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Category: Medical Negligence

Editor Faces Discrimination

Disability Discrimination


Invitation For Journalists – “PIP DISCRIMINATION”

Disabled Entrepreneur Editor Faces Discrimination and Rejection by DWP’s PIP

In a shocking turn of events, the esteemed editor of the “Disabled Entrepreneur” and “Disability UK Online Journal” has been subjected to discrimination and humiliation by the Department for Work and Pensions (DWP) over her Personal Independence Payments (PIP) claim. Despite battling obsessive-compulsive disorder (OCD) for over three decades, her claim was unjustly rejected, with assessors deeming her as fit as an able-bodied individual without considering the overwhelming medical evidence at their disposal.

This courageous editor, who has valiantly confronted the challenges of OCD, Clinical Depression, and Cerebellar Atrophy, has not only managed to maintain her professional life but has also transformed her personal struggles into a source of inspiration for countless individuals with disabilities. The online platform she created, “Disabled Entrepreneur,” originally conceived as a form of self-help therapy, has evolved into a powerful tool for empowerment and support for disabled individuals striving to carve their path in the business world.

In her quest for medical assistance, the NHS failed her. The editor penned not one, not two, but three heartfelt letters to her general practitioner (GP), imploring support for her own health and wellbeing. Regrettably, these pleas seemed to have fallen on deaf ears, as the GP Practice Manager merely entered the letters into the healthcare system without further action, citing that if the editor did not like how the GP surgery operated to find another doctor as they were not obligated to provide any care.

Tragically, because of the PIP rejection (this has happened to her once before which she appealed) and the ensuing emotional distress caused by the DWP’s actions, this remarkable editor has become a virtual recluse, venturing out of her home a mere two times in the last five years. The discriminatory treatment by PIP has not only been a source of humiliation. Still, it has also taken a severe toll on her physical and mental health, leading to a stark deterioration in her overall well-being.

The shocking and deeply troubling case of this editor stands as a glaring example of the injustice that many individuals with disabilities face when attempting to access the support they rightfully deserve. It raises urgent questions about the fairness and accuracy of the PIP assessment process and the vital need for reform to ensure that disabled individuals are treated with the dignity, respect, and compassion they unquestionably deserve.

Editor Calls Upon Journalists to Shed Light on Her Plight

In her pursuit of justice and in the hope of shedding light on the pervasive issues within the disability support system, the editor of “Disabled Entrepreneur” and “Disability UK Online Journal” is extending a heartfelt invitation to journalists and media outlets to share her compelling story.

This courageous editor, who has faced discrimination and unjust rejection of her PIP claim despite her lifelong battle with Obsessive-Compulsive Disorder (OCD) and clinical depression, and in the last decade cerebellar atrophy and cognitive impairment, believes that her ordeal is a poignant reflection of the challenges many disabled individuals encounter when navigating the intricacies of the support system.

By opening her life and struggles to the public eye, she aims to bring attention to the inherent flaws in the PIP assessment process and the emotional distress and hardship it inflicts on countless disabled individuals. She hopes that her story will resonate with journalists who recognize the urgency of reforming the system to ensure fair treatment, respect, and dignity for those living with disabilities.

Through the power of storytelling, the editor aspires to spark a much-needed conversation about the discrimination faced by disabled individuals and the critical need for change within the system. Her invitation to journalists is a call for empathy, awareness, and solidarity, and she is ready to share her experiences, medical evidence, and personal journey with those who are willing to amplify her message. Together, they can help drive the change needed to ensure a more just and equitable future for all individuals with disabilities.

https://disabledentrepreneur.uk/breaking-news-editors-pip-claim-declined/


#pip #personalindependancepaymests #dwp #discrimination #humiliation #mentalhealth #mentalhealthdisorders #ocd #obssessivecompulsivedisorder #mentalhealthdeterioration #selfhelptherapy #medicalnegligence #disabledentrepreneur

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What If Your GP Stonewalls You

GP Business

What to Do When Your GP Stonewalls You:

A Guide to Advocating for Your Health

Your general practitioner (GP) is often your first point of contact when seeking medical advice and treatment. GPs play a crucial role in managing your health and referring you to specialists when necessary. However, there may be instances when you feel that your GP is not adequately addressing your concerns or stonewalling you. When this happens, it’s essential to advocate for your health and navigate the situation effectively.

