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Are there any guidelines set by the American Medical Association for this situation?


I asked this question yesterday but didn't explain very well so i'll do it again. A 19 year old male goes to the Hospital ER (his family Doctor was all booked up for the Day) for a Strong Cough, and Tightness in the Chest. During the Exam the Boy's father tells the Nurse that he is concerned about his breathing, especially while he sleeps.The Nurse says that is what people do to blow of a Temp. the Doctor say's he hears a rattle which indicates fluid in the Lungs. He diagnoses him with Bronchitis without doing Chest X-Rays. Are there guidelines that say X-Rays should have been done.

And before you suggest to get another opinion. It's too late. The 19 year old Died 2 days later of an enlarged Heart.

oh my dear
GOD i am so very sorry and i would be appalled at the hospital sometimes we r just a number there and that's it i am so sorry for your tremendous loss may u have the strength to carry on I'm sorry

I did not see your question yesterday but the answer is that more medical information would be very helpful. I am very sorry to hear of the death of such a young individual and it is always appropriate to wonder if the physician and nurse should or could have done anything to prevent this. There are general guidelines for medical care but these are always dependent upon specific factors in the patient's presentation. In retrospect it sounds as if the 'rattle' that the physician heard was more likely to have been due to the heart problem whether or not there was bronchitis. The presence of a sound when listening to the lungs is seldom cause for a chest x-ray. That having been said a physician should reasonably have been expected to distinquish the sounds of 'heart failure' from bronchitis. In fact bronchitis is a condition of the large airway and it does not lead to a 'rattle' in the lungs. If your question is whether or not the medical care was appropriate I would have to say that based upon this very limited information that most likely it was deficient. I would encourage to obtain a copy of the entire medical record and have it reviewed by an independent physician. Even if the conclusion is that the physician and nurse were not at fault or that there was nothing thay could have been done to alter the patient's outcome (death) such a review serves to help the grieving process. I serve as an expert witness in such cases and I typically review such records without charge. I wish the very best to the young man's family and I appreciate your concern and your question.

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