I suspect that you really needed to be proactive during the treatment time, ie you needed to be present and asking what is happening, what options are there, what are the likely outcomes, what are the risks?
I believe it unreasonable to expect a busy doctor to stop treating a patient and go and ask someone else during treatment.
The normal treatment procedure is, (a) No intervention, (b) do what is necessary.
Others may comment on this, as I am just a layman giving an opinion.
I agree that for run of the mill treatments, the doctor would need to continue treatment on his own recognisance. However in cases where the patient is incapacitated, it is recommended by all authorities that people have an enduring power of attorney for health matters. Obviously, decisions of a major nature occur that require an EPOA ie a substitute decision maker to be consulted - otherwise why have EPOA's. The hospital was fully aware that my relative had appointed me as EPOA (they wrote a letter activating the financial EPOA). Although I rang the hospital on numerous occasions and visited, I was not informed of any treatments that had adverse outcomes nor was I asked to provide any permission for treatments.
The urgency of the treatment may have been a factor. I believe also if a patient is unconscious they automatically give consent to treatment irrespective of EPOA. This happens in first aid situations too - if a first aider arrives at scene and the patient refuses treatment the first aider can't respond, but if the patient then loses consciousness they then give legal consent to the responder for life saving activities.
No - the treatment was not urgent at all. There was plenty of time for the treating doctors to contact me and let me know what was happening and ask me what treatment I wanted in the same way as they would if the relative was able to make their own decisions...it's just that I wasn't fully up to speed on exactly how an EPOA works and the hospital which obviously has far more experience in dealing with situations like this did not contact me or let me know what they expected...I think they should have tried to get my decisions for major changes in treatment or if there was a choice of treatments to be made in the same way they would have if my relative was in full possession of their faculties .
Barry 2019-05-24 12:04:34
My brother was in constant contact with my relative prior to my relative's incapacitation so was well aware of her medical situation. When his contact with my relative abruptly ceased, he became concerned and made contact with my relative's physician who admitted a series of very serious errors had been made which had incapacitated her in all likellihood. After my relative died, my brother pieced together what happened but it was quite complicated, took quite a while and requires research skills I don't have. He then told me what had happened in his opinion and I then complained to the hospital. They accepted mu complaints and said they were so serious they engaged an independent expert who concluded that although the incidents had occurred and contributed to the relative's subsequent death, the actions by the treating staff were reasonable in the circumstances. Obviously, I disagree but so be it. The issue in question is that the hospital said that since I had not complained at the time of my relative's incapacitation, I had therefore requested and given my consent to these various treatments ie silence deems not only consent but also request!
Barry 2019-05-24 13:33:49
I think the EPOA issue is a red herring. It sounds like you may not have lived up to your EPOA obligations but that doesn't alleviate any negligence on the hospitals behalf. You have an expert witness (relatives doctor) who agrees errors were made (whether they would be willing to go against the hospital in a court case would need to be checked). The hospital can't say that because you didn't indicate not to use that treatment that you are responsible for their subsequent negligence. And when they say they engaged an independant person to review what had happened - they weren't intependant at all, they were a third party engaged by the hospital. An independant person would be someone with no engagement by either the hospital or yourself.
Not sure if it's worth pursuing ($$$) but I think you have a legitimate negligence case here.
Barry, yes it sounds that there may have been a major stuff-up on the part of the hospital, I think you need to talk to a medical negligence lawyer. You may find one who will give you an initial hearing at no charge, so that you can see if you have a case.
If they say you have, ask for a quote to do the work.
The various replies have been extremely useful.
I missed that the review was not independent and let the hospital bandy that term around. I will get that clarified ie the term "independent" needs to be qualified in that it was not totally independent but rather that it was maybe someone outside the hospital department where the treatment occurred or someone completely from outside the hospital etc. I have already asked how the individual was chosen to ensure there were no conflicts of interest or knew any of the treating doctors.
I am looking for an explanation and if errors were made (my contention), then an apology and changes to procedures to make sure it doesn't happen again.
I also want to know exactly what I should have done ie been more proactive as EPOA for medical decisions so that I get it right next time someone appoints me as EPOA.
I am also learning a lot. For example, my sister wanted her medical records such as blood tests while she was in hospital. She arranged to have them sent to her when she was not in hospital (pathology departments will do that on request - aim is to get the results straight away and so reduce anxiety). But the pathology department wouldn't do that for her when she was in the hospital. It turns out she or I could have simply asked her doctor for those blood tests and any medical charts etc and we would have been given access to them.
Barry 2019-05-29 05:06:17