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Finding EXTRAordinary in the Ordinary

Terence Kolb, MD

Terence Kolb, MD is a practicing Emergency Medicine physician at Onslow Memorial Hospital in Jacksonville, NC.

Patient:
51-year-old female with an LVAD artificial heart

Reason for Visit:
LVAD battery failure and broken plug, requiring time sensitive urgent care

Patient Outcome:
Dr. Kolb, with guidance from Duke specialists, successfully executed a high-risk LVAD system restart, stabilizing the patient just in time. The patient was later transferred to Duke for a full pump replacement.

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EXTRAordinary Care

When a 51-year-old patient with a left ventricular assist device (LVAD) arrived at Onslow Memorial Hospital, she appeared calm, explaining she had been trying to reach Duke. However, after consulting Duke’s specialists, Dr. Terence Kolb quickly understood the severity of the situation, her LVAD battery was near depletion, and the charging plug was broken.

With no flight transport available, Dr. Kolb had no choice but to follow step-by-step instructions from Duke specialists over the phone, writing down each detail as he prepared to perform the procedure himself. The patient consented, knowing that turning off the pump could result in a failed restart. This LVAD model had been removed from the market due to frequent failure to restart once powered down.

When the drive line was disconnected, the patient immediately lost circulation, causing the patient to go limp. The team had just eight seconds to reconnect the line to a new power unit. In a tense moment, the line was reattached, the control switched, and the activation button pressed. As the RPMs climbed to 26,000, the patient’s circulation was restored, and she regained consciousness.

After stabilization, the patient was transferred to Duke for a new LVAD system. Had the restart failed, Dr. Kolb would have had to rely on chest compressions for the three-hour transport.

Dr. Kolb’s leadership, quick decision-making, and coordination with Duke’s team, alongside the dedicated efforts of the nursing staff, ICU team, and APC Dave Bennett, turned a near-impossible situation into a success.

“The success of this case is a testament to Dr. Kolb’s exceptional leadership and teamwork. He brought together the expertise of the local team and Duke specialists to navigate a nearly impossible scenario with precision and care.”

– Ayaz Pathan, MD, MBA, FACEP

ApolloMD Divisional President

A wide exterior shot of the Onslow Memorial Hospital building, showing the multi-story medical facility with glass and concrete architecture under a clear sky. A wide exterior shot of the Onslow Memorial Hospital building, showing the multi-story medical facility with glass and concrete architecture under a clear sky.

Hospital Partner

Onslow Memorial Hospital is an acute-care facility in coastal North Carolina which holds national accreditation by The Join Commission (TJC) and continually earns distinctions for both patient satisfaction and quality care. Onslow Memorial offers a distinctive Emergency Department and Minor Emergency Care Unit, treating over 50K patients annually.