Actor Dennis Quaid sues drug maker

Last month, we reported in a blog through our website, how actor Dennis Quaid is involved as a patient advocate, after his newborn twins nearly lost their lives back in 2007, from a medical error that could have very easily been prevented.  Put simply, the precious twins were given two doses of Heparin instead of Hep-lock (an anti-coagulant medication widely used for children).  Why is this significant?  Heparin is a drug one thousand times stronger than what the twins were supposed to have received.

Earlier this week, it was reported in the Contra Costa Times, that Mr. Quaid has filed a lawsuit on behalf of his children.  As far as the extent of his children’s injuries, the article states “The children suffered internal injuries and shock, but the extent of what happened to them will probably not be known for years, according to the suit.”  The lawsuit alleges that vials of the 10,000 unit Heparin should have been recalled previous to what happened to his children, because other infants had already died from similar medication errors.  The suit also claims that the company responsible for making the drug, Baxter Healthcare, “was obligated to warn healthcare providers of the previous medication mistakes.”

We wish the best for the Quaid family, and hope that the discovery in this case shines a light on not only finding out exactly what happened in this case, but also makes information available that may be able to save the lives of other children from future similar medical errors.  We will continue to monitor the course of this case.

Child Health: Labels Urged for Food That Can Choke

Earlier this year, we posted a blog on our website in regard to the American Academy of Pediatrics (AAP) policy statement in regard to the prevention of choking among children.  Earlier this week, the New York Times featured an in-depth story on an issue that is very much a part of this policy statement:  food choking hazards among small children.  The article discusses the advocacy efforts to place warning labels on foods, which pose a choking hazard to small children, as well as the proposition that small children should not be allowed to eat certain foods at all.  The article starts with an all too familiar setting that ended in tragedy:

On a July afternoon in 2006, Patrick Hale microwaved a bag of popcorn for his two young children and sat down with them to watch television. When he got up to change the channel, he heard a strange noise behind him, and turned to see his 23-month-old daughter, Allison, turning purple and unable to breathe.

As a Marine, he was certified in CPR, but he could not dislodge the popcorn with blows to her back and finger swipes down her throat. He called 911, but it was too late: by the time Allison arrived at the hospital, her heart had stopped beating. An autopsy found that she had inhaled pieces of popcorn into her vocal cords, her bronchial tubes and a lung.

Does this story make you think twice before giving your little ones popcorn?  On a personal note, I called my wife immediately after reading this story, and we discussed the fact that we should no longer allow our son, who is now two and a half, to have any popcorn. Ironically, she was on her way to take him to a movie that was going to be serving….you guessed it, popcorn.

Now, some of you may say “Well, little kids can choke on anything.”  Well, that is true.  However, there are some foods that pose an increased risk of choking.  Consider the dynamics of how a small child eats, as well as the size of their airway:

Children under 4 are at the highest risk, not only because their airways are small (the back of a toddler’s throat narrows to the diameter of a straw) but also because of the way their eating abilities develop. Front teeth usually come in at 6 or 7 months — so babies can bite off a piece of food — but the first molars, which grind food down, do not arrive until about 15 months, and second molars around 26 months.

“Between the ages of 3 and 4, they’re developing their ability to chew adequately and prepare for swallowing,” said Dr. Nisha Kapadia, a pediatric resident at Johns Hopkins Children’s Center.

When young children chew foods like peanuts, raw carrots and popcorn, some is ground down and some is not, and they tend to swallow unchewed bits of food that can block the airway or be inhaled into the bronchial tubes and lungs.

This concern and the tragic deaths associated with this concern have prompted several organizations to propose various options to attempt to prevent these injuries and deaths.  One such organization is the Center for Science in the Public Interest:

Some advocates say the government should put hazardous foods off limits to young children.

“The F.D.A. needs to set a uniform standard for cautionary information on food that should not be consumed by children under 5,” said Bruce Silverglade, legal director of the Center for Science in the Public Interest, an advocacy group that lobbied unsuccessfully in 2003 for a bill to require the Food and Drug Administration to develop food labeling regulations.

Where this debate will end up, we don’t know.  However, to think that in 2001 there were 17,500 children 14 years old and younger treated in emergency rooms for choking, with 60% of those events caused by food, there must be a way to create a safer environment for our children when they are eating.  Any suggestions?

Allergic to Dairy? Read Before Eating Those Sunflower Seeds!

Ryt-Way Industries, LLC, a food packaging company, is immediately recalling some of the sunflower seed products that they have packaged, as they contain undeclared dairy ingredients.  The recall, which includes products that have been distributed nationwide, is a voluntary recall, and is being done in conjunction with the FDA:

Ryt-way Industries LLC of Lakeville, MN is voluntarily recalling select BIGS ® Original Salted & Roasted Sunflower Seeds because they may contain dairy ingredients that were not declared on the packaging.  The product is packaged in 5.35oz plastic bags with BEST BY Dates of 30MAY2011 and 31MAY2011 with an individual bag UPC code 896887002196.  People who have an allergy or severe sensitivity to dairy run the risk of serious or life-threatening allergic reaction if they consume these products.

It was discovered that the sunflower seed packages at issue, as manufactured by BiGS, do not disclose the presence of dairy within them.  Ryt-Way goes on in their announcement to instruct consumers that are allergic to dairy how to handle this situation, should they be in possession of these recalled items:

Consumers who are allergic to dairy and who have purchased the recalled products are advised not to consume the product and are urged to return it to the place of purchase for a full refund.  Consumers with questions may contact 1-877-722-7556

So, if you are allergic to dairy and/or have a sensitivity to dairy products, and love those sunflower seeds, please check your home for these recalled products.  As the weather gets warmer and we try to snack on “healthier” items to get that “younger figure back for summer”, don’t let this recall pass you by!

Family Feud – Where’s Your Sense of Humor?

Everyone has, at one time or another, been offended by a relative’s hurtful comments. In the case of Sunda Croonquist’s family, however, the offended relatives were not content to let the offending comments pass without notice.  As reported by ABA Journal and other outlets, the family members actually sued her. Turns out that Ms. Croonquist is a comedienne, who takes advantage of her mixed ethnicity – she is half-black and half-Swedish and is married to a Jewish man – to poke fun at her family. Apparently, the family was not laughing, especially when Ms. Croonquist publicly joked that some of them were racist. Several of Ms. Croonquist’s in-laws, including her mother-in-law, filed suit in New Jersey alleging, among other counts, defamation and infliction of emotional distress.

Ms. Croonquist, however, got the last laugh. After Ms. Croonquist’s lawyers filed a motion to dismiss (to add to the familial complexity, Ms. Croonquist was represented by her husband’s law firm), the trial court ruled that Ms. Croonquist’s comments, while perhaps hurtful, were protected by the First Amendment because they were merely her personal opinions. In order to prove a case of defamation, one has to prove that the speaker made a false statement. An opinion, being a subjective belief of the speaker, cannot be considered true or false, so it cannot support a claim for defamation. So Ms. Croonquist is free to continue insulting her relatives, and comedians around the country can continue making mother-in-law jokes.

No word yet on when the next family reunion is going to be held.

Drug-Eluting Stents Found Effective at Preventing Major Amputations

It is generally accepted in the medical community that drug-eluting stents (DES) are helpful in restoring normal blood flow to the heart. In recent years, however, DES treatment has been applied with proven success in other contexts.

For example, consider a patient with peripheral vascular disease (PVD); an unfortunately common medical condition characterized by the occlusion of the arteries of the legs and arms. This disease is usually caused or exacerbated by other medical conditions such as diabetes, high cholesterol, high blood pressure, and kidney disease. People who smoke are at a much higher risk for developing PVD as well. It has been reported that as many as five million adults in the U.S. have PVD.

Patients with PVD tend to experience a gradual decrease in blood flow to their extremities. Over time, this can result in a complete interruption of blood and the development of necrotic tissue. In the past, once necrotic tissue was present, amputation was often the only available medical treatment.

Recent research suggests that DES treatment may be used effectively to prevent or reverse arterial occlusions in patients with PVD. According to an article published by Modern Medicine, researchers studied 106 patients who were treated with DES to restore blood flow in the lower extremities.

There were no procedural deaths, and 96 percent of the patients were discharged within 24 hours. The researchers found that the three-year cumulative incidence of amputation was 6 percent ± 2 percent, survival was 71 percent ± 5 percent, and amputation-free-survival was 68 percent ± 5 percent. Also, only 12 percent of patients who died had a previous major amputation. The target limb revascularization rate was 15 percent.

This study suggests that DES treatment can be effective at preventing major amputations. If you are facing the possibility of amputation as a result of PVD or another ischemic process, ask your doctor about angioplasty and DES treatment.

Contributing author: Jon Stefanuca

Facts You May Not Know, but Should!- Hidden Dangers of Trampolines

Well, it looks like it will be 80 plus degrees and sunny outside for the first weekend of May here in the Nation’s Capital.  This means lots of outdoor activities; pool parties, lawn games, playing in the park…some will even have trampolines on their property, with the neighborhood kids coming over to use them.  CBS News reports on some of the hidden dangers of trampolines, as posted in an article today:        

Last year alone, an estimated 98,000 people were treated in emergency rooms for trampoline related injuries. 82 percent of them were children under the age of 15.

Trampoline safety expert Marc Rabinoff, of Metropolitan State College of Denver, Colo., calls trampolines “quad machines” because they can turn you into a quadriplegic in four seconds.”

Warnings on trampolines say no flips, no jumpers younger than 6 and only one jumper at a time, but those warnings are often ignored. Koeppen pointed out videos from YouTube that show children jumping and falling from trampolines.

Rabinoff says people don’t realize trampolines are a danger in their backyard. Rabinoff demonstrated to Koeppen how jumping with more than one person can throw you off.

The article goes on to state that ‘safety nets’ placed around the trampoline can reduce accidents by up to 50%.  However, they are not required by law.  In addition, and take note – insurance companies may not necessarily cover trampoline accidents on their policies.  Coming from Florida last year, where I practiced plaintiff personal injury law, I can tell you that I was contacted on more than one occasion by families who had a loved one injured as a result of a trampoline accident.  Each time I would check the homeowner’s policy of the responsible homeowner, (if they even had homeowner’s insurance; some didn’t) there was the EXCLUSION for such accidents!  No coverage!

The article also suggests that trampoline owners should erect fences around their property, to prevent others from wandering on the property and injuring themselves on or around the trampoline.  I, for one, will not be allowing my first-born son on any trampoline anytime soon.  In this line of work, you really do get to see the worst of what can happen, when a chain of events causes something to go terribly wrong.  Why ask for trouble?

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.

Bicyclist Dies in Collision With DC Guard Truck

In recent weeks, we have discussed bicycle and pedestrian safety within blogs on our firm website.  Unfortunately, the tragedies continue to mount, and the most recent DC bicycle fatality is related to the traffic issues surrounding the DC Nuclear Security Summit, that is now taking place here in the District.  As NBC News has just reported:

A woman was killed Monday night when her bicycle collided with a five-ton truck doing security work for a motorcade for the Nuclear Security Summit in Northwest Washington.  

The accident happened around 6 p.m. at the intersection of 12th Street and New York Avenue, NW.

The vehicle that collided with the woman was a five-ton truck with the D.C. National Guard.

“It was moving forward to block as a procession was coming through,” said Major Gen. Errol Schwartz of the D.C. Guard.

At this time, it is still unclear who is at fault.  Regardless, we again urge all motorists , pedestrians, and cyclists to obey all applicable traffic laws.  Currently, the road situation in DC is, for lack of a better word, a mess.  A significant section of NW is currently completely inaccessible, and it is taking a very, very long time to get around anywhere in downtown DC.

The NBC article also details the current road closures, which continue all day today.  Click here for a complete list, and to view real-time traffic maps.

Now, I can tell you first-hand from living in the District, that traffic has been just miserable to deal with over the past several days!!  Having a tremendously increased security presence at this time is needed, I know.  However, I can ALSO tell you first-hand that this past Saturday, my wife and I were almost plowed into by an unmarked police escort in Georgetown, as we attempted to leave the area.  This was only one four car motorcade.  Imagine what forty plus motorcades for the various heads of state are doing right now as we speak…BE CAREFUL OUT THERE!

Initiative to Reduce Unnecessary Radiation Exposure from Medical Imaging

The FDA has recently launched a comprehensive new study regarding ways to reduce radiation exposure as a result of medical imaging.  The on-line article sets the background for the study, then provides comprehensive scientific and medical information for support:

Like all medical procedures, computed tomography (CT), fluoroscopy, and nuclear medicine imaging exams present both benefits and risks.  These types of imaging procedures have led to improvements in the diagnosis and treatment of numerous medical conditions.  At the same time, these types of exams expose patients to ionizing radiation, which may elevate a person’s lifetime risk of developing cancer.  As part of a balanced public health approach, the U.S. Food and Drug Administration (FDA) seeks to support the benefits of these medical imaging exams while minimizing the risks.

Through the Initiative to Reduce Unnecessary Radiation Exposure from Medical Imaging, FDA is advocating the universal adoption of two principles of radiation protection: appropriate justification for ordering each procedure, and careful optimization of the radiation dose used during each procedure.  Each patient should get the right imaging exam, at the right time, with the right radiation dose.

The related White Paper discusses types of medical imaging procedures,  factors causing the unnecessary exposure, and proposes possible solutions.  The factors include: Issues relating to Device Use, as well as Issues Relating to Clinical Decision Making.  Solutions include: Promoting Safe Use of Medical Imaging Devices, supporting informed clinical decision making, as well as increasing patient awareness.

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.