DC Medical Malpractice & Patient Safety Blog

June 23, 2017

Obesity spreads as global bane, afflicting 604 million adults, 108 million kids

Although weight issues plague Americans as gravely as anywhere on the planet, obesity also has become a global woe, increasing sharply over the last three decades in 195 countries and afflicting an estimated 604 million adults and 108 million children—roughly 10 percent of the world’s population.

No nation on earth, even with the terrible toll that obesity takes in economic and health terms, has found a way to get its people skinnier and healthier: Weight woes are blowing up in disparate places like Saudi Arabia, Algeria, Egypt, Burkina Faso, Mali, and Guinea-Bissau, international researchers have reported in the New England Journal of Medicine. Obesity is now a major concern, too, for the people of China, Turkey, Venezuela, and Bhutan.

Public health experts worry about the skyrocketing numbers of overweight people around the planet because evidence shows obesity to be a major factor in heart disease, diabetes, cancer, and other debilitating conditions. These afflictions, combined with weight issues—including among those considered to be too heavy but not necessarily obese—contributed to four million deaths in 2015 alone, said the experts, participating as part of the Global Burden of Disease initiative.

June 22, 2017

Big Tobacco, preying on poor and uneducated, also hikes health inequities

by Patrick A. Malone

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Although most Americans finally may be breaking out of cigarette smoking’s killer grip, Big Tobacco keeps inflicting terrible harm on some of the nation’s most vulnerable—the poor, uneducated, and those who live in rural areas.

The federal Centers for Disease Control has just offered its annual assessment on Americans’ smoking habits, providing some rare good news about most of us and especially kids: Cigarette smoking among the nation’s youth is diving to new lows, and the use of smokeless or e-cigarettes for “vaping” showed its first declines.

Anti-smoking campaigns may be working, persuading teens and many adults to avoid smoking or to quit the bad habit that has been proven to cause cancers and to contribute to heart disease and other damaging conditions, the CDC says. The agency also notes that youth vaping and smoking may have declined due to new age-based restrictions on product sales and advertising.

June 20, 2017

Uncle Sam’s bad reverse: nursing homes returning to forced arbitration

by Patrick A. Malone

Look out Baby Boomers and Gen Xers: Just when you or your elderly loved ones may be most vulnerable and needing nursing home care, the government is going back to allowing nursing home administrators to push a pile of documents for you to sign at you at admission time. And when you put your John Hancock on some of these, you will give away important legal protections.

The Centers for Medicare and Medicaid, overseer of 1.5 million nursing home residents and more than $1 trillion in Medicare and Medicaid funding, has posted notice that, under Trump Administration leadership, it soon will reverse its predecessors’ plan to halt agreements that forced patients and their families to give up their right to sue. Instead, Trump officials will push them to the alternative legal process known as arbitration. Officials insist they will require nursing homes to make arbitration requirements simpler, and to ensure they’re written in plain English.

But, in keeping with a recent U.S. Supreme Court ruling in a Kentucky case, regulators are yielding to the nursing home industry’s aggressive lobbying and point of view that arbitration is simpler, easier, and will keep down costs.

June 18, 2017

What’s the Senate hiding on health care bill?

by Patrick A. Malone

Bernie Sanders recently offered on Twitter what he described as a display of all the Senate Republicans’ public considerations of the American Health Care Act, aka Trumpcare: a photo of a blank piece of paper.

Not a bad jibe, and a window into the deepening bipartisan dismay that Majority Leader Mitch McConnell and his Republicans soon will try to jam through the next step in their long-sought effort to repeal and replace the Affordable Care Act, aka Obamacare.

Does McConnell have the 50 votes he needs so Vice President Pence can break a Senate tie and move Trumpcare closer to reality? Will this occur in just days, before Congress heads to its July Fourth recess? Or will it happen in the small period before the long August recess, when Trump Administration officials also want Congress to take up an increase in the debt ceiling and to tackle a budget and maybe some tax law changes?

June 16, 2017

Bicycling injuries, medical costs rise as older, male riders crash with cars

by Patrick A. Malone

As more Americans try to stay healthier and to beat the pains of commuting by car, bus, or light rail systems, many (including yours truly) have turned to bicycling. But as a result, non-fatal bike injuries have skyrocketed—especially for men and for riders older than 45—and two-wheel collision treatment has become expensive: The annual cost of medical care for bike crashes in 2013 alone exceeded $24.4 billion, double the amount for all occupational illnesses.

Those are findings of a multi-year study (1997-2013) of electronic records on 3.8 million non-fatal and 9,839 bike-related deaths, research published in Injury Prevention, an online specialty journal.

A key reason why the cost of cycling wrecks—including for emergency transport, hospital charges, rehabilitation, nursing home stays, and lost work and quality of life—has raced upwards: Bikers more than ever are mixing it up with cars on streets. Road collisions accounted for just under half of biking injuries in 1997. They’re almost two-thirds of such wrecks now.

June 14, 2017

A new infectious threat at hospitals & nursing homes: deadly Legionnaire’s

by Patrick A. Malone

Hospitals and nursing homes, by failing to properly maintain their water systems, may be putting older patients at high risk of an unusual form of pneumonia, with federal officials tracking 1 in 5 suspected or confirmed cases of life-threatening Legionnaire’s Disease to health care facilities.

Anne Suchat, acting director of the Centers for Disease Control and Prevention, has urged caregivers to redouble their efforts to stamp out Legionella bacteria contamination in areas where poor maintenance may allow infections to flourish, including in water storage tanks, pipes, cooling systems, showers, sinks, and bathtubs. She said Legionnaire’s cases were too widespread, “deadly … and preventable.”

CDC researchers analyzed 2,809 of 6,079 Legionnaire’s cases nationwide in 2015 alone. They found 553 cases in 21 different and targeted jurisdictions, including Virginia, definitely or possibly occurring in a nursing home or hospital. The infections caused 66 deaths.

June 12, 2017

FDA can’t ignore oversight of drugs, medical devices once on the market

by Patrick A. Malone

Big Pharma and medical device makers have opened their wallets for a 2017 lobbying spree, throwing tens of millions of dollars around the nation’s capital, including to campaign with lawmakers and regulators to defend their soaring prices and to speed the path for their products to get to markets. But credit’s due to officials and organizations like Stat, the online health information site, for building a greater urgency behind a different narrative: It may be as crucial to monitor and regulate drugs and medical devices after they’re publicly available as pre-approval.

A two-part Stat report, aptly titled “Failure to warn,” dismantles existing oversight of prescription medications, especially regulators deeply flawed, big-data driven initiative dubbed Sentinel. The eight-year-old, $207 million program is supposed to mine insurance records to surface side-effects of drugs recently approved by the federal Food and Drug Administration.

But by examining 500,000 reports of side-effects from drugs targeted at the 1.5 million Americans with debilitating rheumatoid arthritis, Stat shows Sentinel’s shortcomings with Roche’s billion-dollar RA product Actemra. The FDA has received 1, 128 reports, complaining about patients who have died while taking it. But the agency, Stat says, “doesn’t have sophisticated tools to determine whether the drug was a culprit or a bystander in those deaths.”

June 11, 2017

Fla. justices reject keystones of partisans’ plan to undercut patients’ rights

by Patrick A. Malone

As congressional Republicans pursue their counter factual campaign this week to strip patients of their rights to pursue legal redress for harms they suffer while seeking medical services, the Florida Supreme Court has sent a powerful message to federal lawmakers about the wrongheadedness of some of their key notions.

The justices in Tallahassee have repudiated state lawmakers’ assertions of the existence of a “malpractice crisis,” in which dire action is needed to ensure doctors can get affordable liability insurance and be sufficiently protected to practice good medicine.

They also have rejected caps on patients’ claims for pain and suffering, finding that these limits on “non-economic” damages violate constitutional rights to equal protection under the law, and “arbitrarily reduce damage awards for plaintiffs who suffer the most drastic injuries.”

June 9, 2017

As summer softball gets into full swing, a caution on players getting beaned

by Patrick A. Malone

Although fans may fret when pros like the Nationals’ Bryce Harper get hit by a pitcher—and brawls ensue—some amateur athletes are the most likely to be struck and hurt: Ball-contact injuries are highest among female softball players, followed by women who play field hockey.

That’s according to new research on thousands of college athletes that found that less than half of the female athletes’ injuries when hit by balls caused them to lose playing time. Most suffered bruises (30.5 percent) and sprains (23.1 percent). But concussions were among the most commonly recorded serious injuries, occurring in 16.1 percent of cases, with finger fractures an issue, too.

When injuries were compared between men and women in baseball-softball, basketball, and soccer, female athletes had a larger proportion of ball-contact injuries diagnosed as concussions than did men, researchers found.

June 8, 2017

Depression now affects 1 in 3 girls — as young as 11

by Patrick A. Malone

It isn’t a teary topic fit only for moody young adult fiction and sudsy afternoon TV dramas: Depression afflicts as many as a third of girls, becoming a rising problem for some as early as age 11 and increasingly separating out as gender difference in the mental health between boys and girls.

The higher incidence of depression in girls—found in interview research with more than 100,000 young participants from 2009 to 2014 in the annual, statistically representative National Survey of Drug Use and Health—has raised concern among mental health experts. They note that depression can cause patients to struggle with relationships and school. It can lead some to suicide and may require sustained treatment for those with more serious cases.

Researchers could not explain why girls are more affected by depression, and they were surprised to find the earlier gender divergence, with it occurring at younger ages than had been tracked before. This tends to undercut existing psychological theories, they said, that depression in girls may be triggered by hormone changes or other significant life shifts that occur in their teens.