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American Morning

Surgical Branding

Aired January 29, 2003 - 08:46   ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.


PAULA ZAHN, CNN ANCHOR: A bizarre twist on a standard operating procedure. During a hysterectomy, a doctor brands the initials of his alma matter, the University of Kentucky, on a woman's uterus. The doctor, Michael Giller, is now being sued, but he claims that what he did was routine.
Let's page Dr. Gupta, who is here this morning in person this morning to talk about this case.

Good morning.

DR. SANJAY GUPTA, CNN MEDICAL CORRESPONDENT: It probably is routine, perhaps a little pretentious, no question.

ZAHN: What's routine about carving someone's initials on their uterus?

GUPTA: He carved his alma mater's initials. You know, one thing you have to do and a lot of times when tumors come out of the body, or when a uterus comes out of the body, it gets very confusing after it comes out as to which is left, which is right, which is up and which is down. So it's very common actually for surgeons to somehow mark whatever it might be, a tumor or a uterus or something coming out, with a stitch, with a little marking from a coterie or something like that.

Another part of this story, it's also pretty interesting, he videotapes this and gives the videotapes to his patients. And we actually obtained the videotape. So let's see if we can show some of that.

I want to warn you at home, that some of this, if you're a little squeamish, may make you a little squeamish in terms of some of the images you'll see here, but I wanted you to get a sense of exactly what these carvings sort of look like on the woman's uterus.

You'll see there. The instrument that he's using there is a little coterie instrument, and you can see that's a "UK," essentially his alma mater, that he actually carved into the woman's uterus, again, to try to mark one side or the other.

He was actually asked that question, Paula, that you asked me, and this is what he had to say about it.

OK, well you know, I don't think we have the tape right now. Basically, what he said is that it is very routine for him to mark one side of the uterus, so if it's the left side of the uterus, he'll know that when the uterus actually comes out, that was the left side.

ZAHN: Why wouldn't you use an "l" for left and "r" for right side, and University of Kentucky represented which side of the -- I don't get it.

GUPTA: In this case, the University of Kentucky represented one side or the other. You could use "l," you could use an "r." Some surgeons will throw a stitch into the uterus, so if there's a tumor or something to mark that side.

This is what he does, but let me say, Paula, again, you know, while it may not be routine, you can take a look at his response here, the University of Kentucky was, again, just marking the side of the uterus. Whether or not you -- how you mark it, I think, is not as important is the question as to whether or not you mark it at all. Forgetting to mark it might not be a bigger deal.

ZAHN: What he went on to say, I certainly did not mean for this to be demeaning to the patient, if they can roll back to that. I guess we skipped the last part of that -- there we go. "I'm always respectful to" -- let's roll ahead -- "respectful to all the tissues that we remove from the women."

GUPTA: Yes, and you know, like I said, if he could be accused of anything, I think it would be of pretension in this case. A bigger problem would be forgetting to mark something. Let's say there was a tumor on the left side of the uterus and he did not mark it, and that tumor actually involved the left ovary, and that somehow was forgotten, that would be a much bigger problem than forgetting to do it. The "UK" is something that he probably remembers to do each time.

ZAHN: Would it make sense in your practice of medicine, because you do surgery a couple of times a week, to have a universal standard for how you mark stuff?

GUPTA: I think that's an excellent point. And you know, it's not something they specifically go over in surgical training, saying you always mark it this way with a stitch here on the top of the tumor, a stitch here, or something like that. They do tell you, develop some methods, some automatic way of remembering that when the tumor comes out or when the uterus comes out, whatever it might be, you can remember which side is which and orient that again in your own mind as to how that was actually positioned in the woman's body.

ZAHN: How do you mark a brain in surgery?

GUPTA: I usually put a stitch in the top of the tumor, and then I'll actually know that is the most superficial part of the tumor as it comes out, and that's important, because I wanted to distinguish that from the deep part of the tumor in case there were other cells down there that may have invaded the brain. So it is important to make it somehow. I do it with a stitch. That's just the easiest thing to do for me. He does it with a "UK."

ZAHN: Far be it for me to tell you all how to practice the art of medicine. Thank you. GUPTA: Thank you, Sanjay.

