Basildon University Hospital Admits Safety Law Breach

(BBC) – A HOSPITAL IN ESSEX where a severely disabled man died has admitted breaching health and safety law.

Kyle Flack, 20, from Stanford-le-Hope, who had severe cerebral palsy, was found dead at Basildon University Hospital, on 12 October 2006.

His head had become trapped in the rails around his bed, an inquest heard.

The Health and Safety Executive (HSE) brought the prosecution, accusing the hospital of failing to ensure the patient’s safety.

Matthew Taylor, prosecuting on behalf of the Health and Safety Executive (HSE), told magistrates Mr Flack died at the hospital, two days after being admitted with stomach problems.

“The failings of the hospital were causative of death,” Mr Taylor told magistrates.

“Not only do we say that the trust’s failings caused the death of Kyle but we also say they failed to heed previous warnings.”

After the hearing, Mr Flack’s mother, Gill, condemned some care standards at the hospital as “absolute crap”.

She said bosses should be “held accountable” and called for “staff sackings”.

Maggie Rogers, director of nursing at Basildon and Thurrock University Hospitals NHS Foundation Trust , said: “Firstly, I repeat our sincere condolences to the family and friends of Kyle Flack.

“I can reassure our patients that since his tragic death in 2006, we have taken action that includes improving the management of equipment and the care of our patients with special needs.”

The hospital will be sentenced on 15 March after magistrates committed the case to Basildon Crown Court.

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Diabetes Sufferers Warned That Widely-Used Drug Avandia Can Cause Heart Disease And Death

(Daily Mail) – THE SAFETY of a diabetes drug used by thousands of Britons was called into question again yesterday.

U.S. senators said the makers of Avandia, British firm GlaxoSmithKline, knew it carried a higher risk of heart attack than a rival medicine but had tried to keep evidence of the risk from the public.

Senators Max Baucus and Charles Grassley said GSK executives ‘attempted to intimidate independent physicians and focused on strategies to minimise or misrepresent findings that Avandia may increase cardiovascular risk’.

Now the U.S. Food and Drug Administration, the medicines watchdog, has asked an advisory committee to look again at the drug.

Britain’s equivalent, the MHRA, said it would be ‘continuously monitoring’ the safety of Avandia.

The drug is prescribed for patients with type 2 diabetes and up to 100,000 Britons take it.

In their controversial report, senators Max Baucus and Charles Grassley accused the FDA of not having banned the drug because it is too ‘cozy’ with drugs firms like Acandia maker GlaxoSmithKline.

They quoted a memo written by two FDA reviewers which concluded: ‘The risks of (Avandia) are serious and exceed those for’ rival drug Actos.

The reviewers said there was ‘strong evidence that (Avandia) confers an increased risk of’ heart attack and heart failure when compared to Actos.

It followed a 2007 study published in the Journal of the American Medical Association, which found Avandia puts users at a 60 per cent greater risk of heart failure, a 40 per cent greater risk of heart attack and a 29 per cent greater risk of death than other medication.

But the FDA decided later that year against pulling the product from the shelves.

The senators’ report said evidence showed GSK ‘knew for several years’ that there were ‘possible cardiac risks associated with Avandia’.

Executives ‘attempted to intimidate independent physicians, focused on strategies to minimize or misrepresent findings that Avandia may increase cardiovascular risk and sought ways to downplay findings that a competing drug might reduce cardiovascular risk,’ the report said.

Senator Baucus said: ‘Americans have a right to know there are serious health risks associated with Avandia and GlaxoSmithKline had a responsibility to tell them.

‘Patients trust drugs companies with their health and their lives and GlaxoSmithKline abused that trust.’

Today, FDA commissioner Margaret Hamburg said a committee had been asked to look into the safety of Avandia.

‘I await the recommendations of the advisory committee,’ she said. ‘Meanwhile, I am reviewing the inquiry made by Senators Baucus and Grassley and I am reaching out to ensure that I have a complete understanding and awareness of all of the data and issues involved.’

A spokesman for the MHRA, the Medicines and Healthcare products Regulatory Agency, said: ‘We look at any new data that comes to light about a medicine and can update the product information if necessary.’

A spokesman for GSK said it rejected the report’s conclusions.

The company said the report ‘cherry-picks information from documents, which mischaracterises GlaxoSmithKline’s comprehensive efforts to research Avandia and communicate those findings to regulators, physicians and patients.’

It said it had rigorously studied Avandia’s safety and ‘consistently shared this data with regulators around the world’.

The company said it ‘does not condone any effort to silence scientific debate’.

Labour Spending Has Failed To Improve Child Health

(Guardian) – THE GOVERNMENT HAS FAILED to “significantly improve” children’s health despite spending more than £10bn and producing a policy every six months over the last decade, according to the Audit Commission.

In a report published today, the spending watchdog found that childhood obesity has risen from 10.1% to 13.9% between 1995 and 2008. While infant mortality rates have declined, Britain still has the highest number of deaths per 1,000 live births in western Europe, higher than countries such as the Netherlands, France, the Republic of Ireland and Spain.

The commission said it was also concerned about the persistence of health inequalities which meant children under five living in deprived areas had a significantly “higher risk of poor health”. Children in poorer areas are 19% more likely to have bad dental health and 9% more likely to be born underweight.

Steve Bundred, outgoing chief executive of the commission, said the findings were “disappointing. The policies are not delivering commensurate improvement and value for money. Large inequalities persist … and even before [children] are born, for many, place and parents’ income determine their quality of life and their lifespan.”

The government had failed to focus on the youngest in society, the report said. The result was that obesity, a factor in heart disease and diabetes, cost the NHS £4.2bn a year and without action this could double in the decades ahead. Bundred said poor diet lay at the heart of many health inequalities. “Sugary drinks, unhealthy foods are factors that do contribute to [health] inequalities with young children in poorer areas,” he said.

Despite 27 national policies since 1999 aimed at improving the health of under-fives as a way to reduce the gap between rich and poor, Bundred said much of the government’s efforts ended up being concentrated on older children.

The increasing volume of national children’s policy meant there was now “duplication and inconsistencies across government departments, leading to confusion locally about planning and delivering health services for the under-fives”.

The report also pointed out that while councils were aware of health issues facing young children, such as a decline in immunisation rates for mumps, measles and rubella, there had been a 10% drop in the number of health visitors employed in England. The commission also found that parents from vulnerable groups were not using the government’s Sure Start children’s centres, designed to serve those in deprived areas.

This was, according to Bundred, either because they were unaware of the service or because they “found the attitude of the staff off-putting … too judgmental”. The commission called on the government to clearly target spending on vulnerable groups to reduce inequalities and said there should be a single set of priorities to avoid confusion.

Many experts say that what is needed is a bigger “cultural change” that makes children a priority in society.

In today’s Society Guardian, Terence Stephenson, president of the Royal College of Paediatrics and Child Health and Nuffield professor of child health at University College London, says that “of 188 performance indicators available to local authorities, only six relate to under-fives’ health, and none feature in the top 20”.

He added that unequal rich wealthy societies often did not produce high levels of “child wellbeing” .

“Children in countries with more unequal wealth distribution fare worse,” he said. “Similarly, infant mortality is related to inequality in rich countries. The UK has a worse infant mortality rate than Greece, despite having almost double the income per person.”

The government defended its record, saying that there had been increases in breastfeeding rates and that because of a successful immunisation programme no child died of meningitis C in 2008.

“We know there is still more to do and we’re determined to keep up the momentum. This is why we introduced the Healthy Child Programme, the first universal, evidence-based programme to ensure that all children get the best possible start in life,” said Gillian Merron, minister for public health.

Fat Parents To Blame For Childhood Obesity Problems

(Telegraph) – OVERWEIGHT PARENTS who simply feed their children too much at a young age are largely to blame for Britain’s childhood obesity crisis, a report will warn this week.

The study claims that the Government may be misguided in its policy of trying to tackle the problem through expensive projects aimed at persuading children in primary school to eat healthily and exercise more.

Instead, the report suggests, they should focus on educating new parents and parents-to-be to feed their children less before they start school, so they do not become overweight in the first place. Parents must learn to reduce portion sizes it suggests.

The findings from one of the few long-term studies on childhood obesity in Britain show that daughters of overweight mothers are 10 times more likely to be obese by the time they reach the age of eight than a daughter born to a slim mother.

Sons of obese fathers are six times more likely to be overweight, according to the research from scientists working on the EarlyBird Diabetes Project at the medical school in Plymouth.

Children of fat parents tended to be over-fed and under-exercised, setting them on a trajectory towards obesity, it found. The chief cause of weight gain, the report said, was “over-nutrition” of children by their parents.

One of the report’s co-authors, Terry Wilkin, Professor of Endocrinology and Metabolism at Peninsula Medical School, told The Daily Telegraph that the results showed “physical activity will help a child’s fitness but not his or her fatness”.

Prof Wilkin, together with Dr Linda Voss from the school, said in the report: “We have found no evidence that physical inactivity precedes obesity, but good evidence that obesity precedes inactivity.

“A picture is emerging from the EarlyBird study to suggest that weight gain trajectories are set early in life, perhaps very early, by some behavioural sympathy between obese parents and their same-sex offspring.”

More than 2.3million children in Britain are estimated to be overweight or obese and many under-12s already show signs of high blood pressure and cholesterol, diabetes and liver disease.

The Government has spent nearly £2billion over the past decade tackling obesity levels, with a large part of the money being spent on encouraging children to lead healthier lives.

The figures include £733million on school sport, £650million on school food and £235million on play facilities.

However, the scientists said “the implications are clear [from the research] – strategies aimed at increasing physical activity, even if they ever achieved the increase, are unlikely to reduce BMI [Body Mass Index].

“The observation is important, because it may turn the causality of childhood obesity on its head. A large amount of money and effort has been directed at children in the belief that the prevention of childhood obesity would reduce adult obesity.

“Importantly the factors popularly associated with childhood obesity – poor school meals, lack of playing fields, insufficient PE at school, too much screen watching – appear to have little impact, at least at primary school age.”

The report said that while eight out of 10 obese adults were not overweight as children, “a high proportion of obese children are the offspring of overweight/obese adults. Maybe the focus of childhood obesity prevention should be on parents-to-be”.

They said: “Physical inactivity does not lead to obesity, but rather obesity to inactivity, suggesting that the primary cause of childhood obesity is over nutrition.”

The findings have been drawn from the EarlyBird research project, which has been taking blood tests, weight measurements and low level X-rays of the same group of 300 children for the past 10 years.

This week’s new “pointers” report, which is being published on the medical school’s website, is the first time the scientists have started to draw conclusions from the long term study.

Earlier research published in 2008 by the same scientists showed that more than 90 per cent of excess weight gained by girls before puberty is before they are five years old. The figure is 70 per cent for boys.

The project is due to complete in 2013 but there are now fears that the project could end this September because of lack of funds.

Prof Wilkin said he had applied for further funding from the Government, but was turned down because EarlyBird is an observational project, rather than interventionist scheme.

A Department for Health spokesman said: “Our Change4Life campaign is aimed at families – parents and their children. Supporting them to eat better and move more to live longer and healthier lives.

“As part of this, our Start4Life campaign launched in December, will support pregnant women and parents of babies give their families a ‘good start for a healthier life’.”

Anti-Obesity Drug Reductil Banned Across Europe

(Guardian) – ONE OF THE COUNTRY’S most commonly prescribed anti-obesity drugs has been banned across Europe after it was blamed for increasing patients’ chances of suffering a heart attack or a stroke.

The European Medicines Agency (EMA) ordered doctors across the continent to stop prescribing sibutramine and told pharmacists not to dispense the drug, which is marketed in the UK as Reductil.

The watchdog’s Committee for Medicinal Products for Human Use (CHMP) acted after a study of 9,800 patients said the risks of sibutramine outweighed its minimal benefits.

About 86,000 people took the drug last year. It is prescribed alongside lifestyle changes for patients who are classed as clinically obese, because they have a Body Mass Index of at least 30, and also in profoundly overweight people who also have a condition such as type 2 diabetes or abnormal levels of fat in their blood.

Users should not worry and should arrange to see their family doctor to be put on an alternative treatment, according to EMA advice last night, which was endorsed by the Medicines and Healthcare products Regulatory Agency (MHRA).

Dr June Raine, from the MHRA said: “Evidence suggests that there is an increased risk of non-fatal heart attacks and strokes with this medicine that outweigh the benefits of weight loss, which is modest and may not be sustained in the long term after stopping treatment.”

Anyone currently using the weight-loss aid should not face any implications for their health if they decided to stop taking it before seeing their GP, Raine added.There has been concern about the safety of sibutramine since it was first licensed for use in the EU in 1999. Initially it was felt that the drug’s benefits overrode the risks involved.

Legionnaires’ Cases Are Confirmed

(BBC) – TWO PATIENTS at Basildon University Hospital in Essex have Legionnaires’ disease, it has been confirmed.

Tests were carried out at the weekend after two people were suspected of having contracted the illness.

Chief Executive Alan Whittle said the hospital was the probable source based on tests of water samples.

He said both patients had responded to antibiotics, although one patient was still in a critical condition. No more suspected cases have been identified.

Legionnaires’ disease is a potentially fatal infection that is caused by the bacteria legionella.

The bacteria is commonly found in sources of water such as rivers and lakes but can sometimes find their way into artificial water supply systems.

Mr Whittle said: “We routinely and regularly treat and check the water system and independent audits are carried out to ensure our processes are rigorous.

“Experts agree that the legionella bacteria is a common risk in large buildings with an extensive plumbing system.

“We accepted some time ago the advice of experts that we will never be able to completely eradicate the bacteria, but we have worked hard to minimise the risk.”

Teenagers Risk Death In Internet Strangling Craze

(Independent) – CHILDREN ARE POSTING VIDEOS on the internet showing them choking other youngsters to the point of collapse, in a craze that doctors warn has led to brain damage and death.

In one, a group of teenagers set out clear guidelines to the practice in an “instructional video”, while in several others British voices can be heard.

The problem has been increasingly acknowledged in the United States, Canada and France but campaigners warn that Britain is turning a blind eye. The craze is spreading on the internet largely without the knowledge of adults.

“This is disturbing, highly dangerous, very risky and the practice should be avoided at all costs,” said Professor Steve Field, chairman of the Royal College of General Practitioners. The American Centres for Disease Control and Prevention warned recently: “Parents, educators and healthcare providers should become familiar with warning signs that youths are playing the choking game.”

In Britain, the Department for Children, Schools and Families said it was aware of the activity and was monitoring the situation closely. There is no authoritative research on the issue in the UK, despite campaign groups compiling 86 cases of young people in Britain who may have died this way.

Known by a variety of names from funky chicken to space monkey, the “game” involves hyperventilating or squeezing the carotid artery in the neck for a few seconds to achieve a high. Constricting the artery cuts blood flow to the brain; when the pressure is released, the resulting rush of oxygen causes the high. Experts say it is most prevalent among high-achieving adolescents who do not want to get in trouble by taking drugs or drink. The practice is different to autoerotic asphyxiation because it is not done for sexual gratification.

In the troubling footage on YouTube, British teenagers can be seen losing consciousness, their eyes rolled back, as they collapse to the ground to the sound of their friends’ laughter.

The videos show teenagers applying pressure to the necks of friends. Others try to create the high on their own, using a ligature, with a greater risk of killing themselves if anything goes wrong and help is not at hand.

One American entry on MySpace, to background rap lyrics of “spaz if you want to”, claims to be an “instructional video” on the different ways of playing the “pass-out game” and shows different teenagers collapsing among their friends.

