Intended for healthcare professionals


Case of “dysfunctional” Dutch doctor exposes “culture of silence surrounding mistakes”

BMJ 2009; 339 doi: (Published 11 September 2009) Cite this as: BMJ 2009;339:b3720
  1. Tony Sheldon
  1. 1Utrecht

    A report into how a Dutch teaching hospital allowed a “dysfunctional” consultant neurologist to continue working unchecked for more than a decade has raised serious questions about the supervision of hospital consultants in the Netherlands.

    The report, And Where was the Patient . . . ? followed an external investigation into neurologist Ernst Jansen Steur, who worked at the Medisch Spectrum Twente in Enschede between 1992 and 2003.

    Investigators led by Wolter Lemstra, former chairman of the Dutch Hospitals Association, concluded that Dr Jansen harmed patients through misdiagnoses and incorrect prescribing.

    Although alerted to errors by other hospital staff in 1998, the hospital’s management board failed to act. The report concludes, “The …

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