10 July 2011

UK DAILY MAIL: NURSE ERROR causes Lung transplant mistake.

Lung transplant patient dies after 'height error' sees surgeons force oversized organ into her chest

By Martin Delgado And Jo Macfarlane
Last updated at 10:03 PM on 9th July 2011

A lung transplant patient died after medical staff made a mistake in recording the height of the donor – and then failed to report the matter to the coroner.
A specialist nurse fed the wrong figure into the NHS transplant service’s computer system, leading surgeons to force an organ which was too big for the patient into her chest.

The exterior of the Harefield Hospital in west London where a woman died following a mistake by medical staff over a lung transplant

The mistake happened at Harefield Hospital in West London, where a similar incident in 2007 was followed by a two-year period in which managers took no action to suspend the consultant involved.
During that time the consultant bungled a heart bypass on an elderly man who bled to death and then lied to the patient’s family.
After the latest mistake, transplant service officials were told the death had been referred to the coroner but that he had decided not to hold an inquest.
They were also assured the woman’s family had refused permission for a post-mortem examination.
But it later turned out the coroner had not been informed, although he should have been as an inquiry concluded the death was caused by human error.
The woman, who was suffering from advanced bronchial disease, underwent a double lung transplant at Harefield last October. She was 151cm tall and the donor’s height was recorded electronically as 156cm.
The information was stored on the Electronic Offering System – the computerised organ-matching service run by the NHS Blood and Transplant Service (NHSBT).
The right lung was transplanted successfully but the left one had to be compressed to make it fit. And when a member of the transplant team checked the measurements later, it was discovered that the donor had actually been 165cm tall. After initially making progress, the woman developed pneumonia and died two months later.

Surgeons performing a heart transplant operation at the Harefield Hospital

NHSBT, which investigated the incident, said in a report: ‘The transplant surgeon considers that the size of the lungs was a significant contributory factor in the patient’s death.’
A doctor who has also served as a coroner told The Mail on Sunday: ‘It is usual for operation-related deaths to be referred to the coroner. But health care professionals are under no professional or legal obligation to do so.’
Katherine Murphy, chief executive of the Patients Association, said: ‘This must have been a terrible experience for the family.
'When attempts are made to cover up serious incidents like this, public and patient trust hits rock bottom.’

Hamzah Butt aged 16 from Sudbury,an active sportsman who underwent a heart transplant as a 10 day old baby at the Harefield Hospital, north west London. Hamzah is seen here at Harefield hospital Aged three.

Harefield Hospital would not comment on the case.
Anthony Clarkson, assistant director of organ donation at NHSBT, said the service had offered its sincere condolences to the woman’s family.
New checking systems have been introduced and heights are now recorded in both metric and imperial measures.
Neither the surgeon nor the patient in the most recent case has been identified.

06 July 2011

3M/LITTMANN ELECTRONIC STETHOSCOPE with ZARGIS CARDIOSCAN.

3M/Littmann Electronic Stethoscope Model 3200 With Zargis Cardioscan

The scope that never misses a beat

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3M Health Care Littmann Electronic Stethoscope Dan Saelinger

Video: The Bluetooth-Enabled Cardioscan Stethoscope

The stethoscope is older than the x-ray, the ballpoint pen, Popular Science and pretty much everything else in your doctor’s office. Now, 190 years after its invention, the go-to diagnostic tool hanging around every doc’s neck has earned a modern makeover. The sound-amplifying 3M Littmann Electronic Stethoscope 3200 listens to a patient’s heartbeat—lub-DUB, lub-DUB—and beams the beats to Cardioscan software that detects abnormalities.
Even top physicians have trouble discerning the swishing sounds that result from irregular surges of blood after the lub from the ones that follow the DUB. Called murmurs, the former are harmless, but the latter can indicate ailments such as congenital heart defects, holes in the heart wall, and constricted or leaky heart valves that interrupt blood flow. If the heartbeat sounds remotely atypical, many doctors prescribe a conclusive, and expensive, echocardiogram test.
3M’s stethoscope eliminates that guesswork. It transmits heart sounds to a doctor’s PC by Bluetooth, and Cardioscan renders a near real-time graphical representation of the sounds onscreen. The software then analyzes the sound waves and highlights minute abnormalities that signal harmful murmurs. The doctor can play the sound back at half speed to diagnose a problem more confidently, save the file to the patient’s chart, and e-mail it all to a cardiologist to confirm the diagnosis. Early tests of the system suggest that it could eliminate more than eight million unnecessary echocardiograms and cardiologist visits a year, saving some $9.4 billion and, even better, catch more of the dangerous murmurs. For doctors, and anyone with a heart, this stethoscope’s upgrades are well worth the two-century-long wait.
From $765; littmann.com, zargis.com

