UK women dieing due to birth control pill and medical incompetence.

[Deleted]

http://www.itv.com/news/2016-04-28/p...d-link-to-dvt/

In each of these cases, the young women returned to doctors or nurses again and again with similar symptoms – breathlessness, headaches and leg pains. Fallan was told she was perhaps having a panic attack; Sophie was told she had exercise induced asthma; Maria was given painkillers for headaches.
The MHRA guidelines are quite clear.
It’s about understanding the risks of DVT and how to recognise the symptoms – not just the medical professionals but also women who are taking it.

When we spoke to Fallan’s parents, Julia and Brian, they were still deeply traumatised by the loss of a daughter they said was loving and full of life. What emerged was a story of missed opportunities by medical professionals to save her life.

It had started with a pain in her lower leg, which Fallan initially dismissed as having been down to dancing at the weekend. When she became breathless, eventually collapsing, her father took her to the local walk-in clinic where she was seen by a nurse who misdiagnosed her symptoms and sent her home with painkillers.

Fallan collapsed again just a few days later in her mother’s arms. She was taken by ambulance to hospital but she never regained consciousness.

"If we had known that this was an issue, we could have taken her to the A&E and said this is an issue. If Fallan had received the treatment that she needed on the Friday, Fallan would be alive now. The only reason she isn’t alive now is because it was left for another three days and she died", Mrs Kurek said.

It wasn’t until a conversation in hospital that Fallan’s mum realised the pill might be in any way a factor.

People on MMOC people should pay particular attention to this as many of us have sat down and played WoW or other games for far longer than is healthy and puts us at risk of clots and a few other health issues.

[Vanyali]

Doctors really aren't omnipotent. The article itself even says that blood clots as a result of this pill are very rare, and as a doctor you treat the common causes for symptoms before you go to the exotic. Otherwise you're spending a lot of money and time for things that have fuck-all to do with anything, while the common cure might be "go home, drink fluids, have an aspirin if pain is especially bad".

Is it tragic? Sure. Is it something to blame the doctors for when it happened over a weekend, in one of the cases? No. Tragedy usually strikes quickly.


"This equates to between 6 and 12 extra cases of blood clot for every 10,000 women prescribed (depending on the type of pill)."

Your first thought isn't going to be something that rare.

[Annoying]

DVTs are serious business. My company requires me to stand up and walk around for 20s every 20min. While doing that, they have us look at something 20ft away or further to prevent eye strain as well.

[Deleted]

Doctors really aren't omnipotent. The article itself even says that blood clots as a result of this pill are very rare, and as a doctor you treat the common causes for symptoms before you go to the exotic. Otherwise you're spending a lot of money and time for things that have fuck-all to do with anything, while the common cure might be "go home, drink fluids, have an aspirin if pain is especially bad".

Is it tragic? Sure. Is it something to blame the doctors for when it happened over a weekend, in one of the cases? No. Tragedy usually strikes quickly.


"This equates to between 6 and 12 extra cases of blood clot for every 10,000 women prescribed (depending on the type of pill)."

Your first thought isn't going to be something that rare.

I can see your point of view but on the other hand this seems like the tip of the iceberg and of course it's much easier to do nothing and see what happens but then you have serious consequences that could be avoided with a bit more effort and that's not good enough in this day and age.

[Vanyali]

I can see your point of view but on the other hand this seems like the tip of the iceberg and of course it's much easier to do nothing and see what happens but then you have serious consequences that could be avoided with a bit more effort and that's not good enough in this day and age.

...they didn't do nothing. The prescribed them things based on what is generally the cure for said symptoms. That the problems they had were exceedingly rare doesn't make the doctors incompetent - it makes them human. Real life medicine isn't like house, where they cross out all the uncommon shit before going to Lupus, or disease that one guy had back in the fifties that's referenced once in an obscure medical journal but our hero remembers it. It's more "okay, try this. If it doesn't work, come back and we'll try that. If that doesn't work, we'll try this other. If that doesn't work, we'll go further up the rarity scale.".

[Simulacrum]

DVTs are serious business. My company requires me to stand up and walk around for 20s every 20min. While doing that, they have us look at something 20ft away or further to prevent eye strain as well.

It's company policy to have the entire workforce break workflow every 20 minutes? That sounds... stupid enough that it might just be true.

[Annoying]

It's company policy to have the entire workforce break workflow every 20 minutes? That sounds... stupid enough that it might just be true.

It's just 20s. It's not enforced by some timer somewhere or anything, but it's in the policy documents that I got, and my boss at our local operation wants us to do it.

[Deleted]

...they didn't do nothing. The prescribed them things based on what is generally the cure for said symptoms. That the problems they had were exceedingly rare doesn't make the doctors incompetent - it makes them human. Real life medicine isn't like house, where they cross out all the uncommon shit before going to Lupus, or disease that one guy had back in the fifties that's referenced once in an obscure medical journal but our hero remembers it. It's more "okay, try this. If it doesn't work, come back and we'll try that. If that doesn't work, we'll try this other. If that doesn't work, we'll go further up the rarity scale.".

To labour the point, we could all pretend to be doctors and tell people it's probably nothing and to "go home, drink fluids, have an aspirin if pain is especially bad" and then enjoy a high success rate of "curing" people. If anyone does die then we could say it was unavoidable and doesn't justify the costs to investigate it or palm it off to someone else.

[Vanyali]

To labour the point, we could all pretend to be doctors and tell people it's probably nothing and to "go home, drink fluids, have an aspirin if pain is especially bad" and then enjoy a high success rate of "curing" people. If anyone does die then we could say it was unavoidable and doesn't justify the costs to investigate it or palm it off to someone else.

Except that's not what doctors do, at all, but okay.

You're assigning a level of omnipotence to doctors that's just not possible. Watch your GP next time you go in for anything. Watch them when they're on the computer and what they're looking up. They don't have a magical wealth of knowledge in their mind, but at their fingertips, and they're not going to search for DVT when you're gasping for breath after a harsh activity, because that's NOT at all common.

[Kasierith]

Doctors really aren't omnipotent. The article itself even says that blood clots as a result of this pill are very rare.

A 21 year old with first occurrence asthma leading to leg pain?... no, sorry, this was a pretty severe misfire from the physician. A DVT can be discovered with a thorough examination of the leg. It sounds like he was moving people in and out at a pace not suitable for addressing her condition.

As for the PE, it really is as simple as basic pharmacology. Problems breathing is either internal or external (external being inside the lungs). Albuterol should have been administered. With no relief from albuterol, they should have looked for internal causes.... and if she is a healthy 16 year old who is on an estrogen-based birth control, a scan for a PE should have been the first on the list.

This isn't the result of a random chance as much as people addressing the problem piece by piece instead of taking the time to examine the full picture. Which means that fault does rest with the physicians.

- - - Updated - - -

Except that's not what doctors do, at all, but okay.

You're assigning a level of omnipotence to doctors that's just not possible. Watch your GP next time you go in for anything. Watch them when they're on the computer and what they're looking up. They don't have a magical wealth of knowledge in their mind, but at their fingertips, and they're not going to search for DVT when you're gasping for breath after a harsh activity, because that's NOT at all common.

I think you're mixing them up. You're discussing the 16 year old with the pulmonary embolism, not the 21 year old with initial presentation with a DVT. Though so did I at first.

[Vanyali]

A 21 year old with first occurrence asthma leading to leg pain?... no, sorry, this was a pretty severe misfire from the physician. A DVT can be discovered with a thorough examination of the leg. It sounds like he was moving people in and out at a pace not suitable for addressing her condition.

As for the PE, it really is as simple as basic pharmacology. Problems breathing is either internal or external (external being inside the lungs). Albuterol should have been administered. With no relief from albuterol, they should have looked for internal causes.... and if she is a healthy 16 year old who is on an estrogen-based birth control, a scan for a PE should have been the first on the list.

This isn't the result of a random chance as much as people addressing the problem piece by piece instead of taking the time to examine the full picture. Which means that fault does rest with the physicians.

I think you're mixing them up. You're discussing the 16 year old with the pulmonary embolism, not the 21 year old with initial presentation with a DVT.

I wasn't really addressing either in specific, more the idea that after everyone dies the physician is automatically incompetent and at-fault for not finding a rare problem immediately rather than the more common ones.

As an example: my mom gets ALL those symptoms from allergies. Most likely to do with the fact that it's also mixed with RA. It took her roughly 30 years to figure that out, with doctor help, because joint pain for allergies? Not that common. She's also a nurse herself, FWIW. As well as multiple doctors, in multiple states.

As I've said, it's a tragedy, absolutely. But trying to blame the doctors for incompetence for not knowing that it was an ultra-rare condition.. that's a little overboard. We don't even know if she mentioned she was on the BC in the first place, which would be the ONLY reason a blood clot would be even suspected! because why WOULD anyone - "my leg hurts. must be my birth control", say very few people.

[the game]

Doctors should wear body cameras.

[Kasierith]

I wasn't really addressing either in specific, more the idea that after everyone dies the physician is automatically incompetent and at-fault for not finding a rare problem immediately rather than the more common ones.

As an example: my mom gets ALL those symptoms from allergies. Most likely to do with the fact that it's also mixed with RA. It took her roughly 30 years to figure that out, with doctor help, because joint pain for allergies? Not that common. She's also a nurse herself, FWIW. As well as multiple doctors, in multiple states.

As I've said, it's a tragedy, absolutely. But trying to blame the doctors for incompetence for not knowing that it was an ultra-rare condition.. that's a little overboard. We don't even know if she mentioned she was on the BC in the first place, which would be the ONLY reason a blood clot would be even suspected! because why WOULD anyone - "my leg hurts. must be my birth control", say very few people.

An ultra rare condition? It is the side effect of birth control pills. ACE-I can cause coughing, statins can cause rhabdomyolysis, BB's can cause exercise intolerance, SSRI's can cause a shit load of things, and estrogen based birth control pills have a significant risk of blood clots.

Oh, and not working to obtain a med list is gross incompetence on the part of the physician.

[Vanyali]

An ultra rare condition? It is the side effect of birth control pills. ACE-I can cause coughing, statins can cause rhabdomyolysis, BB's can cause exercise intolerance, SSRI's can cause a shit load of things, and estrogen based birth control pills have a significant risk of blood clots.

Oh, and not working to obtain a med list is gross incompetence on the part of the physician.

The stories seem to indicate people were unconscious when symptoms were serious, so unless your family knows your BCs...?

6 or 12 in 10,000 to get a bloodclot is pretty damn rare.

For comparison:

Odds you will be injured by a toilet this year: 1 in 10,000
Odds of finding a four-leaf clover on the first try: 1 in 10,000

If you want a more even comparison, SIDS hits 1 in 1000 kids. If you're 20, you have 1 in 1500 chance for a down's syndrome child.

Point being.. breathlessness, leg pain, and headaches have a great many more common causes than the 1 or .5 in 1000. That's why they try to treat you based on that *first*.

[Kasierith]

The stories seem to indicate people were unconscious when symptoms were serious, so unless your family knows your BCs...?

6 or 12 in 10,000 to get a bloodclot is pretty damn rare.

For comparison:

Odds you will be injured by a toilet this year: 1 in 10,000
Odds of finding a four-leaf clover on the first try: 1 in 10,000

If you want a more even comparison, SIDS hits 1 in 1000 kids. If you're 20, you have 1 in 1500 chance for a down's syndrome child.

Point being.. breathlessness, leg pain, and headaches have a great many more common causes than the 1 or .5 in 1000. That's why they try to treat you based on that *first*.

I'm going to guess that the patient with the PE was conscious at some point in that three week span. And the woman with the DVT appears to have been conscious at presentation with her complaints of weakness and headache, so... yes. They were conscious enough to do a med history.

And, again, you can look anywhere you want.... estrogen based BC is strongly related to elevated risk of blood clots. This is known, has been prevelant in literature for decades, and can raise to as much as a 40% lifetime risk with other cofacters put in.

It honestly seems like you just want to defend the doctors because [no real reason here]. Sometimes people mess up. They did. Over 900,000 people get DVT's every year in the US alone, with a grossly disproportionate amount of younger people with DVT's having been on estrogen birth control. They are not uncommon. And what we see here are not the odd medical anomolies, but the instances where the doctors fucked up and didn't know to resolve what is ultimately one of the most easily addressed possibly lethal conditions.

[Vanyali]

I'm going to guess that the patient with the PE was conscious at some point in that three week span. And the woman with the DVT appears to have been conscious at presentation with her complaints of weakness and headache, so... yes. They were conscious enough to do a med history.

And, again, you can look anywhere you want.... estrogen based BC is strongly related to elevated risk of blood clots. This is known, has been prevelant in literature for decades, and can raise to as much as a 40% lifetime risk with other cofacters put in.

It honestly seems like you just want to defend the doctors because [no real reason here]. Sometimes people mess up. They did. Over 900,000 people get DVT's every year in the US alone, with a grossly disproportionate amount of younger people with DVT's having been on estrogen birth control. They are not uncommon. And what we see here are not the odd medical anomolies, but the instances where the doctors fucked up and didn't know to resolve what is ultimately one of the most easily addressed possibly lethal conditions.

Again though - I'm still speaking in generalities. These doctors could well have messed up. The information is scant at best.. and the symptoms are wide-ranging. I've gone to a doctor for all those symptoms myself, and I've never TOUCHED BC. And it turned out to be a variety of random things (flat feet, sinus infections, and asthma, all occurring within the same period of time).

On a more specific note to the article:

""If we had known that this was an issue, we could have taken her to the A&E and said this is an issue. ""

If "we" had known... which would be reading the side effects of things you put into your body. Which is also just as much on them to realize you have a fairly low chance for a blood clot because of BC, but it CAN happen.

[Kasierith]

Again though - I'm still speaking in generalities. These doctors could well have messed up. The information is scant at best.. and the symptoms are wide-ranging. I've gone to a doctor for all those symptoms myself, and I've never TOUCHED BC. And it turned out to be a variety of random things (flat feet, sinus infections, and asthma, all occurring within the same period of time).

On a more specific note to the article:

""If we had known that this was an issue, we could have taken her to the A&E and said this is an issue. ""

If "we" had known... which would be reading the side effects of things you put into your body. Which is also just as much on them to realize you have a fairly low chance for a blood clot because of BC, but it CAN happen.

Well, lets look at it another way. Not with the 21 year old who presented with a misdiagnosed DVT that turned into a PE.

The 16 year old had 3 weeks of a small PE, with four office visits in that time. She was diagnosed with exercise induced asthma. Treatment is albuterol.
What do you think albuterol would have done? If you aren't familiar with the subject.... jack shit. Absolutely no medical benefit at all (unless she did have some asthma to the side, which is a nebulous point). The problem is further down the line than air flow.
So she comes back to second office visit. Symptoms worse, not improved. The medicine that specifically forces the airways open in an albuterol naive patient has failed and she has gotten worse. If someone is albuterol naive, which someone with a new asthma diagnosis probably is, albuterol is going to pop the lungs open. Which means that the problem is not outside, but either at the gas exchange level or with circulation. At that second visit, continuing with the assumption that it was asthma would have demonstrated gross incompetence, and a lack of understanding of how the medication and how the pulmonary system overall function.

So, gas exchange or circulation.... COPD? Not likely, 16 year old who was listed healthy. Unless she had been smoking hard since she was 6 or something like that, COPD not likely. Chemical burns? Strictly environmental. Cystic fibrosis? Rare (actually rare, as opposed to your theoretical rare), and still responds somewhat to albuterol so would have seen some relief. Pulmonary hypertension? Makes cystic fibrosis look common. Megalocardia? In a 16 year old? Would have taken a pretty odd heart birth defect to have made it all the way to a such a massive onset at 16 as opposed to under 3 years old. Cancer? Possible, but diagnosis with a CT would have shown the PE so.

You can keep going down the list of all the odd conditions like that. But, well... the majority of those odd ones from a major dissection to endocarditis would involve either a CT scan or a blood test.. even an iron level test for general exhaustion. A CT would have shown the PE, and a blood test would have shown clotting markers which would be massive red flags for a clot.

A misdiagnosis on the spot happens. A four times over misdiagnosis from the same doctor? That goes beyond an incidental oversight. That goes straight into she lacked the knowledge to recognize and resolve the issue.