Care AbroadRisks (23)
What goes wrong, how often anybody measures it, and who carries the cost when it does.
Clinical (7)
BBL death, pulmonary fat embolism, macroscopic fat embolism
Fat injected into the buttock enters a torn gluteal vein and travels to the lung. Death can follow within minutes and often on the operating table.
DVT, PE, venous thromboembolism
A clot forms in a deep vein, usually in the leg, and part of it travels to the lung. Surgery raises the risk and long-haul flight raises it, and a patient who has both in the same fortnight carries both.
no responsible adult, discharged to a hotel, nobody at the other end
Discharge from a hospital abroad into a hotel room rather than a household.
unscreened for anaesthesia, pre-operative assessment on arrival, ASA grading at the far end of a flight
Pre-operative assessment compressed into the days between landing and the operation, carried out by a team holding whatever records the patient brought.
counterfeit medicines, falsified medical products, SF medical products
A medicine that is not what its label says: falsified in its identity, composition or source, or substandard because it failed a quality specification, expired, was contaminated, or was stored wrongly.
loss to follow-up, no aftercare
The interval between an operation abroad and the first clinician at home who sees the wound, during which nobody is responsible for the result.
stem cell clinics, regenerative medicine offered direct to consumers
A cell preparation sold as a treatment for a condition it has not been shown to treat, usually paid for out of pocket and usually outside any approval process.
Ethics (1)
transplant tourism, commercial transplantation, organ trafficking
Harm from receiving an organ, tissue or stem cell transplant abroad from an unrelated donor — to the recipient, whose graft and screening were worse; to the donor, who may have been paid, coerced or trafficked; and to…
Infection (7)
AMR, CRE, carbapenem-resistant Enterobacterales
An organism that survives the drugs meant to kill it, carried home in or on a patient who was treated in a hospital where such organisms are common.
transfusion-transmissible infection, TTI, blood screening
Whether the blood a patient may be given during an operation was screened, and screened under a quality system.
hepatitis B, hepatitis C, HIV
Hepatitis B, hepatitis C or HIV transmitted by a reused needle, an inadequately reprocessed instrument, a contaminated injectable or an unscreened transfusion.
C. auris, Candidozyma auris
A yeast that colonises skin, survives on surfaces for long periods, spreads between patients in healthcare facilities, and resists antifungal drugs.
Fusarium solani meningitis, the Matamoros outbreak
Infection of the lining of the brain and spinal cord by a mould introduced at the moment an epidural is placed.
NTM, rapidly growing mycobacteria, Mycobacterium abscessus
Environmental mycobacteria that live in water and soil, are not tuberculosis, resist most ordinary antibiotics, and infect surgical wounds where instruments, rinse water or injectables were contaminated.
SSI, wound infection
An infection of the tissue an operation opened — skin, the layers beneath it, or the space around an implant.
Legal (2)
interpreted consent, language barrier consent, the form in the wrong language
A consent signed after a conversation conducted through a third person.
legal recourse, cross-border liability, suing abroad
The question of which court will hear a claim against a clinician abroad, which country's law it will apply, how long the claimant has to bring it, and whether any judgment can be collected.
Money (5)
medevac, air ambulance, medical evacuation
The cost of moving a patient who cannot fly commercially from where they were treated to a hospital that can finish the job.
putting it right, corrective surgery, the second operation
The second operation, performed in the patient's own country by a surgeon who did not perform the first, on a wound whose details nobody recorded.
prepayment, booking fee, cancellation terms
Money paid before travel to hold a surgical date, and what happens to it when the operation does not take place — because the patient withdrew, because the clinic cancelled, because a visa was refused, or because a…
the companion's costs, medical attendant, refakatci
What the person travelling beside the patient carries: a second fare and a second bed, unpaid leave, and the nursing after discharge that no package quotes.
excluding implant, device billed separately, prosthesis not included
A fixed package price for an operation that installs a manufactured device, quoted without the device.
Travel (1)
fitness to fly, the ten-day rule
A cabin at cruising altitude is pressurised to roughly the outside air pressure at 6,000 to 8,000 feet.