Published: Thursday, 27th November, 2008 10:35
Concern over Dunfermline hospital's 'hidden' C.diff deaths
By Ally McRoberts
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DUNFERMLINE East MSP Helen Eadie has questioned why a number of Queen Margaret Hospital patients who had a superbug and died did not have it recorded on their death certificates.
Mrs Eadie wrote to health secretary Nicola Sturgeon after receiving letters from constituents about apparent omissions.
She had been told that clostridium difficile – C.diff – wasn’t being recorded on death certificates even though the patient had been hit by the bug before they passed away.
The Dunfermline hospital was hit by two C.diff “outbreaks” within weeks of each other this summer.
Mrs Eadie said, “If there is under reporting going on, and it seems to be acknowledged by the minister, then that’s a big issue and could be masking just how serious a problem C.diff is.
“If it’s happening at Queen Margaret Hospital, which my constituents tell me it is, it begs the question is it happening in other parts of Scotland?
“Clearly there’s huge public concern about C.diff and people have told me they’re almost afraid of going into hospital for an operation in case they catch it.”
In her response, Ms Sturgeon said she shared Mrs Eadie’s concerns and that they were taking positive steps to tackle C.diff but worldwide studies showed “inaccuracies” in death certification.
She said, “This is a complex and difficult area because the contents of death certificates may conflict with what relatives of the deceased believe of the situation.”
Ms Sturgeon said there was “no mechanism for ongoing assessment of the standard to which doctors discharge this duty” and that part of the death certificate was “open to interpretation”.
The minister continued, “Herein lies a critical issue, whether C.diff may have contributed to a death is often a matter of judgement and it can be extremely difficult to establish sufficient evidence to support or refute this.
“For example, if a patient has fully recovered from a bout of C.diff three months before death, could that episode have contributed to the death?
"The doctor’s opinion may be that it has not but the family may feel they want it to appear on the certificate.”
Mrs Eadie said, “If they’ve recovered from C.diff and die later then that’s a different matter but if they have it at the time of death and it was a contributory factor then it ought to be included on the death certificate.
“Who knows why it’s not being done?
“It’s one of those situations where there’s not enough emphasis on making sure it’s reported and I think the time has come for clarity on what should and shouldn’t be reported.
“Another concerning factor is different members of the family have received different guidance from hospital staff on what to do when visiting.
“It’s incredible as this is where there should be absolute clarity and no system failures at all.
“Given the huge public outcry about C.diff the guidance leaflets and information have to be consistent.”
Mrs Eadie said she was concerned about proposals to cut the budget for training in the NHS as she said it was “paramount if we’re going to overcome something like this”.
She added, “I’m backing the calls – again – that Jackie Baillie MSP has made for a public inquiry as it’s not enough for the minister to rely on the Lord Advocate’s verdict of what happens next.
“This is too big an issue for her to simply wait until the outcome of a potentially criminal inquiry.
“We want a public inquiry to see what lessons can be learned and not just end up with years of a court wrangle.”
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