Understanding Stonewalling:

Stonewalling by your GP can manifest in various ways. It may involve dismissing your symptoms, not taking your concerns seriously, or avoiding discussions about your health altogether. While GPs have a demanding job, it’s important that they listen to your concerns, provide clear explanations, and involve you in decision-making about your healthcare.

Steps to Take When Facing Stonewalling

  1. Communicate Clearly: The first step in addressing stonewalling by your GP is to communicate your concerns clearly. Be concise and assertive about your symptoms, questions, or worries. Keep a journal of your symptoms, including when they occur, their severity, and any potential triggers. This documentation can help you present a comprehensive picture of your health concerns to your GP.
  2. Ask Questions: Don’t hesitate to ask questions about your condition or treatment options. Your GP should be willing to explain medical terms and provide you with information to help you make informed decisions. If your GP avoids answering your questions or seems evasive, ask them directly to address your concerns.
  3. Seek a Second Opinion: If you feel that your GP is not taking your health concerns seriously, consider seeking a second opinion from another medical professional. A second opinion can provide you with a fresh perspective and alternative treatment options. You can ask your GP for a referral to another specialist or seek one independently.
  4. Advocate for Yourself: Advocating for your health is essential. If your GP is stonewalling, be persistent in seeking the care you deserve. Explain the impact of your symptoms on your daily life, work, or overall well-being. Emphasize the importance of addressing your concerns promptly to prevent potential complications.
  5. Bring a Supportive Friend or Family Member: Sometimes, having a supportive friend or family member accompany you to your GP appointments can be beneficial. They can provide emotional support and act as a witness to the interactions between you and your GP. This can help ensure that your concerns are taken seriously.
  6. Request a Different GP: If your efforts to address stonewalling do not yield positive results, you may consider requesting to see a different GP within the same practice. A different GP may have a different approach and be more receptive to your concerns.
  7. Lodge a Complaint: If you believe that your GP’s stonewalling constitutes a serious breach of professionalism, you can consider filing a complaint with the medical practice or relevant medical board. Ensure that you document the incidents and have any witnesses provide statements if necessary.

What rights do you have to have healthcare from your GP and can they refuse to support you?

In many countries, individuals have certain rights when it comes to healthcare from their general practitioner (GP). While these rights can vary depending on the healthcare system and the specific laws and regulations of your country, there are some general principles that apply in many places. It’s important to note that the details of these rights may change over time, so it’s a good idea to check with your local healthcare authority or legal resources for the most up-to-date information in your area.

Here are some common rights you might have when seeking healthcare from your GP:

  1. Access to Healthcare: In many countries, citizens have the right to access healthcare services, including primary care from a GP. This means you have the right to seek medical advice and treatment from a GP.
  2. Informed Consent: You have the right to be fully informed about your medical condition, treatment options, and potential risks and benefits. Your GP should provide you with clear and understandable information to help you make informed decisions about your healthcare.
  3. Confidentiality: Your GP is legally required to keep your medical information confidential. They cannot share your medical history or details about your condition with others without your consent, except in specific situations outlined by law (e.g., reporting certain infectious diseases).
  4. Respect and Dignity: You have the right to be treated with respect and dignity by your GP and the healthcare team. Discrimination or disrespectful behavior is generally not allowed.
  5. Refusal of Treatment: While GPs have an ethical duty to provide care, there can be circumstances where they may refuse treatment. These situations often involve conflicts of interest, such as when a GP is not qualified to provide a specific treatment or when a patient’s request goes against medical ethics (e.g., requesting unnecessary medications). However, refusal of care must typically be based on legitimate medical or ethical grounds.
  6. Second Opinions: You have the right to seek a second opinion from another healthcare provider if you have concerns about your diagnosis or treatment plan. Your GP should support your decision to seek a second opinion.
  7. Complaints and Feedback: Most healthcare systems have mechanisms for patients to file complaints or provide feedback about their care. You can typically voice your concerns about your GP’s behavior, treatment, or any other aspect of your healthcare.
  8. Access to Medical Records: You generally have the right to access your medical records and request copies. This allows you to review your medical history and ensure accuracy.

Can GPs respond by letter if you have raised your medical issues to them by letter?

GPs can respond to your medical concerns and questions by letter if you’ve raised those issues with them in writing. In fact, written communication is a common and accepted way for patients to communicate with their healthcare providers, including GPs.

Here’s how the process typically works:

  1. Sending a Letter: You can send a letter to your GP detailing your medical concerns, questions, or any information you wish to communicate. Make sure your letter is clear and concise and includes relevant details about your symptoms, medical history, and any treatments or medications you’re currently taking.
  2. Receiving a Response: Your GP will review your letter and may discuss it with you during a subsequent appointment. Depending on the nature of your concerns and the urgency of the situation, your GP may choose to respond by letter or recommend an in-person or phone consultation.
  3. Content of the Response: If your GP chooses to respond by letter, they will typically address your concerns and provide recommendations, advice, or further instructions in the letter. They may also schedule a follow-up appointment if necessary.
  4. Patient Portal: In some healthcare systems, GPs and medical practices offer online patient portals where you can securely exchange messages, view test results, and communicate about your health. This can be an efficient way to have written communication with your GP.
  5. Phone Follow-Up: In certain cases, your GP may prefer to discuss your concerns over the phone. They may call you to provide a response or clarification on the issues you raised in your letter.

It’s important to keep in mind that while written communication can be convenient for both patients and healthcare providers, it may not be suitable for all medical issues. Some concerns may require a face-to-face evaluation, especially if physical examination, diagnostic tests, or immediate treatment is needed.

If you have specific questions or concerns about how your GP prefers to communicate or if you’re unsure about the response you received in a letter, you should reach out to the GP’s office to discuss your preferences and the best way to address your healthcare needs. Effective communication with your healthcare provider is essential for ensuring you receive the care and information you need for your well-being.

It’s important to remember that while you have rights as a patient, you also have responsibilities, such as providing accurate information to your healthcare provider and following their recommendations to the best of your ability.

If you believe your GP is refusing care without a legitimate medical or ethical reason, it’s advisable to seek a second opinion or contact your local healthcare ombudsman or regulatory authority for guidance on how to address the issue. Laws and regulations related to healthcare rights can vary, so consulting local resources is essential to understanding your specific rights and options in your area.

What if your mental health deteriorates because your GP refuses to give you care and address your concerns in writing?

If your mental health deteriorates because your GP refuses to provide you with care or address your concerns, it’s crucial to take immediate action to safeguard your well-being. Here are some steps to consider:

  1. Seek Immediate Assistance: If you are in crisis or experiencing severe mental health issues, don’t hesitate to seek immediate help. Contact a crisis helpline, a mental health crisis center, or go to the nearest emergency room. Your safety and well-being should always be the top priority.
  2. Speak to a Mental Health Professional: Reach out to a mental health professional, such as a psychiatrist, psychologist, or therapist, who specializes in mental health care. They can provide you with an evaluation, support, and treatment options.
  3. Contact Another GP or Healthcare Provider: If your current GP is not addressing your mental health concerns, consider seeking assistance from another GP or healthcare provider. You have the right to access healthcare, and a different GP may be more receptive to your needs.
  4. Document Your Concerns: Keep a record of your interactions with your GP, including dates, details of conversations, and any written communication. This documentation can be useful if you decide to file a complaint or seek legal assistance.
  5. File a Complaint: If you believe that your GP’s refusal to provide care is unjustified or has caused harm to your mental health, consider filing a formal complaint with the medical practice, healthcare regulatory authorities, or a patient ombudsman. Be sure to provide all relevant details and evidence.
  6. Consult Legal Advice: Depending on the circumstances, you may want to consult with a legal professional who specializes in healthcare law. They can advise you on potential legal actions or remedies available to you.
  7. Support Network: Lean on your support network, including friends and family, for emotional support during this challenging time. They can provide comfort and assistance as you navigate the situation.
  8. Explore Mental Health Resources: In addition to seeking professional help, explore mental health resources available in your area, such as support groups, community mental health services, and online resources.

Can you sue your GP if your mental health has deteriorated?

Knowing that you have a telephone phobia and have sent them detailed letters and they have not responded?

In many legal systems, medical malpractice cases are typically based on the principle of a breach of the standard of care. To pursue a lawsuit against your GP, you would typically need to demonstrate the following elements:

  1. Duty of Care: Establish that your GP owes you a duty of care as their patient. This is usually established when you have an established doctor-patient relationship.
  2. Breach of Duty: Show that your GP breached the duty of care by failing to respond to your written communications or adequately address your concerns. In your case, this may involve demonstrating that they did not meet the standard of care expected in your specific circumstances, taking into consideration your phone phobia.
  3. Causation: Establish a direct link between your GP’s breach of duty and the deterioration of your mental health. You would need to provide evidence that your mental health deteriorated as a result of their actions or inactions.
  4. Damages: Prove that you suffered damages as a result of your deteriorating mental health. This could include medical expenses, lost wages, pain and suffering, or other measurable losses.
  5. Expert Testimony: In medical malpractice cases, it’s often necessary to obtain expert medical testimony to support your claim. This expert can help establish the standard of care and whether your GP’s actions deviated from it.
  6. Statute of Limitations: Be aware of the statute of limitations in your jurisdiction, which is the timeframe within which you must file a lawsuit. Missing this deadline can result in your case being dismissed.

It’s important to consult with an experienced medical malpractice solicitor/attorney who can assess the specific details of your case, provide guidance on the merits of your claim, and advise you on the best course of action. Laws regarding medical malpractice can vary significantly from one jurisdiction to another, so it’s crucial to consult with an attorney who is familiar with the laws in your area. Remember that pursuing legal action can be a complex and lengthy process, and success is not guaranteed.

If you believe you have a valid case, consult with an attorney to discuss your options and the best way to proceed.

Further Reading:

https://albanysurgery.nhs.wales/about-us/practice-team/

Google Reviews For: Meddygfa Albany Surgery

219-221  City Road,  Cardiff,  South Glamorgan,  CF243JD United Kingdom

NHS Ombudsman

https://www.gov.wales/nhs-wales-complaints-and-concerns-putting-things-right

Anxiety & Phobia

https://disabledentrepreneur.uk/anxiety-phoning-your-gp/

https://www.mind.org.uk/about-us/our-policy-work/you-and-your-gp/

Conclusion

Your health is of utmost importance, and you should feel comfortable and supported when seeking medical care. While most GPs are dedicated professionals, there may be instances when you encounter stonewalling or resistance to addressing your health concerns. By following the steps outlined above and advocating for your health, you can ensure that you receive the care and attention you deserve. Remember that your well-being should always be the top priority in any medical interaction, and you have the right to seek the best care possible.

It’s important to remember that your mental health is a critical aspect of your overall well-being, and you have the right to receive appropriate care and support.

If you ever feel that your mental health is at risk due to the actions or inactions of your GP, prioritize getting the help you need from mental health professionals and seek alternatives for medical care.

Mental health concerns should always be taken seriously, and timely intervention can make a significant difference in your recovery.

Personal Perspective From The Editor of ‘Disabled Entrepreneur UK’.

The question is how can Meddygfa Albany Surgery be in business if they have a low trust and credibility rating and tell patients if they do not like how they operate to find another doctor? This is absolutely appalling treatment. If their only priority is to get money from the pharmaceutical companies by prescribing medication to fund this business, they should be investigated. There is something seriously wrong when a surgery hires unprofessional people to run the outfit.

The editor of ‘Disabled Entrepreneur UK’ has stated that she uses this surgery to get her medication but they will not respond in writing (despite her writing three in-depth letters). On the other hand, they will send out letters with notifications about updating their records or phone when it suits them to incite you to get flu jabs. If you state you do not want a vaccination they then get shirty because it is in their financial interest each time they vaccinate someone.

To date, the editor has told me she has not had adequate care from the surgery and her mental health has deteriorated as a direct result of the GP’s no action and the recent PIP telephone assessment, which according to her has been written in her online journal and cited in some recent publish articles.

She has chosen to take a step back to try and recover giving the reigns to the senior writer.

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#gp #doctor #gpsurgery #malpractice #medicalnegligence #gpai #nhs #nhsombudsman #mentalhealth #telephonephobia #socialanxiety

A Trainee Phlebotomist Caused a Hematoma

A Trainee Phlebotomist Caused a Hematoma

Hematoma: Understanding the Bruising Beneath the Skin

From the smallest bump to the most severe trauma, our bodies are remarkably adept at healing themselves. One of the body’s remarkable defense mechanisms against injury is the formation of a hematoma. But what exactly is a hematoma, and how does it play a vital role in the healing process?

Defining Hematoma

A hematoma is a localized collection of blood that pools outside the blood vessels, usually within the soft tissues of the body, such as muscles or skin. Essentially, it is a bruise beneath the skin’s surface. Hematomas can range in size from small and inconspicuous to large and painful. They typically occur as a result of trauma, injury, or surgery but can also develop spontaneously in some medical conditions.

The Mechanism of Hematoma Formation

When a blood vessel, such as an artery, vein, or capillary, is damaged due to injury, the body activates a series of processes to stop bleeding and repair the vessel. This process is known as hemostasis.

  1. Vasoconstriction: The initial response to vessel damage is vasoconstriction, where the blood vessel narrows to reduce blood flow to the injured area. This helps minimize blood loss.
  2. Platelet Activation: Platelets, small cell fragments in the bloodstream, play a crucial role in forming blood clots. They quickly adhere to the damaged vessel wall, creating a temporary plug to stop bleeding.
  3. Coagulation Cascade: A complex sequence of events known as the coagulation cascade is initiated. This process involves the activation of various clotting factors in the blood, eventually leading to the formation of a stable blood clot or thrombus.
  4. Clot Retraction: After the initial clot forms, it begins to contract or retract, pulling the edges of the damaged blood vessel together. This helps seal the vessel and prevent further bleeding.
  5. Fibrin Formation: Fibrin, a protein, forms a meshwork within the clot, further strengthening it.

Despite these intricate mechanisms, in some cases, blood can still leak out of the damaged vessel and accumulate in the surrounding tissues, leading to the formation of a hematoma.

Types of Hematomas

Hematomas can be classified into several types based on their location and the underlying cause:

  1. Subcutaneous Hematoma: These occur beneath the skin and are often visible as a bruise or discoloration. They are commonly caused by blunt trauma.
  2. Intramuscular Hematoma: These form within muscles and are typically associated with muscle injuries or strenuous physical activity.
  3. Subdural Hematoma: These are located between the brain and the protective covering (the dura) and often result from head injuries.
  4. Epidural Hematoma: These occur between the skull and the outermost layer of the brain’s protective covering (the dura) and are usually caused by severe head trauma.
  5. Intracranial Hematoma: These hematomas form within the brain tissue and can result from various causes, including head injuries or blood vessel abnormalities.

Treatment and Management

The management of a hematoma depends on its location, size, and the underlying cause. In many cases, small hematomas resolve on their own as the body reabsorbs the trapped blood. However, larger or more severe hematomas may require medical intervention.

Treatment options may include:

  1. Rest and Elevation: Elevating the affected area and resting can help reduce swelling and improve blood circulation.
  2. Cold Compresses: Applying cold compresses or ice packs to the area can help reduce pain and inflammation.
  3. Compression: In some cases, compression bandages may be recommended to prevent further bleeding and reduce swelling.
  4. Surgical Drainage: For large or deep hematomas, surgical drainage may be necessary to remove the accumulated blood and relieve pressure on surrounding tissues.
  5. Medications: In cases where blood clotting is impaired, or to prevent complications like infection, medication may be prescribed.

Medical Negligence: A Trainee Phlebotomist Caused A Hematoma

A hematoma is a common occurrence in the field of phlebotomy, and it can sometimes be an unintended outcome of the blood collection process. A trainee phlebotomist, while learning and perfecting their skills, may inadvertently cause a hematoma. Let’s explore how this can happen and what steps can be taken to minimize the risk of hematoma formation during blood collection.

  1. Needle Insertion Technique: One of the key factors in preventing hematomas is the proper technique for needle insertion. A trainee phlebotomist may sometimes insert the needle too deeply, causing damage to not only the vein but also the surrounding tissues. This can lead to blood leaking out of the vein and into the surrounding tissue, resulting in a hematoma.
  2. Vein Selection: Choosing the right vein is crucial. A trainee phlebotomist might select a vein that is too small, fragile, or prone to rolling. This can make it more challenging to successfully access the vein and increase the risk of hematoma formation.
  3. Needle Positioning: The angle at which the needle is inserted matters. If the needle is not inserted at the correct angle, it can increase the likelihood of vein puncture and hematoma.
  4. Failure to Release Tourniquet: Leaving the tourniquet on for an extended period can cause blood to pool in the vein, increasing the risk of hematoma when the tourniquet is finally released.
  5. Improper Pressure Application: After withdrawing the needle, it’s essential to apply adequate pressure to the puncture site to help prevent blood from leaking into the surrounding tissue. A trainee phlebotomist may not apply sufficient pressure, leading to hematoma formation.
  6. Inadequate Observation: Monitoring the patient for signs of hematoma during and after the procedure is crucial. A trainee phlebotomist may not be experienced enough to recognize the early signs of a hematoma developing.

Minimizing the Risk of Hematomas in Phlebotomy:

To reduce the risk of hematoma formation during blood collection, trainee phlebotomists should follow these best practices:

  1. Proper Training: Thorough training and supervised practice are essential for phlebotomy students. This includes learning proper techniques for needle insertion, vein selection, and patient care.
  2. Vein Assessment: Before attempting venipuncture, assess the patient’s veins carefully. Choose a suitable vein that is visible, palpable, and less likely to roll.
  3. Correct Needle Angle: Ensure that the needle is inserted at the appropriate angle (usually around 15-30 degrees) to minimize the risk of vein damage.
  4. Tourniquet Control: Use the tourniquet judiciously, and release it promptly once the vein is accessed and blood begins to flow.
  5. Proper Pressure Application: After needle removal, apply gentle pressure to the puncture site with gauze or a cotton ball, holding it in place for a sufficient amount of time to allow the vein to seal.
  6. Patient Education: Communicate with the patient throughout the process, explaining what is happening and what they can expect. Reducing anxiety can help minimize patient movement, which can contribute to hematoma formation.
  7. Post-Procedure Observation: After blood collection, monitor the puncture site for any signs of hematoma formation and take appropriate action if necessary.

Understanding the Risks of Thrombotic Thrombocytopenic Purpura (TTP) and Hematoma

Thrombotic Thrombocytopenic Purpura (TTP) and hematoma are distinct medical conditions, each with its own set of risks and implications. However, they can be interconnected in certain scenarios, especially when TTP affects the blood’s ability to clot properly. Let’s explore these two conditions and their associated risks.

Thrombotic Thrombocytopenic Purpura (TTP):

TTP is a rare and potentially life-threatening blood disorder characterized by the formation of small blood clots throughout the body. It primarily affects the smallest blood vessels, leading to a cascade of health issues. TTP is caused by a deficiency of a specific enzyme called ADAMTS13, which is responsible for breaking down a large protein called von Willebrand factor (vWF). Without sufficient ADAMTS13, vWF accumulates, leading to abnormal blood clot formation.

Risks of TTP:

  1. Clot Formation: The hallmark of TTP is the formation of microclots in small blood vessels throughout the body. This can lead to organ damage and dysfunction, as the clots impede blood flow to vital organs like the brain, kidneys, and heart.
  2. Bleeding Tendency: Paradoxically, even though TTP is characterized by clot formation, it can also cause a decrease in platelet count (thrombocytopenia), leading to an increased risk of bleeding. This dual risk of clotting and bleeding makes TTP a challenging condition to manage.
  3. Organ Damage: When clots disrupt blood flow to organs, it can result in damage and failure. For example, TTP-induced clots in the brain can cause strokes, while those in the kidneys can lead to kidney dysfunction.
  4. Neurological Complications: TTP can lead to neurological symptoms, including confusion, weakness, and even coma, due to the impact of clots on the brain.

Risks of Hematoma:

  1. Pain and Swelling: Hematomas can cause significant pain and swelling at the site of the injury. This can interfere with the function of the affected body part and disrupt daily activities.
  2. Infection: There is a risk of infection if the hematoma breaks through the skin or if the injury that caused the hematoma is contaminated.
  3. Compartment Syndrome: In severe cases, a hematoma can cause increased pressure within the affected area, known as compartment syndrome. This can lead to tissue damage and impaired blood flow, necessitating immediate medical attention.
  4. Secondary Complications: Depending on the location and size of the hematoma, it can lead to secondary complications. For example, a hematoma near a joint may result in limited mobility.

The Connection Between TTP and Hematoma:

While TTP primarily involves abnormal clot formation within the bloodstream, it can impact the body’s overall ability to regulate clotting and bleeding. In some cases, individuals with TTP may be at an increased risk of both bleeding and clotting disorders. This dual risk might predispose them to the formation of hematomas, particularly if they experience trauma or injury.

Managing TTP typically involves therapies to suppress abnormal clot formation, such as plasma exchange and medication. In individuals with TTP, healthcare providers must carefully assess and address the risks of both bleeding and clotting to provide effective treatment.

Immune Thrombocytopenia (ITP)

ITP, or Immune Thrombocytopenia, is a medical condition characterized by a low platelet count in the blood. Platelets are a type of blood cell that plays a crucial role in blood clotting, and a low platelet count can lead to bleeding and easy bruising.

In ITP, the immune system mistakenly targets and destroys platelets as if they were foreign invaders. This is typically due to an autoimmune response, where the body’s immune system attacks its own healthy cells and tissues. In the case of ITP, it is believed that antibodies produced by the immune system bind to platelets, marking them for destruction by the spleen or other immune cells.

The exact cause of ITP is not always clear, but it is often considered an autoimmune disorder. It can occur in isolation, known as primary or idiopathic ITP, where there is no underlying cause, or it can be secondary to other autoimmune disorders or conditions such as lupus, rheumatoid arthritis, or certain infections.

The symptoms of ITP can vary from mild to severe and may include:

  1. Easy bruising.
  2. Prolonged bleeding from small cuts.
  3. Petechiae (small red or purple spots on the skin).
  4. Nosebleeds.
  5. Blood in the urine or stools.
  6. Heavy menstrual periods.
  7. In severe cases, internal bleeding can be life-threatening.

Treatment for ITP may vary depending on the severity of the condition. Some individuals with mild ITP may not require treatment and can be managed through regular monitoring. In more severe cases or when bleeding symptoms are significant, treatment options may include:

  1. Corticosteroids to suppress the immune response.
  2. Intravenous immunoglobulin (IVIG) to temporarily raise platelet counts.
  3. Platelet transfusions in cases of severe bleeding.
  4. Medications that affect the immune system, such as rituximab or thrombopoietin receptor agonists.
  5. In extreme cases, surgery to remove the spleen (splenectomy) may be considered.

Managing ITP with an underlying autoimmune disorder may involve treating the primary autoimmune condition as well. It’s essential for individuals with ITP to work closely with their healthcare team to determine the most appropriate treatment plan based on their specific circumstances and symptoms.

Both ITP (Immune Thrombocytopenia) and hematomas involve issues related to blood clotting and can carry certain risks:

Risks of ITP (Immune Thrombocytopenia):

  1. Bleeding: The primary risk associated with ITP is bleeding due to a low platelet count. Platelets are essential for normal blood clotting, and when their numbers are low in ITP, there’s an increased risk of spontaneous bleeding, such as nosebleeds, gum bleeding, easy bruising, and, in severe cases, internal bleeding.
  2. Severe Bleeding Episodes: In severe cases of ITP, there is a risk of life-threatening bleeding, such as gastrointestinal bleeding or intracranial hemorrhage. These are medical emergencies and require immediate attention.
  3. Chronic Disease: ITP can become a chronic condition for some individuals, which means they may experience ongoing issues with low platelet counts and the associated risk of bleeding over an extended period.
  4. Impact on Quality of Life: Living with ITP can be challenging due to the need for frequent medical monitoring, potential treatment side effects, and lifestyle adjustments to reduce the risk of bleeding.

The risks associated with ITP and hematomas can vary depending on the severity of the condition, the individual’s overall health, and the location and size of the hematoma. It’s essential to seek medical attention and follow medical advice for both conditions to manage and reduce these risks effectively. For ITP, this may involve treatments to increase platelet counts or manage bleeding, while for hematomas, treatment may include drainage, wound care, or surgical intervention if necessary.

Personal Experience

As a multiple sclerosis sufferer who has had Alemtuzumab Treatment with regular blood tests required by law, upon visiting the hospital on Wednesday 20th September 2023 I was greeted by a trainee phlebotomist whom may I add was supervised. I did not take either of their names. I explained I have problems with my veins being too thin, The trained phlebotomist looked at my arm and told the trainee phlebotomist to try the fatter vein, after a bit of poking and prodding the needle the trainee nurse took out the needle after several times going in a different direction and with a bit of perseverance she managed to draw blood. When she finally took the needle out this resulted in my arm bruising and swelling to the point it was extremely painful.

If the test tube is not removed when the needle comes out, it can cause a number of issues. For instance, the blood sample may clot inside the tube, making it difficult to extract the required amount of blood for testing. In some cases, if the needle is withdrawn too quickly, it can cause a hematoma. Hematomas can be painful and may require medical attention if they are large or do not resolve on their own.

I did have an independent nurse and pharmacist look at it afterward (not from the hospital) and both agreed it was really bad.

