NHS Lothian has been slammed after a blundering surgeon removed a patient’s appendix without recording it – a mistake that was only discovered eight years later after the patient was wrongly diagnosed with appendicitis.
When Anne Marie Hickey began complaining of severe abdominal pain, doctors believed she had appendicitis and decided her appendix would have to be removed.
But as Ms Hickey lay unconscious in an operating theatre, baffled surgeons could not find the organ – and it eventually transpired that it had been removed in 2002 without her knowledge during a pancreas and kidney transplant operation at the old Edinburgh Royal Infirmary.
Ms Hickey, a 47-year-old theatre nurse, then had to put up with ten days of excruciating pain as she was transferred to the new ERI from Raigmore Hospital, near her home in Inverness, for another operation.
She says she has still not been given a satisfactory explanation as to how her appendix came to be removed without her being informed or it being recorded in her notes, and that she has been left “disgusted” at her treatment by NHS Lothian.
“Initially they said categorically that it hadn’t been removed, I was dumbfounded,” she said. “They said there was no appendix and it was a mystery.”
It was almost a year before NHS Lothian admitted to Ms Hickey that the organ had been removed during the 2002 transplant operation.
“Removing part of somebody’s anatomy should be documented,” she said. “The first thing we are taught is to document everything – and that’s as a nurse not as a doctor. I’ve never heard of anything like this before.
“I had an unnecessary operation. The signs of appendicitis were all there apparently, but if it was in my notes they would have known straight away that it couldn’t have been that. It’s ridiculous and outrageous.”
After being transferred to the ERI following the misdiagnosis of appendicitis in July 2010, it was found that Ms Hickey’s previous pancreas transplant had failed, causing the pain. The organ was removed, leaving her with diabetes. She also suffered a heart attack during the operation.
Then, as she was recovering, she requested assistance from two nurses to help her go to the toilet. Only one nurse agreed to help, and Ms Hickey crashed to the floor after the nurse found she was unable to manoeuvre the patient.
An accumulation of blood in Ms Hickey’s leg burst and she was forced to undergo skin grafts and further physical and mental distress.
A complaint to the Scottish public services ombudsman about Ms Hickey’s treatment has been upheld and recommendations regarding transplant protocol, communication and the investigation of complaints have been made to NHS Lothian. The ombudsman said that the health board’s failure to record the removal of the appendix was “unreasonable” and was compounded by the failure to inform Ms Hickey or her GP.
It was also ruled that the health board had failed to explain the blunder.
Melanie Hornett, NHS Lothian’s nurse director, issued a public apology to Ms Hickey, who was referred to as “Mrs A” in the ombudsman’s report.
She added: “We accept the ombudsman’s recommendations in full and we have already put them into practice.
“Some units routinely remove the appendix during a pancreas transplant, while others do not. We agree that it is imperative that the information is documented and we have written to all transplant surgeons to request that it is noted to prevent a similar incident from happening again.
“As a result of Mrs A’s fall, moving and handling policies have been reviewed, the importance of reading individual care plans and listening to patients has been reiterated to nursing staff.”
NO KNOWN USE FOR HUMANS
The appendix is a finger-like pouch connected to the large intestine, located in the lower right-hand side of the abdomen.
The organ is usually around nine centimetres long, and has no known use for humans. Scientists believe that the appendix has lost its original function through the process of evolution, and that it may have originally been used to digest tough food like tree bark.
The organ has been found to be rich in infection-fighting lymphoid cells, leading some to believe it might have a role in the human immune system. But whether it has a function or not, it can be removed without any ill effects.
Appendicitis, which occurs when the organ swells, is a common condition and is usually cured by removing the appendix. About seven per cent of people in the UK will get appendicitis at some point in their life.