Medical Error

Medical Error

Scalpel-sharp prose, pulse-quickening suspense, characters in jeopardy—and an uplifting remedy. Dr. Richard Mabry's
Medical Error
delivers on all counts.

—CANDACE CALVERT, author of the Mercy Hospital series

Dr. Mabry takes us on an emotion-packed, adrenaline-laced roller coaster ride. Kept me guessing until the final pages, but what a satisfying conclusion. Even better than
Code Blue!

––DEBORAH RANEY, author of
Beneath a Southern Sky
and the Hanover Falls novels

I was riveted by Mabry's
Medical Error—
compelling story and characters with fascinating medical detail! Move over Robin Cook! Mabry has a bright future.

—COLLEEN COBLE, author of
Lonestar Homecoming
and the Rock Harbor series

Other books by Richard L. Mabry

Code Blue,
book 1 in the Prescription for Trouble series

The Tender Scar: Life After the Death of a Spouse

Medical Error

Prescription for Trouble Series

Richard L. Mabry, M.D.

Medical Suspense with Heart

Nashville, Tennessee

Medical Error

Copyright © 2010 by Richard L. Mabry, M.D.

ISBN-13: 978-1-4267-1000-1

Published by Abingdon Press, P.O. Box 801, Nashville, TN 37202

www.abingdonpress.com

All rights reserved.

No part of this publication may be reproduced in any form, stored in

any retrieval system, posted on any website, or transmitted in any form

or by any means—digital, electronic, scanning, photocopy, recording,

or otherwise—without written permission from the publisher,

except for brief quotations in printed reviews and articles.

The persons and events portrayed in this work of fiction are the

creations of the author, and any resemblance to persons

living or dead is purely coincidental.

Published in association with WordServe Literary Group, Ltd.,

10152 S. Knoll Circle, Highlands Ranch, CO 80130

Scripture taken from the Holy Bible, NEW INTERNATIONAL VERSION®.

Copyright © 1973, 1978, 1984 by International Bible Society. All rights reserved

throughout the world. Used by permission of International Bible Society.

Cover design by Anderson Design Group, Nashville, TN

Library of Congress Cataloging-in-Publication Data

Mabry, Richard L.

 Medical error: medical suspense with heart / Richard L. Mabry.

   p. cm. — (Prescription for trouble series)

ISBN 978-1-4267-1000-1 (v. 2 : alk. paper)

 1. Women physicians—Fiction. I. Title.

 PS3613.A2M43   2010

 813'.6—dc22

20010021323

Printed in the United States of America

1 2 3 4 5 6 7 8 9 10 / 15 14 13 12 11 10

For my wife, Kay, whose love made life worth living

once more. In my writing endeavors, she is my biggest

fan, always encouraging me to do my best work. I couldn't

do it without her—nor would I want to.

And for my grandchildren: Cassidy Ann, Kate, Ryan, and

Connor. I hope that, as you grow up, you'll think maybe

your Grandad wasn't too bad a writer (even if there aren't

any pictures in this book).

ACKNOWLEDGMENTS

I want to express my appreciation to my wonderful agent, Rachelle Gardner, as well as to my great editor, Barbara Scott, and everyone at Abingdon Press. Thanks for letting me play on your team.

I'm grateful for the support and encouragement of so many writer friends as I struggled to master the craft of writing and discover the ins and outs of publication. I've learned from each of you. Thank you for the kind words that came just when I needed them. There are too many of you to mention individually, but you know who you are. You have my sincere gratitude.

My long-time friend, attorney, and golf partner, Jerry Gilmore, has been an insightful and supportive reader of my first drafts. Let the record show that any good traits demonstrated by the attorneys in my books are modeled on Jerry, while any legal errors are my own responsibility.

As always, my wife, Kay, has read every word of this novel. She's been lavish with her praise, kind with her criticism, and spot-on with her suggestions. Thank you, dear, for always being there. You make it all worthwhile.

To my readers, you have my undying gratitude for buying my books and giving me feedback, both positive and negative (but mostly positive, I hope). I want you to expect a good reading experience when you pick up one of my novels, and I hope I never betray that trust.

—Richard L. Mabry, M.D.

1

E
RIC HATLEY'S LAST DAY ALIVE BEGAN ROUTINELY ENOUGH.

He paused beside his brown delivery truck, shifted the bulky package, and turned in a tight circle to search for the right apartment.

Shouts filled the air. Firecrackers exploded all around him. A dozen red-hot pokers bored holes through his gut.

The package flew from his arms. He crumpled into a privet hedge at the edge of the sidewalk, clutching his midsection and recoiling when his fingers encountered something wet and slimy.

A wave of nausea swept over him. Cold sweat engulfed him.

Eric managed one strangled cry before everything faded to black.

Dr. Anna McIntyre bumped the swinging door with her hip and backed into Parkland Hospital's Operating Room Six, her dripping hands held in front of her, palms inward. "Luc, tell me what you've got."

Chief surgical resident, Dr. Luc Nguyn, didn't look up from the rectangle of abdomen outlined by green draping sheets and illuminated by strong surgical lights. "UPS driver, making a delivery in the Projects. Got caught in the crossfire of a gang rumble. Took four bullets in the belly. Pretty shocky by the time he got here."

"Find the bleeding source?"

"Most of it was from the gastric artery. Just finished tying it off."

Anna took a sterile towel from the scrub nurse and began the ritual of gowning and gloving made automatic by countless repetitions. "How about fluids and blood replacement?"

Luc held out his hand, and the nurse slapped a clamp into it. "Lactated Ringer's still running wide open. We've already pushed one unit of unmatched O negative. He's finishing his first unit of cross-matched blood. We've got another one ready and four more holding in the blood bank."

"How's he responding?"

"BP is still low but stable, pulse is slower. I think we're catching up with the blood loss."

Anna plunged her hands into thin surgical gloves. "Lab work?"

"Hematocrit was a little over ten on admission, but I don't think he'd had time to fully hemodilute. My guess is he was nine or less."

Anna turned slightly to allow the circulating nurse to tie her surgical gown. "Bowel perforations?"

"So far I see four holes in the small intestine, two in the colon."

"Okay, he'll need antibiotic coverage. Got that started?"

Luc shrugged. "Not yet. We don't know about drug allergies. His wallet had ID, but we're still working on contacting next of kin. Meanwhile, I have Medical Records checking his name in the hospital computer for previous visits."

"And if he's allergic—"

The nursing supervisor pushed through the swinging doors, already reading from the slip of paper in her hand. "They found one prior visit for an Eric Hatley, same address and date of birth as on this man's driver's license. Seen in the ER two weeks ago for a venereal disease. No history of drug allergy. They gave him IM Omnilex. No problems."

The medical student who'd been assisting moved two steps to his left. Anna took his place across the operating table from Luc.

Luc glanced toward the anesthesiologist. "Two grams of Omnilex IV please."

Anna followed Luc's gaze to the head of the operating table."I don't believe I know you. I'm Dr. McIntyre."

The doctor kept his eyes on the syringe he was filling. "Yes, ma'am. I'm JeffMurray, first- year anesthesia resident."

A first-year resident on his own? Where was the staffman? "Keep a close eye on the blood and fluids. Let us know if there's a problem." Anna picked up a surgical sponge and blotted a bit of blood from the edge of the operative area. "Okay, Luc. Let's see what you've got."

In the operating room, Anna was in her element. The green tile walls, the bright lights, the soft beep of the monitors and whoosh of the respirator, the squeak of rubber soles as the circulating nurse moved about the room—all these were as natural to her as water to a fish or air to a bird. Under Anna's direction, the team worked together smoothly. Conversation was at a minimum, something she appreciated. Do the job in the OR, talk in the surgeons' lounge.

"I think that's got it," Luc said.

"Let's check." Anna's fingertips explored the depths of the patient's belly with the delicate touch of a concert violinist. Her eyes roamed the operative field, missing nothing. Luc had done an excellent job. He'd do well in practice when he finished his training in three months.

Anna stepped away from the table. "I think you're through. Routine closure, leave a couple of drains in. Keep him on antibiotic coverage for the next few days."

Luc didn't need to hear that, but she figured the medical student did. She might as well earn her assistant professor's salary with a little low-key teaching.

She stripped off her gloves and tossed them in the waste bucket at the end of the operating table. "If you need me—"

"Luc, we've got a problem. Blood pressure's dropping, pulse is rapid." A hint of panic rose in the anesthesiologist's voice.

The scrub nurse held out fresh gloves, and Anna plunged her hands into them. "He must be bleeding again. Maybe one of the ligatures slipped off."

"No way," Luc said. "Everything was double-tied, with a stick-tie on the major vessels. You saw yourself; the wound was dry when we finished."

"Well, we've got to go back in and look." Anna turned to the anesthesiologist. "Run the IV wide open. Hang another unit of blood and send for at least two more. Keep him oxygenated. And get your staffman in here. Now!"