Never forget: Kent State


Click to enlargePhotograph by John Paul Filo – Pulitzer Prize, 1971

The Kent State shootings occurred at Kent State University in Kent, Ohio, in the United States and involved the shooting of unarmed college students by the Ohio National Guard on Monday, May 4, 1970. Wikipedia

Date: May 4, 1970

Perpetrator: Ohio Army National Guard

Number of deaths: 4

Screwups by the Medical-Industrial Complex are the 3rd biggest cause of death in America

med:ind complex

Medical errors kill more people than car crashes or new disease outbreaks. They kill more people annually than breast cancer, AIDS, plane crashes, or drug overdoses. A new study estimates that they are the third leading cause of death in the United States, causing a quarter-million fatalities in 2013 alone.

Patient safety researchers Marty Makary and Michael Daniel published new data in the British Medical Journal Tuesday suggesting that preventable medical errors resulted in 251,454 deaths in 2013. If that estimate is correct, the only bigger causes of death are heart disease and cancer.

The researchers worry, however, that their number is actually an underestimate — that medical harm kills even more patients than we’re currently able to count

When a patient dies as a result of medical harm, there’s no regulator that has to get notified — the hospital doesn’t send off paperwork about the error that occurred. Sometimes the information gets jotted down in the patient’s medical record, but even that is not a certainty.

This makes estimating the frequency of medical harm very difficult — and researchers generally believe that their figures underestimate the prevalence of harm. Their study uses data from four recent studies, all of which relied on medical records to estimate fatalities caused by medical errors. So the authors know that their estimate of fatalities misses any errors that weren’t captured in the medical record…

Still, they argue that there is value to putting out the best number they can find, as it can draw attention to the potential magnitude of a rarely discussed problem in health care…

Some errors in medicine are stunningly bad….They are terrible and easy to recognize. But they aren’t what cause the most harm in American health care. It’s the less stunning, more quotidian mistakes that are the biggest killers. Take, for example, bed sores.

Bed sores are one of the more mundane complications of modern medicine. They’re called “pressure ulcers” in medical jargon, and are the open wounds that patients develop when they have not moved for long periods of time. The skin literally cracks under the pressure of the body weighing down on it.

A 2006 government survey found that more than half a million Americans are hospitalized annually for bed sores that are the result of other care they have received. And 58,000 of those patients die in the hospital during that admission.

Does this mean that pressure ulcers killed all those patients? No — these are typically frail, elderly patients battling other conditions ranging from pneumonia to dementia. But did bed sores mean some of these patients died who otherwise wouldn’t have? Experts say that’s almost certainly the case.

Like Congressional politics or the average conservative family values agenda – American health care is steadily devolving back towards the 19th Century. The ranks of sub-par management coupled with industrial-level greed is about as dangerous to the public good as populist politics shepherded by a media establishment with no backbone and fewer standards.

South Dakota warehouses thousands with manageable disabilities in nursing homes


No, the fight ain’t new — it ain’t over either

When patients in South Dakota seek help for serious but manageable disabilities such as severe diabetes, blindness or mental illness, the answer is often the same: With few alternatives available, they end up in nursing homes or long-term care facilities, whether they need such care or not.

In a scathing rebuke of the state’s health care system, the Justice Department said on Monday that thousands of patients were being held unnecessarily in sterile, highly restrictive group homes. That is discrimination, it said, making South Dakota the latest target of a federal effort to protect the civil rights of people with disabilities and mental illnesses, outlined in a Supreme Court decision 17 years ago.

The Obama administration has opened more than 50 such investigations and reached settlements with eight states. One investigation, into Florida’s treatment of children with disabilities, ended in a lawsuit over policies that placed those children in nursing homes. With its report Monday, the Justice Department signaled that it might also sue South Dakota.

While the administration has received widespread attention for investigating police abuses and supporting the rights of gay and transgender people, the Justice Department has also steadily made these cases part of its civil rights agenda. The government says that those efforts have allowed more than 53,000 Americans with disabilities to leave institutions or avoid them altogether. It is a small number compared with the 250,000 working-age people who are estimated to be needlessly living in nursing homes, but advocates say the federal campaign has had significant effects.

With help, the Justice Department said, such people could live at home, hold jobs and lead productive lives. Instead, they are confined and segregated from society. Many cannot leave the grounds of their institutions without supervision or perform tasks such as shopping for groceries or cooking meals. One resident told investigators that when friends visited to take him for a car ride, “they have to sign me out, like a kid.”…

Paternalism, patriarchal practices – social and medical – reflect a society unwilling to move to best practices. Modernism is viewed as heresy by some, radicalism by others in the wonderful world of conservative beancounters.

Unless pressure is mounted, locally or through federal oversight, the cost of doing business as usual – defined by 19th Century minds – overrules what should be systems that help folks lead better lives.