The U.S. Attorney's Office and the Pennsylvania Department of Public Welfare filed a complaint Thursday against the Holland-Glen Nursing Facility in Hatboro, Pennsylvania.
The complaint alleges the facility has been operating without a nursing facility license and its services "substantially depart from generally accepted professional standards of care, thereby exposing patients to significant risk and, in some cases, to actual harm."
Read the newspaper reports here and here.
Saturday, June 30, 2007
Friday, June 29, 2007
$54 MILLION ON NURSING HOME VERDICT IN NEW MEXICO
Our congratulations go west today - to attorney Carl Bettinger, who called his jury "heroes" "and said he was honored to have represented Barber's daughter, Lori Keith, in taking on "one of the largest corporations in the country ... so she could show the public what happened to her mother and in so doing save the lives of others.""
Scott Sandlin, reporter for the Albuquerque Journal, reports:
The defendant, ManorCare, one of the largest nursing home corporations in the United States, declined to comment.
Attorney for the Plaintiff asked the jury to award punitive damages totaling 2.5 percent of the corporation's total 2006 assets of $2.3 billion. The punitive damages awarded by the jury ($50,000 million) are just over 2 percent.
Keith said in an interview that she had asked for an autopsy immediately after her 78-year-old mother's death in 2004 because it was so unexpected, despite her mother's medical problems. "I just had a feeling something went terribly wrong," she said. Keith said that she arrived at the facility within three hours of being informed by phone of her mother's death and that staffers had hastily crammed her mother's belongings into four cardboard boxes. Money was also missing, she said. "It was ransacked, really," she said of her mother's room. Lawyers learned a few months before trial that a nursing aide found Barber lying in soiled, bloody sheets, which were immediately removed by staffers. By the time relatives arrived, Barber was lying on clean sheets with her arms crossed over her chest, leading the family to claim in the lawsuit that ManorCare had destroyed evidence. A doctor who performed Barber's autopsy testified that, if a patient dies in suspicious circumstances, the person's immediate surroundings are normally taken to the Office of the Medical Investigator along with the body. He said that, based on his exam, Barber had died of a gastrointestinal hemorrhage. Bettinger and Michael Gross, co-counsel in the case, introduced evidence to show that the internal bleeding had been going on for several days with no response, even though staff members had been aware of it. The family's lawyers said Barber's charting was so inadequate that it showed that Barber had been given an insulin injection 2 1/2 hours after her death. ManorCare's expert testified that Barber had died of a heart attack, and company officials said the cleanup was simply a matter of hygiene and dignity. Bettinger presented evidence of other instances of neglect at ManorCare facilities in New Mexico, including patients repeatedly found in fecal- and urine-soiled bedding, improper restraints and improperly trained staff. He said top company officials testified about being kept apprised of financial data but not about abuse and neglect citations. Adult Protective Services, a state agency, conducted an investigation and cited ManorCare for neglect in connection with Barber's death. The New Mexico Department of Health also issued multiple citations, unsuccessfully appealed by ManorCare, attorneys said. The jury found that ManorCare's negligence was a cause of Barber's death and injuries. The jury apportioned 80 percent of the negligence to ManorCare and 20 percent to two certified nurse practitioners who contracted with the company but were not its employees. ManorCare attorney R.E. Thompson said the company will file post-trial motions, which typically seek to overturn the jury verdict or to reduce or eliminate punitive damages."
Scott Sandlin, reporter for the Albuquerque Journal, reports:
The defendant, ManorCare, one of the largest nursing home corporations in the United States, declined to comment.
Attorney for the Plaintiff asked the jury to award punitive damages totaling 2.5 percent of the corporation's total 2006 assets of $2.3 billion. The punitive damages awarded by the jury ($50,000 million) are just over 2 percent.
Keith said in an interview that she had asked for an autopsy immediately after her 78-year-old mother's death in 2004 because it was so unexpected, despite her mother's medical problems. "I just had a feeling something went terribly wrong," she said. Keith said that she arrived at the facility within three hours of being informed by phone of her mother's death and that staffers had hastily crammed her mother's belongings into four cardboard boxes. Money was also missing, she said. "It was ransacked, really," she said of her mother's room. Lawyers learned a few months before trial that a nursing aide found Barber lying in soiled, bloody sheets, which were immediately removed by staffers. By the time relatives arrived, Barber was lying on clean sheets with her arms crossed over her chest, leading the family to claim in the lawsuit that ManorCare had destroyed evidence. A doctor who performed Barber's autopsy testified that, if a patient dies in suspicious circumstances, the person's immediate surroundings are normally taken to the Office of the Medical Investigator along with the body. He said that, based on his exam, Barber had died of a gastrointestinal hemorrhage. Bettinger and Michael Gross, co-counsel in the case, introduced evidence to show that the internal bleeding had been going on for several days with no response, even though staff members had been aware of it. The family's lawyers said Barber's charting was so inadequate that it showed that Barber had been given an insulin injection 2 1/2 hours after her death. ManorCare's expert testified that Barber had died of a heart attack, and company officials said the cleanup was simply a matter of hygiene and dignity. Bettinger presented evidence of other instances of neglect at ManorCare facilities in New Mexico, including patients repeatedly found in fecal- and urine-soiled bedding, improper restraints and improperly trained staff. He said top company officials testified about being kept apprised of financial data but not about abuse and neglect citations. Adult Protective Services, a state agency, conducted an investigation and cited ManorCare for neglect in connection with Barber's death. The New Mexico Department of Health also issued multiple citations, unsuccessfully appealed by ManorCare, attorneys said. The jury found that ManorCare's negligence was a cause of Barber's death and injuries. The jury apportioned 80 percent of the negligence to ManorCare and 20 percent to two certified nurse practitioners who contracted with the company but were not its employees. ManorCare attorney R.E. Thompson said the company will file post-trial motions, which typically seek to overturn the jury verdict or to reduce or eliminate punitive damages."
PREVENTING MALPRACTICE AND MEDICAL ERRORS
One of my favorite radio shows is The People's Pharmacy - a show based out of the Raleigh Durham N.C. area that airs on public radio. Tomorrow, the program is on how to prevent or avoid malpractice / medical errors from being committed against you. It should be interesting. For a listing schedule - check out www.npr.org, and to follow up with the show itself, check out their website and blog.
ARKANSAS SUPREME COURT ALLOWS CLASS-ACTION AGAINST NURSING HOME
A lawsuit against a Fort Smith, Arkansas based nursing home company can proceed as a class-action suit, the state Supreme Court ruled Thursday. The court affirmed a decision by the trial court which granted class-action certification to a suit alleging Batesville Nursing and Rehabilitation Center failed to live up to contractual and legal obligations to take care of the basic daily needs of hundreds of residents.
The suit, filed in 2005 by Annette Thomas, names the nursing home and its parent company, which was known in 2005 as Beverly Enterprises, as defendants. Beverly changed its name to Golden Horizons last year following its purchase by Golden Gate National Senior Care. The suit alleges between Sept. 13, 2000, and June 30, 2004, the nursing home failed to properly care for 489 residents by, among other things, failing to provide adequate staffing and failing to provide a clean, safe living environment.
This is a great victory for victims of nursing home abuse! Many nursing homes defend civil lawsuits by outspending the plaintiff’s by hiring medical experts to testify that appropriate care was provided. Few individuals have the financial ability to compete with the nursing home industry. Now, at least in Arkansas, the playing field has been leveled.
Read the newspaper report and the Supreme Court decision.
The suit, filed in 2005 by Annette Thomas, names the nursing home and its parent company, which was known in 2005 as Beverly Enterprises, as defendants. Beverly changed its name to Golden Horizons last year following its purchase by Golden Gate National Senior Care. The suit alleges between Sept. 13, 2000, and June 30, 2004, the nursing home failed to properly care for 489 residents by, among other things, failing to provide adequate staffing and failing to provide a clean, safe living environment.
This is a great victory for victims of nursing home abuse! Many nursing homes defend civil lawsuits by outspending the plaintiff’s by hiring medical experts to testify that appropriate care was provided. Few individuals have the financial ability to compete with the nursing home industry. Now, at least in Arkansas, the playing field has been leveled.
Read the newspaper report and the Supreme Court decision.
PENNSYLVANIA: 175 SURGICAL MISTAKES IN 30 MONTHS!
In one case, doctors removed a patient's healthy thyroid after a laboratory mix-up led to an incorrect cancer diagnosis. In another, a neurosurgeon halted a procedure after making an incision on the wrong side of the patient's head. In yet another, a surgeon inserted a needle into a patient's right knee before realizing that the operation was planned for the other leg.
Those surgical misadventures are examples of the 175 errors made by hospitals and surgery centers in Pennsylvania, according to a report released Tuesday from the state's Patient Safety Authority. The survey, the first of its kind, covered the 21/2 years that ended Dec. 31.
Read the newspaper account.
Those surgical misadventures are examples of the 175 errors made by hospitals and surgery centers in Pennsylvania, according to a report released Tuesday from the state's Patient Safety Authority. The survey, the first of its kind, covered the 21/2 years that ended Dec. 31.
Read the newspaper account.
Thursday, June 28, 2007
IS YOUR HOSPITAL TAKING STEPS TO PREVENT INFECTION?
We have all read the stories in the newspaper about otherwise infection free patients contracting horrible and often antibiotic-resistant bacterial infections while in the hospital. It looks like some hospitals are finally doing something about this serious problem.
The Wall Street Journal reported on June 26 that several hospitals are aggressively screening patients with new tests which can rapidly detect one of the most problematic infections – methicillin-resistant staphylococcus (MRSA). Both Newark Beth Israel Medical Center and the University of Maryland Medical Center have been conducting the new tests. The testing allows the hospitals to isolate patients carrying the infection to prevent its spread.
Hey – Carilion Roanoke Memorial Hospital, Danville Regional Medical Center, Memorial Hospital of Martinsville and Henry County, Carilion New River Valley Medical Center, and many others…. Are you guys testing for MRSA?
Read what the Center for Disease Control has to say about MRSA.
The Wall Street Journal reported on June 26 that several hospitals are aggressively screening patients with new tests which can rapidly detect one of the most problematic infections – methicillin-resistant staphylococcus (MRSA). Both Newark Beth Israel Medical Center and the University of Maryland Medical Center have been conducting the new tests. The testing allows the hospitals to isolate patients carrying the infection to prevent its spread.
Hey – Carilion Roanoke Memorial Hospital, Danville Regional Medical Center, Memorial Hospital of Martinsville and Henry County, Carilion New River Valley Medical Center, and many others…. Are you guys testing for MRSA?
Read what the Center for Disease Control has to say about MRSA.
CHRONIC AILMENTS IN KIDS - MEANS MORE ELDERLY WITH DISABILITIES IN LONG RUN
Chronic Ailments Affect More Kids
Associated PressWednesday, June 27, 2007; Page A05
"The number of American children with chronic health problems such as obesity, asthma and attention-deficit hyperactivity disorder has soared in the past four decades, foreshadowing increases in adult disability and public health-care spending, researchers said yesterday.
More time in front of the television and the use of other electronic media, decreased physical activity, increased time spent indoors, increased consumption of fast foods and sugar-sweetened beverages, and changes in parenting are probably all to blame, the researchers wrote in the Journal of the American Medical Association.
In 1960, 1.8 percent of children and adolescents were reported to have a chronic health condition that limited their activities. By 2004, the rate was 7 percent."
So what does that mean for long term care facilities in 50-60 years? Surely the needs will increase as a greater percentage of the population has chronic health problems. It also means, Medicare and State Medicaid programs better be ready. You think Congress is ready for a surge? Me neither.
Associated PressWednesday, June 27, 2007; Page A05
To read the Washington Post Article - go here.
"The number of American children with chronic health problems such as obesity, asthma and attention-deficit hyperactivity disorder has soared in the past four decades, foreshadowing increases in adult disability and public health-care spending, researchers said yesterday.
More time in front of the television and the use of other electronic media, decreased physical activity, increased time spent indoors, increased consumption of fast foods and sugar-sweetened beverages, and changes in parenting are probably all to blame, the researchers wrote in the Journal of the American Medical Association.
In 1960, 1.8 percent of children and adolescents were reported to have a chronic health condition that limited their activities. By 2004, the rate was 7 percent."
So what does that mean for long term care facilities in 50-60 years? Surely the needs will increase as a greater percentage of the population has chronic health problems. It also means, Medicare and State Medicaid programs better be ready. You think Congress is ready for a surge? Me neither.
REDUCE THE RISK OF DEHYDRATION WITH NURSING HOME RESIDENTS
Dehydration is a recurring problem for residents in nursing homes. Many elderly suffer from swallowing problems which can lead to reduced fluid intake and multiple and serious medical complications. Based on the findings of a study that looked at nutrition and hydration in nursing home residents, consultant Jeanie Kayser-Jones, RN, PhD, FAAN, made the following recommendations to reduce the risk of dehydration:
1. Older people should have 1,500 to 2,000 ml of liquids each day.
2. Nursing homes should provide education programs on the importance of adequate fluid intake, and they should teach their staff members how to give beverages safely.
3. Staff members should provide residents with a variety of beverages of their choice.
4. Staff members should make beverages available and accessible to residents throughout the day.
5. Nursing homes should have enough staff to assist residents who cannot drink independently. Kayser-Jones recommends that certified nursing assistants (CNAs) have no more than two to three residents to feed at mealtime. (That is a big boost from typical staffing levels of one CNA for every seven to nine residents.)
6. Professional staff such as registered nurses (RNs) and licensed vocational nurses (LVNs) should supervise the fluid intake of residents.
7. RNs, physicians, dietitians, and speech pathologists should work with LVNs and CNAs to ensure that residents drink enough beverages safely. Nursing homes cannot delegate this part of care to CNAs, Kayser-Jones says.
8. Nursing staff should accurately measure intake and output of all fluids for any residents who are at risk for dehydration.
9. Nursing homes should develop a systematic plan to ensure adequate fluid intake for residents. If, for example, residents drink between 300-450ml (1 1/2 to 2 eight-ounce glasses) at each meal, and 8 ounces between meals and at bedtime, they would consume 1,620-2,070 ml per day, which meets the recommended minimum amount.
10. Special attention to fluid intake during hot weather is essential, as older people can easily become dehydrated and die if they do not receive adequate fluids, according to Kayser.
1. Older people should have 1,500 to 2,000 ml of liquids each day.
2. Nursing homes should provide education programs on the importance of adequate fluid intake, and they should teach their staff members how to give beverages safely.
3. Staff members should provide residents with a variety of beverages of their choice.
4. Staff members should make beverages available and accessible to residents throughout the day.
5. Nursing homes should have enough staff to assist residents who cannot drink independently. Kayser-Jones recommends that certified nursing assistants (CNAs) have no more than two to three residents to feed at mealtime. (That is a big boost from typical staffing levels of one CNA for every seven to nine residents.)
6. Professional staff such as registered nurses (RNs) and licensed vocational nurses (LVNs) should supervise the fluid intake of residents.
7. RNs, physicians, dietitians, and speech pathologists should work with LVNs and CNAs to ensure that residents drink enough beverages safely. Nursing homes cannot delegate this part of care to CNAs, Kayser-Jones says.
8. Nursing staff should accurately measure intake and output of all fluids for any residents who are at risk for dehydration.
9. Nursing homes should develop a systematic plan to ensure adequate fluid intake for residents. If, for example, residents drink between 300-450ml (1 1/2 to 2 eight-ounce glasses) at each meal, and 8 ounces between meals and at bedtime, they would consume 1,620-2,070 ml per day, which meets the recommended minimum amount.
10. Special attention to fluid intake during hot weather is essential, as older people can easily become dehydrated and die if they do not receive adequate fluids, according to Kayser.
Wednesday, June 27, 2007
ER DOCTOR BLOGS ON NURSING HOME RECORDS
Check out an insightful blog from an ER Physician, on nursing home records - here:
DOCTOR WRITES:
"There is a new, intentional and horrible trend in nursing home transfers to the ED, and it’s not the patients. It’s the records that come with them, or more specifically those that don’t. Allow me to explain.
The patient is sent with a chief complaint, a lot of weeks-to-month-old labs and a medication list, but all the administration times have been cut off from their typed MAR’s. (MAR stands for Medication Administration Record, and is the only written record of which patient got what medicine, when). Got that? A patient sent from a nursing home comes into the ED with a list of their medications, but the list has the times and dates of administration removed. Intentionally. They come in with little strips of paper with the medication names and doses, but the administration times are on the paper that wasn’t sent. That’s not an accident. Definitely not.
