The use of antibiotics is a hot topic recently in Hong Kong. Also, I had shared with you something about legal facts on medical negligence previously. So, I would like to share my personal experience on a case about antibiotics and medical negligence with you that happens during my internship year. It is a real case happened when I worked as an intern at the Urology Team of the Surgical Unit of the University of Hong Kong from July to September 2001.
It was the first shift of my internship after graduation. I worked with two Senior Urologists from the team. One was a new Urology Fellow and the other one was a Senior Urologist returned from United Kingdom. Obviously, the new Fellow worked locally for many years and understood the operations of the Hong Kong hospitals very well but the Senior Urologist did not understand anything about local hospital administration. One day, after the morning round, they had decided to prescribe an antibiotics called Gentamicin intravenously to an old gentleman because of resistant urinary tract infection. He was a chronic illness patient with slight impairment of the renal function. After following the seniors for the morning round, I returned to my seat and started all the clerical work of my day. Suddenly, the senior Urologist came to me and asked me to prescribe a dose of Gentamicin at 2 grams intravenously to the patient. As you know, they did not teach anything about the dosage of medication during my undergraduate years and I did not aware the fact that it was an abnormally high dose for Gentamicin. I prescribed the medication and continued my duty as usual. During the next day, the Urology Team Head came to have the Grand Round and he found that the Gentamicin was given at an abnormally high dose and he immediately confronted me and asked me to make a proper explanation to him. Of course, I told him the facts and the Senior Urologist returned from UK denied it and even claimed that the dosage was for Cefuroxime intravenously instead of Gentamicin.
They consulted the Renal Team of the University Medical Unit immediately. After detailed investigation, they found that the nurse responsible for injection did find out that the dose was abnormally high because she used to give injection for Gentamicin previously. But, very stangely, she did not seek clarification from me and she changed the dose to 200 mg intravenously by herself instead (without a supervision from doctors). It was because of this the patient's renal function was not affected much. But, unfortunately, for me I received an extremely bad review of my internship performance. I almost cannot secure the Medical Officer job after completion of my internship. I have to enter the newly created specialty called Family Medicine and worked as a trainee for a few years.
I remember this event so clearly because the 911 terrorist attack in USA happened exactly at the same time when I worked at the urology Team. My mother was so worried at that time because I was always at the top of my class and I always had outstanding performance during my school years. This was the first time I experienced such a big set-back in my life.
Wish all of you have a happy life and successful working experience!