DC Medical Malpractice & Patient Safety Blog

April 7, 2020

With U.S. joblessness spiking, Obamacare once again stays front and center

With 10 million Americans suddenly jobless due to the Covid-19 pandemic, a smack in the face may be coming to partisans who have spent a decade assailing the Affordable Care Act, the landmark measure that offers people help with their health insurance.

Obamacare, studies have shown, already has helped to reduce the ranks of the uninsured by 20 million.

It may play a significant role now in helping the unemployed, too many of whom not only lost their steady income but also their employer-provided health insurance. The preponderance of Americans — more than 150 million of us — get our health coverage through our workplaces.

April 5, 2020

Rethinking end-of-life plans and nursing home care for ourselves and loved ones

by Patrick A. Malone

The Covid-19 pandemic is forcing many Americans to think and act on tough issues they otherwise might wish to avoid, and they’re getting thoughtful reminders on ways they may want to proceed with advanced or end-of-life medical planning and decisions on whether to keep elderly loved ones in nursing homes and other long-term care facilities or to bring them into their residences.

These are hard topics to deal with in the best of times. But failing to do so can leave families with not only a lifetime of regrets but also possibly significant financial consequences. Americans long have insisted that they want to have maximum control over medical decisions that affect their care.

So, thinking ahead about our own advanced medical plans, and revisiting the institutional care of beloved seniors may not only be appropriate, but necessary as the world struggles with the Covid-19 pandemic and medical caregivers are overwhelmed and may be stretched to their limits.

April 3, 2020

Child safety group assails U.S. consumer products agency for lax oversight

by Patrick A. Malone

Federal watchdogs set a shameful low in 2019, allowing the most kids in almost two decades to die due to defective products before ordering their recall, a noted children’s advocacy group reported.

Kids in Danger (KID), a Chicago-based organization that says it has tracked the child-protection activities of the U.S. Consumer Product Safety Commission (CPSC) since 2002, assailed the agency’s recent performance, asserting that lax oversight contributed to 38 youngsters’ deaths before regulators ordered recalls. That was the highest number fatalities since KID began its tracking, and 37 of the 38 deaths involved inclined infant sleepers, specifically the Fisher-Price Rock ‘n Play and Kids II rocking sleeper.

KID said in a news release about its latest, published annual report:

April 2, 2020

Corporate titans faulted for playing dubious roles in opioid-overdose crisis

by Patrick A. Malone

Walmart and Johnson and Johnson, two of America’s corporate titans, each acted in ways that helped to fuel the opioid crisis that federal experts estimate claims 128 Americans’ lives each day, news media investigations show.

Walmart ignored repeated complaints from its own pharmacists and permitted the over-subscribing of hundreds of thousands of potent prescription painkillers by sketchy doctors across the country, with the company’s refusal to deal with rising problems leading federal prosecutors to ready hefty civil and criminal cases, according to ProPublica, a Pulitzer Prize-winning investigative site.

The retailing giant, however, pulled powerful political strings, with Trump Administration officials stepping in to stymie potential lawsuits and criminal charges against Walmart — despite a previously secret settlement the company earlier had signed, pledging to step up its oversight of prescription drugs it sold, ProPublica reported. Reporters Jesse Eisinger and James Bandler wrote:

March 31, 2020

With pandemic straining U.S. health care, what did ACA get done in a decade?

by Patrick A. Malone

As the coronavirus pandemic causes Americans sky-high anxiety about their health and how they might access and afford extensive medical treatment if infected, the nation slid with only modest public attention into the second decade of one of its landmark health care experiments — the Affordable Care Act.

Obamacare became the law of the land on March 23, 2010, when the 45^th president signed the 2,000-page bill for which he had campaigned long and hard. Republicans in the White House and Congress have attacked the ACA relentlessly ever since.

Researchers have spent a decade scrutinizing the ambitious act’s outcomes with zeal. The New York Times summarized some of the independent, nonpartisan evaluations, finding key areas that the public may wish to recognize in how Obamacare changed the complex U.S. health care system, on which Americans spend more than $3.5 trillion annually. In brief, as a result of the ACA, the newspaper reported (with boldface emphases mine):

March 29, 2020

As virus slams U.S., courage and valor are on display — but some not-so-great behavior too

by Patrick A. Malone

As the Covid-19 pandemic slams the United States — with infections exceeding 100,000 and deaths spiking beyond 2,000 — the battle with the viral outbreak underscores the axiom that a crisis brings out true character, good and bad.

