DC Medical Malpractice & Patient Safety Blog

September 25, 2017

Big Insurance ripped for fueling opioid drug epidemic

pills-drugs-300x215 The epidemic of opioid drug abuse, which increasingly is claiming children’s lives, has plenty of blameworthy causes. Here’s a new one: health insurers which steer patients to cheaper, more addictive painkillers while playing Scrooge for less addictive but pricier alternatives.

Pro Publica, a Pulitzer Prize-winning investigative journalism site, and the New York Times get credit for their expose of penny-wise and pound-foolish prescription management practices.

By analyzing “Medicare prescription drug plans covering 35.7 million people in the second quarter of this year,” the news organizations say they saw repeated patterns in which insurers and the spin-off businesses that run their drug payment plans (so-called pharmacy benefit mangers or PBMs) easily and quickly approve opioids for patients in pain, medications that cost relatively little. They throw up all kinds of obstacles, however, to doctors and patients who try to use less potent but more expensive drugs, including patches containing Butrans (a lesser opioid) or lidocaine. They also drag their feet on approving payments for addiction-fighting medications like Suboxone.

September 24, 2017

Sunday pro football games aren’t the place to serve up genetic screening malarkey

by Patrick A. Malone

Let’s give a hurrah for Maryland health officials — they threw a red flag at a high-tech startup that planned with the Baltimore Ravens football team to serve up a mass genetic screening test at a recent game. The blunt reality is this would have been genetic malarkey.

This incident should serve as a reminder, caveat emptor, to consumers, even in settings of good cheer. It should offer a caution to those who stage big public events, like sports leagues, that health matters and highly personal and confidential medical information isn’t handled well at spectacles.

Shall we also offer a Bronx cheer for Orig3N, a Boston company that offers direct-to-consumer “genetic testing,” and talks on its web site about everything from organ donation to regenerative and personalized medicine as well as its commitment to public service? The company, a new Ravens sponsor, planned a recent promotional Sunday when it would offer its mouth swab tests to 55,000 fans flocking to the contest against the Cleveland Browns.

September 22, 2017

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

by Patrick A. Malone

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: