What often happens to the nursing home resident who falls? They break a bone in their leg or arm or hip. Not all residents end up with bone fractures when they fall. Is there a way to determine which of these residents are at "increased risk" of bone fractures? The answer is YES.
The bone mineral density (BMD) of 123 women residents in a nursing home was measured for a research study and the results were presented at a European Medical Symposium in Barcelona, Spain this month. The conclusion(and this is no surprise): Two thirds of the nursing home residents were found to have osteoporotic BMD.
So, with routine screening of newly admitted nursing home residents we can determine which residents are at increased risk of suffering a bone fracture. Armed with this important information, nursing homes can treat these residents with appropriate medications and make certain the at risk resident is getting enough calcium and vitamin D in their diets.
Routine screening for osteoporosis is a no-brainer!
Friday, May 30, 2008
Thursday, May 29, 2008
DEMENTIA PATIENTS AND ANTIPSYCHOTICS: A DEADLY COMBINATION
Many of the elderly in America's nursing homes are taking a long list of medications...for conditions like hypertension, elevated blood sugars, pain control, blood thinners and the list goes on and on and on...
The one type of drug which may be given for reasons other than a medical need are medications known as antipsychotics. These drugs are routinely given to nursing home residents to control behavioral problems associated with dementia. You see, it is easier (and cheaper) to over-medicate a resident with behavioral problems than it is to hire sufficient staff to take care of those residents.
Researchers in Canada wanted to find out the impact of being prescribed antipsychotic therapy to control behavioral problems associated with dementia. They discovered that 17 percent of newly admitted dementia patients are given antipsychotic drugs within the first 100 days of admission to quiet signs of delirium, rage or aggression. However, the down side was an increase in health risks including death, hip fractures, falls and strokes. These patients were twice as likely to be hospitalized or die as those who were not given antipsychotic drugs.
The lesson: Don't let your family member be placed on antipsychotics unless there is a real and medically documented need.
The one type of drug which may be given for reasons other than a medical need are medications known as antipsychotics. These drugs are routinely given to nursing home residents to control behavioral problems associated with dementia. You see, it is easier (and cheaper) to over-medicate a resident with behavioral problems than it is to hire sufficient staff to take care of those residents.
Researchers in Canada wanted to find out the impact of being prescribed antipsychotic therapy to control behavioral problems associated with dementia. They discovered that 17 percent of newly admitted dementia patients are given antipsychotic drugs within the first 100 days of admission to quiet signs of delirium, rage or aggression. However, the down side was an increase in health risks including death, hip fractures, falls and strokes. These patients were twice as likely to be hospitalized or die as those who were not given antipsychotic drugs.
The lesson: Don't let your family member be placed on antipsychotics unless there is a real and medically documented need.
THE LEGACY OF LEAD
The e-journal, ScienceNews, published an interesting article this week concerning the affects of lead on children who grew up in Cincinnati, Ohio. The article is alarming!
Mothers of the studies’ participants were recruited from 1979 to 1984 from neighborhoods in Cincinnati with a lot of old, lead-contaminated houses and historically high rates of childhood lead poisoning. Blood lead levels were measured in the pregnant moms and then, after they were born, in the children at several intervals until they were at least 6 years old. Of the children, now 19 to 24 years old, 250 participated in the study examining the association with criminal behavior and 157 participated in the brain imaging study.
MRI scans of the young adults’ brains revealed that the more lead they were exposed to as children, the smaller their adult brains were, the researchers report. The anterior cingulate cortex — a brain region associated with mood regulation, decision making and impulse control — was particularly affected.
Childhood lead exposure has been linked to lower IQ scores and attention and hyperactivity problems, but the brain-imaging work is the first to look beyond performance to how lead affects the structure and size of children's brains.
Mothers of the studies’ participants were recruited from 1979 to 1984 from neighborhoods in Cincinnati with a lot of old, lead-contaminated houses and historically high rates of childhood lead poisoning. Blood lead levels were measured in the pregnant moms and then, after they were born, in the children at several intervals until they were at least 6 years old. Of the children, now 19 to 24 years old, 250 participated in the study examining the association with criminal behavior and 157 participated in the brain imaging study.
MRI scans of the young adults’ brains revealed that the more lead they were exposed to as children, the smaller their adult brains were, the researchers report. The anterior cingulate cortex — a brain region associated with mood regulation, decision making and impulse control — was particularly affected.
Childhood lead exposure has been linked to lower IQ scores and attention and hyperactivity problems, but the brain-imaging work is the first to look beyond performance to how lead affects the structure and size of children's brains.
Wednesday, May 28, 2008
ANTI-PSYCHOTICS AND DEMENTIA - SCARY BUT NOT SURPRISING PROBLEMS
The Washington Post reported this week, that older people with dementia who take anti-psychotics, are more likely to end up in the hospital or even die, new research shows.
So what are families to do - accept sometimes dangerous aggressive behavior, or use anti-psychotic medications? Many would argue there is no need to chose between these two extremes - but without very detailed and personal care, most families don't have additional options.
The findings were published in the May 26 issue of the Archives of Internal Medicine.
Anti-psychotic drugs are commonly used to treat some of the behavioral complications of dementia, including delirium.
Most of these medications however, have not been tested on elderly patients.
According to the Washington Post, Researchers from the Institute for Clinical Evaluative Sciences in Ontario, Canada, compared 20,682 older adults with dementia living in the community with 20,559 older adults with dementia living in a nursing home between April 1, 1997, and March 31, 2004.
Each group was divided into three subgroups: those not receiving any anti-psychotics, those taking newer anti-psychotics, and those taking older anti-psychotics such as Haldol (haloperidol).
According to information gleaned from medical records, community-dwelling adults who had recently received a prescription for a newer anti-psychotic medication were 3.2 times more likely than individuals who had received no anti-psychotic therapy to be hospitalized or to die during 30 days of follow-up.
Those who received older anti-psychotic therapy were 3.8 times more likely to have such an event, relative to their peers who had received no anti-psychotic therapy.
A similar pattern, albeit less dramatic, emerged in the nursing home group. Individuals taking older anti-psychotics were 2.4 times more likely to be hospitalized or die, while those taking newer drugs were 1.9 times more likely to die or be hospitalized during the 30 days of follow-up.
We see it all the time - over medicated, falls, lead to injury or death; anti-psychotic medications cause decrease in appetite, cause malnourishment, hospitalization, etc...
So what are families to do - accept sometimes dangerous aggressive behavior, or use anti-psychotic medications? Many would argue there is no need to chose between these two extremes - but without very detailed and personal care, most families don't have additional options.
The findings were published in the May 26 issue of the Archives of Internal Medicine.
Anti-psychotic drugs are commonly used to treat some of the behavioral complications of dementia, including delirium.
Most of these medications however, have not been tested on elderly patients.
According to the Washington Post, Researchers from the Institute for Clinical Evaluative Sciences in Ontario, Canada, compared 20,682 older adults with dementia living in the community with 20,559 older adults with dementia living in a nursing home between April 1, 1997, and March 31, 2004.
Each group was divided into three subgroups: those not receiving any anti-psychotics, those taking newer anti-psychotics, and those taking older anti-psychotics such as Haldol (haloperidol).
According to information gleaned from medical records, community-dwelling adults who had recently received a prescription for a newer anti-psychotic medication were 3.2 times more likely than individuals who had received no anti-psychotic therapy to be hospitalized or to die during 30 days of follow-up.
Those who received older anti-psychotic therapy were 3.8 times more likely to have such an event, relative to their peers who had received no anti-psychotic therapy.
A similar pattern, albeit less dramatic, emerged in the nursing home group. Individuals taking older anti-psychotics were 2.4 times more likely to be hospitalized or die, while those taking newer drugs were 1.9 times more likely to die or be hospitalized during the 30 days of follow-up.
We see it all the time - over medicated, falls, lead to injury or death; anti-psychotic medications cause decrease in appetite, cause malnourishment, hospitalization, etc...
ADULT DAY CARE CENTERS IN VIRGINIA
Many families need assistance for elderly parents during the daylight hours....when the grown children are at work and there is no one to care for a parent who needs supervision. Here is where "Adult Day Care" facilities come into play.
Adult Day Care provides a safe and caring setting for adults. Programs are designed to cover the daily individual needs of each participant, including a variety of social and supportive services. Participants may be physically, mentally or functionally impaired, or they may simply need companionship or supervision during part of the day.
I found a great resource on the Internet listing the available facilities by locality including: Roanoke, Salem, Martinsville, Danville, Lynchburg, Clifton Forge, Covington, Blacksburg, Bedford, Wytheville and others.
