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Sam

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  1. Sam
    Documents released in an Ohio court case last month, in a landmark, multi-district opioid lawsuit, gave new insight into an unparalleled opioid epidemic in the United States. It revealed that between 2006 and 2012, some 76 billion opioid pills were distributed in the United States — more than 200 pills for every man, woman and child.
    It paints a damning picture of the tension between drug company profits and patient safety during the time opioid sales were climbing dramatically. In one 2009 exchange, a pharmaceutical company representative emailed a colleague at another company to alert him to a pill shipment. “Keep ’em comin’!” was the response. “Flyin’ out of there. It’s like people are addicted to these things or something. Oh, wait, people are.”
    According to Charles L. Bennett et al. in an editorial published in the Los Angeles Times, the failings are at every point in the system, starting with drug approvals. But the authors believe there is a particularly serious problem with the mechanisms for identifying, monitoring and disseminating information about issues with a drug after its release.
    They suggest a good starting point for reforming the system would be increased transparency about drugs already recognised as particularly dangerous. These drugs, currently numbering about 70 (including opioids), carry the FDA’s so-called 'black box warning,' intended to alert patients and their doctors to the high risks associated with the drugs. But that is not enough. The authors propose a 'black box' database or 'registry,' publicly available and simple to use, that would contain extensive information about where, by whom and for what purpose black box drugs are prescribed, as well as where and in what quantities such drugs are being distributed and sold. Information about adverse side effects, culled from the myriad of government databases that now collect them, would also be consolidated in an open form and format.
    Read full story
    Source: Los Angeles Times, 8 August 2019
  2. Sam
    After two decades of keeping the public in the dark about millions of medical device malfunctions and injuries, the US Food and Drug Administration (FDA) has published the once hidden database online, revealing 5.7 million incidents publicly for the first time.
    The newfound transparency follows a Kaiser Health News investigation that revealed device manufacturers, for the past two decades, had been sending reports of injuries or malfunctions to the little-known database, bypassing the public FDA database that’s pored over by doctors, researchers and patients. Millions of reports, related to everything from breast implants to surgical staplers, were sent to the agency as “alternative summary” reports instead.
    Read full story
    Source: Kaiser Health News, June 27 2019
  3. Sam
    A nurse who was threatened by colleagues for speaking out about care failings at Mid Staffordshire Foundation Trust has said bullying remains a “real problem” in the NHS.
    Helene Donnelly has told MPs that more than 10 years on from the scandal – commonly known as Mid Staffs – she was still seeing “echoes” of what she experienced happening across the country.
    “Although it is in the minority, as we saw at Mid Staffs the results can be absolutely catastrophic”
    She called for the development of a national body to improve workplace cultures in the NHS and “stamp out bullying once and for all”.
    The inquiry into poor standards of care and deaths at Mid Staffordshire indentified issues around staff behaviour, inadequate staffing levels and skills, and lack of effective leadership and support.
    Ms Donnelly told a Health and Social Care Committee hearing today that there were “real negative behaviours” at the trust that created a “real bullying culture of fear and intimidation”.
    “There was not a culture that encouraged and enabled staff to speak up and if they did as I did, we were bullied and threatened,” said Ms Donnelly, who now holds the roles of ambassador for cultural change and lead Freedom to Speak Up Guardian at the organisation where she works.
    Read full story (paywalled)
    Source: The Nursing Times
  4. Sam
    Countries must set ambitious national climate commitments if they are to sustain a healthy and green recovery from the COVID-19 pandemic.
    The WHO COP26 Special Report on Climate Change and Health, spells out the global health community’s prescription for climate action based on a growing body of research that establishes the many and inseparable links between climate and health.
    “The COVID-19 pandemic has shone a light on the intimate and delicate links between humans, animals and our environment,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “The same unsustainable choices that are killing our planet are killing people. WHO calls on all countries to commit to decisive action at COP26 to limit global warming to 1.5°C – not just because it’s the right thing to do, but because it’s in our own interests. WHO’s new report highlights 10 priorities for safeguarding the health of people and the planet that sustains us.”
