DC Medical Malpractice & Patient Safety Blog

July 19, 2019

U.S. must boost hospice oversight, watchdog warns, citing serious lapses

Lawmakers and regulators must significantly improve the oversight of the burgeoning business of hospice care, a federal watchdog says. Its report came with two notable numbers: from 2012 through 2016, health inspectors cited 87% of the end-of-life care facilities for deficiencies, with 20% of them having lapses serious enough to endanger patients.

In one case cited by the Office of the Inspector General in the Department of Health and Human Services (HHS), a hospice patient had a deep, poorly treated pressure wound on the tailbone, apparent pain that caused grimacing and — in a crisis requiring a trip to the emergency room — a “maggot infestation’’ where a feeding tube entered his abdomen, the Washington Post reported.

July 18, 2019

Cutting resident doctors’ hours doesn’t harm quality of patient care, study finds

by Patrick A. Malone

Will the medical educators finally get that it makes no sense to force residents to toil like field animals? Yet another study, this latest from Harvard experts, finds that keeping residency training hours at more humane levels does not significantly affect quality of patient care, including inpatient mortality.

Let’s be clear: The grueling preparation for MDs is only relatively better than before, capping their training time to 80 hours a week.

Medical educators, hospitals, and doctors themselves have criticized that limit since it was imposed after long study and much argument in the profession by the Accreditation Council for Graduate Medical Education (ACGME), the group that accredits MD training programs.

July 16, 2019

Will GOP attack on Obamacare foil good plans to better kidney disease care?

by Patrick A. Malone

More than 37 million Americans who suffer from chronic kidney disease soon may see big changes in the way their disabling condition gets treated, potentially also reducing the $100 billion that the federal Medicare program pays for care of the body’s crucial blood cleaning organs.

President Trump issued an executive order calling on the federal government to use all means possible to attack kidney disease in three key ways:

Reduce the number of patients who suffer from kidney failure;

July 15, 2019

Taming Big Pharma profiteering is no snap, White House learns in dual defeats

by Patrick A. Malone

It takes more than a lot of huffing and puffing to blow down the ever-rising high costs of prescription drugs, the Trump administration has found. Two defeats happened last week: officials were forced to pull a plan to curb profit-making by drug industry middlemen, and a federal judge axed on First Amendment grounds a plan to muscle Big Pharma into including price information in its ubiquitous product ads.

These were key pillars of the president’s multi-part plan to address increasing drug costs, one of Americans’ most pressing concerns with their health care, and Trump had put considerable of his political capital behind them as he rolls toward the 2020 election campaign.

As the New York Times reported:

July 12, 2019

A harsh reminder of hospital infection risks: outbreaks in areas treating kids

by Patrick A. Malone

Parents and the public received grim reminders of the risks of medical care as prominent institutions on opposite coasts battled hospital-related infections among some of the most vulnerable patients around: babies and children.

In the Pacific Northwest, a mold outbreak has taken a terrible toll — with one patient dead, five others infected, 1,000 surgeries postponed and 3,000 people told to watch for infection symptoms — at Seattle Children’s Hospital, which the Washington Post reported, “consistently ranks as one of the best children’s hospitals in the country and this year [was] rated top [for such facilities] in the Northwest.”

In the Northeast, the University of Pittsburgh Medical Center Children’s Hospital has confirmed 12 cases of a drug-resistant staph infection in its neonatal intensive care unit (NICU), CNN reported, adding that, the six babies, including one who is potentially symptomatic, and six symptomatic employees who have tested positive for Methicillin-resistant Staphylococcus aureus (MRSA) are receiving treatment.

July 10, 2019

Critics fear a key watchdog’s decline as FDA eases up its regulatory actions

by Patrick A. Malone

Consumers may want to think long and hard about whether the federal Food and Drug Administration protects the interests of the vulnerable public or profit-raking Big Pharma and medical device makers.

As a scrutiny of data by Science magazine shows:

“From monitoring clinical trials and approving medicines and vaccines, to ensuring the safety of blood transfusions, medical devices, groceries, and more, the U.S. Food and Drug Administration (FDA) is one of the nation’s most vital watchdogs. By several measures, however, FDA’s compliance and enforcement actions have plummeted since President Donald Trump took office … The agency’s ‘warning letters’—a key tool for keeping dangerous or ineffective drugs and devices and tainted foods off the market—have fallen by one-third, for example. Such letters typically demand swift corrections to protect public health and safety. FDA records from Trump’s inauguration through 22 May show the agency issued 1,033 warning letters, compared with 1,532 for the most recent equivalent period under former President Barack Obama. Compared with the start of the Obama presidency, Trump-era letters dropped by nearly half. Warnings from the FDA Center for Devices and Radiological Health, which helps ensure the safety and quality of medical devices, and from some of the agency’s district offices—including Philadelphia, Florida, and New York—have dropped even more steeply, by more than two-thirds. Two district offices have not issued a warning in more than 2 years. The numbers don’t just reflect a new administration’s slow start. FDA sent significantly fewer warning letters in the second year of Trump’s presidency than in his first.

July 9, 2019

53 million Americans suffer ‘second-hand’ harms from booze, study finds

by Patrick A. Malone

Even as the nation grapples with an opioid- and drug-overdose crisis, alcohol, one of the oldest intoxicants known to mankind, causes significant harms, including to as many as a fifth of American grownups who have suffered harm due to drinking by others and not themselves.

A newly published study, based on data from a survey of 8,750 men and women, finds that as many as 53 million American adults experience any of a dozen designated harms due to boozing by others, CNN reported. The injurious actions include: harassment; feeling threatened or afraid; having belongings ruined; having property vandalized; being pushed, hit or assaulted; being physically harmed; being in a traffic accident; being a passenger in a vehicle with a drunk driver; having family or marital problems; and having financial trouble.

Women, the researchers found, are forced to deal with family and marital problems and financial challenges due to alcohol abuse by partners and friends.

July 7, 2019

A $229-million Baltimore malpractice case? It’s worth digging into this news

by Patrick A. Malone

Headlines can command attention while not always fully informing, as might be the case with these eye-catching story titles, one fresh, the others a few years back:

July 5, 2019

San Francisco, Beverly Hills blaze new regulatory path with e-cigarette bans

by Patrick A. Malone

Cities are daring to tread where federal regulators have not: They’re cracking down on vaping and its potential harm, particularly to the young, by banning e-cigarettes and tobacco products.

San Francisco supervisors’ e-cigarette ban, recently enacted, packs a symbolic punch because Juul, a “tech startup” whose product has become the market-dominating maker of vaping devices, is headquartered in the city.

Officials not only banned e-cigarette sales, they also decreed that their makers cannot manufacture the devices on municipal property. Juul is unaffected by this action because it is not retroactive, and the company says it does not make its product in its offices, space that is leased from the city on Pier 70.

July 3, 2019

Suffering of rural poor a reminder of how much health policy debates matter

by Patrick A. Malone

Twenty Democrats who are campaigning for president took to network television for four hours and two nights last week to put health care as a central issue of their campaigns.

The format of this initial candidate “debate,” including hand-raised answers to complex issues, failed to allow the presidential aspirants to delve much into the details of their proposals. But tons of news coverage followed on — and likely will keep doing so up until Americans enter the voting booth — about Medicare, the government health coverage for seniors, and how it might be expanded to benefit tens of millions more. Those interested may wish to check out this podcast primer on the issue.

These future-looking discussions also already have tended to eclipse a key part of the existing Affordable Care Act, the Obama Administration initiative that remains a subject of hot dispute a decade after its passage: The expansion of Medicaid, the federal program to assist the poor and working poor with health coverage.