Caught on camera: CCTV set to be placed in operating theatres to identify cases of surgical negligence

Posted: 03/09/2021

Sky News has recently reported that South Korea is to require CCTV cameras in operating theatres. The proposal has been voted on and approved by its parliament this week, meaning that South Korea will be the first developed country in the world to legally require filming of surgical procedures.

Why is this considered necessary? According to Sky News, pressure has been building in South Korea for operations to be filmed to ensure that the procedure is undertaken by a qualified surgeon. This follows the tragic case of a young man who died after undergoing cosmetic surgery, part of which was performed by an unqualified nurse rather than the plastic surgeon. In his case, the surgery had been filmed and his family were able to demonstrate what happened. Campaigners argue that the requirement for video footage in all surgeries will make it easier for future patients to establish that something has gone wrong.

Recording of surgeries can demonstrate how the procedure was undertaken, as well as by whom, and therefore may help to establish whether errors were made during the operation. Filming can also be valuable for the healthcare professionals themselves, as part of their teaching, training and assessment. If the surgery was undertaken correctly, it is of benefit to the surgical team to be able to reassure a concerned patient by demonstrating this, and therefore reduce the chance of a complaint being pursued.

In the UK, surgery is not usually filmed but it can be, if the patient has consented. Some procedures, such as laparoscopies, require images to be created as part of the patient’s treatment, whereas other surgeries may be filmed for secondary purposes, such as teaching and learning. Healthcare professionals are advised to discuss this with the patient beforehand and should be able to answer any questions or concerns the patient has about the recording.

Opponents of the new law in South Korea have criticised it as showing a lack of trust in the medical profession. There are also significant limitations to what video footage can demonstrate. CCTV in an operating theatre may not be able to record the fine details of the procedure that is undertaken, for example. Even if the surgery itself is recorded in close up, the footage may be open to interpretation, and it cannot necessarily answer questions about whether the procedure was necessary in the first place, how the patient was advised and consented to the surgery, whether appropriate investigations and tests were done both before and after the surgery, and how the patient was cared for afterwards. Therefore, even if surgery is filmed, this does not necessarily mean that it will be clear cut as to whether there were any errors in the patient’s care.

Victoria Johnson, an associate in Penningtons Manches Cooper’s clinical negligence team, said: “Firstly, it is important to remember that surgical errors are very rare. On the sad occasions when something does go wrong, and a patient comes to us to investigate what happened and to see if they can make a claim, there is seldom video footage of the operation itself. If there is, that could be helpful to us and we would certainly ask for a copy of the recording, but we are usually able to instruct medical experts who can consider patients’ written medical records and make assessments of the standard of surgery based on these.

“It is also important for patients to know that it is not just the performance of the surgery that is relevant. We also may want to consider and investigate whether the surgery itself was necessary and appropriate, if the patient was properly advised beforehand and gave their informed consent to the procedure, and whether they were given all the appropriate aftercare. Surgery is just one part of a much wider picture of the care provided.”

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