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The importance of checking for contraindications before surgery

When undertaking any surgery, doctors must make sure the patient has no dangerous conditions that are “contraindications” – that is, reasons not to do the surgery. This is particularly true with elective surgeries and those which are not immediately necessary.

When doctors fail to take the necessary precautions to ensure that surgery is a safe option for the patient, the results can be catastrophic.

Infection ignored

In a recent tragic case, an obstetrician gynecologist performed an elective hysteroscopy procedure on a female patient – who had a Group A strep infection at the time. Group A strep is a very virulent and dangerous bacterial infection that is well known to cause toxic shock syndrome.

After discovering that the patient was harboring a group A strep in her genital tract, the obstetrician had unsuccessfully attempted on two occasions to eradicate the organism with a short course of antibiotic therapy. Without taking any preoperative culture tests, the obstetrician then took the patient in for surgery.

Predictably, the Group A strep was still present. Passing surgical instruments through the vagina, which was infected with Group A strep, and then scraping the uterus, the doctor introduced this dangerous group A strep infection into the patient’s blood stream. This “iatrogenic” – or, physician-induced – invasive infection led to severe septic shock and toxic shock syndrome, cardiac arrest and brain damage. Tragically, the patient is now totally disabled and living in an extended care facility.

Preventable devastation

This devastating and life-destroying mistake was easily avoidable. The doctor merely needed to follow the standard of care and do a preoperative culture – thereby discovering that the bacteria was still present. Performing an elective surgery in an infected field is something that no reasonable or prudent doctor should ever do. This doctor violated the most fundamental maxims of medical care: “first, do no harm.”

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