DC Medical Malpractice & Patient Safety Blog

October 20, 2017

As infertility, testicular cancer rates rise, is it time for male private(s) talk?

Gentlemen, rev those engines of anxiety: Male infertility rates are on the rise, as are those for testicular cancer. Meantime, a global effort to improve one of the most common forms of male contraception may provoke some uncomfortable discussions about masculine misconceptions.

When there’s a break in the Major League Baseball championships, or the NCAA or NFL football regular season football games, or the NBA basketball contests, see how much the buds can be startled by researchers’ latest medical worry about men, as summarized in a summer Newsweek report:

Sperm levels—the most important measurement of male fertility—are declining throughout much of the world, including the U.S. [A review of] thousands of studies … concluded that sperm concentration had fallen by 52 percent among men in Western countries between 1973 and 2011. Four decades ago, the average Western man had a sperm concentration of 99 million per milliliter. By 2011, that had fallen to 47.1 million. The plummet is alarming because sperm concentrations below 40 million per milliliter are considered below normal and can impair fertility.

October 19, 2017

Little red pills, given off-label to seniors by the millions, are no laughing matter

by Patrick A. Malone

With baby boomers leading a graying wave that’s sweeping the nation, there’s little wonder why there’s a furious search under way to medically assist and to support seniors suffering from dementia and Alzheimer’s Disease. But should the appropriate response be to burst out laughing, crying, or just to scream out loud about Avanir Pharmaceuticals’ little red Nudexta pills and how they’re getting foisted by the millions on the elderly in nursing homes?

CNN deserves credit for its reporting on the sketchy prescribing of Nudexta. Millions may know something about this drug due to the barrage of commercials for it, featuring the accomplished actor Danny Glover (hope he got a giant paycheck for this role).

Authorities have approved Nudexta to treat sudden and uncontrollable laughing or crying, aka the pseudobulbar affect or PBA. Less than 1 percent of all Americans suffer from PBA, which most commonly is seen in those with multiple sclerosis (MS) or ALS, also known as Lou Gehrig’s disease.

October 18, 2017

Uncle Sam should be wary in partnering with Big Pharma on cancer treatments

by Patrick A. Malone

Is Uncle Sam launching a way to speed and improve cancer treatments so they get to patients sooner—or is Big Pharma about to fleece taxpayers, yet again? The National Institutes of Health should carefully consider its just announced, five-year public-private partnership with a dozen drug makers, the “Partnership for Accelerating Cancer Therapies” or PACT.

Under this agreement, the makers each will pony up $1 million annually or a total of $55 million over the term of the accord. The NIH, in turn, will provide $160 million of its formidable research support.

The aim is to “identify, develop and validate robust biomarkers — standardized biological markers of disease and treatment response — to advance new immunotherapy treatments that harness the immune system to attack cancer,” the agency says.

October 16, 2017

Latest disastrous strain on medical care: Northern California wildfires

by Patrick A. Malone

As California’s Wine Country deals with the prospect that the toll will rise more and the largely unchecked blazes will wreak greater havoc, doctors and hospitals have struggled with patient evacuations and the destruction of medical facilities. Millions of residents are coping with noxious smoke, terrible air quality, and breathing woes.

The Golden State crisis should offer a tough reminder to all of us in the rest of the country: Fire dangers remain real and lethal, last year alone killing 3,390 Americans, injuring 14,650, and causing an estimated $10.6 billion. Families should not only do what they can to fire-proof their residences, they also should make emergency plans and practice them periodically.

Seniors may be at heightened risk, and they, their friends and loved ones, should make special precautions to safeguard them, planning for dire circumstance.

October 15, 2017

Trump, by executive fiat, tries to blow up ACA with cheap, skimpy alternatives

by Patrick A. Malone

President Trump has made good on his promise to try to blow up the Affordable Care Act, aka Obamacare. His latest, twin executive actions seek to gut the national health insurance program that Republicans have reviled but could not unwind with seven years of congressional action.

If the American health care system was rocky before, and if it breaks, Trump and the GOP now own it, analysts insist. That’s because the president, effectively, has officially given the nation Trumpcare, though it, too, has an uncertain path ahead.

Although partisans had vowed that their ACA repeal and replacement would result in better, more affordable, and more accessible health coverage for Americans, Trumpcare goes nowhere close to any of those goals, experts say.

October 13, 2017

U.S. watchdogs tally $1.5 billion cost for one type of defective medical device

by Patrick A. Malone

Big medical device makers, like Big Pharma, have complained relentlessly that Uncle Sam hamstrings them with red tape and bureaucracy that slows or prevents innovative, life changing and lifesaving products from reaching the public. Most of this criticism has been targeted at the federal Food and Drug Administration, which under the Trump Administration, has promised to speed and ease its industry oversight.

