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"There should be different connectors"
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Thursday, 15 February, 2001, 12:24 GMT
Medical accidents - unstoppable?
ward scene
Hundreds of thousands of accidents happen each year
Public confidence in the medical profession has never been lower in modern times, leading to record complaints against doctors.

Both the General Medical Council and official NHS complaints systems are under severe pressure - almost 5,000 people contacted the GMC alone last year.

And the recent spate of publicity around the terrible consequences of quite preventable medical accidents has led to further calls for tighter controls on the profession.

On Wednesday, the inquest opened into the death of Najiyah Hussain, who died in Newham General Hospital when she was given nitrous oxide gas instead of oxygen.

And in two other cases over the past month, wrongly administered drugs have led to the death of patients in both Nottingham and Brighton.

But a side-effect of this, at a time when the government desperately needs more doctors to make its NHS Plan work, is a sharp fall in the number of teenagers applying to medical schools.

We know you can't prevent these things from happening entirely - after all, doctors are fallible like anyone else

Liz Thomas, AVMA
Doctors protest that while none of these "medical accidents", or "adverse incidents" as they are sometimes termed, is acceptable, doctors, like any other human, will make mistakes.

But there are many groups who say the profession is simply not doing as much as it can to allow for the possibility of human error and protect patients from its devastating consequences.

Liz Thomas, the research and policy manager for Action for the Victims of Medical Accidents (AVMA), said that the medical community is still "complacent" about the toll of accidents.

'High priority'

She told BBC News Online: "The whole issue has been ignored until very recently, when patient safety should be one of the highest priorities for the NHS.

"We know you can't prevent these things from happening entirely - after all, doctors are fallible like anyone else.

"What tends to happen is that the doctor involved tends to be scapegoated, when very often it is the system that has failed them, and somebody else will be in their shoes tomorrow.

Cancer drugs
Dangerous cancer drugs have caused accidents
"But for years we did not even collect figures on the number of medical accidents in the NHS."

The Chief Medical Officer's report last year, "An Organisation with a Memory", revealed that as many as 850,000 adverse incidents are happening in NHS hospitals each year.

This, in terms of litigation and the extra care needed by victims, added up to a 2bn bill.

In future, all such incidents will have to be reported and recorded centrally.

This is not about bad people, it's about good people under pressure. Nobody wants to make an error

Dr Stephen Green, MDU
But experts in "risk management" - the science of making our hospitals safer - say that while it is impossible to eliminate such tragic accidents altogether, there are many things that can be done to minimise them.

Dr Stephen Green, from the Medical Defence Union (MDU), said: "If you have two drugs that have very similar names or are in similar packaging, which both are in clear glass phials, then it's not that difficult to pick up the wrong one.

"If you designed things so that the packaging is differently coloured, and perhaps the phials don't fit the same type of syringe - you could prevent that happening."

Dr Clifford Barthram, a consultant anaesthetist from Perth, said: "There should be different sorts of syringe.

"The aviation industry designs this sort of error out of the system. Different colour coding is important, but I want to see different diameter of connector."

For some years, different medical gases have had different fitments on their nozzles so that the same mask cannot be fitted to different gases. This has made such accidents less likely.

Dr Green said: "This is not about bad people, it's about good people under pressure. Nobody wants to make an error.

"The answer is to design systems that will prevent the error happening."

He said that the profession had made great strides towards "designed-in safety" over the past few years.

However, this has yet to impact on the number of complaints being passed to the regulatory authorities about doctors and their alleged negligence.

And whether the public will ever accept that some doctors will make mistakes is unclear.

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See also:

13 Jun 00 | Health
Spotting medical mistakes
13 Jun 00 | Health
Plan to stop dangerous doctors
17 Jun 00 | Health
Cutting out the medical blunders
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