Tuesday, June 16, 2009

Invisible Disease? - surgical revisions

I had posted on the idea of invisible diseases before. These are hospital related ailments that fewwant made public, and seldom discussed. Some of these may be iatrogenic, but often they are problems associated with management or policy issues. Hospital infection was one of these, and so was medication error. You can add the IVF mistakes to the list. Hospitals/clinics don't really track these problems, and even if they do you don't get to hear of them because no one wants to look bad. So the consumer is none the wiser.

One problem that was brought to my attention was that of surgical revisions, as a consequence of implants and prostheses etc. Unbeknownst to the public, this can be particularly problematic. You see, unlike drugs, which undergo extensive preclinical and clinical testing, medical devices are onlty minimally tested. There are few procedures to regulate the entry of these untested prosthesies and implants into the market, and we have no idea how many of the numerous implant/prosthesis fail, or how many patients need to undergo surgical revisions for these implants.

These figures are obviously important for the patient, but no one tracks these numbers and the surgeons are obviously not going to tell the patient how bad their figures are.

Maybe it's time for HSA to relook this blindspot in the regulation of medical devices so that patients can be better protected. At least they should be aware of the quality of the implants and prostheses being put into their bodies.

Here is some data I manage to pull out from a Swedish study on hip implants.

Makela et al. J Bone Joint Surg Br. 2008 Dec;90(12):1562-9.

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