Check out this comprehensive list of Day Care Centers in Virginia!
Adult Day Care provides a safe and caring setting for adults. Programs are designed to cover the daily individual needs of each participant, including a variety of social and supportive services. Participants may be physically, mentally or functionally impaired, or they may simply need companionship or supervision during part of the day.
I found a great resource on the Internet listing the available facilities by locality including: Roanoke, Salem, Martinsville, Danville, Lynchburg, Clifton Forge, Covington, Blacksburg, Bedford, Wytheville and others.
Check out this comprehensive list of Day Care Centers in Virginia!
Tuesday, May 27, 2008
CHOLESTEROL LOWERING DRUGS....
Probably you can name at least 5 close friends or family members, who take a statin - you know, a cholesterol lowering drug.
Crestor - Lipitor - Lescol - Lovastatin - Vytorin, last year Americans bought 150 million bottles of these meds, and they are not without side effects. Muscle pain is one of the most common side effects. I can see the vicious cycle now - high cholesterol and you are told to change your diet, and exercise, while taking a statin just in case... Muscle pain and weakness begins, and you can't exercise, and they put you on more meds for the muscle pain.
Please be aware of the side effects - even if your doctor doesn't warn you about them!
Crestor - Lipitor - Lescol - Lovastatin - Vytorin, last year Americans bought 150 million bottles of these meds, and they are not without side effects. Muscle pain is one of the most common side effects. I can see the vicious cycle now - high cholesterol and you are told to change your diet, and exercise, while taking a statin just in case... Muscle pain and weakness begins, and you can't exercise, and they put you on more meds for the muscle pain.
Please be aware of the side effects - even if your doctor doesn't warn you about them!
TYPES OF NURSING HOME NEGLECT
I just read an article about a Memphis Tenn. nursing home resident that received 3rd degree burns when hot coffee fell on her. Did the CNA mean to pour hot coffee on the lady? I seriously doubt it- but her carelessness, caused the resident great pain - physical and emotional, damages, and sadly, she died within a few weeks.
Most nursing home negligence cases do not stem out of intentional acts (although there have been some...) they are accidents. Preventable accidents: Medication overdoses; Solid foods given to someone with soft diet orders; blood sugar levels not being checked; formation of pressure ulcers; dehydration; falls; bed rail accidents; wheelchair accidents; someone allowed to leave the building unattended; Someone given the wrong medication or no medication... Be aware, it is nursing home "accidents" that cause the most damage!
Most nursing home negligence cases do not stem out of intentional acts (although there have been some...) they are accidents. Preventable accidents: Medication overdoses; Solid foods given to someone with soft diet orders; blood sugar levels not being checked; formation of pressure ulcers; dehydration; falls; bed rail accidents; wheelchair accidents; someone allowed to leave the building unattended; Someone given the wrong medication or no medication... Be aware, it is nursing home "accidents" that cause the most damage!
Friday, May 23, 2008
NURSING HOME CONTRACTS - EFFORT TO FORBID ARBITRATION AGREEMENTS
House measure would outlaw nursing home arbitration clauses
May 23 2008
Nursing home operators would be unable to subject residents and prospective residents to binding arbitration clauses under a bill introduced Thursday afternoon in the U.S. House. When a companion bill was introduced in the Senate in April, consumer groups enthusiastically praised it and provider advocates roundly criticized it."This legislation will not prohibit arbitration. Instead, it will simply ensure that residents have the choice whether to arbitrate a dispute after it has arisen," said bill co-sponsor Rep. Linda Sanchez (D-CA), whose father recently entered a nursing facility. Sanchez said hosting three recent hearings on the Federal Arbitration Act as the chairwoman of the Subcommittee on Commercial and Administrative Law helped form her opinions on the topic.
"The long term care industry is one stark example where businesses draft take-it-or-leave-it admission agreements for prospective residents that include pre-dispute, mandatory arbitration clauses."AARP, the Alzheimer's Association and the National Senior Citizen's Law Center are among the groups who have come out in support of "The Fairness in Nursing Home Arbitration Act of 2008." The American Health Care Association, which strongly criticized the Senate bill of the same name, is expected to be among the provider groups against it.
WAY TO GO CONGRESS! PUSH IT THROUGH...
Any why? Because arbitration is limiting - less access to documents, witnesses - harder to get the clear picture. And it is not always cheaper, nor is it always quicker.... Gives families a choice - after all, they are signing these documents in times of stress, when no one is considering the nursing home may abuse or neglect their loved one!
May 23 2008
Nursing home operators would be unable to subject residents and prospective residents to binding arbitration clauses under a bill introduced Thursday afternoon in the U.S. House. When a companion bill was introduced in the Senate in April, consumer groups enthusiastically praised it and provider advocates roundly criticized it."This legislation will not prohibit arbitration. Instead, it will simply ensure that residents have the choice whether to arbitrate a dispute after it has arisen," said bill co-sponsor Rep. Linda Sanchez (D-CA), whose father recently entered a nursing facility. Sanchez said hosting three recent hearings on the Federal Arbitration Act as the chairwoman of the Subcommittee on Commercial and Administrative Law helped form her opinions on the topic.
"The long term care industry is one stark example where businesses draft take-it-or-leave-it admission agreements for prospective residents that include pre-dispute, mandatory arbitration clauses."AARP, the Alzheimer's Association and the National Senior Citizen's Law Center are among the groups who have come out in support of "The Fairness in Nursing Home Arbitration Act of 2008." The American Health Care Association, which strongly criticized the Senate bill of the same name, is expected to be among the provider groups against it.
WAY TO GO CONGRESS! PUSH IT THROUGH...
Any why? Because arbitration is limiting - less access to documents, witnesses - harder to get the clear picture. And it is not always cheaper, nor is it always quicker.... Gives families a choice - after all, they are signing these documents in times of stress, when no one is considering the nursing home may abuse or neglect their loved one!
Thursday, May 22, 2008
NURSING HOMES NEED NURSES!
It is my experience the best nursing homes not only have the best nurses and aides, but they have plenty of them. Face it, the primary care givers are the front line, hands -on nurses. The nurse or aide who assists with dressing, hygiene, feeding, medication, bathing, therapy, assessment, treatment, wound care, and the list goes on and on and on…..
Unfortunately, many corporate-owned nursing homes place profits over people and are in a constant mode of "down-sizing" in order to reduce the number of nurses...thereby reducing operating expenses....thereby increasing profits! Unfortunately, it also means less care and sometimes no care.
How much nursing care is needed? A lot. The National Citizens Coalition for Nursing Home Reform (NCCNHR) believes that the "minimal level of staffing" should be 4.13 hours of available nursing time per resident per day.
The law requires all certified nursing homes to publish daily the number of residents at the facility, the number of care providers and actual hours worked per shift at the nursing home.
This information is critical!
Ask for it…study it…and make placement decisions based upon it!
Unfortunately, many corporate-owned nursing homes place profits over people and are in a constant mode of "down-sizing" in order to reduce the number of nurses...thereby reducing operating expenses....thereby increasing profits! Unfortunately, it also means less care and sometimes no care.
How much nursing care is needed? A lot. The National Citizens Coalition for Nursing Home Reform (NCCNHR) believes that the "minimal level of staffing" should be 4.13 hours of available nursing time per resident per day.
The law requires all certified nursing homes to publish daily the number of residents at the facility, the number of care providers and actual hours worked per shift at the nursing home.
This information is critical!
Ask for it…study it…and make placement decisions based upon it!
Tuesday, May 20, 2008
VIRGINIANS.... LISTEN UP, SUNRISE NURSING COVERS UP DEATH!
Sunrise Nursing Home cover up death!
Sunrise staff told Chase's son that she had died in her sleep. The son said he was told his mother had breakfast, was left alone at one point, and the aide returned to find she had died peacefully in her sleep.
The nurisng home lied!
The report from Mount Vernon police shows workers said Chase was sleeping at 7:30 a.m., but was "unresponsive" four hours later. Days after Chase was cremated, however, her family got a tip from someone with second hand knowledge of her death that the woman did not die peacefully.
One nurse claims, she found the woman, with her head caught between the bars of her hospital bed with her feet hanging off the side. The nurse said it appeared as if she struggled and then died of strangulation.
"Her tongue was protruding. It was purple," the nurse said.
The nurse said one of the maintenance workers then lifted Olive's legs while she held onto one of her shoulders.
"We brought her up, laid her flat on her bed," said the nurse. "I brushed her hair. This nursing coordinator told us, 'Don't say anything.'"
The nurse said the last person to treat Olive for a bedsore raised the bed for the treatment but did not lower it after, despite instructions to do so. Olive was known to wander, the nurse said.
"We had a sign on the top of the bed, readily visible, stating to lower the bed at its lowest level when finishing care," the nurse said.
An anonymous call to the state Department of Health days after Olive's death reported that the woman appeared to have died of asphyxiation after her head was caught in the bars, which triggered an investigation.
The department concluded the caller's complaint was valid. The department found that Olive's body had been rearranged after her death, but it was not reported that way in Sunrise's records, authorities told News 4 New York.
The Chase family filed a lawsuit in the state Supreme Court against Sunrise, alleging the staff tried to "cover up the horrific and ghastly manner" of Olive Chase's death, and that she died because of the "negligence, carelessness and recklessness" of Sunrise workers, according to court papers.
Sunrise released the following statement to News 4 New York:
"The state conducted a thorough investigation and nothing was found to substantiate the claim that Mrs. Chase's death was due to anything other than natural causes. (That is) Sunrise's position that the allegations are unsubstantiated."
Yeah, right!
Sunrise staff told Chase's son that she had died in her sleep. The son said he was told his mother had breakfast, was left alone at one point, and the aide returned to find she had died peacefully in her sleep.
The nurisng home lied!
The report from Mount Vernon police shows workers said Chase was sleeping at 7:30 a.m., but was "unresponsive" four hours later. Days after Chase was cremated, however, her family got a tip from someone with second hand knowledge of her death that the woman did not die peacefully.
One nurse claims, she found the woman, with her head caught between the bars of her hospital bed with her feet hanging off the side. The nurse said it appeared as if she struggled and then died of strangulation.
"Her tongue was protruding. It was purple," the nurse said.
The nurse said one of the maintenance workers then lifted Olive's legs while she held onto one of her shoulders.
"We brought her up, laid her flat on her bed," said the nurse. "I brushed her hair. This nursing coordinator told us, 'Don't say anything.'"
The nurse said the last person to treat Olive for a bedsore raised the bed for the treatment but did not lower it after, despite instructions to do so. Olive was known to wander, the nurse said.
"We had a sign on the top of the bed, readily visible, stating to lower the bed at its lowest level when finishing care," the nurse said.
An anonymous call to the state Department of Health days after Olive's death reported that the woman appeared to have died of asphyxiation after her head was caught in the bars, which triggered an investigation.
The department concluded the caller's complaint was valid. The department found that Olive's body had been rearranged after her death, but it was not reported that way in Sunrise's records, authorities told News 4 New York.
The Chase family filed a lawsuit in the state Supreme Court against Sunrise, alleging the staff tried to "cover up the horrific and ghastly manner" of Olive Chase's death, and that she died because of the "negligence, carelessness and recklessness" of Sunrise workers, according to court papers.
Sunrise released the following statement to News 4 New York:
"The state conducted a thorough investigation and nothing was found to substantiate the claim that Mrs. Chase's death was due to anything other than natural causes. (That is) Sunrise's position that the allegations are unsubstantiated."
Yeah, right!
ROANOKE NURSING HOME TO EXPAND
I read with interest an article which appeared in the Roanoke Times today. The article entitled, "Roanoke Council OKs Expansion of Nursing Home" was written by Mason Adams. The article reported that Roanoke City Council voted 6-0 yesterday to approve a 3,000-square-foot expansion of the Raleigh Court Health & Rehabilitation Center for a physical therapy unit. The anticipated cost is $750,000.
Why does this interest me? Because Raleigh Court Health & Rehabilitation is owned by Medical Facilities of America (MFA), which is located here in Roanoke...and this is no "mom and pop" organization. MFA is one of the largest nursing home chains in America with nursing homes throughout Virginia and North Carolina! When I attempt to hold one of MFA's nursing homes accountable for the poor care of one of its residents, I am told by the facility's Administrator and attorneys that MFA just doesn't have the money to hire all of the nurses and aides needed to care for every need of every resident. I am told that the Medicaid reimbursement rate is so low that running a nursing home is barely profitable!
Doesn't look like coming up with $750,000 was any trouble! How many nurses and nurse aides could be hired for $750,000? At an average salary of $25,000, MFA could hire an additional 30 nurses and aides. Think what that would do to improve patient care!
Why does this interest me? Because Raleigh Court Health & Rehabilitation is owned by Medical Facilities of America (MFA), which is located here in Roanoke...and this is no "mom and pop" organization. MFA is one of the largest nursing home chains in America with nursing homes throughout Virginia and North Carolina! When I attempt to hold one of MFA's nursing homes accountable for the poor care of one of its residents, I am told by the facility's Administrator and attorneys that MFA just doesn't have the money to hire all of the nurses and aides needed to care for every need of every resident. I am told that the Medicaid reimbursement rate is so low that running a nursing home is barely profitable!
Doesn't look like coming up with $750,000 was any trouble! How many nurses and nurse aides could be hired for $750,000? At an average salary of $25,000, MFA could hire an additional 30 nurses and aides. Think what that would do to improve patient care!
Monday, May 19, 2008
DOCTORS HEADING TO TEXAS: LET THEM GO!
I recently read an op-ed pieces in the Wall Street Journal entitled, "Why Doctors are Heading to Texas." The article, written by Joseph Nixon a member of what I presume is a conservative pro-business propaganda machine, describes how tort reform in Texas has lead to a massive influx of medical doctors to the state.
Mr. Nixon points to two "reforms" which created the doctors' rush to the Lone Star State. First, the state legislature capped medical malpractice damages for noneconomic damages at $250,000. Second, it changed the standard of proof for suits against Emergency Room physicians from simple negligence to "willful and wanton" negligence.
This type of tort reform produces several results. First, it means that a home maker or child under the age of 18 who is killed due to the negligence of a health care provider is worth a maximum of $250,000 to the grieving family. Second, it means that the Emergency Room physician who misses clear indications of an impending heart attack and discharges a patient who, one week later dies from a heart attack, is not held legally accountable.
Maybe most importantly for Texans....it means that all of the poor doctors who have long track records of lawsuits in other states will move to Texas to practice their craft!
Hey Texans...you might think about moving out of the Lone Star State before you need good medical care!
Mr. Nixon points to two "reforms" which created the doctors' rush to the Lone Star State. First, the state legislature capped medical malpractice damages for noneconomic damages at $250,000. Second, it changed the standard of proof for suits against Emergency Room physicians from simple negligence to "willful and wanton" negligence.
This type of tort reform produces several results. First, it means that a home maker or child under the age of 18 who is killed due to the negligence of a health care provider is worth a maximum of $250,000 to the grieving family. Second, it means that the Emergency Room physician who misses clear indications of an impending heart attack and discharges a patient who, one week later dies from a heart attack, is not held legally accountable.
Maybe most importantly for Texans....it means that all of the poor doctors who have long track records of lawsuits in other states will move to Texas to practice their craft!
Hey Texans...you might think about moving out of the Lone Star State before you need good medical care!
Sunday, May 18, 2008
Virginia's Birth Injury Fund Will Run Out of Money
Virginia's Birth Injury Fund was the first effort in the nation promising lifetime medical care to a small class of infants whose injuries at birth represented a severe malpractice threat against doctors and hospitals. A wonderful plan...but it has never worked!
The plan was "sold" to the Virginia General Assembly by the Medical Society of Virginia as a way to keep Virginia's obstetricians from going broke paying ever increasing medical malpractice insurance premiums and at the same time providing benefits (more easily obtained than by pursuing traditional medical malpractice claims) to those infants severely injured at birth. The plan has failed at both goals. The premiums which obstetricians pay for malpractice insurance fluctuate with the rise and fall of the stock market, as a result of the rise and fall of the value of insurance companies investment portfolio...not the number or severity of malpractice claims.
And what about the infants, the procedure under the plan, promoted as user friendly, is anything but. Bureaucratic delays and gamesmanship prevail...the plan fights almost every request for benefits!
Now, the Richmond Times Dispatch has reported that Virginia's Birth Injury Fund will run out of money in about 20 years. An audit released last week shows that assets of the program climbed to $227 million at the end of last year but that those assets are $127.6 million short of the amount needed to assure lifetime benefit payments to infants admitted into the program.
I SAY LET THE BIRTH INJURY FUND DIE....IT WAS A BAD LAW TO BEGIN WITH!
