Articles Posted in Misdiagnosis

howardhospitallogoHospitals have raised major alarms with insurers, businesses, and patients by asserting that spiking costs for medical staff, especially nurses, will lead them to increase their prices in the days ahead by as much as 15%.

This would be a budget-busting move, breaking contracts the caregiving institutions have struck with employers and insurers, leading not only to potential premium shocks but sharply higher charges for patients, the Wall Street Journal reported.

The newspaper noted that the soaring hospital price plans are coming up in negotiations now among chains like HCA Healthcare and Universal Health Services, companies, and insurers, differing markedly from typical discussions on this always tough issue:

chromosomes-harvardExpectant parents, doctors, and regulators need to reconsider the rising use of gee-whiz genetic testing as  doubts emerge about popular blood screenings to detect rare prenatal disorders and a costly test relied on by couples undergoing in-vitro fertilization (IVF) treatment.

This is what the New York Times reported about what researchers have found about preimplantation genetic testing for aneuploidy, or PGT-A. It is an increasingly common screening in IVF and has led potential parents to discard embryos as unfeasible or unacceptable due to abnormalities to carry to term:

“PGT-A … has, over the last two decades, become a standard add-on to already pricey IVF procedures. But the test, which can cost anywhere from $4,000 to $10,000, has become controversial over the years as studies have cast doubt on whether it increases birthrates from IVF at all. A growing number of scientists have questioned the widespread use of the test, which leads to tens of thousands of discarded embryos per year and causes many women to believe they may not be able to carry biological children. A new study published last week details 50 patients who underwent transfers of abnormal embryos at the Center for Human Reproduction in New York City … The study reported eight births after 57 transfer cycles of embryos with abnormal genetic testing results since 2015. Seven of the babies were born healthy. The average age of the women in the study was 41 years old.

abuse-150x150Women suffer significant, sustained damage from head traumas inflicted on them during domestic abuse, and victims themselves, doctors, law enforcement, and too many others have underestimated the severity of this problem.

Here is the harsh reality of too many women’s terrifying experiences, as reported in a tough-to-read but important New York Times magazine article that quotes, among others, Eve M. Valera, an associate professor of psychiatry at Harvard University and a leading researcher on traumatic brain injuries among survivors of domestic violence:

“The Centers for Disease Control and Prevention estimates that one in five women in the United States experience severe intimate-partner violence over the course of their lifetimes, resulting in physical injuries, most commonly to the head, neck and face. Concussions are likely to appear with alarming regularity. Every year, hundreds of concussions occur in the [National Football League]; thousands occur in the military. Valera’s estimated number of annual brain injuries among survivors of domestic abuse: 1.6 million.

medicalrecords-150x150Patients, for their own protection, long have needed to secure copies of their medical records and correct inaccuracies they find  — a safeguard that has grown even more vital as research builds about unacceptable biases that doctors and others may show in their recorded observations about those in their care.

In two separate, published dives into tens of thousands of medical records, researchers found that black patients were 2½ times more likely than their white counterparts to be labeled with at least one negative description, and African-Americans with diabetes were more likely than whites to be labeled with medically disapproving terms including nonadherence, noncompliance, failed or failure, refuses or refused, and, even combative or argumentative, the New York Times reported.

Dr. Dean Schillinger, who directs the Center for Vulnerable Populations at San Francisco General Hospital and Trauma Center and who was not involved in the studies, told the newspaper this of the disconcerting descriptions found in patient records:

weedn-150x150It’s a grim issue that too many of us would want to ignore in the best of times. But the coronavirus pandemic and its collateral harms have pushed beyond their  limits the medical experts who study death, locally and nationally.

