22 Dec 2020

Patient says gynaecological operation among 'masses of people' breached consent

10:58 am on 22 December 2020

An Auckland woman is furious her gynaecological operation went ahead in a theatre crowded with people she had not given permission to be there.

Iv Drip in hospital corridor

Photo: 123rf

The woman, who RNZ has agreed not to identify, says North Shore Hospital breached her rights to give informed consent.

This comes as the Medical Council is consulting over changing the guidelines to make clear patients should be asked about trainees being in any surgery, though the Health and Disability Commissioner maintains the law and Code of Rights are very clear as they stand.

The woman went in for an operation last year.

"As they pushed me into the theatre, all I could see was masses of people, a lot of people.

"Because this is an environment that I've been in before, I was a little shocked at how many people were in this theatre."

She counted at least 10.

"I didn't know who they were, I didn't know why it was necessary for them to be there. I knew that some of them may know me in another context in my life.

"I felt invaded."

The patient's Code of Rights says patients have the right to say no to extra people being there.

Did the woman get the chance to object?

"Not once I was anaesthetised and that happened very quickly.

"The anaesthetist is speaking to you. The mask is already, they're prepped and ready to go, you're out.

"I was never given a chance to actually even speak.

"You are in a vulnerable position ... there's a hustle and bustle going on around you.

"Unless you were a very assertive person and went, 'Wait, stop. I want to know who all these people are'."

You would also have to be confident that speaking up would not be to the detriment of the care you got, she said.

Her queries later about who was in the room were brushed off, she claimed.

"I felt like my privacy was completely and utterly invaded.

"When you go into a theatre and you're a woman, you don't expect to think, 'Well, my legs are going to be up and all these people are going to see'."

The hospital's health board, Waitematā, at this time had a policy that if trainees were supervised, they did not need explicit consent.

That policy could mean a whole class looked on, the woman said.

Her faith in the health system, shaky before, was now in pieces.

"Completely broken. You'd like to think that the system doesn't just pay lip service to it."

Student training was necessary, but it had to be fully consented, she said.

The Waitematā DHB said it had not received a patient complaint of this nature.

"We have not been provided with any details by RNZ and have, therefore, not been given the opportunity to look into the details of their care to respond to the concerns."

If it did, it would take it extremely seriously and work with the patient to investigate it, the DHB said, adding it had made considerable effort to strengthen its informed consent processes over the last two years.