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本文引用的文献

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India Joining the World of Hip and Knee Registries: Present Status-A Leap Forward.印度加入髋关节和膝关节注册领域:现状——向前迈进的一步
Indian J Orthop. 2020 Sep 16;55(Suppl 1):46-55. doi: 10.1007/s43465-020-00251-y. eCollection 2021 May.
2
Balancing innovation and medical device regulation: the case of modern metal-on-metal hip replacements.平衡创新与医疗器械监管:现代金属对金属髋关节置换术的案例
Med Devices (Auckl). 2016 Aug 9;9:267-75. doi: 10.2147/MDER.S113067. eCollection 2016.
3
Precaution, governance and the failure of medical implants: the ASR((TM)) hip in the UK.预防、管理与医用植入物的失败:英国的ASR髋关节
Life Sci Soc Policy. 2014;10:19. doi: 10.1186/s40504-014-0019-2. Epub 2014 Nov 26.
4
How safe are metal-on-metal hip implants?金属对金属髋关节植入物的安全性如何?
BMJ. 2012 Feb 28;344:e1410. doi: 10.1136/bmj.e1410.
5
What is happening with hip replacement?髋关节置换手术目前的情况如何?
Med J Aust. 2011 Jun 20;194(12):620-1. doi: 10.5694/j.1326-5377.2011.tb03141.x.

印度医疗设备框架中的监管漏洞:以强生公司有缺陷的髋关节植入物为例。

Regulatory gaps in India's medical device framework: The case of Johnson and Johnson's faulty hip implants.

作者信息

Menon Vidya

机构信息

Law, Gujarat National Law University, Ahmedabad 382426, Gujarat, India.

出版信息

World J Orthop. 2024 Dec 18;15(12):1124-1134. doi: 10.5312/wjo.v15.i12.1124.

DOI:10.5312/wjo.v15.i12.1124
PMID:39744726
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11686521/
Abstract

The Johnson and Johnson faulty hip implant case represents one of the most significant crises in medical device history, impacting nearly 93000 patients worldwide. In response to alarming failure rates and a global recall in August 2010, countries such as Australia, the United States, and the United Kingdom quickly implemented revision surgeries and reimbursement programs to protect patient safety. In stark contrast, India's response was alarmingly delayed; defective implants continued to be sold even after the global recall. By the time the import license was revoked, and the Central Drugs Standard Control Organization issued a recall notice, these implants had already been involved in 4700 surgeries across India. This paper explores the systemic weaknesses in India's medical device regulatory framework that contributed to this delayed action, resulting in many patients suffering from serious health complications. It highlights deficiencies in monitoring and reporting mechanisms, inadequate regulatory oversight, and insufficient approval processes. Furthermore, the inability to trace affected patients and provide necessary compensation underscores significant gaps in regulation. Although subsequent legislative reforms were introduced, this paper argues that substantial loopholes remain, posing risks for future incidents. Thus, urgent, comprehensive, and enforceable regulatory measures are needed to increase patient safety.

摘要

强生公司有缺陷的髋关节植入物案例是医疗设备史上最重大的危机之一,影响了全球近93000名患者。鉴于令人担忧的故障率以及2010年8月的全球召回事件,澳大利亚、美国和英国等国家迅速实施了翻修手术和报销计划,以保护患者安全。形成鲜明对比的是,印度的反应令人震惊地迟缓;即使在全球召回之后,有缺陷的植入物仍在继续销售。到进口许可证被吊销、中央药品标准控制组织发布召回通知时,这些植入物已经在印度各地的4700例手术中使用。本文探讨了印度医疗设备监管框架中的系统性弱点,正是这些弱点导致了行动迟缓,致使许多患者出现严重的健康并发症。它突出了监测和报告机制的缺陷、监管监督不足以及审批程序不完善。此外,无法追踪受影响的患者并提供必要的赔偿凸显了监管方面的重大漏洞。尽管随后出台了立法改革措施,但本文认为仍存在大量漏洞,给未来的事件带来风险。因此,需要采取紧急、全面且可执行的监管措施来提高患者安全。