Articles Posted in Infections

CMS-300x105As many as 2 million already ailing Americans will acquire an infection while hospitalized, with 90,000 of them dying as a result. Hospital acquired infections (HAIs) will add to the cost of an individual patient’s care anywhere from $1,000 to $50,000, while they will impose a direct hit of anywhere from $28 billion to $45 billion for institutions’ bottom lines. If HAIs seem like a problem for U.S. health care, they certainly are —  why is Uncle Sam suddenly proposing to retreat on regulations to crack down on them?

USA Today reported that patient safety advocates are sounding alarms about new rules, set to take effect in November, from the Centers for Medicare and Medicaid Services (CMS). The agency, which wields great sway over hospitals because so many patients’ medical costs are covered by Medicaid and Medicare, plans to slash the information it provides to the public on HAIs involving: “super bugs” like MRSA (methicillin-resistant Staphylococcus aureus), post-operative sepsis and surgical site infections, as well as accidents and injuries ranging from bedsores to respiratory failure after surgery.

CMS also would stop informing the public about “never events,” medical mistakes committed in hospitals and considered so ghastly that they “never” are supposed to occur.

eldercare-300x168Uncle Sam soon will step up what may be a positive trend: getting hospitals and nursing homes to halt the unacceptable boomeranging of elderly patients between them. But will Trump officials be as quick with health care providers as they have been with poor, sick, and old patients to employ not just carrots but also sticks to get better outcomes?

The nonprofit, nonpartisan Kaiser Health News Service deserves credit for looking ahead to this fall, when the administration aims to accelerate the end of perverse incentives that have hospitals and nursing homes shuttling the sick and elderly between them far too often. As Jordan Rau of the news service reported:

With hospitals pushing patients out the door earlier, nursing homes are deluged with increasingly frail patients. But many homes, with their sometimes-skeletal medical staffing, often fail to handle post-hospital complications — or create new problems by not heeding or receiving accurate hospital and physician instructions. Patients, caught in the middle, may suffer. One in 5 Medicare patients sent from the hospital to a nursing home boomerang back within 30 days, often for potentially preventable conditions such as dehydration, infections and medication errors, federal records show. Such re-hospitalizations occur 27 percent more frequently than for the Medicare population at large.

salty-200x300If you’ve got a shaker of salt, you may want to empty it on recent news coverage of the American Cancer Society’s announcement about its new guidelines on the age to start colorectal screening. That’s because the organization’s advisory and more than a few health journalists show a shaky grasp of basic disease statistical math.

Cancer specialists, correctly, are concerned because they say they are seeing the disease in younger people, with more colon and rectum cancers detected in patients in their 20s and even in their teens. They’re unsure what’s causing this. But just how many diagnosed cases have there been — and do the numbers mean there’s enough hard science to support a new recommendation that patients get colorectal screening five years earlier than they do now, at age 45 instead of 50?

As Kevin Lomangino, managing editor of Healthnewsreview.org, a health news watchdog site, points out, too many reporters became too accepting of experts’ fuzzy math when describing a screening change that could result in patient harms. The society, and specialists contacted by many reporters, spoke often of “doubled risks,” or impressive seeming percentage increases in colorectal cancer diagnoses — but without providing actual numbers of cases.

olympus-logo-300x64Undeterred by disclosures about the disastrous results of their growing use of dirty medical scopes, doctors, hospitals, and manufacturers have failed to figure how better to sanitize many of the devices. They, instead, may be taking short cuts that ensure the devices stay unsanitary when used in invasive procedures.

Chad Terhune, a reporter now with the independent Kaiser Health News service, deserves credit for staying with the story that he first started to break several years ago at the Los Angeles Times. He reported that tainted medical scopes, used for gastrointestinal exams and made by Olympus Corp. of Japan, were tied to at least 35 deaths since 2013,and had sickened dozens of other patients.

Medical safety experts revisited a key question raised by Terhune’s reporting and investigations by staffers with a U.S. Senate subcommittee: Can medical scopes, with their many and complex components, effectively be sanitized and what must be done?

lettuce-300x225After fading from the headlines in 2015-16 when a major restaurant chain struggled with meals that sickened dozens in multiple states, big worries have erupted anew about the safety of the nation’s food. That’s because federal officials and a supersized-farmer are struggling with salmonella outbreaks tied to more than 200 million now-recalled eggs, even as growers, grocers, and eateries  wrestle with dozens of E. coli illnesses linked to romaine lettuce.

