Monday, August 27, 2012

Study Conducted To Examine Safety of ‘Biologic’ Meds - Rheumatoid Arthritis Patients

The study was published August 8, 2012 in the journal  -> Arthritis & Rheumatism.  The study looked at the 3 most popular TNF-alpha inhibitors used in the United States and in other countries to treat rheumatoid arthritis, and death rates among people treated by them.  
Even although the subjects of the study were RA patients, try looking at the disease factor with a grain of salt.  In my opinion, the more important factor is the overall safety of the Biologic medications (despite what the condition is).  Would the death rates be much different if the subjects of the study were Crohn's disease patients?  Possibly, but my guess would be that the numbers would be around the same.  So, read the article placing significance on the drug, not the disease.

 Article Highlights
"The study was published Aug. 8 in the journal Arthritis & Rheumatism.
The three drugs studied include Humira, Enbrel and Remicade, all from a relatively new class of medications called TNF-alpha inhibitors." 
"...understanding risk versus benefits of treatment with the most commonly prescribed biologics is important for physicians and patients in managing rheumatoid arthritis," study lead author Dr. Julia Fridman Simard, of the Clinical Epidemiology Unit at the Karolinska Institute, in Stockholm, said in a journal news release."
"In the new study, Simard's team compiled information on patients with rheumatoid arthritis who began treatment between 2003 and 2008. Of these patients, more than 1,600 started taking adalimumab (Humira), almost 2,700 were prescribed etanercept (Enbrel), and more than 2,000 began treatment with infliximab (Remicade)."
"During the five-year study, 211 of the patients died. However, the researchers found no difference in death rates among the three drugs."  - The Doctors Lounge

Study Compares Safety of ‘Biologic’ Meds for Rheumatoid Arthritis --Doctors Lounge:

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Sunday, August 26, 2012

Is Getting Sick the Way You Say "No"? | Psychology Today - Food 4 Thought

Something to think about.  Article from Psychology Today.

– people spend their whole life longing to make a certain major change, and are only able to do it once a diagnosis of cancer gives them permission (and pressure) to finally act. After all, when you have cancer who would deny you a chance at happiness, or better health, or your dreams? 

Do you rely on your body to say no for you when you can't? How has this manifested itself in your life?
Look at the occasions or situations that this has happened. Can you see a pattern?

Is Getting Sick the Way You Say "No"? | Psychology Today:

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Thursday, August 23, 2012

Patient Diagnosed w/ Cancer After Humira Treatment - Abbott Labs Lawsuit for Many Claims

Entire Article Below :)    

Reading articles like this one doesn't shock me.  I know everything about these drugs and it's only a matter of time before we start seeing similar sad effects from these horrible toxic drugs.  Watch....  you will see this happen for yourself as time goes on.  
The effects of the drug are available if you search, and I always take time to read about the drug I plan to be putting in my body.  NEVER trust your doctors word... even if he is the greatest doctor.  You have no idea if your doctor is recommending Humira  (or any other drug for that matter) because they are getting "kick backs" - it's discussed in the article below,  a short definition of the meaning - a KICKBACK is a payment made to someone who has facilitated a transaction or appointment, esp. illicitly.  Illegal Yes, paying physicians money to recommend a drug so sales will increase, is not the correct reason to suggest a treatment.  That's why It's so important to do your homework before saying "yes" to a treatment.  It doesn't matter how many positives your doctor tells  you about and that he told you it is a SAFE option .  

I CANNOT STRESS THIS ENOUGH - Do yourself a huge favor, find out the facts for yourself.

This is how---->  Read non biased information (a biased source -  the pharmaceutical company's website about the drug.  Of course they will shed light on mostly the benefits).  Read information from a reputable source (a peer review journal article, Pubmed (where you can find published research results.  Looking up specific keywords of your choice - Pubmed is linked on my side bar for easy access.).  

