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INNOVATIONS IN MEDICAL DEVICE TECHNOLOGY MAKE A DIFFERENCE
After reviewing several possibilities, two options were proposed to the ICU nurse. The customer chose one. HCS called back at 17h30 (Montreal time) therefore, one hour after the initial call and 30 minutes after having initially spoken this nurse and recreated the scenario. She explained to HCS that everything was working well. The pump was administering the prescribed dose of Morphine and Versed and the baby was therefore receiving proper analgesia during his stay in the ICU. The customer expressed gratitude for the rapid help she got and the pump itself was being used to its capacity. In the end, the caregivers were able to treat the child safely and adequately.
Christine Nordhagen was born in 1971 in Grande Prairie, Alberta, and began wrestling at the age of 20 years. Christine has paid for becoming one of the best female wrestlers in the world; when she was left with no cartilage in either of her knees, causing bone-on-bone contact and excruciating pain. “It got to the point that I couldn't even get into my stance without my knees hurting me,” says Calgary, Alberta-based Nordhagen, who just competed in her first Olympics in Athens and is a six-time World Champion. “The doctors tried everything, but the stiffness and pain never went away. I knew that if I wanted to walk again, let alone compete, I needed to get my knees treated.” Enter Synvisc. To treat her condition, Nordhagen's doctor decided to give her injections of Synvisc to supplement the fluid in her knees, and give her the necessary pain relief and mobility needed to compete. “The difference was like night and day,” Nordhagen says. “I was able to wrestle without pain, and get myself into proper shape to continue my wrestling career.”
Lila-Kay Collins was 9 years old when she and her family learned she had diabetes. Following her diagnosis, which was sought out due to symptoms of constant fatigue, she soon learned about insulin needles, self-administered blood tests and a strict timetable with regard to when she should eat and in what amounts. Despite these efforts to manage the disease, Lila-Kay’s condition failed to improve and although her dosage of insulin had been increased to 4 times the amount for a person twice her weight her glucose levels remained elevated and unpredictable. Despite having no insurance coverage, shortly after her 12th birthday, her parents made the “very tough financial decision” to acquire an insulin pump which has “given her back her life” and has ensured the progress in her health that at age 14 she now enjoys.
As a constant barrier against nosocomial infection, all patients and health care providers benefit from Pall filters. New to the Canadian marketplace, the following is a clear indication of a European hospital seeing cost savings as a result of water filtration implementation. “A positive result was that the substantial investment yielded a significant ROI within a brief period of time, as reports Prof. Trautmann. Prof. Dr. Martin Exner (Director of the Institute for Hygiene and Public Health, Bonn):“In order to reduce the risk of life threatening infections as far as possible, additional precautionary measures need to be taken, at the least, in high risk-areas with patients whose immune system is severely suppressed. In these areas, a trend is being noticed towards filtration in point of use position”.
My sister Susan should be paralyzed or dead. Two years ago today, Sue, then 42 and the mother of 10-week-old Genevieve, was ordered by her family doctor, Mirek Dutczak, to get to emergency at Toronto's Mount Sinai Hospital -- fast. She had a severe headache and was slurring her words. “It felt like someone had split my head with an axe,” she says. The hospital gave her an MRI scan and rushed her to nearby Toronto Western Hospital. There, another test determined that she had a “spontaneous dissection of the left internal carotid artery,” immediately beneath the base of the skull. An aneurysm, in other words, in the main artery to the brain. The aneurysm was pressing on the hypoglossal nerve, which controls the tongue. That explained the slurring. Susan was pumped full of blood thinners to reduce the chances of clot formation. Even then, the possibility of a stroke remained high.
