Friday, 29 March 2013

Liverpool Care Pathway - "To Free Up Hospital Beds"

The unthinkable can become thinkable.
 The Mail

That the head of a hospital facility and seven other doctors and nurses are accused of killing patients to free up hospital beds. This is in the south-east city of Curitiba, Brazil.

Virginia Helena Soares de Souza, head of the facility, has pleaded not guilty. Elias Mattar Assad, lawyer, has said she will prove that her orders in the ICU were backed and justified by medical literature.
"Well, we got rid of two today, so let's put that other one off until tomorrow..."
Soarez de Souza acted against the wishes of patients and their families. Her motive, according to wire taps, was to free up hospital beds.

Anesthetics, sedatives and painkillers were used, including withdrawal of oxygen supply.

De Souza was arrested in February, but was later released until trial. Her court appearance Wednesday is part of mandated monthly appearances to avoid going back to jail.
Investigators say between 2006 and 2013, de Souza ordered medical professionals working under her at an intensive care unit to alter medication and oxygen levels.
In an interview with CNN affiliate TV Globo, Mario Lobato, the doctor tasked by the health ministry to investigate the case, said the number of deaths could be much higher.
He said his team is analyzing medical charts of more than 1,700 patients and interviewing more doctors.
During the seven years the incidents occurred, in cases where de Souza did not prescribe the drugs herself, she ordered other doctors to change mechanical ventilation devices, according to authorities. She allowed them access to medical records to issue prescriptions in her name, police said.
CNN affiliate TV Record reported that the investigation began a year ago. In telephone recordings made with the consent of the justice department, de Souza ordered other medical doctors and employees to shut down some ventilation devices.
Euthanasia is considered a crime in Brazil.
Marilia Brocchetto, CNN
March 28, 2013 -- Updated 1737 GMT (0137 HKT)

Over 300 deaths, avoidable deaths...

The Guardian

In the UK, it has been suggested that hospital codes have been 'doctored'...

NHS local

Hospital Standardised Mortality Ratios (HSMRs) are being "gamed"...

A 'Murky' Business


There were concerns about the Royal Bolton hospital after GPs took issue with the high numbers of sepsis cases which coincided with apparent improvements in death rates.

Computer Weekly, using data over a 17 year period, from 1996 to 2013, has demonstrated that the Mid-Staffs deaths are "about average" -
Mid-Staffs maintained and then bettered its rate death even while it bore a large increase in admissions of patients with serious illnesses.
Even so, a pie chart supplied in the Computer Weekly article demonstrates that, during the targeted period, actual deaths, 12,888, were still nearly 6% higher than the predicted 12,162.

Is there murk, murk everywhere and nothing to be seen...?

Evidence produced at the Mid-Staffs inquiry did reveal acts of gross negligence. Does the Computer World interpretation of the figures actually demonstrate a more widespread and consistent picture of unacceptable 'normality' in our hospitals...?

Janet Daley, in the Telegraph, says -
As Mr Foulkes points out, the hacking of telephones is already a crime and the perpetrators of this current pestilential epidemic of it, are – now that the police feel obliged to enforce existing law -  being prosecuted. No further legislation is required – or ever has been required – to put a stop to this practice. And yet, Hacked Off are invited to top level conclaves with leading members of all three major political parties and their demands for new statute are treated with the utmost seriousness.
Contrast that treatment if you will with the pressure group formed by relatives of those patients who died at Mid Staffs Hospital. The deaths of their loved ones were certainly a result of criminal acts of neglect: the most straightforward charge that could be brought against individual members of hospital staff would be criminally negligent manslaughter. That is certainly the offence with which you or I would be charged if an elderly relative died of thirst or hunger while in our care. Or, alternatively, the management of Mid Staffs Hospital Trust could be brought to trial on a charge of corporate manslaughter. If Network Rail could be prosecuted for this offence over the negligent maintenance of railway track which resulted in a fatal accident,  why should not a National Health Service management team be liable in a much more direct case of presiding over dangerous and unacceptable conditions?
So, in Curitiba, they're  still examining the figures, but they have brought charges.

Perhaps, everything is clearer, more black and white in Brazil.

Here, it is more murky. They've examined the figures, and, and...


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