An original feature when King News Media was created in 2002, Medicalwatch became a fast favorite with readers who routinely checked in to read about medical malpractice cases and incidents in healtcare facilities across the nation.

United Healthcare To Pay $44 Million+ To Docs As Part of Final Leg of Six Year Class Lawsuit

(KNM)---It took six years, but doctors in the Cincinatti, Ohio metro region won a class-action lawsuit against several healthcare insurance companies they claimed were underpaying for their services on patients who had policies with the companies. The last company to settle, United Healthcare, finally agreed to pay more than $44 million to the doctors along with a nearly $2 million 'donation' to  the Academy of Medicine of Cincinnati "for the general benefit of the healthcare industry in the Greater Cincinnati/Northern Kentucky area" according to papers released. United Healthcare also has to pay more than $4 million to defer the costs of lawyers for the group of doctors.

A group of some 20,000 doctors were represented in the lawsuit against the insurers and came from several counties in Ohio. The lawsuit charged that Humana Health Plan of Ohio, Humana Insurance Company, Aetna Health, Inc., Anthem Health Plans of Kentucky, Inc. and United Healthcare of Ohio conspired to set rates of insurance reimbursement far lower than those collected by doctors in other areas. In total, the sum cost of the case cost the companies nearly $400 million. All of the companies denied any liability, but all settled.

The doctors showed in court how their colleagues in other parts of the state and region, including Cleveland and Kentucky, received higher reimbursements for the same procedures and services they performed in the Cincinnatti area. Patient advocate and consumer groups had complained that the area was losing many doctors because of the actions of the companies and declared it had resulted in a dangerous health emergency since the quality and quantity of care was now in jeopardy. Advocates praised the settlement but warned citizens to expect premiums to rise due to the companies settling.

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Report Indicates Little Progress Has Been Made In Reducing Medical Errors

 

(KNM)---Consumers Union, a nonprofit watchdog group which publishes Consumer Reports Magazine, blasted  lawmakers for having failed to enact patient safety reforms recommended by a 1999 report by the Institute of Medicine (IOM) which stated medical errors kill nearly 98,000 people annually and cost the United States $17 billion to $29 billion a year. "There is little evidence to suggest that the number of people dying from medical harm has dropped since the IOM first warned about these deadly mistakes a decade ago," Lisa McGiffert of the Consumers Union said.

 

The group says it believes preventable medical errors now account for more than for more than 100,000 deaths each year -- or as many as 1 million lives over the past decade and stated it believed reducing medical harm -- including hospital-acquired infections and medication errors -- would not only improve patient care but also provide significant cost savings to help make expanded access to health coverage possible. "As the debate over health care heats up in Washington, Congress should make sure that improving patient safety is a central part of any reform legislation it adopts," McGiffert said.

 

The 1999 report by the IOM found preventable medication errors cost the nation $3.5 billion each year. Such errors include giving or prescribing the wrong drug, giving patients the wrong dose or giving the drug in the wrong way. Consumers Union urged U.S. lawmakers to make patient safety a key focus of any health reform policy. President Obama has pushed for medical error reform to be a central part of his ambitious healthcare program. The Pharmaceutical Care Management Association in March projected that as many as 75 percent of U.S. doctors will move to electronic prescribing within 5 years, spurred by new rules from Medicare, the federal insurance program for the elderly and disabled, that give doctors an incentive to switch.

 

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New Law Mandates NJ Hospitals Share More Info On Errors

 

(KNM)---Patient and consumer rights advocates are applauding a new bill that is expected to be signed by New Jersey Governor Jon Corzine which requires hospitals to make public more detailed information on medical errors at their institutions. The bill would also bar hospitals from charging insurers or patients for procedures to correct medical mistakes--a common practice that has long been blasted by advocacy groups.

 

The measure requires the Department of Health and Senior Services to publish how often errors, such as operating on the wrong body part or leaving a sponge or instrument inside a patient's body ,occur at each hospital. Health care facilities already report preventable medical mistakes, but the state has published only the number of errors, not the data for individual hospitals.

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Healthcare Access Continues To Worsen In United States; Rural Areas Hard Hit

 

(KNM)---The numbers are staggering. Conservative estimates say at least 38 to 42 million Americans are without health insurance. The highest estimates have the number pushing 50 million. But with the jobless ranks continuing to increase and many with jobs experiecning benefit cuts, even many working Americans are downgrading their health plans. The result is a continuing nosedive of the nation's healthcare situation as more and more Americans simply go without it or are seriously limited to what benefits they can enjoy with the plans they have in place.

 

Health care experts have coined the term "medically disenfranchised" to describe the more than 60 million Americans who lack regular care. They include many but not all of the estimated 47 million officially uninsured people, but also more than 15 million Americans who do have coverage.

A Scripps Howard News Service review found that access to primary care is deteriorating and forcing millions of people outside traditional family practices or leaving them without care. Even millions of insured can only see a doctor in an emergency room or walk-in clinic.  One in five Americans does not have a family doctor and even many who do are often shut out of care - translating to higher rates of illness and death, and higher costs.

The absence of care is stark in some places - like the 148 mostly rural counties with no doctor at all, according to government records analyzed by Scripps Howard. The analysis compared the number of primary care doctors in each U.S. county with the number of deaths and found a clear, consistent pattern:

Counties with more primary care physicians had lower death rates than those with fewer family doctors. They also had a lower rate of death from preventable diseases like hypertension, heart disease and colon cancer.

The death rate from hypertension - elevated blood pressure that usually can be controlled through diet, exercise and medicine - is 32 percent greater in the counties with the fewest doctors when compared to the counties with the highest number of doctors.

The government counts more than 326,000 primary-care doctors, just more than half of all doctors in the nation. But in reality, only about a third of U.S. doctors regularly provide primary care. Family doctors and experts say there are not enough primary-care doctors for two main reasons: time and money.  Despite widespread calls for each American to have a primary-care doctor, neither government programs like Medicare and Medicaid nor private insurance generally pays doctors for quarterbacking patient care, or for visits addressing multiple medical issues. Family doctors, pediatricians and general practitioners end up being paid less because the reimbursement system assumes what they do is less complex than specialists.

