Insufficient warning dangerous drugs by Health Canada

Despite evidence indicating seniors are being prescribed potentially dangerous drugs, Health Canada says it can't do anything more to make its warnings about these medications more effective.

The department is responding to an investigation in December revealing that doctors continue to prescribe anti-psychotic drugs to seniors, despite Health Canada warnings in 2005 that the drugs increased the risk of heart attack, stroke and death.

The analyzed sales data for the drugs indicated that prescriptions increased from seven to 40 percent for a 24-month period after the warnings.

Dr. Marc Berthiaume, director of the Marketed Pharmaceuticals Division at Health Canada, said the department warns doctors and their patients about dangerous drugs through an increasing number of safety alerts such as letters, e-mails and its website.

"We have developed over the years different ways to increase our outreach of that safety information," he said.

But he acknowledges it is up to physicians to read the mailed material. "We cannot open the letter for them. We cannot make them read them."

He said that's because the department doesn't have the legal power to do anything more than publish warnings.

Terence Young, whose 15-year-old daughter Vanessa died seven years ago after taking the drug Prepulsid, said that is nonsense. "Health Canada claims their responsibility stops when the information gets into doctors' hands. I find that disingenuous on several levels.

"The safety warnings sent out to doctors simply don't work, and this was well established at the inquest into Vanessa's death."

Young said Health Canada is wrong to claim it has no legal authority to beef up health warnings, because the law makes it clear the minister's ultimate duty is to protect the safety of Canadians.

Michèle Brill-Edwards, a pediatrician and clinical pharmacologist and one of Health Canada's fiercest critics, agrees. "The minister has in the enabling legislation called the National Department of Health Act very broad powers for the protection of the public."

"I think Dr. Berthiaume is voicing the standard views of the department that seek to limit the department's responsibility for safety."

Although Health Canada refers to its drug alerts as risk communication, Brill-Edwards said that it's hard to call it communication when no one seems to be paying attention.

Source: CBC News

Related article:

Dangerous drugs still prescribed to seniors

Supervisor appointed in Brampton Civic Hospital

Ken White, former CEO at Trillium Health Centre in Mississauga, will at least spend the next six to nine months, coming up with an action plan to improve communication between the hospital and the community, ensure proper staffing and reduce wait times in the emergency ward.

Amid reports that a patient had the wrong leg operated on at Brampton Civic, Ontario's first public-private hospital, Health Minister George Smitherman has named the supervisor who will look into problems at the new facility.

"People in the community should expect more answers to the questions raised ... What we see here is evidence of the need to do better," Smitherman told a press conference at the Brampton site of the William Osler Health Centre yesterday.

Smitherman took the rare step of appointing a supervisor to restore public confidence in Brampton Civic after the deaths of Harnek Sidhu, 52, of pancreatitis and Amarjit Narwal, 42, of a stroke, sparked a huge community protest in early December.

Then, on Christmas Day, 72-year-old Amar Kaur Brar complained doctors cut open her right leg by mistake when she went to hospital for surgery on her fractured left leg.

Although he had been an investigator at Brampton Civic for about a year, helping it to ramp up to its opening on October 28th, White said he was "not at all familiar" with concerns raised by the community about a shortage of staff, unduly long waits in emergency and a lack of beds.

"It's very sad there's all kinds of these misadventures in health care happening across Canada," White told reporters in an interview after the press conference.

Smitherman blamed "mischief makers" and alluded to persistent negative media reports about problems at the hospital since it opened as being a factor in attracting staff to work at the centre.

Some of those reports have been "pretty far off the mark," he said.

Brampton Civic, which replaced Peel Memorial Hospital, "overnight gained 100 beds, which is unheard of in health care" today, said Smitherman.
However, he did acknowledge staffing challenges.

Source: The Star

This is a video from CBC News concerning the appointment of Ken White

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Brampton Civic Hospital operates on wrong leg

Brampton Civic hospital has cost $340 million more than planned

Brampton Civic Hospital under fire

Brampton Civic Hospital operates on wrong leg

A Brampton family is frustrated after their 72-year-old grandmother had the wrong leg cut open during Christmas Day surgery at the city's new hospital.

But residents demanding better hospital care say the alleged medical mistake is one more in a long list of complaints they've heard since the Brampton Civic Hospital opened last October 28th.

Amar Kaur Brar, 72, fractured her thigh bone when she slipped from the stairs at the family's Brampton home, her granddaughter Kanwaljot Brar, 21, told The Sun yesterday.

"She just missed one stair and fell down," Brar said.
The family took her to the emergency room at Brampton Civic where doctors told them her left leg was broken and surgery was needed.

"In the operating room, doctors cut Amar's right leg open," Brar said, adding the cut ran almost the entire length of her grandmother's thigh.

When they realized that the bone in Amar's right leg was okay, they stitched her up and performed surgery on her left leg, she said.

"She's in so much pain now," Brar said. "She can't move either leg ... she can't move at all."