In Maryland, the chief medical examiner has resigned, and a deputy has been designated as the interim head of one of the nation’s busiest morgues, the Washington Post reported. Victor Weedn (shown right), who had served as the operation’s head since 2019, stepped down as the facility has gotten stuck in such snafus that it has more than 200 bodies awaiting autopsy, “the biggest backlog the office has seen.” The nightmarish mess matters, the Washington Post reported:

 “The logjam has left families distraught as they experience extended delays in funerals. It has also created problems with some [criminal] prosecutions, with holdups in courts obtaining autopsy reports and getting stand-in medical examiners for murder trials. In the past couple of months, the caseload in Maryland has increased by nearly 400%. There were 50 bodies awaiting autopsies in late December. The number swelled to 240 last week. Weedn recently estimated that the office would have a backlog of 300 this month. He and other medical examiners across the country have blamed backlogs on a combination of staffing shortages and rising deaths because of violence, Covid-19, and drug overdoses.”

pregnant-300x200Expectant parents have gotten an ugly exposure to a rapacious aspect of modern medicine: Over testing, over diagnosis, and over treatment, specifically with a new, fast-growing high-tech twist.

The grownups — whether over-reaching to safeguard the unborn or in a simply silly way to determine the gender of their hoped-for bundle of joy — are ordering unnecessary, expensive, and too often alarming prenatal genetic blood tests. These rapid exams purport to tell whether a fetus may have the rarest of congenital diseases, the New York Times reported in some admirable digging, triggered by a stack of patients’ surprise medical bills.

Reporters Sarah Kliff and Aatish Bhatia found a big problem with the high-tech prenatal screens: The tests too often are dead flat wrong.

chartgfrresults-300x197Medical specialists and researchers have taken a big step in recognizing that how they diagnose black patients with kidney disease may be racially biased and harmful to a group that already and disproportionately suffers the illness’s harms.

Doctors now should jettison race-based adjustments in equations used in a crucial and fundamental test to assess kidney function, according to studies and editorials published in the New England Journal of Medicine, the American Journal of Kidney Diseases, and the Journal of the American Society of Nephrology.

As the New York Times reported, this step will “affect hundreds of millions of kidney function tests performed yearly in hospitals and outpatient settings, both for acutely ill patients and as part of routine screening blood tests. By one estimate, one million Black Americans might be treated earlier for kidney disease if the diagnostic equation were not adjusted for race.”

portalmedrecord-300x124As doctors and hospitals switch to electronic medical record systems and try to amp up the business efficiency of their enterprises by opening online consumer portals, more patients may access their caregivers’ files on them, including  doctor notes that may be shocking in their inaccuracy.

Heather Gantzer, a doctor practicing at Methodist Hospital in St. Louis Park, Minn., and immediate past chair of the American College of Physicians’ Board of Regents, told Cheryl Clark, a contributor to the MedPage Today medical news site:

“100% of medical records have errors. Some of them are nuisances, but some are really impactful and might make a huge difference for [example for] the person who was said to be on antibiotics” but was not.”

drugselderly-150x150The nation’s nursing homes, battered by the coronavirus pandemic, are under more fire for their resurgent reliance on powerful and risky psychiatric drugs and shaky diagnoses of mental illness to treat elderly residents, as well as for the institutions’ inability to safeguard the old, sick, and injured in their care by ensuring their staff are vaccinated against Covid-19.

Facilities across the country have recorded a 70% spike in dubious designations of elderly residents as schizophrenic. This means they may be dosed with potent antipsychotic drugs, which, critics say, act akin to pharmaceutical restraints and can reduce the vulnerable to near vegetative states, the New York Times reported, based on its investigation of the issue.

The newspaper noted that federal regulators and mental health professionals have campaigned for years to get nursing homes and other long-term care facilities to stop using certain medications, which once were more routinely administered and pack more than a wallop for the old:

colorectalcancerhotspotmap-300x230While technological advances may help provide crucial warnings to young men, especially those who are black, about their heightened risk of early-onset colorectal cancer, the rise of other high-tech diagnostic aids may only worsen built-in, harmful racial biases in an array of medical practices.

Researchers at the University of Chicago, to their credit, have sought the assistance of health providers across the country to inventory and assess increasingly common medical software and the algorithms on which they rely to ensure whiz-bang decision-making tools don’t discriminate against patients of color.

The early results are distressing, showing how well-intentioned experts inject prejudices into programs that can lead to racially unfair choices about patient care. Ziad Obermeyer, an emergency medicine physician and co-author of the Chicago research, told Stat, the science and medical news site, this about algorithms used in many diagnostic tools:

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