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31

AUGUST, 2015

Repeated delays for surgery
Deep vein thrombosis
Inaccurate drug dose

Treatment delays for a broken leg leads to ongoing health problems

When Bill booked a weekend on the mountains of Victoria, treatment delays were the last thing on his mind. A tall, solidly built man in his fifties, Bill was looking forward to a skiing weekend with his family. He had enjoyed the sport as a teenager. Unfortunately, Bill was not as agile as he had been in his teens. One the first day he fell over, experienced severe pain and could not stand or walk.

“I told you not to try and keep up with the kids” warned his wife.

Ambulance stretcher – Pixabay

The ski resort was well organised; people had accidents on the slopes all the time. The man was quickly taken to a nearby hospital. A scan showed a broken bone in his leg. Surgery was required needed. He was admitted and sent to a ward.

Where he waited. And waited. Each day the doctors told him he was ‘on the theatre list’. He was fasted from midnight for two days for theatre that did not happen. On the fourth day he was taken to theatre.

‘This is it at last’ he thought. He had a general anaesthetic and woke up in recovery. To find the operation had not taken place. Theatre had been ‘too busy’ to do the operation. Days past. The man’s leg was bandaged, but pain was continuous, and numbed only by medication that made him both sleepy and constipated.

His wife visited him every day and was furious.

“Why hasn’t my husband gone to theatre!” she asked the nurses every day. “He’s got a broken leg for goodness sake. Isn’t that what hospitals are meant to fix?”

Finally, on the fifth day after the accident, the man went to theatre, had his surgery, and recovered back on the ward. Finally, he though, I can go home.

The doctors advised him to stay in hospital for several days after the operation, to make sure the wound healed, and to have intravenous antibiotics. Reluctantly he agreed. He had been ringing work daily; he ran a small business and had jobs underway and bills to pay. Getting back home was now his main priority.

However his wife, already unhappy with his treatment delays, kept a close eye on his leg. She noticed his calf was becoming swollen. Her husband complained of continuous pain. The wife rang a girlfriend who had medical experience and asked for advice.

“Is he getting regular injections to thin his blood while he is in hospital?” The wife did not know, so she ask the nurse.

The nurse was very helpful and gave the wife both name of the injection and the dose. The wife instantly rang her girlfriend back on her mobile.

“That’s a tiny dose,” said the wife’s friend. Your husband is a six foot six, and probably weighs a hundred and sixty kilos. When I’ve had patients your husband’s size, I’ve given five times that dose. Ask if you can get a doctor to increase the dose”.

The wife asked nurses for a larger dose of the injection to help keep his blood thin. She was told this was not necessary. “But what about the amount of time he had to wait before the surgery? Isn’t he at risk of getting a clot in his leg?” There was nothing to worry about; she was assured. Stop worrying.

A week later the man’s leg was still swollen very painful. He had been discharged, and told that his leg was healing well. Concerned, his wife took him to see their GP. The GP took one look at the man’s leg, and ordered an ultrasound. It showed three large blood clots in the man’s leg. He went back to his GP, and was told he would need to go on a long course of a very powerful blood thinning medication. He would need blood tests every month to check the drug levels in his blood. Possible side effects included bleeding, including stroke.

The side effects of delayed theatre went on for a year. The hospital denied any responsibility in wrong doing. No action was changed to change hospital procedures.

Wikihospitals 2014.

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