Friday, April 24, 2009

Girl, 6, dies after NHS GP failed to carry out blood test which would have saved her life

Once again the chronic delays and indifference that characterize socialized medicine were the real killers

A six-year-old girl died from kidney disease after a GP failed to give her a blood test that would have saved her. Bethany Townsend's death was preventable and her illness treatable, an inquest ruled. Her devastated parents are considering legal action against their GP.

Coroner Dr Nigel Chapman, who recorded a verdict of death by natural causes, said: 'The window of opportunity to save Bethany was huge and that length of time was totally unacceptable. 'Sadly Bethany died because a blood test wasn't done. Had one been done, it would have shown the abnormality and she would have gone into hospital and her death would not have occurred.'

Bethany died three weeks after being taken to her local surgery in Newark, Nottinghamshire, just after Christmas. But instead of carrying out a blood test which would have diagnosed her illness, Dr Julie Barker referred her to Newark Hospital for the test. When Bethany arrived a week later nurses found she was too thin for them to find a vein and referred her back to her doctor's surgery. Ten days later Dr Barker tried to draw a blood sample but could not find a vein.

The GP then managed to refer Bethany to a specialist paediatrician but could get an appointment only a month later. But Bethany died from kidney failure on January 22, 2007, weighing just 30lb.

Dr Barker told Nottingham Coroner's Court she had made 'an error of judgment'. The GP said she now referred children immediately for specialist treatment if required. Dr Barker added: 'Obviously I wish I had referred her straight away. 'I felt that she would need specialist treatment and had planned to do that but I wanted to get some test results back.'

Dr Malcolm Lewis, a specialist in kidney disease at the Royal Manchester Children's Hospital, said he believed Dr Barker should have put in an urgent request for Bethany to see a specialist paediatrician. Had she done so a blood sample would have been taken within a week and the youngster would have been immediately sent to a specialist renal unit, he said. 'My expectation would be that had she been sent, Bethany would have lived,' he said.

'From the post-mortem reports I would have been optimistic she would have been able to return to good kidney function for a period of time, but given the damage that would have been done she would have needed a transplant in the future. 'From the description of Bethany's Manclinical state I would expect a phone call that day to refer Bethany. I would expect with her condition that she would have been seen within a week and if I were taking that phone call about a child with a urinary infection I would say come up immediately and have a test.'

A statement from Bethany's parents said: 'This has been an incredibly harrowing period for the family and friends of Bethany, with today's inquest reminding us all of a young life lost and a loving daughter who is sadly missed. 'The question of "would things have been different had Bethany seen a specialist?" is one that will haunt us for ever but we are grateful for some kind of closure now that the circumstances surrounding her death have been made public. 'Hopefully lessons have been learned and nobody else suffers in similar circumstances.'

Dr Doug Black, medical director at NHS Nottinghamshire County, said: 'This girl's death is a tragedy. 'It was avoidable and our deepest sympathies go to her family. 'It's a complex case and we have led a thorough review to ensure we learn lessons from it. 'We have acted firmly to put in place a comprehensive action plan under which the GP involved has undertaken further specialist training.'


Power-freak British social workers, backed by police with a battering ram, snatched a dementia patient from her daughter's house and took her back to care home

Concerned about the treatment her elderly mother was receiving in a care home, Rosalind Figg decided to look after her personally. She and her partner created an ensuite bedroom with an alarm system to wake them if 86-year-old Betty Figg, who has dementia, got up in the night. When her mother confirmed that she was unhappy, Miss Figg took her home in the hope that it would be the end of an unfortunate chapter in her life.

But two days later, amid astonishing scenes, the old lady was snatched back by social services. A distraught Mrs Figg was wheeled to a car with a blanket over her head after police who had been called in as back-up threatened to smash the door with a battering ram if the family did not hand her over. Yesterday she was back in her room at £2,000-a-month Butts Croft House in Corley, Warwickshire.

'I will fight tooth and nail to get my mum back,' said 55-year- old Miss Figg at her home in Coventry. 'I can't believe this has happened - I keep thinking I'm going to wake up and realise it has been a bad dream.'

Miss Figg's mother had lived alone in Coventry since the death of husband Brian 15 years ago. She was admitted to hospital last June suffering from swollen legs and was becoming increasingly forgetful. Her daughter initially agreed to advice from social services that she should go into a home and she moved to Butts Croft House in August, with the fees being paid by the family.