Once you've gathered and read through enough information , next weight the positives of taking the medication and the negatives (risks). Are the possible dangers worth it for the condition you have, is there a safer option available,  Have you tried all other treatments for your condition and seem to be hitting a wall in regards to medications thatwill bring you relief. What natural therapies are available to treat the condition, who would be a good candidate to take a medication with dangerous side--effects like Humira (your genetics matter)

Arthritis Drug Humira Blamed for Cancer

 CHICAGO (CN) - Abbott Laboratories' blockbuster arthritis drug Humira gave a woman cancer, she claims in Cook County Court.

     Carolyn and Eric Shaw sued Abbott Laboratories for product liability, product defects, failure to warn, misrepresentation, negligence, breach of warranty and loss of consortium.
     "Plaintiff Carolyn Shaw was prescribed Abbott's blockbuster arthritis drug 'Humira' and received bi-monthly injections from October 2008 to August 2010 when she was diagnosed with B-cell non-Hodgkin's follicular lymphoma. She underwent surgery and chemotherapy treatment, and luckily her cancer went into remission. Unfortunately, she will have to undergo treatments every five months for the rest of her life to ensure the cancer will not return," the complaint states.
     The FDA approved Humira to treat arthritis in December 2002. It is Abbott's best-selling drug, according to the complaint.
     "(I)n 2011, Humira's worldwide sales were $7.9 billion," the Shaws say.
     The complaint states: "the data from Humira clinical trials and other peer-reviewed medical literature show that the rate of malignancies in the group of patients treated with Humira was significantly higher than the rate of malignancies in the group that were treated with placebo. The increased rate of lymphomas was statistically significant. This differential in rate was a significant safety signal. It should have prompted a significant clear warning from Abbott to both physicians and patients about this potential side effect.
     "Although the clinical trial data alone should have prompted both a stringent warning and proactive study, instead of conducting further studies and/or otherwise calling attention to the increased risk of life-threatening side effects front and center in the label, and communicating same to Dr. Suarez [Carolyn Shaw's nonparty rheumatologist] Abbott buried and information regarding malignancies in the label. Further, what 'warning' information was mentioned severely downplayed the risk and confused the issue, consistent with its sales message, in RA [rheumatoid arthritis] data."
     The complaint adds: "It is widely recognized within the pharmaceutical industry that adverse side effects of medication are vastly unreported. The industry accepted rule of thumb is that the MedWatch system captures somewhere between 1 percent and 10 percent of real world events. Therefore, the MedWatch reports put Abbott on notice that, in fact, there were somewhere between 250 and 2,500 real world Humira patients who had experienced Humira-related lymphomas or other malignancies.
     "Because FDA regulations require the drug manufacturer to add a warning - in the warnings section of the label - whenever there is a 'reasonable association' between the drug and a dangerous side effect, and further state that 'a causal relationship need not be established' before a warning is required, this information from the adverse event database should have prompted Abbott to issue strong, clear warnings about the risk of lymphomas and other forms of malignancies due to the use of Humira. But Abbott failed to do so until many years later, when the FDA made them do it."
     The Shaws say: "Not until August 4, 2009 - almost a year after Carolyn Shaw began taking Humira - did Abbott put a black box warning on their label alerting patients and doctors of cases of leukemia, hematological cancer, in adults, adolescents, and children."
     Carolyn Shaw developed an enlarged lymph node in her neck in 2010 and was diagnosed with Stage IIA lymphoma. "When Carolyn and Wayne asked Dr. [Mark] Freidman what he thought caused her lymphoma, his answer was 'Humira,'" the complaint states.
     The Shaws claim that Abbott aggressively markets Humira and makes "widespread use of direct payments to physicians utilized by Abbott to both sell more Humira and increase prescriptions across the country."
     "Needless to say, these financial inducements and payments provide incentives, perhaps on a subconscious level but real nonetheless, to skew the 'informed consent' discussion in favor of the benefits of Humira, at the expense of the risks. More importantly, patents are not aware of these types of 'behind the scenes' payments being made to physicians. ... It most certainly was not disclosed by either Abbott or the prescribing physicians to the individual plaintiff and/or patient."
     Abbott Laboratories is the only defendant. Neither of the Shaws' doctors is a party to the case.
     The Shaws claim that Abbott withheld critical information that would have enabled Carolyn to make an informed decision about whether to take Humira: "Although physicians prescribe medications, it is patients who have the ultimate authority to decide whether to put them into their bodies or not. Because of the dangerous side effects of Humira, it is extremely important that both physicians and patients be fully informed - not only about the potential benefits of the drug, but also about the risks of side effects. Neither Carolyn nor her physicians were warned in any meaningful or legally adequate manner about the risk of lymphoma when she began taking Humira," the Shaws claim.
     The Shaws are represented by Gary McCallister.

