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Swedish docs cleared over misplaced colon

Published: 01 Jul 2009 11:06 GMT+02:00

The faulty operation took place in January at Malmö University Hospital on a patient who had previously had surgery for an inflamed rectum following treatment for prostate cancer.

Doctors were planning to carry out a sigmoidostomy, a procedure whereby the patient is given an artificial anus through an opening in the sigmoid colon.

But following the procedure, the doctors managed to sew the man's lower intestine to his bladder.

After the operation, one of the doctors admitted he noticed a difference in the thickness of the intestinal wall and what turned out to be the bladder as he stitched the two together.

“I obviously misjudged the anatomy in the minor pelvis,” wrote one of the doctors in a post operative report cited in a ruling by the National Board of Health and Welfare (Socialstyrelsen).

“In hindsight there are signals that should have made me realize I was on the wrong track. I still can’t, despite going over things several times in my mind, really explain how I could have made such a serious misjudgment of the anatomy.”

The health board’s investigation also revealed that, for certain periods of the complex procedure, only one surgeon was at the operating table.

In addition, one of the doctors admitted that he was “weighed down with social problems” and as a result was “mentally out of sync” at the time of the operation.

The botched operation was repaired in a subsequent surgery four days later, but still resulted in a number of serious complications for the man, forcing him to endure a prolonged hospital stay.

While the health board was “highly critical” of the doctors for not taking a “time out” or asking a colleague for help in light of the operation’s numerous anomalies, it nevertheless elected not to sanction the surgeons for their mistake.

According to the agency, the blunder can be attributed to “the sum of a series of unfortunate circumstances” including a heavy workload for the doctors involved.

“There is nothing to indicate it was deliberate carelessness or that the professionals involved pose a risk to other individuals,” wrote the Board of Health of Welfare in its ruling.

In the future, the agency said it plans to keep close watch over how the workload of doctors at the hospital may affect patient safety.

David Landes (david.landes@thelocal.se)

Your comments about this article

11:51 July 1, 2009 by Random
That is absolutely bs!!

How can this happen, and the surgeon 'gets off'

I cannot believe some of the antics I read about here in Sweden....is that really acceptable??
12:45 July 1, 2009 by Tennin
The doctor isn't at fault!?! I'm speechless. Thank you Swedish hospitals, doctors, and health authorities for all the mistakes they can do on patients and get away with it. Makes me never want to go to the doctors now.
13:58 July 1, 2009 by Morenikeji
Comment: In my opinion the Swedish health care system is a sham (shameful too!), an absolute disgrace to a country that prides itself on high standard. Misdiagnosis, wrong treament, wrong medication couple with non-charlant attitudes of health workers are factors one must always take into consideration whenever one is contemplating seeking a medical help in Sweden. At the beginning of this year I went for consultation on HBP. The doctor took less than ten minutes to write me a prescription without telling me anything about the side-effects of the drugs and the things that can trigger a side-effect. I was lucky to check the internet and found that sucking a slice of grape with the drug could have caused a sudden heart-attack and possibly death. I rang up the doctor afterwards to ask if that information was true and he confirmed it. He said that he was stressed at the time. Well that seems to be the classical explanation for unprofessional and incompetent behaviour in that sector.
14:12 July 1, 2009 by Jeffi
Ask for a time out? "A series of unfortunate circumstances"? Swedish doctors noted for their appalling performances in the UK, an 'accidental" vasectomy and this? Good grief. I pray I never get sick enough to need a doctor here!
15:56 July 1, 2009 by Harding00
Mistakes happen, I understand that, but to not hold people accountable is just downright wrong and unethical. But was this botched surgery really accidental (I am not saying it was intentional, but accidental means there was really no way of avoiding it)? The article states that "The health board's investigation also revealed that, for certain periods of the complex procedure, only one surgeon was at the operating table." I'm not a doctor, and won't pretend to be, but there is something odd about that sentence. Oh wait, It's probably standard procedure to have a least two surgeons at all times so mistakes like these don't happen! And since the health board cleared the doctors, does this mean the patient can't sue them for medical malpractice?
16:36 July 1, 2009 by Renfeh Hguh
Mistakes happen, just live with it!

Why should a doctor be accountable for a little mistake when a computer nerd can screw up a line of code and cause customers an inconvinience and companies large sums of money and not even get a slap on the wrist.

Remember this is Sweden and we belive in Jantelägen (see http://en.wikipedia.org/wiki/Jante_Law if you don't know what it is). By making a doctor accountable for his mistakes and expecting perfection from everything they do, then we are elevating the doctors role and importantce in society and implicitly saying that they are better than the rest of us.