In October, Mrs Figg fell out of her bed and was starting to lose weight and her daughter decided to give up her pottery business to care for her at home. Divorced mother-of-four Miss Figg and her partner Christopher Roberts, 41, created the downstairs bedroom, installed wheelchair ramps and had a special bed delivered with sensors in the mattress so an alarm would wake them if the old lady got up in the night.

But a council occupational health specialist ruled the three-bedroom semi-detached home was still not suitable for Mrs Figg. She was taken back to hospital in November after picking up an oral infection. When she returned to the home, her daughter went to visit and discovered Mrs Figg's mouth was caked in dried blood and she was complaining of feeling hungry.

Last Saturday, as usual, Miss Figg took her out from the home but says her mother was so unhappy there that she decided not to return her. She said she had contacted police before doing this and officers had told her it was a civil matter and did not concern them. Miss Figg, who herself used to work as a carer, said she saw a real improvement in her mother in the next two days, by the end of which she was laughing and chatting to neighbours over a cup of tea.

However, Coventry City Council obtained an 'emergency warrant' from magistrates under the Mental Health Act on the grounds that a 'person believed to be suffering from a mental disorder is being ill treated and neglected'.

'Mum was escorted out of my house in her wheelchair and had a towel thrown over her head as though she was some kind of prisoner,' said Miss Figg. 'She is not happy in the home. She should back with her loving family where she belongs.' A neighbour who witnessed the raid said: 'I can't believe they brought a battering ram. They use them to break into drug dens, not to cart off little old ladies.'

A council spokesman said an independent advocate had been appointed to work in Mrs Figg's best interests. 'Staff from a number of agencies are involved in safeguarding her, including using statutory powers to protect her against further moves and to provide a mental health assessment after she was removed from a residential care home by her daughter against advice.' He said social care staff had been refused entry to Miss Figg's home and returned with police assistance. A police spokesman said: 'Police were asked to assist social services to remove an elderly woman to a place of safety. 'A warrant was granted and an enforcer was taken in order to gain access to the property if needed. The enforcer was not used.'

Butts Croft House is a 28-bed home which specialises in dementia care. It has not been rated by the Care Quality Commission since changing ownership in October. It was inspected for the first time under the new regime last month. A spokesman for the CQC said the report was still being finalised and was not due to be published until late May.


Britain's chief medical attention-seeker is at it again

She quotes no proof of the evils of computers that she discusses because she has none. It is all just her speculation, full of "might be"s and "could be"s. She appears to have no children herself but somehow knows all about them. My son was a heavy computer user since he was a tot but he is now in adulthood very sociable and socially popular. He also has a degree in mathematics and is making good progress towards his doctorate in the subject. So a fat lot of harm heavy computer use did him! Computers can bring kids together. I have seen plenty of examples of it. The lonely nerd would probably be lonely anyway. The lady below needs to get out more. She might learn something. She has probably never even heard of a LAN party. If she had, her discussion below would not have been so unbalanced. As it is, she is just farting at the mouth below

Can you imagine a world without long-term relationships, where people are unable to understand the consequences of their actions or empathise with one another? Such conditions would not only hamper our happiness and prosperity - they could threaten our very survival. Yet this imagined existence isn't as far away as it seems. It is a plausible future. For we are developing an ever deeper dependence on websites such as Facebook, Twitter and Second Life - and these technologies can alter the way our minds work.

As a neuroscientist, I am aware of how susceptible our brains are to change - and our environment has changed drastically over the past decade. Most people spend at least two hours each day in front of a computer, and living this way will result in minds very different from those of past generations. Our brains are changing in unprecedented ways. We know the human brain is exquisitely sensitive to the outside world - this so-called 'plasticity' is famously illustrated by London taxi drivers who need to remember all the streets of the city, and whose part of the brain related to memory is generally bigger than in the rest of us as a result. Indeed, one of the most exciting concepts in neuroscience is that all experience leaves its mark on your brain.

But while adults' brains can change, it is children who are most at risk, for their brains are still growing - and may not have yet had a full range of experiences in three dimensions. Yet 99 per cent of children and young people use the internet, according to an Ofcom study. In 2005, the average time children spent online was 7.1 hours per week. By 2007, it had almost doubled to 13.8 hours. As an expert on the human brain, I am speaking out as I feel we need to protect the young.

Of course, this idea may not be welcomed - when someone first linked smoking and lung cancer, people didn't like that idea; some derided them because they enjoyed smoking. But parallels could well be drawn with this, and I believe similar precautionary thinking should be set in train, as in turn was needed for sunbathing and carbon emissions. We must take this issue of computers seriously because what could be more important than the brains of the next generation?

Three areas of computing are likely to have the most marked effect - social networking sites such as Facebook, MySpace and Twitter, imagined online societies such as Second Life, and computer games.

Facebook turned five years old in February. Arguably, it marks a milestone and a highly significant change in our culture - millions of individuals worldwide are signing up for friendship through a screen. Half of young people aged eight to 17 have their own profile on a social networking site. But two basic, brain-based questions still need to be addressed. First, why are social networking sites growing? Secondly, what features of the young mind, if any, are threatened by them?

In modern life, the appeal of social networking sites to children is easy to understand. As many parents now consider playing outside too dangerous, a child confined to the home can find at the keyboard the kind of freedom of interaction that earlier generations took for granted in the three-dimensional world of the street. Though to many children screen life is even more appealing. Philip Hodson, a fellow of the British Association for Counselling and Psychotherapy, suggests that: 'Building a Facebook profile is one way that individuals can identify themselves, making them feel important and accepted.'

Social networking sites satisfy that basic human need to belong, as well as the ability to experience instant feedback and recognition from someone, somewhere, 24 hours a day. At the same time, this constant reassurance is coupled with a distancing from the stress of face-to-face, real-life conversation. Real-life chatting is, after all, far more perilous than in the cyber world as it occurs in real time, with no opportunity to think up clever responses, and it requires a sensitivity to voice tone, body language and even to physical chemicals such as pheromones.

None of these skills is required when chatting on a networking site. In fact, one user told me: 'You become less conscious of the individuals involved (including yourself), less inhibited, less embarrassed and less concerned about how you will be evaluated.' In other words, Facebook does not require the subtleties of social skill we need in the real world. Not only will this impair individuals' ability to communicate - and build relationships - it could completely change how conversation happens.

Maybe real conversation will give way to sanitised screen dialogues, in much the same way as killing, skinning and butchering an animal to eat has been replaced by the convenience of packages of meat on the supermarket shelf. Perhaps future generations will recoil with similar horror at the messiness, unpredictability and personal involvement of real-time interaction.

Other aspects of brain development may also be in line for a makeover. One is attention span. If the young brain is exposed to a world of action and reaction, of instant screen images, such rapid interchange-might accustom the brain to operate over such timescales. It might be helpful to investigate whether the near total submersion of our culture in screen technologies over the past decade might in some way be linked to the threefold increase over this period in prescriptions for Methylphenidate, the drug prescribed for ADHD.

A second difference in the young 21st-century mind might be a marked preference for the here-and-now, where the immediacy of an experience trumps any regard for the consequences. After all, when you play a computer game, everything you do is reversible. You can switch it off or start again. But the idea that actions don't have consequences is a very bad lesson to learn, when in life they always do. And in games the emphasis is on the thrill of the moment. This type of activity can be compared with the thrill of compulsive gambling.

The third possible change is in empathy. This cannot develop through social networking because we are not aware of how other people are really feeling - we cannot pick up on body language when we are communicating through a screen. As a result, people could become almost autistic. One teacher wrote to me that she had witnessed a change over the 30 years she had been teaching in the ability of her pupils to understand other people and their emotions. She pointed out that previously, reading novels had been a good way of learning about how others feel and think....

More speculative rubbish here

Reforming Britain's schools — a self-correcting system

Plagued by persistent regulation, our system of state education is barred from reaching the level of quality that teachers not only aspire to, but are fully capable of achieving. Schools themselves are better placed than local government to decide where they should be allowed to set up and how they should function.

It takes only a small reform of our current system to allow the potential of our teachers and schools to be fulfilled - the creation of a system where schools of all kinds, whether they are state, private or charity-run, provide free and universal education, funded on a per-pupil basis by government, and given the freedom from burdensome regulation that the private sector enjoys. This is not an imposed reform, instead enabling schools to run themselves, opting in of their own accord, with government acting as the financier rather than the provider of free education.