Courthouse News Service:

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Wednesday, August 22, 2012

Patients w/ Crohn's Disease=Lifelong Battle. + The Man Who Couldn't Eat : a memoir

Watch this video

Olympian Carrie Johnson battles Crohn's disease as she fights for a gold son battles Crohn's disease as she fights for a gold 

                Article Highlights

"Crohn's disease is named after Dr. Burrill Crohn who, along with two colleagues, recognized and documented the symptoms in 1932.
Those diagnosed with it include some well-known personalities such as former President Dwight D. Eisenhower; Mike McCready, guitarist for Pearl Jam; former Miss America Mary Ann Mobley; and actress Shannen Doherty."

"In a healthy body, the immune system creates an infection-fighting protein called tumor necrosis factor. When Crohn's disease is present, TNF is produced in excess as the immune system mistakenly identifies healthy bacteria as a foreign presence.
This causes the body to launch an attack and begin fighting the excess TNF, which leads to more inflammation, which results in more TNF.
As this internal battle takes place, it causes severe pain, abdominal swelling, cramping, bleeding, diarrhea and deterioration of the affected portion of the intestinal tract.

Link to the Story --->   The man who couldn't eat by author Jon Reiner
Jon Reiner is the author of 'The Man Who Couldn't Eat,' a memoir of his months spent without ingesting any food - a "nothing by mouth" order - due to a ruptured intestine, a rare complication from Crohn's disease.

Crohn's disease means lifelong battle -

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Im a night owl!  NOT an early riser like the birds.  Why I said yes to a 9:45am appointment is beyond me.  Has to be noon or after.  I just thought of this and want to post it before I leave.  

Tell me what you would like to know more of.   Anything!  I know the most about IBD/IBS, but know about various other AutoImmune conditions.  
II would really be interested to know what people are looking for, or the thing that raises a question in their mind that they (YOU) have not found the answer to.

I enjoy helping others.  So, I'd be happy to help anyone.  Write a comment or a message :)

Tuesday, August 21, 2012

Pfizer’s Experimental Drug Works for Severe Ulcerative Colitis

Depending on the severity of the disease, I would understand trying this new drug. It should be noted and expressed clearly the severe side-effects that are possible with this drug.  Not just dry mouth and headache.  I guess you would have to weigh the positives and negatives of this proposed treatment.  Do your research before you make a decision on any medication.

In the study, 78 percent of 49 patients given a 15 milligram dose experienced a reduction in symptoms; 61 percent of 33 patients given a 10 milligram dose improved.

Eight-Week Trial

Patients in the trial got Pfizer’s pill for eight weeks, though likely would take it for longer because ulcerative colitis is a chronic disease, said William Sandborn, chief of the division of gastroenterology at the University of California, San Diego, who led the research

Pfizer’s Experimental Drug Works in Ulcerative Colitis - Businessweek:

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Monday, August 20, 2012

*Cornell Study* Inflammation- Driving Factor Leading to Microbial Imbalances -->Crohn's Disease

Interesting study by Cornell  - Inflammation is said to be the driving contributor that leads to microbial imbalances.  Genes are said to play a role in the intensity and severity of the imbalances in our gut.  

"inflammation, in fact, drives microbial imbalances (dysbiosis) and the proliferation of a specific type of E. coli that is adherent, invasive and found in the ileum, reported Cornell researchers July 31 in PLoS (7[7]). And genetics, they said, do play a role in determining the threshold and magnitude of dysbiosis in response to acute inflammation induced by environmental triggers."
"Our findings clearly demonstrate that inflammation drives ileal dysbiosis and proliferation of CD-associated adherent invasive E. coli. Further, in the context of a patient with Crohn's, we found that the host genotype and therapeutically blocking inflammation both impact the onset and extent of ileal dysbiosis. These novel findings are of high relevance to Crohn's disease." 

Inflammation drives Crohn's disease, says study

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Thursday, August 16, 2012

Chicken Pox Linked To Digestive Problems?!

WHAT???!!!  Chicken Pox linked to IBD/IBS?

Article Highlights

"Researchers tested six children who all had chicken pox, and all of them had the virus laying dormant in their intestines. In addition, several people (including a 16-year-old boy) were found to have the virus in ulcers that were removed from their stomachs. "

Read more:

Chicken Pox Now Linked To DIgestive Problems:

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Tuesday, August 14, 2012

Santarus, Inc., Launcher of Drug UCERIS (New Treatment for IBD, Asthma, n-i Rhinitis) Is Delayed by FDA - Full Article Posted

(Reuters) - Santarus Inc said U.S. health regulators extended the action date on its experimental bowel disease drug by three months, sending its shares down as much as 8 percent in extended trade.

The company said the U.S. Food and Drug Administration extended the action date to January 16, 2013 from October 16 this year, as it needs more time for a full review of the submitted information.

Santarus said FDA will communicate proposed labeling and any required post-marketing requirement requests by December 12.

Santarus expects to launch the drug, Uceris, in about two months after determining the final product label.Uceris

Uceris is an investigational oral tablet that aims to release Budesonide throughout the length of the colon.

Budesonide is a type of steroid used for the treatment of asthma, non-infectious rhinitis, and inflammatory bowel disease.

Shares of the company fell 8 percent to $5.87 in extended trade. They closed at $6.41 on Monday on the Nasdaq.

(Reporting by Prateek Kumar in Bangalore)

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Sunday, August 12, 2012

Living with Crohn's disease: 'Today I will fight again' -From

Wow.   No one knows Crohn's like a Crohnie.  I feel like I wrote this.  The 2nd story is me to a T.

It's nice to know that we Crohn's survivors, have each other for support.

Article Highlights
  • Crohn's disease is "horrible, it's overwheming and it's humiliating," Debbi Wynn says
  • Many with Crohn's suffer in silence, Wynn says
  • Even in remission, fear and anxiety linger, she says
  • Wynn says she's learned to be grateful for each day in remission

Living with Crohn's disease: 'Today I will fight again' -

By Debbi Wynn, CNN
updated 8:02 AM EDT, Tue August 7, 2012

'via Blog this'The humiliation factor is a major reason so many with Crohn's disease suffer in silence, Debbi Wynn says.

Saturday, August 11, 2012

Cleveland Clinic Educational Webcasts/Journal Publications---> Specialty - Gastroenterology Page

This is a SWEET FIND!!!  I came across this Webcast (continuing education)  site for not only GI, but there is a slew of other diseases and medical conditions that there are webcasts for at the Cleveland Clinic Education Site (home page).
{you will see the option to browse other specialties located in the green box to the left}

Basically, these webcasts/videos are provided by doctors and surgeons in which the faculty discuss some of the most current issues within the specific area of medicine that are in need of discussion. The important stuff.

NOTE:  Some pictures/videos are GRAPHIC/of real life surgical procedures and are not for all people (ones with a weak stomach).  Also if you are not familiar with medical terminology, you may not understand the discussion well.    

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I have provided you with the GI Webcast topics that you can choose from (since that's my topic of interest and most of my site visitors are seeking GI information).  There are many other specialties available with up to date valuable information.

I have added a link to my side bar under, "Links you should know" to refer back to it in the future.  Bookmark this one! 

These are my next ones to view:

                                ...... & More.  These are the ones that I plan to view next.  

Friday, August 10, 2012

Salix Pharmaceuticals, Ltd.-New Extended Release Formulation of Rifaximin

Medication for Intestinal Conditions   ------ GOOD READ

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About XIFAXAN® (rifaximin)
Rifaximin is a gut-selective antibiotic with negligible systemic absorption and broad-spectrum activity in vitro against both gram-positive and gram-negative pathogens. Rifaximin has a similar tolerability profile to that of placebo.
Important Safety Information
XIFAXAN® (rifaximin) 550 mg tablets
XIFAXAN 550 mg is indicated for reduction in risk of overt hepatic encephalopathy (HE) recurrence in patients ? 18 years of age. In the trials of XIFAXAN for HE, 91% of the patients were using lactulose concomitantly. XIFAXAN has not been studied in patients with MELD scores > 25, and only 8.6% of patients in the controlled trial had MELD scores over 19. There is increased systemic exposure in patients with more severe hepatic dysfunction. Therefore, caution should be exercised when administering XIFAXAN to patients with severe hepatic impairment (Child-Pugh C).
XIFAXAN is contraindicated in patients with a hypersensitivity to rifaximin, any of the rifamycin antimicrobial agents, or any of the components in XIFAXAN. Hypersensitivity reactions have included exfoliative dermatitis, angioneurotic edema, and anaphylaxis.
Clostridium difficile-associated diarrhea (CDAD) has been reported with use of nearly all antibacterial agents, including XIFAXAN, and may range in severity from mild diarrhea to fatal colitis. Treatment with antibacterial agents alters the normal flora of the colon which may lead to overgrowth of C. difficile. If CDAD is suspected or confirmed, ongoing antibiotic use not directed against C. difficile may need to be discontinued.
The most common adverse reactions occurring in >8% of patients in the clinical study were edema peripheral (15%), nausea (14%), dizziness (13%), fatigue (12%), ascites (11%), muscle spasms (9%), pruritus (9%), and abdominal pain (9%).
XIFAXAN® (rifaximin) 200 mg tablets
Rifaximin tablets 200 mg, which Salix markets in the United States under the trade name XIFAXAN®(rifaximin) tablets 200 mg, currently is approved for the treatment of patients, 12 years of age or older, with travelers' diarrhea (TD) caused by non-invasive strains of Escherichia coli. XIFAXAN should not be used in patients with diarrhea complicated by fever or blood in the stool or diarrhea due to pathogens other than Escherichia coli. XIFAXAN should be discontinued if diarrhea symptoms get worse or persist more than 24-48 hours, and alternative antibiotic therapy should be considered. In clinical trials, XIFAXAN was generally well-tolerated. The most common side effects (vs. placebo) were flatulence 11.3 percent (versus 19.7 percent), headache 9.7 percent (versus 9.2 percent), abdominal pain 7.2 percent (versus 10.1 percent) and rectal tenesmus 7.2 percent (versus 8.8 percent).
Rifaximin has been used in Italy for 25 years and is approved and sold in 33 countries under various trademarks. Salix acquired rights to market rifaximin in North America from Alfa Wassermann S.p.A., headquartered in Bologna, Italy.
About Crohn's Disease
According to the Crohn's and Colitis Foundation of America (CCFA), Crohn's disease affects as many as 700,000 Americans. Men and women are equally likely to be affected, and while the disease can occur at any age, Crohn's disease is more prevalent among adolescents and young adults between the ages of 15 and 35. The causes of Crohn's disease are not well understood. Diet and stress can aggravate Crohn's disease, but they do not cause the disease on their own. Recent research suggests hereditary, genetics, bacteria and/or environmental factors contribute to the development of Crohn's disease.
About Salix
Salix Pharmaceuticals, Ltd., headquartered in Raleigh, North Carolina, develops and markets prescription pharmaceutical products for the prevention and treatment of gastrointestinal diseases. Salix's strategy is to in-license late-stage or marketed proprietary therapeutic products, complete any required development and regulatory submission of these products, and market them through the Company's gastroenterology specialty sales and marketing team.
Salix markets XIFAXAN® (rifaximin) tablets 200 mg and 550 mg, MOVIPREP® (PEG 3350, Sodium Sulfate, Sodium Chloride, Potassium Chloride, Sodium Ascorbate and Ascorbic Acid for Oral Solution), OSMOPREP® (sodium phosphate monobasic monohydrate, USP and sodium phosphate dibasic anhydrous, USP) Tablets, APRISO® (mesalamine) extended-release capsules 0.375 g, METOZOLV®ODT (metoclopramide HCl), RELISTOR® (methylnaltrexone bromide) Subcutaneous Injection, SOLESTA®, DEFLUX®, PEPCID® (famotidine) for Oral Suspension, Oral Suspension DIURIL®(Chlorothiazide), AZASAN® (Azathioprine) Tablets, USP, 75/100 mg, ANUSOL-HC® 2.5% (Hydrocortisone Cream, USP), ANUSOL-HC® 25 mg Suppository (Hydrocortisone Acetate), PROCTOCORT® Cream (Hydrocortisone Cream, USP) 1% and PROCTOCORT® Suppository (Hydrocortisone Acetate Rectal Suppositories) 30 mg. Crofelemer, budesonide foam, RELISTOR® , Lumacan® and rifaximin for additional indications are under development.
For full prescribing information and important safety information on Salix products, including BOXED WARNINGS for OSMOPREP and METOZOLV, please visit where the Company promptly posts press releases, SEC filings and other important information or contact the Company at 919 862-1000.
Salix trades on the NASDAQ Global Select Market under the ticker symbol "SLXP".

