Updated: Hospital staff attitude "wrong, uncaring and insensitive" - Ombudsman
Health Ministry to seriously consider Ombudsman's recommendations
Updated: Adds Health Ministry's reaction
The attitude of hospital staff and their failure to provide support to the parents of a 16-month old baby who died suddenly three days after receiving emergency treatment at Mater Dei “was wrong, uncaring and insensitive”, the Ombudsman has concluded.
The child died on December 27, 2009, three days after he was diagnosed with croup at Mater Dei.
The baby’s parents had expressed regret at the attitude of the hospital authorities and their refusal for a long time to give a proper account of their son’s medical condition and the reasons that led to his untimely death. The hospital staff had argued that the issue was the subject of a magisterial inquiry.
In his considerations on the death of the baby, the Ombudsman said it would have been in the interest of the health authorities themselves to set up an internal inquiry alongside the magisterial inquiry, especially when only three days before his death the child had received treatment at the Mater Dei Emergency Department.
The Health Ministry said this afternoon it was deeply saddened by the baby's death. It welcomed the Ombudsman's report and would be taking his observations very seriously.
"It is because of cases like this that Minister Joe Cassar has been advocating the introduction of a Commissioner for Administrative Investigation (Health Ombudsman) within the Ombudsman’s office who can ascertain patients’ rights within Public Health Care Services.
"Discussions to this effect have been held with the Ombudsman. Currently the Ombudsman Act is at Committee Stage in Parliament," the ministry said.
In his report, the Ombudsman said it would have also been appropriate to hold an investigation to establish the facts should civil court action be instituted for alleged negligence or for any other failure in the treatment and for which the hospital could have been held responsible.
The Ombudsman said that he shared the views of a former Chief Justice who was consulted by the health authorities regarding this case, that a magisterial inquiry was not meant to replace a departmental or other inquiry on the same issue under the Inquiries Act.
This former Chief Justice held that the Health Division should not plead that a case was sub judice and use this as a pretext to refrain from providing information to patients or their relatives.
In this case, it remained the function of the health authorities to provide support despite any ongoing judicial intervention.
The Ombudsman said he had also sought to establish whether there was in place a system that enabled citizens to verify what happened in state hospitals to patients who were close to them.
Clearly, there needed to be ways how relatives could be given explanations for their concerns on standards of patient treatment and to any complaints that might arise.
The Ombudsman said that the Health Authorities has said that action was in hand to establish a protocol with a set of standards and procedures to be used by Customer Care Officers when handling complaints related to patients in state hospital. However, the Ombudsman said, at times it was difficult to define the extent of the information that could be given to persons who presented these requests, also in view of any litigation that could possibly arise from the details that are being released.
In this case, the doctor who examined the child at the Emergency Department seemed to have made the right diagnosis The subsequent attitude of health care staff led to a situation where the parents faced an impenetrable wall in their efforts to shed light on this tragic event. The staff had been fearful of saying anything which could in their (mistaken) opinion be in breach of the Court’s orders, coupled with fears lest anything they said could be used as evidence against them in a potential civil court case, the Ombudsman noted.
“This situation was further aggravated when the Mater Dei management turned down the parents’ request for a copy of the child’s medical records," he said.
The Ombudsman insisted that fears of a possible claim for damages could not override a patient’s basic right and that neither was this right affected even if civil court action for damages is instituted.
He said that although the child’s unexpected death occurred at his parents’ home, the fact that three days earlier the child received treatment at the Emergency Department constituted enough grounds to consider this as a case which needed to be subjected to a formal internal inquiry.
Carried out in time, this inquiry would have been in the interest of all concerned, not least the parents and the health authorities themselves, even though the case was reviewed by the senior paediatrician at Mater Dei Hospital on the day of the child’s demise.
The Ombudsman was also deeply appalled that for several months the parents received no bereavement counselling at a time of deep pain caused by their child’s death and when they most needed support to cope with their ordeal. This failure had its roots in the mistaken approach in cases where a magisterial inquiry is in place although it was at least partly remedied when the health authorities agreed to discuss the circumstances surrounding this tragic event with the child’s parents.
The Ombudsman stated that although he cannot investigate the conduct of a magisterial inquiry or its outcome, on the basis of information made available to his Office, including the child’s medical records, there was nothing to substantiate the mother’s belief that her child had pneumonia when she first took him to the Emergency Department.
“In the Ombudsman’s view this belief was the result of poor communication between the parties involved in this painful experience and although he felt that a departmental inquiry should have taken place soon after the death of the child, he expressed his reservation regarding the value of an internal investigation at that late stage.”
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Dr Francis Saliba
Nov 18th 2010, 20:12
Judges and magistrates do not insult court ushers and the police by accusing them of being “wrong, uncaring and insensitive” when they do their duty of maintaining order so that justice/law would be delivered without interference. When these judges start to do that, then that will be the proper time to insult hospital staff who are so harassed that they need to obtain a court order before they could carry out their duty and treat the child of difficult and unreasonable parents.
Dr Francis Saliba
Nov 18th 2010, 19:38
@Michael Hudson
Be relevant. I have not asked you to treat me with courtesy. I am asking you to be courteous to your doctor and not to treat him as a mere chattel to be used and abused according to your humour at any particular time. Being under pressure because of the illness of your child is no excuse unless you apologize to the person to whom you gave offence – respect breeds reciprocal respect.
My “smelling a rat” is no reference to you as a person – it is a colloquial term indicating that I suspect that you may not be giving the full story.
Dr Francis Saliba
Nov 18th 2010, 11:54
@Vince Portelli.
No quibbling please. You were definitely speaking about the limitations of "protocol medicine". You were proposing that qualified doctors are somehow inferior to amateurish health enthusiasts who consult internet “in the face of progress”. Professional doctors do that and much more besides. They actually write the internet medical entries on which enthusiasts rely and they keep abreast of progress by reading expertly written medical journals written by their peers and by attending seminars and international conferences.
Doctors know that they “treat people not diseases”. You do not seem to realize that only the doctor in attendance on the patient can do that. It cannot be done amateurs clipping, cutting and pasting extracts from an internet written by those who are isolated from the patient and totally ignorant of his special individual needs.
Doctors would have more time to dialogue with deserving patients if they are not harassed by unreasonable demands made by those who think that possess DIY medical expertise.
Lawrence Mayo
Nov 18th 2010, 19:06
HI
i am a pharmacy student, and i think that this country relies to much on doctors and nurses only. what about the clinical pharmacist? where are they at mater die? a pharmacist is more then just a dispenser of drugs, we are the professionals on drugs on drugs, an certain drug protocols do have to be utilized in hospital as research show they improve outcomes.
Pharmacists improve quality on the wards and reduce the incidence of drug related deaths, mistakes and offer advice on how a certain therapy should proceed, this can be seen in former Zammit clapp hospital where the adverse events were reduced because of a clinical pharmacist.
The pharmacist is a great source in community as he can diagnose a disease like croup and refer immediately " WITHOUT MONEY free of charge" all u need is to talk to one, and avoig queuing for the doctor's office. This would have saved time and time is a BIG factor in curing disease !!!
Dr Francis Saliba
Nov 19th 2010, 13:12
You mean that a pharmacist is qualified to diagnose "croup" without seeing, let alone examine, the patient, on the say-so of someone calling at the pharmacy and to prescribe treatment? What if the "croup" is not croup at all but something else? I would have thought that a pharmacist would have his hands full enough ensuring that the prescription be accurately and safely dispensed with precise advise how it is to be taken.
P Pace Balzan
Nov 18th 2010, 10:53
The attitude of most Maltese (Authorities/Departments/Mps's/ etc..) is "Wrong , Uncaring and Insensitive". (At least in my opinion)
Is it is very "wrong, Uncaring and Insensitive" to isolate one particular group of people for any specific reason - In this case the dept of health. (At least in my opinion)
Having stated the above I must state that I sympathise with all victims who experience "wrong, Uncaring and Insensitive" attitudes. (Irrespective of opinion)
Dr Francis Saliba
Nov 18th 2010, 09:14
@Vince Portelli.
Practitioners of traditional Western medicine do not receive any training in the many versions of “alternative medicine’ on offer but the vast majority keep themselves up to date in their speciality. It is prudence, not “arrogance” or “audacity”, that induces them to refrain from practicing that for which they have received no training and in which they do not believe. Also, it is the height of stupidity to approach them at all if your faith is not in the type of medicine in which they are proficient. That is were true “arrogance” and “audacity” lie.
Restrictions of visiting facilities are made in the interest of the safety of mothers and their newborn child at a time when they are very vulnerable to infections. Traditional medicine does not consider fathers to be any less dangerous than any other visitors in that respect. I wouldn’t know if “alternative medicine” teaches something different – but I very much doubt it!
Vince Portelli
Nov 18th 2010, 10:22
@ Dr Francis Saliba
I wasn't necessarily talking about "alternative medicine", but also the latest developments in mainstream "western" medicine, and more specifically the attitude problem *some* doctors still have in this day and age that patients are absolutely ignorant in medical matters.
More specifically, *some* doctors don't like to discuss with patients and to hear their points of view (even if based on material from let's say the Mayo Clinic website (isn't that the temple of "western" medicine?), either out of snobbism or impatience/lack of time or, even worse, the influence of "Big Pharma" (monetary commissions or other perks paid by the pharmaceutical companies so that their products are prescribed most of the time, in the face of anything else available - including the possibility of a non pharmaceutical approach which may make sense in some cases).
So, before rushing to any courses in "alternative medicine", I suggest doctors/nurses to take some training in customer relations. And, to repeat what I wrote before, to take an attitude that they treat people not diseases.
There is a fine line between "prudence" and "arrogance" and the wise doctor would not cross it. It's not easy being a doctor, I know!
Edward Zammit
Nov 18th 2010, 12:44
@Vince Portelli
Trust me it's not easy being a doctor. I agree with you that there are some health professionals who are poor communicators or who are not up to date with the latest developments. Fortunately that is changing, continuing education is being emphasised more than ever, treating the patient is becoming the order of the day, more so than in the past. However, there is more work to be done.
I only ask you to acknowledge those who are doing a good job.
Malcolm Mifsud
Nov 18th 2010, 07:56
That's the general attitude at the hospital these days. Sorry to have to say this but if no one is going to look into everyday life at the hospital we'll soon be going back to the good old St Luke's Hospital days. Some of the staff, especially those dealing with the general public, need to be given a good crash course.
Dr Francis Saliba
Nov 17th 2010, 16:21
@Michael Hudson
By “clandestinely” I mean seeking a second opinion behind the back of your first doctor. I find it very suspicious that you reverted to your first doctor whom you had treated with lack of elementary courtesy and, always according to yourself, after this second doctor had commented so adversely on the treatment of your first doctor. I smell a rat.
I do not accept that you appoint me as judge of the ethical standards of my unknown peers. Please, believe me, I am not so idiotic as to judge them after hearing only your side of the story – certainly not after your brazen distortion of my own comment. Speaking for myself, I always answer the telephone, something that I am made to regret by people like you. If I can, I always give emergency treatment to any other doctor’s patients after ensuring that it is a genuine emergency, that the usual doctor knows of my involvement or that he cannot be contacted. I never comment adversely on the treatment of the regular doctor and I contact that doctor to apprise him of my emergency intervention as soon as possible.
Dr Francis Saliba
Nov 17th 2010, 22:38
'There was no concealment going on in my case." ( Michael Hudson)
Of course there WAS concealment. Your concealment was not from the second doctor from whom you asked for a second opinion and who complained about your delay in seeking alternative treatment if you were dissatisfied with the treatment prescribed by your usual doctor. You concealed this change in treatment from your usual doctor and to whom you reverted. Let me guess. Your usual doctor came to know of your "second opinion" not from you, but from the second doctor fulfilling his duty according to the ethics of his profession.
Michael Hudson
Nov 18th 2010, 09:55
U ejja, int bis serjeta jew, you want to be treated with courtesy, as if you were God's gift to mankind. Kemm ha ddum ma tifhem li jien ma qbadtx u mort ghand tabib iehor mill-ewwel, izda wara li il medicina ma hadmitx ghal diversi gimghat. The only thing you did here was disagree with almost everyone who commented, as if only you're right. I did not ask you to judge but to honestly anwer a question and I can clearly see your answer, regretting answering calls from people like me and smelling a rat..........
I won't be wasting more time with you but I do suggest smelling around you, incase the rat is in your very close vicinity.
Have a nice day Dr. Saliba
Edward Zammit
Nov 18th 2010, 12:53
@Micheal Hudson
Everyone should be treated with courtesy, irrespective of their job or profession, even little children. Dr. Saliba should be no exception. You have every right to a second or even third opinion, but courtesy and respect cost you nothing. It is perfectly natural for a doctor or anyone else, for that matter, to be annoyed at this situation, especially if the patient goes right back to him soon after. You either trust him or you don't. I am not saying you're wrong - it's your right, but you can't blame the doctor either.
