A hospital was criticised for serious failings after a woman bled to death.
PC Diane Patt, 34, died hours after giving birth to her daughter at Colchester General Hospital.
The girl was safely delivered, but Mrs Patt suffered a massive haemorrhage and lost up to six litres of blood, which were not replaced.
Coroner Caroline Beasley-Murray said the hospital had failed in its care of Mrs Patt.
She said: “There were very serious failings in the care Mrs Patt received. With the appropriate and timely treatment, Mrs Patt might have survived. Her death was contributed to by neglect.”
Mrs Beasley-Murray said there was a failure of communication between the clinical teams, lack of leadership to deal with the developing situation and lack of clear, overall co-ordination and team work.
It emerged during the inquest surgical teams had not followedasurgical safety check list.
During the three-day hearing, the inquest was told doctors worked to stem Mrs Patt’s bleeding after the birth. Mrs Patt, of Nayland Road, Colchester, was admitted on September 18, 2011.
She asked for a natural birth, having had a Caesarean during the birth of her first child, a boy.
At the time they estimated she had lost about 2.4 litres of blood. In fact, she had lost more than twice that amount.She gave birth to her daughter with the aid of a suction device called a ventouse, at 8.20pm, after a failed forceps delivery. Problems arose afterwards, when staff noted she was suffering “torrential bleeding”.
She was pronounced dead at 11.57pm. A post-mortem showed cause of death as cardiac arrest, caused by massive blood loss.
The coroner described the hours before Mrs Patt’s death as confused and “chaotic’’. She said: “The decision to attempt an instrumental delivery represents sub-optimum care and the decision to use forceps also represented sub-optimum care.”
Mrs Patt’s widower, Sgt Major Jason Patt, of the 7th Parachute Regiment, Royal Horse Artillery, attended the hearing with other members of the family, whom Mrs Beasley-Murray praised for the way they had handled Mrs Patt’s death.
Widower: Our devastation at care errors
A WIDOWER says his family have been left devastated by hospital errors that claimed his wife’s life.
Sgt Major Jason Patt said he hoped Colchester General Hospital had learnt from the mistakes that caused Diane’s death.
Mrs Patt, 34, a police officer based in Colchester, suffered a fatal heart attack after losing five litres of blood. Coroner Caroline Beasley-Murray found “very serious failings’’ in the case and said death was contributed to by neglect.
In a statement after the verdict, Sgt Major Patt, of Colchester’s 7th Parachute Regiment, Royal Horse Artillery, said: “My family has been devastated by the errors made by the hospital.
“It has taken a wonderful mother and wife away from us.
“I had many unanswered questions before the inquest and I am pleased the coroner has carried out such a thorough review.
“She identified a succession of very serious failings in Diane’s care, but my familywill nowhave to deal with the consequences.
“I can only hope the hospital learns from its mistakes, so the same does not happen to someone else.”
Mr and Mrs Patt’s daughter is now two. The couple’s son is aged four.
Paul Sankey, a clinical negligence lawyer with London-based Slater and Gordon, said: “A thorough investigation by the coroner has revealed devastating criticisms of Mrs Patt’s management.
“It is difficult to understand why anaesthetists failed to respond to Mrs Patt’s extensive blood loss and to give her adequate replacement fluids.
“It seems clear with adequate management she would not have died and proper care would have avoided such a catastrophic loss to her family.
"The clinicians need to learn from their avoidable errors and the hospital management must ensure all concerned learn from this tragedy.”
After PC Patt’s death, Lee Davies, her chief inspector at Colchester police station, said: “She was a fantastic officer, a credit to the force and her family.”
This article is courtesy from the Gazette.
Regularly updated blog featuring news, articles and information relating to clinical/medical negligence.
Monday, 30 December 2013
Friday, 27 December 2013
Doctors more likely to receive a complaint than ever before
It is a source of increasing concern to doctors that they are more likely to be the subject of a complaint or claim than ever before.
This news won't come as a surprise to many – a recent Medical Protection Society (MPS) survey indicates more than half – 58% – of respondents have been subject to a complaint, claim, or GMC investigation in the past 12 months. More than 90% know of a colleague who has had a similar experience. Analysing the number of claims that UK members have reported to us, we have seen them increase by 40% from 2011 to 2012.
But why are complaints and claims going up? Put simply, patients expect more from each and every healthcare interaction. There is an increased willingness to take action when things don't turn out as expected – and while patients should not be inhibited from speaking out if they have a negative experience – this has to be considered against a backdrop of clinicians being asked to do more with less.
There is a perfect storm of doctors struggling to provide the service they wish to because of a lack of resources, combined with increasing expectations. Negative press coverage, appearing with relentless regularity, doesn't help morale, either. Advertising by clinical negligence litigators is now commonplace. Recent reforms to legal costs may help redress this balance, but it's still too early to tell. Permeating all these factors is the way healthcare reforms and the pursuit of targets are seen to have steadily eroded the personalised doctor-patient relationship.
Over the last five to ten years, the delivery of healthcare has changed and now has a striking similarity to the manufacture of components in a factory. So driven is the NHS by the idea of targets and productivity, we have lost sight of the most important thing: the patient experience. It's about time that we re-focus on the important values of professionalism and caring for our patients.
The big reviews of 2013 – Francis, Berwick and Keogh – also highlight the need for change. MPS put out a strong plea for the independence of the role of the chief inspector of hospitals (CIH), writing to Jeremy Hunt in conjunction with the BMA in July. We are pleased to see there will now be an appropriate level of impartiality for the public whistleblower. The main challenge for the CIH will be addressing the view that this role will simply add another layer of bureaucracy. 45% of MPS members surveyed believe the role will not support a change to the culture of openness that is needed in hospitals. Healthcare managers have an important role to play in ensuring this isn't just reform for reform's sake.
MPS welcomes Berwick's recommendations for building a patient safety culture rooted in transparency, openness and continual learning. Hospital trusts must genuinely listen to the views of patients and staff, and engage with them to improve services.
For too long healthcare has been driven by targets. A quarter of MPS members believe professional standards have deteriorated, with 81% attributing this to "targets trumping clinical needs". The current call for a change in culture presents an opportunity to take on board the essence of 2013's reports and reassert the importance of professionalism in delivering high-quality care and a better experience for patients and their doctors.
This news won't come as a surprise to many – a recent Medical Protection Society (MPS) survey indicates more than half – 58% – of respondents have been subject to a complaint, claim, or GMC investigation in the past 12 months. More than 90% know of a colleague who has had a similar experience. Analysing the number of claims that UK members have reported to us, we have seen them increase by 40% from 2011 to 2012.
But why are complaints and claims going up? Put simply, patients expect more from each and every healthcare interaction. There is an increased willingness to take action when things don't turn out as expected – and while patients should not be inhibited from speaking out if they have a negative experience – this has to be considered against a backdrop of clinicians being asked to do more with less.
There is a perfect storm of doctors struggling to provide the service they wish to because of a lack of resources, combined with increasing expectations. Negative press coverage, appearing with relentless regularity, doesn't help morale, either. Advertising by clinical negligence litigators is now commonplace. Recent reforms to legal costs may help redress this balance, but it's still too early to tell. Permeating all these factors is the way healthcare reforms and the pursuit of targets are seen to have steadily eroded the personalised doctor-patient relationship.
Over the last five to ten years, the delivery of healthcare has changed and now has a striking similarity to the manufacture of components in a factory. So driven is the NHS by the idea of targets and productivity, we have lost sight of the most important thing: the patient experience. It's about time that we re-focus on the important values of professionalism and caring for our patients.
The big reviews of 2013 – Francis, Berwick and Keogh – also highlight the need for change. MPS put out a strong plea for the independence of the role of the chief inspector of hospitals (CIH), writing to Jeremy Hunt in conjunction with the BMA in July. We are pleased to see there will now be an appropriate level of impartiality for the public whistleblower. The main challenge for the CIH will be addressing the view that this role will simply add another layer of bureaucracy. 45% of MPS members surveyed believe the role will not support a change to the culture of openness that is needed in hospitals. Healthcare managers have an important role to play in ensuring this isn't just reform for reform's sake.
MPS welcomes Berwick's recommendations for building a patient safety culture rooted in transparency, openness and continual learning. Hospital trusts must genuinely listen to the views of patients and staff, and engage with them to improve services.
For too long healthcare has been driven by targets. A quarter of MPS members believe professional standards have deteriorated, with 81% attributing this to "targets trumping clinical needs". The current call for a change in culture presents an opportunity to take on board the essence of 2013's reports and reassert the importance of professionalism in delivering high-quality care and a better experience for patients and their doctors.
This article is courtesy from the Guardian.
