The Health Services Authority has called in a kidney disease expert following a series of incidents on the dialysis unit at the Cayman Islands Hospital, including the death of a patient during dialysis treatment, in the past week.
Three patients suffered medical issues during or immediately after dialysis treatment between Wednesday and Friday last week.
One man died after suffering a “cardiac event” while on dialysis, health officials confirmed. An autopsy has been ordered to determine the precise cause of death. Of the two other affected patients, one has been discharged and the other is still in the critical care unit.
Doctors say there is no obvious link among the three incidents, beyond the dependence of all the affected patients on dialysis.
Professor Everard Barton, an expert in kidney disease and dialysis from the University of the West Indies, is flying into Grand Cayman to conduct a review in what the Health Services Authority described as a “proactive action.”
Safety checks
Dr. Delroy Jefferson, the HSA’s medical director, said safety checks had already been conducted on all dialysis machines as a precautionary measure. He said the proximity of the incidents was likely coincidental and statistics showed that Cayman’s dialysis unit was among the safest in the world.
He said the incidents had shaken the dialysis community and a psychologist had been made available to provide support to patients and staff.
“Had these incidents occurred over a longer period of time, say six months, there would have been no issue. We suspect this is coincidental but when you have a cluster of incidents like this, it does cause you to stop and review the entire process to make sure there is no association.”
There are around 50 patients in Cayman regularly receiving dialysis – a life sustaining treatment that involves patients with chronic kidney disease being hooked up to a machine that essentially cleanses the blood, artificially filling the role of a functioning kidney.
Higher risk
Acute patients typically require dialysis two to three times a week and tend to have a host of associated health issues that make them a higher risk for heart attacks. Patients on dialysis have a death rate of six to eight times higher than healthy individuals.
Dr. Jefferson said health scares involving patients while receiving dialysis, or immediately after, were not uncommon worldwide, but there had been no recent cases in Cayman. He said a series of tests, as well as Dr. Barton’s review, should serve to reassure patients that the treatment was safe.
“We are doing everything we can to confirm that the service is safe. We are conducting additional, in-depth quality testing on the water and machines being utilized. As a further measure, Professor Barton, the regional expert on kidney disease management, will be here on Monday to conduct an independent review of the service,” he said.
The average life expectancy of patients on dialysis is six years. Between eight and 10 dialysis patients have died each year in Cayman in the past two years from associated health issues. However, deaths and health scares related to physically receiving dialysis are relatively rare.
“We haven’t had any dialysis related issues for years. The staff are very close to the patients and have all been shaken by this,” said Dr. Jefferson.
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