5 ms·

No details on what actually caused Harry's death and why the hospital tried to cover it up? Why did Harry need a resuscitation in the first place?

boomboomsubban 4y ago
I assumed it was the botched Caesarean, it doesn't describe how it was botched but I imagine mistakes cause significant problems.
tinco 4y ago
It says in the article that the surgeon (locum?) who performed the caesarean made a mistake that was the direct cause of Harry's death. But it doesn't really matter, blaming the doctor doesn't solve anything, as Derek justly decided. The real problem is the hospital having such a bad culture of consequently shoving stuff under the rug that they're missing out on effectively improving their healthcare across the hospital.
- OJFord 4y ago
  > surgeon (locum?) Not surgeon specifically, it means 'contractor' effectively - in the UK at least doctors can pick up 'locum shifts' at other hospitals (or otherwise outside their contract, or do this exclusively) for a higher fee (hospital needs to fill a spot it's understaffed for). From the Latin, as in 'locus parentis' (e.g. a teacher has a parent-like duty of care over their pupils while they're on school grounds) for similar example.
- endtime 4y ago
  Blaming the doctor (and firing him) might solve the potential problem that the doctor is incompetent in a way that kills babies. The article doesn't haven't enough info to be sure, of course. But if my wife ever needed a C-section, I'd really like to know it wasn't being performed by a doctor with this track record. (One might say, well, then there will be fewer doctors and they'll be more overworked and things will be worse. To which I would say that I have indeed lost family members to NHS incompetence, and separately I was an NHS-delivered emergency C-section (I survived, obviously, but from my understanding it shouldn't have needed to be an emergency procedure). I no longer live in the UK, and would not subject my kids to the NHS. I know this is a secular British heresy; too bad.)
  - badcppdev 4y ago
    Your point would be more clearly made if you shared the details of where you live and the medical system that you trust more than the NHS?
    - abigail95 4y ago
      Having experienced the NHS I'll step in for them and say Australia, Singapore, Hong Kong, India (!) provided me better outcomes, but not per $ spent. If you care strictly about efficiency at bargain basement costs, NHS is probably your favorite model. Unless you are actively dying nobody in the NHS will lift a finger to help you.
      - lostlogin 4y ago
        The linked article is about a child dying from poor care and no one stepping in despite years of warnings the system was broken.
        Arch-TK 4y ago
        I'm not sure how this is a point against what abigail95 said. My experience of the NHS is similar in that you really have to go all out to get help for any non-standard problem. Now I appreciate medicine is not a very well developed field and we really know almost nothing about the human body and how to solve its ailments (although what we do know, which has been greatly focused around the things which kill us the fastest, has greatly reduced human suffering, which is great). As such, expecting any health system to fix any problem is not really fair. But I think I would at least expect sympathy, to be taken seriously, and at least some attempt at helping. But the NHS is not only merely unhelpful when it comes to anything slightly nontrivial, they can be actively negative. I have had severe back pain laughed at and ignored. I have been told that sinuses can't hurt (after describing severe pain in the area of my sinuses which made me want to crawl out of my skull, regardless of whether they can or cannot hurt (the NHS website seems to suggest they can) the right response to "sometimes I have such severe pain that I forget what it's like to live a normal life" is surely not to dismiss it offhand). I have had ibuprofen and paracetamol prescribed simultaneously (by the same person) for severe pain while walking (which turned out to be flat feet, once I got referred to a specialist who produced a pair of tailored inserts in 10 minutes the pain quickly went away). I have had a GP prescribe half a course of antibiotics for suspected lyme disease because she didn't really think there was a chance that the tick that bit me had it (laboratory tests of the tick confirmed it did carry lyme disease). This was after I came back from Poland and had a massive red ring around the point where the tick bit