The experienced superior Yngve Müller Seljeseth will never forget the patient who came by ambulance to the hospital in Ålesund in 2019. The man had become seriously ill and needed help immediately. Legane manages to save him, but after a quarter he is shown a blow with serious consequences. In retrospect, the State Administrator concludes that the employees at the hospital have made several serious mistakes and that the man received unjustifiable help. The criticism is harsh on Seljeseth. He does not agree with the conclusion and thinks it is wrong and unfair. – The first nights I slept relatively little. Even almost a year after the conclusion was clear, the superior constantly wakes up at 5 o’clock in the morning. Right from the dream where he defends himself again and again. – I get weighted up with full stress activation. My pulse beats fast, and I can not calm down again. I keep coming back to that defensive battle, he says. It is the health trust that is formally dismissed, but as the chief physician in charge, Seljeseth knows it as a personal criticism. Yngve Müller Seljeseth struggles with night sleep after the investigation at Ålesund Hospital. He thinks the conclusion is wrong and unfair. Photo: Remi Sagen / NRK Critical of the investigators The state administrator believes that it took too long before the doctors made the correct diagnosis and gave the man the necessary treatment and medicine. They think he should have better monitoring, and that inadequate medical records and poor communication between the wards affected the patient. – They have presented a medical history that does not match what we experienced and then they have misinterpreted the guidelines and used guidelines that were not found when we treated the patient, claims Yngve Müller Seljeseth. He claims that the investigators at the State Administrator are characterized by hindsight and interpret the journal notes in the worst sense. Chief physician Yngve Müller Seljeseth has worked at the hospital in Ålesund for over 20 years. He says he spends less and less time with patients, and more and more on paperwork. Photo: Remi Sagen / NRK Receives support from experts Müller Seljeseth is himself one of those who has been involved in preparing the national guidelines for the treatment of stroke. He receives support from professor of stroke diseases, Bent Indredavik. He also thinks the conclusion about improper health care is wrong on several points. – I mean the professional basis on which the State Administrator in Møre og Romsdal is based, rests on a weak professional basis and partly misinterpretations, he writes. He believes that the deviation has not had significant therapeutic consequences for the patient. Professor of stroke diseases, Bent Indredavik, is critical of the conclusion from the State Administrator in Møre og Romsdal. The medical association calls for more experts The lack of power that the superior in Ålesund feels after a supervisory case is not unique. The medical association is critical of the current supervisory system. In a consultation statement, they write that several members think they are lawless and that the investigators do not have enough knowledge: – Our experience is that external experts are used far too rarely. The threshold should be lowered significantly. This could strengthen confidence in the assessments and the legitimacy of the audit, says President Anne-Karin Rime of the Norwegian Medical Association. – But are the doctors good enough to accept the criticism they receive? Doctors, like others, naturally think it is a burden to be examined and criticized for professional errors. When the criticism is right, our experience is that they take self-criticism and focus on learning from the case. But when the criticism is based on a weak or incorrect professional basis, the criticism will understandably be perceived as unfair, says Rime. The deputy leader of the Medical Association, Anne-Karin Rime, says several of the members feel out of place when they are examined. Photo: Thomas B Eckhoff / The Norwegian Medical Association Very few complaints There is usually little point in protesting when the investigators at the State Administrator or the Norwegian Board of Health Supervision have drawn their conclusion. The decision is final and only the most serious cases can be formally appealed. NRK has asked the ten state administrators how many doctors and nurses are still trying to appeal the decision. They have no exact numbers, but by all accounts there are very few. This wording is used in the letter that goes out to the health service after a case has been investigated. Photo: Screenshot County doctor Karin Müller Mikaelsen has the overall medical responsibility in supervisory cases with the State Administrator in Møre og Romsdal. She denies that they do not have good enough competence, and stands by the conclusion in the case. – In such cases, it is both health personnel, usually a doctor, and a lawyer who look at the cases. All caseworkers undergo training in supervisory work under the auspices of the Norwegian Board of Health Supervision. We assess in each individual case whether there is a need for an external expert, she says. County doctor Karin Müller Mikaelsen says all cases are assessed by both professionals with a health professional and legal background. Photo: Hans-Olav Landsverk / NRK Over the past year, the state administrator in Møre og Romsdal has had three complaints from health personnel who believe that the investigators do not have enough competence: Hoping for a change The morning routines have changed in Yngve Müller Seljeseth’s family over the past year. Father in the house gets up, makes coffee and reads newspapers when he can no longer sleep and struggles with the thoughts of powerlessness. The superior will in no way criticize the patient or the right to complain, but is critical of the system. He believes that the fear of making mistakes can lead to those who work in the health care system spending too much time on documentation and unnecessary and resource-intensive examinations. – I hope we can stop doing things for safety’s sake and concentrate on the patients and not fear for supervision, he says. Hi! Do you have any tips or suggestions on the case? Feel free to send me an email!
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Superior Yngve lost his night’s sleep when the investigators struck
