Dr. Bruce Pancake had a license to practice medicine has an ear, nose, and throat doctor. After receiving numerous complaints Dr. Pancake decided to change his specialty to a plastic surgeon, which he had only attended a weekend seminar that focused on breast augmentation. As a result of numerous complaints as an ear, nose, and throat doctor, Dr. Pancake, lost all privileges at any institution in the Tennessee area. Dr. Pancake opened a spa named “Phoenix Center Spa Medicus”, where he performed all plastic surgeries. Dr. Pancake was never completed a residency, internship, or a fellowship a plastic surgery. This should have been a red flag to all patients that were coming in to get procedures done by Dr. Pancake.
The first question that comes out of this, why did Dr. Pancake’s nurses or staff not report him to the medical board for claiming that he had been a plastic surgeon for twenty years. Were his nurses actually licensed and registered nurses by the state of Tennessee? A plastic surgeon that had completed a residency, internship, or fellowship would have seen that Dr. Pancake was not a plastic surgeon that he claimed that he was. By completing just a weekend course in plastic surgery, which just focused on breast augmentation does not make Dr. Pancake capable of doing any plastic surgery. Dr. Pancake thought just because he had no privileges at any institution that he could open up his Phoenix Center Spa Medicus and perform all plastic surgery in his spa that he opened up in Tennessee. Dr. Pancake held himself out as a board certified plastic surgeon he also represented to his patients also that he was board certified.
The American Board of Plastic Surgery or the American Board of Facial Plastic and Reconstructive Surgery never certified him as a plastic surgeon. However he did pay a fee to join the American Board of Facial Plastic and Reconstructive surgery. Any nurse that is licensed would have seen that Dr. Pancake was not practicing proper techniques as a plastic surgeon. For starters, why did Dr. Pancake only use local anesthesia. Right there somebody should have been self-policing or whistle blowing on Dr. Pancake. By just using local anesthesia the patients would still feel Dr. Pancake during the procedure. In the case of Mrs. Rita Ramsey, she had gone to Dr. Pancake to get her baggy skin around her midsection taken care of by Dr. Pancake.
Dr. Pancake told Mrs. Ramsey that by using local anesthesia that it would be some sort of benefit to her. He also convinced Mrs. Ramsey to get a breast augmentation. Leading up to her procedures at no point did Dr. Pancake order any pre operative test on Mrs. Ramsey. During Mrs. Ramsey operation at one point her blood pressure dropped to 68/36. Dr. Pancake proceeded to take off her blood pressure cuff during her liposuction procedure. A doctor who is certified in plastic surgery and who has had the proper training would never have taken off the patient’s blood pressure cuff. In the physician advocate model as discussed in Ethics in HealthCare, this model sees the nurses as an extension to the physician. Essentially the physicians extra hand. The patient advocate model calls for the nurse to be an independent although interdependent professional whose ethics cannot be dictated my others. The nurses role in Mrs. Ramsey case should have been made the nurses primary obligation to provide the best possible care for the patient and not merely to serve Dr. Pancake. Unfournately, this was not the case, it seems like the nurses just let Dr. Pancake do whatever he pleased like taking off Mrs. Ramsey blood pressure cuff and having the nurses use local anesthesia. Confidentiality is another issue that came up in Mrs. Ramsey case. While Mrs. Ramsey was in our room, neither the nurse nor Dr. Pancake ever closed the door. Even while Dr. Pancake was drawing on Mrs. Ramsey the door remained open.
On the morning of Mrs. Ramsey scheduled surgery, she was given Ativan, Valium, and Ultracet. After she was administered those medications then she was asked to sign the consent forms. I would think after given the regimen of medication that she would be too incoherent to even understand what she was signing. Still I feel like the Dr. Pancake breached confidentiality in her case because he never closed the door during any part of her case. Also other patients were walking past her exam room and could clearly see in there has Dr. Pancake was marking her and talking over the plan for her surgery.
As this relates to Mrs. Ramsey confidentiality, Dr. Pancake was negligent in failing to protect the privacy of Mrs. Ramsey and other patients during the medical procedures. To me I believe confidentiality was breached in all cases that relates to Dr. Pancake. Lastly, Dr. Pancake never once used any sterile techniques while working on Mrs. Ramsey or other patients. First, Dr. Pancake would wear the same gloves that he wore while working on Mrs. Ramsey, leave and go out of her exam room into another patient’s room wearing the same gloves. Never nce did Dr. Pancake ever become sterile while during Mrs. Ramsey procedures.
Why did anyone not blow the whistle on Dr. Pancake? Were they trying to cover up for Dr. Pancake because the nurses knew if they did not cover up for him that he might just lose his job? Never once did Dr. Pancake ever complete a complete history on Mrs. Ramsey. Dr. Pancake also never changed his scrubs when he left Mrs. Ramsey room or even when he walked back there. He also never wore a gown, mask, draping or headgear. As a patient I would have hoped that Dr. Pancake would have used his knowledge that he supposedly gained in medical school to use sterile techniques while performing any type of procedures on Mrs. Ramsey and the other plaintiffs in the case. Surprisingly enough not one patient died from Dr. Bruce Pancake not using proper sterile techniques. I believe Dr. Pancake medical license should have been stripped from him even before he started slicing and dicing on these patients that he supposedly said needed plastic surgeon. I also believe that the nurses were afraid to whistle blow on Dr. Pancake for all the ethical mistakes that he was making.