cases Flashcards
Charlie Gard case 2016-2017
- Charlie gard had MDDS (rare genetic disorder)
- doctors at GOSH believed treatment would not improve his quality of life but parents wanted him to be treated
- a US doctor, Dr Hirano, offered a very experimental treatment, £1.3 million was raised for his treatment
- Court ruled that his life support will be removed and he will not receive the experimental treatment as it will only cause Charlie more suffering
- issue of whose decision it is: parents or medical team
- some would argue even if the treatment is experimental, it is worth trying, any chance of life is better than death
- others would say every day he lived is another day of suffering and the treatment could cause further pain
Montgomery vs Lanarkshire
- Nadine Montgomery gave birth by vaginal delivery to Sam who was diagnosed with cerebral palsy due to O2 deprivation during brith and shoulder injury due to dystocia during brith
- if the doctors had informed her of the 9-10% risk of shoulder dystocia or 0.1% risk of cerebral palsy because of Nadine’s stature and health, she would have opted for caesarean section
- they did not tell her these risks as they were thought to be too small
- the doctor defended himself using the Bolam test
MMR and autism
- In 1998, Dr Andrew Wakefield published a study in the Lancet claiming a causal link between the MMR vaccine and autism
- very small sample size of 12 children, 5 of which had pre-existing developmental disorders that weren’t disclosed
- the study involved invasive lumbar punctures that were not in the children’s best clinical interest
- despite a series of studies confirming the safety of the MMR vaccine, the MMR vaccination rates dropped in the UK from 92% to 73% thus exposing their children to preventable diseases and reducing herd immunity
Harold Shipman
- in Jan 2000 he was found guilty for the murder of an estimated 250 victims by injecting the victim with a lethal dose of painkiller and then signing a death certificate attributing the incident to natural causes
- after this case the GMC now doesn’t allow doctors to work in isolation and checks are done to pick up failing doctors to prevent this happening again
Mid Staffordshire Scandal
- It is estimated that 400-1,200 patients died as a result of poor care between January 2005 and March 2009 at Stafford hospital
- Call bells going unanswered, food and drink left out of reach of patients, a board detached from day to day reality of patient care, understaffing, a culture that failed to challenge practice despite obvious problems, too much focus of saving money which compromised patient care
- highlights importance of whistleblowing and evaluation of practise
- Brexit and COVID19 have caused understaffing, we should apply what is written in the Francis reports to ensure a crisis like the Mid Staffordshire Scandal does not happen again
- some advice from francis reports: Protection of whistleblowers, eradication of the blame culture and bullying, training and regulation of HCAs
Thalidomide
- thalidomide was an over-the-counter sleeping pill
- many doctors recommended it for pregnant woman to ease morning sickness even though it was not tested on pregnant women
- the drug caused physical issues for the babies including hearing/sight problems, undeveloped limbs, brain damage
- now we have a rigorous drug testing process: testing on cells -> living animals -> humans, clinical trials testing dosage, toxicity and efficacy in a variety of humans
Bawa-Garba Case 2011
-6-year-old Jack Adcock had Down’s Syndrome, a known heart condition and required long-term medication.
-Jack’s condition deteriorated that day and unfortunately, he passed away.
Mistakes Dr BG made:
-When Jack was admitted, Dr BG ordered a chest x-ray that showed an infection. The x-ray results were available from 12:30, but didn’t get seen until 3pm.
-When Jack was assessed by Dr BG she stopped the medication for his heart condition. However, she did not document this in his notes, and subsequently, this medication was administered to Jack at 7pm by his mother.
-Jack suffered a cardiac arrest at 8pm. Dr BG mistook Jack for another patient, whose notes were marked as DNAR (do not attempt resuscitation), and therefore Dr BG called off resuscitation. Resuscitation was re-continued shortly after the mistake was identified but it was too late.
However:
-Dr BG was carrying out the work of two Doctors and the hospital was extremely understaffed.
-There was also no system in place to notify Dr BG that the x-ray was ready for analysis.
-Dr BG was found guilty of manslaughter on the grounds of gross negligence.