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Study: Surgical Errors Greatly Increase Risk of Death or Readmission

 

(KNM)---A MedScape report on WebMd details how surgery patients who are injured as a result of their operation are 7 times more likely to die while hospitalized and are also much more likely to be readmitted to hospital within three months of being discharged than are surgery patients who are not injured. The results of the research are published in the May, 2009 issue of Medical Care.

 

The research analyzed 9 types of accidental medical injuries, or "patient safety events," among 1.5 million hospital patients who were initially treated in 1088 short-stay hospitals in 7 states in 2004. All patients were at risk for at least 1 patient safety event. The authors controlled for factors that would affect readmission or death, including the severity of illness, chronic comorbidities, age, and payer group.

 

The investigators report that 2.6% of patients had at least 1 safety event. At 3 months, the readmission rate was about 17% for those with no safety event, but about 25% for those who had a safety event. At 1 month, the readmission rates were 11% for patients with no safety event, and 16% for those who had a safety event.

Patients whose surgical incisions reopened had nearly a 60% greater likelihood of being readmitted than patients who had no safety event, and patients who experienced postoperative respiratory failure had a 14% greater likelihood of being readmitted than patients who had no safety event.

The in-hospital death rate was 1.3% with no safety event, but 9.2% with a safety event. When the researchers compared in-hospital deaths by type of injury, they found that a patient who suffered postoperative respiratory failure was 13 times more likely to die than a patient who was not injured, and that a patient who suffered postoperative sepsis was 5 times more likely to die than one who was not injured.

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 Pharmacists Push Hard for Passage of Laws That Protect Them from Jail

 

(KNM/MedNews)---The death of an infant in Ohio from a wrong prescription is leaving a Cleveland-area pharmacist with the very real possibility of going to prison if convicted of criminal charges. This is not sitting well with pharmacists and trade groups who are lobbying hard to shield them from criminal prosecutions. Former pharmacist Eric Cropp faces up to five years in prison after pleading no contest to involuntary manslaughter.

 

In February of 2006, Cropp approved a pharmacy technician?s mix of chemotherapy solution for 2-year-old Emily Jerry.  The mix was 23 percent salt-based when it should have been only 1 percent. During testimony, the technician said she told Cropp there was something wrong with the mixture, though he still approved it. Emily died a few days later.

 

Cropp was stripped of his license for his error in the Jerry case and 15 subsequent other errors. Ohio legislators passed Emily's Law, which created licensing and minimum education requirements for pharmacy technicians. A federal version of the Ohio law, Emily's Act, was introduced and referred to a Congressional subcommittee last year.

 

But concern over Cropp's fate  and its impact on the pharmacy industry have grown. The non-profit Institute for Safe Medication Practices, which focuses on the prevention of medical errors, called the prosecution "inappropriate and unwarranted." "Cases like this could make pharmacists less likely to report errors and slow systemic change  things that are likely to prevent future tragedies," the institute stated. "Criminal prosecution sends the false message that clinical perfection is an attainable goal, and that 'good' health-care practitioners never make errors and should be criminally punished if they are involved in an error,"  the institute added.

The Ohio Pharmacists Association has joined conversations with other chapters and their national association about pushing for a kind of "no fault" system similar to what was approved in the 1970s by the Federal Aviation Administration.

The Jerry family, in testimony two years ago in front of the Ohio Pharmacy Board, called Cropp's actions reckless and an "inexcusable and intentional homicide" of their daughter. "Eric Cropp's incompetence goes far beyond conducting one reckless act," Kelly Jerry, Emily's mother, said. "Eric Cropp consciously disregarded any and every set standard of protocol regarding patient safety."

 

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 Patient Feared 'They're Liable to Kill Me' During Botched Abortion that Hospitalized Her

 

Patient S. tells from her hospital bed how she was locked in a room against her will for four hours while a raging infection nearly took her life

 

(KNM)--A life-threatening abortion complication landed a Kansas patient of late-term abortionist George R. Tiller in the hospital and she has decided to come forward to tell of her harrowing, near-death experience at Tiller's Women's Health Care Services.

 

VIEW THE VIDEO

 

Patient S. has alleged that abortionist Shelley Sella may have botched an injection into her abdomen, causing sepsis, a systemic infection that rapidly spreads throughout the body and can cause rapid death.She also accuses Sella of misdiagnosing her pregnancy at 19 weeks, even though previous medical examinations placed her pregnancy at 23 weeks, beyond the legal limit in Kansas.

 

While sick, crying, and running a fever of 103.7, she returned to WHCS where she was isolated in a locked room for four hours, during which time her pleas for release were ignored. Patient S. was told that she should be quiet because she was upsetting the other women, and was threatened that unless her attitude changed, they would no longer treat her. She was also told that she would have to drive over three hours to a hospital in Kansas City where her abortion would be completed. She refused to make the trip and demanded that Tiller finish the procedure.

 

Patient S. observed that she continued to feel movements in her womb. Her mother was present during the removal of the baby, and observed Tiller inserting a tube into the baby's skull and removing the brains, a procedure that is illegal if the baby was still alive. Before the final procedure, Patient S. said that she feared, "They're liable to kill me under sedation."During the procedure, Patient S. suffered an asthma attack and cardiac arrest, but was revived.

 

Instead of calling an ambulance, Tiller drove Patient S. to Wesley Medical Center in his personal Jeep. She feared for her safety since Tiller apparently could not see very clearly, and was verbally directed though traffic by a female employee who was with them.She was treated and discharged from the hospital on Saturday, September 27, 2008, even though she was still in pain and feeling sick from her ordeal.

 

Patient S.'s experience closely resembles that of 19-year old Christin Gilbert, who died from untreated sepsis during a third-trimester abortion at WHCS on January 13, 2005.

 

"We have repeatedly begged the authorities in Kansas to hold Tiller accountable for the many women he had hurt just over the past few years. How many women must be maimed or killed before Tiller is brought to justice? We say it again: Tiller is a menace and we demand that he be held accountable for his dangerous, if not criminal, actions. This time, the public should not take 'no' for an answer,"said Operation Rescue President Troy Newman.