Wednesday, 25 December 2013
Ex-Cardiff hospital boss Russell Hopkins says NHS a 'mess'
A former general manager of Wales' largest hospital has condemned the state of the NHS, claiming politicians and managers have "messed it up".
Russell Hopkins, who used to manage the University Hospital of Wales, Cardiff, was left with bladder and nerve damage after an operation in the area in 2011.
He chose to speak out because he claims patients' lives are "endangered".
Cardiff and Vale health board offered "unreserved apologies once again" to Mr Hopkins for his distress.
Mr Hopkins, now living in Newport, Pembrokeshire, is a former consultant oral maxillofacial surgeon at the University Hospital of Wales, and a former chair of the British Medical Association in Wales.
He is one of eight consultants who wrote to the Daily Telegraph calling for the proper staffing of NHS wards at weekends.
“I'm angry for what has happened to the profession and I'm angry for the patients” Russell Hopkins, Former surgeon
He underwent hip surgery at Llandough Hospital near Cardiff in 2011, during which he said a spinal anaesthetic caused a bleed in his spinal column.
"When you get things like that you have got to be decompressed within eight to 12 hours at best - certainly within 24 hours - to relieve the pressure," he told BBC Wales.
"I didn't see a senior doctor despite me telling the nurses there were things wrong.
"Nobody paid any attention until my daughter - who's a hospital consultant - rang up from London and said 'what's wrong with my father'?"
Mr Hopkins said it was four days before he was seen by a consultant.
By the time he was investigated, he said a spinal surgeon told him: "There's no point in doing it."
As a result, Mr Hopkins said he suffered urinary problems which meant "I have been disabled in my plumbing."
He says problems are occurring throughout the NHS "fundamentally because some consultants" - not all - "are no longer looking after their patients in the way they used to do because there's a timetable system in place - the management will pay for that, but nothing else".
He added: "You cannot timetable a doctor to see how Mr Bloggs is doing because that's not on the timetable. It would have to be done in their own time.
"An increasing amount have stopped going to see their patients post-operation, and are leaving it to juniors."
Mr Hopkins said he was seen by a junior doctor after his operation and "the junior doctor didn't spot it".
“We are working very hard with our staff and surgical teams to put in place systems which mean there are always experienced colleagues available”Cardiff and Vale University Health Board
"I'm not embittered, because I'm not that sort of chap," he added.
"But I have been angry with the health service for some time. The politicians have messed it up."
He said he wanted members of the public to know about his experience because he felt as someone with his experience could be affected so could others.
A spokesperson for Cardiff and Vale University Health Board said: "As a health board, we understand how frustrating and upsetting it is for patients when things don't go right, because we share that frustration.
"We are working very hard with our staff and surgical teams to put in place systems which mean there are always experienced colleagues available.
"While we can't comment in detail on the case of Mr Hopkins, we are aware of his concerns and have been in communication with him on the issues he raises.
"We would like to take this opportunity to offer our unreserved apologies once again to Mr Hopkins for the distress he and his family have experienced."
Mr Hopkins said "horrendous stories" about the NHS were reported every day, adding: "The damage done in the last 20 years in the profession has endangered patients.
"I'm angry for what has happened to the profession and I'm angry for the patients."
The three solutions, he says, are firstly to train undergraduates on the wards, shadowing doctors, as well as nurses, who he says "don't do any active clinical work during their three years of training".
Working time directives also have to be addressed, he says, because "if you do shift work you get a scenario where people might say 'it's not my problem, I'm off'."
Finally, he says something needs to be done to improve the professionalism of consultants because "the politicians and managers are destroying the professional values. It's about checking boxes, targets and numbers".
Mr Hopkins is one of the doctors and surgeons who wrote a joint letter to the Telegraph.
Referring to Mr Hopkins's case, the letter says: "The after-care of a hip operation failed him catastrophically, the NHS repaying a lifetime of service with negligence and long-term disability."
It adds: "We, the other signatories, are experienced consultants who share his analysis of how the system failed him and why it fails so many others."
The Welsh government said in a statement: "Every year, the NHS in Wales cares for thousands of patients safely and effectively, and the vast majority are entirely satisfied with their care.
"Cardiff and Vale University Health Board has already responded to Mr Hopkins' specific claims."
The letter from surgeons came as proposals are unveiled which mean hospitals in England would have to ensure senior doctors and key diagnostic tests are available seven days a week under new plans.
The measures form part of a vision unveiled by NHS England to tackle the higher death rates at weekends.
The changes, proposed by medical director Prof Sir Bruce Keogh, will be applied to urgent and emergency services over the next three years.
It comes after a year-long inquiry into NHS care in England following concerns over higher death rates on Saturdays and Sundays.
The Welsh government said health boards and council social services have produced joint plans for the first time this year to manage winter pressures, while an government official did not rule out seven day working as part of an overhaul.
Dr Grant Robinson, the Welsh government's clinical lead for unscheduled care, said radical changes were needed to the system.
"Sometimes there are some big game changers - seven day working is a radical change that as the potential to help," he said.
This article is courtesy from the BBC.
Russell Hopkins, who used to manage the University Hospital of Wales, Cardiff, was left with bladder and nerve damage after an operation in the area in 2011.
He chose to speak out because he claims patients' lives are "endangered".
Cardiff and Vale health board offered "unreserved apologies once again" to Mr Hopkins for his distress.
Mr Hopkins, now living in Newport, Pembrokeshire, is a former consultant oral maxillofacial surgeon at the University Hospital of Wales, and a former chair of the British Medical Association in Wales.
He is one of eight consultants who wrote to the Daily Telegraph calling for the proper staffing of NHS wards at weekends.
“I'm angry for what has happened to the profession and I'm angry for the patients” Russell Hopkins, Former surgeon
He underwent hip surgery at Llandough Hospital near Cardiff in 2011, during which he said a spinal anaesthetic caused a bleed in his spinal column.
"When you get things like that you have got to be decompressed within eight to 12 hours at best - certainly within 24 hours - to relieve the pressure," he told BBC Wales.
"I didn't see a senior doctor despite me telling the nurses there were things wrong.
"Nobody paid any attention until my daughter - who's a hospital consultant - rang up from London and said 'what's wrong with my father'?"
Mr Hopkins said it was four days before he was seen by a consultant.
By the time he was investigated, he said a spinal surgeon told him: "There's no point in doing it."
As a result, Mr Hopkins said he suffered urinary problems which meant "I have been disabled in my plumbing."
He says problems are occurring throughout the NHS "fundamentally because some consultants" - not all - "are no longer looking after their patients in the way they used to do because there's a timetable system in place - the management will pay for that, but nothing else".
He added: "You cannot timetable a doctor to see how Mr Bloggs is doing because that's not on the timetable. It would have to be done in their own time.
"An increasing amount have stopped going to see their patients post-operation, and are leaving it to juniors."
Mr Hopkins said he was seen by a junior doctor after his operation and "the junior doctor didn't spot it".
“We are working very hard with our staff and surgical teams to put in place systems which mean there are always experienced colleagues available”Cardiff and Vale University Health Board
"I'm not embittered, because I'm not that sort of chap," he added.
"But I have been angry with the health service for some time. The politicians have messed it up."
He said he wanted members of the public to know about his experience because he felt as someone with his experience could be affected so could others.
A spokesperson for Cardiff and Vale University Health Board said: "As a health board, we understand how frustrating and upsetting it is for patients when things don't go right, because we share that frustration.
"We are working very hard with our staff and surgical teams to put in place systems which mean there are always experienced colleagues available.
"While we can't comment in detail on the case of Mr Hopkins, we are aware of his concerns and have been in communication with him on the issues he raises.
"We would like to take this opportunity to offer our unreserved apologies once again to Mr Hopkins for the distress he and his family have experienced."
Mr Hopkins said "horrendous stories" about the NHS were reported every day, adding: "The damage done in the last 20 years in the profession has endangered patients.
"I'm angry for what has happened to the profession and I'm angry for the patients."
The three solutions, he says, are firstly to train undergraduates on the wards, shadowing doctors, as well as nurses, who he says "don't do any active clinical work during their three years of training".
Working time directives also have to be addressed, he says, because "if you do shift work you get a scenario where people might say 'it's not my problem, I'm off'."
Finally, he says something needs to be done to improve the professionalism of consultants because "the politicians and managers are destroying the professional values. It's about checking boxes, targets and numbers".
Mr Hopkins is one of the doctors and surgeons who wrote a joint letter to the Telegraph.
Referring to Mr Hopkins's case, the letter says: "The after-care of a hip operation failed him catastrophically, the NHS repaying a lifetime of service with negligence and long-term disability."
It adds: "We, the other signatories, are experienced consultants who share his analysis of how the system failed him and why it fails so many others."
The Welsh government said in a statement: "Every year, the NHS in Wales cares for thousands of patients safely and effectively, and the vast majority are entirely satisfied with their care.
"Cardiff and Vale University Health Board has already responded to Mr Hopkins' specific claims."
The letter from surgeons came as proposals are unveiled which mean hospitals in England would have to ensure senior doctors and key diagnostic tests are available seven days a week under new plans.
The measures form part of a vision unveiled by NHS England to tackle the higher death rates at weekends.
The changes, proposed by medical director Prof Sir Bruce Keogh, will be applied to urgent and emergency services over the next three years.
It comes after a year-long inquiry into NHS care in England following concerns over higher death rates on Saturdays and Sundays.
The Welsh government said health boards and council social services have produced joint plans for the first time this year to manage winter pressures, while an government official did not rule out seven day working as part of an overhaul.
Dr Grant Robinson, the Welsh government's clinical lead for unscheduled care, said radical changes were needed to the system.
"Sometimes there are some big game changers - seven day working is a radical change that as the potential to help," he said.
This article is courtesy from the BBC.
Monday, 23 December 2013
The cost of negligence will hurt us all
The MPS has serious concerns that the rise in the cost of negligence claims may have a negative impact on healthcare, writes Dr Stephanie Bown.
The Medical Protection Society (MPS) has serious concerns about the rise in the cost of clinical negligence claims and the impact that this is having on the public purse, individual healthcare professionals, and the implications that this may have on the quality and choice of healthcare for the Irish public.
As a not-for-profit membership organisation offering professional indemnity to more than 16,000 health professionals in Ireland, we are seeing record numbers of negligence claims being brought against members. Last year, the number of claims notified against private consultants increased more than 2.5 times the level we saw in 2007, while the number of claims against GPs doubled over the same period.
In addition, the total cost of claims is increasing way in excess of retail inflation. The highest settled claim that we have seen in Ireland cost around €6.8 million and related to a patient who died following complications of surgery. The highest value claim to date settled by the MPS on behalf of a GP was around €2.5 million, which involved birth injury leading to cerebral palsy. Claims for catastrophic injuries which might have settled for €3 million five years ago might today be expected to settle for around €6 million or more.
We do not believe the increase in claims reflects a deterioration of professional standards. It is in part a symptom of change in patient expectations. As many patients now expect greater involvement in — and understanding about — their healthcare, an increasing challenge for doctors is to manage patient expectations. It is essential that doctors are able to communicate effectively with their patients and set realistic expectations, which can reduce the likelihood of disappointment and therefore possible claims and complaints.
While patients should not be inhibited from speaking out if they have a negative experience, this has to be considered against a backdrop of clinicians being asked to do more with less. This is a perfect storm; doctors struggling to provide services because of a lack of resources, at a time of increasing expectations and intolerance of human error.
Culture of openness
MPS has long supported and advised members to be open with patients when something has gone wrong. We strongly support the HSE’s policy on open disclosure, and have provided training to help equip hospitals in Ireland to promote a culture of openness, as a critical way to improve the quality and safety of healthcare. We also support members through a range of bespoke workshops.
Myths perpetuate that claims and complaints only arise from poor practice, that only bad doctors are sued and that increased complaints are an indicator of increasingly unsafe medicine. In our experience, it is poor communication before and after an event that influences a patient’s decision to take action.
Effective communication after an adverse outcome lies at the core of rebuilding trust and supporting healing for the patient, their loved ones and the healthcare team involved. Poor or no communication compounds the harm and distress that has already been experienced.
Identifying and addressing patient expectations is also an increasingly important aspect of reducing the risk of a complaint or a claim.
Further to this, sharing information about the risks of particular treatments needs to be communicated to patients and documented in the records.
Legal costs
Plaintiff costs in Ireland are some of the highest and most disproportionate we see across the 40 countries where MPS has members.
Plaintiffs’ legal bills can be wholly disproportionate to the amount the patient receives. It cannot be right that the plaintiff’s solicitors are receiving more in fees than their client receives in compensation.
Our concern is the knock-on effect these costs, coupled with increasing numbers of claims, may have on doctors when considering the affordability of professional indemnity for their private practice. As a mutual organisation that is owned by our members, we are frustrated by this and are acutely aware of the impact that it has on individual doctors at a time when their income is frozen or falling.
Irish healthcare is dependent on the contribution made by the private sector; the State simply could not accommodate the consequences of doctors discontinuing private practice through failure to afford indemnity cover — or for any other reason.
Action needs to be taken now. Options include introducing a legal system that allows for early dispute resolution, avoiding claims going to court unnecessarily, which is where costs escalate. A less adversarial process would be less stressful and time-consuming for patients and doctors. Legal costs should be transparent and easier to challenge. A streamlined, judge-led, claims handling process would bring huge efficiencies, as would mediation for appropriate cases.
Defensive practice
A recent survey we conducted of GP members in Ireland revealed that 80 per cent of respondents practise defensively to avoid complaints and claims.1 They may order more investigations, change their prescribing habits or avoid certain procedures to help protect themselves, rather than because it is necessary in the patient’s best interests.
Doctors cannot always guarantee a successful outcome for every patient, but managing a patient’s treatment appropriately, communicating effectively from the beginning and keeping quality notes will reduce the risk of that patient bringing a successful complaint or a claim.
MPS is actively involved in discussions with the Department of Health and other stakeholders about the best way to address the rising costs of clinical negligence, and understands and addresses the causes of the increase in claims and complaints.
We recognise that the working group on clinical negligence and the Legal Services Regulation Bill has considered some of these issues. However, MPS strongly believes that immediate action is required to address the spiralling costs and the increasing threat this poses to the public purse, public health and health professionals in Ireland.
This article is courtesy from the Irish Medical Times.
The Medical Protection Society (MPS) has serious concerns about the rise in the cost of clinical negligence claims and the impact that this is having on the public purse, individual healthcare professionals, and the implications that this may have on the quality and choice of healthcare for the Irish public.
As a not-for-profit membership organisation offering professional indemnity to more than 16,000 health professionals in Ireland, we are seeing record numbers of negligence claims being brought against members. Last year, the number of claims notified against private consultants increased more than 2.5 times the level we saw in 2007, while the number of claims against GPs doubled over the same period.
In addition, the total cost of claims is increasing way in excess of retail inflation. The highest settled claim that we have seen in Ireland cost around €6.8 million and related to a patient who died following complications of surgery. The highest value claim to date settled by the MPS on behalf of a GP was around €2.5 million, which involved birth injury leading to cerebral palsy. Claims for catastrophic injuries which might have settled for €3 million five years ago might today be expected to settle for around €6 million or more.
We do not believe the increase in claims reflects a deterioration of professional standards. It is in part a symptom of change in patient expectations. As many patients now expect greater involvement in — and understanding about — their healthcare, an increasing challenge for doctors is to manage patient expectations. It is essential that doctors are able to communicate effectively with their patients and set realistic expectations, which can reduce the likelihood of disappointment and therefore possible claims and complaints.
While patients should not be inhibited from speaking out if they have a negative experience, this has to be considered against a backdrop of clinicians being asked to do more with less. This is a perfect storm; doctors struggling to provide services because of a lack of resources, at a time of increasing expectations and intolerance of human error.
Culture of openness
MPS has long supported and advised members to be open with patients when something has gone wrong. We strongly support the HSE’s policy on open disclosure, and have provided training to help equip hospitals in Ireland to promote a culture of openness, as a critical way to improve the quality and safety of healthcare. We also support members through a range of bespoke workshops.
Myths perpetuate that claims and complaints only arise from poor practice, that only bad doctors are sued and that increased complaints are an indicator of increasingly unsafe medicine. In our experience, it is poor communication before and after an event that influences a patient’s decision to take action.
Effective communication after an adverse outcome lies at the core of rebuilding trust and supporting healing for the patient, their loved ones and the healthcare team involved. Poor or no communication compounds the harm and distress that has already been experienced.
Identifying and addressing patient expectations is also an increasingly important aspect of reducing the risk of a complaint or a claim.
Further to this, sharing information about the risks of particular treatments needs to be communicated to patients and documented in the records.
Legal costs
Plaintiff costs in Ireland are some of the highest and most disproportionate we see across the 40 countries where MPS has members.
Plaintiffs’ legal bills can be wholly disproportionate to the amount the patient receives. It cannot be right that the plaintiff’s solicitors are receiving more in fees than their client receives in compensation.
Our concern is the knock-on effect these costs, coupled with increasing numbers of claims, may have on doctors when considering the affordability of professional indemnity for their private practice. As a mutual organisation that is owned by our members, we are frustrated by this and are acutely aware of the impact that it has on individual doctors at a time when their income is frozen or falling.