Australia:Gnathostomiasis

The SUN:UK from Australian Medical Journal

Pair eaten by worms

Deadly ... gnathostomiasis larvae

The 52-year-old man and his wife, 50, became infected after eating fish carrying potentially deadly gnathostomiasis larvae.
They had pan-fried the meal over a campfire, but the 1mm to 3mm worms survived near Derby, Western Australia.
The larvae can travel into the brain, other organs and spinal cord.
The horror marked the first time humans had been infected by the parasite in Australia, the country's Medical Journal said.
The couple survived.

05 July 2011

UK GPs' Real Estate equity as retirement fund.

Health News Daily Teleegraph

The NHS paid GPs £630m in rent for their privately-owned surgeries last year Photo: ALAMY

By Heidi Blake, Holly Watt and Emma Slater

6:00AM BST 04 Jul 2011

88 Comments

Doctors are permitted to buy buildings for their surgeries which are then “rented” back to the Department of Health, often for far more than the mortgage repayments. The surgery is then sold off – either to another doctor or a developer – when the GP retires and they are allowed to keep the profits from the sale of the building.

An investigation by this newspaper and the Bureau of Investigative Journalism has uncovered details of the secretive scheme, which currently costs the Government more than £630m each year.

GPs have boasted that they have made six or even seven figure windfalls from the system – the costs of which have soared by more than 70 percent in just six years.

The terms of the arrangement are even more generous than the controversial system which allowed MPs to profit from the sale of taxpayer-funded properties.

A typical surgery may have been bought for £150,000 a decade ago. The GP then could then claim tens of thousands of pounds in “notional rent” annually which is used to clear the mortgage. They could then sell the property today for more than £500,000, and often substantially more, and keep the profit.

The disclosure is set to lead to renewed public concern over the taxpayer-funded largesse enjoyed by some GPs, amid reports that the best-paid doctors can earn far more than the Prime Minister.
Last week doctors still voted to consider striking in a row over pensions – which would be the first industrial action for more than 30 years.
The Department of Health is the only major Government department to be protected from spending cuts, although many experts believe there is a significant potential for cost savings to be made. Under reform plans, GPs are to be given even more control over health budgets.
The NHS paid GPs £630m in rent for their privately-owned surgeries last year, an increase of 70 per cent since 2004, when the figure stood at £370m.
The total cost to the Department of Health in the past five years has been £2.5bn.
Around 86 per cent of GP premises are either owned by doctors or by private companies and are paid for through the “notional rent” scheme.
The British Medical Association actively encourages its members to buy their own surgeries and promises that the investment will yield “real capital gains”.
James Wharton, a Conservative member of the Commons Public Accounts committee, accused GPs of "fiddling the system" and said he would ask the National Audit Office to open a "full and comprehensive investigation" into surgery funding.
"People are obviously going to be extremely concerned to see that taxpayers' money is being used in this way. For too long these people have profited too easily and the expense of the taxpayer and the government should look at this system and see whether it can be changed to ensure better value for money," he said.
"I will be writing to Margaret Hodge, the chair of the Public Accounts Committee, to request that she asks the National Audit Office for a full and comprehensive investigation into this system."
A Department of Health spokesperson said: "This system incentivises GPs to expand and improve services so that people have proper access to modern facilities. It represents the cost to GPs of renting or owning the premises, and is a cost that would met by government direct if GPs did not."

04 July 2011

UK DAILY MAIL: ABORTIONS on DEMAND.

More than 1,000 girls under 15 every year are having abortions

By Sophie Borland and Tom Kelly
Last updated at 12:16 AM on 5th July 201

Shocking: Nearly 4,000 girls under 16 have abortions every year (picture posed by model)

More than a thousand girls a year aged under 15 have an abortion, figures revealed.

Terminations are being carried out on youngsters aged just 12 or 13 who have only just started secondary school.

And every year nearly 4,000 procedures are undertaken on girls who have not yet reached their 16th birthday, the legal age of consent.

