B.C. doctor accuses medical brass of blocking life-saving fecal transplant
By Sam Cooper, The Province January 18, 2011 7:01 PM
B.C. doctor accuses medical brass of blocking life-saving fecal transplant
VANCOUVER — The feces is hitting the fan at a Burnaby, B.C., hospital as a whistle-blowing doctor accuses bureaucrats of banning her use of an experimental "fecal transplant" procedure — while frail patients get infected in hospital rooms and die of a bowel-attacking bacteria.
C. difficile is a "super-bug that is a very significant threat" in B.C. hospitals, Dr. Jeanne Keegan-Henry told the Vancouver Province.
As first reported by CBC News, Keegan-Henry has argued patients have died needlessly at Burnaby General Hospital because Fraser Health Authority won't allow doctors to perform fecal transplants. Officials say the procedure has not been scientifically proven effective and safe.
A full clinical trial, involving 146 patients, is underway through the University Health Network in Toronto.
But Keegan-Henry said her conscience won't let her wait.
"Do I say to an 83-year-old that is getting frailer and frailer, 'Look I'm sorry. I know of a treatment that can save your life. We have no evidence anywhere that it harms you, but I have to wait until a clinical trial is done. Sorry, you'll be dead."
Keegan-Henry said she believes she saved one woman — 86-year-old Jane Thomas — with the treatment last year before the FHA stopped her. Since then as many as 10 patients — some who could likely been saved — have died, she said.
The treatment — which involves transferring human stool from a healthy donor into the infected patient's bowel, so that "good" bacteria can overpower the bug — was effective in 90 per cent of reported cases worldwide, Keegan-Henry said.
Keegan-Henry added she only proposes to use fecal transplants with patients who don't respond to standard antibiotic treatments.
Dr. Andrew Webb, vice-president of medicine for FHA, told the Province he does not dispute the "promising" case-by-case data cited by Keegan-Henry. But he insisted she is not employing proven safety protocols and standards.
The danger is that deadly infections like HIV could be transferred in body fluids from donors to patients or caregivers, Webb said.
"This is a treatment that does look promising," he said. "There is no evidence presently . . . that this is unsafe. But equally there is no evidence it is safe. She is being blocked by a system that puts patient safety first."
A spokesman from the B.C. Ministry of Health said: "C. difficile is one of the most common infections in health-care facilities worldwide (and) the province has taken steps to reduce rates of C. difficile infection to enhance patient safety and improve quality of care."
The ministry said it believes more research is needed before the treatment can be endorsed.
Dr. Susy Hota of the University Health Network in Toronto said the network's clinical trial should be complete in about two years.
The treatment "could be revolutionary in the way we approach C-diff.," Hota said. "There is the ick factor though. Maybe the acceptability isn't here in North America, but it is being used widely in Europe."
Dr. Ted Steiner is an infectious diseases specialist at Vancouver General Hospital who is seeking approval to complete a trial on the procedure. He said he doesn't agree with Keegan-Henry's bucking of medical authorities.
"I don't think the reality (of C. difficile threat) is as urgent," as Keegan-Henry has claimed, Steiner said. "I think probably this will turn out to be a highly successful treatment, but we don't necessarily know the risks at this point."
Susan Prins, spokeswoman for the BC College of Physicians and Surgeons, says fecal transplant treatment is not condoned, and doctors that complete experimental treatments could face consequences.
"We are aware of the situation in Burnaby," Prins said. "If there are any dangers to patients or donors or caregivers and we were to receive a complaint we would certainly investigate."
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B.C. doctor accuses medical brass of blocking life-saving fecal transplant
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