Deaths due to medical error

It is perhaps an inescapable fact, applicable to countries around the world, that the public has a notoriously short memory. The public’s appetite for news which is dramatic or exciting is well known, and many media providers use language intended to excite and grab the attention of their viewers, listeners or readers as they present the information that they consider to be in the public interest. However, just as “the flame that burns twice as bright burns half as long,” so it seems that the exciting news fed to the public is quickly drowned out by fresh exciting news.

It is said that politicians are the biggest beneficiaries of this fickle attention span of John and Jane Public, and Guyanese politicians are no exception. In fact, the surest way to dissipate public scrutiny on any sensitive matter in Guyana is to announce that the matter is being investigated by the relevant body responsible for such an investigation or else by a special body set up to conduct such an investigation. By the time such investigations are completed the public interest in the particular matter would have long waned with its attention focused elsewhere. It then is up to the “fourth estate” – the news media – to exercise its “indirect but significant influence on society” as per its definition, and seek to once more bring a public focus on the matter, bearing in mind that much of the public’s appetite for that particular matter has already flickered and gone out.

With just a little obfuscation and delaying tactics, even the press is forced to move on and the matter might be totally forgotten for all intents and purposes. And such is the treatment often meted out to the public by political administrations, including this current one, on many matters of public interest. Investigations that should provide a high level of feedback and insight which can be used to fix a problem and prevent its recurrence are rendered meaningless, perhaps because investigations also allow for the laying of blame and the instituting of punishment, including fines and other penalties. Thus an excellent managerial tool  becomes a sometimes costly, academic exercise that is never intended to be placed in the public domain and is only initiated for the purpose of making a problem go away from the immediate scrutiny of the public.

Although this is a dilemma facing all aspects of government’s provision of service to the general public, we would like to place some focus on the medical system in Guyana, particularly those run by the government, but also noting government’s oversight responsibility for all medical centres and medical personnel since they all have to be licensed to operate by the government.

Consumer News and Business Channel (CNBC) of the USA, reported this February, that “medical errors” in hospitals are the third leading cause of death in the USA after heart disease and cancer. In Guyana, the term “medical error” is rarely used and even after suspicious deaths occur, often of pregnant women, the results of the subsequent “investigations” that might actually see the light of day rarely result in any changes in the system or sanctions against those who might have varying degrees of culpability. This unfortunate approach to the problem of deaths in hospitals from potential “medical errors” is one akin to burying one’s head in the sand hoping that the problem goes away. Using the USA again as an example of what could be easily achieved here in Guyana; we find that there is a “National Medical Error Disclosure and Compensation Act – 2005-2006” that gives a legal framework for dealing with a problem that would obviously have severe emotional and financial implications for all the parties concerned.

This Act requires the Director of the Office of Patient Safety and Health Care Quality “to establish and maintain a National Patient Safety Database to receive non-identifiable patient safety work product.” This allows for monitoring without sensitive patient information being thrust into the public domain. Guyana continues to be plagued by seemingly unexpected deaths at hospitals of patients who were not considered to be in a life-threatening situation. The list includes women and children, even babies, and also a case one year ago where a male patient jumped to his death from a window of the West Demerara Regional Hospital.

With a lack of studied investigation of these incidents and a declaration of the causes and remedies unearthed by the investigations, the public will be unable to use its voice to adequately push for implementation of corrective actions in each case where an unexpected death of a patient occurs in a medical facility, whether privately run or managed by the state. Medical treatment is a singular field of endeavour in terms of the nobleness of intent of the practitioners: there can be no more noble a cause than nursing the sick, wounded and infirm back to health and the ability to enjoy life in all its possibilities.

However, when things go wrong, the price that the patient pays is the absolute price that anyone can pay, that is, with their life. It therefore behoves us to treat with the inadequacies with the medical system in Guyana with more serious intent so as to do everything necessary to identify and reduce deaths and injury due to “medical error” and to compensate victims (including surviving family members) according to set guidelines.

Finally, medical practitioners and all suppliers of medical services must be held accountable for any “medical errors” that they may make, after due process of enquiry and investigation.

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