Yes...That quote was an example. Not particularly related to this case.
What should the consequences be to a GP practice
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Yes...That quote was an example. Not particularly related to this case.
Soldato
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No, that isn't my point. We need to be careful about what the standards are and how they are maintained /enforced/punished. We need doctors who try their best. Not everyone is capable of doing the job.
If you are seriously ill and have a choice between a doctor indemnified against human error or no doctor , what do you do?
Caporegime
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A surgeon wouldn't get away with your fantasy scenario and it would be wrong to suggest that happens.
Anyone that dies after surgery must have a coroners post mortem and inquest if undisclosed mistakes were found. That's enshrined in law. A death within 1 year of surgery, even if unrelated, must be reported to the coroner I believe, although it's been a long time since I did adult work so this may have changed.
The system isn't perfect but is pretty robust for events that result in death. The area that is improving/evolving currently is less severe events and near misses where no harm has been done, but could have.
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Exactly. Completely agree. Yet here we've got Drs saying they wouldn't even bother to write a single sentence on notes when that single line could potentially save someone's life. That doesn't sound like someone trying their best, it sounds like someone going through the motions.
Yet my fantasy scenario is analogous to the one that occurred and the one tres proposed. In the actual scenario it is entirely plausible that the organs would have been rejected had the surgeon made his error clear but at least that would have been an informed choice based upon evaluation of the risks involved. They may still have been accepted but at least that decision would have been made. I suspect this is actually the case and the reason nothing further came of it is precisely because of that. My reasoning btw is, as you suggest Candida is not an organism you would usually expect to find in the stomach so would have been overlooked (I don't take umbrage with that) and as stated organs are very precious and the risks associated with the spill are lower than the patients not receiving them. However, it still doesn't mean I think it was right for the surgeon to not note that he made the error, only revealing it later after the death.
Do you think it's right that surgeons also don't document every bleeding vessel they have to cauterise during surgery?
No pun intended but i assume theres a standard operating procedure to some extent however I'd expect notes of any extraneous work required, exactly for the reasons I've highlighted. It enhances patient safety and will certainly help to cover the surgeon in the event something happens to the patient in the future and their work is in question.
Caporegime
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Where has anyone said that?
You're arguing that doctors are getting away with killing people, but then by your own admission the one case you're basing this on probably isn't anything of the sorts. All whilst being completely ignorant of how modern medicine deals with risks, errors and untoward incidents.
I'm not really sure what the point is of all this.
Where has anyone said that? Well...
You're clearly not grasping the argument I've made several times that for the writing of a single sentence a life could have been saved. You are literally arguing against provision of better information to other medical professionals by enhanced note taking and communication of errors.
We're living with a situation whereby the NHS itself admits that up to 8% of its patients die because of negligence and you're not even willing to consider that perhaps better information and recording of mistakes might be beneficial towards reducing figure that and saving lives.
Is that ignorance, hubris or arrogance?
Man of Honour
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It just sounds like he wants to argue about anything.
If Clinicians wrote every little thing down that they see or do, they would only have time for one patient a day and records would quadruple in size.
It's plainly obvious in this case the surgeon cut open a dead body to harvest organs but accidentally cut the stomach lining and had no idea what it could lead to, there would be no reason to write it down because he's just cut through loads of stuff already.
When the diagnosis was made and an MDT was called he would have been asked if anything else had happened, at that point he could have said no if he wanted to cover it up.
Man of Honour
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Wooaahhh, steady on, up to 8% of cases that go to the Coroner.
So potentially more then in cases that don't go to the coroner...
Man of Honour
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Do you find it normal that a fully qualified surgeon who has, I assume, gone through 2 years of A-levels (probably including biology), 5 years of medical school and then multiple years of continued learning doesn't know the potential risks of cutting open the stomach? I don't. That scares the crap out of me.
Up to 8% of cases that go to the coroner are death by medical negligence, yes?
So what about those that don't?
Caporegime
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He says you can't document absolutely everything you do just in case there's some rare unintended consequence and he's completely correct. If you had any perspective on what working in the NHS is like, you'd understand this.
Man of Honour
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They are normal deaths.
So 92% of deaths that go to the Coroner are normal deaths, all the deaths that don't go to the Coroner are normal deaths.
Caporegime
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But the stomach was inside a dead person, haven't we already been through this?
Did the surgeon realise that cutting open the stomach of a dead donor, assessed as fit fororgan donation by the transplant team, risked contaminating the organs with the leak of gastric fungae that wouldn't be picked up or managed by the standard organ donation procedures? I can believe that. The harvesting surgeon may not even have been a transplant surgeon.
No. You're working on an assumption that every death that doesn't go to the coroner is normal. That's incorrect. The correct thinking would be that they are ASSUMED to be normal deaths. Negligence may or may not have played a part.
Of course you wilfully misunderstand me.
There is obviously a lot of science in medicine, but at the same time, unlike say Engineering, there is an awful lot of subjective analysis (Guesswork)and indeed pure luck.
The treatment that will cure 99 people will kill the 100th, and often nobody will really know why.
Peoples insides are roughly similar but they are not all the same. Even with all the sophisticated scan tools we have today. Surgeons often will have to deal with the unexpected and unpredictable and some are just better at handing surprises than others. This does not mean that the less capable have been negligent, incompetent or careless.
Nobody knows how a patient will respond to a medicine until it is tried. Nobody knows how any individual patient will respond to a combination of medicines until it is tried
It is pretty much a mathematical certainty that an I beam of known dimensions and known grade of steel will fail at a certain load. Medicine is not like that!
For all the scientific gloss, there is still far more subjectivity in medicine than in most other professions and the consequences of the need for that subjectivity have to be allowed for when people are considering legal culpability.
That's my point really.
Sure sounds like science to me
no wilful misinterpretation, science is based on educated "guesswork", no?