Dr Francis Saliba
Nov 17th 2010, 12:56
@Michael Hudson
You are falsifying my comment. I did not say that there is anything “disloyal about getting a second opinion” I said categorically that it is perfectly legitimate to do so, but doing so clandestinely would be dangerous, most importantly for the sick child itself and, secondarily for the doctors’ reputation if anything should happen to the child as a result of that stupid concealment.
Your usual doctor would not know that, behind his back, your child would be receiving treatment that could be incompatible with his intended treatment. If any harm resulted to the child the fault would lie with the devious, scheming parent not with the doctors. Nevertheless, rest assured that that same parent would unjustly put the blame on the tricked doctors. It is their reputation that would be dragged through the mud undeservedly – no need to guess by whom!
Michael Hudson
Nov 17th 2010, 13:51
@ Dr. Francis Saliba. Dear Dr., What do you mean exactly by clandestinely seeking another opinion. The second Dr. when presented with the prescribed list of medicines that my child was being administered told me off. He said indirectly that I was stupid to persist with so many medicines without seeing improvemnet. Don't think for a minute that the second doctor wasn't presented with the initial treatment prescribed. There was no concealment going on in my case. I would like to ask you one question, would you refuse to answer your phone if you discover that one of your patients, who seeked a second opinion and you know about it is trying to reach you, because the whole issue here is this fact.
Vince Portelli
Nov 17th 2010, 12:20
Like the parents of Baby Pea, I am also an avid "health enthusiast" on the internet, wary of the limitations of "protocol medicine" in the face of progress. However, if in doubt, I would side with caution and let the doctors do what they normally would (especially in a case like this where a newborn is involved).
Nonetheless, this unfortunate story does bring to the forth a handful of important issues:
1) Doctors/hospital staff frown often upon alternative medicine options. For many of them human and scientific progress stopped as soon as they got their University degrees! And they dislike patients who are more up-to-date then they themselves are...
2) Arrogance and audacity rule amongst many medical/nursing professionals (as other professionals too. Read: lawyers, notaries, etc.,). Most would do with some training in customer relations and better explanations to patients. They are intent on curing diseases, when they should be curing people!
3) It takes 2 experts to cure a person: the medical doctor (an expert in medicine) and the patient (an expert on himself). The two ought to discuss and act together.
4) The hospital policy of treating fathers of newborns as "visitors" is outrightly cruel. Please change it.
Vince Portelli
Nov 17th 2010, 16:20
(This comment was meant to be posted to the other news-story regarding Baby Pea - my apologies for any confusion caused)
J Micallef
Nov 17th 2010, 19:53
Well done! Your first two points are right spot on... all we need now is for you to kindly show us your research to support your hugely intellectual claims!
Edward Zammit
Nov 18th 2010, 13:10
1) ' Most" is wrong. Most doctors are continuously updating themselves, and educating themselves. Only a small minority are guilty of what you say. Complementary medicine, rather than alternative is becoming more popular, but it comprises a wide variety of disciplines, some of which are useless, while others are very effective. The problem is the general lack of scientific evidence backing them up. Hard, scientific evidence, that is.
2)Again, you generalise and exaggerate. Arrogance is not that prevalent - it's there, some have it, but it's not that bad. It's just as common in the patient population encountered.
3) Thankfully, the patient-centred approach is becoming more p[revalent, as opposed to the doctor-centred one practised in the past. However, there is more work to be done.
4) True, the policy can definitely be improved. Just remember that mothers often share the room with others, therefore one woman's husband is perceived as a visitor by another woman, who may not be comfortable breastfeeding her baby in the same room.
Albert Cocker
Nov 18th 2010, 18:02
Doctors are smart, therefore you think they are arrogant when they describe what you are, but in reality they're just being honest.
I'm not a doctor/nurse, but I am honest.
T.Camilleri
Nov 17th 2010, 10:53
This is a very sad case. However I dont think that it is right or fair to generalise and put all the doctors and nurses into one category. It would make more sense to say that in this particular case, the attitudes of the staff were inappropriate.
Let us not forget that there are many caring doctors and nurses who do a great job!
Dr Francis Saliba
Nov 17th 2010, 09:23
@Colette Berman.
The Ombudsman is not accusing the hospital authorities of any “malpractice” if you know what medical malpractice means. The danger is that uninformed people would jump to that wrong conclusion, as you seem to be doing. Hospital staff may nevertheless have to defend themselves in court against that charge. Even if they succeed to prove their innocence reputations would have been unjustly and irreparably tarnished during the interminable court delays. That is what I am “really afraid of”.
