Australia: Health Alert - 2 July 2012

JUDGMENTS

Australian Capital Territory

Dixon v Foote & Calvary Health Care ACT Limited [2012] ACTSC 101 (27 June 2012)

Susan Dixon (plaintiff) commenced proceedings against Dr Andrew Foote (an urogynaecologist) and Calvary Health Care Act Limited (collectively the defendant) for alleged negligence before, during and after surgery.

The plaintiff consulted the defendant regarding the breakdown of a mesh sling that provided support following the prolapse of her uterus. The defendant claimed that he found a prolapse on examination of the plaintiff. She agreed to have an abdominal hysterectomy and sacral colpopexy (the further procedures) in addition to the treatment of the breakdown of the mesh sling.

It was later found that the plaintiff's right ureter was damaged as a result of the surgery and urine had leaked into the peritoneal cavity, requiring emergency surgery.

The court found that:

  • It was more probable that there was no prolapse. The plaintiff would not have undergone the further procedures had she been advised of this.
  • Considering all of the evidence, including evidence of the prevalence of ureteric injury in hysterectomy, there was sufficient evidence to find that the right ureter was injured during the surgery by the defendant.
  • During the surgery, the defendant relied on an observation of urine extraction from the ureter at the time of cystoscopy. This was an unreliable way to detect ureter damage.
  • After the surgery, the defendant became aware that urine was draining from the abdominal cavity. This warranted investigation.

The defendant did not exercise reasonable skill and care in treatment and care of the plaintiff. The court found in favour of the plaintiff.

Victoria. Coroners Court

Broughton Hall Redacted Finding Part 1 (PDF 2.29MB) - Broughton Hall Redacted Finding Part 2 (PDF 2.68MB) - Broughton Hall Appendix 1 Redacted (PDF 2.29MB)

This inquest concerned the deaths of four residents at Broughton Hall Aged Care Facility. A gastroenteritis outbreak was identified on 7 April 2008. The nurse informed the manager and queried the requirements to inform the Department of Human Services (DHS). There was no mandatory statutory obligation to inform DHS or the local council of the outbreak.

On 10 April 2007, DHS and the City of Boroondara (Council) were notified. This delay had ramifications on indentifying the nature of the outbreak.

The Coroner considered evidence about the complications of diagnosing gastroenteritis in an aged care facility. Expert evidence showed that with at risk patients, the judgment as to the probable cause of the outbreak should be a very cautious one.

The treating doctors were unclear as to whether or not they should order faecal tests or whether DHS should order them, and then report back. DHS submitted that during an aged care facility disease outbreak its role was protector of the general public health, rather than treatment of affected individuals. The overall effect of the opinion was that the aged care facility should be responsible for the collection of samples.

The inquest found that the salmonella pathogen either caused or contributed to the deaths. The evidence showed that there was a lack of understanding as between those caring for the patients and the statutory bodies responsible for public health generally. Since this outbreak, there have been legislative changes including a new regime of Regulations for the reporting of "notifiable diseases".

153709 Murugathasan Selvamalar (PDF 1.04MB) Dandenong, blood clot, hospital, medical, procedure.

New South Wales. Nursing and Midwifery Professional Standards Committee

HCCC v Thomas Vockins Lehmann [2012] NSWNMPSC 2 (31 May 2012)

Tasmania. Health Practitioner Tribunal

The Tasmanian Board of the Medical Board of Australia v Dr Arnol Daware (Ref No. 6/2011) [2012] TASHPT 3 (25 June 2012)

Ella Moore, aged 16 months, had previously been well, but from approximately 19 January 2008 she developed symptoms of a cough, runny nose and breathing difficulties. She was taken by her mother to general practitioner Dr Nicole Anderson on 23 January 2008, who assessed her and arranged immediate transfer by ambulance to the North West Regional Hospital. At the hospital Ella was seen and assessed by Paediatric Registrar Dr Sing-Jill Chow, who consulted with Paediatric Consultant Dr Amol Daware and treatment was instituted. At this time Ella was apparently unwell, lethargic, pale with moderate dehydration, had central cyanosis when coughing and had severe increase work of breathing. There was no wheeze audible, but possible crepitation on the right side. Cardiovascular system and abdominal examination was reported as normal. It was felt by the attending medical practitioners that she had asthma or pneumonia and treatment for these conditions was instituted. She was transferred to the Paediatric Ward where management was continued. However her condition continued to deteriorate despite treatment and eventually consultation between Dr Amol Daware and Dr Simon Parsons at the Royal Hobart Hospital Intensive Care Unit occurred. Ella was transferred to the Intensive Care Unit at the North West Regional Hospital and subsequently to the operating theatre for intubation and ventilation, as a decision to transfer to the Royal Hobart Hospital had been made. During the procedure of intubation performed by Dr Bob Stolk cardiac arrest occurred from which she was successfully resuscitated, however apparently significant cerebral hypoxia occurred during the course of the cardiac arrest. Ella was transferred to the Royal Hobart Hospital Paediatric Intensive Care Unit, where a diagnosis of cardiomyopathy and heart failure was made. Tragically, Ella was declared brain dead and intensive supportive care was withdrawn on 25 January 2008, following which Ella died.

Western Australia

Leheste v The Minister for Health [2012] WADC 92 (20 June 2012)

In this action, the plaintiff claims damages against the defendant for injuries she says were sustained as a result of the negligent manner in which an employee of the defendant at the Swan Health Service inserted a cannula into her inside right forearm slightly below the elbow crease. She says that as a result of the way in which the cannula was inserted, she sustained damage to the median nerve of her right arm with consequent numbness, pain and loss of function. The plaintiff also alleges that the injury and its consequences have caused her psychological issues, including an adjustment disorder.

Western Australia. State Administrative Tribunal

Liddell and Medical Board of Australia [2012] WASAT 120 (18 June 2012)

Medical practitioner - Health Practitioner National Law - Immediate action - Imposition of condition on registration - Nature of review of decision - Whether serious risk to persons - Whether necessary to take immediate action to protect public health and safety.

LEGISLATION

Commonwealth

Health Insurance Amendment (Extended Medicare Safety Net) Bill 2012 - C2012B00125 " House of Representatives second reading speech on 27 June 2012.

National Health Reform Amendment (Administrator and National Health Funding Body) Act 2012 - C2012A00062 " Act No. 62 of 2012 as made.

Therapeutic Goods Amendment Regulation 2012 (No. 1) - F2012L01448 " SLI 2012 No. 142 as made.

National Health (Pharmaceutical Benefits) Amendment Regulation 2012 (No. 3) - F2012L01443 " SLI 2012 No. 141 as made.

Aged Care (Amount of Flexible Care Subsidy - Extended Aged Care at Home - Dementia) Determination 2012 (No. 1) - F2012L01420 " as made.

Aged Care (Residential Care Subsidy - Amount of Viability Supplement) Determination 2012 (No. 1) - F2012L01416 " as made.

Aged Care (Residential Care Subsidy - Adjusted Subsidy Reduction) Determination 2012 (No. 1) - F2012L01415 " as made.

Aged Care (Residential Care Subsidy - Amount of Enteral Feeding Supplement) Determination 2012 (No. 1) - F2012L01414 " as made.

Aged Care (Residential Care Subsidy - Amount of Oxygen Supplement) Determination 2012 (No. 1) - F2012L01411 " as made.

Aged Care (Residential Care - Amount of Basic Subsidy) Determination 2012 (No. 1) - F2012L01410 " as made.

Aged Care (Amount of Flexible Care Subsidy - Transition Care Services) Determination 2012 (No. 1) - F2012L01408 " as made.

Aged Care (Amount of Flexible Care Subsidy - Innovative Care Services) Determination 2012 (No. 1) - F2012L01406 " as made.

Healthcare Identifiers Amendment Regulation 2012 (No. 1) - F2012L01401 " SLI 2012 No. 160 as made.

Personally Controlled Electronic Health Records Regulation 2012 - F2012L01399 " SLI 2012 No. 129 as made.

Personally Controlled Electronic Health Records (Consequential Amendments) Proclamation 2012 - F2012L01398 " as made.

Aged Care (Residential Care Subsidy - Amount of Basic Daily Fee Supplement) Determination 2012 (No. 1) - F2012L01348 " as made.

User Rights Amendment Principles 2012 (No. 2) - F2012L01346 " as made.

National Health (Efficient Funding of Chemotherapy) Special Arrangement Amendment Instrument 2012 (No. 5) (No. PB 40 of 2012) - F2012L01332 " PB 40 of 2012 as made.

Queensland

Health and Hospitals Network and Other Legislation Amendment Act 2012 - Assent - 27 June 2012.

Health Legislation (Health Practitioner Regulation National Law) Amendment Act 2012 - Assent - 27 June 2012.

Victoria

Health (Commonwealth State Funding Arrangements) Act 2012 - Assent - 27 June 2012.

Health and Hospitals Network and Other Legislation Amendment Act 2012 - 27 June 2012

Health Legislation (Health Practitioner Regulation National Law) Amendment Act 2012

REPORTS

Australia. Department of Health and Ageing

Private health insurance circulars

The National Aged Care Conference 2012 will be held in Adelaide on 6-7 August.

