332 hip op patients left at risk of toxicity
MORE than 300 hip replacement patients were left at risk of tissue damage and metal toxicity after medics failed to carry out follow-up checks after their operations.
The 332 patients were given the ‘metal-onmetal’ form of the implant at four Pennine Acute Trust hospitals – Rochdale Infirmary, Fairfield General, North Manchester General and Royal Oldham – between 2001 and 2011, a report has revealed.
They should have been given scans or x-rays, blood tests and regular out-patient appointments after the procedure – as well as additional surgery where required.
Appointments for all of the patients have now been arranged, but one is known to have suffered ‘serious harm’.
Health bosses have issued an apology to all of those who were affected.
A report to Heywood, Middleton and Rochdale Clinical Commissioning Group’s governing body says the oversight has been classified as a ‘serious incident’ – although it is understood this is not a life-threatening situation.
The historic issue was identified by the Salford Royal-led Northern Care Alliance, which took leadership of Pennine Acute Trust in 2016.
Paul Downes, the director of patient safety and professional standards across the Northern Care Alliance NHS group said : “Following Salford Royal taking on the leadership of the hospitals run by The Pennine Acute Trust, in September 2018 we identified the need to review and contact a number of patients who previously underwent a metal-onmetal hip replacement that were not followed up in line with national guidance.”
He added: “We would like to apologise to all patients concerned and reassure the public that we have introduced new systems to stop this from happening again.
“This does not affect other specialities and is limited to metal-onmetal follow-up appointments only.
“Since Salford Royal and The Pennine Acute Hospitals NHS Trust were brought together under the Northern Care Alliance NHS Group, we have strengthened our systems and processes for monitoring patient safety and shared learning across our hospitals in Salford, Oldham, Bury, Rochdale and North Manchester and community services.”
NHS literature on metal-on-metal hip replacements – which are no longer carried out by Pennine Acute hospitals – says patients who have the implants should undergo regular monitoring for the life of the implant.
It adds that some metal devices have been found to wear down more quickly in some patients, potentially causing damage and deterioration in the bone and tissue around the hip.
Medicines and Healthcare Products Regulatory Agency (MHRA) guidance issued in 2012 and 2017 recommends patients’ blood is checked for metal ions – particularly cobalt and chromium which are used on the surface of implants.
This is because the level of the electrically charged molecules in the bloodstream can indicate how much wear there is to the artificial hip.
But NHS bosses stress this is not blood poisoning – and does not lead to sepsis – which is ‘an entirely different type of illness’.
Information on the NHS website reads: “There has been no definitive link between ions from metal-onmetal implants and illness, although there has been a small number of cases in which high levels of metal ions in the bloodstream have been associated with symptoms or illnesses elsewhere in the body, including effects on the heart, nervous system and thyroid gland.”