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VA Patients Cool In Pavulon Crisis, Study Says

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VA patients cool in Pavulon crisis, study says

ANN ARBOR, Mich. (AP) - When a series of mysterious breathing failures broke out among patients at the Veterans Administration Hospital three years ago, patients not stricken were less worried about the situation than the staff, according to a survey.

Four hospital psychiatrists who performed the study of patient and staff attitudes at the time of the breathing failures said they were surprised at the results.

“The patients appeared to have a great deal more faith in the hospital during the period of turmoil than did the staff,” said Dr. Phillip Kroll, a co-author of the study.

There were 55 cases of respiratory arrest among 35 of the Ann Arbor hospital’s patients during a six-week period in the summer of 1975. Six of the stricken patients died. Tests on two of the victims detected traces of a muscle-relaxing drug, Pavulon, raising the suspicion of foul play.

Two nurses were convicted of poisoning in connection with the incidents, but the convictions later were overturned and all charges against the women dropped.

Kroll and his colleagues, Drs. Kenneth Silkd, Kenneth Chamberlain and Rosalie Ging, began their study after finding that some of their patients receiving psychiatric treatment were worried about the respiratory failures.

“Simply from an intellectual point of view, we were interested in what the reaction to the crisis would be,” Dr. Kroll said. “Also, in terms of patient care, we wanted to know how people were feeling about this thing."

The survey questioned 112 of the 195 patients in the VA hospital at the time, and 80 percent of them responded. Of the 632 employees questioned, 50 percent responded.

Although 53 percent of the patients indicated they believed there might be a murderer loose in the hospital, 93 percent of them said they would be willing to be a patient there again, the survey showed.

By contrast, just 67 percent of the staff workers who responded said they would be willing to be a patient at the hospital.

“The patients’ strong expression of confidence in the hospital came as a surprise,” Dr. Kroll said.

“We fully expected that they would be more frightened.”

Those patients housed closest to the site of the breathing failures and who depended most on the hospital for life support expressed the least fears about the situation, Kroll said.

But the closer hospital staffers were to the scene, the more critical they felt the problem was. 

“What the study is saying,” Dr. Kroll explained, “is that one of the ways people deal with crises is to deny the more terrible aspects of them. 

‘The amount of denial is usually related to the amount of your helplessness in a situation and the amount you have to use.”