 

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PA Nursing Administrator Convicted

 

(KNM)--The Pittsburgh Post-Gazette is reporting a former nursing home administrator was convicted of stealing payroll funds after a judge ordered her not to touch the money.After a nonjury trial, Common Pleas Judge David R. Cashman found Martha Bell, 62, of West Mifflin, guilty of six theft counts for withdrawing about $51,500 from the corporation's accounts in violation of a court order.

Another judge had issued the order after the death of an Alzheimer's patient who was trapped in an outside patio of the now defunct Ronald Reagan Atrium I Nursing and Rehabilitation Center in Robinson.

This most recent case was the last of several legal proceedings Ms. Bell has faced since the patient died at her facility in 2001.Ms. Bell is serving a five-year federal sentence for health care fraud and eight counts of making false statements about health care matters. She also must serve a consecutive sentence of 22 to 44 months in state prison for neglect of a care-dependent person, involuntary manslaughter, reckless endangerment and conspiracy for trying to cover up the circumstances of the death of Mabel Taylor, 88.

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Six Patient Deaths, Violence & Questionable Hiring Practices Scar NJ Psych Facility

(KNM)--It's New Jersey's largest psychiartic care facility and the state-run Ancora Psychiatric Hospital in Winslow is so poorly-run and riddled with incidents that the federal government has stepped in as its Department of Justice Civil Rights Division begins an inquiry into conditions that has resulted in six deaths in two years along with a vacant chief executive office, patient violence and hiring practices that are under fire. The Justice Department's probe comes on the heels of a year-long Asbury Park Press investigation into patient safety and conditions.

The latest incident at Ancora involves a patient deemed so dangerous to himself that two orderlies were assigned to observe him in his room at all times. Suffering from a condition known as Pica which causes a person to attempt the digestion of harmful objects, the patient managed to stuff a plastic knife, fork and spoon down his throat in the company of two orderlies. Now, after it was revealed orderlies do not have to have a high school diploma and any certified training to manage mental patients, the heat has turned up on the facility.

Assemblywoman Mary Pat Angelini, R-Monmouth, said "I would love to know if these orderlies were indeed within an arm's length of the patient. Obviously, they weren't. Or they just blatantly didn't care. This is horrible," said Angelini, a former social worker who has made improving mental health care a priority.

This latest incident is just one of many plaguing Ancora over the past few years. For example, on July 31, a male patient punched a female patient in the head, landing 42-year-old Stephanie Mason of Cumberland County in a coma. Last December, two orderlies were supposed to stay within one arm's length of a man who, unnoticed, slipped away and hanged himself in a bathroom. Six patient deaths in the last two years have triggered disciplinary actions against the staff.

When DeWitt Crandell Jr. committed suicide while under close watch by the orderlies in December, former Ancora Chief Executive Officer LaTanya Wood-El was removed, though she is still being paid her $115,000 salary. Six months after Wood-El was reassigned, Gov. Corzine visited Ancora to announce that conditions had improved. Ancora has remained without a permanent CEO since Wood-El was removed in December.

Assemblyman Louis D. Greenwald, D-Camden, said the time for Ancora to take the next step  to improve its staff  is long overdue. "We keep ducking this issue. I don't know how many more tragedies are going to have to take place before we do the right thing, go in there, evaluate the staff and evaluate their credentials," Greenwald said.

Robert Ruffin, leader of the union that represents the Ancora orderlies, did not respond to an interview request.
Under current requirements, Ancora's orderlies do not have to have a high school diploma or any prior training on how to deal with mentally ill patients. According to the job description, the orderlies  called "human services assistants" in state jargon , are only required to speak English well enough to "follow uncomplicated verbal directions and written rules and regulations."

NJ Nurse Charged With Murder Of 72-Year-Old Patient

(KNM)--A nurse at Jersey Shore University Medical Center has been charged with the first degree murder of a heart patient who received a fatal dose of a paralyzing drug.  Lorie Hentges, age 39 was indicted in the connection of the April 2007 death of Alvin Flamenbaum, age 72.

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New Research Disputes Belief Flu-Shots Prevent Elderly Deaths

(KNM)--Many people think getting a flu vaccination will protect them from getting the flu and, by extension, reduce the number of deaths attributed to an influenza outbreak.  New research, however, reveals the flu vaccination does not prevent death in elderly patients to the degree widely believed.  With meticulous evaluation strategies upon which to base their conclusion, a team of researchers in Alberta, Canada, suggests the flu vaccine?s benefits have been exaggerated over time and that "good" patients may sway the outcome of studies of the vaccine.

Dean T. Eurich, PhD, says the healthy-user effect may play a more significant role in studies conducted to examine the benefits of flu vaccinations on the elderly than previously thought.  In the past 20 years, the rate of vaccination in the United States elderly population has gone from only 15% to 65% but there has not been a comparative decline in the number of hospitalizations or of deaths attributed to influenza in this segment of the population.  Eurich, an assistant professor and clinical epidemiologist at the University of Alberta's School of Public Health says the individuals themselves getting vaccinated, or the healthy-user benefit, may be the reason for only about 10% of all deaths in the winter being attributed to the flu, even though the suggestion that flu vaccinations reduce death from influenza by 50%.

Have a story or topic you feel is not getting coverage in the mainstream media? Let us know!

Reach us at editor@kingnewsmedia.com

Chicago Man Beaten To Death In Nursing Home

(KNM)-An elderly man living in a South Side Chicago nursing home with a history of negligence and state-mandated fines was beaten to death earlier this year and the family is still seeking answers.

77-year-old Ivory Jackson died from blunt head trauma due to an assault, cranio-cerebral injuries and sepsis, according to an autopsy performed by the Cook County Medical Examiner's Office. Jackson's death was ruled a homicide. An alarm clock in his room is thought to have been at least one of the weapons used against him. Reports say Jackson may have been murdered by another patient in the facility. Ironcially, Jackson came to the facility after being a victim of another beating at a separate facility.

Jackson came to the long-care facility Renaissance at 87th Street the week of June 16, according to Fran Meehan, an attorney for the nursing home. He was the victim of an assault at his last nursing home, underwent surgery at a local hospital and was then taken to Renaissance."He was only in [the Renaissance] facility for four or five days before he expired," Meehan said. "He had an altercation of some kind at a previous nursing home."