Irish healthcare is dependent on the contribution made by the private sector; the State simply could not accommodate the consequences of doctors discontinuing private practice through failure to afford indemnity cover — or for any other reason.
Action needs to be taken now. Options include introducing a legal system that allows for early dispute resolution, avoiding claims going to court unnecessarily, which is where costs escalate. A less adversarial process would be less stressful and time-consuming for patients and doctors. Legal costs should be transparent and easier to challenge. A streamlined, judge-led, claims handling process would bring huge efficiencies, as would mediation for appropriate cases.
Defensive practice
A recent survey we conducted of GP members in Ireland revealed that 80 per cent of respondents practise defensively to avoid complaints and claims.1 They may order more investigations, change their prescribing habits or avoid certain procedures to help protect themselves, rather than because it is necessary in the patient’s best interests.
Doctors cannot always guarantee a successful outcome for every patient, but managing a patient’s treatment appropriately, communicating effectively from the beginning and keeping quality notes will reduce the risk of that patient bringing a successful complaint or a claim.
MPS is actively involved in discussions with the Department of Health and other stakeholders about the best way to address the rising costs of clinical negligence, and understands and addresses the causes of the increase in claims and complaints.
We recognise that the working group on clinical negligence and the Legal Services Regulation Bill has considered some of these issues. However, MPS strongly believes that immediate action is required to address the spiralling costs and the increasing threat this poses to the public purse, public health and health professionals in Ireland.
This article is courtesy from the Irish Medical Times.
Friday, 20 December 2013
Woman died in hospital after going into premature labour
The parents of a young woman who died in hospital after going into premature labour said they will not rest until they get justice for their daughter.
Christine and Robert Harper claim negligent medical care while in the maternity unit was to blame for the death of Carly Harper at Arrowe Park Hospital.
The 26-year-old hairdresser was admitted three days earlier after experiencing a rupture of membranes while nearly 24 weeks pregnant.
Carly, of Orrysdale Road, West Kirby, was expecting a baby with her boyfriend Alex Dearden when she developed severe sepsis (infection), and the decision was taken to deliver the baby, resulting in a miscarriage.
Carly was taken to critical care but died the next morning after going into multiple organ failure.
Her parents, who live in Heswall, claimed there was a failure to recognise, manage and treat the sepsis which led to Carly’s death on May 20 last year.
Mr Harper said: “We were all talking to Carly, trying to encourage her to stay with us but she just wasn’t responding. Seeing your daughter like that is absolutely devastating. All we could do was watch as she drifted away from us, and then she was gone.
“It felt like someone had pulled the rug from under us.
“Serious questions must be asked of the staff, procedures must be scrutinised and someone must be held accountable. Two lives were lost that day and I will never let it go until our daughter and her baby receive justice.”
Solicitors representing Mr Harper said Wirral University Teaching Hospitals NHS Foundation Trust had produced a Serious Incident Review Report which recognised a number of failings in the care provided.
Stephanie Forman, from Simpson Millar LLP Solicitors, said: “The window of time when Carly’s life might have been saved was lost and her family are now living with the consequences.
“The very least they deserve is absolute clarity about what happened on that fatal day in May, and to be reassured steps are taken to prevent the senseless loss of such young lives again in the future.”
An inquest was opened in Birkenhead yesterday but was adjourned until the new year to allow for the disclosure of further documents.
A spokesman for the hospital trust said it was not appropriate for them to comment until the conclusion of the inquest.
This article is courtesy from Liverpool Echo.
Christine and Robert Harper claim negligent medical care while in the maternity unit was to blame for the death of Carly Harper at Arrowe Park Hospital.
The 26-year-old hairdresser was admitted three days earlier after experiencing a rupture of membranes while nearly 24 weeks pregnant.
Carly, of Orrysdale Road, West Kirby, was expecting a baby with her boyfriend Alex Dearden when she developed severe sepsis (infection), and the decision was taken to deliver the baby, resulting in a miscarriage.
Carly was taken to critical care but died the next morning after going into multiple organ failure.
Her parents, who live in Heswall, claimed there was a failure to recognise, manage and treat the sepsis which led to Carly’s death on May 20 last year.
Mr Harper said: “We were all talking to Carly, trying to encourage her to stay with us but she just wasn’t responding. Seeing your daughter like that is absolutely devastating. All we could do was watch as she drifted away from us, and then she was gone.
“It felt like someone had pulled the rug from under us.
“Serious questions must be asked of the staff, procedures must be scrutinised and someone must be held accountable. Two lives were lost that day and I will never let it go until our daughter and her baby receive justice.”
Solicitors representing Mr Harper said Wirral University Teaching Hospitals NHS Foundation Trust had produced a Serious Incident Review Report which recognised a number of failings in the care provided.
Stephanie Forman, from Simpson Millar LLP Solicitors, said: “The window of time when Carly’s life might have been saved was lost and her family are now living with the consequences.
“The very least they deserve is absolute clarity about what happened on that fatal day in May, and to be reassured steps are taken to prevent the senseless loss of such young lives again in the future.”
An inquest was opened in Birkenhead yesterday but was adjourned until the new year to allow for the disclosure of further documents.
A spokesman for the hospital trust said it was not appropriate for them to comment until the conclusion of the inquest.
This article is courtesy from Liverpool Echo.
Wednesday, 18 December 2013
NHS forced to pay £11m damages over botched care at Huddersfield and Halifax hospitals
Payouts for botched care at Calderdale and Huddersfield hospitals have rocketed to more than £11m in one year – the highest ever.
NHS lawyers have been forced to compensate dozens of patients for failures at Huddersfield Royal Infirmary and Calderdale Royal Hospital, Halifax.
A top Huddersfield solicitor has told the Examiner she is overwhelmed with cases against local maternity units.
In 2012/13 the NHS Litigation Authority, the body that deals with claims against hospitals, forked out a total of £11,543,140 for incidents involving the two hospitals.
The figure is almost four times higher than five years ago.
There were 102 claims were made against Calderdale and Huddersfield Foundation Trust (CHFT), resulting in more than £8m paid out for clinical negligence.
The legal defeats also lumber the NHS with millions of pounds of court costs.
The average payout for clinical negligence last year was just over £113,000.
No other West Yorkshire hospital trust has increased as fast as CHFT.
Leeds Teaching Hospitals topped the region’s list with £18m damages, but that is only triple their £6m figure of five years ago.
The figures come as recent data also reveals CHFT as one of the worst hospitals for serious patient safety incidents.
The trust suffered 83 ‘severe’ incidents – the most serious category of patient harm – and two deaths between October, 2012, and March, 2013.
The level of serious incidents was 2.3% of all patient safety incidents, almost four times higher than the average of 0.6% for large hospitals in England.
Clinical negligence solicitor, Suzanne Munroe, from Huddersfield-based Switalskis, said she was so busy she was having to turn clients away.
“I have worked within West and South Yorkshire as a clinical negligence solicitor for over 20 years,” she said.
“In my specialised area of birth injury to both mothers and babies I am sad to say that in my experience the severity of claims has not reduced.
“I have more cerebral palsy claims now than ever and the number of enquiries for still birth-claims has increased.
“Those working within the NHS are under increasing pressure and midwives in particular are stretched to the limit.
“We know that there is a national midwifery shortage and that midwives and doctors are working at an unbearable pace at times.
“What we see here at Switalskis is the true human cost of the mistakes that are inevitably made.
“I am just in the process of settling a claim for a local young man which, over his lifetime, will cost the NHS over £6m for his care and other needs.
“He suffered a severe brain injury in the early days after he was born which was entirely avoidable.
“All that needed to happen in his case was for the midwives to listen to his mum when she was concerned that he wasn’t feeding properly.
“They didn’t listen to her and he suffered a hypoglycaemic fit which caused uncontrollable epilepsy and irreversible brain damage.
“What we have been able to do is to obtain compensation that will provide 24-hour care, appropriate and supportive therapy for the rest of his life, even when his parents are not around to do that for him.
“I have always been keen to share my experiences from the patient’s side and have been involved in training programmes within hospitals looking at patient safety issues.
“We have so many more enquiries now than we can deal with and so often we have to turn cases away.
“This is not a position I was in when I started out in this work.”
CHFT’s medical director, Barbara Crosse, said: “Nationally negligence claims have risen.
“In the past five years the NHS Litigation Authority has seen an increase in reported new claims from members, which includes hospital Trusts, of approximately 40%.
“Whenever we have a claim of negligence it is looked at in detail to identify any learning for us.
“With regard to patient safety incidents, we positively encourage staff to report them.
“There is a degree of subjectivity in how Trusts grade incidents, for example we would grade a serious pressure ulcer as ‘serious harm’ when in the past other Trusts may not have done.
“We take the safety of our patients extremely seriously”.
This article is courtesy from The Examiner.
NHS lawyers have been forced to compensate dozens of patients for failures at Huddersfield Royal Infirmary and Calderdale Royal Hospital, Halifax.
A top Huddersfield solicitor has told the Examiner she is overwhelmed with cases against local maternity units.
In 2012/13 the NHS Litigation Authority, the body that deals with claims against hospitals, forked out a total of £11,543,140 for incidents involving the two hospitals.
The figure is almost four times higher than five years ago.
There were 102 claims were made against Calderdale and Huddersfield Foundation Trust (CHFT), resulting in more than £8m paid out for clinical negligence.
The legal defeats also lumber the NHS with millions of pounds of court costs.
The average payout for clinical negligence last year was just over £113,000.
No other West Yorkshire hospital trust has increased as fast as CHFT.
Leeds Teaching Hospitals topped the region’s list with £18m damages, but that is only triple their £6m figure of five years ago.
The figures come as recent data also reveals CHFT as one of the worst hospitals for serious patient safety incidents.
The trust suffered 83 ‘severe’ incidents – the most serious category of patient harm – and two deaths between October, 2012, and March, 2013.
The level of serious incidents was 2.3% of all patient safety incidents, almost four times higher than the average of 0.6% for large hospitals in England.
Clinical negligence solicitor, Suzanne Munroe, from Huddersfield-based Switalskis, said she was so busy she was having to turn clients away.
“I have worked within West and South Yorkshire as a clinical negligence solicitor for over 20 years,” she said.
“In my specialised area of birth injury to both mothers and babies I am sad to say that in my experience the severity of claims has not reduced.
“I have more cerebral palsy claims now than ever and the number of enquiries for still birth-claims has increased.
“Those working within the NHS are under increasing pressure and midwives in particular are stretched to the limit.
“We know that there is a national midwifery shortage and that midwives and doctors are working at an unbearable pace at times.
“What we see here at Switalskis is the true human cost of the mistakes that are inevitably made.
“I am just in the process of settling a claim for a local young man which, over his lifetime, will cost the NHS over £6m for his care and other needs.
“He suffered a severe brain injury in the early days after he was born which was entirely avoidable.
“All that needed to happen in his case was for the midwives to listen to his mum when she was concerned that he wasn’t feeding properly.
“They didn’t listen to her and he suffered a hypoglycaemic fit which caused uncontrollable epilepsy and irreversible brain damage.
“What we have been able to do is to obtain compensation that will provide 24-hour care, appropriate and supportive therapy for the rest of his life, even when his parents are not around to do that for him.
“I have always been keen to share my experiences from the patient’s side and have been involved in training programmes within hospitals looking at patient safety issues.
“We have so many more enquiries now than we can deal with and so often we have to turn cases away.
“This is not a position I was in when I started out in this work.”
CHFT’s medical director, Barbara Crosse, said: “Nationally negligence claims have risen.
“In the past five years the NHS Litigation Authority has seen an increase in reported new claims from members, which includes hospital Trusts, of approximately 40%.
“Whenever we have a claim of negligence it is looked at in detail to identify any learning for us.
“With regard to patient safety incidents, we positively encourage staff to report them.
“There is a degree of subjectivity in how Trusts grade incidents, for example we would grade a serious pressure ulcer as ‘serious harm’ when in the past other Trusts may not have done.
“We take the safety of our patients extremely seriously”.
This article is courtesy from The Examiner.
Monday, 16 December 2013
Trust’s £12.9m pay out in negligence cases as five cases of sexual abuse are investigated
Five cases of alleged sexual abuse have been under investigation by the health care trust that runs the South West Acute Hospital and health and social care here, newly released figures show.
In addition, in the last financial year, the Trust paid out almost £13 million in costs to plaintiffs in negligence cases. The pay-outs from the Western Trust represent more than a quarter of the £50.4 million in payments paid to plaintiffs across Northern Ireland last year.
In a Department of Health report on Clinical and Social Care Negligence cases for the past financial year, of the 582 cases of alleged negligence cases that were open against the Western Health and Social Care Trust, five of them related to alleged abuse of a sexual nature.
No health care system can be guaranteed to be risk or error free, the Trust said. “The Trust takes the health and safety of our patients, clients and staff very seriously, yet this is set against the context where no health and social care system can ever guarantee to be risk or error free. However, the Trust proactively rather than reactively manages such risk and takes appropriate action to ensure lessons are learnt following investigation of such cases, working closely with staff to address safety issues should they need to be addressed. The Trust continues to makes every effort to ensure the highest standards of care are provided to our patients and clients,” a spokesperson said.
Asked about whether the settings for these sexual abuse allegations were in hospital or community, the spokesperson added: “For confidentiality reasons the Trust cannot comment on individual cases and will not be commenting further.”
The Western Trust was also dealing with claims relating to allegations of 30 cases of birth defects, eight cases of a foreign body left in situ in an operation and 116 cases of inappropriate treatment.
The Trust’s negligence costs at £12.9 million are the second highest in Northern Ireland, less than a million under the payments made by the Belfast Trust, which paid the highest amount in negligence costs at £13.7 million.
The largest total at £4.1 million of Western Trust payments was for complaints which arose out of allegations about operations, which can relate to complaints about treatment such as intra-operative problems and operator error. This total includes £3.3 million paid in damages, £233,876 in defence costs and £525,199 in plaintiff costs.
Complaints relating to pregnancy and childbirth -- which can include issues such as birth defects and failure to monitor at first stage labour -- resulted in £2.9 million in payments. These included £2.2 million in damages paid, £248,410 in defence costs paid and £380,435 in plaintiff costs paid.
In the last year, the majority of negligence allegations received by the Trust have related to treatment. 182 cases were open in relation to complaints arising out of allegations of failure to treat or delay in treatment (34), inappropriate treatment (116) and fail to recognise complication of treatment (25).
The number of alleged negligence cases being dealt with by the Western Trust is on the rise. In 2010/11, 500 cases were open. In 2012/13, it was 582, an increase of 16.4 per cent, the second highest increase in the five current Trusts. As for those open in 2012/13, at 582 the number of cases in the Western Trust is the second highest in Northern Ireland, coming behind Belfast Trust at 1,158.
Of those 582 cases, 482 were open, 33 were settled and 125 were closed as at March 31 this year.
Of the 125 that were closed, 40 were closed without payment, while 85 were closed with payment.
Since 2010/11 the Western Trust has reported the largest increase in the number of negligence cases settled at March 31, 2013 from 1 to 33 in 2012/13.
In the same period, the Western Trust reported the largest increase in the number of negligence cases closed at March 31, 2013 from 85 in 2010/11 to 125 in 2012/13.
As for new cases opened in the Western Trust, in 2010/11, it was 75, in 2011/12, it was 85 and in 2012/13, it was 70.
The Trust pays claims through central funding from the Department of Health. “The Trust has robust procedures in place to manage cases. The £12.9 million referred to is the total payments to date for all clinical/social care negligence cases open during 2012/13. However, it should be noted that costs associated with a case may not be paid out in the same financial year in which the case has been received and therefore the information refers to the amount paid on each case up to and including 31 March 2013.”
The Trust was asked to comment on the increase in the number of alleged negligence cases to the Trust over three years. A spokesperson said: “It should be noted that the figures provided within the DHSSPSNI report detail the number of clinical/social care negligence cases which were open at any stage during each of the last three years, and if a case was open in each of the last three years it will be counted in each year. The figure of 582 includes any claims that remained open as at 31 March 2013, plus any that had been settled or closed for any other reason during 2012/13.
“Claims may remain open for a number of reasons, the main reasons are on-going investigations (either by the Trust or the plaintiff) or the plaintiff has not progressed their claim, but has not notified the Trust or its legal advisers of their decision. In some cases, this will result in the claim becoming “statute barred” or the claim is listed for Hearing at a future date. The Trust currently has claims listed for Hearing up to December 2014. Open claims are regularly reviewed by the Trust and its legal advisers. The number of unresolved medical negligence/professional negligence claims, as at 2 December 2013, is 408.”
In addition, in the last financial year, the Trust paid out almost £13 million in costs to plaintiffs in negligence cases. The pay-outs from the Western Trust represent more than a quarter of the £50.4 million in payments paid to plaintiffs across Northern Ireland last year.
In a Department of Health report on Clinical and Social Care Negligence cases for the past financial year, of the 582 cases of alleged negligence cases that were open against the Western Health and Social Care Trust, five of them related to alleged abuse of a sexual nature.
No health care system can be guaranteed to be risk or error free, the Trust said. “The Trust takes the health and safety of our patients, clients and staff very seriously, yet this is set against the context where no health and social care system can ever guarantee to be risk or error free. However, the Trust proactively rather than reactively manages such risk and takes appropriate action to ensure lessons are learnt following investigation of such cases, working closely with staff to address safety issues should they need to be addressed. The Trust continues to makes every effort to ensure the highest standards of care are provided to our patients and clients,” a spokesperson said.
