Gisborne Hospital Report - Health and Disability Commissioner

Gisborne Hospital 1999 – 2000
Operating Theatre Protocols
6.9 One anaesthetic technician had seen ice used before. The anaesthetic
technician commented that for those anaesthetic technicians who had not seen
ice used before, it became a “big issue”. The anaesthetic technician compared
Dr Lucas’ use of ice with other anaesthetists the technician had worked with:
“Dr Lucas however went for maximum exposure of the patient and very
aggressive touching. Staff tried to cover the patient once he had tested
an area. Dr Lucas would start at the thigh and work right up to the
shoulders. The ice went over the breast but I could not tell if it was
rubbed over the nipple but I do not think so. I did not see it. It was the
way in which Dr Lucas used the ice which was different from how I had
seen it used elsewhere. He used a large amount of ice and rapid
movements. He had an aggressive manner. If the patient gave the
wrong answer he would rub the ice again and again until the patient got
confused and could not say whether the sensation was cold because if
you rub ice long enough on skin, the skin starts to feel numb anyway.
Patients looked confused.”
6.10 A surgeon reported never witnessing any inappropriate use of ice. His view
was that Dr Lucas’ use of ice was not suggestive or disgusting, and the ice was
not used in a sensual way.
6.11 A patient who was to have a vaginal hysterectomy recalls Dr Lucas applying
the ice to her thighs. She wanted a general anaesthetic but Dr Lucas preferred
to administer a spinal. The issue of whether to have a spinal or a general was
debated in the theatre and the patient became upset. A spinal was initially
administered but Dr Lucas gave a general when he realised that the patient
wanted a general. While Dr Lucas was administering the spinal, ice was used
to measure the extent of the block. The patient found it difficult to describe
the sensation. Because she was “dilly dallying” with her answers to Dr Lucas
“he got short with me” and said “listen to the question, I’ll rephrase it”. The
patient remembers this as brusque. The patient reported that she “felt like a
little school girl”.
6.12 This patient wrote to me expressing her concerns about the ice and her right to
choose the anaesthetic method that was used:
“On February 10th 2000, I had a vaginal hysterectomy and pelvic floor
repair at Gisborne Hospital, performed by [a surgeon]. My anaesthetist
was Mr Brian Lucas, and I was not happy with the way I was treated by
him, at the time leading up to the operation. I had decided long before,
and stated to several different people, including I think, … the House
Surgeon, that I definitely did not want to be awake during surgery, yet
Mr Lucas continued, while I was on the table preparing to be
anaesthetised, to try to persuade me to have only a spinal anaesthetic.
To illustrate his point he began pushing me on my hip area for what
seemed unnecessarily long, saying that this is how it would feel while
the operation was in progress. At one point he became annoyed when I
did not answer the question correctly, and spoke to me like one would a
small school child.
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