Doctors told the family after surgery that they opened the wrong leg, she said.
Along with the pain, Amar has been confused and disoriented since the operation.
She remains in the hospital with her son Gurcharan Singh Brar at her side.

"We don't know what to do now for her," Brar said.

The issue is further complicated because Amar arrived in Canada from India in August and wasn't issued a health card until Thursday.
Brar said the family isn't certain if they will have to pay for the hospital care up to that point.

This week's incident comes a few weeks after 1,000 residents took to the streets protesting conditions at the hospital, where they claim patients wait up to 12 hours in the emergency room only to deal with understaffed and insensitive health-care workers.

In response to inquiries about Amar's case yesterday, the hospital issued a statement.
"William Osler Health Centre's top priority is the well-being and safety of our patients and staff," the statement reads.

The centre is made up of Brampton, Peel and Etobicoke hospitals.

In order to protect patient privacy, the hospital said it could not comment on the specific case. "We cannot release any information about a patient or any information about the care provided to a patient without his or her written consent," the release states.

The hospital does have a quality of care committee, a patient incident reporting system and a patient safety committee in place to respond if an incident occurs.

"We're following all of our processes with regard to this case," hospital communications director Gillian Williams McClean said.

Rajinder Saini of Bramptonians for Better Health Care said the incident is another in a long list of complaints the group has heard about the hospital.

"Things are not good at this new facility," Saini said.
"They use excuses like shortages of funds and staff." He called operating on the wrong leg an 'unbelievable' mistake."

"She had swelling on the broken leg, they had X-rays, they had everything," Saini said.

Media attention focused on the hospital in November when Brampton resident Harnek Sidhu, 52, allegedly waited 12 hours for a bed before he died of pancreatitis 10 days later.

Following the protests in early December, the province stepped in and appointed a hospital supervisor.

Amid the problems at the new hospital the future of the old hospital, Peel Memorial, remains uncertain.
Protesters have maintained the fast-growing city needs both hospitals to serve the burgeoning population.
A plan for the old site, that has been temporarily closed when the new hospital opened, is being developed.
Two public meetings, one January 9th at the Pearson Convention Centre and January 17th at Courtyard by Marriott on Biscayne Court, have been scheduled.
Both meetings start at 7:30 p.m.

Source: Toronto Sun

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Brampton Civic hospital has cost $340 million more than planned

Brampton Civic Hospital under fire

Quebecer complians about "English treatment" in hospital

The reaction of many people to being kept waiting for 20 hours in a hospital emergency ward in Quebec might be to worry, or complain, about what seems like a chronic shortage of medical personnel.

Sitting for hours on a hard chair in a room with other injured or ill people, watching for the faintest hint that the one overworked doctor might see you now, could lead a sensible person to think that whatever Quebec is doing to find more health care workers, it isn't enough.

Jean Dorion, the head of the Société St. Jean Baptiste de Montréal, takes a different approach. His reaction to waiting nearly a day for care was to call for French to be made the working language in all Quebec hospitals, including the few remaining bilingual hospitals.

Why? Because when he was finally seen by a doctor, the doctor asked if he spoke English.
Dorion said he replied that he did speak English. "I was treated in English," he said. "I found it humiliating."
He further suggested that if he had asked for treatment in French the doctor might not have looked at his case "with a very favourable prejudice."

This is ridiculous, to say nothing of offensive. Dorion has the nerve to suggest that a medical practitioner would take less care with his health if he asked to be treated in one of Canada's two official languages.

Dorion provides nothing in the line of proof for this odious suggestion. So pressed is he for ammunition for his make-everything-French cause that he has to go back seven years to unearth a study by the Office Québécois de la langue française.

This dusty study shows, Dorion said, that 18 percent of francophone patients treated in bilingual hospitals said they had been "in contact" with medical workers or other personnel who lacked a "sufficient" knowledge of French. Is he kidding? What does "in contact" mean? Who defines "sufficient"?

More recently, according to information compiled by the Office québécois de la langue française, it received a grand total of five complaints on the subject of language use in hospitals. Four of the complaints concerned language on signs; only one had to do with language of service. Exactly one complaint in the course of a year. In a normal world, that would be considered a triumph. It is a triumph.

Some hospitals in Quebec are allowed to be bilingual but must make French service available - and by the evidence, they do just that. This requirement does not mean that every single person working in a bilingual hospital has to be perfectly bilingual. Dorion, for instance, doesn't even know if the doctor who asked if he spoke English was bilingual. It appears that Dorion preferred getting a chance to complain to the simple expedient of asserting his right to be helped in French. What nonsense.

If any group is having trouble communicating in hospitals, it is rural anglophones. The regions are becoming more unilingually French even as unilingual anglophones grow older and require more medical care. Now there is a real problem.

Source: The Gazette

Editor's opinion:

"How does that work, open heart surgery in French? Or getting a French flu shot? Complaining about something like that, after having waited for 20 hours? To magnify a futility like that can only come from a French speaking nitpicker. Humiliated? What's so humiliating about the English language? How many people, on a world-scale, actually speak French and why is that do you think? Of course there are many nice francophone people, but in general as a people, is there anyone that likes the French? I know in Europe nobody really does. They don't even like each other, hence the cold relationship between the French from France and the ones from Quebec!"

IT solution makes Jewish General Hospital in Montreal more efficient

At Jewish General Hospital in Montreal, you won’t hear the buzzers triggered by patients’ call buttons, and you won’t hear the public address system paging doctors.

Physicians and nurses now carry wireless telephones that work over the hospital’s computer network.
Call buttons with voice capabilities are linked to the phone system, so a patient in need can let an assigned nurse know what the problem is right away rather than just ringing a buzzer at the nursing station.

"It means better response to patients’ needs and it means doctors waste less time," says Stephen Rosenthal, the hospital’s associate director of medical informatics.

In the past, Dr. Rosenthal explains, the usual way to reach a doctor was to page him or her via the public address system. This added noise in an already busy environment where patients need quiet. The doctor being paged had to find a telephone to call back, and by that time the person at the other end might be unavailable.

Cellphones weren’t an option because of potential interference with some sensitive medical equipment, Dr. Rosenthal says.
But the wireless IP phones serve the same purpose: Calls can now go directly to the doctor, eliminating the paging and telephone tag.

Jewish General first tried a wireless phone system in its emergency room, using older technology, then switched to a voice over IP (VOIP) network and expanded throughout inpatient areas about a year ago. This past summer it was extended into outpatient clinics as well.
Put together by IBM Canada Ltd. and Symbol Technologies Inc., the system now supports about 100 phones for physicians, nurses and administrators.

Read the full story here

Editor's opinion:

"This is a great example of how technology can make communication processes in the hospital more efficient. It will reduce time which can be better used to serve patients. More institutions in health care and hospitals should adopt initiatives like this to cut costs.

There's a task for IT companies to promote their solutions and cater to the health care industry."

New Brunswick hospital improves bilingual service after complaint

Last week, the Saint John Regional Hospital in New Brunswick has apologized to a French-speaking couple from Campbellton in the same Provence, who filed a complaint they were not offered proper medical service in French.

The francophone couple from northern New Brunswick, Annelle and Romain Bouchard, spent 21 days at the hospital last November.

While Romain developed complications during his heart treatment and was near death, Bouchard said she wasn't able to find anyone on staff who could explain what was happening in French.

On a number of occasions, Mrs. Bouchard said she had to depend on help of family members of other patients who were bilingual, to translate for her.

Dr. Marc Pelletier, the cardiac surgeon, said the hospital is now taking necessary steps to avoid future language problems.

"We've already called back every one of our patients who is on the waiting list to identify their preferred language," Pelletier state. "This information will be listed on their charts".

He also said that the hospital is establishing a paging system that will ensure a translator is close at hand, he said.

Patients from all parts of the province who need cardiac care go to the heart center in Saint John.

"The heart centre has a mandate and a "moral obligation" to service patients in their language", Pelletier said.

Approximately 50 percent of the nurses at the hospital are certified as bilingual, he said, and several members of the staff are currently taking language training.

Pelletier said he is sorry the Bouchards had an unfortunate experience at the hospital but said it was a rare situation.

About 95 per cent of the communication with the Bouchards during their stay was in French, he said, but there were at least two situations where it was not promptly provided.

"People are trying so hard," Pelletier said, "and to have people come up to me in the hallway and say, 'You know, I really was trying. I was speaking to them in French every day. It's kind of my broken French and to have this come out, is this my fault? To explain to that nurse, 'No it's not your fault. You did a great job.'"

"Most francophone patients who are treated at the hospital leave having had a good experience," he said.

CBC

Vaccination opposition leverages social networks to spread opinion

Opponents of vaccinations are using YouTube, FaceBook and other internet social networks to promote their views that vaccines are dangerous, says a research letter published Wednesday in the Journal of the American Medical Association.

Public health officials need to understand the impact these efforts can have on universal vaccination campaigns and find ways to counter this dangerous trend, said researchers from the University of Toronto and York University in Canada, the CP reported.

"This is their new strategy for communicating," said senior author Dr. Kumanan Wilson, an internal medicine specialist and public health policy researcher.

"These people believe their viewpoint is not being aired in public. They believe that they are being shut out of the discourse and they want to get their viewpoint out. And this is their way of creating commercials for their viewpoints."

Wilson said vaccination opponents are putting a lot of effort into using internet social networks to promote their opinions.

"And other people ... just from the view counts and the ratings, are coming on and wanting to find out more about these viewpoints. Their videos are being viewed and rated highly," Wilson said.

Healthday

Editors opinion:

"Instead of criticizing this phenomenon, the healthcare industry should cease the opportunity to start promoting social networks among their peers themselves. The industry can really benefit from the more efficient, more targeted and better accessible forms of communication.
Also, if they want to grab the attention of many for certain important health care related messages to the public, social networks are one of the better and fastest ways of doing that.
It's about time that the industry moves away from their good old ancient faxes and starts adopting today's ways of communication"