Joe: Ooh, that's a good idea!!!! I'm printing out this thread. But Joe, while it says "Posted Today, or Posted yesterday", it never specifically states: "Posted March 22, 2007". I saved it all to my hard drive and I can print it any time I wish.

Jeez. imagine waiting to see if your husband come down with a MRSA type of infection. I don't even know what I'm supposed to be looking for.

When he got up this morning, I expected him to be all exhausted, all achy, well, I expected him to be SOMETHING!!!

He gets up, takes a shower, I get up and go over and put my arms around him and say "how are you, how do you feel"??? and he says 'oh, I'm fine,", I'm off to Dr. Fred's office to get my blood work done. This was his regular appointment for blood work.

That's when I carefully explained what the guys on the boards said and how we should just make a record of what happened in the kitchen, and we should save the bags in the refrigerator. I showed him the note I wrote, half expecting him to start yelling "Oh my god, they think I have MRSA??" (BELIEVE ME, HE DOESN'T KNOW WHAT MRSA IS). But he just said "oh, good, you wrote a note, I'll show it to Frank and he'll put it in my file.".

Let me say one thing. WHAT WOULD THIS MAN DO WITHOUT A WIFE??? I would just like someone to tell me.

See, this is where I get all emotional and hostile about my son who left home 5 years ago and couldn't care less about us because he is a gambler who also has aspergers.

Anyone else would call up their son and they would get comfort and phone calls and be told "mom, what can I do?".

We never get that and we WILL NEVER GET THAT!!!!!

Sometimes, it gets very hard to have all these health stuff going on (and believe me, you guys have it a lot worse than Alan and I), but sometimes, it would have been nice to have a son who gave a damm.

I guess I have to get over my pity party.

He'll come bouncing in the door any minute and I'll just massage him to death like I always do. I do Rolfing down his back and goes into heaven.

But I'll just wait and see how he's feeling.

Exactly what should I be looking for? (if the bag was contaminated).
Thanks,
Melody

Hi Melody:

In answer to your rhetorical question "What would Alan do without a wife?": My answer is: "What would any man do without a wife?"

(Having typed that, dodging cyber bullets and tomatoes!)

So glad that Alan is doing all right this morning. Relieved hugs to both of you.

Shirley H.,

I would keep the bag too - as evidence - you dont know what may happen down the line - as Mrs D Said..... and again, contact those concerned.


ALso, the nurses try to hurry the home infusions because they want to get along on their schedules - again - the doctor sets the rate - not the nursing agency...... you need to mention that to your doctor too... it is not true that side effects only happen the first time - there is a chance of going into shock that is high with every the beginning of each infusion which is why they usually run it a bit slower at first and why with every infusion you get benadry and pain killers, to try to prevent side effects all thru the infusion - which can be made worse if the nurse tries to run too fast..... they are not following your doctors instructions and he set up the rate for Alan, not to accomodate the nurse.... they are trying to make their day shorter.... Alan is the patient and instructions are made by the doctors, NOT the nurses.......

Melody in a few days it will have the date on the post. After it passes the today and yesterday stage. I really dont know what to look for except any rashes or fever or not feeling well.

As far as another comment from another poster what would men do without wives, there are many men, such as myself, who have to stay on top of things also or else it wont be taken care of.

I also commiserate with you about your son, I am having a lot of problems with my 16 year old and am desperately trying to save him, turn him around. Its heartbreaking.

I would ask of all parties involved about the proper protocol -
of the drs time line infusion orders,
and what is the proper thing to do in case of a leaky IVIG bag?

Get that info in writing if you can.

but I really think the nurse?? did not follow correct procedures with the transferring.
I would think there should be some rules in place for this sort of situation.
she should at least called her office to report and ask how to proceed.

and how do you know that any residue might still be on your sink or counters?
You might ask about the clean up of it also, just to be sure.
I don't know if it could hurt you that way or not .. but..

