- A 6-year-old Auckland boy died following complications from a routine tonsil operation last week
- The operation took place at a Southern Cross hospital, which is assisting Health New Zealand with an investigation.
- A leading surgeon says bleeding is a common complication but fatal haemorrhages were highly unusual.
A death after a routine tonsil operation is extremely rare but not unheard of in New Zealand, a leading surgeon said after the sudden death of a young boy in Auckland.
The Herald reported yesterday that a 6-year-boy died following complications from a tonsillectomy at a Southern Cross hospital last week.
After being discharged home, the boy had complained of a sore throat, vomited blood and then collapsed before being rushed to Starship children’s hospital.
He died surrounding by family when life support was switched off on Monday.
“This is a very sad case, and my heart goes out to the family of this little boy,” said Dr Julian White, president of the New Zealand Society of Otolaryngology - Head and Neck Surgery and a representative for the Royal Australasian College of Surgeons.
“Unfortunately, nothing anyone can say will bring him back. It’s nothing short of a tragedy. I hope they are getting all the support they need.”
Clinicians the Herald spoke to also said the fatal case would be “devastating” for the surgeon and staff involved.
White said a tonsillectomy was one of the most common of all surgical operations and thousands were performed every year in New Zealand.
Bleeding was the main complication after such a procedure, and the risk of it occurring was between 1-to-5%. It could occur up to three weeks after the patient left hospital and in most cases it was relatively minor and settled with medical treatment and observation.
In more severe cases, a patient’s fluid volume could be replaced - in some cases this would include blood transfusion - and the patient had further surgery.
White said complications resulting in death were extremely rare.
Publicly-available coronial records in New Zealand showed just one case of a person dying following a tonsillectomy, in 2008, though the coroner said that the cause was a heart issue which may not have been related to the operation.
Dr Julian White said thousands of tonsil surgeries were done every year in New Zealand and the risk of bleeding was roughly 1 to 5%. Most of those cases were relatively mild, he said.
Several investigations are now under way into the 6-year-old boy’s death, and New Zealand Police are investigating on behalf of the coroner.
Starship guidelines say the main problems that can arise from the procedure are obstruction of the airway and shock from blood loss.
The guidelines say that bleeding may be difficult to notice in younger people because children often swallow blood rather than spit it out.
Vomiting or nausea is common after a tonsillectomy, and this can contain some old blood. But patients and parents should watch for fresh bleeding or any bleeding which occurs after hospital discharge.
Parents or patients who might be rattled by this week’s case should know that a tonsillectomy was a very common procedure which could greatly improve patients’ quality of life, he said.
“Sadly, complications such as this tragic outcome can and do occur, despite the best of care. Fortunately, a complication of this magnitude is very rare. All surgical complications are discussed with colleagues to see if there is anything which can be learnt from an adverse outcome, as we constantly try to improve safety.
“Patients and whānau need to be aware of the risks of surgery, as well as alternatives to surgery, although tonsillectomy will still often be the best course of action.”
Health New Zealand group director of operations at Auckland City Hospital, Mike Shepherd, confirmed an investigation was under way into the child’s death.
“We extend our deepest sympathies and heartfelt condolences to this family for the loss of their child.”
Southern Cross Healthcare chief medical officer Dr Erica Whineray Kelly said the organisation was “devastated” that a patient had died following surgery at one of its hospitals and it was supporting Health NZ’s review.
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