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usc-300x279Yet another big university is learning a costly lesson about the perils of ignoring rogue doctors and their harming of vulnerable young people: The University of Southern California has offered to pay $215 million to settle federal lawsuits by hundreds of coeds who say they were sexually harassed and abused by the head gynecologist at the Los Angeles school’s health service.

Women who ever saw Dr. George Tyndall at a campus clinic may receive $2,500 each, while those with claims they were sexually abused by him could be paid up to $250,000 each.

USC said its proposed, tentative settlement has not been reviewed and approved by a federal judge who has been assigned a class-action suit involving hundreds of women.

mitchAt a time when Americans experience high anxiety and financial insecurity due to medical costs — with more than 20 percent of those with health insurance experiencing trouble paying for necessities, more than a quarter of them saying they had bills in collection, and 13 percent forced to borrowed money as a result of illness — politicians and special interests are closing the midterm campaigns as if they can prank voters. Just how gullible do they think the electorate can be?

Republican congressional candidates, after howling about the Affordable Care Act and campaigning unsuccessfully to repeal it in dozens of votes for years, including in the first of the Trump Administration, now are claiming to constituents that they support key parts of Obamacare.

Even as GOP state attorneys general argue in a pending federal court case to gut ACA protections on preexisting conditions, minimum benefits, and lifetime limits, Republican candidates are telling voters, counter factually, how much they embrace and support those Obamacare components. They’re trotting out sad tales about their own relatives’ illnesses to claim to support a position that they opposed in legislative votes and actions just weeks ago.

Scotus-300x167Although Uncle Sam makes a special vow to provide medical care for those who fight for this nation, he also enjoys special legal shields from lawsuits from them if anything goes wrong with medical services they’re provided. But recent news reports show how past and present service personnel not only suffer shabby medical care but also “grossly unfair” situations when pursuing malpractice claims  — and why lawmakers and courts may need to step in to provide fairer remedies.

Kaiser Health News (KHN) and the ABC-TV news affiliate in Los Angeles both deserve credit for spotlighting tough cases involving service personnel and medical malpractice, particularly the Federal Tort Claims Act and the Feres doctrine, a 68-year-old Supreme Court case that bars active-duty military members from suing the federal government for their own injuries.

Walter Daniel, a former Coast Guard officer, has petitioned the Supreme Court to “amend the 1950 [Feres] ruling, creating an exception that would allow service members to sue for medical malpractice the same way civilians can,” KHN reported, noting this would affect patients in a military health system “with 54 hospitals and 377 medical clinics, serv[ing] about 9.4 million beneficiaries, including nearly 1.4 million active-duty members.

andrews-300x208Celebrities can play an out-sized role in medicine and health care: Just consider the public attention paid to Angela Jolie or Ben Stiller and their discussions about cancer screening and the disease’s risks, or Michael Phelps, Mariah Carey, and Carrie Fisher raising awareness about mental health issues, or, yes, Gwyneth Paltrow promoting a rash of wellness goop.

But even with their wealth, accomplishment, looks, and social standing, public figures also can be savaged just like ordinary folks by medical errors that harm and even kill them and their loved ones, according to the Center for Justice and Democracy.

Michael_Jackson_in_1988-169x300The group has put out a study with 22 cases, documented by lawsuits and medical board sanctions, to show that, “Celebrity is no safeguard when it comes to medical malpractice,” Emily Gottlieb, the report’s author and the center’s deputy director for law and policy, said in a statement. “As this report illustrates, patients with fame and fortune are just as likely to be horrifically injured or killed by dangerous health providers as the general public.”

aspirinDoctors subject older patients to risky, costly, invasive, and painful tests and treatments, perhaps with good intention but also because they fail to see that the seniors in their care are individuals with specific situations with real needs that must be considered.

If  physicians too readily accept conventional wisdom in their field, for example, they may push patients 65 and older to take low-aspirin, with the popular but mistaken belief that this practice will help prevent heart attacks, strokes, and dementia. This doesn’t work, and, it increases the risk in seniors of “significant bleeding in the digestive tract, brain or other sites that required transfusions or admission to the hospital,” the New York Times reported.

The newspaper cited a trio of studies, published in the New England Journal of Medicine and based on “more than 19,000 people, including whites 70 and older, and blacks and Hispanics 65 and older. They took low-dose aspirin — 100 milligrams — or a placebo every day for a median of 4.7 years.”

docshistoric-300x234Doctors put their patients at grave risk by failing to stay current with professional best practices, eliminating outdated and ineffective therapies and approaches and instead learning and adapting better ways of care, notably treatments to help deal with the opioid crisis.

