Gisborne Hospital Report - Health and Disability Commissioner

Gisborne Hospital 1999 – 2000
Operating Theatre Protocols
possibility of blood contamination in general. Sometimes this concern
seemed to affect her overall performance. This has some bearing on
intravenous inductions because I note that one incident report listed
danger to the assistant as being a criticism of intravenous inductions in
children. I have never heard of that being a consideration either before
or after being in Gisborne. Again, it is my opinion that, if it is hospital
policy for the nurses and technicians to critique the choice of procedures
done by senior medical staff, then that was not at all well brought [out]
in my orientation. I do not do intravenous inductions in children
because I believe they are as good as or as safe as inhalation inductions;
I do them because I believe they are superior to and safer than
inhalational inductions. This is not a criticism of anaesthetists who do
inhalational inductions; it is the prerogative of each consultant to choose
what is safest in his or her own hands. I don’t believe the Nurses or the
Administration grasps the subtlety of this point.”
Staff comments on Dr Lucas’ method of child induction
9.7 A surgeon commented that although Dr Lucas was said to be insensitive and
uncaring in the way he induced children, the locum who replaced Dr Lucas
induced children the same way, yet was not subject to complaints about his
methods of induction.
9.8 The acting Medical Director noted that in the interviews he conducted with
staff about the syringe incident one staff member was concerned at the way a
child was put under anaesthetic by Dr Lucas. Another senior anaesthetic
technician thought he was “great” at working with child patients.
9.9 One anaesthetic technician considered the intubations in the rapid sequence
discussed above involved a safety issue, but at the end of the day Dr Lucas
“carries the can”, so he can do procedures the way he wants. He did not talk
to Dr Lucas about his concerns in relation to this incident because of the need
to get the procedure done. After this incident the anaesthetic technician tried
to avoid working with Dr Lucas whenever he could. This did not need
explaining as everybody else was doing the same thing by trying to avoid Dr
Lucas’ list. “Those who came to work earliest in the morning could choose
the list they did.”
Management response
9.10 The Group Manager (Hospital) stated that the practice at Gisborne Hospital for
anaesthetising children is gas induction. The matter was discussed at a theatre
management committee meeting. The Group Manager (Hospital) wrote to the
anaesthetists collectively and he copied this correspondence to the Theatre
Manager.
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