OT: NYC Train Victims Sue Engineers Dx?

[Todzo]

So the doctors searched diligently and found obesity, hypothyroidism, high cholesterol, low testosterone, vitamin D and B12 deficiencies, and mild high-frequency hearing loss[1]. Could the engineers last visit to the doctor May of 2013 have been looking for causes of fatigue?!

With his observable large neck size as well as the above mentioned how in the world did they not check for Sleep Apnea?

So why should not the victims of the NYC Train Crash go after the engineer's doctors?

[1] http://www.sleepdt.com/nyc-train-driver ... leep-apnea

[49er]

So the doctors searched diligently and found obesity, hypothyroidism, high cholesterol, low testosterone, vitamin D and B12 deficiencies, and mild high-frequency hearing loss[1]. Could the engineers last visit to the doctor May of 2013 have been looking for causes of fatigue?!

With his observable large neck size as well as the above mentioned how in the world did they not check for Sleep Apnea?

So why should not the victims of the NYC Train Crash go after the engineer's doctors?

[1] http://www.sleepdt.com/nyc-train-driver ... leep-apnea

Not everyone with a large neck has sleep apnea just like you can't assume that if you're thin and have a small one, you don't.

It also depends on whether the engineer complained about sleep issues or not. If he did and the doctor blew him off, then yeah, I could see a suit as a possibility although I am not sure what the legal standard would be.

But if he didn't complain about having sleep issues, I don't see where there would be a legal basis for a suit.

49er

[Todzo]

So the doctors searched diligently and found obesity, hypothyroidism, high cholesterol, low testosterone, vitamin D and B12 deficiencies, and mild high-frequency hearing loss[1]. Could the engineers last visit to the doctor May of 2013 have been looking for causes of fatigue?!

With his observable large neck size as well as the above mentioned how in the world did they not check for Sleep Apnea?

So why should not the victims of the NYC Train Crash go after the engineer's doctors?

[1] http://www.sleepdt.com/nyc-train-driver ... leep-apnea

Not everyone with a large neck has sleep apnea just like you can't assume that if you're thin and have a small one, you don't.

It also depends on whether the engineer complained about sleep issues or not. If he did and the doctor blew him off, then yeah, I could see a suit as a possibility although I am not sure what the legal standard would be.

But if he didn't complain about having sleep issues, I don't see where there would be a legal basis for a suit.

49er

If he were a truck driver obesity + large neck = Sleep test

[Kitatonic]

If the doctor prescribed testosterone to treat this "low testosterone", this might have worsened his sleep apnea. Even the TV ads note this precaution. The man's work-up does look as if he complained of fatigue. Interesting case to follow.

[Todzo]

It also depends on whether the engineer complained about sleep issues or not. If he did and the doctor blew him off, then yeah, I could see a suit as a possibility although I am not sure what the legal standard would be.

But if he didn't complain about having sleep issues, I don't see where there would be a legal basis for a suit.

49er

One of the things that people with sleep apnea tend to loose is the ability to self monitor. This is literally a part of why people do not think they have sleep apnea I do believe.

As well, with job potentially on the line I think anyone would be hard pressed to admit to such a thing. It is the way we tend to be.

With both of those against him I would not expect him to complain to the doctor specifically about being tired.

However, the work up does indeed look to be looking for causes of fatigue. But absolutely lacks sleep apnea. Why?!

[49er]

It also depends on whether the engineer complained about sleep issues or not. If he did and the doctor blew him off, then yeah, I could see a suit as a possibility although I am not sure what the legal standard would be.

But if he didn't complain about having sleep issues, I don't see where there would be a legal basis for a suit.

49er

One of the things that people with sleep apnea tend to loose is the ability to self monitor. This is literally a part of why people do not think they have sleep apnea I do believe.

As well, with job potentially on the line I think anyone would be hard pressed to admit to such a thing. It is the way we tend to be.

With both of those against him I would not expect him to complain to the doctor specifically about being tired.

However, the work up does indeed look to be looking for causes of fatigue. But absolutely lacks sleep apnea. Why?!

It does look like the doctor should have referred this guy for a sleep test. But as someone who is quite leery of doctors in general, until all the facts of the case some out, I am not willing to say this person should be sued.

