My experience with the precautionary principle/ A đŸ§”
A young lady attended ED on Friday with a confirmed unruptured ectopic pregnancy on US.
She was haemodynamically well & fitted the criteria for use of methotrexate & this was administered with consent /1
https://obgyn.onlinelibrary.wiley.com/doi/epdf/10.1111/1471-0528.14189
The young lady was readmitted on Sunday with abdominal pain. She continued to remain well apart from pain. I was concerned that she may have a ruptured ectopic pregnancy, a known possibility following methotrexate. An urgent scan showed fluid in the pelvis. She stayed fasted /2
I was faced with 2 options:
-Operate on Sunday night
-Wait until Monday morning
That night I made the decision to wait until Monday morning.
Uncomplicated surgery was performed on Monday morning, patient recovered well, discharged Tuesday morning, the end.
But was it the end /3
No, Reader, it was not the end.
A complaint was made about my decision to wait until Monday morning.
I was declared incompetent & dangerous. Too dangerous to continue working because I had endangered the patient’s life.
Did I not know that ectopic pregnancy could be lethal? /4
I had not applied the ‘precautionary principle’ of the potential for a life threatening outcome for my patient.
A full investigation followed during which I was stood down from clinical work. I won’t describe the mental trauma of standing ‘accused’ of negligence. /5
So, my question Reader is this:
Are those in decision making positions currently using the same precautionary principle when they make 🩠PPE decisions?
And if they are not, what disciplinary actions will they face for the actual harm caused to thousands of HCW affected? /Fin
Addendum: This happened a long time ago. Thank you for your supportive messages. I made a full recovery.
The reason for this thread is to to ensure that the same rules apply across the board to everyone who makes decisions in healthcare đŸ™đŸœ
You can follow @Nishaobgyn.
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