How Dennis Quaid Became a Patient Advocate

On Monday, Dennis Quaid appeared on “The Early Show.” He talked about how he and his wife almost lost their newborn twins in 2007 as a result medical negligence.

According to Quaid, Thomas and Zoe Quaid were supposed to be given the anticoagulant drug, Hep-lock soon after their birth.  Hep-lock is a widely used anticoagulant designed for children. It is not nearly as potent as its adult counterpart, Heparin. By mistake, the newborns were given two doses of Heparin, which is 1,000 times stronger.  Quaid noted that the Heparin administration reduced the consistency of the newborns’ blood to that of water.  There was no justification for administering Heparin instead Hep-lock.

While the newborns managed to survive this ordeal, this experience has transformed Quaid into an active patient advocate. The actor helped create the Quaid Foundation, an organization dedicated to reducing medical errors. According to the article by CBS News:

Quaid has testified to Congress on behalf of patients’ rights, and Monday, he was to speak at the National Press Club to address the problem of dangerous medical mistakes.

The article further notes that the Centers for Disease Control and Prevention estimated that approximately 99,000 deaths every year are due to preventable medical errors. This is shocking to say the least.

Contributing author: Jon Stefanuca

FHA Announces New “Toward Zero Deaths” Initiative

The Federal Highway Administration has launched a new initiative called ‘Toward Zero Deaths,’ a national strategy on highway safety, aimed at ELIMINATING, not reducing, all highway deaths.  The strategy is explained in a new article just posted by USA TODAY:    

The approach is called Toward Zero Deaths, based on a philosophy that even one road death is morally and ethically unacceptable. The goal: to alter behaviors that cause fatalities, such as speeding, drunken or distracted driving, and lack of seat belts. Speeding is a factor in more than 31% of road deaths, drunken driving in 32%, and distracted driving in about 16%. And 55% of those killed in passenger vehicles are not wearing seat belts, according to the National Highway Traffic Safety Administration.

More details regarding the purpose of the initiative are found within the announcement on the Federal Highway Administration’s website:

Toward Zero Deaths: A National Strategy on Highway Safety will be a data-driven effort focusing on identifying and creating opportunities for changing American culture as it relates to highway safety. The effort will also focus on developing strong leadership and champions in the organizations that can directly impact highway safety through engineering, enforcement, education, emergency medical service (EMS), policy, public health, communications, and other efforts. The national strategy will be utilized as a guide and framework by safety stakeholder organizations to enhance current national, state and local safety planning and implementation efforts. The intent is to develop a mechanism for bringing together a wider range of highway safety stakeholders to work toward institutional and cultural changes.

One of the most significant needs is to change Americans’ attitudes toward highway safety. There are already programs and technologies that can result in substantial reductions in fatalities; however, those benefits will not be realized as long as the public and elected officials are not willing to pass laws or take the actions needed to implement them.

Sound like a grassroots effort?  In part, it is.  A lot also has to do with technology, and several states have already implemented state versions of the national campaign.  As an example, Utah has already implemented the initiative, and has seen clear, convincing results in just four years.  Robert Hull, the director of traffic and safety at the Utah Department of Transportation, explains:

Since launching a zero traffic deaths program in 2006, the state’s traffic deaths have fallen almost 15%, from 287 to 245 last year, Hull says. The state already had cut road deaths by 24% from 2000 to 2005, partly by implementing engineering changes such as rumble strips and median separations, he says. He acknowledges that the economic downturn likely accounted for some of the recent decline as people drove less.

The next steps, in regard to the national effort led by the Federal Department of Transportation, are “to identify and understand challenges and opportunities in reducing highway fatalities.”  In addition, “the impact must include projections of lives saved as well as the health care costs of highway injuries and deaths, best practices, effective means of creating a cultural change, and other issues,” as stated by the Department.

