Gisborne Hospital Report - Health and Disability Commissioner

Gisborne Hospital 1999 – 2000
Operating Theatre Protocols
Opinion
I think it would be fair if you acknowledged the fact that more than one
anaesthetist asked me how I did my spinals implying that my technique
was worth emulating on the basis of its results. Why had they not
chosen to emulate the anaesthetist that you quote in [para 6.25]?”
6.28 The use of ice by Dr Lucas was described as “aggressive” and by himself as “a
trifle frenetic”, but there appears to be no evidence that it was clinically
inappropriate. I accept my expert advice that Dr Lucas did not breach
professional anaesthetic standards in his use of ice. Nor do I find any evidence
that Dr Lucas breached ethical standards by using ice in an improper manner.
Accordingly, in my opinion, Dr Lucas did not breach Right 4(2) of the Code
by his use of ice.
6.29 Right 6(1) of the Code states that “every consumer has the right to all
information that a reasonable consumer, in that consumer’s circumstances,
would expect to receive”.
6.30 Dr Lucas noted that from 1982 to 1997 he treated countless Canadians in the
same way as he did the women of Gisborne. In my opinion female patients in
New Zealand, on whom ice is to be rubbed for anaesthetic purposes prior to a
surgical procedure, would expect a reasonably full explanation of how and
why the ice is to be applied. Any surgical patient is likely to be apprehensive
about surgery and may be ill at ease in the unfamiliar surroundings of an
operating theatre. A procedure which involves intimate parts of the body may
cause additional stress and embarrassment.
6.31 One patient wrote to me that she did not “think it necessary to keep testing
with the ice right on up to and including [her] bosom area”. This patient was
entitled to an explanation of how and why Dr Lucas proposed to apply the ice.
Had such an explanation been given, her concerns could have been alleviated,
or another method of testing the level of an anaesthetic block could have been
offered to her.
6.32 I note that, although a number of Dr Lucas’ nurse and anaesthetic technician
colleagues expressed concern about his use of ice, only one of the many
female patients on whom he used the technique complained about it,
notwithstanding the widespread publicity in Gisborne about the allegations
and the availability of my investigation team for interviews.
6.33 In these circumstances, I find that Dr Lucas failed to give one patient the
information that a reasonable patient in her circumstances would have
expected to receive, and therefore breached Right 6(1) of the Code.
7. TILTING THE OPERATING TABLE
The alleged incidents
7.1 It was alleged that Dr Lucas failed to treat patients with respect and failed to
provide services in a manner that respected the dignity of individuals by tilting
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