Probe after double eye op blunder at Blackpool Vic

A department at Blackpool Victoria Hospital which treats eye conditions is under scrutiny once more after serious errors in treatment occurred for the second time in two years.
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The latest incident at the Ophthalmology Department saw a patient given two injections into the wrong eye after the surgeon was interrupted and reviewed another patient’s scan by mistake

The error was one of two 'never events' reported to the latest meeting of the board of directors of Blackpool Teaching Hospitals NHS Trust.

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Never events are defined by the NHS as serious incidents that are wholly preventable.

A probe has been launched after two 'never incidents' at Blackpool Victoria HospitalA probe has been launched after two 'never incidents' at Blackpool Victoria Hospital
A probe has been launched after two 'never incidents' at Blackpool Victoria Hospital

A report to the board said: "The lady had been receiving treatment to her left eye, which had resolved and when the surgeon reviewed the scan of her right eye, he was interrupted and reviewed another patient’s scan by mistake and referred the original patient for treatment which was not required.

"The patient came to no harm, but had to undergo two unnecessary injections, with the associated risks involved."

A previous 'never event' in the Ophthalmology Department, reported in January 2020, involved the wrong lens being implanted into a patient's eye during a cataract procedure at the Ophthalmic Surgical Unit.

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Dr Jim Gardner, medical director at Blackpool Teaching Hospitals, said: "We have reported untoward incidents in Ophthalmology before and that has led to a review by the Royal College of Ophthalmology.

"We asked the Ophthalmology Department to bring a detailed action plan to executive which they did a couple of weeks ago, so we really make sure we are confident that our colleagues in the Ophthalmology Department have learned lessons from these incidents and are addressing them."

In the other incident, a pneumonia patient staying in the Intensive Therapy Unit had a needle inserted to help relieve air pressure into the wrong side of their body.

Dr Gardner said: "The wrong side drain was very quickly spotted and put right and the team in critical care did a very thorough job of analysing what went wrong and learning from it."

Dr Gardner added: "In both these 'never events' the outcome for the patients was fine."

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