MEDICAL NEGLIGENCE PATIENT SAFETY
UNDEFINED NOTIFIABLE INCIDENT
Patient Safety Inadequate Post Surgical Care
John Whelan Solicitor 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 the Patient Safety Act 2023.
There are 13 Notifiable Incidents set out in the Act but other notifiable incidents may be introduced by Ministerial regulation under Section 8 of the Act.
An example of a Notifiable Incident regarding Inadequate Post Surgical Care could be:
Postoperative Infection Not Properly Managed
Case:
A Patient underwent abdominal surgery to remove the Patients appendix (appendectomy). After the surgery, the Patient was discharged without clear instructions on how to care for his surgical wound. During follow up care, the surgical team did not thoroughly inspect the incision site, relying solely on the Patient's description of mild discomfort. The Patient, unfamiliar with signs of infection, assumed it was normal post surgical pain.
Over the next few days, the Patient developed increasing pain, redness, and swelling around the incision site. However, the Patient was not advised to return for a check-up and was not informed that these symptoms could indicate a serious problem. Eventually, the infection worsened, causing fever and the formation of an abscess at the surgical site. When the Patient finally returned to the hospital, he required emergency intervention to drain the abscess and received intravenous antibiotics. The infection extended the Patient’s recovery time significantly and left a larger scar due to the wound reopening.
Impact:
a) The Patient developed a severe postoperative infection that could have been prevented with earlier detection and proper wound care.
b) Prolonged recovery, additional hospital stay, and the need for more invasive treatment, including abscess drainage and antibiotics.
c) Increased medical costs, additional pain, and emotional distress due to the complications.
d) A worsened cosmetic outcome, as the abscess drainage left a more significant scar than the original surgery.
Cause:
a) Lack of clear discharge instructions regarding wound care and signs of infection.
b) Failure to educate the patient about warning signs that require immediate medical attention, such as increasing redness, swelling, and fever.
c) Insufficient follow up care, as the surgical team did not thoroughly examine the incision site during routine check ups.
d) Inadequate communication between healthcare providers, leading to missed opportunities for early intervention.
Prevention:
a) Providing detailed discharge instructions, both verbally and in writing, explaining how to care for the wound and what symptoms should prompt a return visit (e.g., increasing pain, redness, swelling, fever).
b) Thorough examination of the incision site during follow up visits, regardless of the patient's subjective report of symptoms.
c) Ensuring a structured follow up plan, with clear guidelines on when to return for wound checks.
d) Training healthcare staff to provide consistent and comprehensive post surgical care, including wound assessment and patient education.
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/