I have received calls before, where potential clients ask if they can join a class action suit against a nursing home.
I often explain that we evaluate every case on its merits and don't file federal class action claims, etc.
BUT it looks like a few chain facilities are faced with both individual suits alleging nursing home abuse, but also, class action suits, alleging widespread fraud.
Looks interesting. We will follow and keep you posted.
Friday, October 31, 2008
Wednesday, October 29, 2008
IMPORTANCE OF INSURANCE REFLECTED LOCALLY
This week I wrote about the importance of insurance. In our small City, Roanoke, there is a coalition for responsible health care trying to protect the public from increased health care prices set by a large local hospital system.
In today's paper is an article on the Coaltion. Roanoke Times reporter Sarah Bruyn Jones writes about the latest meeting wherein "Much of the discussion focused on the price for care and the discrepancy between a hospital charge and what an insurance company actually pays for a particular service.
"If you don't have insurance, you pay top dollar because you don't have someone negotiating for you," King said. "When we know what the price is we can compare, and once we can compare we can choose. And when we can choose we are no longer in the dark. As long as we are in the dark, we are paying far more than we should be."
Lewis Hopkins said that because he has insurance with a $5,000 deductible he wanted to be able to price medical care like he could when shopping around for other purchases. But, he said, he couldn't get straight answers from providers.
"I think these stories are enlightening and I think they are the good if it brings us together to do something to change the system," said Sandra Meador, one of the coalition's active members.
The coalition unveiled six goals, including asking that all medical service providers supply itemized bills for services and making lists of charges available to the public."
Not knowing prices of health care - I know, sounds crazy. Could you imagine calling a lawyer and asking what their hourly rate is, and the answer is "well - we will see.." or "it depends." How about getting an oil change at the same place for years and never knowing what they will charge. So why should healthcare be different?
According to free market, competition is vital - so how can you compete when you don't know the charges?
Keep up the good work coaltition!
NO
In today's paper is an article on the Coaltion. Roanoke Times reporter Sarah Bruyn Jones writes about the latest meeting wherein "Much of the discussion focused on the price for care and the discrepancy between a hospital charge and what an insurance company actually pays for a particular service.
"If you don't have insurance, you pay top dollar because you don't have someone negotiating for you," King said. "When we know what the price is we can compare, and once we can compare we can choose. And when we can choose we are no longer in the dark. As long as we are in the dark, we are paying far more than we should be."
Lewis Hopkins said that because he has insurance with a $5,000 deductible he wanted to be able to price medical care like he could when shopping around for other purchases. But, he said, he couldn't get straight answers from providers.
"I think these stories are enlightening and I think they are the good if it brings us together to do something to change the system," said Sandra Meador, one of the coalition's active members.
The coalition unveiled six goals, including asking that all medical service providers supply itemized bills for services and making lists of charges available to the public."
Not knowing prices of health care - I know, sounds crazy. Could you imagine calling a lawyer and asking what their hourly rate is, and the answer is "well - we will see.." or "it depends." How about getting an oil change at the same place for years and never knowing what they will charge. So why should healthcare be different?
According to free market, competition is vital - so how can you compete when you don't know the charges?
Keep up the good work coaltition!
NO
DON'T GO TO THE HOSPITAL ALONE!
Pure and simple...this is a warning to all hospital patients! Having someone with you in a hospital who is alert and asking questions can help stave off all kinds of potential problems, from mistaken identity to medication mixups to MRSA infections.
An estimated 100,000 hospital patients die every year in the U.S. because of preventable errors. A recent article in the Wall Street Journal details the importance of having an advocate present during hospital stays.
"If we could make only one change in health care, it should be to change the notion that families are visitors. Families are allies and partners for safety and quality," says Beverly Johnson, president of the nonprofit Institute for Family-Centered Care, which is leading a movement to involve families more.
My take: Be smart. Whenever possible have a family member present!
An estimated 100,000 hospital patients die every year in the U.S. because of preventable errors. A recent article in the Wall Street Journal details the importance of having an advocate present during hospital stays.
"If we could make only one change in health care, it should be to change the notion that families are visitors. Families are allies and partners for safety and quality," says Beverly Johnson, president of the nonprofit Institute for Family-Centered Care, which is leading a movement to involve families more.
My take: Be smart. Whenever possible have a family member present!
Tuesday, October 28, 2008
INSURANCE - A NECESSARY EVIL
I am not pro-insurance companies, trust me - but having health insurance in the United States is becoming increasingly important.
