DC Medical Malpractice & Patient Safety Blog

June 19, 2019

Is this any way to learn you’re dying — hearing MDs chat outside exam room?

Ron Naito already had been rebuffed by one specialist about the severity of his illness. He was awaiting in a doctor’s examining room for his lab test results and a consultation with a second expert about his already advanced cancer. What happened next stunned the Portland, Ore., resident. But now he’s doing something to help other patients in this way too common situation.

Naito overheard his doctor and a medical student talking about him and his lab results as they passed by the open room door, saying a tumor in his pancreas was “5 centimeters,” and was “very bad.”

That was the way Naito, who has practiced as an internist for 40 years, learned his condition was terminal. The cruel delivery of that crucial news convinced him that he needed to spend what time he has left working with his medical colleagues about their communication skills, especially in conveying the news to patients that they are dying.

June 18, 2019

UCLA ripped for poor handling of another scandal over a staff physician

by Patrick A. Malone

USC, Ohio State, Michigan State, and now, UCLA: How can big universities, with all the supposedly smart folks who head them, be so blind and deaf to student complaints that school personnel may be sexually abusing them? And why do academics keep getting caught up in situations where they appear to or may be covering up wrongdoing against the young?

Officials at the University of California Los Angeles find themselves apologizing profusely for failing to disclose that they knew of accusations of inappropriate conduct by a gynecologist on the school’s staff while treating patients in university facilities, the Los Angeles Times reported.

Women say that Dr. James Mason Heaps wrongly touched their private parts, and UCLA learned of the accusations in 2017, putting the longtime staff gynecologist on leave in 2018. The school, however, did not disclose why Heaps was gone — until criminal charges were filed against him in recent days and he pleaded not guilty to them in court.

June 16, 2019

For Insys, infamy in two opioid crisis firsts: convicted founder and bankruptcy

by Patrick A. Malone

Insys Therapeutics, a drug maker that peddled powerful and addictive painkillers in sordid ways, entered yet another phase of its penalties for its criminal conduct: The firm in quick fashion agreed first to pay $225 million to resolve federal bribery charges, then promptly sought bankruptcy protection.

Federal prosecutors, who earlier had won criminal racketeering convictions against the firm’s CEO and other Insys executives, emphasized that the Big Pharma firm hasn’t declared itself insolvent in its bankruptcy action and will pay up for damages caused by Susbsys, its chief product.

Subsys is a liquid containing the super potent painkiller fentanyl. It is administered as a drop under the tongue and was supposed to benefit cancer patients with grueling pain. Instead, Insys CEO John Kapoor “used speaker’s fees and lap dances to lure doctors into prescribing Subsys for far more patients than the drug was approved for and cheated insurers into covering prescriptions for the costly medication,” the Washington Post reported. Kapoor and other Insys execs await sentencing after their federal felony convictions.

June 14, 2019

As temperatures rise, so can dangers to kids and pets locked in hot cars

by Patrick A. Malone

As the weather turns toasty, it’s worth remembering that common sense and a bit of caution can save the lives of children and pets: Please don’t forget they are in your vehicle’s back seats, and don’t lock them in there with the windows rolled up — even for the briefest moment.

The New York Times reported this, in a timely news article:

As the summer months heat up across America, advocates are hoping to draw attention to the issue [of children dying in locked vehicles] as well as their push for legislation to help address the problem. Dozens of children die of heatstroke each year in cars whose temperatures, even on relatively mild days, can quickly soar past 100 degrees. Many of those children were left behind by a distracted caregiver.

June 13, 2019

With seniors, special focus can be beneficial — in tough surgeries and more

by Patrick A. Malone

Recognizing that seniors face different health challenges than younger folks could help doctors and hospitals better safeguard older patients who undergo complex and demanding surgery.

Paying heightened attention to age’s changes also can be beneficial to older adults in protecting themselves from damaging falls and getting retirees to keep moving to stay fitter — without getting hung up on a mistaken exercise measure.

A specialty group within the American College of Surgeons may be on a beneficial course in recommending new geriatric guidelines for older patients, a rising number of whom undergo extensive procedures that once were considered risky for those of an advanced age, the New York Times reported. This is a significant issue in surgical practice, the newspaper reported:

June 11, 2019

Faith-based charity as the answer to crushing medical debt? Only in America.

by Patrick A. Malone

Praise be: Churches nationwide are leaping in with their congregations’ blessing and financial support, putting up small sums to buy up and wipe out one of the huge shames of the American health care system: patients’ medical debt.

