Is It Perfectly OK For Doctors To Knowingly Kill Patients?

24th February 2014

I've mentioned this before - some medical staff neglect patients and they die. Some perform so badly that they die.

This one wants to carry on performing surgery knowing that patients will die (5 already have).

If the British Gas boiler man fitted the boiler incorrectly, he could be done for manslaughter.

Please discuss.

A cardiac surgeon who spread an infection that led to five hospital deaths today (MON) argued against NHS patients being warned of his dubious history. John Chen Lui Lu claims that if he was forced to disclose his past to patients, it would render 'his return to any meaningful practice as a cardiac surgeon impossible'. Mr Lu passed on the a bug during heart valve surgery between December 2008 and July 2010 at the Nottingham University Hospitals NHS Trust, the High Court heard. The outbreak of PVE [Prosthetic Value Endocarditis ], a serious heart surgery complication, was found by a coroner to stem from Mr Lu's habit of swapping gloves during operations. - See more at: http://www.courtnewsuk.co.uk/newsgallery/#sthash.xnQWkqti.dpuf

Unfortunately fitting boilers is a lot more precise than fixing the human body.
If the precise cause of infections has been highlighted and corrected via training so he never does it again then you have to consider if more people will die because he is not practising.

sphinx wrote:Unfortunately fitting boilers is a lot more precise than fixing the human body.
If the precise cause of infections has been highlighted and corrected via training so he never does it again then you have to consider if more people will die because he is not practising.

If the result is the same - the death of a person - why would one have his freedom taken off him but the other get £££'s of extra training, lovely job with good pay and freedom?

Your answer was lovely though sphinx.

 

TONE DOWN that green printing, B'Andy == it's too bright to read on my monitor !

OH, yes, and ~ another day, and another stupid headline from the regular files of BigAndy's weird and whacky shock titles..   

HOWEVER, in this case I do lean towards Andy's apparent feelings on this matter ~ this particular surgeon shouldn't be allowed to practice again ~ not even in an abattoir in Afghanistan.

BigAndy9 wrote:

sphinx wrote:Unfortunately fitting boilers is a lot more precise than fixing the human body.
If the precise cause of infections has been highlighted and corrected via training so he never does it again then you have to consider if more people will die because he is not practising.

If the result is the same - the death of a person - why would one have his freedom taken off him but the other get £££'s of extra training, lovely job with good pay and freedom?

Your answer was lovely though sphinx.

No for a professional to be imprisoned for causing death it has to be proven that they were knowingly negligent.

As fitting boilers is simpler than fixing bodies negligence is much easier to prove. If what this surgeon did was not a banned practice that had not previously been associated with increased deaths and there was no reason to suspect that such a thing would be the case then how has he been negligent?

You know, I'm just going to say yes -- it IS perfectly OK for doctors to knowingly kill patients. Why the hell not.

I presume he didn't knowingly give them the infection.

Ben_Reilly wrote:You know, I'm just going to say yes -- it IS perfectly OK for doctors to knowingly kill patients. Why the hell not.

Yes, why not indeed, let's not make the. Accountable for not practicing to their best abilities , or perhaps lacking the required skills.

There are always the same one or two defending the incompetent on matters so serious as this Ben, yet would call for the heads of those who say failed to make enough profits for their employer.

Andy the green typeface is killing my eyes - I actually agree with beekeeper.

Of course people should know about a doctors past! Why the hell was he not practising better hygiene anyway??

And Ben? Stop being a grumpy old git.

Sadly though there are one or two on this forum who would agree that if they had the chance , older folk should be killed as they are viewed as a drain on the NHS...

As ridiculous as it sounds, I'm right, there are a couple of posters who are of that view.

eddie wrote:Andy the green typeface is killing my eyes - I actually agree with beekeeper.

Of course people should know about a doctors past! Why the hell was he not practising  better hygiene anyway??

And Ben? Stop being a grumpy old git.

Yeah I think the colours have been changed - not sure which my green is now.

Agreed eddie - if people don't give sensible answers back then what's the point?

Did he know he was passing on infection?

How is changing gloves poor hygiene? I mean I have had professionals use more than one set of gloves during procedures - I would have thought it good hygiene?

sphinx wrote:

BigAndy9 wrote:

If the result is the same - the death of a person - why would one have his freedom taken off him but the other get £££'s of extra training, lovely job with good pay and freedom?