For more information, please visit our Website at or contact the Company at 919-862-1000. Follow us on Twitter (@SalixPharma) 

Tuesday, August 07, 2012

Junior Doctors in The UK - Released To Treat Hospital Patients - Increases #s of Medical Negligence Cases....

.... In simple terms, this means that the chances that you will not be treated correctly, at risk of being harmed and not helped, is more likely to happen in hospitals across the UK.  What a nightmare!! 
Hope no one in the UK needs an ER visit anytime soon. 

This article was published a few days ago.... July 30th  


Article Highlights
‘The junior doctors arrive fresh out of university and are expected to get on with it...... many of them are really nervous and unsure what to do. 
'Most of them are keen for help and advice, but some arrive on the ward and you can tell that the fact that they have qualified as a doctor has gone to their head, and they think they know it all.’ 
Sir Bruce Keogh, medical director of the NHS, recently admitted that patients were at risk during this transition period, saying: ‘We recognise the change-over period in August puts patients at risk.
‘Junior doctors are under stress as they change from being a student to a professional, and they need help to adapt to a working environment when they’ve never done a job before.’
To try to put an end to the ‘killing season’, as this period has been dubbed, from next year junior doctors will have to shadow senior colleagues for four days before they start out.
LOL.... 4 days!!! I'm sure it makes people feel sooooo much more at ease now!!! 


Why people living in the UK are 6% more at risk of dying in a hospital ?

  • *  Junior doctors across the country start working on wards on first Wednesday in August
  • *  They have spent five years at medical school and now work independently in hospitals for two years to 'learn the ropes'
  • *  Senior doctors complain not given enough time to train their juniors

As the latest tranche of junior doctors is launched on hospital wards, Lisa Whelan recounts how a junior doctor overseeing her care thought she had trapped wind, when in fact her bowel had been perforated and become septic...