    The WHO report was launched at the same time as an open letter, signed by over two thirds of the global health workforce - 300 organisations representing at least 45 million doctors and health professionals worldwide, calling for national leaders and COP26 country delegations to step up climate action.
    “Wherever we deliver care, in our hospitals, clinics and communities around the world, we are already responding to the health harms caused by climate change,” the letter from health professionals reads. “We call on the leaders of every country and their representatives at COP26 to avert the impending health catastrophe by limiting global warming to 1.5°C, and to make human health and equity central to all climate change mitigation and adaptation actions.”
    Read full story
    Source: World Health Organization, 11 October 2021
  5. Sam
    Four carers who were convicted of abusing patients at a secure hospital have been given suspended sentences.
    An undercover BBC Panorama investigation showed patients being mocked by staff at Whorlton Hall in County Durham between 2018 and 2019.
    The four former staff, who are all men, were sentenced on Friday after being convicted by a jury last year.
    Judge Chris Smith said Whorlton Hall was an "unpredictable and inherently frightening place to live".
    The specialist hospital for people with complex needs was privately run by Cygnet, but funded by the NHS.
    It has since closed.
    Judge Smith said Whorlton Hall had a "malign culture" and was an "unpredictable and inherently frightening place to live."
    He added: "Each of you failed those patients and their families. It was a fundamental breach of trust."
    Read full story
    Source: BBC New, 20 January 2024
  6. Sam
    When 60-year-old Milind Ketkar returned home after spending nearly a month in hospital battling COVID-19, he thought the worst was over.
    People had to carry him to his third-floor flat as his building didn't have a lift. He spent the next few days feeling constantly breathless and weak. When he didn't start to feel better, he contacted Dr Lancelot Pinto at Mumbai's PD Hinduja hospital, where he had been treated.
    Dr Pinto told him inflammation in the lungs, caused by Covid-19, had given him deep vein thrombosis - it occurs when blood clots form in the body and it often happens in the legs.
    Fragments can break off and move up the body into the lungs, blocking blood vessels and, said Dr Pinto, this can be life-threatening if not diagnosed and treated in time.
    Mr Ketkar spent the next month confined to his flat, taking tablets for his condition. "I was not able to move much. My legs constantly hurt and I struggled to do even daily chores. It was a nightmare," he says.
    He is still on medication, but he says he is on the road to recovery.
    Mr Ketkar is not alone in this - tens of thousands of people have been reporting post-Covid health complications from across the world. Thrombosis is common - it has been found in 30% of seriously ill coronavirus patients, according to experts. These problems have been generally described as "long Covid" or "long-haul Covid".
    Awareness around post-Covid care is crucial, but its not the focus in India because the country is still struggling to control the spread of the virus. It has the world's second-highest caseload and has been averaging 90,000 cases daily in recent weeks.
    Dr Natalie Lambert, research professor of medicine at Indiana University in the US, was one of the early voices to warn against post-Covid complications.
    She surveyed thousands of people on social media and noticed that an alarmingly high number of them were complaining about post-Covid complications such as extreme fatigue, breathlessness and even hair loss.
    The Centre for Disease Control (CDC) in the US reported its own survey results a few weeks later and acknowledged that at least 35% of those surveyed had not returned to their usual state of health.
    Post-Covid complications are more common among those who were seriously ill, but Dr Lambert says an increasing number of moderately ill patients - even those who didn't need to be admitted to hospital - haven't recovered fully.
    Read full story
    Source: BBC News, 28 September 2020
  7. Sam
    Cancer patients in this country should have the best survival chances in the world. With its universal healthcare system and world-leading researchers, the UK should be able to offer every patient the knowledge and reassurance that their disease will be picked up quickly and treated rapidly, with the best that science can throw at it.
    Yet Britain languishes towards the bottom of developed nations’ league tables of cancer performance. On nearly every metric this is one of the worst places in the western world to get cancer — and some experts fear that survival rates are about to go backwards for the first time in a generation.
