Culture of fear endangered patient safety at Amsterdam UMC: report

The anesthesiology department of the Amsterdam UMC has been under a reign of terror for 11 years, endangering patient safety, Follow the Money reports after speaking to employees. They said medical errors get covered up, and critical doctors are sent away with a gag order. The hospital board was aware of this for years but did not intervene, according to FTM.

One alleged cover-up revolved around a foreign woman rushed to the Amsterdam UMC for an emergency open-heart surgery on 29 June 2022. In a hurry, someone from the anesthesia team poured a bottle of disinfectant - chlorhexidine dissolved in alcohol - over her chest. Too much, but they were in a rush. The surgeon made the incision with a heated diathermic knife to cauterize blood vessels as he cut.

But the combination of a hot knife and an abundance of alcohol on her chest set the woman’s torso on fire. When the surgeon noticed the heat of the invisible alcohol flames and realized that the patient was on fire, the surgery staff quickly extinguished it, and the procedure continued. Afterward, the severely burned woman was taken to intensive care, where she died.

The incident was never reported to the Health Care and Youth Inspectorate, despite several hospital executives knowing about it, FTM’s sources said. They called it one of several cover-ups hidden behind patients’ poor chances of survival when they arrived at the hospital.

According to FTM, this cover-up culture developed under the leadership of Wolfgang Schlack, recruited from Dusseldorf to lead the department in 2006, and his second, Markus Hollmann. Schlack left the hospital last year. Employees described him as a harsh manager who left behind a department where many didn’t feel safe. Employees felt forced to cover up or not report problems and errors. In the best case, nothing would happen to a report; in the worst, they’d face retaliation.

They describe second-in-charge Hollmann as a man with regular outbursts of anger who repeatedly berated subordinates in public or even physically intimidated them. Anyone in Schalck and Hollmann’s bad books received no privileges, like non-patient days for research. Anyone who dared to criticize them faced difficult schedules, received no challenging surgeries, or was banished to the outpatient clinic. Colleagues over the age of 60, entitled to less demanding shifts according to the collective labor agreement, got pressured to work them anyway or face salary cuts.

FTM heard this from 26 sources within the anesthesiology department, supported by documents, emails, and messages spanning a period of 13 years. Almost none of the sources were immediately willing to talk to the journalists. About half were still working at the hospital when FTM spoke to them.

“All statements are presented anonymously because almost every source fears for their job - even those who have not worked at Amsterdam UMC for a long time,” FTM said. One employee worried that the FTM journalist was a spy for the hospital. “I was a little worried that you were hired by the hospital to secretly find out what dirty laundry we were sharing with the outside world,” he told FTM.

Schlack left the hospital last year. His farewell symposium on 29 June 2023 was filled with praise and applause. “Patient safety has actually been the common threat throughout your entire career,” said division head Margreeth Vroom, responsible for the ICU, operating rooms, and anesthesiology department. “Safety really comes first for you.”