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The Nurses Are Innocent: The Digoxin Poisoning Fallacy
 
 

The Nurses Are Innocent: The Digoxin Poisoning Fallacy [Paperback]

Gavin Hamilton MD FRCP(C)
5.0 out of 5 stars  See all reviews (2 customer reviews)
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"...The real parallel remains unknown to most Canadians even now; it's not that the wrong person was fingered for murder, but that no murders were commited at all. That's the conclusion meticulously and persuasively argued by retired physician Gavin Hamilton in The Nursses are Innocent. (Maclean's magazine )

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In 1980–81, 43 babies died at Toronto's Hospital for Sick Children from a supposed digoxin overdose. Serial murder was suspected, leading to the arrest of nurse Susan Nelles. In order to clear Nelles's name, an investigation was launched to find an alternate explanation.

No one on the Grange Royal Commission of Inquiry had expertise in diagnosis. The post-mortem diagnosis of digoxin poisoning was based on a single biochemical test without knowledge of the normal values. Gavin Hamilton's extensive research shows that a toxin found in natural rubber, a digoxin-like substance, might well have been the culprit in the babies' deaths. He clearly demonstrates that explanations other than serial murder account for the cluster of infant deaths at HSC.

What can be learned from this black stain on Canada's judicial system? One lesson certainly stands out: we can't ever again allow a group of unqualified amateur diagnosticians make life-and-death decisions about such important matters as potential serial murders.

(20111215)

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5.0 out of 5 stars Fascinating - couldn't put it down, Jan 18 2012
This review is from: The Nurses Are Innocent: The Digoxin Poisoning Fallacy (Paperback)
Yesterday I received a book that I ordered over Christmas. It is called "The Nurses are Innocent - The Digoxin Poisoning Fallacy" by Gavin Hamilton MD. Before bedtime, I had read the whole thing. There are two major themes in the book. The writer is a radiologist who specialised in IVP tests. About 1 in 1000 patients would have a really bad reaction to one of the drugs given to show up the kidneys on x-ray. A very small number of those reactions would result in death from anaphylactic shock. He finally stumbles on the fact that the drug is administered with a syringe with a rubber plunger, and a substance in the rubber is causing the reaction, not the drug itself.

The second theme is about the nurses who were blamed for digoxin poisoning at Sick Kids. I think he makes a good case that the babies dying at Sick Kids in the early 1980's were being poisoned by the same compound, but by build up in the body rather than anaphylactic shock. He really tears apart the bad testing that was done in trying to implicate Susan Nelles. (The Grange Royal Commission of Inquiry is available on the Internet, and it is also required reading for those who do not remember these tragedies.)

After the problem was improved by avoiding natural rubber in the syringes, there was another outbreak which he put down to natural rubber stoppers in drug vials.

Throughout all this, the people at Health Canada were more concerned with not upsetting the manufacturers than in fixing the problem. Unfortunately, nurses are at the forefront of those who administer drugs, and they can get blamed for things that were caused by bureaucratic incompetence and inertia.

My daughter is a nurse, married to a policeman. I have ordered a copy for them.
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1 of 1 people found the following review helpful:
5.0 out of 5 stars Eye-opening and informative!, Nov 27 2011
This review is from: The Nurses Are Innocent: The Digoxin Poisoning Fallacy (Paperback)
Every member of the medical community needs to be aware of these discoveries. Doctors, dentists, nurses, vets...all could potentially have seen effects of this rubber contamination and not known it. I am not a member of the medical community but I found this book to be approachable and engaging. It read somewhat like a thriller, with a "cover-up" and a string of evidence building throughout. The book is nicely concluded with the connection to Dr. Charles Smith, who has been in the news more recently as having a history of incorrect autopsy interpretations. Don't expect a happy ending though...luckily, Susan Nelles has received her happy ending and freedom, but there are many babies and others worldwide today that may not be so lucky. Inform yourselves...an important read!
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4.0 out of 5 stars Real life "CSI", Dec 4 2011
By Leonard I. Goldman - Published on Amazon.com
This review is from: The Nurses Are Innocent: The Digoxin Poisoning Fallacy (Paperback)
Currently there is great interest in the role that forensic medicine plays in crime investigation. At least six television programs (three "CSI's,"two "NCIS's" and "Body of Proof") all stress how medical procedures are used to determine the guilt or innocence of alleged criminals. Unfortunately the limitations of these studies are rarely identified. Dr. Gavin Hamilton's book, "The Nurses are Innocent, The Digoxin Poisoning Fallacy," addresses this issue in great detail. He identifies the medical problems that resulted in the indictment of a nurse at the Hospital for Sick Children in Toronto, Canada for the deaths of children alleged due to her administration of the cardiac drug Digoxin. His clinical observations on the contaminants present within intravenous solutions, as well as the misuse of postmortem blood digoxin levels provide the fascinating scenario which eventually resulted in the nurse's proof of innocence. I recommend this book for all "CSI" buffs who want the insight of an astute observer into the many phases of forensic medicine as well as their potential limitations.
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