A 75-year-old patient died after a dietary blunder at the Caritas Medical Centre in Sham Shui Po. - Photo: Edmond So
HONG KONG: A 75-year-old Hong Kong resident with swallowing difficulty choked and then died after he was fed with the wrong food by a student nurse at Caritas Medical Centre, in a blunder which the hospital said was caused by misinterpretation of dietary advice by the healthcare team.
The hospital in Sham Shui Po on Wednesday (March 5) made a public apology, and said a root cause analysis panel would be formed to look into details of the case and measures preventing similar incidents in the future.
“This is a very unfortunate incident,” said Dr Alexander Law Chun-bon, cluster chief executive of the Kowloon West group of public hospitals.
“On behalf of the Hospital Authority and the cluster, I would like to apologise to the public and to the patient’s family.”
The blunder happened on Monday, three days after the 75-year-old man was admitted to the hospital for a bloated stomach and lack of defecation.
The man, who had to initially fast and receive intravenous injection for hydration on admission, was allowed by doctors on Monday to return to his usual diet, after showing signs of improvement.
The man, who had a history of high blood pressure and dementia, had been eating puréed meals since February.
The doctor wrote the term “DAT”, which means “diet as tolerated”, in the man’s medical record.
“We believe that there was a communication problem between doctors and nurses responsible for the case,” said Dr Gladys Kwan Wai-man, the hospital’s chief executive.
Kwan said a student nurse, based on instructions from their supervising nurse, gave the patient the normal meal, which usually consisted of rice, chopped vegetables and sliced meat.
The patient started to cough after managing to swallow the food for a short while, before the student nurse immediately stopped the feeding and notified other healthcare staff.
The man’s breathing and heart beat stopped during resuscitation attempts, and he was certified dead at 1.30pm.
Dr Raymond Cheung Wai-man, the authority’s chief manager in patient safety and risk management, said experts familiar with ward procedures would be appointed to form part of the root cause analysis panel to look into the matter.
The panel is expected to submit a report in eight weeks’ time. - South China Morning Post