21 June 2012 - Aged Care Reform Update

21 June 2012 - Aged Care Funding Instrument Information

PBS - Review of Anticoagulation Therapies in Atrial Fibrillation: Issues and Options Paper and Stakeholder Forum. - 29 June 2012 - The Issues and Options Paper (PDF 1MB) for the Review of Anticoagulation Therapies in Atrial Fibrillation is now available. A Stakeholder Forum will be held on 4 July 2012 for affected parties and individuals to provide feedback on the paper. Registrations close on 2 July 2012. Feedback can also be provided in writing to the Department of Health and Ageing and must be received by 11 July 2012. Further information is available at: Review of Anticoagulation Therapies in Atrial Fibrillation.

Australia. National Blood Authority

Blood Service processing to move from Adelaide to Melbourne

Australian Health Practitioner Regulation Agency and The Boards

27 June 2012 - New fees released: The Medical Board of Australia has set its registration fees for 2012-2013. | Read Article

27 June 2012 - The [Chinese Medicine] Board has released the Chinese translation to its Registration applications and CPD Frequently asked questions document. | Read Article

26 June 2012 - The [Dental] Board releases its latest newsletter. | Read Article

25 June 2012 - Consultation open on options for refining international criminal history checks used to assess applications for registration, closes 17 August 2012. | Read Article

22 June 2012 - The [Osteopathy] Board has released a fact sheet to inform osteopaths about their obligations in relation to acupuncture. | Read Article

22 June 2012 - The [Medical Radiation Practice] Board has released information on its Registration Standards for transitioning practitioners. | Read Article

Australia. Therapeutic Goods Administration (TGA)

29 June 2012 - Regulation impact statement (RIS) for reclassification of hip, knee and shoulder joint implants - The purpose of this RIS is to assist Federal Government decision-making on how to address safety concerns.

29 June 2012 - PIP breast implants - TGA update - Updated information on safety concerns with PIP breast implants.

29 June 2012 - Cost recovery impact statements - Added three cost recovery impact statements: medical devices, good manufacturing practice and addendum.

29 June 2012 - International Regulators Consortium - The TGA is part of the International Regulators Consortium along with Health Canada, HSA Singapore and Swissmedic.

27 June 2012 - S38 guidelines for Australian manufacturing licences covering multiple manufacturing sites - Circumstances when manufacturing licence may cover two or more manufacturing sites.

25 June 2012 - Over-the-counter (OTC) medicines reform - The TGA and Medsafe are reviewing the business process for the evaluation of OTC medicine registration applications to reform the current system and develop a common approach in both countries.

Australia. National Health & Medical Research Council

22 June 2012 - Statement from the Australian Institute of Health Welfare on the release of Cause of Death Unit Record Files data

Australian Institute of Health & Welfare (AIHW)

28 June 2012 - Nursing and midwifery workforce 2011 (media release)

19 June 2012 - National Opioid Pharmacotherapy Statistics Annual Data collection: 2011 report | National Opioid Pharmacothe

rapy Statistics Annual Data 2012 collection data guide (media release)

18 June 2012 - Trends in serious injury due to land transport accidents, Australia 2000-01 to 2008-09 - Serious injury due to land transport accidents involving a railway train, Australia 2004-05 to 2008-09 - Serious injury due to land transport accidents, Australia 2008-09 - Serious injury due to land transport accidents, Australia 2007-08 (media release)

15 June 2012 - The health of Australia's males (media release)

12 June 2012 - AIHW Access no. 33

Australian National Council on Drugs

Media release

25 June 2012 - Second Australian Needle and Syringe Program Return on Investment Study

Australia. Private Health Insurance Administration Council

28 June 2012 - Circular 12/14 - End of Financial Reporting - End of Financial Year Reporting

28 June 2012 - Annual Regulatory Plan 2012-2013

Australian Capital Territory. Department of Health

Media releases

New South Wales. Department of Health

Media releases

Policy directives and guidelines

Northern Territory. Department of Health

Media releases

Queensland. Department of Health

Media releases

Queensland. Health Quality and Complaints Commission

Investigating for improvement: A special report on investigations finalised 1 July to 31 December 2011

Doctor Right: A special report on credentialing and defining the scope of clinical practice for doctors working in licensed private acute and day hospitals (Volume 2)

Victoria. Department of Health

Media releases

Victorian Home and Community Care Quality Review Resource 2012 (580kb, PDF)

Western Australia. Department of Health

Media releases

New Zealand. Ministry of Health

28 June 2012 - Review of Health Education Resources on Gout Medication: Summary of report to the Ministry of Health - This report summarises a review of the suitability of publicly available resources on gout medication and its use – for health professionals as well as consumers and their whanau.

United Kingdom. Department of Health

Health visitors early implementer sites rolled out - In this 150th year of health visiting, new parents around the country are to receive more support from health visitors in the home and community.

"Get involved" says Responsibility Deal network chair to all in alcohol industry - Henry Ashworth, Chair of the Public Health Responsibility Deal alcohol network, is urging more businesses to sign up to the Responsibility Deal alcohol pledges.