My Mom was on a drug for MS for many years. Without insurance, it was over $300 a week! Not only did her insurance pay for it, but the insurance company and drug maker had earlier agreed to a lower price for the shot. The average person paying cash would pay $300 a dose, my Mom's insurance company was only charged $150. Clearly a huge savings of $7,000 a year!
The same happens in hospitals. Without insurance, the Tylenol you are given may cost $2.00 but if you had insurance, you would only be charged what the insurance company previously agreed to pay, $.50.
Why else is insurance so helpful at any age? If you are in a car accident, have no insurance, your ED bill could be $20,000. If you can't pay it, you are almost forced into a lawsuit which costs time and money. If you had health insurance and didn't miss any work, you could essentially walk away from the accident without a loss of thousands in dollars.
What about young people - is insurance needed?
Birth Control without insurance is about $50-$70 a month. With, it is around $10-$15.
Just try to get an appointment for a dermatologist without insurance. If the dermatologist removes a mole, you will be charged the rate of a small surgery - do you have a few hundred dollars extra for a mole biopsy or two a year?
I know it is expensive, but beyond food and shelter, it should be a necessity to most Americans.
My Mom was on a drug for MS for many years. Without insurance, it was over $300 a week! Not only did her insurance pay for it, but the insurance company and drug maker had earlier agreed to a lower price for the shot. The average person paying cash would pay $300 a dose, my Mom's insurance company was only charged $150. Clearly a huge savings of $7,000 a year!
The same happens in hospitals. Without insurance, the Tylenol you are given may cost $2.00 but if you had insurance, you would only be charged what the insurance company previously agreed to pay, $.50.
Why else is insurance so helpful at any age? If you are in a car accident, have no insurance, your ED bill could be $20,000. If you can't pay it, you are almost forced into a lawsuit which costs time and money. If you had health insurance and didn't miss any work, you could essentially walk away from the accident without a loss of thousands in dollars.
What about young people - is insurance needed?
Birth Control without insurance is about $50-$70 a month. With, it is around $10-$15.
Just try to get an appointment for a dermatologist without insurance. If the dermatologist removes a mole, you will be charged the rate of a small surgery - do you have a few hundred dollars extra for a mole biopsy or two a year?
I know it is expensive, but beyond food and shelter, it should be a necessity to most Americans.
Monday, October 27, 2008
VIRGINIA CUTS MEDICAID: LOOK OUT NURSING HOME RESIDENTS!
The economy in Virginia is much like it is in the rest of the U.S....bad! Now, Virginia is considering reducing Medicaid benefits to the poor and elderly to help balance its budget and that's real bad!
Medicaid, funded by the state and federal government, pays for over one-half of the nursing home bills in the U.S. But getting Medicaid benefits is very difficult in Virginia. My state ranks 48th in the country in per capita Medicaid spending and has some of the nation's tightest eligibility requirements.
What does all of this mean to those residing in Virginia's nursing homes? It means reduced staffing and reduced medical care. It means more trips to the emergency room to deal with problems that could have been dealt with weeks before but went undisclosed or undiagnosed due to the reduction in staff. Face it...the owners of long term care facilities are going to continue to make money in these difficult economic times. Only the elderly will suffer!
Medicaid, funded by the state and federal government, pays for over one-half of the nursing home bills in the U.S. But getting Medicaid benefits is very difficult in Virginia. My state ranks 48th in the country in per capita Medicaid spending and has some of the nation's tightest eligibility requirements.
What does all of this mean to those residing in Virginia's nursing homes? It means reduced staffing and reduced medical care. It means more trips to the emergency room to deal with problems that could have been dealt with weeks before but went undisclosed or undiagnosed due to the reduction in staff. Face it...the owners of long term care facilities are going to continue to make money in these difficult economic times. Only the elderly will suffer!
Friday, October 24, 2008
MIXING MEDS
My brother is in town and first thing upon arrival, ran to the pharmacy to get some cold medicine.
PLEASE FOLKS - tell your doctors if you are taking over the counter meds, supplements, vitamins etc.
What if they prescribe a medication that has known problems with your fav cold medicine? What if your supplements actually affect the way your medications are absorbed into your body.
Don't Mix without telling yoru physician.
PLEASE FOLKS - tell your doctors if you are taking over the counter meds, supplements, vitamins etc.
What if they prescribe a medication that has known problems with your fav cold medicine? What if your supplements actually affect the way your medications are absorbed into your body.
Don't Mix without telling yoru physician.
Thursday, October 23, 2008
GRANNY CAM CATCHES ABUSER
Dan wrote about granny cams a few days ago. Please watch this -- elderly man abused in his own home, caught by granny cam!
CANCER TREATMENT - IN A PILL?
Occassionaly I branch out of the normal news media and make my way to www.slate.com.
Today I found this article - "Take a Chill, Pill"
Why oral cancer drugs are not all they're cracked up to be.By Jessica Wapner. Check it out - it is thoughtful and thoughtprovoking.
Posted Tuesday, Oct. 21, 2008, at 1:09 PM ET
Ms. Wapner discusses the pros and cons of "oral drugs" as cancer treatment. Do these
new drugs change the face of cancer treatment?
Although the idea may be great, she argues that a "host of problems means their use could end up in calamity, causing a far bigger headache than lying in a chair at a cancer clinic ever could."
Today I found this article - "Take a Chill, Pill"
Why oral cancer drugs are not all they're cracked up to be.By Jessica Wapner. Check it out - it is thoughtful and thoughtprovoking.
Posted Tuesday, Oct. 21, 2008, at 1:09 PM ET
Ms. Wapner discusses the pros and cons of "oral drugs" as cancer treatment. Do these
new drugs change the face of cancer treatment?
Although the idea may be great, she argues that a "host of problems means their use could end up in calamity, causing a far bigger headache than lying in a chair at a cancer clinic ever could."
HIDDEN CAMERAS IN NURSING HOMES: THREE CHEERS FOR AG CUOMO
We have written several blogs over the years about the use of hidden cameras in nursing homes(most recently on Thursday, October 18). I believe that, if set up correctly to protect the privacy of roommates, hidden cameras are a great idea! They are a strong deterrent against nursing home abuse.
And now it appears that New York Attorney General, Andrew Cuomo, agrees. Cuomo is expanding his practice of installing hidden cameras in nursing homes to deter abuse. The Attorney General already has used hidden-camera footage taken at nursing homes in Rochester to prosecute staff members for abuse and neglect.
I live in Virginia so...how about it Attorney General Bob McDonnell?
And now it appears that New York Attorney General, Andrew Cuomo, agrees. Cuomo is expanding his practice of installing hidden cameras in nursing homes to deter abuse. The Attorney General already has used hidden-camera footage taken at nursing homes in Rochester to prosecute staff members for abuse and neglect.
I live in Virginia so...how about it Attorney General Bob McDonnell?
Tuesday, October 21, 2008
DANVILLE REGIONAL HOSPITAL IN THE NEWS!
As many of our readers know, Danville (VA) Regional Medical Center (DRMC) has been a news topic for quite some time....most of it for problems with the delivery of health care. Well, here we go again!
It appears that DRMC is being sued in federal court for its Emergency Room staff"s failure to provide competent medical care. The case, Everett W. Scruggs v. Danville Regional Medical Center, involves among other issues, an allegation that the hospital Emergency Room did not provide competent medical care as required by federal law called the Emergency Medical Treatment and Active Labor Act (EMTALA). The EMTALA statute imposes two primary obligations on hospitals. First, it requires that when an individual seeks medical treatment in a hospital’s emergency room, the hospital must provide for an appropriate medical screening examination . . . to determine whether or not an emergency medical condition exists. Second, if the screening examination reveals the presence of an emergency medical condition, the hospital must stabilize the medical condition before transferring or discharging the patient.
The lawsuit alleges Scruggs arrived at DRMC Emergency Department at 1:50 a.m. on September 3, 2006 complaining of prolonged dry heaves over the previous two days. Upon arrival, Scruggs was triaged by a registered nurse and prioritized as a "non-urgent" patient based upon the nurse's triage screening examination. The nurse’s triage report did not include Scrugg's diabetic ketoacidosis condition or his history of diabetes.
The Emergency Room doctor did not examine Scruggs for over 11 hours after he arrived in the ER. That physician ordered various tests but, unfortunately, Scruggs was found unresponsive and in cardiac arrest approximately 20 minutes later.
The hospital argued that its Emergency Department had meet the requirements of EMTLA as a result of the nurse's triage assessment. Thankfully, the trial court disagreed!
It appears that DRMC is being sued in federal court for its Emergency Room staff"s failure to provide competent medical care. The case, Everett W. Scruggs v. Danville Regional Medical Center, involves among other issues, an allegation that the hospital Emergency Room did not provide competent medical care as required by federal law called the Emergency Medical Treatment and Active Labor Act (EMTALA). The EMTALA statute imposes two primary obligations on hospitals. First, it requires that when an individual seeks medical treatment in a hospital’s emergency room, the hospital must provide for an appropriate medical screening examination . . . to determine whether or not an emergency medical condition exists. Second, if the screening examination reveals the presence of an emergency medical condition, the hospital must stabilize the medical condition before transferring or discharging the patient.