Anne Phillips, who lost her teenage son to the practice, is trying to raise awareness in Britain. She says that while the problem has been acknowledged by the authorities in several other countries, the UK remains in denial. “It becomes addictive and kids progress to using a ligature for greater effect,” said Mrs Phillips, from Somerset. “Deaths by hanging are put down as suicide or as an open verdict because coroners are not looking for this as a cause,” she added.

This month, France’s Ministry of Health hosted an international symposium on the “jeu du foulard” (“scarf game”). Politicians and doctors heard from teachers, paediatricians, police, psychologists and grieving parents from around the world.

In July last year, police in Swansea investigated a case where a 13-year-old at Ysgol Bryn Tawe school collapsed after apparently playing the choking game. Days later an eight-year-old at another school also reportedly had to be revived. Last August parents at Hardenhuish School in Chippenham, Wiltshire, were warned of the dangers. Deputy head Jan Hatherell explained that the school felt it was its social responsibility: “We got wind of the fact that some of our young people had seen this on the internet and had thought about trying it out on themselves.

“As yet, we do not know of anyone locally being injured from this, but our concern remains that they might be.”

On one website a girl using the name Tiltal described how she had fainted while playing the game and “like shaking, was it a fit? and my eyes were open and rolling back and stuff is this normal? when i woke up i had no idea what happened and i didn’t feel high or anything… and now everyone is doing it at school and apparently if i was doing all this i could of died, is that true? I’m trying to get everyone to stop doing it now, what could i say?”

Doctors warn the choking game can lead to seizures, head injuries, strokes, heart failure and brain damage. Parents are warned to look out for unexplainable headaches, bruising round the neck, bloodshot eyes or ear pain.

A spokeswoman for the Department for Children, Schools and Families said officials were aware of the activity: “Through the UK Council for Child Internet Safety, we will continue to work with the internet industry to keep young people safe online, including through reducing the availability of harmful and inappropriate content.”

Last year the US Centres for Disease Control and Prevention (CDC) estimated that at least 82 young people had died in the US from the choking game between 1995 and 2007, of whom 87 per cent were boys. The average age of the victims was just over 13, and most had been playing alone.

But the campaign group Games Adolescents Shouldn’t Play claims that as many as 458 children in the US have been killed this way, and that 86 British youngsters have died because of the craze since 1995.

The CDC admitted it had only tracked the problem through newspaper reports and had not included cases where the cause of death might have been either unintentional or intentional strangulation. A 2008 Centre for Addiction and Mental Health study found that 79,000 students in the Canadian province of Ontario had participated in the practice, while last year a survey of Texas students found that 68 per cent had heard of the game and 45 per cent knew someone who had played it.

Mrs Phillips, who has four other children, said: “There is no research being done in England. This issue needs to be addressed; parents need to know.

“It is a global problem but in England there is a denial. There is a stigma. Everyone is afraid that if you mention it, it is going to give kids ideas. But they already know about it … As a parent I am fighting because I want to make sure that something worthwhile comes out of the death of my child.”

Both YouTube and MySpace said they remove unsuitable content when it is flagged by other users. YouTube said: “Sadly, as with any form of communication, a tiny minority of people try to break the rules. On YouTube, these rules prohibit content like pornography or gratuitous violence.”

A MySpace spokesman insisted it had “robust procedures in place to protect young people”.

Mrs Phillips was living in Canada 16 years ago when her son Mike, 18, who had planned to study mechanical engineering at university, died after he and his friends played the fainting game.

He passed out, hit his head on a kerb and suffered such severe brain damage that he never recovered from a coma. His friends insisted he had slipped, but the police later discovered they had been playing the game. His mother, who returned to Britain after his death, said: “It’s a long time since Mike died but sometimes it hits me as if it was yesterday. The whole family was messed up and when you know it is because of a game and was totally needless, it is particularly terrible.”

… (Independent, 05/02/2010) – ‘Our sons were victims of the deadly strangling craze’