MEDICAL NEGLIGENCE PATIENT SAFETY 1.3A

UNDEFINED NOTIFIABLE INCIDENT WRONG PROCEDURE

John Whelan with Specialist expertise in Medical Negligence and Patient Safety gives an example of a case which falls outside of the definition of a Notifiable Incident as envisaged by item 1.3 of the Patient Safety Act 2023.      This example involves similar mistakes to that envisaged by item 1.3 of the Act but yet since it doesn’t lead to the death of the Patient it is not a Notifiable Incident as defined by Item 1.3.

Item 1.3A

An example of a Notifiable Incident involving a wrong surgical procedure on a Patient which did not involve the death of the Patient.

Incident Description: A Patient, was scheduled for a knee arthroscopy to address a torn meniscus in the left knee.   Due to a miscommunication between the surgical team and a failure to properly follow the surgical site marking protocol, the surgeon mistakenly performed the procedure on the Patient’s right knee instead of the left.

Important Details:

a) The mistake was identified post surgery when the Patient woke up and complained of pain in the wrong knee.

b) The right knee, which had no prior issues, underwent an unnecessary invasive procedure, leading to temporary discomfort, recovery time, and a potential risk of complications such as infection, swelling, or impaired mobility.

c) The torn meniscus in the left knee, the intended target of the surgery, was not treated, requiring the Patient to undergo another surgery to address the correct problem.

Outcome:

The Patient did not suffer life threatening consequences from the wrong procedure, but did experience physical and emotional distress due to the additional surgery and recovery.

For more detailed insights into how the Patient Safety Act 2023 impacts you and how Whelan Law can support you, please visit our Patient Safety Rights Legal Advice https://www.whelanlaw.ie/news/medical-negligence-and-patient-safety/