    Britain is now operating a “late diagnosis service” for the disease, a former UK cancer tsar has said, while waiting times are creeping up and up and nearly half of patients are diagnosed when their tumours have already spread, slashing their survival chances.
    Read full story (paywalled)
    Source: The Times, 22 October 2022
  8. Sam
    The first wave of COVID-19 may gave subsided in some areas of the United States, but in others it is growing and hospitals everywhere are continuing to face significant challenges.
    The American Hospital Association recently estimated that hospitals will incur at least $323.1 billion in losses through the end of this year due to COVID-19. Key contributors include postponed and cancelled elective procedures, lower patient volumes across all departments, and higher costs for supplies and devices.
    Other factors compound the financial challenges, including pressure for hospitals to implement new initiatives that foster a safer care environment for COVID-19 patients, non-COVID-19 patients, and healthcare providers. This pressure is mounting, as spikes in cases continue to appear in various regions, and as concerns grow about the flu season.
    The good news is that improving patient, staff, and visitor safety can actually help hospitals recover from the financial losses they are experiencing due to the pandemic. For example, enhanced patient safety leads to:
    Fewer costly events, such as hospital-acquired infections or conditions, acute kidney injuries, adverse drug events, readmissions, and return visits to the emergency department. Faster and more proactive identification of cost-saving opportunities, such as IV to PO conversions and more optimal management of high-cost drugs. Higher patient volumes due to a stronger quality and safety reputation.  Hospitals face significant financial challenges, but they must also act quickly to ensure patient, staff, and visitor safety. Luckily, improving margins and enhancing patient safety don’t need to be competing priorities. When hospitals implement effective safety improvement approaches, margin improvements naturally follow.
    Read full story
    Source: MedCity News, 25 October 2020
  9. Sam
    The past year has seen wide concern about the safety of medical implants. Some of the worst scandals have involved devices for women, such as textured breast implants with links to cancer, and transvaginal mesh implants, which were the subject of the asenate inquiry. But women are harmed not only by 'women's devices' such as breast implants and vaginal mesh. Women are also more likely to be harmed by apparently gender-neutral devices, like joint replacements and heart implants according to Katrina Hutchison in a recent MENAFN article.
    Bias starts with design and then lab testing: biological and social factors can affect how women present when injured or ill, and how well treatments work. Often, device designers do not take these differences into account. The lab tests used to make sure implants are safe often ignore the possibility women could have different reactions to materials, or their activities could place different loads on implants.
    Bias continues with clinical trials. And then there's the doctor-patient relationship; the gender of the doctor and patient can make a difference to what women learn about their implant. 
    Read full story
    Source: MENAFN, 11 August 2019
  10. Sam
    Gender bias is leaving many women with attention deficit hyperactivity disorder undiagnosed, leading psychologists are warning.
    The prevailing stereotype ADHD affects only "naughty boys" means at least tens of thousands in the UK, it is estimated, are unaware they have the condition and not receiving the help they need.
    "I used to tell doctors and therapists all the time, 'You've got to make this constant noise in my head stop. I can't think. I can't sleep. I can't get any peace,' but this was always dismissed as anxiety or women's problems," Hester says.
    Diagnosed with depression at 16, she spent much of her 20s unsuccessfully battling to be referred to a psychiatrist.
    And she constantly felt she was not reaching her true potential.
    Hester was finally diagnosed with ADHD in 2015, aged 34, and only, she says, because her husband had discovered he had the condition, a year earlier.
    His diagnosis took 12 months.
    "At no point did anyone say to Chris, 'This sounds like anxiety,' or 'Have some tablets,'" Hester says. "He was taken seriously."
    "Whereas with me, I was on the doctor's radar from the age of 16.
    "Bluntly, it took so long for me to be diagnosed because I'm a woman."
    Read full story
    Source: BBC News, 26 October 2021
  11. Sam
    More than 900 invitees converged on Manchester Central last night to find out which projects would emerge winners in the latest edition of our Patient Safety Awards.
    The awards recognise and reward the hard-working teams and individuals who, in these times of austerity, pay restraints and workforce shortages, are striving to deliver improved patient care.
    HSJ correspondent Annabelle Collins gave a welcome speech before comedian and writer Justin Moorhouse hosted the event, which was held at the end of the first day of the Patient Safety Congress.
    Ms Collins said: “Not only are you treating more and more patients, in difficult circumstances, you’re treating them safely and innovating during a time when the health service is being told by the government to be more efficient. To do more, with less. I think this makes your work and achievements even more special.
    This year, the awards were presented under four key areas:
    Clinical and specialist excellence; Enacting organisation-wide change; Proactive prevention and harm avoidance; and Service/system innovation. Read about the winners
    Source: HSJ, 25 October 2022
  13. Sam
    A 33-year-old New Zealand woman who was accused of faking debilitating symptoms has died of Ehlers-Danlos Syndrome (EDS).
    Stephanie Aston became an advocate for patients' rights after doctors refused to take her EDS symptoms seriously and blamed them on mental illness. She was just 25 when those symptoms began in October 2015. At the time, she did not know she had inherited the health condition.
    EDS refers to a group of inherited disorders caused by gene mutations that weaken the connective tissues. There are at least 13 different types of EDS, and the conditions range from mild to life-threatening. EDS is extremely rare.
    Aston sought medical help after her symptoms—which included severe migraines, abdominal pain, joint dislocations, easy bruising, iron deficiency, fainting, tachycardia, and multiple injuries—began in 2015, per the New Zealand Herald. She was referred to Auckland Hospital, where a doctor accused her of causing her own illness.
    Because of his accusations, Aston was placed on psychiatric watch. She had to undergo rectal examinations and was accused of practising self-harming behaviours. She was suspected of faking fainting spells, fevers, and coughing fits, and there were also suggestions that her mother was physically harming her.
    There was no basis for the doctor’s accusations that her illness was caused by psychiatric issues, Aston told the New Zealand Herald. “There was no evaluation prior to this, no psych consultation, nothing,” she said.
    She eventually complained to the Auckland District Health Board and the Health and Disability Commissioner of New Zealand. “I feel like I have had my dignity stripped and my rights seriously breached,” she said.
    Read full story
    Source: The Independent, 6 September 2023
  14. Sam
    Women are being disproportionately affected by a rise in mental health problems caused by increasing workloads as people do their jobs from home amid the pandemic.
    The length of the working day has increased steadily, resulting in a 49% rise in mental distress reported by employees when compared with 2017-19. Women are bearing the brunt of problems as they juggle work and childcare, according to a report by the 4 Day Week campaign and thinktanks Compass and Autonomy.
    The report, Burnout Britain, cshows that women are 43% more likely to have increased their hours beyond a standard working week than men, and for those with children, this was even more clearly associated with mental health problems: 86% of women who are carrying out a standard working week alongside childcare, which is more than or equivalent to the UK average, experienced problems in April this year.
    The report warns that “as well as an impending recession and mass unemployment, we are heading into an unprecedented mental health crisis”.
    Read full story
    Source: The Guardian, 9 October 2020
     
  15. Sam
    Caroline remembers screaming. It was like an electric shock which went from her neck to her toes. It was like being tasered in her most intimate area. She could not move because she was scared. She called out to the doctor to stop.
    “I can’t believe what happened to me was done in an NHS hospital,” Caroline, 56, says. “I feel that if they were wearing black balaclavas it would have suited what I experienced more. I felt like I was subjected to a very violent assault. That is the trauma that I’m dealing with now.”
    Caroline is one of thousands of women who have faced excruciating pain when undergoing a hysteroscopy, a medical procedure used to examine inside the womb, where biopsies may be taken. It is used to detect cancer, pre-cancer and other benign abnormalities.
    One in three women face severe pain during a hysteroscopy – rating it at least seven out of 10 – according to the Royal College of Obstetricians and Gynaecologists. That means thousands of women in the UK could be left traumatised by this medical procedure each year.
    Campaigners believe the NHS is failing to properly inform patients of the pain they may endure. The NHS website describes it as a “simple” and “relatively quick” procedure which is “not usually carried out under anaesthetic”.
    But women who have spoken to The Big Issue describe feeling “violated” during a hysteroscopy. They believe they were unable to give “informed consent” and some have been left with long-term physical and psychological trauma.
    Read full story
    Source: The Big Issue, 18 January 2024
    Related reading on the hub:
    Painful hysteroscopy Through the hysteroscope: Reflections of a gynaecologist The normalisation of women’s pain
  16. Sam
    Women undergoing NHS operations are not being routinely informed that a drug commonly used in anaesthesia may make their contraception less effective, putting them at risk of an unplanned pregnancy, doctors have warned.
    Administered at the end of surgery before patients wake up, sugammadex reverses the action of drugs that are given earlier in the procedure to relax the patient’s muscles. The drug is known to interact with the hormone progesterone and may reduce the effectiveness of hormonal contraceptives, including the progesterone-only pill, combined pill, vaginal rings, implants and intra-uterine devices.
    However, new research suggests that robust methods for identifying at-risk patients and informing them of the associated risk of contraceptive failures is not common practice across anaesthetic departments in the UK.
    Current guidance says doctors must inform women of child-bearing age about the drug. Women taking oral hormonal contraceptives should be advised to follow the missed pill advice in the leaflet that comes with their contraceptives, and those using other types of hormonal contraceptive should be advised to use an additional non-hormonal means of contraception for seven days.
    But doctors at a major London hospital trust found no record within the medical notes of relevant patients that they had been given advice on the risks of contraceptive failure due to sugammadex.
    Read full story
    Source: The Guardian, 2 June 2022
  17. Sam
    Women are waiting too long for abortions, according to a major review into a leading UK provider.
    The Care Quality Commission (CQC) review of the leadership at the abortion provider the British Pregnancy Advisory Service found there were “delays” in “investigating incidents”.
    The remains of some pregnancies were sometimes not stored properly and there were issues were record keeping, patient monitoring and safe care, the review found.
    The watchdog also noted “women did not always receive care in a timely way to meet their needs”.
    The health watchdog said: “In August 2021 we found significant concerns in we found that safe care was not being provided; ineffective safeguarding processes; incomplete risk assessments were not fully completed; observations were not monitored or recorded; records were not fully completed, clear or up to date.”
    Read full story
    Source: The Independent, 2 June 2023
  18. Sam
    Women and girls in England are being asked to share their experiences of the health system as part of a government strategy to address inequalities.
    Ministers say there is "strong evidence" services for female patients need improving. Fertility, maternity and menopause care are among the areas to be discussed.
    Campaigners say they are "delighted" steps are "finally" being taken to close the so-called "gender health gap".
    While women in the UK have a longer life expectancy than men, the Department for Health and Social Care says they are spending less of their life in good health.
    Nadine Dorries, minister for women's health, said: "Women's experiences of healthcare can vary and we want to ensure women are able to access the treatment and services they need.
    "It's crucial women's voices are at the front and centre of this strategy so we understand their experiences and how to improve their outcomes."
    Studies suggest gender biases in clinical trials are a contributing factor. Less is also said to be known about many female-specific conditions and how to treat them.
    Patients have repeatedly reported to the BBC that they have felt overlooked when talking to doctors about conditions like endometriosis or complications following a pelvic mesh repair.
    Read full story
    Source: BBC News, 6 March 2021
  19. Sam
    The numbers waiting over a year for hospital treatment have hit a 12-year high in England as hospitals struggle to get services back to normal. Nearly 2m patients have been waiting more than the target time of 18 weeks for routine care with 111,000 left for over a year, NHS England figures show.
    The numbers starting cancer treatment and getting urgent checks are also below the levels seen a year ago.
    But NHS England said "progress" was being made.
    It pointed out more patients were starting to be seen - although there are now warnings service may have to be cut back on again as admissions for Covid continue to rise.
