Ship of Fools: medical incompetence

Thread: medical incompetence Board: Oblivion / Ship of Fools.

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Posted by Tukai (# 12960) on :

Mrs T had eye surgery this year, which went off well - no problem there , except the cost! But afterward she needed new glasses for her "new" eyes - just as one would expect. So after a few weeks interval for the eye to settle down, she went to her usual optometrist , who duly issued a new prescription. Again so far, so good.

But her new glasses didn't seem to be working - she couldn't see properly at all distances. This seriously addled Mrs T's brain - giving her headaches. When we complained and got it checked, it turned out the dispenser of the glasses had fitted one lens of the wrong prescription! Not so good.

Akin in my forcefully expressed opinion to a dentist extracting the wrong tooth or a surgeon amputating the wrong foot.

Fortunately taking out the wrong lens and replacing it with a correct one is easier than replacing a foot, but the principle is the same. Since the error was corrected without monetary charge, I refrained [just!] from threatening to sue them for "professional incompetence".

So does anyone else have similar experiences, not just with opticians but with other "medical" professions?

Note to hosts: I was going to post this in TICH but that option is no longer open, it seems. However others may have similar experiences to this, so maybe a discussion will emerge.

Posted by Erroneous Monk (# 10858) on :

No. No I don't. I've been affected (in a life-changing way) by honest mistakes by hard-working doctors and midwives who were doing their best.

The occasions to be deeply grateful to doctors and healthcare professionals far outweigh the problems.

Posted by Spike (# 36) on :

Someone made a mistake, realised their mistake and corrected it free of charge. What's the problem?

Posted by ExclamationMark (# 14715) on :

quote:
Originally posted by Spike:
Someone made a mistake, realised their mistake and corrected it free of charge. What's the problem?

Fine provided some one accepts the problem and puts it right.

But it seems that the OP refers to an event other than in the UK. In the UK Healthcare professionals are routinely advised not to admit to mistakes or this will invalidate their (and the hospital's insurance).

This happens to touch a personal nerve: a close relative suffered appalling care and neglect in a flagship hospital. This included their death - which the hospital knew was imminent and did not discuss with the family. The person concerned and the family could have had time to prepare/say goodbye, but they didn't.

Roll forward. The hospital would only discuss the events if an agreement not to prosecute was signed. Not wanting to do that, the letter was signed and an 8 page apology subsequently received covering all aspects of care/non care.

The fact that the family had a case is immutable. The only question was the size of the compensation: no one wanted that, not least because 4 members of very close family to the deceased are active employees of the NHS and know that things go wrong.

The family even held off despite having drawn attention to the issues before death and being actively and aggressively fobbed off. No one tried to use NHS muscle but from the words used they must've twigged that some of us knew what we were talking about.

Why can't people just say sorry - we aren't all ambulance chasers? Trouble is NHS your unwillingness to meet anyone even near halfway makes people take action. Everyone makes mistakes - and sometimes they have serious implications. It never helps to cover up, to lie or to treat people like idiots. If you do the latter then sooner or later they will believe you and behave like it.

Posted by Doublethink. (# 1984) on :

Now that there is a legal duty of candour, I think that it is not true to say people are advised not to apologise. In fact there is written advise on the importantance of apologising.

Posted by Boogie (# 13538) on :

I had a hysterectomy, just before the op the surgeon came rushing in to me to ask what two strange shadows on the x-ray might be! They were some kind of clips from my gall stone operation and I was able to tell him, then my op went ahead.

My point is that my notes are over six inches thick as I have had a lot of medical stuff going on. This is crazy. No doctor could find everything relevant in all that paper. We should have two A4 sheets each, maximum four. With all the important details in there.

Crazy.

Posted by Patdys (# 9397) on :

Tukai, I wish you and your wife had had a simpler journey. And I can't imagine how upsetting it was for your wife to have had the issues with constant headaches - particularly when they could have been avoided (and when you paid so much). I am wondering if other factors also influenced your distress.

ExclamationMark, your experience sounds dreadful. An apology is not an admission of culpability. The way you have been treated certainly flies against good medical practice and what google reveals is taught these days in the UK.

Your experience may reflect some years past and I hope that future dealings you have with the health system would occur in the setting of much, much better communication.

It may be worth noting most health professionals are not perfect. And communication training is a relatively new concept.

Posted by Doc Tor (# 9748) on :

Hostly furry hat on

We're more than happy to host this thread here in Hell. But I'd like to get in this now, before we get any further: would patrons kindly refrain from mentioning any particular hospital, hospital trust, medical practice or practitioner by name, unless and only unless your particular case has been concluded and is in the public domain.

For obvious reasons...

Hostly furry hat off

DT
HH

Posted by Patdys (# 9397) on :

Typical Doc Tor cover up. [Razz]

Posted by Doc Tor (# 9748) on :

Oh hush. Just remember: I'm a doctor, but not the sort that helps people...

Posted by Twilight (# 2832) on :

Glad to hear it, Doc Tor. It's those helpful ones who have really messed up me and my son. Most of it too long and depressing to go into right now, but most recently:

Son paid over $700 for new trifocals because he was having trouble reading numbers at work. He brought them home and I asked to try them on out of curiosity. I noticed right off that the bottom section didn't seem to have any prescription in it at all. He went to work and couldn't read the numbers, etc. He went back to the optometrist and said they didn't seem right. He was told to try them for a month to "get used to them." They've been sitting in his dresser drawer for a few months now and he's making do with the old ones. He is too shy to go back again.

Back in the old days when glasses cost about $50, it was automatic for the doctor to give the patient a quick eye chart test when the new glasses came in. Now that the prices are astronomical, we don't get that anymore.

Posted by Boogie (# 13538) on :

My Dad died due to going into hospital.

He went in for a simple, routine operation - contracted e-coli and had died within a week. They did all they could once they knew he had it, isolation, barrier nursing etc. But it was too late, his 86 year old body didn't cope.

I didn't blame them then, and I still don't now. But I am rather more skeptical about how kind they were to us during the time he was dying. They gave us a room for the family to camp out in so that one of us could be with him all the time - and brought food, drinks etc to us. Thinking back, that may well have been to keep us 'sweet' for fear of litigation [Frown]

Posted by Lamb Chopped (# 5528) on :

quote:
Originally posted by Spike:
Someone made a mistake, realised their mistake and corrected it free of charge. What's the problem?

This works for me.

I had to have a dental implant last year, and that meant drilling a hole in my jaw. [Eek!]

My bone is unusually hard there, and I gather oddly shaped, and the poor man had the devil of a time getting the hole drilled. In the end a small piece of bone broke off and I needed to have a chip of transplant bone put in to replace it.

The man was very apologetic and made no excuses, though he could have done so easily. I've known him for 25 years and he's always been good. So we just took it as one of those things that happen, and got on with the next job.

It helps when you actually know the people.

Posted by Heavenly Anarchist (# 13313) on :

quote:
Originally posted by Doublethink.:
Now that there is a legal duty of candour, I think that it is not true to say people are advised not to apologise. In fact there is written advise on the importantance of apologising.

It was not the case in the 1990s/2000s in the London outpatients' where I was Sister either. I knew the importance of early recognition of issues and the need to apologise and there was lots of earlier research on communication and complaints available already. Hospital staff are human and no way perfect. I was also an RCN shop steward in the 1990s and my experience representing staff at disciplinaries was that the management at my hospital were keen on being open to patients and their relatives. One problem, at least from a nursing perspective, was junior staff not having the confidence to admit to a problem; I often wanted them to 'just tell me what happened so I can sort it out'! More work is needed on educating staff but it is hard to build up confidence when the workplace is hierarchal and staff at the front line are often subject to aggression, threats and violence (as I have been myself). Certainly there is always room for improvement and management need to lead on this.

Posted by no prophet's flag is set so... (# 15560) on :

I had an inflammatory eye condition mistakenly treated as infection for a week 30 years ago. As a consequence bits of my iris are still on the lens of that eye such that one eye sees colours differently. If I hadn't seen someone else and not had hospital treatment, which was it's own hell - an injection of steroid directly into the eyeball - loss of sight was the predicted outcome for that eye if not treated properly. I never returned to said doctor. I regret that, because I think he should have been informed. In today's world, I would have probably filled out the online complaining form. It has been made easy where before it took more steps. Complaints about professionals create its own special bit of hell for the practitioner. I wish there was something different than complaints/ lawsuits / prosections. Professional complaints are akin to criminal prosecution these days unfortunately. But leaving it go is no answer either. I don' t believe this doctor was careless or anything else, just not informed or careful about a rarer condition.

Posted by Belle Ringer (# 13379) on :

I told doc something was wrong with finger joint, a little swollen, minor pain, reduced motion, not bad but not normal. Doc said you strained it, buy an OTC splint, rest it a few weeks.

That's why I now have a permanently frozen finger joint on a dominant finger, a prompt Xray would have revealed dislocation while it was still easily fixable. (Hand doc seen recently for other reasons says no way to fix it it now.)

Then there's the doc who told me to take Advil 24/7 for knee pain. I did some research, went back to protest Advil destroys knee cartilage. He said that is true, take Advil anyway. (My PT was horrified at the idea of taking Advil, it can damage all your joints over a year or two!)

Never trust a doctor. Research everything. Get a second opinion from someone who learned from different teachers (so the 2nd is a true second opinion, not just the same teacher speaking through 2 mouthpieces).

Posted by Lamb Chopped (# 5528) on :

quote:
Originally posted by no prophet's flag is set so...:
I had an inflammatory eye condition mistakenly treated as infection for a week 30 years ago. ... I never returned to said doctor. I regret that, because I think he should have been informed. In today's world, I would have probably filled out the online complaining form. It has been made easy where before it took more steps. Complaints about professionals create its own special bit of hell for the practitioner. I wish there was something different than complaints/ lawsuits / prosections. Professional complaints are akin to criminal prosecution these days unfortunately. But leaving it go is no answer either. I don' t believe this doctor was careless or anything else, just not informed or careful about a rarer condition.

Write said doctor a letter and indicate that you aren't filing a lawsuit, you just think he/she needs to know. Easy.

Posted by Moo (# 107) on :

In the mid-1990s I got sick with an assortment of symptoms including a rash, a fever, numbness in my toes and fingers which gradually spread to my hands and feet, then my ankles and wrists.

The first time I went to the doctor, he ordered certain tests. When I came back a week later, he said that the tests showed some sort of infection, but it was nothing to worry about. (By this time the numbness was getting worse, and I had cramps in my calf muscles at night.)

I kept going back, and he kept saying nothing much was wrong. After three weeks, when I bent my left knee and lifted my foot, my toes pointed at the ground. At that point he realized there was a problem. He immediately put me on a powerful antibiotic and sent me to a neurologist for a nerve conductance test. The test showed that the nerve axons of my hands, feet, lower legs, and forearms were severely damaged. I stopped getting worse within two days of starting the antibiotic. However, the damage remained.

The most disturbing thing about this was that my friends and neighbors who saw me during this time all said that I looked really sick. Unfortunately, the doctor didn't look at me carefully; he ordered tests.

I would have changed doctors, but I was planning to move in a few years, and I don't like to change doctors too often. When I moved here and went to my new doctor for the first time, I was pleased to note that he looked at me carefully. It was very reassuring.

The nerves have been regenerating at one-millionth of a snail's pace. The process will not be completed during my lifetime.

Moo

Posted by Doublethink. (# 1984) on :

I think it would help if people understood more clearly about differential diagnosis.

Posted by Arabella Purity Winterbottom (# 3434) on :

I've had a lifetime of familiarity with orthopaedic surgeons due to (as my current one says) "wonky biomechanical build." I can only say that treatment has improved exponentially in that time.

When I was growing up, I had a surgeon I always called Mr Toad. He was rude, he was unnecessarily cruel, and he botched my care repeatedly. Because the bottom half of my legs can be completely lifted away from the top half (by about 10 cm when I was little, now about 3 cm) he did it repeatedly to show colleagues, as it is apparently very unusual. When I did it accidentally (about 1-2 times a week right through my adolescence) I was called stupid and careless.

Subsequently, everything has been helped with orthotics (and more surgery), but I only started using them when I was about 30, so there were 30 years of my feet and knees being wrenched around with consequent loss of bone, cartilage and muscle function.

I know its Hell, but my God am I pleased that I now have a surgeon who recognises that when he touches my knees I will flinch, and takes it gently, warning me if he has to rotate or poke at me.

Edited to add that I first saw Mr Toad when I was only 3 years old, so I was thoroughly conditioned to expect pain from orthopods.

[ 06. August 2015, 22:44: Message edited by: Arabella Purity Winterbottom ]

Posted by no prophet's flag is set so... (# 15560) on :

Indeed DT, and make sure your doc is using a computer. There are several collaborative medicine apps where consultation about rarer things can be crowd diagnosed in confidence.

Posted by L'organist (# 17338) on :

Back in the 1970s when I was 17 I self-diagnosed a duodenal ulcer; my GP was surprised but when he examined me he agreed that I showed every sign of same and packed me off to our local hospital (no longer operating as such, to the benefit of everyone in the town) with a note to say he thought I'd duodenal ulcer(s) and then went fly-fishing for a week.

At our local hospital I encountered a 'team' headed by a consultant who had written one of the definitive books on ulcers and their treatment. He decided that, if only because of my age, I couldn't have a duodenal ulcer and his team all agreed with the great man and proceeded to do their best to shoehorn all subsequent test results into their chosen diagnosis - acute indigestion, would you believe, and lack of sensible eating habits. When, after 8 days of increasing pain and vomiting, things weren't reacting the way they wanted them to, I was visited by a registrar who announced I thought you'd liketo know, we've decided you've probably got advanced stomach cancer. and then left the ward.

At this point I called our GP who promptly hit the roof and began a rescue operation: first, I discharged myself, then I was admitted to another hospital 20 miles away where, within 6 hours they diagnosed a duodenal ulcer and started to treat me.

The treatment worked in that the ulcer healed up, but the delay in getting proper treatment, and the actions of virtually force-feeding me in the first hospital, left me with permanently wrecked tripes.

Posted by Erroneous Monk (# 10858) on :

quote:
Originally posted by Doublethink.:
I think it would help if people understood more clearly about differential diagnosis.

My sister (consultant cardiologist) explained it to me like this.

"You see the leaves moving in a tree. It could be the wind. if it's not that, it could be a bird. If it's not that, it could be a cat. But nobody sees the leaves moving in a tree and, first of all, wonders if it's a shark."

Posted by Sandemaniac (# 12829) on :

The NHS are running about evens on trying to save and nearly killing my elderly father.

He had some varicose veins tidied up a few years ago and went down with a monstrous post-op infection - his whole leg swelled from thigh to toes, and he ended up back in hospital after Mum called an ambulance when he started struggling to breathe. They had to drain an abcess in his thigh you could have put a fist into.

Then last year he was suffering from increasing pain in his hip, and had a fall. His hip (already replaced twice) was completely ignored by the doctor in A&E who proceeded to have his knee X-rayed because it was what was bruised. Nothing wrong - just bruising - go home. After several days of severe pain Mum got the GP to get him another X-ray, and this time they did his hip. Turned out that his replacement hip had come loose in the thighbone and was breaking his femur up - probably causing the fall, rather than caused by it. Result - massive surgery. It would have been needed anyway, but it's hard to imagine someone who can so utterly miss the cause of a problem.

AG

Posted by bib (# 13074) on :

I don't think it is realistic to expect perfection in medical treatment as people's bodies aren't perfect and react differently to therapies. What works well for one person isn't the correct management for another but medical science hasn't reached the stage where every treatment can be tweaked and personalised. However,things are improving very rapidly and I can only say I'm grateful for the advances in medicine. I have undergone fairly traumatic cancer treatment, but I'm still here and hopefully am in remission. My last stint of surgery was very successful, but unfortunately I developed MRSA and was very unwell for many months afterwards. However, this wasn't the doctor's fault, but just an unfortunate infection problem occuring in all hospitals at present which is difficult to control.

Posted by Fineline (# 12143) on :

If you have a complex eye prescription, this happens a lot. I have a complex prescription and have found here in the UK that it's better to go to a more specialised optician, rather than one of the cheaper chain ones. I don't know why you'd want to sue for it though. I did get very frustrated with one chain optician, because they refused to believe my new glasses had the wrong prescription, and kept telling me I just had to get used to it, and that everyone is a bit uncomfortable with new glasses. I had to go to a more specialised optician to get them to check it (turns out they'd actually got my prescription wrong too when they tested my eyes, as well as giving me glasses that didn't match it at all!) and then I used that evidence to get my money back. I wouldn't want to sue them though. Getting my money back so I could return the glasses and go elsewhere was what I wanted.

Thing is, though, if your eye prescription is really complex, it could be that you never get glasses that are perfectly right. I find that, even though I go to a much better optician now. If the glasses move down my nose a fraction of a millimeter it affects my vision, and my glasses often make me dizzy. It's just one of those things.

Posted by Leorning Cniht (# 17564) on :

quote:
Originally posted by Fineline:
I don't know why you'd want to sue for it though. I did get very frustrated with one chain optician, because they refused to believe my new glasses had the wrong prescription, and kept telling me I just had to get used to it, and that everyone is a bit uncomfortable with new glasses.

It shouldn't happen. Measuring whether a pair of glasses correctly matches the prescription is fairly straightforward optics. An optometrist who is unwilling to verify that a pair of glasses matches a prescription would appear to be not fit for purpose.

Why would you want to sue? It seems like these days there's no other feedback mechanism to make someone buck their ideas up and do a proper job. Most people, I think, would far rather have some mechanism to help ensure that fewer mistakes happen in the future, and aren't out to get a cash payout for a bit of inconvenience. That doesn't seem to be available, though.

Posted by Patdys (# 9397) on :

Hippocrates wept.

Posted by Palimpsest (# 16772) on :

There are the occasional acts of mistake and incompetence in Medicine as well as anyone.

