Patient Safety in the News December 2014

Recent changes in drug labels: The following drugs had modifications to the contraindications, warnings or precautions section of their labels: Adcetris (brentuximab vedotin) for Injection; Arava (leflunomide) Tablets; AVELOX (moxifloxacin hydrochloride) Tablets and IV; Bosulif (bosutinib) Tablets; Cardizem (diltiazem hydrochloride) Tablets; Cubicin (daptomycin for injection) Intravenous; Cymbalta (duloxetine) Delayed-release Capsules; Foscavir (foscarnet sodium) Injection; Lopid (gemfibrozil) Tablets; Mycobutin (rifabutin) Capsules; Mytelase (ambenonium chloride) Tablets; Sensipar (cinacalcet hydrochloride) Tablets; Sovaldi (sofosbuvir) Tablet; Sylatron (peginterferon alfa-2b); Taxotere (docetaxel) Injection Concentrate; Unasyn (ampicillin sodium/sulbactam sodium) Injection; Votrient (pazopanib hydrocholoride) Tablets and Zelboraf (vemurafenib) Tablet. Click here for more information from the FDA.

Robert Pear, for the New York Times, reported on a study which revealed that half of the physicians listed as serving Medicaid patients were unavailable either because they were not actually taking Medicaid patients or because the information about their medical practice was outdated.

Robert Preidt, for Health Day, discussed a study in the Annals of Epidemiology that indicated that despite lower smoking rates, cigarettes are still responsible for 3 out of 10 cancer deaths in the United States.   

Marie Ellis, with Medical News Today, reported on an article in JAMA Pediatrics which found that children diagnosed with autism spectrum disorder were twice as likely to be born with mothers with preeclampsia during pregnancy.

Patient Safety in the News through November 9, 2014

NEJM published a study revealing that by merely adopting an I-PASS patient hand-off system (“I” illness severity,  “P” patient summary,  “A” action list,  “S” situation awareness and contingency plans and “S” synthesis) residents decreased miscommunications and medical errors by 23%.  

Pediatrics published a study analyzing outpatient medication errors amount young children. 27% of medication errors were related to parents inadvertently giving children medication twice.

Joseph Goedert reported that the Cleveland Clinic will be expanding its use of the IBM Watson Supercomputer to help oncologists deliver personalized treatment to cancer patients. The computer be used to identify patterns in genome sequences and also to review databases of medical journals.

Hannah Nichols discussed a study published in Arthritis Care & Research, which demonstrated that low birth weight and preterm birth are associated with an increased risk of hip osteoarthritis requiring surgery.

Academic Radiology published a study that demonstrated that when residents were interrupted while interpreting radiographic studies, they committed more errors.

Mary Elizabeth Dallas discussed an article published in the Journal of Athletic Training which demonstrated that (a) 50% of highs school athletes are not likely to report a concussion and (b) 25% of college players are likely to play with a concussion. Additionally, 25% of high school athletes surveyed reported receiving no education about concussions at all.

Latest Questions and Answers - July and August 2014

Here are the latest answers to the questions that were posted online. Please note that I do not edit the questions.

Question.

How do I go about finding an attorney that will represent my father’s medical issue? He resides in Florida, but transplant was in Tennessee. Since he had his kidney transplant he’s been having complications and hasn’t been treated the right way. We have been trying to resolve this matter the right way and it seems almost impossible. We need immediate assistance for our father.

Answer.

I have no idea whether you have a viable malpractice case because you didn’t provide enough information about the complications your father has been experiencing. Nevertheless, if you want to hire an attorney to investigate a case you’re going to have to hire someone in Tennessee. Attorneys take these cases on a contingency basis which means you only have to pay if you succeed. Additionally, initial consultations are usually free. You can use the “Find a Lawyer” service through this website to research medical malpractice attorneys. Then, visit each attorney’s website and look for a firm that has a record of successful verdicts. If you are unable to find a lawyer who meets these qualifications within your state, sometimes you may contact an out of state lawyer who can refer you to a qualified attorney in your state while providing support related to the issues of medicine.

Below are some articles you may find helpful. They are written for a New Jersey audience (where I practice) but the ideas discussed in these articles usually apply in most other jurisdictions as well.

Question.

I had upper abdomen pains. Could not move, was nauseaed, became very hot, started sweatting alot, pain went to into back. Went to ER, spoke to a nurse they gave me some malox with a pain killer in it. I also took a chest xray and a ekg and then was released. I was told that I had gas. I never saw a doctor. 2 months later went to a different ER for same thing and was told that I had to have surgery very soon. I had a golf ball size gall stone. Do I have some kind of case against the 1st ER and doctors.

Answer.

The usual presentation of a patient who was suffering from gallstones include symptoms of pain in the upper abdomen and upper back, nausea, vomiting, bloating, indigestion, heartburn, and gas. So, gallstones should have been in the differential diagnosis of the physicians. I think the real question in the case is whether it is financially viable because presumably you would’ve needed surgery if the diagnosis was earler. Consequently, assuming there was no permanent harm the damages in the case amount to two months of pain and suffering. I wouldn’t take on a case like that, but financial viability is a judgment call. The articles below explain this in more detail.

