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[top: Mrs Wong Chen Li Chu showing where she was injected with Aclasta. Her husband, Mr Wong Ching Loong, is in the background.]
SHE had gone to see a surgeon for a broken wrist. He fixed it.
Some time later, he diagnosed her with osteoporosis. She was then told that she needed a $1,500 injection to make herself better.
But Mrs Wong Chen Li Chu ended up getting kidney failure instead.
Doctors have told the 61-year-old that she will need to go on dialysis soon. Mrs Wong, a beautician and mother of two, said she had not had any kidney-related problems earlier, and was not diabetic.
In January, she filed a complaint of medical negligence with the Singapore Medical Council (SMC), against an orthopaedic surgeon here.
She alleges that the surgeon had given her the Aclasta injection, which cost her $1,500, without testing her blood or warning her of any side effects.
Her problems started when she broke her wrist in June last year. A friend recommended an orthopaedic surgeon in private practice.
The surgeon repaired her fractured wrist.
In October, during a follow-up visit, the surgeon told her she has osteoporosis. He suggested an injection of Aclasta, which would last her a year.
It is a prescription medicine used to treat osteoporosis in women after menopause.
It reduces the incidence of fractures. Said Mrs Wong: 'Despite the steep cost, my husband and I thought I should have it because the doctor recommended it and it would make my osteoporosis better.'
She had the injection on 7 Oct last year after drinking two small cups of water and taking two Panadol pills. After the injection, she was directed to the clinic receptionist who told her that she had to take Panadol every eight hours after the injection.
Mrs Wong was surprised.
'Since the surgeon had not told me that there would be any side effects, I asked why it was necessary to take the Panadol pills,' she said.
The next day, she experienced sharp pain throughout her limbs, chest and waist.
'My face became swollen. Rashes appeared throughout my body and I felt extremely itchy,' she said.
She called up the clinic to ask for the surgeon's advice but was told by the receptionist that he had gone overseas and would be back only on 20 Oct.
'She instructed me to take Panadol pills again to ease the pain,' said Mrs Wong.
On 9 Oct, she said her head and limbs started to feel numb and sensations similar to those of slight electric shocks started to go through her body.
On 10 Oct, her condition worsened.
The feelings of numbness got stronger, her head started to shake involuntarily and there were tingling sensations around her mouth. 'My whole body was numb and breathing became difficult,' she said.
She went to the accident and emergency department at Mount Elizabeth Hospital.
Her husband, Mr Wong Ching Loong, 63, explained to the doctor that she had been treated with Aclasta.
The doctor did a blood test and found that her blood creatinine levels, which measures how much waste the kidneys are removing, were very high.
It meant her kidneys were not functioning as they should.
Said Mr Wong: 'The doctor advised me to ward my wife for the night as he feared her condition would worsen if she went home.'
He found out that her symptoms were that of hypocalcemia, which is caused by loss of calcium from or insufficient entry of calcium into the body's circulation.
Said Mrs Wong: 'The doctor at Mount Elizabeth instructed the nurses to infuse calcium into my blood until the next day.'
As her blood creatinine remained high and she and her husband were worried about her escalating medical bills, she moved to the Singapore General Hospital.
Since then, Mr Wong has found out a few more things about Aclasta on the manufacturer's website.
- It is not recommended for patients with severe renal impairment. Patients should have their blood creatinine level tested before receiving Aclasta. Those with high levels should not be given Aclasta.
- Zoledronic acid, an active component in Aclasta, has been associated with deterioration in kidney function and in rare cases, acute kidney failure.
- Kidney deterioration has also been observed in patients after being given a single dose of Aclasta.
- Pre-existing hypocalcemia must be treated by adequate intake of calcium and vitamin D before initiating therapy with Aclasta.
A Health Sciences Authority (HSA) spokesman said Aclasta, an injection containing zoledronic acid, has been approved in Singapore from March 2006.
'From HSA's local adverse reaction database, there is one report of adverse reaction suspected to be associated with this drug. The reactions reported are known potential side effects of the drug,' said the spokesman.
It is not known if the one adverse reaction is Mrs Wong's as HSA is not at liberty to reveal the patient's identity.
Her 26-year-old daughter has offered to donate her kidney for her to get a transplant.
'But how can I accept? She's still so young and not married. Her health might be impacted later on,' Mrs Wong said with tears in her eyes.
She and her husband have set up a website detailing her experience. For more information, go to http://www.novartis-aclasta.com/
Surgeon says: The surgeon involved in Mrs Wong's case declined comment when contacted by The New Paper. He said that the case is now before the SMC and every one should wait for the SMC's judgement before speaking to the press.
SMC says: It is not able to give any comment.
In a letter to Mrs Wong, it said that a Complaints Committee has been appointed to investigate the matter and that she would be informed of the outcome as soon as a decision has been reached by the committee.
Related:
Teen suffers Kidney failure after op for fracture
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