DC Medical Malpractice & Patient Safety Blog

October 17, 2018

Hurricane Michael shows extreme planning may be key to protect medical care

As Florida, Georgia, and the Carolinas struggle with Hurricane Michael’s devastation and slow-rising death toll, hospitals, nursing homes, and other caregiving facilities across the country may need to reexamine their disaster planning, paying heightened attention to extreme and worst-case scenarios.

Although doctors, nurses, and other medical personnel deserve great credit, as always, for their courage and fortitude in helping the sick and injured, the New York Times reported that, even with disaster plans in place, care-giving facilities got caught short by the latest powerful hurricane:

As Michael bore down and then passed, some hospitals in the region closed entirely, and others evacuated their patients, but kept staff in place to run overwhelmed emergency rooms. In Florida, four hospitals and 11 nursing facilities were closed, according to the Federal Emergency Management Agency. Panama City has five hospitals, according to the Florida Health Association. Bay Medical, with 323 beds, and Gulf Coast Regional Medical Center, with 238, are the biggest. Florida officials also said food and supplies were being dropped in by air to the state’s mental hospital in Chattahoochee, which is cut off by land. The mental hospital has a section that houses the criminally insane, but the facility itself has not been breached, officials said. Gov. Nathan Deal of Georgia said 35 hospitals or nursing homes in that state were without electricity and operating with generators. Federal health officials said they were moving approximately 400 medical and public health responders into affected areas, including six disaster teams that can set up medical operations outdoors. Some were heading to an overwhelmed emergency department in Tallahassee. Other federal medical personnel were being assigned to search-and-rescue teams to triage people who were rescued. University of Florida Health Shands Hospital sent ambulances and four helicopters to assist in rescue efforts, transporting patients out of Panhandle hospitals.

October 16, 2018

Hundreds of supplements for diet, muscle, and sex are tainted with risky drugs

by Patrick A. Malone

Same story, new data, and a message that needs repeating: Over-the-counter supplements — sold as safe alternatives to prescription drugs for weight loss, muscle building, and sexual enhancement — may be risky and not beneficial to your health. Indeed, many of them are adulterated with strong prescription drugs.

As the Washington Post reported of a newly published study:

Researchers found unapproved and sometimes dangerous drugs in 746 dietary supplements, almost all of them marketed for sexual enhancement, weight loss or muscle growth … [A scientific] review of a Food and Drug Administration database of contaminated supplements for the years 2007 to 2016 most commonly turned up sildenafil — the drug sold as Viagra — and other erectile dysfunction drugs in sex enhancement products; sibutramine and the laxative phenolphthalein, both banned by the FDA, in weight-loss supplements; and steroids or their analogues in muscle-building products. About 80 percent of the supplements were contaminated by one pharmaceutical that should not have been in the product. Twenty percent contained at least two such drugs, and two of the supplements contained six unapproved drugs. One product contained a drug that raises blood pressure and another drug that lowers it. Despite these contaminants, fewer than half the products were recalled.

October 15, 2018

Will Supreme Court reconsider government’s immunity from medical malpractice suits by active-duty military?

by Patrick A. Malone

Although Uncle Sam makes a special vow to provide medical care for those who fight for this nation, he also enjoys special legal shields from lawsuits from them if anything goes wrong with medical services they’re provided. But recent news reports show how past and present service personnel not only suffer shabby medical care but also “grossly unfair” situations when pursuing malpractice claims — and why lawmakers and courts may need to step in to provide fairer remedies.

Kaiser Health News (KHN) and the ABC-TV news affiliate in Los Angeles both deserve credit for spotlighting tough cases involving service personnel and medical malpractice, particularly the Federal Tort Claims Act and the Feres doctrine, a 68-year-old Supreme Court case that bars active-duty military members from suing the federal government for their own injuries.

Walter Daniel, a former Coast Guard officer, has petitioned the Supreme Court to “amend the 1950 [Feres] ruling, creating an exception that would allow service members to sue for medical malpractice the same way civilians can,” KHN reported, noting this would affect patients in a military health system “with 54 hospitals and 377 medical clinics, serv[ing] about 9.4 million beneficiaries, including nearly 1.4 million active-duty members.”

October 12, 2018

Unhappy meals: Fast food still tops out too many time-stressed eaters’ menus

by Patrick A. Malone

Americans can’t stop chowing down on fast foods, despite years of warnings about their health harms.

The federal Centers for Disease Control and Prevention has found that 36.6 percent of Americans — 37.9 percent of men and 35.4 percent of women — eat some kind of fast food on any given day.

As the Los Angeles Times reported:

October 11, 2018

Congrats on the raise. Too bad it’s gone already. For health insurance.

by Patrick A. Malone

As various news organizations reported, anxious Americans will vote in less than a month with health care as a dominating concern. A new annual report shows why: Medical costs keep rising, as does the cost of health insurance, notably the coverage most of us get from our employers. Companies keep pushing on to workers higher premiums and deductibles that race ahead of inflation and devour wage growth.

Deductibles — the out-of-pocket costs that patients must pay before their coverage kicks in and benefits them — have skyrocketed since 2008, growing by 212 percent. That’s eight times faster than wage growth, and 12 times faster than inflation, according to the latest research by the Kaiser Family Foundation.

The average deductible, $303 a decade ago, now has hit $1,573 for single coverage.

October 10, 2018

Not so noble: Big Pharma profiteering off the work of Nobel laureates

by Patrick A. Malone

The 2018 Nobel Prizes represent a pinnacle of global recognition for path-breaking research, but the awards also surface some less than noble aspects of modern science and medicine.

This year’s prizes cast a spotlight on breakthrough findings on how to take off the immune system’s natural brakes to allow it to attack cancer, and on speeding evolutionary processes so enzymes and bacteria-fighting viruses can be harnessed to create compounds helpful to mankind. Advances in these areas promise to improve and lengthen lives around the planet.

And it was terrific at a time of so much gender-based discrimination and abuses of women in science, technology, engineering, mathematics, and medicine, to see prestigious prizes, finally, awarded to two women in chemistry (the fifth such Laureate) and physics (the third).

October 9, 2018

Congress approves 650-page bill to attack opioid crisis, as doubts abound

by Patrick A. Malone

Congress has approved a major new push to deal with the opioid crisis that kills tens of thousands of Americans annually. Voters can expect President Trump to sign the big bill, passed easily and with rare bipartisan support in the House and Senate, just in time for politicians in the mid-term elections to campaign on their drug-fighting initiatives. But critics say it won’t be enough.

The opioids legislation covers 650 pages, and, in brief, the Washington Post reported, would:

Require the U.S. Postal Service to screen packages for fentanyl shipped from overseas, mainly China. Synthetic opioids that are difficult to detect are increasingly being found in pills and heroin and are responsible for an increase in overdose deaths.

October 4, 2018

Big Pharma takes rare price cut on hepatitis C drugs, but other drug prices continue to march north

by Patrick A. Malone

Big Pharma has given baby boomers, members of under-represented communities, and American taxpayers rare and promising good news about a product price cut: A drug used in a highly effective multi-course treatment for hepatitis C will see its sky-high price continue to plunge.

Gilead Sciences Inc., facing steep competition from other makers and innovations from non-profits, has decided to sell cheaper, just as potent versions of its hep C fighting drugs Epclusa and Harvoni. The company’s “authorized generics” will be sold for $24,000 for a regimen of care that has been shown to clear the once lethal hepatitis virus in patients. The new medications’ costs also compare to launch list prices of their branded predecessors: $94,500 for Harvoni and $74,760 for Epclusa.

Those drugs had generated huge profits for Gilead, boosting its market valuation to almost $100 billion. At the same time, critics assailed the company for profiteering, leading to congressional hearings. Gilead also found itself embroiled in a market competition, with drug makers AbbieVie and Merck introducing alternative and cheaper products that slashed into profits of the Foster City, Calif., company that broke ground in hep C treatment.

October 3, 2018

As partisans scuffle, Medicare surprises by reducing per-patient spending

by Patrick A. Malone

Critics may want to carve it up and make it tougher to join, while proponents would expand it and add more money to it. But what could the U.S. health system overall learn from real, rigorous research on Medicare, the major health coverage method for tens of millions of Americans age 65 and older?

Politico, the politics- and Beltway-focused news web site, has renewed attention on the work of Ph.D. economist Melinda B. Buntin, a professor who heads Vanderbilt University’s health policy department. She and her colleagues have spent years digging into the money flowing into Medicare, a program that in 2017 paid out $700 billion in benefits, compared with $425 billion in 2007.

As Politico reported, the research shows a surprise beneath the big, aggregate, and problematic Medicare cost: “One of the best-kept secrets in American health care might be that Medicare spending — in important ways — is going down.”

October 2, 2018

Battle is on to bring down sky-high costs of emergency medical transport

by Patrick A. Malone

Even as District of Columbia officials gave a cautious, interim report on their push to reduce with nurses’ help the expensive misuses of the 911 emergency system, a news organization’s story on a sky-high medical transport bill has underscored why regulators and lawmakers need to fix a pricey part of the health care system: Why can’t sick and injured patients get to treatment, quickly but without breaking the bank?

In the nation’s capital, it will take special nurses more time to settle in, overcome excess caution, and better help emergency dispatchers decide: When can they avoid sending expensive EMS vehicles and teams and when can patients with less urgent medical complaints be helped to get to care with cheaper commercial options, like app-based ride-sharing services Uber and Lyft, D.C. Fire Chief Gregory Dean has said.

The data from the first 90 days of the $1-million “Right care, right now” program to tap nurses’ expertise to divert non-emergency medical care out of the 911 system may offer modest cause for optimism, as the Washington Post reported: