Patients ‘deserve answers’ over the treatment that sparked investigation
Epidural blood patch patients have been "kept in the dark" over the procedure which triggered the investigation behind a mass patient recall, an MLA has claimed.
In correspondence in February, the Belfast Health Trust said the Royal College of Physicians' independent review, which led to the recall of more than 2,500 patients, was "initially prompted following concerns raised in relation to a number of patients being managed with blood patching".
It added: "There have been no concerns raised to date regarding the outcome of these procedures."
The Belfast Trust sent letters to blood patch patients at the end of April, informing them that it had completed a review of patients on the waiting list for epidural blood patch testing.
It had previously written to patients over the issue in November 2017.
According to a Belfast Trust timeline document, which has been seen by this newspaper, concerns around intracranial hypotension and blood patching surfaced on December 5, 2016, when a GP contacted the trust's clinical director.
On December 12, the trust's consultant working in private practise raised a separate concern around intracranial hypotension (IH), and the medical director moved to restrict Dr Michael Watt's in this area.
Private practice medical directors were also advised.
A case review was implemented that day into all diagnoses IH.
By March 16, 2017, a consultant leading a review of IH diagnoses advised that concerns had been found around "suggesting blood patching".
And on April 25, 2017, a case note review of 200 patients was considered after the Belfast Trust was directed to the Royal College of Physicians.
On May 4, a blood patching audit was completed and "restrictions confirmed" on Dr Watt.
It notes that there "was no evidence of any harm to any patient".
The internal review of IH patients had been completed by June 1, 2017.
At a trust meeting on June 6, it was agreed that "the current restrictions in practice ensured the safety of patients in relation to intracranial hypotension".
Restrictions were also put on Dr Watt regarding multiple sclerosis diagnoses and treatment.
Dr Watt was suspended from clinical practice that month.
SDLP deputy leader Nichola Mallon says the health service has serious questions to answer over the issue.
"I have asked the Belfast Trust and the Department of Health when they were first made aware of complaints or any concerns about Dr Watt and the blood patch procedure," she said.
"How serious were the concerns raised that on December 12, the day of the second complaint, the medical director of the Belfast Trust moved to immediately restrict Dr Watt's practice, and on the same day immediately initiate a case review?
"Why, if the review was completed by June 1, 2017, were blood patch patients only informed six months later, in November?"
Ms Mallon, an MLA for North Belfast, said she has been contacted by an increasing number of blood patch patients and there is "a number of consistent concerns" about their suitability for the procedure and how it was carried out.
She added: "Blood patch patients deserve answers, and the truth is they are being left in the dark, so much so that they are now trying to form their own support group.
"They aren't getting any answers from the Belfast Trust.
"I met with the Belfast Trust in May and specifically asked about blood patch patients. I then followed it up in writing and have just got the answer, five weeks later."
The Belfast Trust said the Department of Health had published terms of reference for the independent inquiry which "will examine in full the circumstances which led to the recall and the trust's handling of issues related to potential concerns around patient care and safety".
"Therefore we are unable to provide any further information at this time."
It added: "The full picture on the extent of changed or updated diagnoses and treatments will only be ascertained at the conclusion of both the recall process and any follow-up appointments."
The Belfast Trust said it had "responded to Ms Mallon in as much detail as we are able".