Below are some articles you may find helpful. They are written for a New Jersey audience (where I practice) but the ideas discussed in these articles usually apply in most other jurisdictions as well.

Patient Safety in the News July and August 2014

Jessica Firger, for CBS News,  on increased reports of West Nile Virus in western, central and southern states. Early signs and symptoms of the disease include fever, headaches, body aches, joint pains, vomiting, diarrhea and rash.

Robert Preidt, for CBS News,an article appearing in BMJ that concluded that light to moderate alcohol consumption can result in heart damage.

Nicholas Bakalar, for the NYT, on a study appearing in the journal Circulation that calls into question the necessity of fasting before undergoing blood lipid tests.

Nicholas Bakalar, for the NYT, an article appearing on Obstetrics and Gynecology that concluded that sutures are safer than staples when closing incisions following cesarean sections.

Robert Preidt, for CBS News,study at Harvard which suggested that vasectomies can increase the risk of fatal prostate cancer.

Liz Szabo, with USA Today, that the child “Mississippi baby” previously diagnosed as cured of HIV by the NEJM, was found to have a return of the disease.

Patient Safety in the News - June 2014

Tim Darragh reported that there are 43% fewer medical malpractice cases being filed in Pennsylvania today than there were ten years ago. The article attributes the decrease two new rules which require (a) medical malpractice cases to be filed in the county where the malpractice took place and (b) the filing of an affidavit of merit at the outset of a case.

Dennis Slattery, for the Daily News, wrote about the New York Judiciary’s adoption of a program formerly run by Judge Douglas McKeon in the Bronx which seeks to reach early settlements in meritorious medical malpractice cases filed against municipal hospitals.  The program has resulted in decreased litigation costs and safer care because hospitals have implemented safety programs to learn from the mistakes.

Steven Reinberg, for CBS News, wrote about the rise in the mosquito-borne chikungunya virus. The virus has still not been contracted in the United States, but it is predicted that it could arrive this summer. The virus causes high fevers, joint pain and swelling, headaches and a rash. In rare instances it is fatal.

Andrew Pollack, for the New York Times, reported on how health insurance plans are lowering drug costs by requiring pharmaceutical companies to choose between discounting their drugs or not being covered.

Patient Safety in the News - May 2014

Kate Thomas, reporting for the New York Times, discussed how Insys Therapeutics, maker of  Subsys, a narcotic pain killer, increased sales by aggressively marketing Subsys to physicians for off-label use. The medication was approved by the FDA for use in cancer patients, but just 1% of prescriptions are now written by oncologists.

Melissa Healy, of the LA Times, reported that the United Nations’ leading expert on food and nutrition declared that the international community must focus and mobilize against unhealthy diets that contribute to the global obesity problem.

Sharon Begley of Reuters discussed a study by biologists Tony Wyss-Coray of Stanford University and Saul Villeda of the University of California San Francisco which revealed that when old mice were transfused blood from young mice, the aging process in the brain was reversed.

Karen Kaplan wrote about a recent study appearing in JAMA that revealed that while 40 years of clinical trials have unequivocally demonstrated that antibiotics do not help patients suffering from acute bronchitis, 70% of patients treated for that condition are still prescribed these drugs. In fact, antibiotic prescriptions for acute bronchitis have increased since 1996, despite the fact that the Centers for Disease Control and Prevention have been trying to stop this practice for the last 15 years.

CBC reported that a study published in the 1970s suggesting that fish oil lowers the risk of heart disease is fatally flawed and its conclusions are based on faulty research.

Patient Safety in the News February 2014

In this story, NPR highlighted Senator Joe Manchin’s attempts to introduce legislation to force the FDA to ban a new painkiller, Zohydro, which was placed on the market this week. Zohydro is one of the most powerful prescription pain medications created and it is crushable, so that it can be abused by snorting it. The drug is so potent that swallowing one tablet could kill a child. 42 different public health organizations have called for the FDA to ban the drug, as well as attorneys general from 28 states. The FDA’s own advisory panel voted 11-2 against approving the drug, but top FDA officials over-ruled this decision, taking the position that the drug was needed. Emails later became public that showed that FDA officials participated in private meetings with pain drug companies that paid organizers thousands of dollars to attend, including Zohydro’s manufacturer.  Matthew Perrone wrote a similar story for ABC.  Huffington Post Live discussed this story in the context of the nation’s current hydrocodone abuse epidemic.

Yolanda Kennedy, for Medical Xpress, discussed a study appearing in the British Medical Journal Quality & Safety which demonstrated that by requiring hospital pharmacists to collaborate with health care providers during key points of a hospital admission, overall prescription errors were reduced 79% and  severely harmful medication errors were entirely eliminated. 

Errors due to the failure of junior physicians and nurses to speak up about concerns of patient safety were discussed in this article appearing on BMC Health Services Research.

Vineet Chopra, MD and Laurence F. McMahon Jr., MD, argued in JAMA that the rudimentary alarm systems in hospitals need to be updated with new technology that analyzes information and sends meaningful warnings to health practitioners.