Donor Dies (killed) Doctors/Hospital Blames Tool...
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nothing is fail-safe. every operation carries a risk
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I agree.Originally posted by vito_corleone:nothing is fail-safe. every operation carries a risk
But blaming a tool for the failure? Izzit it too irresponsible? -
To be fair to them, if they did not know the tool could likely fail how could they possibly be blamed for it? A pilot that takes off with a problem with his plane that is beyond his ability to know or correct for before the flight will not be blamed if the plane gets into an accident.Originally posted by Hogzilla:I agree.
But blaming a tool for the failure? Izzit it too irresponsible?
If they knew that if could fail and did not take the steps to make sure then they would be at fault... but this is not the case here.
Nobody knew about the safety issues until after the incidents... I find it hard to blame the doctors in this case, and I don't think it's really fair to all directly involved to try to twist what is already a tragedy just of our own causes... whatever it may be. -
Docs?? no blame!!!Originally posted by SingaporeTyrannosaur:To be fair to them, if they did not know the tool could likely fail how could they possibly be blamed for it? A pilot that takes off with a problem with his plane that is beyond his ability to know or correct for before the flight will not be blamed if the plane gets into an accident.
If they knew that if could fail and did not take the steps to make sure then they would be at fault... but this is not the case here.
Nobody knew about the safety issues until after the incidents... I find it hard to blame the doctors in this case, and I don't think it's really fair to all directly involved to try to twist what is already a tragedy just of our own causes... whatever it may be.
Hospital??? no blame!!!
Tools manufacturer???no blame!!!
May be the deceased is unlucky!!!!!
We r lucky 2 know all these Gov Hospitals r so cheap !!!!!!
Life vs cost again???OMG -
You know, it would aid your credibility a lot if you stopped ranting aimlessly and started analysing the facts properly and objectively.Originally posted by foomwee88:Docs?? no blame!!!
Hospital??? no blame!!!
Tools manufacturer???no blame!!!
May be the deceased is unlucky!!!!!
We r lucky 2 know all these Gov Hospitals r so cheap !!!!!!
Life vs cost again???OMG
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Well I might actually agree with you if you could actually find something REAL to pin the blame on... but you are making it hard for anybody to even understand if you have a proper train of thought in here... let alone even consider what you are talking about.Originally posted by foomwee88:Docs?? no blame!!!
Hospital??? no blame!!!
Tools manufacturer???no blame!!!
May be the deceased is unlucky!!!!!
We r lucky 2 know all these Gov Hospitals r so cheap !!!!!!
Life vs cost again???OMG
And yes, from all that we know so far... it does seem the deceased was unfortunate to be one of those to be the victim of undiscovered (at that time) defects in the tools then of outright incompetence...
So who can we pin the blame on? Do you like being blamed for the problems Windows XP gives if you sold a person a laptop? -
we r as stupid as pigs!!!dont know wat u r talking about!!!!Originally posted by fudgester:You know, it would aid your credibility a lot if you stopped ranting aimlessly and started analysing the facts properly and objectively.
pls enlightened us!!!cauz We r a bunch of PSLE cer holders!!!!
R u a Gods????? -
Then talk C!!!which is very itchy now!!!!Originally posted by SingaporeTyrannosaur:Well I might actually agree with you if you could actually find something REAL to pin the blame on... but you are making it hard for anybody to even understand if you have a proper train of thought in here... let alone even consider what you are talking about.
And yes, from all that we know so far... it does seem the deceased was unfortunate to be one of those to be the victim of undiscovered (at that time) defects in the tools then of outright incompetence...
So who can we pin the blame on? Do you like being blamed for the problems Windows XP gives if you sold a person a laptop? -
Originally posted by ShutterBug:
Shutterbug,sorry !!use yr thread 2 play again!!
[b]SURGICAL CLIPS IN THE SPOTLIGHT: Each surgeon has own preference, but...
Skill and safety count, say doctors
Clips that slipped and cost kidney donor Narinder Kaur her life are just one of the procedures that surgeons use to tie blood vessels
By Ng Wan Ching
March 06, 2007
METAL clips, staples, Hem-o-lok clips, special ties. These are all part of an arsenal of devices used by surgeons to close blood vessels during surgery.
Some of the devices surgeons use to close up blood vessels during surgery. -- CHOO CHWEE HUA
As surgical methods have advanced, so has the need for such devices.
Minimally invasive procedures such as laparoscopic (keyhole) surgery, is becoming more common.
The death of a kidney donor came after such surgery in 2005.
Compared with open surgery, these procedures are more delicate and call for more surgical skill.
MANIPULATION THROUGH INCISIONS
Instead of operating directly on an organ, surgeons have to manipulate instruments through small incisions to get to the organ.
One of the challenges with using laparoscopy is for surgeons to safely tie up or ligate blood vessels.
This would not be an issue with open surgery as surgeons would have space to tie up the blood vessels with sutures.
