Surgeon has refused to operate on litigious patient

[justasking111]

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.

Actually I don't think the op has said what the surgery was for. Just that there was a wound.

Also op you have said "litigious", but no one has been sued?

This is a very confusing thread.

I'm sorry - without "taking sides", because there is absolutely no clarity here about what has happened - but every single surgery carries risks (I know - I have been on both sides of surgery) and people are clearly warned about those risks and asked to sign that they have been told, and understand the risks. Your friend may be an expert in HR. Bit they are not an expert in medicine, and neither are you - so what you may or may not have seen has no relevance as to whether they are fit enough for further invasive procedures. And how can they be "litigious" if they haven't even seen a solicitor yet?

But one thing I can say with absolute certainty. If his flesh is rotting away, and if antibiotics after this length of time are only holding it at bay, then there is absolutely no way on God's earth that any responsible surgeon would undertake surgery because that surgery would, in all probability, kill him.

Whether or not an error was made in infection control during, or immediately after, surgery, is something neither you nor we know. But there is no actual evidence being produced here that this is anything other than damned bad luck, a tragedy, and a responsible surgeon saying that he will not further risk this persons life until it is safe to do so.

So yes, you are being unreasonable. And, frankly, leaping to conclusions even you cannot evidence or support. Having sympathy for a tragic outcome is one thing. Levelling unreasoned allegations without evidence is pointless. And outing - I am going to take a wild leap and say that there are very, very few people in Wales in this situation, and it isn't appropriate for third parties to level allegations on their behalf. If the person believes that there is malpractice, they must speak to a solicitor.

When you sign the consent form for sugery you accept there are risks. infection being one of them. My DH ended up in hospital for two months post surgery. The surgeon didnt make a mistake. Everyones tissue heals differently, he ended up requiring a number of procedures to fix the problem. my DH brother got preoccupied about 'negligence', mistakes and getting folks in to investigate. It was absolute nonsense. The trust has a very clear process for reporting serious incidents and have a duty of candour. If your friend is so sure there has been an medical error then escalate it via the chief executive and get it investigated. As for surgery.. who has told him he needs surgery? It would seem odd to be told you need surgery but then the same surgeon refusing to do it. So it all sounds like you know parts of the story here....

'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

 Anybody at home with a serious longterm  open wound infection  should NOT be  exposing it  on view to visitors  who could be exhaling  more bacteria and viruses into the air.

Its difficult to give an opinion on such limited facts. Is the infection MRSA? Are there multiple sinuses erupting from the area? After a year of infection, they desperately do need to eradicate it as a matter of urgency, because its likely the bone is being badly damaged beyond repair. And its a hip, so its not as if amputation is going to give a good result. The GP may wish to refer to another NHS trust and a specific orthopaedic surgeon for a second opinion at this stage.

The patient hasn't been litigious because he hasn't yet sued and I would doubt thats the reason for lack of effective treatment, as it would be an obvious case for medical negligence. Its more likely that (1) ongoing treatment is effective/exemplary or (2) there has been negligence and it isn't being addressed correctly.

I'm amazed in the faith of some posters in the NHS. The NHS is sued for negligence all the time, many heartbreaking mistakes are made which could easily have been avoided by better organisation and attention to detail. I've put links below to a couple of random cases (I have no connection with these whatsoever) and in the first, it shows the sort of pointless delays that can arise - a break of 6 weeks in treatment because the consultant in charge was on an extended holiday and the juniors didn't want to make any decisions until he returned, a failure to give the correct antibiotics for heavily-resistant MRSA, and so on.

"The main reference orthopaedic text book Rockwood and Green's Fractures in Adults, Volume 1, 4th Edition states that "the cornerstone of the successful treatment of chronic osteomyelitis is the complete removal of all involved bone and soft tissue".

news.bbc.co.uk/1/hi/scotland/south_of_scotland/7059622.stm

www.fieldfisher.com/en/injury-claims/case-studies/225-000-for-leg-amputation-after-wrexham-park-hospital-delays-diagnosis-of-compartment-syndrome

www.scotcourts.gov.uk/search-judgments/judgment?id=4fcf86a6-8980-69d2-b500-ff0000d74aa7

You are telling your friend's story and hearing only one side. The surgeon will likely have refused based on justifiable medical grounds. They won't be just picking and choosing patients. It may be that Futher surgery will put your friend in a worse position. Surgery is not always a magical cure. Infection is a risk of surgery. Many people choose to go ahead with surgeries thinking they will get cured. They brush over the risks until it hits them like a ton of bricks. Then they go about claiming "something went wrong" and trying to sue as if they were not aware of these risks. They were told. They chose to ignore it. They chose to risk it. For some the gamble doesn't pay off.

