Hospitals

July 28, 2019

Can lives be saved with lessons learned from a space pioneer’s botched care?

Neil Armstrong served as a naval aviator, test pilot, federal administrator, and a university professor. He earned his place in history as space pioneer — the first astronaut to walk on the moon. The American hero, who spoke the legendary phrase about “one small step for man and one giant leap for mankind,” also now offers a textbook case about nightmares in health care. Can others avoid these by learning about what happened to him?

As the nation celebrates the 50^th anniversary of Armstrong’s Apollo 11 flight, an anonymous tipster has disclosed information to two news organizations that his death was due to botched care. His family, which included a lawyer who represented their interests, reached a $6 million settlement with the community hospital involved.

Armstrong was known for keeping out of the media and public glare. His family kept that tradition in keeping private how he died in 2012, why, and the tense negotiations that resulted in the sizable payment to them by the hospital. Full information about his case may never be fully disclosed. But it already provides a possible series of check points for patients to protect themselves and their loved ones in dealing with doctors and hospitals:

July 26, 2019

For patients facing high-risk operations, an alarm on hospital surgical volumes

by Patrick A. Malone

Would a major league baseball team start a pitcher who played only once in the season for the deciding game of the World Series? Would passengers want to be aboard a jet whose pilot flew just once a year? Would any high-end sports car owner let a mechanic under the vehicle’s hood if she fixed that model one time every 365 days?

If rigorous tasks benefit from regular, quality practice — and they do — then why do hospitals allow low-volume surgeons to undertake procedures they rarely perform? That’s a tough question posed by new research from the Leapfrog Group, a national nonprofit organization seeking to improve the quality and safety of American health care.

Leapfrog, working with medical experts, identified eight high-risk surgeries and sought to estimate from rigorous published research the correlation between how often surgeons perform these and their procedures optimal outcomes.

July 23, 2019

As overdose deaths dip, new outrages disclosed on Big Pharma and opioids

by Patrick A. Malone

The nation may be hitting an inflection point in the opioid crisis. But Big Pharma, regulators, and politicians have much to answer for prescription painkillers’ terrible toll and their sluggish efforts to reduce the tens of thousands of casualties.

The spare good news about U.S. drug abuse — the first drop in overdose deaths since 1990 — came from the federal Centers for Disease Control and Prevention. The agency also warned its findings were freighted with many “yes, but …” elements, including:

The reported 5% decline occurred in deaths from prescription opioids;

July 19, 2019

U.S. must boost hospice oversight, watchdog warns, citing serious lapses

by Patrick A. Malone

Lawmakers and regulators must significantly improve the oversight of the burgeoning business of hospice care, a federal watchdog says. Its report came with two notable numbers: from 2012 through 2016, health inspectors cited 87% of the end-of-life care facilities for deficiencies, with 20% of them having lapses serious enough to endanger patients.

In one case cited by the Office of the Inspector General in the Department of Health and Human Services (HHS), a hospice patient had a deep, poorly treated pressure wound on the tailbone, apparent pain that caused grimacing and — in a crisis requiring a trip to the emergency room — a “maggot infestation’’ where a feeding tube entered his abdomen, the Washington Post reported.

July 18, 2019

Cutting resident doctors’ hours doesn’t harm quality of patient care, study finds

by Patrick A. Malone

Will the medical educators finally get that it makes no sense to force residents to toil like field animals? Yet another study, this latest from Harvard experts, finds that keeping residency training hours at more humane levels does not significantly affect quality of patient care, including inpatient mortality.

Let’s be clear: The grueling preparation for MDs is only relatively better than before, capping their training time to 80 hours a week.

Medical educators, hospitals, and doctors themselves have criticized that limit since it was imposed after long study and much argument in the profession by the Accreditation Council for Graduate Medical Education (ACGME), the group that accredits MD training programs.

July 12, 2019

A harsh reminder of hospital infection risks: outbreaks in areas treating kids

by Patrick A. Malone

Parents and the public received grim reminders of the risks of medical care as prominent institutions on opposite coasts battled hospital-related infections among some of the most vulnerable patients around: babies and children.