It is very natural for relatives of recently deceased relatives to be emotionally disturbed and to seek scapegoats for a natural death. The time and energies of overworked doctors and other hospital staff should not be diverted from their proper responsibility which is that of treating and saving the lives of severely ill but still living patients - not fending off unjustified allegations of “malpractice” from emotionally afflicted relatives. It is not a question of being “uncaring or insensitive”. It is a question of setting the right priorities. Aggrieved relatives must be excused in their distress. The Ombudsman does not have that excuse.
Colette Berman
Nov 17th 2010, 19:34
Dear Dr. Saliba,
You said: The Ombudsman is not accusing the hospital authorities of any “malpractice” if you know what medical malpractice means.
Yes, I do know what malpractice means, and I never suggested that the Ombudsman accused the hospital authorities of malpractice. What I suggested was that if there was no malpractice, there was no need to be so defensive when it came to supplying information.
Patients and parents, however emotional, need respect; this includes having their questions answered with as much information as they can cope with at the time, and repeated at a later stage when they are less stressed. Being refused information is actually more stressful as they feel that they and their worries have been negated. I appreciate that doctors may not always have the time or the inter-personal skills to do this, which is why inter-disciplinary team work is being introduced - successfully at other locations, but it appears less so at MDH.
Perhaps if there was on-going training in communication, we would be seeing less of these sad exchanges.
Colette Berman
Nov 17th 2010, 20:01
?? The danger is that uninformed people would jump to that wrong conclusion, as you seem to be doing.
This is far from this being the case on both counts. I am neither uninformed, nor jumping to conclusions. I have expressed my personal opinion that much of the distress of two sad cases which have featured and been commented upon on this site could have been avoided through better communication.
Colette Berman
Nov 17th 2010, 23:07
Ooooh! Touchy!
steve bajada
Nov 17th 2010, 07:10
i remember my self that when one of my daughters was born i went in before the elapsed visit time and fortunatley i was in the right time in the right place. the midwife that was taking care of my kid at that time i could hear her shouting that my daughter was not getting any bottles so i stood at the edge of the door when she raise up my kid and sat down in a manner that she was going to slap the baby on her leg i went in the room . all six midwifes started to look at each other waiting for my reaction but i did nothing . i couldnt tell my wife at that time because she had another two days two stay there. what was done is that i was continously braking all times and made my precense often letting the staff know that subconciously no one can tell me not to come when i wanted to . when the two days passed i bought something as an apreciation to the staff except that one in particular . i can still see her reaction and cant remove it from my head.
Chrissey Zammit
Nov 16th 2010, 20:38
My heartfelt sympathy is with this family at this very sad time. However, the attitude of staff is not just localised to the hospital, the attitude is all over Malta in supermarkets, restaurants etc. All staff who deal with the public, should be made to take a course in customer/ patient care, before they are allowed to deal with the public. Unfortunatley this does not happen, hence the reason you are treated so badly, With an attitude problem if you dare to challenge them.
George Debono
Nov 16th 2010, 16:55
Continues This incident happened in a UK hospital about 50years ago - it was normal for junior doctors to work 100–120 hours a week. Medical staff (all levels) have been through painful experiences which left them feeling guilty and inadequate. If you are run off your feet it is impossible to be perfect. An important ingredient is that staff are sometimes themselves stressed/overworked/underpaid (or insufficiently trained)-----then things can go wrong. But it is also a matter of MONEY and priorities---------(eg the 10,000s of Euros spent on Inaugurating St Georges Square would have been better spent on employing more doctors at MDH) I sympathise absolutely and utterly with the parents and with the comments but there is one question which needs to be asked and that is whether incidents as these can be due to undue pressure owing to understaffing & insufficient allocation of funds. A defining point was a legal case in the USA where a dity-doctor hadn’t slept for 37 hours. Legislation was changed to ensure that doctors/staff got enough rest between duties.
Michael Hudson
Nov 17th 2010, 09:56
Dear Mr. Debono, that is why enquiries should be made, so that if the staff is overworked, it is known to the public and the public syphatises with the staff if this is the case and not vice versa as is seen here. MONEY, well don't all doctors have their private little thing, Aren't they allowed to not provide you with a receipt...........I wish I had a way around tax like that.