Lisa Whelan knew within hours of her Caesarean that something was wrong.
As her baby girl lay contentedly snuffling in a cot beside her, Lisa started suffering from ‘agonising stomach cramps — just about as bad as labour pains’. 
As the 32-year-old mother from Leeds recalls: ‘By the next day, my stomach was not only painful, it was swollen. 
'It looked as if I was about to give birth to twins.
Turmoil: Doctors didn't spot Lisa Whelan's Caesarean complications
Turmoil: Doctors didn't spot Lisa Whelan's Caesarean complications. 'I had to spend five months in hospital,' she said
‘I’d had a Caesarean with my first daughter 11 years ago — and I just knew this wasn’t normal.’ 
The junior doctor overseeing Lisa’s care thought it was trapped wind, and prescribed peppermint oil and suppositories.
Another junior doctor sent her for an X-ray but could see nothing wrong.
Three days after giving birth, Lisa started vomiting.
‘It was only then that a surgeon reviewed my notes and they realised something was seriously wrong,’ she says.
But by then it was too late: Lisa’s bowel had been perforated and had become septic. 
She was rushed to theatre to remove the infected parts and was given only a 20 per cent chance of survival. 
In the end, despite multiple operations, it was not possible to save any of her bowel.
‘I had to spend five months in hospital and was sedated for so long I did not realise I’d had my baby until she was around two months old,’ says Lisa.
‘I finally got home in March, 2011.’
Not only that, but Lisa now has to face the future with a permanent colostomy bag.
What makes it so galling for her is that the hospital has since admitted that had she not been left in the care of junior doctors, this might have been avoided.
Junior doctor error led to an even more tragic outcome for Anita and Patrick Bowyer.
Their 26-year-old son Ben underwent an operation in March 2010 to relieve pressure due to a build-up of fluid on his brain, caused by a benign cyst. 
Doctors at the John Radcliffe Hospital in Oxford inserted a device to allow the fluid to drain off. 
‘We were told at the time that this was a holding operation and that they would remove the cyst a few days later,’ recalls Patrick, a self-employed plumber. 
‘However, the consultant neurologist who had been in charge of Ben’s case then went off to London to teach for a week.
‘Ben was put on to a neurosurgical ward and left in the care of doctors in their first or second year out of medical school.’
On the first Wednesday of August every year, the latest tranche of junior doctors is launched on hospital wards
On the first Wednesday of August every year, the latest tranche of junior doctors is launched on hospital wards
Although Ben was ‘screaming and writhing in pain’, these junior doctors failed to realise how much his condition was deteriorating.
A week after his operation, and in the absence of the consultant, Ben died.
The inquest into his death heard that the drain was taking fluid from one but not both sides of the brain, causing fatal brain damage. 
The juniors did not recognise this, and while one did try to find a senior consultant to ask what he should do, this consultant later told the inquest he hadn’t been given the proper facts.
‘If he had, he said he would have authorised immediate  surgery,’ says Patrick.
The medical director of Oxford University NHS Hospital Trusts has since apologised to the family, saying: ‘The staff looking after Ben failed to recognise his deteriorating condition, which led to his death.’ The hospital has offered the family compensation.
A ‘junior doctor’ is a newly-qualified doctor who has spent five years at medical school and is now learning the ropes, working independently in a two-year foundation course in a hospital. 
It can be a sharp learning curve, with sometimes disastrous results.
On the first Wednesday of August every year, the latest tranche of junior doctors is launched on hospital wards. 
On that day the number of mortalities among patients brought into hospital increases by 6 per cent compared with the previous Wednesday, according to new research carried out by Dr Foster Intelligence.
‘I wouldn’t want a relative of mine to be admitted into hospital in August,’ one nurse who has been working in hospitals for the past 13 years told the Mail.
‘The junior doctors arrive fresh out of university and are expected to get on with it and you can see that many of them are really nervous and unsure what to do. 
'Most of them are keen for help and advice, but some arrive on the ward and you can tell that the fact that they have qualified as a doctor has gone to their head, and they think they know it all.’ 
