Danish junior doctors start viral campaign to overturn key ruling against colleague

Doctors across Denmark have used a viral social media campaign to protest against the result of a court case against a colleague.

Danish junior doctors start viral campaign to overturn key ruling against colleague
File photo: Søren Bidstrup/Scanpix

The ruling, which will be appealed at the country’s Supreme Court, could have dire consequences for the way medical staff pass on information in the course of patient care, say doctors involved in the campaign.

Doctors also feel that an individual has shouldered the blame for a tragic sequence of events symptomatic of a stressed healthcare system.

A campaign with the hashtag #detkuhaværetmig (‘it could have been me’) has spread on social media in recent days as junior doctors and senior colleagues throughout the country began to rebel against the court ruling.

Over 4,000 doctors have now joined a Facebook support group and an online petition supporting the appeal has now been signed by almost 7,000 people.

The convicted doctor, who was sentenced for negligence by the Østre Landsret higher court in August, was ordered to pay 5,000 kroner (670 euros) in fines plus court costs, reports broadcaster DR.

Doctor Lotte Smedegaard, who started the Facebook support group, was one of the first to post the hashtag.

Doctor and social commentator Haifaa Awad is one of thousands of Danish doctors who have now publicly pledged support for the growing campaign.

Danish Medical Association (Lægeforeningen) chairperson Andreas Rudkjøbing told the Ugeskriftet medical professionals’ journal that the sentence was “unreasonably harsh”.

The case in question dates back to the death of a patient at Svendborg Hospital in 2013 in a sequence of events now referred to as the ‘Svendborg case’ (Svendborgsagen).

After seeing a patient who was complaining of stomach pain at the hospital’s accident and emergency unit on August 5th, the on-duty junior doctor, having read the patient’s records, ordered a blood sugar test, having seen that he was a diabetes sufferer.

That request was made by word of mouth to a nurse, rather than on paper – and was not carried out either before or after the individual was later kept in for scanning, according to a summary published by Ugeskriftet.

The patient was then started on a fasting schedule in preparation for a CT scan. It remains unclear who initiated the fasting schedule, with no record in the patient’s journals and no medical reason for this type of scan. The doctor denies requesting the fast.

The patient was later found unconscious and died nearly four weeks later on September 1st, 2013, most likely as a result of low blood sugar-related brain damage.

Subsequent police investigation of the sequence of events led to the junior doctor being charged with breaching a medical conduct paragraph relating to “severe or repeated negligence of duty or carelessness in the practicing of duties”, because she failed to register the request for a basic blood sugar measurement in the patient chart and didn’t check that the nurse had followed her instruction, writes Ugeskriftet.

Although the doctor was acquitted by Svendborg City Court, the higher Østre Landsret court later overturned that acquittal.

The three judges at the Østre Landsret sentencing said the error by the junior doctor “was not directly connected to the patient’s death”.

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Rudkjøbing told Ugeskriftet that the sequence of events was “incredibly sad, first and foremost for patients and loved ones.”

“Mistakes have been made, but it is the view of the Danish Medical Association that it is out of proportion to convict her [the junior doctor, ed.] for severe or repeated negligence,” he said.

One of the key issues for protesting doctors is the legal sentencing of a colleague for what is generally considered daily practice – namely, giving instructions verbally.

Requiring all verbal instructions to be followed up by doctors to ensure they had been carried out would create an impossible and impractical workload, medics say.

Doctors speaking out in support of their convicted colleague also say she has been made scapegoat for a tragic outcome in a department which has received criticism from the Danish Health Authority for overstretched working conditions.

“Patients deserve competent and conscientious doctors that are allowed to use their professional competencies, rather than spending all their time documenting and double-checking based on over-detailed guidelines and concerns about being sued,” junior doctor Martine Aabye told Ugeskriftet last week.

“The mistakes that were made in [the Svendborg] case happen every single day at all departments. Unfortunately in this case there was an unlucky combination and the consequences for the patient were tragic – of course we are sympathetic to the loved ones. But the solution is not to place individual blame for the events on the youngest person or to create more guidelines or documentation requirements, closely detailing how we spend every minute of every day. That is already unrealistic if we are to live up to [demands] while carrying out our most important duty, which in the end is to care for patients,” Aabye said.

Another doctor who has supported the campaign told broadcaster DR that overstrained systems in Danish hospitals can be a large part of the reason for dangerous communication breakdowns.

“We want to bring attention to the fact that it’s not necessarily mistakes by doctors that lead to patient deaths. It can be problems with the system, and the system is simply under too much strain,” Iza Alfredsen, a former colleague of the convicted doctor, told DR Fyn.

The junior doctor will now appeal against the charges at the Højesteret, Denmark’s Supreme Court. The appeal will be supported by the Danish Medical Association as well as the Yngre Læger young doctors’ association.

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