A “Widespread Practice” Kills a Child — And No One Pays

There isn’t a large enough bold-faced font to show you how angry this makes me.

Add this special delivery from the UK’s National Health Service (NHS) to the “deadly perils of nationalized health care” file:

The NHS scandal that cost a young boy’s life
12:11pm 22nd August 2006

Earlier this month, leading orthopaedic surgeon Simon Moyes, who put patients at risk of infections by re-using surgical equipment, escaped punishment after it was claimed such practices are widespread in the NHS due to cost cutting. It was news that shattered the Clowes family, whose nine-year-old son Tony died exactly five years ago this month after (a) breathing apparatus was reused in what should have been a minor operation.

The UK’s Daily mail interviewed Tony’s father George:

He says: “After reading about Simon Moyes in the newspaper last week, I was left feeling as though I’d been run over by a truck.

….. And to hear at the same time that the very practices that killed our son are still going on was shattering.

After Tony’s death, we were promised that lessons would be learned, which, given this latest investigation, we find difficult to believe.

One of the consultants who gave evidence in support of Mr Moyes said it was common practice to reuse equipment because the NHS is so short of funds.

To us, the thought of doctors still risking people’s lives for the sake of a little penny pinching feels like a slur on Tony’s memory.

….. At the time of his death, he was in perfect health. He wouldn’t have ended up in hospital at all had he not lacerated his right index finger while trying to repair the chain of his bike.

….. I had no idea that as I flicked casually through magazines, doctors were struggling to save Tony’s life.

I thought in a couple of hours, Tony would be ready to go home and would be chatting away about the welcome back dinner his mother was making him.

The first I knew anything was wrong was about an hour later, when a doctor and his assistant came and found me and ushered me into a side room. He looked at me and said “I don’t know how to tell you this but there’s been an absolute disaster.”

Then he said that Tony had died. It was impossible to take in what they told me next. I listened in total disbelief as they told me that they’d discovered Tony wasn’t getting any oxygen through the breathing tube they’d put down his throat while he was under the general anaesthetic.

At first, after checking the breathing equipment and discovering it was all fine, they’d thought he’d had an allergic reaction to the anaesthetic drug.

So they’d started injecting him with a cocktail of other drugs, including adrenaline, in order to counter the anaesthetic.

It was only after other senior anaesthetists had rushed in to examine Tony, that one of the doctors finally lifted Tony’s mask and discovered one of the connectors inside it had slipped into the tubing and was blocking the airflow. Tony had suffocated to death.

….. We still can’t believe not only did they break guidelines but they didn’t do something as basic as mouth-to-mouth which would have saved his life.

….. If doctors continue to get away with such behaviour, then there will be little incentive for them to change their ways and more people will die as a result of NHS budgetary constraints.

Even five years on, we still miss Tony desperately. There is still a gaping hole in this family and although we have days now when we’re able to laugh, we will never be as happy as we once were.

Read the whole sickening thing.

So what’s the point of “free universal access” to medical care if this is what you and your loved ones get access to?

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UPDATE: Dean at Dean’s World relates a horror story with his lovely bride, and makes the point that indifference is not unique to nationalized systems. Fair enough — but I would suggest that the unsanitary and dangerous reuse of disposable items is NOT a widespread practice here as it has been found to be with the NHS. He also e-mailed and questioned why health care should be employer-based as it is in this country. That is of course an important issue. Employer involvement is an accident of history that goes back to World War II and evolved (or devolved) from there. Ideally, individuals should pay their own medical insurance and medical care costs, as with auto insurance, but getting from where we are to the ideal is going to be difficult (Medical Savings Accounts are the bridge). One thing that I believe experience shows won’t work is pretending that a government takeover of the healthcare system will be an improvement.

UPDATE 2: The Socialized Medicine blog posted on this and received this e-mail from a reader who said he/she is an anesthesiologist in a U.S. public hospital:

Local anesthesia can also be dangerous, or fatal, in the wrong hands. This boy was in the wrong hands. We have separate “ambu bags” to ventilate patients. If the machine malfunctions, we reach for the ambu bag, ventilate the patient, and then troubleshoot the machine. We have “pulse oximeters” to measure oxygen in the skin, and “end tidal carbon dioxide” to measure ventilation. Alarms are set to go offf if these become abnormal, as would occur if the ventilation circuit was blocked. In addition, the anesthetist should be observing the patient – obviously not the case here. The time of neglect must have been significant. A healthy patient has enough “reserve” oxygen that it would take a number of minutes to die even if the oxygen supply was cut off. In the USA, this would be negligence – plain and simple – and a multi million dollar out of court settlement.