Asked about whether the settings for these sexual abuse allegations were in hospital or community, the spokesperson added: “For confidentiality reasons the Trust cannot comment on individual cases and will not be commenting further.”
The Western Trust was also dealing with claims relating to allegations of 30 cases of birth defects, eight cases of a foreign body left in situ in an operation and 116 cases of inappropriate treatment.
The Trust’s negligence costs at £12.9 million are the second highest in Northern Ireland, less than a million under the payments made by the Belfast Trust, which paid the highest amount in negligence costs at £13.7 million.
The largest total at £4.1 million of Western Trust payments was for complaints which arose out of allegations about operations, which can relate to complaints about treatment such as intra-operative problems and operator error. This total includes £3.3 million paid in damages, £233,876 in defence costs and £525,199 in plaintiff costs.
Complaints relating to pregnancy and childbirth -- which can include issues such as birth defects and failure to monitor at first stage labour -- resulted in £2.9 million in payments. These included £2.2 million in damages paid, £248,410 in defence costs paid and £380,435 in plaintiff costs paid.
In the last year, the majority of negligence allegations received by the Trust have related to treatment. 182 cases were open in relation to complaints arising out of allegations of failure to treat or delay in treatment (34), inappropriate treatment (116) and fail to recognise complication of treatment (25).
The number of alleged negligence cases being dealt with by the Western Trust is on the rise. In 2010/11, 500 cases were open. In 2012/13, it was 582, an increase of 16.4 per cent, the second highest increase in the five current Trusts. As for those open in 2012/13, at 582 the number of cases in the Western Trust is the second highest in Northern Ireland, coming behind Belfast Trust at 1,158.
Of those 582 cases, 482 were open, 33 were settled and 125 were closed as at March 31 this year.
Of the 125 that were closed, 40 were closed without payment, while 85 were closed with payment.
Since 2010/11 the Western Trust has reported the largest increase in the number of negligence cases settled at March 31, 2013 from 1 to 33 in 2012/13.
In the same period, the Western Trust reported the largest increase in the number of negligence cases closed at March 31, 2013 from 85 in 2010/11 to 125 in 2012/13.
As for new cases opened in the Western Trust, in 2010/11, it was 75, in 2011/12, it was 85 and in 2012/13, it was 70.
The Trust pays claims through central funding from the Department of Health. “The Trust has robust procedures in place to manage cases. The £12.9 million referred to is the total payments to date for all clinical/social care negligence cases open during 2012/13. However, it should be noted that costs associated with a case may not be paid out in the same financial year in which the case has been received and therefore the information refers to the amount paid on each case up to and including 31 March 2013.”
The Trust was asked to comment on the increase in the number of alleged negligence cases to the Trust over three years. A spokesperson said: “It should be noted that the figures provided within the DHSSPSNI report detail the number of clinical/social care negligence cases which were open at any stage during each of the last three years, and if a case was open in each of the last three years it will be counted in each year. The figure of 582 includes any claims that remained open as at 31 March 2013, plus any that had been settled or closed for any other reason during 2012/13.
“Claims may remain open for a number of reasons, the main reasons are on-going investigations (either by the Trust or the plaintiff) or the plaintiff has not progressed their claim, but has not notified the Trust or its legal advisers of their decision. In some cases, this will result in the claim becoming “statute barred” or the claim is listed for Hearing at a future date. The Trust currently has claims listed for Hearing up to December 2014. Open claims are regularly reviewed by the Trust and its legal advisers. The number of unresolved medical negligence/professional negligence claims, as at 2 December 2013, is 408.”
This article is courtesy from the Impartial Reporter.
Friday, 13 December 2013
Mum tells of 'nightmare' at hands of suspended Nuneaton gynaecologist
A mum has spoken of her “nightmare before Christmas” at the hands of a doctor who has now been suspended.
Marianne Hind, of Bedworth, was one of scores of woman put at risk when they were operated on by gynaecologist Dr Ihimire Paul Okojie.
As the Telegraph previously reported, the specialist in gynaecology and obstetrics at George Eliot Hospital, Nuneaton, was served with a four-month ban by the General Medical Council in October for his private work in Nuneaton and Coventry.
The conduct hearing heard how he put patients at “significant risk” when he carried out 260 operations privately without medical indemnity insurance over five years at the former Nuneaton Private Hospital from 2007 - 2008 and afterwards at BMI The Meriden Hospital in Walsgrave until 2012.
It meant he would not be covered financially if a private patient made a successful claim against him.
The matter came to light when Marianne, 43, made a successful claim for clinical negligence against Dr Okojie for failing to diagnose a significant gynaecological condition.
He advised her to undergo a complete hysterectomy but she then had to have an emergency procedure and tests found she was suffering from an enlarged kidney caused by a mistake made during the hysterectomy.
Two years after her hysterectomy at BMI Meriden in December 2010, Dr Okojie eventually agreed to pay an undisclosed five-figure sum in damages, which he is paying in instalments.
When he admitted to not having insurance, the matter was raised with BMI Healthcare who immediately suspended his practising privileges there.
Marianne, who is suffering with recurring infections, says she is still counting the cost of the operation she describes as her “nightmare before Christmas 2010”.
The single mum of three sons, aged 11, eight and six, was made redundant from a well-paid payroll support job last year which she puts down to having numerous weeks off sick.
“I put my trust in him, and believed that he knew what he was doing,” she said.
“Luckily I am getting better each year, it could have been much worse.”
Marianne Hind, of Bedworth, was one of scores of woman put at risk when they were operated on by gynaecologist Dr Ihimire Paul Okojie.
As the Telegraph previously reported, the specialist in gynaecology and obstetrics at George Eliot Hospital, Nuneaton, was served with a four-month ban by the General Medical Council in October for his private work in Nuneaton and Coventry.
The conduct hearing heard how he put patients at “significant risk” when he carried out 260 operations privately without medical indemnity insurance over five years at the former Nuneaton Private Hospital from 2007 - 2008 and afterwards at BMI The Meriden Hospital in Walsgrave until 2012.
It meant he would not be covered financially if a private patient made a successful claim against him.
The matter came to light when Marianne, 43, made a successful claim for clinical negligence against Dr Okojie for failing to diagnose a significant gynaecological condition.
He advised her to undergo a complete hysterectomy but she then had to have an emergency procedure and tests found she was suffering from an enlarged kidney caused by a mistake made during the hysterectomy.
Two years after her hysterectomy at BMI Meriden in December 2010, Dr Okojie eventually agreed to pay an undisclosed five-figure sum in damages, which he is paying in instalments.
When he admitted to not having insurance, the matter was raised with BMI Healthcare who immediately suspended his practising privileges there.
Marianne, who is suffering with recurring infections, says she is still counting the cost of the operation she describes as her “nightmare before Christmas 2010”.
The single mum of three sons, aged 11, eight and six, was made redundant from a well-paid payroll support job last year which she puts down to having numerous weeks off sick.
“I put my trust in him, and believed that he knew what he was doing,” she said.
“Luckily I am getting better each year, it could have been much worse.”
This article is courtesy from Coventry Telegraph.
Wednesday, 11 December 2013
Bournemouth hospital doctors 'signed death warrant'
Doctors at a Dorset hospital signed a "do not resuscitate" order on a patient without informing her or her family.
June Brook, 79, had been admitted to Royal Bournemouth Hospital with sickness and diarrhoea but during her stay the order was issued to allow her to die if she needed resuscitating.
The order, which states the family were "not available", was found in Mrs Brook's bag after she was discharged.
The hospital has apologised and promised an investigation.
The order, which stays on a patient's records, was signed by two doctors and dated 10 October 2013. It states CPR would be inappropriate because Mrs Brook has dementia.'Legalised euthanasia'
Mrs Brook's son, Kevin, said: "It would basically have meant that they would have not resuscitated her and she would now no longer be with us.
"To me it looks like a death warrant.
"It's like legalised euthanasia. I'm gobsmacked - I don't know why they have written it."
A hospital spokesman said: "When a clinical decision needs to be made that CPR should not be attempted, and the patient is not able to do this, relatives must be consulted. They may be able to help by indicating what the patient would decide, if able to do so.
"On this occasion this discussion did not happen, for which we sincerely apologise. The reasons why this did not happen and why proper processes for communicating with next of kin were not followed are being investigated.
"We have not received any communication from the patient's family and we will therefore be contacting them to clearly understand their concerns and help us carry out a thorough investigation and learn from this. Further education for staff on this part of the patient pathway would form part of this improvement."