The Hem-o-lok clips, which are made of plastic, came in for particular scrutiny recently, when it was revealed that they had slipped after being used to close the left renal artery and vein of Madam Narindar Kaur.
She had undergone hand-assisted laparoscopic surgery at National University Hospital to remove her left kidney which she donated to her husband, Mr Surender Singh. (See report at top of facing page.)
The slippage resulted in sudden, internal bleeding in her abdomen. The 33-year-old woman died a few hours after the operation.
State Coroner Tan Boon Heng recorded a verdict of misadventure last Monday.
Surgeons The New Paper spoke to, say that slippage, through very rare, can happen.
And what each surgeon uses to tie up blood vessels is up to his own experience and personal preference.
If a surgeon feels that a certain device cannot do the job, he will choose another.
Take Associate Professor Eu Kong Weng, senior consultant and head of Singapore General Hospital's colorectal surgery department.
He uses laparoscopic methods for more than 80 per cent of his elective procedures. 'Sometimes we use clips, sometimes staples,' he said.
'Sometimes a clip can slip and bleeding occurs. If this occurs during the surgery itself, another clip can be easily re-applied.
BLEEDING
'Delayed slippage of clips is rare, though not unheard of. This can, of course, result in bleeding. Close post-operative monitoring and care is crucial to catch such an occurrence.'
Patients can then be brought back to the operating room to have the vessels ligated (tied up) again.
He prefers to use staples as he can apply three rows of staples in one shot.
'With the Hem-o-lok, which is made of plastic, you can clip only once. Then you have to remove the applicator, reload it with another clip, put it back into the patient's body and clip again. It's not so convenient,' he said.
SPEED
Another reason he chooses staples is speed.
'Staples are fast. Every minute counts in surgery. For example, you can use a special suture tie to close up the vessel, but that would take a few minutes, compared to seconds for the staple,' he said.
Dr T Ravintharan, a general surgeon in private practice, said he would usually put in two or three clips to close off one blood vessel.
'It depends on how comfortable I feel. Safety comes first,' he said.
About 95 per cent of his work involves laparoscopic surgery and he has been doing it since 1990. Currently he is the chairman of the Minimal Access Surgery Centre at Mount Elizabeth Hospital.
He usually uses large Hem-o-lok clips for larger blood vessels.
Metal clips and smaller Hem-o-lok clips are better for smaller vessels, he said.
'Clips generally can be applied in confined places,' he said.
Sometimes, he also adds sutures for safety.
COST
'But sutures require far more skill in application,' he said.
Cost may be a consideration too.
Sutures cost about $100. Staplers cost more than $360.
'If several staples are needed, it will sometimes drive up the cost. Staplers are better if there are lots of tissues and several vessels within to be tied off. But staplers require more space and therefore cannot be used in tight spaces,' he said.
Hem-o-lok is cheaper. It costs $42 per instrument and comes with six plastic clips.
WARNING
During the hearing last Monday, It was revealed that the manufacturer for Hem-o-lok clips, US firm Teleflex Medical, issued a warning last year about their use on living kidney donors.
Since then, National University Hospital - where Madam Kaur and Mr Singh had their operations - has reinforced the clips with the use of sutures or metal clips.
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timewasterOriginally posted by foomwee88:we r as stupid as pigs!!!dont know wat u r talking about!!!!
pls enlightened us!!!cauz We r a bunch of PSLE cer holders!!!!
R u a Gods????? -
Hallo Gods!!!!Originally posted by saffron60:timewaster
we shd play 2 c who is the dog n pig??
u owe me S$10 per post oh!!!
But i m not cheap u know,other ppls pay me S$1k per day,i also dont want but 4 u ok lah just S$10 per post!!!! -
I'm a local Govt hospital doctor. My 2 cents worth, if I may:
1. Drugs and medical devices are subjected to several phases of trials before allowed into general use. All are tested rigorously in the lab, before a phase of animal testing, then finally human trials, before they are allowed to be marketed. Thereafter postmarketing surveillance is carried out to pick up any defects that might somehow have been missed by the above steps. I could be wrong but my guess is the 2006 warning against the clips might have been in the postmarketing phase.
2. Different doctors have preferences for different devices (clips vs sutures vs staples) and I think this needs to be respected. These preferences are a result of our individual experience and may also reflect particular aptitude in a technique that calls for a different device. All devices have their pros and cons, indications and contraindications, and the choice is often not straightforward.
3. Believe me, no doctor would knowingly implant a faulty clip in a patient. Hippocratic oath aside, it is ethically unforgiveable, and I have yet to come across such a colleague. Besides, the current media circus surrounding this case is every doctor's nightmare - trust me, nobody would risk their career like this.
