Chapter 23: Terrible knockoff drugs
After reading the medical records, Director Lou found no useful clues.
His eyes couldn't help but fall on the child.
"The patient is 11 years old, with a body temperature of 39.7 degrees, a high fever. He is short of breath, and his blood pressure keeps dropping to 86/54 mmHg. His heart rate is 155/minute."
Each of these basic data is worrying.
The child’s current situation is extremely dangerous. If the cause of shock cannot be found in time, he may die in the emergency room.
The doctor has fulfilled his duty to rescue the patient and does not need to bear any responsibility.
But it will have a negative impact on the hospital's reputation.
Judging from the family members’ previous behavior, there is a high possibility of medical trouble.
Director Lou and the doctor who received the patient looked more and more solemn, with a hint of anxiety between their brows.
"Have you done all the necessary checks?"
Doctors are human beings, not gods.
When experience and medical knowledge alone cannot diagnose the cause of the disease, we can only rely on modern advanced medical equipment.
"These are the results of the blood test, as well as the X-rays of the brain, chest and abdomen. No abnormalities were found."
There are many reasons for shock, such as massive abdominal hemorrhage, brain tumors compressing important blood vessels and nerves, etc.
Director Lou took the examination form and examined it carefully, trying to find any clues from it.
Oily sweat continued to seep from his forehead.
It gathered into a size of mung beans and slid down his forehead, but he didn't bother to wipe it off.
"Based on the blood test results, the possibility of poisoning can be basically ruled out. Sepsis can also be ruled out. The film can basically determine that the patient has no internal bleeding and no obvious brain damage. No, I have to ask the family, how is the treatment in the small clinic?"
Director Lou is very experienced and has already started to find problems with the medicines used in the clinic.
Of course, this is just a suspicion.
"I have already asked about it. The family bought Ganmaoling capsules for the child to take. Apart from that, the child was given plenty of boiled water according to the clinic doctor's instructions. No other treatment was given."
The doctor who receives the patient is very experienced and the consultation process is very rigorous.
All the questions that need to be asked have been asked clearly.
There is nothing wrong with taking the medication.
"Small clinics love giving intravenous drips to patients. Are you sure they have never given intravenous drips to children?"
"The family said no."
Sometimes what family members say may not be trustworthy.
"Have you checked the child's arms and arms?"
"I looked carefully and found no needle marks left by the infusion."
The person who answered this time was a thin middle-aged doctor with dark skin. He looked very stern, and because of frowning for a long time, a deep wrinkle formed between his eyebrows.
His eyes are like knives, piercing straight into people's hearts.
"Doctor Xu has examined it himself, so I don't think he's wrong. I don't need to look at it again. The patient's condition is critical and we can't delay any longer. Contact the internal medicine department and ask them to send a doctor over for a consultation."
Director Lou made a prompt decision and decided to consult with an internal medicine doctor.
Internal medicine is called the mother of medicine. It is very professional in the definition of diseases, causes, pathogenic mechanisms, epidemiology, natural history, symptoms, signs, laboratory diagnosis, differential diagnosis of imaging examinations, pathological diagnosis, treatment, and prognosis.
When encountering this kind of shock with no identifiable cause, I am afraid only an internal medicine doctor can give a more professional diagnosis.
"I have called the cardiology department and asked them to send someone over for consultation. I also told them that the patient's condition is urgent. I hope they can send a chief physician over."
The nurse next to her whispered.
Director Lou was silent for two seconds. "How long have you been calling?"
"Almost fifteen minutes."
The nurse puffed out her cheeks and muttered.
Internal medicine doctors are always aloof and arrogant, and are not easy to hire.
The emergency department is not as prestigious as the internal medicine department, so it's okay to invite them once or twice. But if you invite them too often, they will get impatient.
"Push again."
Director Lou also knows that it is difficult to hire an internal medicine doctor.
It's just that human life is at stake, and the hospital has this mechanism. The emergency department was originally just an emergency diversion platform. When encountering such a patient who can't be treated, it has the right to ask any doctor from any department for consultation.
No department may refuse.
"Forget it, I'll call Director Tan !" Director Lou was worried that it would be useless even if the nurse urged him, so he swallowed his pride and called Director Tan of the internal medicine department himself.
Director Tan did not refuse and agreed to urge the cardiologist to come over immediately.