George Debono
Nov 16th 2010, 16:52
Maybe I should comment Not to make excuses but to put it into perspective. It is partly a situation of “don’t blame the staff blame the system.” My experience did not necessarily resemble this one---a seriously ill child was admitted at about 3 am when I was on (weekend) duty. It was my second sleepless night on duty and there was such a huge caseload of admissions to my ward that I hadn’t slept or even changed clothes for about 40 hours. I prescribed treatment and told the ward sister that I would have a quick rest and be back to see how the child was doing. I went to my room in the doctor’s quarters for short rest -------the next thing I knew was waking up in broad daylight still fully dressed. It seemed like 5minutes later – but it was hours later - 9.00 am or thereabouts. I was literally comatose with exhaustion. The (day) ward sister told me child had died even though I had made the correct treatment decision. Continues
M. Cassar
Nov 16th 2010, 16:36
Has anyone reading this article figured out which staff was found to have the 'wrong, uncaring and insensitive' attitude? With the inclusion of the photo of the Emergency Department sign, right underneath the title, there seems to be a strong implication but I assume that the picture was the choice of the author and nothing to do with the ombudsman. Can someone clarify please?
J Galea
Nov 16th 2010, 15:30
Of course, there should be transparency and justice, but purely from a legal perspective one must ask why, if a magisterial enquiry is under way on such an important matter as a child's tragic death, is the Ombudsman getting in its way? Isn't the magisterial enquiry meant to provide for transparency and justice? What are those being investigated supposed to do when the Ombudsman suddenly turns up? By law they have a right not to incriminate themselves and if the case is so serious there is clearly the possibility that they might be defendants in an eventual criminal action brought against them.
David Caruana
Nov 16th 2010, 13:22
I would like to hear the comments of those who were so quick to judge David Ellul and Marissa Bose, parents of baby Pea who was on this same online newspaper in these past few days.
A Cassar
Nov 16th 2010, 15:09
It is a complete different issue!!!! In this case the couple are complaining because there was some lack of communication and empathy in a tragedy. In the case of baby Pea, the parents were refusing investigation for a possible problem.....which was resolved only with a magistrate removing parental rights.
Karl Farrugia
Nov 17th 2010, 15:09
I would say it's the same identical issue!
David and Marissa have asked the authorities at Mater Dei to release the baby to consult a private doctor at a private hospital, but the request was refused. Moreover, they were not given any information whatsoever on the state of their newborn, and were effectively stripped off their parental rights. They should have had the right to consult any doctor they wanted at any institution. It is blatantly FALSE that they refused medical care for their child. Do not twist the story in your own liking. They only consulted the internet because they had no trust in the hospitals medics, which would not be the case if they consulted their own.
Fenech MD
Nov 17th 2010, 19:04
@Karl Farrugia
In the case of baby Pea, the parents were refusing treatment not because they wanted a second opinion, but because they believed what they read on the net. Would the magistrate not have taken a second opinion herself if she thought that the doctors were not giving proper treatment to the baby?
I think the magistrate did not trust the parents enough, maybe she thought that they were saying that they were going to have a second opinion just to get the baby out of hospital, then doing nothing. If something would have happened to the baby (after being released from hospital), what then? Who would be the culprit?
Albert Cocker
Nov 18th 2010, 18:32
Fenech MD, if parents want nature to its course, then let them.
Also the Internet is not a trusted source of information, unless they got this "information" from well cited medical journals, which is unlikely. The most likely thing they did was get bogus stories from a bunch of unqualified and ignorant people (who think they know a lot, but in reality know nothing).
Also, they could have called other doctors and spent the money themselves if they wanted a second opinion.
J Brownie
Nov 16th 2010, 13:12
I experienced this attitude when my mother was convalescing and eventually passed away in a particular ward . When , after her death , I highlighted the negative attitude and carelessness to the professor of the respective ward he just did even want to listen because the clinical outcome of the autopsy determined heart failure . He was absolutely right and it never crossed my mind to counter that. However , the point I tried to make was that some of the nurses’ attitude was so negative and rough that it led to unacceptable stress to my mother and other patients – really and truly my objective was out of pity for the other patients and possibly to avoid unnecessary stress to them and perhaps similar outcome.
I know that it is impossible to attribute my mother death with the staff attitude but what I found most shocking that the professor didn’t even want to listen and rebuked me for simply making the point. So I ask myself, with such people playing God with us defenceless mortals whilst defending what is downright wrong how things could ever improve in this country.