When they’re my patients I now ask for a faxing of the patient’s MAR from the nursing home with the removed information included, because it is, you know, part of the medical record, and may well be useful in the diagnosis and treatment of the patient. A patient often sent in with “AMS” (altered mental status) as the one-line explanation for the transfer, and the patient is on several (usually more than a dozen) medications, at least a third of which could cause an altered mental status. It would, in that case, be nice to know if they got their regular, let alone their PRN (as needed) sedative(s), as well as all their other medications.
The kicker is, since I cannot determine when their medications were administered (because the times were cut off of the copies sent to the ED), a lot of very useful information is now denied to me, the ED physician, and then most likely to the admitting team, since none of us can say who got what medication, and cannot account for their altered mental status. (I’m using AMS as the example here, but there are other complaints that could be medication related).
This intentional removal has happened often enough ( from different nursing homes and at different ED’s) that it’s clearly part of an organized effort on the part of Nursing Homes. I’m at a loss to think of a single innocent reason why this practice would have started. When I’ve called personally to have the information faxed (for patient care, the reason they sent the patient to the ED) the Nursing Home nurses routinely say that “It’s policy”, and then sometimes send the information, and sometimes they don’t.
This is, frankly, outrageous. A chronicaly ill patient is sent to a higher level of care for an acute problem, and without a complete information base; but not just that, information crucial to the care of the patient that’s being intentionally withheld."...
Read it all
WOW - that is incredible, and I agree, outrageous.
DOCTOR WRITES:
"There is a new, intentional and horrible trend in nursing home transfers to the ED, and it’s not the patients. It’s the records that come with them, or more specifically those that don’t. Allow me to explain.
The patient is sent with a chief complaint, a lot of weeks-to-month-old labs and a medication list, but all the administration times have been cut off from their typed MAR’s. (MAR stands for Medication Administration Record, and is the only written record of which patient got what medicine, when). Got that? A patient sent from a nursing home comes into the ED with a list of their medications, but the list has the times and dates of administration removed. Intentionally. They come in with little strips of paper with the medication names and doses, but the administration times are on the paper that wasn’t sent. That’s not an accident. Definitely not.
When they’re my patients I now ask for a faxing of the patient’s MAR from the nursing home with the removed information included, because it is, you know, part of the medical record, and may well be useful in the diagnosis and treatment of the patient. A patient often sent in with “AMS” (altered mental status) as the one-line explanation for the transfer, and the patient is on several (usually more than a dozen) medications, at least a third of which could cause an altered mental status. It would, in that case, be nice to know if they got their regular, let alone their PRN (as needed) sedative(s), as well as all their other medications.
The kicker is, since I cannot determine when their medications were administered (because the times were cut off of the copies sent to the ED), a lot of very useful information is now denied to me, the ED physician, and then most likely to the admitting team, since none of us can say who got what medication, and cannot account for their altered mental status. (I’m using AMS as the example here, but there are other complaints that could be medication related).
This intentional removal has happened often enough ( from different nursing homes and at different ED’s) that it’s clearly part of an organized effort on the part of Nursing Homes. I’m at a loss to think of a single innocent reason why this practice would have started. When I’ve called personally to have the information faxed (for patient care, the reason they sent the patient to the ED) the Nursing Home nurses routinely say that “It’s policy”, and then sometimes send the information, and sometimes they don’t.
This is, frankly, outrageous. A chronicaly ill patient is sent to a higher level of care for an acute problem, and without a complete information base; but not just that, information crucial to the care of the patient that’s being intentionally withheld."...
Read it all
WOW - that is incredible, and I agree, outrageous.
ELDER CARE RESOURCES
Thanks to USA Today for the following list of resources to help you care for your aging loved one.
National Family Caregivers Association
www.thefamilycaregiver.org
This site provides information about organizations providing caregiver support, tips for family caregivers, workshops and educational campaigns.
BenefitsCheckUp
www.benefitscheckup.org
This site, a service of the National Council on Aging, provides information on more than 1,550 public and private benefits programs in all 50 states and the District of Columbia. It offers information on programs that help low-income seniors pay for everything from prescription drugs to electricity bills. You can also use the site to apply for benefits programs.
Medicare.gov
The official site for Medicare, the federal health insurance program for people 65 and older. Click on "Medicare & You 2007" to learn what Medicare covers — and, perhaps more important, what it doesn't cover. Seniors and caregivers can also use this site to compare prescription drug plans and supplemental insurance policies. You can also use the site to search for Medicare- and Medicaid-certified nursing homes in your area.
National Association of Professional Geriatric Care Managers
www.caremanager.org
NAPGCM is the primary trade group for geriatric care managers, professionals who help family members monitor and manage care for aging parents. You can use the site to search for a care manager in your area.
Eldercare Locator
www.eldercare.gov
A nationwide directory of support services for older Americans and their caregivers.
LongTermCareLiving.com
This site, sponsored by the National Center for Assisted Living and the American Health Care Association, provides information about assisted living, nursing homes and other types of long-term care.
AARP
www.aarp.org/families
Site offers information on caregiving, housing for seniors, legal issues and driver safety. Also includes tips on hiring a home health care worker.
National Family Caregivers Association
www.thefamilycaregiver.org
This site provides information about organizations providing caregiver support, tips for family caregivers, workshops and educational campaigns.
BenefitsCheckUp
www.benefitscheckup.org
This site, a service of the National Council on Aging, provides information on more than 1,550 public and private benefits programs in all 50 states and the District of Columbia. It offers information on programs that help low-income seniors pay for everything from prescription drugs to electricity bills. You can also use the site to apply for benefits programs.
Medicare.gov
The official site for Medicare, the federal health insurance program for people 65 and older. Click on "Medicare & You 2007" to learn what Medicare covers — and, perhaps more important, what it doesn't cover. Seniors and caregivers can also use this site to compare prescription drug plans and supplemental insurance policies. You can also use the site to search for Medicare- and Medicaid-certified nursing homes in your area.
National Association of Professional Geriatric Care Managers
www.caremanager.org
NAPGCM is the primary trade group for geriatric care managers, professionals who help family members monitor and manage care for aging parents. You can use the site to search for a care manager in your area.
Eldercare Locator
www.eldercare.gov
A nationwide directory of support services for older Americans and their caregivers.
LongTermCareLiving.com
This site, sponsored by the National Center for Assisted Living and the American Health Care Association, provides information about assisted living, nursing homes and other types of long-term care.
AARP
www.aarp.org/families
Site offers information on caregiving, housing for seniors, legal issues and driver safety. Also includes tips on hiring a home health care worker.
TIPS ON GETTING THE BEST CARE FOR YOUR AGING LOVED ONE
USA Today is running a series this week on “Role Reversal – Your Aging Parents and You.” One article provides several tips on caring for your aging parent including:
- Don’t wait for a crisis. You can make more informed choices if you are not also reacting to an emergency, such as a fall or a stroke.
- Avoid role reversal. Even though you will be caring for them, you are not your parent’s parent. They will make their own choices and you have to respect that, even if you do not agree with their choice.
- Find out what resources are available. The Family Caregiver Alliance provides a database of publicly funded caregiving resources in every state. You can also use a service of the National Council on Aging at www.benefitscheckup.org
- Manage from afar. There are many resources now for children who live farther away from their parents. You can find information about agencies in your parent’s area through the Eldercare Locator.
Something new that has come around in recent years are geriatric managers who help families coordinate the care of their loved ones. They usually charge by the hour and are willing to check in on your family members and help you manage and monitor their care. You can find one near you at www.caremanager.org.
Stay tuned as we bring you more news from this series. You can also check out the full series here.
- Don’t wait for a crisis. You can make more informed choices if you are not also reacting to an emergency, such as a fall or a stroke.
- Avoid role reversal. Even though you will be caring for them, you are not your parent’s parent. They will make their own choices and you have to respect that, even if you do not agree with their choice.
- Find out what resources are available. The Family Caregiver Alliance provides a database of publicly funded caregiving resources in every state. You can also use a service of the National Council on Aging at www.benefitscheckup.org
- Manage from afar. There are many resources now for children who live farther away from their parents. You can find information about agencies in your parent’s area through the Eldercare Locator.
Something new that has come around in recent years are geriatric managers who help families coordinate the care of their loved ones. They usually charge by the hour and are willing to check in on your family members and help you manage and monitor their care. You can find one near you at www.caremanager.org.
Stay tuned as we bring you more news from this series. You can also check out the full series here.
TENESSEE NURSING HOME BARRED FROM ADMITTING NEW RESIDENTS
Nashville's city-owned Bordeaux nursing home is being fined and stripped of its ability to accept new patients because of violations uncovered by state inspectors.
This is not the first time that Bordeaux has had problems. The U.S. Department of Justice began looking into the nursing home in March 2003, following state reports that found serious problems with patient care. The federal government found that Bordeaux was violating its patients' rights under the federal Civil Rights of Institutionalized Persons Act and threatened the nursing home with a lawsuit if it didn't fix the problems.
Follow the story here.
This is not the first time that Bordeaux has had problems. The U.S. Department of Justice began looking into the nursing home in March 2003, following state reports that found serious problems with patient care. The federal government found that Bordeaux was violating its patients' rights under the federal Civil Rights of Institutionalized Persons Act and threatened the nursing home with a lawsuit if it didn't fix the problems.
Follow the story here.
Tuesday, June 26, 2007
SICKO: THE MOVIE
Well it’s finally here… Michael Moore’s much ballyhooed movie, “Sicko,” which takes a very hard look at the American health care system. I know the American Medical Association will hate it! I know the health insurance industry will hate it! I know the pharmaceutical giants will hate it! I know I am going to see and enjoy it!
I won’t believe everything I see and hear but the movie should help motivate those living in the dark as to the very serious problems with the health care industry!
See you at the movies!
I won’t believe everything I see and hear but the movie should help motivate those living in the dark as to the very serious problems with the health care industry!
See you at the movies!
GENERIC DRUGS MAY NOT BE SAFE
We have heard almost every day this month - something exported from China has problems. This week, The Washington Post writer Marc Kaufman took a detailed look into regulation of generic drugs made overseas - read it here.
"India and China, countries where the Food and Drug Administration rarely conducts quality-control inspections, have become major suppliers of low-cost drugs and drug ingredients to American consumers. Analysts say their products are becoming pervasive in the generic and over-the-counter marketplace.
Over the past seven years, amid explosive growth in imports from India and China, the FDA conducted only about 200 inspections of plants in those countries, and a few were the kind that U.S. firms face regularly to ensure that the drugs they make are of high quality...
"Five years ago, Chinese drugmakers exported about $300 million worth of products to the United States. Eager to meet Americans' demand for lower-cost medicines, they, too, have expanded rapidly. Last year, they sold more than $675 million in pharmaceutical ingredients and products in the U.S. market."
Are these drugs being checked by FDA? The article goes on to say the checks are not sufficient. Read more about the problems with generic drugs, and testing - at the peoplespharmacy.com Blog - here.
Maybe now we will think twice before telling our physicians we will take the generic brand.
"India and China, countries where the Food and Drug Administration rarely conducts quality-control inspections, have become major suppliers of low-cost drugs and drug ingredients to American consumers. Analysts say their products are becoming pervasive in the generic and over-the-counter marketplace.
Over the past seven years, amid explosive growth in imports from India and China, the FDA conducted only about 200 inspections of plants in those countries, and a few were the kind that U.S. firms face regularly to ensure that the drugs they make are of high quality...
"Five years ago, Chinese drugmakers exported about $300 million worth of products to the United States. Eager to meet Americans' demand for lower-cost medicines, they, too, have expanded rapidly. Last year, they sold more than $675 million in pharmaceutical ingredients and products in the U.S. market."
Are these drugs being checked by FDA? The article goes on to say the checks are not sufficient. Read more about the problems with generic drugs, and testing - at the peoplespharmacy.com Blog - here.
Maybe now we will think twice before telling our physicians we will take the generic brand.
NURSE SHORTAGE
There was a good, but discouraging feature on NPR a few weeks ago - on the shortage of nurses nationwide. Read and listen to the feature, here.
All Things Considered
U.S. Faces Critical Nurse Shortage
"The demand for nurses is expected to outstrip the number coming out of nursing schools in the coming years, as some 80 million baby-boomers near retirement age.
Although applications to nursing schools are up 40 percent from a decade ago, there aren't enough educators to train them.
Nursing educators are on average even older than their RN colleagues, and half of them are expected to retire within the decade.
At Brigham and Women's Hospital in Boston, Jean Cabral, 58, has been an intensive care nurse for more than 30 years. Last year, however, she injured her shoulder while trying to lift a patient."...
"Nurses who get a higher degree can make a lot more money nursing than they can teaching. They are also choosing other higher paying jobs in biotech, insurance and the pharmaceutical industry.
"Why would I want to be an educator when my salary is 50 percent of my colleague who is VP of nursing in the local hospital?" asks Mary Jane Williams, who teaches nursing at the University of Hartford.
There's a lack of nurse educators in both the classroom and on the hospital floor. This has caused a bottleneck and most nursing programs have long waiting lists. In 2005, 147,000 qualified applicants were turned away from U.S. nursing schools.
"We're thriving, but we're also overwhelmed by trying to meet the demand for our school," said Judy Shindul Rothschild, a professor at the Boston College School of Nursing.
Last year, Boston College turned away 650 applicants to its nursing schools. This year, the college doubled its class size but, like most nursing programs, is struggling to find faculty.
"We beg, borrow and steal," Rothschild said. "Boston College is trying to come up with all sorts of benefits for our clinical faculty to entice them – football tickets, hockey tickets. I'm not above scrounging for anything to entice people because the money is not terrific."
Schools have raised faculty salaries in an effort to compete with more lucrative industry jobs.
Several states are also trying to address the issue, but the White House wants to cut federal aid to nursing schools. Many see this as a shortsighted plan.
"We are not going to forever have all this interest in nursing," said Peter Buerhaus, a professor of nursing at Vanderbilt University.
"The more we turn people away, the less likely they are to come back next year. We're not talking about a lot of money, were talking at most $1 billion, which is decimal dust," he said.
Even if the U.S. manages to train more nurses, the federal government estimates there will need to be a 90 percent increase in the number of nurse graduates to meet the demand."
All Things Considered
U.S. Faces Critical Nurse Shortage
"The demand for nurses is expected to outstrip the number coming out of nursing schools in the coming years, as some 80 million baby-boomers near retirement age.
Although applications to nursing schools are up 40 percent from a decade ago, there aren't enough educators to train them.
Nursing educators are on average even older than their RN colleagues, and half of them are expected to retire within the decade.
At Brigham and Women's Hospital in Boston, Jean Cabral, 58, has been an intensive care nurse for more than 30 years. Last year, however, she injured her shoulder while trying to lift a patient."...
"Nurses who get a higher degree can make a lot more money nursing than they can teaching. They are also choosing other higher paying jobs in biotech, insurance and the pharmaceutical industry.
"Why would I want to be an educator when my salary is 50 percent of my colleague who is VP of nursing in the local hospital?" asks Mary Jane Williams, who teaches nursing at the University of Hartford.
There's a lack of nurse educators in both the classroom and on the hospital floor. This has caused a bottleneck and most nursing programs have long waiting lists. In 2005, 147,000 qualified applicants were turned away from U.S. nursing schools.
"We're thriving, but we're also overwhelmed by trying to meet the demand for our school," said Judy Shindul Rothschild, a professor at the Boston College School of Nursing.
Last year, Boston College turned away 650 applicants to its nursing schools. This year, the college doubled its class size but, like most nursing programs, is struggling to find faculty.
"We beg, borrow and steal," Rothschild said. "Boston College is trying to come up with all sorts of benefits for our clinical faculty to entice them – football tickets, hockey tickets. I'm not above scrounging for anything to entice people because the money is not terrific."
Schools have raised faculty salaries in an effort to compete with more lucrative industry jobs.
Several states are also trying to address the issue, but the White House wants to cut federal aid to nursing schools. Many see this as a shortsighted plan.
"We are not going to forever have all this interest in nursing," said Peter Buerhaus, a professor of nursing at Vanderbilt University.
"The more we turn people away, the less likely they are to come back next year. We're not talking about a lot of money, were talking at most $1 billion, which is decimal dust," he said.
Even if the U.S. manages to train more nurses, the federal government estimates there will need to be a 90 percent increase in the number of nurse graduates to meet the demand."
