Patient Story

Kerry O'Connell

My second orthopedic surgeon began each day’s medical record with the phrase “Patient Kerry O’Connell is a very personable 48-­‐year-­‐old male with a very complicated arm.”  I grew pretty fond of that brief summary of my life. My complications started when I fell off a ladder painting  my  house  and  dislocated my  left  elbow.  The  dislocation  included  a  fractured  radial  head  and  a displaced coronoid  process. Years  later  I  would  learn  that  surgeons  call  this  injury  “the terrible  triad of the elbow” or in orthopedic slang just “triad.”  The ominous name comes from some very poor rates of successful outcomes. 

My first surgery was a medical disaster. The surgeon elected to use an  off-­‐label configuration  of  an  external  elbow  fixator  to  save  30  minutes on a late Friday afternoon. The configuration placed his drill directly  over  my  radial  nerve.  He then decided  to  use  small  ½-­‐inch  long incisions, which didn’t allow him to see the nerve. The assistant holding  the  soft  tissue  guide  didn’t  keep  it  tight  to  the bone;  my  nerve slid under the guide and wrapped around the spinning drill bit, 

grinding  about  four  inches  of  the  nerve  into  mush.  One  third  of  the  muscles in my  left  arm  became  permanently paralyzed. My doctor couldn’t muster the courage to tell me what had happened. We tinkered with electrical stimulation and physical therapy for four months to no avail. Eventually I consulted four other doctors who all told me I needed a nerve graft.  

I found a new doctor who transplanted the sural nerve from my left leg into my left arm. Unfortunately long nerve  grafts  like  mine  seldom  work.    Months  later  we

decided  to  clean  the  scar  tissue  out  of  my  elbow  to  restore supination and pronation. We had a very aggressive post-­‐surgery therapy plan that involved placingmy arm in a continuous passive motion machine that would bend my arm back and forth 24 hours a day for a week. The surgery seemed to go well. The range of motion was great.  I noticed that a surgical drain tube that came out my arm just above the elbow was only secured with a piece of gauze. It slid in and out of my bending arm for three days, then fell out.  This  seemingly  minor  detail  led  to  a deep  Staph epidermidis  infection which took four debridement surgeries and two months of Vancomycin to kill off. A month after the infection was gone I rolled back into  the OR for  last-­‐chance  tendon  transfer  surgery  which  thankfully worked pretty well. 

Looking  back  over  my  two-­‐year  ordeal  I  am  struck  by  the profound  contrasts I  found  within  the  medical  profession.  I  was privileged  to meet  dozens  of competent,  kind,  and  compassionate  people  who taught me many wonderful lessons in life. Yet I also experienced a handful of the most brutalindividuals I have ever known, who caused emotional wounds so deep that they may never fully heal. I told this sad tale to the chief medical  officer  of  a  local  hospital  who  replied  that he  had  never  met  another  person who  had  experienced  all  of  healthcare’s major  problems  in  such  a  short  time. I  believe  that  God  gave  me  this  very complicated arm for a reason. It has taken a few years to figure that reason out but I now spend a great deal of my time promoting infection control, helping wounded patients, and promoting compassion and empathy within  the  healthcare  Industry. Along  the  way  I have  been  privileged  to  meet  dozens  of  fellow  wounded patient advocates who are making a profound difference in this world.  The bottom line is, perhaps non-­‐fatal medical errors can have the unintended side effect of extreme personal growth.

 

-­‐Kerry O’Connell