Statement of Principles concerning peritoneal adhesions No. 104 of 2007

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Statement of Principles
concerning
 
PERITONEAL ADHESIONS
No. 104 of 2007
 
for the purposes of the
 
Veterans’ Entitlements Act 1986
and
Military Rehabilitation and Compensation Act 2004
           
Title
1.                  This Instrument may be cited as Statement of Principles concerning peritoneal adhesions No. 104 of 2007.
 
Determination
2.                  This Statement of Principles is determined by the Repatriation Medical Authority under subsection 196B(3) of the Veterans’ Entitlements Act 1986 (the VEA).
 
Kind of injury, disease or death
3.         (a)        This Statement of Principles is about peritoneal adhesions and death from peritoneal adhesions.
(b)              For the purposes of this Statement of Principles, "peritoneal adhesions" means fibrous connective tissues that abnormally join abdominopelvic organs to each other or to the abdominal wall or diaphragm.
(c)              Peritoneal adhesions attracts ICD-10-AM code K66.0, K56.5, N73.6 or N99.4.
(d)              In the application of this Statement of Principles, the definition of "peritoneal adhesions" is that given at paragraph 3(b) above.
 
Basis for determining the factors
4.         On the sound medical-scientific evidence available, the Repatriation Medical Authority is of the view that it is more probable than not that peritoneal adhesions and death from peritoneal adhesions can be related to relevant service rendered by veterans or members of the Forces under the VEA, or members under the Military Rehabilitation and Compensation Act 2004 (the MRCA).
 
Factors that must be related to service
5.         Subject to clause 7, at least one of the factors set out in clause 6 must be related to the relevant service rendered by the person.
 
Factors
6.         The factor that must exist before it can be said that, on the balance of probabilities, peritoneal adhesions or death from peritoneal adhesions is connected with the circumstances of a person’s relevant service is:
 
(a)               having laparotomy or laparoscopy at least seven days before the clinical onset of peritoneal adhesions; or
 
(b)               having peritonitis at least seven days before the clinical onset of peritoneal adhesions; or
 
(c)                having cholecystitis, appendicitis, pancreatitis, diverticular disease of the colon, bowel inflammation or inflammatory bowel disease at least seven days before the clinical onset of peritoneal adhesions; or
 
(d)               having a perforation of the peritoneum at least seven days before the clinical onset of peritoneal adhesions; or
 
(e)                having penetrating trauma to the peritoneum at least seven days before the clinical onset of peritoneal adhesions; or
 
(f)                 having a bacterial or fungal infection involving the peritoneal cavity at least seven days before the clinical onset of peritoneal adhesions; or
 
(g)                having endometriosis at least seven days before the clinical onset of peritoneal adhesions; or
 
(h)                having pelvic inflammatory disease at least seven days before the clinical onset of peritoneal adhesions; or
 
(i)                  undergoing a course of therapeutic radiation involving the abdominopelvic region at least seven days before the clinical onset of peritoneal adhesions; or
 
(j)                 undergoing intraperitoneal chemotherapy or intraperitoneal dialysis at least seven days before the clinical onset of peritoneal adhesions; or
 
(k)               having a primary or secondary malignant neoplasm involving the peritoneum at least seven days before the clinical onset of peritoneal adhesions; or
 
(l)                  having blunt trauma to the abdominopelvic region at least seven days before the clinical onset of peritoneal adhesions; or
 
(m)              inability to obtain appropriate clinical management for peritoneal adhesions.
 
Factors that apply only to material contribution or aggravation
7.                  Paragraph 6(m) applies only to material contribution to, or aggravation of, peritoneal adhesions where the person’s peritoneal adhesions was suffered or contracted before or during (but not arising out of) the person’s relevant service.
 
Inclusion of Statements of Principles
8.                  In this Statement of Principles if a relevant factor applies and that factor includes an injury or disease in respect of which there is a Statement of Principles then the factors in that last mentioned Statement of Principles apply in accordance with the terms of that Statement of Principles as in force from time to time.
 
Other definitions
9.           For the purposes of this Statement of Principles:
 
"a course of therapeutic radiation" means one or more fractions (treatment portions) of ionising radiation administered with the aim of achieving palliation or cure with gamma rays, x-rays, alpha particles or beta particles;
 
"blunt trauma" means non-penetrating trauma that causes the immediate development of pain and tenderness lasting for a period of at least three days;
 
"death from peritoneal adhesions" in relation to a person includes death from a terminal event or condition that was contributed to by the person’s peritoneal adhesions;
 
"ICD-10-AM code" means a number assigned to a particular kind of injury or disease in The International Statistical Classification of Diseases and Related Health Problems, 10th revision, Australian Modification (ICD-10-AM), Fifth Edition, effective date of 1 July 2006, copyrighted by the National Centre for Classification in Health, Sydney, NSW, and having ISBN 1 86487 772 3;
 
"relevant service" means:
(a)     eligible war service (other than operational service) under the VEA; or
(b)          defence service (other than hazardous service) under the VEA; or
(c)          peacetime service under the MRCA;
 
"terminal event" means the proximate or ultimate cause of death and includes:
(a)     pneumonia;
(b)     respiratory failure;
(c)     cardiac arrest;
(d)     circulatory failure; or
(e)     cessation of brain function.
 
Date of effect
10.       This Instrument takes effect from 19 September 2007.
 
Dated this       fifth         day of              September           2007
 
 
The Common Seal of the                  )
Repatriation Medical Authority       )
was affixed to this instrument          )
in the presence of:                            )
 
KEN DONALD
CHAIRPERSON

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