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Elective Surgery
Not picked up from box 4
Odd pattern
Elderly Woman
Elective digit amputation
Day case
Warfarin - INR checked over a month ago
Pre-op Bloods done some weeks earlier
No major comorbidities
Operation is uneventful
Goes home later that day
No bleeding or concern
Routine analgesia
Foot bandage becomes blood soaked overnight
6 am patient gets up to go to toilet and faints.
Husband finds on the floor soon after
Ambulance called
Arrest in Ambulance (hypotension / tachycardia)
At arrival A/E resuscitation unsuccessful
Routine Deaths Review
Elderly man
Known Bowel Cancer with mets
Resection and Radiotherapy
Currently on Chemo
Diverticular Disease
Attends with abdo pain / vomiting / distension
CT confirms Acute Intestinal Obstruction and ascites / liver mets / rectal mass.
Offered surgery and risks explained.
Surgery goes well and defunctioning colostomy performed.
Rectal mass confirmed = Tumour.
Post op HDU with good progress.
Day 6 faeculent fluid in abdominal drain.
Perforation of rectal stump with ischaemia and faeculent peritonitis.
Paliation provided
Was this a surgical complication / error?
Patient 1
Patient 2