A CONSULTANT told a fatal accident inquiry at Glasgow Sheriff Court
yesterday that it was a ''shoddy and unsafe'' practice for doctors not
to have a patient's case notes with them during ward rounds.
Mr Philip Myerscough told the inquiry into the death of 14-year-old
Lorraine McGalliard that in all the hospitals he had worked in the case
notes were readily at hand.
Advocate Adam Ardrey, representing Greater Glasgow Health Board, said:
''I would suggest to you that is not the practice across the medical
profession in Scotland, but you suggest there is an equally good
practice which involves having the notes in the ward although not always
in a doctor's hands.''
Mr Myerscough: ''I would completely reject that, and call it a shoddy
and unsafe practice.''
The inquiry at Glasgow Sheriff Court has heard earlier that a
consultant surgeon, Mr Robert Darling, did not read the medical notes on
Lorraine during morning ward rounds on Sunday, September 12, last year.
Lorraine, of Waverley Crescent, Kirkintilloch, died next day at
Stobhill Hospital, Glasgow, from septic shock and multi-organ failure
after an ovarian cyst twisted and turned.
Another Stobhill consultant surgeon, Mr Matthew Calvert, also said
earlier that he had failed to see vital information on the girl's case
notes when he examined her on ward rounds the previous Friday. He failed
to notice a grossly abnormal high white blood cell count and said he
could not explain how he missed seeing it.
Mr Myerscough, 70, formerly of Edinburgh's Royal Infirmary, who is
retired but who still lectures on gynaecology, was asked by Mr Ardrey if
it was not proper for a consultant to go on ward rounds without
patients' notes and to rely on information from a junior doctor.
Mr Myerscough replied: ''In all the hospitals in which I have worked
in the last 10 to 15 years the ward case notes were kept on a trolley so
they could readily be conducted round the ward so I would find that
suggestion contrary to my experience.''
Mr Ardrey: ''Am I to understand that you are saying that on each
occasion a consultant on ward rounds will take out the case notes
relative to each patient?''
Mr Myerscough: ''Normally and personally he would not take them, but
it would be the duty of the house doctor with him so to do.''
The inquiry was told that Lorraine was sent home twice from the
hospital in the six days before her death only to be re-admitted a third
time.
Family doctors could find no trace of a urinary infection and there
was evidence that the hospital continued to believe she had one and
ignored a junior doctor's request for an ultrasonic scan which would
have revealed the problem with the cyst.
Mr Ardrey asked, given the nature of Lorraine's case and the
diagnosis, whether a gynaecologist or a surgeon would make the decision
about surgery.
Mr Myerscough: ''The problem is that no diagnosis had been reached,
and on that basis it is impossible to assign anybody.''
Asked if surgery always depended on a diagnosis, Mr Myerscough said
that there could be circumstances where a patient was very ill and the
dianosis still uncertain when haste was of the essence.
Mr Myerscough then disagreed that in Lorraine's case she was not
''apparently ill'' and that there appeared to be no need for hasty
surgery. He said there was an urgency because of the girl's high white
cell count, the persistence of pain, and an an unusally low urine
output.
The inquiry continues.
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