Organ donation errors 'avoidable'

19 October 2010 Last updated at 06:35 ET By Michelle Roberts Health reporter, BBC News

An independent review finds avoidable errors led to the wrong organs being removed from 25 NHS donors in the UK.

Sir Gordon Duff, who led the review, says the blunder was due to faulty computer software used by UK Transplant to record donor wishes.

As many as 800,000 people on the UK donor register may have had their preferences about which organs they wished to donate recorded incorrectly.

He said new measures should avoid another error occurring.

Sir Gordon praised the actions already taken by NHS Blood and Transplant (NHSBT) to safeguard the system.

But he said in his report that the longer-term solution would be to enlist the help of experts to create a more secure, interactive system with better data verification and cross reference functions.

With over 17 million registrants, there is a growing need for the register to become more interactive, he said, and urged the NHSBT to have a redesign "as soon as resources allow".

The error originated when faulty data conversion software was used to upload data on donation wishes from the Driver and Vehicle Licensing Agency (DVLA) when it moved to a new computer system.

Continue reading the main story

"Start Quote

We would like to take this opportunity to reiterate our unreserved apologies to the families of those people"

End Quote NHS Blood and Transplant

The issue only came to light in 2009 when NHS Blood and Transplant started to write to donors to check their organ donor preferences in the event of death - some withhold consent for certain parts of the body like the eyes, for example.

Many donors wrote back to say their information was incorrect.

Regrettable

Sir Gordon Duff said: "People who generously agree to donate their organs should be reassured that the error has been dealt with effectively and that steps have been taken to minimise the risk of it happening again."

Public health minister Anne Milton said: "Organ Transplants are vital and I know that NHS Blood and Transplant will make sure such a situation never arises again."

NHSBT said it sincerely regretted that the error was not uncovered earlier and that the donations of 25 individuals were affected by it.

A spokesman said: "We would like to take this opportunity to reiterate our unreserved apologies to the families of those people.

"After discovering the error, the NHSBT Board carried out its own investigations resulting in a detailed remedial action plan.

"We accept in full the recommendations of Professor Sir Gordon Duff, which will contribute significantly to strengthening the Organ Donor Register and public confidence in it as a way to record organ donation wishes.

"Since the error related to the way in which we received data from one of our partners, our immediate focus has been to take forward those actions that relate to our working arrangements with partner organisations."

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Ex doctors' leader denies claims

19 October 2010 Last updated at 06:57 ET By Jane Dreaper Health correspondent, BBC News

A surgeon and ex head of the British Medical Association has denied putting representing doctors above patients.

James Johnson is facing a General Medical Council hearing over operations on 14 patients in Cheshire.

He is also alleged to have accidentally struck a needle into the forehead of a female doctor who was assisting him.

He told the hearing he did the same amount of surgery as his colleagues - despite working a "100-hour week most of the time" to include his BMA duties.

Time-consuming

Mr Johnson told the GMC panel in Manchester: "It was certainly a busy life.

"But colleagues at Halton hospital were used to my rather unusual way of life.

"I always made myself available. We had a well-honed system for dealing with problems.

"The work I did for various organisations was very time-consuming, but my first loyalty was and is to my patients.

"If I had to choose between them, without the slightest shadow of a doubt, I would have chosen the clinical work, which I always found rewarding and highly satisfactory."

Mr Johnson was BMA chairman from 2003 to 2007, when he resigned amid a row about a controversial new system for allocating junior doctors to training posts.

The panel has heard claims that the stresses on his time meant his patients missed out on care.

He was said to have behaved "like a caricature of surgical arrogance".

Mr Johnson, who has been a vascular surgeon since 1985, denies this and is continuing to give evidence in his defence.

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Scenes of nature 'reduces pain'

19 October 2010 Last updated at 03:43 ET By Dave Lee BBC World Service

Cancer patients who have to endure excruciating procedures on a daily basis may be able to lessen their pain - by being transported to Zambia.

The patient need not even leave their bed.

Just simply showing relaxing pictures of idyllic scenes and playing out relaxing sounds at a patient's bed is enough reduce the feeling of pain for many patients.

This is according to researchers from Johns Hopkins University in Baltimore, United States.

They set up a series of tests analysing patients undergoing bone marrow aspiration and biopsy (BMAB) - known to be a particularly painful form of cancer treatment.

A large needle is inserted into the back of the pelvic bone and bone marrow is drawn out. It can sometimes take up to ten minutes, and is often performed with just a local anaesthetic.

For some cancer sufferers, BMAB is a regular unwanted experience - and techniques such as hypnosis or sedation have been tested to try and help patients deal with the pain.

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However, the researchers believe they have come up with a cheap, inexpensive way of making painful procedures like BMAB more bearable.

"We wanted to find a way to improve their experience," explained Noah Lechtzin from the department of medicine at Johns Hopkins University in Baltimore.

"So we did a study in which patients were assigned to either standard care, to have the procedure done with a nature scene and accompanying nature sounds, or a city scene and city sounds.

"We measured pain during the procedure."

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Our scene was a very open picture that had running water, the sounds had birds chirping and wind rustling through trees"

End Quote Noah Lechtzin Johns Hopkins University

The nature scene consisted of typically relaxing images, such as Victoria Falls in Zambia, painted onto bed curtains surrounding the patient as he or she is being treated.

The city scene had pictures of your average urban environment. Busy streets, people rushing - an altogether more stressful experience.

To add to the atmosphere and help with the process, the nature scene added sounds of birds chirping and wind rustling through trees was played to the patient through headphones.

For the city scene, the noise of traffic was played instead.

The found these two simple additions to the hospital environment changed the way patients reacted to the invasive treatment.

Pain Scale

The severity of pain was measured using a ten point scale known as the Hopkins Pain Rating Instrument. Before and after a procedure, patients are asked to indicate how uncomfortable they felt.

Anything above a four is classed as moderate to severe pain.

A control group - which had neither nature nor city scenes - on average marked BMAB as 5.7 on the pain scale.

But, those patients exposed to the nature sounds and images recorded an average of 3.9 on the pain scale - a significant reduction.

The city scene had no significant effect on the ranking - patients found the treatment just as painful.

This, Mr Lechtzin says, shows that the reduction in pain is not simply just a case of distracting the patient.

"I certainly do think distraction must play a role. But there is a lot of thought that there's specific elements to nature that people relate to and have particularly a soothing effect."

He insists that the choice of picture is very important if the theory is to work to its full potential.

"I think there are certain elements of nature that are beneficial and others that could be frightening.

"You wouldn't want to have rocks that potentially dangerous animals could hide behind, whereas our scene was a very open picture that had running water, the sounds had birds chirping and wind rustling through trees - so I think there are certain elements that are helpful."

His hope now is that hospitals will see these findings as a way of cheaply and easily helping patients deal with BMAB and other painful experiences - even if by just adopting the idea of displaying a particular picture.

"It's a large mural that can hang on a hospital curtain, it can be wheeled on a stand from bed-to-bed. Fairly inexpensive, doesn't require any training and is easy to use."

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