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Practice dilemma: Patient suffered hearing damage in hospital

One of your patients with renal impairment has recently been discharged from hospital. At hospital she received treatment with Gentamicin and her husband tells you she has become deaf. He says it was explained to them that it was ‘bad luck’ and a well-recognised complication of a ‘life-saving treatment’. You fear they may not have been told the whole story. What should you do?

One of your patients with renal impairment has recently been discharged from hospital. At hospital she received treatment with Gentamicin and her husband tells you she has become deaf. He says it was explained to them that it was ‘bad luck' and a well-recognised complication of a ‘life-saving treatment'. You fear they may not have been told the whole story. What should you do?

Vestibular and auditory damage together with nephrotoxicity are recognised side effects of aminoglycosides such as Gentamicin. Serum concentrations require monitoring in order to prevent excessive concentrations thus preventing toxicity, particularly if there is renal impairment. You should ask for an investigation to establish whether an error in monitoring has resulted in your patient suffering harm.

The GMC guidance, Good Medical Practice, says: ‘If a patient under your care has suffered harm or distress, you must act immediately to put matters right, if that is possible. You should offer an apology and explain fully and promptly to the patient what has happened, and the likely short-term and long-term effects.' (Paragraph 30)

As it is not clear what happened with your patient's consent, you should contact her consultant to clarify the issues. If an error has been made you should ask the hospital to provide a full and adequate explanation to the patient and ensure that she's made aware of how to seek redress.

Rob Hendry is head of medical services (Edinburgh), Medical Protection Society

Hearing aid

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