Gisborne Hospital Report - Health and Disability Commissioner

Gisborne Hospital 1999 – 2000
Operating Theatre Protocols
Appropriate standards
4.15 THL’s policy on sharps disposal includes the statement:
“3. Whenever sharps are used, approved sharps containers will be
available for disposal.
4. The original sharps user is to dispose of it at its point of use in an
approved sharps container.”
The policy on the treatment of used items at THL is: “When handling used
items universal precautions shall be followed at all stages of handling to
prevent exposure to blood and body substances.” Under universal precautions
it is recommended that all health care workers take precautions to prevent
injuries caused by needles, scalpels, and other sharp instruments or devices.
The policy states: “All single use items should be discarded appropriately after
use according to local regulations”.
Opinion
4.16 Although the allegation was sensationalised and some of the people involved
did not like Dr Lucas, there is evidence that Dr Lucas did not follow THL’s
policy on sharps disposal. Specifically, he failed to dispose of sharps in an
approved sharps container or temporarily place them in a suitable alternative
receptacle.
4.17 In my opinion, by failing to comply with a “relevant standard” Dr Lucas
breached Right 4(2) of the Code.
5. RIPPING OR CUTTING PATIENTS’ GOWNS
The alleged incidents
5.1 Dr Lucas was alleged to have failed to treat consumers with respect and
provide services in a manner that respected the dignity of individuals, by
ripping or cutting off patients’ gowns and objecting, between anaesthetic
procedures, to nurses or technicians covering women’s breasts after their
gowns had been removed.
5.2 In the letter to the Minister, NZNO noted that Dr Lucas “had a practice of
ripping or cutting gowns off patients, invariably [those of] women”.
5.3 The Head of Department (Anaesthesia) advised the investigation team that
maternity patients came to theatre with gowns wrapped round them, not
operating gowns with the usual split up the back. The gowns needed to be
pulled up to gain access to insert the epidural and to tape tubing on patients’
backs. Dr Lucas wanted patients to wear the standard operating gowns to
prevent all the tugging and pulling of the wrap-around gowns. “It was difficult
to turn patients on the narrow bed, and it is far better to have a clearer view
when inserting an epidural. It is better for the patient.” It was the way Dr
Lucas did this that was said to create conflict and a tense atmosphere.
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