Zhou Can interned at Tuya Hospital for one year and rotated through several important departments.
He could sense some of the mutual contempt between departments.
Internal medicine is one of the two most powerful departments in the hospital. Almost all critically ill patients, as well as various cancers, leukemia, etc., need the support of internal medicine. About 60% of the drugs prescribed by the pharmacy come from internal medicine.
Whether in terms of medical status or money-making ability, internal medicine is the undisputed leader.
The Department of Cardiology is one of the flagship departments of internal medicine.
It's normal for a cardiologist to be a little arrogant when you call him for an emergency.
After all, cardiologists are notoriously arrogant.
Maybe they also want to use this method to subtly remind the emergency department not to always ask them to come to the emergency department for trivial matters, as everyone is very busy.
Time passes by every second.
Zhou Can's eyes were fixed on the sick child who was still in a state of shock.
His face was pale, but there were two sickly red spots on both sides of his cheeks due to the high fever. He was not sweating, and his fingertips were cyanotic... These symptoms seemed familiar to me. I must have seen them in a book.
It’s just that I’ve read so many books that I can’t remember them all at once.
"Ask the family members, maybe you can get some results."
Zhou Can walked outside.
At this time, no one cared about him as a junior intern. Director Lou just turned his head and glanced at him, then continued to study the blood test report.
Colds can easily lead to viral myocarditis and may also cause shock.
But this situation rarely occurs in children.
Both X-rays and blood tests showed normal results.
It can basically be ruled out.
Zhou Can walked out of the emergency room and went straight to the family members.
"Excuse me, who are Zhu Wenwen's parents?"
"I'm the child's mother. Doctor, how is my son?"
"They are trying to save him, but the situation is not optimistic. Has Zhu Wenwen been living with you recently?"
"Yes! My son is so well behaved. I never thought that a cold could be so serious, wuwu..."
As Zhu Wenwen's mother spoke, tears began to fall.
"Listen to me, the hospital is doing its best to save the patient. If you can provide some important information, it may be of great help to the rescue work."
Zhou Can communicated with the family members patiently.
"If you want to know anything, just ask me. I will definitely cooperate."
She looked at Zhou Can with tears in her eyes. Now the only one she could count on was the doctor.
"After Zhu Wenwen caught a cold, you're sure she didn't get any injections or infusions at the clinic, right?"
"Definitely not."
"You only took the Ganmao Ling capsules?"
"Yes. I fed it to my son myself."
"How many pills did you take in total?"
"Four pills. I took two last night and two this morning. I followed the instructions exactly. It said to take two pills at a time, three times a day."
"Did you bring the rest of the medicine?"
"I brought it with me. I was worried that he would have to continue taking medicines at the hospital, so I brought everything with me."
She pulled out a small plastic bag from her bag, which contained a box of medicine.
Zhou Can took it and looked at it.
The packaging box says Ganmaoling Capsules and Granules, specially for treating headaches, stuffy noses, runny noses...
That’s not right. Why is the packaging box different from the Ganmao Ling Capsules in the hospital pharmacy?
Looking again, wow, it turns out to be a copycat brand.
Nowadays, pharmaceutical companies have also learned to ride on the popularity of others.
They will package similar drugs they produce as drugs with high market visibility.
For example, the most well-known one is 999 Cold Relief Capsules.
This pharmaceutical company removed three nines and played a gray area.
All the information about the manufacturer is true. It's a pharmaceutical company name I've never heard of.
What Zhou Can is most concerned about is the composition of the medicine.
All drugs that are put on the market must undergo multiple reviews by regulatory authorities. This cannot be faked.
The ingredients of the drug must also be declared truthfully.
"Trichosanthes, wild chrysanthemum, caffeine, acetaminophen, chlorpheniramine maleate, mint leaves, and the auxiliary material is talcum powder."
The ingredients are exactly the same as 999 Cold Relief Capsules.
I have to admire the strong copycat capabilities of these small pharmaceutical companies.
I took out the medicine. There were twelve pills in a plate, but only eight were left.
This shows that the child’s mother did not lie.
The patient took four pills.
In fact, the dosage is tailored for adults. For a twelve-year-old child, the dosage should be halved.
However, many parents worry that the dosage is too small and will not be effective, so they usually choose to let their children take the adult dosage.
Usually, there should also be a paper instruction manual inside.
