'Vet left dog to die alone overnight at surgery despite advertising '24-hour care' ' Daily Mirror

RE: Vet left dog to die alone overnight at surgery despite advertising '24-hour care'

Kate Richardson — Fri, 12 Jul 2019 20:17:52 GMT

[quote user="Gillian Mostyn"]

Sometimes you get away with providing an inadequate service because nothing bad happened.

[/quote]

Arlo Guthrie can you add a ‘sadly agree’ Button

sometimes that inadequate service doesn’t manifest itself until later in time

RE: Vet left dog to die alone overnight at surgery despite advertising '24-hour care'

Gillian Mostyn — Fri, 12 Jul 2019 20:01:04 GMT

[quote user="al9903221"]I am able to monitor my solitary OOh case more closely in my independent practice job than the majority of locum shifts i've done for corporate OOh providers, because i only have that one case to monitor, even if i'm visiting from off site.[/quote]

Fair enough. If this vet had come back to the practice for checks, or been shown to be providing some degree of overnight care, then things would have been different. If an OOH provider was shown to have provided inadequate care, they would also be open to a successful complaint. I don't think anyone has said that there is one perfect model ... Just that 24hr care should mean just that.

RE: Vet left dog to die alone overnight at surgery despite advertising '24-hour care'

Gillian Mostyn — Fri, 12 Jul 2019 19:57:29 GMT

[quote user="al9903221"]But it was the cause of the complaint. If the dog had lived, even if the owners discovered that it wasn't monitored, I don't believe for a second that a complaint would have been made. [/quote]

Isn't that always the case? No complaint, in our business or any other, comes from a happy satisfied customer. Sometimes you get away with providing an inadequate service because nothing bad happened.

RE: Vet left dog to die alone overnight at surgery despite advertising '24-hour care'

al9903221 — Fri, 12 Jul 2019 18:47:11 GMT

[quote user="Gillian Mostyn"]

"When we stopped doing our own OOH we did get comments on the increased cost at the OOH centre. However, once I explained the difference in provision most clients were content. "

Little do they know! The majority of "OOH providers" i've locumed at, the level of monitoring is often no better given the workload coming through the door. I am able to monitor my solitary OOh case more closely in my independent practice job than the majority of locum shifts i've done for corporate OOh providers, because i only have that one case to monitor, even if i'm visiting from off site.

Whereas in a busy, usually grossly understaffed OOh provider I'm usually struggling to give each case the attention it deserves. There's a huge difference between overnight provision and overnight care.

[/quote]

RE: Vet left dog to die alone overnight at surgery despite advertising '24-hour care'

al9903221 — Fri, 12 Jul 2019 18:42:35 GMT

[quote user="Gillian Mostyn"]

[quote user="Michael Woodhouse"]I doubt the outcome would be any different anywhere else, I know for a fact animals get discovered dead in cages at OOH providers. People get found dead in hospital beds.[/quote]

The fact that it died was not part of the complaint.

[/quote]But it was the cause of the complaint. If the dog had lived, even if the owners discovered that it wasn't monitored, I don't believe for a second that a complaint would have been made.

RE: Vet left dog to die alone overnight at surgery despite advertising '24-hour care'

Evelyn Barbour-Hill — Fri, 12 Jul 2019 18:04:12 GMT

[quote user="Anthony Todd"]

[quote user="Evelyn Barbour-Hill"] negligence, which is not the concern of the RCVS.[/quote]

Now I really am confused, can someone explain please.

[/quote]

Sure.

Negligence is not the province of the disciplinary system of the RCVS, unless so gross, repeated and reckless as to constitute gross professional misconduct.

RE: Vet left dog to die alone overnight at surgery despite advertising '24-hour care'

Bob Russell — Fri, 12 Jul 2019 18:00:16 GMT

Chikosi and the support structure on the night of that incident did not work. He did not offer a defence or interact. Some idiocy within the DC came up with some daft reasons why his behaviour fell well below acceptable standards so he was hung out to dry. I would not have given him houseroom because he did not bother to defend himself. He could have put forward many good reasons for his actions and been cleared.