TEXAS SUES DRUG COMPANIES
According to the Houston Chronicle, Texas is suing three drug companies alleging the companies took advantage of the Medicare system and cost the state tens of millions of dollars in overpayments.
The lawsuit was filed against Sandoz, Inc. of New Jersey, Mylan Laboratories of Pennsylvania and Teva Pharmaceuticals, Inc., along with some of their subsidiaries. Texas Attorney General, Greg Abbott, alleged the companies sold Medicaid-covered drugs to large retailers at deep discounts that were not reported to the state. The Texas Medicaid program sets their reimbursements for drugs based upon prices which are disclosed by the drug manufacturers. The failure of the drug companies to report the discounts resulted in the state’s overpayment for drugs. The retailers are not named in the suit because they are not required to disclose their drug prices. The purpose of the discounts was to encourage retailers to purchase drugs from these companies, thus increasing their profit.
Read the full article here.
The lawsuit was filed against Sandoz, Inc. of New Jersey, Mylan Laboratories of Pennsylvania and Teva Pharmaceuticals, Inc., along with some of their subsidiaries. Texas Attorney General, Greg Abbott, alleged the companies sold Medicaid-covered drugs to large retailers at deep discounts that were not reported to the state. The Texas Medicaid program sets their reimbursements for drugs based upon prices which are disclosed by the drug manufacturers. The failure of the drug companies to report the discounts resulted in the state’s overpayment for drugs. The retailers are not named in the suit because they are not required to disclose their drug prices. The purpose of the discounts was to encourage retailers to purchase drugs from these companies, thus increasing their profit.
Read the full article here.
FORMER LPN BLOGS ABOUT HER NURSING HOME EMPLOYER
There is an Internet site called JobSchmob.com where anyone can post information, rants, etc. about their job. The post that most interests me is one entitled “Valley View nursing home in Williamsport PA is DEATH VALLEY VIEW!” You can view Valley View's website here.
This post is from a former LPN that worked at a nursing home and is now fighting an uphill battle to have that nursing home shut down for good! She talks about things that we see in many of our cases, residents being abused and neglected and even dying just before they were to be released from the nursing home!
This is the type of environment we are trying to fight! In an ideal world, there wouldn’t be a need for our services in nursing home litigation. However, the world we live in is far from ideal as the poor care and neglect discussed in this LPN’s blog occur in nursing homes around the country every day.
The best advice we can give you when you have a loved one in a nursing home is to stay on top of their care and visit often and at unannounced times!
There is an article on our website entitled “Nursing Home Visitation Rights” which informs you of your rights regarding visitation. If you have a loved one in a nursing home, there are many articles on our site which can help guide you along the way so that you or your loved one don’t end up as part of a story like the one on Valley View Nursing Home.
This post is from a former LPN that worked at a nursing home and is now fighting an uphill battle to have that nursing home shut down for good! She talks about things that we see in many of our cases, residents being abused and neglected and even dying just before they were to be released from the nursing home!
This is the type of environment we are trying to fight! In an ideal world, there wouldn’t be a need for our services in nursing home litigation. However, the world we live in is far from ideal as the poor care and neglect discussed in this LPN’s blog occur in nursing homes around the country every day.
The best advice we can give you when you have a loved one in a nursing home is to stay on top of their care and visit often and at unannounced times!
There is an article on our website entitled “Nursing Home Visitation Rights” which informs you of your rights regarding visitation. If you have a loved one in a nursing home, there are many articles on our site which can help guide you along the way so that you or your loved one don’t end up as part of a story like the one on Valley View Nursing Home.
MORE PROBLEMS FOR DANVILLE REGIONAL MEDICAL CENTER
Danville Regional Medical Center (DRMC) was purchased by Nashville, TN based Lifepoint Hospitals, Inc. in 2005….and the problems have not stopped since! The last two years brought about a number of changes at the management level, including last week’s announced departure of the hospital’s fourth CEO since 2005. More importantly for hospital patients, DRMC was Virginia’s only hospital to receive a preliminary withdrawal of accreditation status by the Joint Commission.
Sadly, it appears Lifepoint’s biggest concern is not about providing excellent patient care but realizing a good return on its investment! Read this newspaper account.
Sadly, it appears Lifepoint’s biggest concern is not about providing excellent patient care but realizing a good return on its investment! Read this newspaper account.
Monday, June 25, 2007
IS YOUR SURGEON SCAMMING YOU?
The sub-title on this article sends chills down my spine…” Doctors across the country keep wheeling us in and cutting us open, even when they’re missing something vitally important: a good reason.”
Here at Legal Medicine, we are always suggesting that you need to take charge of your own medical care. Here is another reason why.
In an article on MSN and also on Men’s Health, they list these questions that you should ask your doctor:
1. How necessary is this procedure? Some doctors are salesman in that they know the odds you will come back to purchase drop dramatically once you leave their office.
2. What are the alternatives to surgery? There is almost always an alternative to invasive or risky surgeries.
3. What will this test show? Some tests show anomalies that might otherwise go unnoticed. But just because you have an anomaly doesn’t mean you are sick and need treatment right away.
4. Can I see a specialist in another group? Doctors who work closely with one another will tend to have the same views and opinions on treatment. When you get a referral, ask to see someone outside of your doctor’s group.
Surgeons performing unnecessary surgeries has been a problem from the start of medicine. In 1974, Congress supported a major investigation into unnecessary surgeries and found that surgeons had performed 2.4 million unnecessary operations, resulting in a price tag of almost $4 billion and 11,900 deaths. It has been just over 30 years since that first study and the numbers have remained disturbingly steady.
Dr. Ronald Grelsamer , an orthopedic surgeon and knee specialist at Mount Sinai Medical Center is quoted, “The only defenses for a patient in today’s climate are skepticism and education…If you take your sore knee to a doctor and he orders an MRI before thoroughly examining you, then get off the table and limp out as fast as possible. There is no replacement for listening to a patient and thinking through a problem. Unfortunately, a lot of doctors, and a whole lot of patients, think surgery can be a substitute. The end result is a whole lot of pain.”
I don’t think it could be better said. So…do your homework and don’t just accept surgery as the only option. You will only be helping yourself!
Read the full article here.
Here at Legal Medicine, we are always suggesting that you need to take charge of your own medical care. Here is another reason why.
In an article on MSN and also on Men’s Health, they list these questions that you should ask your doctor:
1. How necessary is this procedure? Some doctors are salesman in that they know the odds you will come back to purchase drop dramatically once you leave their office.
2. What are the alternatives to surgery? There is almost always an alternative to invasive or risky surgeries.
3. What will this test show? Some tests show anomalies that might otherwise go unnoticed. But just because you have an anomaly doesn’t mean you are sick and need treatment right away.
4. Can I see a specialist in another group? Doctors who work closely with one another will tend to have the same views and opinions on treatment. When you get a referral, ask to see someone outside of your doctor’s group.
Surgeons performing unnecessary surgeries has been a problem from the start of medicine. In 1974, Congress supported a major investigation into unnecessary surgeries and found that surgeons had performed 2.4 million unnecessary operations, resulting in a price tag of almost $4 billion and 11,900 deaths. It has been just over 30 years since that first study and the numbers have remained disturbingly steady.
Dr. Ronald Grelsamer , an orthopedic surgeon and knee specialist at Mount Sinai Medical Center is quoted, “The only defenses for a patient in today’s climate are skepticism and education…If you take your sore knee to a doctor and he orders an MRI before thoroughly examining you, then get off the table and limp out as fast as possible. There is no replacement for listening to a patient and thinking through a problem. Unfortunately, a lot of doctors, and a whole lot of patients, think surgery can be a substitute. The end result is a whole lot of pain.”
I don’t think it could be better said. So…do your homework and don’t just accept surgery as the only option. You will only be helping yourself!
Read the full article here.
CLASS ACTION NURSING HOME SUIT
Arkansas Supreme Court upholds prior ruling to allow a class action lawsuit againt nursing home owned by Beverly Healthcare (who owns/owned nursing homes across the United States, including Virginia). Read the latest here:
"On May 1, 2006, Harkey granted class-action certification to the suit with respect to claims of statutory and contractual violations only, not claims of malpractice or personal injury. The defendants appealed that ruling.In oral arguments before the Supreme Court last week, Little Rock attorney Sam Jones argued against class-action certification, saying it would be impossible to examine the issues in the case and, if necessary, determine appropriate damages without considering each plaintiff separately.
"You're not going to have uniformity," Jones told the justices. "You're not going to have homogeneity. You're going to have a mixed bag."Attorney Philip Bohrer of Baton Rouge, La., argued the case did not include personal injury claims, but rather claims involving issues such as understaffing which would have affected all residents of the facility. Granting class-action status was preferable to "having 400 individual trials on the same issue and the same evidence," he said. Bohrer also said many of the plaintiffs are elderly and unaware of their rights and would not be able to file individual claims against the company. In its decision Thursday, the Supreme Court said the plaintiffs showed the case met the criteria for class-action certification. The justices agreed with Harkey the defendants would benefit from class-action status."A class action is clearly a more efficient way of handling a case where there is a predominating, common issue to be resolved for all 489 class members. A class action is also fair to both sides in this case, as it is a vehicle for all class members to have their claims heard, and Beverly will not have to defend against the same assertion of liability in a multitude of different lawsuits," Justice Robert Brown wrote.
Article By John Lyon
"On May 1, 2006, Harkey granted class-action certification to the suit with respect to claims of statutory and contractual violations only, not claims of malpractice or personal injury. The defendants appealed that ruling.In oral arguments before the Supreme Court last week, Little Rock attorney Sam Jones argued against class-action certification, saying it would be impossible to examine the issues in the case and, if necessary, determine appropriate damages without considering each plaintiff separately.
"You're not going to have uniformity," Jones told the justices. "You're not going to have homogeneity. You're going to have a mixed bag."Attorney Philip Bohrer of Baton Rouge, La., argued the case did not include personal injury claims, but rather claims involving issues such as understaffing which would have affected all residents of the facility. Granting class-action status was preferable to "having 400 individual trials on the same issue and the same evidence," he said. Bohrer also said many of the plaintiffs are elderly and unaware of their rights and would not be able to file individual claims against the company. In its decision Thursday, the Supreme Court said the plaintiffs showed the case met the criteria for class-action certification. The justices agreed with Harkey the defendants would benefit from class-action status."A class action is clearly a more efficient way of handling a case where there is a predominating, common issue to be resolved for all 489 class members. A class action is also fair to both sides in this case, as it is a vehicle for all class members to have their claims heard, and Beverly will not have to defend against the same assertion of liability in a multitude of different lawsuits," Justice Robert Brown wrote.
Article By John Lyon
ROANOKE TIMES’ REPORT ON DRUG RESISTANT STAPH INFECTIONS
The Roanoke Times newspaper contained an Associated Press article today (June 25, 2007) entitled “Drug-Resistant Staph Superbug Increasingly Prevalent, Study Says.”
The article is about the shocking numbers of hospital and nursing home patients who are becoming sick with Methicillin-resistant Staphylococcus aureus (MRSA), which cannot be controlled by normal antibiotics. A survey released by the Association for Professionals in Infection Control and Epidemiology reveals that at least 30,000 hospital patients may have this superbug at any one time.
The article stresses the need for better hygiene in all health care settings. Maybe we, as consumers of healthcare, should be asking our doctors and nurses to wash their hands and use protective equipment more frequently.
The article is about the shocking numbers of hospital and nursing home patients who are becoming sick with Methicillin-resistant Staphylococcus aureus (MRSA), which cannot be controlled by normal antibiotics. A survey released by the Association for Professionals in Infection Control and Epidemiology reveals that at least 30,000 hospital patients may have this superbug at any one time.
The article stresses the need for better hygiene in all health care settings. Maybe we, as consumers of healthcare, should be asking our doctors and nurses to wash their hands and use protective equipment more frequently.
HOSPITALS GET REPORT CARD FROM GOVERNMENT
It is reported on MSNBC that the government recently gave hospitals around the country a report card based upon how they have treated patients with heart attacks or heart failure.
Officials scored almost 4,500 hospitals around the country and most performed around the national average when their patient mortality rates were considered. The Secretary of Health and Human Services, Mike Leavitt, explained that posting the performance for the hospitals helps consumers know what type of care they are getting for their money. HHS hopes the postings will motivate the hospitals to improve their care as well.
The ratings took into account the following data for each hospital:
- mortality rate
- patient mix (some hospitals have a larger number of elderly or sick patients)
Rich Umbdenstock, president and CEO of the American Hospital Association said “hospitals strongly back the government’s effort to give consumers information about the quality of care provided.”
Search for your hospital here.
Hospital Compare was created through the efforts of the Centers for Medicare and Medicaid Services (CMS), the Department of Health and Human Services, and other members of the Hospital Quality Alliance: Improving Care Through Information (HQA).
Officials scored almost 4,500 hospitals around the country and most performed around the national average when their patient mortality rates were considered. The Secretary of Health and Human Services, Mike Leavitt, explained that posting the performance for the hospitals helps consumers know what type of care they are getting for their money. HHS hopes the postings will motivate the hospitals to improve their care as well.
The ratings took into account the following data for each hospital:
- mortality rate
- patient mix (some hospitals have a larger number of elderly or sick patients)
Rich Umbdenstock, president and CEO of the American Hospital Association said “hospitals strongly back the government’s effort to give consumers information about the quality of care provided.”
Search for your hospital here.
Hospital Compare was created through the efforts of the Centers for Medicare and Medicaid Services (CMS), the Department of Health and Human Services, and other members of the Hospital Quality Alliance: Improving Care Through Information (HQA).
Saturday, June 23, 2007
VIRGINIA BOARD OF MEDICINE IS BACKLOGGED ON DOCTOR COMPLAINTS
The state Board of Medicine will give staff members more authority over many disciplinary cases to try to reduce a backlog of more than 2,000 complaints against doctors and other health professionals. It is about time!
Under Gov. Timothy M. Kaine's "Virginia Performs" initiative, all of the state boards are being asked to resolve 90 percent of their complaints related to patient care within 250 days. So far this year, the boards have met that goal about 40 percent of the time.
Follow this story.
Under Gov. Timothy M. Kaine's "Virginia Performs" initiative, all of the state boards are being asked to resolve 90 percent of their complaints related to patient care within 250 days. So far this year, the boards have met that goal about 40 percent of the time.
Follow this story.
WV JUDGE SEALS RECORDS IN MEDICAL MALPRACTICE LAWSUITS
I thought we enjoyed an open judicial system in America. Maybe I was wrong!
Legal documents in the numerous lawsuits filed against a former Putnam County General Hospital osteopath have been placed off limits by a West Virginia judge overseeing the cases. The Putnam County Circuit Judge ordered documents sealed in the medical malpractice lawsuits involving Dr. John King. Lawyers representing Putnam General pushed to seal the files due to pretrial publicity. King faces more than 100 medical malpractice lawsuits brought by former patients or their survivors from his seven-month stint at Putnam General. King left the hospital in 2003 and has since changed his name to Christopher Wallace Martin. King's medical privileges have been taken away by West Virginia and several other states.
Follow the story here.
Legal documents in the numerous lawsuits filed against a former Putnam County General Hospital osteopath have been placed off limits by a West Virginia judge overseeing the cases. The Putnam County Circuit Judge ordered documents sealed in the medical malpractice lawsuits involving Dr. John King. Lawyers representing Putnam General pushed to seal the files due to pretrial publicity. King faces more than 100 medical malpractice lawsuits brought by former patients or their survivors from his seven-month stint at Putnam General. King left the hospital in 2003 and has since changed his name to Christopher Wallace Martin. King's medical privileges have been taken away by West Virginia and several other states.
Follow the story here.
PENNSYLVANIA LEGISLATURE DOESN’T TRUST JURIES
Every day jurors decide whether people live or die. Now, the medical and insurance lobbies are pushing a proposal that assumes those same jurors can’t be trusted to sit in judgment of doctors and hospitals in malpractice cases.
“Health Courts” are the latest salvo in the war being waged by powerful health-care special interests against the constitutional right of injured patients to have their cases decided by juries. A bill is pending in Congress to set up pilot programs in 10 states, and legislation has been introduced in the Pennsylvania Legislature to divert all medical malpractice cases to special legal venues. Read the article here.
Is anyone looking out for the consumer of health care?
“Health Courts” are the latest salvo in the war being waged by powerful health-care special interests against the constitutional right of injured patients to have their cases decided by juries. A bill is pending in Congress to set up pilot programs in 10 states, and legislation has been introduced in the Pennsylvania Legislature to divert all medical malpractice cases to special legal venues. Read the article here.
Is anyone looking out for the consumer of health care?
Friday, June 22, 2007
GASTRIC BYPASS HEALS DIABETES?
This morning my local paper, the Roanoke Times, printed a story on how gastric bypass surgery may be treating and or healing type II diabetes in some recipients. Well - apparently, this is not news to everyone.
Diabetes Health printed the following article in May - so while little is know about the long term effects of the surgery, the immediate results seem promising. Check it out here.
"Gastric Bypass Surgery Being Considered as Treatment for Type 2
Linda von Wartburg19 May 2007
Bariatric surgery, formerly used only for treating obesity, is being explored as a cure for type 2 diabetes in normal weight or moderately overweight people.
A recent analysis of 22,094 patients showed that 84 percent who underwent Roux-en-Y gastric bypass (RYGB) experienced complete reversal of their type 2 diabetes. Most of them stopped their oral meds or insulin before they even left the hospital.
Researchers initially thought that weight loss caused the remission of type 2, but new findings are pointing to hormonal and metabolic changes caused by the surgery. Ghrelin, a peptide that stimulates appetite, is decreased after bypass surgery. Other peptides secreted by intestinal cells, including glucagon-like peptide 1 (GLP-1), increase after the operation. (GLP-1 is the protein that Byetta mimics.)
Recently, the RYGB procedure was used on two mildly overweight patients. Within a month post-surgery, these patients had dramatically lower fasting glucose, fasting insulin, and A1c’s.
Specific recommendations regarding the audience for this surgery are due out this summer. The researchers believe that a bit of a turf war may consequently develop between endocrinologists and bariatric surgeons, who have their eye on type 2s as a potential market for surgical procedures."
Source: Medscape Medical NewsAmercian Association of Clinical Endocrinologists
Diabetes Health printed the following article in May - so while little is know about the long term effects of the surgery, the immediate results seem promising. Check it out here.
"Gastric Bypass Surgery Being Considered as Treatment for Type 2
Linda von Wartburg19 May 2007
Bariatric surgery, formerly used only for treating obesity, is being explored as a cure for type 2 diabetes in normal weight or moderately overweight people.
A recent analysis of 22,094 patients showed that 84 percent who underwent Roux-en-Y gastric bypass (RYGB) experienced complete reversal of their type 2 diabetes. Most of them stopped their oral meds or insulin before they even left the hospital.
Researchers initially thought that weight loss caused the remission of type 2, but new findings are pointing to hormonal and metabolic changes caused by the surgery. Ghrelin, a peptide that stimulates appetite, is decreased after bypass surgery. Other peptides secreted by intestinal cells, including glucagon-like peptide 1 (GLP-1), increase after the operation. (GLP-1 is the protein that Byetta mimics.)
Recently, the RYGB procedure was used on two mildly overweight patients. Within a month post-surgery, these patients had dramatically lower fasting glucose, fasting insulin, and A1c’s.
Specific recommendations regarding the audience for this surgery are due out this summer. The researchers believe that a bit of a turf war may consequently develop between endocrinologists and bariatric surgeons, who have their eye on type 2s as a potential market for surgical procedures."
Source: Medscape Medical NewsAmercian Association of Clinical Endocrinologists
Thursday, June 21, 2007
PARENTS SETTLE WRONGFUL BIRTH SUIT FOR $1.5 MILLION
The parents of a Wanaque, New Jersey boy born with severe birth defects have won a $1.5 million settlement in their wrongful birth lawsuit against Physicians for Women of Wayne. The parents alleged that medical professionals responsible for reading a 19-1/2 week sonogram failed to observe a hand defect and diagnosed the pregnancy as normal. Upon his birth in 1997, Michael Matasker was diagnosed with CHARGE Syndrome, a group of birth defects that, in Matasker's case, include deformed hands, heart anomalies, and brain conditions that cause incurable cognitive difficulties.
"Discovery of the defect from the sonogram would have led to more tests that would have shown the multiple deformities," says Robert Hicks, an attorney who represented the family. By the time the problems were picked up, in a later ultrasound performed when the mother began preterm labor, it was too late to terminate the pregnancy, Hicks says. The $1.5 million settlement will fund a special-needs trust for Matasker.
"Discovery of the defect from the sonogram would have led to more tests that would have shown the multiple deformities," says Robert Hicks, an attorney who represented the family. By the time the problems were picked up, in a later ultrasound performed when the mother began preterm labor, it was too late to terminate the pregnancy, Hicks says. The $1.5 million settlement will fund a special-needs trust for Matasker.
NEW REPORT SHOWS SEPSIS IS NOT PROPERLY TREATED
The Institute for Healthcare Improvement (IHI) has highlighted sepsis (an infection of the blood) and identified several deficiencies which may lead to poor outcomes with patients with severe sepsis. The deficiencies include inconsistency in the early diagnosis of severe sepsis and septic shock, inadequate volume resuscitation, delayed use of antibiotics, and failure to control hyperglycemia adequately.
To address these deficiencies, the Surviving Sepsis Campaign and IHI have revised and added to the Surviving Sepsis Guidelines and created 2 sepsis treatment bundles (resuscitation and management) to guide therapy for patients with severe sepsis.
Read the report here.
To address these deficiencies, the Surviving Sepsis Campaign and IHI have revised and added to the Surviving Sepsis Guidelines and created 2 sepsis treatment bundles (resuscitation and management) to guide therapy for patients with severe sepsis.
Read the report here.
Wednesday, June 20, 2007
BREAST CANCER RESEARCH
Check out this article in the Washington Post by RoB Stein: LINK
Breast Cancer Drug Study Canceled
By Rob SteinWashington Post Staff Writer
Wednesday, June 20, 2007
The federal government yesterday canceled a $100 million study designed to test a new generation of drugs to prevent breast cancer in women at risk for the disease.
The National Cancer Institute took the unusual step of terminating the long-planned study, saying the massive project could not be justified amid questions about the study's usefulness and the drugs' safety.
"The numerous scientific concerns . . . are sufficiently formidable that the NCI will not commit to the funding of this particular trial," the agency wrote. "While the . . . study may provide another possible option for women at risk for breast cancer, the dangers of introducing these drugs, with their many known side effects, outweighs their potential until we are better able to determine who will benefit from these interventions and what the longer term effect may be."
The decision was criticized by proponents, who argued that the study would have been crucial to determining the best drugs to prevent breast cancer, potentially protecting thousands of women from the common malignancy.
"We're certainly disappointed," said D. Lawrence Wickerham of the National Surgical Adjuvant Breast and Bowel Project in Pittsburgh, which was organizing the study. "We feel this trial is scientifically valid and one that has the potential to impact the health of thousands of women in this country and around the world."...
_______
Read the rest - but also, consider, does this happen often? Why would the plug get pulled - could it really be about the money, or is there a growing concern about the business of healthcare or rather, the profits of healthcare?
Breast Cancer Drug Study Canceled
By Rob SteinWashington Post Staff Writer
Wednesday, June 20, 2007
The federal government yesterday canceled a $100 million study designed to test a new generation of drugs to prevent breast cancer in women at risk for the disease.
The National Cancer Institute took the unusual step of terminating the long-planned study, saying the massive project could not be justified amid questions about the study's usefulness and the drugs' safety.
"The numerous scientific concerns . . . are sufficiently formidable that the NCI will not commit to the funding of this particular trial," the agency wrote. "While the . . . study may provide another possible option for women at risk for breast cancer, the dangers of introducing these drugs, with their many known side effects, outweighs their potential until we are better able to determine who will benefit from these interventions and what the longer term effect may be."
The decision was criticized by proponents, who argued that the study would have been crucial to determining the best drugs to prevent breast cancer, potentially protecting thousands of women from the common malignancy.
"We're certainly disappointed," said D. Lawrence Wickerham of the National Surgical Adjuvant Breast and Bowel Project in Pittsburgh, which was organizing the study. "We feel this trial is scientifically valid and one that has the potential to impact the health of thousands of women in this country and around the world."...
_______
Read the rest - but also, consider, does this happen often? Why would the plug get pulled - could it really be about the money, or is there a growing concern about the business of healthcare or rather, the profits of healthcare?
Tuesday, June 19, 2007
NEW ADMISSIONS SUSPENDED AT TENNESSEE NURSING HOME
The Tennessee Health Department fined and suspended new admissions to a nursing home in Murfreesboro, Tennessee. The 140-bed nursing home was ordered not to admit any new patients after the state conducted a complaint investigation June 3- 13.
The state also imposed a $3,000 fine on Tennessee Veterans Home for having been cited with immediate jeopardy level deficiencies since June 2006, according to a health department news release. Read the full report here.
This facility has a long track record of problems.
The state also imposed a $3,000 fine on Tennessee Veterans Home for having been cited with immediate jeopardy level deficiencies since June 2006, according to a health department news release. Read the full report here.
This facility has a long track record of problems.
DOES THE HOSPITAL MAKE PEOPLE SICKER?
According to an article on MSNBC, even though it is a standing joke for medical residents, hospitals can be a terrible place for a sick person.
A large number of people (100,000+ according to the Center for Disease Control) end up with potentially deadly infections while they are in the hospital. Incisions which become infected are especially dangerous, as many of the germs in a hospital are more likely to be resistant to the antibiotics a doctor would use to treat them. To further complicate matters, “superbugs” (germs and diseases resistant to the drugs normally used to kill them) are cropping up in alarming numbers.
Worse still, an estimated 40,000 – 100,000 people die each year due to mistakes made by doctors or other healthcare staff. According to this article, “One big problem: Hospital patients may get the wrong drug ONE TIME OUT OF FIVE according to a study by Auburn University.” This means there is a 20% chance that you will be given the wrong medication if you are in the hospital!
These numbers are unacceptable!
A large number of people (100,000+ according to the Center for Disease Control) end up with potentially deadly infections while they are in the hospital. Incisions which become infected are especially dangerous, as many of the germs in a hospital are more likely to be resistant to the antibiotics a doctor would use to treat them. To further complicate matters, “superbugs” (germs and diseases resistant to the drugs normally used to kill them) are cropping up in alarming numbers.
Worse still, an estimated 40,000 – 100,000 people die each year due to mistakes made by doctors or other healthcare staff. According to this article, “One big problem: Hospital patients may get the wrong drug ONE TIME OUT OF FIVE according to a study by Auburn University.” This means there is a 20% chance that you will be given the wrong medication if you are in the hospital!
These numbers are unacceptable!
$850,000 JURY VERDICT IN DANVILLE VIRGINIA
Wow... Medical Facilities of America, Piney Forest Nursing Home was sued in the City of DANVILLE, for the wrongful death of Charlie Musgrove. Check out the Danville Register Bee, that reports: "The family of the 80-year-old claimed his death was caused by dehydration and an infection caused by bedsores." The family and their attorney Jeff Downey claims the facility's negligence caused his death - and a DANVILLE JURY AGREED, awarding the family $850,000 for their loss. THAT'S A BIG VERDICT FOR DANVILLE - HUGE FOR A NURSING HOME CASE. We will keep you updated as we learn more!
MOTION SENSORS DETECT DEMENTIA?
Can Motion Sensors Predict Dementia?
By LAURAN NEERGAARD
The Associated Press
Monday, June 18, 2007; 11:13 PM
WASHINGTON -- Tiny motion sensors are attached to the walls, doorways and even the refrigerator of Elaine Bloomquist's home, tracking the seemingly healthy 86-year-old's daily activity.
It's like spying in the name of science with her permission to see if round-the-clock tracking of elderly people's movements can provide early clues of impending Alzheimer's disease.
Elaine Bloomquist points to a motion sensor in the bathroom of her home Monday, June 18, 2007, in Milwaukie, Ore. Tiny motion sensors are attached to the walls, doorways, and even the refrigerator of Elaine Bloomquist's home, tracking the seemingly healthy 86-year-old's daily activity. It's like spying in the name of science with her permission to see if round-the-clock tracking of elderly people's movements can provide early clues of impending Alzheimer's disease.
"Now it takes years to determine if someone's developing dementia," laments Dr. Jeffrey Kaye of Oregon Health & Science University, which is placing the monitors in 300 homes of Portland-area octogenarians as part of a $7 million federally funded project.
The goal: Shave off that time by spotting subtle changes in mobility and behavior that Alzheimer's specialists are convinced precede the disease's telltale memory loss.
Early predictors may be as simple as variations in speed while people walk their hallways, or getting slower at dressing or typing. Also under study are in-home interactive "kiosks" that administer monthly memory and cognition tests, computer keyboards bugged to track typing speed, and pill boxes that record when seniors forget to take their medicines.
More than 5 million Americans, and 26 million people worldwide, have Alzheimer's, and cases are projected to skyrocket as the population ages. Today's medications only temporarily alleviate symptoms. Researchers are desperately hunting new ones that might at least slow the relentless brain decay if taken very early in the disease, before serious memory problems become obvious.
So dozens of early diagnosis methods also are under study, from tests of blood and spinal fluid to MRI scans of people's brains. Even if some pan out, they're expensive tests that would require lots of doctor intervention, when getting someone to visit a physician for suspicion of dementia is a huge hurdle. And during routine checkups, even doctors easily can miss the signs.
Bloomquist, of Milwaukee, Ore., knows the conundrum all too well. She volunteered for Kaye's research because her husband died of Alzheimer's, as did his parents and her own mother.
"It's hard to know when people begin Alzheimer's," she reflects. "Alzheimer people do very well socially for short periods of time. If it's just a casual conversation, they rise to the occasion."
Measuring how people fare at home, on bad days as well as good ones, not just when they're doing their best for the doctor may spot changes that signal someone's at high risk long before they're actually demented, Kaye told the Alzheimer's Association's international dementia-prevention meeting last week.
"If you only assess them every once-in-a-blue-moon, you really are at a loss to know what they are like on a typical day," Kaye explains.
Read more here.
By LAURAN NEERGAARD
The Associated Press
Monday, June 18, 2007; 11:13 PM
WASHINGTON -- Tiny motion sensors are attached to the walls, doorways and even the refrigerator of Elaine Bloomquist's home, tracking the seemingly healthy 86-year-old's daily activity.
It's like spying in the name of science with her permission to see if round-the-clock tracking of elderly people's movements can provide early clues of impending Alzheimer's disease.
Elaine Bloomquist points to a motion sensor in the bathroom of her home Monday, June 18, 2007, in Milwaukie, Ore. Tiny motion sensors are attached to the walls, doorways, and even the refrigerator of Elaine Bloomquist's home, tracking the seemingly healthy 86-year-old's daily activity. It's like spying in the name of science with her permission to see if round-the-clock tracking of elderly people's movements can provide early clues of impending Alzheimer's disease.
"Now it takes years to determine if someone's developing dementia," laments Dr. Jeffrey Kaye of Oregon Health & Science University, which is placing the monitors in 300 homes of Portland-area octogenarians as part of a $7 million federally funded project.
The goal: Shave off that time by spotting subtle changes in mobility and behavior that Alzheimer's specialists are convinced precede the disease's telltale memory loss.
Early predictors may be as simple as variations in speed while people walk their hallways, or getting slower at dressing or typing. Also under study are in-home interactive "kiosks" that administer monthly memory and cognition tests, computer keyboards bugged to track typing speed, and pill boxes that record when seniors forget to take their medicines.
More than 5 million Americans, and 26 million people worldwide, have Alzheimer's, and cases are projected to skyrocket as the population ages. Today's medications only temporarily alleviate symptoms. Researchers are desperately hunting new ones that might at least slow the relentless brain decay if taken very early in the disease, before serious memory problems become obvious.
So dozens of early diagnosis methods also are under study, from tests of blood and spinal fluid to MRI scans of people's brains. Even if some pan out, they're expensive tests that would require lots of doctor intervention, when getting someone to visit a physician for suspicion of dementia is a huge hurdle. And during routine checkups, even doctors easily can miss the signs.
Bloomquist, of Milwaukee, Ore., knows the conundrum all too well. She volunteered for Kaye's research because her husband died of Alzheimer's, as did his parents and her own mother.
"It's hard to know when people begin Alzheimer's," she reflects. "Alzheimer people do very well socially for short periods of time. If it's just a casual conversation, they rise to the occasion."
Measuring how people fare at home, on bad days as well as good ones, not just when they're doing their best for the doctor may spot changes that signal someone's at high risk long before they're actually demented, Kaye told the Alzheimer's Association's international dementia-prevention meeting last week.
