Caja will give implant recipients option of removing them

The Caja Costarricense de Seguro Social confirmed in a press release Thursday that it will begin to take measures to assess the status of all the patients to whom it gave faulty breast implants and give the patients the option of removing them.

The Caja confirmed that the implants manufactured by the French firm Poly Implant Prothèse or PIP, are more likely to rupture and many were manufactured with potentially dangerous industrial grade silicone that can cause inflammation and infection.

Earlier health official statements had calculated that the PIPs were imported and distributed within Costa Rica between 2008 and 2011 by a company called Biocare Medical. But now the Caja officials claim its doctors began using the implants in 2006 until discontinuing their use in 2010 when health officials deemed them a potential danger.

According to Adolfo Ortiz, a vice minister of Salud, the health license for the product was not revoked until last April.

The Caja calculated its surgeons placed implants in roughly 400 women, predominantly in hospitals México and San Juan de Dios. Many other women could have been given the implants in private clinics in the country, but a large majority of the women given the implant through the Caja were given them for breast reconstruction following a mastectomy because of breast cancer.

Fabiola Ross, an advisor for the Anna Gabriela Ross anti-cancer foundation, said the situation points to flaws in the protocol the Caja uses to address breast cancer. She said
no national policy exists in public hospitals and diagnosis treatment is often left to individual doctors, meaning the reconstructive surgeries administered to the women now with PIPs was not standard policy.

“It’s usually up to the doctor as to whether you will get a mastectomy and usually up to the doctor to decide about the reconstruction,” Ms. Ross said. “In Costa Rica, there is no standard policy for screening, treatment or policy for survivors. So there’s not a list of things doctors must do.”

Ms. Ross said one of the factors that may contribute to the choice a doctor will make to conduct a mastectomy is the stage at which the breast cancer is discovered. She said early detection is the most effective tool in treatment, allowing doctors to act before drastic more serious medical measures must be taken. She said she hopes officials will take steps towards developing a national policy on treatment protocol.

Government doctors are now calling on each woman who knowingly has the implant to schedule an appointment with the hospital where they received the surgery. Those patients who are unsure of the brand name of their implant can contact the appropriate hospital to review the records and determine if it is a PIP. The Caja press release said the appointment will entail an exhaustive physical evaluation to determine a proper course, whose decision will ultimately be the patient’s.

Assisting in the preventative removal of the implants puts Costa Rica more in line with other countries such as Venezuela , France and Colombia which have committed to assisting patients in the removing of them before problems arise. Only days ago Ministerio de Salud officials had said Costa Rica’s public policy would be regular monitoring.

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