The Case Study of Michael Skolnik and His Colloid cyst

Medical cases can either be something that doctors can treat easily or something that they might require the help of other specialist but in some case which is very little, there can be errors at so many point by medical practitioners and these mistakes and errors can be detrimental but today's case study isn't one of mistake but of supposed medical malpractice and misconduct. One that touched me while reading on the case.

Michael Skolnik was a nursing student born in Denver Colorado on March 15, 1979 and he was the only child of this parents. He attended nursing school while doing EMT and this allowed him to gather a lot of experience in the healthcare field but things began to take a different turn on September 17, 2001 when he began to suffer health challenges. After class on that day, he suddenly collapsed and after a while he regained consciousness. This was not the first time that it had happened to him as he had a previous episode some months back so he decided to visit the hospital with his parents.

Just like every other normal procedure, the doctor asked about his medical history and any drug being used currently. He answered that he was using Wellbutrin (Ibupropion Hydrochloride) which is an anti-depressant but can also be used to treat smoking withdrawal. With this, the doctor concluded that it his fainting might have been as a result of the drug he was taking.

A spinal tap was requested and his cerebral spinal fluid was gotten. After the test, the doctor came back with words that the result was inconclusive (Actually I do not hear this word much in the hospital here, I hear the word inconclusive more with elections in my country). Back to the case, the doctor requested a CT scan where they found a small round dot in his brain and the doctor's first suspect was a Colloid cyst.

An MRI was advised to be done and Michael did it and the practitioners said that there was a 4.2mm area which most likely represented a colloid cyst which caused no ventricular obstruction. Te parents went home with their boy but so they can be certain, the mother began to sought for a second opinion and it was then that she met a neurosurgeon whose conversation with her would change their lives and that of their son's.

He requested that the boy be admitted into the ICU because his condition was terrible and she was lucky to have reached out to him or her son would have died. He told her that Colloid cyst was so dangerous and she needed to get to the hospital so fast. Upon reaching the hospital, the surgeon said they were going to perform their own tests and scans, and so they requested for another CT scan. When the result came out, the surgeon mentioned that the Colloid cyst was very big and the vessels in his brain were so enlarged that it allowed for fluid to be in his brain thereby putting a whole lot of pressure on his brain. According to his interpretation of the CT scan, the Colloid cyst was causing ventricular obstruction.

The doctor said a ventricular vein would be inserted into his head to drain the fluid in his head and decrease the pressure in his brain followed by a brain surgery to remove the cyst. He sounded confident and was telling the parents that the boy would be out in six days with no complications since he has done similar surgeries numerous times.

The parents and the Son signed the consent form and they decided to get the draining done. The parents were asked to leave the room so they could prepare him for operation and once the parents left, the surgeon began the operation. What the parent noticed was that instead of him to be prepared for an operating room, the procedure was done just by his bed in the room. Also, the surgeon used a hand drill to perform the surgery. This was were the parents began to see red flags.

Soon, the procedure went south and he needed to be helped for him to breath and soon he became unconscious. The Surgeon maintained that it was the fluid in his head that mad him unconscious. Soon the doctor mentioned that he would have to operate on him in 48 hours or they would lose their son. The parents went home for the night and it was then that they got a letter on their fax machine. Before Michael's mum sought the surgeon, she had sought a second opinion from their primary care physician and in the letter on the fax, he had replied that the cyst wasn't something they needed to worry about as the cyst was benign and would never grow or change. It was at this point that they began to panic for their son's life.

The surgeon pumped Michael with so much drugs that it would be difficult to ascertain how he was feeling and doing physically and mentally. It was at this point that the doctor requested that Michael signed the consent form for a brain surgery and this was done with his parent's knowledge. The procedure was suppose to last 3 hours but ended up for 6 and half hours and when the doctor came out, the told the parents that he might have mistakenly punctured the cyst and it might take longer for the boy to wake up and he would have to be in recovery for a very long time.

When they got into the room, their son was head swollen with his head wrapped with bandages. Neurological examinations showed that he had suffered brain trauma as a result of the procedure and all the parents would hope for was for their son to wake up. Soon the drain was to be removed and it was at this point they noticed that unlike what the doctor had told them, a craniotomy was performed on their son which means a part of their son's skull was removed so as to be able to access his brain.

Throughout his stay in the ICU, he experienced several complications and suffered a lot during the months as the complications included intracerebral hemorrhage, recurring brain abscesses, hydrocephalus, pulmonary embolism, respiratory arrest, intracerebral yeast infection and so on.

As if this was not enough, 5 months after the operation when he was going to be sent to a rehabilitation hospital, the doctors told them that the surgeon had done a serious manipulation in the brain of their son and it wasn't only the craniotomy that was done instead he also removed part of the the hypothalamus and with this, their son was expected to suffer serious complications like 50% blindness, partial paralysis, loss of short memory, experience thalmic chronic pain syndrome, and multiple seizures.

This complications led him to spending 22 months in rehabilitation hospitals and ICUs. After the 22 months, their son was to be discharged and the parents were happy but their joy was short-lived when their son went into multiple organ failure and he suffered other neurological complications. His parents turned their house to an ICU as they were left to take care of him.

Soon he was at the hospital again but this time on life support because he was experiencing a lot of neurological pain, he opted for being removed from life support so he could pass away comfortably. On June 4, 2004, Micheal was removed from life support and he passed away.

This was very heartbreaking for the parent but what was more heartbreaking was the parent finding out that 2 years before their son's case, an article was written to state categorically that the procedure was not the first line of action to take as treatment. The parents also found out that their son was the second patient the surgeon would perform such procedure on which wasn't what he told them. Also, he had multiple suits of medical malpractice from different states.

This case led to the March 22, 2007 medical act known as the Micheal Skolnik Medical Transparency act in Colorado. This act ensures that every detail about a medical practitioner including lawsuits should be listed on healthcare public records. I used the word supposed at the beginning because the board didn't take any disciplinary action against the surgeon even after investigation. The family sued but later settled out of court for their mental sanity but were able to make sure that the health system wasn't the same way their son met it.