DC Medical Malpractice & Patient Safety Blog

June 22, 2018

Depression and suicide risk are side-effects in too many common drugs

Patients, doctors, and pharmacists may want to be more wary about more than 200 commonly prescribed drugs that not only treat an array of medical conditions but also carry depression and suicide risk as side effects. More than a third of Americans take the medications, and they report higher depression rates than those who don’t, with their risks increasing as they add in more of these drugs, a new study finds.

The medications, researchers said, are seemingly ubiquitous, and polypharmacy ── patients taking multiple drugs for different conditions at the same time ── with the depression- and suicide-risk meds is frequent in an alarming fashion. As NPR, the New York Times, and the news site Vox reported, the drugs include:

Certain types of proton pump inhibitors (PPIs) used to treat acid reflux. These are sold, by prescription and over the counter, under brand names like Prilosec and Zantac.

June 20, 2018

Lasik surgery: a study in medical risks, complications, lack of official followup

by Patrick A. Malone

Caveat emptor, federal officials are reminding patients anew about an eye surgery that tens of millions of Americans already have undergone and all too many may believe ── wrongly ── is all but risk-free.

In fact, significant numbers of the 9.5 million Americans who had laser-assisted operations, the so-called Lasik procedure, may show vision improvements, but they also may be under-reporting problems connected with their surgeries, the New York Times reported.

The federal Food and Drug Administration approved Lasik in the 1990s, but the agency only recently has supported the gold-standard of medical research, a randomized clinical trial, to check in on long-running complaints about the surgery.

June 19, 2018

Hospitals and nursing homes need to do more to stop ‘boomerang’ abuses

by Patrick A. Malone

Uncle Sam soon will step up what may be a positive trend: getting hospitals and nursing homes to halt the unacceptable boomeranging of elderly patients between them. But will Trump officials be as quick with health care providers as they have been with poor, sick, and old patients to employ not just carrots but also sticks to get better outcomes?

The nonprofit, nonpartisan Kaiser Health News Service deserves credit for looking ahead to this fall, when the administration aims to accelerate the end of perverse incentives that have hospitals and nursing homes shuttling the sick and elderly between them far too often. As Jordan Rau of the news service reported:

With hospitals pushing patients out the door earlier, nursing homes are deluged with increasingly frail patients. But many homes, with their sometimes-skeletal medical staffing, often fail to handle post-hospital complications — or create new problems by not heeding or receiving accurate hospital and physician instructions. Patients, caught in the middle, may suffer. One in 5 Medicare patients sent from the hospital to a nursing home boomerang back within 30 days, often for potentially preventable conditions such as dehydration, infections and medication errors, federal records show. Such re-hospitalizations occur 27 percent more frequently than for the Medicare population at large.

June 17, 2018

NIH ripped for Big Alcohol funding and advising on $100-million drinking study

by Patrick A. Malone

The National Institutes of Health, perhaps the world’s leading medical research institution, has moved fast to try to fix self-inflicted damage to its reputation caused by a controversial $100-million study on alcohol and its harms.

NIH Director Francis Collins halted the study, and an advisory group backed his action, lambasting researchers for soliciting funding and counsel from the alcohol industry for a work that purported to answer key and fundamental questions about booze but from its outset leaned toward seeing benefit in moderate drinking.

The New York Times deserves credit for digging into the dubious actions by researchers supported by the National Institute on Alcohol Abuse and Alcoholism, an arm of NIH.

June 15, 2018

San Francisco voters send strong message cracking down on kids’ vaping

by Patrick A. Malone

San Francisco voters, upholding their elected leaders’ enlightened lawmaking, bashed Big Tobacco and its interests, providing a potent primary election message to public health officials nationwide to curb the growing menace to young people posed by e-cigarettes and vaping.

By a 2-to-1 margin, Bay Area residents supported their Board of Supervisors’ tough ban — which may be the most stringent in the nation — on sales of flavored tobacco products, including vaping liquids packaged as candies and juice boxes, and menthol cigarettes.

Specialized liquids, peddled in flavors like bubble gum, chicken and waffles, and unicorn milk, are key to the youth craze for vaping, in which teens use small devices about the size of a computer flash drive to get a nicotine-fueled boost. They can, with standard hits from liquids in devices like the trendy Juul, regularly consume as much nicotine as is found in a pack of cigarettes.

