0
Editorials |

Transparency in Health Care : An Issue Throughout US History

Joseph G. Murphy, MD, FCCP; William Dunn, MD, FCCP
Author and Funding Information

Rochester, MN

Correspondence to: Joseph G. Murphy, MD, FCCP, Division of Cardiology, Mayo Clinic, 200 First St SW, Rochester, MN; e-mail: murphy.joseph@mayo.edu



Chest. 2008;133(1):9-10. doi:10.1378/chest.07-2100
Text Size: A A A
Published online

Extract

George Washington Custis, Recollections and Private Memoirs of Washington1

George Washington, America’s first president, died due to a combination of asphyxiation (probably due to bacterial epiglottitis secondary to Haemophilus influenzae or Corynebacterium diphtheriae infection) and physician error that led to hypovolemic shock due to exsanguinating blood loss following therapeutic bloodletting. The total quantity of blood removed from George Washington by bloodletting was estimated to amount to between 82 and 126 fluid ounces, or 2.4 to 3.75 L, drawn over a period of 9 to 10 h on Saturday, December 14, 1799.2 Washington had an estimated blood volume of approximately 7 L based on his height of 6 feet 3 inches and weight of 230 lb. Exsanguination of 30 to 50% of a patient’s blood volume over a period of approximately 10 h almost certainly led to hypovolemia, hypotension, and shock. While some of the details of Washington’s death have been lost in the mists of time, physician mismanagement by well-intentioned doctors almost certainly contributed to his death. The above quotation illustrates that, unfortunately, medical errors have always been part of medical practice; can happen to anybody, including presidents; and are frequently covered up. In the case of George Washington, the cover up lasted for > 100 years until the seminal paper by Bricknell in 1903.2

First Page Preview

View Large
First page PDF preview

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Figures

Tables

References

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Related Content

Customize your page view by dragging & repositioning the boxes below.

  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543