"If you only assess them every once-in-a-blue-moon, you really are at a loss to know what they are like on a typical day," Kaye explains.
Read more here.
Monday, June 18, 2007
SERVING TWO MASTERS
Today I read that a hedge fund is calling to sell their interest in Sunrise Assisted Living / Nursing Homes - a Virginia Corporation valued at $2 billion. The fund is clearly in the interest of making money for its members - and fears that continued litigation against the health care provider will decrease the value of the stock.
Wow. Think about this. A Health care provider has a duty to its staff and the residents they provide for, but they also have a LEGAL duty to make money for their shareholders. Aren't these competing interests? Better for Grandma if she is the only priority. Better for staff if the botom line is not the overall goal, but when the company is public - fiscal duties create an interesting balancing act between serving the "owners" of the company, and serving the "customers."
Solution? Be weary of publically owned health care providers. If they have a duty to maximize profits, its fair to say their focus is not always on Grandma.
Wow. Think about this. A Health care provider has a duty to its staff and the residents they provide for, but they also have a LEGAL duty to make money for their shareholders. Aren't these competing interests? Better for Grandma if she is the only priority. Better for staff if the botom line is not the overall goal, but when the company is public - fiscal duties create an interesting balancing act between serving the "owners" of the company, and serving the "customers."
Solution? Be weary of publically owned health care providers. If they have a duty to maximize profits, its fair to say their focus is not always on Grandma.
3 HEPATITIS CASES CONNECTED TO ANESTHESIOLOGIST
In New York, authorities are urging 4,500 people who were treated by the same anesthesiologist to be tested for Hepatitis C . Three people who have tested positive for Hepatitis C were treated by the same anesthesiologist during outpatient procedures. The New York Department of Health and Mental Hygiene is trying to notify everyone who could be at risk. Hepatitis C cannot be spread by casual contact and is fully treatable, but they are attempting to contact anyone who could possibly be at risk. The doctor has stopped practicing during this investigation.
In a statement from the agency’s assistant commissioner for communicable disease, Dr. Marci Layton said, “transmission of hepatitis in a medical setting is rare, but as a precaution we are reaching out to anyone who could have potentially been exposed.”
See the article here.
In a statement from the agency’s assistant commissioner for communicable disease, Dr. Marci Layton said, “transmission of hepatitis in a medical setting is rare, but as a precaution we are reaching out to anyone who could have potentially been exposed.”
See the article here.
ARE NECK ADJUSTMENTS TOO RISKY?
An article on MSNBC implies that they are. The article describes events in the life of Christa Heck, a 43 year old mother and full time pharmaceutical representative. Heck went to see a chiropractor in 2003 for headaches. The chiropractor adjusted her back and neck. Later that day her head was still hurting and when she turned her head to the left, the room spun and she felt nauseous. Heck returned to the chiropractor and advised him of her strange symptoms. The chiropractor adjusted her neck again to try to get rid of the headache. On the way home that day, Heck suffered a major stroke in her car. Her medical doctor told her that she was lucky to be alive. He was “convinced that the stroke was caused by Heck’s neck adjustment which tore a critical artery that keeps blood flowing to the brain.”
Americans visit the chiropractor about 250 million times each year and 105 million of those visits include neck manipulations. The theory behind chiropractic is that when your vertebrae become misaligned there is extra pressure on nerves and the body cannot function as efficiently as it should. So, by improving the misalignment, they are improving your overall health. Neck adjustments are a regular part of chiropractic adjustments.
Injuries that can occur on the chiropractor’s table are soft tissue damage, joint dislocations, bone fractures in the neck and back, and the most common - disk injury in the neck or lower back. However, only neck manipulations can cause the major side effect that changed Christa Heck’s life.
The vertigo and queasiness after Heck’s first appointment should have been red flags, as both are symptoms of a stroke. The American Chiropractic Association (ACA) spokesperson, Willam J. Lauretti, is quoted, “A good chiropractor doesn’t merely grab people’s necks and crack them. You take a thorough exam. If there is a history of dizziness, stroke, visual or auditory disturbances, and to a certain extent a history of migraine, I’m going to be much more cautious. “
Brad Stewart, a neurologist from Edmonton, Alberta, stated, “the expectation of benefit is almost negligible. The risk, though small, is very real…You can’t predict who this will happen to, and for that reason alone, it just shouldn’t be done.”
There are arguments for both sides, of course. However, this is just another example of why you should do your own research and be in charge of your own healthcare. Know the possible risks of treatment before you go and be on the lookout for symptoms of those risks after your treatment starts. If you have any questions, speak to a medical professional. As the popular saying goes…Better Safe Than Sorry!
Americans visit the chiropractor about 250 million times each year and 105 million of those visits include neck manipulations. The theory behind chiropractic is that when your vertebrae become misaligned there is extra pressure on nerves and the body cannot function as efficiently as it should. So, by improving the misalignment, they are improving your overall health. Neck adjustments are a regular part of chiropractic adjustments.
Injuries that can occur on the chiropractor’s table are soft tissue damage, joint dislocations, bone fractures in the neck and back, and the most common - disk injury in the neck or lower back. However, only neck manipulations can cause the major side effect that changed Christa Heck’s life.
The vertigo and queasiness after Heck’s first appointment should have been red flags, as both are symptoms of a stroke. The American Chiropractic Association (ACA) spokesperson, Willam J. Lauretti, is quoted, “A good chiropractor doesn’t merely grab people’s necks and crack them. You take a thorough exam. If there is a history of dizziness, stroke, visual or auditory disturbances, and to a certain extent a history of migraine, I’m going to be much more cautious. “
Brad Stewart, a neurologist from Edmonton, Alberta, stated, “the expectation of benefit is almost negligible. The risk, though small, is very real…You can’t predict who this will happen to, and for that reason alone, it just shouldn’t be done.”
There are arguments for both sides, of course. However, this is just another example of why you should do your own research and be in charge of your own healthcare. Know the possible risks of treatment before you go and be on the lookout for symptoms of those risks after your treatment starts. If you have any questions, speak to a medical professional. As the popular saying goes…Better Safe Than Sorry!
NURSING HOME CORPORATION INDICTED IN RESIDENT DEATH
A nursing home corporation has been indicted in the 2004 death of a woman who lived in their Portland, Maine facility. Tennessee-based Life Care Centers of America is charged with manslaughter, abuse and neglect of a long-term care resident. Read the report here.
My home state of Virginia also has laws on the books which make it a crime to abuse or neglect the elderly. I have practice law for 25 years and have NEVER witnessed the enforcement of this law! Why? One prosecutor told me they were too busy to pursue these claims!
It is a crime to abuse and neglect the elderly….so lets start treating it as such and prosecute those responsible as criminals!
My home state of Virginia also has laws on the books which make it a crime to abuse or neglect the elderly. I have practice law for 25 years and have NEVER witnessed the enforcement of this law! Why? One prosecutor told me they were too busy to pursue these claims!
It is a crime to abuse and neglect the elderly….so lets start treating it as such and prosecute those responsible as criminals!
DIABETES TREATMENT IN NURSING HOMES
Check out this article:
Reuters HealthThursday, June 7, 2007
NEW YORK (Reuters Health) -The care of people with diabetes in nursing homes may be falling short in a number of important areas, a new study suggests.
The study, of 11 nursing homes in Ohio and West Virginia, found that diabetic residents' care generally failed to meet several of the American Diabetes Association's standards of care.
Those standards were developed for diabetic adults living on their own, and not in nursing homes, the study authors note, but as there are no specific diabetes guidelines for nursing homes, the ADA standards are the primary yardstick for judging residents' care.
For the 108 nursing home residents in the current study, that care was sub par in ways that could put them at greater risk of heart disease and other diabetes complications, according to the study authors.
They found that while most of the patients had had their blood pressure measured in the past year, only about half had their high blood pressure under control. The picture was much the same for measuring and controlling cholesterol.
When it came to blood sugar control, nearly all residents had their blood sugar regularly monitored, but just 38 percent were meeting the ADA goals for blood sugar control.
Rachel M. Holt and her colleagues at the Ohio University College of Osteopathic Medicine report the findings in the journal Diabetes Care.
"This study not only demonstrates that care of the institutionalized elderly is less than optimal," they write, "but also that practice guidelines for this population are greatly needed."
Based on their findings, the researchers have developed a set of diabetes treatment guidelines for nursing homes. They say they're planning a second study that will see whether those guidelines can improve patients' quality of life.
SOURCE: Diabetes Care, June 2007. Reuters Health
Oh boy - we would love to have Diabetes guidelines - we have had clients with uncontrolled diabetes for months - with wounds that don't heal and infections that spread - wonder why? Not difficult to connect elevated sugar levels and difficulty healing and fighting infection.
Reuters HealthThursday, June 7, 2007
NEW YORK (Reuters Health) -The care of people with diabetes in nursing homes may be falling short in a number of important areas, a new study suggests.
The study, of 11 nursing homes in Ohio and West Virginia, found that diabetic residents' care generally failed to meet several of the American Diabetes Association's standards of care.
Those standards were developed for diabetic adults living on their own, and not in nursing homes, the study authors note, but as there are no specific diabetes guidelines for nursing homes, the ADA standards are the primary yardstick for judging residents' care.
For the 108 nursing home residents in the current study, that care was sub par in ways that could put them at greater risk of heart disease and other diabetes complications, according to the study authors.
They found that while most of the patients had had their blood pressure measured in the past year, only about half had their high blood pressure under control. The picture was much the same for measuring and controlling cholesterol.
When it came to blood sugar control, nearly all residents had their blood sugar regularly monitored, but just 38 percent were meeting the ADA goals for blood sugar control.
Rachel M. Holt and her colleagues at the Ohio University College of Osteopathic Medicine report the findings in the journal Diabetes Care.
"This study not only demonstrates that care of the institutionalized elderly is less than optimal," they write, "but also that practice guidelines for this population are greatly needed."
Based on their findings, the researchers have developed a set of diabetes treatment guidelines for nursing homes. They say they're planning a second study that will see whether those guidelines can improve patients' quality of life.
SOURCE: Diabetes Care, June 2007. Reuters Health
Oh boy - we would love to have Diabetes guidelines - we have had clients with uncontrolled diabetes for months - with wounds that don't heal and infections that spread - wonder why? Not difficult to connect elevated sugar levels and difficulty healing and fighting infection.
OSTEOPOROSIS TREATMENT
Here www.washingtonpost.com/wp-dyn/content/article/2007/06/11/AR2007061101927.html is a great commentary on Washington Post.com.... It's about a topic many women over 45 think about daily - bone appropriate treatment.
The side effects can be serious and many - so is Fosomax appropriate for everyone? First of all, for your nursing home or assisted living resident - it may not be. Fosomax should only be given to someone who can sit up for 30 minutes after taking it - so if your loved one is bed-ridden or non ambulatory, it may not be appropriate for them. Read the insert - speak to your doctor, and then decide.
The side effects can be serious and many - so is Fosomax appropriate for everyone? First of all, for your nursing home or assisted living resident - it may not be. Fosomax should only be given to someone who can sit up for 30 minutes after taking it - so if your loved one is bed-ridden or non ambulatory, it may not be appropriate for them. Read the insert - speak to your doctor, and then decide.
Friday, June 15, 2007
HOW PATIENTS CAN HELP REDUCE MEDICAL ERRORS
We spend most of our professional time representing the victims of medical malpractice and those who have been abused and neglected in nursing homes. A recent article in USA Today states that 34 percent of people say either they or a family member has experienced a medical error. Read the article here.
Patients and family member can take an active role in preventing such errors. Eight simple strategies include:
1. Bring an advocate. Your advocates can step in if you are too groggy or weak to speak for yourself.
2. Prepare a Health Profile. Write down your medical conditions, allergies and medications.
3. Avoid wrong-site surgery.
4. Double-check all your medications and treatments before accepting them.
5. Take notes or bring a tape recorder. Studies show that patients remember less than 30%
of what doctors say.
6. Follow up. Ask when your test results will be available, then follow up if your doctor or nurse doesn't call.
7. Educate yourself. Learn about your medications.
8. Guard against superbugs. Ask every-one who enters your hospital room to wash their hands with either soap or an alcohol-based gel.
Patients and family member can take an active role in preventing such errors. Eight simple strategies include:
1. Bring an advocate. Your advocates can step in if you are too groggy or weak to speak for yourself.
2. Prepare a Health Profile. Write down your medical conditions, allergies and medications.
3. Avoid wrong-site surgery.
4. Double-check all your medications and treatments before accepting them.
5. Take notes or bring a tape recorder. Studies show that patients remember less than 30%
of what doctors say.
6. Follow up. Ask when your test results will be available, then follow up if your doctor or nurse doesn't call.
7. Educate yourself. Learn about your medications.
8. Guard against superbugs. Ask every-one who enters your hospital room to wash their hands with either soap or an alcohol-based gel.
ASSISTED LIVING FACILITIES OPERATOR’S SUBSTANDARD CARE
The Philadelphia Inquirer reports that Alterra Healthcare Corporation, which was one of the nation’s largest assisted living facility operators, had more than 200 residents who experienced neglect, injury, or death because of inadequate care during a four year period. The company paid more than $15.9 million to settle claims from more than 50 lawsuits, with more than 20 cases yet to be resolved.
News reporter Ken Dilanian wrote a series of articles in the Philadelphia Inquirer about poor care in assisted living facilities in Pennsylvania. Not a pretty track record!
News reporter Ken Dilanian wrote a series of articles in the Philadelphia Inquirer about poor care in assisted living facilities in Pennsylvania. Not a pretty track record!
CAMPAIGN SEEKS TO LIMIT DOCTORS’ COZINESS WITH DRUG COMPANIES
A consumer advocacy group and a research group at Columbia University have launched a campaign to limit the number of meals and gifts that doctors receive from pharmaceutical companies. What a great idea! Maybe this movement will encourage doctors to prescribe medications based upon empirical studies and not which company bought her an expensive steak dinner last night or is paying for that “educational trip” to Cabo San Lucas in February!
The new initiative, called the Prescription Project, is an outgrowth of an article published in January 2006 in The Journal of the American Medical Association in which a coalition of scholars and doctors proposed that academic medical centers across the country take the lead in restricting interactions between doctors and the health care industry.
Read the New York Times article on the campaign (may require free registration).
The new initiative, called the Prescription Project, is an outgrowth of an article published in January 2006 in The Journal of the American Medical Association in which a coalition of scholars and doctors proposed that academic medical centers across the country take the lead in restricting interactions between doctors and the health care industry.
Read the New York Times article on the campaign (may require free registration).
NEW IMAGING TECHNIQUES COULD LEAD TO BETTER TREATMENTS
At the Society for Nuclear Medicine’s annual meeting in Washington, D.C. this week, researchers made several announcements of ways they are using new imaging techniques to better diagnose and treat certain diseases, including heart disease, Alzheimer’s disease, and ovarian cancer.
Two imaging techniques, multidetector computed tomography (CT) and imaging positron emission tomography (PET) along with the use of N1177 (a contrast agent that highlights plaques), provides imaging to determine the amount of inflammation with atherosclerotic plaque and estimates the chances of plaque causing a future heart attack or stroke. Another new technique dealing with the heart is a molecular imaging technique that gives a three dimensional image of the heart.
Positron Emission Tomography (PET) and Magnetic Resonance (MR) will hopefully give researchers insight into the pathologies and progression of such diseases as Alzheimer’s, Parkinson’s, epilepsy, depression and schizophrenia. PET scans detect changes in the brain which have been shown to be the early changes of Alzheimers, long before dementia sets in. If doctors can detect it and begin treatment early, the patients would be less likely to develop Alzheimers.
The PET scan is also a helpful tool in the treatment of women with ovarian cancer. Replacing routine CT scans of the abdomen area and pelvis with PET/CT imaging could reduce costs and provide better care for patients.
By using these techniques, the hope is to both detect and treat diseases earlier.
See the full article here.
Two imaging techniques, multidetector computed tomography (CT) and imaging positron emission tomography (PET) along with the use of N1177 (a contrast agent that highlights plaques), provides imaging to determine the amount of inflammation with atherosclerotic plaque and estimates the chances of plaque causing a future heart attack or stroke. Another new technique dealing with the heart is a molecular imaging technique that gives a three dimensional image of the heart.
Positron Emission Tomography (PET) and Magnetic Resonance (MR) will hopefully give researchers insight into the pathologies and progression of such diseases as Alzheimer’s, Parkinson’s, epilepsy, depression and schizophrenia. PET scans detect changes in the brain which have been shown to be the early changes of Alzheimers, long before dementia sets in. If doctors can detect it and begin treatment early, the patients would be less likely to develop Alzheimers.
