UMC denies misconduct charges

By Craig Sanders

Arizona Daily Wildcat

The CEO for University Medical Center denied allegations Friday by various media sources which stated that recognized procedures were not followed in the death of UA football player Damon Terrell.

Greg Pivirotto stated that allegations concerning misconduct by UMC in Terrell's death were false and that because of patient-doctor confidentiality, further details could not be released.

"It would be very tempting to respond in great detail to the unfounded allegations that were broadcast on Channel 13 last night," Pivirotto said. "However, Damon Terrell specifically requested that no information about his condition be released. In addition, after his death, his parents made that same request, and it is our intention to honor those requests."

KVOA-TV channel 13 and the Tucson Citizen reported that an air bubble may have been injected into Terrell accidentally, causing his death. Pivirotto did not specifically mention which allegations he considered false, but he did say that the description of the procedure performed was not medically accurate.

"It would be inappropriate for anyone to speculate as to the cause of Damon Terrell's death," Pivirotto said.

Pivirotto refused to comment when asked whether he denied allegations of malpractice.

"I think what people in the community need to be aware of is that University Medical Center does not release information about their patient when they have been specifically instructed not to do so," UMC spokeswoman Janet Bingham said. "Damon made it very clear, felt so strongly about it, that he put it in writing that we were not to release information about him. The statement that was just provided is to ensure that everyone knows that the allegation that was made last night on Channel 13 was absolutely unfounded."

Bingham did say that the case was being reviewed by UMC.

Terrell was a senior and was slated to be Arizona's starting tight end this season. He collapsed during conditioning drills on Aug. 10 and subsequently was taken to UMC. Terrell was diagnosed with a ruptured spleen and irreversible internal damage.

His spleen had ruptured and was removed the next day. Doctors said at the time he had suffered muscle, kidney and other physical damage perhaps as a result of dehydration.

Pivirotto said further details concerning Terrell's death would not be made available until the Pima County Medical Examiner released the autopsy report and it had been reviewed.

However, a source told the Arizona Daily Star Friday the rupture of Terrell's spleen resulted in massive loss of blood and potential toxicity to other organs.

The Star's primary source gave this additional account:

Terrell was afflicted with a blood disorder called ''sickle cell trait'' a typically benign variant of sickle cell anemia, a hereditary disease found chiefly among blacks. The trait sometimes causes red blood cells to bend into a sickle shape and clot, which may be what caused Terrell's spleen to rupture, the source said.

Terrell's kidneys failed, requiring use of dialysis, a mechanical blood-filtering process that replaces normal kidney function.

The failure stemmed from a rare, acute muscle disorder called rhabdomyalisis a collapse of muscle tissue sometimes brought on by dehydration and physical exertion, the source said. It causes a release of chemicals into the bloodstream, and can also cause organ damage.

Damage to Terrell's lower legs left him unable to walk, requiring physical therapy, the source told the Star.

Kidney improvement by Sept. 7 had been sufficient that doctors decided he was well enough to be taken off dialysis, the source said. The Star was told a resident, assisted by a nurse, removed the dialysis catheter that had been inserted into one of Terrell's major veins either a jugular vein in his neck or a subclavian vein just below his collarbone.

The resident applied a pressure bandage to the removal site to prevent bleeding, holding it for several minutes, the source said.

''The big risk when you take out a catheter is bleeding,'' the source explained. Terrell was lying down, as he should have been, during the catheter removal, the source said.

Half an hour later, when physical therapists came to work on Terrell's legs, Terrell's heart stopped when he sat up, the Star said.

Hospital staff began cardiopulmonary resuscitation, inserting new catheters which may have caused the air bubble, the source said.

The Star source dismissed the possibility that air was injected into Terrell's vein during the dialysis catheter removal. ''If you do it wrong, blood comes out. Air doesn't go in,'' the source said.

Dr. Kenneth Iserson, a UMC emergency physician who was not involved in Terrell's care, agreed, telling the Star: ''The problems come when you put them (catheters) in, not when you take them out.''

The Associated Press contributed to this report.

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