@dragongal35

The issue you're talking about sounds like a mod conflict. Can you list all the mods that you're playing with? I'm particularly interested in department mods. Ideally sending over the save file would help me figure out the issue.

You can find the save file in:

C:\Users\USERNAME\AppData\LocalLow\Oxymoron Games\Project Hospital\maps

If you can send me the zipped file on Discord I can probably take a look and see what's happening. But in all likelihood this sounds like a mod conflict that I'm probably not aware of.

My discord is Butch #5509

Actually, before you do that, were any of those patients in the Trauma department?

One was in Emergency (was in process of arriving; was triaged by receptionists), other was in ICU.

All DLCs, Easy Tweaks, More Names, Maximum floors, Curtains + New Designs, Realistic Collapses and Disease Incidence, Bedside Examinations (DLC version), and Community Resource Pack.

Looking at your mod list, it looks like Easy Tweaks probably has some conflicts with this mod. The description of the mod says:

Makes the game a bit easier.

It tweaks the game so it takes a while longer before patients collapse.
Makes it so that certain drugs don't require hospitalization (Nothing unrealistic, just drugs that i know are prescribed without hospitalization)
Staff level up earlier.

Which is something I've done with this mod as well. I've edited almost all of the vanilla game diagnoses in some way or another to tone down how frequent your patients collapse. I bet that's the issue. Can you try unsubscribing to that mod and see if the problem persists?

Still persists. No difference.

Do you think you could send me the save through discord?

Friend request sent.

Issue resolved.

Hello Butch. Thanks a lot for your mods for PH. I'd like to report that since using this DLC-specific mod, I can no longer treat patients arriving in ambulance with a stroke/ictus, as IV TPA is not available for any doctor in Emergency nor in the ICU. I could heal those patients in the non-DLC version of this mod. Is this intentional? The in-game dialog mentions that IV TPA is only available in the Diagnostic Room for the Cardiology Department (which I've not opened yet). However, if the patient arrives in a critical condition in ambulance I think doctors in the Trauma Center or, at least, in the ICU should be able to treat them. Thanks in advance for your help. Best regards.

@df

The problem here is that I probably forgot to update the tooltip for IV TPA which is the in game dialog you're referring to. In this mod, stroke is no longer a cardiology diagnosis, it is now a neurology diagnosis which is accurate. The fact that you haven't even opened a cardiology department and you're getting stroke patients is proof that this is working as intended. The reason I know this is because the game will not generate diagnoses that belong to departments you haven't opened yet.

As for where IV TPA can be given... Looking at the edits I made, the treatment can only be prescribed by doctors with the Cardiology, Neurology or ICU specializations. The treatment can be given in any ward (which includes HDU and the ICU). I need to update the tooltip so that this is made clear.

Finally, your point about giving the treatment in the emergency department is valid. In the real world, an emergency department physician will typically get on the phone with a neurologist and take instructions on how to approach a stroke patient depending on diagnostic imaging and other factors (such as how many minutes since the stroke symptoms began). So I will be changing the treatment so that it can also be done in the ER.

Thank you for the fixes, @Butch!

I'd like to comment too about patients arriving in ambulance with ruptured gallbladders symptoms.

The game actually requires to perform on them two surgeries to fully heal them: one (abdominal surgery) to remove the ruptured gallbladder (and I guess also clean bile leaks and repair any damages caused by it), and the second one (laparoscopic/keyhole surgery) to treat the gallstones symptoms.

I'd say the second one is superfluous considering that you'll get your gallbladder removed in the first (open, non-keyhole) surgery, right? If so, is this something that can be modded to avoid the patient to undergo two surgeries?

If for some reason gallstones were left in the ducts, I'd assume a post-surgery ERCP would be enough to get them removed (however I think surgeons do actually check for "leftovers" when removing gallbladders nonetheless, or at least I was told that when they removed mine).

Thank you.

This is fantastic feedback. So yes, you're absolutely right that a patient with a perforated gall bladder is going to have the gallstones and the gallbladder removed simultaneously during the initial emergency laparatomy. A second laparoscopic procedure is redundant in this case - I'll remove that in the next update. When I initially created this mod, I was focused on the very specific collapse symptoms and didn't concern myself too much with the medical errors because they're pretty much everywhere. I'll continue to update all the different diagnoses in each department. So please keep reporting these inaccuracies, I really appreciate you pointing things like this out.

I'll take a look at the entire diagnosis you're talking about here and make some changes. I might even add ERCP into the game as an examination and I can spice up a lot of the existing general surgery cases related to billiary and pancreatic disease.

Hello Butch,
the description of SYM_B._HENSELAE_DETECTED in SymptomsMain file is wrong. I reported it to Oxymoron but they never fixed it. The right description is SYM_B._HENSELAE_DETECTED_DESCRIPTION. Can you please fix it?

@neoxes

Done.

Hello Butch, symptom SYM_PANCREATIC_ENZYMES_ELEVATED_RCDI has an empty treatment filled in, which breaks the game as soon as any patient with Acute Pancreatitis collapses. Would you please take a look into this issue?