4. It is true that we have tight budget constraints to work within in the restructured hospitals, but it NEVER becomes a "life vs cost" issue as alluded to previously, particularly in elective cases like this when the patient was healthy and well before the surgery. -
Thk u!!!Originally posted by cherry_garcia:I'm a local Govt hospital doctor. My 2 cents worth, if I may:
1. Drugs and medical devices are subjected to several phases of trials before allowed into general use. All are tested rigorously in the lab, before a phase of animal testing, then finally human trials, before they are allowed to be marketed. Thereafter postmarketing surveillance is carried out to pick up any defects that might somehow have been missed by the above steps. I could be wrong but my guess is the 2006 warning against the clips might have been in the postmarketing phase.
2. Different doctors have preferences for different devices (clips vs sutures vs staples) and I think this needs to be respected. These preferences are a result of our individual experience and may also reflect particular aptitude in a technique that calls for a different device. All devices have their pros and cons, indications and contraindications, and the choice is often not straightforward.
3. Believe me, no doctor would knowingly implant a faulty clip in a patient. Hippocratic oath aside, it is ethically unforgiveable, and I have yet to come across such a colleague. Besides, the current media circus surrounding this case is every doctor's nightmare - trust me, nobody would risk their career like this.
4. It is true that we have tight budget constraints to work within in the restructured hospitals, but it NEVER becomes a "life vs cost" issue as alluded to previously, particularly in elective cases like this when the patient was healthy and well before the surgery.
But can u PM me yr real name?
Cauz there r alot of fake Docs!!!
I heard my 2 Doc sons,the Docs from India alway make mistakes,is it true??? -
I don't think I need to prove to you I'm a real doctor. The MBBS is hanging on my wall. PM me your 2 doctor sons' names first.Originally posted by foomwee88:Thk u!!!
But can u PM me yr real name?
Cauz there r alot of fake Docs!!!
I heard my 2 Doc sons,the Docs from India alway make mistakes,is it true???
No comment on the Indian doctors. Everyone makes mistakes sometimes.
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But the fake Docs like OM said the Indian Docs r paid S$800 per month!!!!Originally posted by cherry_garcia:I don't think I need to prove to you I'm a real doctor. The MBBS is hanging on my wall. PM me your 2 doctor sons' names first.
No comment on the Indian doctors. Everyone makes mistakes sometimes.
That why making us worried 2 c Indian Docs in H n C!!! -
Cauz my daughter wants to study in NUS as an undergraduate,do u know how much is the tuition fee per yr now????
Real Doc???? -
I paid $17K my final year in NUS. Your "real doctor" sons couldn't tell you this?Originally posted by foomwee88:Cauz my daughter wants to study in NUS as an undergraduate,do u know how much is the tuition fee per yr now????
Real Doc????
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Testing u!!!!Originally posted by cherry_garcia:I paid $17K my final year in NUS. Your "real doctor" sons couldn't tell you this? -
$800 per month?And you believe him?Originally posted by foomwee88:But the fake Docs like OM said the Indian Docs r paid S$800 per month!!!!
That why making us worried 2 c Indian Docs in H n C!!!
$800 a month won't get you an A-lvl grad to file papers in an office man.. -
Had u served NS???if yes,Originally posted by cherry_garcia:I paid $17K my final year in NUS. Your "real doctor" sons couldn't tell you this?
Can the 2 yrs NS be taken into acct of the bond of 6 yrs with Gov???? -
Dude, you really need to take a deep breath and relax. Else it will make you more angry and unable to debate properly..Originally posted by foomwee88:Had u served NS???if yes,
Can the 2 yrs NS be taken into acct of the bond of 6 yrs with Gov???? -
Dont worry!!!the card will be out very soon!!!1Originally posted by LazerLordz:Dude, you really need to take a deep breath and relax. Else it will make you more angry and unable to debate properly..
I m good in testing all these fake Gods!!! -
So much for you having "real doctor" sons. Sheesh.Originally posted by foomwee88:Had u served NS???if yes,
Can the 2 yrs NS be taken into acct of the bond of 6 yrs with Gov????
The bond is 5 years. Yes NS counted towards its discharge.
I'm female. No NS liabilty
That's the last of your questions I'm answering! -
Hahaha!!! c yr tail comes out liao i!!!!Originally posted by cherry_garcia:So much for you having "real doctor" sons. Sheesh.
The bond is 5 years. Yes NS counted towards its discharge.
I'm female. No NS liabilty
That's the last of your questions I'm answering!
The bond is 6 yrs!!!
2 yrs NS is counted in the bond of 6 yrs!!!
Wat the BS doc U r!!!! no diff from OM, know how 2 cut n paste only!!!
Good 9!!! -
It's 5 years.Unless your sons are foreigners.Originally posted by foomwee88:Hahaha!!! c yr tail comes out liao i!!!!
The bond is 6 yrs!!!
2 yrs NS is counted in the bond of 6 yrs!!!
Wat the BS doc U r!!!! no diff from OM, know how 2 cut n paste only!!!
Good 9!!!