Loss of sight in right eye: Misdiagnosis of illness

What happened
A crew member on an ocean-going cargo vessel lost the sight in his right eye. He was self-medicating what he thought was a common cold for 4-5 days before he sought help from the Master. The Master initially continued to treat what he also believed to be a common cold.

The crewman had a liver infection which, due to some deficiency in his immune system, quickly spread and affected his right eye. It became apparent that the crewman had a more serious condition affecting his eyes, particularly his right eye. Medical advice was sought on the radio, and that advice was to administer antibiotics (Septrin) and paracetamol for fever while on board. He was later referred to hospital when the vessel reached port, for further treatment.

What went wrong/causes

• The immediate cause was found to be that the crewman did not report to the Master earlier or seek immediate medical attention;
• A causal factor was that the Master assumed that the diagnosis was not critical – that it was a common cold;
• The root cause was found to be ‘Inadequate Compliance/Tolerable risk – Self-medicating for common cold’.

Lessons learnt/actions taken

• Crew encouraged to report diagnosis and seek immediate attention for any medical treatment;
• Private medication held by vessel crew to be registered with shipboard management and reason for its use to be known to the Master.

Members may wish to review the following incident:

• Dangers of medicine abuse

Members may wish to refer to IMCA SEL 033 – Guidance on occupational health