The Times News Paper recently reported about a senior colorectal surgeon who was found guilty of manslaughter in 2013 for the death of a patient who was under his care at a private hospital in West London. He was released recently after spending two and a half years in jail.

Mr. Sellu is a senior colorectal surgeon with considerable experience. However the circumstances that lead to the death of the patient under his care is worrying and can happen easily if the systems are not controlled properly. The incident will also make one think twice before getting admitted to a private hospital.

The patient a 66 old man was admitted under an orthopaedic surgeon for knee surgery. A few days after surgery he developed acute abdominal pain for which he was referred to the colorectal surgeon. After a series of delays he was finally operated on as an emergency. It appeared that the delay was caused because the surgeon could not find an anaesthetist on time, being a Friday afternoon. When an anaesthetist was finally found the patient was in a critical state. Following surgery he died the next day.

During the investigation that followed it was noted that there was an unusual delay in treating the patient. The hospital’s procedures for dealing with emergencies that developed after routine operations were not robust enough to prevent a systemic failure. The monitoring was inadequate and there were failings in the procedures for escalating concerns. There was also delay in getting a CT scan done, confusion over when Mr Selu had seen the patient and whether antibiotics were prescribed. They also noted that the hospital did not have an emergency anaesthetist on its rota.

Let us analyse this scenario:
Would this have happened if the patient had been admitted to a state (NHS) hospital? Was the surgeon entirely at fault for the delay in treatment. Should not the hospital administration be penalised for the poor set up in dealing with emergencies?

Emergencies are generally better managed in the NHS hospitals in UK where a full team including an anesthetist is on standby 24/7. Many believe that emergencies are poorly dealt with over a week end when most senior doctors do not want to work. It happens particularly in private hospitals in UK and many corporate hospitals in India. We often hear about a relative dying in a prestigious private hospital in India, after being admitted over a weekend when no senior doctor came to examine or treat them.

Private hospitals in UK are generally not geared for dealing with emergencies. Patients are usually admitted for routine surgery where no complications are expected. The staffing levels at night are often poor and there may be only one resident doctor on duty. So before getting admitted to a private hospital for a procedure it might be well worth checking what their staffing levels are at night and whether they have a full team including an anaesthetist available for resuscitation if an emergency arises at any time!