IOM DHSC & MANX CARE

[The Phantom]

On 12/19/2021 at 12:56 AM, James Blonde said:

I imagine they would be interested in a fortnight's secondment to Noble's but that would be about it. All pretty bog standard stuff the other 48 weeks of the year I guess (or 52 once they cancel TT22) 

I was told by an old friend still in the military that they sometimes have Special Forces medics on the helicopters during TT. 

The injuries of hitting a wall at 150mph and an IED are fairly similar. 

 

Edited December 23, 2021 by The Phantom

[Dr. Grumpy]

4 hours ago, Overdose said:

@wrighty just pondering something here, do routine operations require four anaesthetists to be present?

I am not Wrighty, but no.

[Paulos The Great]

4 hours ago, Overdose said:

@wrighty just pondering something here, do routine operations require four anaesthetists to be present?

Just the ones that go wrong most likely. You can probably assume if four were present something had gone wrong which needed extra supervision or assistance.

[opusManx]

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Edited January 13, 2022 by opusManx

[Paulos The Great]

1 hour ago, opusManx said:

For example, an urgent delivery of a distressed foetus starts with two. If things go south, you may get to four. And as I recall, that one ended up with lawyers involved.

There have been civil actions (for negligence and compensation) though from what I recall which seems to happen a lot at Nobles. They seem to be proposing that this is a criminal matter (ie, an investigation for manslaughter) which is an entirely different thing to an accident or oversight. They tried to do the same at Abbotswood I think and were lucky in the end to get some fairly minor health and safety breaches to stick. The rest of it (the accusation of manslaughter in relation to Covid deaths) was totally thrown out before it even got to court. 

Edited December 23, 2021 by Paulos The Great
Changed for clarity my opening phrasing was poor

[opusManx]

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Edited January 13, 2022 by opusManx

[Overdose]

1 hour ago, Paulos The Great said:

Just the ones that go wrong most likely. You can probably assume if four were present something had gone wrong which needed extra supervision or assistance.

Right, so hear me out: if it's the case that extra anaesthetists we're required to try and help after the operation went massively sideways, yet they're all being investigated/prosecuted for manslaughter, then would that set a legal precedence against anyone trying to administer corrective action/first aid to someone that ultimately passes away?

Could this possibly snowball to, say, anyone in the workplace that unsuccessfully administers first aid like the  police, St Johns ambulance or even your average Joe than has to use those defibrillators in the street?

@John Wright?

[Paulos The Great]

49 minutes ago, opusManx said:

Oh sorry, I wasn't referring to any case on IOM. It was actually in Montreal whilst I was studying there.

There’s been several here in the last few years I believe. I wasn’t either and have amended my post.

Edited December 23, 2021 by Paulos The Great
Amended etc

[Paulos The Great]

42 minutes ago, Overdose said:

Right, so hear me out: if it's the case that extra anaesthetists we're required to try and help after the operation went massively sideways, yet they're all being investigated/prosecuted for manslaughter, then would that set a legal precedence against anyone trying to administer corrective action/first aid to someone that ultimately passes away?

Could this possibly snowball to, say, anyone in the workplace that unsuccessfully administers first aid like the  police, St Johns ambulance or even your average Joe than has to use those defibrillators in the street?

As I said in the TT 2022 thread my understanding is this is what is spooking some other medical staff and some of the UK healthcare trusts who supply locums to work in the IOM. I’m no expert I’m literally picking up on things I’ve heard from others. But I have heard that Nobles is now being told certain hospital trusts won’t supply consultants or other medical staff to work in the IOM because of that potential risk you discuss. So TT etc may well not be staffed adequately. 

Edited December 23, 2021 by Paulos The Great
Again for clarity.

[John Wright]

10 minutes ago, Overdose said:

Right, so hear me out: if it's the case that extra anaesthetists we're required to try and help after the operation went massively sideways, yet they're all being investigated/prosecuted for manslaughter, then would that set a legal precedence against anyone trying to administer corrective action/first aid to someone that ultimately passes away?