Michael Hudson
Nov 16th 2010, 12:50
Unfortunately this country does not enforce the rights of every individual. It never did and most probably never will. We also experienced a paediatrician who was refusing to answer our calls without letting us know that she does not want to see our kids anymore. It was an emergency and valuable hours were lost. Thank god nothing drastic happened. We got someone else to call her and she answered, so it was evident she was recognising our numbers and not answering deliberately. Later she confirmed this with a reply via text message that she doesn't want to see our kids anymore because we checked on her. This checking was a second opinion we took for a cough our son had, which was not cured with her prescription of 2 types of inhalers, steroid based suppositaries and also a syrup. Our child was having a cocktail of medicines which did not help and she expected us not to take another opinion. She was offended by this and the victims were our kids. Shame on these people. Where is the oath they took..........
M. Calleja
Nov 16th 2010, 16:00
@ Michael Hudson.
You are right. We had an almost identical experience. Instead of "hippocratic oath" ... it should be called "hypocritical oath" ...
Dr Francis Saliba
Nov 16th 2010, 16:06
I can sympathise with any parent's anxiety about their baby's illness and their desire to have second opinions but there are safe/unsafe, ethical/unethical ways of going about it. This is in the interest of the child itself. If you do not have faith in your doctor it is perfectly proper and ethical to change doctors or to seek other opinions but don't do it disloyally behind the back of the doctor who is currently treating your child and who probably will remain saddled with the responsibility of treatment still to come. The doctor whose second opinion you seek should know what investigations and what treatments have already been carried out, why and with what result. Believe me a distressed parent is not the best parent to do this properly. I remember a case where a patient of mine managed to reduce his pulse to 20 per minute with the imminent risk of sudden death from heart block because he foolishly sought treatment from another doctor behind my back.
Colette Berman
Nov 16th 2010, 19:38
QUOTE: The doctor whose second opinion you seek should know what investigations and what treatments have already been carried out, why and with what result. Dr. Saliba, this is very true, but difficult when Mater Dei doctors routinely refuse to co-operate with doctors in other hospitals. Also, when parents request information this not only a courtesy, but also their right. As for hospital staff 'incriminating themselves' this could only happens in the case of malpractice, so if hospital staff have followed best practice and acted in good faith, what are your really afraid of?
Dr Francis Saliba
Nov 16th 2010, 21:11
@Colette Berman
My doctor has no difficulty in obtaining all my MDH records over the net - the service is only available to those entitled to it, not to every Tom Dick or Harry who claims to be a relative or to have an interest.
An accused person (and therefore an innocent person until the contrary is proved), is entitled to remain silent whether he is truly guilty or, much more so, if he is innocent but is being harassed by a false accusation intended to blackmail him to pay up so as to avoid adverse publicity or to extort undeserved damages from his insurance company. It is a reasonable and fundamental principle of law that he can choose to remain silent . That is applicable to everybody - not just doctors and hospitals. It is applicable not only in cases of actual malpractice but also in cases of alleged malpractice instituted vengefully, out of spite or to extort "damages". Such proven cases are legion abroad, especially in the USA where lawyers follow ambulaces and police hearses and advertise "no damages earned, no fees paid". The practice of attempting to damage doctors' reputations unjustifiably is regrettably gaining ground locally also.
Michael Hudson
Nov 17th 2010, 09:46
@ Dr. Francis Saliba, I think most of the parents. There is nothing disloyal about getting a second opinion, there is no contract here. If after your child has been prescribed half a pharmacy of medicines and it's not working, it's natural you seek a second opinion. One needs to be either stupid or doesn't love his child if he doesn't seek a second opinion. YOU KNOW WHAT IS UNSAFE AND UNETHICAL, A DOCTOR WHO DELIBERATELY REFUSES TO ANSWER YOUR CALL WITHOUT HAVING THE GUTS TO TELL YOU TO YOUR FACE THAT SHE DOESN'T CARE ABOUT OUR KIDS, AFTER ALL IF SOMEONE OFFENDED HER, IT WAS ME AND NOT THE KIDS.
j gatt
Nov 18th 2010, 14:21
@Dr Saliba
In the good ol US of A, undergraduates do not live with Mummy, they pay rent, they work part time waiters in the evenings, there`s no minimum wage either, they make it on tips, so need to be good with clients, or they get the boot.
They get bank loans for their studies, so they are accountable to the bank, ie they pay the loan back with interest.