All Faith Pavilion (formerly William L. Dawson Nursing Home) is located at the Giles Avenue address and has a history of public health violations, according to a news release from the Illinois Department of Public Health. The All Faith Pavilion and the William L. Dawson Nursing Home has been forced to pay at least $80,000 in fines since 2004 for "A" violations from the IDPH. "A" violations are given when a nursing home neglects patients, fails to properly instruct staff, or any other behavior that results in the "substantial probability that death or serious mental or physical harm will result," the release said.

The nursing home's violations include at least two deaths linked to neglect. Police News Affairs Officer Laura Kubiak said that Wentworth Area detectives were conducting an ongoing investigation of Jackson's death.

CAUGHT ON TAPE: CARETAKER BEATS DOWN ELDERLY MAN; FLEES BACK TO KENYA

(KNM)---A disturbing video graphically showing a cartaker beating a 90-year-old-man she was paid to take care of at home while his family worked has caused outrage in Baltimore as law enforcement seeks to find the woman, a native of Kenya, who it is believed may have fled the country knowing her crimes were revealed.

The victim's daughter, Jaki Taylor, made the discovery thanks to cameras she had put in her home. The caretaker Anastacia Oluoch was arrested and charged in the beating. But she was able to make bail and eventually flee from the law. Taylor says, "It makes me really irate that she bailed herself out with the money I had been paying her to take care of my dad.

Eight days before the trial, she flees the country and goes back home to Nairobi, Kenya." The caretaker never stood trial. That prompted Taylor to push for legislation in her father's name. It's called the John Taylor act and the bill would stiffen penalties and deny bail to anyone charged with first degree elder abuse. Senator Lisa Gladden is sponsoring the bill. "It is not right that we allow our elders be abused in this manner and if you do, we're gonna hold you in jail until you come to court." Since the beating, Taylor's father has been in a nursing home. Taylor says,

"His health just rapidly declined and he has not been back home yet, he's still in the critical care unit in the nursing home." Although it's unclear if the bill will pass this session, supporters say it's a start to protecting the elderly from abuse. The bill would also allow officials to withhold the suspect's passport to prevent that person from fleeing the country.

"Health Net dramatically underpaid claims to New Jerseyans to reimburse them for out-of-network health care services," Banking and Insurance Commissioner Steven Goldman said. "I'm pleased that we were able to obtain the return of this money to Health Net's New Jersey subscribers, together with interest, since this is what Health Net promised to pay but had not. The fine represents an appropriate penalty for this improper business practice."

 "The checks ranging from a 'few dollars to a couple thousand dollars' went out in July and August to 50,000 current or former policy owners, benefiting 88,000 people, including individual family members, according to Alice Ferreira, a spokesperson for Health Net."We're pleased this is fully resolved. Today's news lets folks know we have worked cooperatively with the department and we have made restitution,'' she said.

Sick of being sick, Pe initially went to her doctor in January. Diagnosis: Bronchitis. She was given antibiotics. A few weeks later, still sick, the doctor gave her a chest X-ray. Diagnosis: Pneumonia. She was given stronger antibiotics. Weeks afterward, she went to another doctor and had another chest X-ray. "Then I got the phone call that said there was a spot on my lungs," Pe says. "I immediately thought the worst ? cancer. The doctor wanted to do a CT scan on the day of my daughter's birthday party."At that point, I thought I was dying and didn't want to miss the party. I took the test a few days later."

And, at last, Pe has given a definitive diagnosis: sarcoidosis---the same disease that contributed in the death of actor and comedian Bernie Mac.

"They tried to explain it to my husband and I," she says, "but it's hard to understand at first." They quickly learned that this immune-system disorder causes tiny lumps of cells to cluster in the body's organs. There is no cure, and researchers have yet to identify its causes. Often, the condition goes into remission and occasionally goes away with use of the steroid prednisone.

In some cases, sarcoidosis has led to complications of stroke, organ failure, and death.

"It affects mostly the lungs, but sarc is called the Great Mimicker," says Dr. Amit Karmakar, a pulmonologist at Mercy San Juan Medical Center. "Sometimes, people don't even know they have it because they are asymptomatic. Or they'll have some nonspecific complaints like fatigue or muscle aches."  In Pe's case, it was fatigue and chest tightness. But her CT scan showed that the sarcoidosis had settled in her lungs, spleen and liver. After three months of taking prednisone, Pe says she feels much better.

What she doesn't like are the side effects from the steroid weight gain and acne, in her case  but she notices the fatigue and chest tightness return when her dosage goes down.  Her husband, Isaias, who is a jujitsu instructor, has encouraged her to exercise, but Pe says she has learned to conserve her energy for her children, son Nichos, 7, and daughter Arissa, 5.

"The thing that's bad about this disease is that people can't see it because it's internal," she says. "You look fine on the outside, and they expect you to keep going like you would normally if you weren't sick. You can't. They say, 'Why are you sitting there? Why don't you get up and do something?' "

The lawsuit highlights problems long known by local advocates and health officials regarding Extendicare, one of the largest nursing-home chains in North America. The company runs 268 facilities for up to 30,000 residents.In Washington, two of the company's homes -- in Auburn and in Spokane -- are on a federal list of troubled facilities that require extra inspections by the U.S. Department of Health and Human Services.

Four of its homes, including Aldercrest and the Auburn center, have been temporarily barred in the past by the state from accepting new residents, according to the state Department of Social and Health Services. Five have been hit with fines totaling thousands of dollars.And nearly all of Extendicare's homes, which can accommodate up to 1,500 people, have higher-than-average scores for health deficiencies found by state inspectors.

"They're bad news," said Louise Ryan, the state's long-term care ombudsman. "They are a very troubled corporation. It's just very sad that they are as bad as they are."Ryan said many complaints, including those alleging wrongful deaths, stemmed from neglect and poor treatment for such conditions as pressure sores and diabetes.She said the company appeared to have a high turnover in management. She also said the homes routinely accepted more residents -- and more acutely sick residents -- than staff members could handle.Extendicare representatives were not available to respond to Ryan's comments.

(KNM)--The thorny issue of patients' privacy rights has another challenge to overcome---it's the internet and the popular form of communication called 'blogging'---but the culprits are not insurance companies, reporters or strangers......it's the doctors and nurses of patients.

Blogs written by medical professionals may pose a threat to patient privacy, because the authors of the blogs typically   reveal patient information according to Dr. Tara Lagu, Robert Wood Johnson Foundation Clinical Scholar and her research colleagues at the University of Pennsylvania.  The study, in the Journal of General Internal Medicine, analyzed 271 medical blogs and found that 57 percent contained enough information to reveal the author's identity. Supposedly anonymous medical bloggers who provide information about their location, subspecialty or other personal details can also reveal their identity to blog readers and jeopardize the identity and privacy of the patients they are writing about.

In some cases, patients described in medical blogs were able to identify themselves, the researchers said.Three of the blogs in the study even had recognizable photos of patients, including one with an extensive description of the patient and links to photos.  The researchers also found that some of the medical blogs allowed advertisements, and some promoted health -care products within the blog text. None of the bloggers who described products within the text adhered to medical ethics standards of providing information on conflicts of interest, or whether payment was received for promotion of the products.

"While many medical blogs provide valuable information to the public, are respectful in tone and are written anonymously, others pose a threat to patient privacy and have the potential to threaten the integrity of the medical profession," Lagu said. She added, "Unfortunately, no professional organization has taken the initiative to provide guidance on this issue. As the number of medical blogs grows, professional organizations, medical educators, and the blogging community must address the challenge of this new medium by setting guidelines and standards for what is appropriate."

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Court Defends Firing Of Nurse Who Had Sex With Patient After Heart Surgery

(KNM)--A Pennsylvania court agreed with Temple University Hospital for the dismissal of a male nurse who had consensual sex in the hospital with a heart surgery patient two days after the procedure.

The woman had double bypass surgery at Temple University and had sex with registered nurse Richard J. Baldwin. The matter came to light a few days later, when the woman asked a doctor to determine if the unprotected sex had resulted in any sexually transmitted diseases. Hospital investigators said the patient indicated she was attracted to Baldwin and that the medications she was taking had nothing to do with what happened.

Baldwin, 44, apparently gave conflicting statements about the encounter to hospital investigators and the arbitrator. He testified before the arbitrator that he did not have sex with the woman, but investigators said he told them that the woman had come on to him and that he was being fired for having consensual sex.  Even if it was consensual, Temple hospital officials argued, the sex act was a violation of state nursing standards and hospital policy.

Baldwin now works as a nurse at another undisclosed hospital.

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Private Health Aide Caught By Hospital Surveillance Abusing Patient

(KNM)--A woman hired as a private health aide to care for a patient instead abused the patient several ways until she was caught by closed circuit camera in the Florida hospital.

Paulette Noble was arrested after being caught abusing a 63-year-old woman on a hospital surveillance camera. The woman was hospitalized for conditions including depression and bipolar disease. She had been pushed, hit and covered with a sheet by Noble, police said. Noble worked as a private health aide for the woman hospitalized at the Fair Oaks Pavilion at the Delray Medical Center. Hospital personnel said they saw Noble abuse the patient when she tried to get out of bed.  According to investigators, Noble hit the woman in the face, put a sheet over her head and continued hitting her.

Delray Medical Center said it followed policy by checking out Noble's background, but the attorney general's office said she's not licensed to work as a private aide. "Unfortunately you see a lot of people who are placed in facilities and their relatives believe they're going to be put there to be cared for," said a representative from the attorney general's office. "Unfortunately you see caretakers taking advantage of their roles and taking advantage of victims. That's something the attorney general is absolutely not going to tolerate." The victim's husband told investigators that Noble had worked for his family for three years, originally taking care of his mother until she died.

The attorney general's office is using a specialized division called the Patient Abuse, Neglect and Exploitation Team to investigate these types of cases. Noble was arrested, jailed and charged with felony elder abuse.

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Vet's Companion Blasts Florida VA Hospital For Avoidable Death

(St.Petersburg Times & KNM)--Mary Nicholl is grieving and angry. Her longtime companion Richard Stecher's death is to her a clear example of laziness, negligence and inefficiency on part of the Veterans' Administration  and the James A. Haley VA Medical Center in the Tampa/St.Petersburg area after several "missed opportunities" to treat him went by until the situation became critical and an emergency surgery was too late.

Stecher, a Coast Guard veteran, died primarily from complications caused by a perforated bowel obstruction. Minutes after emergency surgery, he suffered a heart attack and never regained consciousness. But to Mary Nicholl, Stecher's live-in companion of 19 years, the care Haley provided before surgery amounted to gross inattention by a hospital where, she said, care was often chaotic and substandard.

"No veteran," Nicholl said, "should endure what Richie endured." Dr. Edward Cutolo , the chief of staff at  Haley VA Medical Center, the nation's busiest veterans' hospital, met last month with Nicholl and apologized.

A surgeon, a primary care physician and a gastroenterologist failed to adequately treat Stecher for more than two months.VA records say Stecher should have been admitted after an April CAT scan but was not admitted until two months later, when the emergency surgery was performed. Short on personnel, the VA sent Stecher to a private company in April for a CAT scan. The results were viewed by a non-VA radiologist without access to previous VA scans for comparison, according to a VA document.  That communication gap, Nicholl said, may have led to the failure of Haley to recognize how seriously ill Stecher was. His primary care physician at the VA, located at a VA clinic in Pasco County, strongly suspected an obstruction, records show.

Nicholl and her son, Eddie Enright, 44, said they demanded the  meeting with Cutolo because they wanted answers. They both said Cutolo, who was not Stecher's physician, was extremely apologetic. "Cutolo admitted it was their fault, they screwed up and they were going to put measures in place so it never happened again," Enright said. "They said he would still be alive if they had admitted him in April.

Stecher, a retired general manager of a New Jersey manufacturer, began getting sick early this year. He lost up to 50 pounds, had little appetite and his abdomen protruded markedly, Nicholl said. "It was like he was carrying twins," Enright said. Stecher began visiting Haley or the Pasco clinic regularly in March. Visit followed visit ? up to a dozen or more, Nicholl said. "He just kept getting sicker and sicker," she said.

