Chapter 542: Tragic Amputation: The Consequences of Negligent Pre-Surgery Checks

“Even the speed of a chief surgeon can’t match our boss!”

Yang Zhi chuckled beside Zhou Can.

After all, a team leader typically needed to be at least an associate chief physician with a professor title. Zhou Can held the authority of a team leader but not the official title.

Everyone had gotten used to calling him ‘Boss’ instead.

The nickname first came from Luo Shishen.

Back then, Luo Shishen, an intern, followed Zhou Can around, desperate to become his apprentice. Sadly, Zhou Can found his talent too ordinary and declined.

So, Luo Shishen started calling him ‘Boss.’

That kid was currently in residency training. Once it ended, he’d likely come begging to join Zhou Can’s team again.

Rumor had it he was doing well, even earning the favor of two chief physicians and getting slotted into a key development track.

Even though residency forced him to leave Zhou Can’s team temporarily, he still frequently messaged Zhou Can on WeChat for medical advice. Zhou Can treated him kindly, and the kid knew how to show gratitude.

During holidays, he’d call to send his regards and often spoke highly of Zhou Can in front of others.

“Looks like quitting my job to join Dr. Zhou was a brilliant move! Now I just hope he lets me stay. Help me put in a good word, and I’ll treat everyone to dinner after work.”

Her voice brimmed with confidence when she mentioned treating them.

With an annual salary of at least 300,000, a couple of meals were hardly a dent in her wallet.

“You’re so talented. I bet Dr. Zhou has already approved you in his mind!” Qiao Yu said with a smile, speaking up for her.

“Qiao Yu’s right. I can see ‘satisfied’ written all over Boss’s face!”

Ma Xiaolan also seemed to have a good impression of Jiang Wei.

Who knows what kind of charm Jiang Wei worked on them yesterday? Both were so eager to support her.

Especially Ma Xiaolan. Normally, she acted like a stern mother-in-law from old times, always giving new team members—be they doctors or nurses—a hard time to establish dominance. But this time, she seemed like a different person.

“Let’s focus on the surgery! Jiang Wei is indeed impressive, but I’ll need to see more from her.” Zhou Can didn’t give an easy pass. As the boss, his words carried weight, and he spoke with caution.

“Jiang Wei, we have three level-three surgeries today. Your performance earlier was solid, so I believe you can handle them. Do your best. As for operating room matters, it’s not up to me—Dr. Xu has to be satisfied for you to pass.”

No matter how exceptional Zhou Can was, he was still junior.

For level-two and level-three surgeries, he had to work under Dr. Xu’s name. He lacked the authority to independently lead such procedures.

According to the surgical grading system, only attending-level doctors could lead level-two surgeries and start participating in level-three ones. Senior attending doctors could perform level-three surgeries under the guidance of a chief or associate chief physician.

Around 11 a.m., a male patient in his forties was wheeled into the operating room.

This patient’s right lower limb had been diagnosed with varicose veins six years ago, accompanied by some swelling. But due to a demanding job and low income, he bore the entire financial burden of his family through labor.

Afraid of the costs, he never got surgery.

It wasn’t until recently, when the pain became unbearable and walking turned difficult, that he sought treatment at a hospital.

The local city center hospital performed a high ligation and stripping of the great saphenous vein on him.

This procedure was a common method for treating superficial varicose veins in the lower limbs when deep veins remained unobstructed. Most cases of varicose veins occurred in superficial veins; it was rare for deep veins to be affected as well.

After a checkup, as long as the patient met the surgical criteria, they could undergo high ligation and stripping of the great saphenous vein.

The treatment often yielded good results, significantly reducing swelling and pain in the lower limb.

After the surgery at the city center hospital, the doctors used an elastic bandage to apply pressure from the dorsum of his foot upward to the groin.

This was a standard post-surgery measure.

After all, since superficial vein stripping had been done, applying pressure was necessary.

But soon, the patient noticed severe swelling in the toes of the affected limb, accompanied by intense pain.

The family quickly pressed the call bell for a nurse to check.

The nurse, not daring to handle it alone, called in the attending doctor.

After an examination, the attending doctor suspected the elastic bandage was wrapped too tightly, causing the issue.

Zhou Can recalled Director Liu mentioning during such pressure bandaging that the pressure should increase as it went upward.

The attending doctor immediately loosened the elastic bandage and elevated the affected limb.

