DC Medical Malpractice & Patient Safety Blog

September 20, 2019

Nursing homes and long-term care facilities may be infection ‘cauldrons’

The battle to reduce the sky-high cost of hospital care may have created its own unforeseen and harmful consequence: By hastening to get patients out of traditional hospitals and into skilled nursing facilities and long-term care centers, doctors and policy-makers may be contributing to a medical nightmare — serious infections acquired in health care institutions.

The New York Times reported that “public health experts say that nursing facilities, and long-term hospitals, are a dangerously weak link in the health care system, often understaffed and ill-equipped to enforce rigorous infection control, yet continuously cycling infected patients, or those who carry the germ, into hospitals and back again.”

Hospital-acquired infections (HAIs) pose significant risks to already ill and injured patients, as well as adding to the fearsome costs of institutional care, the Leapfrog Group, an independent patient safety and advocacy group has found. As Leapfrog has reported:

September 18, 2019

There hospitals go again: UVA Health backpedals on draconian debt collection

by Patrick A. Malone

Is a public pillorying the only way to stop big hospitals from pursuing patients for medical debt with the zeal of demons from the underworld?

The University of Virginia Health System — an enterprise that racked up an $87 million operating profit on revenue of $1.7 billion in the fiscal year ending in June and that holds stocks, bonds and other investments worth about $1 billion — has become the latest institution to get a journalistic blaming and shaming for extreme debt collection practices that would make proud Inspector Javert in Les Miserables.

The independent, nonpartisan Kaiser Health News Service and the Washington Post deserve credit for their investigation into UVA avariciousness. As KHN reported of the state operation:

September 17, 2019

With GOP still tearing at ACA, uninsured rate rises for first time in decade

by Patrick A. Malone

The Grand Old Party may have just won the dictionary definition of a Pyrrhic Victory. That’s because Republicans’ decade-long assault on the Affordable Care Act his finally showing predictable results, with the share of Americans lacking health insurance increasing for the first time in 10 years.

The rate and number of people without health insurance increased from 7.9%, or 25.6 million, in 2017 to 8.5%, or 27.5 million, in 2018, officials reported.

The nation’s children got a kick in the face, too, with almost half a million more youngsters uninsured in 2018 versus 2017 — a decline attributable mostly to a reduction in the number of kids covered by safety net programs like Medicaid and the Children’s Health Insurance Program aka CHIP.

September 15, 2019

Trump administration now seeks to vaporize vaping, banning candy flavorings

by Patrick A. Malone

After standing to one side while vaping hooked a generation of young Americans on nicotine, the Trump Administration has now abruptly decided to try to vaporize youthful vaping by banning candy-like flavorings favored by e-cigarette users.

The president and Alex Azar, the chief of the Health and Human Services agency, announced the latest e-cigarette and vaping crackdown. It still must be defined in regulations, practices, and the financial support for the federal Food and Drug Administration to enforce it. FDA Commissioner Ned Sharpless and First Lady Melania Trump also participated in the Oval Office session.

The White House announcement came as public officials add daily to the toll of a sudden outbreak of reported deaths (at least a half dozen) and serious respiratory harms (hundreds of cases in three dozen or so states) blamed on vaping. Investigations continue as to the cause of the e-cigarette-related fatalities and injuries.

September 13, 2019

Home care for the aged has become a quiet calamity for all involved

by Patrick A. Malone

Americans are confronting a care-giving calamity with the elderly at home, and the alarms are sounding loudly about it. But are experts and politicians grasping the severity of this crushing health care shortfall?

The New York Times, Vox, Washington Post, and Forbes all published detailed and solid news articles about the nation’s quiet nightmare with the workforce needed to deal with the booming population of aging baby boomers.

Just a reminder: This is a huge group that is graying rapidly, with 10,000 boomers each day turning 65 and this startling reality continuing for the next decade or so. Seniors long have said they prefer to age at home, that they dread and may not be able to afford nursing home care, and they are panicked about who will help them in their daily lives as they become debilitated, especially with dementia or Alzheimer’s — conditions predicted to explode in prevalence and cost as the nation’s elderly population increases.

September 12, 2019

Go figure: In era of Big Data, numbers and statistics still bedevil medicine

by Patrick A. Malone

Big data and numbers may seem to drive the world these days, but human factors can play a dizzying role when it comes to statistics and medical treatments.

For those fascinated by numeracy in health care, writer Hannah Fry, in a readable New Yorker essay, details how medicine and patients alike have been bedeviled by attempts to quantify life-and-death decision making.

She tracks centuries of investigators experiments in applying rationality, logic, and mathematics to human lives and their care by doctors and others, reporting about Adolphe Quetelet, an 1830s Belgian astronomer and mathematician:

September 10, 2019

Consumers blame, shame and prod corporations to win health safeguards

by Patrick A. Malone

Consumers, regulators, politicians, and journalists need to keep pressing big corporations to better protect the public’s health because such campaigning can work.

It has led to steps that may cut down on reckless promotion of expensive, burgeoning, and dubious treatments involving purported stem cells. It may make vehicles safer, so children and pets don’t die or suffer heat injury when mistakenly left in rear seats.

More tough work still needs to be done, however, with a new version of the persistently problematic off-road vehicle, and, indeed, with the federal agency that oversees road safety.

September 8, 2019

As deaths and lung damage cases rise, isn’t it clear that vaping is unhealthy?

by Patrick A. Malone

How well does Scott Gottlieb, the former federal Food and Drug Commissioner, sleep at night? Or does he even pause to think much about his role in opening the door to what has become a widening and lethal health menace: vaping and e-cigarettes?

The federal Centers for Disease Control and Prevention has joined with respected specialists in public health and lung disorders to urge the public, most especially young Americans, to stop vaping and using e-cigarettes at least until authorities can sort out an outbreak of serious problems connected with the trendy practices involving inhaling of substances catalyzed by electric devices.

Vaping suddenly has been implicated in 450 cases in 33 states and it has been tied to at least five deaths. Dozens of young people have been hospitalized, some with significant and sustained lung damage requiring extensive medical treatment.

September 6, 2019

Europe is seeing a ‘dramatic resurgence’ of measles, and the U.S. may not be far behind

by Patrick A. Malone

A key feature of great civilizations is that they strive to prevent outbreaks of deadly contagious diseases. So it’s more than worrisome that measles is making what the World Health Organization calls a “dramatic resurgence” in Europe.

Measles, an entirely preventable disease, has in a single year doubled the number of its cases in four European nations, including Great Britain, in the first half of 2019: 90,000 cases versus 44,000 in 2018. Measles has come back with such force that the countries no longer may be considered as having eliminated the infection.

This is a continental meance, too, as the New York Times reported:

September 5, 2019

Let’s put a halt to this killer traffic trend: Blown red lights rise by 31%

by Patrick A. Malone

Red means stop, right? That’s a driving basic. But Americans’ flouting of a fundamental traffic regulation — the red light — is costing more lives than it has in a decade.

The AAA Foundation for Traffic Safety has found that two people die daily in vehicle wrecks involving the running of a red light, NPR reported, noting:

“Drivers blowing through red lights killed 939 people in 2017. That’s an increase of 31% from a low in 2009, when 715 people were killed. More than half of those killed were passengers or people riding in other vehicles. About 35% were the drivers who ran the red light. Pedestrian and cyclist deaths connected to red light running represented about 5% of total deaths.”