Health scare prompted review
A kidney disease expert has given Cayman’s dialysis unit a clean bill of health after flying in to review the facility following a series of incidents, including the death of a patient while on dialysis.
Professor Everard Barton, of the University of the West Indies, told the Cayman Compass his investigations revealed no connection between three separate incidents in which patients suffered medical issues during or immediately after dialysis treatment last week.
One man died after suffering a “cardiac event” while on dialysis and two others suffered health scares, prompting health officials to request an investigation. A fourth incident involving a patient at the unit was said to be unconnected to dialysis.
The Health Services Authority’s medical director, Delroy Jefferson, said he suspected from the outset that the proximity of the incidents was coincidental. But he said it was reassuring to have this confirmed by an outside expert.
Professor Barton said his review suggested a well-run unit that was getting good results for its patients. He said he reviewed patient records, met with doctors, nurses and technicians, examined the machine service and water quality logs, and reviewed the policies and procedures of the dialysis unit.
“I must say, I was really quite impressed,” said Mr. Barton, who is professor of medicine and nephrology at the University of the West Indies.
“I don’t think there is any link between the dialysis unit and what has happened. The management was very good, the water quality meets international standards. I concluded that what I see here is superb management and excellent systems.”
He added, “I think it is a coincidence. These are patients with complex problems and I think it is just coincidence that [the medical issues] seem to have happened all at one time.”
He said dialysis units often deal with patients with many other health problems, including a higher risk of heart issues.
He said Cayman’s unit stood out because it did not “screen out” or select patients as some units are forced to do, meaning it caters to patients with more complex health problems.
“That’s why I was quite impressed that the service is so good, despite the fact that they are taking patients with many complicating factors,” he said.
He added that the unit had a good mortality rate, compared to other jurisdictions.
Dr. Jefferson said it was reassuring to receive such a glowing report, which he said backed up statistics that suggest the unit is doing a good job.
He said the morbidity rate on the unit is just over 12 percent, which compares favorably with many international centers, including the U.S. (24 percent), England (15 percent) and Australia (14 percent).
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.
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.
According to figures from the Cayman Islands Health Services Authority, 6,600 dialysis treatments are carried out annually. Cayman’s dialysis patients range in age from 21 to 88 years, with some having been on dialysis for as long as 18 years.
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