Case report:

“Underwent an elective revision total knee replacement in [private] hospital. Extensive co-morbidity including diabetes, ischaemic heart disease and chronic kidney disease. Arrived from Pakistan the night before surgery, therefore may not have been through usual pre-assessment process. Sustained a large myocardial infarct post operatively and admitted to intensive care unit at [local NHS hospital] in cardiogenic shock. Underwent coronary angiography. Developed multi organ failure and died from ventricular fibrillation (VF) arrest [nine days later].”

Commentary:

The NHS unit had had no involvement with the patient prior to their deterioration. They made the comment that the root cause analysis was being performed by the private hospital and “we await sharing of learning.” 

As hinted at by the reporter, the patient cannot have been pre-assessed to the same standard as if had they been in this country before admission. How this came to pass will be of concern to the private organisation, surgeon and anaesthetist in equal measure.