Search

The article presents a case study of a sixty-six-year-old obese woman, who suffered from fatigue failure of medical equipment maker Mizuho OSI's Orthopedic Trauma Table Top during orthopaedic open reduction and internal fixation. Topics discussed include presence of traction-related skin and soft-tissue patient injury in patient, need of monitoring operating tables, and taking precautions for medical equipment failure.

Case report We describe an unusual complication of a routine arthroscopic procedure to treat fragmentation of the medial portion of the coronoid process in a 1-year-old Labrador Retriever. While the lesion was being curetted, the tip of the arthroscopic curette broke off. Attempts were made to remove it, but failed, and the broken fragment migrated out of the arthroscopic field. Conversion from arthroscopy to arthrotomy was unsuccessful. On intraoperative radiographs, the metallic fragment was detected in the radial fossa of the humeral condyle. A limited surgical approach to this area, guided by ultrasound, also proved ineffective. Finally, the broken curette tip was left in situ. The dog made an uneventful recovery and 6 months after surgery it showed no lameness except after rest and there was no evidence of migration of the metallic fragment on radiographs. Conclusions On such occasions, we recommend: (1) stop both the inflow and outflow of fluids; (2) attempt arthroscopic retrieval with a magnetic retriever and large forceps; (3) use diagnostic imaging to localise the broken fragment if it migrates out of the arthroscopic field; and (4) leave in situ if it is no longer accessible to arthroscopic extraction. This is the first report of an instrument breakage during arthroscopy in a dog. [ABSTRACT FROM AUTHOR]

The article offers information on the history, development and significance of the National Medical Device Injury Compensation Program, which assists in internalizing costs of harms caused by defective medical products of medical device companies in the U.S. It informs that U.S. Government modeled the Program after the National Vaccine Injury Compensation Program to provide a remedy for patients harmed by defective medical devices under the National Medical Device Insurance Fund.

Mercury is a metal toxic to humans. In spite of these known facts and adverse health effects, mercury continues to be used in various medical devices such as thermometers and sphygmomanometers, and in laboratories. During 2009, a survey was conducted at the University Hospital in Zagreb, Croatia, in order to estimate the possibility of occupational mercury exposure among hospital nurses using mercury-based medical equipment (thermometers and sphygmomanometers). Thirty one nurses working in different hospital wards were interviewed on their familiarity with the facts concerning mercury toxicity, on the handling of and exposure to broken mercury-based medical equipment and on their preferences regarding the use of certain equipment type, i.e. mercury-based or electronically operated. It was found that all interviewed hospital nurses are exposed to mercury from broken equipment and all are aware of its toxicity. Nevertheless, most prefer mercury-based equipment over electronically operated one because it is more precise and accurate, and because of the lack of technical support and education in the maintenance of electronic equipment. Health and safety at work are issues affecting both employers and employees regardless of professional background. Nowadays, the implementation of an occupational health and safety system is a requirement imposed by law in many countries. To improve health conditions at work, all hospitals in Croatia should implement procedures and follow guidelines for worker and employer protection. The results of the survey indicate that future research on occupational mercury exposure among hospital nurses using mercury-based medical equipment is "a must" [ABSTRACT FROM AUTHOR]

The article discusses a study on the risk of occupational blood exposure through needlestick among U.S. paramedics and estimated risk ratios of several management practices. The mail survey of U.S. paramedics in 2002-2003 showed a range of 2.5 to 3.2 risk ratios for provision of safety-engineered medical devices and two supervisory behaviors. Results suggest that risk of needlestick among U.S. paramedics can be reduced by providing safety devices and interventions targeting management practices.

OBJECTIVES: The purposes of this study were to provide national estimates of emergency department (ED) visits for medical device-associated adverse events (MDAEs) in the pediatric population and to characterize these events further. METHODS: ED medical record reports from the National Electronic Injury Surveillance System All Injury Program database from January 1, 2004, through December 21, 2005, were reviewed. MDAEs among pediatric patients were identified, and data were abstracted. National estimates for pediatric MDAEs were determined according to medical specialty, device category and class, injury diagnosis, and patient characteristics and outcome. RESULTS: The total estimated number of pediatric MDAEs during the 24-month period was 144 799 (95% confidence interval: 113051183 903), involving devices from 13 medical specialties. Contact lenses accounted for most MDAEs (23%), followed by hypodermic needles (8%). The distribution of MDAEs according to medical specialty varied according to age subgroup. The most-prevalent types of injuries included contusions/abrasions, foreign-body intrusions, punctures, lacerations, and infections. The most-frequently affected body parts were the eyeball, pubic region, finger, face, and ear. The majority of pediatric MDAEs involved class II (moderate-risk) devices. The incidence of pediatric MDAEs decreased with increasing age from early to late childhood and then spiked after 10 years of age. More girls than boys were affected at older ages (16-21 years) and more boys than girls at younger ages (⩽10 years). Hospitalizations were more likely to involve invasive or implanted devices. CONCLUSIONS: This study provides national estimates of pediatric MDAEs resulting in ED visits and highlights the need to develop interventions to prevent pediatric device-related injuries. [ABSTRACT FROM AUTHOR]

Copyright of Revista Brasileira em Promoção da Saúde is the property of Revista Brasileira em Promocao da Saude and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: The use of an oscillating saw for cast removal creates a potential for iatrogenic injury and patient discomfort. Burns and abrasions can occur from the heat created by frictional forces and direct blade contact. With use of a cadaver model system, skin temperature measurements were recorded during cast removal with an oscillating saw. Methods: Casts of uniform thickness were applied to cadavers equilibrated to body temperature. The casts were removed by a single individual while simultaneously measuring temperatures at the skin-padding interface, cast-padding inter-face, and the blade. Variables tested include two removal techniques, two casting materials (fiberglass and plaster), and two cast-padding thicknesses. Results: A poor removal technique (the cast saw blade never leaving the cast material during cutting), fiberglass casting material, and thinner cast padding resulted in significantly higher skin temperatures. The poor technique increased skin temperatures by an average of 5.0°C (p < 0.05). Fiberglass casting materials increased skin temperatures by an average of 7.4°C (p <0.05). Four layers of cast padding compared with two layers decreased skin temperatures by 8.0°C (p <0.05). Conclusions: The highest skin temperatures were recorded for fiberglass casts with two layers of padding. The lowest skin temperatures were recorded for plaster casts with four layers of padding. Four layers of cast padding compared with two layers significantly reduced skin temperatures for both plaster and fiberglass casts. Clinical Relevance: A routine assessment of the layers of padding and the type of cast material prior to splitting casts with an oscillating saw can help clinicians to identify cast removal conditions with a higher risk for causing patient discomfort, abrasions, or burns. [ABSTRACT FROM AUTHOR]

The article focuses on a research on incidental findings on cardiac multidetector row computed tomography (MDCT) among older adults. The objective of the research was to determine the prevalence of incidental findings using the cardiac MDCT scanner. The research conducted a MDCT cross-sectional analysis on healthy men and women aged 60 to 90 years without cardiovascular disease diagnosis for the detection of coronary artery calcification. Results showed that incidental findings are usual in MDCT, specifically in diagnosing coronary artery calcification.

The approach to forensic investigation of a medical device related accident differs from that for consumer products, industrial equipment, and vehicles. Techniques for investigating and providing case assistance related to suspected medical device incidents are presented, including essential elements of the investigation, investigative techniques, and information resources on device failures and standards. User error versus design defect is discussed, along with the causes of medical device-related incident and the mechanisms by which they cause injury and death. Since a patient is a variable biological system, it must also be considered that the alleged cause of the incident was not attributable to the medical device. [ABSTRACT FROM AUTHOR]

