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Following is a question by the Hon Paul Tse and a written reply by the Secretary for Food and Health, Dr Ko Wing-man, in the Legislative Council today (July 11):
Question:
It has been reported that a newborn baby boy had his finger almost cut to the bone during the caesarean delivery process performed for his mother at Kwong Wah Hospital; when the baby boy was less than a month old, his large intestine was perforated during the examination by suprapubic tapping, which was suspected to be the cause leading to his subsequent rectal constriction and intestinal abscess, and an operation was arranged to be performed on him to remove part of the obstructed rectum and an abdominal stoma was created for defecation. The baby boy is barely four months old and he has been put under general anaesthesia for three times and has repeatedly been injected antibiotics with his abdomen incised for removal of necrotic intestine. While Kwong Wah Hospital pointed out in its reply letter to the baby boy's mother on May 30 this year that there was a "known uncommon risk" that babies might be cut during delivery and their large intestine might be perforated when suprapubic tapping was performed, the President of the Hong Kong Medical Association pointed out that doctors cutting the baby's finger when performing caesarean section on the mother was uncommon and it was also uncommon that baby's intestine was perforated during urine sample collection. He also indicated that accidents could be avoided if an ultrasound scan was performed to confirm the location before tapping for urine sample collection, and hence, this was obviously a technical fault of the doctor and parents could seek compensation. Apart from the aforesaid case, a magazine also reported quite a number of other medical incidents involving newborn babies. In this connection, will the Government inform this Council:
(a) whether it has followed up the aforesaid case; if so, of the progress;
(b) whether it knows the numbers of medical incidents involving newborn babies in public hospitals under the Hospital Authority (HA) in each of the past five years, as well as the numbers of relevant complaints received; how many cases were proved to be caused by human errors and negligence upon investigation;
(c) given that the President of the Hong Kong Medical Association has pointed out that the aforesaid incident is an "obvious(ly) technical fault", "the blunder may be related to staff shortage in public hospitals" and that "with so many patients, blunders are unavoidable in such busy schedules, and patients' rights can be safeguarded only if the authorities tackle expeditiously these problems", whether it knows if HA has investigated whether a number of medical incidents involving newborn babies were caused by shortage of staff; if it has, of the investigation result; if not, whether an investigation will be conducted immediately; in addition, what policies and measures are in place to prevent the recurrence of medical incidents involving newborn babies in public hospitals; and
(d) given that a representative of a patients' rights group has pointed out that doctors are investigated by their peers under the existing complaint handling mechanism, which might not be fair, and most people seeking assistance would give up pursuing because of the hassle involved, whether the Government has reviewed the existing complaint mechanism to enhance the objectivity of the mechanism?
Reply:
President,
With the increasing advancement of medical technology, treatment procedures have become more sophisticated. The emergence of complications, the side-effects of drugs, as well as the changes in patients' conditions may also increase the risks involved in treatment procedures. In the event that a medical incident occurs, it is necessary to conduct a detailed analysis to find out whether it is caused by known risks, complications, clinical conditions of the patient or human factors. Since not all treatment procedures can achieve 100% of their intended medical outcome, healthcare professionals will explain to the patient and his/her family members in detail the treatment procedures involved, including the known risks and possible complications, etc. before the treatment is carried out.
My reply to the various parts of the question is as follows:
(a) The sick baby involved in the case mentioned in the question has already undergone surgical procedures and his recovery is progressing in a satisfactory manner. The hospital concerned has also arranged follow-up consultation for the baby to follow up on his conditions.
(b) and (c) The Hospital Authority (HA) has all along attached great importance to the quality of its services and patient safety and has since 2004 introduced an electronic Advanced Incidents Reporting System to enable frontline staff to report incidents directly. Subsequently, HA has also implemented a Sentinel and Serious Untoward Events Policy to standardise the process for reporting, investigation and management of these medical incidents in public hospitals to facilitate immediate and proper handling of the incidents so as to minimise any possible harm caused to patients, their family members and the staff involved and provide them with the necessary support.
The number of complaints received by HA regarding its medical services since 2007 is set out in Table 1, and the number of sentinel and serious untoward events is set out in Table 2.
Although the number of medical incidents in public hospitals in Hong Kong remains stable generally, HA has handled each and every of these cases in a serious manner. Each sentinel event and serious untoward event will be investigated by an expert panel appointed by HA, with a view to identifying the likely causes of the incident and formulating improvement measures.
HA has over the years sought to ensure service standards and continued to improve service quality through implementing measures such as hospital accreditation, clinical audits, schemes to monitor and improve the effectiveness of surgical services, mechanisms for introducing new medical technology and drug handling, as well as internal mechanism to govern research ethics etc. In addition, HA has established a clinical governance structure to safeguard the service quality of clinical departments, and provide training, clinical guidance and supervision to staff in various grades to ensure professional standards and patient safety. HA has also engaged overseas experts to conduct a review on its clinical governance system with reference to the highest international standards. HA will study in details and follow up on the improvement recommendations as appropriate upon completion of the review.
(d) HA has established a two-tier complaint system, with checks and balances, to handle complaints. There is a Patient Relations Officer or Patient Relations Manager in each of the hospitals under HA. Their role is to deal with complaints from patients and their families and provide them with assistance, which includes assisting them to take legal action where necessary. Therefore, all initial complaints and views will be handled and responded to directly by the hospitals or clinics concerned.
If the complainant wishes to put forward further views or is not satisfied with the handling or outcome of his/her complaint, he/she can file an appeal with the Public Complaints Committee (PCC) of HA. PCC is responsible for deliberating and adjudicating all appeal cases independently and making service improvement recommendations to hospitals. It is comprised of a total of 24 members with 20 of them having no affiliation with HA. As one of the special features of PCC, 17 of its 24 members are non-medical professionals coming from different sectors of the community, including patients' representatives. By virtue of the independent status of its members, we believe that PCC can handle all complaints fairly and impartially.
Ends/Wednesday, July 11, 2012
Issued at HKT 13:50
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