iPhones save a life at Sonoma Hospital

MD, phone home. It could save a life.
Lester Mundel was driving family members home to Sonoma when a leg infection caused so much pain that a short trip from San Francisco turned into a two-week stay at Sonoma Valley Hospital. If it hadn’t been for the smart thinking of a pair of physicians using their iPhones, the 64-year-old Roseville resident might have lost his leg or perhaps even his life.
Mundel, accompanied by his daughter and son-in-law, went to the emergency room late on the evening of June 3. The pain in his leg had become so intense that he could barely move. He was consulted by Dr. David Streeter, an internist at the hospital, who was immediately concerned by what he saw.
“Mr. Mundel had a very nasty looking leg, and his heel was a deep purple,” said Streeter. “He told me the infection had virtually popped up overnight, so I suspected it was more serious than what we see daily in hospital practice.”
With Mundel’s temperature rising to 106 degrees, there was no time to wait for test results. “Something ominous was occurring, and I needed another opinion quickly.”
Streeter contacted his colleague Dr. Javeed Siddiqui at UC Davis Medical Center, an infectious disease specialist who has provided SVH with consultations via a telemedicine connection for nearly two years. Siddiqui was reached at home, away from the usual videoconferencing connection. They improvised, using their iPhones to share and view the images of Mundel’s infected leg.
Able to enlarge the pictures, Siddiqui saw evidence of an aggressive, life-threatening disease. Commonly known as “flesh-eating” bacteria, necrotizing fasciitis is typically caused by the same bacteria that cause strep throat. In extreme cases it can be life-threatening. Mundel’s infection, traced to a small cut on his foot, had spread within hours from his calf all the way up his leg. His blood pressure was dropping dangerously, as well.
At Siddiqui’s urging, Streeter called in a surgeon to remove the infected areas of tissue. “The surgeon warned me that he might have to take my entire leg,” said Mundel, who had signed the form authorizing an amputation. “That’s how bad things looked.”
Ultimately, after two weeks in the hospital, a massive course of antibiotics beat the infection. Mundel was released yesterday.
Streeter and Siddiqui will continue to use telemedicine consultations to discuss infectious-disease cases. The partnership, which began in 2007, was the first of its kind in the country. “For a hospital that does not have a lot of sub-specialists on staff,” Siddiqui said, “telemedicine is an effective way to connect patients in Sonoma with experts located elsewhere. Digital technology has empowered the practice of medicine in amazing ways.”