That’s why House Speaker Paul D. Ryan (R-Wis.) and Rep. Tom Price (R-Ga.), tapped to be the nation’s top health official by President-elect Donald Trump, are vowing to make tort reform a key part of their replacement plan for the Affordable Care Act.
Some new cautions have been issued on some key aspects of children’s health care. The federal government is increasing its warnings on anesthetic use for children and expectant moms, while a newspaper investigation is raising issues with common newborn screenings and their inconsistency and inaccuracy. Meantime, a health news site is adding to questions about a much-touted program to reduce head trauma harms in kids’ athletics.
FDA warnings on anesthetics for babies, expectant moms
Let’s start with the federal Food and Drug Administration cautions on “repeated and lengthy use of general anesthetic and sedation drugs” with children younger than 3 and pregnant women. The agency says it has been studying potential harms of these powerful medications for these two groups since 1999, and will label almost a dozen common anesthetics and sedation drugs with new warnings.
Three Washington, D.C.-area teaching hospitals have ranked in the lowest-scoring group nationally on preventing infections when their patients are hooked up to central lines, intravenous tubes that supply fluids, medications, and nutrients to those in dire need. Two institutions in the region rated highly.
Consumer Reports deserves credit for its continuing reporting on hospital acquired infections (HAIs), a scourge that in 2011 afflicted 650,000 already ailing Americans and which contributed to 75,000 deaths. The advocacy group says 27,000 patients were felled with central line infections in 2015, with a quarter of these especially sick and frail individuals dying of them. Treating patients for central line infections cost on average $46,000—more than for any other HAI.
The area teaching hospitals that the magazine ranked poorly, based on an analysis of federal data from 2011 to 2015, were: George Washington University Hospital, Holy Cross Hospital in Silver Spring, and Howard University Hospital. The two high-ranking institutions were: MedStar Franklin Square Medical Center in Baltimore and Sentara Norfolk (Va.) General Hospital.
Just how difficult can it be to stop a highly credentialed but dangerous doctor from hop-scotching around a metropolitan area to perform brutal spinal surgeries in different hospitals, including a respected academic medical center? Just ask crippled patients, neurosurgeons, medical licensing officials, and prosecutors in Dallas what it took to derail Dr. Christopher Duntsch.
As detailed well in the latest edition of the upscale city magazine D, Duntsch was a high-flying physician who moved from Tennessee to Texas, carrying with him an excellent reputation, which later would be challenged, as a medical scientist. Although established as a cancer stem cell-researcher, the neurosurgeon also morphed himself into a spinal surgeon based on training earlier in his career. He eventually won privileges to operate at three Dallas area hospitals, including the well-regarded Baylor Regional Medical Center at Plano, Texas.
He was a loner and boastful, though colleagues liked him at first. They quickly were horrified by his surgeries. Among the damages he is criminally accused of inflicting: amputating a patient’s spinal nerve, causing paralysis; cutting another patient’s vertebral artery and ignoring the major bleeding that occurred; installing a too-long screw so that it punctured a big vein, causing extensive bleeding and nerve damage; slashing a patient’s esophagus and a neck artery, leaving the man struggling to eat, breathe, and with blood loss to the brain.
South Dakotans will need their state lawmakers’ help now to pry open physicians’ iron grip on secret decisions about which doctors get to practice in hospitals and why. That’s because the state’s Supreme Court ruled this vital information must be kept confidential, even if releasing it would serve a wider good of disclosing possible criminal or fraudulent conduct.
The high court ducked its potential role in helping more than 30 patients who claim they were mangled in excruciating, needless surgeries performed by Allen Sossan, an osteopath with an easily discovered criminal past and a checkered medical practice record in the area around Yankton, S.D. I’ve written about this case before.
Several South Dakota hospitals gave Sossan practice privileges after his credentials were reviewed by physician committees, which, since have fought mightily to keep secret what they knew and when they knew it about him. Sossan since has been indicted for providing false information to medical licensing authorities. The convicted burglar and check kiter apparently has fled the country and may be back in his native Iran.
