DC Medical Malpractice & Patient Safety Blog

August 21, 2018

Maryland tragedy underscores need for tough safeguards for players’ health

In College Park, Md., new cooling tents have sprouted on the University of Maryland’s football practice field, where the training staff also is taking pains now to provide adequate cold drinks and breaks to players. Observers say the pre-season regimens, however, are not only marked by greater attentiveness to the young athletes’ needs, they’re also eerily quiet and somber.

That’s because top Terps leaders have apologized and conceded the school shares blame for the tragic and preventable heat stroke death of Jordan McNair, 19, a Maryland offensive lineman. Coaches forced the young man to run and over-exert himself during a May 29 practice. More importantly, they failed to diagnose the severity of his condition, neglecting to so much as take his pulse and blood pressure, and, in a disputed account, not noticing that he was suffering seizures, or acting fast to drop his body temperature with ice and cooling baths.

Published reports suggest he showed heatstroke signs before 5 that afternoon, though trainers did not call for emergency help and an ambulance until nearly 6, when his body temperature may have hit 106 degrees. He was admitted to a hospital, where nurses and doctors immersed him in a cooling bath and reduced his temperature to 102 degrees — 90 minutes or so after he apparently got into distress.

August 20, 2018

Drug overdose toll hits another record as abusers fall prey to synthetic opioids

by Patrick A. Malone

In 2017, drug overdoses killed 72,000 Americans, a 10 percent increase over 2016 and yet another record, according to the latest provisional federal estimates.

That single year toll would be more than double the American deaths attributed to the Korean War, and almost 1.25 times those caused by the Vietnam War. The New York Times reported that 2017’s overdose deaths were “higher than the peak yearly death totals from HIV, car crashes or gun deaths.”

The newspaper said experts, analyzing the numbers, blamed them on a few reasons (see NYT chart above): “A growing number of Americans are using opioids, and drugs are becoming more deadly. It is the second factor that most likely explains the bulk of the increased number of overdoses last year.”

August 17, 2018

A worthy campaign to prevent the daily toll of children dying from gunfire: ‘End Family Fire’

by Patrick A. Malone

On the eighteenth day of the eighth month of the year 2018, can Americans be persuaded to start saving more youngsters’ lives — specifically, by preventing the eight children slain each day in a shooting or injury involving an improperly stored or misused gun found in the home?

That’s the ambition of “End Family Fire,” a national, multimedia campaign that’s launching this weekend and is aimed at averting incidents, including “unintentional shootings, suicides, and other gun-related tragedies,” its advocates say.

August 16, 2018

Lax oversight and safety nightmares burgeon with boom in surgical centers

by Patrick A. Malone

An innovation in medical treatment — which was supposed to offer more affordable, accessible, and even convenient care — instead may be getting swamped with safety problems that long have plagued hospitals and academic medical centers.

USA Today and Kaiser Health News Service deserve credit for digging into patients’ nightmares with specialized surgical centers, not only those performing “routine” procedures but also those handling increasingly longer, more complex, and difficult operations. The many surgeries, once the province only of big and well-staffed hospitals, put patients at risk, the newspaper reported, saying:

[Our] investigation found that surgery centers operate under such an uneven mix of rules across U.S. states that fatalities or serious injuries can result in no warning to government officials, much less to potential patients. The gaps in oversight enable centers hit with federal regulators’ toughest sanctions to keep operating, according to interviews, a review of hundreds of pages of court filings and government records obtained under open records laws. No rule stops a doctor exiled by a hospital for misconduct from opening a surgery center down the street.

August 15, 2018

NFL settlements raise new questions on head trauma and Parkinson’s and ALS

by Patrick A. Malone

The National Football League, which long has resisted the growing reality that game-related head blows can cause major harms to its players, may be providing yet new and unintended warnings about the sustained damages of concussions.

The Los Angeles Times reported that pro football’s pay-outs, as part of its billion-dollar head-injuries settlement with NFL players and their union, have been surprisingly high in cases where retirees have claimed damages due to Parkinson’s and ALS.

Parkinson’s, the newspaper noted, is a “progressive movement disorder that produces tremors, impaired movement, and slurred speech.” It is “marked by the buildup of proteins called Lewy bodies in brain cells.” ALS, also known as amyotrophic lateral sclerosis or Lou Gehrig’s disease, is a condition affecting “nerve cells in the brain and spinal cord and ultimately results in a fatal inability to initiate and control muscle movement.”

August 13, 2018

After feds bust U.S. rep for insider trading in Pharma stock, will Congress drain ethics swamp?

by Patrick A. Malone

At a time when prescription drug prices keep skyrocketing and Americans pay hundreds of billions of dollars for medications that account for as much as 15 percent of all U.S. health care spending, federal law enforcers provided a rare and jarring sight with the public arrest of a congressman on charges he engaged in insider trading involving an Australian drug maker.

Chris Collins, a Republican who represents a western New York district and was among President Trump’s earliest and most vocal supporters in Congress, insists he committed no wrong. He says he will be exonerated, but he has pulled the plug on his plans to seek reelection in November.

The sordid details of his financial dealings, as laid out in news stories and a damning indictment, however, may keep front and center not only the charges against him but also troubling questions about members of Congress and their private investing, corporate board roles, and especially their tenacity as Big Pharma lapdogs, instead of being watchdogs on behalf of besieged, too often bankrupted American patient-consumers.

August 12, 2018

Say what? Mar-a-Lago trio acting as ‘shadow rulers’ of Trump’s VA

by Patrick A. Malone

So, see, Ike, Marc, and Bruce may be pretty swell guys. They’ve done well in business: Ike in comic books and entertainment, Marc in the law and consulting on white collar crime, and Bruce as a medical concierge who gets affluent patients in to see big name doctors.

But this odd trio —Ike Perlmutter, Bruce Moskowitz and Marc Sherman — never served in the U.S. military. They’re certainly not veterans. Perlmutter and Sherman have zero experience in health care. And Moskowitz, while a doctor, is a respected primary care practitioner — not someone known for his direct experience in running big, complex operations.

They also, however, happen to be FOT — Friends of (President) Trump. They pay him to belong to his Mar-a-Lago country club. And, apparently at his request and with the assistance of powerful partisans and the acquiescence of sheepish bureaucrats, Perlmutter, Moskowitz, and Sherman have become “shadow rulers” of the U.S. Department of Veterans Affairs.

August 9, 2018

For sick seniors, hospitals and nursing homes can be nothing but bad news

by Patrick A. Malone

In many parts of the developing world, families play a big part in patients’ hospital care. They not only sit for long hours with loved ones, supporting and encouraging their recovery. They also may help with direct services, bathing and cleaning patients, tending to their beds and quarters, and even assisting with their medications and treatments.

Such attentiveness from loved ones— once common in this country, too — may be deemed by many now as quaint and unnecessary, what with the rise of big, shiny, expensive American hospitals.

But think again: As Paula Span reported in her New York Times column on “The New Old Age,” care-giving institutions across the country have become such stressful, disruptive places that seniors, especially, not only heal poorly in them but also may be launched into a downward cycle of repeat admissions.

August 8, 2018

Shift-and-shaft: Why is it always patients’ burden to hunt for affordable care?

by Patrick A. Malone

The health policy wonks and those who purport to “reform” the U.S. health care system may be long on academic and other fancy credentials. But they also persist in demonstrating they can be short on old-fashioned common sense, especially about the way most of us lead our lives.

That’s a point emphasized in a recent column in the evidence-based “Upshot” feature of the New York Times, written by Austin Frakt. He directs the Partnered Evidence-Based Policy Resource Center at the VA Boston Healthcare System and is an associate professor with Boston University’s School of Public Health and an adjunct associate professor with the Harvard T.H. Chan School of Public Health.

Frakt looked at some recent research to dissect a question that occupies many experts: Could Americans cut their health care costs by shopping around more for medical services? This is a fond notion held by a slice of health care “reformers,” whom Frankt proceeds to disabuse.

August 6, 2018

As Big Pharma rivals battled to hype opioids, watchdogs dozed. They slumber still.

by Patrick A. Malone

When Big Pharma pursues rapacious profits and regulators snooze, patients suffer terrible consequences, as new revelations about the opioid crisis show.

Kaiser Health News Service , via the Washington Post, and The New York Times both have done excellent investigative digging into drug makers’ role in fueling the prescription painkiller mess that authorities estimate claims 116 lives a day due to overdoses.

Fred Schulte, writing for the independent, nonpartisan Kaiser service, reported that rival makers — seeing how much money Purdue Pharma was making with its powerful and addictive OxyContin drug and that it was encountering law enforcement and regulatory challenges — stepped in with “similarly dangerous painkillers, such as fentanyl, morphine and methadone.”