Month: August 2013

Hospital Infections Likely due to Poor Hygiene Claims HIQA

A series of reports produced by the Health Information Quality Authority (HIQA) have revealed that there is a high risk of hospital infections in Ireland due to poor hygiene in hospitals.

Five hospitals were inspected during the summer by HIQA – an independent authority which checks on the quality and safety of the Irish Health Service – and their reports show, among other issues, a general lack of hand hygiene which is likely to result in patients, visitors and staff contracting hospital infections.

The worst of the five hospitals was Waterford Regional Hospital; where inspectors observed medical and nursing staff using only five in twenty-three hand hygiene opportunities during their unannounced inspection and found that soap dispensers provided for staff in the Accident & Emergency Department were either empty or blocked by soap residue.

Mould was also found to be developing in toilets and shower units used by patients and – on one occasion – a patient suspected of having a transmittable infection was treated in a general bay of the Accident & Emergency Department – despite isolation units being available.

Hand hygiene issues which were likely to result in hospital infections were also identified during unannounced inspections at St Michael´s Hospital in Dun Laoghaire, Portiuncila Hospital in Galway, Louth County Hospital in Dundalk and Our Lady´s Hospital in Navan – where the walls of the patients´ toilets were described as “heavily stained”.

Rob Landers – Clinical Director at Waterford Regional Hospital – said that the hospital was “extremely disappointed” with the findings published in the report, but reassured patients that it was safe to attend the hospital.

He said that the Accident and Emergency Department had been extremely busy on the day of the inspection and – although he admitted that this was no excuse for potentially transmitting hospital infections – announced that compulsory hand hygiene training would be introduced for all workers at the hospital in the future.

Waterford Regional Hospital has been given six weeks from the date of the report by HIQA to develop a quality improvement plan and post it on the hospital website.

Misdiagnosis and Prescription Errors Responsible in Most Claims for Negligence against GPs

Misdiagnosis and prescription errors have been identified as being the most common reasons for claims for negligence against GPs according to a report commissioned by the Royal College of Surgeons Ireland.

The report – “The Epidemiology of Malpractice Claims in Primary Care: A Systematic Review” – was prepared by the Centre for Primary Care Research in Dublin with the aim of identifying which areas of primary care needed specific attention when planning future educational strategies and developing risk management systems for primary healthcare practitioners.

The key findings of the report were published in the British Medical Journal and included:-

  • The misdiagnosis or delayed diagnosis of cancer was the most common individual reasons for making claims for negligence against GPs.
  • The most frequently misdiagnosed cancers were breast cancer, colon cancer, lung cancer and cancer of the female genital tract.
  • The second most common grounds for successful negligence claims against GPs were prescription and medication errors.
  • The misdiagnosis of heart attacks also accounted for a significant number of claims for negligence against GPs and primary healthcare practitioners.
  • The most frequently misdiagnosed condition for children was appendicitis, but the incorrect diagnosis of meningitis accounted for 30% of compensation paid.
  • The annual prevalence of claims for negligence against GPs for missed diagnosis or delayed diagnosis appears to be on the increase

Lead researcher for the report – Dr Emma Wallace – admitted that primary healthcare practitioners are referring patients to consultants more frequently, as the fear of litigation inhibits their willingness to make diagnoses. This situation is leading to patients´ conditions deteriorating unnecessarily and creating more pressure on an under-resourced health service.

Dr Wallace – who is herself a GP – acknowledged that claims for negligence against GPs were “not a perfect substitute for adverse events”, but said that when medical negligence claims are made against GPs, the medical practitioners involved often experience increased levels of stress – reducing the effectiveness of service they are able to offer, and placing more patients at risk of a delayed diagnosis or medication error.

She added “this systematic review is timely considering the increased interest in focusing on primary care as a way of improving patient care and safety” and she hoped that the report would provide an insight into the types of adverse effects in clinical practice and their causes, which would subsequently increase the standard of primary care and reduce the number claims for negligence against GPs in Ireland.

Post Traumatic Stress Compensation Offered to Airplane Crash Survivors

Survivors of the San Francisco airplane crash last month have been offered $10,000 post traumatic stress compensation from the airline company.

Three passengers died in the crash at San Francisco International Airport on July 6th, when a Boeing 777 carrying passengers from Seoul misjudged the height of a seawall on the perimeter of the airport and crash-landed on the runway. Forty-nine of the 181 passengers taken to hospital that day still remain in a serious condition, with doctors fearing that the spinal injuries suffered by some could become a permanent disability.

The offer of post traumatic stress compensation offered by Asiana Airlines will be paid to all of the 288 survivors who were travelling on the plane – whether they suffered a physical injury or not – and is not conditional on passengers waiving their right to claim further personal injury compensation for a plane crash under the terms of the Montreal Convention.

Under the Montreal Agreement, any airline carrier is automatically liable for injuries sustained by a passenger while travelling on an airplane, however US citizens will be entitled to far higher settlements of compensation due to their own national legislation than other nationalities once the investigation by the US National Transportation Safety Board (USNTSB) into the cause of the crash is completed.

Final settlements of plane crash injury compensation may take many months to determine, for as well as the possibility of spine injuries deteriorating into a permanent disability, it may be the case that passengers may be eligible for further payments of post traumatic stress compensation if a high degree of psychological injury is diagnosed once the USNTSB´s investigation is completed.

Family Claim Compensation for Lack of Nursing Care after Hospital Death

The family of a 26 year-old woman who drowned in a bath two days after she was admitted to hospital are to make a claim for compensation for a lack of nursing care.

Amy Hauserman had voluntarily entered the psychiatric ward of Frankston Hospital in Melbourne in March 2008 after doctors had feared she was relapsing into a schizophrenic condition from which she had previously suffered with anorexia.

Two days after her admission, Amy was discovered face-down in a bath – having either lapsed into unconsciousness during the bath or having slipped and fallen while trying to get out of it according to Coroner Peter White.

At the inquest into Amy´s death, the Coroner highlighted the fact that the bath had been taken without supervision and, had a nurse been present, there would have been the opportunity to rescue her irrespective of the nature of the accident which led to her drowning.

The Coroner´s report also revealed that no risk evaluation had been conducted before Amy was allowed to take the bath without supervision and her consultant had not been consulted. It was also noted that one of the nurses who worked on the ward at the time gave evidence that she was unaware there was a protocol for patients taking baths.

Following the release of the Coroner´s Report, Frankston Hospital announced it was no longer offer baths to patients in its high dependency psychiatric ward – a move which the Coroner said was an “appropriate response to this tragic episode”.

However, Amy´s father said “these findings confirm ours and the Coroner’s belief that if the hospital had looked after Amy better and showed her the due and proper care she deserved, she would still be with us now.”

He confirmed that the family had already made a compensation claim for the lack of nursing care and that a court date had been arranged in May 2014 for the claim against the Mornington Peninsula Health Service to be heard.