To date, there are members of over 30 organizations interested in participating in the Stakeholder Group.  With over 35,000 deaths ocurring on the Nation’s highways every year, assistance from more highway safety stakeholder organizations may certainly be put to good use within the initiative.

Is this possible?  Can it be done?   Think about how difficult that would be, all of the challenges involved.  Having said It is a noble but impossible cause .  We will continue to monitor this initiative and will report on its progress.

Fat-Melting Injections (a.k.a. Lipodissolve) May Not Be As Safe As You Think

According to an article published by WebMD, the FDA reprimanded six U.S. spas (Monarch Medspa in King of Prussia, Pa., Spa 35 in Boise, Idaho, Medical Cosmetic Enhancements in Chevy Chase, Md., Innovative Directions in Health in Edina, Minn., PURE Med Spa in Boca Raton, Fla., All About You Med Spa in Madison, Ind.) and one Brazilian company for making misleading statements about the safety and side-effects of fat-melting therapy (a.k.a. mesotherapy, lipodissolve, lipozap, lipotherapy, or injection lipolysis).

FDA’s Deputy Director of the Division of New Drugs and Labeling Compliance noted:

They make it sound so good and so safe. … [They claim] it dissolves fat — melts it away with no side effects — and they have done thousands of procedures, and it really sells well. … We are really concerned because we have had reports of complications, and we have no good data that say this is safe and this is effective.

Lipodissolve is a process whereby a series of subcutaneous injections are administered (usually injections of phosphatidylcholine and deoxycholate) to a specific part of the body in an attempt to melt the subcutaneous fat. According to the article, some of the reported side-effects of this therapy have been scaring of the skin and the developments of painful subcutaneous knots.

If you are considering Lipodissolve, be aware that this treatment is yet to be approved by the FDA, and there is no medical data or scientific research demonstrating that Lipodissolve is safe for consumers.

Contributing author: Jon Stefanuca

Aging Motorcyclists Hit the Road, But at Greater Risk of Injury, Death

Yes; Spring is upon us.  With the warmer, sunny weather comes more outdoor activity, including motorcycle riding.  The University of Rochester has just released a new study in regard to a noticeable increase in motorcycle injuries in the older population .  This study was the subject of a recent article, as published on the University’s website.  The study also details why older riders are injured more severely in motorcycle mishaps:

The increase in injury severity for older riders may be related to the reduced capacity to withstand injury as the body ages. Age-related changes, such as decreases in bone strength and brain size, may make older riders more susceptible to injury. Other factors associated with aging, such as impaired vision, delayed reaction time, and altered balance contribute to motorcycle crashes in this population, explaining in part the researchers’ finding that older riders crashed more often as a result of loss of control than younger riders.    

The figures regarding the increase in severity of injuries were compared to the younger population.  A short summary of those findings were listed in the article:

Between 1996 and 2005, researchers found the average age of motorcyclists involved in crashes increased from approximately 34 to 39 years, and the proportion of injured riders above the age of 40 increased from around 28 percent to close to 50 percent. Of all injured riders included in the study, 50- to 59-year-olds represented the fastest growing group, while 20- to 29-year-olds were the most rapidly declining.

The article also details the unfortunate use of alcohol by motorcycle riders, and the fact that intoxicated riders are less likely to wear a helmet.  The combination of alcohol and the lack of a helmet may prove to be a deadly combination:

The younger and older riders did have two things in common: helmet use and alcohol use. Overall helmet use was around 73 percent for both groups, and alcohol use was seen in approximately one third of injured motorcyclists, with no significant difference between the older and younger riders.

Alcohol use and helmet use have been linked in prior reports, with intoxicated drivers less likely to be wearing a helmet and therefore at greater risk for injury and death. It is not surprising that the researchers at the University of Rochester found that riders who tested positive for alcohol use were two-and-a-half times more likely to not be wearing a helmet at the time of injury. Despite abundant evidence that helmets reduce mortality, brain injury, length of hospital stay and economic burden, only 20 states have universal helmet laws.