Your answer was lovely though sphinx.

No for a professional to be imprisoned for causing death it has to be proven that they were knowingly negligent.  

As fitting boilers is simpler than fixing bodies negligence is much easier to prove.  If what this surgeon did was not a banned practice that had not previously been associated with increased deaths and there was no reason to suspect that such a thing would be the case then how has he been negligent?

I think my pet worm in the garden could prove this man's negligence.

A surgeon who was changing surgical gloves (I'm guessing not for nice new clean ones each time) during surgery for 2 years was passing on infections to patients and killed 5 of them.

He was using gloves from one lot of surgery and then using the same ones on a different patient - a qualified (I'm assuming) surgeon - I think he should know what he was doing, but he did it anyway - NEGLIGENCE!

sphinx wrote:Did he know he was passing on infection?

How is changing gloves poor hygiene?  I mean I have had professionals use more than one set of gloves during procedures - I would have thought it good hygiene?

Ah I just re-read it and it said that he "swapped" gloves during operations!? I take it that it means he didn't use the same gloves for each person but rather swapped them about between each of his patients?
Either way, if he wasn't practising good hygiene, which he clearly wasn't, he should not be able to have that information hidden away!

eddie wrote:

sphinx wrote:Did he know he was passing on infection?

How is changing gloves poor hygiene?  I mean I have had professionals use more than one set of gloves during procedures - I would have thought it good hygiene?

Ah I just re-read it and it said that he "swapped" gloves during operations!? I take it that it means he didn't use the same gloves for each person but rather swapped them about between each of his patients?
Either way, if he wasn't practising good hygiene, which he clearly wasn't, he should not be able to have that information hidden away!

Correct.

It wasn't a terrible accident - he's a blumming surgeon - he knows and has passed tests on hygiene (I hope) - therefore, it can't be called anything but negligence!

It's not very clear. I would have thought the problem was that he wasn't swapping gloves between patients.

Raggamuffin wrote:It's not very clear. I would have thought the problem was that he wasn't swapping gloves between patients.

True Ragga.

What is clear is that this highly qualified surgeon was negligent.

Fcuk sake, one time when one of my kids was about to be born by C-section, I was allowed in for this particular birth, and as I was getting geared up in all the theatre green outfit next to the toilet, one of the theatre staff done a huge log in the toilet , it was till there when I went in, stinking,,,but he never washed his fcuking hands man!!!!  

BigAndy9 wrote:

eddie wrote:Andy the green typeface is killing my eyes - I actually agree with beekeeper.

Of course people should know about a doctors past! Why the hell was he not practising  better hygiene anyway??

And Ben? Stop being a grumpy old git.

Yeah I think the colours have been changed - not sure which my green is now.

Agreed eddie - if people don't give sensible answers back then what's the point?

Just showing my irritation with the question; you set it up so that there's only one way to answer it. Of course it's not perfectly OK for doctors to knowingly kill their patients!

But you're a long way from proving that he knew he was killing them. And who in this scenario is positing that if he did know he was doing it, that was all "perfectly okay"?

Joy Division wrote:Fcuk sake, one time when one of my kids was about to be born by C-section, I was allowed in for this particular birth, and as I was getting geared up in all the theatre green outfit next to the toilet, one of the theatre staff done a huge log in the toilet , it was till there when I went in, stinking,,,but he never washed his fcuking hands man!!!!  

You were getting dressed in the toilets JD?

Is it really that bad up there?

Just googled it. He used new gloves in the middle of operations, he didn't use the same gloves on different patients. Apparently, sweat could contaminate the second pair of gloves whilst they were being put on or something.

Right ok Ragga. So either way he's still liable.
He should know this as part of his training.

eddie wrote: .......was found by a coroner to stem from Mr Lu's habit of swapping gloves during operations.

"His habit of swapping gloves"

Okay it's written poorly, but I think we're nit-picking, as it's obvious to me, that it means swapping gloves between patients and not swapping them for clean gloves!!

No, it doesn't mean that.

Raggamuffin wrote:

eddie wrote: .......was found by a coroner to stem from Mr Lu's habit of swapping gloves during operations.