But internal watchdogs for the Health and Human Services department have provided a rebuke to the move-faster crowd, detailing the costly cleanup—paid for by taxpayers like you and me— that results from defective medical devices.

The HHS inspector general’s office, in what some patient advocates are calling “a drop in the bucket” of the magnitude of this concern, has found that Medicare paid “at least $1.5 billion over a decade to replace seven types of defective heart devices [that] apparently failed for thousands of patients,” according to a story by Pro Publica, the Pulitzer Prize-winning investigative reporting web site.

October 12, 2017

Plastic surgery patients don’t need surgeons who are social media clowns

by Patrick A. Malone

Social media have become a “circus” for some plastic and cosmetic surgeons to clown around in unprofessional ways, including: videos in which one doctor has cradled fat removed from a tummy-tuck like an infant and put a baby face on it using a Snapchat filter. Other costumed surgeons have posted visual displays of themselves dancing before surgery and showing off on camera procedures or with tissues they have removed.

The abuses have become so bad that faculty and students from Northwestern University’s medical school, after researching incidents online, have published a prospective social media code of ethics for plastic surgeons, calling for its adoption by specialists at their next major meeting.

Robert Dorfman, one of the Northwestern students and an author of the draft ethics proposal, has described plastic surgery’s social media landscape “like the Wild West out there, with no guidelines or rules.” Clark Schierle, senior author of the guidelines, a plastic surgeon, and a medical school faculty member, has observed that practitioners in the field are “uniquely drawn to social media because we tend to do more marketing and we are a visual specialty.”

October 10, 2017

40 percent of diagnosed cancers linked with patients’ excess weight

by Patrick A. Malone

Those carrying around a few pounds extra, or maybe even a lot more, may want to get moving and to drop that excess weight for yet more compelling health causes: That’s because more than 630,000 Americans were diagnosed in 2014 with cancers linked to obesity or overweight, the federal Centers for Disease Control and Prevention has reported.

The CDC says 40 percent of all diagnosed cancers were associated with obesity. At a time when the nation is seeing some success in reducing overall rates of diagnosed cancers, a baker’s dozen of overweight-related cancers increased 7 percent between 2005 and 2014. Two out of three of the cancers occurred in those 50- to 74-years-old.

Federal officials have found that more than half of Americans don’t know there’s a connection between 13 kinds of cancers (see diagram) and excess weight. It took public health officials decades to persuade the public that smoking posed cancer health risks and people needed to stop—and Big Tobacco still resorts to unceasing, deceptive tactics to undermine this awareness.

October 9, 2017

Las Vegas tragedy helps highlight what’s right with nation’s health care system

by Patrick A. Malone

Caregivers and the community in Las Vegas, Nev., deserve a salute for their response to the gun violence last week, which could have overwhelmed a less-prepared community’s medical system.

Las Vegas isn’t a giant metropolis (pop. 2 million in its metro area), and, due to the high costs to operate such a facility, it has just one Level 1 trauma center. That’s a facility staffed and equipped to provide a “gold standard” of emergency care. In the state of Nevada, the only such center is at the 541-bed University Medical Center of Southern Nevada.

It was slammed with more than 100 critical patients, many with life-threatening or fatal gunshot wounds. A torrent of patients also was routed to the hospital, some for treatment of injuries they suffered while fleeing Stephen Paddock’s rampage. First-responders soon were flooding another facility, Sunrise Hospital and Medical Center in Las Vegas—a Level II trauma facility—with hundreds more.

October 6, 2017

For young athletes, head contact and infections can pose costly risks

by Patrick A. Malone

Parents happily send their eager youngsters off to a demanding array of sports activities, in the belief that athletics will improve their health and well-being. But, especially for active young men, life as a jock can carry costly long-term risks and immediate infection perils.

A Yale economist and colleagues have scrutinized available public data and estimated that by changing some contact sports like football into their less violent forms (like touch or flag versions), almost 50,000 fewer collegiate and 600,000 or so high school injuries would be averted. Figuring in the costs of medical care and time lost, this could mean a savings of $1.5 billion at the college level and $19.2 billion for high schools.

The researchers came to these big sum conclusions after looking at four types of serious injuries: concussions and damage to the nervous system, bone injuries, torn tissue, and muscle and cartilage injuries. They said that the popularity and prevalence of high contact sports like football in explaining why athletics’ economic toll can be so high.