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        riddles >> what happened >> Heart Failure
        
(Message started by: denis on Mar 10th, 2007, 12:13pm)
Title: Heart Failure
Post by denis on Mar 10th, 2007, 12:13pm
The Chief cardiologist at a large hospital is diagnosed with a failing heart valve and will require a replacement valve. His assistant, a very competent heart surgeon in his own right, is to perform the operation at the request of the Chief.

Now a couple of people at the department know that his assistant very ambitious and unscrupulous and that this surgery would be a perfect opportunity to surreptitiously eliminate the person between him and the top job at the Cardiology department.  They bring this up to the Chief who would have none if it. The Chief said that his assistant is the best for the operation and that no surgeons could arrive at their position without a lot of ambition anyways.

So they did two things: One, they filmed the operation from the amphitheatre to record any false move that the assistant would make to cause his patient to die. This is not unusual. many operations are filmed for the teaching Hospital's Medical School. Second, they marked the artificial valve that was to be used so they would know if the assistant tried to switch with a defective one.

Well, it turns out the operation went extremely well. The assistant expertly removed the faulty valve and installed the artificial one (the correct one that was previously marked), stitched it in place with expert precision and dexterity then closed up the patient. No false moves were recorded, there was no bleeding and no tools or foreign substance were left in the patient’s chest cavity.

The patient was doing great after the operation but unfortunately died four days later. The verdict was that he died of heart failure due to the stress of the operation but he actually died as a result of something that his assistant did during the operation that eluded everyone else.  Also, he acted alone without the involvement of any other. What did he do?
Title: Re: Heart Failure
Post by Whiskey Tango Foxtrot on Mar 10th, 2007, 12:18pm
[hide]Didn't use an anti-coagulant?[/hide]
Title: Re: Heart Failure
Post by denis on Mar 10th, 2007, 12:21pm
Nope... The records show that the proper [hide]medication were prescribed. As well, the nurse confirmed that she admistered the anticoagulants and other medications such as anti-rejection[/hide].
Title: Re: Heart Failure
Post by Iceman on Mar 10th, 2007, 12:29pm
The artificial valve was also faulty? :P Never trust your assistant.     ;D    


Or the stitches, somehow, contracted after few days, sinking like sharp teeth into his heart.   ???
Title: Re: Heart Failure
Post by denis on Mar 10th, 2007, 12:31pm
Nope, he used a valve that was in good working order.  And the stiches were correctly applied. How could he make the stiches cut into the heart after the operation is over? That is a stretch ....
Title: Re: Heart Failure
Post by Iceman on Mar 10th, 2007, 12:42pm
How about this then: [hide]he switched the tapes[/hide].  8)
Title: Re: Heart Failure
Post by denis on Mar 10th, 2007, 12:46pm
nope: [hide] the correct video tape of the operation was reviewed to arrive at their conclusions[/hide]
Title: Re: Heart Failure
Post by Iceman on Mar 10th, 2007, 12:51pm
He [hide]sabotaged the video camera, so it was taping backwards?[/hide]  ::)
Title: Re: Heart Failure
Post by denis on Mar 10th, 2007, 12:55pm
Nah... [hide]The operation was correctly recorded. Whatever the assistant did they could not tell by looking at the tape. They looked at it over and over but nothing was apparent[/hide]
Title: Re: Heart Failure
Post by Iceman on Mar 10th, 2007, 12:58pm
The assistant [hide]replaced his heart before the above operation. So he put a really weak heart in his chest, which could not possibly take the operation well.[/hide]   :P
Title: Re: Heart Failure
Post by denis on Mar 10th, 2007, 1:02pm
Nope... [hide] Remeber he acted alone. It would be impossible to orchestrate an operation of this complexity to replace a heart surreptitiously without any assistants. [/hide]
Title: Re: Heart Failure
Post by Whiskey Tango Foxtrot on Mar 10th, 2007, 1:09pm
[hide]He dipped his hands in something before performing the operation?[/hide]
Title: Re: Heart Failure
Post by denis on Mar 10th, 2007, 1:13pm
No.. [hide]His hands were aseptic and free of any foreign substance when he operated (other than the operating gloves of course).[/hide]
Title: Re: Heart Failure
Post by Iceman on Mar 10th, 2007, 1:13pm
Well if there was one camera only, all he had to do was to turn his back to it for a moment, and do his deed, whatever it was.  
Title: Re: Heart Failure
Post by denis on Mar 10th, 2007, 1:19pm
OK I will allow that there is only one camera wich is pointed to the cavity and the assistant. So suppose he could turn his back, what do you suppose he could do that fools the camera afterwards when he is working inside the cavity? Still a stretch...
Title: Re: Heart Failure
Post by Iceman on Mar 10th, 2007, 1:19pm

on 03/10/07 at 12:21:00, denis wrote:
nurse confirmed that she admistered the anticoagulants and other medications such as anti-rejection[/hide].

He put [hide]a false vein in his arm before the major operation.[/hide]  8)
Title: Re: Heart Failure
Post by denis on Mar 10th, 2007, 1:21pm
No [hide]recall I said he died as a result of something he did during the heart surgery. He did not come into contact with the patient before the surgery. [/hide]
Title: Re: Heart Failure
Post by Iceman on Mar 10th, 2007, 2:10pm
Do you have to know a lot about surgery to answer it? If so, you can count me out.  :-[ :P
Title: Re: Heart Failure
Post by denis on Mar 10th, 2007, 2:14pm
No...no need to know very much about surgery....

In fact, what he used to cause his delayed death I feel is  pretty much common knowledge.
Title: Re: Heart Failure
Post by denis on Mar 10th, 2007, 2:19pm
btw, one of the guesses (I will not say who)  is on the right track.... Since only Ice and WTF provided guesses, I can say its one of you two!
Title: Re: Heart Failure
Post by Iceman on Mar 10th, 2007, 2:33pm
Maverick is a talented pilot, but unpredictable. I am cold as ice – I never make a mistake. I wonder who is on the right track..  ;)
Title: Re: Heart Failure
Post by Icarus on Mar 10th, 2007, 3:27pm
Was his assistant played by Leonard Nimoy? Of course, in that episode, the crusty old Chief was saved by the crusty detective. It was the nurse who stumbled on the truth who got whacked.

And I wouldn't call the trick in that show common knowledge, either.
Title: Re: Heart Failure
Post by denis on Mar 10th, 2007, 3:30pm
Icarus got it... While the "trick" itself is not common, after all, its not everyday occurrence you want to kill someone in surgery and make it look like natural death, what he used to do it with is fairly common.
Title: Re: Heart Failure
Post by Whiskey Tango Foxtrot on Mar 10th, 2007, 3:33pm

on 03/10/07 at 14:33:33, Iceman wrote:
Maverick is a talented pilot, but unpredictable. I am cold as ice – I never make a mistake. I wonder who is on the right track..  ;)

;D

As to the answer, I must say I'm not much of a Trekkie.  I really don't know what Icarus is talking about.
Title: Re: Heart Failure
Post by Icarus on Mar 10th, 2007, 3:37pm
I'm right? And you actually recognized the reference? ??

(By the way - the reference is misleading. L.M. has been known to work in other genres on occasion.)
Title: Re: Heart Failure
Post by denis on Mar 10th, 2007, 3:37pm
Nothing to do with Star Treck WTF... Mr. Nimoy was a guest star in a detective series that appreared in the early 70's.

(I can surmise that Icarus and I are about or at least both above a certain age since he recalls this episode.)

From here you can easily google for the answer..
Title: Re: Heart Failure
Post by Whiskey Tango Foxtrot on Mar 10th, 2007, 3:41pm
Was he not also Mr. Spock?

After some research, I found the episode you spoke of.  "A Stitch in Crime" was its name.  Quite an ingenious way to perform such a deed, whether it was common or not.
Title: Re: Heart Failure
Post by denis on Mar 10th, 2007, 3:42pm

on 03/10/07 at 15:41:48, Whiskey Tango Foxtrot wrote:
Was he not also Mr. Spock?



Yes he was but not in this particular appearance.
Title: Re: Heart Failure
Post by Icarus on Mar 10th, 2007, 3:53pm
My age is public knowledge, to be found in my profile. Though the reason I remember it is because 10-15 years ago I was working third shift, which left me on occasions with a lot of free time when there was not much to do, and the best thing on TV was old reruns. Fortunately, I've forgotten much of the dreck from my misspent youth, but my misspent adulthood still lurks around to haunt me.
Title: Re: Heart Failure
Post by Iceman on Mar 10th, 2007, 3:59pm
Icarus, you are so old!  :P
Title: Re: Heart Failure
Post by Whiskey Tango Foxtrot on Mar 10th, 2007, 4:08pm
I've heard that the 40's are the golden years.  Then again, it was a 40 year old who told me that.  ;)

By the way, excellent riddle denis.  Yours keep getting more and more entertaining.  Keep up the good work.
Title: Re: Heart Failure
Post by Iceman on Mar 10th, 2007, 4:12pm

on 03/10/07 at 16:08:41, Whiskey Tango Foxtrot wrote:
I've heard that the 40's are the golden years.  Then again, it was a 40 year old who told me that.

Don't tell me: it was Icarus. ;D
Title: Re: Heart Failure
Post by denis on Mar 10th, 2007, 6:08pm
Actually, that episode was notable for Columbo dropping all ususual pretences and ingratiating manners and angrily challenged Nemoy by loudly banging a jug on his desk and declaring "I believe you killed Sharon Martin (nurse) and I believe you're trying to kill Dr. Heideman (Chief). I want you to take good care of Dr. Heideman because if he dies we're going to have to have an autopsy, aren't we? I mean, we're going to have to know whether a heart attack killed him"

When I saw that I found it quite unusual, and interesting.

Well Nemoy had to operate again and undo his deed which is where he was caught by our crusty detective as Icarus said. I modified the riddle a bit so that it had a cleaner story line.

I thought this episode one the best of all episodes in the first and second season.
Title: Re: Heart Failure
Post by tiber13 on Mar 10th, 2007, 9:56pm
i am 11 so i have no clue about some tv show in the 70's, so just tell me the anser
Title: Re: Heart Failure
Post by denis on Mar 10th, 2007, 10:20pm
Tiber13,

Here's the answer (spoiler alert)!

[hide]there are two types of stitch material: Permanent or self-disolving. The self disolving kind is used on wounds that heal. Instead of using the permanent kind of sutures on the valve, he used the self-disolving kind with disastrous results a few days later[/hide]
Title: Re: Heart Failure
Post by Icarus on Mar 10th, 2007, 10:30pm
The show was "Columbo". It starred Peter Falk as a rather scruffy murder detective in L.A. These were not mysteries, as they started off by showing you the crime. The show was built around showing Columbo badger the bad guys in a bumbling sort of way until he uncovers the truth.

In the show in question, Leonard Nimoy guest starred as a young surgeon whose mentor has a heart valve replacement done by him. For reasons I don't remember, he wants to kill his mentor.

There are two types of thread used for sutures. In situations such as heart valves, you want a permanent suture that will hold the artificial valve in place forever. However, most sutures are just to hold tissue together until it heals naturally. For these, a suture that will eventually dissolve is preferred, as they will only be needed for a short time. The two types of thread are color coded to make sure doctors know which type they have.

Nimoy uses dissolving sutures for the heart valve, knowing that they will give out in a few days or weeks, killing the patient. To disguise this from the rest of the operating staff, he dyes the sutures so they look like permanent ones. Unfortunately for him, the assisting nurse is familiar enough with the look and feel of both types of sutures that she can tell something is wrong. He kills her by running her down in a car. This gets Columbo involved, who eventually reasons enough for Nimoy to realize if the mentor dies, there will be an investigation of the valve. So he uses drugs to induce complications, giving him an excuse to do a second surgery and replace the dissolving sutures before he gets caught. Columbo however seizes the removed sutures before they can be destroyed, giving him the evidence he needs to arrest the doctor for killing the nurse.

[ added: evidently it took me more than 10 minutes to write this. denis had not responded when I started. ]
Title: Re: Heart Failure
Post by denis on Mar 11th, 2007, 9:29am
Just a small clarification,

The murder weapon used on the nurse was a crowbar just as she was about to enter her car. Later on, when it was confirmed to Columbo that the crowbar was the murder weapon, he non-chalantly cracked his harboiled egg on it so he can start eating his breakfast which he brought in a brown bag.
Title: Re: Heart Failure
Post by JiNbOtAk on Mar 11th, 2007, 11:26pm
My initial idea upon reading the riddle was a bit different, the surgeon had prepared the stitches beforehand, by predipping it into a mixture of superglue and crushed glass. ( when its dry, it looks similar to normal stitches ) Using the stitches, he sew up the old man, knowing that the glass would injure the heart slowly, causing a cardiac arrest..

Not having tried it, I'm not sure about the exact result though..  :P
Title: Re: Heart Failure
Post by BNC on Mar 12th, 2007, 9:59am
Speaking of alternatives: I though initially that he noticed the marking on the velve, so he re-marked it, only this time he used poisonous coloring.
Title: Re: Heart Failure
Post by denis on Mar 12th, 2007, 10:42am

on 03/11/07 at 23:26:27, JiNbOtAk wrote:
My initial idea upon reading the riddle was a bit different, the surgeon had prepared the stitches beforehand, by predipping it into a mixture of superglue and crushed glass. ( when its dry, it looks similar to normal stitches ) Using the stitches, he sew up the old man, knowing that the glass would injure the heart slowly, causing a cardiac arrest..

Not having tried it, I'm not sure about the exact result though..  :P



Not bad Jinbotak. It turns out he did have to dye the sutures beforehand so that they would look identical to the permanent ones. So you're idea is not far removed from the intended answer. The superglue might make the stiches a little rigid though.  Perhaps a different substance would be more suitable.

And BNC's answer could work too, as would introducing any kind of slow acting poison into the artificial valve before the operation.
Title: Re: Heart Failure
Post by tiber13 on Mar 12th, 2007, 5:52pm
how could it dissolve?
Title: Re: Heart Failure
Post by tiber13 on Mar 12th, 2007, 5:52pm
I LIKE TO POST!
Title: Re: Heart Failure
Post by denis on Mar 12th, 2007, 6:10pm

on 03/12/07 at 17:52:22, tiber13 wrote:
how could it dissolve?



Self-disolving sutures are make it with a material that is disovled by itself with help from the moisture of the body. It takes about a week or two to disolve completely.

Check the following link for more info:
http://health.howstuffworks.com/question611.htm


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