South Dakota’s highest court has been asked to reject hospitals’ attempts to keep secret why a doctor, who also is a convicted burglar with a checkered medical past that could have easily been uncovered, passed a peer review that permitted him to perform brutal, excruciating, and unnecessary spinal surgeries on dozens of patients.
A lower court rejected the sweeping claims by the hospitals that the reviews can never be disclosed. The judge said that indications of crimes or fraud, as raised by evidence-based malpractice lawsuits, are sufficient reason to breach confidentiality protections shielding vital insights into how hospitals judge physician performance and permit doctors to practice in their institutions.
More than 30 patients have sued surgeon Allen Sossan. He is a convicted felon, who had changed his name, and who apparently has fled to Iran. Patients assert he caused them great pain and maimed them with unnecessary, complex back procedures. Further, patients have sued more than a dozen doctors who reviewed his credentials and granted him privileges at Avera Sacred Heart and Lewis & Clark Specialty Hospital, both in Yankton, S.D.
A conscience-stricken surgeon in South Dakota has publicly confirmed one of the great frustrations for patients pursuing medical malpractice claims after they have been harmed: He says doctors are too willing to lie in court to protect themselves and colleagues, as he did two decades ago in a case involving a partner in his practice.
Dr. Lars Aanning says he no longer could live with his lie. Because he is 77, retired, and cannot be subject to colleagues’ retribution, he decided to ‘fess up, and to help attorneys who represent injured patients. Aanning says he does not know whether his false testimony was decisive in his partner’s lawsuit. But he confesses that he knew his colleague’s patient had suffered because of the treatment this stroke victim received. He also had had doubts before about his partner’s work.
He tells a reporter for Pro Publica, the Pulitzer Prize-winning online investigative site, that he knew at the moment he uttered his untruths that his lying flew in the face of everything he thought he stood for. But he says, “I did it as a matter of course. And I did it because there was a cultural attitude I was immersed in: You viewed all attorneys as a threat and anything that you did was OK to thwart their efforts to sue your colleagues. I just accepted that as normal. It wasn’t like, ‘I’m going to lie. It was, ‘I’m going to support my colleague.’ ”
We’ve seen this playbook before, and it’s never pretty how wealthy industries can distort scientific research and harm the public health for decades. Think tobacco and cancer, oil and climate change, football and brain injury. Now: sugar.
Big Sugar secretly paid influential experts, steered and reviewed their inquiry, and, as a result, American health policy at a critical point in the 1960s–and since–has emphasized the role of fats and downplayed sugar’s harms in the rising incidence of heart disease, researchers have found.
This influence-peddling involved then-prominent (now dead) Harvard nutrition experts and the highly respected New England Journal of Medicine (NEJM). The prevailing ethics then differed. Authors were not required by medical journals to disclose conflicts of interest, as they are supposed to now.
The spots in hospitals where patients in the direst shape receive specialized treatment are themselves in need of urgent care, experts say, explaining that antiquated intensive care units (ICUs)
contribute to needless harm. But how exactly to yank them and the therapies they provide into the 21st century?
Usha Lee McFarling, a Pulitzer Prize winner, examines ICU reforms for the online health news site Stat, finding that these crucial and “heroic” hospital facilities fundamentally have changed little in a half century, although they now are jammed with new technology and devices. They serve almost 6 million Americans in grave condition, but in them, she says, “studies show serious and sometimes fatal medical errors are routine. And a recent review published in the journal Critical Care found no major advances in ICU care since the field’s inception in the 1960s.”
More than a quarter million Americans die from it each year, more than succumb to heart attacks. U.S. hospitals spend an estimated $55 million a day battling it. Most Americans know next to nothing about it, and all too many medical caregivers fail to recognize its fast-moving symptoms that can lead to death. Leaders at the federal Centers for Disease Control and Prevention have grown so wary of its health and economic toll that they have declared a medical emergency over this disease. Its name is sepsis.
It’s an all too common affliction in which the body responds in overpowering fashion to an infection. The CDC says sepsis can “lead to tissue damage, organ failure, and death. It is difficult to predict, diagnose, and treat. Patients who develop sepsis have an increased risk of complications and death and face higher healthcare costs and longer treatment.”