DC Metro Area Medical Malpractice Law Blog

According to the American Cancer Society's National Cancer Information Center, more hospitals are requesting payments upfront before allowing patients to access the care they need.  Upfront fees are frequently imposed upon the underinsured and recently uninsured.  However, even the  privately-insured patient is sometimes asked for upfront payment, typically up to 23% of the bill.  In addition, copayments and deductibles continue to increase, along with caps on the total number and cost of certain therapies.

AARP offers several suggestions for consumers to protect themselves from some of the unexpected upfront costs of medical treatment.

Electronic medical record systems have been touted as the wave of the future in healthcare and research has demonstrated their value in preventing medical errors.  According to new data published in the New England Journal of Medicine, however, only 4% of physicians have extensive, fully-functioning electronic systems, and only 13% have even a basic system.

The U.S. Food and Drug Administration (FDA) utilized its new authority this month under the Food and Drug Administration Amendments Act of 2007 (FDAAA) to require manufacturers of older or "conventional" antipsychotic drugs to make safety-related changes to prescription information and labeling.  The required changes are to warn of an increased risk of death linked to the off-label use of these drugs to treat behavioral problems in older people suffering with dementia. 

Public Citizen, a consumer advocacy group, has recently sued the FDA over the organization's failure to respond to a petition addressing the risks of prescribing Darvon, Darvocet, and other medications containing propoxyphene.  Public Citizen filed a lawsuit in the U.S. District Court in Washington, DC alleging the FDA's failure to respond to their petition to ban the drug within the six months mandated by law.

According to the U.S. Food and Drug Administration, 23 U.S. companies and two international manufacturers have been warned to cease their production and marketing of fraudulent cancer remedies.  The agency is also warning consumers not to purchase the products, which include ingredients such as bloodroot, coral calcium, cesium, shark cartilage and Cat's Claw, among others. 

The FDA has recently issued a public heath notification alerting healthcare practitioners of the dangers associated with unretrieved device fragments (UDFs) unintentionally left behind after surgery.  The UDF is a fragment of a medical device, for example, a screw, wire, or broken needle. 

Whole milk is as effective as diluted barium when used as an oral contrast agent for patients undergoing a gastrointestinal CT scan.  It's cheaper and safer for patients, according to a new study published in a recent edition of the American Journal of Roentgenology.

The reliability of mammography results varies significantly between medical facilities, according to new research published in a recent edition of the Journal of the National Cancer Institute (JNCI).  Even more importantly, certain organizational characteristics tend to predict which facilities will return a more accurate reading.

The National Center for Complementary and Alternative Medicine (NCCAM) -- a division of the National Institutes of Health (NIH), recently launched an educational campaign to encourage patients (particularly those 50 years of age or older) to speak openly with their primary care providers about complementary and alternative medicines.  The campaign, known as Time to Talk, focuses on medical practices and products that aren't presently considered to be conventional medicine -- items such as herbal supplements, meditation and acupuncture.

The FDA has recently settled a lawsuit with Moms Against Mercury, and has set a deadline of July 28, 2009 for the reclassification of amalgam fillings.  The reclassification would not change the product itself, but it would make the public more aware of the benefits and risks of amalgam dental work and would most likely include a warning label informing the public of the mercury content.

The Houston Chronicle reports that more than 700,000 Americans suffer strokes each year and more than one-third will develop depression in the next two years.  Previous research indicates that stroke patients with depression recover more slowly and are more likely to die.  However, new research suggests that doctors may want to give stroke victims antidepressants right away instead of waiting until they develop depression. 

Bacterial infections such as E. coli and Staphylococcus aureus -- sometimes acquired in medical facilities -- may be responsible for many cases of sudden infant death syndrome (SIDS).  The finding is the result of new research published in a recent edition of the British medical journal The Lancet.

The New York Times reported on the Food and Drug Administration's announcement last week of a new system to track already-released drugs' effectiveness. Called the Sentinel Initiative, many bodies such as the Institute of Medicine have recommended such a system for years. Additionally, the Sentinel Initiative is supported by recently-released research showing fast-tracked approval of new drugs leads to problems down the road. However, there are also many criticisms regarding the system's method of collecting data and its accuracy.

Patients who suffer a heart attack often subsequently develop acute kidney injury, a complication significantly increases a patient's risk of death.  The finding is the result of new research published in a recent edition of the Archives of Internal Medicine.

Women who quit smoking lower their risk of dying from coronary heart disease by 47% within five years of smoking their last cigarette.  The risks associated with dying from other smoking-related diseases also decreases, but after different lengths of time, depending on the disease.  The findings are the result of new research recently published in the Journal of the American Medical Association (JAMA).

A new study has confirmed that hospital patients given Trasylol (aprotinin), a drug used to reduce bleeding during heart surgery, are 53% more likely to die than patients who are given other anti-bleeding drugs.  The drug's manufacturer, Bayer AG, has informed the U.S. Food and Drug Administration (FDA) that it has begun removing all remaining stock of Trasylol from all pharmacies and health care facilities in the U.S.

The latest Trasylol study was released Wednesday is slated to appear in print in the May 29 issue of the New England Journal of Medicine.

A recent survey conducted in 13 states and the District of Columbia has indicated that most people lack awareness of the 5 most common stroke symptoms.  According to researchers at the U.S. Centers for Disease Control and Prevention, that lack of awareness could lead to critical delays in life-saving treatment.  Prompt treatment following the onset of a stroke is critical in saving brain tissue and improving functional outcomes for survivors.

Regular mammography reduces the risk of being diagnosed with late-stage breast cancer in women 80 years of age or older, but only about 20% of U.S. women over 80 have regular mammograms.  The finding is the result of new research published in a recent edition of the Journal of Clinical Oncology.  Authors of the study note that women over 80 years of age account for 17% of all breast cancer cases in the U.S.

A newly updated annual ranking of state medical boards by the consumer advocacy group Public Citizen has revealed widespread discrepancies in both the numbers of disciplinary actions taken against physicians' licenses, and the rates of those disciplinary actions from state to state.  Though the specific numbers have changed again this year, a pronounced trend of significant discrepancies between individual states has held constant for years.  Unless geography influences a physician's competence, these state-by-state discrepancies point to a dangerously inadequate national system of physician oversight -- one that could conceivably allow dangerous, incompetent physicians to continue to practice medicine by moving from state to state.

New hemoglobin-based artificial blood -- still unapproved for use in the U.S., but heavily studied -- appears to raise a patient's risk of heart attack and death according to an exhaustive review of clinical research data.  This latest research was published in a recent edition of the Journal of the American Medical Association (JAMA).  The findings have spurred critics to allege that the U.S. Food and Drug Administration (FDA) put clinical trial participants in imminent danger by failing to detect or act on research data illustrating significant increases in the rates of heart attack and death reported in trials of these blood substitutes.

Laser eye surgeries such as LASIK (Laser-Assisted In Situ Keratomileusis) are quickly becoming some of the most common and technologically sophisticated procedures available for correcting relatively minor vision problems.  Generally performed on an out-patient basis with the aid of only anesthetic eye drops, LASIK procedures are usually quick and easy, and the results are often remarkable.  Unfortunately, however, the results can be underwhelming, too -- and occasionally even catastrophic. 

To help clear up some misconceptions and misinformation regarding LASIK procedures, and to help consumers better understand the risks of laser eye surgeries, the U.S. Food and Drug Administration (FDA) has established a web page devoted specifically to patient education.  According to the agency, there are a few categories of people who should think twice before they attempt to resolve their vision problems with LASIK surgery.

Melanoma is one of the deadliest skin cancers, but new research demonstrates that melanomas located on the scalp or neck are even twice as deadly as those found on other parts of the body.  The finding is the result of a study published in a recent edition of the medical journal Archives of Dermatology. 

The American Heart Association has issued new pediatric recommendations that call for heart fitness screenings prior to stimulant treatment for all children diagnosed with attention-deficit hyperactivity disorder (ADHD).  The new patient safety guidelines were published in a recent issue of the journal Circulation -- official journal of the American Heart Association -- and they address growing fears that stimulant medications can cause serious heart complications in children with underlying, undiagnosed heart disease.

New figures released by the federal government have revealed a steep and potentially deadly spike of a serious, hospital-based infection that gives patients blood poisoning and sometimes incurable diarrhea.  This latest public health research data, released by the U.S.Agency for Healthcare Research and Quality (AHRQ) shows an increase of 200% in the prevalence of Clostridium difficile (C. Diff.) infections among U.S. hospital patients between the years of 2000 and 2005.

Heart attack patients who arrive at a hospital during regular weekday hours tend to receive faster, higher-quality care than those who show up in the evenings, over the weekend or on holidays, according to new research published in a recent edition of the medical journal Circulation.

The U.S. Food and Drug Administration (FDA) has announced that some flavors of the dietary supplements "Total Body Formula" and "Total Body Mega Formula" have been found to contain dangerously high levels of selenium -- a naturally-occurring mineral that is toxic in high doses.  The sole distributer of the product, Total Body Essential Nutrition, Inc., has issued a voluntary recall. 

New U.S. Food and Drug Administration (FDA) guidelines for oversight of "off-label" drug use -- still in draft form and unfinalized -- could allow pharmaceutical companies to market more drugs for unapproved uses.  The proposed guidelines are a step in the wrong direction according to Dr. Randall Stafford, an associate professor of medicine at the Stanford Prevention Research Center.  His concern for patient safety was articulated in a recent edition of the New England Journal of Medicine.

Patient safety errors resulted in 238,337 potentially preventable deaths of U.S. Medicare patients and drove up the cost of the Medicare program by $8.8 billion from 2004 to 2006, according to the 5th Annual Patient Safety in American Hospitals Study.

The U.S. Food and Drug Administration (FDA) has announced that it is working with Merck, Inc., the pharmaceutical company, to explore a possible link between the popular asthma and allergy drug Singulair (known generically as montelukast) and behavioral changes, mood changes, and increased rates of suicide among users.  The investigation could take nine months, and although the agency is not yet recommending that anyone stop taking the drug, it is asking health care professionals to monitor Singulair patients for changes in condition that may indicate a suicide risk.

Physicians treating chest pain in patients who are young, or in those who have no obvious risk factors for heart disease, should ask those patients about their potential cocaine use.  The advice is a key recommendation by the American Heart Association (AHA), recently published in the medical journal Circulation. 

If you see someone suffer a heart attack and go unconscious, immediately dial 9-1-1 and begin pushing on his or her chest as hard and as often as you can -- don't stop until someone else can take over, or until paramedics arrive.  Those are the latest instructions from the American Heart Association (AHA), which is now confident that hands-only cardiopulmonary resuscitation (CPR) can be done in an emergency, even by people who have no CPR training.  Throat sweeping and mouth-to-mouth emergency breathing are still recommended, but not for bystanders -- those components are only encouraged for trained medical personnel.  The organization's new position appears in the March 29 issue of the medical journal Circulation.

Adverse drug events affect about 7% of U.S. children in hospitals -- adverse events such as getting the wrong medication, the wrong doses of medication, and dangerous, preventable reactions.  The percentage is much higher than previous estimates, too, underscoring growing concerns about medical errors involving hospitalized children, according to new research published in the journal Pediatrics.

Now that the spring and summer sports season has arrived, the American Association of Endodontists (AAE) is urging all young athletes to "watch their mouths," and to wear a mouth guard for every sport this year, including even those spring sports typically thought of as "non-contact" sports -- like soccer, softball, baseball and gymnastics.

Body art (including practices like tattooing and piercing) is a popular form of self-expression.  These permanent markings are typically created by professional artists, but the health and safety regulations they must follow vary according to the city, county or state regulations under which they practice.   Furthermore, certain aspects of body art, such as tattooing, entail unavoidable health risks, such as exposure to inks and dyes that have never been approved by the U.S. Food and Drug Administration (FDA) for use on human skin.  Some of those inks have also been known to react badly when exposed to diagnostic magnetic resonance imaging (MRI) scans.

Breathing muscles which go unused during ventilator-assisted respiration weaken more rapidly than previously understood, according to a new study published in a recent edition of the New England Journal of Medicine. 

Spiriva, a pulmonary drug marketed by Pfizer and Boehringer Ingelheim Pharmaceutical, appears to increase the risk of stroke, according to a public warning from the the  U.S. Food and Drug Administration (FDA).  Though a comprehensive assessment of the drug's safety is not yet complete, a potential for adverse events has prompted the agency to issue a warning, to assist patients and physicians in identifying any potential problems immediately.

Emergency Room patients treated for severe asthma often continue to have poorly controlled symptoms as much as one month afterward, according to new research published in a recent issue of  Annals of Allergy, Asthma and Immunology.

It has previously been documented that humans and dogs can infect one another with methicillin-resistant Staphylococcus aureus (MRSA), but it now appears that humans and cats can spread the virulent bacteria back and forth between one another, as well.  What may be the first documented instance of such transmission has been reported in a recent edition of the New England Journal of Medicine. 

Nearly 10% of U.S. military personnel deployed to Afghanistan are not suitable candidates for mefloquine, an anti-malaria drug commonly administered by the military.  The drug is also known by its trade name Lariam.  The finding is the result of research published in a recent edition of Malaria Journal. 

An American woman's risk of developing particular skin cancers is influenced by where she lives, according to a new study published in a recent edition of Archives of Internal Medicine.

A simple new lab test can reliably predict which patients will suffer acute kidney failure following surgery, giving physicians as many as three additional days in which to initiate treatment.  The development could lead to significantly improved patient outcomes, according to researchers whose findings appear in the latest edition of the Clinical Journal of the American Society of Nephrology.

On average, U.S. trauma room patients are exposed to radiation levels equivalent to 1,005 chest x-rays during a single visit -- enough to put them at risk of developing cancer.  The finding is the result of new research published in a recent issue of Annals of Emergency Medicine.

Though patients and even dentists are often unaware, crowns, bridges and other dental devices produced by foreign manufacturers contain dangerous levels of lead in many instances, according to an investigative report by WBNS-10 TV  -- an Ohio television station that has captured the attention of the American Dental Association (ADA) and millions of concerned patients.

Unnecessary appendectomies have become drastically less common since 1996, thanks to the increased use of CT scanning in the diagnosis of acute appendicitis.  The finding was announced by a research team led by Dr. Steven Raman of the University of California - Los Angeles, and appears in a recent letter to the New England Journal of Medicine (NEJM).

According to the U.S. Food and Drug Administration (FDA), Baxter Healthcare Corp. has announced that it is recalling all remaining multi-dose vials of their heparin, as well as single-dose vials and Hep-Lock heparin flush products, which prevent blood clots in intravenous (IV) lines.  Baxter widened its initial recall after another manufacturer of multi-dose heparin vials -- APP Pharmaceuticals of Schaumburg, Ill. -- was able to assure the FDA that it could meet the demand for the entire supply of the blood thinner in the United States.  Several U.S. manufacturers produce items similar to Baxter's Hep-Lock.

As a hospital patient, you're significantly less likely to survive a heart attack on night and weekend shifts, according to a new study published in a recent edition of the Journal of the American Medical Association (JAMA). 

Patients suffering from Post-Traumatic Stress Disorder (PTSD) are every bit as likely to have correlative long-term health complications as patients who have chronic disease risk factors such as elevated white blood cell counts and other biological symptoms -- but most physicians fail to screen for PTSD in the same manner that they would screen for other risk factors.  The finding is the result of recent research conducted at the Geisinger Health System and published in a recent edition of the Journal of Nervous and Mental Disease.

Many over-the-counter Icy Hot therapy products have been voluntarily recalled by Chattem, Inc., according to a recent announcement by the U.S. Food and Drug Administration (FDA).  According to the agency, customers suffered first, second and third degree burns, skin irritation and skin removal due to their use of the Icy Hot Heat Therapy Air Activated Heat patch.

