Wednesday, April 29, 2020
By TANYA SMITH-CARTWRIGHT
ts-cartwright@tribunemedia.net
A ROW erupted in Princess Margaret Hospital’s Dialysis Unit recently, when, in what he says was a bid to prevent the spread of COVID-19, Dr Frederick Smith asked that all patients remove their shoes or not receive treatment.
Giavano Bowe, feels his father Marvin Johnson, a dialysis patient, was “ill-treated” by Dr Smith, director of nephrology at PMH, while at the hospital’s Dialysis Unit on April 24.
“My dad went for his routine dialysis treatment on April 24 to the Princess Margaret Hospital as per usual,” Mr Bowe recalled. “During treatment, Dr Smith told my dad that he needed to remove his shoes while on the dialysis machine due to the recent COVID-19 outbreak. My dad, being a forty-year diabetic patient with diabetic feet and severe nerve damage to his feet refused to take off his shoes and explained his reasoning to Dr Smith.
“Because my dad did not comply, angrily, Dr Smith then made a statement to the staff on the ward in a very audible voice, ‘from now on, if this patient or any others refuse to remove their shoes on this ward, do not allow them access to the dialysis machine.’ Well, needless to say my dad felt threatened and uncomfortable about the statement. He called me immediately and we discussed how we were going to handle this situation.
“I advised my dad to make a complaint to the police department for the record’s sake in the event that something were to happen to him as a result of a rule/law that was not yet in writing. In addition, my dad and I put together a letter of complaint which would then be given to the administrator of PMH and the head of PHA on Monday, April 27, 2020.”
According to Mr Bowe, the incident continued on the following Monday when his father went for dialysis treatment and was met again by Dr Smith asking him to remove his shoes.
“My dad asked for a shoe cover as he was not prepared to have his feet exposed to the ground due to his current condition,” said Mr Bowe. “Also, my dad had a copy of the letter for Dr Smith and handed him the same within moments of him making that statement. About an hour after handing Dr Smith the letter and being admitted to the dialysis ward, my dad calls me in a state of panic only to relay to me the worst – Dr Smith had instructed the dialysis ward staff to take my dad off the dialysis machine and deny him dialysis treatment effective immediately.
“A dialysis patient being denied access to the healthcare system is an indirect breach of the Hippocratic Oath and a signing of his/her death warrant, in my perspective. Furthermore, I am quite positive that Dr Frederick Smith nor anyone employed under the Public Hospital Authority working for a public healthcare facility has the right to deny a Bahamian tax paying citizen any form of health care treatment.”
The Tribune contacted Dr Smith and asked him about the incident. Dr Smith said for the past two weeks or so, he has made it his routine to go into the Dialysis Unit and remind everyone, including staff and patients, of what the rules are - to wear masks at all times, no eating or drinking, not to come to the unit more than an hour before treatment and to remove shoes when on the dialysis machines as the bottom of shoes can hold the COVID-19 virus and put patients and staff at risk.
“On the evening of April 24, I did not call any names. I stood in the front of the unit and I said, ‘Ladies and gentlemen can you all take off your shoes, please.’” Dr Smith said. “Some patients took them off others didn’t. Again I said, ‘Ladies and gentlemen can you all take off your shoes please. The reason I am asking this is to prevent COVID from being spread.’ Some people took off their shoes and one patient says, ‘I am not taking off my f*g shoes.’ And, I asked him again to take off his shoes. He said he was not taking off his shoes because I was making up rules. I told him those are the rules, we have to enforce them to keep us safe. I also told him if he doesn’t take off the shoes, we are in our right to deny him treatment and to disconnect him from the circuit because he was not abiding by the rules.”
Dr Smith said the patient then said, “I ain’t comin’ off this machine” and the doctor asked the nurse to take the patient off the machine. The nurse, he said, subsequently went to the patient and begged him to take his shoes off and told him she would give him booties to put on. The patient still refused, Dr Smith said.
“I called in the risk manager who told the gentleman we were well within our rights to discontinue the service to him because we have to make the environment safe for everyone and that everyone needs to abide by the rules,” said Dr Smith. “I then told the nurse going forward no one would be put on a dialysis machine unless they are following all of the rules. I then said, ‘ladies and gentlemen, dialysis is life saving and I want you to have your treatments, however, if you do not abide by the rules we cannot put you on the machine.’ His dialysis was continued for the evening.”
Dr Smith said the patient returned on the evening of April 27 and was again asked to remove his shoes. He said the patient refused and was told by a nurse that he could not be put on the machine with his shoes on.
“He then said, ‘That’s okay then I am not going to do the treatment. This ain’t gonna end like this, all of y’all trying to kill me.’ The reality is there are some people who are more difficult than others and this just happens to be one of the repeat offenders,” Dr Smith said.
He added that he never threatened Mr Johnson, but was enforcing the rules of the Dialysis Unit and trying to keep patients and staff from contracting COVID-19.
However, Mr Bowe said he wants this “type of behaviour” addressed immediately.
Comments
joeblow says...
It is well documented that COVID can be carried on the soles of shoes. It makes sense not to allow patients who are already vulnerable to be exposed to additional risk by creating simple rules. I applaud doctors who continue to try and treat the sublimely idiotic among us while risking their own lives!
Posted 29 April 2020, 5:43 p.m. Suggest removal
Well_mudda_take_sic says...
Bullshiit!
Frederick Smith could have sprayed or wiped the soles of Mr. Johnson's shoes with isopropyl alcohol 70%+ which would have instantly killed any covid-19 virus present, much faster than even concentrated bleach. Moreover, what about Frederick Smith's own footwear?!
Here we see a man ill-suited to be a medical doctor; a man more concerned about the rules and his orders being obeyed than the health issues of his patient. He reminds me of another medical doctor who seems to think the same way warped way.
Posted 29 April 2020, 7:13 p.m. Suggest removal
joeblow says...
… and you honestly believe that a doctor should wipe the bottom of a resistant patients shoes in this scenario or engage staff for this additional function as opposed to asking ALL persons to simply leave their shoes? Really?
Without knowing all the details that the doctor and staff would know, the story is clear that there are those who had no difficulty complying with the suggestion! Do they even have alcohol in amounts to provide this additional service? I don't know, but this is akin to business saying that if you do not have a mask on you cannot enter their business, I do not see that as wrong, in this situation where a potential threat exists to others!!
Posted 29 April 2020, 8:51 p.m. Suggest removal
ohdrap4 says...
Perhaps the man has great difficulty removing his shoes. They likely will not allow his son to come in to assist in taking the shoes off and putting them on. This doctor is ruthless.
Posted 30 April 2020, 8:25 a.m. Suggest removal
Well_mudda_take_sic says...
@joeblow: You obviously haven't heard about the Pope washing the unclean feet of prisoners at Easter time....but I guess that would be even more lowly for a medical doctor or medical assistant to do than spraying the soles of a patient's shoes with isopropyl alcohol 70%+ if need be. And no medical doctor should unnecessarily withhold vital medical treatment from any patient simply because they may happen to be a little disagreeable, especially when there is more than one easy way available to skin the cat. All physicians take an important oath for their privilege to practice medicine and if they can't live up to it then they should simply hang up their white robe for good.
Posted 30 April 2020, 8:34 a.m. Suggest removal
joeblow says...
no Mudda. this is my perspective:
1) One kidney doctor has already died from COVID-19 (Judson Eneas).
2) Dr Sands recently said that around 15 COVID positive cases are doctors, that did not include nurses.
3) They just recently had to close a ward because of one COVID patient who had no symptoms.
4) The way I see it, is the director of the department has a duty to protect himself, his staff and other patients who use that department. That would involve having rules in place. Bahamians simply do not like to follow simple rules. Look at how many people cannot follow the simple advice to have one designated shopper per household (every time I go in the grocery store there are people in groups of 2 or 3 three shopping or wearing their masks below their noses).
5) Imagine what would happen to other patients if they had to close dialysis to sanitize.
I find it more egregious to ask the elderly to remove their shoes going through security for domestic flights!
Posted 30 April 2020, 9:25 a.m. Suggest removal
Well_mudda_take_sic says...
But presumably you readily accept you would not want the following hard-and-fast rules put in place to fully protect the categories of persons indicated from occupational harm:
Firemen should not fight fires;
Policemen should not stop crime;
Soldiers should not enter combat zones;
Medical doctors should not treat their patients;
And so on.
Incidentally, even TSA officials will allow an elderly diabetic suffering from swollen feet with serious nerve pain to keep his or her shoes on by electing a physical pat-down type inspection in lieu of the more common machine scanned one. And no doubt this is because they recognize it is better to exercise good discretion and temperance in cases where doing so is clearly warranted.
Posted 30 April 2020, 11:17 a.m. Suggest removal
TalRussell says...
If PMH doesn't even have fifty cents disposable foot covering for their patients' good luck they'll have a virus test kit when you need one?
Posted 29 April 2020, 5:58 p.m. Suggest removal
thomas says...
Pick your battles. No need to fight. Enjoy your last days.
Posted 29 April 2020, 7:06 p.m. Suggest removal
mandela says...
When flying to the USA everyone takes off their shoes gladly without being asked and without a squeak. When they arrive in the USA and jumps into a vehicle they put on their seatbelts, automatically. When in the USA they comply to the T. When they return home they feel as though now I am home I don't have to respect any laws of the Bahamas they don't want to comply, they only want to complain and stir up trouble. If the protocol is shoes have to be removed, then remove them, the time you take being stubborn, non-complainant, argumentative, running around complaining you can just do like when in the USA. COMPLY.
Posted 29 April 2020, 11:20 p.m. Suggest removal
John says...
When you go to the Bahamas Humane Society and certain viruses are active, you have to step into a foot bath ( shoes on) before you enter the Building. Athletes and persons who use public showers develop athletes foot and jock itch ( not sure what it’s called in females) because bacteria develops in the shower or on the floor of the locker room. They then develop jock itch be either allowing underwear to come in close contact with the floor or even by passing the underwear over their own ( infected) feet. But persons who walk around in socks are even more at risks of picking up something especially if they jump in bed with the same socks they walked around in all day. and especially if they have pets or have stray animals roaming the area where they walk. Single use plastic bags are scarce, but you can take two bags to cover your feet when found dialysis .
Posted 30 April 2020, 7:13 a.m. Suggest removal
truetruebahamian says...
Tell your Dad to comply and stop being a belligerant a**-hole.
Posted 30 April 2020, 9:04 a.m. Suggest removal
Well_mudda_take_sic says...
You would be much more tolerant if you were a diabetic with swollen feet that cause severe nerve pain.
Posted 30 April 2020, 9:23 a.m. Suggest removal
Well_mudda_take_sic says...
I sincerely hope you're not a healthcare provider, especially one with such views who might like to think of himself as being a qualified M.D.
Posted 30 April 2020, 12:03 p.m. Suggest removal
pablojay says...
The only thing that i can say about this it that Giavano must have inherited some of his
mother's ways due to the fact that his response was to go to the media . I say this because
with a father on dialysis, who tells the doctor that he is not taking off his "effin" shoes,comes
back the next day with the same attitude, then Giavano's response should have been,at
minimum to return with a cutlass.
Posted 30 April 2020, 12:17 p.m. Suggest removal
bogart says...
Put him diabetic patient with shoes on a gurney/stretcher/wheelchair and wrap it with suitable material mabye plastic bags, plastic gown over his feet with shoes still on and tape it.....and as to the other individual cussing in hospital use the appropriate procedures.
Posted 30 April 2020, 12:31 p.m. Suggest removal
Proguing says...
I support 100% our doctors. They are putting their life on the line, many have been infected and some have died. Contamination of the hospital from infected shoes would be a disaster and could result in many deaths. Follow the hospital rules or stay home.
BTW how would father and son feel if they caught Covid 19 at the hospital because others did not follow protocol? I bet this would have resulted in a much bigger "row".
Posted 30 April 2020, 2:37 p.m. Suggest removal
Jim says...
A patient denial of shoe removal leading to withholding lifesaving medical treatment in other words is called medical negligence.
Both Smith, alluding to be a doctor, and the risk manager, who concedes to Smith's foot fetish delusions should both be temoved from the facilty, and not reinstated intil they are both investigated and their mental status stabilizes.
Mr. Bowe, you and your dad Mr. Johnson are both correct not to follow auch a ridiculous rule.
Posted 30 April 2020, 2:43 p.m. Suggest removal
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