The plan was "sold" to the Virginia General Assembly by the Medical Society of Virginia as a way to keep Virginia's obstetricians from going broke paying ever increasing medical malpractice insurance premiums and at the same time providing benefits (more easily obtained than by pursuing traditional medical malpractice claims) to those infants severely injured at birth. The plan has failed at both goals. The premiums which obstetricians pay for malpractice insurance fluctuate with the rise and fall of the stock market, as a result of the rise and fall of the value of insurance companies investment portfolio...not the number or severity of malpractice claims.
And what about the infants, the procedure under the plan, promoted as user friendly, is anything but. Bureaucratic delays and gamesmanship prevail...the plan fights almost every request for benefits!
Now, the Richmond Times Dispatch has reported that Virginia's Birth Injury Fund will run out of money in about 20 years. An audit released last week shows that assets of the program climbed to $227 million at the end of last year but that those assets are $127.6 million short of the amount needed to assure lifetime benefit payments to infants admitted into the program.
I SAY LET THE BIRTH INJURY FUND DIE....IT WAS A BAD LAW TO BEGIN WITH!
Medications Can Cause Eye Disease
I was surprised to learn that commonly prescribed medications can impair our vision and cause diseases of the eye. A recent report, published in Drug Safety, identified 62 drugs that can cause adverse reactions to the eye.
Public Citizen, on its WorstPills.org web site, summarizes the report and details how the medications can cause cataracts, glaucoma, conjunctival diseases, optic nerve diseases, and retinal abnormalities.
Be an informed consumer....You eyesight may depend upon it!
Public Citizen, on its WorstPills.org web site, summarizes the report and details how the medications can cause cataracts, glaucoma, conjunctival diseases, optic nerve diseases, and retinal abnormalities.
Be an informed consumer....You eyesight may depend upon it!
Saturday, May 17, 2008
Drug Mistakes in Nursing Homes
The press has been filled with articles recently about drug mistakes in hospitals. The wrong drug given to the wrong patient...the right drug given to the wrong patient...and even the right drug given to the right patient but in the wrong dose (actor Dennis Quaid's newborn twins)!
These articles got me to wondering about just how prevalent these medication errors are in nursing homes. We see them all of the time in our cases but do our cases reflect what is happening across the United States? Apparently so!
A 2005 study published in the American Journal of Medicine revealed that 1 out of every 10 nursing home residents has suffered a medication-related injury and that 73 percent of the most severe injuries, including internal bleeding and death, were preventable.
Not very encouraging news!
These articles got me to wondering about just how prevalent these medication errors are in nursing homes. We see them all of the time in our cases but do our cases reflect what is happening across the United States? Apparently so!
A 2005 study published in the American Journal of Medicine revealed that 1 out of every 10 nursing home residents has suffered a medication-related injury and that 73 percent of the most severe injuries, including internal bleeding and death, were preventable.
Not very encouraging news!
Friday, May 16, 2008
Problems in Nursing Homes Often Overlooked and Underreported
To anyone who regularly reads this blog, it will not come as a surprise to hear me say (once again) that the medical - industrial complex which runs America's long term care industry puts profits ahead of people. Always have and always will! The result is overwhelmingly poor care.
Some of critics of my position counter with the argument that, "many nursing homes get good inspection reports when surveyed by state agencies - so they can't be as bad as you say." My response, yes they are just as bad as I say and here is more proof.
In a report to be released today, investigators, from the Government Accountability Office (GAO), say they have found widespread “understatement of deficiencies,” including malnutrition, severe bedsores, overuse of prescription medications and abuse of nursing home residents. Nursing homes are typically inspected once a year by state employees working under contract with the federal government, which sets stringent standards. Federal officials try to validate the work of state inspectors by accompanying them or doing follow-up surveys within a few weeks.
The GAO found that state employees had missed at least one serious deficiency in 15 percent of the inspections checked by federal officials. In nine states, inspectors missed serious problems in more than 25 percent of the surveys analyzed from 2002 to 2007. The nine states most likely to miss serious deficiencies were Alabama, Arizona, Missouri, New Mexico, Oklahoma, South Carolina, South Dakota, Tennessee and Wyoming.
Okay corporate owners of nursing homes....what do you have to say now?
Some of critics of my position counter with the argument that, "many nursing homes get good inspection reports when surveyed by state agencies - so they can't be as bad as you say." My response, yes they are just as bad as I say and here is more proof.
In a report to be released today, investigators, from the Government Accountability Office (GAO), say they have found widespread “understatement of deficiencies,” including malnutrition, severe bedsores, overuse of prescription medications and abuse of nursing home residents. Nursing homes are typically inspected once a year by state employees working under contract with the federal government, which sets stringent standards. Federal officials try to validate the work of state inspectors by accompanying them or doing follow-up surveys within a few weeks.
The GAO found that state employees had missed at least one serious deficiency in 15 percent of the inspections checked by federal officials. In nine states, inspectors missed serious problems in more than 25 percent of the surveys analyzed from 2002 to 2007. The nine states most likely to miss serious deficiencies were Alabama, Arizona, Missouri, New Mexico, Oklahoma, South Carolina, South Dakota, Tennessee and Wyoming.
Okay corporate owners of nursing homes....what do you have to say now?
Thursday, May 15, 2008
Bayer Antibleeding Drug Removed From Market
Bayer AG of Germany, agreed to temporarily suspend sales of Trasylol last November following requests from the Food and Drug Administration (FDA). The antibleeding drug may have received its final blow with a new study that shows it is associated with a greater risk of death compared to competing medications.
The results of that study, published by the New England Journal of Medicine, confirmed the earlier findings: a more than 50% increase in the relative risk of death. The study found that 6% of patients who received Trasylol, or aprotinin, died within 30 days of surgery compared to 4% of patients who received tranexamic acid or aminocaproic acid. All three drugs are used to prevent blood loss during heart surgery.
What was the best comment about the drug and the tests results? "This study could have been done by the company five to ten years ago," Dr. Paul Hébert said, adding that Trasylol costs about $1,400 compared to about $4 for aminocaproic acid. Dr. Hebert was one of the studies lead investigators.
83 patients have filed lawsuits against Bayer over the use of the drug. And if President George Bush has his way...those lawsuits would be banned because the FDA initially approved the drug.
Doesn't seem fair does it?
The results of that study, published by the New England Journal of Medicine, confirmed the earlier findings: a more than 50% increase in the relative risk of death. The study found that 6% of patients who received Trasylol, or aprotinin, died within 30 days of surgery compared to 4% of patients who received tranexamic acid or aminocaproic acid. All three drugs are used to prevent blood loss during heart surgery.
What was the best comment about the drug and the tests results? "This study could have been done by the company five to ten years ago," Dr. Paul Hébert said, adding that Trasylol costs about $1,400 compared to about $4 for aminocaproic acid. Dr. Hebert was one of the studies lead investigators.
83 patients have filed lawsuits against Bayer over the use of the drug. And if President George Bush has his way...those lawsuits would be banned because the FDA initially approved the drug.
Doesn't seem fair does it?
Wednesday, May 14, 2008
PROTESTS AT LONG TERM CARE COMPANY ANNUAL MEETING
That is what I like to see... don't like the way seniors are being cared for? You could sue. You could lobby congress to change the laws... or you could show up and protest their annual meeting!
Protesters question Lazard Ltd. bosses about senior care homes
By Ruth O'Kelly-Lynch
"Protesters questioned multi-billion dollar Wall Street investment bank directors about senior care facilities outside a shareholders meeting at the Elbow Beach Resort yesterday, as the company announced a 71-percent plummet in its profits.
Lazard Ltd., the investment bank currently advising Bear Stearns in its sale to JP Morgan, said its first-quarter profit was hit by a $28.5 million write-down in its holdings of corporate debt and losses in its corporate equity portfolio.
Security was tight in the Elbow Beach Hotel as protesters had made it clear they were planning on attending the shareholders meeting yesterday.
The protesters claim executives of Lazard Ltd., which is incorporated in Bermuda, have failed to improve the quality of care at one of the largest elderly care home companies in the US, Atria Senior Living Centers. During the meeting some of the issues were raised by the protesters.
They have also questioned why workers earn as little as $300 a week while Mr. Wasserstein earned $41 million, or $19,711 an hour, in 2007. He is reported to be worth $2 billion.
Robin Berson was one of the protesters who flew in for the meeting because she is worried about the treatment her mother receives in an Atria facility in Brooklyn.
"In my situation I have had such a hard time getting Atria to do what my 88-year-old mother needs," she claimed. "The facility management is unresponsive and too often it seems they are interested in only making money. The facilities are too short-staffed. Many of these residents suffer from disorientation and dementia."
Ms Berson asked Lazard directors to "honour a commitment to community, to decency and to ethics" and added: "You have the power to act decently and humanely and improve the lives of thousands of elderly in the last years of their lives and workers who are just asking for a living wage and the right to unionise."
But she was told Lazard Ltd. did not control Atria and Scott Hoffman, general counsel for Lazard, offered to facilitate communication with the people who do own Atria. Atria is actually owned by Lazard Alternative Investments (LAI) which has operated separately from its publicly traded namesake since 2005. However the protesters allege that ultimately Mr. Wasserstein and Lazard directors still have large stakes in LAI and could influence decisions there, if they chose to. "
WAY TO GO MS. BENSON! I am proud you went down there... Maybe some personal embarrassment will lead to corporate accountability.
Protesters question Lazard Ltd. bosses about senior care homes
By Ruth O'Kelly-Lynch
"Protesters questioned multi-billion dollar Wall Street investment bank directors about senior care facilities outside a shareholders meeting at the Elbow Beach Resort yesterday, as the company announced a 71-percent plummet in its profits.
Lazard Ltd., the investment bank currently advising Bear Stearns in its sale to JP Morgan, said its first-quarter profit was hit by a $28.5 million write-down in its holdings of corporate debt and losses in its corporate equity portfolio.
Security was tight in the Elbow Beach Hotel as protesters had made it clear they were planning on attending the shareholders meeting yesterday.
The protesters claim executives of Lazard Ltd., which is incorporated in Bermuda, have failed to improve the quality of care at one of the largest elderly care home companies in the US, Atria Senior Living Centers. During the meeting some of the issues were raised by the protesters.
They have also questioned why workers earn as little as $300 a week while Mr. Wasserstein earned $41 million, or $19,711 an hour, in 2007. He is reported to be worth $2 billion.
Robin Berson was one of the protesters who flew in for the meeting because she is worried about the treatment her mother receives in an Atria facility in Brooklyn.
"In my situation I have had such a hard time getting Atria to do what my 88-year-old mother needs," she claimed. "The facility management is unresponsive and too often it seems they are interested in only making money. The facilities are too short-staffed. Many of these residents suffer from disorientation and dementia."
Ms Berson asked Lazard directors to "honour a commitment to community, to decency and to ethics" and added: "You have the power to act decently and humanely and improve the lives of thousands of elderly in the last years of their lives and workers who are just asking for a living wage and the right to unionise."
But she was told Lazard Ltd. did not control Atria and Scott Hoffman, general counsel for Lazard, offered to facilitate communication with the people who do own Atria. Atria is actually owned by Lazard Alternative Investments (LAI) which has operated separately from its publicly traded namesake since 2005. However the protesters allege that ultimately Mr. Wasserstein and Lazard directors still have large stakes in LAI and could influence decisions there, if they chose to. "
WAY TO GO MS. BENSON! I am proud you went down there... Maybe some personal embarrassment will lead to corporate accountability.
TENNESSEE NURSING HOMES IN THE NEWS FOR ALL THE WRONG REASONS
I have previously blogged on the bad state of nursing home care in Tennessee...but it seems to just keep getting worse and worse!
The Tennessee Department of Heath officials have suspended admissions of residents to three nursing homes as a result of safety violations and sub-standard care. The list includes:
1. Dove Health & Rehabilitation in Collierville, Tennessee
2. Claiborne County Nursing Home in Tazewell, Tennessee
3. Hillcrest-West Nursing Home in Knoxville, Tennessee
If you cannot take care of your loved ones in the state of Tennessee....where do you turn? Not to these facilities!
The Tennessee Department of Heath officials have suspended admissions of residents to three nursing homes as a result of safety violations and sub-standard care. The list includes:
1. Dove Health & Rehabilitation in Collierville, Tennessee
2. Claiborne County Nursing Home in Tazewell, Tennessee
3. Hillcrest-West Nursing Home in Knoxville, Tennessee
If you cannot take care of your loved ones in the state of Tennessee....where do you turn? Not to these facilities!
Tuesday, May 13, 2008
FAILURE TO DIAGNOSE AND TREAT CANCER CASES
I am proud of the Virginia General Assembly this past session. I know they fought like kids (disgracefully) over the appointment of judges but not all was lost.
For many years, plaintiff's in medical malpractice cases involving the misdiagnosis of cancer have been treated unfairly in Virginia. The unfairness arose from an onerous and often impossible statute of limitations. Everyone knows that the statute of limitation places an outside date by which a plaintiff must file his/her suit or be forever barred from making a claim.
Here is how the unfairness worked in Virginia cancer cases: A 40 year old woman feels a lump in her breast. She goes to her doctor who orders a mammogram. Unfortunately, the radiologist who reviews and interprets the mammogram misses the obvious cancer and gives the patient a clean bill of health. Three years later the lump becomes larger and painful and upon surgical removal it is found to be cancerous...and it has metastasized into the patent's lungs and spine. She has a death sentence.
Until this year's changes by our General Assembly[8.01-243(3)], that 40 year old woman's medical malpractice claim against her radiologist was barred by the statute of limitations! Under the old law, the negligence occurred and the statute begin to run at the time the radiologist negligently interpreted the mammogram...even though the patient had no idea she had cancer and did everything her doctor requested.
Now, for all claims arising after July 1, 2008, patients have a period of one year from the date the diagnosis of a malignant tumor or cancer is communicated to the patient by a health care provider.
For many years, plaintiff's in medical malpractice cases involving the misdiagnosis of cancer have been treated unfairly in Virginia. The unfairness arose from an onerous and often impossible statute of limitations. Everyone knows that the statute of limitation places an outside date by which a plaintiff must file his/her suit or be forever barred from making a claim.
Here is how the unfairness worked in Virginia cancer cases: A 40 year old woman feels a lump in her breast. She goes to her doctor who orders a mammogram. Unfortunately, the radiologist who reviews and interprets the mammogram misses the obvious cancer and gives the patient a clean bill of health. Three years later the lump becomes larger and painful and upon surgical removal it is found to be cancerous...and it has metastasized into the patent's lungs and spine. She has a death sentence.
Until this year's changes by our General Assembly[8.01-243(3)], that 40 year old woman's medical malpractice claim against her radiologist was barred by the statute of limitations! Under the old law, the negligence occurred and the statute begin to run at the time the radiologist negligently interpreted the mammogram...even though the patient had no idea she had cancer and did everything her doctor requested.
Now, for all claims arising after July 1, 2008, patients have a period of one year from the date the diagnosis of a malignant tumor or cancer is communicated to the patient by a health care provider.
Monday, May 12, 2008
PREEMPTIOn (which means you cannot sue a medical device company, because Federal law may prevent it)
On Wednesday, May 14th, victims of faulty medical devices and dangerous drugs will finally receive a voice in Congress. As you may recall, this past February the Supreme Court held that state tort claims regarding medical devices were preempted if the Food and Drug Administration had granted premarket approval for a medical device.
The House Committee on Oversight and Government Reform will hold a hearing this week to explore this issue. Detailed information is listed below, and the committee should offer live streaming video of the hearing on their website.
Should FDA Drug and Medical Device Regulation Bar State Liability Claims?
Committee on Oversight and Government Reform
Wednesday, May 14, 2008, 10:00 AM at 2154 Rayburn House Office Building
http://www.oversight.house.gov/
Witnesses: Actor Dennis Quaid and his wife Kimberly, parents of newborn twins, Thomas Boone Quaid and Zoe Grace Quaid, who were victims of a heparin overdose; William Maisel, director of the Medical Device Safety Institute, Department of Medicine, Beth Israel Deaconess Medical Center, Boston; Aaron Kesselheim of the Harvard Medical School's Division of Pharmacoepidemiology; David Kessler, professor of pediatrics and epidemiology and biostatistics at the School of Medicine, University of California, San Francisco; David Vladeck, professor of law at the Georgetown University Law Center; Gregory Curfman, editor of the New England Journal of Medicine; Christine Ruther, president and chief engineer for C&R Engineering, Inc.; and Utah State Representative David Clark (R) of the National Conference of State Legislatures.
It is a unique and important debate. Afterall, if you experienced great pain and suffering because of a mistake, would you be satisfied that the device "was FDA approved?" Not me - not when the FDA has approved many drugs that cause problems everyday!
find out more at http://www.atlanet.org/
The House Committee on Oversight and Government Reform will hold a hearing this week to explore this issue. Detailed information is listed below, and the committee should offer live streaming video of the hearing on their website.
Should FDA Drug and Medical Device Regulation Bar State Liability Claims?
Committee on Oversight and Government Reform
Wednesday, May 14, 2008, 10:00 AM at 2154 Rayburn House Office Building
http://www.oversight.house.gov/
Witnesses: Actor Dennis Quaid and his wife Kimberly, parents of newborn twins, Thomas Boone Quaid and Zoe Grace Quaid, who were victims of a heparin overdose; William Maisel, director of the Medical Device Safety Institute, Department of Medicine, Beth Israel Deaconess Medical Center, Boston; Aaron Kesselheim of the Harvard Medical School's Division of Pharmacoepidemiology; David Kessler, professor of pediatrics and epidemiology and biostatistics at the School of Medicine, University of California, San Francisco; David Vladeck, professor of law at the Georgetown University Law Center; Gregory Curfman, editor of the New England Journal of Medicine; Christine Ruther, president and chief engineer for C&R Engineering, Inc.; and Utah State Representative David Clark (R) of the National Conference of State Legislatures.
It is a unique and important debate. Afterall, if you experienced great pain and suffering because of a mistake, would you be satisfied that the device "was FDA approved?" Not me - not when the FDA has approved many drugs that cause problems everyday!
find out more at http://www.atlanet.org/
Sunday, May 11, 2008
EPA SETTLES WITH LANDLORD OVER LEAD PAINT VIOLATIONS
This story comes to us from Spokane, Washington...but is equally applicable to about any city in America.
A Spokane area landlord, has agreed to pay a $4,000 penalty to settle alleged violations of the Environmental Protection Agency’s (EPA) lead-based paint disclosure rules. The single family home used as rental property is considered by the EPA and the Department of Housing and Urban Development (HUD) to be "target housing": a dwelling built prior to the 1978 Consumer Products Safety Commission ban on the manufacture and sale of lead-based paint. The EPA alleged the landlord, as a building owner and landlord, failed to carry-out required disclosure activities with his tenants and their children.
The federal lead-based paint and/or lead-based hazards Disclosure Rule requires sellers, owners and lessors (as well as property management firms) of pre-1978 rental housing to provide disclosures and other information to tenants. The Rule helps ensure that tenants can make informed decisions about protecting their children and themselves from lead-based paint and lead-based paint hazards before they sign a lease.
Individuals who are concerned that they or their children may have been exposed to lead hazards can determine if they have elevated blood-lead levels through a simple, inexpensive test at their doctor’s office or local health clinic.
A Spokane area landlord, has agreed to pay a $4,000 penalty to settle alleged violations of the Environmental Protection Agency’s (EPA) lead-based paint disclosure rules. The single family home used as rental property is considered by the EPA and the Department of Housing and Urban Development (HUD) to be "target housing": a dwelling built prior to the 1978 Consumer Products Safety Commission ban on the manufacture and sale of lead-based paint. The EPA alleged the landlord, as a building owner and landlord, failed to carry-out required disclosure activities with his tenants and their children.
The federal lead-based paint and/or lead-based hazards Disclosure Rule requires sellers, owners and lessors (as well as property management firms) of pre-1978 rental housing to provide disclosures and other information to tenants. The Rule helps ensure that tenants can make informed decisions about protecting their children and themselves from lead-based paint and lead-based paint hazards before they sign a lease.
Individuals who are concerned that they or their children may have been exposed to lead hazards can determine if they have elevated blood-lead levels through a simple, inexpensive test at their doctor’s office or local health clinic.
Saturday, May 10, 2008
DOCTORS AND BOOKS
I try to read as many books written about and by medicine and the medical profession as I can. Frankly, I enjoy the reading and always learn something new. Today, I want to share (and recommend) two good books.
Sacred Trust, written by Dr. Phyliss Hollenbeck is an excellent read and a very accurate critique of the current state of the practice of medicine. Dr. Hollenbeck identifies the "10 rules of life, death, and medicine" and tells you how to identify the jerks in medicine and how to fire them as your care providers. Dr. Hollenbeck, a general practitioner living in Northern Virginia, stresses the need for more competent family practice doctors. Her book may be purchased from Book Publishers Network for $13.95.
Overtreated: Why Too Much Medicine is Making Us Sicker and Poorer, by Shannon Brownlee who writes about medicine, healthcare, and biotechnology for the New York Times Magazine, the New Republic, and the Atlantic Monthly. Ms. Brownlee takes the reader inside the hospital to provide vivid examples of unnecessary care that is not only expensive and wasteful but care that actually threatens the health of patients. We have all heard about the dangers of the military-industrial complex but Brownlee warns us to be wary of the "medical-industrial complex." The book is published by Bloomsbury USA and is priced at $25.95
Sacred Trust, written by Dr. Phyliss Hollenbeck is an excellent read and a very accurate critique of the current state of the practice of medicine. Dr. Hollenbeck identifies the "10 rules of life, death, and medicine" and tells you how to identify the jerks in medicine and how to fire them as your care providers. Dr. Hollenbeck, a general practitioner living in Northern Virginia, stresses the need for more competent family practice doctors. Her book may be purchased from Book Publishers Network for $13.95.
Overtreated: Why Too Much Medicine is Making Us Sicker and Poorer, by Shannon Brownlee who writes about medicine, healthcare, and biotechnology for the New York Times Magazine, the New Republic, and the Atlantic Monthly. Ms. Brownlee takes the reader inside the hospital to provide vivid examples of unnecessary care that is not only expensive and wasteful but care that actually threatens the health of patients. We have all heard about the dangers of the military-industrial complex but Brownlee warns us to be wary of the "medical-industrial complex." The book is published by Bloomsbury USA and is priced at $25.95
Friday, May 09, 2008
PLEASE CALL ASAP
I received a call this week from a very kind, smart lady who was calling on behalf of her Aunt who was the victim of nursing home negligence. The lady told me - "I want to be upfront with you, this happened in 2006." "When in 2006?" I asked. "May 14" she replied.
YIKES. In ALL states there is a statute of limitations to when you can file a lawsuit. A statute of limitation is essentially a deadline - usually 2 years from the date of the accident, you must have the lawsuit filed in the appropriate court, or you will lose your right to pursue your claim.
It takes our office (which is very efficient) at least 4 weeks to evaluate a lawsuit, before we even get experts involved. When experts support the claim, then and only then do we file the lawsuit. (In Virginia, you must have an expert in order to serve the lawsuit. Proceeding without expert support will get the attorney in trouble, and the case thrown out).
So I had to explain to this nice lady, there was NO WAY we could help her. No way to get all medical records in 1 week, review the case, find an expert, have them do a good review of the records, and draft the lawsuit.
So please - if you think you may have a case, do not wait, call right away. Even 2 months may not be enough time to evaluate a good case, and get it ready for filing.
YIKES. In ALL states there is a statute of limitations to when you can file a lawsuit. A statute of limitation is essentially a deadline - usually 2 years from the date of the accident, you must have the lawsuit filed in the appropriate court, or you will lose your right to pursue your claim.
It takes our office (which is very efficient) at least 4 weeks to evaluate a lawsuit, before we even get experts involved. When experts support the claim, then and only then do we file the lawsuit. (In Virginia, you must have an expert in order to serve the lawsuit. Proceeding without expert support will get the attorney in trouble, and the case thrown out).
So I had to explain to this nice lady, there was NO WAY we could help her. No way to get all medical records in 1 week, review the case, find an expert, have them do a good review of the records, and draft the lawsuit.
So please - if you think you may have a case, do not wait, call right away. Even 2 months may not be enough time to evaluate a good case, and get it ready for filing.
YOUR "RIGHTS" AGAINST MEDICAL DEVICE COMPANIES
If the doctor puts a bad pace maker in your chest, and it causes problems such that you need additional medical care, you have the right to sue the pace maker company for damages, right?
Sorry - this is a trick question. The Medical Device Amendments (federal law) prohibits (or preempts) state tort claims against medical devices that the FDA approved through the pre-market approval process. I know what you are thinking, the same FDA that approved Heparin that killed 89 people. The same FDA that can't get to China to check on drug manufacturing there. The same FDA that has missed mad cow disease and spinach ecoli in the US. YUP. So we should feel very confident in any device they approve...
Sadly, this year, the Supreme Court (all but 1 Justice) held that a man could not sue Medtronic because of this federal preemption. Sounds like bad news to me. If you think such an erosion of your rights is unacceptable, let your Senators and Congressmen and Women know. After all, most of our rights exist after someone has fought hard for them!
Sorry - this is a trick question. The Medical Device Amendments (federal law) prohibits (or preempts) state tort claims against medical devices that the FDA approved through the pre-market approval process. I know what you are thinking, the same FDA that approved Heparin that killed 89 people. The same FDA that can't get to China to check on drug manufacturing there. The same FDA that has missed mad cow disease and spinach ecoli in the US. YUP. So we should feel very confident in any device they approve...
Sadly, this year, the Supreme Court (all but 1 Justice) held that a man could not sue Medtronic because of this federal preemption. Sounds like bad news to me. If you think such an erosion of your rights is unacceptable, let your Senators and Congressmen and Women know. After all, most of our rights exist after someone has fought hard for them!
WEST VIRGINIA JUDGE APPROVES MALPRACTICE SETTLEMENTS
Putnam County (Hurricane, WV) Circuit Court Judge O.C. Spaulding has approved settlements totaling $2.4 million for three malpractice lawsuits involving Dr. John A. King and Putnam General Hospital and the hospital's former owner, Nashville, Tenn.-based Hospital Corporation of America Inc. Dr. King had practiced at Putnam General from November 2002 to June 2003. The lawsuits allege King, an osteopath, botched surgeries or otherwise harmed patients during his six-month stint at the hospital. A total of 124 suits were filed.
Of the three cases which settled one patient died three years after multiple infections resulting from back surgery. A second patient never regained consciousness after a spinal operation. The third patient died less than three months after surgery to repair fractures and counter infections. "I have never experienced anything like these 124 cases in my 15 years on the bench,'' Spaulding said. "These cases have generated a tremendous amount of publicity, both in West Virginia and nationally.''
Records show King has been licensed in more than a dozen states but has surrendered, lost his license or had his license suspended in at least six. He let his license expire in two other states.
Do the tort reformers believe that greedy patients and their lawyers are abusing the system? I believe that Dr. King has abused his patients!
Of the three cases which settled one patient died three years after multiple infections resulting from back surgery. A second patient never regained consciousness after a spinal operation. The third patient died less than three months after surgery to repair fractures and counter infections. "I have never experienced anything like these 124 cases in my 15 years on the bench,'' Spaulding said. "These cases have generated a tremendous amount of publicity, both in West Virginia and nationally.''
Records show King has been licensed in more than a dozen states but has surrendered, lost his license or had his license suspended in at least six. He let his license expire in two other states.
Do the tort reformers believe that greedy patients and their lawyers are abusing the system? I believe that Dr. King has abused his patients!
Thursday, May 08, 2008
IMPORTANT INFORMATION FOR CARDIAC PATIENTS IN VIRGINIA
Everyone should be concerned about their heart. Most of us have family members or friends who have suffered from a heart attack or more minor heart problem. The consequences of these "cardiac events"can be devastating so do your homework before choosing a cardiologist or being admitted to your local hospital.
The three basic types of cardiac care and treatment include: Medical Cardiology (diagnosing and therapy for heart diseases like angina, congestive heart failure, and myocardial infarction); Invasive Cardiology (surgeries such as cardiac catheterization, cardiac pacemaker insertion, balloon angioplasty, and placement of cardiac stents); and Open Heart Surgery (coronary artery bypass surgery and cardiac valve procedures).
Virginia Health Information has recently released survey results which you should know before you select a hospital for your cardiac care. For example, the following hospitals in western Virginia had a higher mortality rate for cardiac patients than would typically be expected:
Lewis-Gale Medical Center, Memorial Hospital of Martinsville and Henry County, Buchanan General Hospital, Johnston Memorial Hospital, Lee Regional Medical Center, Pulaski Communty Hospital, Twin County Regional Hospital, Wythe County Community Hospital, Smyth County Community Hospital, and Tazewell Community Hospital
I think I might skip selecting a hosptial from this group. Remember - checking out your hospital might save your life!
The three basic types of cardiac care and treatment include: Medical Cardiology (diagnosing and therapy for heart diseases like angina, congestive heart failure, and myocardial infarction); Invasive Cardiology (surgeries such as cardiac catheterization, cardiac pacemaker insertion, balloon angioplasty, and placement of cardiac stents); and Open Heart Surgery (coronary artery bypass surgery and cardiac valve procedures).
Virginia Health Information has recently released survey results which you should know before you select a hospital for your cardiac care. For example, the following hospitals in western Virginia had a higher mortality rate for cardiac patients than would typically be expected:
Lewis-Gale Medical Center, Memorial Hospital of Martinsville and Henry County, Buchanan General Hospital, Johnston Memorial Hospital, Lee Regional Medical Center, Pulaski Communty Hospital, Twin County Regional Hospital, Wythe County Community Hospital, Smyth County Community Hospital, and Tazewell Community Hospital
I think I might skip selecting a hosptial from this group. Remember - checking out your hospital might save your life!
Wednesday, May 07, 2008
DISEASE OUTBREAK
New disease outbreaks in China; 15K children infected
By HENRY SANDERSON
The Associated Press
Wednesday, May 7, 2008; 1:37 AM
BEIJING -- New outbreaks in China reported Wednesday put the number of children infected with hand, foot and mouth disease above 15,000 and the death toll has risen to at least 28 across the country.
A 2-year-old girl in the southern province of Hunan died of the disease after being in a coma, the provincial health bureau said on its Web site.
Another death was reported in the neighboring Guangxi region, Guangxi health officials said but did not give any details. The official Xinhua News Agency said the victim was a 3-year-old boy who died May 3.
Two kindergartens in Beijing were temporarily shut down Tuesday after children there showed symptoms of the disease, Xinhua said. There have been 1,482 cases in Beijing, most in kindergartens, it said.
So far, 15,799 outbreaks of the disease have been reported throughout the country this year, Xinhua said.
Enterovirus causes a severe form of hand, foot and mouth disease with symptoms including fever, mouth sores and rashes with blisters. It is easily spread by sneezing or coughing. The viruses mainly strike children ages 10 and younger. Some cases can lead to fatal swelling of the brain.
There is no vaccine or specific treatment, but most children affected by mild forms of the disease typically recover quickly without problems."
15,000 kids with a disease is scary stuff - lets hope they know how to treat these kids and prevent the spread
By HENRY SANDERSON
The Associated Press
Wednesday, May 7, 2008; 1:37 AM
BEIJING -- New outbreaks in China reported Wednesday put the number of children infected with hand, foot and mouth disease above 15,000 and the death toll has risen to at least 28 across the country.
A 2-year-old girl in the southern province of Hunan died of the disease after being in a coma, the provincial health bureau said on its Web site.
Another death was reported in the neighboring Guangxi region, Guangxi health officials said but did not give any details. The official Xinhua News Agency said the victim was a 3-year-old boy who died May 3.
Two kindergartens in Beijing were temporarily shut down Tuesday after children there showed symptoms of the disease, Xinhua said. There have been 1,482 cases in Beijing, most in kindergartens, it said.
So far, 15,799 outbreaks of the disease have been reported throughout the country this year, Xinhua said.
Enterovirus causes a severe form of hand, foot and mouth disease with symptoms including fever, mouth sores and rashes with blisters. It is easily spread by sneezing or coughing. The viruses mainly strike children ages 10 and younger. Some cases can lead to fatal swelling of the brain.
There is no vaccine or specific treatment, but most children affected by mild forms of the disease typically recover quickly without problems."
15,000 kids with a disease is scary stuff - lets hope they know how to treat these kids and prevent the spread
Tuesday, May 06, 2008
CAN YOU GET YOUR MEDICAL RECORDS?
Not one week goes by in our office without a caller telling us that their doctor or hospital or nursing home will not provide them with a complete copy of their medical records. Our response is always the same....UPON REQUEST YOU MUST BE GIVEN ALL OF YOUR MEDICAL RECORDS!! No ifs...ands...or buts. The only requirement is the payment of reasonable copy costs.
I practice law in Virginia so can quickly refer to our statute which requires health care providers to produce medical records upon request. Every state has such a law and the federal government requires it! The federal law giving patients and family members access to medical records is the Health Information Portability and Accountability Act (HIPAA). HIPAA allows health care providers to withhold records only in very limited circumstances, such as psychiatric records.
Some families are provided with a selection of records or a summary of the records. Don't allow your doctor, hospital, or nursing home to get away with this - it is wrong and violates state and federal law. Tell the health care provider you want your records produced within a reasonable length of time (10 - 15 days) and if they are not produced you will contact legal counsel.
I practice law in Virginia so can quickly refer to our statute which requires health care providers to produce medical records upon request. Every state has such a law and the federal government requires it! The federal law giving patients and family members access to medical records is the Health Information Portability and Accountability Act (HIPAA). HIPAA allows health care providers to withhold records only in very limited circumstances, such as psychiatric records.
