31 January 2013

Hundreds of hospital deaths deemed 'preventable', national audit finds

CLINICAL management issues may have contributed to the death of 401 surgery patients according to a new national report.
A total of 10,000 deaths were referred to the Australian and New Zealand audit between January 2009 and December 2011.

Four per cent of the deaths, or 121, were considered adverse events - a 1 per cent decline from the 2010 report.

The Royal Australasian College of Surgeons audit also found clinical management issues, which included delays in treatment, the decision to operate and poor choice of procedure, were detected in 2613 cases.
There was a "significant criticism" of clinical management in 1262 of cases.

More than 500 of the clinical incidents detected were definitely preventable and 1082 were probably preventable.

These issues "probably caused'' the death of 92 patients.

Overall the median age of death was 74 for elective admissions and 80 for emergency surgery.
The ages of patients ranged from two days to 105 years.

The majority - 85 per cent - had several underlying health problems, including cardiovascular, renal and respiratory diseases and were undergoing emergency surgery.

"Just because you are old and have lots of comorbidities does not mean that you should necessarily have a bad outcome it just means you are at greater risk than that," ANZASM chair Professor Guy Maddern said.
"With older and sicker patients we would still like to be convinced that they have had the optimal plan of treatment to try and avert the death, particularly if it involves an operation."

The audit is designed to improve surgical outcomes for patients.

On a positive note the number of surgeons taking part in the audit rose from 60 to 90 per cent in 2011.
Respiratory failure, heart issues, organ failure and neurological problems were the most common causes of death.

Professor Maddern said was hard to determine if a death was entirely preventable.
"What you can say is that with hindsight you may have managed it differently and that may have lead to a different outcome."

Of the 7567 patients who had surgery, almost a third had post operative complications and 15 per cent had an unplanned return to the operating theatre.

The most common complications included sepsis, bleeding, and tissue death.

Transporting patients to other hospitals was an area of concern identified with insufficient clinical documentation and delays in transfers the most common criticisms.

Auditors also found that surgeons inappropriately withheld treatments - such as stockings and medication - that could prevent potentially deadly blood clots in 60 people.

dailytelegraph.com.au  30 Jan 2013

Doctors are able to get away with 'killing' patients with no repercussions.

An indemnity form MUST be signed by a patient before a doctor will even contemplate operating.

The law in this country is deliberately set up in this manner, to cull a bit of the cannon fodder.

Once you have reached retirement age, and are no longer a working tax payer your health rights are put on the proverbial shelf.

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