The Hi-tech Hospital Mattress that Left this Man with Third-degree Burns

Equipment similar to an electric blanket overheated during surgery


Mike Wilcock suffered third-degree burns after a mattress designed to keep patients warm during surgery overheated

As a health-and-safety inspector, Mike Wilcock has a keen eye for detail and an appreciation for proper procedure.

But he had no reason to suspect anything untoward when he arrived at hospital for routine keyhole surgery two years ago.

'I wasn't unduly nervous - I'd been told it was just a minor procedure,' says Mike, 58.

However, when he came round from the op - to remove a benign cyst from his kidney - at Maidstone Hospital, Mike quickly realised something had gone very wrong during the two hours he was unconscious.

'I immediately noticed a burning pain in my backside. As the anaesthetic wore off the pain got worse. I reached under my hospital gown and could feel blistering and flesh came away in my hand. It felt like my bottom was on fire.'

Mike, from Tunbridge Wells, Kent, had suffered third-degree burns on his right hip and buttock, caused when a mattress designed to keep patients warm during surgery had overheated.

Such devices are commonly used to maintain patients' core body temperature during surgery.

A general anaesthetic reduces the body's ability to control its temperature - and if the patient gets too cold, it could affect blood's ability to clot, increasing the risk of bleeding. The quipment used in Mike's surgery works in a similar way to an electric blanket.

But what appears to have happened in Mike's case is that a heat sensor which should have monitored his temperature during the operation was placed on a cold saline bag rather than his body.

'Because it registered such a low temperature, the mattress kept heating to the point where it could cook flesh,' he explains.

The next 24 hours were a terrifying blur. 'That period is very tough for me to think about.

'The staff first noticed the injury when I complained of pain in the recovery room. Then all hell seemed to break loose with people rushing to look at my backside.

'But all I remember is being given is a bit of ice for the burn and some painkillers. Nothing made much difference to the terrible pain.

'It was only the next day that I was visited by a burns nurse.'

  Mike Wilcock suffered third-degree burns after a mattress designed to keep patients warm during surgery overheated   Mike Wilcock suffered third-degree burns after a mattress designed to keep patients warm during surgery overheated

A mattress designed to keep patients warm during surgery overheated leaving Mr Smith with a painful burn (pictured left).

Even two years later (pictured right) the burn is so painful Mr Smith has had to give up sailing

The following day he was admitted to a specialist burns hospital, where doctors said that the burnt area - around 8in by 6in (20cm by 15cm) - was of full thickness, meaning all three layers of skin were damaged.

Mike was there for a week, undergoing procedures to remove dead tissue and have an emergency skin graft. But during the skin graft he suffered a heart attack, thought to be down to a combination of three anaesthetics in quick succession, as well as the trauma he'd endured.

After Mike's injury, in September 2012, the incident was investigated by the Health and Safety Executive (HSE) - where, by coincidence, Mike is head of operations for the South East.

The HSE found the staff did not have sufficient training or information to ensure the mattress had been used correctly.

Last month, Maidstone and Tunbridge Wells NHS Trust pleaded guilty to a breach of the Health and Safety at Work Act - it is yet to be fined.

During the court case it emerged that two other patients had received minor burns in similar circumstances, months before Mike's ordeal. 'If the trust had learnt from these, they could have prevented what happened to me,' says Mike, who has launched his own legal action against the trust.

Mistakes in the use of medical devices - which cover a broad spectrum, from high-tech scanners to sticking plasters - cause much needless pain. Latest figures show that in 2013 there were 448 incidents relating to poor use of medical devices reported to the Medical and Healthcare Products Regulatory Agency.

Mike's was an extreme case although not a one-off, with seven severe burns from warming devices reported since January 2012.

Mr Wilcock underwent procedures to remove dead tissue and had to have an emergency skin graft. The injury site is pictured three weeks after the grafting

Other injuries caused by high-tech equipment include minor burns in MRI scanners. Staff are meant to ensure patients are not wearing any metal but in these cases, they were wearing nicotine patches, which can contain traces of aluminium.

And a patient was injured by an ultrasound probe after staff sterilised it too many times - after a certain number of cleans, the device should have been replaced.

A major problem is training, says Peter Walsh, chief executive of the charity Action Against Medical Accidents.

'Technology is constantly advancing and has a valuable and usually positive role to play.

But it does mean more risks are introduced, so the system has to be able to deal with that risk. The problems can be avoided with proper training.'

In Mike's case, the court heard that staff had failed to read the manual that came with the device, which was introduced to the trust in 2011.

Mr Walsh says another issue is that there is inconsistency across the NHS when it comes to makes and models of medical devices used. 'It makes it harder for staff to be familiar with how exactly how each device works,' he says.

Two years since his injury, Mike's life has changed dramatically. After the operation, he was unable to work for five months.

He is now back at work full time, but has to work two days a week from home and because sitting for long periods is uncomfortable, often has to stand in meetings.

Mike, a qualified sailing instructor, also had to give up his hobby of racing dinghies because crouching in boats is too painful.

The law firm representing him, Slater & Gordon, says his case is 'extremely worrying'. 'If this had been a much more vulnerable patient, we could have been looking at a significantly different case,' solicitor Laura Craig said.

A spokeswoman for Maidstone and Tunbridge Wells NHS Trust has confirmed that the type of device used on Mike is no longer used by the trust following the incident, but could not comment further while the case was still active.


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