' Doctors tell of fatigue errors '

TIRED doctors working long and erractic hours are putting patient safety at risk,
research has found. Four out of 10 doctors had made a fatigue-related medical
error over a six-month period, a Massey University study of 1366 junior doctors found.
Twice as many doctors scored as excessively sleepy on a standard test compared
with the general population; nearly half (42 per cent) reported having fallen asleep
at the wheel driving home from work and most said work patterns caused problems
in their personal life.

Lead researcher and director of the university's Sleep/ Wake Research Centre Philippa
Gander said the results were worrying. " The reported levels of sleepiness, fatigue
related clincial error, and problems outside work caused by work patterns are all of concern,
for the safety and wellbeing of doctors and patients."
Professor Gander said a high number of night hours or unstable work patterns made it more
difficult to plan proper sleep.
Resident Doctors Association spokeswoman Deborah Powell said a lot of work had already
been done to limit junior doctors' working hours but more improvement was needed.
" The way we are working at the moment is not acceptable. There are health and safety risks to
employees and risks to patients. District health boards can't ignore that. "
A reduction in hours and roster re-organisation would help, she said.
Two North Island health boards have been trialling alternative rosters that reduce
night shifts from seven to four consecutive shifts and limit doctors to a 10-day stint
without a break, instead of the current 12. Both have been successful and the union would
push to introduce them nationwide, Dr Powell said.
She did not believe more doctors would have to be trained to work the extra hours.
The gaps could be filled by retaining some of the 20-25 percent who took their skills
overseas.
District Health Boards New Zealand spokeswoman Margot Mains said Health Boards were
aware of the problem and had been working to find solutions. A resident medical officer working party was set up in January, with representatives from District Health Boards, senior and junior doctors. As well as reviewing the whole system, the group would look at a national role out of the alternative rosters, she said. The problem of junior doctor fatigue was not unique to New Zealand and significant progress had been made here compared with other countries, she said.
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Two lives lost and another ruined

On that day, 75km north of Mackay, Mr [David Fliedner], who had driven a truck for more than 20 consecutive hours, fell asleep at the wheel and crashed into the rear of another vehicle, killing British doctors Scott Wilson and Catriona Maher.

Mr Fliedner, who was employed by Harker Transport at the time, was sentenced to three years' jail, suspended after one year, on two counts of dangerous driving causing death......

© The Courier-Mail, Brisbane 18th March 2004.

"Driver in fatal crash asleep at the wheel"

Mark Joseph Williams, was killed instantly when he crashed his work van into the back of a stationary truck about 12.30am.

Mr Williams's girlfriend of 20 years, Betty Brown, said he had been a workaholic and that he had barely slept in the 24 hours leading up to the crash. The couple had been taking care of Ms Brown's six year old nephew, Mark, who saw Mr Williams as a father figure......

© The Courier-Mail, Brisbane 17th October 2003.

"Couple make lucky escape as runaway ute lands in bed"

Toowoomba couple Michael Marsham and Kay Talbot were asleep in their Panda St home about 5.45am when a Holden Commodore ute failed to stop at a T-intersection.

As the car continued to move forwards it bullbar punched through the wall of the adjoining room, pushing debris into the bedroom where a piece of falling timber is believed to have struck the couple's younger daughter Michelle, 5, on the head.
Ms Talbot has a broken leg and underwent surgery yesterday at Toowooomba Base Hospital. Mr Marsham was treated for neck and chest pains and burns to his arm.
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"Sleepless chef jailed for six years over road death"

Joel Leigh Johnstone had not slept for more than 24 hours but said that he "didn't feel out of it" when he left Crown Casino one summer's day in 2001.
An hour later, the 21 year-old apprentice chef fell asleep behind the wheel of his utility and knocked over a concrete light pole, killing one man and seriously injuring two others.

Johnstone, now 24, of Beaumaris, was jailed yesterday for six years and nine months, with a minimum of four years. He was disqualified from driving for four years.
"You ended a life and .altered forever the lives of a number of persons, including your own," Judge Tom Wodak said at the County Court.
On February 12, 2001, Johnstone was driving on the Nepean Highway with Patrick Merkus. He had smoked marijuana, and amphetamines were found in his blood.
At 1.15pm, Johnstone's car hit a light pole, became airborne and hit a station wagon travelling in the opposite way. The pole fell across the two cars as well as a third behind the station wagon. Jan Wilmink, a stationwagon passenger, died. His driver, Ashley Trebilcock, suffered life threatening injuries and Mr Merkus had a fractured vertebra and fractured ankle.
Johnstone pleaded guilty to culpable driving causing death, and two counts of negligently causing serious injury.
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