The following is issued on behalf of the Hospital Authority:

     The Hospital Authority (HA) today (November 21) announced the establishment of a Root Cause Analysis (RCA) Panel following three cases of undue oversight of abnormal X-ray findings that happened recently.
 
     The HA noted three incidents of undue oversight of abnormal X-ray findings reported by hospitals via the Advance Incident Reporting System recently. Due to the coincidence in reporting time and similarities in the nature of the incidents, the Quality and Safety Department decided to set up an RCA Panel at the Head Office level to collectively examine the three cases with a view to exploring means to better support healthcare workers and ensure that they can identify abnormalities in chest X-ray findings in a more timely manner.
 
     In consideration of patients' and families' wishes of masking their individual particulars, below is the salient information of the cases concerned.

1) A patient was admitted to the surgical ward of Prince of Wales Hospital via the Accident and Emergency Department (AED) for cholecystitis in November this year. Chest X-ray examination was arranged and an opacity over the left upper zone of the lung was found. Upon reviewing the patient's previous chest X-ray films, the doctor noted that the patient had taken an X-ray examination at the hospital in March 2017 and the X-ray film also showed a shadow on the left lung. Computed tomography (CT) scanning of the thorax, the abdomen and the pelvis was then arranged and the report showed a left upper lobe lung mass highly suspected to be malignant. Further investigations confirmed that the patient has a metastatic lung tumour. The patient is receiving appropriate medical treatment as indicated.

2) A patient of Queen Mary Hospital (QMH) sought medical treatment at Ruttonjee Hospital in October this year due to epigastric discomfort. A chest X-ray was performed and the report showed a mass suspected to be malignant. The patient was referred to Grantham Hospital for further assessment from the Tuberculosis and Chest Medicine Unit. Upon reviewing the patient record, it was found that among the chest X-rays taken in QMH since 2016, the mass had not been detected three times. The hospital has now arranged follow-up examinations for the patient to establish the most suitable treatment plan.

3) A patient attended the AED of Princess Margaret Hospital in November this year due to a fall accident. The patient was suffering from dyspnea and was admitted to the Medicine and Geriatrics ward. Chest X-ray examination suggested massive pleural effusion and therefore a chest drain procedure was arranged to deal with the condition. A subsequent pleural fluid cytology finding confirmed that the patient has lung cancer. Upon reviewing patient's chest X-ray films taken in February 2017 and May 2018, it was found that a shadow in the right lung was unnoticed on both occasions. The patient is now being taken care of by the Medicine and Geriatrics Department as well as the Oncology Department. CT scanning has been arranged for further examination and devising a treatment plan.

     Open disclosure has been conducted by the three hospitals concerned in addition to expressing apologies to the patients and their families. The three hospitals will continue to provide follow-up treatment according to the patients' clinical conditions and to provide assistance as necessary to the patients and their families. The hospitals have reminded front-line colleagues to be cautious in reviewing patients' examination findings to ensure timely diagnosis and treatment.
 
     The HA attaches great importance to the quality and safety of patient services and has grave concern over the irregularities. The HA will invite representatives from Central Co-ordinating Committees of respective specialties to participate in the RCA Panel. The report will be completed and disclosed in eight weeks.

     Two men and a woman were charged with contravening the Hotel and Guesthouse Accommodation Ordinance at the Kowloon City Magistrates' Courts today (November 21). The woman was sentenced to one month's imprisonment, suspended for one year, and fined $3,000. The two men were fined $6,000 each.
      
     The courts heard that in April this year, officers of the Office of the Licensing Authority (OLA), the Home Affairs Department, inspected three suspected unlicensed guesthouses on Shanghai Street, Portland Street and Mong Kok Road in Mong Kok. During the inspections, the OLA officers posed as lodgers and successfully rented rooms in these guesthouses on a daily basis.
      
     According to the OLA's records, these guesthouses did not possess licences under the Ordinance on the days of inspection. The men and woman responsible for managing the premises were charged with contravening section 5(1) of the Ordinance.
      
     A department spokesman stressed that operating or managing an unlicensed guesthouse is a criminal offence and will lead to a criminal record. Upon conviction, the offender is liable to a maximum fine of $200,000 and two years' imprisonment.
           
     The spokesman appealed to anyone with information about suspected unlicensed guesthouses to report it to the OLA through the hotline (Tel: 2881 7498), by email (hadlaenq@had.gov.hk), by fax (2504 5805) using the report form downloaded from the OLA website (www.hadla.gov.hk), or through the mobile application "Hong Kong Licensed Hotels and Guesthouses".

     The Centre for Health Protection (CHP) of the Department of Health is today (November 21) investigating an influenza A outbreak at a primary school in Eastern District, and again reminded the public to maintain strict personal and environmental hygiene against influenza.
 
     The outbreak involves 10 boys and nine girls aged 10 to 11, as well as one female staff member, who developed cough, sore throat and fever since November 13. All of them sought medical attention and none required hospitalisation. They are now in a stable condition.
 
     The nasopharyngeal swab of four students tested positive for influenza A virus. 

     Officers of the CHP have conducted a site visit and advised the school to adopt necessary infection control measures against respiratory infections. The school has been put under medical surveillance.
 
     A spokesman for the CHP said, "To prevent outbreaks of influenza and other respiratory infections, it is of prime importance that children with fever, regardless of the presence of respiratory symptoms, should not be allowed to attend school. They should seek medical advice and avoid school till 48 hours after the fever has subsided. Schools should also measure and record students' body temperature properly."

     Schools are reminded to follow the Guidelines on Prevention of Communicable Diseases on preventive and control measures as well as management of outbreaks, which should be reported to the CHP for prompt follow-up.

      "Influenza can cause serious illnesses in high-risk individuals and even healthy persons. Given that influenza vaccines are safe and effective, all persons aged 6 months or above, except those with known contraindications, are recommended to receive Seasonal Influenza Vaccine(SIV) for personal protection," the spokesman said.
 
     Based on past epidemiological patterns, the winter influenza season usually occurs from January to March/April each year. As it takes about two weeks to develop antibodies, we urge eligible persons to receive SIV early for protection against seasonal influenza. Vaccination among family members is key to protecting their personal and family's health."
 
     Besides receiving seasonal influenza vaccine for personal protection, the public should maintain good personal and environmental hygiene for protection against influenza and other respiratory illnesses. For more information, please visit the CHP's influenza page and weekly Flu Express.

The following is issued on behalf of the Hong Kong Monetary Authority:

     The Hong Kong Monetary Authority (HKMA) wishes to alert members of the public to a press release issued by China CITIC Bank International Limited on fraudulent website, which has been reported to the HKMA. Hyperlink to the press release is available on the HKMA website for ease of reference by members of the public.

     Anyone who has provided his or her personal information to the website concerned or has conducted any financial transactions through the website should contact the bank concerned using the contact information provided in the press release, and report to the Police or contact the Cyber Security and Technology Crime Bureau of the Hong Kong Police Force at 2860 5012.

     Following is a question by the Dr Hon Chiang Lai-wan and a written reply by the Secretary for Food and Health, Professor Sophia Chan, in the Legislative Council today (November 21):

Question:

     It has been reported that painting the shells of live red-eared sliders (painted turtles) with colourful oil paints has become popular overseas in recent years, and this trend has spread to Hong Kong in recent months. Painted turtles are available for sale in some shops, and a red-eared slider fully painted in gold colour was found by some members of the public in a pond in Kowloon Park. Some experts have pointed out that the harmful substances in paints will enter the bloodstream of turtles through the shells; paints will hinder turtles' absorption of sunlight, making it difficult for them to produce vitamin D and hence affecting their bone structures; and paints applied on the noses and heads of turtles may cause turtles to suffocate to death because of blockage of their airways. In this connection, will the Government inform this Council:

(1) of the number of complaints relating to painted turtles received in the past 12 months, and whether follow-up actions were taken, by the authorities; if so, of the details; if not, the reasons for that;

(2) whether the acts of painting the shells of live turtles with oil paints and selling painted turtles are subject to regulation under the existing legislation; if so, of the details; if not, the reasons for that; and

(3) whether it has taken measures to curb the trend of painting the shells of live turtles with oil paints, e.g. calling upon members of the public and shops not to buy or sell painted turtles; if so, of the details; if not, the reasons for that?

Reply:

President,

     My reply to various parts of the question is as follows:

(1) In the past 12 months, the Agriculture, Fisheries and Conservation Department (AFCD) has received a public enquiry about painted turtles being sold in shops. After receiving the enquiry, AFCD immediately contacted and inspected all licensed shops selling pet turtles over the territory, and did not find any act of selling painted turtles. AFCD also visited the Kowloon Park and did not find any painted turtles there.

(2) and (3) All animal traders are required to obtain a licence for their operations from the Director of Agriculture, Fisheries and Conservation under the Public Health (Animals and Birds) (Trading and Breeding) Regulations (Cap. 139B). AFCD also issues codes of practice (CoPs) to licenced animal traders, requiring them, among others, to observe the relevant regulations on prevention of cruelty to animals. Any breach of the CoPs may be considered as a breach of the licence condition, and that AFCD may take further action. Applying oil paints on turtles is not encouraged by AFCD for the sake of animal health. AFCD will advise licenced animal traders against selling painted turtles during inspections.

     If the substances in paints have negative impact on the health of turtles, the act of painting may constitute a breach of the Prevention of Cruelty to Animals Ordinance (Cap. 169). Any person who cruelly treats an animal and causes it unnecessary suffering commits an offence and is liable on conviction to a maximum fine of $200,000 and imprisonment for up to three years. AFCD or other related departments will take follow-up actions upon receiving reports of cruelty to animals.

     AFCD will continue to enhance public education to promote messages on responsible pet ownership and prevention of cruelty to animals. To further safeguard animal welfare, as announced by the Chief Executive in her 2018 Policy Address, the Government is mapping out the major direction and drawing up preliminary proposals for amending the legislation related to animal welfare, with a view to consulting the public early next year. The proposals include introducing a positive duty of care on animal keepers and exploring raising the penalties for acts of cruelty to animals.