June Brook, 79, had been admitted to Royal Bournemouth Hospital with sickness and diarrhoea but during her stay the order was issued to allow her to die if she needed resuscitating.
The order, which states the family were "not available", was found in Mrs Brook's bag after she was discharged.
The hospital has apologised and promised an investigation.
The order, which stays on a patient's records, was signed by two doctors and dated 10 October 2013. It states CPR would be inappropriate because Mrs Brook has dementia.'Legalised euthanasia'
Mrs Brook's son, Kevin, said: "It would basically have meant that they would have not resuscitated her and she would now no longer be with us.
"To me it looks like a death warrant.
"It's like legalised euthanasia. I'm gobsmacked - I don't know why they have written it."
A hospital spokesman said: "When a clinical decision needs to be made that CPR should not be attempted, and the patient is not able to do this, relatives must be consulted. They may be able to help by indicating what the patient would decide, if able to do so.
"On this occasion this discussion did not happen, for which we sincerely apologise. The reasons why this did not happen and why proper processes for communicating with next of kin were not followed are being investigated.
"We have not received any communication from the patient's family and we will therefore be contacting them to clearly understand their concerns and help us carry out a thorough investigation and learn from this. Further education for staff on this part of the patient pathway would form part of this improvement."
This article is courtesy from the BBC.
Monday, 9 December 2013
Surgeon convicted of patient manslaughter through negligence
Surgeon David Sellu, who has been found guilty of manslaughter through gross negligence.
A consultant surgeon has been convicted of the manslaughter of a patient at a private London hospital and sentenced to two and a half years in prison.
David Sellu, 66, was found guilty of manslaughter through gross negligence over the death of James Hughes, who died three days after developing a life-threatening condition while undergoing treatment in 2010.
Hughes, 67, died at the Clementine Churchill Hospital in Harrow, north-west London, following knee replacement surgery. The operation went smoothly but while recovering from surgery he developed abdominal pain and was transferred to Sellu's care.
Sellu suspected there had been a rupture in the patient's bowel – a potentially life-threatening condition that requires surgery – but the surgeon ignored the urgency that the case demanded and the patient later died.
The judge at the Old Bailey, Mr Justice Nicol, said that Sellu had failed to give instructions to prescribe antibiotics and should have carried out and examined abdominal scans of Hughes far earlier.
In his sentencing remarks, the judge said: "Even if you had acted more speedily, there was a chance that Mr Hughes would have died anyway. There is always such a risk with major abdominal surgery of the kind he needed.
"But the chance would have been very, very much smaller if you had acted as a reasonable surgeon would have done on the Thursday night.
"The risks would have increased if the operation had not taken place until Friday morning and would have got progressively larger as the day went on, but at each stage the chances of his survival would still have been better than when he finally did get to the operating theatre late in the evening of Friday 12 February."
He added: "It was you who was responsible for determining his treatment. It is your several failures in that regard which amounted to gross negligence. I am afraid that it means your culpability is high. And that negligence contributed significantly to the death of Mr Hughes."
Elizabeth Joslin, a specialist lawyer for the Crown Prosecution Service, said: "James Joseph Hughes was in hospital for knee surgery when he by chance suffered a perforated bowel. David Sellu's care fell far below the expected standard, with terrible consequences.
"Prosecution of doctors for gross negligence manslaughter is rare and the threshold for criminal prosecution is high, but this doctor's actions were not mistakes or errors of judgment, but negligence so serious that he has now been convicted of a criminal offence. Our thoughts are with the family of Mr Hughes."
His wife, Ann, described the suffering experienced by the family in a victim impact statement put before the court. It said: "For three years we have struggled to discover and then accept the truth of what happened to Jim. The world does not stand still but for us we have been subjected to a tortuous purgatory that can only be brought to an end by truth and justice.
"Our trust in normal processes, authorities and structures of society was shattered by the inexplicable, callous and deceitful actions of the medical profession entrusted with the most basic responsibility to protect human life."
This article is courtesy from The Guardian.
A consultant surgeon has been convicted of the manslaughter of a patient at a private London hospital and sentenced to two and a half years in prison.
David Sellu, 66, was found guilty of manslaughter through gross negligence over the death of James Hughes, who died three days after developing a life-threatening condition while undergoing treatment in 2010.
Hughes, 67, died at the Clementine Churchill Hospital in Harrow, north-west London, following knee replacement surgery. The operation went smoothly but while recovering from surgery he developed abdominal pain and was transferred to Sellu's care.
Sellu suspected there had been a rupture in the patient's bowel – a potentially life-threatening condition that requires surgery – but the surgeon ignored the urgency that the case demanded and the patient later died.
The judge at the Old Bailey, Mr Justice Nicol, said that Sellu had failed to give instructions to prescribe antibiotics and should have carried out and examined abdominal scans of Hughes far earlier.
In his sentencing remarks, the judge said: "Even if you had acted more speedily, there was a chance that Mr Hughes would have died anyway. There is always such a risk with major abdominal surgery of the kind he needed.
"But the chance would have been very, very much smaller if you had acted as a reasonable surgeon would have done on the Thursday night.
"The risks would have increased if the operation had not taken place until Friday morning and would have got progressively larger as the day went on, but at each stage the chances of his survival would still have been better than when he finally did get to the operating theatre late in the evening of Friday 12 February."
He added: "It was you who was responsible for determining his treatment. It is your several failures in that regard which amounted to gross negligence. I am afraid that it means your culpability is high. And that negligence contributed significantly to the death of Mr Hughes."
Elizabeth Joslin, a specialist lawyer for the Crown Prosecution Service, said: "James Joseph Hughes was in hospital for knee surgery when he by chance suffered a perforated bowel. David Sellu's care fell far below the expected standard, with terrible consequences.
"Prosecution of doctors for gross negligence manslaughter is rare and the threshold for criminal prosecution is high, but this doctor's actions were not mistakes or errors of judgment, but negligence so serious that he has now been convicted of a criminal offence. Our thoughts are with the family of Mr Hughes."
His wife, Ann, described the suffering experienced by the family in a victim impact statement put before the court. It said: "For three years we have struggled to discover and then accept the truth of what happened to Jim. The world does not stand still but for us we have been subjected to a tortuous purgatory that can only be brought to an end by truth and justice.
"Our trust in normal processes, authorities and structures of society was shattered by the inexplicable, callous and deceitful actions of the medical profession entrusted with the most basic responsibility to protect human life."
This article is courtesy from The Guardian.
Friday, 6 December 2013
Patient bled to death on ward at Queen’s Medical Centre
A patient was “left to bleed to death” on a hospital ward after nurses did not carry out observations on her for 16 hours.
Susan Wilson, 58, of Larkhill Village, Clifton, was recovering on Ward E15 at the Queen’s Medical Centre after having her gallbladder removed last October.
Staff nurse Neil Bailey only realised he had not carried out four-hourly observations on her at the end of his night shift, when Mrs Wilson may well have been dead for several hours.
He told an inquest into her death yesterday he was too busy on his shift to check observations on Mrs Wilson and admitted her requirements were “overlooked”.
“At no point did I make a conscious decision not to attend to Susan,” he said.
He told Deputy Coroner Heidi Connor that he felt “somewhat overwhelmed that night” and at times found it “very difficult” to deliver care in an organised and orderly manner.
“When I handed over my patients (at the end of my shift), I became aware I had entirely overlooked Susan’s needs and requirements and went to check her and it was at that time I discovered her to have no signs of life,” he said.
Mrs Wilson had decided to go ahead with the operation to deal with a painful gallbladder and was aware of the risks because of an existing heart problem.
After the op, she spent time on a high-dependency unit before she was moved to Ward E18, where nursing observations should have been carried out.
The coroner recorded a narrative verdict and deemed the cause of Mrs Wilson’s death was a heart attack caused by bleeding she suffered after the operation.
However, she said there were “too many unknowns” to say whether her death would have been avoided if observations had been carried out.
“To miss or delay one observation is one thing but to have no observations in an entire 12-hour shift and no notes at all is nothing short of shocking,” Said Mrs Connor. “It’s clear he (Mr Bailey) felt overwhelmed and I have some sympathy in that respect. Staff Nurse Bailey failed to provide the medical attention Susan needed.”
The court had heard about staffing in the ward and concerns that Mr Bailey, who had been caring for ten of the 28 patients, had previously raised.
The coroner said staffing was a national crisis and not unique to this geographical area, adding: “It goes without saying this is something the trust needs to prioritise to avoid tragedies like the one we have heard about today.”
After the hearing, Paul Sankey, clinical negligence lawyer with London law firm Slater and Gordon, said: “Susan Wilson’s tragic death was wholly avoidable. She was left to bleed to death on a ward and no one noticed.