Since blood circulation in the lower limbs was the farthest from the heart, it faced the greatest challenge. In cases of severe swelling, likely due to blocked blood flow, elevating the limb helped blood return to the heart.

This could reduce swelling and quickly ease foot pain.

Even after loosening the bandage, the patient still cried out in excruciating pain. The attending doctor prescribed painkillers to manage it.

He also instructed the patient to observe for 48 hours before deciding on the next treatment plan.

These were all standard procedures.

At least the diagnostic approach was compliant.

Who could’ve guessed that after over 30 hours of observation, the patient’s right leg skin turned dark purple, the dorsal foot artery pulse vanished, and the skin temperature dropped drastically? To put it bluntly, it was like a corpse cooling rapidly after death.

Moreover, the swelling in the right leg had worsened significantly.

At this point, the family was both heartbroken and furious, shouting that they’d beat the doctor responsible to death.

The attending doctor was so scared he didn’t dare show his face.

Hospital leaders talked themselves hoarse to convince the family to transfer the patient to a major hospital in the capital city for emergency care. Saving his life was the priority now.

The family also feared that delaying further could cost him his life.

Swallowing their grief, they let the city center hospital’s ambulance transport him to a top-tier hospital in the capital city.

In truth, the city center hospital was also a tertiary Grade A hospital.

But in terms of capability, it paled in comparison to provincial tertiary Grade A hospitals like Tuyu Hospital or Provincial People’s Hospital.

The patient’s son had heard of Tuyu Hospital’s high standards and insisted on transferring him there for treatment. The accompanying doctor and nurse, fearing a beating, naturally complied.

After arriving, word was that the accompanying doctor and nurse bolted on the spot.

They were just hospital employees. Facing over a dozen enraged family members glaring murderously, who wouldn’t be terrified?

Better to return and face a scolding from superiors than risk a broken bone from a beating.

So, after dropping off the patient, they slipped away.

Once Tuyu Hospital took over, they examined the patient and found he was in shock with wet gangrene in the lower limb.

They immediately informed the family that an amputation surgery was urgent to save his life.

Hearing about the amputation, the family was overwhelmed with grief. The man was only in his forties, the backbone of the household. Losing a right leg—how could he live on after this?

They wanted to confront the city center hospital’s doctor and nurse, only to discover that the accompanying staff had long vanished.

Lucky for those staff members that they fled quickly, or they’d have become the target of the furious family’s wrath.

During medical disputes, especially when a patient dies or suffers severe harm, families can be extremely dangerous. It’s easy for them to act out in extreme, irrational ways.

Some doctors have been beaten into disability under such circumstances.

Another terrifying scenario is delayed revenge.

During an immediate dispute, doctors and nurses can at least be on guard. But some families and patients hide their anger at the time, only to return later with weapons—often sharp knives—and attack the involved doctor in a frenzy at the hospital.

In such cases, with no warning, doctors and nurses are easily gravely injured or even killed.

Why do doctors and nurses get nervous seeing family members carrying long, wrapped packages?

Because no one knows if they’ll unwrap it to reveal a sharp blade.

After failing to find the city center hospital staff, the patient’s family could only sign the consent for amputation with tears in their eyes. Saving his life was the top priority.

Ultimately, this amputation surgery fell to Zhou Can.

For patients involved in disputes, the second hospital receiving them often exercised extra caution.

Assigning Zhou Can to perform this amputation was a sign of trust in his surgical skills.

Dr. Xu personally supervised on-site.

It was clear that with Dr. Xu present, Jiang Wei seemed a bit nervous.

This showed Dr. Xu’s commanding presence was formidable.

At least in front of Zhou Can, his presence didn’t intimidate her.

The entire amputation process was straightforward yet brutal, steeped in blood.

Jiang Wei’s performance remained outstanding as always.

“Zhou Can, do you know what caused the patient’s amputation?”

Dr. Xu asked calmly.

“Jiang Wei, what’s your take on this?” Zhou Can didn’t answer but turned the question to her.

He wanted to gauge the true depth of this nurse’s abilities.

So far, she felt like an enigma to him. The skills she’d shown might just be the tip of the iceberg.

“Judging by his post-surgery condition, it’s likely due to a venous thrombosis.”

Her response was swift and decisive.

She didn’t even pause to think, suggesting she’d already formed this diagnosis in her mind.

“Qiao Yu, what’s your opinion?”

“I… I’m not sure.” Qiao Yu’s face flushed with embarrassment.

