SURGERY:MALLOW GENERAL Hospital was providing complex surgery to patients even though it had no intensive care unit, the Hiqa investigation into safety of services at the hospital found.
The investigation followed the receipt by Hiqa of confidential information in relation to the care of a patient at the hospital who had undergone major surgery. The patient was subsequently transferred elsewhere and died but Hiqa could not say if he might have lived, had he undergone his surgery elsewhere.
Hiqa was also concerned about the absence of senior decision makers from the hospital out of hours. This would have affected patients attending the emergency department or those whose conditions deteriorated inhouse. This was rectified by the HSE in February this year.
The investigation found that in the first six months of last year eight patients at the hospital required Level 3 critical care, the highest level of intensive care, but the hospital only has a high dependency unit.
The report acknowledged staff in Mallow had tried to send some patients to Cork University Hospital for this but there were no beds. Two critical care beds were closed at CUH due to nursing staff shortages.
A protocol has been put in place to prevent transfers being refused by CUH in future.
Hiqa also found the facilities for anaesthesia and surgery in Mallow were “basic”, and low volumes of major and complex surgery were being performed. There were 54 such surgeries in 2009 including 36 patients who had major bowel surgery.
Hiqa said it was not raising concerns about the competence of the existing surgeons in the hospital, rather about the volumes of major surgery performed. “The HSE must ensure that all major acute and complex surgery is ceased at Mallow as intended,” it said.
Meanwhile, two suspected radiological reporting discrepancies dating from 2008 and 2009 at the hospital were drawn to the attention of Hiqa.
One led to a patient having a delayed diagnosis but the delay had not adversely affected the patient’s prognosis. The HSE did not tell the patients and Hiqa is critical of this.