Dr Graham Howarth, Head of Medical Services (Southern Africa) at Medical Protection details how a simple mistake could still result in competent students or junior doctors being charged as criminals.
This case outlines how we used the power of discretionary indemnity to assist a student member, where other providers may not have. The case itself may be well known to many junior medical staff and senior medical students working in South African State hospitals.
Students and junior doctors soon learn that an integral part of their daily job is to draw blood on patients and ensure that special investigations are performed. Almost simultaneously they learn that when in the ward it is not unusual to lack for a syringe, a needle, the necessary tube or other paraphernalia associated with drawing blood.
Some wards always seem to be well equipped while others are not, but even the former occasionally run out. The only certainty is that you never know what you will need and when you will struggle to obtain equipment.
Spot the bumbag
So experienced and well organised students and junior doctors are soon identified by the carrying of a small bumbag with syringes, needles, swabs and laboratory tubes so one is always ready, and you have all the equipment available when you need to draw blood. When news spreads that a rare syringe size, butterfly set or needle becomes available in a particular ward, that ward is oversubscribed by the well prepared, who ensure that their supplies are replenished. Sadly the habits of the efficient do nothing to relieve the problems of shortages on the wards.
So it is something that we all recognise and accept as being part and parcel of working in a less efficient system.
The case
The problem occurred when prudent practice bumped up against policy. A hard-working student and well respected bumbag aficionado, W, was running late one day. Normally at the end of a call the bumbag was stored in W’s locker. On the day in question, W was running late and had an important meeting so rather than go to her locker she dropped it on the front seat of her car – in full view of all and sundry; so no intention to conceal it. As fate would have it, just prior to leaving, she had had the opportunity to restock her bag so although it was small it was full.
The problem came as she left the hospital premises and she was stopped at the exit gate for a random security check. She thought nothing of it, she had nothing to hide and it was not the first time she had been stopped. Initially all was well and the security guard did a cursory check all in good humour. He saw the bumbag, picked it up and looked inside and that is when the atmosphere changed. When he saw the syringes, needles and swabs he knew things were amiss. He looked at W and asked her if she knew how serious it was to steal things from the hospital. She tried to explain but to no avail. Within minutes a supervisor was there and the supervisor was even more officious. Other students stopped and tried to intervene but that merely seemed to exacerbate the situation.
Once it was established who W was and how she could be contacted and followed up she was allowed to leave – without the incriminating evidence. The next day she was called in by the hospital security and warned that they were inclined to pursue her for stealing the equipment and reporting her to SAPS. Given, as a student, she was registered with the HPCSA they were also minded to report her to them. Other students and the university tried to intervene but sadly to no avail.
That evening W was contacted by a senior member of the hospital’s staff and also a prominent academic, who was extremely supportive, and having spoken to her it was agreed that she would not attend at the hospital the next day. The academic also asked her to contact Medical Protection.
How we assisted
W phoned us for advice. Clearly there was an element of personal conduct here, given that W stood accused of robbery, but there was a strong clinical element in the genesis of the predicament in which W found herself. Fortunately Medical Protection offers discretionary assistance and under the circumstances we were able to exercise discretion to help W.
We contacted our local solicitors who in turn contacted the hospital authorities. They were informed that the matter was receiving the hospital management’s urgent attention. Our solicitors also contacted the supportive academic who collaborated W’s explanation concerning students carrying provisions in the hospital. It was decided that a brief factual explanation would be provided to hospital management as well as a confirmatory letter of the state of affairs from the supportive academic.
W decided she would not attend at the hospital for the rest of the week as per the agreement. She did inform us that she had heard that several fellow students had also contacted hospital management to inform management of the necessary practice in the hospital. Understandably W was worried and made use of the Medical Protection counselling service, which is available as part of Medical Protection membership.
Fortunately common sense prevailed and the hospital informed us that they accepted W’s explanation. Hospital management informed us that their security could not turn a blind eye to the removal of hospital stock and they suggested that in future students would be well advised not to remove equipment from the hospital. Management also promised to improve the provision of stock in the wards. When we subsequently spoke to W a couple of months later she informed us that sadly, despite management’s promises, bumbags remained an essential requirement for diligent students.