The lawsuit alleges Scruggs arrived at DRMC Emergency Department at 1:50 a.m. on September 3, 2006 complaining of prolonged dry heaves over the previous two days. Upon arrival, Scruggs was triaged by a registered nurse and prioritized as a "non-urgent" patient based upon the nurse's triage screening examination. The nurse’s triage report did not include Scrugg's diabetic ketoacidosis condition or his history of diabetes.
The Emergency Room doctor did not examine Scruggs for over 11 hours after he arrived in the ER. That physician ordered various tests but, unfortunately, Scruggs was found unresponsive and in cardiac arrest approximately 20 minutes later.
The hospital argued that its Emergency Department had meet the requirements of EMTLA as a result of the nurse's triage assessment. Thankfully, the trial court disagreed!
Monday, October 20, 2008
NURSING HOMES DURING HOLIDAYS
I don't want to work on Christmas Eve or Thanksgiving - my guess is most nursing home employees don't want to either.
We see MANY mistakes and problems occur at facilities during the holidays. It could be staffing numbers; it could be employees want to be home and so they are not as attentive; it could be the confusion of some residents leaving for trips home; temp agencies providing staff, etc.
We have seen patients develop gangrene, elopements, pressure ulcers go untreated - and I imagine falls, medicine mistakes etc also occur at an increased rate.
So please, ask questions - who will be working at your loved ones' nursing home during the holidays? Will there be staffing from a temp agency? Do the temps receive any training? Will someone be there to help you get Grandmom to the car for Thanksgiving dinner?
These are important issues - and need to be considered well in advance of November and December.
We see MANY mistakes and problems occur at facilities during the holidays. It could be staffing numbers; it could be employees want to be home and so they are not as attentive; it could be the confusion of some residents leaving for trips home; temp agencies providing staff, etc.
We have seen patients develop gangrene, elopements, pressure ulcers go untreated - and I imagine falls, medicine mistakes etc also occur at an increased rate.
So please, ask questions - who will be working at your loved ones' nursing home during the holidays? Will there be staffing from a temp agency? Do the temps receive any training? Will someone be there to help you get Grandmom to the car for Thanksgiving dinner?
These are important issues - and need to be considered well in advance of November and December.
Thursday, October 16, 2008
HIDDEN CAMERAS IN NURSING HOMES
....are they a good idea! YES.
Family members who are concerned over the care received by their loved ones cannot be at the nursing home watching what happens and doesn't happen 24 hours a day 7 days a week. However, a camera (often called a "Granny Cam") can be there watching what goes on.
Look what a hidden camera picked up at the Medford Multicare Center for Living in Suffolk, New York. An investigation using hidden surveillance cameras inside the nursing home has led to criminal neglect and other charges against four employees, Attorney General Andrew Cuomo announced Tuesday. The employees of Medford Multicare Center for Living in Suffolk were accused of failing to move and turn over a patient for hours on end, Cuomo said. The employees also denied the patient water and left him sitting in his own waste, the attorney general said.
Pretty good evidence I would say! The only caution I offer to my readers is that make sure your camera doesn't invade the privacy of a roommate...make sure the hidden camera is aimed only at your family member.
Does Virginia law permit the use of Granny Cams? Yes but there are restrictions to the use of cameras. The Virginia Department of Health has established guidelines for the use of cameras in nursing homes which should be followed before installing a hidden camera.
Family members who are concerned over the care received by their loved ones cannot be at the nursing home watching what happens and doesn't happen 24 hours a day 7 days a week. However, a camera (often called a "Granny Cam") can be there watching what goes on.
Look what a hidden camera picked up at the Medford Multicare Center for Living in Suffolk, New York. An investigation using hidden surveillance cameras inside the nursing home has led to criminal neglect and other charges against four employees, Attorney General Andrew Cuomo announced Tuesday. The employees of Medford Multicare Center for Living in Suffolk were accused of failing to move and turn over a patient for hours on end, Cuomo said. The employees also denied the patient water and left him sitting in his own waste, the attorney general said.
Pretty good evidence I would say! The only caution I offer to my readers is that make sure your camera doesn't invade the privacy of a roommate...make sure the hidden camera is aimed only at your family member.
Does Virginia law permit the use of Granny Cams? Yes but there are restrictions to the use of cameras. The Virginia Department of Health has established guidelines for the use of cameras in nursing homes which should be followed before installing a hidden camera.
Wednesday, October 15, 2008
ELDER ABUSE - NOT ENOUGH
Twice this week I have turned down cases where a nursing home was clearly negligent. Why would we turn these hurting families away?
In Virginia you must prove two elements to successfuly pursue a claim of elder abuse or nursing home negligence. You must prove (1) that teh facility was negligent and (2) that their negligence directly caused the resident pain and suffering.
In both cases, the victims of elder abuse had pre-existing conditions that caused them pain and suffering. Although the facility failed to provide care, we couldn't link the their negligence to physicial pain or suffering.
Is that fair? I am not sure - but it is the law in Virginia... So when you call our office regarding a nursing home abuse case, please note, we will have to investigate what damage was caused by the facility's mistakes...
In Virginia you must prove two elements to successfuly pursue a claim of elder abuse or nursing home negligence. You must prove (1) that teh facility was negligent and (2) that their negligence directly caused the resident pain and suffering.
In both cases, the victims of elder abuse had pre-existing conditions that caused them pain and suffering. Although the facility failed to provide care, we couldn't link the their negligence to physicial pain or suffering.
Is that fair? I am not sure - but it is the law in Virginia... So when you call our office regarding a nursing home abuse case, please note, we will have to investigate what damage was caused by the facility's mistakes...
MEDICARE DOESN'T COVER IT
I know you will be shocked to hear this - but it seems our health care laws, rules and regs, may not be serving Americans very well.
In today's Wall Street Journal, Laura Landro writes about the increased use of IV medical treatment for patients that need home in-fusion therapy. A;though private insurance often covers the home therapy, apparently, Medicare does not.
So what does this mean for a Medicare patient in need to IV therapy? It means they have to be in the hospital. The article interviews one such patient that had to stay in the hospital for two months, at a rate of $2000 a day, rather than stay at home and receive in home therapy.
Seems like a huge waste to me --- And sadly, when the issue involves MEdicare, its a federal legislative issue.
The moral to this story - we truly live in a society where private insurance is needed, even supplements.
In today's Wall Street Journal, Laura Landro writes about the increased use of IV medical treatment for patients that need home in-fusion therapy. A;though private insurance often covers the home therapy, apparently, Medicare does not.
So what does this mean for a Medicare patient in need to IV therapy? It means they have to be in the hospital. The article interviews one such patient that had to stay in the hospital for two months, at a rate of $2000 a day, rather than stay at home and receive in home therapy.
Seems like a huge waste to me --- And sadly, when the issue involves MEdicare, its a federal legislative issue.
The moral to this story - we truly live in a society where private insurance is needed, even supplements.
Monday, October 13, 2008
NURSING HOME AIDE GOING TO JAIL
This story should disturb everyone! A Portland, Oregon Judge ripped the staff for the deplorable conditions at the Gateway Care and Rehabilitation Center. An aide at the facility, Cammy Elaine Nye, dropped a 60 year old resident (Linda Ober) who broke her legs as a result. The worst part...the nursing staff allowed Mrs. Ober to cry out in pain for five days before calling the rescue squad to take her to the local hospital!
A jury found Nye guilty of misdemeanor reckless endangerment after a five-day trial. The Judge then sentenced Nye to 30 days in jail, 640 hours of community service and three years of bench probation. The Judge was obviously outraged at what happened and stated, "I can't imagine that if that place is still open that anybody would take their parent or spouse or someone who's aged because it was set up as a marketing place first. It's just incredible what happened there."
My Take: While I agree with the sentence handed down by the Judge, my bet is that the Administration is really to blame for cutting staff to the bone in order to increase profits!
A jury found Nye guilty of misdemeanor reckless endangerment after a five-day trial. The Judge then sentenced Nye to 30 days in jail, 640 hours of community service and three years of bench probation. The Judge was obviously outraged at what happened and stated, "I can't imagine that if that place is still open that anybody would take their parent or spouse or someone who's aged because it was set up as a marketing place first. It's just incredible what happened there."
My Take: While I agree with the sentence handed down by the Judge, my bet is that the Administration is really to blame for cutting staff to the bone in order to increase profits!
Saturday, October 11, 2008
TIME FOR FLU SHOTS
If you have elderly parents...tell them now is the time to get their flu shot! If you have elderly parents in a nursing home....just don't tell them to get their flu shot...make them get the vaccination.
Older adults are at the greatest risk of problems associated with the flu. Because older adults have reduced cough and gag reflexes, they often have increased respiratory problems associated with flu. In addition, older adults have weakened immune systems, which makes it harder for their bodies to fight flu complications such as pneumonia.
Just how serious is the flu for our elderly parents? The flu killed more than 32,000 Americans who were 65 or older in 2003! Unbelievably, only six of every ten senior citizens received the life-saving shots, according to testimony before the U.S. Senate Special Committee on Aging. The flu and pneumonia (the most common complication of the flu) combined are the fifth leading cause of death among Americans age 65 and older.
My take: Don't take "no" for an answer...get your elderly parents immunized!
Older adults are at the greatest risk of problems associated with the flu. Because older adults have reduced cough and gag reflexes, they often have increased respiratory problems associated with flu. In addition, older adults have weakened immune systems, which makes it harder for their bodies to fight flu complications such as pneumonia.
Just how serious is the flu for our elderly parents? The flu killed more than 32,000 Americans who were 65 or older in 2003! Unbelievably, only six of every ten senior citizens received the life-saving shots, according to testimony before the U.S. Senate Special Committee on Aging. The flu and pneumonia (the most common complication of the flu) combined are the fifth leading cause of death among Americans age 65 and older.
My take: Don't take "no" for an answer...get your elderly parents immunized!
Friday, October 10, 2008
FINANCIAL KICKBACKS AND DOCTORS
Years ago my firm handled multiple medical negligence cases against a local spine surgeon who operated on dozens of patients within a very short time of his arrival in our community. The patients all had various degree of low back pain and, invariably, the doctor would perform a surgery where lumbar discs were "fused" together with pedicle screws and rods....a big and scary operation! Many of those patients had more pain after the surgery than before.
I often wondered why this surgeon, relatively new to our community, was performing so many back operations and using all of this medical hardware.
An article appearing in today's edition of Newsday.com (October 9) may provide some answers. It appears that certain manufacturers of medical devices are paying doctors financial incentives to use their products. The article states that Senate lawmakers are pressuring Medtronic (an international medical products manufacturer) to disclose more about its consulting arrangements with physicians, citing prior allegations the company paid kickbacks to surgeons to boost sales of spinal implants. In separate letters issued Tuesday, Sens. Charles Grassley, R-Iowa, and Herb Kohl, D-Wis., asked the company to provide details about physicians who receive company payments for consulting services. The two lawmakers have repeatedly criticized the influence pharmaceutical and medical device companies hold over physicians.
Go get 'em Senators Grassley and Kohl!
I often wondered why this surgeon, relatively new to our community, was performing so many back operations and using all of this medical hardware.
An article appearing in today's edition of Newsday.com (October 9) may provide some answers. It appears that certain manufacturers of medical devices are paying doctors financial incentives to use their products. The article states that Senate lawmakers are pressuring Medtronic (an international medical products manufacturer) to disclose more about its consulting arrangements with physicians, citing prior allegations the company paid kickbacks to surgeons to boost sales of spinal implants. In separate letters issued Tuesday, Sens. Charles Grassley, R-Iowa, and Herb Kohl, D-Wis., asked the company to provide details about physicians who receive company payments for consulting services. The two lawmakers have repeatedly criticized the influence pharmaceutical and medical device companies hold over physicians.
Go get 'em Senators Grassley and Kohl!
Tuesday, October 07, 2008
FUNERAL HOME NEGLIGENCE
If a physician causes harm, it is medical malpractice.
If a lawyer causes harm, it is legal malpractice.
When a funeral home causes harm, it is Mortuary Malpractice... and this happens more than you think.
Now, how could you claim "damages" to a person that is no longer alive? In two ways:
(1) Emotional Distress of experiencing a loved ones' remains being mistreated.
(2) Damage to property - yes, it sounds crazy, but your loved one is considered property.
In Virginia, an Emotional Distress claim must be filed with 1 year of the incident. I read an article today of a family that learned their loved one was moved from their burial site. That might be a breach of contract case, or an emotional distress case. What about mistreatment of the body - exposure to bugs, critters. Another reported case reflects the family purchased the casket, and after the funeral, the company removed the body from the casket and re-used it, burying the loved one in a bag.
This happens sadly, more than you would think. Remember the Georgia Funeral home that was not cremating folks but placing their bodies in the back?
Like any other industry, it requires regulation and a close eye. Afterall, you wanted your loved one to have the very best while they were alive - and that doesn't change!
If a lawyer causes harm, it is legal malpractice.
When a funeral home causes harm, it is Mortuary Malpractice... and this happens more than you think.
Now, how could you claim "damages" to a person that is no longer alive? In two ways:
(1) Emotional Distress of experiencing a loved ones' remains being mistreated.
(2) Damage to property - yes, it sounds crazy, but your loved one is considered property.
In Virginia, an Emotional Distress claim must be filed with 1 year of the incident. I read an article today of a family that learned their loved one was moved from their burial site. That might be a breach of contract case, or an emotional distress case. What about mistreatment of the body - exposure to bugs, critters. Another reported case reflects the family purchased the casket, and after the funeral, the company removed the body from the casket and re-used it, burying the loved one in a bag.
This happens sadly, more than you would think. Remember the Georgia Funeral home that was not cremating folks but placing their bodies in the back?
Like any other industry, it requires regulation and a close eye. Afterall, you wanted your loved one to have the very best while they were alive - and that doesn't change!
FDA - FRIEND OR FOE?
Consumer advocates often criticize the Food and Drug Administration (FDA) for failing to miss substantial problems. Have you heard criticism for their approving drugs with terrible side effects? Or allowing contaminated drugs or food from China into the stream of commerce?
Criticism aside, they are called to monitor safety of products, and report.
One such report got my attention this week:
Potentially Fatal Glucose Monitoring Errors with Icodextrin
The Institute for Safe Medication Practices (ISMP) is warning again about the possibility of potentially fatal glucose monitoring errors in patients receiving products that contain other sugars. These include oral xylose, parenterals that contain maltose or galactose, and peritoneal dialysis solutions that contain icodextrin. This issue was also reported in an earlier edition of FDA Patient Safety News.
The problem is that some point-of-care glucose meters use a type of test strip that cannot distinguish between glucose and other sugars. So in these cases, the meter's reading of the test strip will reflect both the patient's actual blood glucose and the other sugar the patient has received. This falsely elevated reading can lead to aggressive insulin treatment, which can result in hypoglycemic shock and death.
The latest ISMP report concentrates on Extraneal, a peritoneal dialysis solution containing icodextrin, which is metabolized in the body to maltose. The ISMP report notes that FDA has received 18 reports of hypoglycemic adverse events associated with Extraneal since it was first marketed in 2002. In three cases, the patient or a family member told the hospital staff about the potential problem, but the staff still relied on erroneous readings from portable monitors.
In one of the reported cases, a 62 year-old hospitalized dialysis patient on Extraneal therapy died from severe hypoglycemia because his treatment was based on falsely elevated glucose readings from an inappropriate meter. This occurred despite glucose readings from the hospital lab that were strikingly lower than those produced by the meter.
Test strips that cannot distinguish between glucose and other sugars contain reagents called GDH-PQQ or GDO. Other types of meters use reagents that are capable of distinguishing glucose from the other sugars. These reagents are called GDH-NAD, GDH-FAD, glucose oxidase and glucose hexokinase. It is important to check the package insert that comes with the test strips to determine which type of reagent they contain.
Here is what ISMP recommends to prevent these glucose monitoring errors in hospitals. Consider using only glucose meters that use test strips that can distinguish between glucose and other sugars. If you use meters and strips that cannot distinguish between the sugars, take these additional precautions:
• On admission and periodically during the hospital stay, find out whether the patient is receiving medications containing other sugars. If so, monitor glucose using only hospital laboratory methods.
• Periodically verify point-of-care blood glucose readings with laboratory results. This can detect errors in glucose meter readings early enough to prevent harm. This is especially important in patients who are unconscious or unable to communicate, since it may be difficult to ascertain the symptoms of hypoglycemia or the medication history.
• Educate the staff about this potentially fatal problem, and consider safeguards such as drug interaction alerts in computer order entry systems, patient profiles and charts.
Scary STUFF - we all know that diabetics rely on glucose levels to regulate their insulin, and now we have report that the levels are inaccurate.
Please share this information with friends or family that are insulin dependent... Afterall, I haven't heard much about this in the media - so you might be the only one who shares it with them.
Criticism aside, they are called to monitor safety of products, and report.
One such report got my attention this week:
Potentially Fatal Glucose Monitoring Errors with Icodextrin
The Institute for Safe Medication Practices (ISMP) is warning again about the possibility of potentially fatal glucose monitoring errors in patients receiving products that contain other sugars. These include oral xylose, parenterals that contain maltose or galactose, and peritoneal dialysis solutions that contain icodextrin. This issue was also reported in an earlier edition of FDA Patient Safety News.
The problem is that some point-of-care glucose meters use a type of test strip that cannot distinguish between glucose and other sugars. So in these cases, the meter's reading of the test strip will reflect both the patient's actual blood glucose and the other sugar the patient has received. This falsely elevated reading can lead to aggressive insulin treatment, which can result in hypoglycemic shock and death.
The latest ISMP report concentrates on Extraneal, a peritoneal dialysis solution containing icodextrin, which is metabolized in the body to maltose. The ISMP report notes that FDA has received 18 reports of hypoglycemic adverse events associated with Extraneal since it was first marketed in 2002. In three cases, the patient or a family member told the hospital staff about the potential problem, but the staff still relied on erroneous readings from portable monitors.