The complete study can be found in the March 2010 issue of The American Surgeon.

Poisonings From Opioids, Sedatives, And Tranquilizers On The Rise

According to an article published by WebMD, a recent research study revealed a dramatic increase in poisonings from prescription drugs such as opioids, sedatives, and tranquilizers. The study, which was published in the April issue of the American Journal of Preventive Medicine, indicates a 65% increase in such poisonings between 1999 and 2006.

Jeffrey H. Coben, MD, the study author noted:

[Certain prescription drugs] are just as powerful and dangerous as other notorious street drugs, and we need to ensure people are aware of these dangers and that treatment services are available for those with substance abuse problems.

After examining data from about eight million hospitalizations a year, the researchers made the following findings:

• Unintentional poisoning is now the second leading cause of unintentional injury death in the U.S.
• In 2005, unintentional poisoning surpassed motor vehicle crashes as the leading cause of unintentional injury death for people 35 to 54.
• Unintentional poisoning deaths have been on the rise for more than 15 years.
• Intentional poisonings from prescription rose 130% during the seven-year period, compared to 53% in intentional poisonings from other substances.
• The largest increase in the number of hospitalizations was caused by benzodiazepines. Hospitalizations from that class of drug increased 39% during the period studied.
• Hospitalizations for poisoning by barbiturates decreased 41% and hospitalizations for poisoning by antidepressants decreased 13%.
• Hospitalizations for poisoning by other drugs, medicinal, and biological substances increased 33%.
• Unintentional poisonings by other substances increased 21%.
• Unintentional drug-poisoning deaths increased 68% between 1999 and 2004, and the majority of the increase has been attributed to deaths associated with prescription opioids.

If you are currently taking opioids, sedatives, or tranquilizers, ask your doctor if these medications are truly necessary. Many of these drugs are highly addictive. If you have developed an addiction, now is the time to step up and seek help. Ask your primary care physician for assistance and information about available resources.

Contributing author: Jon Stefanuca

Evenflo Recalls Top-of-Stair Plus Wood Gates Due to Fall Hazard

The Consumer Product Safety Commission (CPSC) has just announced that they are working in conjunction with Evenflo in regard to a voluntary recall of approximately 183,000 wood gates, used primarily to assist in preventing small children from having access to stairs, where they could fall and sustain serious injuries.  Here is some of the important information in regard to the recall:

Name of product: Evenflo Top-of-Stair™ Plus Wood Gates

Units: About 150,000 in the United States and 33,000 in Canada

Manufacturer: Evenflo Co. Inc. of Miamisburg, Ohio

Hazard: The slats on the gate can break or detach, posing a fall hazard to children.

Incidents/Injuries: Evenflo has received 142 reports of slats breaking and/or detaching from the gate. Three children gained access to stairs. One of those children fell through the gate and down five steps; another fell down one step. Injuries included four children who sustained bumps and bruises to the head and seven children who sustained minor injuries including scratches, scrapes and bruises.

Description: The recall involves Evenflo models 10502 and 10512 Top-of-Stair Plus Wood Gates made from October 2007 through July 2009. The model number can be found on the bottom rail. No other Evenflo model numbers or gates are affected by this recall.

Sold at: Toys “R” Us, Burlington Baby Depot, Kmart and other juvenile product and mass merchandise retailers nationwide in the U.S. and Canada, and on the Web at Amazon.com and other online retailers from October 2007 through March 2010 for about $40.

If you have this product at your home, here is the remedy and consumer contact information:

Remedy: Consumers should stop using the recalled gate and contact Evenflo to obtain a free newer model 10503 or 10513 Top-of-Stair™ Plus Wood replacement gate.

Consumer Contact: For additional information, call Evenflo toll-free at (800) 233-5921 between 8 a.m. and 5 p.m. ET Monday through Friday or visit the firm’s Web site at safety.evenflo.com

Earphones Connected to More Injuries and Deaths

A report last week, as published on http://www.myfoxdc.com, states that there is an increase in the number of both pedestrians and bicyclists being killed or seriously injured, as a result of wearing earphones.  The article refers a warning issued by the American Automobile Association (AAA), whose officials state that this troubling trend is occurring across the United States:

Local officials are seeing a rise in the number of pedestrians and bicyclists who are being killed or seriously injured while wearing earphones.              

Transportation officials say several people have been killed in the Washington, DC area. Recently, a 51-year-old jogger was killed by a tractor-trailer truck while crossing Constitution Avenue. DC police say the woman was wearing headphones.

AAA officials say across the United States the number of pedestrian injuries and deaths are increasing because people wearing earphones are not aware of their surroundings.

This is a good time to remind everyone of the rules of the road, as cherry blossom season is upon us, and our local traffic significantly increases.  Please remember, regardless of whether you are a pedestrian, bicyclist, or operator of an automobile, be safe and follow all applicable safety and traffic laws.

Georgia Supreme Court Overturns Malpractice Cap

In a unanimous decision, the Georgia Supreme Court has just declared non-economic damages caps unconstitutional in medical malpractice cases.  CBSAtlanta.com reports the following:  

Monday, the Georgia Supreme Court ruled that a controversial law capping the amount of money an injured patient could recover from a negligent medical provider is unconstitutional. The 7-0 decision was written by Justice Hunstein. Senate Bill 3, enacted in 2005, stated that a victim of medical malpractice could be limited in the amount of damages they can receive from a jury verdict, even if the harm caused was catastrophic in nature.

Nestlehutt v. Atlanta Oculoplastic Surgery, P.C, from Fulton County State Court, highlighted how caps on damages fundamentally restrict the constitutional rights of those who have been harmed by a healthcare provider. The malpractice case was brought by plaintiff Betty Nestlehutt, who is represented by attorneys Adam Malone and Frank Ilardi.

This case is one of horrific physical injuries and pain and suffering.  The tragic story of the victim, Betty Nestelhutt, is recounted in the article:

Betty Nestlehutt and her husband of more than 50 years worked together in their real estate business. Betty handled most of the client interaction for the firm, and she eventually noticed that many potential customers were going to younger agents. Concerned with the bags under her eyes and lines around her mouth, Betty Nestlehutt eventually decided to schedule a consultation with Dr. Harvey P. Cole of Atlanta Oculoplastic Surgery, P.C. Even though Betty was 71 at the time, Dr. Cole recommended a full facelift as well as a battery of other surgical procedures.

The combination of procedures was risky for someone of Betty’s age. The surgery severely impacted the blood flow to her face. After several weeks, the skin on Betty Nestlehutt’s face began to die and fall off.

“Betty Nestlehutt was the face of her real estate business,” Malone said. “Her face was so horrifically disfigured that she was no longer able to even leave her house. The pain she experienced over a long period of time is difficult to comprehend. Photographs of her disfigurement are too gruesome for public distribution. The damage is permanent.”

The case outcome has also just been announced on the website for GeorgiaWatch, a consumer advocacy organization:

The case was heard in Fulton State Court before a jury of 12 citizens. After hearing the testimony and seeing the evidence, they returned a verdict in favor of the Nestlehutts. The jury granted recovery for past and future medical expenses and concluded that the severe impact to Betty Nestlehutt’s quality of life warranted $900,000 in “non-economic” damages. However, this was more than the $350,000 cap on noneconomic damages in the 2005 law, which overrides the judgment of a jury that has been presented with the facts.

Judge Diane Bessen ruled that the statute capping a jury’s verdict was unconstitutional. The decision was appealed by the defendants to the Georgia Supreme Court. After hearing arguments in the fall of 2009, the Supreme Court agreed with Judge Bessen and ruled the statute unconstitutional.

We applaud Mr. Malone and Mr. Ilardi’s efforts in this case as well as the Court’s ruling.

