Articles Posted in Emergency Medicine

blkmom-300x222The bad news for expectant black moms isn’t confined to those living in the nation’s capital: A new investigation has found higher risks of harm for women in New York, Florida, and Illinois when they deliver at hospitals that disproportionately serve black mothers.

ProPublica, a Pulitzer Prize-winning investigative site, analyzed two years of hospital inpatient discharge data from the three states to “look in-depth at how well different facilities treat women who experience one particular problem — hemorrhages — while giving birth.” Reporters found negative patterns that underscored big woes identified by other research before:

[B]lack women … fare worse in pregnancy and childbirth, dying at a rate more than triple that of white mothers. And while part of the disparity can be attributed to factors like poverty and inadequate access to health care, there is growing evidence that points to the quality of care at hospitals where a disproportionate number of black women deliver, which are often in neighborhoods disadvantaged by segregation. Researchers have found that women who deliver at these so-called ‘black-serving’ hospitals are more likely to have serious complications — from infections to birth-related embolisms to emergency hysterectomies — than mothers who deliver at institutions that serve fewer black women.

bullets-300x245When illness, accidents, and natural- or man-made calamities strike, victims discover in their long slog to recovery that our health insurance system only aggravates their pain and anxiety.  That’s a painful lesson that hundreds of Americans will keep struggling with in 2018, months after a madman rained gunfire from high-powered rifles down into a Las Vegas music festival crowd.

Modern Healthcare deserves credit for its follow-up of the October mayhem Nevada. It was part of what the industry publication calls an “epidemic of mass shootings,” tragedies stretching from San Bernardino, Calif., to Newton, Mass. They’re taxing hospitals’ capacities not only to provide large-scale emergency medicine but also to provide follow-up care — especially assisting survivors and their families and friends in dealing with their staggering medical expenses.

Victims in mass shootings, Modern Healthcare reported, confront a “proliferation of health plans with high deductibles and coinsurance requirements, leaving [them] exposed to many thousands of dollars in cost-sharing. Severely injured patients needing repeat surgeries may hit their out-of-pocket spending limits multiple years in a row, forcing them into bankruptcy. On top of that, even insured patients may face big balance bills if they are treated by out-of-network providers.”

usfs-thomas-fire-300x200The clock may be counting down to 2017’s end but Mother Nature isn’t giving up on whipping up calamities that wreak havoc on parts of the nation’s health care system and millions of Americans’ well-being. After swaths of the country were inundated by hurricanes and flooding, the West Coast is now battling yet more huge blazes.

Raging wildfires in Southern California not only have added big time to the billions of dollars that such blazes have caused this year in damage and suffering to people, property, and animals, they also have provided the entire coast with a harsh reminder of the importance of air quality to health.

With luck, public cooperation, and outstanding work by fire fighters, police, and other first-responders, the loss of life has been low in a series of blazes on the Westside of Los Angeles, in the city’s northern reaches, in San Diego, and most especially in Ventura and Santa Barbara. The “Thomas Fire,” burning over hundreds of acres in Ventura and Santa Barbara, has become the third largest wildfire in California record books. The Southern California blazes follow hard on the heels of disastrous infernos in Northern California’s wine country.

alive-300x115Nick Tullier once was a handsome, strapping sheriff’s deputy in Baton Rouge, La. Then, in a blink, he and five others were gunned down by a former Marine and black separatist who had come from Missouri to Louisiana to kill cops. Tullier was one of three deputies who survived the attack.

What happened next to him is part of a series worth reading in the Houston Chronicle, a year-long dig the newspaper has dubbed “Alive Inside.” The work asks whether doctors and hospitals across the country have stayed current with medical advances that maybe, just might, possibly offer greater glimmers of hope to patients like Tullier who suffer traumatic brain injuries.

Such individuals, the Chronicle carefully says, may too quickly be deemed too injured to survive. Doctors, in sincere acts of perceived compassion, may be too fast to urge family and loved ones to withhold or halt medical services for the brain-injured, partly out of the pragmatic reality that their recovery prospects remain poor.

emergency-services_overviewThe last thing Americans need to fret about as they struggle to keep down medical costs is worrying about getting hit with a  surprise bill for a ride in an ambulance.  Just how ridiculous can those bills be? Think thousands of bucks for a few miles.

