Hospital Authority issues reminder on prophylactic antiviral treatment following Serious Untoward Event at Queen Mary Hospital

Hong Kong (HKSAR) - The following is issued on behalf of the Hospital Authority:

     The Hospital Authority (HA) today (July 12) issued an internal reminder to all relevant clinical departments on the need for prophylactic antiviral prescription after initiating immunosuppressive therapy to patients with hepatitis B infection, following the report of a Serious Untoward Event (SUE) at Queen Mary Hospital (QMH).

     The reminder echoed the recommendations of the Root Cause Analysis Panel report on an SUE at United Christian Hospital stipulating "the importance of maintaining a high level of vigilance when prescribing immunosuppressive treatment to patients who carry the hepatitis B virus".

     The HA spokesperson said front-line clinical units were reminded to refer to the latest "Guideline on Pre-emptive Use of Nucleos(t)ide Analogues in Patients with Hepatitis B Infection Receiving Immunosuppressive Therapy" effective from July 1 this year.

     The HA started to develop the Guideline in April 2016, making reference to a similar guideline issued by the American Gastroenterological Association Institute issued in 2015. "Following in-depth cross-specialty discussions across the HA led by a working group of clinical experts, the HA Guideline was first released on May 12, 2017, and updated on July 1 together with a set of 'Frequently Asked Questions' for the front line," the HA spokesperson added.

     The HA spokesperson said that the HA Head Office (HAHO) received a report from QMH on an SUE yesterday (July 11).

     An elderly cancer patient who is a chronic hepatitis B carrier completed her chemotherapy in May 2016. Prior to the recent follow-up session scheduled for July 3, a pre-consultation blood test result showed an elevated liver enzyme level. Urgent clinical admission was arranged on June 30 and the patient is now in serious condition.

     Preliminary review by the clinical department found that an anti-hepatitis B drug was not prescribed in three consultations between May 2016 and March 2017.

     QMH is very concerned about this incident and reported it to the HAHO through the Advance Incident Reporting System on July 8 while flagging it as an SUE on July 11 upon reviewing the clinical details. An Investigation Panel will be set up to investigate the incident and submit its report to the HAHO in eight weeks.

The clinical teams met the patient's relatives yesterday for open disclosure of the incident. QMH will maintain close contact with the patient's family and will continue to provide appropriate treatment to the patient.

Published on: 2017-07-12

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