Sir Bruce Keogh, medical director of the NHS, recently admitted that patients were at risk during this transition period, saying: ‘We recognise the change-over period in August puts patients at risk.
‘Junior doctors are under stress as they change from being a student to a professional, and they need help to adapt to a working environment when they’ve never done a job before.’
To try to put an end to the ‘killing season’, as this period has been dubbed, from next year junior doctors will have to shadow senior colleagues for four days before they start out.
A pilot scheme in Bristol found this tiny change reduced the amount of mistakes made by junior doctors in their first four months at work by half.
The students benefited from familiarising themselves with the hospital, watching how seniors interacted with patients and nurses, and learning to locate life-saving equipment more quickly. 
However, some believe there are other issues to addressed. 
Indeed, it could be argued that it is a year-round problem. 
Another study carried out by Dr Foster Intelligence has found that in some hospitals the death rate at weekends rises by as much as 10 per cent — a time when, typically, senior staff are in short supply and it’s junior doctors who are in charge.
Lawyers involved with medical negligence cases have a high volume of complaints involving junior doctors. 
‘Often they don’t seem to have the experience to see the severity of a situation,’ says Helen Hammond from Penningtons Solicitors.
‘In fairness, we also see quite a few cases where junior doctors are left to deal with a situation where they seek input from a more senior doctor but don’t get it. 
'We also find that junior doctors are often left on their own during anti-social hours and help from a senior colleague is not that easy to find.’ 
This is a scenario Patrick Bowyer recognises.
‘At the inquest into Ben’s death, the two junior doctors involved were squirming and fearful,’ he says. 
‘The point is, they did what they felt was right. The problem was there was no one of seniority around to guide them.’
In the past, too, medical students had more experience on the frontline with patients before they became junior doctors, says Dr Ben Dean, a registrar in orthopaedics based in Oxford, who himself qualified nine years ago. 
‘That changed when the General Medical Council took responsibility for a lot of a doctor’s training in about 2005;  it became more bureaucratic. 
'Now there’s more formal  teaching, which is a good thing, but because of that there is less emphasis on clinical experience.’
It’s a problem junior doctors themselves recognise. 
When Dr Dean recently conducted a survey of 615 foundation doctors, a staggering 87 per cent believed that ‘incompetent trainees’ could still be allowed to pass the foundation stage because the testing was too focused on ticking boxes and less on core clinical experience. 
Another issue is the cut in hours. 
In 2009, a new European directive was introduced which capped the number of hours junior doctors can work to 48 a week.
‘Most junior doctors would be in favour of an increase in hours to around 50 or 60 per week, which would be better for doctors in terms of training continuity and better for patients in terms of continuity of care,’ says Dr Dean.
Junior doctors themselves recognise their limitations. 
‘Part of being a doctor is recognising your limits and knowing when something is outside your competence and referring upward,’ says Dr Tom Dolphin, chair of the Junior Doctors Committee of the British Medical Association.
‘There have been some studies that suggest patients fare a little worse during the first few weeks of August, but that will also be contributed to by the fact that many other grades of doctor also rotate between hospitals on training programmes on the same day, and are therefore perhaps unfamiliar with the new hospital’s systems.
‘The problem is that training is not given much priority in a lot of hospitals and senior doctors are not being given time in their jobs to train their juniors.
‘Likewise, a lack of supervision overnight reflects understaffing and having too few doctors around to provide advice and support.
'Learning requires supervision.’ 
Currently, many patients may be cared for by junior doctors whose only supervision is by consultants at the end of the phone. 
As Carolyn Lowe of Henmans, the law firm that represented Ben Bowyer’s family, says: ‘We see far too many cases where junior doctors are left without adequate supervision and support.
‘They’re often put in charge of wards and expected to look after large numbers of patients — and, unsurprisingly, they struggle. 
‘We welcome the shadowing scheme.
'However, one week just does not seem sufficient when patients’ lives are at risk.’