DC Medical Malpractice & Patient Safety Blog

September 22, 2017

New questions on safety, for old and young, about medications for the mind

Psychiatric medications, which doctors have prescribed freely and patients have taken dutifully, not only may have demonstrated risks for the young but also under-considered problems for adults older than 40 — 1 in 7 of whom has filled a script, for example, for an antidepressant.

The New York Times has done a service by bringing to the fore some lesser known issues of psych meds by reporting on a successful lawsuit involving a 57-year-old Chicago lawyer. He apparently suffered from severe physical and mental agitation after he started taking paroxetine, the generic form of the brand-name drug Paxil. His anxiety became so acute, a jury found, the lawyer threw himself fatally in front of an oncoming train.

Antidepressants, including Paxil, long have been controversial for the young, especially after reports cropped up describing serious issues with their use. All such meds have carried a “black box” warning label, reviewed and approved by the federal Food and Drug Administration, warning that they increase the risk of suicidal thinking and behavior in children, teens, and those younger than 25.

September 21, 2017

Regulators probing sanitary & staffing woes at leading D.C. hospital

by Patrick A. Malone

MedStar Washington Hospital Center, described by its chief medical officer as “the most important hospital in the most important city in the most important country in the world,” is under investigation by regulators in the District of Columbia due to maintenance failures that allowed sewage to seep down walls and onto operating room floors.

USA Today deserves credit for reporting on problems in the 900-plus-bed hospital, which serves many of the District’s poor as well as providing trauma care sufficiently vital that it is supposed to be the go-to place of emergency treatment for top officials.

Its elite patients have included House Majority Whip Steve Scalise, who was taken to MedStar Washington after a deranged gunman wounded him while shooting up a Congressional baseball practice. USA Today says a room where Scalise was treated, later, after he was out of it, was among those affected by maintenance and sanitation woes.

September 20, 2017

In hurricanes’ wake, new concerns about elderly and tainted waters

by Patrick A. Malone

Although Hurricanes Harvey and Irma have stormed off into the record books, their harms, particularly to health, persist for Texans, Floridians, and residents of the Caribbean. Recovery and return to normalcy will take the ravaged areas longer than many Americans realize, experts say. And they already are uncovering systemic woes, some fatal, with which planners and lawmakers will need to reckon with to better prepare for the next storm.

In Florida, for example, while hospitals, generally speaking, had adapted and rode out Irma maybe better than might be expected, nursing homes did not. They’re under new scrutiny, notably after eight residents died in an already troubled and roasting Hollywood, Fla., nursing home.

That incident refocused official attention on a sizable and particularly storm-afflicted population in the Sunshine State: its senior citizens. Whether in others’ care or ostensibly on their own, millions of older Floridians were left even more vulnerable after Irma, which cut off critical life services, including power, cooling, transportation, and access to medical services and food and other supplies.

September 19, 2017

‘Poor me’ cries from Big Pharma, medical device makers? They’re bunk

by Patrick A. Malone

Big Pharma and medical device makers have mastered the art of crying “Poor me!” complaining without end about the time and costs of getting products to the market and the need for regulators to lighten up. New information, however, undercuts this industry whine—and it reminds that the nation’s watchdogs need, if anything, to be tougher and more vigilant.

Let’s start with new research, published in JAMA Internal Medicine, that calls into question Big Pharma’s long-espoused position that its whopping prices (which the public wants official action on—see graphic) are warranted because a new drug costs upward of $3 billion to research and develop. But based on a scrutiny of public information about expenses to develop 10 new cancer drugs—among the most costly to get to market—researchers found drug makers’ R&D costs were far less — closer to $650 million.

Although independent experts praised the new study, drug makers challenged the cheaper R&D estimates, with backing from Tufts researchers’ who had set the earlier, pricier benchmark. It’s difficult to make apples and oranges comparisons. That’s because Big Pharma wants any tally of its drug development expenses to include its costly failures.

September 18, 2017

GOP senators trying to sneak in one more push to repeal, replace Obamacare

by Patrick A. Malone

As the 40^th President of the United States used to mutter, well, there they go again.

The Republicans in the 115^th Congress apparently will make another go at repealing and replacing the Affordable Care Act, what may be their 70-something such try. It may come in the form of legislation advanced by GOP Senators Lindsay Graham of South Carolina, Bill Cassidy of Louisiana, Dean Heller of Nevada, and Ron Johnson of Wisconsin.

The so-called Graham-Cassidy bill, which analysts say would slash tens of millions of Americans from health coverage, cut tens of billions of dollars in federal aid for health care, and convert the ACA into state-controlled block grant funding, must overcome major obstacles to advance.

September 15, 2017

Dr. Watson? IBM’s super computer may not be such a medical whiz, after all

by Patrick A. Malone

Technology is transforming medicine without a doubt, but its proponents—including one of the computing industry’s titans—may be getting ahead of themselves in boasting about their devices’ capacities.

Stat, the online health information news site that had a rocky week of its own, deserves credit for reporting that IBM at present is overselling the medical capacities of its Watson super computer.

Big Blue’s “Dr. Watson,” promoted as an innovative, speedy, and influential diagnostician and medical advisor nonpareil, may be more like the Dr. Watson played by Nigel Bruce in black and white Sherlock Holmes movies starring Basil Rathbone. Watson’s pleasant, records what somebody more important is doing, and, occasionally, with bumbling good luck, he stumbles his way into valuable insight.

September 14, 2017

Joint Commission assailed for lax oversight of hospitals’ safety, quality

by Patrick A. Malone

The nation’s leading watchdog of hospital safety and quality is quick to hand out its “Gold Seal of Approval” and rarely penalizes care-giving institutions, even when state and federal officials find serious problems.

The Wall Street Journal deserves credit for its investigation of the Joint Commission, the nonprofit and industry-supported organization that is supposed to inspect and accredit hospitals nationwide. It does so for 80 percent of them, as well as for institutions serving military veterans, federal prisoners, and Native American patients in the Indian Health System.

Hospitals can either join the commission and undergo its accreditation process—including regular inspections that typically are announced in advance, conducted with flourish, and which can cost institutions tens of thousands of dollars depending on their size and membership levels—or they can be inspected by state and federal officials. Most choose the Joint Commission.

September 13, 2017

A new tool for finding how your hospital rates

by Patrick A. Malone

Patrick Malone & Associates has a new tool for patients to easily check out how their hospital stacks up on quality and safety measures.

The tool is on our website here, and covers all hospitals in the Washington D.C. metropolitan area, including northern Virginia, the Maryland suburbs of DC and the District of Columbia itself.

When you click on the link, you will see a map of the DC area with hospital locations pinned. Click on any hospital, and a small window will open up giving you an array of stats. Each statistic has an arrow next to it– up for “better than average” and down for “worse than average. Our site features these quality measures:

September 12, 2017

In a sadly still unequal U.S., parasites flourish and rural moms can’t get care

by Patrick A. Malone

It can be too easy to forget the unfortunate, inequitable legacy of the Old South, especially how racist Dixie created stark racial health disparities. But sometimes a foreigner’s jab in the ribs can remind us how making America great again could mean tending much better to our collective p’s and q’s in public health, especially so poor, rural people of color don’t get tropical parasite infections and they do get reasonable access to critical maternal care.

The Guardian, a British news outlet, has pointed out that new, published research shows a disgusting resurgence in Americans, notably in Alabama, testing positive for hookworms, a debilitating “gastrointestinal parasite that was thought to have been eradicated from the U.S. decades ago.”

As the Guardian reports:

September 11, 2017

In hospitals, angry guys with guns (even with badges) are a bad idea

by Patrick A. Malone

Medicine and law enforcement can be a combustible combination, as a widely publicized incident in a Utah emergency room has reminded. The ugly incident has underscored the importance of hospitals keeping big, upset guys with guns cordoned off from caregivers, as well as the importance of front-line medical personnel knowing, respecting, and protecting patients’ privacy rights about their medical treatment.

Nurse Alex Wubbels became a heroine for firmly and politely telling Salt Lake detectives that the law forbade them from ordering blood extraction and testing on patient William Gray. The unconscious truck driver turned out to be a reserve cop in a nearby small town, and he had been involved in a crash connected to a high-speed chase by Salt Lake officers.