On June 26, she said, she rushed Stecher to Haley because he was so sick. The next day, he received a barium enema for an X-ray of the intestine. Somehow, Nicholl said, Stecher suffered a perforated intestine during the procedure. Attendants, she said, simply finished the procedure and tried to send him home. Nicholl alerted a physician's assistant who, she said, immediately saw how ill Stecher was. That PA wrote a note, Nicholl said, saying Stecher needed immediate surgery or a procedure to decompress and clear the intestine. He handed her the note and told her to take it to the emergency room, she said.

The 63-year-old woman said she had to push Stecher alone to the ER on another floor in a wheelchair via Haley's slow and crowded public elevators, at least a 10-minute trip. At the ER, the couple then waited 45 minutes, nobody taking Stecher's vitals, Nicholl said.

Finally, he was examined and rushed to the ultimately unsuccessful surgery.

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Evening Heart Attacks Linked To Sleep Apnea

(KNM)--A new study links night-time heart attacks with the breathing disorder sleep apnea, which makes people gasp for breath every few minutes. The link is not fully established, but it seems logical, said Dr. Virend Somers, a cardiologist from the Mayo Clinic who is lead author of the report in the issue of the Journal of the American College of Cardiology.

Most heart attacks occur in the day, generally between 6 a.m. and noon, Somers said. Having one during the night, when the heart should be most at rest, means that something unusual happened, he said. Somers and his colleagues have been working for a decade to show that sleep apnea is to blame. Their studies have looked at the most common form, obstructive sleep apnea, in which the tube carrying air to the lungs, collapses periodically, blocking the flow. "About 10 years ago, we showed that obstructive sleep apnea has a powerful effect on the sympathetic nervous system, causing an acute increase in adrenaline flow, high blood pressure and lack of oxygen," Somers said.

That study was followed by another showing that sudden death at night is more common for people with sleep apnea. An obvious cause of sudden death is a heart attack, so in this latest study, Somers and his colleagues studied the breathing patterns of 92 people admitted to the hospital after heart attacks. "For those who had heart attacks at night, the vast majority had undiagnosed sleep apnea," Somers said. "So, perhaps sleep apnea is acting as a trigger for night-time heart attacks." 

Several studies have shown a link between sleep apnea and cardiac problems, said Dr. Allan Pack, director of the sleep center at the University of Pennsylvania. The largest, done several years ago, followed thousands of individuals. "It showed that people with sleep apnea who refused treatment had a three- to fourfold increased risk of cardiac events," Pack said.

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Patient Advocacy Group Finds Many Sex Offenders In Nursing Homes

(KNM)--The founder of A Perfect Cause, an advocacy group for nursing home patients created in 2001 after the his grandmother died in an Oklahoma City facility, reported research the group has done which discovered nursing homes across America are filled with violent sex offenders who put other patients in potential danger.

Wes Bledsoe's group found that at least 1600 registered sex offenders are in nursing homes across the nation in a system that does not necessarily know the past records of these patients and are not taking precautionary safety steps. Bledsoe tracked the number of offenders living at these homes over the past four years by matching addresses from sex offender registries with a database of care facilities from Medicare.

Surprisingly, many of these offenders are young ranging from late teens to early forties. The group also uncovered more than 60 rapes, murders, and assaults committed by criminal offenders in these facilities  Bledsoe, along with other patient advocates and elected officials will speak in Congress this week about the situation. Pennsylvania Attorney Sean McDonough will appear at the hearing to speak about Lillian Guernsey, who was 86 years-old in 2002 when she was raped by another resident at a Pennsylvania facility. The assailant, a 31 year old fellow resident, had eight prior adult arrests, three convictions and two adult commitments to correctional facilities before he arrived at the home

 Sandra Banning will testify six years to the day after her elderly mother was raped in a Florida nursing home.Banning said she had no choice but to place her mother in a nursing home beacuse she suffered from dementia and was repeatedly found wandering the streets alone in the middle of the night. Banning said she had no idea that the facility she placed her mother in was also the home of a violent offender with a history of arrests. She found out after nursing home staff called her to tell her the offender had raped her mother who was 77 at the time.  "They found him right in the act," said Banning. "This man was 83 years-old and in a wheelchair. Not someone you'd think would be a rapist." It was only after the rape occurred that she found out the man had been arrested 58 times and that a court ordered him to move from a homeless shelter into the assisted-living facility.

"There is no law, federal or state, that keeps violent or sexual offenders out of long-term care facilities as residents," said Bledsoe. "The problem we have is that these offenders are being warehoused in nursing homes because the excuse is, 'Well, where else are we going to put them?'"

Bledsoe said that offenders are placed in long-term care facilities by district court judges, county sheriffs, adult protective services workers, and corrections workers, as well as by offenders themselves and their families. And he said that while these offenders deserve care, seniors living in the homes deserve protection.

Bledsoe is calling for the establishment of separate and secure long-term care facilities for violent and sexual offenders, criminal background checks for all residents, and notification of offenders residing in the facilities

California Facilty Receives Maximum Fine for Patient Death

(KNM)--Bakersfield Health Care, a skilled nursing facility, received an "AA" citation, the most severe penalty under state law, and fined $100,000 by the California Department of Public Health after an investigation that concluded the facility failed to address adverse medication interactions leading to a patient's death.

The state said it issues a citation at this level about once a month. This is out of 1,400 facilities statewide. The facility has submitted a plan of correction to the state, which was accepted. An investigation on the convalescent home death said the patient was taking medications that potentially could create complications if mixed with the wrong drugs, and that's what investigators say happened.The man was given a deadly combination of blood thinning medications that eventually put him in the emergency room. He later died from complications.

Washington State Calls for Investigation Into Dental Deaths

(KNM)--The Department of Health of Washington State issued an urgent call for an investgation into deaths related to dental surgeries.  The head of the department, Mary Selecky submitted a letter to the Dental Quality Assurance Commission after  investigations by the Seattle Post-Intelligencer and The Spokesman-Review revealed three recent dental patient deaths had not been investigated by the commission.

James Marks died last year in a Spokane hospital after dental surgery in the office of Spokane dentist Mark C. Paxton. A Seattle man died after his wisdom teeth were removed, and an elderly woman died after Spokane oral surgeon Dr. Terrance Hauck removed her teeth in 2005 in preparation for dentures. The Spokesman-Review found a fourth, unreported case of a Spokane man who died following palate surgery.

