Friday, July 23, 2010

The Need for Obesetical Change

A recently filed lawsuit against St. Joseph's Hospital of St. Paul, Minnesota brings the obesity epidemic into focus. The decedent, Max DeVries, fell off of an operating room table.

The patient, who had previously stroked, was having a routine procedure to change a lumbar drain. The sixty-five inch Mr. DeVries weighed 300 pounds.

Based on Mr. DeVries height and weight, his ideal body weight would have been 146-160.6 pounds. Overweight by about 140 pounds, the 61 year old patient had a body mass index of 50. Morbidly obese people are described as being 100 pounds overweight or having a BMI between 40 and 45. In this case, the patient would be better described as being super obese.

The tragedy occurred when the three Velcro straps holding the patient to the operating room table gave out. The victim fell to the floor hitting among other things, his head. Having suffered these new damages, he couldn't continue his recovery and his rehabilitation. He died. As might be expected, his family filed a negligence claim.

At least 30% of Americans are obese and the trend is moving upwards. Nowadays even children are obese. It is common for the obese to break seats and benches. Hospitals are poorly equipped, for the most part, to handle the bulk of its heavier clients. Stretchers, wheel chairs, x-ray and OR tables all need to be made wider and stronger and more stable to assure safety for the infirm obese. Also, the injuries sustained by health care workers related to moving and handling the bulkier patients is on the rise. The hospital will need to motorize its gurneys, stretchers and wheelchairs, if not now, soon. Lifts and cranes need to be available to lift these patients from one place to another. Doorways will need to widened to accommodate the wide bodied hospital conveyances. Toilets must be made larger and wider to offer a better fit.

In a way, it's almost like a new race of Americans has arisen. Previous norms for weight have become incorrect. Much like the normal lab values for Vitamin D, which are too low, definitions of normal weights and BMI's need to be recalculated and moved upwards. If the normal values can be adjusted for today's realities, less reprobation based on weight, will be bandied about. The new Americans will be able to fit ideals of normalcy.

For some, the recognition of seeing that obesity is a medical problem remains an issue. For others, the inability to see the suffering and morbidity the obese suffer is a limiting factor. Obesity is not simply a cosmetic problem for people too weak to pass up dessert. It is not that simple. Obesity is a societal problem. It is costly, not only in terms of the obvious health issues, but also in lost productivity.

This case will put all hospitals and medical institutions on notice that they need not only be handicapped equipped but also "obesitically" correct. There is no excuse for what happened to poor Mr. DeVries. His table dive is an example of res ipsa loquitur. There is no way such an incident could occur absent negligence. Medical institutions will need to make obesitical changes, much like they did when ramps became de rigueur. A good start would be wide, motorized wheelchairs at every hospital or medical building entrance. If supermarkets can provide conveyance, why can't hospitals, medical labs and doctor's offices? Times change, people change and survivors change. Dinosaurs couldn't change. So it goes...

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