死亡医师（2021）

Dr. Death S01E08

Part 7 July 28, 2021, 11:20 a.m.

非常少见
Exceptionally rare.
你几次划破过它
How many times have you hit it?
从来没有
Never.
伯克太太术后情况如何
And what happened to Mrs. Burke after her surgery?
她心率加快没法睁眼
Her heart rate elevated. She couldn't open her eyes.
对与提问或指令无法做出语言回答
No verbal response to questioning or commands.
这对医护人员来说这意味着什么
And what does that indicate to anyone in the medical field?
大难临头
An impending disaster.
邓奇先生得知这个消息后
What should Mr. Duntsch have done
应该做些什么呢
as soon as he was informed of that information?
检查患者身体情况
Physically examine the patient.
开相应的检查拍片
Order appropriate studies. Scans.
但最后是重症病房♥医师开了检查
They were ordered by the ICU physician,
显示她脑死亡
which showed she was brain dead.
邓奇医生人当时在哪里
Where was Dr. Duntsch?
他在给玛德琳·贝尔动手术
He was operating on Madeline Beyer.
如果当时被告专心治疗桃乐西·伯克
Had the defendant focused on Dorothy Burke
而不是玛德琳·贝尔她有可能活下来吗
rather than Madeline Beyer, would she still be alive today?
基于我所知的
Based on what I know
邓奇医生的手术方式
of Dr. Duntsch's approach to surgery,
伯克太太同意他做手术那刻起就已经完蛋了
Mrs. Burke was dead the moment she agreed for him to operate.
反对
Objection.
有效
Sustained.
玛德琳·贝尔呢
Madeline Beyer?
贝尔太太是我今天出庭作证的原因
Mrs. Beyer is the reason I'm sitting here today.
我我努力挽救她
I--I tried to fix her.
有一枚螺钉插入了她的椎管
One of the screws was violating the spinal canal,
伤及她的硬脑膜和神经根
damaging dura and nerve roots.
你怎么知道你伤到了硬脑膜
How do you know when you've hit the dura?
会有脑脊液溢出
Cerebral spinal fluid leaks out.
我找到了他在左侧三次试图
I found evidence of three attempted screw placements
插入螺钉后留下的痕迹
on the left side where he put no screws.
最令人不安的是
The most disturbing part was,
他做手术的全部理由
the entire reason he was operating
是为了移除椎间盘但他完全没动它
was to remove the disc, and he didn't touch it.
他移除了什么东西
What did he take out?
很大一块腰大肌
A large piece of the psoas muscle.
他在腰大肌间建立通道
He made a portal through that muscle
然后塞进了一块植入物
and stuffed an implant in there.
融合器
Cage.
一个受训的神外医生
Is a trained neurosurgeon
能够识别骨骼和肌肉的区别吗
going to know the difference between bone and muscle?
-能 -锤子
- Yes. - Mallet.
一个受训的神外医生是否知晓
Would a trained neurosurgeon know
错误地放置锥体融合器
that by malpositioning the interbody device,
几乎肯定会导致患者受伤
he was reasonably certain to cause her injury?
知道
Yes.
一个受训的神外医是否知道
Would a trained neurosurgeon have been aware
如果错误地打入椎弓根螺钉
that if he malpositioned the pedicle screws,
几乎肯定
he was reasonably certain
会导致患者肢体严重损伤
to cause her serious bodily injury?
知道
Yes.
一个受训的神外医是否知晓
Would a trained neurosurgeon have been aware
如果切断神经根
that if he amputated the nerve root,
几乎肯定
he was reasonably certain
会导致患者肢体严重损伤
to cause her serious bodily injury?
知道
Yes.
对于在玛德琳·贝尔一例中
The way the surgical tools were used
手术器材的使用方式
in Madeline Beyer's case,
你是否认为这种方式
do you think they were used in a manner
会导致患者死亡或收到严重肢体损伤
that was capable of causing death or serious bodily injury?
是的
Yes.
检方问询完毕
We pass the witness.
亨德森医生舒格特女士
Dr. Henderson, Ms. Shughart made
明确指出了一个受训的神外医生
quite the point that a trained neurosurgeon
应该能够做这做那
should have done this or done that.
你知道克里斯托弗在田纳西大学
You're aware Christopher has both an MD and a PhD