The faithful work with RIP Medical Debt, a nonprofit organization based in Rye, N.Y., that provides the know-how to many kinds of donors to help eliminate bills that can crush patients and their loved ones for a lifetime, the Kaiser Health News service reported. Roxie Hammill wrote how this all works in modern medicine:

June 9, 2019

Uncle Sam forced to disclose secret list of 400 poorly performing nursing homes

by Patrick A. Malone

Federal regulators have given up the unwarranted secrecy enshrouding their watchdog efforts on the nation’s most problematic nursing homes.

With prodding from the U.S. senators from Pennsylvania, Democrat Bob Casey (above left) and Republican Pat Toomey (above right), the Centers for Medicare and Medicaid Services (CMS) disclosed its list of hundreds of nursing homes that perform so poorly they are on the brink of regulators’ most dire supervision.

CMS had declined to disclose its candidates for designation as a “Special Focus Facility” (SFF), preferring instead just to tell the public about its worst of the worst nursing homes, 88 facilities with the SFF tag that receive a targeted, higher level of inspection because of their poor performance. The most rigorous oversight can be resource intensive, and CMS can only scrutinize at the highest level a few poor performing homes, whose infamy is made public. When one facility “works its way off” an SFF designation by improving its failings, others are on the heretofore secret list to take their place.

June 7, 2019

In season of higher risk for kids, cautions about mowers and pool chemicals

by Patrick A. Malone

As the nation slips into summer and the statistical 100 deadliest days for kids, there are some timely reminders about keeping youngsters safer around swimming pools and the chemicals used with them and protecting them from the harms of riding mowers when the devices are run in reverse.

The Red Cross, of course, reminds that “10 people die each day from unintentional drowning, and on average two of them are younger than 14. Drowning is responsible for more deaths among children ages one to four than any other cause except birth defects. And among those 1-14, drowning is the second-leading cause of unintentional injury-related death behind motor vehicle crashes. For every child who dies from drowning, another five receive emergency care for nonfatal submersion injuries.”

The safety group, which urges parents to supervise kids closely near water and get them swimming lessons and instruction in ways to prevent water-borne mishaps, underscores that little kids drown most often at home — in pools, hot tubs, and spas, but also buckets, bath seats, wells, cisterns, septic tanks, decorative ponds, and toilets. Youngsters 5 and older drown more often in ponds, lakes, and the ocean.

June 5, 2019

Hospitals raise legal concerns by lavishing pay and perks on staff doctors

by Patrick A. Malone

As hospitals boost their size and power to push their profits even higher, they’re also raising alarms with federal regulators over their too cozy relationships with doctors who are pulling down big pay from them now as part of their staffs.

Uncle Sam long has sought to ensure that the billions of tax dollars that get spent in the health care system don’t become medical spoils, riches that get passed around a select few through kick-back and self-referral schemes. These are barred by regulation, notably in Medicare- and Medicaid-funded care, and by the “Stark law.”

Jordan Rau of the Kaiser Health News service reported that a hospital in Wheeling, W. Va., has gotten regulators attention by lavishing pay and perks on specialists in its employ, including $1.2 million a year for a pain specialist and $770,000 annually and 12 weeks’ vacation for a cardiothoracic surgeon. The money is far higher than what such experts command in the area and it’s more surprising because the treatment areas these high-paid doctors work in are big financial losers for Wheeling Hospital.

June 4, 2019

Can we avoid getting dopey about hype, use, regulation of dope-derived CBD?

by Patrick A. Malone

The federal Food and Drug Administration has waded into its potential oversight of a substance that already is becoming wildly popular. The process of figuring government rules for cannabidiol, aka CBD, well could be called Confusion By Design.

The New York Times and Washington Post both reported on the parade of dozens of parties, pared from hundreds of aspirants, wanting to influence the FDA’s path with the agency’s first hearing on CBD. It already is sold in thousands of products on the market now. These include pet foods, soft drinks, bath salts, and oils and solutions that users add to food and rub on themselves.

Of great concern to the FDA are the extreme and proliferating claims that vendors are making for unproven health-related benefits of use of CBD, which is a nonintoxicating extract that can be derived from hemp and marijuana. As the popular health information WebMD site reported: