Articles Posted in Conflicts of Interest

ny-med-premiereHospital patients who are dying or in extreme duress should not have their privacy exploited by reality television camera shows, federal health care regulators now have made clear. They have just settled with a noted New York hospital on $2.2 million in penalties and fines for its role in cooperating with a celebrity doctor whose crews recorded for broadcast the last throes of a an elderly Manhattan resident fatally injured when hit by a garbage truck.

The dead patient’s family complained that neither he nor they gave the hospital permission to film during his unsuccessful emergency treatment. Further, they said repeated broadcasts of the reality TV show “New York Med,” headlined by Mehmet Oz (the heart surgeon-cum-TV show celebrity known as “Dr. Oz”), caused them great pain and distress, as well as invading their and their loved one’s privacy.

Federal authorities, who oversee patient privacy matters under the Health Insurance Portability and Accountability Act (HIPAA), finally agreed with the family years after they filed complaints, posting online this stance about patients’ protected health information (PHI):

zapSome recent health headlines have made stories sound so enticing they’re hard to resist:  Are there genetic superheroes walking among us who can provide invaluable clues to preventing deadly diseases? What’s the secret of a big, long lost research study and could it have changed contemporary views on the risks of dietary fat? Should many older Americans who take statins, one of the most commonly prescribed medications, give them up in favor of a more costly therapy? And is there really a dazzling new way to test the blood for health markers?

Skeptics to the front, please. Somehow some very good, very savvy folks, again, are pushing health-related information that needs careful scrutiny or outright howls of complaint. I’ve written about the problems with health care information, and it gives me no pleasure to detail this quartet:

Superhero hype

bwhospitalBecause money makes such a difference in health care in the United States, what happens when it’s no object? The results aren’t pretty, a prestigious Boston hospital has found. It rolled out the red carpet and penthouse suites for a Saudi prince who stayed for seven months of therapy for a drug-resistant infection.

His lavish ways, however, ended up tainting the institution’s best practices, resulting in internal and Massachusetts state investigations. The Boston Globe said the episode, in which the unidentified prince and his entourage made unusual care demands and lavished gifts on staff in violation of hospital policies, shows the risks of so-called VIP care.

The paper said the post-mortem of the royal treatment found that: medical staff failed to adhere to best practices in wearing protective gowns when treating the princely patient who found the attire “off-putting” and dirty; nurses and others were accused of mishandling narcotics, giving them to members of the royal entourage and not administering them to the patient himself.

University_of_Maryland_Seal.svgThe University of Maryland has taken a hit to its credibility as a major research institution─and for one of the silliest reasons possible: The Terps, officials have conceded, showed almost no internal rigor nor basic research processes in promoting a product endorsement. Let’s give kudos to HealthNewsReview.org, a nonprofit health information watchdog, and local media for crying bull on the U’s news releases asserting that high school and collegiate athletes who drank a named brand of chocolate milk fared better on measures related to concussion recovery.

It took the folks in College Park months to fess up to their error, pointed out to them repeatedly and pointedly by outsiders concerned that the university was giving out bad health information.

It gets worse, as the school has conceded in releasing its own investigation: A bevy of highly credentialed experts failed to recognize not only the fatuousness of the so-called research the university promoted. They also went blind to blatant conflicts of interest with this study─notably that an industry group gave the work’s principal investigator a $200,000 gift to support his lab and staff just before the questionable news releases went flying. The U also seemed to play fast and loose with tough rules and principles about human experimentation.

valeantAlthough they may have been high-flyers just a few months ago, some big players in Big Pharma have gotten a brutal kind of karmic comeuppance for their craven business strategy of jacking up drug prices to maximize profits, the sick be damned.

Financial journalists have had a field day chronicling the recent, spectacular fall of Valeant Pharmaceuticals and its CEO Michael Pearson. He once  entranced Wall Street with his plan to use Valeant, which was acquired cheaply, as a way to take older, existing drugs and to push their prices into the stratosphere. Hedge funds and big investors loved Pearson and his plan. The company’s stock boomed.

But many who looked at the venal company and its consumer-attacking strategy dissented, calling Valeant as scandalous, suspect, and ready to collapse as the infamous energy company Enron.

prescriptionNew reports show how physicians can improve patient safety and help themselves with two simple steps: Stopping the practice of conducting surgeries at the same time on different patients, and writing prescriptions electronically instead of by hand.

Jamming up on complex surgeries

Investigative journalists at the Boston Globe deserve credit for reporting on a dispute over elite surgeons’ conducting several complicated operations at the same time. Surgeons defend this long-standing practice, saying it lets them help more patients and teach residents, and hasn’t been shown to be detrimental.

NFL-vector-logosThe National Football League may have taken a page from Big Tobacco’s playbook, and played fast and loose with data used in “scientific studies” to downplay players’ risks from concussions, a New York Times investigation finds.

The Times scrutinized the underlying information the league and its top officials provided to researchers on five years of its athletes’ concussion-related injuries. This data became the basis for 13 peer-reviewed studies, including research published in the prestigious journal  Neurosurgery, that the league relied on as a public relations shield against mounting evidence that head trauma posed significant short- and long-term harm to players.

But, the newspaper said, the league – which then did not require teams to report such incidents–left out roughly 10 percent of the head injuries that occurred in the study period (1996-2001). The omissions were blatant because they were hugely public and affected NFL superstars like quarterbacks Troy Aikman, Steve Young, and Kurt Warner.

For-profit clinics that market to patients with eating disorders or alcohol or drug abuse problems have grown in popularity in recent years. They can be pricey, but their operators insist the residential facilities offer expertise, attentive, needed, and specialized care that hospitals and medical centers cannot. But as the centers have proliferated, health care experts are expressing growing concern about their costs, safety, effectiveness, and marketing.

And now local prosecutors have stepped in, asserting in what may be a landmark case, that a California addiction treatment center is guilty of a patient’s negligent homicide.

The case in Riverside County involves an ailing 53-year-old, longtime smoker and alcohol abuser who sought detox care at one of the 1,500 addiction treatment centers just in the Golden State.

Can the sleaze get any worse with the maker of a dirty medical device that investigators say sickened dozens and played a role in killing 21? Sadly, it can. Federal prosecutors say that the  maker of a flexible scope used in endoscopic exams will pay $623.2 million to settle criminal and civil charges over its payment of kickbacks to unnamed physicians and hospitals.

The penalties against Olympus Corp. of Japan were the largest ever levied under U.S. anti-kickback laws. The company, according to the criminal complaint, forked out kickbacks to bring in $600 million in sales of endoscopes and other medical equipment, earning it more than $230 million in gross profits.

Prosecutors did not name the recipients of the kickbacks but said they included:

michlawblogA Michigan lawyer may write about the untruthful testimony of an “expert” medical witness because his online blog post and his comments are protected speech under the First Amendment, officials from the Michigan Bar have decided. That’s good news for the lawyer, who had his law license challenged by the witness─a psychiatrist who also happens to be a member of Michigan’s lawyer licensing board. She had demanded that either his post about her or his license be pulled. Now neither will happen.

The case still leaves a lingering odor around that board, the doctor who served as a so-called Independent Medical Examiner (IME), and the process in which she sought sanctions against a legal professional, instead of receiving public condemnation when she got caught, on videotape, fabricating statements about a severely injured plaintiff.

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