UPDATE: In response to this ruling, Dr. J. James Rohack, AMA President, posted his reaction on the AMA’s website.

“The action puts Georgia’s patients at risk for the severe access problems suffered prior to 2005 when the state’s unrestrained legal system pushed premiums to record highs and forced physicians to limit services, retire early, or move to other states where liability premiums were more stable.”

“The AMA continues to vigorously support strong, proven medical liability reforms at the state and federal levels to keep physicians caring for patients, while still allowing patients their day in court.”

Who is he kidding?  By putting unreasonable ‘caps’ on damages and creating standards such as “gross negligence” for cases against emergency room healthcare providers, this goes to “allowing patients their day in court”?  I’m sure the AMA is driven by altruistic motives to make such a ridiculous statement.

CDC Features – Data Show 1 in 303 Children Have Cerebral Palsy

Cerebral palsy – how common is it? A recent “Features” posting by the CDC (Centers for Disease Control and Prevention) provides some answers and gives parents some ‘early signs’ of which to be aware.

While everyone knows that cerebral palsy (CP) can be a devastating condition, it is less well-known how common CP actually is. The Center for Disease Control recently released new data on the frequency of CP. In its study, it found that CP affects 3.3 per 1,000 eight-year-old children, or 1 in 303 children. This data was collected from select communities in Georgia, Alabama and Wisconsin, not the nation overall. Rates may differ slightly in other localities. However, the CDC pointed out that its most current findings on CP frequency were similar to previous studies which showed that CP affected 3.6 per 1,000, or 1 in 278 children.  

In reporting the data, the CDC also advised parents what to look out for in terms of signs of CP, based on the age of the child. Parents should consult a physician if they notice any of the following signs:

A child over 2 months with cerebral palsy might have difficulty controlling head when picked up, or have stiff legs that cross or “scissor” when picked up;

A child over 6 months with cerebral palsy might continue to have a hard time controlling head when picked up, or reach with only one hand while keeping the other in a fist;

A child over 10 months with cerebral palsy might crawl by pushing off with one hand and leg while dragging the opposite hand and leg, or not sit by himself or herself;

A child over 12 months with cerebral palsy might not crawl, or not be able to stand with support;

A child over 24 months with cerebral palsy might not be able to walk, or not be able to push a toy with wheels.`

Parents, be aware of these early signs!  If you are not sure what to do or to whom you can turn, the CDC offers the following information:

To find out who to speak to in your area, contact the National Dissemination Center for Children with Disabilities by calling 1-800-695-0285 or visiting the Center’s Web site

Of course, you always have your child’s pediatrician as a starting point.

Serious flaws in D.C.’s paramedic system

So says an editorial in last week’s The Washington Post.  The editorial details multiple deaths, allegedly caused by the inadequacies of  DC emergency response units.  One of the cases is the tragic story of Stephanie Stevens:

Responding to a call of a child with trouble breathing, emergency personnel went to Stephanie’s home on Feb. 10. But instead of taking her to a hospital, they advised her mother to run a hot shower to clear the child’s congested lungs. Less than 24 hours later, after another 911 call, she was dead, reportedly from complications of pneumonia.

This horrible set of circumstances follows other deaths in recent years – one with striking similarities:

Yet another problematic case was that of Edward L. Givens, who died in December 2008 after complaining of chest pains and being advised by emergency medical personnel to take Pepto-Bismol for what was likely acid reflux.

According to The Washington Post, a task force has been formed and has made some limited progress.  However, some of the main goals involve equal pay for medical personnel and to unify operations.  To date, this has not been accomplished.  An in-depth exclusive was featured by The Washington Post last year, regarding DC EMS problems.  A very concerning assessment of the quality of the training and performance of D.C.’s emergency response units was the subject of a Washington Times report of April 2009, which contains a ‘must see’ interview of Paul Werfel, Stony Brook University’s EMT/paramedic program director conducted by NBC 4, Washington, D.C.