And by the way, if a patient has lost the ability to complain about symptoms for various reasons, that isn't the doctor's fault. Still, one would hope they would raise the issue of sleep apnea in obvious cases like with the engineer. But whether that is cause for a suit is a whole other issue.

49er

[chunkyfrog]

I can personally vouch for the fact that pain and lack of sleep can sneak up on you
so slowly that you have no idea something is horribly wrong.

[SleepyToo2]

And if your ability to make sensible decisions is impaired (mine was) you may ignore what you sense is "creeping up" on you.

[Todzo]

It also depends on whether the engineer complained about sleep issues or not. If he did and the doctor blew him off, then yeah, I could see a suit as a possibility although I am not sure what the legal standard would be.

But if he didn't complain about having sleep issues, I don't see where there would be a legal basis for a suit.

49er

One of the things that people with sleep apnea tend to loose is the ability to self monitor. This is literally a part of why people do not think they have sleep apnea I do believe.

As well, with job potentially on the line I think anyone would be hard pressed to admit to such a thing. It is the way we tend to be.

With both of those against him I would not expect him to complain to the doctor specifically about being tired.

However, the work up does indeed look to be looking for causes of fatigue. But absolutely lacks sleep apnea. Why?!

It does look like the doctor should have referred this guy for a sleep test. But as someone who is quite leery of doctors in general, until all the facts of the case some out, I am not willing to say this person should be sued.

And by the way, if a patient has lost the ability to complain about symptoms for various reasons, that isn't the doctor's fault. Still, one would hope they would raise the issue of sleep apnea in obvious cases like with the engineer. But whether that is cause for a suit is a whole other issue.

49er

49er this is one case where I absolutely positively disagree!!! The fact is that the patient is disabled from knowing. So the doctor must understand this and ask the right questions. Honestly, a sleep questionnaire such as the University of Maryland sleep apnea quiz (see: http://umm.edu/programs/sleep/health/qu ... leep-apnea ) takes less than five minutes. In a clinical setting STOP BANG (see: http://www.sleepapnea.org/assets/files/ ... nnaire.pdf ) can be added for further verification. It is NOT hard. It SHOULD be done!!!

If it had been done most likely the loss of peace, loss of resources, loss of health, indeed loss of life could have been avoided.

If they are sued perhaps the rest of the doctors will finally listen!!!

[49er]

Todzo,

If I forget to tell a doctor I am allergic to Penicillin because of my brain fog and die from the drug reaction, is that the doctor's fault or mine?

49er

[chunkyfrog]

If I had a life-threatening allergy, I would get a tattoo.
(unless I was also allergic to the ink.)

[BlackSpinner]

If they are sued perhaps the rest of the doctors will finally listen!!!

Nah they will just pay more for insurance and bill you higher.

[Todzo]

Todzo,

If I forget to tell a doctor I am allergic to Penicillin because of my brain fog and die from the drug reaction, is that the doctor's fault or mine?

49er

Obesity + Large observable neck size = Sleep test for truckers.

Your example is not at all the same in the first place.

If your doctor observes "brain fog" they have a responsibility to obtain and check your charts!!!

We need to move away from medical care being the third leading cause of death anyway!!!

[Todzo]

And if your ability to make sensible decisions is impaired (mine was) you may ignore what you sense is "creeping up" on you.

Executive dysfunction with sleep apnea is very real and very observable (although it is intermittent in character).

Self reporting cannot be relied upon, observation is limited so a compromised driver who, for that matter, can be compromised by many causes is likely to slip through.

We really need full time vigilance monitoring on those whose actions so seriously affect our lives!!

[JDS74]

The story linked to does not say the basis for the post-facto diagnosis of severe sleep apnea.
Without a PSG, such a medical diagnosis would be problematical.

Rather if just lists some test abnormalities that the driver had.
A routine checkup that included a complete metabolic panel (CMP), a thyroid series, and a complete blood count (CBC) exams would have turned most of those items up. Those would be normal if his large neck size suggested an enlarged thyroid (goiter). If the CBC showed something in the hematocrit or hemoglobin measurements, then a vitamin series might have been in order to try and find the cause.

The odd ball is the low testosterone and there could be other reasons for testing for that outside of complaints of fatigue.
Perhaps he complained of ED?