A woman is in a serious medical condition after she was allegedly put on tuberculosis treatment, yet she was suffering from a different ailment altogether. The medical boob follows a recent one in
which another woman died following two major operations conducted by a local gynaecologist.
Vimbai Ndongwe (25) is now battling for life at Mutare Provincial Hospital where she is due to undergo operation for a complicated stomach ailment that is making her excrete bucket loads of puss daily.
Her husband, Mandlankosi Mguni, is bitter saying his wife's condition deteriorated at the beginning of the year after she was wrongly put on tuberculosis treatment for two months by a medical doctor (name withheld) at a mission hospital in Mutare.
He said what started as a simple headache has turned into a litany of ailments because his wife reacted to the wrongly prescribed TB treatment. The situation has also dug deep into his pockets having used more than $4 000 in medical bills since January.
"I need another $1 000 for the operation," he said.
When contacted for comment, the doctor said he was not in a position to say anything over the phone.
"We see a lot of patients on a daily basis and anyone with complaints must come in person so that we sit, look at the medical notes and find out their problem. I am in the dark and it will be helpful if those with queries visit the hospital. I will attend to them," he said.
Mguni's bone of contention is that had his wife been given the right prescription in the first place she would not be in the dire state she was today.
"I confronted the doctor over the issue after my wife had been referred to another hospital because her condition was deteriorating. Doctors at the new hospital diagnosed and found out that my wife who had been put on TB treatment was not suffering from that disease after all.
"After this, I went back to the doctor and confronted him over the issue. He apologised and said he thought that my wife had TB. I wanted to wage a war against him then, but my relatives dissuaded me saying I should make sure that my wife recovers first," he said.
Mguni said he smelt a rat after his wife's medical treatment card vanished from her hospital bed.
"This was a cover up because that card had all the information concerning the TB treatment. Hospital staff tried to locate it, but they found nothing and I knew that someone was trying to cover his tracks. Right now my wife is in pain and bed-ridden and what that doctor only did was to say I am sorry.
“That will not help me. At least he must show remorse by visiting his patient but, as it stands, his misdeeds are now my problems. It's not fair," he said.
Mguni said his wife now has swollen feet, backache and she excretes puss daily.
"She is due to undergo an operation which doctors say would stop the puss. She is also undergoing blood transfusion because her blood levels are too low. I had to sell some of my property to meet these costs which could have been avoided in the first place.
“What eats me is that I paid a lot of money to this doctor to treat my wife but he messed up. My money is gone and my wife is in a serious condition. Can't you see I am being hit from all angles," he said.
Manicaland medical director Dr Tawanda Murambi said patients with queries must visit his offices and lodge them.
"I think most of these cases are happening because of poor communication between the doctors and the patients. Medical issues are complicated and there cannot be one answer to a complication. Maybe that patient is right or maybe the doctor is right.
“It is also possible that the second doctor who told the patient that she was on wrong TB medicine failed to properly diagnose the root of the chronic headache. Maybe that patient had TB as diagnosed by the first doctor and this might explain why she is still ill because she might be on wrong treatment after all.
“So this is a complex issue that requires constant communication between the doctors and patients or their relatives. When doctors don't give patients information this leads to speculation," he said.
This article is courtesy of the Manica Post.
Regularly updated blog featuring news, articles and information relating to clinical/medical negligence.
Saturday, 27 April 2013
Tuesday, 23 April 2013
Doctor dismissed fear over infected baby
When nine-month-old Venice Kowalczyk was admitted to the Royal Children's Hospital, there were significant warning signs to indicate she had a serious bacterial infection, a court has heard.
Infectious diseases expert Associate Professor Peter Stanley told the Supreme Court that Venice should have been immediately admitted to the hospital for observation on July 23, 2004, and blood tests carried out, but instead she was given painkillers and sent home.
Venice's father, Danny, had earlier asked hospital registrar Dr Tanya Moyle to test his daughter for meningococcal disease, but Dr Moyle replied, "I don't think it's that serious", the court has heard.
Mr Kowalczyk and his wife, Nadia, later rushed their seriously ill daughter back to the hospital, where she was diagnosed with the deadly meningococcal septicaemia.
Venice spent five days in the intensive care unit as doctors fought to save her life and later had to have her feet, left hand and the tips of three fingers on her right hand amputated.
The Kowalczyks are suing the hospital for negligence, claiming it failed to treat her promptly and effectively when she was first admitted.
Dr Stanley told the jury in the civil damages trial on Tuesday that he was critical of Dr Moyle's clinical notes for when Venice was first admitted, saying the notes had "major deficiencies".
Dr Moyle had noted that Venice was "miserable" at 5.35am but "much better" at 7am after she had been given painkillers.
Dr Stanley said there was no real information in the registrar's notes on the child's appearance or behaviour.
He said in his opinion Venice fitted the "child looks unwell" category because she had an elevated heart rate and a high temperature, and was moaning and refusing to take fluids.
It was important for doctors to listen to parents' concerns about their children and not dismiss them too easily, he said.
A blood test was never taken and Venice's parents were told to go home and give their child another dose of painkillers after four hours if she had not settled.
They took Venice back to the hospital about 4pm after she had had diarrhoea, her temperature had risen to 39.8 and Mrs Kowalczyk had noticed a small rash on her baby's right hand and stomach.
A trained nurse, Mrs Kowalczyk was aware of the symptoms of meningococcal disease and remembered watching something about it on television.
The Kowalczyks were with Venice in a cubicle waiting for a doctor when she started gasping for air, threw her arms back and stopped breathing.
When cross-examining Mrs Kowalczyk on Monday, barrister Jeremy Ruskin, QC, representing the hospital, said Dr Moyle would give evidence that she thought Venice had the early signs of a viral infection but it had yet to show itself.
Dr Moyle would claim she told Mrs Kowalczyk if she had any concerns about Venice's condition to come straight back to the hospital.
The Kowalczyks barrister, David Curtain, QC, said the hospital had failed its own medical guidelines by not immediately admitting Venice.
"You will hear that any child with a fever who appears seriously unwell should be investigated and admitted irrespective of fever and this was not done," he said.
Mr Curtain said Venice had been left "grossly disabled".
"In addition to this she has understandable psychological reaction to her condition. She is now nine and a half years old and attending school but has special needs.
"She walks with prosthetic legs and cannot do many of the things her classmates can. In a few years she will reach puberty and then become a teenager. She will see her friends socialise and interact with boys and engage in sport and other active past times and she will be able to do nothing more than look on.
"It does not take much imagination to understand that this will be a grievous loss for her, and that her circle of friends is likely to narrow as they move on from childhood."
Dr Stanley said he believed Venice would have recovered if she had been treated immediately.
An emotional Mr Kowalczyk broke down this afternoon when telling the jury how Dr Moyle had ignored him when he suggested she check Venice for meningococcal disease.
He said Dr Moyle looked over her shoulder and told him Venice’s condition was not that serious.
Hospital staff had also never told the family why blood tests were not carried out on Venice.
Mr Kowalczyk was far from happy when Venice was discharged from hospital.
‘‘I felt like she was quite sick and nothing was really done,’’ he said.
The hospital and doctors had never apologised to the family for what had happened to Venice.
The trial continues.
This article is courtesy of The Age.
Infectious diseases expert Associate Professor Peter Stanley told the Supreme Court that Venice should have been immediately admitted to the hospital for observation on July 23, 2004, and blood tests carried out, but instead she was given painkillers and sent home.
Venice's father, Danny, had earlier asked hospital registrar Dr Tanya Moyle to test his daughter for meningococcal disease, but Dr Moyle replied, "I don't think it's that serious", the court has heard.
Mr Kowalczyk and his wife, Nadia, later rushed their seriously ill daughter back to the hospital, where she was diagnosed with the deadly meningococcal septicaemia.
Venice spent five days in the intensive care unit as doctors fought to save her life and later had to have her feet, left hand and the tips of three fingers on her right hand amputated.
The Kowalczyks are suing the hospital for negligence, claiming it failed to treat her promptly and effectively when she was first admitted.
Dr Stanley told the jury in the civil damages trial on Tuesday that he was critical of Dr Moyle's clinical notes for when Venice was first admitted, saying the notes had "major deficiencies".
Dr Moyle had noted that Venice was "miserable" at 5.35am but "much better" at 7am after she had been given painkillers.
Dr Stanley said there was no real information in the registrar's notes on the child's appearance or behaviour.
He said in his opinion Venice fitted the "child looks unwell" category because she had an elevated heart rate and a high temperature, and was moaning and refusing to take fluids.
It was important for doctors to listen to parents' concerns about their children and not dismiss them too easily, he said.
A blood test was never taken and Venice's parents were told to go home and give their child another dose of painkillers after four hours if she had not settled.
They took Venice back to the hospital about 4pm after she had had diarrhoea, her temperature had risen to 39.8 and Mrs Kowalczyk had noticed a small rash on her baby's right hand and stomach.
A trained nurse, Mrs Kowalczyk was aware of the symptoms of meningococcal disease and remembered watching something about it on television.
The Kowalczyks were with Venice in a cubicle waiting for a doctor when she started gasping for air, threw her arms back and stopped breathing.
When cross-examining Mrs Kowalczyk on Monday, barrister Jeremy Ruskin, QC, representing the hospital, said Dr Moyle would give evidence that she thought Venice had the early signs of a viral infection but it had yet to show itself.
Dr Moyle would claim she told Mrs Kowalczyk if she had any concerns about Venice's condition to come straight back to the hospital.
The Kowalczyks barrister, David Curtain, QC, said the hospital had failed its own medical guidelines by not immediately admitting Venice.
"You will hear that any child with a fever who appears seriously unwell should be investigated and admitted irrespective of fever and this was not done," he said.
Mr Curtain said Venice had been left "grossly disabled".
"In addition to this she has understandable psychological reaction to her condition. She is now nine and a half years old and attending school but has special needs.
"She walks with prosthetic legs and cannot do many of the things her classmates can. In a few years she will reach puberty and then become a teenager. She will see her friends socialise and interact with boys and engage in sport and other active past times and she will be able to do nothing more than look on.
"It does not take much imagination to understand that this will be a grievous loss for her, and that her circle of friends is likely to narrow as they move on from childhood."
Dr Stanley said he believed Venice would have recovered if she had been treated immediately.
An emotional Mr Kowalczyk broke down this afternoon when telling the jury how Dr Moyle had ignored him when he suggested she check Venice for meningococcal disease.
He said Dr Moyle looked over her shoulder and told him Venice’s condition was not that serious.
Hospital staff had also never told the family why blood tests were not carried out on Venice.
Mr Kowalczyk was far from happy when Venice was discharged from hospital.
‘‘I felt like she was quite sick and nothing was really done,’’ he said.
The hospital and doctors had never apologised to the family for what had happened to Venice.
The trial continues.
This article is courtesy of The Age.
Monday, 22 April 2013
Patient safety fears as doctors dodge official watchdog
At least 60 doctors have both kept their jobs and avoided referral to the General Medical Council even though the hospitals they work for have paid compensation to patients for negligence, new figures have disclosed.
And 204 NHS doctors have had at least two complaints made against them alleging clinical negligence, but just eight were referred to the GMC for a full investigation.
However, the number of potentially dangerous doctors may be considerably higher, as only one third of England's 163 trusts provided information.
Last night health groups warned patients may be at risk from doctors who have repeated accusations against them, and are not being referred to the watchdog.
It comes after plans propsed following an inquiry into Harold Shipman, which would have placed a legal obligation on trusts and GP practices to report incidents to the GMC, were quietly abandoned by ministers, according to campaigners.
The figures show that:
* At one hospital - Burton Hospital NHS Foundation Trust - 33 consultants had at least two allegations of negligence made against them in five years from January 2008, with one facing 13 complaints, one 12 and a third ten;
* Sixteen doctors at South Tees Hospital NHS Foundation Trust had allegations of negligence logged against them. Despite compensation being paid in every case, all but two doctors had kept their jobs and just one was referred to the GMC.
* At the Royal National Orthopaedic Hospital two doctors had eight allegations made against them and neither was referred to the GMC
Peter Walsh, chief executive of Action Against Medical Accidents said the regulations drawn up after the Shipman inquiry would offer more protection.
"We think these regulations are vital. The reason they were initially drawn up is because patient groups, professional bodies and the previous government felt they were important for patient safety,” he said.
He said while many cases of clinical negligence didn’t indicate a doctor posed an immediate danger, there was a chance, particularly where there had been multiple allegations of negligence, that dangerous practise was not being detected.
He added: “Ultimately we are talking about a small number of cases where there are potentially dangerous health professionals, and introducing regulations to stop them from falling through the net.”
The NHS has recently had to set aside one seventh of its annual budget, £17.5bn, to pay compensation to thousands of people making clinical negligence claims.
Mr Walsh said this also raised serious concerns about GPs, as surgeries are not legally required to report allegations of clinical negligence to the GMC. He added: “There is a risk of a dangerous doctor or other health professional slipping through the net because employers haven’t collected and shared information about incidents.”
A spokesperson for the GMC said hospitals have a legal duty to refer concerns about a doctor to the watchdog, but this decision is not based on a threshold but on the allegations themselves.
The Patients Association said the lack of referrals was a concern, particularly following the Francis Enquiry into the Mid Staffordshire disaster, which found mistakes at an ailing hospital were being ignored, and 1,200 patients died needlessly. A spokesman said: “The Francis Enquiry makes it clear that the NHS has a duty of candour towards its users. It has an equal duty to ensure that regulators are made aware of any potential issues relating to the fitness of doctors to practise. If these issues are kept quiet patients could be put at risk."
The FOI request issued by BBC Radio 5 Live Investigates asked NHS trusts for the number of doctors who had two or more allegations of clinical negligence against them in the last five years, and how many had resulted in compensation payouts and information being passed to the GMC. It also asked if the doctors were still employed.
At South Tees Hospital 16 doctors had three or more allegations logged and compensation was paid out in all cases, with just one referral to the GMC. Professor Rob Wilson, medical director and deputy chief executive for the trust, said: "Before a doctor is referred to the GMC a number of issues need to be considered including past appraisals, whether there have been any previous issues/complaints and whether the allegations have been proven.”
While Burton Hospital, which said 33 consultants had more than two allegations against them, said all accusations are investigated fully, with the medical director alerted if serious concerns are raised.
Patient Surinder Venables is an example of how a lack of reporting can put patient safety at risk. The 49-year old was admitted to Basildon Hospital in 2008 for a minor operation to remove three cysts. Dr Nikolas Papnikolau performed the operation and perforated her uterus when he tried to remove what he thought was abnormal tissue. As a result she had to have further operations and later died.
The doctor was struck off the medical register by the GMC this month after allegations relating to seven cases, five which related to patients admitted six months before Ms Venables, were proven. In one case the hospital said it carried out a full investigation, but it still did not refer the doctor to the GMC.
Basildon and Thurrock University Hospitals NHS trust said when concerns were raised about his practice he was placed on supervision and they told his new employer, Ashford & St Peter's Hospitals NHS Trust, about the concerns around some aspects of his clinical work. He later went on to work at Basingstoke and North Hampshire Hospital where he was found by the GMC to have made six further areas in relation to one patient in January 2011.
This article is courtesy of The Telegraph.
And 204 NHS doctors have had at least two complaints made against them alleging clinical negligence, but just eight were referred to the GMC for a full investigation.
However, the number of potentially dangerous doctors may be considerably higher, as only one third of England's 163 trusts provided information.
Last night health groups warned patients may be at risk from doctors who have repeated accusations against them, and are not being referred to the watchdog.
It comes after plans propsed following an inquiry into Harold Shipman, which would have placed a legal obligation on trusts and GP practices to report incidents to the GMC, were quietly abandoned by ministers, according to campaigners.
The figures show that:
* At one hospital - Burton Hospital NHS Foundation Trust - 33 consultants had at least two allegations of negligence made against them in five years from January 2008, with one facing 13 complaints, one 12 and a third ten;
* Sixteen doctors at South Tees Hospital NHS Foundation Trust had allegations of negligence logged against them. Despite compensation being paid in every case, all but two doctors had kept their jobs and just one was referred to the GMC.
* At the Royal National Orthopaedic Hospital two doctors had eight allegations made against them and neither was referred to the GMC
Peter Walsh, chief executive of Action Against Medical Accidents said the regulations drawn up after the Shipman inquiry would offer more protection.
"We think these regulations are vital. The reason they were initially drawn up is because patient groups, professional bodies and the previous government felt they were important for patient safety,” he said.
He said while many cases of clinical negligence didn’t indicate a doctor posed an immediate danger, there was a chance, particularly where there had been multiple allegations of negligence, that dangerous practise was not being detected.
He added: “Ultimately we are talking about a small number of cases where there are potentially dangerous health professionals, and introducing regulations to stop them from falling through the net.”
The NHS has recently had to set aside one seventh of its annual budget, £17.5bn, to pay compensation to thousands of people making clinical negligence claims.
Mr Walsh said this also raised serious concerns about GPs, as surgeries are not legally required to report allegations of clinical negligence to the GMC. He added: “There is a risk of a dangerous doctor or other health professional slipping through the net because employers haven’t collected and shared information about incidents.”
A spokesperson for the GMC said hospitals have a legal duty to refer concerns about a doctor to the watchdog, but this decision is not based on a threshold but on the allegations themselves.
The Patients Association said the lack of referrals was a concern, particularly following the Francis Enquiry into the Mid Staffordshire disaster, which found mistakes at an ailing hospital were being ignored, and 1,200 patients died needlessly. A spokesman said: “The Francis Enquiry makes it clear that the NHS has a duty of candour towards its users. It has an equal duty to ensure that regulators are made aware of any potential issues relating to the fitness of doctors to practise. If these issues are kept quiet patients could be put at risk."
The FOI request issued by BBC Radio 5 Live Investigates asked NHS trusts for the number of doctors who had two or more allegations of clinical negligence against them in the last five years, and how many had resulted in compensation payouts and information being passed to the GMC. It also asked if the doctors were still employed.
At South Tees Hospital 16 doctors had three or more allegations logged and compensation was paid out in all cases, with just one referral to the GMC. Professor Rob Wilson, medical director and deputy chief executive for the trust, said: "Before a doctor is referred to the GMC a number of issues need to be considered including past appraisals, whether there have been any previous issues/complaints and whether the allegations have been proven.”
While Burton Hospital, which said 33 consultants had more than two allegations against them, said all accusations are investigated fully, with the medical director alerted if serious concerns are raised.
Patient Surinder Venables is an example of how a lack of reporting can put patient safety at risk. The 49-year old was admitted to Basildon Hospital in 2008 for a minor operation to remove three cysts. Dr Nikolas Papnikolau performed the operation and perforated her uterus when he tried to remove what he thought was abnormal tissue. As a result she had to have further operations and later died.
The doctor was struck off the medical register by the GMC this month after allegations relating to seven cases, five which related to patients admitted six months before Ms Venables, were proven. In one case the hospital said it carried out a full investigation, but it still did not refer the doctor to the GMC.
Basildon and Thurrock University Hospitals NHS trust said when concerns were raised about his practice he was placed on supervision and they told his new employer, Ashford & St Peter's Hospitals NHS Trust, about the concerns around some aspects of his clinical work. He later went on to work at Basingstoke and North Hampshire Hospital where he was found by the GMC to have made six further areas in relation to one patient in January 2011.
This article is courtesy of The Telegraph.
Sunday, 21 April 2013
Patient wins £7k settlement for Gossops Green dentist's negligence
A patient has been awarded £7,000 in an out-of-court settlement against her dentist, with her case of misaligned teeth called the "most severe" ever seen by a specialist.
Heather Turner sued Dr William Clinton, from The Dental Surgery on Gossops Drive, Gossops Green, after he failed to refer her for corrective orthodontic treatment and to address her gum disease.
Ms Turner, from Ifield, said: "I had an accident as a child and this pushed my teeth back into my mouth. At the time I was told my teeth needed time to settle as I was only young, but as I got older and into my teens I wanted something done as I became more embarrassed about my teeth.
"I was advised by Dr Clinton that this wasn't an option. He said I was not entitled to NHS care as I was over 18.
"I had no reason to query this information and did not think there was any danger to my health as my regular six-month check-ups carried on as normal."
However, Ms Turner, 48, started to experience severe bleeding of the gum, especially when she ate.
"It was horrible," she added.
"My gums would bleed so severely, that when I ate a sandwich it would be covered in blood. It was even worse when I went for my check-ups and Mr Clinton would floss and clean my teeth.
"I would have to be wiped down as there was so much blood on my face."
She was only seen by a specialist after she was referred by her GP when, out of the blue, her jaw went into severe spasm – and he immediately realised something was drastically wrong.
Ms Turner said: "He told me this was the most severe case of misaligned teeth he had ever seen. My top teeth were actually digging into my lower gums, causing the bleeding.
"He also indicated that due to the severity of the condition I would have been entitled to NHS care regardless of my age."
Ms Turner was immediately booked in to have her wisdom teeth removed and it took five years to put everything right.
After the initial tooth extraction and bone graft, Ms Turner underwent an intensive course of gum disease treatment to make sure she did not suffer any tooth or bone loss.
She then had to wear braces for two years before undergoing surgery which moved her jaw by eight millimetres to align her teeth, and then had a further year of wearing braces.
Jonathan Owen, Heather's lawyer from the Dental Law Partnership, said: "The delay in referring Heather for specialist treatment has not only resulted in a substantial expense, but a prolonged period of discomfort and misery which was completely avoidable.
"If she had been referred when needed it could have been a simple process to correct her issues."
Dr Clinton did not admit any liability.
In a statement, he said: "I am pleased this case has now been resolved and a settlement has been reached.
"I hope this will go some way towards compensating for the pain and distress the patient has experienced.
"I have always striven to provide the best care for my patients and I am sorry that this has happened."
Last September the News reported on a separate out-of-court settlement for a former patient of Dr Clinton.
Mike Watts, from Maidenbower, was awarded £17,500 due to the extensive tooth decay he had suffered.
This article is courtesy of This is Sussex.
Heather Turner sued Dr William Clinton, from The Dental Surgery on Gossops Drive, Gossops Green, after he failed to refer her for corrective orthodontic treatment and to address her gum disease.
Ms Turner, from Ifield, said: "I had an accident as a child and this pushed my teeth back into my mouth. At the time I was told my teeth needed time to settle as I was only young, but as I got older and into my teens I wanted something done as I became more embarrassed about my teeth.
"I was advised by Dr Clinton that this wasn't an option. He said I was not entitled to NHS care as I was over 18.
"I had no reason to query this information and did not think there was any danger to my health as my regular six-month check-ups carried on as normal."
However, Ms Turner, 48, started to experience severe bleeding of the gum, especially when she ate.
"It was horrible," she added.
"My gums would bleed so severely, that when I ate a sandwich it would be covered in blood. It was even worse when I went for my check-ups and Mr Clinton would floss and clean my teeth.
"I would have to be wiped down as there was so much blood on my face."
She was only seen by a specialist after she was referred by her GP when, out of the blue, her jaw went into severe spasm – and he immediately realised something was drastically wrong.
Ms Turner said: "He told me this was the most severe case of misaligned teeth he had ever seen. My top teeth were actually digging into my lower gums, causing the bleeding.
"He also indicated that due to the severity of the condition I would have been entitled to NHS care regardless of my age."
Ms Turner was immediately booked in to have her wisdom teeth removed and it took five years to put everything right.
After the initial tooth extraction and bone graft, Ms Turner underwent an intensive course of gum disease treatment to make sure she did not suffer any tooth or bone loss.
She then had to wear braces for two years before undergoing surgery which moved her jaw by eight millimetres to align her teeth, and then had a further year of wearing braces.
Jonathan Owen, Heather's lawyer from the Dental Law Partnership, said: "The delay in referring Heather for specialist treatment has not only resulted in a substantial expense, but a prolonged period of discomfort and misery which was completely avoidable.
"If she had been referred when needed it could have been a simple process to correct her issues."
Dr Clinton did not admit any liability.
In a statement, he said: "I am pleased this case has now been resolved and a settlement has been reached.
"I hope this will go some way towards compensating for the pain and distress the patient has experienced.
"I have always striven to provide the best care for my patients and I am sorry that this has happened."
Last September the News reported on a separate out-of-court settlement for a former patient of Dr Clinton.
Mike Watts, from Maidenbower, was awarded £17,500 due to the extensive tooth decay he had suffered.
This article is courtesy of This is Sussex.
Saturday, 20 April 2013
Teen dies ten days after tonsillitis misdiagnosis
A teenage English girl died of a rare form of leukaemia 10 days after doctors sent her home from hospital saying she had tonsillitis and fatigue.
Birmingham 17-year-old Sophie Coldwell went to a walk-in medical centre on March 7 this year after feeling tired for a long time, the Daily Mail reports.
She was diagnosed with fatigue, swollen gums and tonsillitis by a doctor who failed to recognise she was instead suffering from acute monoblastic myeloid leukaemia, a rare cancer.
Nine days later her breathing became shallow and raspy, prompting her parents to call an ambulance.
Sophie lost consciousness on the way to hospital and died early the next morning.
Her father Andy said they initially put her weariness down to additional schoolwork she had taken on in her first year at college.
"As a father, I question everything I did and whether any more could have been done," he said.
"The fact it took everybody by surprise doesn't mean you still don't do that as parents."
Her parents told the Birmingham Mail they were happy their daughter got to experience love, after beginning a relationship with boyfriend Matt Robinson.
"You've gone from a girl I added on Facebook to being my life, my heart, my soul, my world, my rock, my shoulder, my everything," Matt wrote to her in a text message after finding out she was unwell.
"Everything about you is stunning, from your smile to your eyes, from your hair to your half-painted nails, from your freckles on top of your shoulders to the freckles on your forehead — my perfection."
Author: Nick Pearson. Approving editor: Matthew Henry.
This article is courtesy of nine news.
Birmingham 17-year-old Sophie Coldwell went to a walk-in medical centre on March 7 this year after feeling tired for a long time, the Daily Mail reports.
She was diagnosed with fatigue, swollen gums and tonsillitis by a doctor who failed to recognise she was instead suffering from acute monoblastic myeloid leukaemia, a rare cancer.
Nine days later her breathing became shallow and raspy, prompting her parents to call an ambulance.
Sophie lost consciousness on the way to hospital and died early the next morning.
Her father Andy said they initially put her weariness down to additional schoolwork she had taken on in her first year at college.
"As a father, I question everything I did and whether any more could have been done," he said.
"The fact it took everybody by surprise doesn't mean you still don't do that as parents."
Her parents told the Birmingham Mail they were happy their daughter got to experience love, after beginning a relationship with boyfriend Matt Robinson.
"You've gone from a girl I added on Facebook to being my life, my heart, my soul, my world, my rock, my shoulder, my everything," Matt wrote to her in a text message after finding out she was unwell.
"Everything about you is stunning, from your smile to your eyes, from your hair to your half-painted nails, from your freckles on top of your shoulders to the freckles on your forehead — my perfection."
Author: Nick Pearson. Approving editor: Matthew Henry.
This article is courtesy of nine news.
Friday, 19 April 2013
Woman claims breast cancer diagnosis missed
A St. Clair County couple is suing a Swansea doctor and medical imaging company for allegedly misdiagnosing a patient’s breast cancer.
Julia and Eric Lewis filed a lawsuit March 4 in St. Clair County Circuit Court against Dr. Thomas Schroyer and Belleville Imaging Inc.
Dr. Schroyer worked at Belleville Imaging in August 2011 when, according to the complaint, Julia Lewis underwent a sonogram on her right breast. Lewis claims Dr. Schroyer and Belleville Imaging failed to properly interpret the sonogram images, missing the cancer that was present in her breast at the time of the exam.
Because of the alleged misdiagnoses, Lewis says she is now battling a more aggressive form of cancer.
The Lewises accuse Dr. Schroyer and the medical imaging company of negligence and ask for more than $300,000 in damages for medical expenses, loss of income and consortium in addition to court fees.
They are represented by attorney Thomas Q. Keefe Jr. of Belleville.
St. Clair County Circuit Court Case No. 13-L-119
This article is courtesy of The Madison-St. Clair Record.
Julia and Eric Lewis filed a lawsuit March 4 in St. Clair County Circuit Court against Dr. Thomas Schroyer and Belleville Imaging Inc.
Dr. Schroyer worked at Belleville Imaging in August 2011 when, according to the complaint, Julia Lewis underwent a sonogram on her right breast. Lewis claims Dr. Schroyer and Belleville Imaging failed to properly interpret the sonogram images, missing the cancer that was present in her breast at the time of the exam.
Because of the alleged misdiagnoses, Lewis says she is now battling a more aggressive form of cancer.
The Lewises accuse Dr. Schroyer and the medical imaging company of negligence and ask for more than $300,000 in damages for medical expenses, loss of income and consortium in addition to court fees.
They are represented by attorney Thomas Q. Keefe Jr. of Belleville.
St. Clair County Circuit Court Case No. 13-L-119
This article is courtesy of The Madison-St. Clair Record.
Thursday, 18 April 2013
Severe colon cancer goes undetected
Dr. D was a primary-care clinician with her own practice. One thing that Dr. D had learned over the course of more than three decades in practice was that patients differed greatly in what they wanted from a health-care provider.
One of Dr. D's more unusual patients was Mr. T, age 67 years. At their first appointment, Mr. T told her that he was not looking for a primary-care provider and that he only wanted her to check his BP.
“I know my BP is borderline high, and I want to have it monitored by you. I will come see you twice a year. I will pay out of pocket. But I am not looking for anything more than having my BP checked.”
At first, Dr. D tried to reason with the patient. “If you don't have a primary-care provider, you should,” she explained. “And don't you want to have a complete physical?”
“No,” insisted Mr. T. “I don't want a physical or anything else. Just take my BP, please.”
Dr. D was somewhat puzzled, but she started a patient file for Mr. T. In the file, she noted his BP readings every six months. Mr. T stayed under Dr. D's treatment for more than five years.
One day, Mr. T failed to show up for his regular appointment, and Dr. D had her office manager give him a call.
“He is in the hospital,” reported the office manager, after speaking with Mr. T's wife. “He had had some very bad stomach pain and no bowel movement for several days. So he went to the emergency department.”
“I'll see how he's feeling,” replied Dr. D. Mr. T was not doing well. An abdominal pelvic ultrasound and a pelvic CT scan showed free intraperitoneal air, indicating a perforated bowel. Mr. T was taken for emergency surgery. During the surgery, it was discovered that
he had colon cancer. The pathology report revealed invasive adenocarcinoma that had metastasized to the lymph nodes. Mr. T was told that he had stage 3 colon cancer.
Within the next few months, the cancer spread to Mr. T's lungs, and his condition deteriorated. He died fewer than six months after his diagnosis. After Mr. T's death, his widow contacted an attorney to explore her options.
“My husband was going to Dr. D's office every six months for five years before he was diagnosed with cancer,” she told the attorney. “I don't think that doctor ever once suggested that my husband get a colonoscopy or anything. Maybe if she had, he would still be alive.”
“If it is true that he was seeing this clinician for five years and she never suggested any screenings, then perhaps we do have a case,” replied the attorney. “I will get copies of his medical records from Dr. D.”
Once the attorney obtained the medical records, he hired an expert physician to review them and then give his opinion.
“These are some of the strangest medical records I have ever seen,” the expert remarked. “It's hard to believe, but it appears that the clinician did nothing other than check Mr. T's BP for five years.”
“What should the doctor have been doing?” asked the attorney.
“A general physical, blood work, and certainly some sort of colorectal cancer screening — either a digital rectal exam, a fecal occult blood test, or a sigmoidoscopy or colonoscopy. For a patient of that age, these things should be standard.”
The attorney called Mr. T's widow and told her that he would take the case. He filed a malpractice lawsuit against Dr. D.
Dr. D's heart sank when she received the papers notifying her about the lawsuit. She immediately realized that the medical records looked odd with just BP readings. Plus, she had never made notes anywhere — including in the patient's file — about the special arrangement that she and Mr. T had in which he had declined any other services.
Dr. D met with the defense attorney provided by her malpractice insurance provider.The attorney recommended that they begin the discovery and deposition process but consider a settlement if it looked like the case would go to trial.
Dr. D's attorney warned her that during the depositions she would be questioned by the plaintiff's attorney and that it was very important that she be honest and consistent since anything she said in the deposition could be used in the trial. As expected, the plaintiff's counsel questioned Dr. D regarding whether the standard of care had been met by not providing or suggesting any colorectal cancer screenings.
Dr. D was forced to admit that the standard of care for a primary-care physician does require such screenings, but she immediately informed Mrs. T's attorney that she wasn't Mr. T's primary-care physician, and that he'd only hired her to do BP screenings.
The attorney looked skeptical, and asked whether Dr. D had written that in the patient file or anywhere in the notes from the past five years. Dr. D had no choice but to respond that she had not. On the advice of her own lawyer, Dr. D settled the case for a sum of $1.5 million.
Legal background
Depositions provide both parties in a lawsuit with the opportunity to question witnesses in preparation for trial. They are conducted as part of the discovery process in civil cases. During depositions, witness testimony is transcribed. The transcript then can be used at trial to contradict what the witness says at that time. No judge is present at depositions; the attorneys handle the entire process.
