Articles Posted in Surgery

covervf-300x210As the nation’s opioid and drug overdose crisis deepens, it can be hard to watch as the “Not My Fault” crowd clucks about its blamelessness in pushing potent painkillers that have played a part in killing more Americans in 2016 and 2017 alone than lost their lives in the Vietnam War.

The latest NMF protagonists include:

childrensunclogo-300x51Although big hospitals may love to pat themselves on the back and boost their profits and professional standings by claiming to offer “comprehensive” services, children may suffer and die due to the reality versus the hubris of institutions’ excessive initiatives with specialized care.

Officials at the University of North Carolina blew past anguished warnings from their own pediatric cardiology staff of significant problems in the pediatric heart surgery program at the medical center’s children’s hospital, the New York Times reported. Brushing aside their concerns about a lack of resources within and to support the program, UNC declined to make public, as most similar specialty efforts do, key performance measures. They would show that the UNC pediatric heart surgery program had a higher death rate than “nearly all 82 institutions that do publicly report” this and other measures of patient care.

The newspaper, in a rare move, has internal tape recordings of doctors disputing among themselves whether dwindling resources, staff departures, and other problems meant that UNC should do what many of the specialists demanded — take a long hard look at what was going wrong, and, in the meantime, refer sick kids to other institutions to safeguard their care.

kneestemcell-300x169When doctors and regulators crack down on the burgeoning and risky use of purported stem cell therapies, some well-known and respected big hospitals and health systems may have their own practices to explain, too.

As Liz Szabo reported for the nonpartisan Kaiser Health News Service:

Swedish Medical Center, the largest nonprofit health provider in the Seattle area … is one of a growing number of respected hospitals and health systems—including the Mayo Clinic, the Cleveland Clinic and the University of Miami—that have entered the lucrative business of stem cells and related therapies. Typical treatments involve injecting patients’ joints with their own fat or bone marrow cells, or with extracts of platelets, the cell fragments known for their role in clotting blood. Many patients seek out regenerative medicine to stave off surgery, even though the evidence supporting these experimental therapies is thin at best

aspirinlowdose-300x225After persuading as many as 7 in 10 American adults to take a daily low dose of a common painkiller to protect against heart disease and cancer, experts now say it is time for more nuanced advice on who should and who shouldn’t take the daily baby aspirin regimen.

Recent studies have shown that the believed protective benefits of low-dose aspirin need to be balanced against the risks of bleeding caused by the drug, the American Heart Association and the American College of Cardiology have declared.

Here is who should NOT go on low-dose daily aspirin:

Doctors and hospitals finally are owning up to and treating mental and physical damages inflicted on some of the sickest and most vulnerable individuals in their care—the 5 million or so patients who get helped in intensive care units, published research shows.

Although ICU patients may get dramatic emergency care that saves them from deadly infections, major disease, and significant accident or injury, experts only recently have begun to recognize and assist them with a condition associated with their stays: post-intensive care syndrome (PICS). A readable new study in the medical journal JAMA says that ICU patients may suffer a “constellation of symptoms” with PICS that hinders their recovery to their pre-hospitalization well-being, including: “muscle weakness, cognitive impairment, depression, anxiety, and post-traumatic stress disorder (PTSD).”

Kaiserexempt-300x205If a surgical staple gun malfunctioned so seriously that it generated not a few dozen formal complaints but more than 10,000 reported incidents, shouldn’t patients, doctors, and hospitals have the right to know that information from the federal agency overseeing the safety of medical devices?

Apparently not. Or maybe not without a big kick in the pants from journalists.

Instead, the staff at the federal Food and Drug Administration turned a move to ease paperwork and bureaucracy into a giant and little-known system that lets medical device makers hide serious and significant numbers of reports about failures and flaws with at least 100 products, a Kaiser Health News Service investigation found.

davincirobot-300x176The federal Food and Drug Administration finally has pushed back at surgeons and hospitals for experimenting on patients, spending $3 billion a year for surgical robots. The devices should not be used for mastectomies and other cancer-related procedures without caution, regulators warn.

The FDA acted after studies have shown that minimally invasive procedures for early-stage cervical cancer, many robot-aided, were more likely than standard, large-incision surgeries to result in recurrences of the disease and deaths.

Regulators also may have been prodded by their poor history in halting harms to women with so-called keyhole procedures, particularly the nightmares the FDA was slow to react to involving minimally invasive hysterectomies and a tissue-grinding tool called a morcellator.

mesh-300x134
Tens of thousands of women complain that a surgery to implant mesh to bolster weak abdominal tissue, instead has inflicted on them incontinence, chronic pelvic pain as well as pains in the groin, hip, and leg, and with intercourse. Others say they suffer complications as if they had the immune system attacking disease lupus, leaving them with persistent runny noses, muscle pain, fogginess, and lethargy.

The federal Food and Drug Administration in mid-February will convene its expert panel on women’s reproductive surgeries to see advice on next steps in what has become a legal and medical morass over transvaginal mesh operations.

As many as 4 million women globally have undergone mesh surgeries to treat urinary incontinence and weakening of walls in the abdominal area that causes prolapses, the Washington Post reported, quoting a UCLA reconstructive expert as estimating that 5 percent — or 150,000 to 200,000 — of those patients have experienced complications.

knees-300x81With a graying nation projected to see millions of patients undergoing knee replacements each year at an annual cost to taxpayers running in the billions of dollars, it may be past time to ask if surgeons and hospitals promote and perform these popular procedures to excess.

Liz Szabo, in a story written for the nonprofit, nonpartisan Kaiser Health News Service (KHN) and published in the Washington Post, reported that knee surgeries have their “risks and limitations,” and “doctors are increasingly concerned that the procedure is overused and that its benefits have been oversold.”

As she wrote:

hospital-unit-300x150As the new year gets under way, regulators and lawmakers need to look hard at a nightmare in New Jersey involving a free-standing surgical center and to a nationwide harms occurring in psychiatric hospitals to ensure that these and other institutions improve the safety and quality of their patient care.

USA Today and the Wall Street Journal, in separate stories, reported about shoddy practices and lax oversight that contributed to significant problems in the medical facilities.

The Journal investigated hospitals for the mentally ill and found that, “More than 100 psychiatric hospitals have remained fully accredited by a major hospital watchdog despite serious safety violations that include lapses linked to the death, abuse or sexual assault of patients.”

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