10/07/2015

SGH hit by hepatitis C outbreak – 4 dead

It was quite normal to hear the Transport Minister Lui Tuck Yew saying he was upset and disappointed with the breakdown and disruption of train services.  Education Minister Heng Swee Kiat also had to brave himself up to say the same thing after the Kota Kinabalu quake when several students and teachers died. Today, the Health Minister said the same thing in front page news.  According to Mypaper, Gan Kim Yong said, ‘I am gravely concerned and disappointed with the occurrence of the cluster of hepatitis C cases in SGH. My thoughts are with the affected patients and families.’ The CEO of SGH was also quoted to share his concern and apologized to the families and patients affected.

The medical fraternity was shocked. It has never happened before in our world class hospitals staffed by the best medical professionals and with the most modern facilities and equipment. Hepatitis C is rare in Singapore and can only be transmitted by intravenous blood transfusion. It is not easy to get transmitted though the hospital had reported an increase in infection rate from 2 to 4 a year.  In SGH, there were 22 cases within 3 months and leading to 4 deaths.  And with the long incubation period, there could be more walking out there.

This is a very serious outbreak that should not happen in a first world country but it happened. The 3rd World must be having a good laugh. The hospital is doing a thorough investigation to uncover the lapses if any and is reviewing its procedures all over to make sure that it would not happen again. Let’s hope it would not be like the Transport Minister repeating it over and over again when the trains kept breaking down.  Someone must be turning in his grave for this to happen in a country that is ranked very high in medical standard and services.

Where to go from here? Best facilities, best medical professionals, best equipment, best procedures, where is the weak link? The patients? Cannot be, hepatitis is rare in Singapore.

33 comments:

  1. The hepatitis C outbreak with 4 dead at SGH will not make the opposition strong and ready to be govt. Even with more disease outbreak or more dead at SGH or other hospitals will also not make the opposition strong and ready to be govt.

    And as such, PAP will continue to win big at the next election, just like the last.

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  2. What is the source and culprit, human lah. Tool used, syringe lah. Cause lazy or couldnt be bothered nurse. Guess what race , u know lah. Nevermind lah , 70% asked for it lah , we all share the consequences lah.

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  3. Don't Play Play!

    I agreed that we must first rule out human error!

    Why the police and CID not involved in this case?

    Don't play play! Don't play play! Don't play play!

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  4. You cannot rule out any possibilities. People died. And not one and may be more.

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  5. Why the police and CID not involved in this case?
    Anon 9:27 a.m.

    Because no foul play (eg "screw loose" nurse purposely want to kill patient) suspected, that's why police and CID not involved lah.



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  6. You cannot rule out any possibilities.
    RB 9:34 a.m.

    Yes you and I cannot rule out but others can and is also their business to rule whatever they think fit. Just too bad lah, if you suffer from their ruling.

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  7. Doctors in shock over news of hepatitis C cluster at SGH
    http://www.channelnewsasia.com/news/singapore/doctors-in-shock-over/2174842.html

    4 deaths at renal ward could be linked to Hepatitis C: SGH
    A total of 22 patients at a renal ward in Singapore General Hospital have been diagnosed with the Hepatitis C virus.

    http://www.channelnewsasia.com/news/singapore/4-deaths-at-renal-ward/2172724.html

    --------------------------------------------------------
    The first case was detected on 14 May 2015.
    SGH stepped in to investigate less than one month later, after the 5th case was detected.

    The average time period from exposure to symptom onset is two to 24 weeks.
    If left untreated, the long-term effect of the virus is cirrhosis, liver failure, or liver cancer.

    GE 2015 was held on 11 Sep 2015

    Official news report to the public appeared at around 6 Oct 2015

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  8. http://www.channelnewsasia.com/news/singapore/doctors-in-shock-over/2174842.html

    Colorectal surgeon Koh Poh Koon, who is also a Member of Parliament for Ang Mo Kio Group Representation Constituency, said that human error could be a “logical reason” for the SGH outbreak.
    Unlike other countries with poor sterilisation techniques, the local healthcare system has “robust” practices in place, said Dr Koh, who will leave private practice and become Minister of State (National Development, and Trade and Industry) from January.

    He added: “The first thing we need to establish is whether any human error was involved in this whole administration of medication.
    And if so, whether we can prevent it by having more protocols that would ensure multi levels of check…
    We have had so many years of practice, but nothing has happened — that means the process on the whole is very robust.”

    ---------------------
    It is indeed good news to see that Singapore has so many Singaporean doctors that we can afford to release them to serve in a non-related industry like the Ministry of National Development, and Trade and Industry.

    Are there other similarly well deployed Singaporean doctors in our Singapore cabinet?

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  9. Cheap is definitely not good. Welcome to the 3rd World.

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  10. Actually they already discussed and wanted to apologise a long time ago, well before the GE. Ask Mr. Yakult about it. He knows.

    This incident happened in June, well before the GE. Now they are apologising, More than three months after. Is it because of the GE? Ask Mr. Yakult about it too. He will tell you all those changes trotted out during GE were thought out well before GE2015. How come this was not. Lives were lost. What is not so important about it that the incident had to be hidden for months?

    And I know some Khongcum will again blame it on the WP not being ready to be Government. It figures why the PAP got a landslide with such voters among us.

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  11. PAPies embargoed & blacked-out this Hep C mass infection till after GE. Otherwise very high chance Gan Kim Yong (health minister) will be kicked out.

    This incident also shows SGH trying to save money even on insulin vials which are damn fucking cheap. I can tell you that all those patients are C Class patients. And from the way the news is being portrayed and what Gan Kim Yong & the SGH CEO is saying, it seems not much compensation if any is being offered to the victims.

    In my previous hospital, even C Class diabetic patients are provided (and charged) with their own personal insulin vial. There is no such thing as sharing medication/drug vials. Each vial is labeled with patient's name, NRIC, date opened, and date to be discarded.

    And even though using your own personal vial, swabbing with alcohol for disinfection & using brand new sterile needles/syringes are STANDARD UNIVERSAL PRACTICE. This is the MINIMUM standard as practised by all 1st world medical settings around the world.

    And insulin vials MUST be discarded after 28 days of first use, even if still got insulin left.

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  12. This incident happened in June, well before the GE. Now they are apologising, More than three months after.
    Anon 10:40 a.m.

    On hindsight, they should have apologised before the GE, because the apology will also not make the WP ready to be govt.

    And as WP chief Teochew Ah Hia already said, in a GE, majority (70%) Sinkies are very scared to accidentally vote PAP out because WP is not ready to govt.

    And indeed events on 11 Sep had vindicated what Ah Hia said, incident or not, early apology or not.

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  13. Possibilities
    1. Foul play
    2. Negligent
    3. Cheating
    4. ?

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  14. All

    Are you aware that we have alot of foreign nurses?
    Burma..Cambodia. .India...China. ..

    Are you aware that our resident doctors are over worked? They worked 80 hours a week with a mere SGD 5000 monthly income after two years in NATIONAL service and 6 years in SGH as Medical doctor.

    Mr Gan Kim Yong need to review that labour law is protective of our young doctors working only 48 hours a week with full pay and not 88 hours a week with no over time pay and no after office transport allowance.

    Claims often rejected in the name of thrifty national budget. Yet we sponsor china students here to study for free!

    Over worked doctors can make more errors too. Then mass resignation is expected.

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  15. Are you aware that we have alot of foreign nurses?
    Burma..Cambodia. .India...China. ..
    Anon 11:24 a.m.

    Because not enough Sinkies want to be nurses what.

    So having foreign nurses, even though they are not that good, is still better than not enough nurses lah. A lesser of the 2 evils for Gan Kim Yong to choose. Just like 70% choose PAP, as the lesser of 2 evils to be govt and Gan Kim Yong appointed by PM as Health minister, even though Gan may not be a good minister.

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  16. Stop complaining.
    70% of Singaporeans voted for this standard of hospital care.
    You get the hospital care you deserve.
    And don't forget.
    70% of your friends and relatives also voted for this.

    To the patients who died.
    70% of your friends and relatives voted for the hospital care you received.

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  17. A bit ridiculous to tie this incidence to PAP. With so many foreign nurses around, such incidence sure will happen.

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  18. And why are there no local nurses?

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  19. Gan Kim Yong - What happened?

    Is it time to give Kim Yong a pay rise?
    To further incentivize him to work betterer and fasterer?

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  20. I think we must give Kim Yong a stronger mandate of 90% in GE 2020.

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  21. Anon 10.1am,

    There are 2 more mps that I am aware:

    Chia Shi Lu (Tanjong Pagar grc) - Orthopaedic Surgeon
    Tan Wu Meng (Jurong grc) - oncologist

    Although they currently have no appointment in the cabinet, their mp duties will certain take away time that they could have devote to their patients.

    We reap what we sow.

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  22. Many years ago, we have shortage of teachers in MOE. To address the situation, the government embarked on an aggressive scheme to raise the pay. Now, the pay is so attractive that mid-career professionals will consider teaching a favorable option.