In one of the reported cases, a 62 year-old hospitalized dialysis patient on Extraneal therapy died from severe hypoglycemia because his treatment was based on falsely elevated glucose readings from an inappropriate meter. This occurred despite glucose readings from the hospital lab that were strikingly lower than those produced by the meter.
Test strips that cannot distinguish between glucose and other sugars contain reagents called GDH-PQQ or GDO. Other types of meters use reagents that are capable of distinguishing glucose from the other sugars. These reagents are called GDH-NAD, GDH-FAD, glucose oxidase and glucose hexokinase. It is important to check the package insert that comes with the test strips to determine which type of reagent they contain.
Here is what ISMP recommends to prevent these glucose monitoring errors in hospitals. Consider using only glucose meters that use test strips that can distinguish between glucose and other sugars. If you use meters and strips that cannot distinguish between the sugars, take these additional precautions:
• On admission and periodically during the hospital stay, find out whether the patient is receiving medications containing other sugars. If so, monitor glucose using only hospital laboratory methods.
• Periodically verify point-of-care blood glucose readings with laboratory results. This can detect errors in glucose meter readings early enough to prevent harm. This is especially important in patients who are unconscious or unable to communicate, since it may be difficult to ascertain the symptoms of hypoglycemia or the medication history.
• Educate the staff about this potentially fatal problem, and consider safeguards such as drug interaction alerts in computer order entry systems, patient profiles and charts.
Scary STUFF - we all know that diabetics rely on glucose levels to regulate their insulin, and now we have report that the levels are inaccurate.
Please share this information with friends or family that are insulin dependent... Afterall, I haven't heard much about this in the media - so you might be the only one who shares it with them.
DO HOSPITALS "PUSH" CERTAIN NURSING HOMES?
I've just heard a story which, if true, bothers me a great deal. According to the story, it appears our local hospital, Carilion Roanoke Memorial Hospital, may have employees of a certain nursing home chain working in their hospital "assisting" discharged patients in finding an appropriate nursing home.
Why would a hospital allow outside personnel to provide guidance to its patients on which local nursing home would best suit the patient's needs? Would it be a situation of "you scratch my back and I will scratch your back"?
The discharge departments of all hospitals should be staffed with hospital employees who provide patients with accurate and unbiased advice and recommendations about which nursing home would best suit the needs of the patient.
Has anyone encountered this problem?
Why would a hospital allow outside personnel to provide guidance to its patients on which local nursing home would best suit the patient's needs? Would it be a situation of "you scratch my back and I will scratch your back"?
The discharge departments of all hospitals should be staffed with hospital employees who provide patients with accurate and unbiased advice and recommendations about which nursing home would best suit the needs of the patient.
Has anyone encountered this problem?
Monday, October 06, 2008
POOR GRADES FOR ROANOKE AREA NURSING HOMES
The report card is out and things don't look very good for nursing homes in Western Virginia. A new national study finds that such problems are not uncommon. Inspectors cited 94 percent of nursing homes last year for federal health and safety standards, the Department of Health and Human Services reported this week.
Sadly, the number of violations reported in Roanoke-area nursing homes was higher than the national average in 13 out of 31 facilities. For example, Avante at Roanoke, a 130-bed facility in the Old Southwest neighborhood, had the most violations, with 28 health-inspection infractions and six fire and safety deficiencies. Average daily certified nursing assistant time per patient at Avante was one hour, 40 minutes -- less than the region's top performer by 70 minutes. The 180-bed Virginia Veterans Care Center had 26 health and three fire and safety violations.
Read reporter Beth Macy's recent article in the Roanoke Times on the sad state of nursing homes.
My take: Poor care will continue to be the norm in Virginia's nursing homes until the General Assembly passes minimum staffing requirements. Presently, to reduce costs and increase profits, many nursing homes are operating without a sufficient number of nurses to care for its residents.
Sadly, the number of violations reported in Roanoke-area nursing homes was higher than the national average in 13 out of 31 facilities. For example, Avante at Roanoke, a 130-bed facility in the Old Southwest neighborhood, had the most violations, with 28 health-inspection infractions and six fire and safety deficiencies. Average daily certified nursing assistant time per patient at Avante was one hour, 40 minutes -- less than the region's top performer by 70 minutes. The 180-bed Virginia Veterans Care Center had 26 health and three fire and safety violations.
Read reporter Beth Macy's recent article in the Roanoke Times on the sad state of nursing homes.
My take: Poor care will continue to be the norm in Virginia's nursing homes until the General Assembly passes minimum staffing requirements. Presently, to reduce costs and increase profits, many nursing homes are operating without a sufficient number of nurses to care for its residents.
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