Can he not get a second opinion even if he has to travel a bit?

Has he asked to be seen by someone else or for a second opinion?

OP, presumably this isn't the only surgeon in the speciality in the world? Perhaps your friend's GP could refer to a different treatment centre. No surgeon should be made to operate on a patient if the relationship isn;t working. Having my hackles raised by the tone of the posts, PMSL at the notion of 'HR expertise' being more transferable to healthcare than bus driver expertise, electrician expertise or teacher expertise.

You paint a very antagonistic picture and do so in black and white. Life and medicine are not usually like that.

@justasking111

The call logging, e mails only started after the operation went wrong and he spent three months in a hospital on an iv. It was the follow up care that was logged. 57 is no age for all this to go so spectacularly wrong, to see a fit man reduced to an invalid who is now refused further surgery is heartbreaking. It is not the same surgeon but it is the same health board.

No-one has been sued but there has been a cover up. Our health board has form for this.

Thing is, when you have a major operation, infection is a possible side effect. It's not "the operation went wrong", but the nature of opening up your entire body to the possibility of bacteria. You sign a paper before the operation to accept the risks. Nothing is risk-free. Your relative or whoever has been unlucky for sure.

But that is a world away from saying the surgeon is negligent. The surgeon could be the best in the world and a patient could still develop an infection.

All this call logging and emailing sounds like the patient is seeing the ££££ signs for a medical negligence case, even where there is no negligence. Also making a complaint is not the same as suing for medical negligence.

You also make a strong case for better teaching of punctuation.

Your op isn't very clear.
I dont think they should be kicked to the curb.
Why cant they just find a different surgeon. I'm not surprised the current surgeon doesnt want to operate. I think once the trust has been lost between the patient and doctor it's time to move on.
He should find a different surgeon, there is no need for him to just die.

Ask about using leeches

In order to prove negligence you have to apply the Bolam test
www.bmj.com/content/suppl/2004/10/28/329.7473.1024.DC

Basically this states that if a doctor reaches the standard of a responsible body of medical opinion, they are not negligent
Your friend needs to get a copy of his medical records and find a solicitor specialising in medical negligence to see if there even is a case
Just because things go wrong ( which unfortunately it can do even in modern 21st century medicine ) it does not mean there was negligence

I think I’d probably stay out of it. Be kind to friend but there may be more to this story.

Fast forward a few months surgeon has refused to do a further op. because my friend an expert HR person

Or because it’s medically inappropriate?

My fit and well DB had a wound infection following knee surgery when he was 21, it's a complication of surgery that can happen at any age. Months of antibiotics and rehab. Sometimes it just happens, all.procedures have risks. Wasn't the surgeon's fault. If your friend is still on antibiotics with an ongoing infection it doesn't sound like a good time to take him back for surgery. That's a fair decision by his surgeon and probably nothing to do with him being 'difficult' and more to do with risks of repeat procedure while he's in the state he's in.

OP your friend seems to be an example of why the NHS struggles to recruit and why it's paying £1000s/hour just to get a doctor willing to work. I'd hate to think how this must be affecting the poor surgeons mental health. Poor person must be walking on eggshells. Imagine spending decades training to help people only to have vultures like OPs friend waiting for the surgeon to slip up so he can sue for a few ££!
It's no wonder so many of the good doctors are moving abroad. I don't blame them!

What is that went wrong Op? What is it that the surgical team did or didnt do that they should have done

Infection is not surgery gone wrong.

Why are they saying no?

There are many reasons you wouldnt operate, if its not safe, if its not going to work, if there isnt an appropriate operation, if the patient isnt well enough, if the problem is too far progressed. If an operation isnt suitable its not suitable

The fact that hes litigous is neither here nor there tbh. But he sounds confrontational, and not willing to present the full facts

I think your friend should go to the daily mail and pull a sad face.

Maybe its too risky to operate if he has an open infected wound. Has he been to hospital to get that seen by the wound specialists.

I don't think you have a clear grasp of the whole story. Did they do the surgery wrong or did he simply end up with an infection? Every surgery has risks, was it one of those risks that happened? Did the surgeon actively cause the infection (doubtful) or did it just happen because the world isn't a sterile place?

Did the operation go wrong because of negligence or did it just have untoward complications as operations sometimes do? There is always a risk with any operation. The human body is very complex and each persons body responds differently.