- February 13, 2016
- Posted by: emobile
- Category: Uncategorized
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Mistakes in medicine, whose side are you?
Mistakes happen. Some have serious consequences. Professionalism requires that doctors acknowledge their errors and figure out how to avoid making similar ones in the future. Until recently, doctors would generally only acknowledge errors to each other, not to their patients, if they acknowledged them at all. Over the last few decades, doctors have gotten better at acknowledging mistakes and apologizing to patients when a mistake happens.
Disclosure is especially complicated when one becomes aware of an error made by a colleague. Who, then, has the responsibility to deal with the disclosure? To whom should disclosure take place? Who is accountable to whom? We present a case in which consultant surgeons become aware that a colleague has made a serious error.
A newborn was diagnosed with Hirschprung’s disease on day 6 of life. A local surgeon, with limited pediatric surgical training, operated on the neonate. Postoperatively, the neonate developed serious complications. He was unable to take adequate nutrition by mouth, became malnourished, and, after a few weeks, was transferred to a children’s hospital. The surgeons there discovered that, during the first operation, the original surgeon had become confused about the child’s anatomy, and removed the healthy portion of the colon while leaving in place the diseased sigmoid colon and rectum.
In essence, his error converted a manageable case of Hirschprung’s into the total colonic type that was far more difficult to manage and vastly more costly for the patient and family to endure. Final reconstruction was not feasible for years.
The parents were unaware that a mistake had been made although they were aware that this was an unanticipated outcome. The surgical staff at the children’s hospital was deeply troubled by the child’s previous care and ambivalent about what to do about it. Should they confront the referring surgeon or inform his supervisors? Should they report the case to the state licensing board? Should they tell the parents what happened? Should they encourage the parents to sue the original surgeon?