The key to success would be a special stent, or short tube that is inserted in blood vessels to prevent them from constricting or leaking. In most cases, stents are used in the heart (to reinforce blocked vessels after they have been cleared in an angioplasty procedure, for example), and my sister's doctors opted for a lattice model made by Boston Scientific in the United States. Called Symbiot, it is six millimetres wide and 40 millimetres long and is made of a highly flexible yet immensely strong nickel-titanium alloy called nitinol that is covered with a polymer membrane. Symbiots had not been approved by Health Canada for use in brain arteries, yet on Christmas Day, the doctors managed to find a Health Canada official to grant such approval for Sue on compassionate grounds. Incredibly, they also managed to find a Boston Scientific salesman who had a Symbiot in stock; the hospital had none. The actual stent deployment took about 20 seconds and worked beautifully. “The aneurysm started to shrink within minutes,” Dr. Farb says. The slurring stopped within weeks, although the headaches persisted for at least three months. The doctors monitored her closely. In the autumn of 2003, she resumed teaching, but only part-time. Today, no one can tell that Sue had an aneurysm. She speaks a bit more slowly than she used to, but only we know that. She praises her doctors and Toronto Western Hospital, and says: “I'm going to give them chocolates every Christmas for the rest of my life.” |
Needlestick and other sharps injuries are a key Canadian public health issue, affecting 70,000 people per year and costing some $140 million. A safety program at Toronto East General Hospital - focusing on blood collection and patient injection - achieved an 80% reduction in injuries within one year, with blood collection injuries eliminated. TEGH partnered with medical technology company BD to achieve these results, initially adopting BD Vacutainer® Eclipse™ needle for blood collection and BD Eclipse™ needles and syringes for injection. The BD Vacutainer® Eclipse™ technology features a patented safety shield that is activated with one hand to cover the needle immediately after use. The product requires minimal change in technique and is easy to activate.
On May 12th 2005, a call came into Hospira’s Clinical Support (HCS) department at the Montreal Head Office at 16h30. An ICU nurse from the Dr. Everett Chalmer’s Hospital, had an urgent issue regarding the administration of critical drugs via the Plum A+ Tripple Channel infusion pump. The situation was even more acute as the patient involved was a 1 year old baby. They had to give a combination of two drugs Morphine and Versed via a triple lumen Central line in order to keep the patient sedated and comfortable. They also wanted to infuse an intravenous solution Sodium Chloride to keep the line open. The issue was that they could not give both drugs concurrently on one channel. The pump would indicate the following message: “Concurrency Violation”. They obviously could not increase the drug doses due to the patient's age and status. Therefore they wanted to know if there existed a way to get around this “violation message”. Getting around this “violation message” would not be possible as this safety feature is there to prevent any medication over deliveries or under deliveries. Such safety features are very important in all patient age groups and particularly significant in pediatrics. Therefore, although there was no way to get “around” this feature, there was a way to administer the desired drugs as prescribed safely using all functions of the Plum A+ Tripple Channel pump.
Mark McGregor, of Hamilton, Ontario was in his mid 30’s when he suffered a sudden cardiac arrest while playing hockey. Mark was fortunate enough to be revived by paramedics, in Ontario only 5% of people who suffer from a sudden cardiac arrest are as fortunate as Mark. Mark’s cardiovascular specialists at the Hamilton Health Sciences Centre decided Mark should receive an Implantable Cardioverter Defibrillator to protect him from any subsiquent lethal arrhythmias. Mark has been protected by his ICD for almost 8 years now and has gone on to develop a career as a public motivational speaker and advocate for improved access to life saving ICD technology for Ontarians.
Prof. Dr. Matthias Trautmann (Institute for Clinical Hygiene, Stuttgart):“In the critical care unit of a certain hospital, a constantly high rate of 10-12 Pseudomonas infections per month could not be reduced despite comprehensive disinfection measures. After the partial fitting of some sinks with Pall sterile filters led to an instant reduction of the infection rate by approx. 50%, it was decided to fit sterile filters to all taps within the critical care area (n=7). This caused the numbers of infections to go down to a permanent level of 0-1 monthly.”
A 35 year-old female patient presented to the ER at St-Paul’s Hospital in Vancouver suffering from severe shortness of breath. Initial diagnosis was congenital heart problem and the patient was scheduled for valve replacement. NT-proBNP test (result above 35,000) revealed end-stage heart failure and the patient was put on the transplant list immediately. NT-proBNP not only confirmed the presence of heart failure but provided crucial information on the severity of the disease – which in the case of this young patient was life threatening.
The doctors had several options. They could open up Susan's neck and “sacrifice” the artery; that is, clip it just below the aneurysm. They could obstruct, or “occlude,” the artery with a tiny balloon. Or they could do something innovative that would not involve cutting flesh or inserting balloons. The last option was a non-invasive procedure done only once before at Western, by Dr. Montanera, and very few times anywhere else. The idea was to block off the aneurysm inside the artery, because conducting surgeries within blood vessels has a lot of benefits: no cutting, no blood, little or no pain, quick treatment, quick recoveries and less expense. 
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