Junior doctor said he was 'out of his depth' when he operated on pregnant woman who died

[Dedworth]

Junior doctor said he was 'out of his depth' when he operated on pregnant woman who died after her ovary was removed by MISTAKE instead of her appendix


Read more: http://www.dailymail.co.uk/news/arti...#ixzz2zjwLuQAo

I won't speculate on these peoples suitability to be working for the NHS

[joebloggs]

he's not a junior doctor he's a 5th year registrar

they make it sounds like he's just left uni

[Dedworth]

I'll correct it for the Mail Joe

Experienced "doctor" said he was 'out of his depth' when he operated on pregnant woman who died after her ovary was removed by MISTAKE instead of her appendix

[joebloggs]

I'm not defending him dedworth, but he's on his 5yr, 'mistakes' like this shouldn't happen

[Dedworth]

i'm not defending him dedworth, but he's on his 5yr, 'mistakes' like this shouldn't happen

Cheers Joe hopefully the rubber toothed GMC will strike them off

[Doc Alan]

ANY death in pregnancy is a tragedy. Women should be able to look forward to the birth of their children, knowing that if things go wrong, medical teams can help them – for free – such that the vast majority will be safely delivered. Only a handful in the UK ( less than 100 / year – obviously still too many ) - die from causes related to pregnancy.


At least 11 women are claimed to die EVERY DAY in the Philippines from PREVENTABLE complications arising from pregnancy and childbirth. Mothers’ lives can’t be saved by any one intervention alone. It requires family planning information and means, then quality antenatal / obstetric care when and where it is needed. Otherwise they die from treatable complications – haemorrhage, infection and high blood pressure.


The 32 year pregnant lady, reported in the link, died from complications of appendicitis, the least uncommon general surgical problem found during pregnancy ( and less common than appendicitis in non-pregnant but otherwise similar women ).


Anyone studying biology knows where the appendix usually is ! Recognising that abdominal pain is DUE to appendicitis is NOT always easy. The appendix may vary in anatomical position, and LOOK normal. Only after removal for symptoms suggesting inflammation is it either confirmed with microscopy to be inflamed ( or normal ). Many other conditions may mimic appendicitis.


The problem is greater in pregnancy. There are even more possible causes of abdominal pain. The risks of surgery have to be balanced against delayed diagnosis. The appendix is displaced upwards by the pregnant uterus, and in the presence of inflammation from ANY cause, the diagnosis is difficult.


That is why the 5th year trainee surgeon found himself “ out of his depth “ when he operated on this unfortunate lady. His mistake appears to have been in not informing his senior, the on-duty consultant.


Unfortunately EU rules on doctors’ working hours put patients at risk. Under the EWTD ( European Working Time Directive ) junior doctors may only work a 48 hour week. It’s meant to prevent medical errors made by tired doctors. An unintended consequence is lack of “ hands-on “ training on wards or operating theatres. Doctors in training are keen to gain experience – which may be why they attempt procedures without informing their seniors.


As for “ striking off “ these two surgeons, and quality of the GMC, I’m not qualified to offer an opinion . It’s hard to say whether the roughly 300 doctors struck off in the past few years is too few or too many, out of the 260,000 on the medical register in the UK.


The MPTS ( Medical Practitioners Tribunal Service ) is accountable to Parliament and the GMC for decisions about doctors’ fitness to practise. They have 300 panellists - a mix of medical and non-medical people, appointed through open competition, and identifiable to the public. Most of their hearings are HELD in public. For anyone interested in or unhappy with, the present situation, why not apply to become a member ?

[imagine]

You mean he couldn't tell the difference between an overy and an appendix

[Doc Alan]

You mean he couldn't tell the difference between an ovary and an appendix

Correct.

There was presumably severe inflammation around the appendix, in addition to bleeding, which could also have involved nearby structures like the right ovary and ( fallopian ) tube.

Signs / symptoms of appendicitis, and " normal / textbook " anatomy, are changed in pregnancy. There are MANY possible causes of severe abdominal pain in pregnancy, which may be hard to diagnose. Local peritonitis ( inflammation ) and bleeding would have contributed to that difficulty by obscuring what was seen at operation.

I'm not making excuses, just explaining what the media have told us.

I also didn't choose to raise the topic.

[Arthur Little]

I also didn't choose to raise the topic.

, Alan ... it wasn't your choice to raise the topic ... nonetheless, we're so very, very fortunate in being able to rely upon someone of your calibre and expertise to *set the record straight for those who appear all too keen to lambast our NHS - an organisation which - though not infallible - has more than earned its reputation worldwide for excellence ... and for *that, your fellow members are extremely grateful.

[joebloggs]

you mean he couldn't tell the difference between an overy and an appendix

Giving evidence, the medic added: 'At that time I felt I was capable to do this operation having done so many appendectomies, both supervised and unsupervised - that it's within my capabilities.

'Clearly this is not the case because I didn't have enough experience to operate on a pregnant woman.'

Read more: http://www.dailymail.co.uk/news/arti...#ixzz2zsBEVYSe

[imagine]

Correct.

There was presumably severe inflammation around the appendix, in addition to bleeding, which could also have involved nearby structures like the right ovary and ( fallopian ) tube.

Signs / symptoms of appendicitis, and " normal / textbook " anatomy, are changed in pregnancy. There are MANY possible causes of severe abdominal pain in pregnancy, which may be hard to diagnose. Local peritonitis ( inflammation ) and bleeding would have contributed to that difficulty by obscuring what was seen at operation.

I'm not making excuses, just explaining what the media have told us.

I also didn't choose to raise the topic.

Ah I see, thanks Doc Alan.