The independent and nonpartisan Kaiser Health News service and the Washington Post deserve credit for their recent story on how companies slam patients with huge tabs for transporting them in dire medical circumstance. Ambulance rides, the news organizations have reported, based on a review of 350 consumer complaints in 32 states, “can leave patients stuck with hundreds or even thousands of dollars in bills and with few options for recourse.”

Lawmakers in 21 states have passed measures to protect consumers from “surprise” medical bills, many inflicted on them for “out of network services” by profit-seeking medical providers. But as much as patients would like legal protections against getting gouged by ambulance services —some run by local governments, including police and fire agencies —the issue gets complex and daunting.

traumatower2-300x205In the torrent of the relentless 24/7 news cycle, let’s not allow a new normal to prevail. We can’t forget that just days ago, a madman opened fire on a church in a small town south of San Antonio, Texas, killing at least 26 and wounding 20 or so. It was the worst mass shooting in the Lone Star State’s history, and it added to a horrific and growing toll for recent such gun-related outbreaks.

These incidents not only devastate the communities in which they occur. They also put giant strains of doctors, nurses, emergency medical technicians, and hospitals. All respond in ways that deserve a major salute, as well as empathy, compassion, and shared grief for the victims, their families, and those who seek to save and protect lives in chaotic situations.

The killing in Sutherland, Texas, posed its own unique stresses, with medical experts heaping praise on EMTs and first-responders for their heroic work at the scene, and then speeding those in need to care at hospitals at least 35 miles away.

epipen-300x119Big Pharma’s rapacious profit-seeking can seem to hit no bounds, even if it afflicts millions: Just consider what federal and state regulators are mulling about the makers of a popular anti-allergy therapy and those who supply a critical diabetes medication.

The federal Food and Drug Administration has replied to Bloomberg News Service that, so far, in 2017, it has recorded 228 reports of EpiPen or EpiPen Jr. failures, and the failure of EpiPens to deploy correctly has been cited in seven deaths through mid-September.

The agency said it is monitoring closely these “adverse event complaints.” These are unconfirmed reports that do not necessarily tie a product to a harm. But they might constitute sufficient grounds to investigate further and to potentially order product recalls, though, so far, the FDA says it believes patients can keep using EpiPens on the market without worry.

bowser-240x300Even as District of Columbia officials struggle with deepening woes at the United Medical Center (UMC), advocates from a national, independent, and nonprofit group have offered a dim review of hospitals in the DC area.

The bad news keeps piling on at UMC, a leading provider of medical care for communities of color in the District’s Southeast area and in Prince George’s County, Md.

To its credit, the sometimes locally slumbering Washington Post has put out a disturbing, well-documented report about the death of a 47-year-old HIV-AIDS patient in UMC’s nursing home care. As others witnessing the scene clamored for them to help, UMC nurses, the Post says, let the patient fall to the floor, where he sprawled in his own waste for 20 minutes while his caregivers argued with a security guard. When the patient finally was returned to his bed, he was dead.

calwildfire-300x222As California’s Wine Country deals with the prospect that the toll will rise more and the largely unchecked blazes will wreak greater havoc, doctors and hospitals have struggled with patient evacuations and the destruction of medical facilities. Millions of residents are coping with noxious smoke, terrible air quality, and breathing woes.

The Golden State crisis should offer a tough reminder to all of us in the rest of the country: Fire dangers remain real and lethal,  last year alone killing 3,390 Americans, injuring 14,650, and causing an estimated $10.6 billion. Families should not only do what they can to fire-proof their residences, they also should make emergency plans and practice them periodically.

Seniors may be at heightened risk, and they, their friends and loved ones, should make special precautions to safeguard them, planning for dire circumstance.

LV100117-300x215Caregivers and the community in Las Vegas, Nev., deserve a salute for their response to the gun violence last week, which could have overwhelmed a less-prepared community’s medical system.

Las Vegas  isn’t a giant metropolis (pop. 2 million in its metro area), and, due to the high costs to operate such a facility, it has just one Level 1 trauma center. That’s a facility staffed and equipped to provide a “gold standard” of emergency care. In the state of Nevada, the only such center is at the 541-bed University Medical Center of Southern Nevada.

It was slammed with more than 100 critical patients, many with life-threatening or fatal gunshot wounds.  A torrent of patients also was routed to the hospital, some for treatment of injuries they suffered while fleeing Stephen Paddock’s rampage. First-responders soon were flooding another facility, Sunrise Hospital and Medical Center in Las Vegas—a Level II trauma facility—with hundreds more.

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