    With so many unemployed pmets, MOH should be able to attract locals to join in healthcare ranks as nurses, allied health professionals. The problem is the pay. Unlike MOE which has been revising their pay schemes, MOH has not. To solve the nurse crunch, it hires from third world.

    Our shortage in nurses and allied health personnel is due to our lack of political will. If we can pay to get good teachers to teach our next generation, why can't we pay to get locals to join our healthcare industry? As it is, we are already paying first world cost for treatment.

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  23. Thought this type of things can only happen in villages in backward countries.

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  24. Alright, alright just follow the Khongcum and blame everything on the WP not being ready to become the Govt. All problems solved and no need to argue.

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  25. Because WP is not ready to be govt and hence no competition to PAP, so this make PAP complacent.
    And because PAP become complacent, there was, among other incidents, hepatitis C outbreak in SGH with 4 deaths. This type of incident won't happen if PAP is not complacent.

    Just like in business, if there is no competition, the monopoly business will become complacent and will not be motivated to improve their product and service quality.

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  26. If we can pay to get good teachers to teach our next generation, why can't we pay to get locals to join our healthcare industry?
    Anon 1:50 p.m.

    Why? Because PAP is confident of foreigners can provide as good service as locals in our healthcare industry mah. And some more they are cheap!

    Whereas PAP is not confident, and for good reasons, of foreigners being as good teachers as locals lah.

    It's that simple. So now u understand?

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  27. The Khongcums deserve the Government they voted for. No need to kpkb. QED

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  28. Why SGH kpkb?
    Why bring in an independent study team?

    If PAP government ownself can check ownself on audit failures highlighted by the Auditor General Office.
    Then why not SGH ownself check ownself on the Hepatitis C outbreak and deaths?

    /// There is no irregularity at the systemic level in the People’s Association (PA) and grassroots organisations, PA deputy chairman Lim Swee Say told Parliament today (Aug 17).

    Detailing the instances of non-compliance by grassroots leaders highlighted by the Auditor-General’s Office (AGO) in its latest annual audit report, Mr Lim said most of these were borne out of “good intentions”. ////

    http://www.todayonline.com/singapore/no-systemic-irregularities-peoples-association-and-grassroots-organisations-lim-swee-say

    http://www.channelnewsasia.com/news/singapore/auditor-general-s-report/1985518.html

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  29. SAR period handled by local doctors and nursing staff. How many dead??

    Doctors like Dr Chao scarified his life.

    Now trash doctors and nurses.

    Sure many casulities even not in outbreaks

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  30. Die already.
    Can make family feel better by giving them money is it?

    But if they voted PAP.
    Then maybe it's karma.
    Cannot complain liao.
    They got the hospital care they voted for.

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  31. If this was reported before the GE.

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  32. Do you guys buy the story that it's caused by shared serum? I don't, I think it's entirely illogical. Furthermore, I think it's intended to conceal something.

    Let's examine the process. Disposable needles are used to extract serum from the shared container. The only way for the shared serum to be contaminated is when disposable needles are not disposed but re-used. By focusing our attention to the part played by shared serum, they are hiding from us the role played when disposable needles are not being disposed.

    Now, who do you think would want to re-use cheap disposable needles and pilfer the balance of unused fresh needles for sale elsewhere? Is it likely to be done by Singaporeans who stay in million-dollar HDB flats or foreign workers who come from villages?

    It appears to me that by blaming the shared serum, our authorities have given up on the fail-safe feature of disposable needles. It seems like they know they cannot prevent foreign workers from pinching disposable needles.

    The trouble with this is that by failing to govern the disposal of disposable needles, they are not really able to prevent contamination. Contamination will still carry on, at a rate of one or two cases who happen to share that needle, and it will not be detectable as in the present case of so many patients being infected. The hospitals may well be happy with this outcome, as long as nobody can find out that contamination is going on, but I'll bet that the victims in that one or two cases will not be as happy. You can only hope that you are not that one or two cases.

    I must apologise for slanting this against foreign workers. I'll blame it on the fishy way the authorities are slanting the investigation towards shared serum, and quietly withholding information on the re-use of disposable needles. When a govt is less than honest to its citizens, then the citizens are left with no choice but to rely on best guess.

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  33. Right, visits to polyclinics often for regular blood tests as ordered by doctors for HP medication mointoring.

    Practically all local staff in the labs and each patient they changed disposal gloves and.needles.

    Sure strict procedure in their daily duties.

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