Kathryn George/Stuff
A surgeon failed to recognise a patient was deteriorating or to intervene with surgery. (File photo)
A man who died from sepsis after faeces leaked from his bowel into his abdomen was failed by the doctor who treated him, the health watchdog has found.
In a report released on Monday, Health and Disability Commissioner Morag McDowell found a consultant surgeon, who was not named in the report, in breach of the Code of Health and Disability Services Consumers’ Rights.
The man went to his local hospital with abdominal pain and a likely perforated bowel, following a colonoscopy where polyps were removed.
Due to his high-risk status, the man, who was in his 70s, was transferred to a larger hospital for treatment. That hospital was also not named.
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There, clinicians decided to treat him “conservatively” without surgery due to his existing medical conditions. However, his condition began to deteriorate.
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When the consultant surgeon reviewed the man three days after he arrived, he did not identify the deterioration and continued with the original conservative course of treatment.
The next day, the patient’s condition worsened and he underwent surgery, which showed “extensive” faecal contamination from a hole in his bowel.
He died shortly after the surgery from sepsis.
McDowell found the initial treatment plan was reasonable and appropriate.
However, she said when the consultant surgeon reviewed the patient on the third day, he failed to recognise his deterioration and intervene with surgery.
ROSA WOODS/Stuff
McDowell said the surgeon failed to recognise the man’s deterioration and missed the opportunity to intervene with surgery. (File photo)
“I acknowledge that the signs of sepsis were subtle and non-typical.
“However, it is well documented in the clinical notes that in the preceding 24 hours, the man had multiple reviews indicating that he was not well.”
McDowell acknowledged staff did not volunteer information to the surgeon about changes in the patient’s condition.
However, it was his responsibility to obtain relevant information from his more junior colleagues, she said.
McDowell said the errors were the result of individual clinical judgement, not organisation issues at the district health board, and did not find the DHB in breach of the patients’ rights code.
But she was critical of several aspects of the man’s care, including the delayed medical review and care and communication.
She recommended the consultant surgeon apologise to the patient’s family.
It was also recommended the DHB provide further training on documentation to junior staff in the surgery department, consider a review of the training provided and develop a guideline for documentation of patient handover.
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