June 13, 2018

For early-stage breast cancer patients, dreaded chemo may be unneeded

by Patrick A. Malone

Breast cancer patients may get a welcome respite from one of the disease’s dreaded aspects — its aggressive and costly treatments. New research suggests that thousands of women with early-stage breast cancer who now are told to get chemotherapy don’t need it, while a larger, significant number of patients can benefit by halving the time they’re told to take an expensive drug with harsh side-effects, especially for the heart.

Although this information should be taken in a positive light, patients should consult with their doctors about appropriate treatment for their individual case.

The prospective shifts in breast cancer treatment, based on new findings, may add to rumblings and criticisms about over-treatment and whether doctors have taken too lightly the toll — physically, mentally, and financially — that this and other forms of cancer inflict on patients.

June 11, 2018

Will voters recall what Trump and GOP do on health, not just what they say?

by Patrick A. Malone

As voters make up their minds about this fall’s mid-term races, they may wish to burn into their memories how the Trump Administration has dealt, so far, and especially in recent days, with government social programs that have huge effects on Americans’ health and lives.

Take, for example, the late-week, late night announcement by the U.S. Department of Justice that it will decline to defend yet another part of the Affordable Care Act, as 19 states, most red and led by Texas, attack Obamacare in the courts. The legal aspects of this decision will keep lots of law degree holders and their kindred men and women in black robes arguing, heatedly, for a while. There also may be huge political smoke clouds.

But keep in mind this basic fact from the actions by the Justice Department led by Attorney General Jeff Sessions: The nation’s crack legal team is asserting that it is unconstitutional for the ACA to bar insurers from declining coverage due to preexisting conditions.

June 10, 2018

It’s not just celebrities; CDC warns of public health crisis in suicides

by Patrick A. Malone

Uncle Sam’s sobering new report about suicide rates rising in all but one state between 1999 and 2016, with fatal increases across age, gender, race and ethnicity, became even more somber and urgent with the shock and grief expressed widely over the self-inflicted deaths of chef-raconteur Anthony Bourdain in France and fashion designer-entrepreneur Kate Spade in Manhattan.

Suicide no longer should be viewed solely as a personal mental health problem but also now as a public health crisis, the federal Centers for Disease Control and Prevention warned. Anne Schuchat, the CDC’s principal deputy director, told the Washington Post: “The data are disturbing. The widespread nature of the [suicide rate] increase, in every state but one, really suggests that this is a national problem hitting most communities.”

The suicides of Bourdain, 61, and Spade, 55, hit many hard, as was reflected in the extensive media coverage and social media reactions. Both Bourdain and Spade rose from modest circumstances, with abundant hard work, talent, personality, and ambition, to lead lives in the spotlight, and with an economic comfort that others would envy and consider glamorous. They were “successes.”

June 8, 2018

Is there a doctor aboard? While flying this summer, you may hope so

by Patrick A. Malone

With tens of millions hopping on jets to get to summer vacation destinations, it’s worth noting that medical emergencies aloft aren’t as rare as many travelers might imagine — and it may be beneficial if a doctor happens to be aboard when the need arises.

The nation’s top doctor, U.S. Surgeon General Jerome Adams, of course, may have spotlighted sky-high medical care, when he answered flight attendants’ emergency page to all those aboard a Delta flight from Fort Lauderdale to Atlanta. Details are a bit sketchy. But a passenger on the early May trip apparently passed out, and worried crew needed medical assistance and an evaluation of potential next steps.

Adams said he was pleased to step up and assist the crew as the flight, which was on the tarmac, returned to the airport gate, where a crew member took the ailing passenger off for care, while the Delta plane resumed its planned trip.

June 7, 2018

Stigma inflicts harsh toll on mentally ill, but society pays too

by Patrick A. Malone

Although Americans keep making progress toward ending the stigma associated with mental disorders, including trying to put public funding for the diseases’ treatment on a more even footing, patients with serious mental illness suffer unfairly and harshly still due to their conditions.

Dhruv Khullar, a doctor at NewYork-Presbyterian Hospital and a researcher at the Weill Cornell Department of Healthcare Policy and Research, has written a painful piece for the “Upshot,” an evidence-based column for the New York Times. His article, “The Largest Health Disparity We Don’t Talk About,” reports that:

Americans with depression, bipolar disorder or other serious mental illnesses die 15 to 30 years younge r than those without mental illness — a disparity larger than for race, ethnicity, geography or socioeconomic status. It’s a gap, unlike many others, that has been growing, but it receives considerably less academic study or public attention. The extraordinary life expectancy gains of the past half-century [for most in this country] have left these patients behind, with the result that Americans with serious mental illness live shorter lives than those in many of the world’s poorest countries.