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I realize the hospital (UHW) is a teaching hospital but the departments should get the patient’s permission first before letting trainee doctors/nurses and phlebotomists train on a patient. I was never informed until after the fact and by that time it was too late. Had I known from the start a trainee phlebotomist would be taking my blood I would have refused. This is not the first time I have had a hematoma.

My arm a week later is still bruised and swollen. This is a lesson learned. I would like to add I do not hold a grievance to the trainee phlebotomist but with my history of blood tests proving difficult, I would expect a professional fully trained nurse to take my blood.

Conclusion

Hematomas are a natural part of the body’s response to injury and play a crucial role in the healing process. While they can be painful and concerning, most hematomas resolve with time and appropriate care. However, it is essential to seek medical attention if you suspect a severe hematoma, especially if it is associated with head trauma, as prompt treatment may be necessary to prevent complications. Understanding how hematomas form and the importance of their role in the healing process can help individuals make informed decisions about their care when faced with these common injuries.

It’s important to remember that hematoma formation is a potential risk in phlebotomy, even for experienced practitioners. Trainee phlebotomists should focus on learning and consistently applying proper techniques to minimize this risk and ensure safe and adequate blood collection procedures. Supervision and feedback from experienced phlebotomists are valuable tools in the learning process.

TTP and hematoma are distinct medical conditions, each associated with its own set of risks and complications. However, in some cases, individuals with TTP may be more susceptible to hematoma formation due to disruptions in their blood clotting and bleeding mechanisms. It is essential for healthcare professionals to consider these risks when managing patients with TTP and tailor treatment accordingly.

What should a patient do if a trainee phlebotomist causes a hematoma in high-risk patients who are susceptible to ITP having blood tests because of Lemtrada alemtuzumab treatment?

If a trainee phlebotomist causes a hematoma in a high-risk patient who is susceptible to ITP (Immune Thrombocytopenia) due to Lemtrada (alemtuzumab) treatment, it is crucial for the patient to take the following steps:

  1. Notify the Phlebotomist: Immediately inform the phlebotomist about the hematoma and any discomfort or pain you may be experiencing. They need to be aware of the issue to provide assistance and documentation.
  2. Apply Pressure: If the hematoma is actively bleeding or swelling, gently apply pressure to the area with a clean cloth or sterile gauze to help control bleeding and minimize the size of the hematoma. Do not press too hard, as this could exacerbate the issue.
  3. Elevate the Affected Area: If possible, keep the affected limb elevated. Elevating the area can help reduce swelling and minimize further blood accumulation in the hematoma.
  4. Seek Medical Attention: Given the patient’s susceptibility to ITP and the potential complications associated with hematoma, it is advisable to seek immediate medical attention. This is especially important because ITP is a condition characterized by abnormal clot formation and bleeding tendencies, and it could be exacerbated by a hematoma.
  5. Notify Healthcare Provider: Contact the healthcare provider responsible for managing your Lemtrada treatment. Inform them of the situation, including details about the hematoma and any symptoms you are experiencing. They may need to adjust your treatment plan or monitor your condition closely.
  6. Follow Medical Advice: Follow the guidance provided by your healthcare provider regarding the management of the hematoma and any potential treatment adjustments necessary to mitigate the risk of ITP.
  7. Document the Incident: Keep detailed records of the hematoma incident, including the date, time, and name of the phlebotomist involved. This documentation may be valuable for future reference, especially if it leads to complications related to your ITP susceptibility or Lemtrada treatment.
  8. Consider Future Precautions: Discuss with your healthcare provider and the phlebotomy department whether any additional precautions or modifications to the blood collection process are necessary to minimize the risk of hematoma formation during future blood tests. This could include using experienced phlebotomists or employing alternative blood collection methods.

It is essential to prioritize your health and safety in this situation, especially if you are a high-risk patient with ITP susceptibility due to Lemtrada treatment. Prompt and effective communication with healthcare providers is critical to ensure that any potential complications are addressed promptly, and your treatment plan is adjusted as needed.

Photographic Evidence

Further Reading

Lemtrada (alemtuzumab) | MS Trust

Relapsing MS Infusion Treatment: LEMTRADA® (alemtuzumab)

Immune Thrombocytopenic Purpura (ITP) | Patient

Thrombotic Thrombocytopenic Purpura (also known as ‘TTP’) | CUH

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