Post-Procedure Complications Monitoring Programme 32nd Review Meeting Friday, 23 August 2013 4:00-5:20pm, AKC Li Surgical Library

Attendance Present Dr. Simon Wong (Chairman) Team 1 – Dr. Tommy Yip Team 2 – Dr. Sally Luk Team 4 – Dr. Micah Chan PRAS – Dr. David Wong & Dr. Teresa Tan NS – Dr. W K Mak & Dr. Alberto Chu PSU – Dr. Sammi Wong & Dr. Jennifer Mou URO – Dr. C K Chan & Dr. Samuel Yee CTS – Dr. Micky Kwok Mr. Alfred Chan Ms Eunice Tam

Items discussed Complications report – June 2013 AOB

June,2013 Summary (case collection progress and Complication rate) Complication rate and Magnitude

Team 1 – Hepatobiliary & Pancreatic Surgery Code 567.2 abdominal

Team 1 – Hepatobiliary & Pancreatic Surgery (Cont’d 2/4) Seems that sepsis was present before surgery but Team decided to count this as complication Likely a result of contamination during surgery

Team 1 – Hepatobiliary & Pancreatic Surgery (Cont’d 3/4) Complicated post-op course

Team 1 – Hepatobiliary & Pancreatic Surgery (Cont’d 4/4) For consideration in M & M after the patient is discharged Mortality after 2nd OT done by T2 (2nd OT to be discussed in next meeting)

Team 2 – Upper Gastro-intestinal Surgery

Team 2 – Upper Gastro-intestinal Surgery (Cont’d 2/2)

Team 3 – Colorectal Surgery Team 3 cases reviewed in the absence of Team 3 representatives No D/C summary available for discussion

Team 3 – Colorectal Surgery (Cont’d 2/4) Only an incidental finding. Should not be counted as a complication. Team 3 should review whether this case should be counted as complication.

Team 3 – Colorectal Surgery (Cont’d 3/4) No details on the type of OT performed. To add the following complications : + DVT + Bedsore

Team 3 – Colorectal Surgery (Cont’d 4/4) M & M case

Team 4 – Vascular Surgery Patient refused injection RLN palsy missed in D/C summary 6 stents inserted by cardiologists previously Ischaemic bowel Patient passed away in Union Hospital (private ICU care) Should be counted as mortality though patient did not die in HA hospital

Team 4 – Vascular Surgery (Cont’d 2/2)

Plastic, Reconstructive and Aesthetic Surgery Expected death

Plastic, Reconstructive and Aesthetic Surgery (Cont’d 2/3) discharge was too early - recipient site loss Case belong to NS

Plastic, Reconstructive and Aesthetic Surgery (Cont’d 3/3)

Neurosurgery Cass to be discussed in Sept 2013 review meeting

Paediatric Surgery and Paediatric Urology

Paediatric Surgery and Paediatric Urology (Cont’d 2/2)

Urology The complication (revision of ureteric fluitux) (primary) of the 1st OT should be coded. Same patient M & M 23

Urology (Cont’d 2/2) Team should review whether performing OT in LKSSC was appropriate.

Cardiothoracic Surgery Cass to be discussed in Sept 2013 Review Meeting

AOB As the cases for NS and CTS (June 2013) could only be discussed in conjunction with July 2013 cases in the next Review Meeting, the Review Meeting to be held on 27 September 2013 is expected to take more time than usual.

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