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Case report 01/05/2008

The danger of the casual aside

The danger of the casual aside

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Mr J, a 28-year-old teacher, called his local out-of-hours service one evening complaining of vomiting and diarrhoea, some abdominal pain and dysuria. He said that he had just returned from the cinema with his wife and the symptoms had come on during the film.

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Case report 01/01/2007

A problem with the system, not the patient

A problem with the system, not the patient

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Mr C, a 47-year-old self-employed electrician, was admitted for a routine arthroscopic menisectomy of the knee. He was in good health and did not take any regular medication. His past medical history was unremarkable. He was keen to resume his active lifestyle, and return to work as soon as possible since he was the sole breadwinner. Preoperative assessment confirmed that he was healthy and fit for the procedure.

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Case report 01/09/2006

Respiratory depression from postoperative analgesia

Respiratory depression from postoperative analgesia

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Mr K, a 37-year-old professional, was admitted for an elective anterior resection of the bowel. Dr A, a consultant anaesthetist, performed the anaesthetic, inserting an epidural catheter to manage postoperative pain with a continuous infusion.

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Case report 01/05/2006

Unseen x-ray indicated fracture

Unseen x-ray indicated fracture

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A 67-year-old housewife, Ms T, was admitted to an A&E department having collapsed at home and been unconscious for five minutes. Ms T had fainted eight weeks previously and been admitted to a different hospital. She had also fainted six weeks previously. There was no evidence Ms T had experienced a fit.

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Case report 02/01/2006

Three visits in four days don't go

Three visits in four days don't go

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Baby O, the son of a European mother and North African father, was born at term in the early 1990s and had his first vaccinations at three months old; the health visitor left the section dealing with TB and BCG tests blank on the vaccination card.

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Case report 01/11/2005

Inappropriate advice

Inappropriate advice

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Mrs G, a 50-year-old baker, became unwell with what appeared to be flu. There was an outbreak of flu in the area at the time. Mrs G telephoned her GP surgery and spoke to a receptionist who told her to take bed rest, plenty of fluids and paracetamol.

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Case report 01/05/2005

Warning signs

Warning signs

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Mr Y, a 41-year-old father of five, was involved in a high-impact, head-on road crash late at night on a country road. He was wearing a seatbelt and was able to talk to the ambulance crew when they attended. On initial assessment, his BP was 140/90 mmHg with heart rate at 120 bpm.

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Case report 01/02/2005

Inadequate assessment

Inadequate assessment

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A man in his forties, Mr B, had suffered a recurrence of the pulmonary tuberculosis he had originally been diagnosed with some ten years earlier. He was being maintained on pyridoxine, pyrazinamide and rifampicin, although urine tests carried out at his periodic appointments at the chest clinic suggested his compliance was patchy.

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Case report 01/11/2003

Monitoring fails; kidney fails

Monitoring fails; kidney fails

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As a young man, Mr T had bouts of flank pain and haematuria. Repeated dipstick testing of his urine showed evidence of haematuria and proteinuria. This was investigated by a urologist, with no cause being found. A few years later he had episodes of gout, receiving NSAID treatment.

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Case report 01/08/2003

Tardy surgical intervention

Tardy surgical intervention

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Mr W, a diabetic gentleman in his sixties, saw his GP because of abdominal pain and vomiting. His doctor suspected appendicitis and made an urgent referral to his local hospital. He was seen there by Mr F, a locum consultant. No notes were kept of the initial consultation.

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