Maybe they are so agressive as they have a tough time, and need to make it on their own. In other words, there`s no free lunch over there
M Attard
Nov 16th 2010, 12:49
State of the art!!!!!!!! not the service
Vicki Soler
Nov 16th 2010, 22:45
I cannot agree with you there. I am very sorry for the family of this poor child though not all the staff at Mater Dei should be blamed for this incident.
Joseph N Attard
Nov 16th 2010, 12:18
Many state and parastatal employees, in all grades, still have antiquated ideas ingrained in their minds. They always act in the belief that they are the final arbiters of all conflicts with 'customers'. They are still living in colonial times, mentally decades behind modern thinking about democratic citizens' rights. And have successive governments done anything to change this mentality? Not much, it seems.
Brian Camilleri
Nov 16th 2010, 12:08
The Ombudsman in my opinion is being arrogant when concluding a case before he retires and steps on the toes of a magisterial Inquiry. This is arrogance of the first degree. The law does not give him this power to investigate what the Magisterial inquiry is doing. He is trying to look good in the eyes of the parents and the popolin. Mistakes yes happen. But the Ombudsman should not have entered territory on which he knows absolutely nothing. He's just a lawyer not a medic.
Malvin Debono
Nov 16th 2010, 12:38
@Brian Camilleri. So in your opinion , medics are the only ones who can assess whether patients and relatives have been treated properly?? Your comment does not make sense and if you think that medical authorities can do what they like without being held to account you are sadly mistake. A magisterial inquiry does not preclude the ombudsman from investigating the operational procedures of a department. I would suggest that next time you think before you comment.
Dr Francis Saliba
Nov 16th 2010, 14:51
@MalvinDebono.
Obviously, doctors cannot do what they like, without being held to account, because they are answerable before the courts of law and the Medical Board. It should be obvious that lawyers are not competent to overrule doctors in technical matters how to treat patients properly, secundum artem, just as medics are not competent to overrule lawyers in legal matters. As regards disclosure of hospital records, apart from any confidentiality issue, no one can be obliged, not even by the courts of law, to incriminate himself. Now, that is a matter on which the Ombudsman, being a lawyer would be highly competent to enlighten the rest of us.
c. Muscat
Nov 16th 2010, 15:50
Arrogance Mr or Dr. Camilleri? You called the Ombudsman 'JUST A LAWYER' who is trying to look good in the eyes of the parents and the 'POPOLIN'. You've also baselessly implied that the Ombudsman's findings were not objective but a way to make the headlines or step on the Magisterial Inquiry's toes 'before he retires'. That's funny, I always thought that people who use such crass language are arrogant and that generally people who are on their way out want to do so quietly and as painless as possible! If you are JUST A DOCTOR or other HEALTH PROFESSIONAL who got his education through the taxes of the 'POPOLIN' please do not bother to enlighten me as to what constitutes arrogance....only an English professor with a PHD will do!!! And no I am not a lawyer, not even close to one....i just respect people and their professions whatever they may be. I also have a high regard for the health professionals.
John M. Grima
Nov 16th 2010, 21:20
Another, "poor communication", by the staff and management of this hospital???? No matter how good nurses, staff, doctors and management are. There is always room for improvement.
And surly any patient is ENTITLED to a copy of his or her medical record! What is there to hide? Also, an Ombudsman HAS the power to not only go over every scrap of paper &/or document, but also to make the finding public. That's what s/he gets paid for.
j gatt
Nov 17th 2010, 11:03
@C Muscat, well said, seems that some professionals need to be reminded that our University, with all the associated financial support required, is at the expence of the hard earned (in the majority of cases) tax payers money, so they should be accountable to the tax payer, especially those professional serving at Goverment institutions.
It seems that once one Graduates and walks out of the premises (University) the local mentality (of the majority & this applies to all other professions) is that all other mortals are only there to serve and be exploited by the now priviledged, elite class, no matter their previous background or status.
To quote an old saying that - man makes clothes not other way round, likewise qualifications does not necessarily makes humanity, at times unfortunately, the system just creates plain arrogance.
victor caruana
Nov 16th 2010, 11:44
The best justice is objective self justice followed by self determined follow ups.
This, applies when the state institutions fail to clarify or justify matters.
axuereb
Nov 16th 2010, 11:34
What a sad, terrible thing to happen to any parent. May they find strength and courage to go on. Our thoughts and prayers go out to this family.