and ID the spider, only doctors. The suddenness of the child's death is not really consistent with most known, documented Loxosceles envenomations, and as harsh and pessimistic as it sounds, whenever a child dies suddenly like this, my gut reaction, a result of nearly 30 years of working with children, is to suspect the adult caregivers/parents. A rural ER doctor and a FUNERAL HOME EMPLOYEE(wonder if that person was related to the family?) diagnose the cause of death as a "spider bite"-anyone see any red flags on the play there? It is possible, thought not PROBABLE, that the child died from a spider bite, but to anyone with real knowledge of medicine, of spiders, and of human nature, especially someone who has seen more than a fair share of abused children and unstable parents, there is a significant amount of suspicion to go around.

pitbulllady

Ah, the new issue of Snarks rants is out.

Hanska said:

Ah, the new issue of Snarks rants is out.

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I've missed them and always enjoyed them

I've reserved the best for last. From Doctor K M, expert pathologist who has seen more than his fair share of courtrooms as an expert witness.

R---, Recall if you can. 53 yr old male, apprx 5'6" 235 lbs. cardio arrest. M----- ER Sup team lead, Doctors A M------ and K M----- attending. You were doing compressions. D W------ RT palpating carotid. Code called after 23 minutes. The trend was quite obvious. Doctor A M------ stated the diagnosis which everyone no doubt suspected, ruptured aneurism aortic. Remember?
Who determined the actual cause of death? It wasn't until the autopsy was performed and the diagnosis of the pathologist, my father, confirmed by the county ME, that the cause was clinically determined. Even after the POD had arrived at a tentative.
YOIU KNEW - and W-----. The reflux was retarded. Doctor M----- called for slow down on compression twice. Palpation continuously monitored was delayed. But it required the CFP letters on the form to put the seal of approval on the Cause of Death. So show me the pathologists determinations or at the least impressions on any of these spider biyes in the tabloids. Inexpert assumptions are not valid. Would you leap to that conclusion with your wife or daughter and not ask for final determination even if the MOI* was present and identified?


(*MOI Mechanism Of Injury - a spider corpse)
So from the horses mouth so to speak, no pathologist report cited, these spider bite deaths are presumed, not proven. Even if a medical doctor has reached a tentative conclusion.

PBL, you brought up a valid point. In the case where the venom cannot be extracted and identified, a pathologist or medical examiner has to punt. The wording is usually, 'lacking evidence to the contrary...'