Tuesday 18 February 2014
mandatory requirement for the removal of donor organs is the brain death. On the strictly regimented diagnostic path but even seasoned doctors make mistakes. But contradiction is in the hospital hierarchy often difficult.
In German hospitals, people often mistakenly declared brain dead. The reports the “Süddeutsche Zeitung”, which refers to their present documents. Thus, it always comes back to issue death certificates without brain death has been diagnosed according to the provided guidelines. The main reason for this is that many doctors are inadequately trained for the correct determination of brain death.
In one case, have been taken in an infant organs for transplantation without brain death had been properly diagnosed. In eight other cases from the past three years, over which the SZ reported the errors were discovered just in time for the organ removal.
error of even supposed experts
is a prerequisite for the determination of brain death, that all circumstances are excluded, the only numb the brain – drugs, too low a body temperature, coma, or about poisoning. According SZ brain death has been determined but, although the patients had received strong painkillers in several cases. In another, the test was not performed correctly on respiratory arrest. The errors were not only made in small hospitals, but also at university hospitals and in specialist departments.
Brain death is the first condition for an organ donation. He is diagnosed each year in Germany at about 2000 people. For diagnosis, a substantial corpus of the German Medical Association applies. This means for example, that two qualified doctors “” consistent and independent “from each other need to determine brain death before the death certificate can be issued. As a qualification but suffice” several years of experience in the intensive treatment of patients with severe brain damage. “
That does not seem to be sufficient in practice. “The training of doctors has a strong quality deficit ‘, the SZ quotes the transplant surgeon Gundolf Gubernatis. The former managing physician of the German Stifung Organ Transplantation (DSO) emphasizes the importance of such a diagnosis: “Dead or not dead – no other finding in medicine but require so much precision.” Together with the neurologist Hermann German man from the northern city of Hanover Hospital calls Gubernatis for years a tested by the Medical Association additional qualification. Because German man was found already in 2004, as his colleagues often tell people mistakenly left for dead. In about 30 percent of cases in which German man was added called as second supervisor for brain death determination, he could not confirm the diagnosis of his colleagues.
hierarchy problems with specialists
of the Medical Association, however, one considers the quality of the brain death diagnosis for sufficient: this is “backed up and high,” write the chairmen of the three, hosted by the German Medical Association Control Commissions of the transplant system – the Examination Board, the Supervisory Commission and the Permanent Commission organ transplantation – in a joint statement. And Rainer Hess, CEO of the German Foundation for Organ Transplantation, said: Only in two cases it was also come in recent years by an irregular brain death determination to organ removal. Both times have been shown later that the donor had actually been brain dead for organ removal. In the other cases, the SZ present employee of the Foundation have just discovered the error in time for the removal of organs.
The DSO staff, however, are not responsible for the control of brain death diagnosis, as well as Hess admits. Even to the doctors in the hierarchy are much higher than the DSO staff. This therefore often do not dare to inform the physicians, their ignorance. “Many colleagues resist a correction., Take the wrong diagnosis easy and then pass an organ donation,” said an insider of the SZ. An earlier DSO staff member confirms this: “The courage to mess with the specialists, have the least.”