Health Alert is a summary of the critical judgments, legislation, press releases and news items which have come to our attention each week.
The summaries contain links to more detailed information and many items of special interest will also contain commentary.
Health Alert is a quick and effective means of ensuring that you are aware of significant recent changes.
New South Wales. District Court
Catchwords:- Negligence – professional negligence – causation – PTSD – hypernatremia – alleged failure to diagnose and treat – negligent treatment by hospital – relationship of any negligent act to damage sustained.
This case concerns aspects of the recent High Court authority of Tabet v Gett  HCA 12 which reinforced that a plaintiff must be able to satisfy the court that (1) the defendant was factually negligent, in that their treatment fell below the required standard of care, and (2) the negligence was in fact, more probably than not, a cause of the plaintiff's injury.
The plaintiff was a participant in a staged rowing marathon and began to feel ill after the event. She was treated by the race doctor for hypothermia and transferred to a local Hospital where her condition worsened. She was subsequently diagnosed with Hyponatremia. The plaintiff recovered successfully (aside from a few minor physical effects) but has ongoing post traumatic stress disorder and depression.
The plaintiff claimed the delayed diagnosis of her condition, and inappropriate I/V drip solution (including dextrose) for her condition which temporarily worsened her condition, caused her PTSD and depression.
Williams DCJ found no evidence of negligence in the delayed diagnosis of Hyponatremia because of the difficulty of diagnosing Hyponatremia. He found the hospital may have been negligent in commencing a drip solution incorporating dextrose but that in any event neither the treating doctor nor the hospital were liable. This is because the plaintiff had not provided evidence that the treatment was the cause of her PTSD and depression. The plaintiff was fearful for her life from the onset of the symptoms of Hyponatremia which included the feeling of losing consciousness and the need for hospitalisation. The plaintiff's psychiatric injury was caused by a "non-negligent shock" which she suffered as a natural result of the circumstances.
His honour observed that where a plaintiff suffers a psychiatric injury, not a physical injury, as a result of treatment during hospitalisation, the causal link between negligence and psychiatric injury may be harder to satisfy.
TORTS – professional negligence – medical – orthopaedic out-patient management of complex Type 3 Pilon tibial fracture following initial operative repair – whether unreasonable delay in arranging further orthopaedic surgery for non-union or delayed union of fracture – whether breach of duty of care by hospital – whether breach of duty of care by consultant visiting medical officer – whether defendants proved cigarette smoking by plaintiff constituted contributory negligence – whether legal test for causation of harm satisfied – considerations of Civil Liability Act 2002, s 5O
Victoria. Coroners Court
The Victorian Coroner examined the death of a young woman following liposuction surgery. The coroner found her treating doctors did not provide adequate post-operative care. In particular, her presentation three days post surgery, with pain and a departure from normal or expected clinical course, should have prompted an investigation of the cause of the pain, even if there were no physical symptoms of swelling in the area of liposuction.
Other aspects of the post-operative management that concerned the Coroner included the appointment of a doctor, other than the patient's treating surgeon, to be the patient's contact post-surgery and perform aspects of the post-operative management. In the circumstances, the Coroner found that appointing another Doctor to provide post-operative management, may modify, but does not relieve the treating surgeon of his/her obligations to the patient.
Further the Coroner cautioned practitioners that this case raises issues of post-operative management in day surgery facilities and the need for good lines of communication and clear communication between practitioners, staff and patients as well as the clear demarcation of responsibilities between practitioners.
New South Wales. Nurses and Midwives Tribunal
National Health Act (Pharmaceutical Benefits - Early Supply) Amendment September 2010 - specification under subsection 84AAA(2) (No. PB 86 of 2010) - F2010L02273 - Health - This instrument amends the National Health Act (Pharmaceutical Benefits - Early Supply) - specification under subsection 84AAA(2) Instrument 2009 (No. PB 30 of 2009) to amend the list of medicines for which Pharmaceutical Benefits Scheme (PBS) Safety Net entitlements will not apply when the next supply of the same medicine is obtained within 20 days.
National Health (Highly specialised drugs program for public hospitals) Special Arrangements Amendment Instrument 2010 (No. 2) (No. PB 83 of 2010) - F2010L02266 - Health - These Arrangements amend the National Health (Highly specialised drugs program for public hospitals) Special Arrangements Instrument 2010 (No. PB 63 of 2010) to provide for changes to highly specialised drugs available at public hospitals to non-admitted patients, day admitted patients or patients on discharge.
National Health Act 1953 - Amendment determination under section 84AF - responsible persons (No. PB 82 of 2010) - F2010L02248 - Health - This Determination amends the National Health Act 1953 - Determination under section 84AF - responsible persons (No. PB 69 of 2010) to provide for additions and changes to the responsible persons for the brands of pharmaceutical items.
