Articles Posted in Medical Error

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.

lasik-199x300Caveat emptor, federal officials are reminding patients anew about an eye surgery that tens of millions of Americans already have undergone and all too many may believe ── wrongly ── is all but risk-free.

In fact, significant numbers of the 9.5 million Americans who had laser-assisted operations, the so-called Lasik procedure, may show vision improvements, but they also may be under-reporting problems connected with their surgeries, the New York Times reported.

The federal Food and Drug Administration approved Lasik in the 1990s, but the agency only recently has supported the gold-standard of medical research, a randomized clinical trial, to check in on long-running complaints about the surgery.

nags-300x166If you can get your favorite sports fans peeled away from the latest broadcast pro event  ─ whether it’s the basketball playoffs, hockey championship series, golf tourneys, or the heating up baseball season ─  a conversation of sorts could be sparked by dropping numbers on them. See what kind of rise you can get by telling them their data-driven obsession with improving their own athletic performance may be built on shoddy calculation.

In the “Moneyball,” statistics’ crazy world of contemporary sports and athletic fandom, that statement could be heretical. But the numbers-driven folks at the web site “528” deserve credit for digging into a popular but dubious approach employed by researchers in sports medical science: Magnitude-based inference, aka MBI. Their article’s worth a read, especially for wonks and the numerically inclined. For those who are less so, here’s a taste of what’s at stake, as 528 reported:

At first blush, the studies look reasonable enough. Low-intensity stretching seems to reduce muscle soreness. Beta-alanine supplements may boost performance in water polo players. Isokinetic strength training could improve swing kinematics in golfers. Foam rollers can reduce muscle soreness after exercise. The problem: All of these studies shared a statistical analysis method unique to sports science. And that method is severely flawed.

Doctors and hospitals have a right to blow their own horn a bit when they’re onto something good, don’t they? What’s the harm? Plenty, as reported by Healthnewsreview.org, an independent, nonpartisan health information watchdog site.

As part of a series on patient harm from misleading media, Joy Victory, the site’s managing editor, details the tragic results from superficial news stories, typically on smaller media outlets, that deceive patients and their families about the Nuss procedure, a surgery to correct a congenital condition that results in a concave or “funnel” chest (see photo).

This is a serious operation, as I know from my practice. But as Victory points out, this hard, cold fact somehow gets glossed over in glowing reports about the surgery, written by news services and by reporters at smaller papers in South Carolina, Virginia, and Myrtle Beach, Fla., and even in a larger daily in Kansas City, Mo.

mom-300x171Big Medicine can paper over its troubles with basic fairness by slapping fancy terms on them: take “health and gender disparities,” for instance. But doctors, hospitals, and the rest of us can’t make medical care more equitable, accessible, safe, and affordable without looking at inequities, square on.

That’s why the New York Times, Washington Post, and Associated Press deserve credit for recent deep digs into the struggles of women, poor women, and especially black women with modern medicine:

ivf-300x271Equipment failures in two clinics in Cleveland and San Francisco not only resulted in the loss of thousands of frozen human embryos and eggs, the incidents also have raised new concerns about safeguards and regulation of booming and costly fertility programs.

Experts said the mishaps were uncommon, and they were hard pressed to explain how advanced refrigeration systems, with rigorous checks and back-ups, could have malfunctioned at large, respected facilities, leading to a likely boom of lawsuits by women and couples against the University Hospitals Ahuja Medical Center’s Fertility Center in Cleveland and the  Pacific Fertility Center in San Francisco.

The centers serve different types of women and couples, with the San Francisco facility dealing with younger, career-driven, and international patients eager to freeze eggs and embryos in hopes of starting families later in life. It has attracted public notice, partly because high-tech firms in the nearby Silicon Valley offer financial assistance to women employees who want to freeze their eggs. The Cleveland center, meantime, seeks to assist women and couples in the city’s western suburbs with infertility issues, especially through in vitro fertilization.

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.

wheartatttack-238x300As cardiologists and oncologists swap cross-fire about the conditions they treat and how they do so, here’s hoping that, above all, their female patients end up helped and not harmed, getting vital information about risks and benefits of therapies for two of the leading killers of women: heart disease and breast cancer.

What’s behind the medical specialists’ cross currents? Cardiologists and the American Heart Association are pointing to a major therapeutic statement published in the medical journal Circulation.

On the one hand, it provides what many see as an important, needed call to doctors of all kinds to recognize that heart disease among women goes “dangerously under-diagnosed and under-treated,” due in no small part because practitioners still fail to see that women suffer heart attacks in different ways than do many men. They do not, for example, suffer stabbing chest pain, radiating into the arm. Instead, as they experience clogs in tiny veins and arteries, they may feel a constant exhaustion and a discomfort as if they were having their chest squeezed or crushed.

precise-223x300Although billions of dollars and lots of positive public attention have been lavished on the promise of genetic-based “precision medicine,” this therapeutic approach to treating cancer and other serious diseases may need more scrutiny for basics of quality control.

National Public Radio deserves credit for airing some less-heard experts’ worries about the roles of at least two groups of little-seen and often-ignored medical specialists — pathologists and med techs — and how their common practices may undercut the potential of efforts to target disease treatments to individual patients based on maps of their genes.

Despite its powerful and progress-promising name, precision medicine relies on some old-fashioned, unchanged, and possibly problematic medical techniques, experts told NPR. Blood and tissue samples, which later will be analyzed with costly and supposedly state-of-the-art equipment, still get taken by med techs with limited training. Little attention typically gets paid to how they collect samples and how carefully they get handled before arriving in labs. They may sit on carts for hours, and they may be dragged through different parts of hospitals where temperatures vary widely and can hit extremes.

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.

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