This time a vet accepted things were not done as they should have been, took responsibility for these actions and received a fair sanction (eventually). She is unlikely to repeat this mistake and has an otherwise unblemished record. I would happily employ someone willing to take this responsibility despite having screwed up.

The DC really did make it clear that the post-op care was inadequate and unacceptable. It was not just about communicating the level of care!

RE: Vet left dog to die alone overnight at surgery despite advertising '24-hour care'

Anthony Todd — Fri, 12 Jul 2019 16:30:47 GMT

[quote user="Evelyn Barbour-Hill"] negligence, which is not the concern of the RCVS.[/quote]

Now I really am confused, can someone explain please.

RE: Vet left dog to die alone overnight at surgery despite advertising '24-hour care'

Evelyn Barbour-Hill — Fri, 12 Jul 2019 16:19:42 GMT

[quote user="Anthony Todd"] if a clear warning had been given that there would be, actually, no care at all, then this, the warning or advice, would completely satisfy the RCVS.[/quote]

Well, yes, because then it would have been, if anything, negligence, which is not the concern of the RCVS.

The businesses about fluid rates and analgesia also were matters of possible negligence and nothing really to do with RCVS unless so grossly reckless and careless (which in this case they were not) as to constitute gross professional misconduct.

RE: Vet left dog to die alone overnight at surgery despite advertising '24-hour care'

Anthony Todd — Fri, 12 Jul 2019 16:11:15 GMT

[quote user="Richard Stephenson"]No it's not. Chikosi did not offer any defence, respond to the RCVs nor turn up for his own hearing[/quote]

Sorry, I was referring to the tragic outcome and the emotional effect the owner's statement had on the decision and findings. in my opinion. After all the owner, and key witness, accidentally killed his own dog, although totally accidentally.

Had another vet attended promptly, although the outcome would have been the same, I think the decision at the hearing may have been somewhat different.

There seemed to be much more emphasis on Mr. Chicosi's action after the event than his actions, or lack of them, on the night.

I am disturbed now, in this case, by the apparent idea that, if a clear warning had been given that there would be, actually, no care at all, then this, the warning or advice, would completely satisfy the RCVS.

RE: Vet left dog to die alone overnight at surgery despite advertising '24-hour care'

Jill Butterworth — Fri, 12 Jul 2019 15:37:58 GMT

[quote user="Nicola M"]

[quote user="Dinu Catilina"]

I'm sorry Jill but the title is more appropriate for the daily mail rather than Vetsurgeon. Using words like abandoning, left to die already imply that the vet involved did not care where it might have been an erroneous clinical judgement.

[/quote]

I think Jill was just quoting what had been written in the paper for the title-to indicate the backlash the vet was getting from the tabloids.

[/quote]

It is a quote from the Daily Mail, I was being provocative to stimulate discussion, which it has. Apologies, I should have used quotation marks.

RE: Vet left dog to die alone overnight at surgery despite advertising '24-hour care'

Gillian Mostyn — Fri, 12 Jul 2019 15:17:50 GMT

[quote user="Dinu Catilina"] a dog dieing peacefully [/quote]

I'm not convinced a peaceful death happensv often ... even exsanguinating dogs end up panting and with a massive tachycardia ... that can't feel nice.

[quote user="Dinu Catilina"]If the dog dies in the cage and the vet on call lives 15 minutes away, is there a realistic way of stopping that death?[/quote]

No, but there is a known, finite length of time the dog could have suffered for.

[quote user="Dinu Catilina"]We really don't know if the owners were really not aware of the on-call situation. [/quote]

I think we probably do. I haven't known a single owner who would choose to leave their dog alone in this situation, when given the facts.

RE: Vet left dog to die alone overnight at surgery despite advertising '24-hour care'

Anthony Todd — Fri, 12 Jul 2019 12:56:54 GMT

[quote user="robloxley"]Your statement that there was an "actual total lack of care!!"[/quote]

Well wasn't there? I was referring to a post-op found dead in cage next morning [or even after "hourly checks"]

Even an owner, at home, would have been able to see when an animal couldn't or wasn't breathing or had the tongue caught etc. etc.

I suggest that post-op care by an owner at home, if circumstances dictate, is better than unattended, in a cage even at a vet's. and might well be considered, under certain circumstances, to be adequate.

RE: Vet left dog to die alone overnight at surgery despite advertising '24-hour care'

Nicola Cole — Fri, 12 Jul 2019 12:30:40 GMT

[quote user="Dinu Catilina"]

[/quote]

I think Jill was just quoting what had been written in the paper for the title-to indicate the backlash the vet was getting from the tabloids.

RE: Vet left dog to die alone overnight at surgery despite advertising '24-hour care'

Dinu Catilina — Fri, 12 Jul 2019 12:12:40 GMT

"Vet left dog to die alone" is pure sensationalism. Is it relevant if the dog died alone? I think more relevant is if the dog died suffering.

Remote cameras can not assess pain and differentiate between a dog dieing peacefully or sleeping.

If the dog dies in the cage and the vet on call lives 15 minutes away, is there a realistic way of stopping that death?

We really don't know if the owners were really not aware of the on-call situation. They say they weren't and appear to be experienced, whatever that might mean (in my books it means nothing) but I've seen owners that feel quility after a pet's death and their coping mecanism is taking it on to someone else.

RE: Vet left dog to die alone overnight at surgery despite advertising '24-hour care'

Jill Butterworth — Fri, 12 Jul 2019 09:43:09 GMT

To be fair, although most of us are sympathetic to the vet involved, there is a general consensus that abandoning the dog to its fate overnight without some effort to check it either actually or virtually was a step too far. That is what Anthony means. There have been other similar cases brought before the Disciplinary Committee, it's not new. Remote cameras are really cheap now and an easy way round the problem.

Wearable patient monitoring devices are being developed for humans and so one day, we might be able to avoid the 'dead in cage/bed' scenario.

RE: Vet left dog to die alone overnight at surgery despite advertising '24-hour care'

Rob Loxley — Fri, 12 Jul 2019 08:51:45 GMT

[quote user="Anthony Todd"]

Rob, what do you disagree with??

[/quote]

Your statement that there was an "actual total lack of care!!"

RE: Vet left dog to die alone overnight at surgery despite advertising '24-hour care'

Anthony Todd — Thu, 11 Jul 2019 21:22:56 GMT

Rob, what do you disagree with??

RE: Vet left dog to die alone overnight at surgery despite advertising '24-hour care'

Anthony Todd — Thu, 11 Jul 2019 19:16:34 GMT

The only thing that worries me after 4 "pages" is that the powers that be seem more concerned about the warning of clients of [obviously inadequate, or no] care than the actual total lack of care!!

Has anyone had a cat asphyxiate by jamming it's head in the corner of a cage??.............

Doesn't anyone turn recovering GAs, or even put them on their sternums anymore?

RE: Vet left dog to die alone overnight at surgery despite advertising '24-hour care'

Arlo Guthrie — Thu, 11 Jul 2019 13:55:43 GMT

[quote user="Bob Russell"]We have a video set up that allows remote viewing but so far it has only been used to make the cleaner jump!![/quote]

That made me chortle, thank you!

RE: Vet left dog to die alone overnight at surgery despite advertising '24-hour care'

Bob Russell — Thu, 11 Jul 2019 13:54:05 GMT

The owners concern (as would mine) is that the dog died on its own and may have suffered. Someone there to euthanase may have prevented suffering. We just don't know whether it was an easy end or not. With video recording it may have been able to reassure the owners (with hindsight) but I have real doubts that the outcome would have been different.

The owners needed reassurance which the vet could not offer without being untruthful.

We have a video set up that allows remote viewing but so far it has only been used to make the cleaner jump!!

RE: Vet left dog to die alone overnight at surgery despite advertising '24-hour care'

Gillian Mostyn — Thu, 11 Jul 2019 12:42:31 GMT

The profession being more open in what is being provided is a good thing though.

When we stopped doing our own OOH we did get comments on the increased cost at the OOH centre. However, once I explained the difference in provision most clients were content. I do think a lot of clients just assume staff are there all night. Afterall, a 24hr supermarket is open 24 hours ... Why not a 24hr practice?

RE: Vet left dog to die alone overnight at surgery despite advertising '24-hour care'

bob lehner — Thu, 11 Jul 2019 11:44:45 GMT

[quote user="Clive Ansell"]And don't forget, not all patients that attend an OOH centre (I don't call them emergency clinics, they are not!) will receive constant monitoring and supervision either. Sometimes it is so busy and understaffed, that it can be hours between checks; other occasions, staff will go to bed (I Rarely did) and check cases 6AM. [/quote]

i think everyone agrees that an elderly GDV patient is a high-risk - and many will die post op from cardiac arythmias/elecrolyte disturbance/DIC or whatever. Unless under constant ECG monitoring/electrolytes every 15 minutes/platelets ditto, then just having someone in the building/watching the patient is not going to make a jot of difference to the outcome. Plus the need for the necessary knowledge/skills/medicines to combat the likely problems.

Not going to happen - except in the most high-end of places.

Anyway - take home message - make jolly sure the owners know what level of care your practice can provide OOH.

RE: Vet left dog to die alone overnight at surgery despite advertising '24-hour care'

Glen McIntosh — Thu, 11 Jul 2019 10:03:51 GMT

[quote user="Gillian Mostyn"]

The fact that it died was not part of the complaint.

[/quote]

But there would have been no complaint had the dog recovered.

And there would have been no disciplinary hearing, let alone a guilty verdict, had the dog died in circumstances where either a) the animal was monitored overnight as per the owners expectations, or b) the owner had been fully informed about the level of care available at the practice such that the owners expectations were in line with the reality of the situation AND other available options discussed with the owner if they were unwilling to accept that reality (such as transfer to a clinic that could provide a level of care that met the owner's expectations). The owner might still complain for one reason or another, but it is unlikely that the RCVS would pursue disciplinary action in those circumstances.

Yes, unfortunately, some animals will be found dead in their cage, sometimes even in facilities providing on site 24 hour care, and sometimes those deaths might occur in cases that seem far more stable than a recently post op GDV. But I think the lesson from this case is that should a complaint arise because of a death of an animal while hospitalised then it might be hard to defend against that complaint if the death occurred in premises that are unmanned, and especially so if (1) the owner is unaware of the actual level of care being provided and (2) in cases where closer supervision would be deemed necessary by most reasonable vets (and a post op GDV would be a classic example of that type of case).

And probably fair enough in this day and age. It might have been acceptable 20 years ago, but even back then it was still not great to come back in the morning to find an animal dead in the cage. And client expectations have changed a lot since then.

So definitely buy that A3 printer and add that extra line to your consent form.

RE: Vet left dog to die alone overnight at surgery despite advertising '24-hour care'

Iain Richards — Thu, 11 Jul 2019 09:55:15 GMT

[quote user="Evelyn Barbour-Hill"]Not picking on you, Iain, but how do you know? How would anyone know?[/quote]

Good point. However I'm basing this on the court apearances I've done (one speeding, and one being sued for a skiing accident) plus the bit of expert witness stuff I've done. The setting of the hearing is intimidating, even for those with a clear conscience, and in my experience, the poor evidence is quickly exposed.