National Health Act 1953 - Amendment determinations under sections 85, 85A and 88 - pharmaceutical benefits (No. PB 81 of 2010) F2010L02247 - Health - This Determination amends the National Health Act 1953 - Determinations under sections 85, 85A and 88 - Pharmaceutical benefits (No. PB 68 of 2010) to provide for additional changes to the names, forms and brands of listed drugs on the Pharmaceutical Benefits Scheme and the conditions for prescribing pharmaceutical benefits.
National Health (Highly specialised drugs program for private hospitals) Special Arrangements Amendment Instrument 2010 (No. 2) (No. PB 84 of 2010) - F2010L02249 - Health - These Arrangements amend the National Health (Highly specialised drugs program for private hospitals) Special Arrangements Instrument 2010 (No. PB 64 of 2010) to provide for changes to highly specialised drugs available at private hospitals to non-admitted patients, day admitted patients or patients on discharge.
Severe Substance Dependence Treatment Act 2010No. 43 - assented to on 10/08/2010
The purpose of this Act is to provide for the detention and treatment of persons with a severe substance dependence
Australia. Pharmacy Board of Australia
Australia. Nursing and Midwifery Board
Nursing and IELTS FAQs has been released along with an Information sheet on visa requirements for international nursing students.
Australian Institute of Health & Welfare
BreastScreen Australia monitoring report 2006-2007 and 2007-2008 - Breast cancer is the second most common cause of death from cancer in Australian women. BreastScreen Australia monitoring report 2006-2007 and 2007-2008 is the tenth report presenting national statistics (combining ... Published 13 August 2010.
BreastScreen Australia monitoring report 2006-2007 and 2007-2008: supplementary data tables - This publication provides supplementary data tables to the BreastScreen Australia monitoring report 2006-2007 and 2007-2008 report. ... Published 13 August 2010.
Mental health services in Australia 2007-08 - Mental Health Services in Australia 2007-08 is the twelfth in the series of annual reports providing a detailed picture of the national response to the mental health care needs of ... Published 12 August 2010.
Australian Capital Territory. Department of Health
- ACT welcomes Gillard Labor Government's commitment to build a local GP Super Clinic Katy Gallagher, MLA August 11 2010
New South Wales. Department of Health
Discussion Paper on Local Health Networks released - Feedback is now encouraged on the proposed LHNs configuration.
- INFLUENZA 20/07/2010
- Changes to Public Sector Appeals Processes and Coverage IB2010_042 12/08/2010
- Health Records and Medical/Clinical Reports - Rates IB2010_041 11/08/2010
- Overtime Meal Allowances IB2010_040 11/08/2010
Northern Territory. Department of Health & Families
- Kon Vatskalis - Alice Springs Hospital's New General Manager Announced - Health Minister Kon Vatskalis has welcomed the appointment of Mr Mike Melino to the position of General Manager, Alice Springs Hospital (ASH).
- Kon Vatskalis - Mental Health Boost with In-Patient Bed Increase at RDH - A major refurbishment will be undertaken at Royal Darwin Hospital with the awarding of a tender to provide five additional mental health in-patient beds.
Queensland. Department of Health
- RECORD YEAR FOR ELECTIVE SURGERYA record number of patients received elective surgery in Queensland's public hospitals in the 2009-2010 financial year
- 10/08/2010 Patients to benefit from new cardiac facility at Cairns
- 10/08/2010 ABBOTT'S PLAN WILL SLASH FUTURE CANCER SERVICES
- 06/08/2010 EARLY INTERVENTION KEY TO MANAGING PSYCHOSIS IN YOUTH
Tasmania. Department of Health & Human Services
- Tasmanian Government welcomes radiation therapy commitment Minister for Health 12 August 2010
- Tasmanians Getting Healthy Minister for Health 11 August 2010
- North West Cancer Services Minister for Health 8 August 2010
- MR ABBOTT'S HEALTH POLICY WILL RIP $100 MILLION OUT OF TASMANIA'S HOSPITALS Minister for Health 7 August 2010
- Liberal Party's North West Cancer Plan Underfunded and Undeliverable Minister for Health 6 August 2010
- Don't ignore swine flu threat< - 9 Aug 2010
- Recruitment - Commissioner for Children 03 Aug 2010
Victoria. Department of Health
- WORK STARTS ON NORTH RICHMOND COMMUNITY HEALTH REDEVELOPMENT - Saturday, 07 August 2010 - Construction has started on the $24 million redevelopment of the North Richmond Community Health Centre.
Hospital circular - Publication Number 17 / 2010 - 5 August 2010 - Date Issued: 30 July 2010. Subject: Highly Specialised Drugs Program
DVD for medical staff - 6 August 2010 - Sunshine Hospital has produced a DVD that teaches medical staff how to help families who have suffered a miscarriage.
Western Australia. Department of Health
- 13 August 2010 - Help for new parents just a click away.
The Department of Health has launched a new website as a one-stop information point for new and expecting parents across the State. The site contains a comprehensive range of information to help prepare for pregnancy, being pregnant, labour and birth and after their baby is born.
- 12 August 2010 - Awards to boost WA Health research
- 11 Aug 2010 - Review finds vaccination program suspension 'right decision'
- 11 Aug 2010 - Fiona Stanley Hospital Stage Two contract awarded
New Zealand. Ministry of Health
13 Aug: Website improvements respond to your feedback - The look and feel of this website has been refreshed. We hope you find the site easier to use as a result of these improvements.
13 Aug: Changes to the Well Child/Tamariki Ora Framework - This document sets out the changes that are being made to the 2002 Well Child/Tamariki Ora Framework following a major review.
United Kingdom. Department of Health
United States of America. Centers for Disease Control
CDC Report looks at Foods and Foodborne agents associated with Outbreaks in the United States A total of 1,097 foodborne disease outbreaks were reported in 2007 to the Centers for Disease Control and Prevention, according to a CDC analysis. State investigators reported 21,244 illnesses and 18 deaths as a result of these outbreaks. (Published: 8/12/2010)
WHO Declares End to 2009 H1N1 Influenza Pandemic - On August 10, 2010, the World Health Organization (WHO) International Health Regulations (IHR) Emergency Committee and the WHO Director-General, Dr. Margaret Chan, declared an end to the 2009 H1N1 influenza pandemic. (Published: 8/10/2010)
ACIP Recommendation for Use of CSL Influenza Vaccine - On Thursday, August 5, 2010, CDC's Advisory Committee on Immunization Practices (ACIP) met to discuss recommendations for use in the United States of seasonal influenza trivalent inactivated vaccine (TIV) [Afluria] manufactured by CSL Limited during 2010-11. (Published: 8/6/2010)
Australian Medical Association
Healthy kids check needs stronger evidence base 11 August 2010 - 4:00pm - AMA President, Dr Andrew Pesce, said today that the AMA supports the principle that parents should be given greater incentive to take personal responsibility for making sure that their children have a healthy start to life, but the Healthy Kids Check, in its current form, is not the right way to achieve this outcome. Dr Pesce said the Healthy Kids Check needs to be redesigned in consultation with the medical profession to ensure that it targets the right risk factors in children at the right age and that there is an evidence base for this approach.
AMA calls for action on Indigenous health 10 August 2010 - 2:30pm - AMA President, Dr Andrew Pesce, said today that it is unacceptable that the major parties are yet to make significant policy announcements to address the health needs of Indigenous Australians. Dr Pesce said Indigenous health must be a priority in this election, not an afterthought.
AMA calls for proper indexation of the Medicare Benefits Schedule (MBS) and no further cuts to medicare rebates 10 August 2010 - 2:10pm - The AMA is today calling on the major parties to commit to proper indexation of the Medicare Benefits Schedule (MBS) and to promise to increase Medicare patient rebates, not cut them. AMA President, Dr Andrew Pesce, said that Medicare rebates are set by the Government and are paid to patients to assist them with the cost of professional medical care and treatment, but the current rebates do not reflect the realistic cost of providing medical services.
AMA condemns killing of doctors in Afghanistan 9 August 2010 - 6:00pm - AMA President, Dr Andrew Pesce, said today that the AMA condemns the killing of eight foreign doctors in Afghanistan. Dr Pesce said it is a tragedy that these doctors could lose their lives while seeking to provide medical care to poor and oppressed people in a country at war. "Many doctors, including Australians, travel to the world's trouble spots to provide vital medical services to the innocent victims of conflict," Dr Pesce said.
Commitment to boost local health infrastructure 6 August 2010 - 3:40pm - AMA President, Dr Andrew Pesce, said today that the Coalition's commitment to invest $85 million in health infrastructure in local communities is a small but good start in meeting growing demand for important services and equipment, especially for public hospitals. Dr Pesce said that capital investment in health infrastructure, particularly in neglected areas of rural, regional and remote Australia, is sorely needed.
British Medical Association
Doctors raise alarm at NHS plans to ban use of locums - Welsh health board adopts 'zero tolerance' to use of agency staff
Doctors back malaria awareness drive - Publicity about Cheryl Cole used to spread warning of infection dangers
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