Background: While breakage of an orthopaedic instrument is a relatively rare occurrence, orthopaedic surgeons need to be familiar with this complication and how to deal with it. Relatively little information about this subject has been published. Methods: Every case of instrument breakage during orthopaedic procedures performed in two hospitals during a two-year period was documented prospectively. All patients were followed for a postoperative period ranging from twelve to thirty-six months, during which radiographs in two planes were made to assess changes in, or migration of, the broken object. Results: During the observation period, 11,856 surgical procedures were performed in the two hospitals. The overall rate of instrument breakage was 0.35%. The broken piece was removed in five cases, and the broken instrument was left in situ in thirty-seven cases. During the follow-up period, none of the patients had any symptoms. Conclusions: In most cases, breakage of an orthopaedic instrument is not a problem. Any instance of instrument breakage should be fully documented in the surgical report. [ABSTRACT FROM AUTHOR]

A letter to the editor about a case report of a 60-year-old male patient with a history of upper and middle lobe right lung aspergillosis and who experienced tracheal cuff rupture during placement of double-lumen tubes (DLT), is presented.

The article presents a case study of a 60-year-old patient was admitted to the emergency room due to cough and fever and has undergone a series of examinations which later revealed that the patient has signs of tracheal laceration due to misplacement of endotracheal intubation instrument.

Objective The objective of this study was to present a detailed examination of unintentional injuries in infants <12 months of age treated in emergency departments. Methods We conducted a retrospective analysis of data for infants <12 months of age from the National Electronic Surveillance System – All Injury Program for 2001–2004. Sample weights provided by the National Electronic Surveillance System – All Injury Program were used to make national estimates. Results An estimated 1 314 000 injured infants were treated in US emergency departments for non-fatal unintentional injuries during the 4-year period of 2001–2004, ∼1 infant every 1.5 minutes. Falls were the leading cause of non-fatal unintentional injuries for infants. Overall, the patients were more likely to be male (55.2%) than female (44.8%). Contusions/abrasions were the leading diagnosis overall (26.7%). Contusion/abrasion, laceration, hematoma, foreign body and puncture injuries occurred most frequently to the head or neck region. More than one-third of fractures (37.2%) were to the arm or hand. Bed was the product most frequently noted as being involved in the injury event for every age except 2 and 12 months (car seat was the most frequently noted product at 2 months of age, and stairs were top ranked at 12 months). Product rank changed markedly as age increased. Conclusions The influences of the social environment, the physical environment and products change as infants mature in the first year of life; this was substantiated in our study by the shift in the relative importance of products involved in injuries according to month of age. The concept that aspects of safety must adapt in anticipation of developmental stage is critical. [ABSTRACT FROM AUTHOR]

A 28-year-old G1P1 presented complaining of urine leakage per vaginum following caesarean delivery, accompanied by amenorrhoea, cyclic haematuria and cyclic pelvic pain. Examination findings were suggestive of vesicouterine fistula and the patient was taken for exploratory laparotomy, during which the foley catheter could not be identified within the bladder. During separation of the bladder from the uterus, the catheter was found to be traversing the fistulous tract into the uterine cavity. Vesicouterine fistula is a fairly uncommon type of urogenital fistula that is frequently associated with caesarean section. Surgical treatment remains the mainstay and successfully cured this patient. [ABSTRACT FROM PUBLISHER]

The article focuses on alerts from the British Medicines and Healthcare products Regulatory Agency. Problems with the Arjo Passive Clip sling manufactured by Medibo are discussed. The article notes risk of injury from the C-Max U/2 stair climber manufactured by Alber Antriebstechnik GmbH. There are revised instructions for the Action 3 and Action 4 manual wheelchairs manufactured by Invacare.

The article discusses the problems associated with malfunctions of the Therac-25 radiation machine in the 1980s. Used for treating cancer, the Therac-25 caused six known cases of radiation overdose due to changes in the design and development of the machine over previous versions. The moving of most of the Therac machine's safety checks to software control is noted, as well as the removal of its hardware safety interlocks.