Our highest praise continues to go out to first responders and medical personnel who have demonstrated huge courage and resolve in treating the sick and dying, despite too few resources still and at giant risk to themselves.

Institutions have stepped up to provide valuable information and services, including:

March 27, 2020

With youngsters ages 10 to 14, a tragic and scary spike in suicides

by Patrick A. Malone

While alarms have been raised about the nation’s ever-increasing numbers of suicides, mental health experts, educators, and medical researchers also are making urgent pleas for grownups to pay heightened attention to the spike in cases in which youngsters are taking their own lives.

As the independent, nonprofit Kaiser Health News Service reported:

“[S]uicide by children ages 10 to 14 has gone up and up. The suicide rate for that age group almost tripled from 2007 to 2017. Newly released 2018 data from the Centers for Disease Control and Prevention show a 16% increase over the previous year. While experts point to a host of explanations for the alarming rise, scientific proof about cause isn’t conclusive. Some research shows correlations with social media use, cyberbullying and the internet, but studies citing them as a suicide cause are less decisive.”

March 25, 2020

For 70+ women and their MDs, more reasons to rethink routine mammograms

by Patrick A. Malone

As Americans live longer, clinicians may need to reconsider whether they need to subject older patients to routine screenings that may trigger even more costly, invasive, painful, and unnecessary medical testing and procedures. For women 70 and older, for example, yet more new evidence raises doubts about mammograms designed to detect breast cancers.

As the New York Times reported, researchers in Boston examined 2000-2008 Medicare claims “to follow more than one million women, ages 70 to 84, who had undergone a mammogram.” Quoting Dr. Xabier Garcia-Albéniz, an oncologist and epidemiologist at RTI Health Solutions and lead author of a new observational study of their women subjects:

“They had never had breast cancer and had a ‘high probability,’ based on their medical histories, of living at least 10 more years. ‘That’s the population who will reap the benefit of screening,’ Dr. Garcia-Albéniz said, because it takes 10 years for mammography to show reduced mortality. The researchers divided the subjects into two groups: one that stopped screening, and another that continued having mammograms at least every 15 months. They found that mammograms provided a survival benefit, if a modest one, for women ages 70 to 74. In line with previous research, the study found that annually screening 1,000 women in that age group would result, after 10 years, in one less death from breast cancer. But among the women who were 75 to 84, annual mammograms did not reduce deaths, although they did, predictably, detect more cancer than in the group that discontinued screening. ‘You’re diagnosing more cancer, but that’s not translating to a mortality benefit,’ Dr. Garcia-Albéniz said.”

March 23, 2020

Trump storms into medical-ethics minefield by flogging drugs’ untested use

by Patrick A. Malone

President Trump has stormed past accepted professional practices and triggered alarms about ethical decision making by caregivers, as he persists in his noisy advocacy for treating seriously ill patients with Covid-19 infections with an unproven pair of prescription drugs.

Promoting this drug regimen — on social media and in White House news conferences — has pitted the onetime real estate developer and reality show host with an undergraduate economics degree squarely against Dr. Anthony Fauci, one of the nation’s foremost infectious disease experts at the National Institutes of Health.

They have squared off publicly, with the leader of the free world talking about how he “feels good” about giving patients two, long-used antimalarial drugs — chloroquine and hydroxychloroquine (aka plaquenil) — while Fauci has insisted such prescribing has no basis now, and, at best, should be subjected to rigorous clinical trial to determine their effectiveness.

March 22, 2020

As pandemic grips the globe, outbreaks, too, of ‘What were they thinking?’

by Patrick A. Malone

Even as Covid-19 wreaked unprecedented harms, there also have been actions that might lead even the most jaded observer to cry out: What were these people thinking?

The pandemic’s global toll has risen to hundreds of thousands of infections and thousands of deaths. The U.S. toll at the end of the third week in March, the New York Times reported, exceeded 21,000 infections and nearly 300 deaths, with 1 in 5 Americans also now living under tough restrictions that have shut non-essential businesses, schools, colleges and universities, restaurants, gyms and health clubs, and sports and cultural events.

In the throes of such calamitous circumstances, consider: