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Monday, February 5, 2007

Nobody was there to assist them: Dialysis errors

The chief medical examiner of Maryland has identified 24 kidney dialysis patients who bled to death, usually at home alone. And the Mid-Atlantic Renal Coalition, which oversees kidney programs in three states and the District of Columbia, knows of even more cases.

In dialysis, a life-saving treatment for kidney disease, a patient's blood is cycled through a machine that removes impurities and waste products. In most cases, doctors tap a vein in the arm or leg, creating a "vascular access site" or portal that can be used for years. Most of the people died after their access sites weakened from repeated use and finally leaked.

"Most of these people seemed to be alone at the time the bleeding occurred," the Medical Examiner said in an interview. "Nobody was there to assist them."

Dr. Jeffrey Fink, former chairman of the Maryland Kidney Commission, said he has never had a patient bleed to death, though one recently woke up in time to get help. "The patient had a hemorrhage and happened to wake up wet," he said. "Everybody I talked to has a few cases where this has happened."

Advice to dialysis patients: Get a friend or family member to check on you during dialysis, if possible. And get educational sessions about the proper care of your access sites and the signs of trouble.

Read another kidney story, or see Jonathan Bor’s article in the Baltimore Sun. Thanks to Helen Haskell for spotting this.

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