“After 16 hours on a ward, none of her four-hourly observations had been done. Had nurses checked her vital signs, they would have realised that she was deteriorating, infused blood and returned her to the high-dependency unit.
“She would not have died. The nursing care she received was inadequate and there were too few staff on the ward.
“The Care Quality Commission has raised concerns about staffing levels at Queen’s Medical Centre and the trust running the hospital need to take note.”
Jenny Leggott, director of nursing and midwifery for Nottingham University Hospitals Trust, said: “We extend our condolences and reiterate our apology to the family for failing our basic duties of care and letting Mrs Wilson and them down so badly.
“The absence of regular clinical observations and checks on Mrs Wilson overnight when she passed away meant her deteriorating condition regrettably went unnoticed.
“We have learnt from this tragic case and made changes to improve safety and outcomes for our future patients.
“We are closely monitoring the implementation of all of the recommendations at the highest level.”
Ms Leggott said the trust had implemented a series of improvements, including better communication and a training programme for junior doctors and nurses to help them recognise the deterioration of patients and alert senior colleagues.
This article is courtesy from The Nottingham Post.
Susan Wilson, 58, of Larkhill Village, Clifton, was recovering on Ward E15 at the Queen’s Medical Centre after having her gallbladder removed last October.
Staff nurse Neil Bailey only realised he had not carried out four-hourly observations on her at the end of his night shift, when Mrs Wilson may well have been dead for several hours.
He told an inquest into her death yesterday he was too busy on his shift to check observations on Mrs Wilson and admitted her requirements were “overlooked”.
“At no point did I make a conscious decision not to attend to Susan,” he said.
He told Deputy Coroner Heidi Connor that he felt “somewhat overwhelmed that night” and at times found it “very difficult” to deliver care in an organised and orderly manner.
“When I handed over my patients (at the end of my shift), I became aware I had entirely overlooked Susan’s needs and requirements and went to check her and it was at that time I discovered her to have no signs of life,” he said.
Mrs Wilson had decided to go ahead with the operation to deal with a painful gallbladder and was aware of the risks because of an existing heart problem.
After the op, she spent time on a high-dependency unit before she was moved to Ward E18, where nursing observations should have been carried out.
The coroner recorded a narrative verdict and deemed the cause of Mrs Wilson’s death was a heart attack caused by bleeding she suffered after the operation.
However, she said there were “too many unknowns” to say whether her death would have been avoided if observations had been carried out.
“To miss or delay one observation is one thing but to have no observations in an entire 12-hour shift and no notes at all is nothing short of shocking,” Said Mrs Connor. “It’s clear he (Mr Bailey) felt overwhelmed and I have some sympathy in that respect. Staff Nurse Bailey failed to provide the medical attention Susan needed.”
The court had heard about staffing in the ward and concerns that Mr Bailey, who had been caring for ten of the 28 patients, had previously raised.
The coroner said staffing was a national crisis and not unique to this geographical area, adding: “It goes without saying this is something the trust needs to prioritise to avoid tragedies like the one we have heard about today.”
After the hearing, Paul Sankey, clinical negligence lawyer with London law firm Slater and Gordon, said: “Susan Wilson’s tragic death was wholly avoidable. She was left to bleed to death on a ward and no one noticed.
“After 16 hours on a ward, none of her four-hourly observations had been done. Had nurses checked her vital signs, they would have realised that she was deteriorating, infused blood and returned her to the high-dependency unit.
“She would not have died. The nursing care she received was inadequate and there were too few staff on the ward.
“The Care Quality Commission has raised concerns about staffing levels at Queen’s Medical Centre and the trust running the hospital need to take note.”
Jenny Leggott, director of nursing and midwifery for Nottingham University Hospitals Trust, said: “We extend our condolences and reiterate our apology to the family for failing our basic duties of care and letting Mrs Wilson and them down so badly.
“The absence of regular clinical observations and checks on Mrs Wilson overnight when she passed away meant her deteriorating condition regrettably went unnoticed.
“We have learnt from this tragic case and made changes to improve safety and outcomes for our future patients.
“We are closely monitoring the implementation of all of the recommendations at the highest level.”
Ms Leggott said the trust had implemented a series of improvements, including better communication and a training programme for junior doctors and nurses to help them recognise the deterioration of patients and alert senior colleagues.
This article is courtesy from The Nottingham Post.
Wednesday, 4 December 2013
Negligence cases cost health service £50.4m last year
Cases of clinical and social negligence have risen by 5%, costing the Department of Health £50m in one year, new figures have revealed.
A legal bill totalling £50.4m has been paid on the 3,315 cases across Northern Ireland during 2012/13.
The figures released by the Department of Health also revealed almost a fifth – 565 – of cases had been treated in the Accident and Emergency departments.
This was a 4.8% rise since 2010/11.
It also reported £18.7m was paid out for cases involving obstetrics – the care of pregnant women – with £15.1m paid on damages to patients.
Overall, £37.2m was awarded in damages and £13.2m paid out in legal costs.
As of March 31 this year, 579 new cases were opened, 529 cases were closed and 150 cases were settled.
Over a quarter (955) of cases were referred to treatment.
A spokesman for the department said there are a variety of reasons why there has been a rise in negligence cases.
This includes people being more willing to challenge the system and healthcare professionals when services are below standard.
And having a better system of reporting problems.
Health Minister Edwin Poots said he had "every confidence" in the staff delivering health and social care services to the people of Northern Ireland.
He said his main priority is the quality and safety of health and social care services.
"In cases where things go wrong, our primary responsibilities are to provide support and assistance to the people affected and their families and to ensure that lessons are learned," he said.
"It is only right and proper that those who are affected should be compensated."
Mr Poots said attendances at hospital each year include 1.5 million outpatient attendances, over 700,000 treatments at A&E and around 500,000 in-patient cases.
"The overwhelming experience of people using our health and social care services is positive."
The minister added: "I have every confidence in the staff delivering health and social care services to the people of Northern Ireland.
"They are a caring, well- trained, highly motivated and regulated group of staff seeking to provide the best possible level of care to patients and clients and, overwhelmingly, they are successful in doing so."
The figures come after it emerged Northern Ireland's health service spent more than £146m on legal costs and compensation over the last four years.
Belfast Health and Social Care Trust spent the most on legal proceedings, paying out around £5m each year since 2010/11.
Earlier this month, Traditional Unionist Voice leader Jim Allister raised the issue of health service negligence payouts in the Assembly.
"Of course, anyone with a legitimate claim against a trust must be compensated, but why is the trend so much upwards?
"Is there increasing negligence? And why are legal fees almost as high as the payouts?" he said.
This article is courtesy from Belfast Telegraph.
A legal bill totalling £50.4m has been paid on the 3,315 cases across Northern Ireland during 2012/13.
The figures released by the Department of Health also revealed almost a fifth – 565 – of cases had been treated in the Accident and Emergency departments.
This was a 4.8% rise since 2010/11.
It also reported £18.7m was paid out for cases involving obstetrics – the care of pregnant women – with £15.1m paid on damages to patients.
Overall, £37.2m was awarded in damages and £13.2m paid out in legal costs.
As of March 31 this year, 579 new cases were opened, 529 cases were closed and 150 cases were settled.
Over a quarter (955) of cases were referred to treatment.
A spokesman for the department said there are a variety of reasons why there has been a rise in negligence cases.
This includes people being more willing to challenge the system and healthcare professionals when services are below standard.
And having a better system of reporting problems.
Health Minister Edwin Poots said he had "every confidence" in the staff delivering health and social care services to the people of Northern Ireland.
He said his main priority is the quality and safety of health and social care services.
"In cases where things go wrong, our primary responsibilities are to provide support and assistance to the people affected and their families and to ensure that lessons are learned," he said.
"It is only right and proper that those who are affected should be compensated."
Mr Poots said attendances at hospital each year include 1.5 million outpatient attendances, over 700,000 treatments at A&E and around 500,000 in-patient cases.
"The overwhelming experience of people using our health and social care services is positive."
The minister added: "I have every confidence in the staff delivering health and social care services to the people of Northern Ireland.
"They are a caring, well- trained, highly motivated and regulated group of staff seeking to provide the best possible level of care to patients and clients and, overwhelmingly, they are successful in doing so."
The figures come after it emerged Northern Ireland's health service spent more than £146m on legal costs and compensation over the last four years.
Belfast Health and Social Care Trust spent the most on legal proceedings, paying out around £5m each year since 2010/11.
Earlier this month, Traditional Unionist Voice leader Jim Allister raised the issue of health service negligence payouts in the Assembly.
"Of course, anyone with a legitimate claim against a trust must be compensated, but why is the trend so much upwards?
"Is there increasing negligence? And why are legal fees almost as high as the payouts?" he said.
This article is courtesy from Belfast Telegraph.
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