Would you say something if you noticed one of your surgeons was looking more tired than usual – like maybe he forgot to grab his morning coffee before that first case of the day? How about if you caught his eyelids drooping in the middle of a procedure?
Last June, a surgeon at Boston’s Beth Israel Deaconess Medical Center didn’t just come to work tired — he actually dozed off during surgery. According to a state investigation, the surgical team noticed that Loren J. Borud, MD, was off his game, but the "signs and symptoms of [his] impairment were not immediately called out." A nurse reportedly suggested that he take a break after he nodded off during surgery, but the surgeon kept on going.
The patient, Michael Hicks, later sued the hospital, 6 doctors and 2 nurses, claiming that he suffered complications from the liposuction and scar repair procedures he underwent that day. Mr. Hicks’s operation, which the patient said was supposed to last 90 minutes, ended up lasting 7 hours, according to the state Department of Public Health’s report.
Investigators found that while several staff members reported Dr. Borud’s impairment to their superiors, no senior medical or administrative staff member ordered the surgeon to stop operating. Kenneth Sands, MD, senior vice president of healthcare quality at Beth Israel Deaconess, says the hospital’s nurse managers have since been trained on ways to deal with underperforming staff. The hospital also fired Dr. Borud last summer.
Patient safety consultant Allan Frankel, MD, told the Boston Globe that healthcare facilities all too often don’t have policies in place to handle such situations. "How common is it that nurses and other personnel don’t speak up? I can’t think of any [hospital] in the world where this isn’t an issue."
—Irene Tsikitas
