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Dublin: 8 °C Wednesday 20 November, 2019

'Lax' response by Cavan hospital to electro-shock blunder

An inspection found a patient was not given the proper muscle relaxant before being shocked.

Image: electro-shock machine via Shutterstock

A PATIENT AT a psychiatric unit in Cavan was not given any muscle relaxant before receiving electro convulsive therapy, an inspection has found.

In an unannounced inspection by the Mental Health Commission, it was discovered that a clinical file at the Acute Psychiatric Unit in Cavan General Hospital, identified an “adverse event in relation to the administration” of the treatment.

The patient in this instance had consented to a course of ECT. Prior to one of the treatment sessions, the anaesthetist failed to administer the required muscle relaxant medication.

Muscle relaxants help minimise seizures during the treatment and prevent injury to patients. Patients are also given an anaesthetic before the treatments start.

There was no record of this even having been entered into the incident log or reviewed by all relevant clinical personnel and the risk manager. The responsible consultant psychiatrist had recorded in the clinical file that this event would be discussed with the patient.

However, there was no further record of this discussion taking place or the outcome.

A lax response

“The clinical governance response to this incident appeared to be lax,” the inspection report said.

The inspectorate immediately requested a report on this event from the Clinical Director and notified the Mental Health Commission of this matter of serious concern.

According to the report, it is clear that ECT is administered on an infrequent basis at this hospital and this “underscores the importance of maintaining acceptable practice standards in this area”.

A review took place on foot of recommendations by the inspectorate and basic risk control measures have now been put in place.

Fit for purpose

As part of this report, issues with the design and fit-out of the unit were also identified.

The day room had been designed as a dormitory ward and featured sockets and panels for medical equipment. The armchairs and television did little to create a social communal environment. The dining room had 14 chairs for the 23 persons who were resident at the time of inspection.

For the third successive year, the occupational therapy kitchen and mini gym room remained inaccessible.

It was recommended that communal spaces within the unit might be enhanced with décor and furnishings aimed at creating a social space.

Read: Electroshock still used without consent despite promises>

Read: Calls to end electroshock therapy, it can be carried out on people “unwilling or unable” to consent>

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