[ad_1]
the Weekend herald has obtained the findings of an investigation into the extraordinary breach of security and privacy, in which a medical student gave uniforms, instructions and a magnetic card to her roommate, who observed the entirety of the major surgery on the 25 of August.
Capital & Coast DHB says the fact that there was no formal procedure for verifying student ID cards as they entered theaters left an “unacceptable void”, exploited by a “massive betrayal of trust.”
“Our systems have failed the patient and his family in this case,” said Medical Director John Tait.
“This was a clear violation of the code of conduct that students sign when starting a placement.”
However, the University of Otago, which has not yet completed its own research, says its student “explained that they believed they had followed the appropriate process to arrange for a third party who aspired to study medicine to attend the procedure.”
The student was in the final year of a six-year bachelor’s degree and completed a six-week placement in the intensive care unit at Wellington Regional Hospital. She was “well regarded as an enthusiastic and hardworking student and gained the trust of the medical staff with whom they worked,” stated the DHB report, which was published under the Official Information Act.
Interns-in-training often observe elective heart surgeries, with the patient’s permission, and the student in question did so in June. In August, he sent a message to a cardiothoracic registrar who helped organize that, asking: “I have an aspiring cardiothoracic surgeon named [name redacted] I would be very interested in seeing a case. Let me know if that would be possible. “
The student used an IT system to search for surgery, which the DHB says was a violation, as it was not for the performance of her duties, and followed up with the registrar, “only regarding my friend who came to Seeing some cases, we were wondering if Tuesday works. “
“Tuesday would work fine,” replied the doctor. “I’ll be around so they can call me around 7.30 to 8 am and we can fix something.”
That morning, August 25, the apprentice builder texted the registrar and they told him to meet at the theater. He entered the hospital through a door that connected to the Otago School of Medicine, dressed in a robe, overshoes and a hat, and used the medical student’s magnetic card to enter the theater area.
The registrar introduced him to another doctor when he was a medical student, according to the report. The patient (who had consented for a medical student to be present) was in the operating room, but it is unclear whether he was sedated or unconscious at the time.
Typically, a student was introduced and their name was written on a blackboard, but the staff said they couldn’t remember if this happened.
The man, now wearing a mask and goggles, stood at the head of the bed and watched for about 3.5 hours. The anesthetist showed him where to stand and discussed the operation.
“The observer never interacted or touched [the patient] at any time during the operation. The observer knew how to move around the operating room to avoid the equipment and the sterile field. [an area kept free of microorganisms to protect against infection]”the DHB report stated.
“When observing the operation, the observer leaned forward over the sterile barrier with his hands placed behind his back. Theater staff commented that: ‘It felt as if the observer had been trained on how to behave in the theater.’ .
Between 12:20 and 12:40 pm the surgeon left the operating room and the cardiothoracic recorder who had exchanged the text messages completed the suture of the chest wall. They asked him about his plans after graduation and if his stitching skills were good.
“Not very well,” he replied.
“When is your final exam, where are you next year?” the doctor asked, according to the report.
“I am not a medical student,” he said. “I hope to start in three years. I am an apprentice builder.”
The man thanked and left. The registrar, after calling the surgeon to relay the news, texted him: “I didn’t realize you’re not a medical student! Maybe it’s best not to tell anyone that you came today. Usually , we would follow you a bit. of a different process for non-medical students! “
He apologized – “I thought [the medical student] he may have mentioned it “- and promised to keep what he had witnessed to himself.
Among those alerted are the executive director of the DHB and the professional vice-rector of the university. The Privacy Commissioner was informed and the police contacted (they refused to take any action).
Shortly after 2 p.m., the medical student was contacted by phone.
“[She] said the observer was a housemate who wanted to see an operation, “the DHB report stated.”[She] described feeling upset and sick. “
The report made recommendations including a formal process to verify the identities of medical students at the entrance to the theater (already held) and for Otago to review the information and training. The reviewers did not interview the medical student or the trainee builder.
“We really don’t know what was going on in the mind of the medical student or the observer. These may be questions that the university can answer,” Tait said.
“The student accessed information from our systems, which is against the code of conduct. The delivery of a security card is also against any code of conduct.”
All staff had assumed the man was a medical student, Tait said, and the text message from the registrar was to try to “make sure this person was not going to count [his] colleagues what he saw in the operation. “
When asked if he was disappointed that the police did not take action, he said: “His opinion, and probably quite correctly, was that it was our processes that allowed this to happen, rather than the person being there under false pretenses.” (When the Herald weekend released the story last month, Tait said false pretenses were used.)
He again apologized to the patient and his family.
Currently, the student is unable to carry out clinical practices, and the university and the Medical Council are considering what additional measures could be taken.
A spokesman for the University of Otago said it agreed with DHB’s recommendations and is working to “eliminate the possibility of any future such incidents.” His own investigation is ongoing and focuses on the student’s explanation that he believed the appropriate process was followed.
Tait, who has been a consultant OB-GYN in Wellington since 1986 and chairs the Health Safety and Quality Commission, said he had never heard of such a case.
“We have had unauthorized people in hospitals, but not in the operating room.”
