Articles Posted in Ethics

FDA-logo-300x129When 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.

vcuhospital-300x200A  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.”

ihs-300x197Although doctors, hospitals, and insurers may howl about the professional harms they claim to suffer due to medical malpractice lawsuits, research studies show that it’s just a tiny slice of MDs who  lose in court and must pay up for injuring patients. Further, the data show that the problem few doctors don’t rack up one, but two or three malpractice losses before they even start to see their work curtailed.

Common sense would suggest that if judges and juries find doctors’ conduct egregious enough to slap “frequent flyers” with multiple losing malpractice verdicts, these MDs might best be parted of the privilege of treating patients. Not only doesn’t that occur often enough, a Wall Street Journal investigation has shown the terrible consequences that can result for patients and taxpayers alike when it doesn’t.

The federal government, the newspaper reported, long has struggled to provide promised care through the Indian Health Service (IHS) to those who live on rugged, spare, and sprawling reservation lands. This obligation to provide such medical services is embedded in the Constitution and old treaties. But if it’s tough to get doctors to practice in rural America — where the hours may be extra long and the pay decidedly lower than cities — it had become a nightmare for the IHS to fill its many vacancies.

There seems to be a never-ending outbreak of a certain kind of pathology in the United States. Big Pharma has it and spreads it around, a lot. So, too, do public health figures. Let’s call this scourge what it is — unmitigated gall.

The problem with this nasty condition is that it afflicts the rest of us. Just consider how stomach-churning these shenanigans can be:

Penalties for bogus prescribing of ‘little red pills’ on elderly dementia patients

logopurdue-300x169For those who get a rise out of following the plight of plundering plutocrats, forget about pop culture shows like Succession, Dynasty, or Empire. Instead, it may be worth peeking in on the true-life Sackler family saga. It also underscores the truth of this idea: Never get between Big Pharma and a buck.

The Sackler story, turning on the fate of the family’s Purdue pharmaceutical firm and a fortune estimated at $13 billion, has been ripe with recent developments, including a potential settlement of thousands of claims by states, counties, cities, Indian tribes, and others — all claiming billions of dollars in damages due to the maker’s aggressive and less than accurate sales and marketing of its prescription painkiller OxyContin.

With a federal judge in Ohio consolidating and pushing a “global resolution” of a giant number of opioid-related lawsuits, Purdue and the Sacklers announced a tentative settlement of many of the governments-filed claims. Roughly half the plaintiffs were eager to get what money they could — to not only help constituents staggered by damages due to opioids, overdoses, and addictions, but also to refill government coffers depleted by the huge costs of dealing with nightmares caused by the painkillers.

uvahealthlogo-300x108Is a public pillorying the only way to stop big hospitals from pursuing patients for medical debt with the zeal of demons from the underworld?

The University of Virginia Health System — an enterprise that racked up an $87 million operating profit on revenue of $1.7 billion in the fiscal year ending in June and that holds stocks, bonds and other investments worth about $1 billion — has become the latest institution to get a journalistic blaming and shaming for extreme debt collection practices that would make proud Inspector Javert in Les Miserables.

The independent, nonpartisan Kaiser Health News Service and the Washington Post deserve credit for their investigation into UVA avariciousness. As KHN reported of the state operation:

https://www.protectpatientsblog.com/wp-content/uploads/sites/69/2019/09/google2.0.0-300x200.jpgConsumers, regulators, politicians, and journalists need to keep pressing big corporations to better protect the public’s health because such campaigning can work.

It has led to steps that may cut down on reckless promotion of expensive, burgeoning, and dubious treatments involving purported stem cells. It may make vehicles safer, so children and pets don’t die or suffer heat injury when mistakenly left in rear seats.

More tough work still needs to be done, however, with a new version of the persistently problematic off-road vehicle, and, indeed, with the federal agency that oversees road safety.

brandjj-300x106Big Pharma has hit at least two pain points of potential significance as government officials and trial lawyers work to hold drug makers accountable for at least some of the carnage caused by prescription painkillers.

There’s still a far way to go before companies see a full legal reckoning in the civil justice system for opioid overdose deaths that have killed an estimated 400,000 Americans since 2007, as well the drugs causing tens of thousands of cases of suffering and addiction.

brandpurdue-300x170But Oklahoma officials have struck hard at pharmaceutical interests by winning a $572-million nuisance ruling from a state judge against Johnson and Johnson, a legendary and once-respected health care brand.

fda3smokewarns-300x166The U.S. government will try to tackle two of the toughest health care challenges around with new pushes involving graphic imagery and smoking prevention and the encouragement for doctors to screen their adult patients to better detect, avert, and treat drug abuse.

Both initiatives have their soft spots.

But officials say they must act in as many ways as they can. That’s because 480,000 people in the United States die each year from illnesses related to tobacco use, the American Cancer Society reports, adding, “This means each year smoking causes about 1 out of 5 deaths in the US.” Drug abuse and overdoses, meantime, killed more than 68,000 Americans in 2018 alone, exceeding the nation’s peak annual deaths from car crashes, AIDS or guns, the New York Times reported, based on data from the federal Centers for Disease Control and Prevention (CDC).

beaumonthospital-300x115When doctors become medical outliers, shouldn’t hospitals, colleagues, insurers, and the rest of us ask how and why an individual practitioner diverges so much from the way others provide care?

Olga Khazan details for the Atlantic magazine the disturbing charges involving Yasser Awaad, a pediatric neurologist at a hospital in Dearborn, Mich. As she describes him, for a decade he racked up hundreds of cases in which he is accused by patients of “intentionally misreading their EEGs and misdiagnosing them with epilepsy in childhood, all to increase his pay.” Khazan says his case “shines a light on the grim world of health-care fraud—specifically, the growing number of doctors who are accused of performing unnecessary procedures, sometimes for their own personal gain.”

In the malpractice cases that are unfolding against him, Awaad’s pay has become a central issue, with evidence showing his hospital contract rewarded him for boosting the number of screenings he ordered and diagnoses he made. Jurors have been told that Awaad, whose salary increased from 1997 to 2007 from $185,000 annually to $300,000, “turned that EEG machine into an ATM.” He earned bonuses exceeding $200,000, if he hit billing targets.

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