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EDITIONS
 Tuesday, 31 December, 2002, 11:38 GMT
Surgical instrument inquiry call
scalpels
Single-use instruments have been linked with bleeding
Shadow Health Secretary Dr Liam Fox has called for a public inquiry into the safety of single-use surgical instruments.

Dr Fox said the instruments should be banned across the UK until their safety had been conclusively proven.

The Department of Health said a suspension on the use of such equipment in tonsil and adenoid surgery in England was likely to remain in place.

The use of single-use equipment has been linked to 20 adverse incidents, including the deaths of two patients.

Two-year-old Crawford Roney haemorrhaged and died in June 2001 following surgery at the Alexandra Hospital in Cheadle.

And Elaine Basham, 33, from Cleveland, died in December 2001 after doctors at Middlesbrough's North Riding Infirmary were unable to staunch bleeding during what should have been routine surgery.

Dr Fox said: "The deaths of Crawford Roney and Elaine Basham are utterly heartbreaking.

"The very least their families deserve now is that an attempt be made to find out why they happened, and if it was the fault of the instruments.

"I am calling for a full inquiry, and the withdrawal of single use instruments from hospitals throughout the United Kingdom until we know whether they are safe or not."

CJD fears

Dr Liam Fox
Dr Liam Fox wants a total ban
Single-use equipment was introduced after fears that medical instruments that could be used several times might retain the protein that can transmit CJD, even after sterilisation.

In January 2001 the NHS in Scotland was allocated 3m to fund the introduction of single-use instruments.

By June 2001, about 300,000 single-use tonsillectomy instruments had been issued to NHS hospitals.

However surgeons have expressed concern that single-use instruments are problematic, and that they are of dubious quality.

They complained that they did not give them the access they needed, and that they were simply inadequate.

Heated forceps caused particular worry, as their electric current was irregular.

In December 2001 the Department of Health ended the ban on re-usable surgical tools in tonsil operations.

However, it said that if no conclusive link was found between disposable instruments and the rise in the number of deaths, adverse incidents and secondary haemorrhaging, and that disposable instruments could be reintroduced in England within a year.

Single use instruments remain legal in Scotland, Wales and Northern Ireland, if surgeons think they are safe.

Inadequate consultation

Dr Fox said: "The decision to switch to single use instruments seems to have been taken after totally inadequate consultation.

"Surgeons are known to have complained about the quality of the instruments - particularly the heated forceps as their electrical current was irregular. It is now clear that their use was experimental.

"These instruments can still be used in Scotland, Wales and Northern Ireland, and there remains the possibility that they could be reintroduced in England. When it comes to the public's health, to have different policies for different part of the UK is ridiculous.

"Only a comprehensive, independent and public inquiry will ally fears about their safety, and get to the root of this issue."

A Department of Health spokesman said: "In December 2001 the Department of Health suspended the use of all single-use electrosurgical diathermy forceps in tonsil and adenoid surgery.

"There are currently no plans to reintroduce single use instruments."

Scottish situation

A spokesperson for the Scottish Executive said: "Single use instruments are currently being used for tonsillectomies in Scotland as such procedures are deemed to carry a higher theoretical risk in terms of vCJD contamination.

"Single use instruments, such as syringes and scalpel blades are also being used for a range of other procedures, and are used wherever possible as part of our overall strategy to tackle Hospital Acquired Infections.

"In terms of multi-use instruments, we making sure that decontamination facilities throughout Scotland are of the highest possible standards, to ensure the maximum safety of our patients."

A spokeswoman for the Welsh Assembly said surgeons had been advised to stop operations to remove tonsils and adenoids except in emergencies.

See also:

15 Dec 01 | Health
04 Jan 01 | Scotland
04 Jan 01 | Health
18 Aug 99 | Medical notes
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