After Zhou Can took out the capsule, he checked and found a folded white instruction manual in the box.
The content above is basically the same as the instructions on the box.
Ordinary consumers are often too lazy to watch it.
Only professional medical personnel can see some different information from the instructions inside.
"This medicine contains a powerful paracetamol ingredient that will quickly relieve pain and get you back on your feet."
Just this one sentence, which sounded like an advertising slogan, attracted Zhou Can's great attention.
What is powerful?
Only increasing the dosage can produce a stronger effect.
What is paracetamol? Most people don't know, but Zhou Can knows very well. Acetaminophen and paracetamol are the same drug.
This also means that the acetaminophen content in this box of counterfeit cold capsules is likely to far exceed that of the genuine 999 Cold Relief Capsules.
In order to seize market share, small pharmaceutical companies often use increasing the amount of key drug ingredients and enhancing drug efficacy.
As for the safety of patients, the unscrupulous bosses don't care at all.
As long as it doesn't kill people or cause serious consequences like disability, then it's fine.
"I understand. The patient is likely allergic to paracetamol, or has taken an overdose, which has led to shock and critical condition."
Zhou Can's heart brightened.
No wonder I always felt that the sick child’s symptoms were familiar. I had seen a similar description in a medical book in the library before.
I didn't expect to encounter such a case today.
[Pathological diagnosis experience value +1. ]
Experience points are credited on time.
It seems that the cause of the child's shock was an overdose of acetaminophen.
"This time, we don't need to ask those emperors in the cardiology department for help."
Zhou Can is now a doctor in the emergency department, and his honor and disgrace are naturally tied to the emergency department.
He was very happy to share the burden of the emergency department.
"Thank you for the valuable information you provided. This box of medicine is not genuine. I will take it to test the drug ingredients first." Zhou Can explained a few words to the family members and returned to the emergency room excitedly.
After entering the room, he found that the 'Emperor' of Cardiology had finally arrived.
He is a young doctor in his mid-thirties.
Judging from the situation, he should have just arrived.
Checking on the condition of the sick child.
He is so young, he is definitely not a chief physician . The cardiology department probably just sent a random doctor to do the job.
"We need to consult our cardiologists for a cold. Don't you emergency doctors read books?"
This person had a cold face and, without finding the cause of the disease, he started to ridicule the doctor in the emergency department.
The doctors in the emergency room were all furious, but dared not speak out. Now they had to be patient as they needed help.
"Judging from the symptoms, heart rate, blood pressure, blood oxygen and other indicators, the patient's shock state is not particularly serious. It will not endanger his life for the time being. Let me see the blood test report."
The bossy tone makes people feel uncomfortable.
It was not appropriate to ask Director Lou to hand over the inspection report in person, especially when the man spoke in a tone that sounded like he was ordering a servant around.
Just imagine, the emperor of one country hands documents to the minister of another country like a servant. Is this appropriate?
Although the status of the emergency department is low, it is not so lowly.
Zhou Can was just about to step forward and act as a messenger.
Unexpectedly, the nurse got there first.
She naturally took the examination report from Director Lou and handed it over.
"Doctor He, this is the patient's blood test report."
After the other party took it, he looked at it carefully, but it seemed that he did not find any valuable information.
"Have you ever made a movie?"
"We took a color ultrasound and a CT scan, but no problems were found."
Hand over the film as well.
Dr. He carefully examined each image but still found nothing.
In fact, we should not glorify cardiologists too much. When it comes to basic medicine, everyone's level is not that different.
If I can't even see an X-ray or a blood test result, there's no way I can stay in Tuya Hospital.
"Doctor He, have you found the problem?" Director Lou asked.
What he is most concerned about now is how to save the patient.
"Don't worry, this patient's condition is a bit complicated, I need to think about it." Dr. He just spoke too high a tone, and he got himself into a position where he couldn't get down. He could only hold on.
"Haha, even Doctor He in the heart had to think seriously before diagnosing the cause. It seems that this cold is not simple!"
An angry emergency doctor opened fire.
It's not an open mockery, just a sarcastic remark.
After all, when Dr. He first came in, he arrogantly retorted to them that even a cold required a consultation with a cardiologist. Had the emergency doctors never read any books?
"It's not difficult, it's just a little complicated, and we need to be more rigorous when making the diagnosis." Doctor He was still trying to be stubborn.