Some families are provided with a selection of records or a summary of the records. Don't allow your doctor, hospital, or nursing home to get away with this - it is wrong and violates state and federal law. Tell the health care provider you want your records produced within a reasonable length of time (10 - 15 days) and if they are not produced you will contact legal counsel.
Friday, May 02, 2008
CASE REPORT: THE DANGERS OF TELERADIOLOGY
Teleradiology, what is it? It is the electronic transmission of radiological patient images, such as x-rays, CT's and MRI's, from one location to another for the purposes of interpretation and/or consultation....and almost all hospitals today are using these services. Hospitals like to use teleradiology services because it provides around the clock professional services, often at lower cost than having a fully-staffed radiology department on site.
We just concluded a medical malpractice case in Virginia involving teleradiology, and sadly the failures of the teleradiologist in our case resulted in the unnecessary death of a 47 year old man. The teleradiology company involved in the case is one of the largest such companies in the world, NightHawk Radiology Services. Our local hospital, Carilion Roanoke Memorial Hospital, contracted with NightHawk to provide radiologic services. The patient arrived at the hospital with a history of a thoracic aneurysm and complaining of back and flank pain. The attending Emergency Room doctor was aware of the possibility that the aneurysm could be the cause of the patient's symptoms and was also aware that a ruptured thoracic aneurysm meant certain death. So he correctly ordered a thoracic/abdominal CT scan to verify the status of the aneurysm.
No radiologist was available at the hospital so the CT films were sent, basically as an attachment to an email, to NightHawk Radiology Services. NightHawk then forwarded the CT films, again via the Internet, to a radiologist sitting at his home in Louisiana for interpretation. Unfortunately, the radiologist mis-read the CT films and determined there had been no change in the aneurysm and reported his findings back to the Emergency Room doctor, who gave the patient pain medication and sent him home. The CT film actually showed the aneurysm had gotten larger and was leaking, or bleeding. The patient was found dead by a family member 5 days later. The cause of death - ruptured thoracic aneurysm!
I am all for using technology to make us more productive, safer, and happier. However, when we go to our local hospital, how do we know who is really diagnosing our condition? Is it a local doctor who is easily accessible (and accountable) or is it a doctor sitting at home in Louisiana or India or China? It is something to think about!
We just concluded a medical malpractice case in Virginia involving teleradiology, and sadly the failures of the teleradiologist in our case resulted in the unnecessary death of a 47 year old man. The teleradiology company involved in the case is one of the largest such companies in the world, NightHawk Radiology Services. Our local hospital, Carilion Roanoke Memorial Hospital, contracted with NightHawk to provide radiologic services. The patient arrived at the hospital with a history of a thoracic aneurysm and complaining of back and flank pain. The attending Emergency Room doctor was aware of the possibility that the aneurysm could be the cause of the patient's symptoms and was also aware that a ruptured thoracic aneurysm meant certain death. So he correctly ordered a thoracic/abdominal CT scan to verify the status of the aneurysm.
No radiologist was available at the hospital so the CT films were sent, basically as an attachment to an email, to NightHawk Radiology Services. NightHawk then forwarded the CT films, again via the Internet, to a radiologist sitting at his home in Louisiana for interpretation. Unfortunately, the radiologist mis-read the CT films and determined there had been no change in the aneurysm and reported his findings back to the Emergency Room doctor, who gave the patient pain medication and sent him home. The CT film actually showed the aneurysm had gotten larger and was leaking, or bleeding. The patient was found dead by a family member 5 days later. The cause of death - ruptured thoracic aneurysm!
I am all for using technology to make us more productive, safer, and happier. However, when we go to our local hospital, how do we know who is really diagnosing our condition? Is it a local doctor who is easily accessible (and accountable) or is it a doctor sitting at home in Louisiana or India or China? It is something to think about!
Thursday, May 01, 2008
RESEARCH VIRGINIA NURSING HOMES
If you have heard a facility does not provide quality care, don't just let the rumors control your decision, investigate yourself!
Here is how:
www.medicare.gov - you can look at recent Medicare surveys
Send a request for surveys taken by Virginia Department of Health. How? Send a Freedom of Information Act Request, to Virginia Department of Health. They will charge a fee for documents, but the information may be well worth it.
Look up physicians at Virginia Department of Health - you can learn about past lawsuits and Medical investigations.
Check Circuit Court records in the county or city where the nursing home is located - to see if recent lawsuits have been filed.
Last but not least - take a tour. Actions speak louder than words!!!
Here is how:
www.medicare.gov - you can look at recent Medicare surveys
Send a request for surveys taken by Virginia Department of Health. How? Send a Freedom of Information Act Request, to Virginia Department of Health. They will charge a fee for documents, but the information may be well worth it.
Look up physicians at Virginia Department of Health - you can learn about past lawsuits and Medical investigations.
Check Circuit Court records in the county or city where the nursing home is located - to see if recent lawsuits have been filed.
Last but not least - take a tour. Actions speak louder than words!!!
CASE REPORT: VIRGINIA MEDMAL CASE SETTLES
This is sort of a sad news/good news/bad news settlement of a medical malpractice case in Virginia. The sad news is that an infant (Hunter Morris) who was delivered in 2001 at the University of Virginia Hospital suffered horrible injuries at birth, including cerebral palsy and brain damage, due to the negligence of his doctors.
The good news is the case just settled for $1.35 million. The settlement was a long time in coming due to the fact the foundation which employed the doctors who delivered Hunter argued it (and the doctors) were immune from suit by any patient because of the charity care they provide to indigent patients. You see, Virginia recognizes the doctrine of "charitable immunity." However, the Virginia Supreme Court found the foundation's charitable losses represented only 0.66 percent of the $225, 898,000 million in revenue generated in 2005 by foundation doctors. The Virginia Supreme Court held the foundation, and its doctors, were not protected from the lawsuit as their operation did constitute a charity.
The bad news is that Virginia has a cap on damages which limited Hunter's recovery. The estimated cost to care for Hunter for the rest of his life - $9 million. So the settlement will never come close to paying for what is needed. Who will pay the remainder? The family and the taxpayers...not the foundation which had over $225,000 in revenues in just one year!
The good news is the case just settled for $1.35 million. The settlement was a long time in coming due to the fact the foundation which employed the doctors who delivered Hunter argued it (and the doctors) were immune from suit by any patient because of the charity care they provide to indigent patients. You see, Virginia recognizes the doctrine of "charitable immunity." However, the Virginia Supreme Court found the foundation's charitable losses represented only 0.66 percent of the $225, 898,000 million in revenue generated in 2005 by foundation doctors. The Virginia Supreme Court held the foundation, and its doctors, were not protected from the lawsuit as their operation did constitute a charity.
The bad news is that Virginia has a cap on damages which limited Hunter's recovery. The estimated cost to care for Hunter for the rest of his life - $9 million. So the settlement will never come close to paying for what is needed. Who will pay the remainder? The family and the taxpayers...not the foundation which had over $225,000 in revenues in just one year!
NURSING HOME CHARGES ON THE RISE
A recently released study reveals that costs for nursing homes and assisted living facilities have increased for a fifth consecutive year. The survey by Genworth Financial Inc., comes as baby boomers are approaching retirement and worry that they haven't saved enough to cover day-to-day expenses as well as long-term medical care costs.
The study found that the average annual cost for a private room in a nursing home rose to $76,460, or $209 per day, this year, a 17 percent increase over the $65,185 cost in 2004. Nursing home costs this year ranged from $515 per day in Alaska to $125 per day in Louisiana. An elderly person typically spends 2-1/2 years in a nursing home, or more than $190,000 on average at today's costs.
The cost for assisted living facilities, meanwhile, averaged $36,090 nationally, up 25 percent from $28,763 in 2004. Costs ranged from $4,921 per month in New Jersey to $1,981 per month in Arkansas.
Scary news indeed!
The study found that the average annual cost for a private room in a nursing home rose to $76,460, or $209 per day, this year, a 17 percent increase over the $65,185 cost in 2004. Nursing home costs this year ranged from $515 per day in Alaska to $125 per day in Louisiana. An elderly person typically spends 2-1/2 years in a nursing home, or more than $190,000 on average at today's costs.
The cost for assisted living facilities, meanwhile, averaged $36,090 nationally, up 25 percent from $28,763 in 2004. Costs ranged from $4,921 per month in New Jersey to $1,981 per month in Arkansas.
Scary news indeed!
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