Comments during procedure recorded on cell phone — Patient says staff members were mocking him
A patient underwent a colonoscopy last year during which he says he was mocked by staff members who said he had syphilis and discussed firing a gun up his rectum, according to Courthouse News Service.1 On the ride home with his wife, the patient determined that he had accidentally left on his phone after recording postoperative instructions, the news report said. They said they listened in disgust to the recording.
The patient claims that comments from the OR staff included comments on the amount of anesthetic needed. The patient also claims comments were made about his being "a big wimp" and that another physician "would eat him for lunch." He says one staff members said that "after five minutes of talking to you in pre-op I wanted to punch you in the face and man you up a little bit." Staff members also commented on the patient attending a college that was once a women’s college and speculated that the patient was gay, the patient claims.
A staff member also said the patient was a "retard" for looking at an IV placement that he earlier said makes him pass out, he claims. The patient says comments were made regarding an irritation on his penis and that a medical assistant touched his penis during the procedure. The patient claims the doctors also talked about "misleading and avoiding" him after the procedure. One staff member said she would make a note in the medical record that the patient had hemorrhoids, even though he didn’t, the claim says.
The patient seeks $1 million in compensatory damages and $350,000 in punitive damages for defamation, infliction of emotional distress, and illegally disclosing his health records.
Comments made during a surgical procedure can be more than unprofessional or even libelous; they can be a distraction that causes safety issues which negatively impact the patient’s outcome, say sources. "If there is a negative outcome, and others can argue or show that was due to lack of attention being paid to the procedure or the patient, it can have a liability impact by creating or increasing liability," says Stephen Trosty, JD, MHA, ARM, CPHRM, president of Risk Management Consulting in Haslett, MI, and a past president of the American Society for Healthcare Risk Management (ASHRM).
Trosty shares this example: At a medium-sized hospital in Ohio, there was talking and joking in the OR that distracted the anesthesiologist and surgeon, who missed monitoring the patient. The patient had a problem with the anesthesia and ended up in a permanent vegetative state. "This resulted in a horrific patient outcome and a very large judgment against the hospital and physician," Trosty says.
Michelle Feil, MSN, RN, senior patient safety analyst at the Pennsylvania Patient Safety Authority in Plymouth Meeting, PA, says, "When human beings are distracted from a primary task, one of two things will occur: He or she will have a delay in resuming the primary task, or they will commit an error."
A leading international researcher on distraction in healthcare says there have been multiple serious safety incidents in United Kingdom ORs in which distraction played a role, including a surgeon doing the wrong anastomosis in a colorectal case and one entirely forgetting to do part of a procedure. "Being distracted was one of many contributing factors in these cases," says Nick Sevdalis, PhD, senior lecturer in the Faculty of Medicine, Department of Surgery & Cancer, Imperial College London. "From what we know, I would say extraneous talking, i.e. discussions that have nothing to do with the patient on the table, tend to distract the surgeon and the wider OR team. This may be harmless in most cases, but on occasion reduced concentration and focus can reduce safety checks during cases and thus result in potential increase to risks to the patient."
The Pennsylvania Patient Safety Authority recently released a report in which the authors said distraction is a threat to patient safety in the OR.2 An analysis of reported events from January 2010 through May 2013 found 304 reports of OR events in which distractions and/or interruptions were contributing factors.
"The types of events we are seeing most frequently reported to the Pennsylvania Patient Safety Authority that involve distraction in the OR are incorrect counts and specimen handling problems," Feil says. "But there have been reports of distractions contributing to serious events ranging from wrong-side surgery, to failure to notice a significant loss of evoked potential from a patient’s arm during spinal surgery, to transfusion of the wrong blood to the wrong patient."
- Abbott R. Unconscious patient says doctors mocked him. Courthouse News Service. Accessed at http://www.courthousenews.com/2014/04/22/67225.htm.
- Feil M. Distractions in the operating room. Pennsylvania Patient Safety Authority. Accessed at http://bit.ly/SIdpOd.
- To access the free Pennsylvania Patient Safety Authority report "Distractions in the Operating Room," go to http://bit.ly/SIdpOd.
