Thursday 16th April 1992   Practice complaints meeting 13:30

Dr Lewis has had what my Dad calls a vexatious complaint. John Jones had collapsed in the waiting room. Harriet and Dr Lewis had successfully resuscitated him. Because of their enthusiasm, he had suffered four broken ribs. Mr Jones claims that he had only fainted and not had a cardiac arrest. He insists that he did not need to be resuscitated and certainly did not need four broken ribs. He says that Dr Lewis did not check his pulse.

Dr Lewis admitted that she had not checked the patient’s pulse. However, she had no doubt that he had had a cardiac arrest. Harriet, the practice nurse, concurred with Dr Lewis.  She was first to arrive on the scene and was also adamant that the patient had arrested.
“He stopped breathing and his head flopped to one side,” Harriet said. “He quickly began to turn blue and cold. His eyes were staring blankly up at the ceiling. I could see his pupils dilating in front of me.”

“Now, look ladies,” said my Dad, “let’s think about it from the patient’s point of view.” He always likes to smooth these situations over. “I am not saying that it happened on this particular occasion but it is possible that a health professional might try to resuscitate a patient who had not had a cardiac arrest. It could happen in the heat of the moment.”
Dr Lewis looked at the floor. Harriet went bright red.
“I always consider it useful in dilemmas like this to consider the worst case scenario,” he continued. “Harriet, what is the worst thing that could have happened here?”
“Well . . . I suppose he could’ve had six broken ribs.”
“No . . . I didn’t mean that.”
“Are you thinking of a punctured lung, then?” Harriet looked annoyed.
“No, as far as I can see, the worst case scenario would be if the patient had had a cardiac arrest but you and Dr Lewis thought he had fainted and, as a consequence, you did not attempt to resuscitate him and he died.”
“Don’t be stupid, Desmond!” Harriet and Dr Lewis both exclaimed in angry unison. “We would never do that and it’s far worse.”

Mrs Andrea Jones brought our coffees over. “At least he wouldn’t have complained, then,” she said and sat down.

Four broken ribs.
Tagged on: