This doctor has a system

Chapter 627, Chapter 689: The Unexpected Truth

“Some medications, when used in combination, can cause abnormal metabolism of one of them, leading to accumulation in the body,” Gao Feng said after a moment’s thought. “Has your spouse taken any other medications in the past few days?”

"Apart from prednisone, that's all." Jia Tianyuan's wife was very certain. The two had a good relationship, and she usually brought her husband medicine and water when he needed it.

"He trusted your hospital a lot before he passed away, and he always received treatment for his rhinitis here."

Several people looked at each other speechlessly.

"You're so busy, why are you getting involved?" Dean Guo personally poured Gao Feng a cup of tea.

"I'm really curious about the cause of this patient's death." Gao Feng took the sip and asked, "What's this? Why does it smell musty?"

"This tastes just like Tieguanyin tea," Dean Guo said with a smile. "You can tell you don't drink tea often."

"No, I've had Tieguanyin tea before, it doesn't taste like this."

"Really?" Dean Guo asked, still somewhat doubtful, as he took out the tin can containing the tea.

"Oh dear, it's really moldy, and there's even white fuzz on it!"

“We should have fired Ma Liang back then. Look at him, he caused trouble himself, and now he’s dragged you into it too.” Dean Guo said angrily after washing their cups. “Doctor-patient disputes are a real pain to deal with, so don’t get involved.”

"I know you're close to him. I'll just give you a heads-up after this is over and let you handle it gently."

No hospital leader likes medical disputes. When Dean Guo was the deputy director, he was in charge of all aspects of the hospital's work, and at that time, he was responsible for knowing about all medical disputes.

We've dealt with enough cases. Some are indeed the hospital's responsibility, but most of the time it's due to patients' excessively high expectations.

Some are simply trying to extort money.

Some family members got really agitated and actually hit people. Dean Guo was once shoved several times, which he now thinks was truly disgraceful.

"Your work and research are far more important than these things. Let the medical affairs office handle it," Dean Guo said. In any case, the hospital doesn't bear much responsibility for this matter; in the end, it will only have to pay some compensation.

As long as the public outcry subsides soon, nothing else matters.

“I think the family is having a hard time accepting this,” Gao Feng said. “They have questions about the cause of death stated in the current autopsy report.”

“Even if you find out the cause of death, they will find it hard to accept,” Dean Guo told him. “It will get better with time.”

Time heals all wounds.

However, after thinking it over, Gao Feng decided to get deeply involved in this medical dispute.

He was really curious about what could be causing such a high concentration of terfenadine in the patient's blood.

"What?! Go to the patient's home to check on them? Isn't that inappropriate?" Officer Liu from the Medical Affairs Office looked at him with an expression that said, "Your idea has shocked me."

“Yes, the families have a lot of complaints about our hospital these days, so I don’t feel comfortable going to their homes,” Li Youliang advised.

At Gao Feng's insistence, Liu, the staff member of the medical affairs office, reluctantly made a phone call to Jia Tianyuan's wife.

The latter was clearly a little surprised, but did not refuse.

"Come on over, I've been staying home."

Jia Tianyuan's home is about a 15-minute drive from the provincial hospital. Upon learning that hospital staff were coming to his home, his son quickly returned home from work.

"Mom, why did we have to come to our house to negotiate?"

“I don’t know what happened either,” Jia Tianyuan’s wife said. “They said they wanted to come and visit our home.”

Her mind was in a mess right now, and she wasn't thinking of refusing.

Gao Feng and his group quickly arrived at their destination.

Jia Tianyuan's home has three bedrooms and one living room. He and his wife live in the master bedroom, the guest bedroom is where his son's family stays when they come back, and the remaining small room is a study.

"Where do you usually keep your household medicines?" Gao Feng asked.

“There’s a medicine box,” Jia Tianyuan’s wife said, leading them into the study. “It’s in the bottom cabinet.”

Gao Feng flipped through the contents and found some Banlangen granules, montmorillonite powder, ibuprofen, and several boxes of metformin extended-release tablets.

“I have diabetes, that’s what I ate,” Jia Tianyuan’s wife explained.

Gao Feng checked the master bedroom again; it was very messy, probably because it hadn't been tidied up in the past few days.

There was an old-fashioned thermos on the bedside table, which was the cup that Jia Tianyuan usually used to drink water.

Gao Feng picked it up and looked at it; there was still water inside.

"He went to bed right after taking his medicine, and then suddenly..." Jia Tianyuan's wife couldn't control herself and started sobbing softly as she spoke.

Gao Feng went to the kitchen again and saw two dehydrated cabbages on the floor, while the refrigerator was empty.

"Did you throw everything away?" Gao Feng asked.

"No, there was nothing to begin with."

Jia Tianyuan's son doesn't live with them. There's a supermarket downstairs, so they buy food and cook it themselves, and there's practically nothing left over.

"what is this?"

"Oh, this is the grape juice I bought," Jia Tianyuan's son replied after glancing at it.

According to him, Jia Tianyuan usually likes to drink fruit juice, but most of the juice he buys is diluted, and it's too much trouble to squeeze it himself. So his son went to a large supermarket and bought some with a higher juice content for him to drink at home.

Gao Feng picked up a bottle and looked at it. It said that the beverage contained ≥90% grape juice.

The concentration is indeed quite high, but it will not react with terfenadine and thus have no effect on the human body.

Gao Feng was slightly disappointed. He looked around the living room again and then decided to take his leave.

Just as the group stepped out the door, and Jia Tianyuan's son was about to close the door to see them off, Jia Tianyuan's wife suddenly spoke.

“I don’t drink these grape juices either, Ahui, you can take them later. Oh, and there are a few bottles of grapefruit juice inside, they’re almost expired,” she said.

"It seems that Master Jia really likes drinking fruit juice," Li Youliang said.

"Hmm," Gao Feng replied casually.

When the group returned to the hospital, it was almost time to leave work, and Liu, the staff member from the medical affairs office, said goodbye.

After he left, Li Youliang suggested going out to get something to eat.

Gao Feng nodded, but after the two had walked a short distance, he suddenly stopped.

"Call Officer Li back immediately!"

Li Youliang didn't know what his boss was planning, but he didn't ask any questions. Instead, he immediately called Liu, the clerk.

"What's wrong? I just started eating." Inside the restaurant, Manager Liu looked at his plain egg soup noodles with a bit of a dilemma. "Should I wait until I finish eating?"

"Come on over, Brother Liu, I'll treat your whole family to a big meal in Jianye tonight!"

"Okay then." Officer Liu immediately stood up. A bowl of clear soup with eggs costing 8 yuan is definitely not comparable to a 500 yuan buffet.

However, he's been dieting lately, so he'll continue tomorrow.

"Going again?" Officer Liu was quite surprised. "Sure, I'll contact them right now."

Soon the three of them arrived at Jia Tianyuan's house again.

"Before you left, I heard you say you had a few bottles of grapefruit juice at home," Gao Feng stated succinctly, explaining his purpose. "I need to take a look."

Grapefruit juice and grape juice are produced by the same manufacturer, and the juice concentration is also labeled as greater than 90%.
"Does Master Jia usually like to drink this grapefruit juice?" he asked.

“He doesn’t like drinking this; he says the taste is a bit strange,” Jia Tianyuan’s wife replied.

But the box of grapefruit juice had been bought for too long and was almost expired. Jia Tianyuan was worried about wasting it, so he opened it and drank one bottle every day.

A case contains 24 bottles, but now only 5 bottles remain.

"So you're saying he's been drinking grapefruit juice for the past 20 days?"

“Yes.” Jia Tianyuan’s wife nodded.

"Doctor, is there something wrong with this grapefruit juice?" Jia Tianyuan's son came up.

“Yes, if I’m not mistaken, your father’s death is related to this grapefruit juice,” Gao Feng said after a moment’s thought.

When these words were spoken, everyone present was stunned.

"You have uncovered the true cause of Jia Tianyuan's death and have gained 10 skill points," the system notification announced.

"Director Gao, isn't this just some ordinary juice? What could this possibly be?" Officer Liu from the Medical Affairs Office asked, voicing the common thought on everyone's mind.

Regular fruit juice won't work, but this high-concentration grapefruit juice will.

Grapefruit belongs to the Rutaceae family and the Citrus genus.

As a fruit, when ripe, its peel is generally an uneven orange or red, and the flesh is pale yellow-white or pink, tender, juicy, refreshing, slightly fragrant, and has a sour taste. Some varieties also have a bitter and numbing taste.

Grapefruit is rich in vitamin C and other vitamins, and it is also a fruit with low sugar content, making it very suitable for people who are trying to lose weight.

However, grapefruit should be avoided when taking certain oral medications.

This is because the active ingredients in grapefruit can inhibit cytochrome P450 enzymes, especially CYP3A4, in the intestines and liver.

This enzyme is responsible for metabolizing a variety of drugs. When its activity is inhibited, the rate of drug metabolism slows down, leading to an increase in the concentration of the drug in the blood. This may increase the efficacy of the drug, but it may also increase the risk of side effects and toxicity.

Terfenadine is one of these drugs.

A few days ago, Jia Tianyuan had taken terfenadine orally. After drinking grapefruit juice, the drug concentration in his body continued to accumulate.

The last prescription for medication at the Provincial People's Hospital turned out to be the final straw that broke the camel's back.

“Many medical journals have described similar situations, and I will compile them and give them to you later,” Gao Feng said.

Jia Tianyuan's family, especially his son, was very unwilling to accept this result.

However, after joint discussion by a third-party appraisal committee, the matter was finally concluded.

In the final judgment, the judge held that the hospital had failed to provide sufficient instructions on precautions when dispensing the medication, and therefore bore minor responsibility, requiring it to pay 5 yuan in compensation.

Ma Liang was fined 2000 yuan.

(End of this chapter)