DC Medical Malpractice & Patient Safety Blog

December 13, 2019

How does science advance on brain injuries? One star’s grim diagnosis at a time.

Clinicians drew in a postmortem conference a full portrait of patient K-0623, based on a detailed questionnaire and research they had conducted into his life. They learned all about the deceased’s happy childhood, his early high school graduation, and his athletic prowess, including his stardom in an elite collegiate football program.

The neurologists, neuropsychologists, and psychiatrists also learned that the subject, known to them for now only by a number, had taken painkillers at one point, so he could keep up an all-too-brief NFL career.

December 12, 2019

Top experts, by failing to disclose conflicts of interest, shortchange taxpayers

by Patrick A. Malone

Elite researchers — professors and staff with ties to 20 of the nation’s top universities and the respected National Institutes of Health — may be failing to be as candid as institutions and laws require about their potential professional conflicts of interest, notably the significant sums they get from Big Pharma and medical device makers.

ProPublica, the Pulitzer Prize-winning investigative organization, and the Los Angeles Times jointly scrutinized the experts’ required disclosures, finding they not only fall short. They may fail to give the public a fair view of the credibility of their findings. And, in California, they may be a unique rip-off of the state’s top university system. The “UCs” provide research faculty with costly facilities and other support, as well as sharing its global renown — in exchange for revenue the experts may earn outside the system.

In total, after examining records on tens of thousands of university scholars and NIH experts, ProPublica not only has made public its “Dollars for Profs” database, it also quotes federal watchdogs as estimating that with the NIH alone, conflicts of interest with agency grants amounts to $1 billion.

December 10, 2019

Hospitals’ preventable patient deaths add to big concerns in mental health care

by Patrick A. Malone

With mental health services stretched thin and failing to fill significant need, it may be more distressing still for the public to confront growing evidence of big problems in existing facilities that try to treat those with serious psychiatric ills.

The Los Angeles Times, based on its investigation, has found “nearly 100 preventable deaths over the last decade at California psychiatric facilities, including at La Casa Mental Health Rehabilition Center (shown here). It marks the first public count of deaths at California’s mental health facilities and highlights breakdowns in care at these hospitals as well as the struggles of regulators to reduce the number of deaths.”

The newspaper said it “submitted more than 100 public record requests to nearly 50 county and state agencies to obtain death certificates, coroner’s reports and hospital inspection records with information about these deaths.” Reporter Soumya Karlamangla said she had to look far and wide for data on problems in psychiatric facilities because, “No single agency keeps tabs on the number of deaths at psychiatric facilities in California, or elsewhere in the nation.”

December 8, 2019

Investigations rip FDA for laxity on asbestos-tainted talc and medical devices

by Patrick A. Malone

When it comes to medical products — devices put in or substances put on our bodies — consumers may be ill-served by the federal regulators who are supposed to protect them from injury.

The federal Food and Drug Administration has taken a double hit in recent news reports, with an investigation by Reuters news service raising big doubts about the agency’s oversight of products with supposedly safe talc — but that long may have been tainted with disease-causing asbestos. The Kaiser Health News service, meantime, has followed up on the wave of lawsuits and research that has resulted from its discovery that the FDA for years allowed device makers to hide from public view a million complaints about medical devices.

The scathing findings in these two reports, combined with other deep digs into agency work, might well prompt members of Congress to conduct hearings into whether the FDA is acting as the watchdog that the public deserves or as a lap kitten beholden to the rich, powerful, and booming medical device industry.

December 6, 2019

Samoa, a Pacific speck, provides a big and sad lesson about vaccinations

by Patrick A. Malone

The distant nation of Samoa may have more to offer the United States than prominent athletes and warm Pacific Islander culture. Its deadly experiences with a raging outbreak of an infectious disease underscore a timely and important message: Vaccinations matter and we should all get them.

A confluence of unfortunate events has led to a measles epidemic in Samoa, news organizations reported, with more than 40 deaths and 3,000 illnesses among the nation’s 200,000 people. Schools and colleges have been shut due to the illness.

International health organizations, including the U.S. Centers for Disease Control and Prevention, are flying in medical experts to assist with the dangerous and growing epidemic, which has hit children on the island hard.