Mel

It doesn't matter who poked the hole in, regardless of how the hole got there, it was a potential source of infection. You can't tape a hole in an IV bag...or a hole in an IV tube. You can tape connections of tubes to keep them secure, provided they are working to being with...you can not tape a 'leak' to stop it anywhere in the system....Forbotten!!!! NIX, NIE, in any language.

IVIG is given at x number of milligrams per minutes. If his time is 4 hours it is four hours....you may not know this but some agencies pay nurses by the visit...the shorter the visit the more pay they make, as they make more visits...they make exceptions for IV visits as they take longer.

IVIG is generally mixed by the pharmacy and delivered to the place of infusion. I had mine at an infusion center, which they insisted on me going to, despite being a home care nurse myself. Why? Because, one bag of IVIG contains antibodies from over 1,000 donors, and you never know when one of those donors may have some offending antibody which causes a reaction. usually people have a reaction right away, but not always.

Now the thing to do is watch for signs of infection, which are not the same as signs of infusion reaction.

This is not a minor error on the nurses part....what does she think she can do brain surgery too???

Alan likely has an immune system that can handle any germ he got, but you need to call attention to what occurred to you.

Call and speak with the nursing supervisor or director of nursing...not the secretary or scheduler.

Call your doc and let him know what happened.

You are likely going to be unable to prove how the hole got there and that is irrelevant...simply the fact that there was a puncture in the bag is enough to assume it is contaminated.

Transferring contaminated contents via sterile procedure is a joke.

Think of it this way....hm, some cockroach poop got poked into this bag and now I am going to sterily transfer the contents into a new sterile bag...(even though I am transferring cockroach poop contaminated liquid into a new bag.)

This is just an illustration, not what actually happened, but microbes are very tiny, thousands can enter in a pin prick. Millions enter our bodies everyday and we fight them off. Alan will likely not have any problem but if he does, you have the right to establish that this is how they entered. Again, who poked the hole doesn't matter....the dumb move was infusing it!

With people with autonomic neuropathy, they sometimes do not know they are sick with an infection....Just let your doc know. I would feel so much better...and call the Home Care Agency. This nurse needs to be corrected and realize that this is not appropriate practice.

Just give them the facts...Mel, write down the facts---do not say more than the facts....do not make assumptions---just the facts...

She hung the bag
A leak was found
She wanted tape to tape the leak
She transfered contents...blah blah blah.
Facts only....no assumptions.

Let them know about the infusion time being cut short....it is OK in some circumstances when you are being monitored....I was monitored with BP, P and Temp every 15 minutes, for every single bag I ever had infused....and this was at the infusion center....which was the only place they would allow me to have it infused...as it is a blood product. If orders say over 4 hours, and it is in the home setting, I would do it in 4 hours. It makes me wonder if allan got his whole dose...how much was lost in the leak etc.

Do not panic...do not accuse....again, write down what you are going to say, and just read your script.

Sorry, not the infusion company, the VISITING NURSE SERVICE, I always have to go through them.

I have a good raport with the woman who has been arranging Alan's infusion. I called her and she said "Melody, how are you, how did it go yesterday?"

So I told her EXACTLY WHAT HAPPENED. I didn't offer any comments on my part. I just stated the facts. I said:

1. I took out the bag of gammimune out of the fridge one hour before and hung it up on the pole.

2. The nurse arrived, attempted to hook up the tubes to te bottom of the Bag of Gammimune and exclaimed "oh, we have a leak".

3. She tried to tape it where the leak was (only a few drops came out). The tape was not successful.

4. She went out to her car and got a bag of saline solution and took everything into my kitchen, and she took a big hypo syringe thing and (while wearing gloves all during this process), she transferred the stuff from the Gammimune bag to the Saline Bag.

I then said "I don't know anything about IVIG but I do know this is a blood product and I just wanted to tell you exactly what happened".

Her reponse: "We ordinarily don't approve of this thing being done this way, it sounds like she found a solution to the problem of the leak". But we don't encourage this action" I said "okay, what happens next"???

She said "if there was contamination (note that I never mentioned the word,she did") If there contamination in the product, you might see a reaction within 24 hours" I said "well this happened last night ". She said "what time did the nurse leave"? and I said 8:45 p.m."

She said "I am giving you my cell phone number. Call me at 9:30 p.m. this evening and tell me how he is doing." I said: "I'm not trying to cause any problems, I just wanted to tell you what happened" and she said "you did the right thing, just don't tell anyone else".

I think she is just trying to wait and see if Alan has any reaction to what happened.

He just came home and he has a headache. He says "I feel like I did when I came out of detox, all aches and pains". He is going to take a nap.

Now this was the first time he got a 3 hour infusion. Ordinarily it's always 4 to 4 and a half hours. (And believe me from now on if anybody tells me "oh, it's okay to give him 3, I'll be on the phone to the visiting nurse service so fast it will make your head spin!!!!!

So I have no idea if this is why he has a headache. I don't want my mind to play tricks on me.

I'm not leaving him alone the whole day.

Tomorrow we have to go to Court.

Oh vey!!!!!

Everybody cross their fingers and toes that there was no contaminents.


Oh, by the way, Alan gave the note (describing everything that happened) to Frank and after he read it he said "Alan, I don't know what to tell you" and Alan said "just show this to Dr. Fred when he comes in this afternoon"

So I believe I covered all my bases.

If you think I should do anything else, please let me know. For now, it's a waiting game.

After his blood test,he went to NYC to pick up his check from the security firm. So I guess so far so good.

So guys, you are all updated and know everything I know.

Will let you know how it goes later on.

bye for now.

Melody

LOL I like the part where the lady said "don't tell anyone" LOL
sounds like a bit of a coverup

at the very least the nurse should be reprimanded- whether Alan has any reaction or not.

They could be doing this to many other patients too and maybe those people don't have a forum to ask about it on.

Her reponse: "We ordinarily don't approve of this thing being done this way, it sounds like she found a solution to the problem of the leak". But we don't encourage this action" I said "okay, what happens next"???

She said "if there was contamination (note that I never mentioned the word,she did") If there contamination in the product, you might see a reaction within 24 hours" I said "well this happened last night ". She said "what time did the nurse leave"? and I said 8:45 p.m."

She said "I am giving you my cell phone number. Call me at 9:30 p.m. this evening and tell me how he is doing." I said: "I'm not trying to cause any problems, I just wanted to tell you what happened" and she said "you did the right thing, just don't tell anyone else".

Oh brother........


Ask to file a written grievance. You need to document. You can also call your state board of regulation and licensing or who ever oversees nursing licensure in your state.

Her response is utterly ridiculous. She should have told you to call your physician...they should have called your physician....they are busy right now, compiling their legal defense. Change providers if you can.

Big boo boo number 3 "don't tell any one" ...number 1 being giving fluids from a leaky bag..boo boo number 2 being 'skillfully and with the appearance of sterile technique", transfering that contaminant exposed fluid into another bag...Oh and there might be one more boo boo...I read IVIG is not compatible with normal saline. I am not completely sure on this one, but I read on pharmacy page on mixing it, that it is not compatible with normal saline...now please realize that not all IV bags contain normal saline....I honestly can't say off the top of my head what IVIG is mixed in. Keep all bags, tubes etc in a bag....don't monkey around with them.

A reaction to IVIG is not the same as an infection which could take a few days to brew up....the best way to find an infection of this sort will be to draw blood, CBC and blood cultures. Your doc will know what to do. I think you need to make it clear to your doc what happend.

Administering a fluid from a leaking bag, regardless of how the leak got there is an error. It is a medication error, this one being rather deliberate.

I will say it again...

No nurse is dumb enough to think for a minute that this fluid was still sterile.

Allan will likely be fine. In the remote chance he isn't, you need to have this incident documented.

Your doc needs to know what happend, and given the response of the infusion provider, I would get a new one....'don't tell any one' is not an acceptable answer to your question...it is exactly the opposite of what you should have been told. I am aghast.

Melody:

It might be a good idea to print out your posting and then the posts from others on this Forum, so that you have a better recall of how things occurred. Just a thought.

Shirley H.