In the Pacific Northwest, a mold outbreak has taken a terrible toll — with one patient dead, five others infected, 1,000 surgeries postponed and 3,000 people told to watch for infection symptoms — at Seattle Children’s Hospital, which the Washington Post reported, “consistently ranks as one of the best children’s hospitals in the country and this year [was] rated top [for such facilities] in the Northwest.”

In the Northeast, the University of Pittsburgh Medical Center Children’s Hospital has confirmed 12 cases of a drug-resistant staph infection in its neonatal intensive care unit (NICU), CNN reported, adding that, the six babies, including one who is potentially symptomatic, and six symptomatic employees who have tested positive for Methicillin-resistant Staphylococcus aureus (MRSA) are receiving treatment.

July 7, 2019

A $229-million Baltimore malpractice case? It’s worth digging into this news

by Patrick A. Malone

Headlines can command attention while not always fully informing, as might be the case with these eye-catching story titles, one fresh, the others a few years back:

July 3, 2019

Suffering of rural poor a reminder of how much health policy debates matter

by Patrick A. Malone

Twenty Democrats who are campaigning for president took to network television for four hours and two nights last week to put health care as a central issue of their campaigns.

The format of this initial candidate “debate,” including hand-raised answers to complex issues, failed to allow the presidential aspirants to delve much into the details of their proposals. But tons of news coverage followed on — and likely will keep doing so up until Americans enter the voting booth — about Medicare, the government health coverage for seniors, and how it might be expanded to benefit tens of millions more. Those interested may wish to check out this podcast primer on the issue.

These future-looking discussions also already have tended to eclipse a key part of the existing Affordable Care Act, the Obama Administration initiative that remains a subject of hot dispute a decade after its passage: The expansion of Medicaid, the federal program to assist the poor and working poor with health coverage.

July 2, 2019

Courts, by too readily sealing records, contributed to opioid crisis, report finds

by Patrick A. Malone

The blame and shame for the opioid-drug overdose crisis that kills tens of thousands Americans annually has moved to yet another set of individuals and institutions now — judges and courts that handled Big Pharma lawsuits and may have been too quick to seal from the public information that would have warned of painkillers’ addictive and lethal characteristics.

Makers’ false claims about opioids and their problematic practices in promoting, selling, and distributing the drugs were hidden, too, in the “pervasive and deadly secrecy that shrouds product-liability cases in U.S. courts, enabled by judges who routinely allow the makers of those products to keep information pertinent to public health and safety under wraps,” Reuters reported.

The news agency dug deep into the judicial practices, finding:

June 30, 2019

Nonprofit hospitals hound patients with draconian debt collections

by Patrick A. Malone

Nonprofit hospitals added almost $40 billion to their bottom lines in the last year and lavished a $3.5 million average salary on their chiefs. But their relentless grubbing for cash apparently was unsated still. The institutions, exempted from federal, state and local taxes in exchange for “community benefits” like charity care and financial support for patients in need, are acting like Dickensian debt collectors, harassing patients with lawsuits and wage garnishments.

Pro Publica, the Pulitzer Prize-winning investigative web site, partnered with MLK50, a local news organization, to describe the avalanche of financial travail with which Methodist Le Bonheur Healthcare has inundated its poor and middle-class patients in Memphis, Tenn. The hospital, affiliated with the United Methodist Church, has filed more than 8,300 lawsuits pursing “aggressive collection practices [that] stand out in a city where nearly 1 in 4 residents live below the poverty line.” As the journalists reported of Le Bonheur:

“Its handling of poor patients begins with a financial assistance policy that, unlike many of its peers around the country, all but ignores patients with any form of health insurance, no matter their out-of-pocket costs. If they are unable to afford their bills, patients then face what experts say is rare: A licensed collection agency owned by the hospital. Lawsuits follow. Finally, after the hospital wins a judgment, it repeatedly tries to garnish patients’ wages, which it does in a far higher share of cases than other nonprofit hospitals in Memphis. Its own employees are no exception. Since 2014, Methodist has sued dozens of its workers for unpaid medical bills, including a hospital housekeeper sued in 2017 for more than $23,000. That year, she told the court, she made $16,000. She’s in a court-ordered payment plan, but in the case of more than 70 other employees, Methodist has garnished the wages it pays them to recoup its medical charges.”