One time I was having an operation to implant a double tube catheter inserted behind my ears. As part of milking the cost they required me to go to the surgeon before the operation and have a doctor explain it to me. My surgeon to be was out, so another bored doctor started explaining the procedure to me. I realized he was taking about the wrong kind of cather. So I objected, he went and checked and came to explain to me. When the operation came, I was quite insistent about talking to the surgeon before they put me under anaesthesia to make sure the right catheter was being put in.

My other favorite came when I was trying an experimental cancer treatment at a Research lab. When I went in the first time to talk about it, and was told I had to fill in an intake form that was two pages both sides. The bottom half was a section for cause of death. I told them I didn't have to fill out that part, they'd have to do it/
[Snigger]

Posted by Fineline (# 12143) on :

quote:
Originally posted by Leorning Cniht:

quote:
Originally posted by Fineline:
I don't know why you'd want to sue for it though. I did get very frustrated with one chain optician, because they refused to believe my new glasses had the wrong prescription, and kept telling me I just had to get used to it, and that everyone is a bit uncomfortable with new glasses.
It shouldn't happen. Measuring whether a pair of glasses correctly matches the prescription is fairly straightforward optics. An optometrist who is unwilling to verify that a pair of glasses matches a prescription would appear to be not fit for purpose.

Why would you want to sue? It seems like these days there's no other feedback mechanism to make someone buck their ideas up and do a proper job. Most people, I think, would far rather have some mechanism to help ensure that fewer mistakes happen in the future, and aren't out to get a cash payout for a bit of inconvenience. That doesn't seem to be available, though.

Well, yes, in my case, it was more than a simple mistake. It was poor customer service too - hence I was annoyed. It wasn't the optometrist refusing though - it was the staff on the shop floor who fit the glasses. I wouldn't sue though - seems a rather extreme method of giving feedback, and plenty of people are fine with that opticians. It's cheap and if they have a simple prescription, they don't tend to encounter problems. If they do, they'd go elsewhere, and realistically, if the opticians was totally crap, then everyone would go elsewhere, and they'd lose business. As it was, I spoke to the manager, and got my money back, and they realised they'd made an error, and had lost me as a customer. And as my glasses are pretty expensive, they lost several hundred pounds out of it.

Posted by Patdys (# 9397) on :

And Fineline's post elegantly explains the issue.

You can be wrong.
You can be arrogant.
You can never be both.

And unfortunately, the perfect storm is not uncommon.

[ 08. August 2015, 22:15: Message edited by: Patdys ]

Posted by Tukai (# 12960) on :

quote:
Originally posted by Spike:
Someone made a mistake, realised their mistake and corrected it free of charge. What's the problem?

In this case, not a major problem, I agree. My OP was a bit of a rant straight after the event. Indeed after many years of living in a developing country, I am well aware that there are things no medic can fix. Hence our reaction after our second child died in infancy of a congenital condition was more along the lines of "God is great" rather than "why didn't the doctor try harder to save him" - as might have happened in a richer country but with the same result in the end.

But there are sometimes serious cases of unforgiveable incompetence, such as those perpetrated by the inadequately skilled "Dr Death" in Queensland a few years ago, which led to a royal commission when one of the nurses blew the whistle on him.

[ 09. August 2015, 04:37: Message edited by: Tukai ]

Posted by Huia (# 3473) on :

I had been prescribed a medication that was new to New Zealand, although it had to used overseas. The specialist who prescribed it then went back to his own country for a holiday. I started feeling really tired, so I went to the G.P who rang the hospital and was admitted urgently. The next day when they came around with the medication I refused to take it because I thought the new drug was probably responsible for my liver not functioning very well. I kept up this refusal although they continued to pressure me to co-operate and started getting better. The hospital discharged me, although they said they still were unsure of why I had got so sick.

I went to the Pharmacist who had filled the prescription, and asked for the patient information sheet, which said new patients should be monitored for liver problems.

I took the sheet when I went back for my follow-up outpatients appointment and the Doctor asked if he could keep it. He then leafed through my file. The information sheet was already on file but no one had actually read it.

(The medication was banned in NZ after it had killed 20 people, and I understand it was also banned in Canada because of the number of people requiring liver transplants).

Huia - still alive and still angry

Posted by HughWillRidmee (# 15614) on :

An unfortunately positioned mark within the paper used to formulate my prescription meant that I spent a year wearing, with little but just discernable effect, glasses where one lens was made to "Axis 175" rather than Axis "75".

Back to usual, even cheaper, suppliers this year and no harm done.

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