An industry-wide culture of long hours, speedy service and staffing shortages contributes to millions of potentially serious medication errors in pharmacies across the United States, according to a recent investigative article by USA Today.

Though unintentional and accidental burns to the mouth occasionally occur during tonsillectomy, relatively few are ever reported as medical errors, according to new research published in the Archives of Otolaryngology and Head and Neck Surgery.  Researchers report that some injuries have been so severe as to require reconstructive surgery.

Health complications during pregnancy can be scary and complicated, not to mention fatal.  Fortunately, there are a number of well-understood pregnancy-related health risks that can be eliminated through education and careful prevention measures.  The U.S. Centers for Disease Control and Prevention (CDC) offer the following infection prevention tips to ensure prenatal health, in observance of National Prenatal Infection Prevention Month:

Although 8 hours of sleep is recommended for all adults, the average American receives only 7, and obstetricians and other physicians may receive much less, particularly during training.  As a result of increasing awareness of the danger of physician fatigue, the American College of Obstetricians and Gynecologists (ACOG) has issued an opinion related to OB-GYN working hours in the latest issue of Obstetrics & Gynecology.

The U.S. Food and Drug Administration (FDA) is warning that three products:  Botox, Botox Cosmetic (Botulinum toxin Type A), and Myobloc (Botulinum toxin Type B) have been linked to fatal adverse reactions including respiratory failure.  The most severe adverse reactions have occurred in children with cerebral palsy, who rely on the drug for treatment of limb spasticity.  The FDA warns that it has not approved any Botulinum toxins for treatment of spasticity in either children or adults, though it is not advising healthcare professionals to stop prescribing the products at this time. 

The pharmaceutical industry has made nurses "soft targets" for drug marketing purposes, but nursing education still does little to teach nurses to recognize and question pharmaceutical industry bias in marketing literature or sales tactics.  The finding is the result of a scientific review of nursing literature recently published in PLoS Medicine, a peer-reviewed medical journal published by the Public Library of Science.

Each year more than 7,000 children 11 years of age or younger visit hospital emergency rooms due to incidents involving over-the-counter cough and cold medications.  Two-thirds of those incidents involve kids taking the medications without adult supervision.  The findings are the result of recent research published in the journal Pediatrics, the official journal of the American Academy of Pediatrics.

According to a recent study of more than 800,000 seniors, patients receiving care from a geriatrician are much more likely to have safe and positive prescription drug outcomes than those receiving care from non-geriatrician specialists or general practitioners.  The study appears in the latest issue of the journal Medical Care, an official journal of the American Public Health Association.

Congenital cytomegalovirus (CMV) infection affects 1 in 150 live births in the U.S., and 1 in 750 newborns suffer lifelong, debilitating injuries such as hearing loss, vision loss or cognitive impairment as a result of those infections.  Preventing CMV infection in babies can be as simple as instructing new mothers to wash their hands thoroughly after diaper changes -- 90% of OB-GYNs report their knowledge of this fact, but only 60% routinely counsel patients regarding hand-washing.  Only 44% counsel their patients specifically about CMV prevention.  These findings are the result of research published recently in the Morbidity and Mortality Weekly Report (MMWR), a publication of the U.S. Centers for Disease Control and Prevention (CDC).

The earlier evenings and colder weather of winter are hardly as uplifting as a crisp, spring morning.  For people with Seasonal Affective Disorder (SAD), however, the winter season can be dangerously depressing.  According to experts at the Mayo Clinic, SAD may be rooted in three components of patients' chemical makeup:

Silvery dental fillings containing mercury have no effect on children's brain development or neurological status, according to a team of international researchers whose report will appear in the February edition of the Journal of the American Dental Association, according to an American Dental Association press release.

Breast cancer patients who elect reconstruction surgery immediately following a mastectomy suffer substantially higher rates of surgical infection when they choose to use surgical implants, rather than their own abdominal fat, to shape their breasts.  The finding is the result of new research published in the journal Archives of Surgery.