Monday, May 04, 2009

NHS 'wanted to send me home so I threatened to chain myself to the bed': British swine flu victim's hospital ordeal

He found the viral attack extremely distressing and debilitating but the NHS doctors were not concerned about how he felt and could not be bothered to do any diagnostic testing before they discharged him. Being Italian, however, he protested -- where a British person would almost certainly have done meekly what they were told. The doctors probably thought to themselves: "Bloody wop" ("Bloody" is the British version of "goddam") but it seems to me that they need more "bloody wops" to keep them on their toes. Sending very ill people home is all too common in the NHS -- with death the result on some occasions

A British victim of swine flu had to beg doctors to keep him in hospital while he was still suffering from the virus. Student Stefano Boccino, 22, was taken to hospital on Wednesday after falling ill while travelling back from the Mexican resort of Cancun. Suffering from a fever, dizziness and nausea and barely able to move, Stefano feared he might die in an isolation ward at the Royal Free Hospital in London as fears grew over a potential swine flu pandemic.

But just 24 hours later doctors told him he was being discharged because he ‘looked better’. Stefano, who still had severe symptoms of the virulent H1N1 flu, said he had to threaten to chain himself to his bed to persuade doctors to keep him in for observation. He said: ‘The doctors had told me that they had never dealt with a case like this. But then, just 24 hours later, they wanted to send me home. A doctor said I was looking a lot better, but I said, “Don’t be fooled. Someone with a tan and of Italian descent will always look healthier than most. I’m not leaving. I’ll chain myself to the bed if I have to.” ‘Eventually, they agreed to keep me in and blood tests revealed on Friday that the virus was leaving my system.’

Stefano is now recovering at the home he shares with his parents in Mill Hill, North London, where he has been told he must stay until this evening to avoid spreading the virus. His father Alberto, 50, and sister Rosamaria, 30, were also ordered to remain in the house in case they had become infected.

Stefano, who is in his third year of a human resources and business psychology degree at London Metropolitan University, started to feel ill as he returned home from a luxury two-week break in Cancun. He and his friends Anna Driscoll and Suzanne Buick, both 23, used student loans and savings to pay £1,000 each for the trip. They spent their days relaxing on Cancun’s beach with pina colada cocktails and their evenings dancing in the town’s bars and clubs.

Stefano, who is gay, said that he was mostly the ‘party pooper’, going home alone at 3am while the girls stayed out. But on his two connecting Continental Airlines flights home he began to feel unwell. He had received a text from his father warning him of a flu outbreak in Mexico City, but because it was hundreds of miles away he thought nothing of it. ‘First I developed a bad chesty cough,’ he said. ‘I was getting dizzy and feeling sick. I slept during the first leg of our journey – a two-hour flight to Houston – and I was pretty floored when we got there. Then we had a six-hour transfer window and during that time I felt like I was dying.’

He bought some flu capsules but they had no effect and, crouched in a ball on the airport floor, he asked Anna to look after him. On the flight to Heathrow, Stefano was sweating and nauseous and said that ‘every limb felt like lead’. He asked a flight attendant for water and a cold towel for his burning forehead. Despite the fact that some passengers on the flight had come from Mexico, he said that none of the crew asked him whether he had been there.

Three hours into the flight, he took his temperature with a thermometer he had packed for the trip and was stunned to see it read 40C. A normal temperature is 37C. ‘I thought it must be wrong, so I did it again and it was the same,’ he said. ‘I thought, that’s the reason I don’t feel too good.’ Barely able to walk when the plane landed on Monday, he asked an airport steward if he could use a wheelchair.

He saw posters throughout the terminal building advising passengers returning from Mexico to be vigilant of swine flu symptoms, and assumed that airport staff would be on alert. But a steward suggested only that Stefano visit his GP. ‘I should have been quarantined at the airport,’ he said. ‘Not to do that is terrible. I put so many other people at risk. ‘I didn’t tell anyone I had come from Mexico, but the staff must have had the flight details and would have known that there were people on that plane who had connected from Mexico.’

Stefano was picked up by his cousin, Vivianna, who took him straight home. A self-confessed ‘clean freak’, he began unpacking and washing clothes. But he was soon laid out on the sofa, unable to move, with his muscles in spasm. He was alone at this point. His mother, Cherry, 52, was in hospital having a disc removed from her back and his father was at work. When Alberto returned, he and Stefano’s sister Rosamaria became concerned and phoned their GP.

Alerted by the fact that Stefano had just returned from Mexico, but without a supply of protective masks, she phoned the Health Protection Agency. Staff there sent round supplies of the anti-viral drug Tamiflu and saliva test kits, and warned the family to stay inside as a precaution. Stefano’s mother was not allowed home and instead went to stay with her sister, while Rosamaria’s ten-year-old twins, a boy and a girl, had to stay with a family friend. All were terrified.

