Few doctors in Lebanon held accountable for medical malpractice: LTA study

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Two wounded Syrian girls lie on their hospital beds in the northern Lebanese port city of Tripoli. March 19, 2012. AFP

Published Saturday, November 22, 2014

The Lebanese Transparency Association (LTA) has released a study conducted by Atallah al-Salim which tries to shed light on the reality of medical errors being made at hospitals, health centers, and clinics in Lebanon.

Between 1996 and 2013, more than a thousand complaints related to medical malpractice were filed at the Order of Doctors. While 400 of these complaints were referred to the disciplinary council, about 300 disciplinary rulings and penalties were issued in accordance with the law. Doctors were suspended from work for limited periods ranging between two and six months in only 50 of the 300 issued rulings. Only one doctor was permanently banned from practicing medicine, in 2001.

The syndicate receives between 100 and 150 cases of suspected medical malpractice annually. This is a small percentage of the number of surgeries, medical interventions, and treatments carried out at the Lebanese hospitals, which amount to thousands of operations per year.

Medical errors committed in Lebanon do not receive proper attention in the media regardless of the case, whether it is due to practitioners’ or medical assistants’ lack of experience or competence, new experimental methods of treatment or surgery, an emergency situation that requires a fast operation at the expense of precision, or due to complex medical care.
Such cases are usually handled with discretion and go unreported, either because the patients themselves may be unaware that they have fallen victim to medical malpractice, or because of skepticism on their part regarding the possibility of holding [these doctors] accountable or liable [for their errors]. Add to this the difficulty of documenting medical errors because patients often do not scrutinize all details related to their health or psychological condition, given their medical situation and their confidence in the doctors.

The study was based on another one conducted by the American University of Beirut (AUB), which stated that most medical errors are not reported, referring to the fact that 81.7 percent of hospital staff surveyed feel that reporting mistakes they may have committed will affect them negatively, and 82.3 percent of them are concerned that their mistakes are kept in their records instead of being used to examine the problem and avoid repeating it in the future.

The study also showed that the shortage of staff and work pressure directly affect the safety of patients. In this context, 40 percent of respondents stated that [the hospitals they work in] suffer from a shortage of staff required to undertake nursing tasks, 66.9 percent suffer from long working hours, and 72.7 percent said they complete their tasks quickly when under pressure at work.

Less important factors were included in the study, such as poor communication and transfer of information between various departments, which was reported by over 72.6 percent of respondents. In this context, only 38.9 percent of respondents expressed a willingness to speak out if they observed something that may adversely affect the patient’s health and life, and 43.1 percent of them said they were afraid to inquire or ask questions when they noticed something unusual.

The study presented the case of a patient’s death at a hospital, where a complaint was immediately filed against the doctor. The investigations committee at the Order of Doctors concluded in its report that what happened was not a medical error, but the result of an amniotic clot. However, the judiciary refuted the report because it was incomplete, and ruled that negligence by the defendant caused the death of the victim and her unborn child – the doctor disregarded the complications that preceded the amniotic clot and could have avoided the results that ensued.

Here, the problematic issue of the transparency of the investigations carried out by the Order of Doctors is apparent. The study provides a number of recommendations and suggestions in this regard. It concludes that the problem is not with the laws concerning the regulation of the medical profession, but with the regulatory systems and control mechanisms.

The doctor is not always the sole cause of medical errors. According to the study, the best public safety conditions should be available at hospitals and clinics, including medical equipment and devices and the necessary skills to operate them, good management of human resources, a competent nursing staff, the monitoring of technological systems, compliance to hygiene standards, and providing psychological comfort to patients.

(Al-Akhbar)

This article is an edited translation from the Arabic Edition.

Comments

I bet my last pound that there is no hospital in Australia like El Hayat in Beirut. A woman was hospitalized at El Khayat eight years ago, because of a cist in her bludder. After the removal of the cist, the doctor closed not only the wound but the whole ureter. She could not pee for some days and barely survived. Finally, the people in the hospital found out their mistake. The same doctor reopened the ureter. Not enough of that, the second operation caused a terrible inflamation and the woman recovered slowly during the next year, after several new operations, now made at other places. In 2008, another ordeal happend. The same woman went to El Hayat because of a lung inflamation. She told the doctor that the cure should not involve Cortisone due an advice given to her before - she had Diabetes II. The same urgent advice was given to the same doctor by her mother. The doctor deliberately ignored the advice , and he ordered the nurse to give her several times a dosis of Cortison, and without letting her know. The next two days her situation worsened, she then had fibrillation, could barely see and barely breath. When she found out that the nurse had given her the bad medicine, she was outraged. The nurse responded to her, word for word: 'If you want to live, you should go home.' At that time I was the boyfriend of the woman (I don't want to hide it, later we married, now we live together in Germany). When I learned about the incident I went to the hospital and we left together. The story is a warning to everyone: Don't ever go to that 'hospital'.

Please know that it is exactly the same in Australia....that is if you can get into hospital in the first place, the waiting lists are months long. Considering that of a hospital with 10 floors that only 1/2/ maybe 3 floors are actually open & working.
I am in no way trying to comfort you - the Medical profession are vile creatures / bottom feeders as are their masters the political arena.
The Australian medical profession are on a very generous retainers - so they do not need to perform. (?)
NOTHING CAN TOUCH THEM NO MATTER WHAT THEY DO.
The Medical Practitioners Board will blatantly & in full view white wash all their sins. Whats more - seeking a hearing at the M.P.B. is a "one shot deal" DOUBLE JEOPARDY - which means you cannot appeal.

personal story:
I was referred to a physiotherapist - I could hardly walk - sever pain - I crawled there & crawled home - heat treatment which made it worse / ultrasound treatment / a 3 minute intense & painful massage / 10 visits later at $A 68 a visit. I was 40% in less pain.

Several years later - I pulled a muscle - I purchased a hand held Ultrasound machine from my local chemist shop for $A200 within 3 hours the pain was almost gone - 5 hours later it was gone completely.
The Physiotherapist only turned on the timer which ticked away but did not turn on the actual ultrasound itself.
These are vile, evil creatures.

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