PIG Meeting: 1st July 2021
37-year-old lady for elective repair of an epigastric hernia
- Significant mental health history with multiple inpatient admissions – voluntary and involuntary
- Polysubstance abuse
- Multiple previous hernia repairs
- On day of surgery, patient thought she was being admitted for a caesarean section
- Support person confirmed this, and alleged patient had been using amphetamines recently
- Procedural anaesthetist reviewed patient who reiterated she was pregnant, and it was her due date.
- Patient thought that the investigations for the hernia were for obstetric purposes
- Beta-HCG negative
- Postponed in conjunction with surgical team
- Psych liaison contacted and recommended admission, but patient absconded post review
- Outpatient welfare visit and psychiatry follow-up organised by Psych-Liaison nurse
Could the acute Psychiatric deterioration have been identified preoperatively?
- Unlikely, may have been very acute. Alleged recent excessive amphetamine use.
- Difficult via phone consult
Management of Patient
- Appropriate care provided to patient
- Unable to consent at time of elective procedure
- Psych Liaison services available at JHH and very helpful with this case