Last week in the news (http://www.bbc.co.uk/news/health-11083236), it has been reported that written complaints against the NHS has seen the biggest annual rise ever seen since records began 12 years ago.

Over 100,000 complaints were made in 2009/2010 and this was a 13.4% increase on the complaints made in the previous year.

On average, the annual increase in complaints per year from 1997/1998 has been 1.1%; so the rise seen this year is drastic.
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Have you ever been to hospital or your GP for tests and told “no news is good news”? The idea being that, if there is something wrong with the result, you will be informed and the correct action is taken. This is something we take for granted;  but should we?

A 3 year old girl, Miss R, was taken to A+E by her worried parents. She was examined and kept in overnight as it was noted that she had a high temperature. One of the junior doctors also sent a urine sample to check for infection. The next day, as the patient was much better she was discharged by the Consultant, with the diagnosis being “Likely Viral Illness”.

Unfortunately, the microbiology department had found that there was, in fact, a urinary infection. These results were phoned through to A+E, but never passed onto the Consultant. A day later a formal report arrived, and was signed by a junior doctor, but not acted on.
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I recently wrote a blog about the Daniel Ubani case. He was the German surgeon who came over to the UK to do a GP out of hours shift and ended up killing a patient by prescribing a huge amount of the drug diamorphine. This was a very sad case, but it was hoped that the media prominence of the events would ensure that reforms were brought in and that this tragedy was never repeated.

However, on the 12^th of August, the Guardian newspaper published figures from the NHS that they had obtained under a Freedom of Information request. These are extremely disturbing. They noted that, in less than a year, health workers made 1,300 errors related to opiate analgesics. These resulted in 2 patients suffering “severe” harm and 3 patients actually dying.

In addition, the report revealed that two other GPs working for the same company as Dr Ubani , the ironically named ‘Take Care Now’, had also been involved in errors related to diamorphine prescribing. Fortunately, these events were not fatal.
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Bipolar disorder is a relatively common mental illness that is characterised by periods of very low moods or depression, contrasted with very high moods or mania. Many people have become increasingly familiar with the disorder due to its portrayal in the Stacey Slater character in the popular soap “Eastenders”.

One of the drugs used to stabilise the mood is Lithium. This is an extremely effective treatment and a number of patients remain on lithium for many years. However, it is important that the blood level does not get too high as it can then become toxic. As the level becomes higher, the patient may suffer with symptoms such as diarrhoea, vomiting, confusion and dizziness. If the level becomes higher still, the patient may suffer seizures, pass into a coma and suffer irreversible neurological damage. For these reasons, it is very important that levels of this drug are monitored with blood tests, especially after starting new medicines.

In a case from the MPS casebook, a patient in her forties (Mrs L) was newly diagnosed with Bipolar Disorder and started on lithium by her psychiatrist. When her lithium levels were stable, after several changes in dose and regular monitoring, she was discharged back to her regular GP, Dr G.
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An elderly woman of the age of 88 was dragged along the road as she attempted to get in a taxi in Westgate, Peterborough. Dozens of shoppers in the town centre watched on in horror.

The lady was waiting for a taxi, when it arrived she opened the door and attempted to get into the vehicle. The taxi started moving forward before the lady was safely inside the vehicle.

There were many people who witnessed the accident and a shop assistant, from the shop located near the scene of the accident, called an ambulance for the elderly lady. Witnesses reportedly said that the lady seemed to be in extreme pain and also she was shaking badly.
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Most people know that before they have any pre-planned surgery, they ought to be properly consented by the surgeon. In order to consent to the operation you must be advised of the possible risks and the procedure itself should be explained. If this has not occurred and you believe that surgery took place when you did not have the information to make an informative decision as to whether to go ahead or you were not aware of the extent of the operation then you may have a claim for medical negligence.

In one incident last year, a 31 year old woman with 2 children went to her GP with lower abdomen pain. After some investigation it was discovered that she had a cyst on her left ovary which needed removing. To remove the cyst, she would need a left Oophorectomy, the surgical removal of her left ovary. She was therefore referred to a consultant Gynecologist for the operation.
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A very sad case has been recently exposed by Channel 4 News (source).

Baby Lucus, seven and a half months old, suffered from a neurological disorder called Sturge-Weber, a rare but treatable condition which causes regular convulsions in young children. He was admitted into the Homerton Hospital in East London for treatment following a number of fits. He was under the care of three experienced doctors: a paediatrician consultant, a senior registrar, and a senior house officer. Despite this, Baby Lucus was administered with between 9 and 12 times the recommended dose for a child of his age and weight of an anti-epileptic drug.

The anti-epileptic drug called Phenytoin has the effect of slowing down the heart rate and reducing blood pressure, and once administered, there is no way for the drugs’ effects to be reversed. This meant that, even though the doctors seemed to realise quickly that they had provided an overdose, they were unable to do anything about it. Baby Lucus’ parents report a lengthy silence after the drugs had been administered and then the parents were quickly informed of the mistake. Ms Holzscheiter, Lucus’ mother, recalls that one of the doctors was crying as they came into their room to give them the sad news. Baby Lucus sadly died shortly after the drugs were administered.   
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Whenever you are seen by a medical practitioner, you should always make sure that the practitioner is aware of any drugs that you may be taking which could effect the treatment you are given. If this is not done, it could have devastating effects.

In one case reported in May 2010 by the Medical Protection Society (source), a 30-year old seemingly fit and healthy looking male was actually being treated with immunosuppressive for his rheumatoid arthritis. Unrelated to this, he attended the A&E department of his local hospital with symptoms of an itchy rash and a general lack of energy.

The junior doctor who saw the patient recognised the rash as chicken pox and noted that he had not suffered with this common disease in his childhood. The doctor informed the patient of his diagnosis and advised him to stay at home and take paracetamol and use calamine lotion to reduce the itch. At no point did he check what prescription medications the patient may be taking.
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Any personal injury lawyer will tell you that a claimant has only 3 years to bring a claim to court. If it is not brought within this time, the claim is barred from being brought at court.

However, this time limit does not necessarily run from the time when the negligence claimed for actually occurred. The time actually runs from the date of the cause of the action or from the date of knowledge of the negligence, whichever is the later. In cases such as road traffic accident claims, this distinction is not often important as those involved in the accident are usually aware of it as soon as it occurs. However, this can be a very important distinction in cases of medical negligence where you may be unaware of your doctor’s negligence for time.

A case recently reported by the MPS (Medical Protection Society) (source) proves that a claim can be made some 20 years after the medical negligence occurred.
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According to a latest report from the BBC (source) the recent National Patient Safety Agency figures indicate that women are not being checked for pregnancy before ongoing surgery. The figures reported show that there have been 42 serious incidents between 2003 and 2009 as a result of surgery on a patient where the surgeons were unaware that the patient was pregnant. Three of these reported incidents sadly culminated in miscarriage. 

Under national guidelines, medical practitioners must always check with the patient whether there is a chance that she may be pregnant before she undergoes surgery, and particularly if that surgery is to the abdomen or the pelvis.

Surgery in the early stages of pregnancy is very risky to the developing foetus and therefore it is vitally important that the surgeon is aware of any early pregnancy. If the surgeon is aware of the patient’s pregnancy then they may be able to make some changes to their plans to limit any risks to the patient or the foetus. The surgery may be delayed or they may be able to change the type of procedure or the anesthetic used to make the surgery less risky.
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