取得了博士和医学博士学位
from the University of Tennessee.
是的
I am.
田纳西大学不是什么野鸡医科大学
UT isn't some fly-by-night medical school.
不像那些
It's not like one of those in--
瓜达拉哈拉或者格拉纳达的大学不是吗
in Guadalajara or Granada, is it?
对田纳西大学在孟菲斯市
No, it's in Memphis.
你知道杰弗里·斯卡顿医生吗
Do you know Dr. Geoffrey Skadden?
他是否口碑甚佳
Does he have a good reputation?
我知道他的确是
I do, and he does.
他在克里斯托弗·邓奇的培训中
And what was he responsible for
担任什么角色呢
in Christopher Duntsch's training?
邓奇医生在田纳西大学完成了住院实习
After Dr. Duntsch finished his residency at UT,
他参加了斯卡顿医生的
he came under the tutelage of Dr. Skadden
研究项目
for a fellowship training
研究微创脊椎手术
in minimally invasive spine surgery.
你是否知晓邓奇医生
Were you familiar with the fact that Dr. Duntsch
同时在进行着癌症医学研究
was doing medical cancer research on the side
且斯卡顿医生参与了该项研究
and that Dr. Skadden was involved in that research?
我当时并不知道
I wasn't at the time, no.
任何医生在任何情况下
Should any doctor under any circumstances
应该允许研究项目影响其外科培训的时长吗
have their surgical training hours disrupted by research?
绝对不应该
Absolutely not.
所以一个神经外科住院医师或者研究生
So a neurosurgical resident or fellow
不能直接略过这些培训时长
can't just skip those hours.
必须有导师签字无论什么理由
The supervisor has to sign off, no matter the excuse.
没错
Correct.
项目监管医生需要签字确认
Do the doctors in charge of the program have to sign off
他们够格毕业并从业吗
that they're qualified to go and operate?
需要
Yes.
斯卡顿医生是否
Did Dr. Skadden write letters
曾为邓奇医生写推荐信
of recommendation for Dr. Duntsch?
是的他声称邓奇医生
Yes, he stated Dr. Duntsch
在他的研究项目中表现优异
was a satisfactory surgeon in his fellowship.
斯卡顿医生是否听说得克萨斯州发生的事故
Well, had Dr. Skadden heard what was happening in Texas?
听说了因为他在森林公园医院的
Yes, because he had mentioned poor outcomes at Baylor
认证表格上提到了在贝勒医院的不良结果
when filling out a credentialing form at Forest Park.
你知道他为什么没有明确告诉
Do you have any idea why he wouldn't have explicitly told
这些医院不要雇佣邓奇医生吗
these hospitals not to hire Dr. Duntsch?
斯卡顿医生说他只根据他所见的
Dr. Skadden said that he had to write recommendations
学生在其研究项目中的表现来写推荐信
based on what he'd witnessed in his program.
他无法知晓在得克萨斯州发生的任何事件
He couldn't speak to whatever was happening in Texas.
我们交谈后他没有再为邓奇医生
He didn't write any more recommendations for Mr. Duntsch
写推荐信
after we spoke.
是否曾有医生
Has there ever been an instance
因拒绝写推荐信而被起诉
in which a doctor was sued for not writing a recommendation?
是的
Yes.
那很吓人不是吗
Well, that's frightening, is it not?
我认为是很吓人
It is to me.
因此斯卡顿医生必须他签字放行
So Skadden had to sign off on him,
否则他拿不到行医认证书
or he wouldn't have been able to get their credentials?
没错
Correct.
我说贝勒医院不可能
I mean, Baylor wouldn't let
让大街上随便什么人
somebody just walk in off the street,
都去操刀神经外科手术
start doing neurosurgery.
我还以为他们会向有关部门
I also assumed they would have reported
报告他的手术结果
the outcomes of his surgeries to the authorities.
而事实上
As a matter of fact,
他们没有向任何人提起过这些负面的结果
they didn't say anything negative to anybody.
神经外科是摇钱树
Neurosurgery is a big moneymaker.
你是否认为医院的公♥司♥层面
Do you think the corporate level of the hospital
比起保护患者权益
was more interested in making money
更在乎医院盈利情况
than in protecting their patients?
是的我这么认为
Yes, I do.