• Sweden edition

Children's hospital faces probe over baby death

Published: 22 Jan 10 08:09 CET | Double click on a word to get a translation
Online: http://www.thelocal.se/24524/20100122/

Parents of an 18-month-old girl who died after being admitted to the Astrid Lindgren Children's Hospital with pneumonia say a shortfall in the quality of care led to their child's death.

The baby was admitted after a visit to the emergency department of the hospital in Solna in December 2008 with symptoms including a high fever, writes newspaper Svenska Dagbladet.

After being diagnosed with pneumonia, the parents noticed her condition began to deteriorate the following day and made a number of attempts to bring their concerns to the attention of medical staff.

They say the hospital only took action when her heart stopped beating.

"It still feels unreal that we could be so ill-treated and ignored," they said. "She died in front of our eyes without anyone caring before it was too late."

The baby was left brain dead and a decision was taken three days later to switch off a life-support machine.

The case has now been handed over to Sweden's Medical Responsibility Board (HSAN) for investigation.

The hospital admits that the baby's symptoms were not followed up according to correct procedure.

Senior doctor Svante Baehrendtz said there are obvious shortfalls in the quality of care she received.

"We have taken actions to ensure this never happens again," he told SvD.

The hospital faces mounting pressure after a number of negligence cases have been reported.

Last year, a baby was mistakenly prescribed a dose of painkillers ten-times higher than the recommended level.

In 2008, a newborn died after a similar incident but both staff and the hospital was vindicated in both cases after investigation.



TT/Christine Demsteader
news@thelocal.se

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13:15 January 22, 2010 by voiceofreason
Swedish hospitals are some of the best in the world and the cost of treatment if very affordable but the bureaucracy is killing.

The doctors and nurses treat people like specimen and they have no EMPATHY.

My wife ( a medical doctor) had to tell them everything to do. With a BP of 220/120 which could have killed both her and the baby, the doctors stuck to the textbook treatment which clearly wasn't working.
13:41 January 22, 2010 by krrodman
I am a doctor in the USA , married to a Swede for 30 years. Her family still resides in Sweden and I have been directly involved in the care of the Swedish half of my family for 30 years.

Let me say this outright so that I will not be accused of bias: the two medical systems are vastly different. It would be a gross oversimplification to say that one system is "better" than the other.

Without question one of the strengths of the American system is that a patient chooses their physicians(internist, surgeon, obstetrician,pediatrician) and has a very strong personal relationship with that doctor. I agree with VOICEOFREASON when he reports that Swedish "doctors and nurses treat people like specimen and they have no empathy." In my experience that is more true in the Swedish system than in the American one.

I believe that if the very same baby went to a hospital in the USA, ill with pneumonia, he would have been cared for by specialists at the hospital, but he would also have had an advocate at his side, the pediatrician who had cared for him his entire life and had a close relationship with both the child and the family.
15:41 January 22, 2010 by SaxSymbol73
Doctors in Sweden are of a much lower quality than in the US. I'm not sure exactly why, but I know that in the US, the best students by and large want to become doctors for any number of reasons--prestige, money, altruism?? The Swedish system is far less selective than the US, whose size perhaps affords it the ability to be so particular.

My experience with Swedish doctors is what causes my concern. I have had several serious conditions (a sinus infection and later pneumonia) which were completely missed and/or misdiagnosed in Sweden. It was only after I went to the US and paid out of pocket to receive care, that I was treated correctly and became well.

Finally, people can complain about the expense of lawsuits and their impact on the US medical system, but this sort of lax treatment would be highly unlikely there. If anything, doctors are overly cautious for fear of being sued, ordering more tests to back up their decisions. In Sweden doctors get a slap on the rest and a "forlåt" for making serious mistakes but often nothing more. If their livelihood was truly at risk--as it is in the US--perhaps they would handle treatment differently.

I feel sad for the poor parents in this article, because not only have they lost their child, but the system won't be corrected to prevent a similar fate from befalling another unlucky set of parents.
18:18 January 22, 2010 by Kaethar
And let the bashing begin...

Oh, and krrodman, people can choose their doctors here too. For someone so ignorant of the Swedish system you sure try hard to disprove it. :)
18:33 January 22, 2010 by DAVID T
If you pay peanuts you get monkeys. All the good doctors leave and go abroad once thwy have qualified or go private - a lot of these positions are then filled by third world country doctors. I've went to my local Vardcentral for 8 years and never once saw a swedish doctor. 2 years ago I started going private and they are all Swedes.
20:08 January 22, 2010 by insect
@DAVID T

I don't know if you are using "third world country doctors" as a way of getting a point across that people from that part of the world belong to the lower caste when it comes to brains & education. Or maybe you meant to use it as a phrase to just show how bad the situation is, but either way you are way off! Education in the third world has such stiff competition and it is always a case of BEST of the BEST and survival for the fittest. Sweden is one of those countries that doesn't readily accept qualifications from other countries and prefers to train people from scratch. Adding to the fact that you have to learn the language, I think these "third world doctors" are in the unique group that have managed to defy all odds and excel here. And in the town I live in (in Sweden), I have never seen a single foreign doctor at the local hospital.

Another thing to think about is that if all the swedes are private doctors, then they didn't go abroad, they are just money minded.
20:18 January 22, 2010 by Gretchen
Sweden is good when it comes to caring for the masses. I heard the term "cattle care" once and think it fits well.

You do not need large amounts of money to be cared for and everyone gets relatively equal treatment - but it is cattle care after all. It is not very personal compared to the German, US and Spanish system I know.

It is often basic and of lower quality than I would have expected from a country like Sweden, but they are equally low for all.

I have a friend who is working in Sweden as a nurse since 3 years - after working in the UK for some years - and she is of the opinion that the hospitals here are worse-worse stress, worse quality.

Personally I do all medical treatments possible abroad. Especially preventive care, such as skin cancer checks, gyno checks etc. The normal response when I asked for them here was: Do you have this problem in the family? or You are not old enough.

Best,

G.
20:40 January 22, 2010 by dmj123
I have been to a lot of hospitals over the years. In cars I have had 3 head on collisions, hit by 3 semi's in less than 5 seconds, hit while walking on the sidewalk, and rear ended 7 times. I have also fallen through a plate glass window and 40 feet down a tree. I have a total of over 400 stitches but have never broken a bone. (I attribute this to my hard nordic skull). I have never had to use a hospital in europe though I spent 5 years there so I can only attest to my experiance in the US. The only time I was totally misdiagnosed/cared for after an accident, a head on where the combined speed of the cars was in excess of 120 mph), was by a nigerian doctor. He stitiched me up and failed to repair the arteries in the eye socket nor remove the glass peices that were there on a Friday night and put on the chart not to recheck the wounds until Monday. Luckily my mother, a nurse, took one look at me and had me checked out and into another hospital. I was operated on in less than 3 hours and still have two functional eyes as a consequense. They pulled 32 peices of glass out of the eye socket, some as big as a kernal of corn, as well as ablood clot that would fill a tablespoon. To this day I insist on doctors from the US, Europe, or India. Call me silly but once bitten twice shy.
21:46 January 22, 2010 by soomro
I'm new to swdish health care system. But unfortunately i had to go to the hospital.

When i went there was a lady on counter, who was not very much intrested in talking to me while she was on phone busy. Finaly she ended this call and talked to me, and i explained to her that i have some skin problem on my back.

I been waiting for my number for around 30 min (but people say, its usually hours). Then when nurse saw the rashes and skin. She said you can come on Monday, so doctor can check you in detail. [i was like what the hell, why did i came to the hospital ..when there is no doctor here].

Its worse health care system here. I might not stay any longer after my studies finish.

I'm feeling sad about the people who suffer it quite often.
22:38 January 22, 2010 by krrodman
@Kaether

My father-in-law needs a total knee replacement. I went with him last summer to his general orthopedist. There was agreement by everyone that the surgery was indicated and necessary. The orthopedist referred my father-in-law to a joint replacement surgeon. I asked him if he would have the opportunity to interview and choose his surgeon. I was told that "all the joint replacement surgeons in Sweden are expert in the procedure and that he would be assigned a surgeon. That is how we do it here."

I have worked as an anesthesiologist in some of the most prestigious university hospitals in the United States. At the present time I manage an operating room that performs over 8000 surgeries per year. The suggestion that all surgeons are equally skilled is preposterous.

I, for one, would chose the surgeon with the most experience and the lowest complication rate. That data is available in the USA.

In the most tactful way possible I asked the orthopedist a hypothetical question: " If you were to have knee replacement surgery, would you pick a particular surgeon or would you take the luck of the draw?" His response was a bureaucratic non-answer: "You have to understand this is how we do it here."

There are many problems with health care in the USA. Let's start with the shameful fact that we have 40 million uninsured. I make no excuses for the faults in our system. I am always surprised at how blind Swedes are to the glaring faults in Swedish health care.
03:54 January 23, 2010 by Kaethar
@krrodman: I said you get to choose your doctors (as in general care doctors), not your surgeons. When it comes to a doctor you want someone you feel comfortable with and the system allows this. When it comes to a surgeon anyone can do the job. And DON'T give me bullshit about "not all surgeons are as good." Yeah, and? Why do you think YOU deserve the best surgeon? What makes YOU special? You can't have been living in Sweden for long since you clearly don't understand the Swedish mentality. This is not a fault in the system. The fault is in the American system where those with the most money and best contacts get the best healthcare.
05:34 January 23, 2010 by krrodman
@Kaether

So much anger. You really should get a get a handle on it.

I trust that you have been following the debate in the USA about how to pay for universal health care. The United States Senate want to tax people who have the most expensive health care insurance. Their logic is that people who have the most expensive insurance (insurance in the USA is a benefit that is not subject to tax) are getting a larger tax free benefit than the average person and they believe that to be unfair. This proposal is opposed by the unions in the USA because it is union workers that have the best benefits. So, you first assumption that the people with the "most money and the best contacts" get the best care is wrong. Workers who belong to unions have the best health care policies in the USA and the best access to health care.

And, do you really think a surgeon is no more than a technician? If it is important to have trust in your general care doctor, don't you think it equally important to have trust in your surgeon? Not to say that there are many different ways to perform the same surgery. An informed patient may desire to have, for example, his colon resection done through a laparoscope instead of a traditional incision. Why shouldn't the patient get to interview the surgeon and choose the method of surgery?

And finally, let me ask you this. Let's say, Kaethar, you are scheduled to have your gallbladder removed. You are assigned a surgeon and on when you meet him he looks terribly young. So, you gather up your Swedish courage and you ask him how long he has been a surgeon and how many gallbladder operations he has done on his own without supervision. He says to you, "Kaethar, you are my very first case." What do you do, Kaethar? Do you let this surgeon in diapers operate on you because that is the Swedish way? Or, would you insist on a surgeon with experience?
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