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AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

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Original poster

Surgeon has refused to operate on litigious patient

194 replies

justasking111 · 15/10/2020 14:27

Long story, friends OH had hip op. all went wrong afterwards infection set in was in hospital three months on iv antibiotics, when home had antibiotics, further surgery needed. Fast forward a few months surgeon has refused to do a further op. because my friend an expert HR person had logged each call, e mail so thoroughly with the hospital admin. and surgeon challenging them when they bull shitted, that the result is he is on morphine which the surgeon will not prescribe will have to go to GP. Now patient is in his fifties not elderly with no prospect of any kind of care. He is going to die isn`t he.

My question is is it reasonable if you question the medical system is it ok to just be kicked to the curb.

AIBU he should be kicked to the kerb
YANBU he should get the op.

OP posts:

Rae36 · 15/10/2020 14:43

My mil had a hip replacement and it got infected. She ended up needing to have it done again. Lots of antibiotics in the meantime, it wasn't fun. And her mobility is less, but she knew that a revision is never as successful as a first time op.
I don't think getting an infection in itself is a reason to complain. It's a risk of the surgery. So I'm guessing something else went on after that? Since we don't know what that is it's hard to say.
But on the face of it yanbu, a patient should get the treatment they need. Not necessarily from a particular person if a relationship has broken down, but from the NHS somewhere.

Original poster

justasking111 · 15/10/2020 14:43

@ivykaty44

It sounds as if calls were logged therefore the patient knew it would be needed to do such before things went wrong....

Thing had gone wrong he spent three months in hospital, they did not start logging until after he was at home and things continued to go wrong.

OP posts:

Original poster

justasking111 · 15/10/2020 14:44

It is not the original surgeon but it is the original health board if that helps folk.

OP posts:

janetmendoza · 15/10/2020 14:44

You have a right to health care, but not to determine the actual health care you get. That is what the practitioners professional opinion decides. So no you can't just insist on anti-ds or physiotherapy or an operation and you certainly can't make any named practitioner deliver it! If the operation is valid and provided in your locality, then a surgeon will provide it after a wait according to clinical priority.

oiboi · 15/10/2020 14:45

I have a patient with a similar circumstance from what I can get (from your rather unclear) op.
In this case the surgeon is very concerned that further surgery will be unsuccessful and may result in further disability. However they haven't refused surgery they're holding specialist mdts and awaiting to see if infection improves. This process has taken a number of months and in the interim the patient is in a lot of pain and feels nothing is being done. It is, it's just not instant enough.
It's normal gp would provide ongoing pain relief. His gp should be advocating for your friends DH, has he spoken to the GP.

Original poster

justasking111 · 15/10/2020 14:45

@Rae36

My mil had a hip replacement and it got infected. She ended up needing to have it done again. Lots of antibiotics in the meantime, it wasn't fun. And her mobility is less, but she knew that a revision is never as successful as a first time op. I don't think getting an infection in itself is a reason to complain. It's a risk of the surgery. So I'm guessing something else went on after that? Since we don't know what that is it's hard to say. But on the face of it yanbu, a patient should get the treatment they need. Not necessarily from a particular person if a relationship has broken down, but from the NHS somewhere.

Did MIL spend three months in hospital being treated for original op infection. How long was it before she had the revised operation may I ask?

OP posts:

lljkk · 15/10/2020 14:45

I'll play...

copy here the letter that the surgeon or "Health Board" wrote to state and explain why they will not do another surgery.

picklemewalnuts · 15/10/2020 14:46

I can't comment on the specifics of his case, whether care was adequate etc.

I do know that every operation has the capacity to go wrong and leave the person worse off. My gran lost her leg due to a knee replacement. Sometimes there are infections, secondary conditions and so on that mean the outcome is really bad. That's a risk each of us has to weigh up.

Original poster

justasking111 · 15/10/2020 14:47

@oiboi

I have a patient with a similar circumstance from what I can get (from your rather unclear) op. In this case the surgeon is very concerned that further surgery will be unsuccessful and may result in further disability. However they haven't refused surgery they're holding specialist mdts and awaiting to see if infection improves. This process has taken a number of months and in the interim the patient is in a lot of pain and feels nothing is being done. It is, it's just not instant enough. It's normal gp would provide ongoing pain relief. His gp should be advocating for your friends DH, has he spoken to the GP.

We are talking over a year here not a number of months.

OP posts:

AmICrazyorWhat2 · 15/10/2020 14:48

Unfortunately, contracting an infection after surgery isn’t uncommon. My FIL had a knee replacement last year and contracted an infection while he was recovering at home. Luckily my mil was keeping a close eye and took him to the doctor’s as soon as his temperature increased, so he went on antibiotics early and it cleared up.

It was nothing to do with the quality of the surgery, you’re simply vulnerable to infection post-op. So I don’t think the surgeon can be blamed for it.

