It has been discovered that NHS hip operations have claimed the lives of more than 40 people, despite warnings which were issued regarding the dangers of the operation five years ago.
The former Chief Medical Officer, Sir Liam Donaldson, and a team from Imperial College London, discovered that 62 people had died or suffered harm after undergoing a toxic reaction to the bone cement which was used during their hip operations.
The alarm about the cement was first raised by patient safety and drug watchdogs during 2009, but the health system continued using it in hip operations. The procedures were carried out despite the evidence that the use of the cement could result in high blood pressure, heart attack and heart arrhythmia. It was found that many of the victims already suffered with heart problems and were elderly.
Patient groups have said that these figures were concerning and may be understated due to under-reporting.
The report stipulated that a total of 41 deaths occurred, 14 patients suffered heart attacks and were resuscitated, but suffered a period where their condition became very unstable. In 55 of the reported 62 cases, the problems happened within three minutes of the application of the cement.
Sir Liam was the chief medical officer for the period from 1990 to 2010, said that the guidance to monitor the cardiac health of patients before their hip operations was being ignored. He said that the orthopaedic surgery community appears to have come to the conclusion that the benefits of using cement far outweigh the risks.
He said that the NHS would have to reconsider when it is absolutely necessary to use cement and if the operation may be a success without its use. In Britain, the use of cement has always been standard procedure, but many countries globally do not use it at all.
Sir Liam stated that the question about the use of cement should be re-opened and further evaluation and research of the risks involved in its use should be done.
During 2009, the now defunct National Patient Safety Agency raised its concerns about the use of cement during hip replacements when the patient has suffered a fractured femur. It issued guidance to the health care service on ways of minimising the risks.
The agency found that 26 patients had died and six had suffered severe harm due to ‘Bone Cement Implantation Syndrome’.
Reports regarding deaths were received by the Medicines and Healthcare Products Regulatory Agency and warnings were issued to surgeons asking them to assess the patients and make use of revised anaesthetic and surgical methods.
The team has concluded that the implementation of the guidelines was ‘suboptimal’ since most of the deaths occurred after 2009.
NHS England has stated that the health service is working with Royal colleges and patient safety groups in an attempt to eliminate this problem.
Image Credit: Sadasiv Swain