Cape & Islands District Attorney Michael O'Keefe said Smith died of cardiopulmonary arrest while under anesthesia. "Basically, her heart stopped as a result of the manner which the medical procedure was undertaken," O'Keefe said. "The manner in which it was done was, in our view, willful, wanton and reckless conduct."

Smith's mother alleged in a lawsuit that Osathanondh did not properly monitor Smith while she was under anesthesia."Had she been on the proper monitoring equipment, her heart rate, her pulse rate, her oxygen level, would have been monitored and any dangerous decrease could have been picked up immediately. Resuscitative or corrective measures could have been taken promptly and would have avoided her death," said Eileen Smith's attorney, David Angueira.

Osathanondh's attorney, Paul Cirel, called Smith's death "an unfortunate tragedy," but said Osathanondh is not to blame."Medical science has gotten to the point where anytime this happens, people look to point blame, but sometimes these things are inexplicable," Cirel said. "It is a tragedy, but it doesn't mean that he bore responsibility for it."

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Feds Release Stunning Death Data At Texas Facility

(KNM)--Nineteen patient deaths occurred at DaVita Lufkin Dialysis in Lufkin (East Texas) in a five-month period before its temporary closure, according to a survey released by the U.S. Department of Health and Human Services.

State and federal health officials conducted an investigation following the facility's closure in late April after a spike in patient deaths and health complications. The center reopened  after fixing staffing and operations problems to meet state-required standards. DaVita spokesman Michael Chee has said the state survey conducted  found no link between the deficiencies outlined in the report and patient deaths. The state, which acts as a regulatory department making sure health facilities are operating within state guidelines, imposed a level three corrective plan of action at the Lufkin facility the highest it can give out.

The center closed  after two patients witnessed a nurse intentionally inject two patients with bleach. Both patients survived and police have since charged former DaVita nurse Kimberly Clark Saenz, 34, with two counts of aggravated assault. Chee has previously said the company suspects the nurse is linked to a cluster of four patient deaths.

The survey released  stated DaVita officials failed to monitor care provided to patients and did not immediately detect an increase in adverse events related to health and safety. It also found the facility did not keep complete and accurate patient medical records, including patient deaths which were not properly documented. Causes of death or possible death trends from September 2007 through April 2008 were not documented, the survey stated.

The facility had a 7.1 percent higher patient death rate in 2007 than the state average, at 27 percent from the state's 19.9 percent, according to the report. Twenty-five patient deaths occurred between Jan. 1 - Dec. 31, 2007, the report stated.

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(KNM)--A report from the Institute for Safe Medication Practices warns about the dangers of misprescribing fentanyl transdermal patches, such as Duragesic. ISMP reminds practitioners that these patches are intended only for patients who are opioid-tolerant, and should not be used for acute pain. 

ISMP also pointed out other prescribing errors. In some cases, deaths occurred in patients who were prescribed multiple fentanyl patches, resulting in overdose. In other cases the fentanyl was prescribed in addition to other pain medications, such as oxycodone, or it was prescribed for patients with pre-existing respiratory compromise. ISMP points out that sometimes pharmacists have dispensed these prescriptions without questioning them, and nurses have applied the patches without recognizing the prescribing error.

 Emergency Rooms Crowded With Those Needing Psychiatric Care

(KNM)---A troubling discovery about who is crowding emergency rooms across America is pouring salt in the wound that is the broken hospital system where patients wait hours for help amid the uninsured and an increasing volume of fatalities due to poor care or outright negligence is becoming commonplace.

The American College of Emergency Physicians surveyed hundreds of hospitals last month and found 79 percent routinely "boarded" psychiatric patients in their waiting rooms for at least some period of time due to limited healthcare services. "We try to find a place to put them," said Dr. David Mendelson, an emergency physician in Dallas who authored the ACEP report. One-third of emergency rooms reported psychiatric patient stays averaged at least eight hours. Six percent said they had average waits of more than 24 hours waiting for the next step in a patient's care.  "Unfortunately, sometimes the only thing we can do is restrain them, or medicate them," Mendelson said.

Many leading doctors and administrators at hospitals across the nation blame the situation on a glaring lack of mental health resources in the country. Most psychiatric facilities, including private ones, are at capacity with long-term patients leaving those who cannot be admitted to eventually wind up at the local hospital where general and emergency care patients are priority. Another leading cause for the overflow of psychiatric patients at ER's is, according to doctors and hospital managers, the insurance industry which has made it increasingly difficult for patients with mental disorders to receive prompt treatment if any at all.

Typically, patients are denied psychiatric treatments by insurance companies which results in an appeal by a physician which begins a long process of paperwork and arbitration. Many patients, it is feared, will be lost to the streets if released and could become a danger to themselves and others so doctors routinely "house" these patients where they can find space which usually means the emergency room.

"There's no place to put them in the community, so we literally hold onto them," said Dr. Michael Cohen, director of the emergency psychiatric unit at Stony Brook University Medical Center on Long Island.

Horror stories emanating from crowded hospitals are becoming the norm. Among the most glaring is what has been taking place at Kings County Hospital in New York. In addition to the cruel death of a Jamaican woman who was left to die on the floor of a waiting room this month, reports reveal patients fighting for beds when they leave their own to go to the restroom, patients being mugged for their belongings while sitting in hallways waiting for care and a lack of soap and clean linens.

Hospital officials in Austin, Texas, have complained a county decision to reduce the number of patients sent to a state psychiatric hospital has bombarded their emergency rooms with mentally ill people who have no alternate place to stay. Massachusetts parents have complained about days-long waits in the emergency room for children who need help from a pediatric psychiatric service.  Statehouses across the country are beginning to pass laws that fine hospitals for such incidents by the billion-dollar medical industry is fighting these tactics and calling for more aid for patient care instead.

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California: Land of the Medical Death

(KNM)---Research conducted and released by the California Department of Public Health stunned even those who have criticized the hospital industry for years as the scope of medical error deaths or serious mistakes have climbed to at least 100 per month.

The findings have caused an immediate uproar in the state's capital and have consumer-advovate and safety groups fuming at what continues to be the poor state of medical care in the nation's largest state.  One lawmaker has called for stopping reimbursements to hospitals involved in some of these errors. The errors reported read like something straight out of the manual for incompetents including the placement of a CT scan of one patient into the file of another leading to the removal of the wrong person?s appendix in the Dominican Hospital in Santa Cruz and the improper connection of a ventilator hose leading to inadequate oxygen supply to a 9-day old infant.

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West Virginia Hospital Sued for Patient Death & Botched Surgery

(KNM)---A West Virginia hospital in Morgantown has received two separate lawsuits--one for a post-surgery cardiac arrest that resulted in a patient death and the other for a gallblader operation that was wrongly done and resulted in complications including a bile leak. The lawsuits were filed in Monongalia County Circuit Court not long after a consultant hired to evaluate West Virgina University Health Sciences criticized the West Virginia University Hospital's ability to care for patients.

The estate of the late Douglas Ray Tawney Jr., is suing WVU Hospitals and WVU Board of Governors, claiming that the groups are guilty of medical malpractice and negligence. Tawney, 44, was admitted to WVU Hospital for surgery to repair a broken jaw. His jaw was wired and immobilized as part of the procedure, the lawsuit said. The lawsuit alleges that Tawney was not properly monitored and treated post-surgery, allowing his airway to deteriorate and resulting in respiratory and cardiac arrest that wasn't timely discovered. The suit says that when it was discovered that Tawney had no pulse, heart rate, blood pressure or respiratory rate, the hospital failed to "either utilize or properly maintain medical equipment to treat and respond to" Tawney's medical emergency and failed to timely call a code."

As a result of the hospital's "failure to properly monitor and provide treatment to preserve [Tawney's] airway and as a result of the failure to timely discover and provide treatment for [Tawney's] respiratory and cardiac arrest, Tawney suffered a severe permanent brain injury, multi-system organ failure and death," the lawsuit said. Tawney remained in a vegetative state until he was removed from life support.

The second suit was filed by Crystal Adams, a 24-year-old nurse's aide, against WVU and Dr. Syed Hashmi, a board certified surgeon and assistant professor of surgery in the Division of Trauma and Emergency Surgery after she entered the hospital for gallblader surgery. Hashmi recommended immediate laparoscopic surgery, a less invasive procedure done with small incisions and a video monitor, rather than an open cholecystectomy (gallbladder removal), done with a larger incision, the lawsuit said.

During the laparoscopic cholecystectomy, Hashmi misidentified the cystic duct as the cystic artery and didn't clip the duct, which resulted in a bile leak, the lawsuit said which also says  Hashmi left part of the gallbladder  inside Adams.  Adams' attorney she has to get a second surgery to remove the gallbladder and has had numerous outpatient and in-patient treatments and has yet to fully recover.

The Fight Against A Deadly Infection In Hospitals Curtailed By Lack of Hand Washing

(KNM)--Washing hands by staffers should be as automatic at a hospital as the way they collect your insurance information but a new report concludes hospital workers still fail to wash their hands at an alarming rate which in turn has allowed MRSA, a deadly mutated form of staph infection that has become resistant to most antibiotic forms of treatment to rapidly spread into the general public. 

Stopping the spread of methicillan-resistant Staphylococcus aureus MRSA has been a challenge that has all but consumed the nation's healthcare system.  Once seen chiefly in hospitals, MRSA is now striking healthy people outside of hospitals and nursing homes and has emerged as a community-based?as opposed to hospital-derived?disease. 

Over 2,000 infection experts met at a national conference to discuss MRSA and focus on how to reduce MRSA when colleagues are unwilling to wash their hands.  "They'll know somebody is watching and they still wont wash!" said Kathy Bryant, a registered nurse and infection control director at Spartanburg Regional Hospital in Spartanburg, South Carolina. The majority of participants reported that their hospitals and health care centers have done more to educate and enhance procedures; however, over half said that facilities are not taking sufficient measures to reduce MRSA risks. 

Shockingly, a variety of studies confirm under half of all US health workers wash as often required, a point of frustration among the over 4,000 conference attendees.  "It doesn't matter if it's God himself or the governor or whoever, you have to wash up," said Rebecca Peters, an infection control staffer at York Hospital in York, Pennsylvania. The infection preventionists confirmed they experience resistance when trying to implement infection control standards and point to a number of issues such as too little time, too many patients, inconvenience, and low paid staffers not understanding or implementing appropriate and consistent procedures. 

According to Center of Disease Control and Prevention (CDC) figures for 2005, nearly 19,000 people died in the US from MRSA; an additional 94,000 were seriously sickened.

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VA Hospitals Remain Riskier for Medical Errors

(KNM)--Various federal and private studies agree that medical errors are the 8th leading cause of death in the United States. It is estimated that 7,000 Americans die via nurse or physcian medication error alone each year. Disturbingly, the rate of error deaths at facilities run by the Veterans Administration has remained constantly higher than at other hospitals over the past several years.

One particularly startling revelation that many feel is a root cause of inferior care is the fact VA doctors don't need to purchase malpractice insurance because the government compensates patients harmed by a physician's negligence. One case in point:  in 2007, a surgeon with a history of malpractice complaints in Massachusetts was involved in "aggressive, complex surgeries" at a Veterans Affairs medical center in southern Illinois that went beyond what that site could handle, resulting in a spike in deaths at the hospital.

According to Lawyers & Settlements, the VA hired Dr. Jose Veizaga-Mendez, despite his being barred from practicing in Massachusetts. During his time at the VA hospital, nine people died during a six-month period. It was later discovered that those deaths were due to "aggressive, complex surgeries that were beyond the normal capacity of the Marion VA hospital," which meant the surgeries were beyond the surgeon's expertise, the equipment was insufficient, or there were not enough medical personnel.

The widow of one of Veizaga-Mendez's patients filed an administrative complaint with the VA. Her husband died after gallbladder surgery. Veizaga-Mendez surrendered his Massachusetts medical license in mid-2006, and told VA administrators that he didn't want to pay the licensing fees. As well, there was a malpractice suit against him in Massachusetts. Apparently, the doctor had a long history of medical malpractice cases and claims but the VA hired him anyway.

Ignoring the topic, the VA issued an internal study this month about care at its facilities that focused on the need to improve services for women. In addition, the VA report said that