Get real, this is Sweden!
16:37 July 1, 2009 by Jeffi
Going in for a prostate biopsy any time soon, Renfeh?
17:58 July 1, 2009 by GefleFrequentFlyer
Americans, take note of how socialized healthcare operates.
22:16 July 1, 2009 by Greg in Canada
"Why should a doctor be accountable for a little mistake "

If it was your operation they screwed up would you still feel the same?
23:15 July 1, 2009 by Renfeh Hguh
I was being a little sarcastic, ok totally

This has got nothing to do with socialised health care and all about societies attitudes, expectations and accountability

If the US offered universal free health care and doctor made mistakes, those doctors would be still sued out of existance.

I always find it funny how both Swedes and Americans use each other country as an example of "what will happen if ..."

Both countries are polar opposites in many areas. Sweden will never become like the US as it moves to the right and the US will never become like Sweden with a left swing.
07:41 July 2, 2009 by Bender B Rodriquez
If you don't know how to use those dots - just don't use them. It is jantelagen, not jantelägen.
12:20 July 3, 2009 by ameribrit
Jantelagen, that's funny! If we are all of equal worth then why does a physician get paid such a stupid amount of tax payer money but a, (insert your occupation here) of "equal worth" has to make do with less.

If only Sweden would wake up and realize that it actually could be the way it pretends to be.
12:56 July 3, 2009 by skane refugee
In the above quoted thread a few months ago relating to another Swedish medical scandal, Puffin seemed to be able to demonstrate that there was a system for dealing with medical malpractice complaints in Sweden.

My question to anyone who can answer is 'what exactly were those doctors doing that did get punished/suffered some sort of penalty' under the existing system ... since it seems that many fairly extreme cases are happening regularly with no apparent consequences for the medical practitioners concerned ...
20:06 July 3, 2009 by volvoman9
What vocation is without it's mistakes? Do we sanction all mistakes in the workplace. We have long held the medical profession to standards that we do not hold anyone else to. We need to be realistic here. Does punishment minimize risk exposure? Who knows? Should the patient be compensated? Perhaps. However as we continually raise the bar for physicians often in hopes of a monetary reward fewer of our brightest and best will find reason to pursue this vocation. It's much easier to make big money screwing people in the political, oil or banking industries than spending years in school only to gamble with the specter of ruin for one mistake. Now a pattern of mistakes signals another issue altogether.
21:31 July 3, 2009 by skane refugee
Isn't the use of that expression such a grievous and blatant breach of 'jantelagen' that it's grounds for immediate deportation from Sweden? ;o) ;o)
08:10 July 4, 2009 by Marley420
Everything worked out the best, I mean, the dry cleaners found the colon in his suit pocket. In hind sight...check your pockets before sending to dry cleaners!
16:07 July 4, 2009 by Stüpid
I did not understand exactly what you have written.

But accordingly I say... Is a Doctor getting paid salary from tax payers money?

Well why don't you think he is paying tax for you instead from his little salary(comparativey less with other countries).

Doctor works hard in his life and studies. and finally becomes a professional. It's simplw to pick garbage. With less responsibility. You just pick garbage and home.

Always blaming some professional has become a fashion in this society.

Once one doctor said... well I would be happy to stop my profession. If a doctor stops work then to make someone doctor is not easy. He can pick garbage easily and pay tax. But garbage picker cannot become a doctor so easily.

Facing something which we are not in life is something not easy. I regret if we both said the same thing... if you mentioned opposite then I do not regret it.
16:40 July 4, 2009 by Stüpid
I Don't think this rule Jantelagen works perfectly either.

If it works... then why would people compare to each other...

Why would someone buy expensive cars, clothes etc?

Why would someone go to a beauty parlour?

this guidelines. Everything cannot be equal. If everything is equal then why would there be courts? why we would behave in different manner.

We have to appreciate if someone did a good job. Otherwise the society would get worse. See the laws have changed already... no longer like before... 9 to 10 years extended 18 years and life imprisonment. The world is slowly adjusting equally.

One day this nebero will destroy all of us and we will be left with nothing.
22:26 July 5, 2009 by dtes
NO ACCOUNTABILITY FOR ONES ACTIONS IS TO BE FOUND IN THIS TOILET OF A COUNTRY!

and yet we get taxed to pay these peoples way through life, and i dont even make but 800 dollars a month.
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