Vulnerable children can pay an unacceptable price, for example, for pediatricians’ unwillingness to “unlearn” what they were taught decades earlier in medical school, reported Aaron Carrol, a professor of pediatrics at Indiana University School of Medicine, a health researcher, and a contributor to the New York Times’ evidence-based column “The Upshot.” As he wrote:

In May, a systematic review in JAMA Pediatrics looked at the medical literature related to overuse in pediatric care published in 2016. The articles were ranked by the quality of methods; the magnitude of potential harm to patients from overuse; and the potential number of children that might be harmed. In 2016 alone, studies were published that showed that we still recommend that children consume commercial rehydration drinks (like Pedialyte), which cost more, when their drink of choice would do. We give antidepressants to children too often. We induce deliveries too early, instead of waiting for labor to kick in naturally, which is associated with developmental issues in children born that way. We get X-rays of ankles looking for injuries we almost never find. And although there’s almost no evidence that hydrolyzed formulas do anything to prevent allergic or autoimmune disease, they’re still recommended in many guidelines.

brca-cancer-risk-261x300Even as a pair of prominent researchers saw their reputations crumble over controversies connected to their work, a University of Washington team showed anew the importance of rigorous, transparent, independent, and widely shared medical science  to patients, in this case those with cancer.

Let’s start with the seemingly positive take that’s accompanying publication in the journal Nature of research regarding an open database with prospectively valuable information on BRCA1 variants, what some have dubbed the “cancer risk” gene.

Everybody carries both BRCA-1 and BRCA-2 genes, named because BR stands for breast and CA for cancer. All of us have two copies of each gene, one passed down from our mother, the other from our father. The genes make proteins that help repair errors in our DNA that pop up from time to time when our cells divide and duplicate their genetic code.  Mutations in either BRCA gene can disable the repair process and make both women and men carriers of the defect susceptible to certain kinds of cancer.

cduntsch-300x300It carries the plot line of a compelling crime story: A knife-wielding assailant works his way into exclusive institutions across a metropolis. There, time after time, he rips into  victims, inflicting great pain and suffering. He acts under the noses of people who should know better. He gets stopped only when someone in law enforcement steps beyond norms to bring him to justice. There’s even a systemic flaw that makes the drug abusing criminal’s acts more awful.

It’s painful and tragic, however, that the saga of Christopher Duntsch, aka “Dr. Death,” is all too gory, true, and potentially avoidable. It has become even more public via modern technology, an increasingly popular and free podcast by Laura Beil on the Wondery site.

Duntsch, now serving a life sentence in prison, moved from one hospital to another in Dallas, where the cancer-researcher and neurosurgeon morphed himself into a spinal surgeon. He was awful. Colleagues reported him to hospitals and medical licensing officials. They stepped in front of him in operating suites and took instruments out of his hands during surgeries. Duntsch, D magazine says, abused drugs, partied, and talked about having wild sex often before long, complex operations. There have been reports that he may intentionally have tried to maim patients. His surgeries were tied to deaths.

theater-228x300What’s an internist to do when an 81-year-old patient, already in failing health with advanced emphysema, seeks a second opinion because he’s been told his prostate specific antigen (PSA) levels are unacceptably high? This senior also has been advised to schedule a prostate biopsy urgently to determine if he has cancer. Can this discussion with both a scared patient — and his bright, concerned personal doctor — be any tougher?

For Andrew Lazris, who is also a geriatric specialist practicing in Maryland, this was a hard, complicated case because it involved his dying dad.

It also exemplified for him the work that he has undertaken with Eric Rifkin, an environmental scientist and adjunct researcher at Johns Hopkins University, in ensuring that patients retain their fundamental and critical right to have a say in their care. And, in doing so, they have developed what they argue is a clear, comprehensible way to help patients grasp and deal with the inevitable uncertainties, risks, and complexities of the array of medical treatments they can get overwhelmed with by doctors, hospitals, Big Pharma, medical device makers, and others in health care.

Nursing homes, by scrimping on their staffing to maximize their profits, put their residents at grave risk for infections that too often have grisly and deadly results. Low-rated facilities run by Uncle Sam to care for elderly veterans also may be concerning. And those oft-pricey assisted living facilities may have their own response to dealing with difficult to care for elders — putting them out on the street.

Kaiser Health News Service, the Chicago Tribune, USA Today, and the Boston Globe all deserve credit for their digging into problems at facilities caring for the old, focusing on issues that should be at the fore for regulators, policy-makers, and politicians as the nation grays.

Patrick Malone & Associates, P.C. listed in Best Lawyers Rated by Super Lawyers Patrick A. Malone
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