"His habit of swapping gloves"

Okay it's written poorly, but I think we're nit-picking, as it's obvious to me, that it means swapping gloves between patients and not swapping them for clean gloves!!

No, it doesn't mean that.

Crossed posts Ragga! Lol I read yours then edited mine  ::D:: 

Raggamuffin wrote:Just googled it. He used new gloves in the middle of operations, he didn't use the same gloves on different patients. Apparently, sweat could contaminate the second pair of gloves whilst they were being put on or something.

Errrrm, still not completely explained though, is it?

BigAndy9 wrote:

Raggamuffin wrote:Just googled it. He used new gloves in the middle of operations, he didn't use the same gloves on different patients. Apparently, sweat could contaminate the second pair of gloves whilst they were being put on or something.

Errrrm, still not completely explained though, is it?

No, not really. This bug is on the skin of most people and usually does no harm. Presumably, once the gloves are on there is no contact between the surgeon's skin and the patient, but if he changes the gloves he could contaminate them himself. I don't know how they know for sure how the infections happened, but I don't suppose he meant to harm anyone.

Raggamuffin wrote:

BigAndy9 wrote:


Errrrm, still not completely explained though, is it?

No, not really. This bug is on the skin of most people and usually does no harm. Presumably, once the gloves are on there is no contact between the surgeon's skin and the patient, but if he changes the gloves he could contaminate them himself. I don't know how they know for sure how the infections happened, but I don't suppose he meant to harm anyone.

No, meaning to harm somebody would be intent.

Not following the rules you have been taught and signed papers and received certification for is negligence.


And can result in needless deaths!!!!

BigAndy9 wrote:24th February 2014

I've mentioned this before - some medical staff neglect patients and they die.  Some perform so badly that they die.

This one wants to carry on performing surgery knowing that patients will die (5 already have).

If the British Gas boiler man fitted the boiler incorrectly, he could be done for manslaughter.

Please discuss.

A cardiac surgeon who spread an infection that led to five hospital deaths today (MON) argued against NHS patients being warned of his dubious history. John Chen Lui Lu claims that if he was forced to disclose his past to patients, it would render 'his return to any meaningful practice as a cardiac surgeon impossible'. Mr Lu passed on the a bug during heart valve surgery between December 2008 and July 2010 at the Nottingham University Hospitals NHS Trust, the High Court heard. The outbreak of PVE [Prosthetic Value Endocarditis ], a serious heart surgery complication, was found by a coroner to stem from Mr Lu's habit of swapping gloves during operations. - See more at: http://www.courtnewsuk.co.uk/newsgallery/#sthash.xnQWkqti.dpuf

absolutely ridiculous, the patients should be able to see his track record as a surgeon..

BigAndy9 wrote:

sphinx wrote:

No for a professional to be imprisoned for causing death it has to be proven that they were knowingly negligent.  

As fitting boilers is simpler than fixing bodies negligence is much easier to prove.  If what this surgeon did was not a banned practice that had not previously been associated with increased deaths and there was no reason to suspect that such a thing would be the case then how has he been negligent?

I think my pet worm in the garden could prove this man's negligence.

A surgeon who was changing surgical gloves (I'm guessing not for nice new clean ones each time) during surgery for 2 years was passing on infections to patients and killed 5 of them.

He was using gloves from one lot of surgery and then using the same ones on a different patient - a qualified (I'm assuming) surgeon - I think he should know what he was doing, but he did it anyway - NEGLIGENCE!

Your evidence for this beyond your imagination?

Do you know what a scrub nurse is and what their role is?

Your suggestion is as feasible as me flying to the moon by flapping my arms.

eddie wrote:

sphinx wrote:Did he know he was passing on infection?

How is changing gloves poor hygiene?  I mean I have had professionals use more than one set of gloves during procedures - I would have thought it good hygiene?

Ah I just re-read it and it said that he "swapped" gloves during operations!? I take it that it means he didn't use the same gloves for each person but rather swapped them about between each of his patients?
Either way, if he wasn't practising good hygiene, which he clearly wasn't, he should not be able to have that information hidden away!

It cannot happen like that - it may be possible he changed gloves at different points in the same operation and reused gloves from earlier in the same patient it is not possible he used gloves from multiple patients.

There seems to be some serious misunderstanding of theatre procedure and what is and is not normal.

Basically off all operating theatres there is a "scrub room" where all staff expected to enter the "sterile field" will "scrub up" and make themselves as sterile as possible.

This is an involved washing procedure - especially for surgeons, taking time and intended to leave the skin as sterile as possible - it is immediatately followed by the surgeon being "gloved and gowned" as they have sterile outer coverings applied over their clothing and already sterilized hands. (this is done by another member of staff so the surgeon at no point touches any outer surface)

Gloves come in different types sizes thicknesses and linings. It is not unusual for a surgeon to change during a procedure as sweating can severely affect their ability to work delicately. It is usual for each change to involve a completely fresh set of gloves.

I suspect in this case the surgeon was reusing pairs from earlier in the procedures believing that as they had gone on sterile and been removed in a sterile environment they would still be sterile.

I would not be surprised is this is not a one off - and I would be interested to know where he developed the habit as it smacks of the short sighted budget saving that NHS managers who have never done front line medical work love.

I do not see a problem with this man returning to work so long as he fully grasps the necessity of always using new gloves. The figures we are not given is how many patients he operated on that survived and recovered who would have died without surgery.

sphinx wrote:There seems to be some serious misunderstanding of theatre procedure and what is and is not normal.

Basically off all operating theatres there is a "scrub room" where all staff expected to enter the "sterile field" will "scrub up" and make themselves as sterile as possible.

This is an involved washing procedure - especially for surgeons, taking time and intended to leave the skin as sterile as possible - it is immediatately followed by the surgeon being "gloved and gowned"  as they have sterile outer coverings applied over their clothing and already sterilized hands.  (this is done by another member of staff so the surgeon at no point touches any outer surface)

Gloves come in different types sizes thicknesses and linings.  It is not unusual for a surgeon to change during a procedure as sweating can severely affect their ability to work delicately.  It is usual for each change to involve a completely fresh set of gloves.  

I suspect in this case the surgeon was reusing pairs  from earlier in the procedures believing that as they had gone on sterile and been removed in a sterile environment they would still be sterile.  

I would not be surprised is this is not a one off - and I would be interested to know where he developed the habit as it smacks of the short sighted budget saving that NHS managers who have never done front line medical work love.  

I do not see a problem with this man returning to work so long as he fully grasps the necessity of always using new gloves.  The figures we are not given is how many patients he operated on that survived and recovered who would have died without surgery.

Is it not possible that he took off his gloves and put new ones on himself? In that case, he could have touched the outside of the new gloves after wiping his brow or something.

Raggamuffin wrote:

sphinx wrote:There seems to be some serious misunderstanding of theatre procedure and what is and is not normal.

Basically off all operating theatres there is a "scrub room" where all staff expected to enter the "sterile field" will "scrub up" and make themselves as sterile as possible.

This is an involved washing procedure - especially for surgeons, taking time and intended to leave the skin as sterile as possible - it is immediatately followed by the surgeon being "gloved and gowned"  as they have sterile outer coverings applied over their clothing and already sterilized hands.  (this is done by another member of staff so the surgeon at no point touches any outer surface)

Gloves come in different types sizes thicknesses and linings.  It is not unusual for a surgeon to change during a procedure as sweating can severely affect their ability to work delicately.  It is usual for each change to involve a completely fresh set of gloves.  

I suspect in this case the surgeon was reusing pairs  from earlier in the procedures believing that as they had gone on sterile and been removed in a sterile environment they would still be sterile.  

I would not be surprised is this is not a one off - and I would be interested to know where he developed the habit as it smacks of the short sighted budget saving that NHS managers who have never done front line medical work love.  

I do not see a problem with this man returning to work so long as he fully grasps the necessity of always using new gloves.  The figures we are not given is how many patients he operated on that survived and recovered who would have died without surgery.

Is it not possible that he took off his gloves and put new ones on himself? In that case, he could have touched the outside of the new gloves after wiping his brow or something.

Sphinx you need to read back, we know he didn't swap gloves and use them on other patients.
See Raggas post back further.

I'm just saying what I read when I googled it. Tbh, there isn't much info about it.

Raggamuffin wrote:

sphinx wrote:There seems to be some serious misunderstanding of theatre procedure and what is and is not normal.

Basically off all operating theatres there is a "scrub room" where all staff expected to enter the "sterile field" will "scrub up" and make themselves as sterile as possible.

This is an involved washing procedure - especially for surgeons, taking time and intended to leave the skin as sterile as possible - it is immediatately followed by the surgeon being "gloved and gowned"  as they have sterile outer coverings applied over their clothing and already sterilized hands.  (this is done by another member of staff so the surgeon at no point touches any outer surface)

Gloves come in different types sizes thicknesses and linings.  It is not unusual for a surgeon to change during a procedure as sweating can severely affect their ability to work delicately.  It is usual for each change to involve a completely fresh set of gloves.  

I suspect in this case the surgeon was reusing pairs  from earlier in the procedures believing that as they had gone on sterile and been removed in a sterile environment they would still be sterile.  

I would not be surprised is this is not a one off - and I would be interested to know where he developed the habit as it smacks of the short sighted budget saving that NHS managers who have never done front line medical work love.  

I do not see a problem with this man returning to work so long as he fully grasps the necessity of always using new gloves.  The figures we are not given is how many patients he operated on that survived and recovered who would have died without surgery.

Is it not possible that he took off his gloves and put new ones on himself? In that case, he could have touched the outside of the new gloves after wiping his brow or something.

That would be highly unlikely within a theatre environment - specialist nurses or possibly theatre techs these days, are trained to firstly wipe surgeons brows for them (that is not actually some tacky romantic sexual plot device used in bad TV shows - nurses do wipe surgeons brows because the lights are hot, surgery can be very tense, and dripping sweat is dangerous both because of infection if it hits the patient and because it can get in the surgeons eyes and blind him at a vital moment) and are also trained in the rather tricky job of putting latex type gloves onto hands of someone else without letting the outside of the glove contact the outside of the the persons hand.

Sorry if this sounds rather lecturish - its just I did originally want to become a nurse and did some courses towards that as well as becoming familiar with the different work environments and I know how strict the protocols are and how they work. There are certain things that just could not or would not be allowed to happen - or if they did would mean a whole team being sanctioned not just one man.

eddie wrote:

Raggamuffin wrote:

Is it not possible that he took off his gloves and put new ones on himself? In that case, he could have touched the outside of the new gloves after wiping his brow or something.

Sphinx you need to read back, we know he didn't swap gloves and use them on other patients.
See Raggas post back further.

Sorry eds - because there is not multi quote on here I answer one post at a time in post order and miss things.

sphinx wrote:

Raggamuffin wrote:

Is it not possible that he took off his gloves and put new ones on himself? In that case, he could have touched the outside of the new gloves after wiping his brow or something.

That would be highly unlikely within a theatre environment - specialist nurses or possibly theatre techs these days, are trained to firstly wipe surgeons brows for them (that is not actually some tacky romantic sexual plot device used in bad TV shows - nurses do wipe surgeons brows because the lights are hot, surgery can be very tense, and dripping sweat is dangerous both because of infection if it hits the patient and because it can get in the surgeons eyes and blind him at a vital moment) and are also trained in the rather tricky job of putting latex type gloves onto hands of someone else without letting the outside of the glove contact the outside of the the persons hand.

Sorry if this sounds rather lecturish - its just I did originally want to become a nurse and did some courses towards that as well as becoming familiar with the different work environments and I know how strict the protocols are and how they work.  There are certain things that just could not or would not be allowed to happen - or if they did would mean a whole team being sanctioned not just one man.

Well then how would he manage to use old gloves with the nurse around?

Raggamuffin wrote:

sphinx wrote:

That would be highly unlikely within a theatre environment - specialist nurses or possibly theatre techs these days, are trained to firstly wipe surgeons brows for them (that is not actually some tacky romantic sexual plot device used in bad TV shows - nurses do wipe surgeons brows because the lights are hot, surgery can be very tense, and dripping sweat is dangerous both because of infection if it hits the patient and because it can get in the surgeons eyes and blind him at a vital moment) and are also trained in the rather tricky job of putting latex type gloves onto hands of someone else without letting the outside of the glove contact the outside of the the persons hand.

Sorry if this sounds rather lecturish - its just I did originally want to become a nurse and did some courses towards that as well as becoming familiar with the different work environments and I know how strict the protocols are and how they work.  There are certain things that just could not or would not be allowed to happen - or if they did would mean a whole team being sanctioned not just one man.

Well then how would he manage to use old gloves with the nurse around?

Re use could be possible - some things in surgery maybe reused like forceps, needles, even swabs. So if gloves are removed and put to one side they could be put back on and it may be thought that would not be an infection risk because they had not been out of the theatre and were being replace - it may be thought there was no contact between outside of the gloves and the surgeon and such contact would be minimal. There may also be a variable in the germ involved - but that is getting beyond what I can comment on.

I mean I would not expect glove reuse to be standard but like I said earlier it is the sort of stupid money saving idea non medical managers come up with - I can see them putting a request around theatres that everyone try and use less gloves - with an unwritten unofficial hint that people could try reusing. Or if the surgeon has done voluntary work in 3rd world countries with limited supplies it may have been done and got to be a habit that was continued once returned to this country.

Maybe that's how he was trained sphinx, why just voluntary work?

sphinx wrote:

Raggamuffin wrote:

Well then how would he manage to use old gloves with the nurse around?

Re use could be possible - some things in surgery maybe reused like forceps, needles, even swabs.  So if gloves are removed and put to one side they could be put back on and it may be thought that would not be an infection risk because they had not been out of the theatre and were being replace - it may be thought there was no contact between outside of the gloves and the surgeon and such contact would be minimal.  There may also be a variable in the germ involved - but that is getting beyond what I can comment on.

I mean I would not expect glove reuse to be standard but like I said earlier it is the sort of stupid money saving idea non medical managers come up with - I can see them putting a request around theatres that everyone try and use less gloves - with an unwritten unofficial hint that people could try reusing.  Or if the surgeon has done voluntary work in 3rd world countries with limited supplies it may have been done and got to be a habit that was continued once returned to this country.

Well if there was no contact between the surgeon and the outside of the gloves, they must have been taken off by a nurse. I doubt that anyone would think that putting gloves to one side and then putting them back on again would be a sensible thing to do. I would have thought that the staph bug responsible could also be on the patient's skin.

BigAndy9 wrote:Maybe that's how he was trained sphinx, why just voluntary work?

Because unlike you I have some understanding of the requirements of medical registration procedures Andy.

Raggamuffin wrote:

sphinx wrote:

Re use could be possible - some things in surgery maybe reused like forceps, needles, even swabs.  So if gloves are removed and put to one side they could be put back on and it may be thought that would not be an infection risk because they had not been out of the theatre and were being replace - it may be thought there was no contact between outside of the gloves and the surgeon and such contact would be minimal.  There may also be a variable in the germ involved - but that is getting beyond what I can comment on.

I mean I would not expect glove reuse to be standard but like I said earlier it is the sort of stupid money saving idea non medical managers come up with - I can see them putting a request around theatres that everyone try and use less gloves - with an unwritten unofficial hint that people could try reusing.  Or if the surgeon has done voluntary work in 3rd world countries with limited supplies it may have been done and got to be a habit that was continued once returned to this country.

Well if there was no contact between the surgeon and the outside of the gloves, they must have been taken off by a nurse. I doubt that anyone would think that putting gloves to one side and then putting them back on again would be a sensible thing to do. I would have thought that the staph bug responsible could also be on the patient's skin.

Most likely scenario would be sweat contamination around the wrist area during removal - and the time then either contact between wrist area and outside fingers or just spreading down from wrist area.

sphinx wrote:

BigAndy9 wrote:Maybe that's how he was trained sphinx, why just voluntary work?

Because unlike you I have some understanding of the requirements of medical registration procedures Andy.

Ah - my wife watches Greys Anatomy too.

BigAndy9 wrote:

sphinx wrote:

Because unlike you I have some understanding of the requirements of medical registration procedures Andy.

Ah - my wife watches Greys Anatomy too.

I have never seen it - and I believe from those who watch it that is is American and deals with the US system.

I am talking about professional body registration and right to practice in this country.

Anyway, they don't know for sure how this bug was passed on. It does happen sometimes in surgery. The chap was found to be carrying this bug and had treatment for it himself.

There's more here about it.

http://www.telegraph.co.uk/health/healthnews/10658014/Surgeon-who-transmitted-lethal-heart-bug-fights-to-keep-past-secret.html