TO ORDER A VIDEO OF THIS TRANSCRIPT, PLEASE CALL 800-CNN-NEWS OR USE OUR SECURE ONLINE ORDER FORM LOCATED AT www.fdch.com






Aired January 29, 2003 - 08:46   ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
PAULA ZAHN, CNN ANCHOR: A bizarre twist on a standard operating procedure. During a hysterectomy, a doctor brands the initials of his alma matter, the University of Kentucky, on a woman's uterus. The doctor, Michael Giller, is now being sued, but he claims that what he did was routine.
Let's page Dr. Gupta, who is here this morning in person this morning to talk about this case.

Good morning.

DR. SANJAY GUPTA, CNN MEDICAL CORRESPONDENT: It probably is routine, perhaps a little pretentious, no question.

ZAHN: What's routine about carving someone's initials on their uterus?

GUPTA: He carved his alma mater's initials. You know, one thing you have to do and a lot of times when tumors come out of the body, or when a uterus comes out of the body, it gets very confusing after it comes out as to which is left, which is right, which is up and which is down. So it's very common actually for surgeons to somehow mark whatever it might be, a tumor or a uterus or something coming out, with a stitch, with a little marking from a coterie or something like that.

Another part of this story, it's also pretty interesting, he videotapes this and gives the videotapes to his patients. And we actually obtained the videotape. So let's see if we can show some of that.

I want to warn you at home, that some of this, if you're a little squeamish, may make you a little squeamish in terms of some of the images you'll see here, but I wanted you to get a sense of exactly what these carvings sort of look like on the woman's uterus.

You'll see there. The instrument that he's using there is a little coterie instrument, and you can see that's a "UK," essentially his alma mater, that he actually carved into the woman's uterus, again, to try to mark one side or the other.

He was actually asked that question, Paula, that you asked me, and this is what he had to say about it.

OK, well you know, I don't think we have the tape right now. Basically, what he said is that it is very routine for him to mark one side of the uterus, so if it's the left side of the uterus, he'll know that when the uterus actually comes out, that was the left side.

ZAHN: Why wouldn't you use an "l" for left and "r" for right side, and University of Kentucky represented which side of the -- I don't get it.

GUPTA: In this case, the University of Kentucky represented one side or the other. You could use "l," you could use an "r." Some surgeons will throw a stitch into the uterus, so if there's a tumor or something to mark that side.

This is what he does, but let me say, Paula, again, you know, while it may not be routine, you can take a look at his response here, the University of Kentucky was, again, just marking the side of the uterus. Whether or not you -- how you mark it, I think, is not as important is the question as to whether or not you mark it at all. Forgetting to mark it might not be a bigger deal.

ZAHN: What he went on to say, I certainly did not mean for this to be demeaning to the patient, if they can roll back to that. I guess we skipped the last part of that -- there we go. "I'm always respectful to" -- let's roll ahead -- "respectful to all the tissues that we remove from the women."

GUPTA: Yes, and you know, like I said, if he could be accused of anything, I think it would be of pretension in this case. A bigger problem would be forgetting to mark something. Let's say there was a tumor on the left side of the uterus and he did not mark it, and that tumor actually involved the left ovary, and that somehow was forgotten, that would be a much bigger problem than forgetting to do it. The "UK" is something that he probably remembers to do each time.

ZAHN: Would it make sense in your practice of medicine, because you do surgery a couple of times a week, to have a universal standard for how you mark stuff?

GUPTA: I think that's an excellent point. And you know, it's not something they specifically go over in surgical training, saying you always mark it this way with a stitch here on the top of the tumor, a stitch here, or something like that. They do tell you, develop some methods, some automatic way of remembering that when the tumor comes out or when the uterus comes out, whatever it might be, you can remember which side is which and orient that again in your own mind as to how that was actually positioned in the woman's body.

ZAHN: How do you mark a brain in surgery?

GUPTA: I usually put a stitch in the top of the tumor, and then I'll actually know that is the most superficial part of the tumor as it comes out, and that's important, because I wanted to distinguish that from the deep part of the tumor in case there were other cells down there that may have invaded the brain. So it is important to make it somehow. I do it with a stitch. That's just the easiest thing to do for me. He does it with a "UK."

ZAHN: Far be it for me to tell you all how to practice the art of medicine. Thank you. GUPTA: Thank you, Sanjay.

TO ORDER A VIDEO OF THIS TRANSCRIPT, PLEASE CALL 800-CNN-NEWS OR USE OUR SECURE ONLINE ORDER FORM LOCATED AT www.fdch.com