Patient had wrong eye operation after name mix-up
A patient had the wrong operation carried out on their eye because they had the same surname as another patient on a hospital waiting list, it can be revealed today.
The error was the fifth so-called 'never event' to happen at Sandwell and West Birmingham Hospitals NHS Trust in the past 12 months.
Health chiefs introduced the term in 2009, to highlight cases of bad care which should never take place. This 'wrong implant' never event took place on January 3 at the Birmingham & Midland Eye Centre, where three of the five similar cases have occurred at the trust.
It comes after eye surgeons carried out an operation on the wrong patient less than three months ago. The latest case comes despite bosses approving an external review of their safety processes to stop such things happening, at a meeting last month.
Roger Stedman, trust medical director said: "It is frustrating that we have had three 'never events' in eye theatres in two years. The analysis of each event shows that each one demonstrated errors in the process."
A report into the incident said it saw a lens implanted in the eye in a procedure which can be to treat cataracts or short-sightedness. Bosses temporarily suspended similar operations at the centre in the wake of its third never event to 'examine why lessons from previous incidents were still not preventing these errors occurring'.
There was an error at the time of booking – two patients with the same surname needed the same operation on the same eye – and they were both in a potential waiting list 'pool'.
The error was spotted after the operation and the patient was 'immediately offered an explanation, apology and corrective surgery.