    About 500 patients a day are being admitted to hospital with the disease - double the number two weeks ago.
    Health Secretary Matt Hancock said the UK was in a "perilous" position and the ability of the NHS to see non-Covid patients was under threat.
    Health minister Nadine Dorries predicted within 10 days hospitals would be a "critical" point.
    Read full story
    Source: BBC News, 8 October 2020
  20. Sam
    Ten workers at a mental health unit have been suspended amid claims patients were "dragged, slapped and kicked". Inspectors said CCTV footage recorded at the Yew Trees hospital in Kirby-le-Soken, Essex, appeared to show episodes of "physical and emotional abuse".
    The details emerged in a Care Quality Commission (CQC) report after the unit was inspected in July and August. A spokeswoman for the care provider said footage had been passed to police.
    The unannounced inspections were prompted by managers at Cygnet Health Care, who monitored CCTV footage of an incident on 18 July.
    At the time, the 10-bed hospital held eight adult female patients with autism or learning difficulties.
    The CQC reviewed 21 separate pieces of footage, concluding that 40% "included examples of inappropriate staff behaviour". "People who lived there were subjected not only to poor care, but to abuse," a CQC spokesman said.
    Workers were captured "physically and emotionally abusing a patient", and failing to use "appropriate restraint techniques", the report said. It identified "negative interactions where staff visibly became angry with patients" and two cases where staff "dragged patients across the floor".
    "We witnessed abusive, disrespectful, intimidating, aggressive and inappropriate behaviour," the inspectors said.
    Read full story
    Source: BBC News, 23 September 2020
  21. Sam
    More than a quarter of million people dipped into their savings or took a loan to pay for a private hospital operation or appointment last year — a record high. This year could exceed that.
    And who can blame them? With the NHS waiting list at a staggering 7.6 million and monthly strikes by doctors lengthening waiting times, patients are increasingly prepared to jump the queue and pay hard cash to do so.
    In an effort to cut waits and expand choice for patients, Rishi Sunak is funnelling thousands more NHS patients into the private sector.
    Yet private healthcare is not without risks, many of which are not fully understood. There is a difference between the NHS, which — for all its faults — has been a dependable, free at the point of use health service for more than 75 years, and the sometimes murky world of private doctors and hospital companies who use them.
    Can you trust your private doctor? When you look under the bonnet of private healthcare, beyond the glossy adverts, things can get a little uncertain.
    Read full story (paywalled)
    Source: The Times, 10 September 2023
  22. Sam
    A vulnerable woman judged to be at medium risk of self harm was on a mental-health ward that catered for low-risk patients, an inquest heard.
    Zoe Wilson, 22, died on the Larch Ward at Bristol's Callington Road Hospital in June 2019 after being found unconscious in her room at 01.30 BST.
    She had previously told staff that voices were telling her to kill herself, her inquest heard.
    Healthcare assistant Sarah Sharma found her and immediately called for help. Addressing a jury inquest at Avon Coroners' Court, she said that "patients admitted to Larch should have all been low risk". 
    This meant they would "preferably" have hourly observations by staff and be able to take their medication without any issues. Many were ready to be discharged and they were there because something was holding them up, normally housing, she said.
    The experienced healthcare assistant said if the patient's risk increased they should be placed under "one to one" monitoring with a member of staff until they were moved to a more suitable unit.
    The inquest heard earlier that Ms Wilson had been judged to be medium risk and was placed on 30-minute observations on 18 June.
    Her risk level was re-assessed when she handed a belt to staff and informed them voices were telling her to kill herself.
    Ms Sharma told the court that she was on her first overnight shift in two and a half weeks that night, and was informed in a handover that Ms Wilson was at risk of self-harming.
    Having never met Ms Wilson - who had schizophrenia - she queried what kind of self-harm the patient was at risk of but said the nurse performing the handover told her he "didn't know".
    Ms Sharma told the inquest she was unaware of the belt incident or that Ms Wilson had not been sleeping well and had requested medication to calm her down.
    Read full story
    Source: BBC News, 24 January 2022
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