I agree with PP’s that your friend should see a different consultant though, the relationship is soured.

fallfallfall · 15/10/2020 14:49

So he takes the antibiotics, eats well rests and importantly doesn’t smoke!! Does he or anyone smoke? Let’s the infection heal then returns for surgery. It may take a full year to heal. Certainly not unheard of in orthopedic cases.

Original poster

justasking111 · 15/10/2020 14:50

@fallfallfall

It has been over a year of antibiotics, no he does not nor ever has smoked, nor does his wife.

OP posts:

oiboi · 15/10/2020 14:51

My patient cannot have any surgery until her infection has resolved. It sounds like that is the same for this man. Have they taken the hip out or suggested that as an option?

Is he having IV antibiotics? Who is managing his care?

Are you just ranting?

GoldenBlue · 15/10/2020 14:52

The surgeon is either saying an operation is not needed, or that the patient is not in fit shape for an operation, or the operation may be delayed with no forecast date yet (as is the case for many elayed by COVID).

Infections happen in a proportion of every operation type, it is one of the known risks that would have been discussed when the patient consented to the operation. However obviously it is awful when this occurs to you or someone you care about.

If there was malpractice then every hospital has a complaints process in place to deal with this. All clinicians are insured as part of their licensing process to cover for individual responsibility.

All prescriptions for drugs beyond the first 5 days from hospital are generally the responsibility of the GP to prescribe rather than the consultant/hospital.

Goosefoot · 15/10/2020 14:53

I'm not sure why you think this sort of thing doesn't happen. Post-op infection is a major risk of any surgery, even a minor one, and antibiotic resistant bacteria can be found in almost every hospital. And yes, it can take a year for things to be resolves, sometimes they are never resolved.

I'm not sure what your beef about pain relief is.

People often don't seem to have a very good understanding of the risks of surgery and being in hospital generally.

JacobReesMogadishu · 15/10/2020 14:54

Sounds like it’s too risky to do anymore surgery. Sadly not everything can be resolved.

fallfallfall · 15/10/2020 14:55

Good on the smoking, keep up with the antibiotics. Does the community have nurse specialists who do wound care at home? There are several special techniques to assist (medical vacuum dressings, fancy bandages that draw out infection, irrigation techniques etc.)

Spidey66 · 15/10/2020 14:58

I had a UTI following a hysterectomy. Admittedly, it was picked up and successfully treated quickly but no it was nobody's fault that I caught an infection. I was warned it was a common complication.

Doggybiccys · 15/10/2020 15:00

surgery to bones can be problematic as bone infections are very difficult to treat - sometimes end in amputation - I've nursed a patient who ended up with an above knee amputation following a broken ankle (skiing accident) which just wouldn't heal or respond to antibiotics - no-one's fault, just bad luck.

It sounds like he might have nectrotising fasciitis or something like that. I've worked with surgeons who have god-like delusions but never have I seen one who wouldnt operate out of spite. It sounds more like the patient is an anaesthetic or other risk and they don't want to risk it rather than because he is threatening legal action.

GrumpyHoonMain · 15/10/2020 15:01

Seems like you aren’t close enough to know what the real story is and have been fed bullshit from your friend or the friend’s wife. There is no way a severely infected person is going to get revision surgery while they are still sick. My guess is he has diabetes or something else which might not have been disclosed

GeorgeDavidson · 15/10/2020 15:04

'He is not a nightmare patient he is a real poppet, his wife is fighting for him because she does not wish to be widowed. I have seen the wound it is barf material'

Sorry, but this is all bizarre. The NHS isn't perfect but they don't let patients die of routine wounds because they don't like the patient. There's more to it and there's other surgeons who can operate if the op is actually needed.

Sparkletastic · 15/10/2020 15:05

I'm not sure you've got the full story. We moved care for a family member from one Acute Trust to another in a completely different part of the country. Simple process via GP and a short conversation with the CCG complaints lead.

Montybojangles · 15/10/2020 15:07

If there’s an ongoing infection that is not responding to treatment I doubt any bone surgery would be advisable. I’m very sorry your friend is suffering so badly though. Could his gp refer him to a pain clinic and tissue viability team (though I would hope TV would have been involved already).

toomanyplants · 15/10/2020 15:09

I don't think by any means he has been "kicked to the curb"
Further surgery whilst infection still raging wouldn't be performed regardless
If your friend has been threatening to sue, or using any kind of litigious language... the surgeon can see this as a breakdown in confidence and therefore refer to a colleague to further treat.

GeorgiaGirl52 · 15/10/2020 15:11

In the US it is expected that any doctor will refuse to treat a patient who has sued or threatened to sue. The assumption is that if they have a history of filing suits, they are unlikely to be satisfied with another doctor. ALSO, many doctors will refuse to accept patients who are litigation attorneys or employees of law firms that accept suits against medical representatives.
In our state a lawyer's pregnant secretary had to drive 200 miles to the nearest obstetrician because none of those nearby would treat her, since her employer had filed a suit for a client against a doctor.

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