The worrisome poultry products came from Rose Acre Farms’ North Carolina operation, which produces 2.3 million eggs a day from 3 million hens. Its products go to stores and restaurants in Colorado, Florida, New Jersey, Pennsylvania, Virginia, West Virginia, and the Carolinas, the Washington Post reported. Those eggs have been blamed for Salmonella braenderup infections that have sickened 23 people from nine states. No deaths have been reported.

Rose Acres, which has 17 facilities in eight states, has acted with “an abundance of caution,” federal officials noted, and recalled more than 200 million eggs, sold under the brand names  Great Value, Country Daybreak, and Crystal Farms. Waffle House restaurants and Food Lion stores also were sold the potentially bad egg.

superbugs-300x118Hospitals may be providing us all with too many causes for high anxiety, with reports on increasing findings of “nightmare” bacteria stalking more health care facilities than had been known, more disclosures about how taxpayers may foot an even bigger bill to deal with a beleaguered public hospital in Washington, D.C.,  and a respected reform advocate’s detailing of just how traumatizing many hospital stays may be.

Let’s start with the new research by the federal Centers for Disease Control and Prevention, a study that tried to determine just how many cases there might already be of patients infected in hospitals, nursing homes, and other medical care facilities with so-called Superbugs, bacteria that resist treatment not only with most standard antibiotics but also drugs that are deemed therapies of last resort. These include three types of bacterial infections deemed especially urgent but difficult to control: Clostridium difficile (C. difficile), aka C-diff; carbapenem-resistant Enterobacteriaceae (CREs, as shown above); and Neisseria gonorrhoeae.

CDC officials weren’t sure how many of the Superbug cases — which leave doctors and hospitals little option but to provide only supportive care — they might detect by scrutinizing records from pathology labs nationwide.

cdc-opoid-overdose-300x136America’s drug overdose crisis keeps  worsening, with federal officials reporting that emergency room treatment of opioid overdoses spiked by 30 percent across the nation in 2017.

Abuse of opioids, including the synthetic painkiller fentanyl and heroin, also is triggering significant outbreaks of diseases, including hepatitis C, which is costly to treat, and deadly major bacterial infections.

And the prescription painkiller crisis — which studies increasingly show was been launched, in part, based on wrong information about drugs’ purported benefits — may be masking the worrisome rise, yet again, of cocaine abuse.

jetsons-300x231Although big, rich hospitals and their sprawling campuses jammed with shiny new buildings may be reaching a point where they’re unsustainable for competitive cost, safety, and efficiency reasons, a rising health care alternative already may be hitting its own major woes that can’t be ignored.

The Wall Street Journal and New York Times have put up pieces with intriguing projections about the future of hospitals, including how economics may force them, as is occurring now, to spin off major functions, including many kinds of surgery, which will be handled, instead, in smaller, free-standing surgical centers.

At the same time, USA Today and the independent and nonpartisan Kaiser Health News Service have presented their investigation into dangers and deaths that patients encounter at the such centers, which already are burgeoning nationwide.

pneumonia-300x233As tens of thousands of Americans flood hospitals for treatment during the current flu epidemic, some also may end up sicker than when admitted, notably due to an infectious disease that’s a persistent and increasing worry for caregiving institutions: pneumonia.

The Wall Street Journal — citing federal statistics that pneumonia is the leading hospital acquired infection (HAI), sickening more than 150,000 patients annually in acute care hospitals — has highlighted new research showing that the disease is more common and problematic than now recognized.

Doctors and hospitals may have thought pneumonia struck mostly among elderly patients and those in intensive care units, particularly those needing ventilators and other machinery to assist their breathing. But the disease, “occurs across all units in all types and sizes of U.S. hospitals, putting every patient—the young included—at higher risk for developing the infection,” the researchers concluded after examining data on more than 1,300 patients at 21 hospitals.

influenza-virus-fulltext-300x203As the flu epidemic rages across the country, it also may be testing the oft-tenuous public respect for preventive medicine, especially as patients get hit with surprise medical bills and experts struggle to explain the complexities and limits of protections afforded by vaccinations.

Are flu shots useful or not?, many Americans may be asking, as this season’s infections hit marks not seen for at least a decade. (Spoiler alert: Yes, get that shot!) Flu kills many more patients than many realize, and this year, the virus is on track to claim as many as 4,000 lives a week.

The toll among children has been scary, with the deaths of 84 youngsters blamed on flu. Three out of four of the youngsters who died from flu had not been immunized, officials say.

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