Consultation launched on fertility and human tissue regulators - Proposals to change responsibility for regulating fertility treatment and human tissue are set out today with the launch of a consultation on the future of the Human Fertilisation and Embryology Authority.

Employers urged to offer flexible working to support mental health needs - Thousands of individuals with mental health needs could be offered more flexible working under a new initiative launched today by Health Minister Lord Howe.

Winners of the second round of innovation challenges announced - Last night the winners of the second round of innovation challenges were announced and included prizes for an early detection of cancer programme and improvements in turnaround times for cancer tests.

Agreement extended on predictive genetic tests and insurance - Thousands of people who have genetic tests for conditions such as Alzheimer's and cancer will continue to benefit when taking out insurance thanks to an extended agreement announced today.

Department of Health publishes interim Winterbourne report setting out actions to improve care and support of vulnerable people with learning disabilities - The Department of Health has published an interim report as part of a review of events at Winterbourne View private hospital.

Canada. Health Canada

27 June 2012 - Harper Government Invests in Health Research - Reporting to Canadians on Health Investments

United States of America. Department of Health & Human Services (HHS)

AIDS.gov embraces new digital government strategy - On National HIV Testing Day, the US Department of Health and Human Services announced that AIDS.gov, the gateway to all federal HIV/AIDS information and resources, has been relaunched and redesigned using responsive design.

Health and Human Services brings innovative approach to solving health care challenges - Health and Human Services Deputy Secretary Bill Corr today announced that the department is exploring new ways of bringing an entrepreneurial spirit to solving the nation's health and health care challenges.The new HHS Innovation Fellows Program aims to bring fresh, innovative ideas and expertise from outside the agency to help HHS accelerate health and health care innovation.

Australian Medical Association (AMA)

27 June 2012 - GP leaders discuss primary care issues with Minister - The leaders of members of United General Practice Australia yesterday met Health Minister Tanya Plibersek at Parliament House in Canberra to discuss the major issues affecting hardworking GPs across the country. Discussions centred on medical workforce, changes to Practice Incentive Payments and the imminent implementation of the Personally Controlled Electronic Health Record.

26 June 2012 - AMA urges more people to become organ donors - The AMA has developed a Position Statement on organ and tissue donation and transplantation. The AMA supports organ and tissue donation and strongly encourages individuals to consider their views and discuss them with their family.

26 June 2012 - e-dit: Issue 92

25 June 2012 - AMACGP flags bigger local role for AMA in supporting general practice - The AMA Council of General Practice (AMACGP) has flagged a more active role for the AMA at the local level in supporting general practice in the new Medicare Locals environment. The AMACGP – the peak independent national Council for GPs – met in Canberra over the weekend.

23 June 2012 - AMA backs campaign to stop binge drinking - AMA President, Dr Steve Hambleton, said today that the AMA strongly supports a new Federal Government sport sponsorship program that addresses binge drinking, specifically the link between sport and alcohol sponsorship. The Community Sponsorship Fund, part of the Government's National Binge Drinking Strategy, provides an alternative sponsorship source for major sporting groups and will involve them in promoting a new campaign to address binge drinking.

British Medical Association (BMA)

28 June 2012 - Scrap work capability assessment, doctors demand

28 June 2012 - Consultant Mark Porter elected as BMA council chair

27 June 2012 - Doctors call for worldwide ban on using drugs for execution

27 June 2012 - Non-directive abortion counselling wins backing

27 June 2012 - Med schools accused of flouting cap on international students

Canadian Medical Association (CMA)

25 June 2012 - "We cannot leave the most vulnerable to fend for themselves": CMA

22 June 2012 - New CMA course tackles HIV in Aboriginal community

American Medical Association (AMA)

28 June 2012 - AMA: Supreme Court Decision Protects Much-Needed Health Insurance Coverage for Millions of Americans - AMA Statement - The American Medical Association has long supported health insurance coverage for all, and we are pleased that this decision means millions of Americans can look forward to the coverage they need to get healthy and stay healthy.

22 June 2012 - AMA Applauds HHS Pilot Programs to Reduce Prescription Drug Abuse - AMA Statement - The AMA is deeply involved and committed to efforts that will curb prescription drug abuse and diversion.

28 June 2012 - American Medical News - CT orders level off as awareness of radiation risk grows - Urging by physician organisations to think twice before doing imaging studies is having an impact.

This publication is intended as a general overview and discussion of the subjects dealt with. It is not intended to be, and should not used as, a substitute for taking legal advice in any specific situation. DLA Piper Australia will accept no responsibility for any actions taken or not taken on the basis of this publication.


DLA Piper Australia is part of DLA Piper, a global law firm, operating through various separate and distinct legal entities. For further information, please refer to www.dlapiper.com

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Michael Regos
 
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