Two nurses were recently cleared of wilfully neglecting patients in a specialist stroke unit; they had risked going to prison. The problem these two innocent nurses experienced could have happened to anyone in any hospital.
The hospital’s computerised blood glucometer records differed from what the nurses had written in the records. It was therefore alleged the two nurses had falsified patient records.
Once the police start exploring the vast amount of electronic records in a hospital, it is almost inevitable they will find problems. It just takes one complaint to start the process, and staff suspensions and arrests then follow with horrible predictability. It took three years of police work to bring this case to trial, and there was a vast amount of evidence, both paper and electronic.
The prosecution believed the computer records were a true and complete record.
The defence argued that the electronic data’s integrity and provenance was not reliable; in fact the data had been manipulated. Because there was no auditing in the data trail, showing the data was unreliable was a complex technical process.
The pre-trial review consisted of two weeks of cross-examination of the expert witness and others in order to work through the reliability of the evidence.
In his ruling the judge said that presenting unreliable evidence to the jury would be misleading, and he therefore excluded it. The trial proper then started with the jury present, but the prosecution was unable to submit any evidence. The case collapsed, and the judge directed the jury to deliver a not guilty verdict. The nurses were set free.
There are important lessons for all of us:
- If you or a colleague are caught up in an incident, don’t automatically assume that computer data is reliable. Check any legal advice you is based on an accurate understanding of computers!
- If one hospital’s IT system cannot produce data that can stand up in court, are your hospital IT systems reliable and adequate enough for clinical use?
- This incident arose around one simple device in an ordinary hospital. What might happen where you are?
- How will anyone be able to know when there are problems like this when we have gone paperless and have no paper to fall back on?
Prof Harold Thimbleby HonFRCP, Expert Advisor on IT to the RCP, was the expert witness in this case.