When it came to pathology diagnosis, her experience and skill needed work. She couldn’t compare to a prodigy like Jiang Wei.

“Jiang Wei, do you think the thrombosis occurred before or after the surgery?”

Zhou Can pressed further.

“I’m not entirely sure. I’d guess it was post-surgery.”

While Jiang Wei could pinpoint a general cause, she couldn’t diagnose with finer detail. That stemmed from the different focus of a nurse’s training.

If a nurse could diagnose specific causes like a doctor, that’d be unreal.

Take Zhou Can—he excelled in pathology diagnosis and surgery, but in nursing, he only had basic knowledge. He couldn’t match Qiao Yu or Jiang Wei in that area.

“Mentor, I believe it’s due to inadequate pre-surgery checks failing to detect the thrombosis, leading to the need for amputation.”

Zhou Can turned to Dr. Xu.

He’d just gotten a glimpse of Jiang Wei’s depth.

“That’s a strong possibility. Even if pre-surgery checks were lacking, there was still a chance to save the situation post-surgery. But the attending doctor was negligent, assuming it was just the elastic bandage being too tight, which led to this tragedy. When practicing medicine, you must be thorough—always prioritize the patient’s life.”

Dr. Xu’s face was stern as he warned everyone.

After the amputation, they discovered during surgery that the patient had thrombosis in both the iliac and femoral veins.

At last, the truth came to light.

This was a textbook medical error, a case worth deep reflection and vigilance.

Post-amputation, the patient underwent anti-shock and anti-infection treatments. By the time Zhou Can checked on him after finishing surgeries at noon, the patient had woken up.

But his mental state was poor.

His face was deathly pale.

This poor man likely didn’t yet realize he’d danced with death at the gates of hell.

Though his right leg was gone, his life had been saved.

Over lunch at the cafeteria, Yang Zhi couldn’t help but ask, “Boss, if I encounter a similar case with a right limb amputation in the future, how can I prevent such an accident?”

Of his two subordinate doctors, Yang Zhi was the more outgoing one, while Pu Dingdong was honest and reserved.

Pu Dingdong rarely asked questions主动, preferring to quietly take notes.

Only when he couldn’t figure something out through research would he seek Zhou Can’s guidance.

There was another amusing quirk about him.

Whenever he asked Zhou Can for advice, he’d lower his head like a shy schoolboy.

“For such patients, pre-surgery ultrasound, deep vein patency tests, and deep vein angiography can detect issues. The surgeon at the city center hospital failed to conduct thorough pre-surgery checks and missed the deep vein thrombosis. They performed great saphenous vein stripping, which caused lower limb venous return obstruction. Even when issues arose post-surgery, the attending doctor wrongly assumed the toe swelling and severe pain were due to overly tight bandaging, missing yet another chance to rectify the situation. This ultimately led to lower limb gangrene, leaving amputation as the only option to save his life.”

Zhou Can broke down the pathological mechanisms for his two subordinate doctors.

Since his pathology diagnosis skill had reached level six, his analyses were on par with a chief physician’s. Yang Zhi and Pu Dingdong could only nod in admiration.

Of course, Qiao Yu and Ma Xiaolan also picked up plenty of knowledge on the side.

Today, there was one more person—Jiang Wei.

Though Dr. Xu hadn’t given the final nod for her to stay, Zhou Can had already approved her. Director Lou’s approval was secured long ago. Her chances of staying were nearly 100%.

She wolfed down her food while intently listening to Zhou Can’s pathology analysis.

You could see the admiration on her face.

For someone as young as Zhou Can, still just a resident doctor, to have such expertise was truly remarkable.

“Boss, if deep vein thrombosis is discovered post-surgery, how can it be remedied?”

Pu Dingdong asked shyly.

Only when he was deeply intrigued and eager for an answer would he ask on the spot like this.

“It’s quite straightforward. Like handling other lower limb deep vein thrombosis, first perform a bypass surgery on the downstream blood vessel to restore blood flow to the limb. Then, plan a venous thrombectomy. The preferred method is interventional angiography. It’s minimally invasive, reducing harm to the patient, while also ensuring the clot is fully removed. For venous thrombosis like this, interventional thrombectomy is an excellent first choice.”

Zhou Can gave Pu Dingdong an approving look before patiently explaining the solution.

The oldest thrombectomy method involved cutting open the blood vessel—a major procedure with high difficulty and significant trauma. But with advancing technology, interventional thrombectomy has become the mainstream approach.