December 4, 2019

As life expectancy and fertility rates decline, health politics more key than ever

by Patrick A. Malone

Ohio, Pennsylvania, Kentucky, and Indiana — if you’re obsessed with national politics, these states might register in your mind as key partisan battlegrounds. But if you’re focused on Americans’ health and well-being, these states — along with New Hampshire, Maine, Vermont, and West Virginia — may be causes for different and considerable concern: the nation’s plummeting life expectancy.

These states are flashing warning signs, racking up the greatest relative increases in death rates among young and middle-aged adults (New Hampshire, Maine, Vermont, West Virginia, and Ohio).

Excess deaths among Americans in their prime, that is individuals in the 25 to 64 age group who would live longer if mortality rates improved, also were highly concentrated geographically, with fully a third of them in just four states: Ohio, Pennsylvania, Kentucky and Indiana, experts say.

December 2, 2019

Grim way to increase nursing home profit: Toss out frail seniors and disabled

by Patrick A. Malone

Profit-hungry nursing home operators persist in throwing out vulnerable seniors and disabled patients from needed care, too often because the facilities find they can get higher-paying patients to fill their already costly beds.

Thousands of complaints about potentially improper discharges or transfers from nursing homes and assisted living facilities dominate the work of ombudsmen, whose work is federally required, and state supported, an NBC News investigation found.

The broadcast journalists reported:

December 1, 2019

With new heat on THC and CBD use, will zeal for marijuana keep growing?

by Patrick A. Malone

Fans of marijuana and its related products may want to take careful note of developments regarding their health and safety effects.

Federal researchers are racing to trace thousands of cases of lung damage and dozens of deaths to so-called smokeless consumption of tetrahydrocannabinol or THC, the ingredient that produces the marijuana high. Other federal officials also are warning about cannabidiol or CBD — a derivative of marijuana or its cousin hemp — and its burgeoning and unapproved use in an array of products on the market.

To be sure, because blue-nose attitudes blocked rigorous research on marijuana and other drugs, medical scientists have been scrupulous in declining to make sweeping declarations about grass and its potential benefits or harms.

November 29, 2019

Virginia hospital assailed for seeking court actions to strip patients of decisions on care

by Patrick A. Malone

A Virginia hospital has found an eyebrow-raising solution to some of its struggles with elderly, poor, and sick patients who take up beds and medical resources that might generate more revenue and less headache for the institution: Administrators hired a law firm and turned to the courts to strip legal control over the frail seniors from their loved ones.

Over families’ objections, the seniors’ newly appointed guardians then allowed the patients to be moved out of the Virginia Commonwealth University Health System hospital in Richmond and into poorly rated nursing homes. As the Richmond Times-Dispatch reported:

“A yearlong investigation by the Richmond Times-Dispatch, which involved analyzing more than 250 court cases and interviewing more than two dozen people, revealed that VCU Health System has taken hundreds of low-income patients to court over the past decade to remove their rights to make decisions about their medical care. This process, which frees up hospital beds at VCU Health System and saves thousands in uncompensated costs, often results in sick, elderly or disabled patients being placed in poorly rated nursing homes, sometimes against the wishes of their own family members. In these cases, VCU Health asks the court to grant an attorney at the ThompsonMcMullan law firm the power to make critical medical and life decisions for its patients. The court orders the attorney to represent the best interests of those patients, but the law firm continues to look out for the hospital’s interests on dozens of guardianship cases each year.”

November 27, 2019

On the road, in the kitchen, at the table — have a safe, healthy holiday!

by Patrick A. Malone

With the launch of a season of eating, drinking, getting together with friends and family, and celebrating, it may be worth a moment to ponder how to keep those you care most about as healthy and safe as possible, but with a good dollop of fun too. Herewith some suggestions:

Food safety

When it comes to the centerpiece of Thanksgiving — the festive eating — hygiene and moderation matter. Nothing would ruin the holiday more than to sicken the guests, right? So, cooks and their helpers should take special care to keep their hands washed, the tools and prep areas sanitary, and to ensure that the food gets handled correctly, especially in thawing and thoroughly cooking the turkey and stuffing. It may seem counter intuitive, but experts warn against rinsing the turkey or any other fowl that might be store-bought and served. That’s because the birds get cleaned as part of the processing and rinsing with warm water may only spread microbial contaminants all around the kitchen. The key to kill off harmful bugs, by the way, rests in cooking foodstuffs for long enough and at high enough temperatures to ensure they’re safe to eat. Consult those published recipes carefully. Cooks need to plan well, so they get various menu items in and out of the stove and oven, so hungry diners get their fill at the appointed time.