The PET scan is also a helpful tool in the treatment of women with ovarian cancer. Replacing routine CT scans of the abdomen area and pelvis with PET/CT imaging could reduce costs and provide better care for patients.
By using these techniques, the hope is to both detect and treat diseases earlier.
See the full article here.
A 1-2-3 APPROACH TO DIAGNOSE PULMONARY EMBOLISM
Too many Americans die (unnecessarily) as the result of undiagnosed pulmonary embolisms. In a recent online seminar on Medscape, three doctors discussed the procedure for diagnosing pulmonary embolisms http://en.wikipedia.org/wiki/Pulmonary_Embolism.
Three doctors participated:
- Dr. Sam Goldhaber, Professor of Medicine at Harvard Medical School and Director of the Venous Thromboembolism Research Group at Brigham and Women’s Hospital
- Dr. Art Sasahara, Professor Emeritus and Senior Physician at Brigham and Women’s Hospital in Harvard Medical School
- Dr. Greg Piazza, Fellow in Cardiovascular Disease at Beth Israel Deaconess Medical Center
Diagnosing the presence of a pulmonary embolism is a crucial diagnosis for internal medicine physicians and something all doctors learn in medical school. The problem is that mistakes and failures continue to occur.
The procedure proposed by the panel includes:
1. Using a clinical decision scoring system during the history and physical portion of the examination. Physicians can decide if their patient is pulmonary embolism-unlikely or pulmonary embolism-likely;
2. If the patient has a high score, they go immediately for a CT chest scan. If the patient has a medium or low score, the physician orders a D-dimer test; and
3. If the patient has a high clinical decision score or an elevated D-dimer test score, the physician orders a CT scan
Once a pulmonary embolism is diagnosed it can be treated. The present problem is the physician’s failure to identify the symptoms and a failure to acknowledge that the presence of a pulmonary embolism is a possibility. Doctors need to become proactive in diagnosing pulmonary embolism rather than waiting for the patient to become hypotensive.
Dr. Piazza also presented an abstract at the American College of Cardiology (ACC) entitled “Double Trouble in Medical Patients” which shows that hospitalized medical patients receive venous thromboembolism prophylaxis only a quarter of the time and they suffer pulmonary embolism more often than non-medical patients.
Three doctors participated:
- Dr. Sam Goldhaber, Professor of Medicine at Harvard Medical School and Director of the Venous Thromboembolism Research Group at Brigham and Women’s Hospital
- Dr. Art Sasahara, Professor Emeritus and Senior Physician at Brigham and Women’s Hospital in Harvard Medical School
- Dr. Greg Piazza, Fellow in Cardiovascular Disease at Beth Israel Deaconess Medical Center
Diagnosing the presence of a pulmonary embolism is a crucial diagnosis for internal medicine physicians and something all doctors learn in medical school. The problem is that mistakes and failures continue to occur.
The procedure proposed by the panel includes:
1. Using a clinical decision scoring system during the history and physical portion of the examination. Physicians can decide if their patient is pulmonary embolism-unlikely or pulmonary embolism-likely;
2. If the patient has a high score, they go immediately for a CT chest scan. If the patient has a medium or low score, the physician orders a D-dimer test; and
3. If the patient has a high clinical decision score or an elevated D-dimer test score, the physician orders a CT scan
Once a pulmonary embolism is diagnosed it can be treated. The present problem is the physician’s failure to identify the symptoms and a failure to acknowledge that the presence of a pulmonary embolism is a possibility. Doctors need to become proactive in diagnosing pulmonary embolism rather than waiting for the patient to become hypotensive.
Dr. Piazza also presented an abstract at the American College of Cardiology (ACC) entitled “Double Trouble in Medical Patients” which shows that hospitalized medical patients receive venous thromboembolism prophylaxis only a quarter of the time and they suffer pulmonary embolism more often than non-medical patients.
FIRE SUPPRESSION SYSTEMS AND NURSING HOMES
Congratulations to the State of Alabama! A recent newspaper report announced that all nursing homes and assisted living facilities in Alabama were in compliance with fire sprinkler requirements. Read the article here.
Recent nursing home fires in Connecticut, North Carolina and Tennessee have become a reminder of the need to fully sprinkler all nursing homes. Alabama’s nursing homes are committed to the safety and protection of our nearly 24,000 nursing home residents.
Does your nursing home have a fire sprinkler system in compliance with state law? Better find out!
Recent nursing home fires in Connecticut, North Carolina and Tennessee have become a reminder of the need to fully sprinkler all nursing homes. Alabama’s nursing homes are committed to the safety and protection of our nearly 24,000 nursing home residents.
Does your nursing home have a fire sprinkler system in compliance with state law? Better find out!
Thursday, June 14, 2007
911 REFUSES TO HELP WOMAN IN ER
In a Los Angeles hospital, a woman died after two calls to 911 WHILE SHE WAS IN THE ER. Edith Isabel Rodriguez died of a perforated bowel while she was in the hospital waiting area. Her relatives have stated that she was bleeding from the mouth and in a great deal of pain for at least 45 minutes while she was in the waiting area.
Two people even called 911 to try to get help for Rodriguez but were told them only the hospital could help and there was nothing they (911) could do. The first call was from Rodriguez’s boyfriend, who said “I’m in the emergency room. My wife is dying and the nurses don’t want to help her out.” Eight minutes later, a bystander called 911 and requested an ambulance to take her to another hospital. She was quoted saying “She’s definitely sick and there’s a guy that’s ignoring her.” The dispatcher of that call even argued with the woman as to whether or not this was an emergency and refused to call paramedics to help Rodriguez.
According to an article on MSNBC, Dr. Bruce Chernoff, director of the county Department of Health Services, which oversees the facility, has called Rodriguez’s death “inexcusable” and said it was “important to understand that this was fundamentally a failure of caring.” Federal inspectors recently determined that emergency room patients were in “immediate jeopardy” of harm or death and gave King-Harbor 23 days to improve or lose federal funding.
Dr. Roger Peels, the chief medical officer, was placed on “ordered absence” while the matter is being investigated. Dr. Robert Splawn, chief medical officer for the health department is being named as interim chief medical officer of the hospital. Don’t we all deserve better medical care than this?
See video reports from NBC here.
Another article about problems at King Harbor Hospital.
Two people even called 911 to try to get help for Rodriguez but were told them only the hospital could help and there was nothing they (911) could do. The first call was from Rodriguez’s boyfriend, who said “I’m in the emergency room. My wife is dying and the nurses don’t want to help her out.” Eight minutes later, a bystander called 911 and requested an ambulance to take her to another hospital. She was quoted saying “She’s definitely sick and there’s a guy that’s ignoring her.” The dispatcher of that call even argued with the woman as to whether or not this was an emergency and refused to call paramedics to help Rodriguez.
According to an article on MSNBC, Dr. Bruce Chernoff, director of the county Department of Health Services, which oversees the facility, has called Rodriguez’s death “inexcusable” and said it was “important to understand that this was fundamentally a failure of caring.” Federal inspectors recently determined that emergency room patients were in “immediate jeopardy” of harm or death and gave King-Harbor 23 days to improve or lose federal funding.
Dr. Roger Peels, the chief medical officer, was placed on “ordered absence” while the matter is being investigated. Dr. Robert Splawn, chief medical officer for the health department is being named as interim chief medical officer of the hospital. Don’t we all deserve better medical care than this?
See video reports from NBC here.
Another article about problems at King Harbor Hospital.
SEPSIS TREATMENT - BEST WHEN TREATED EARLY
Sepsis is a term we hear frequently in nursing home cases.
- Pressure Ulcer develops, infection sets in and resident is hospitilized for treatment of "sepsis."
- Resident stubs her toe, gangrene develops and she is hospitilized for treatment of gangrene and "sepsis."
- Resident is incontinent, gets a UTI that goes untreated. Finally UTI is treated but the infection has spread and it is "sepsis."
What is "sepsis" and how is it treated? www.medterm.com defines Sepsis as:
"Sepsis: Commonly called a "blood stream infection." The presence of bacteria (bacteremia) or other infectious organisms or their toxins in the blood (septicemia) or in other tissue of the body. Sepsis may be associated with clinical symptoms of systemic (bodywide) illness, such as fever, chills, malaise (generally feeling "rotten"), low blood pressure, and mental status changes. Sepsis can be a serious situation, a life threatening disease calling for urgent and comprehensive care.
Treatment depends on the type of infection, but usually begins with antibiotics or similar medications. Also known as blood poisoning, septicemia. "
It is serious, scary - and causes the death of thousands of elderly, long term care patients every year.
Today, the American Journal of Emergency Medicine (http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6W9K-4NW0V7C-K&_user=10&_coverDate=06%2F30%2F2007&_rdoc=17&_fmt=summary&_orig=browse&_srch=doc-info(%23toc%236685%232007%23999749994%23659447%23FLA%23display%23Volume)&_cdi=6685&_sort=d&_docanchor=&view=c&_ct=24&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=b0318144cfe4e3fa49aa5a7de567be4d
published a study on sepsis treatment. The conclusion was that early treatment is the most effective.
What does that mean in a nursing home setting? Well - that a pressure ulcer, scar, UTI, fever - are more than they seem, and require aggressive treatment. So if you are told Granddad has a fever - get him to the hospital. A bruise or ulcer doesn't heal - get your Mom checked out. Fast, before the infection spreads to the blood and sepsis occurs.
- Pressure Ulcer develops, infection sets in and resident is hospitilized for treatment of "sepsis."
- Resident stubs her toe, gangrene develops and she is hospitilized for treatment of gangrene and "sepsis."
- Resident is incontinent, gets a UTI that goes untreated. Finally UTI is treated but the infection has spread and it is "sepsis."
What is "sepsis" and how is it treated? www.medterm.com defines Sepsis as:
"Sepsis: Commonly called a "blood stream infection." The presence of bacteria (bacteremia) or other infectious organisms or their toxins in the blood (septicemia) or in other tissue of the body. Sepsis may be associated with clinical symptoms of systemic (bodywide) illness, such as fever, chills, malaise (generally feeling "rotten"), low blood pressure, and mental status changes. Sepsis can be a serious situation, a life threatening disease calling for urgent and comprehensive care.
Treatment depends on the type of infection, but usually begins with antibiotics or similar medications. Also known as blood poisoning, septicemia. "
It is serious, scary - and causes the death of thousands of elderly, long term care patients every year.
Today, the American Journal of Emergency Medicine (http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6W9K-4NW0V7C-K&_user=10&_coverDate=06%2F30%2F2007&_rdoc=17&_fmt=summary&_orig=browse&_srch=doc-info(%23toc%236685%232007%23999749994%23659447%23FLA%23display%23Volume)&_cdi=6685&_sort=d&_docanchor=&view=c&_ct=24&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=b0318144cfe4e3fa49aa5a7de567be4d
published a study on sepsis treatment. The conclusion was that early treatment is the most effective.
What does that mean in a nursing home setting? Well - that a pressure ulcer, scar, UTI, fever - are more than they seem, and require aggressive treatment. So if you are told Granddad has a fever - get him to the hospital. A bruise or ulcer doesn't heal - get your Mom checked out. Fast, before the infection spreads to the blood and sepsis occurs.
DEPRESSION AND DIABETES
A few weeks ago I reported on a survey that said depression leads to bone loss. Now, studies are showing that diabetes can lead to depression.
The Archives of Internal Medicine published a study yesterday, reflecting that "Among well-functioning older adults, Diabetes is associated with increased risk of depressive symptoms." Hmm. Well I could see where losing a leg, or a limb due to diabetes would be depressing - but the study reflected even "well-functioning" adults experienced depressive symptoms.
What an interesting study.
The Archives of Internal Medicine published a study yesterday, reflecting that "Among well-functioning older adults, Diabetes is associated with increased risk of depressive symptoms." Hmm. Well I could see where losing a leg, or a limb due to diabetes would be depressing - but the study reflected even "well-functioning" adults experienced depressive symptoms.
What an interesting study.
Wednesday, June 13, 2007
CAN ALZHEIMER’S AFFECT THE YOUNG?
According to an article in USA Today, it can and it is more common than you would think. Most people develop Alzheimer’s long after their life has slowed down, mainly after the age of 65. But people can develop the disease as early as their 20s.
Patty Smith, 49, was a successful businesswoman for BB&T when all of a sudden, she started becoming forgetful, fumbling for words, and missing appointments. After taking some time off, the symptoms did not improve, telling Smith that it was not stress that was causing her forgetfulness. In November 2005, at the age of 51, she was diagnosed with Alzheimer’s. It was a shock to Smith, who had no family history of the disease.
Smith is one of an estimated 500,000 Americans who have Alzheimer’s before the age of 65. These people have additional pressures to face, as most of them are in the prime of their lives with careers, families, mortgages and other bills. In addition, since Alzheimer’s is not prevalent in those under 65, their symptoms can easily be dismissed as being lazy or under-performing. Many of them lose their jobs due to the disease or are forced to take early retirement. Most of them lose their health insurance and have trouble getting government aid that is designed for the elderly.
For more information on Alzheimer’s, please visit The Alzheimer’s Association and the Alzheimer’s Foundation of America.
Patty Smith, 49, was a successful businesswoman for BB&T when all of a sudden, she started becoming forgetful, fumbling for words, and missing appointments. After taking some time off, the symptoms did not improve, telling Smith that it was not stress that was causing her forgetfulness. In November 2005, at the age of 51, she was diagnosed with Alzheimer’s. It was a shock to Smith, who had no family history of the disease.
Smith is one of an estimated 500,000 Americans who have Alzheimer’s before the age of 65. These people have additional pressures to face, as most of them are in the prime of their lives with careers, families, mortgages and other bills. In addition, since Alzheimer’s is not prevalent in those under 65, their symptoms can easily be dismissed as being lazy or under-performing. Many of them lose their jobs due to the disease or are forced to take early retirement. Most of them lose their health insurance and have trouble getting government aid that is designed for the elderly.
For more information on Alzheimer’s, please visit The Alzheimer’s Association and the Alzheimer’s Foundation of America.
Tuesday, June 12, 2007
SAD BUT FUNNY
Ok friends - I will admit that many believe my line of work is not in any way, a service to mankind. You know, plaintiff attorneys file so many frivolous lawsuits...
Well today I stand proud knowing I have never and will never file a frivlous lawsuit - unlike the attorney in DC who is suing his dry - cleaners for over 50 million dollars. The hilarious play by play can be found on washington post's blog site - ENJOY!
Well today I stand proud knowing I have never and will never file a frivlous lawsuit - unlike the attorney in DC who is suing his dry - cleaners for over 50 million dollars. The hilarious play by play can be found on washington post's blog site - ENJOY!
HOSPITALS DELAY “RIGHT TO KNOW” LEGISLATION
Hospital lawyers in Florida have convinced the Florida Supreme Court to delay a new state amendment that gives patients the “right to know” about past mistakes made by doctors and medical facilities, according to the Insurance Journal. They have also asked the justices to reverse other rulings, including one that would lift limits on the records that patients can obtain regarding “adverse medical incidents.”
One major disagreement about the “right to know” legislation is when it will take effect. There are arguments for the amendment being only prospective and for the amendment being retroactive. A judge in one case in Daytona Beach denied the request for records after the amendment was passed, but the court in Tallahassee came to the opposite decision for three of their cases. Of course, the hospitals are arguing that the amendment should not be retroactive and the patients and attorneys are arguing that the amendment should be retroactive.
“Notami lawyer Steven Wisotksy urged the justices to uphold the law, which limits patients’ to getting only final reports of adverse actions. Without that restriction, hospitals and doctors would be overwhelmed trying to provide ‘any records’ as called for by the amendment. … Thomas Equals responded for the plaintiffs, arguing the law ‘effectively disabled or eviscerated the whole concept’ of the amendment.”
See the full article here.
One major disagreement about the “right to know” legislation is when it will take effect. There are arguments for the amendment being only prospective and for the amendment being retroactive. A judge in one case in Daytona Beach denied the request for records after the amendment was passed, but the court in Tallahassee came to the opposite decision for three of their cases. Of course, the hospitals are arguing that the amendment should not be retroactive and the patients and attorneys are arguing that the amendment should be retroactive.