Protecting yourself
At one point or another, most clinicians will likely be confronted with a patient who does not want to follow advice or declines full examinations. While you cannot force an individual to undergo a blood test, Pap smear, or colorectal-cancer screening, the standard of practice requires the clinician to offer these services and inform patients about the benefits and risks. If a patient opts to decline services, be sure to record it in his or her record so that there is evidence of vital care being offered and refused.
Dr. D had an unusual relationship with her patient, who simply wanted hypertension screenings and nothing else. The patient made it clear what he did, and did not want right from the beginning, which was his right. However, Dr. D's error was in not detailing this arrangement anywhere in the patient record or in her notes.
Once Mr. T passed away, there was no one left to confirm the arrangement, and Dr. D appeared to be negligent. A note in the patient's chart could have changed the outcome of this case.
This article is courtesy of the Clinical Adviser.
One of Dr. D's more unusual patients was Mr. T, age 67 years. At their first appointment, Mr. T told her that he was not looking for a primary-care provider and that he only wanted her to check his BP.
“I know my BP is borderline high, and I want to have it monitored by you. I will come see you twice a year. I will pay out of pocket. But I am not looking for anything more than having my BP checked.”
At first, Dr. D tried to reason with the patient. “If you don't have a primary-care provider, you should,” she explained. “And don't you want to have a complete physical?”
“No,” insisted Mr. T. “I don't want a physical or anything else. Just take my BP, please.”
Dr. D was somewhat puzzled, but she started a patient file for Mr. T. In the file, she noted his BP readings every six months. Mr. T stayed under Dr. D's treatment for more than five years.
One day, Mr. T failed to show up for his regular appointment, and Dr. D had her office manager give him a call.
“He is in the hospital,” reported the office manager, after speaking with Mr. T's wife. “He had had some very bad stomach pain and no bowel movement for several days. So he went to the emergency department.”
“I'll see how he's feeling,” replied Dr. D. Mr. T was not doing well. An abdominal pelvic ultrasound and a pelvic CT scan showed free intraperitoneal air, indicating a perforated bowel. Mr. T was taken for emergency surgery. During the surgery, it was discovered that
he had colon cancer. The pathology report revealed invasive adenocarcinoma that had metastasized to the lymph nodes. Mr. T was told that he had stage 3 colon cancer.
Within the next few months, the cancer spread to Mr. T's lungs, and his condition deteriorated. He died fewer than six months after his diagnosis. After Mr. T's death, his widow contacted an attorney to explore her options.
“My husband was going to Dr. D's office every six months for five years before he was diagnosed with cancer,” she told the attorney. “I don't think that doctor ever once suggested that my husband get a colonoscopy or anything. Maybe if she had, he would still be alive.”
“If it is true that he was seeing this clinician for five years and she never suggested any screenings, then perhaps we do have a case,” replied the attorney. “I will get copies of his medical records from Dr. D.”
Once the attorney obtained the medical records, he hired an expert physician to review them and then give his opinion.
“These are some of the strangest medical records I have ever seen,” the expert remarked. “It's hard to believe, but it appears that the clinician did nothing other than check Mr. T's BP for five years.”
“What should the doctor have been doing?” asked the attorney.
“A general physical, blood work, and certainly some sort of colorectal cancer screening — either a digital rectal exam, a fecal occult blood test, or a sigmoidoscopy or colonoscopy. For a patient of that age, these things should be standard.”
The attorney called Mr. T's widow and told her that he would take the case. He filed a malpractice lawsuit against Dr. D.
Dr. D's heart sank when she received the papers notifying her about the lawsuit. She immediately realized that the medical records looked odd with just BP readings. Plus, she had never made notes anywhere — including in the patient's file — about the special arrangement that she and Mr. T had in which he had declined any other services.
Dr. D met with the defense attorney provided by her malpractice insurance provider.The attorney recommended that they begin the discovery and deposition process but consider a settlement if it looked like the case would go to trial.
Dr. D's attorney warned her that during the depositions she would be questioned by the plaintiff's attorney and that it was very important that she be honest and consistent since anything she said in the deposition could be used in the trial. As expected, the plaintiff's counsel questioned Dr. D regarding whether the standard of care had been met by not providing or suggesting any colorectal cancer screenings.
Dr. D was forced to admit that the standard of care for a primary-care physician does require such screenings, but she immediately informed Mrs. T's attorney that she wasn't Mr. T's primary-care physician, and that he'd only hired her to do BP screenings.
The attorney looked skeptical, and asked whether Dr. D had written that in the patient file or anywhere in the notes from the past five years. Dr. D had no choice but to respond that she had not. On the advice of her own lawyer, Dr. D settled the case for a sum of $1.5 million.
Legal background
Depositions provide both parties in a lawsuit with the opportunity to question witnesses in preparation for trial. They are conducted as part of the discovery process in civil cases. During depositions, witness testimony is transcribed. The transcript then can be used at trial to contradict what the witness says at that time. No judge is present at depositions; the attorneys handle the entire process.
Protecting yourself
At one point or another, most clinicians will likely be confronted with a patient who does not want to follow advice or declines full examinations. While you cannot force an individual to undergo a blood test, Pap smear, or colorectal-cancer screening, the standard of practice requires the clinician to offer these services and inform patients about the benefits and risks. If a patient opts to decline services, be sure to record it in his or her record so that there is evidence of vital care being offered and refused.
Dr. D had an unusual relationship with her patient, who simply wanted hypertension screenings and nothing else. The patient made it clear what he did, and did not want right from the beginning, which was his right. However, Dr. D's error was in not detailing this arrangement anywhere in the patient record or in her notes.
Once Mr. T passed away, there was no one left to confirm the arrangement, and Dr. D appeared to be negligent. A note in the patient's chart could have changed the outcome of this case.
This article is courtesy of the Clinical Adviser.
Wednesday, 17 April 2013
'Better safe than sorry': What doctors told patient after removing his bowel by mistake because blundering staff wrongly said he had cancer
A man who went to his GP with a stomach upset has told how doctors removed part of his bowel after wrongly diagnosing cancer.
James McLeish was left having to wear a colostomy bag and was not even told of the disastrous cancer mistake until he returned to hospital for a check-up.
A surgeon told him: ‘I’ve got some good news for you. You haven’t got cancer after all.’
When the retired bus driver, who had previously enjoyed good health, expressed his astonishment, the consultant said: ‘Better safe than sorry.’
The Mail on Sunday has seen a confidential report which exposes a catalogue of incompetence and failure of leadership at the Queen Alexandra Hospital in Portsmouth, where Mr McLeish was treated.
In one of the most glaring mistakes, the phrase ‘no dysplasia’ – referring to an absence of abnormal cells on an ulcer found in Mr McLeish’s body – was read at a case conference as ‘dysplasia’. The omission of the word ‘no’ led doctors to believe cancer was likely and on that basis they went ahead with the operation.
The document also reveals that:
The sequence of events began when the 69-year-old widower, from Havant, went to his GP after a bout of diarrhoea. He was referred to the Queen Alexandra where he underwent a series of tests and was told that a tumour had been found in his colon.
In November 2011 surgeons removed part of his bowel and he spent two weeks in hospital recovering from the operation, which left him needing to use a colostomy bag.
He moved in with his son and, when he eventually returned home, became a virtual recluse, too embarrassed to see friends and family.
Mr McLeish said: ‘I changed my lifestyle and didn’t see anyone. I would not leave the house as the bag would tend to burst on me. I had to change it at home which made me very sick and it was very inconvenient. I was in good health until all this happened.’
He had another operation to repair the colon and remove the colostomy bag but this still left him with major problems with everyday life.
‘I completely lost my appetite and over a stone in weight. Physically and psychologically I did not feel like myself,’ he said.
It was only when he returned to the Queen Alexandra for a routine check-up that he was told his suffering had been entirely unnecessary because the cancer diagnosis had been wrong.
Trust chief executive Ursula Ward has now written to him, apologising for the substandard care.
Mr McLeish’s solicitor, Paul Crook, of law firm Ross Aldridge, said: ‘As a result of an appalling clinical error Mr McLeish was subjected to extremely invasive and wholly unnecessary surgery.
'While no amount of money will turn the clock back, the settlement does in part recompense him for all the unnecessary pain and suffering he has endured and will continue to live with.’
Katherine Murphy, chief executive of the Patients Association, said: ‘Patients deserve to feel confident that their prescribed course of treatment is clinically right.
‘Trusts need to ensure their procedures prevent avoidable surgery which can have devastating long-terms impacts on the quality of patients’ lives.’
This article is courtesy of the Mail Online.
James McLeish was left having to wear a colostomy bag and was not even told of the disastrous cancer mistake until he returned to hospital for a check-up.
A surgeon told him: ‘I’ve got some good news for you. You haven’t got cancer after all.’
When the retired bus driver, who had previously enjoyed good health, expressed his astonishment, the consultant said: ‘Better safe than sorry.’
The Mail on Sunday has seen a confidential report which exposes a catalogue of incompetence and failure of leadership at the Queen Alexandra Hospital in Portsmouth, where Mr McLeish was treated.
In one of the most glaring mistakes, the phrase ‘no dysplasia’ – referring to an absence of abnormal cells on an ulcer found in Mr McLeish’s body – was read at a case conference as ‘dysplasia’. The omission of the word ‘no’ led doctors to believe cancer was likely and on that basis they went ahead with the operation.
The document also reveals that:
- A biopsy was wrongly interpreted as showing signs of cancer;
- Surgeons operated without first reading his pathology report, which plays a vital role in cancer diagnosis;
- Consultants were given incomplete medical notes
- Three surgeons had expressed concern about hospital procedures but their complaints were apparently ignored.
The sequence of events began when the 69-year-old widower, from Havant, went to his GP after a bout of diarrhoea. He was referred to the Queen Alexandra where he underwent a series of tests and was told that a tumour had been found in his colon.
In November 2011 surgeons removed part of his bowel and he spent two weeks in hospital recovering from the operation, which left him needing to use a colostomy bag.
He moved in with his son and, when he eventually returned home, became a virtual recluse, too embarrassed to see friends and family.
Mr McLeish said: ‘I changed my lifestyle and didn’t see anyone. I would not leave the house as the bag would tend to burst on me. I had to change it at home which made me very sick and it was very inconvenient. I was in good health until all this happened.’
He had another operation to repair the colon and remove the colostomy bag but this still left him with major problems with everyday life.
‘I completely lost my appetite and over a stone in weight. Physically and psychologically I did not feel like myself,’ he said.
It was only when he returned to the Queen Alexandra for a routine check-up that he was told his suffering had been entirely unnecessary because the cancer diagnosis had been wrong.
Trust chief executive Ursula Ward has now written to him, apologising for the substandard care.
Mr McLeish’s solicitor, Paul Crook, of law firm Ross Aldridge, said: ‘As a result of an appalling clinical error Mr McLeish was subjected to extremely invasive and wholly unnecessary surgery.
'While no amount of money will turn the clock back, the settlement does in part recompense him for all the unnecessary pain and suffering he has endured and will continue to live with.’
Katherine Murphy, chief executive of the Patients Association, said: ‘Patients deserve to feel confident that their prescribed course of treatment is clinically right.
‘Trusts need to ensure their procedures prevent avoidable surgery which can have devastating long-terms impacts on the quality of patients’ lives.’
This article is courtesy of the Mail Online.
Tuesday, 16 April 2013
HIV test urged for 7,000 Oklahoma dental patients
Dental practices of a Tulsa-area oral surgeon are being investigated and health officials warn patients may have been exposed to HIV, hepatitis B and C.
Health officials are urging 7,000 patients of an Oklahoma dentist to be tested for potential exposure to HIV, hepatitis B and hepatitis C.
The possible exposure happened at the dental practice of Dr. W. Scott Harrington in Tulsa, Okla., and Owasso, Okla. Officials are sending letters to 7,000 patients who have visited the facilities since 2007, according to a health department news release.
Records were available only from 2007 through March, so patients who visited Harrington's practice before then were urged to contact health officials.
Harrington, an oral surgeon who has been licensed since the 1970s, surrendered his credentials March 20 and discontinued his practice after investigators discovered alleged health and safety violations. Authorities say he is cooperating.
The health departments noted that transmissions of these diseases in this type of occupational setting are rare. Kristy Bradley, state epidemiologist, stressed that "this is not an outbreak."
The state health department said that HIV and hepatitis B "have been known to be transmitted in the dental setting" but that there is no documentation of hepatitis C infection. The tests are being recommended as a precaution.
According to the Oklahoma Board of Dentistry, the investigation so far has uncovered "numerous violations of health and safety laws and major violations of the state dental act."
Tulsa television station KOTV cites 17 violations:
Charges include: a patient testing positive for HIV and Hepatitis C; the dental practice being unsafe, unsanitary and lacking of sterilization checks; committing gross negligence related to decisions related to the dental health care of patients; practicing dentistry without proper display of licenses and certifications; violation of provisions of the State Dental Act by failure to keep a suitable record of dangerous drugs; unlawful practices in authorizing dental assistants to practice dentistry; and having open vials or medication and unsanitary dental materials in an unclean environment.
Alleged violations include allowing assistants to administer IV sedation, which only a licensed dentist may perform, and keeping incomplete drug logs and expired medications, the Tulsa World reported. Inspectors found an unlocked, disorganized drug cabinet with a vial that had expired in 1993.
Susan Rogers, the executive director of the dental board, called the allegations "very, very unusual." She told KOTV that Harrington handled a high volume of patients with hepatitis or HIV. She said Harrington had no previous complaints.
Free testing will be available Saturday and Monday at a Tulsa Health Department clinic. Results were expected within one to two weeks.
This article is courtesy of USA Today.
Health officials are urging 7,000 patients of an Oklahoma dentist to be tested for potential exposure to HIV, hepatitis B and hepatitis C.
The possible exposure happened at the dental practice of Dr. W. Scott Harrington in Tulsa, Okla., and Owasso, Okla. Officials are sending letters to 7,000 patients who have visited the facilities since 2007, according to a health department news release.
Records were available only from 2007 through March, so patients who visited Harrington's practice before then were urged to contact health officials.
Harrington, an oral surgeon who has been licensed since the 1970s, surrendered his credentials March 20 and discontinued his practice after investigators discovered alleged health and safety violations. Authorities say he is cooperating.
The health departments noted that transmissions of these diseases in this type of occupational setting are rare. Kristy Bradley, state epidemiologist, stressed that "this is not an outbreak."
The state health department said that HIV and hepatitis B "have been known to be transmitted in the dental setting" but that there is no documentation of hepatitis C infection. The tests are being recommended as a precaution.
According to the Oklahoma Board of Dentistry, the investigation so far has uncovered "numerous violations of health and safety laws and major violations of the state dental act."
Tulsa television station KOTV cites 17 violations:
Charges include: a patient testing positive for HIV and Hepatitis C; the dental practice being unsafe, unsanitary and lacking of sterilization checks; committing gross negligence related to decisions related to the dental health care of patients; practicing dentistry without proper display of licenses and certifications; violation of provisions of the State Dental Act by failure to keep a suitable record of dangerous drugs; unlawful practices in authorizing dental assistants to practice dentistry; and having open vials or medication and unsanitary dental materials in an unclean environment.
Alleged violations include allowing assistants to administer IV sedation, which only a licensed dentist may perform, and keeping incomplete drug logs and expired medications, the Tulsa World reported. Inspectors found an unlocked, disorganized drug cabinet with a vial that had expired in 1993.
Susan Rogers, the executive director of the dental board, called the allegations "very, very unusual." She told KOTV that Harrington handled a high volume of patients with hepatitis or HIV. She said Harrington had no previous complaints.
Free testing will be available Saturday and Monday at a Tulsa Health Department clinic. Results were expected within one to two weeks.
This article is courtesy of USA Today.
Monday, 15 April 2013
Symphysiotomy sufferers want compensation ban lifted
Women whose pelvises were severed during childbirth want politicians to back a draft law to temporarily lift a legal ban preventing them from suing for compensation.
A Private Members' Bill published today (TUES) lifting the Statute of Limitations for women who experienced symphysiotomy and pubiotomy "without medical justification" is due before the Dail on April 16 next.
The Statute of Limitations act lays down a two-year period within which personal injury proceedings must be initiated.
But most of the pelvis widening cases go back 40 or 50 years leaving up to 200 women, many now in their 70s and 80s, statute barred.
The statute of limitations act was amended in 2000 to allow minors who were sexually abused in residential institutions to sue.
This morning (TUES) Caoimhghin O Caolain TD, convenor of the Victims of Symphysiotomy All Party Oireachtas Support Group, launched a new bill calling for a temporary one year lifting of the statute ban to allow the women to sue for damages.
The new bill mirrors the 2000 law amending the statute of limitations.
"While in other jurisidctions judges retain inherent jurisdiction to allow cases to proceed where justice demands, Irish legislation provides no discretion whatsoever to the courts in determining whether cases may advance," said Mr O'Caolain who called on Taoiseach Enda Kenny and Tanaiste Eamon Gilmore to "embrace" the draft law.
Mr O'Caolain thanked TDs and Senators of all parties, as well as independents, who supported the campaign of the victims of symphysiotomy for justice in recent years.
An estimated 1,500 operations were performed here between 1942 and 2005, mostly in Catholic teaching hospitals.
Some 200 women are still alive and could benefit from the proposed law if passed.
One of the survivors recently died, a press conference in Dublin heard this morning (TUES).
The explanatory memorandum to the Statute of Limitations (Amendment) Bill 2013 says that the vast majority of symphysiotomy victims were very young women having their first child whose knowledge of childbirth was extremely limited.
This article is courtesy of the Irish Independent.
A Private Members' Bill published today (TUES) lifting the Statute of Limitations for women who experienced symphysiotomy and pubiotomy "without medical justification" is due before the Dail on April 16 next.
The Statute of Limitations act lays down a two-year period within which personal injury proceedings must be initiated.
But most of the pelvis widening cases go back 40 or 50 years leaving up to 200 women, many now in their 70s and 80s, statute barred.
The statute of limitations act was amended in 2000 to allow minors who were sexually abused in residential institutions to sue.
This morning (TUES) Caoimhghin O Caolain TD, convenor of the Victims of Symphysiotomy All Party Oireachtas Support Group, launched a new bill calling for a temporary one year lifting of the statute ban to allow the women to sue for damages.
The new bill mirrors the 2000 law amending the statute of limitations.
"While in other jurisidctions judges retain inherent jurisdiction to allow cases to proceed where justice demands, Irish legislation provides no discretion whatsoever to the courts in determining whether cases may advance," said Mr O'Caolain who called on Taoiseach Enda Kenny and Tanaiste Eamon Gilmore to "embrace" the draft law.
Mr O'Caolain thanked TDs and Senators of all parties, as well as independents, who supported the campaign of the victims of symphysiotomy for justice in recent years.
An estimated 1,500 operations were performed here between 1942 and 2005, mostly in Catholic teaching hospitals.
Some 200 women are still alive and could benefit from the proposed law if passed.
One of the survivors recently died, a press conference in Dublin heard this morning (TUES).
The explanatory memorandum to the Statute of Limitations (Amendment) Bill 2013 says that the vast majority of symphysiotomy victims were very young women having their first child whose knowledge of childbirth was extremely limited.
This article is courtesy of the Irish Independent.
Sunday, 14 April 2013
Hack plastic surgeon Oleg Davie faces murder rap for performing liposuction on heart transplant patient
Davie, 51, was indicted on manslaughter and criminally negligent homicide charges for operating on Isel Pineda in last May, knowing she had a heart transplant and was on anti-rejection drugs, said Brooklyn District Attorney Charles Hynes.
Saturday, 13 April 2013
What we can learn from fatal mistakes in surgery
In 2005 Elaine Bromiley, a 37-year-old woman attending hospital for what was supposed to be a routine operation on her nasal air passages, suffered catastrophic brain damage after unexpected complications occurred at the start of the procedure.
An emergency had arisen shortly after the anaesthetic drugs had been injected. Elaine's airway - the path from her mouth to her lungs through which air normally flows - had become obstructed. It was a rare event, of the type that occurs in fewer than one in 50,000 routine cases.
But that day the anaesthetic team suddenly found themselves unable to assist Elaine's breathing or get fresh oxygen into her lungs. During a desperate struggle that lasted some 20 minutes the medical team were unable to remedy the situation.
As a result Elaine's brain became starved of oxygen. She was transferred to the intensive care unit but died several days later.
If someone you loved - your wife or husband - died unexpectedly in a hospital during a routine operation you'd have a right to feel angry. You'd be forgiven for looking for someone to blame, you'd demand perhaps that someone should be fired from their job.
In 2005 Elaine's husband, Martin Bromiley, faced precisely this nightmarish scenario but - remarkably - decided to do none of those things. Martin instead focussed his energy on trying to understand what had gone wrong and why.
As a commercial airline pilot Martin was familiar with how the world of aviation would have responded to a similarly catastrophic event.
Human fallibility
There would have been an independent investigation, the goal of which would have been to discover the root cause of the incident. And the primary focus of that exercise would not have been to apportion blame or determine legal liability but to learn lessons - lessons that might save lives in the future.
The independent investigation into Elaine's death, carried out in large part because of Martin's insistence, was revealing. It highlighted many elements of the incident in which those present could have performed better.
But upon reading the report Martin's conclusion was that the system had let Elaine down, that the team members were insufficiently protected from their own fallibility.
In the airline industry, faced with a complex task in which human life is at stake, steps are taken to standardise operational procedures, leaving as little as possible up to chance or the frailties of human psychology.
But in examining the events surrounding his wife's death it appeared to Martin that such measures were often absent from the practice of healthcare as it stood in 2005.
In the years since Elaine's death Martin has taken it upon himself to advocate fiercely for an improved safety culture in medicine, using his personal experience as a sober illustration of how exposed medical teams are when control of a situation is suddenly lost.
He has told his tragic story to all in healthcare who are prepared to listen, addressing conferences and delivering lectures spelling out the lessons that we as medical professionals should learn.
In so doing he has succeeded in forcing a radical rethink amongst healthcare workers, particularly those involved in frontline anaesthetic practice.
The message he sends is clear - in healthcare there should be greater standardisation of procedures and more use of checklists to ensure that vital tasks are not omitted.
But most importantly there should be systems of blame-free reporting and, in the wake of disasters, investigations that seek essential lessons rather than scapegoats.
This is not to say that all of healthcare should be run the way our airports and commercial airlines are. There are fundamental differences between the aviation industry and the practice of medicine that make it unsafe to draw too close an analogy between the two.
The scenarios we face in medicine are more variable in character and evolve less predictably. And substantial risks often have to be accepted in pursuit of life saving medical benefit.
But this is not a reason to completely ignore the lessons we might learn from other organisations. There are indeed important aspects of airline safety culture that the health service would do well to adopt.
Martin has pursued this agenda relentlessly. I met him while we were lecturing together at a patient safety conference some years ago.
We have for some time been trying to find ways to bring these messages to a wider audience, to help people understand simultaneously how great the challenge of safe delivery of healthcare is, and underline how far we still have to go in pursuit of this goal.
This incident happened in a private hospital. But that is beside the point. This is not about the relative merits and demerits of the NHS. It is about lessons that should be learnt by all those involved in the delivery of healthcare, in whatever sector, at whatever level of hierarchy.
The detailed investigation into the death of Elaine Bromiley identified many elements which could or should have been managed differently. The report states, however, that even if the management of this case had been perfect, Elaine's life might still have been lost.
The loss of control of a patient's airway during anaesthesia is a rarely experienced event. And it is hard to prepare for situations which may arise only once in a career lifetime.
But there are nevertheless steps that can be taken, to give ourselves the best of all possible chances, no matter how slim the chances of success.
And none of this is about a search for blame. Martin never sought the dismissal of those involved in his wife's case. On the contrary, if he or any member of his family were to have an anaesthetic today he tells me that he would be happy to have that same anaesthetic team.
He feels that, through this process of review, they have collectively learnt the important lessons that stemmed from this tragedy and moved on - safer as practitioners of healthcare than they were before.
Amongst the many things that we might all take away from Martin Bromiley's experience, this is perhaps the most important.
This article is courtesy of BBC News.
An emergency had arisen shortly after the anaesthetic drugs had been injected. Elaine's airway - the path from her mouth to her lungs through which air normally flows - had become obstructed. It was a rare event, of the type that occurs in fewer than one in 50,000 routine cases.
But that day the anaesthetic team suddenly found themselves unable to assist Elaine's breathing or get fresh oxygen into her lungs. During a desperate struggle that lasted some 20 minutes the medical team were unable to remedy the situation.
As a result Elaine's brain became starved of oxygen. She was transferred to the intensive care unit but died several days later.
If someone you loved - your wife or husband - died unexpectedly in a hospital during a routine operation you'd have a right to feel angry. You'd be forgiven for looking for someone to blame, you'd demand perhaps that someone should be fired from their job.
In 2005 Elaine's husband, Martin Bromiley, faced precisely this nightmarish scenario but - remarkably - decided to do none of those things. Martin instead focussed his energy on trying to understand what had gone wrong and why.
As a commercial airline pilot Martin was familiar with how the world of aviation would have responded to a similarly catastrophic event.
Human fallibility
There would have been an independent investigation, the goal of which would have been to discover the root cause of the incident. And the primary focus of that exercise would not have been to apportion blame or determine legal liability but to learn lessons - lessons that might save lives in the future.
The independent investigation into Elaine's death, carried out in large part because of Martin's insistence, was revealing. It highlighted many elements of the incident in which those present could have performed better.
But upon reading the report Martin's conclusion was that the system had let Elaine down, that the team members were insufficiently protected from their own fallibility.
In the airline industry, faced with a complex task in which human life is at stake, steps are taken to standardise operational procedures, leaving as little as possible up to chance or the frailties of human psychology.
But in examining the events surrounding his wife's death it appeared to Martin that such measures were often absent from the practice of healthcare as it stood in 2005.
In the years since Elaine's death Martin has taken it upon himself to advocate fiercely for an improved safety culture in medicine, using his personal experience as a sober illustration of how exposed medical teams are when control of a situation is suddenly lost.
He has told his tragic story to all in healthcare who are prepared to listen, addressing conferences and delivering lectures spelling out the lessons that we as medical professionals should learn.
In so doing he has succeeded in forcing a radical rethink amongst healthcare workers, particularly those involved in frontline anaesthetic practice.
The message he sends is clear - in healthcare there should be greater standardisation of procedures and more use of checklists to ensure that vital tasks are not omitted.
But most importantly there should be systems of blame-free reporting and, in the wake of disasters, investigations that seek essential lessons rather than scapegoats.
This is not to say that all of healthcare should be run the way our airports and commercial airlines are. There are fundamental differences between the aviation industry and the practice of medicine that make it unsafe to draw too close an analogy between the two.
The scenarios we face in medicine are more variable in character and evolve less predictably. And substantial risks often have to be accepted in pursuit of life saving medical benefit.
But this is not a reason to completely ignore the lessons we might learn from other organisations. There are indeed important aspects of airline safety culture that the health service would do well to adopt.
Martin has pursued this agenda relentlessly. I met him while we were lecturing together at a patient safety conference some years ago.
We have for some time been trying to find ways to bring these messages to a wider audience, to help people understand simultaneously how great the challenge of safe delivery of healthcare is, and underline how far we still have to go in pursuit of this goal.
This incident happened in a private hospital. But that is beside the point. This is not about the relative merits and demerits of the NHS. It is about lessons that should be learnt by all those involved in the delivery of healthcare, in whatever sector, at whatever level of hierarchy.
The detailed investigation into the death of Elaine Bromiley identified many elements which could or should have been managed differently. The report states, however, that even if the management of this case had been perfect, Elaine's life might still have been lost.
The loss of control of a patient's airway during anaesthesia is a rarely experienced event. And it is hard to prepare for situations which may arise only once in a career lifetime.
But there are nevertheless steps that can be taken, to give ourselves the best of all possible chances, no matter how slim the chances of success.
And none of this is about a search for blame. Martin never sought the dismissal of those involved in his wife's case. On the contrary, if he or any member of his family were to have an anaesthetic today he tells me that he would be happy to have that same anaesthetic team.
He feels that, through this process of review, they have collectively learnt the important lessons that stemmed from this tragedy and moved on - safer as practitioners of healthcare than they were before.
Amongst the many things that we might all take away from Martin Bromiley's experience, this is perhaps the most important.
This article is courtesy of BBC News.
Friday, 12 April 2013
Heart expert queries Leeds surgery reopening
The government's ex-national director for heart disease says he would not want his daughter treated at Leeds General Infirmary's child cardiac unit.
Heart operations were suspended when incomplete data suggested the hospital had a mortality rate twice the national average but they resumed this week.
Prof Sir Roger Boyle told the BBC Leeds remains "on the edge of acceptability".
Leeds Teaching Hospitals NHS Trust said it has comparable rates to all other centres and there should be no concern.
The children's heart surgery unit was closed for 11 days after NHS England's medical director, Sir Bruce Keogh, suspended procedures for what he called a "constellation" of reasons.
These included an apparent higher mortality rate than the national average, concerns raised by families treated at the hospital and reports from two senior surgeons at other units.
The mortality data had been leaked by Sir Roger - director of the National Institute of Clinical Outcomes Research, which oversees mortality figures across the NHS - the night before last month's suspension.
A rapid response team was dispatched to Leeds General Infirmary last weekend to assess the immediate safety concerns that triggered the suspension.
NHS England said that assurances had been received about the quality of surgery and staffing levels that were sufficient to allow the phased resumption of operations.
Earlier this week, Sir Bruce told the BBC he would now trust his own baby to be treated at the unit.
However, speaking to BBC Radio 4's The Report, Sir Roger - the Department of Health's former National Director for Heart Disease - said he still would not send his children to Leeds.
"I tell you that I have a young daughter, I would go somewhere else. I would go to Newcastle."
When asked whether operations should have remained suspended, Sir Roger said: "It's not my decision. I've not been involved in the inspections. I did my duty to say there is a concern here and that's all I said."
Sir Roger said that despite safety assurances over Leeds General Infirmary, the full analysis of the data called for the children's heart surgery unit to remain under supervision.
"We find they're just on the edge of what we call an alert. In other words, showing that they were at right on the edge of acceptability."
Figures released by NHS England confirm that Leeds was "very close to the 'alert' threshold."
NHS England data highlights that two other children's heart units are also close to this threshold - Alder Hey Children's NHS Foundation Trust and Guy's and St Thomas's NHS Foundation Trust.
Guy's and St Thomas's did not wish to comment on the findings, but a spokesperson for Alder Hey said that while it was yet to see the numbers "we are pleased to learn that all children's heart units in England, including Alder Hey, are safe".
In response to Sir Roger's comments, Leeds Teaching Hospitals NHS Trust said analysis had shown Leeds to have comparable rates to all other centres.
Consultant cardiologist at Leeds General Infirmary, Dr John Thomson, said Sir Roger's assessment was unfair.
"I haven't had a chance to fully scrutinise these graphs, but in a rough look at the graphs I'm not absolutely sure that they're accurate," he explained.
"We are still going through some of this data. I would say that the wording is unfortunate there."
Sharon Cheng, of Save Our Surgery which campaigned for surgery to be resumed at Leeds, said Sir Roger Boyle's comments contradicted the rulings of NHS England, the Care Quality Commission and NHS medical director, Sir Bruce Keogh, who all said the unit was safe.
"Let me be absolutely clear - the Leeds unit would not be operating if there were any concerns whatsoever about mortality rates or anything else," she said.
"Once again, this is an example of Sir Roger Boyle speaking out without due regard to the necessary process, the verified facts or the implications of his actions on patients and their families. He is not an impartial party in regards to Leeds and as an adviser to the Safe and Sustainable review, we do question his motives."
Stuart Andrew, MP for Pudsey, Horsfirth and Aireborough also said there was "no basis" for Sir Roger's comments.
"The only person who seems to have a problem is Sir Roger Boyle. What is his other role? To advise the Safe and Sustainable Review into the long term future of heart surgery. He chose Newcastle and now here he is again. He has clearly shown his hand and this is awful, frankly," he said.
This article is courtesy of BBC News.
Heart operations were suspended when incomplete data suggested the hospital had a mortality rate twice the national average but they resumed this week.
Prof Sir Roger Boyle told the BBC Leeds remains "on the edge of acceptability".
Leeds Teaching Hospitals NHS Trust said it has comparable rates to all other centres and there should be no concern.
The children's heart surgery unit was closed for 11 days after NHS England's medical director, Sir Bruce Keogh, suspended procedures for what he called a "constellation" of reasons.
These included an apparent higher mortality rate than the national average, concerns raised by families treated at the hospital and reports from two senior surgeons at other units.
The mortality data had been leaked by Sir Roger - director of the National Institute of Clinical Outcomes Research, which oversees mortality figures across the NHS - the night before last month's suspension.
A rapid response team was dispatched to Leeds General Infirmary last weekend to assess the immediate safety concerns that triggered the suspension.
NHS England said that assurances had been received about the quality of surgery and staffing levels that were sufficient to allow the phased resumption of operations.
Earlier this week, Sir Bruce told the BBC he would now trust his own baby to be treated at the unit.
However, speaking to BBC Radio 4's The Report, Sir Roger - the Department of Health's former National Director for Heart Disease - said he still would not send his children to Leeds.
"I tell you that I have a young daughter, I would go somewhere else. I would go to Newcastle."
When asked whether operations should have remained suspended, Sir Roger said: "It's not my decision. I've not been involved in the inspections. I did my duty to say there is a concern here and that's all I said."
Sir Roger said that despite safety assurances over Leeds General Infirmary, the full analysis of the data called for the children's heart surgery unit to remain under supervision.
"We find they're just on the edge of what we call an alert. In other words, showing that they were at right on the edge of acceptability."
Figures released by NHS England confirm that Leeds was "very close to the 'alert' threshold."
NHS England data highlights that two other children's heart units are also close to this threshold - Alder Hey Children's NHS Foundation Trust and Guy's and St Thomas's NHS Foundation Trust.
Guy's and St Thomas's did not wish to comment on the findings, but a spokesperson for Alder Hey said that while it was yet to see the numbers "we are pleased to learn that all children's heart units in England, including Alder Hey, are safe".
In response to Sir Roger's comments, Leeds Teaching Hospitals NHS Trust said analysis had shown Leeds to have comparable rates to all other centres.
Consultant cardiologist at Leeds General Infirmary, Dr John Thomson, said Sir Roger's assessment was unfair.
"I haven't had a chance to fully scrutinise these graphs, but in a rough look at the graphs I'm not absolutely sure that they're accurate," he explained.
"We are still going through some of this data. I would say that the wording is unfortunate there."
Sharon Cheng, of Save Our Surgery which campaigned for surgery to be resumed at Leeds, said Sir Roger Boyle's comments contradicted the rulings of NHS England, the Care Quality Commission and NHS medical director, Sir Bruce Keogh, who all said the unit was safe.
"Let me be absolutely clear - the Leeds unit would not be operating if there were any concerns whatsoever about mortality rates or anything else," she said.
"Once again, this is an example of Sir Roger Boyle speaking out without due regard to the necessary process, the verified facts or the implications of his actions on patients and their families. He is not an impartial party in regards to Leeds and as an adviser to the Safe and Sustainable review, we do question his motives."
Stuart Andrew, MP for Pudsey, Horsfirth and Aireborough also said there was "no basis" for Sir Roger's comments.
"The only person who seems to have a problem is Sir Roger Boyle. What is his other role? To advise the Safe and Sustainable Review into the long term future of heart surgery. He chose Newcastle and now here he is again. He has clearly shown his hand and this is awful, frankly," he said.
This article is courtesy of BBC News.
Laparoscopy: The controversial beginnings of a surgical revolution
The emergence of laparoscopy and laparoscopic technologies has represented one of the most essential paradigm shifts in the practice of surgery. Surgical practice has witnessed the introduction of the aseptic technique, general anesthesia and antibiotics, all of which decreased patients’ pain and the rate of infection during surgery.
“There are milestones in the progress of modern surgery that cannot be denied,” said Robert Sewell, MD, a general surgeon at the Master Center for Minimally Invasive Surgery, in Southlake, Texas. When laparoscopy—a minimally invasive approach to surgery—emerged, patients experienced less pain and potentially fewer complications after surgery. “This event rivaled the others in terms of benefits to patients,” Dr. Sewell said.
Over the next several months, General Surgery News will explore the historical landmarks in laparoscopy—from the first-ever procedure attempted on a dog, to today’s experience with single-incision laparoscopy and natural orifice transluminal endoscopic surgery—including interviews with some of the pioneers who helped shape the minimally invasive approach to surgery.
Start of a Transformation
On Sept. 23, 1901, Georg Kelling, MD, a surgeon and gastroenterologist, performed a laparoscopy on a live dog in front of an audience at the 73rd Congress of the Naturalist Scientist’s Medical Conference, in Hamburg, Germany. He named the procedure ‘coelioscopy’ (also spelled coelioskopie or koelioscopie).
“Kelling was the first to establish modern laparoscopy as a field by synthesizing existing technologies to form the trio of features that still defines the procedure today: an abdominal approach, at least two entry ports and artificial insufflation,” wrote gynecological surgeon Camran Nezhat, MD, FACS, FACOG, in his 2011 book, Nezhat’s History of Endoscopy: A Historical Analysis of Endoscopy’s Ascension since Antiquity’ (Endo Press).
Born in Dresden, Germany, on July 7, 1866, Dr. Kelling began his medical education when he was 18 years old, at the Universities of Leipzig and Berlin. In the summer of 1898, he went to the Royal Surgical Clinic in Breslau, where he learned his endoscopic skills from several well-known surgeons. He learned how to perform oral gastrointestinal insufflations—pumping gas into the abdomen to generate enough pressure to create a space between the stomach and small intestine—a skill that would become essential during his first laparoscopic procedure.
Dr. Kelling earned a doctorate in 1890, with a specialty in gastric and intestinal disease. Six years later, he opened a practice in Dresden, Germany. Although a surgeon by profession, he became intrigued by the idea of nonsurgical treatments and wanted to address the problem of gastrointestinal bleeding. Hemorrhaging into the abdomen proved fatal for patients, but many never showed the telltale signs, such as the presence of blood in vomit. At that time, the only conclusive way to diagnose or treat the condition was through laparotomy. However, Dr. Kelling believed that trying to address the problem by opening the abdomen could put the patient in greater danger. Dr. Kelling devised a nonsurgical approach to diagnosing and treating intra-abdominal bleeding safely. He wrote: “I asked myself, how do the organs react to the introduction of air? To find out, I devised a method of using an endoscope on an unopened abdominal cavity” (Münch Med Wochenschr 1901;48:1480-1483,1535-1538).
His instincts proved correct. More recent research shows that making a larger incision impairs an individual’s immunity, said J. Barry McKernan, MD, PhD, the surgeon credited with performing the first laparoscopic cholecystectomy in the United States.
By 1901, Dr. Kelling had found a safe way to view the abdomen using insufflation and determined that creating a pressure of 50 mm Hg alleviated bleeding into the abdomen, a technique he called ‘Luft-tamponade’ (air tamponade) (Figure 1). He also recognized the risk for injuring internal organs by incorrectly placing a trocar and found the best angle of entry was 45 degrees.
During Dr. Kelling’s demonstration of a laparoscopy using a live dog as a subject, he made an incision through which he inserted a Nitze-Leiter cystoscope to magnify and view the inside of the abdomen. The Nitze-Leiter cystoscope, first used in 1872, created illumination through an electrically heated platinum wire that allowed Dr. Kelling to see the interior of the abdomen through telescopic lenses. He then created a second incision, placing a trocar in the abdomen to insufflate the cavity with air, which allowed a better visual. This event marked the first laparoscopic endeavor. The dog survived the procedure. After performing coelioscopy on 20 dogs, Dr. Kelling deemed the procedure safe, noting that “after an examination, a dog is as cheerful as it was before [the procedure]” (Münch Med Wochenschr 1901;48:1480-1483,1535-1538).
Laparoscopy, however, was not Dr. Kelling’s main interest, and he initially did not publish his work on coelioscopy (Zeitschr Biol 1903;44:161-258).
Nine years after Dr. Kelling performed laparoscopy on dogs, Hans Christian Jacobaeus, MD, a Swedish internist, performed clinical laparoscopic surgery on a human—an electrical worker who had been diagnosed with hepatic cirrhosis (Münch Med Wochenschr 1910;57:2090-2092). Unlike Dr. Kelling, Dr. Jacobaeus did not use insufflation. Although not much is known about how Dr. Jacobaeus got involved in laparoscopic surgery, in 1912 he published a monograph describing the 97 laparoscopies he had performed between 1910 and 1912, in Stockholm’s community hospital (Beitr Klin Tuberk 1912;25:185-354). He observed that all of his patients, except one, improved after undergoing the procedure.
Despite these events, which physician performed the first laparoscopic procedure in a human remains somewhat ambiguous. Dr. Jacobaeus often is credited with this accomplishment; he was certainly the first to perform a large series of laparoscopic procedures in human patients and the first to broadcast his experience, but Dr. Kelling claimed he had done two such procedures in humans before Dr. Jacobaeus. Having read about Dr. Jacobaeus’ laparoscopic procedures, Dr. Kelling tried to defend his crown and wrote to journal editors with a detailed account of his work in humans (Nezhat C. Endo Press; 2011). By 1923, Dr. Kelling had published a history of his clinical experience over two decades.
In the 50 to 60 years that followed the first laparoscopic procedure in humans, early pioneers of laparoscopy experimented with the technique, but it did not make much headway in the general surgery community until the 1970s and 1980s.
“The work of Dr. Jacobaeus sparked some interest in laparoscopy around the world. Progress was occurring, but in small pockets and in small measures,” said Dr. Nezhat, president of the Association of the Adjunct Clinical Faculty, Stanford University Medical School, and adjunct clinical professor of surgery and gynecology at Stanford University, in California.
Dr. Nezhat pointed to the discovery that carbon dioxide was better than oxygen or air for insufflation. “Operating rooms [literally] exploded and patients died because people didn’t realize oxygen was flammable. Patients also died from air embolism because initially no one realized that too much pressure during insufflation could cause serious complications,” he said. “All of these [issues] took decades to discover and were, unfortunately for the patient, often only learned by trial and error.”
Additionally, the surgery itself was difficult for innovators and researchers. “Laparoscopy was a ‘one-man band,’” said Dr. Nezhat. “Surgeons had to look through the eyepiece of the laparoscope [holding it in one hand] and do the procedure with their free hand. That’s why there was minimal progress.”
Gaining Traction
A German gynecologist, Kurt Semm, MD, then appeared on the scene. Born on March 23, 1927, in Munich, Dr. Semm attended Ludwig Maximilians University School of Medicine and received his degree in 1951, with a specialty in obstetrics and gynecology. He became fascinated with laparoscopy and explored the technique for almost 20 years before performing a laparoscopic appendectomy.
However, by the 1960s, laparoscopy had earned a bad reputation in Germany. It was associated with high complication rates, in part because surgeons were burning patients during laparoscopic procedures, so the technique was banned there temporarily.
“I started in 1963 with surgical [pelviscopy], now called laparoscopy, and everybody—the whole world—was against me,” Dr. Semm recalled in an interview with James Daniell, MD, at the 1999 International Society of Gynecological Endocrinology conference in Montreal. The ban was lifted in 1964.
By the late 1970s, Dr. was performing a range of laparoscopic procedures, including myomectomy, ovariectomy, tubal ligation and ovarian cyst resection, and had helped to create new technologies such as the electronic insufflator (Figure 2).
In an interview with journalist Grzegorz Litynski, Dr. Semm described how he devised a way to suture during laparoscopic surgery. Dr. Semm recalled being on a plane traveling from the United States to Germany, when he thought of a way to create a knot outside the abdomen and transfer it inside. This account may not be completely accurate. Another gynecologist from Buffalo, N.Y., H. Courtenay Clarke, MD, already had developed a method for laparoscopic extracorporeal knot tying, and had published and patented his technique—the extracorporeal knot-pusher—before Dr. Semm (Fertil Steril 1972;23:274). Dr. Semm may have learned of Dr. Clarke’s technique during his stay in the United States, and had the idea to adopt it as a disposable extracorporeal knot-pusher on the plane ride home to Germany.
Soon after, Dr. Semm was able to pass a knot into the abdomen through a 5 mm trocar. “After the loop became routine, I thought to myself that I could do everything in a different way,” Dr. Semm said in the interview (JSLS 1998;2:309-313). Extracorporeal knotting soon became common practice in the Women’s University Clinic in Kiel, Germany, and “from there, it went step by step: the intracorporeal knot, the microsuture,” Dr. Semm recalled.
In the Feb. 1, 1980, issue of The Medical Tribune, Dr. Semm was asked: “When will the first appendix or gallbladder disappear into an endoscope?” Eight months later, on Sept. 13, Dr. Semm successfully completed a laparoscopic appendectomy.
Although Dr. Semm often is credited with being the first physician to perform a laparoscopic appendectomy, a surgeon in The Netherlands, Henk de Kok, MD, performed a laparoscopic appendectomy three years earlier (Arch Chir Neerl 1977;29:195-198).
“Dr. de Kok did the first laparoscopic appendectomy,” Dr. Nezhat said. “And contrary to reports, he did not perform a mini laparotomy.” Dr. de Kok used a laparoscope to identify and mobilize the appendix and removed it through a 1-cm incision, Dr. Nezhat recalled. In fact, he had done 320 laparoscopic appendectomies by 1980, but he downplayed his accomplishment because the medical establishment continued to be wary of laparoscopy.
It was Dr. Semm who publicized the technique, and much of the surgical community in Germany persecuted Dr. Semm for his work. Some surgeons asked for him to be suspended from medicine and many thought his actions to be unethical. “People accused him of being crazy,” Dr. Nezhat recalled.
At the 2002 meeting of the Society for Laparoendoscopic Surgeons, where Dr. Semm was being honored, a former student, Liselotte Mettler, MD, relayed several anecdotes describing the disdain he encountered for his work during the 1970s and 1980s. Dr. Mettler, now professor emeritus in the Department of Obstetrics and Gynecology, University Hospitals of Schleswig-Holstein, Kiel, revealed that in 1970, after Dr. Semm had introduced laparoscopic surgery to the University of Kiel, his colleagues made him have a brain scan to check for brain damage. She also recalled that during a slide presentation Dr. Semm was giving on ovarian cysts, an audience member unplugged the projector, saying the surgery was unethical and should not be presented (JSLS 2003;7:185-188).
Despite the intense criticism, Dr. Semm pressed onward. After his paper on laparoscopic appendectomy was rejected by the American Journal of Obstetrics and Gynecology because the editors deemed the procedure “unethical,” Dr. Semm found a home for his work in the journal Endoscopy (1983;15:59-64).
In the 1980s, Dr. Nezhat was performing complex procedures, including laparoscopic treatments for severe endometriosis (Fertil Steril 1986;45:778-783), and in 1985, German surgeon Erich Muhe, who had seen Dr. Semm’s technique, performed the first laparoscopic cholecystectomy.
“If you can treat severe endometriosis [using a] laparoscope, you can do practically anything laparoscopically,” Dr. Nezhat noted.
For almost a decade, Dr. Nezhat also had been working to popularize video laparoscopic techniques. Although he encountered resistance, video laparoscopy eventually was recognized as an important paradigm shift in surgery.
“It was the video laparoscope that made it possible to operate with two hands, look on the monitor and engage the whole operating room,” Dr. Nezhat said. “That is why these procedures become so advanced after video laparoscopic appendectomies.”
In 1988, Dr. Semm traveled to Baltimore to present a video of his laparoscopic appendectomy. When Dr. McKernan heard about this, he also traveled to Baltimore to view it. “Dr. Semm’s procedure was on a horrible 8-mm film, but the second I watched it, I could see it involved basic surgical principles,” he recalled. Intrigued, Dr. McKernan returned home to Marietta, Ga., to work on laparoscopy, and shortly after, he performed the first laparoscopic cholecystectomy in the United States. “Dr. Semm was the father of operative gynecology,” Dr. McKernan said. “He was so ahead of everyone else at that time.”
This article is courtesy of General Surgery News.
“There are milestones in the progress of modern surgery that cannot be denied,” said Robert Sewell, MD, a general surgeon at the Master Center for Minimally Invasive Surgery, in Southlake, Texas. When laparoscopy—a minimally invasive approach to surgery—emerged, patients experienced less pain and potentially fewer complications after surgery. “This event rivaled the others in terms of benefits to patients,” Dr. Sewell said.
Over the next several months, General Surgery News will explore the historical landmarks in laparoscopy—from the first-ever procedure attempted on a dog, to today’s experience with single-incision laparoscopy and natural orifice transluminal endoscopic surgery—including interviews with some of the pioneers who helped shape the minimally invasive approach to surgery.
Start of a Transformation
On Sept. 23, 1901, Georg Kelling, MD, a surgeon and gastroenterologist, performed a laparoscopy on a live dog in front of an audience at the 73rd Congress of the Naturalist Scientist’s Medical Conference, in Hamburg, Germany. He named the procedure ‘coelioscopy’ (also spelled coelioskopie or koelioscopie).
“Kelling was the first to establish modern laparoscopy as a field by synthesizing existing technologies to form the trio of features that still defines the procedure today: an abdominal approach, at least two entry ports and artificial insufflation,” wrote gynecological surgeon Camran Nezhat, MD, FACS, FACOG, in his 2011 book, Nezhat’s History of Endoscopy: A Historical Analysis of Endoscopy’s Ascension since Antiquity’ (Endo Press).
Born in Dresden, Germany, on July 7, 1866, Dr. Kelling began his medical education when he was 18 years old, at the Universities of Leipzig and Berlin. In the summer of 1898, he went to the Royal Surgical Clinic in Breslau, where he learned his endoscopic skills from several well-known surgeons. He learned how to perform oral gastrointestinal insufflations—pumping gas into the abdomen to generate enough pressure to create a space between the stomach and small intestine—a skill that would become essential during his first laparoscopic procedure.
Dr. Kelling earned a doctorate in 1890, with a specialty in gastric and intestinal disease. Six years later, he opened a practice in Dresden, Germany. Although a surgeon by profession, he became intrigued by the idea of nonsurgical treatments and wanted to address the problem of gastrointestinal bleeding. Hemorrhaging into the abdomen proved fatal for patients, but many never showed the telltale signs, such as the presence of blood in vomit. At that time, the only conclusive way to diagnose or treat the condition was through laparotomy. However, Dr. Kelling believed that trying to address the problem by opening the abdomen could put the patient in greater danger. Dr. Kelling devised a nonsurgical approach to diagnosing and treating intra-abdominal bleeding safely. He wrote: “I asked myself, how do the organs react to the introduction of air? To find out, I devised a method of using an endoscope on an unopened abdominal cavity” (Münch Med Wochenschr 1901;48:1480-1483,1535-1538).
His instincts proved correct. More recent research shows that making a larger incision impairs an individual’s immunity, said J. Barry McKernan, MD, PhD, the surgeon credited with performing the first laparoscopic cholecystectomy in the United States.
By 1901, Dr. Kelling had found a safe way to view the abdomen using insufflation and determined that creating a pressure of 50 mm Hg alleviated bleeding into the abdomen, a technique he called ‘Luft-tamponade’ (air tamponade) (Figure 1). He also recognized the risk for injuring internal organs by incorrectly placing a trocar and found the best angle of entry was 45 degrees.
During Dr. Kelling’s demonstration of a laparoscopy using a live dog as a subject, he made an incision through which he inserted a Nitze-Leiter cystoscope to magnify and view the inside of the abdomen. The Nitze-Leiter cystoscope, first used in 1872, created illumination through an electrically heated platinum wire that allowed Dr. Kelling to see the interior of the abdomen through telescopic lenses. He then created a second incision, placing a trocar in the abdomen to insufflate the cavity with air, which allowed a better visual. This event marked the first laparoscopic endeavor. The dog survived the procedure. After performing coelioscopy on 20 dogs, Dr. Kelling deemed the procedure safe, noting that “after an examination, a dog is as cheerful as it was before [the procedure]” (Münch Med Wochenschr 1901;48:1480-1483,1535-1538).
Laparoscopy, however, was not Dr. Kelling’s main interest, and he initially did not publish his work on coelioscopy (Zeitschr Biol 1903;44:161-258).
Nine years after Dr. Kelling performed laparoscopy on dogs, Hans Christian Jacobaeus, MD, a Swedish internist, performed clinical laparoscopic surgery on a human—an electrical worker who had been diagnosed with hepatic cirrhosis (Münch Med Wochenschr 1910;57:2090-2092). Unlike Dr. Kelling, Dr. Jacobaeus did not use insufflation. Although not much is known about how Dr. Jacobaeus got involved in laparoscopic surgery, in 1912 he published a monograph describing the 97 laparoscopies he had performed between 1910 and 1912, in Stockholm’s community hospital (Beitr Klin Tuberk 1912;25:185-354). He observed that all of his patients, except one, improved after undergoing the procedure.
Despite these events, which physician performed the first laparoscopic procedure in a human remains somewhat ambiguous. Dr. Jacobaeus often is credited with this accomplishment; he was certainly the first to perform a large series of laparoscopic procedures in human patients and the first to broadcast his experience, but Dr. Kelling claimed he had done two such procedures in humans before Dr. Jacobaeus. Having read about Dr. Jacobaeus’ laparoscopic procedures, Dr. Kelling tried to defend his crown and wrote to journal editors with a detailed account of his work in humans (Nezhat C. Endo Press; 2011). By 1923, Dr. Kelling had published a history of his clinical experience over two decades.
In the 50 to 60 years that followed the first laparoscopic procedure in humans, early pioneers of laparoscopy experimented with the technique, but it did not make much headway in the general surgery community until the 1970s and 1980s.
“The work of Dr. Jacobaeus sparked some interest in laparoscopy around the world. Progress was occurring, but in small pockets and in small measures,” said Dr. Nezhat, president of the Association of the Adjunct Clinical Faculty, Stanford University Medical School, and adjunct clinical professor of surgery and gynecology at Stanford University, in California.
Dr. Nezhat pointed to the discovery that carbon dioxide was better than oxygen or air for insufflation. “Operating rooms [literally] exploded and patients died because people didn’t realize oxygen was flammable. Patients also died from air embolism because initially no one realized that too much pressure during insufflation could cause serious complications,” he said. “All of these [issues] took decades to discover and were, unfortunately for the patient, often only learned by trial and error.”
Additionally, the surgery itself was difficult for innovators and researchers. “Laparoscopy was a ‘one-man band,’” said Dr. Nezhat. “Surgeons had to look through the eyepiece of the laparoscope [holding it in one hand] and do the procedure with their free hand. That’s why there was minimal progress.”
Gaining Traction
A German gynecologist, Kurt Semm, MD, then appeared on the scene. Born on March 23, 1927, in Munich, Dr. Semm attended Ludwig Maximilians University School of Medicine and received his degree in 1951, with a specialty in obstetrics and gynecology. He became fascinated with laparoscopy and explored the technique for almost 20 years before performing a laparoscopic appendectomy.
However, by the 1960s, laparoscopy had earned a bad reputation in Germany. It was associated with high complication rates, in part because surgeons were burning patients during laparoscopic procedures, so the technique was banned there temporarily.
“I started in 1963 with surgical [pelviscopy], now called laparoscopy, and everybody—the whole world—was against me,” Dr. Semm recalled in an interview with James Daniell, MD, at the 1999 International Society of Gynecological Endocrinology conference in Montreal. The ban was lifted in 1964.
By the late 1970s, Dr. was performing a range of laparoscopic procedures, including myomectomy, ovariectomy, tubal ligation and ovarian cyst resection, and had helped to create new technologies such as the electronic insufflator (Figure 2).
In an interview with journalist Grzegorz Litynski, Dr. Semm described how he devised a way to suture during laparoscopic surgery. Dr. Semm recalled being on a plane traveling from the United States to Germany, when he thought of a way to create a knot outside the abdomen and transfer it inside. This account may not be completely accurate. Another gynecologist from Buffalo, N.Y., H. Courtenay Clarke, MD, already had developed a method for laparoscopic extracorporeal knot tying, and had published and patented his technique—the extracorporeal knot-pusher—before Dr. Semm (Fertil Steril 1972;23:274). Dr. Semm may have learned of Dr. Clarke’s technique during his stay in the United States, and had the idea to adopt it as a disposable extracorporeal knot-pusher on the plane ride home to Germany.
Soon after, Dr. Semm was able to pass a knot into the abdomen through a 5 mm trocar. “After the loop became routine, I thought to myself that I could do everything in a different way,” Dr. Semm said in the interview (JSLS 1998;2:309-313). Extracorporeal knotting soon became common practice in the Women’s University Clinic in Kiel, Germany, and “from there, it went step by step: the intracorporeal knot, the microsuture,” Dr. Semm recalled.
In the Feb. 1, 1980, issue of The Medical Tribune, Dr. Semm was asked: “When will the first appendix or gallbladder disappear into an endoscope?” Eight months later, on Sept. 13, Dr. Semm successfully completed a laparoscopic appendectomy.
Although Dr. Semm often is credited with being the first physician to perform a laparoscopic appendectomy, a surgeon in The Netherlands, Henk de Kok, MD, performed a laparoscopic appendectomy three years earlier (Arch Chir Neerl 1977;29:195-198).
“Dr. de Kok did the first laparoscopic appendectomy,” Dr. Nezhat said. “And contrary to reports, he did not perform a mini laparotomy.” Dr. de Kok used a laparoscope to identify and mobilize the appendix and removed it through a 1-cm incision, Dr. Nezhat recalled. In fact, he had done 320 laparoscopic appendectomies by 1980, but he downplayed his accomplishment because the medical establishment continued to be wary of laparoscopy.
It was Dr. Semm who publicized the technique, and much of the surgical community in Germany persecuted Dr. Semm for his work. Some surgeons asked for him to be suspended from medicine and many thought his actions to be unethical. “People accused him of being crazy,” Dr. Nezhat recalled.
At the 2002 meeting of the Society for Laparoendoscopic Surgeons, where Dr. Semm was being honored, a former student, Liselotte Mettler, MD, relayed several anecdotes describing the disdain he encountered for his work during the 1970s and 1980s. Dr. Mettler, now professor emeritus in the Department of Obstetrics and Gynecology, University Hospitals of Schleswig-Holstein, Kiel, revealed that in 1970, after Dr. Semm had introduced laparoscopic surgery to the University of Kiel, his colleagues made him have a brain scan to check for brain damage. She also recalled that during a slide presentation Dr. Semm was giving on ovarian cysts, an audience member unplugged the projector, saying the surgery was unethical and should not be presented (JSLS 2003;7:185-188).
Despite the intense criticism, Dr. Semm pressed onward. After his paper on laparoscopic appendectomy was rejected by the American Journal of Obstetrics and Gynecology because the editors deemed the procedure “unethical,” Dr. Semm found a home for his work in the journal Endoscopy (1983;15:59-64).
In the 1980s, Dr. Nezhat was performing complex procedures, including laparoscopic treatments for severe endometriosis (Fertil Steril 1986;45:778-783), and in 1985, German surgeon Erich Muhe, who had seen Dr. Semm’s technique, performed the first laparoscopic cholecystectomy.
“If you can treat severe endometriosis [using a] laparoscope, you can do practically anything laparoscopically,” Dr. Nezhat noted.
For almost a decade, Dr. Nezhat also had been working to popularize video laparoscopic techniques. Although he encountered resistance, video laparoscopy eventually was recognized as an important paradigm shift in surgery.
“It was the video laparoscope that made it possible to operate with two hands, look on the monitor and engage the whole operating room,” Dr. Nezhat said. “That is why these procedures become so advanced after video laparoscopic appendectomies.”
In 1988, Dr. Semm traveled to Baltimore to present a video of his laparoscopic appendectomy. When Dr. McKernan heard about this, he also traveled to Baltimore to view it. “Dr. Semm’s procedure was on a horrible 8-mm film, but the second I watched it, I could see it involved basic surgical principles,” he recalled. Intrigued, Dr. McKernan returned home to Marietta, Ga., to work on laparoscopy, and shortly after, he performed the first laparoscopic cholecystectomy in the United States. “Dr. Semm was the father of operative gynecology,” Dr. McKernan said. “He was so ahead of everyone else at that time.”
This article is courtesy of General Surgery News.
Sioux City doctor fined $7,500 for surgery error
The Iowa Board of Medicine has fined a Sioux City gynecologist for mistakenly removing a woman’s healthy ovaries during a hysterectomy. A civil suit also has been filed.
Dr. Kevin Hamburger, 50, was fined $7,500 for the incident.
Hamburger did not respond to messages at his office, Siouxland Women's Health Care. The office administrator, Julie Bartow, said Hamburger is still working at the practice. She would not comment about the situation.
It is the first time Hamburger has been cited by the board, which issues state medical licenses, since he became a doctor in 1993. The board in a statement said Hamburger apologized for the mistake.
Hamburger also is being sued for damages related to the July 29, 2011, incident. According to the lawsuit filed in April, patient Erin Rehan, 29, was told by Hamburger that her ovaries would not be removed during the procedure. A hysterectomy is the surgical removal of the uterus.
Rehan and her attorney, Paul Lundberg, did not respond to messages asking for comments about the lawsuit or the board's decision. A representative from Lundberg's office said he wouldn't comment on pending litigation.
Rehan is seeking damages of more than $10,000 for severe and permanent physical, mental and emotional injury. It accuses Hamburger of professional negligence and medical battery. A Nov. 19 trial is scheduled.
Attorney John Gray, who represents Hamburger, said he would not comment about the allegations.
The Board of Medicine announced the fine Thursday. It also requires Hamburger to submit a plan describing how he’ll avoid future errors.
This article is courtesy of Sioux City Journal.
Dr. Kevin Hamburger, 50, was fined $7,500 for the incident.
Hamburger did not respond to messages at his office, Siouxland Women's Health Care. The office administrator, Julie Bartow, said Hamburger is still working at the practice. She would not comment about the situation.
It is the first time Hamburger has been cited by the board, which issues state medical licenses, since he became a doctor in 1993. The board in a statement said Hamburger apologized for the mistake.
Hamburger also is being sued for damages related to the July 29, 2011, incident. According to the lawsuit filed in April, patient Erin Rehan, 29, was told by Hamburger that her ovaries would not be removed during the procedure. A hysterectomy is the surgical removal of the uterus.
Rehan and her attorney, Paul Lundberg, did not respond to messages asking for comments about the lawsuit or the board's decision. A representative from Lundberg's office said he wouldn't comment on pending litigation.
Rehan is seeking damages of more than $10,000 for severe and permanent physical, mental and emotional injury. It accuses Hamburger of professional negligence and medical battery. A Nov. 19 trial is scheduled.
Attorney John Gray, who represents Hamburger, said he would not comment about the allegations.
The Board of Medicine announced the fine Thursday. It also requires Hamburger to submit a plan describing how he’ll avoid future errors.
This article is courtesy of Sioux City Journal.
Thursday, 11 April 2013
Woman sues Ohio clinic over failed abortion after delivering healthy 'miracle' baby
An Ohio woman is suing an abortion clinic after she says she made the painful decision to terminate her pregnancy because her life was in danger, only to discover she was still pregnant after the procedure.
The northeast Ohio clinic in a court filing denied Ariel Knights' allegations that doctors were negligent and failed to successfully perform the abortion she sought, eventually leading to the birth of her healthy baby daughter.
The Akron Women’s Medical Group and two doctors acknowledge Knights, of Cuyahoga Falls, sought an abortion March 3, 2012. However, they deny any negligence and seek to have the case dismissed, citing a long list of possible defenses.
“I believe my client absolutely met the standard of care and that this case has no basis to be in litigation,”attorney D. Cheryl Atwell, who represents the medical group and the doctors, said Monday.
Lawyers still are exchanging medical records, and Atwell said she couldn’t comment further.
The malpractice lawsuit was filed March 4 on behalf of 22-year-old Knights. Her attorney, James Gutbrod, said Monday the medical group’s legal response was general and he had no comment on it.
Knights has said she sought the abortion because she has a medical condition called uterine didelphys, resulting in a double uterus with individual cervices, and a doctor had told her that her pregnancy and her life could be threatened because the fetus was carried in an unstable uterus.
Knights tells the Akron Beacon Journal she agonized over the decision to terminate the pregnancy, but felt she had no choice because of her preschool-aged son.
“It was a decision I made because my life was in danger,” she told the paper in an interview March 15. “I was put in jeopardy. And I have a son that I am supposed to be taking care of.”
She learned about a week after the abortion procedure that she still was pregnant, according to the lawsuit alleging the defendants “were negligent and deviated from the appropriate standard of care.”
The lawsuit also indicates Knights was referred to a second abortion clinic after she found out she still was pregnant, but that clinic was unwilling to become involved in “somebody else’s mistake,” and she refused to return to the original clinic for a second abortion attempt.
Knights made a second appointment with the medical group but did not show up for it, according to the defendants’ filing. It doesn’t specify the date of the second appointment.
Knights says she spent the rest of her pregnancy in a state of constant fear.
“I can’t explain how I felt," she told the Akron Beacon Journal. "It was just a sense of being overwhelmed, wondering what happened to the baby, wondering what’s happening to me and what did (the clinic) think they did."
Knights says she considers her daughter her "miracle" baby, saying she does not like to think about what would have happened had the abortion been successful.
This article is courtesy of Fox News.
The northeast Ohio clinic in a court filing denied Ariel Knights' allegations that doctors were negligent and failed to successfully perform the abortion she sought, eventually leading to the birth of her healthy baby daughter.
The Akron Women’s Medical Group and two doctors acknowledge Knights, of Cuyahoga Falls, sought an abortion March 3, 2012. However, they deny any negligence and seek to have the case dismissed, citing a long list of possible defenses.
“I believe my client absolutely met the standard of care and that this case has no basis to be in litigation,”attorney D. Cheryl Atwell, who represents the medical group and the doctors, said Monday.
Lawyers still are exchanging medical records, and Atwell said she couldn’t comment further.
The malpractice lawsuit was filed March 4 on behalf of 22-year-old Knights. Her attorney, James Gutbrod, said Monday the medical group’s legal response was general and he had no comment on it.
Knights has said she sought the abortion because she has a medical condition called uterine didelphys, resulting in a double uterus with individual cervices, and a doctor had told her that her pregnancy and her life could be threatened because the fetus was carried in an unstable uterus.
Knights tells the Akron Beacon Journal she agonized over the decision to terminate the pregnancy, but felt she had no choice because of her preschool-aged son.