Could this possibly snowball to, say, anyone in the workplace that unsuccessfully administers first aid like the  police, St Johns ambulance or even your average Joe than has to use those defibrillators in the street?

@John Wright?

I know nothing of the case. It’s sub judice. So I’m not commenting about specific facts of the case.

Let’s look at a theoretical case where a patient in a routine operation, with one anaesthetist, suffers cardiac arrest, a risk in any procedure. The anaesthetist tries CPR. Can’t revive.

Calls in other anaesthetists, they too attempt to revive. Failure. It can happen. Patient dies.

Anyone offering life saving intervention is under a duty of care to exercise skill in that intervention. The skill level will be higher the more specific your qualifications are.

So, a lay man doing CPR on a very young child and causing fractures of ribs and lung collapse would be judged to a very much lower standard than a paediatric consultant anaesthetist who caused the same fatal injury and loss of chance of survival.

So, patients suffers cardiac arrest and stops breathing whilst on operating table. Let’s speculate it was due to some recognised risk in the anaesthesia procedure which goes unrecognised by the original anaesthetist and those called in to try and assist. There’s a generalised urgent attempt to save life and a long, but eventually futile, attempt to revive, but no one thinks to check the basics.

That might amount to gross negligence manslaughter for the anaesthetist and those who were called in. But the level of proof would be very high that the original error was grossly negligent, and the failure to identify by those trying to help was grossly negligent. And it would all be down to expert evidence from competing anaesthetists etc.

Unpleasant for the family of the deceased, the professionals who set out to save life, and not good for retention, recruitment etc of staff, or morale, or ability to continue delivering full hospital cover.

[Overdose]

Thanks John, I don't know anything of the case either hence my first question about the quantity of anaesthetists and the consequential charges.

Either way, I hope this can be sorted out sensibly in a timely manner.  Reading the replies above it looks like the Hospital could be a big dilemma otherwise.

[Gladys]

57 minutes ago, Paulos The Great said:

There have been civil actions (for negligence and compensation) though from what I recall which seems to happen a lot at Nobles. They seem to be proposing that this is a criminal matter (ie, an investigation for manslaughter) which is an entirely different thing to an accident or oversight. They tried to do the same at Abbotswood I think and were lucky in the end to get some fairly minor health and safety breaches to stick. The rest of it (the accusation of manslaughter in relation to Covid deaths) was totally thrown out before it even got to court. 

Have the Abbotswood H&S charges gone to trial yet? Last I remember was that the manslaughter charges were dropped but a H&S investigation would follow, then nothing more.

[Paulos The Great]

1 minute ago, Gladys said:

Have the Abbotswood H&S charges gone to trial yet? Last I remember was that the manslaughter charges were dropped but a H&S investigation would follow, then nothing more.

They haven’t from what I can see. But it seems to take ages for stuff to get to court with the Covid backlogs. It’s quite a drop though isn’t it? Manslaughter to a health and safety breach? It affected one of the accused very very badly mentally. 

[opusManx]

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Edited January 13, 2022 by opusManx

[Paulos The Great]

2 minutes ago, opusManx said:

For comparison, the U.S. is a vastly more litiginous environment for physicians than Canada. Yet, many physicians go to practice in the U.S from Canada. As with many people's attitudes to unfortunate events, physicians too are suscepible to "Oh, that will never happen to me. I know what I'm doing." Unfortunately, I don't have any studies to back this opinion up, just personal experience.

I think I’ll back out as John Wrights post above is bang onreally. As I said I’m no expert. Yes I understand the US and Canada thing. Litigation is something I suppose any medical professional is insured for and probably used to the threat of in the modern world. But this is potential prison stuff the route they’re seeking to go down here. Which is what I believe tipped one of the Abbotswood accused over the edge. The threat of doing time for just doing your job.