“Notami lawyer Steven Wisotksy urged the justices to uphold the law, which limits patients’ to getting only final reports of adverse actions. Without that restriction, hospitals and doctors would be overwhelmed trying to provide ‘any records’ as called for by the amendment. … Thomas Equals responded for the plaintiffs, arguing the law ‘effectively disabled or eviscerated the whole concept’ of the amendment.”
See the full article here.
Monday, June 11, 2007
CHILDRENS’ HOSPITALS USE AVIATION SAFETY TOOL TO REDUCE ERRORS
According to an article on Medical News Today, several children’s’ hospitals are implementing safety procedures used by the aviation industry to reduce errors in their hospitals.
LifeWings is the largest provider of CRM (Crew Resource Management) based systems in the United States. Life Wings is implementing the program at Vanderbilt Children’s Hospital in Nashville, TN.
CRM is used in the aviation industry to teach new pilots, flight attendants and mechanics the importance of working as a team to ensure safety and reduce errors. The President of LifeWings, Captain Stephen Harden is quoted “The medical teams we work with are in many respects just like the flight crews we’ve worked with in aviation. They provide incredibly good individual care. But unlike aviation, sometimes the system of care in hospitals makes it difficult to coordinate and collaborate their efforts…And because children can’t crosscheck what their doctor or nurse is doing, it is critically important to have a proven safety system in place to provide this function for them.”
Way to go Vanderbilt Children’s Hospital! We hope that more hospitals will follow your lead to ensure the safety of their patients.
LifeWings is the largest provider of CRM (Crew Resource Management) based systems in the United States. Life Wings is implementing the program at Vanderbilt Children’s Hospital in Nashville, TN.
CRM is used in the aviation industry to teach new pilots, flight attendants and mechanics the importance of working as a team to ensure safety and reduce errors. The President of LifeWings, Captain Stephen Harden is quoted “The medical teams we work with are in many respects just like the flight crews we’ve worked with in aviation. They provide incredibly good individual care. But unlike aviation, sometimes the system of care in hospitals makes it difficult to coordinate and collaborate their efforts…And because children can’t crosscheck what their doctor or nurse is doing, it is critically important to have a proven safety system in place to provide this function for them.”
Way to go Vanderbilt Children’s Hospital! We hope that more hospitals will follow your lead to ensure the safety of their patients.
NEW TEST FOR ALZHEIMER'S DISEASE?
Check out this article in yesterday's Washington Post: http://www.washingtonpost.com/wp-dyn/content/article/2007/06/10/AR2007061001148.html
"WASHINGTON (Reuters) - New tests involving blood and brain scans can detect symptoms of Alzheimer's disease, and brief appraisals of real-life functioning can predict who is likely to develop it, researchers saidSunday.
The tests will be critical, experts told a meeting on Alzheimer's disease, because more than 26 million people now have the brain-wasting disease and this number will quadruple, to 106 million, by 2050."
The article states that "Detecting the disease early can help patients and their families plan better for the future but can also help researchers develop drugs to treat and perhaps even prevent the disease."
Check it out - finally, a little hope for such a discouraging disease.
Article is written by REUTERS.
"WASHINGTON (Reuters) - New tests involving blood and brain scans can detect symptoms of Alzheimer's disease, and brief appraisals of real-life functioning can predict who is likely to develop it, researchers saidSunday.
The tests will be critical, experts told a meeting on Alzheimer's disease, because more than 26 million people now have the brain-wasting disease and this number will quadruple, to 106 million, by 2050."
The article states that "Detecting the disease early can help patients and their families plan better for the future but can also help researchers develop drugs to treat and perhaps even prevent the disease."
Check it out - finally, a little hope for such a discouraging disease.
Article is written by REUTERS.
Friday, June 08, 2007
ARE ANTI-PSYCHOTIC DRUGS THE BEST CHOICE FOR THE ELDERLY?
An article on MSN Health concludes there is a correlation between elderly people who take anti-psychotic drugs and earlier deaths.
Elderly people are often given anti-psychotic drugs when their behavior problems become too much for doctors or family members to handle. Anti-psychotics have been used since the 1950s to treat people with schizophrenia and other mental illnesses. Over the years, doctors have begun to use the drugs to treat behavior problems that may develop with dementia. The percentage of elderly patients using anti-psychotic drugs increased to 3 percent in 2002, up from 2.2 percent in 1993. Fifteen of seventeen studies of elderly patients suffering from dementia “found a 1.6 to 1.7 fold increase in death rates in those who took the drugs.” Researchers found that conventional antipsychotics, such as Haldol, Loxitane, Mellaril, Thorazine and Trilafon were more likely to cause an early death than the newer atypical antipsychotic drugs, Zyprexa, Abilify, Risperdal and Seroquel.
Dr. Sudeep Gill, Assistant Professor at Queen’s University in Kingston, Ontario, Canada is quoted as saying “I suspect this is because older patients are more vulnerable to adverse effects, since they much more often have underlying heart disease and problems swallowing, and the antipsychotic drug effects are the ‘last straw’ that precipitates a lethal event.” His colleague, Dr. James S. Goodwin, director of the Sealy Center on Aging at the University of Texas Medical Branch in Galveston adds “there is a class of demented patients with real bad behavioral problems, like striking other residents in a nursing home, where antipsychotics might be the lease bad solution.”
Find more about dementia from the U.S. National Institutes of Health.
Elderly people are often given anti-psychotic drugs when their behavior problems become too much for doctors or family members to handle. Anti-psychotics have been used since the 1950s to treat people with schizophrenia and other mental illnesses. Over the years, doctors have begun to use the drugs to treat behavior problems that may develop with dementia. The percentage of elderly patients using anti-psychotic drugs increased to 3 percent in 2002, up from 2.2 percent in 1993. Fifteen of seventeen studies of elderly patients suffering from dementia “found a 1.6 to 1.7 fold increase in death rates in those who took the drugs.” Researchers found that conventional antipsychotics, such as Haldol, Loxitane, Mellaril, Thorazine and Trilafon were more likely to cause an early death than the newer atypical antipsychotic drugs, Zyprexa, Abilify, Risperdal and Seroquel.
Dr. Sudeep Gill, Assistant Professor at Queen’s University in Kingston, Ontario, Canada is quoted as saying “I suspect this is because older patients are more vulnerable to adverse effects, since they much more often have underlying heart disease and problems swallowing, and the antipsychotic drug effects are the ‘last straw’ that precipitates a lethal event.” His colleague, Dr. James S. Goodwin, director of the Sealy Center on Aging at the University of Texas Medical Branch in Galveston adds “there is a class of demented patients with real bad behavioral problems, like striking other residents in a nursing home, where antipsychotics might be the lease bad solution.”
Find more about dementia from the U.S. National Institutes of Health.
Thursday, June 07, 2007
DRUGS TO BOOST LONG TERM MEMORY
Researchers have found that certain anti-cancer drugs improved the long term memory of mice. These drugs, called histone deacetylase (HDAC) inhibitors are hoped to strengthen connectors in the brain and improve long term memory in people with Alzheimers and other brain diseases. One of the co-authors of the study, Marcelo Wood, is quoted in this article, “We have demonstrated for the first time that HDAC inhibitors applied directly to the hippocampus enhance memory and synaptic plasticity in the brain, and we now know a molecular mechanism through which these enhancements occur.”
Find more information about memory loss here on the website of the Food and Drug Administration.
Find more information about memory loss here on the website of the Food and Drug Administration.
CASE REPORT: FAMILY SUCCESSFULLY SUES SOUTH CAROLINA HOSPITAL
This one is hard to believe! Swain Walter Wright Jr., a 71-year-old father of two, was homicidal and suicidal in December 2001 when he twice sought admission to the psychiatric unit at Piedmont Medical Center in Rock Hill, South Carolina. He later hanged himself from a tree in his backyard.
Swain Wright had struggled with the death of his wife of 38 years and his retirement after 40 years with Rock Hill Printing & Finishing Co., Joey Wright said. He had never experienced any previous psychiatric problems.
Wright's family sued Amisub of South Carolina, which does business as Piedmont Medical Center. Amisub, a subsidiary of Tenet Healthcare, will pay $1 million, according to the suit, filed by attorneys Joey Wright and Johnny Felder.
The suit is the second one settled by the hospital since March 19. The family of Herbert Cogan received $1.77 million in a wrongful death lawsuit after he was given the wrong drug because of a doctor's error.
Not a great track record for this hospital.
Swain Wright had struggled with the death of his wife of 38 years and his retirement after 40 years with Rock Hill Printing & Finishing Co., Joey Wright said. He had never experienced any previous psychiatric problems.
Wright's family sued Amisub of South Carolina, which does business as Piedmont Medical Center. Amisub, a subsidiary of Tenet Healthcare, will pay $1 million, according to the suit, filed by attorneys Joey Wright and Johnny Felder.
The suit is the second one settled by the hospital since March 19. The family of Herbert Cogan received $1.77 million in a wrongful death lawsuit after he was given the wrong drug because of a doctor's error.
Not a great track record for this hospital.
RECENT STUDY SHEDS LIGHT ON CAUSES OF DECUBITUS ULCERS
Chronic lower extremity ulcers affect approximately 2.5 million to 4.5 million people in the US. This growing clinical problem is most prominent among the elderly residents of nursing homes. In many of our cases against nursing homes where poor care has resulted in the development of decubitus ulcers, the facilities defend their inaction by arguing the resident suffered from other comorbid conditions which either caused the decubitus ulcer or prevented the ulcer from healing. A recent study conducted at Case Western Reserve University in Cleveland, Ohio reveals this defense to poor care of the elderly to be exactly what it is, “hogwash”!
Diabetes, renal disease, cardiac disease, pulmonary disease, endocrine disorders, GI disease, blood disorders, neurological disease, and smoking were not associated with poor wound healing in the study. However, diagnoses of malnutrition, infection, CVA, and dementia were important. History of stroke and presence of cognitive impairment are likely to be related to poorer functional status and reduced activity levels, making healing more difficult to achieve. Nutritional status has been linked to the development of pressure ulcers, and is considered an important factor in successful healing of chronic wounds.
If nursing homes made sure its residents received proper nutrition and repositioning, the problems with decubitus ulcers would become a thing of the past.
Read the report for yourself (requires free registration).
Diabetes, renal disease, cardiac disease, pulmonary disease, endocrine disorders, GI disease, blood disorders, neurological disease, and smoking were not associated with poor wound healing in the study. However, diagnoses of malnutrition, infection, CVA, and dementia were important. History of stroke and presence of cognitive impairment are likely to be related to poorer functional status and reduced activity levels, making healing more difficult to achieve. Nutritional status has been linked to the development of pressure ulcers, and is considered an important factor in successful healing of chronic wounds.
If nursing homes made sure its residents received proper nutrition and repositioning, the problems with decubitus ulcers would become a thing of the past.
Read the report for yourself (requires free registration).
Wednesday, June 06, 2007
ALZHEIMER’S PATIENTS DECLINE FASTER AFTER ENTERING A NURSING HOME
Alzheimer’s disease patients experienced a more rapid decline in their mental abilities after being placed in a nursing home, except for those that had prior experience in adult day care. These patients did not experience this faster rate of cognitive decline according to a new study by the Rush Alzheimer’s Disease Center.
The study, published in the June issue of the American Journal of Psychiatry, finds that prior experience in adult day care may make the transition to a nursing home less stressful.
Read the article in SeniorJournal.com.
The study, published in the June issue of the American Journal of Psychiatry, finds that prior experience in adult day care may make the transition to a nursing home less stressful.
Read the article in SeniorJournal.com.
DC HOSPITAL FALLING APART
I wonder if we will ever read a report like this one in SW Virginia - my guess is, we might someday. http://www.washingtonpost.com/wp-dyn/content/article/2007/06/05/AR2007060502558.html?hpid=topnews
"From an emergency department with faulty monitors, IV pumps and broken stretchers to an operating room running part time for lack of staff, patient care is increasingly limited and uncertain at Greater Southeast Community Hospital, according to a draft report by District health regulators.
The report lists worker and equipment shortages extending throughout the 110-bed facility, with the situation in radiology particularly severe. Housekeeping and maintenance crews have been cut so much they cannot keep up with basic chores, leading the regulators to conclude that the hospital "is not maintained in a safe and sanitary manner.""
"From an emergency department with faulty monitors, IV pumps and broken stretchers to an operating room running part time for lack of staff, patient care is increasingly limited and uncertain at Greater Southeast Community Hospital, according to a draft report by District health regulators.
The report lists worker and equipment shortages extending throughout the 110-bed facility, with the situation in radiology particularly severe. Housekeeping and maintenance crews have been cut so much they cannot keep up with basic chores, leading the regulators to conclude that the hospital "is not maintained in a safe and sanitary manner.""
CASE REPORT: NURSING HOME LAWSUIT IN DUNBAR, WV
According to this article, a woman in Charleston, West Virginia has filed suit against Sunbridge Care and Rehabilitation Center in Dunbar, West Virginia. Tammy Rae Combs filed the suit alleging the nursing home was negligent and that as a result her father, Ray Combs, suffered from pneumonia, dehydration, pressure sores, multiple fractures, malnutrition, contractures and loss of weight.
Tammy Rae Combs, said “doctors were shocked at her father’s condition when the nursing home staff sent him to Charleston Area Medical Center.” The hospital later amputated both of her father’s legs, but could not save him.
Sunbridge’s parent company, Sun Healthcare Group of New Mexico, has been named in the suit as well as the administrator at that time, Tammy Jo Painter. Sun Healthcare Group of New Mexico owns 104 nursing facilities and operates an additional 37 facilities.
The defendants assured Mr. Combs’ family they would provide him with appropriate and adequate care while he resided at Sunbridge Care and Rehabilitation Center, but due to budgetary restrictions on staff and supplies, the family feels that this was a misrepresentation. Sun Healthcare Group filed for bankruptcy in 1999.
The case will be tried on Kanawha Circuit Court.
Tammy Rae Combs, said “doctors were shocked at her father’s condition when the nursing home staff sent him to Charleston Area Medical Center.” The hospital later amputated both of her father’s legs, but could not save him.
Sunbridge’s parent company, Sun Healthcare Group of New Mexico, has been named in the suit as well as the administrator at that time, Tammy Jo Painter. Sun Healthcare Group of New Mexico owns 104 nursing facilities and operates an additional 37 facilities.
The defendants assured Mr. Combs’ family they would provide him with appropriate and adequate care while he resided at Sunbridge Care and Rehabilitation Center, but due to budgetary restrictions on staff and supplies, the family feels that this was a misrepresentation. Sun Healthcare Group filed for bankruptcy in 1999.
The case will be tried on Kanawha Circuit Court.
PATIENT SAFETY GROUPS ON THE INTERNET
We have received several requests from the readers of Legal Medicine to identify other patient advocacy groups available on the Internet. Well here you go…..
Consumers Advancing Patient Safety – provides patient safety information, online forums on medical error experiences.
Persons United Limiting Substandards and Errors in Healthcare – a national network of patient-rights advocates and victims of medical errors, links for patient rights and chat rooms
Surgicalfire.org – information on surgical-fire risks and prevention
Medically Induced Trauma Support Services – education and support for patients, families, and medical professionals involved in errors.
Josie King Foundation – consumer patient-safety information, hospital safety programs, online forum to share medical error experiences.
Consumers Advancing Patient Safety – provides patient safety information, online forums on medical error experiences.
Persons United Limiting Substandards and Errors in Healthcare – a national network of patient-rights advocates and victims of medical errors, links for patient rights and chat rooms
Surgicalfire.org – information on surgical-fire risks and prevention
Medically Induced Trauma Support Services – education and support for patients, families, and medical professionals involved in errors.
Josie King Foundation – consumer patient-safety information, hospital safety programs, online forum to share medical error experiences.
Tuesday, June 05, 2007
BETTER ARTICLE ON NEW DEMENTIA STUDY
My friends at the Washington Post must have had access to the whole study on elderly patients with dementia, and psychotropic drugs - their very detailed article can be found:
http://www.washingtonpost.com/wp-dyn/content/article/2007/06/05/AR2007060500572.html
http://www.washingtonpost.com/wp-dyn/content/article/2007/06/05/AR2007060500572.html
RESEARCHERS ANNOUNCE LIVER CANCER TREATMENT
At today’s annual meeting of the American Society of Clinical Oncology (ASCO), researchers announced the results of a clinical trial of Nexavar. The drug, made by Bayer, was used in a clinical trial which was stopped early due to the overwhelmingly good response. The liver cancer patients who took Nexavar had 44% more time to live, than those that did not take the drug.
This is a significant development for those with cancer of the liver. Dr. Len Lichtenfeld, deputy chief medical officer of the American Cancer Society, is quoted “This is going to change the standard of practice.”
Liver cancer is one of the most aggressive cancers and most patients often pass away within a year of diagnosis. It is the third most deadly cancer in the United States. Surgery, radiation, and chemotherapy treatments are all used to treat this deadly disease but, until now, there were no systemic treatments which work through the bloodstream.
Nexavar has already been approved in the United States as a treatment for advanced kidney cancer and is being studied for other cancers as well.
See the full article on MSN Health here.
You can read about it on Bloomberg.com here.
This is a significant development for those with cancer of the liver. Dr. Len Lichtenfeld, deputy chief medical officer of the American Cancer Society, is quoted “This is going to change the standard of practice.”
Liver cancer is one of the most aggressive cancers and most patients often pass away within a year of diagnosis. It is the third most deadly cancer in the United States. Surgery, radiation, and chemotherapy treatments are all used to treat this deadly disease but, until now, there were no systemic treatments which work through the bloodstream.
Nexavar has already been approved in the United States as a treatment for advanced kidney cancer and is being studied for other cancers as well.
See the full article on MSN Health here.
You can read about it on Bloomberg.com here.
CANCER MAY BE NEXT WAVE OF WTC ILLS
That is the title of an article on MSNBC. Dr. Robin Herbert is the co-director of a program that monitors the health of ground zero workers. The World Trade Center Medical Monitoring Program is based at Mount Sinai Medical Center and monitors people who worked at ground zero for health problems.
Mount Sinai released reports last year that 70% of the workers screened had some sort of respiratory illness. Now they are starting to see another wave of people who are developing multiple myeloma, a type of cancer that usually only appears in later stages of life. More than half of all cases of multiple myeloma occur in adults over 70 and only 1 percent of cases occur in people under the age of 40, according to the Multiple Myeloma Research Foundation.
According to the article, the first wave of illnesses was chronic coughing and acute respiratory problems which workers experienced right after their Sept. 11 work. The second wave is more serious chronic lung diseases, such as sarcoidosis.
The mayor of New York, Michael Bloomberg, has down played the problem. However, David Worby, an attorney for thousands of workers disagrees, saying “It’s not a threat to the general public, but to people who are already sick and have these blood cell cancers and who gave up their lives…it’s a great threat to them because a lot of them are going to die.”
The World Trade Center Medical Monitoring Program will continue to monitor and screen the health of those who worked at the towers or lived there. Other researchers at Johns Hopkins University and the University of Rochester plan to monitor residents’ and workers’ health for 20 years.
Mount Sinai released reports last year that 70% of the workers screened had some sort of respiratory illness. Now they are starting to see another wave of people who are developing multiple myeloma, a type of cancer that usually only appears in later stages of life. More than half of all cases of multiple myeloma occur in adults over 70 and only 1 percent of cases occur in people under the age of 40, according to the Multiple Myeloma Research Foundation.
According to the article, the first wave of illnesses was chronic coughing and acute respiratory problems which workers experienced right after their Sept. 11 work. The second wave is more serious chronic lung diseases, such as sarcoidosis.
The mayor of New York, Michael Bloomberg, has down played the problem. However, David Worby, an attorney for thousands of workers disagrees, saying “It’s not a threat to the general public, but to people who are already sick and have these blood cell cancers and who gave up their lives…it’s a great threat to them because a lot of them are going to die.”
The World Trade Center Medical Monitoring Program will continue to monitor and screen the health of those who worked at the towers or lived there. Other researchers at Johns Hopkins University and the University of Rochester plan to monitor residents’ and workers’ health for 20 years.
250,000 MEDICARE PATIENT DEATHS COULD HAVE BEEN PREVENTED
HealthGrades has released their “Fourth Annual Patient Safety in American Hospitals Study.” HealthGrades researches and reports information on patient safety in hospitals throughout the United States. They use the Agency for Healthcare Research and Quality’s (AHRQ) Patient Safety Indicators to “identify the patient safety incident rates for every non-federal hospital in the country using three years of Medicare data (2003-2005).” HealthGrades created a composite score to rate the hospitals and the hospitals that performed the best and had the least amount of patient safety incidents are included in their “2007 Distinguished Hospitals for Patient Safety.”
In their study, they found (excerpts from the study):
- Approximately 1.16 million total patient safety incidents occurred in over 40 million hospitalizations in the Medicare population.
- More than half (10 of 16) of the patient safety incident (PSI) rates studied worsened from 2003 to 2005. The PSIs with the greatest increases were post-operative sepsis (34.28%), post-operative respiratory failure (18.70%), and selected infections due to medical care (12.32%).
- The PSI’s with the highest incident rates were decubitus ulcer, failure to rescue, and post-operative respiratory failure. These three PSIs accounted for almost 71.7 percent of all patient safety incidents.
- Of the 284,798 deaths that occurred among patients who developed one or more patient safety incidents, 247,662 were potentially preventable.
- If all hospitals performed at the level of Distinguished Hospitals for Patient Safety, approximately 206,286 patient safety incidents and 34,393 Medicare deaths could have been avoided while saving the U.S. approximately $1.74 billion during 200 to 2005.
According to this report, U.S. Hospitals have a long way to go before patient safety can be touted as a strong point. According to HealthGrades’ report, it is the Distinguished Hospitals which are getting better and creating the overall decrease in patient safety incidents. You will find Martha Jefferson Hospital in Charlottesville, Virginia and Winchester Medical Center in Winchester, Virginia on the list of Distinguished Hospitals for Patient Safety. Congratulations to those two hospitals – we hope that more hospitals will follow in your footsteps.
In their study, they found (excerpts from the study):
- Approximately 1.16 million total patient safety incidents occurred in over 40 million hospitalizations in the Medicare population.
- More than half (10 of 16) of the patient safety incident (PSI) rates studied worsened from 2003 to 2005. The PSIs with the greatest increases were post-operative sepsis (34.28%), post-operative respiratory failure (18.70%), and selected infections due to medical care (12.32%).
- The PSI’s with the highest incident rates were decubitus ulcer, failure to rescue, and post-operative respiratory failure. These three PSIs accounted for almost 71.7 percent of all patient safety incidents.
- Of the 284,798 deaths that occurred among patients who developed one or more patient safety incidents, 247,662 were potentially preventable.
- If all hospitals performed at the level of Distinguished Hospitals for Patient Safety, approximately 206,286 patient safety incidents and 34,393 Medicare deaths could have been avoided while saving the U.S. approximately $1.74 billion during 200 to 2005.
According to this report, U.S. Hospitals have a long way to go before patient safety can be touted as a strong point. According to HealthGrades’ report, it is the Distinguished Hospitals which are getting better and creating the overall decrease in patient safety incidents. You will find Martha Jefferson Hospital in Charlottesville, Virginia and Winchester Medical Center in Winchester, Virginia on the list of Distinguished Hospitals for Patient Safety. Congratulations to those two hospitals – we hope that more hospitals will follow in your footsteps.
DEMENTIA MEDICATION -
Anyone with experience knows that dementia is a sad and scary disease. Typically physicians treat symptoms of dementia with antipsychotic medications to reduce some of the manifestations of the disease, like aggressiveness etc.
A recent study, published in the Annals of Internal Medicine this month, followed older adults with dementia between 1 April 1997 and 31 March 2003 on antipsychotic medications. The study measured the connection between these medications and the risk for death at 30, 60, 120, and 180 days after the initial dispensing of the medication.
The results - "New use of atypical antipsychotics was associated with a statistically significant increase in the risk for death at 30 days compared with nonuse."
"Excess risk seemed to persist to 180 days, but unequal rates of censoring over time may have affected these results. Relative to atypical antipsychotic use, conventional antipsychotic use was associated with a higher risk for death at all time points. Sensitivity analysis revealed that unmeasured confounders that increase the risk for death could diminish or eliminate the observed associations."
"Conclusions: Atypical antipsychotic use is associated with an increased risk for death compared with nonuse among older adults with dementia. The risk for death may be greater with conventional antipsychotics than with atypical antipsychotics."
http://www.annals.org/cgi/content/abstract/146/11/775
So why would these medications cause or be related to death? Although I cannot access the entire article or study, from personal experience, we see these medications directly and indirectly cause falls, loss of appetite, dehyrdation and many other problems in adults in long term care settings. If your loved one is placed on such a medication - ADDITIONAL OBSERVATION is required. Too much, they may be unable to function so be sure to weigh the pros and cons before taking the medications or allowing your loved one to do so.
A recent study, published in the Annals of Internal Medicine this month, followed older adults with dementia between 1 April 1997 and 31 March 2003 on antipsychotic medications. The study measured the connection between these medications and the risk for death at 30, 60, 120, and 180 days after the initial dispensing of the medication.
The results - "New use of atypical antipsychotics was associated with a statistically significant increase in the risk for death at 30 days compared with nonuse."
"Excess risk seemed to persist to 180 days, but unequal rates of censoring over time may have affected these results. Relative to atypical antipsychotic use, conventional antipsychotic use was associated with a higher risk for death at all time points. Sensitivity analysis revealed that unmeasured confounders that increase the risk for death could diminish or eliminate the observed associations."
"Conclusions: Atypical antipsychotic use is associated with an increased risk for death compared with nonuse among older adults with dementia. The risk for death may be greater with conventional antipsychotics than with atypical antipsychotics."
http://www.annals.org/cgi/content/abstract/146/11/775
So why would these medications cause or be related to death? Although I cannot access the entire article or study, from personal experience, we see these medications directly and indirectly cause falls, loss of appetite, dehyrdation and many other problems in adults in long term care settings. If your loved one is placed on such a medication - ADDITIONAL OBSERVATION is required. Too much, they may be unable to function so be sure to weigh the pros and cons before taking the medications or allowing your loved one to do so.
JOSIEKING.ORG: FAMILIY TAKES UP THE CAUSE OF HOSPITAL SAFETY
“When her 18-month-old daughter Josie died after a series of medical mistakes at Johns Hopkins Children's Center in Baltimore six years ago, Sorrel King was consumed by grief and anger, wanting to destroy the hospital and even end her own life. But with three other children to live for, she and her husband Tony decided they had to help fix a broken system.
‘We had to do something good that would prevent this from ever happening to a child again,’ Ms. King says. When the hospital offered a financial settlement, Ms. King, a former fashion designer who had become a stay-at-home mom, asked Johns Hopkins to take some of the money back to start a children's safety program. She also created the Josie King Foundation to fund safety initiatives at other hospitals. Now, to take the message to a broader audience of both consumers and medical professionals, she is launching a new Web site, josieking.org, with her own blog on patient safety; an online community where families can post their medical-error experiences and provide emotional support; advice from medical and legal experts on how to avoid error and deal with it when occurs; and resources for hospitals seeking to improve safety.”
Read the Wall Street Journal article on the Josie King Foundation here.
‘We had to do something good that would prevent this from ever happening to a child again,’ Ms. King says. When the hospital offered a financial settlement, Ms. King, a former fashion designer who had become a stay-at-home mom, asked Johns Hopkins to take some of the money back to start a children's safety program. She also created the Josie King Foundation to fund safety initiatives at other hospitals. Now, to take the message to a broader audience of both consumers and medical professionals, she is launching a new Web site, josieking.org, with her own blog on patient safety; an online community where families can post their medical-error experiences and provide emotional support; advice from medical and legal experts on how to avoid error and deal with it when occurs; and resources for hospitals seeking to improve safety.”
Read the Wall Street Journal article on the Josie King Foundation here.
Monday, June 04, 2007
CASE REPORT: JURY AWARDS DAMAMGES IN SKIN CANCER CASE
A Superior Court (San Diego, California) jury awarded $5.7 million in damages to a bedridden man who claimed a doctor failed to diagnose his skin cancer. The verdict is the largest medical-malpractice award in California this year, but will be cut to $1.9 million under a state statute limiting damages in malpractice suits.
Regis M. Reilly, 53, claimed dermatologist Dr. James C. Powers failed to biopsy a cyst that later metastasized into cancer. Reilly has a family history of skin cancer. Read the newspaper account here.
Regis M. Reilly, 53, claimed dermatologist Dr. James C. Powers failed to biopsy a cyst that later metastasized into cancer. Reilly has a family history of skin cancer. Read the newspaper account here.
NURSING HOME SOLD - BIG BUSINESS
Health Management Associates, Naples, Fla., has agreed to sell 133-bed Mountain View Regional Medical Center, Norton, Va., and 50-bed Lee Regional Medical Center, Pennington Gap, Va., to Wellmont Health System, of Kingsport, Tenn.
Although the terms were not disclosed, I imagine there is a pretty big pricetag.
Read more - modernhealthcare.com.
The purpose? President of Wellmont Health says it will improve local healthcqare. http://www.tricities.com/tristate/tri/news.apx.-content-articles-TRI-2007-06-04-0032.html
Although the terms were not disclosed, I imagine there is a pretty big pricetag.
Read more - modernhealthcare.com.
The purpose? President of Wellmont Health says it will improve local healthcqare. http://www.tricities.com/tristate/tri/news.apx.-content-articles-TRI-2007-06-04-0032.html
SERMO AND AMA PARTNER FOR DOCTOR FORUM
Sermo, a company out of Cambridge, Massachusetts, has partnered with the American Medical Association (AMA) to create a forum that encourages doctors to swap ideas and information over the internet. While the company set this up as a tool for investment firms, the doctors seem to like the sense of community and ease of use. A doctor can post anonymously with such things as “I’ve got this one complicated case. Here’s the workup. Have you ever seen this before, and how would you manage it?” According to this article on MSNBC, within three hours you can have a “dozen responses from physicians in three or four different specialties. With all the burdens of practicing medicine today, there is not a lot of time and effort put into creating a physician-to-physician community. That is really something that Sermo has built.”
Doctors can sign up for this service free of charge. So, what pays the bills?? Sermo charges investment firms $100,000 to $500,000 a year to view the posts, giving the firms a heads up on side effects and other medical market trends. As of the date of this article, drug companies and drug representatives are not allowed access to the forum. Doctors sign up by sharing personal information and medical license numbers. Sermo then compares the information to available databases to avoid postings by non-doctors with “an axe to grind” or drug representatives trying to promote a certain drug.
While there are still some doctors and pharmaceutical companies that are skeptical of this service, so far it seems to be working both for the doctors involved and the investment companies involved.
Doctors can sign up for this service free of charge. So, what pays the bills?? Sermo charges investment firms $100,000 to $500,000 a year to view the posts, giving the firms a heads up on side effects and other medical market trends. As of the date of this article, drug companies and drug representatives are not allowed access to the forum. Doctors sign up by sharing personal information and medical license numbers. Sermo then compares the information to available databases to avoid postings by non-doctors with “an axe to grind” or drug representatives trying to promote a certain drug.
While there are still some doctors and pharmaceutical companies that are skeptical of this service, so far it seems to be working both for the doctors involved and the investment companies involved.
Friday, June 01, 2007
CHECKING IN
Want to check on a certain nursing home? See how they have been doing?
You can go to medicare's website to look for citations - www.medicare.gov
You can make a Freedom of Information Act request to your local state health authority (in Va. call 1-800-955-1819) and ask for the most recent state survey results;
You can check in on the licenses of the attending physician (in Virginia www.vahealthprovider.com) or the nurses (in Virginia http://www.dhp.state.va.us)
It certainly couldn't hurt to check it out....
You can go to medicare's website to look for citations - www.medicare.gov
You can make a Freedom of Information Act request to your local state health authority (in Va. call 1-800-955-1819) and ask for the most recent state survey results;
You can check in on the licenses of the attending physician (in Virginia www.vahealthprovider.com) or the nurses (in Virginia http://www.dhp.state.va.us)
It certainly couldn't hurt to check it out....
HOSPITAL IS SANCTIONED BY COURT IN WEST VIRGINIA
Wow! $1.3 million dollar sanction ordered against a hospital for misconduct in a pending malpractice lawsuit. Failing to answer discovery truthfully, tell the plaintiff's family who individuals with knowledge were --- and even after the $6 million dollar plaintiff's verdict, now the hospital must pay $1.3 million in sanctions. Read all about it - and it's great news for an attorney that does play by the rules, because it teaches us that it never pays to cheat!
http://www.dailymail.com/story/News/2007053042/Hospital-sanctioned-1-3-million-over-lawsuit/
http://www.dailymail.com/story/News/2007053042/Hospital-sanctioned-1-3-million-over-lawsuit/
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