On Tuesday morning, Stefano received a phone call from the HPA. ‘A woman told me that the swabs had tested positive for influenza A,’ he said. ‘She said they had to do more tests to confirm swine flu, which is an A type, but she said it was likely I had contracted it. ‘It’s hard to say whether I was in shock or upset because I simply felt like I was dying, I honestly did. I was in a daze. Being Italian, I’m a very big eater. I love my food but I had completely lost my appetite. ‘When the HPA rang on Wednesday, they asked first if I was sitting down. By this point I was feeling really, really bad. I was feverish, dizzy and nauseous. ‘The woman said, “You’ve tested positive for swine flu. You’re the first case in London.”’

Even now, Stefano’s voice is tinged with disbelief. ‘No matter how much I’d considered I might have swine flu, the reality was a real shock,’ he admitted. ‘I kept thinking, I’m going to die, I’m going to die.’

The HPA contacted everyone Stefano had been in contact with. Officials wanted to know where he had stayed in Mexico, his and his friends’ room numbers, the people they had met and his flight details, including seat numbers.

Anna and Suzanne were put in isolation and given Tamiflu as a precaution while they were being tested for the virus. Stefano’s neighbours looked on horrified on Wednesday as was bundled into an ambulance by two paramedics. ‘They were wearing what looked like space suits with visors, goggles, gloves, aprons and jackets,’ he said. ‘The whole thing was bizarre – like something from the film ET.

‘They handed me a mask and said, “You need to put this on.” I had to wave my family goodbye. It was all rather emotional. ‘I was taken to an isolation unit at the hospital, and had to pass through three separate locked doors just to get to my room. Each door had to be opened and locked again before we could go through the next one.’

He spent the next couple of days in isolation, watching the sitcom Will And Grace on a portable DVD player, listening to his iPod and reading books. Doctors did allow him to have a mobile phone to keep in touch with friends and family.

Stefano was treated using Tamiflu, paracetamol, aspirin and anti-sickness drugs and was put on a drip to keep him hydrated. Nurses approached him with caution, appearing only briefly for a chat or to deliver food – having spent ten minutes each time dressing in full protective gear.

Gradually, his symptoms subsided. An ambulance, with paramedics again wearing protective gear, took him home on Friday evening, where his father and sister were still in quarantine. They, as well as Anna and Suzanne, had tested negative for the swine flu virus. ‘My Dad and sister were so glad to see me,’ said Stefano. ‘But I felt guilty that my mum couldn’t come home from hospital because of me. This has all been such a huge inconvenience to our whole family...

A spokesman for the Royal Free Hospital said: ‘We are unable to comment due to patient confidentiality.’


Australia: Another disaster looming as NSW hospitals computerize

Such projects rarely work. The British version has cost 12 BILLION pounds so far and is still not working properly after many years of trying

BY THE end of next year, every public hospital in NSW will move from paper patient notes to electronic medical records that can be accessed by any health worker, the Government has announced. The Minister for Health, John Della Bosca, said the $100 million project to digitise 250 hospitals will save money by eliminating duplicate diagnostic tests and imaging. It will also improve patient safety by alerting staff to a deteriorating patient and reduce the likelihood of errors.

Mr Della Bosca said doctors, nurses, allied health and social workers will be able to access a centralised repository of a patient's medical chart, laboratory results, prescriptions and referrals, no matter where the patient enters the health system.

Peter Garling, SC, recommended an urgent roll-out of electronic medical records (eMR) in his special commission of inquiry into acute care services, which found NSW's record-keeping system is "a relic of the pre-computer age" that puts patient safety at risk.

He said various hospitals and community health centres have established ad hoc databases but they were "spasmodic and patchy". The inability of distinct IT systems to synchronise with each other and lack of IT support staff meant clinicians had to rely on incomplete data to make important medical decisions and spent time chasing information.

Mr Della Bosca said the Government would make implementing information and communication technology within its capital works program a priority, which will make NSW Health the biggest IT user in Australia. A basic eMR system that allowed clinicians to order diagnostic tests and view results online was successfully trialled at St George, Calvary, Sutherland and Lismore hospitals last year and by last month 20 hospitals were using it.

"Prior to the introduction of eMR, some requests for medical imaging and pathology could require referral back to the requesting clinician due to incomplete or illegible hand-written records," Mr Della Bosca said. "This technology will improve the efficiency of hospital care and free up doctors and nurses to focus on patients and not paperwork, which will further improve patient safety."

The next step will link hospital-based records to primary care providers, such as GPs, by way of an electronic discharge summary. But the Health Action Plan For NSW, released in March, revealed the Government would not meet Mr Garling's 18-month deadline for a digital radiological imaging system. This is to be set up in every public hospital to electronically transmit medical images to remote locations.

And an electronic health record, which would extend patients' information beyond hospital walls to all GPs, specialists and health systems in other states, was not possible without a national e-health strategy, it said.

A report commissioned by the Federal Government last December found state and federal governments have spent $5 billion on electronic health initiatives over the past 10 years but have made little progress towards creating a national system for sharing information.

NSW Health has admitted that two previous attempts to implement electronic medical records in 1991 and 1999 had failed, at a cost of $12 million and $30 million respectively.

The National Health and Hospitals Reform Commission has recommended an individual patient-controlled electronic health record owned by the patient who decides which health care providers can access it.


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