“It was a decision I made because my life was in danger,” she told the paper in an interview March 15. “I was put in jeopardy. And I have a son that I am supposed to be taking care of.”
She learned about a week after the abortion procedure that she still was pregnant, according to the lawsuit alleging the defendants “were negligent and deviated from the appropriate standard of care.”
The lawsuit also indicates Knights was referred to a second abortion clinic after she found out she still was pregnant, but that clinic was unwilling to become involved in “somebody else’s mistake,” and she refused to return to the original clinic for a second abortion attempt.
Knights made a second appointment with the medical group but did not show up for it, according to the defendants’ filing. It doesn’t specify the date of the second appointment.
Knights says she spent the rest of her pregnancy in a state of constant fear.
“I can’t explain how I felt," she told the Akron Beacon Journal. "It was just a sense of being overwhelmed, wondering what happened to the baby, wondering what’s happening to me and what did (the clinic) think they did."
Knights says she considers her daughter her "miracle" baby, saying she does not like to think about what would have happened had the abortion been successful.
This article is courtesy of Fox News.
Wednesday, 10 April 2013
Judge orders $30 million judgment against former Florida pain clinic
A Glynn County judge has awarded $30 million to the widow of a man who died of a drug overdose after his treatment at a Brunswick pain clinic closed since agents raided it in 2012.
Superior Court Judge Stephen Scarlett set the damages Monday in a default judgment after the Wellness Center of Brunswick failed to respond to a malpractice and wrongful death suit that Susan Bennett, wife of the late William Wardell Bennett, filed in January.
Scarlett also awarded $5,570 to Bennett’s estate for his funeral expenses and immediate pain and suffering.
The suit claims that Bennett, 52, went to Brunswick Wellness Jan. 5, 2011, for treatment for chronic pain and died six days later of an overdose of drugs that physician Dennis S. Momah prescribed.
He was found dead at his Appling County home two days after he had been treated for respiratory problems, said Susan Bennett’s lawyer, J. Dow III.
The Georgia Bureau of Investigation autopsy showed that he died of having multiple drugs in his system that reacted in an adverse way, Dow said.
“That was his one and only visit to that facility,’’ Dow said.
Momah pleaded guilty this year to prescribing addictive pain medication for no legitimate medical purpose and is awaiting sentencing. The owner of the business, Roland R. Colandrea, Jr., 43, pleaded guilty Friday to a single count of conspiracy to distribute drugs while the former office manager, Natalie Anderson, has pleaded guilty to two counts of money laundering. The business opened in November 2010 and never reopened after it was raided July 14, 2011.
Bennett has a long medical history that is laid out in the suit. It included shortness of breath, emphysema/asthma, smoking, a nervous disorder, anxiety, depression, chronic back pain, degenerative disc disease, a heart condition and high blood pressure.
He had positive drug screens for opiates or morphine, the active ingredient of Xanax, and the addictive painkiller oxycodone. Bennett also had a prescription from another physician for Roxicodone and Xanax.
In spite of that history, Momah conducted a short examination of Bennett and prescribed 270 tablets of Roxicodone, a variation of oxycodone, and 90 doses of Xanax.
The suit says Momah prescribed an excessive number of short-acting opiads that have no legitimate used in the care and treatment of chronic back pain.
The suit said the owners and managers of Brunswick Wellness were negligent in that they booked so many patients a day that it was impossible to evaluate patients.
A federal indictment of the clinic’s owner, manager and three physicians said the doctors treated 35 patients in a day and that one of the prescribing physicians saw 63 in a single day
The two other physicians, Cleveland J. Enmon and Bruce I. Tetalman, are awaiting trial on drug distribution charges.
Superior Court Judge Stephen Scarlett set the damages Monday in a default judgment after the Wellness Center of Brunswick failed to respond to a malpractice and wrongful death suit that Susan Bennett, wife of the late William Wardell Bennett, filed in January.
Scarlett also awarded $5,570 to Bennett’s estate for his funeral expenses and immediate pain and suffering.
The suit claims that Bennett, 52, went to Brunswick Wellness Jan. 5, 2011, for treatment for chronic pain and died six days later of an overdose of drugs that physician Dennis S. Momah prescribed.
He was found dead at his Appling County home two days after he had been treated for respiratory problems, said Susan Bennett’s lawyer, J. Dow III.
The Georgia Bureau of Investigation autopsy showed that he died of having multiple drugs in his system that reacted in an adverse way, Dow said.
“That was his one and only visit to that facility,’’ Dow said.
Momah pleaded guilty this year to prescribing addictive pain medication for no legitimate medical purpose and is awaiting sentencing. The owner of the business, Roland R. Colandrea, Jr., 43, pleaded guilty Friday to a single count of conspiracy to distribute drugs while the former office manager, Natalie Anderson, has pleaded guilty to two counts of money laundering. The business opened in November 2010 and never reopened after it was raided July 14, 2011.
Bennett has a long medical history that is laid out in the suit. It included shortness of breath, emphysema/asthma, smoking, a nervous disorder, anxiety, depression, chronic back pain, degenerative disc disease, a heart condition and high blood pressure.
He had positive drug screens for opiates or morphine, the active ingredient of Xanax, and the addictive painkiller oxycodone. Bennett also had a prescription from another physician for Roxicodone and Xanax.
In spite of that history, Momah conducted a short examination of Bennett and prescribed 270 tablets of Roxicodone, a variation of oxycodone, and 90 doses of Xanax.
The suit says Momah prescribed an excessive number of short-acting opiads that have no legitimate used in the care and treatment of chronic back pain.
The suit said the owners and managers of Brunswick Wellness were negligent in that they booked so many patients a day that it was impossible to evaluate patients.
A federal indictment of the clinic’s owner, manager and three physicians said the doctors treated 35 patients in a day and that one of the prescribing physicians saw 63 in a single day
The two other physicians, Cleveland J. Enmon and Bruce I. Tetalman, are awaiting trial on drug distribution charges.
Father dies after blundering doctor forgot medicine for six days
A father died on the bathroom floor of a hospital after a bungling junior doctor forgot to give him life-saving drugs six days in a row.
Medics failed to realise that Edward McKean, 52, was not receiving vital blood-thinners for almost a week following brain surgery to remove a benign tumour.
The father-of-three did not receive the drugs, designed to reduce the risk of blood clots, after a junior doctor missed them off his medication chart when she copied it up, an inquest heard.
As a result, a clot in Mr McKean's leg broke free and blocked an artery, causing a fatal pulmonary embolism as he walked to the toilet.
Doctors and nurses missed numerous opportunities to spot their mistake, said the coroner, who ruled that "neglect" had been a contributing factor to his death.
An inquest at Coventry Magistrates Court heard that the keen walker's life could probably have been saved if the mistake had been picked up.
Mr McKean had surgery to correct a rare tumour in his nasal cavity and skull at University Hospital Coventry on April 3 last year.
He initially received the anti-coagulant medication after the operation but stopped receiving it following the error by the junior.
The contracts manager, from Solihull, West Midlands, collapsed and died as he walked to the toilet on April 22 last year, almost three weeks after his operation.
Mr McKean's partner Susan Rickards told the inquest she "fought for a year" to stop the tragedy being "swept under the carpet".
Describing the moment she learned of his death, she told the inquest: "The hospital rang me at five in the morning and told me there was an emergency, so I shot up there.
"I assumed Eddie had fallen over so I sat in the car and put mascara on. I thought if he saw I was calm it would help him to keep calm.
"I thought he might have broken his arm or leg, but when I got to the ward they told me he was gone."
Consultant neurosurgeon Hussien El-Maghraby admitted the mistake should have been detected sooner.
He said: "What is serious was that it was not picked up for six days."
Mr El-Maghraby added that when he learned what had happened, he sent an email to the hospital's chief executive.
Deputy coroner Louise Hunt, who recorded a narrative verdict, asked him: "On a scale of one to 10, how serious would you say these collective failings were?"
He replied: "Very serious, 10 out of 10. That's what made me send an email."
The inquest on Friday heard the hospital had since improved ward rounds and made other changes to minimise the risk of a similar tragedy.
Ruling that neglect had contributed to Mr McKean's death, Ms Hunt asked the hospital to send her written confirmation that it had implemented measures to prevent similar mistakes occurring again.
Dr Mike Iredale, deputy medical director, apologised to the family for the "unimaginable distress and grief" the hospital had caused them.
He accepted serious mistakes were made and promised the hospital would continue to improve its procedures.
This article is courtesy of The Telegraph.
Medics failed to realise that Edward McKean, 52, was not receiving vital blood-thinners for almost a week following brain surgery to remove a benign tumour.
The father-of-three did not receive the drugs, designed to reduce the risk of blood clots, after a junior doctor missed them off his medication chart when she copied it up, an inquest heard.
As a result, a clot in Mr McKean's leg broke free and blocked an artery, causing a fatal pulmonary embolism as he walked to the toilet.
Doctors and nurses missed numerous opportunities to spot their mistake, said the coroner, who ruled that "neglect" had been a contributing factor to his death.
An inquest at Coventry Magistrates Court heard that the keen walker's life could probably have been saved if the mistake had been picked up.
Mr McKean had surgery to correct a rare tumour in his nasal cavity and skull at University Hospital Coventry on April 3 last year.
He initially received the anti-coagulant medication after the operation but stopped receiving it following the error by the junior.
The contracts manager, from Solihull, West Midlands, collapsed and died as he walked to the toilet on April 22 last year, almost three weeks after his operation.
Mr McKean's partner Susan Rickards told the inquest she "fought for a year" to stop the tragedy being "swept under the carpet".
Describing the moment she learned of his death, she told the inquest: "The hospital rang me at five in the morning and told me there was an emergency, so I shot up there.
"I assumed Eddie had fallen over so I sat in the car and put mascara on. I thought if he saw I was calm it would help him to keep calm.
"I thought he might have broken his arm or leg, but when I got to the ward they told me he was gone."
Consultant neurosurgeon Hussien El-Maghraby admitted the mistake should have been detected sooner.
He said: "What is serious was that it was not picked up for six days."
Mr El-Maghraby added that when he learned what had happened, he sent an email to the hospital's chief executive.
Deputy coroner Louise Hunt, who recorded a narrative verdict, asked him: "On a scale of one to 10, how serious would you say these collective failings were?"
He replied: "Very serious, 10 out of 10. That's what made me send an email."
The inquest on Friday heard the hospital had since improved ward rounds and made other changes to minimise the risk of a similar tragedy.
Ruling that neglect had contributed to Mr McKean's death, Ms Hunt asked the hospital to send her written confirmation that it had implemented measures to prevent similar mistakes occurring again.
Dr Mike Iredale, deputy medical director, apologised to the family for the "unimaginable distress and grief" the hospital had caused them.
He accepted serious mistakes were made and promised the hospital would continue to improve its procedures.
This article is courtesy of The Telegraph.
Five-year-old girl died from meningitis after doctor said hospital was 'waste of time'
Kelsey Smart saw two GPs in the days before her death, both of whom failed to spot she had contracted the deadly brain condition.
Her parents, Jamie and Hannah Smart, had taken her to see an out-of-hours GP who said she was suffering from a stomach bug, despite a rash on her chin, stomach and legs - telltale symptoms of meningitis.
One GP said he could refer Kelsey to the hospital to be seen but it would only be a "four-hour waste of time".
The schoolgirl, from Kingswood, Gloucestershire, later died in hospital on February 28 last year, the hearing at Avon Coroner's Court heard.
Mrs Smart told the inquest that her daughter was examined by a second GP and she spoke to a third by telephone in the days before she died.
Three hours after her last examination, Kelsey, who was a Year 1 pupil at The Park Primary School, suffered a fit and was admitted to Bristol Children's Hospital but never recovered.
The inquest heard that Kelsey first starting feeling unwell on the night of February 25 and was vomiting hourly throughout the night.
She was also tired, had a temperature and had developed a small pinprick rash on her abdomen and left upper leg.
Mrs Smart said that by the following afternoon Kelsey was still unwell and she called Frendoc - an out of hours GP service based in south Gloucestershire.
A doctor rang back and having spoken to Mrs Smart told her to give Kelsey Dioralyte - a brand of rehydration medication - and to ring back if she could not keep that down.
When she continued to be sick Mrs Smart telephoned again and was told to take Kelsey in.
Mrs Smart and her daughter were seen by locum GP Jens Rohrbeck at Frendoc's clinic at Frenchay Hospital.
"To me Dr Rohrbeck did not seem very interested in Kelsey or her illness. For a lot of the consultation he seemed to be staring at me looking blank as if he didn't know what to do," she told the inquest.
"When I asked him what was wrong with Kelsey he said she had picked up a virus.
"He explained he would send us down to the hospital to be seen but this would be a four-hour waste of time.
"He said it would be better for me to take Kelsey home and if she continued to be sick overnight I should take her to our family GP the next day."
The following morning Mrs Smart rang her doctors' surgery, Orchard Medical Centre in Kingswood, asking for an appointment.
Kelsey and her mother were seen by Dr Sarah Grant.
Mrs Smart said: "While we were in the consultation room she was very agitated and she pulled a clump of hair out of her head.
"Dr Grant did not pass comment on this or suggest it was anything to worry about.
"I again highlighted Kelsey's rash which was still present in the various places on her body.
"Dr Grant prodded the rash with her finger and said it was linked to the virus. She said children often come up in rashes when they have a virus.
"Dr Grant did seem to realise that I was very concerned about Kelsey and she told me to bring Kelsey back at 4pm if there was no change.
"All in all we were in the consultation room for about five minutes."
By lunchtime Mrs Smart thought her daughter was suffering from appendicitis and decided to drive her to hospital.
Kelsey started fitting and Mrs Smart pulled over and called an ambulance and she was rushed to Bristol Children's Hospital.
She was placed on life support but deteriorated and doctors informed Mrs Smart and her husband, a self-employed painter and decorator, that Kelsey was brain dead.
A narrative verdict was recorded by the Avon Coroner Maria Voisin.
Mrs Voisin said she was mindful of both Kelsey's presentation when she was seen by each doctor and the evidence of the two consultants from the children's hospital.
"It is clear from their evidence that earlier intervention is better but what cannot be said is whether earlier treatment would have resulted in a different outcome for Kelsey.
"Neither can we say exactly what would have happened if Kelsey had been admitted sooner.
"So based on the evidence I consider the appropriate verdict to be a narrative verdict."
This article is courtesy of The Telegraph.
Her parents, Jamie and Hannah Smart, had taken her to see an out-of-hours GP who said she was suffering from a stomach bug, despite a rash on her chin, stomach and legs - telltale symptoms of meningitis.
One GP said he could refer Kelsey to the hospital to be seen but it would only be a "four-hour waste of time".
The schoolgirl, from Kingswood, Gloucestershire, later died in hospital on February 28 last year, the hearing at Avon Coroner's Court heard.
Mrs Smart told the inquest that her daughter was examined by a second GP and she spoke to a third by telephone in the days before she died.
Three hours after her last examination, Kelsey, who was a Year 1 pupil at The Park Primary School, suffered a fit and was admitted to Bristol Children's Hospital but never recovered.
The inquest heard that Kelsey first starting feeling unwell on the night of February 25 and was vomiting hourly throughout the night.
She was also tired, had a temperature and had developed a small pinprick rash on her abdomen and left upper leg.
Mrs Smart said that by the following afternoon Kelsey was still unwell and she called Frendoc - an out of hours GP service based in south Gloucestershire.
A doctor rang back and having spoken to Mrs Smart told her to give Kelsey Dioralyte - a brand of rehydration medication - and to ring back if she could not keep that down.
When she continued to be sick Mrs Smart telephoned again and was told to take Kelsey in.
Mrs Smart and her daughter were seen by locum GP Jens Rohrbeck at Frendoc's clinic at Frenchay Hospital.
"To me Dr Rohrbeck did not seem very interested in Kelsey or her illness. For a lot of the consultation he seemed to be staring at me looking blank as if he didn't know what to do," she told the inquest.
"When I asked him what was wrong with Kelsey he said she had picked up a virus.
"He explained he would send us down to the hospital to be seen but this would be a four-hour waste of time.
"He said it would be better for me to take Kelsey home and if she continued to be sick overnight I should take her to our family GP the next day."
The following morning Mrs Smart rang her doctors' surgery, Orchard Medical Centre in Kingswood, asking for an appointment.
Kelsey and her mother were seen by Dr Sarah Grant.
Mrs Smart said: "While we were in the consultation room she was very agitated and she pulled a clump of hair out of her head.
"Dr Grant did not pass comment on this or suggest it was anything to worry about.
"I again highlighted Kelsey's rash which was still present in the various places on her body.
"Dr Grant prodded the rash with her finger and said it was linked to the virus. She said children often come up in rashes when they have a virus.
"Dr Grant did seem to realise that I was very concerned about Kelsey and she told me to bring Kelsey back at 4pm if there was no change.