The beauty of the reform is its self-correcting nature - the first of these free schools will appear where education is most in demand. As a school becomes popular, more parents will choose to send their children there and since it is paid per pupil, its income will increase. If a school is unpopular, then fewer and fewer pupils will be sent there until it either improves or fails. Schools will be able to innovate, directly rewarded for successful models of education through their popularity. Even if the amount paid per pupil is too low, then fewer schools will opt into the system until it can be increased.

However, this reform requires that all schools that have opted into the system be allowed to make a profit - something that the opposition party have shied away from, despite it being the principal reason for the system's success in Sweden. Without the entitlement to make a profit, not only will uptake of the system be slow, but successful schools will also be unable to expand and spread that success to other parts of the country for all pupils, parents and teachers to enjoy.


Aspirin now under attack!

Kids worldwide have been given this stuff for generations -- but suddenly it's wrong. But again it's all speculation

Children under 16 should not be given the ulcer treatments Bonjela or Bonjela Cool mint gel because of potential health risks, the medicines watchdog warns today. The Medicines and Healthcare products Regulatory Agency (MHRA) issued a precautionary alert on pain relief gels for the mouth that contain salicylate salts. These have the same effect on the body as aspirin, which is not recommended for those under the age of 16.

Bonjela is among the pain relief gels that contain the salts, which have been linked to Reye’s syndrome, a rare but potentially fatal condition in children. It is thought [There a lot of silly things thought. I have pretty silly thoughts myself at times] that a previous viral infection, such as flu or chickenpox, and exposure to aspirin could cause Reye’s syndrome, a metabolic disorder that can cause serious liver and brain damage.

The MHRA said that Bonjela’s adult formulations — designed to relieve the pain and swelling caused by mouth ulcers and denture and brace sores — were not recommended for children, but that Bonjela Teething Gel was safe. In a statement, the Agency added: “This is a precautionary measure only and there are no new safety concerns.

“The advice is being introduced due to a theoretical risk that these products could increase the possibility of a child developing Reye’s syndrome — a rare but serious condition,” the agency said. “There are a number of options and alternative treatments for pain associated with teething and mouth ulcers. If parents, carers or young people are unsure how best to treat these problems they should ask a GP, health visitor, dentist or pharmacist.” [Eating peanuts rapidly cures any mouth ulcers I get. So there's some free advice]

As of April 16, three suspected serious adverse drug reaction reports were received by the MHRA in association with the use of oral gels containing choline salicylate. All three cases were in children and all ended up in hospital. However, Reye’s syndrome was not confirmed in any child. The MHRA also received another four reports of vomiting or diarrhoea in children after the use of Bonjela, three of which related to the child being given the gel for teething pain. All made a full recovery.

June Raine, the MHRA’s director of vigilance and risk management of medicines, said the advice brought the products into line with others containing aspirin. “We are not aware of any confirmed cases but, when there are alternatives available, any risk is not worth taking. The new advice is to stop using these products in children and young people under 16, and to use alternative treatments.

“For infants with teething there is helpful advice in the Department of Health’s Birth to Five publication.” Reckitt Benckiser, the manufacturer of Bonjela, said that it had redesigned packaging to make it easier for consumers to choose the right gel in light of the new recommendations. Bonjela and Bonjela Cool will now be clearly labelled Adults and Children over 16 and the packaging for Bonjela Teething Gel has also been changed. The company added: “There have been no confirmed cases of Reye’s syndrome associated with Bonjela or Bonjela Cool, which remain safe and effective treatments for adults and children 16 years and over.

“The MHRA’s new advice on oral salicylate gels for use in under-16s does not affect Bonjela Teething Gel . . . has been specially formulated to provide targeted relief without the use of salicylates.”


Right on! "Police officers should wear name tags on their uniforms and those who deliberately hide their identity could be sacked, Met Commissioner Sir Paul Stephenson said today. The police has come under severe criticism for its handling of the G20 protests and Sir Paul, Britain's most senior policeman, said he wants officers to be more easily identifiable to the public. He also made it clear though that he wanted his senior officers to take a more robust approach in supervising the rank and file officers to ensure they could both be praised and have problem areas identified."

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