Campaigners warned that the alarming figures, revealed by the Department of Health, were representative of a society where abortion was ‘on demand’ – even for very young girls who legally should not be having sex.

The official statistics show that since 2002 more than 35,262 abortions were carried out on girls under the age of 16.

Last year 3,718 procedures were carried out on girls aged 15 or under – including 1,042 on girls aged 14 or younger. Of these girls, 134 were just 13 and two just 12 years old. For the first time the figures show the exact numbers of abortions carried out on girls in each age group under 16.

In the past the Department of Health has only published figures for the under-14s as a whole and the under-16s, never with a breakdown per year.

More...

Revealed: The thousands of pregnancies aborted for 'abnormalities' including cleft palates and Down's

The figures show that previously abortions have been carried out on girls aged 11 who may not even have started secondary school. Since 2002 three such terminations were performed, although there were none last year.

Many of these girls will have only just entered puberty and started their periods. The average age of menstruation when a girl begins producing eggs is 12 or 13.

Enlarge

Campaigners said the figures were extremely worrying, particularly as a termination could be very upsetting for the youngsters. Many may have been cajoled into sexual activity by older boys unaware of the consequences of their actions.

Norman Wells, director of the Family Education Trust charity, said: ‘Every abortion involves a personal tragedy for a mother and a child, and none more so than where the mother herself is a child.

‘But these figures are just the tip of the iceberg. For every child who has had an abortion under the age of 16, there will be many more who are engaging in illegal sexual activity and suffering physical and emotional harm as a result.’

Damage: Experts have warned that having abortions at a very young age could leave mental scars

Mr Wells pointed to research showing it was not ignorance of contraception that leads to high rates of teenage abortions, and said instead the ‘contraceptive culture’ was to blame.
‘Those who imagine the answer lies in more sex education and more contraceptive schemes are sadly mistaken,’ he said. ‘As a result of the contraceptive culture we have tended to separate sexual activity from childbearing in our minds. There is always the possibility intimacy will result in the creation of a new life – that is not something to be done lightly.’

The Rev Joanna Jepson, who campaigned against terminations for minor deformities, warned abortions were being offered without any concern for the gravity of the procedure. She said: ‘The figures for underage girls suggests we have to have a debate about the kind of society we’re creating that leads to so many abortions on demand.

‘One side want to advertise abortion as a “breeze in, breeze out in your lunch hour”, as if it doesn’t have any psychological or physical consequences.’

Revealed: The Pregnancies ended because of minor deformities

Court battle: The Rev Joanna Jepson is challenging the legality of the abortion of a baby with a cleft palate

Babies are routinely being aborted because they have minor deformities including cleft palates or a club foot.
For the first time, the Government has been forced to release information on the number of terminations carried out on foetuses known to have physical disabilities or illnesses.
These include relatively minor deformities as well as serious conditions that would impair the quality of life of the unborn child.
The figures show that between 2002 and 2010, 45 babies were aborted because they had a cleft palate, club foot or extra finger or toe – minor deformities which can easily be corrected with surgery.
Over the same period, 3,968 pregnancies were terminated because the foetus was found to have Down’s syndrome.
The Department of Health was forced to release the figures after a High Court ruling following a long battle with campaigners.
Figures on the numbers of abortions carried out for minor deformities and serious life-threatening illnesses have been kept secret since 2003 following a public outcry over a baby terminated at 28 weeks because it was found to have a cleft palate. The case prompted a Church of England curate, the Rev Joanna Jepson, to go to the High Court to challenge the legality of the abortion.
Miss Jepson, who was born with a jaw deformation that was corrected with surgery, said the case represented an example of the ‘culture of physical perfection’.
At the time she said the doctor responsible should be prosecuted although the Crown Prosecution Service eventually dropped charges in 2005.
The department had refused to release the figures on the grounds that the numbers were so small that if they were made public the doctors who carried out the terminations could be identified and targeted by anti-abortion campaigners.
But the ProLife Alliance pressure group campaigned for their release and in April the High Court ruled that they should be made public. Yesterday the figures were made available on the department’s website.
Miss Jepson, 34, who is now a chaplain to the London College of Fashion, said: ‘It’s unacceptable that the Department of Health has derailed this debate by withholding the statistics and stifling accountability.’

BMJ: London Gt.Ormond St Childrens' Hosp Cardiology Head J.Philipp BONHOEFFER

ISHAC - Phillip Bonhoeffer, MD, FSCAI Bio

Philipp Bonhoeffer, MD, FSCAI grew up in Germany, trained in medicine in Milan, Italy and specialized in Cardiology in Pavia. In 1996 he became the Director of the Catheterisation Laboratory at the Necker Hospital in Paris, France. In 2001 he moved to Great Ormond Street Hospital in London where he later became the Head of Cardiology and Professor of Cardiology at the Institue of Child Health at University College of London. Early in his career Dr. Bonhoeffer showed interest in the strategic organisation of cardiology in developing countires, specifically in East Africa, where his interest in cardiovascular research led to the design of a cost effective catheter for the treatment of mitral stenosis (Multi-Track System). In 1999 he began a research program with the aim of replacing the pulmonary valve without open heart surgery. He performed the world's first human trans-catheter heart valve implantation in France in September 2000. In 2004 he founded, with Carlo Ruiz, the Transcatheter Valve Symposium which joined EuroPCR in 2007. In 2003 he was the winner of the ETHICA award shared with Prof. Alain Cribier. He was awarded the Grand Scientific Prize of Lefoulon-Delalande de L'Institute de France which was shared with Prof. Francis Fontan in 2006. Dr. Bonhoeffer is also an accomplished concert musician (VIOLIN) who has played to audiences worldwide.

GMC suspended Dr.Bonhoeffer on HEARSAY of sexual activity in KENYA where he performed charity work.

GMC decision Appealed to High Court by Temple Barrister Keiran COONAN Q.C.. http://www.1cor.com/ Free webinars.

(Prof.Bonhoeffer is the Grand-Nephew of Nazi executed Pastor Dietrich Bonhoeffer)

Kieran Coonan practices in three principal areas of law. He acts for both Claimants and Defendants in clinical negligence matters. He represents doctors and dentists in professional disciplinary proceedings before the Fitness to Practice Panels of the General Medical Council and the General Dental Council. He undertakes the defence of those doctors and dentists and other professionals charged with criminal offences arising out of their professional activities.

These areas of practice have led to appearances in the Crown Court; Administrative Court; Court of Appeal; the Privy Council and the House of Lords.

He has acted as Chairman in two notable public inquiries into the provision of mental health care by the NHS, Police and Prison Services.

kieran.coonan@1cor.com

He is listed as a leader in the fields of clinical negligence and professional discipline and is described by Chambers (2008) as an "incredibly able and versatile tactician"; by Chambers (2007) as an "absolutely devastating advocate"; "polished and experienced"; and by Chambers (2006) as "one of the finest advocates of his time" and a "well prepared skilful lawyer with charm and exceptional judgment". The Legal 500 (2007) described him as "a truly great tactician".

Children's doctor Philipp Bonhoeffer wins hearsay evidence case

Philipp Bonhoeffer worked at Great Ormond Street Children's Hospital until 2009

A paediatric cardiologist has won his High Court bid to prevent hearsay evidence being used in disciplinary proceedings over child abuse claims.

Prof Philipp Bonhoeffer, of Camden, north London, denies allegations of sexually abusing children in Kenya.
The General Medical Council referred his case to a fitness to practise panel, which decided to consider hearsay evidence from a Kenyan man.
The court has quashed the panel's decision to admit the hearsay evidence.
Lord Justice Laws and Mr Justice Stadlen declared the panel's conclusion that it was fair to admit the hearsay evidence was "irrational".
The judges added that it breached the former Great Ormond Street Hospital doctor's rights to a fair hearing.
In the ruling Mr Justice Stadlen said: "The more serious the allegation, the greater the importance of ensuring that the accused doctor is afforded fair and proper procedural safeguards. There is no public interest in a wrong result.
"For these reasons in my judgment the (panel's) conclusion that it was fair to admit the hearsay evidence of Witness A and its decision to admit it was irrational and constituted a breach of the claimant's Article 6(1) right to a fair hearing and cannot stand. The decision must accordingly be quashed."
'Single source'
Following the decision, GMC chief executive Niall Dickson said: "We will need to study the judgment carefully, but it is important to note that the judicial review was on a narrow point of law about the admissibility of some of the evidence.
"The GMC case remains open."
He said the cardiologist "continues to be suspended from the medical register under an interim order".

03 July 2011

BMJ: UK MDs frightened to examine patients because of possible complaints.

See BMJ.