"All in all we were in the consultation room for about five minutes."
By lunchtime Mrs Smart thought her daughter was suffering from appendicitis and decided to drive her to hospital.
Kelsey started fitting and Mrs Smart pulled over and called an ambulance and she was rushed to Bristol Children's Hospital.
She was placed on life support but deteriorated and doctors informed Mrs Smart and her husband, a self-employed painter and decorator, that Kelsey was brain dead.
A narrative verdict was recorded by the Avon Coroner Maria Voisin.
Mrs Voisin said she was mindful of both Kelsey's presentation when she was seen by each doctor and the evidence of the two consultants from the children's hospital.
"It is clear from their evidence that earlier intervention is better but what cannot be said is whether earlier treatment would have resulted in a different outcome for Kelsey.
"Neither can we say exactly what would have happened if Kelsey had been admitted sooner.
"So based on the evidence I consider the appropriate verdict to be a narrative verdict."
This article is courtesy of The Telegraph.
Tuesday, 9 April 2013
Husband claims hospital is liable in death of wife
The husband of a woman who died last year after being treated at Kentucy Hospital, Pattie A. Clay Regional Medical Center, has filed a wrongful death suit against the hospital.
Roger Harrison, acting as the administrator for the estate of Patricia Harrison, also is suing two physicians, Dr. Ted R. Qualls and Dr. Raymond C. Jackson. The medical provider the physicians worked for at the time of Harrison’s death, MESA Medical Group, is named as a defendant.
Patricia Harrison was 70 when she died March 20, 2012, according to her obituary. She had been a greeter at the Richmond Walmart for eight years.
The lawsuit states Harrison became a patient at the Richmond hospital March 19, 2012.
Roger Harrison alleges that the hospital and physicians “failed to exercise the degree of care and skill that would be expected of an ordinarily prudent or reasonably competent physician or health care provider under like or similar circumstances.”
The court documents do not provide information about Harrison’s ailment or diagnosis.
The care Patricia Harrison received at the hospital was a “substantial factor” in causing injury and death, the lawsuit claims.
Roger Harrison is asking the court for compensation for his wife’s medical expenses, severe physical pain and mental anguish, extreme emotional distress and funeral expenses.
He also is suing as an individual and asking for damages since he was deprived of his wife’s consortium and companionship.
The hospital has responded to the lawsuit, denying the allegations and asserting the claims fall outside the statute of limitations, among other defenses, according to court documents.
Roger Harrison is being represented by attorney Stephen Harrison III. The case has been assigned to Judge William G. Clouse and no court dates have been set yet.
Civil trial against hospital started on Monday
A 2006 civil suit filed against Pattie A. Clay Regional Medical Center and medical staffers alleging malpractice is set for trial Monday in Madison Circuit Court.
Linda Mitchell, the plaintiff, is suing in her capacity as the legal guardian of Chandice Renee Mitchell. Linda Mitchell claims that because of the hospital and staffers’ negligence, the child suffered permanent injury at the time of her delivery in 1996.
This article is courtesy of the Richmond Register.
Roger Harrison, acting as the administrator for the estate of Patricia Harrison, also is suing two physicians, Dr. Ted R. Qualls and Dr. Raymond C. Jackson. The medical provider the physicians worked for at the time of Harrison’s death, MESA Medical Group, is named as a defendant.
Patricia Harrison was 70 when she died March 20, 2012, according to her obituary. She had been a greeter at the Richmond Walmart for eight years.
The lawsuit states Harrison became a patient at the Richmond hospital March 19, 2012.
Roger Harrison alleges that the hospital and physicians “failed to exercise the degree of care and skill that would be expected of an ordinarily prudent or reasonably competent physician or health care provider under like or similar circumstances.”
The court documents do not provide information about Harrison’s ailment or diagnosis.
The care Patricia Harrison received at the hospital was a “substantial factor” in causing injury and death, the lawsuit claims.
Roger Harrison is asking the court for compensation for his wife’s medical expenses, severe physical pain and mental anguish, extreme emotional distress and funeral expenses.
He also is suing as an individual and asking for damages since he was deprived of his wife’s consortium and companionship.
The hospital has responded to the lawsuit, denying the allegations and asserting the claims fall outside the statute of limitations, among other defenses, according to court documents.
Roger Harrison is being represented by attorney Stephen Harrison III. The case has been assigned to Judge William G. Clouse and no court dates have been set yet.
Civil trial against hospital started on Monday
A 2006 civil suit filed against Pattie A. Clay Regional Medical Center and medical staffers alleging malpractice is set for trial Monday in Madison Circuit Court.
Linda Mitchell, the plaintiff, is suing in her capacity as the legal guardian of Chandice Renee Mitchell. Linda Mitchell claims that because of the hospital and staffers’ negligence, the child suffered permanent injury at the time of her delivery in 1996.
This article is courtesy of the Richmond Register.
Hospital sued over children left neglected and dying on wards
Hospital sued over children left neglected and dying on wards.
University Hospitals Bristol Foundation trust is being sued by a group of families over its treatment of newborn babies and young children who died or suffered complications at the hospital in a landmark case which raises fresh questions over the NHS's treatment of its patients.
The ten families - of whom seven lost children, while three children survived - are seeking an admission of wrongdoing by the hospital trust, which would also open the way for compensation payments for those who face looking after the surviving children who were damaged by their treatment.
In some cases nurses are accused of switching off or turning down alarms supposed to warn them that children's conditions were deteriorating.
Other parents say that there were so few nurses caring for children who had undergone heart surgery that they administered medication, monitored oxygen levels and even cleaned up vomit themselves.
The legal case is the latest to hit the NHS and comes in the wake of the damning report into Stafford Hospital, where up to 1,200 patients died needlessly and hundreds more suffered appalling care.
The ten cases include:
* Luke Jenkins, 7, who died of a cardiac arrest within a week of heart surgery last April after hospital staff failed to recognise that he was deteriorating. His parents say they witnessed nurses "resetting" alarms which indicated his condition was deteriorating.
* Sean Turner, 4, died of a brain haemorrhage last March after staff did not identify that his condition was worsening. All around the ward, alarms were left unanswered, his parents said.
* Maisie Waters, just one week old when she died last August, after a nurse accidentally fed her a day's worth of food in just one hour, using an infusion machine.
* Oscar Willcox, died aged 9 weeks last April. His mother said his death followed a catalogue of failings, with nurses failing to clean up his vomit or change his nappies while he was dangerously ill.
* Jack Casey, left with brain damage, causing developmental problems, since complications following surgery in 2010, aged just 10 months, and a subsequent procedure in which his lung lining was pierced.
Bereaved parents said they had been left devastated after their children's deaths, which they say followed a catalogue of failings and severe neglect.
Luke's father, Stephen Jenkins, 31, from Cardiff, said he and his partner were left "screaming and shouting for help" because they could see their child was dying, yet nurses refused to listen, and failed to call senior doctors.
Although monitoring alarms were repeatedly sounding, warning that the child's condition was worsening, nurses reset the alarms to a lower threshold, so they were less likely to go off, he said.
Laywers will accuse the trust of negligence in the post-operative care given to children, and in some cases in the surgery they received. They will say that without the failings, such as missing clear signs of deterioration, the children who died could have survived, while others might have suffered less extensive damage.
The trust has already admitted that failures to detect the worsening condition of Sean and Luke may have contributed to their deaths.
The cases, which occurred between 2008 and last autumn, will also deepen concerns about failings in NHS systems of regulation.
The legal actions come after the trust was censured by the Care Quality Commission (CQC), after an inspection found that too many children were receiving unsafe care and treatment, because there were not enough nurses to care for those recovering from surgery.
That visit only took place after regulators were repeatedly contacted by the bereaved parents of Sean Turner and Luke Jenkins, who expressed their fears that more children would die, if action was not taken.
CQC then issued a warning notice in October which said that staffing levels were unsafe on the cardiac ward for children who had undergone surgery.
Seven weeks later, it declared the hospital "compliant" with its standards. In fact the hospital only achieved this by reducing the number of patients it would accept for heart surgery, so that there are fewer children for nurses to care for.
Experts said the move by the hospital was a desperate measure, which could ultimately increase the risks to children treated at the cardiac unit as surgeons are supposed to carry out hundreds of procedures each year, in order to maintain their skills.
The cases are disclosed the day before a judicial review attempts to halt changes to children's heart surgery, which were proposed to improve the safety of all of England's 10 units.
The recommendation to centralise hospitals, so that ensure all centres had enough surgeons carrying out high numbers of specialist procedures, followed a public inquiry into dozens of baby deaths in Bristol during the 1990s.
Most of the cases disclosed today occurred at the cardiac unit of Bristol Royal Hospital for Children.
The hospital was opened in 2001 after the children's cardiac unit based in the Bristol Royal Infirmary was closed, having been dubbed "the killing fields" after the deaths, which followed botched operations by surgeons.
Lawyers acting for the families say children are being put at risk because successive Governments have failed to act on the recommendation, which was made by Prof Sir Ian Kennedy in 2001. Twelve years on, a decision on which units should close has yet to be taken.
Plans were finally drawn up last July to close specialist cardiac children's services in Leeds, Leicester and from Royal Brompton Hospital, and to expand the seven remaining units, including Bristol, so that each performs at least 400 procedures a year.
Even before its surgery programme was scaled back, Bristol was among four units carrying out less than 280 operations a year. Last night, the trust refused to say how many operations it is now carrying out.
After arguments between hospital trusts fighting to keep their services, and pressure from local MPs and campaign groups, ministers have referred the decision to an independent panel, which reports next month.
Laurence Vick, from legal firm Michelmores, who is representing nine of the families has written to the panel, urging them to carry out an analysis of detailed mortality data from all the units, to ensure a fair decision.
Mr Vick, who acted for dozens of those bereaved by the 1990s Bristol babies scandal said: "We have waited far too long already for this. We need a fair decision so that the safety of all units can be improved, instead of being endlesssly open to challenge."
However, before that, a judicial review from a campaign group fighting to save services at Leeds Teaching Hospitals trust will tomorrow argue that the process to decide which units close has been flawed. If it succeeds, the process could be forced to start again. Royal Brompton Hospital in London has already failed in its arguments against the decision.
The trust said data showed that between 2000 and 2008, the trust's mortality were the third best of 11 units which were then in operation.
Robert Woolley, the trust's chief executive, said the latest mortality figures, covering the three years up to 2010, showed a 1.6 per cent mortality rate for children below the age of one, and 1 per cent among older children, but that unaudited figures since then were not yet available.
He said. "All paediatric cardiac surgery carries with it significant risk and these risks are explained to parents. Despite these risks and the complex needs of the children we care for, we have results among the best in England."
The trust said it could not comment on cases which had yet to go to an inquest, but apologised for the death of Maisie Waters. A spokesman said the trust had taken every possible step to minimise the chance of a similar human error occurring.
This article is courtesy of The Telegraph.
University Hospitals Bristol Foundation trust is being sued by a group of families over its treatment of newborn babies and young children who died or suffered complications at the hospital in a landmark case which raises fresh questions over the NHS's treatment of its patients.
The ten families - of whom seven lost children, while three children survived - are seeking an admission of wrongdoing by the hospital trust, which would also open the way for compensation payments for those who face looking after the surviving children who were damaged by their treatment.
In some cases nurses are accused of switching off or turning down alarms supposed to warn them that children's conditions were deteriorating.
Other parents say that there were so few nurses caring for children who had undergone heart surgery that they administered medication, monitored oxygen levels and even cleaned up vomit themselves.
The legal case is the latest to hit the NHS and comes in the wake of the damning report into Stafford Hospital, where up to 1,200 patients died needlessly and hundreds more suffered appalling care.
The ten cases include:
* Luke Jenkins, 7, who died of a cardiac arrest within a week of heart surgery last April after hospital staff failed to recognise that he was deteriorating. His parents say they witnessed nurses "resetting" alarms which indicated his condition was deteriorating.
* Sean Turner, 4, died of a brain haemorrhage last March after staff did not identify that his condition was worsening. All around the ward, alarms were left unanswered, his parents said.
* Maisie Waters, just one week old when she died last August, after a nurse accidentally fed her a day's worth of food in just one hour, using an infusion machine.
* Oscar Willcox, died aged 9 weeks last April. His mother said his death followed a catalogue of failings, with nurses failing to clean up his vomit or change his nappies while he was dangerously ill.
* Jack Casey, left with brain damage, causing developmental problems, since complications following surgery in 2010, aged just 10 months, and a subsequent procedure in which his lung lining was pierced.
Bereaved parents said they had been left devastated after their children's deaths, which they say followed a catalogue of failings and severe neglect.
Luke's father, Stephen Jenkins, 31, from Cardiff, said he and his partner were left "screaming and shouting for help" because they could see their child was dying, yet nurses refused to listen, and failed to call senior doctors.
Although monitoring alarms were repeatedly sounding, warning that the child's condition was worsening, nurses reset the alarms to a lower threshold, so they were less likely to go off, he said.
Laywers will accuse the trust of negligence in the post-operative care given to children, and in some cases in the surgery they received. They will say that without the failings, such as missing clear signs of deterioration, the children who died could have survived, while others might have suffered less extensive damage.
The trust has already admitted that failures to detect the worsening condition of Sean and Luke may have contributed to their deaths.
The cases, which occurred between 2008 and last autumn, will also deepen concerns about failings in NHS systems of regulation.
The legal actions come after the trust was censured by the Care Quality Commission (CQC), after an inspection found that too many children were receiving unsafe care and treatment, because there were not enough nurses to care for those recovering from surgery.
That visit only took place after regulators were repeatedly contacted by the bereaved parents of Sean Turner and Luke Jenkins, who expressed their fears that more children would die, if action was not taken.
CQC then issued a warning notice in October which said that staffing levels were unsafe on the cardiac ward for children who had undergone surgery.
Seven weeks later, it declared the hospital "compliant" with its standards. In fact the hospital only achieved this by reducing the number of patients it would accept for heart surgery, so that there are fewer children for nurses to care for.
Experts said the move by the hospital was a desperate measure, which could ultimately increase the risks to children treated at the cardiac unit as surgeons are supposed to carry out hundreds of procedures each year, in order to maintain their skills.
The cases are disclosed the day before a judicial review attempts to halt changes to children's heart surgery, which were proposed to improve the safety of all of England's 10 units.
The recommendation to centralise hospitals, so that ensure all centres had enough surgeons carrying out high numbers of specialist procedures, followed a public inquiry into dozens of baby deaths in Bristol during the 1990s.
Most of the cases disclosed today occurred at the cardiac unit of Bristol Royal Hospital for Children.
The hospital was opened in 2001 after the children's cardiac unit based in the Bristol Royal Infirmary was closed, having been dubbed "the killing fields" after the deaths, which followed botched operations by surgeons.
Lawyers acting for the families say children are being put at risk because successive Governments have failed to act on the recommendation, which was made by Prof Sir Ian Kennedy in 2001. Twelve years on, a decision on which units should close has yet to be taken.
Plans were finally drawn up last July to close specialist cardiac children's services in Leeds, Leicester and from Royal Brompton Hospital, and to expand the seven remaining units, including Bristol, so that each performs at least 400 procedures a year.
Even before its surgery programme was scaled back, Bristol was among four units carrying out less than 280 operations a year. Last night, the trust refused to say how many operations it is now carrying out.
After arguments between hospital trusts fighting to keep their services, and pressure from local MPs and campaign groups, ministers have referred the decision to an independent panel, which reports next month.
Laurence Vick, from legal firm Michelmores, who is representing nine of the families has written to the panel, urging them to carry out an analysis of detailed mortality data from all the units, to ensure a fair decision.
Mr Vick, who acted for dozens of those bereaved by the 1990s Bristol babies scandal said: "We have waited far too long already for this. We need a fair decision so that the safety of all units can be improved, instead of being endlesssly open to challenge."
However, before that, a judicial review from a campaign group fighting to save services at Leeds Teaching Hospitals trust will tomorrow argue that the process to decide which units close has been flawed. If it succeeds, the process could be forced to start again. Royal Brompton Hospital in London has already failed in its arguments against the decision.
The trust said data showed that between 2000 and 2008, the trust's mortality were the third best of 11 units which were then in operation.
Robert Woolley, the trust's chief executive, said the latest mortality figures, covering the three years up to 2010, showed a 1.6 per cent mortality rate for children below the age of one, and 1 per cent among older children, but that unaudited figures since then were not yet available.
He said. "All paediatric cardiac surgery carries with it significant risk and these risks are explained to parents. Despite these risks and the complex needs of the children we care for, we have results among the best in England."
The trust said it could not comment on cases which had yet to go to an inquest, but apologised for the death of Maisie Waters. A spokesman said the trust had taken every possible step to minimise the chance of a similar human error occurring.
This article is courtesy of The Telegraph.
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