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Postoperative care of patient with special needs (06HDC19538)
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(06HDC19538, 12 March
Public hospital ~ District health board ~ Breast cancer ~
Surgery ~ Post-anaesthetic care ~ Blood-pressure monitoring ~ High
dependency unit bed ~ Staffing ~ Communication ~ Rights 4(1),
A man complained about the care his 55-year-old wife received
following a routine operation in a public hospital. It had been
agreed between the woman and her surgeon prior to surgery that she
would have her operation in the local public hospital rather than a
private hospital, because she required a high dependency unit (HDU)
bed because of significant co-morbidities.
Unfortunately, when the operation was completed and the woman
was in recovery, it was found that no HDU bed had been booked, as
the system for arranging this had broken down. In addition, a bed
was not available in the appropriate surgical ward, and she was
transferred from theatre to a busy orthopaedic ward without the
knowledge of the surgeon.
Once transferred to the ward, despite knowing that the woman
would require the use of a larger bed, this had not been arranged
and, with some difficulty, the nursing staff attempted to provide
her postoperative care. The woman's postoperative care was
jeopardised on the ward as monitoring equipment was unsuitable for
the task or was not functioning, and the ward was inadequately
staffed for providing the woman with appropriate care, given her
Unfortunately, the woman died the evening after surgery. When
called to the ward after her death, and in the stages afterwards,
the woman's family was not treated appropriately, and this caused
them further distress.
It was held that the woman did not receive postoperative care of
an appropriate standard, and clinical staff did not properly
co-ordinate their care. In these circumstances, the district health
board breached Rights 4(1), 4(2) and 4(5).
It was noted that the poor communication with the family after
her death was naturally very distressing to them. It showed a lack
of compassion and a disregard of the duty that hospital staff owe
to the family of a recently deceased patient. At a time when
accurate and sympathetic responses would have been of the greatest
importance, the family did not receive the help they needed.