me. Not sure what the logic was there, had to go to a private GP to get the other half prescribed. I think realistically for the average Joe who is mostly healthy until the age of 55 and only ever gets a broken leg, cut, or whatnot the experience of the NHS must be stellar. But for people like me, the experience can leave you in serious pain for large and important portions of your life. Now I don't really know what the health system in the US is like, whether it's better or not. Doesn't sound better to me. But in the instances where I've paid for healthcare in the UK and in Poland I was at least met with people who didn't offhandedly dismiss my problems or laugh at me. I don't think the problems which the NHS has are endemic to public healthcare systems, I've certainly met people in the NHS who did try to be helpful, but from all appearances of what I've heard, the NHS is constantly encouraged to be like this. I think the NHS could be a lot better.
pevey 4y ago
This particular article is short on details. In another article I read some time ago, there were allegations of a general theme of being a bit too dogmatic about natural birth, even in emergent circumstances. Women and their families were often ignored when they complained of specific medical symptoms that should have been alarming. This led to significantly worse outcomes for women and babies than in peer hospital systems. It seems in this particular case, a C-section was decided on very late, and then botched. The baby need resuscitation, which was not given in time to prevent brain damage.
ckemere 4y ago
As someone who's wife had an emergency c-section, it also sounded like (a) the decision for surgery should have been done early based on measured distress in the infant and (b) perhaps the post-birth resuscitation was not done correctly. As someone who would love an NHS for the US, I was somewhat disturbed by the outcome being a fine for the hospital. It seems like they should have fired some administrators and funded more full time OBs??!?!?
- LorenPechtel 4y ago
  That would actually cost money. UHC systems have the same people paying as making the rules for what's acceptable, of course there is a tremendous problem with lowering the standards to save money.
FireBeyond 4y ago
Paramedic here, not a physician, though I did part of what would be considered medical school. From what it sounds like, there was trouble with the vaginal delivery - either mother's birth canal was too small or there was a breech, cord issue, or even placenta previa (unlikely because if mother had been receiving neonatal care, this would have been identified) or abruptio placenta (where the placenta comes free of the uterine wall prematurely). Either way, the decision was made, more slowly than it should have, to perform a C-section, and a locum (fill-in) was to conduct the procedure (the fill-in part isn't inherently the problem, though it does mean they were likely unfamiliar with the patient). At some point in the process, between the complications of vaginal delivery and the C-section being completed (going off the 'coming out floppy'), the baby was likely starved of oxygen, likely to the point of needing resuscitation. The 'life saving tube' was most likely an ET tube for intubation and ventilation, but even for the most experienced obstetricians, paramedics, etc., intubation of a neonate is absurdly complicated, due to the tiny size of things (a neonate's trachea is about the same diameter as a pinkie finger, at most). If it took 26 minutes of attempting to place this (and who knows what mechanical ventilation was happening in the process, if any), then absolutely, that was a HUGE failure (for reference, in our protocols for working cardiac arrests, pauses to compressions for intubation placement are limited to TEN SECONDS. The average adult has sufficient oxygenation of the blood supply to last several minutes, but obviously the neonate has much less, and probably had near zero blood oxygenation by the time they were delivered and resuscitation efforts started). At the risk of armchair quarterbacking, if I'd had that much of an issue intubating, we would have gone with blow-by oxygen (if there was any spontaneous ventilation), holding a mask close to the face, or continuing manual ventilation with a bag valve mask alone, or attempted something close to an ET, like an I-gel, an invasive but less complex airway management device - if ET is considered the "gold" standard, then an SGA (supraglottic airway) would be a "silver" standard.

boomboomsubban 4y ago

I assumed it was the botched Caesarean, it doesn't describe how it was botched but I imagine mistakes cause significant problems.

tinco 4y ago

It says in the article that the surgeon (locum?) who performed the caesarean made a mistake that was the direct cause of Harry's death. But it doesn't really matter, blaming the doctor doesn't solve anything, as Derek justly decided. The real problem is the hospital having such a bad culture of consequently shoving stuff under the rug that they're missing out on effectively improving their healthcare across the hospital.

OJFord 4y ago
> surgeon (locum?) Not surgeon specifically, it means 'contractor' effectively - in the UK at least doctors can pick up 'locum shifts' at other hospitals (or otherwise outside their contract, or do this exclusively) for a higher fee (hospital needs to fill a spot it's understaffed for). From the Latin, as in 'locus parentis' (e.g. a teacher has a parent-like duty of care over their pupils while they're on school grounds) for similar example.
endtime 4y ago
Blaming the doctor (and firing him) might solve the potential problem that the doctor is incompetent in a way that kills babies. The article doesn't haven't enough info to be sure, of course. But if my wife ever needed a C-section, I'd really like to know it wasn't being performed by a doctor with this track record. (One might say, well, then there will be fewer doctors and they'll be more overworked and things will be worse. To which I would say that I have indeed lost family members to NHS incompetence, and separately I was an NHS-delivered emergency C-section (I survived, obviously, but from my understanding it shouldn't have needed to be an emergency procedure). I no longer live in the UK, and would not subject my kids to the NHS. I know this is a secular British heresy; too bad.)
- badcppdev 4y ago
  Your point would be more clearly made if you shared the details of where you live and the medical system that you trust more than the NHS?
  - abigail95 4y ago
    Having experienced the NHS I'll step in for them and say Australia, Singapore, Hong Kong, India (!) provided me better outcomes, but not per $ spent. If you care strictly about efficiency at bargain basement costs, NHS is probably your favorite model. Unless you are actively dying nobody in the NHS will lift a finger to help you.
    - lostlogin 4y ago
      The linked article is about a child dying from poor care and no one stepping in despite years of warnings the system was broken.
      - Arch-TK 4y ago
        I'm not sure how this is a point against what abigail95 said. My experience of the NHS is similar in that you really have to go all out to get help for any non-standard problem. Now I appreciate medicine is not a very well developed field and we really know almost nothing about the human body and how to solve its ailments (although what we do know, which has been greatly focused around the things which kill us the fastest, has greatly reduced human suffering, which is great). As such, expecting any health system to fix any problem is not really fair. But I think I would at least expect sympathy, to be taken seriously, and at least some attempt at helping. But the NHS is not only merely unhelpful when it comes to anything slightly nontrivial, they can be actively negative. I have had severe back pain laughed at and ignored. I have been told that sinuses can't hurt (after describing severe pain in the area of my sinuses which made me want to crawl out of my skull, regardless of whether they can or cannot hurt (the NHS website seems to suggest they can) the right response to "sometimes I have such severe pain that I forget what it's like to live a normal life" is surely not to dismiss it offhand). I have had ibuprofen and paracetamol prescribed simultaneously (by the same person) for severe pain while walking (which turned out to be flat feet, once I got referred to a specialist who produced a pair of tailored inserts in 10 minutes the pain quickly went away). I have had a GP prescribe half a course of antibiotics for suspected lyme disease because she didn't really think there was a chance that the tick that bit me had it (laboratory tests of the tick confirmed it did carry lyme disease). This was after I came back from Poland and had a massive red ring around the point where the tick bit me. Not sure what the logic was there, had to go to a private GP to get the other half prescribed. I think realistically for the average Joe who is mostly healthy until the age of 55 and only ever gets a broken leg, cut, or whatnot the experience of the NHS must be stellar. But for people like me, the experience can leave you in serious pain for large and important portions of your life. Now I don't really know what the health system in the US is like, whether it's better or not. Doesn't sound better to me. But in the instances where I've paid for healthcare in the UK and in Poland I was at least met with people who didn't offhandedly dismiss my problems or laugh at me. I don't think the problems which the NHS has are endemic to public healthcare systems, I've certainly met people in the NHS who did try to be helpful, but from all appearances of what I've heard, the NHS is constantly encouraged to be like this. I think the NHS could be a lot better.

pevey 4y ago

This particular article is short on details. In another article I read some time ago, there were allegations of a general theme of being a bit too dogmatic about natural birth, even in emergent circumstances. Women and their families were often ignored when they complained of specific medical symptoms that should have been alarming. This led to significantly worse outcomes for women and babies than in peer hospital systems. It seems in this particular case, a C-section was decided on very late, and then botched. The baby need resuscitation, which was not given in time to prevent brain damage.

ckemere 4y ago

As someone who's wife had an emergency c-section, it also sounded like (a) the decision for surgery should have been done early based on measured distress in the infant and (b) perhaps the post-birth resuscitation was not done correctly. As someone who would love an NHS for the US, I was somewhat disturbed by the outcome being a fine for the hospital. It seems like they should have fired some administrators and funded more full time OBs??!?!?

LorenPechtel 4y ago
That would actually cost money. UHC systems have the same people paying as making the rules for what's acceptable, of course there is a tremendous problem with lowering the standards to save money.

FireBeyond 4y ago

Paramedic here, not a physician, though I did part of what would be considered medical school. From what it sounds like, there was trouble with the vaginal delivery - either mother's birth canal was too small or there was a breech, cord issue, or even placenta previa (unlikely because if mother had been receiving neonatal care, this would have been identified) or abruptio placenta (where the placenta comes free of the uterine wall prematurely). Either way, the decision was made, more slowly than it should have, to perform a C-section, and a locum (fill-in) was to conduct the procedure (the fill-in part isn't inherently the problem, though it does mean they were likely unfamiliar with the patient). At some point in the process, between the complications of vaginal delivery and the C-section being completed (going off the 'coming out floppy'), the baby was likely starved of oxygen, likely to the point of needing resuscitation. The 'life saving tube' was most likely an ET tube for intubation and ventilation, but even for the most experienced obstetricians, paramedics, etc., intubation of a neonate is absurdly complicated, due to the tiny size of things (a neonate's trachea is about the same diameter as a pinkie finger, at most). If it took 26 minutes of attempting to place this (and who knows what mechanical ventilation was happening in the process, if any), then absolutely, that was a HUGE failure (for reference, in our protocols for working cardiac arrests, pauses to compressions for intubation placement are limited to TEN SECONDS. The average adult has sufficient oxygenation of the blood supply to last several minutes, but obviously the neonate has much less, and probably had near zero blood oxygenation by the time they were delivered and resuscitation efforts started). At the risk of armchair quarterbacking, if I'd had that much of an issue intubating, we would have gone with blow-by oxygen (if there was any spontaneous ventilation), holding a mask close to the face, or continuing manual ventilation with a bag valve mask alone, or attempted something close to an ET, like an I-gel, an invasive but less complex airway management device - if ET is considered the "gold" standard, then an SGA (supraglottic airway) would be a "silver" standard.