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.

Breathalyzer test for lung cancer to be trialed at UK pharmacies


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With lung cancer survival rates greatly improved by early detection, we’ve seen a number of efforts to develop a better way to detect the disease in its early stages. So-called lung cancer breathalyzers are one technology being developed by a number of research teams, including one from the University of Huddersfield in the UK, which plans to trial a breathalyzer device in pharmacies.

The project to develop the device, which is taking place over three years, involves researching a lung cancer “biomarker signature” that is detectable in breath. Previous studies have already shown that carbon-based sensors embedded with gold nanoparticles and even dogs can detect chemicals in the breath indicating the presence of the disease in the lungs…

The project has secured £105,000 in funding from the SG Court Pharmacy Group that operates a chain of pharmacies in the South East of England. It is in these pharmacies that initial trials of the technology will be carried out. The University of Huddersfield has provided matching funding for the project…

“There are 12,000 community pharmacies in Britain and there is a big move for them to get involved in primary diagnostics, because people visit their pharmacies not just when they are ill but when they are well,” says Dr Airley. “A pharmacy is a lot less scary than a doctor’s surgery.”

Bravo. Everything from mobile apps to pre-clinical testing at your local pharmacy provides an expanding range of opportunities for better health. Access is as important in early detection of illness as a well-studied physician. The latter ain’t doing you much good if you can’t get in to see anyone. And the odds get better when society at large has that early access.

Pharma giant Johnson & Johnson to pay $2.2 billion settlement

Pharma company Johnson & Johnson has agreed to pay over $2.2 billion to resolve criminal and civil allegations in the US that it promoted powerful psychiatric drugs for unapproved uses in children, seniors and disabled patients.

The allegations include paying kickbacks to doctors and pharmacies to recommend and prescribe Risperdal and Invega, both anti-psychotic drugs, and Natrecor, which is used to treat heart failure…

The figure includes $1.72 billion in civil settlements with federal and state governments as well as $485 million in criminal fines and forfeited profits.

The agreement is the third-largest US settlement involving a drug-maker, and the latest in a string of legal actions against drug companies allegedly putting profits ahead of patients.

These companies lined their pockets at the expense of American taxpayers, patients and the private insurance industry,” said Attorney General Eric Holder, at a news conference…

“Every time pharmaceutical companies engage in this type of conduct, they corrupt medical decisions by health care providers, jeopardise the public health and take money out of taxpayers’ pockets,” the Attorney General said…

In a separate civil complaint, the government alleges Janssen Pharmaceuticals also promoted the drug as a way to control behavioural problems in children and mentally disabled.

The drugmaker allegedly downplayed Risperdal’s side effects while also paying kickbacks to the nation’s largest long-term care pharmacy to recommend the drug to prescribers.

Please, please – in addition to the cash settlement, throw the creeps in jail who made the decision to pursue criminal fraud to maximize profits. That is the polite definition of corporate theft, right?

Born in the USA? Costliest birth in the world!

Seven months pregnant, at a time when most expectant couples are stockpiling diapers and choosing car seats, Renée Martin was struggling with bigger purchases.

At a prenatal class in March, she was told about epidural anesthesia and was given the option of using a birthing tub during labor. To each offer, she had one gnawing question: “How much is that going to cost?”

Though Ms. Martin, 31, and her husband, Mark Willett, are both professionals with health insurance, her current policy does not cover maternity care. So the couple had to approach the nine months that led to the birth of their daughter in May like an extended shopping trip though the American health care bazaar, sorting through an array of maternity services that most often have no clear price and — with no insurer to haggle on their behalf — trying to negotiate discounts from hospitals and doctors…

When she became pregnant, Ms. Martin called her local hospital inquiring about the price of maternity care; the finance office at first said it did not know, and then gave her a range of $4,000 to $45,000. “It was unreal,” Ms. Martin said. “I was like, How could you not know this? You’re a hospital.”

Midway through her pregnancy, she fought for a deep discount on a $935 bill for an ultrasound, arguing that she had already paid a radiologist $256 to read the scan, which took only 20 minutes of a technician’s time using a machine that had been bought years ago. She ended up paying $655. “I feel like I’m in a used-car lot,” said Ms. Martin, a former art gallery manager who is starting graduate school in the fall.

Like Ms. Martin, plenty of other pregnant women are getting sticker shock in the United States, where charges for delivery have about tripled since 1996, according to an analysis done for The New York Times by Truven Health Analytics. Childbirth in the United States is uniquely expensive, and maternity and newborn care constitute the single biggest category of hospital payouts for most commercial insurers and state Medicaid programs. The cumulative costs of approximately four million annual births is well over $50 billion.

And though maternity care costs far less in other developed countries than it does in the United States, studies show that their citizens do not have less access to care or to high-tech care during pregnancy than Americans.

RTFA. It’s long, detailed, and scary.

When Dwight Eisenhower left office as president he warned of the political power of the military-industrial complex. Well, they ended up owning enough of Congress that they suck down the lion’s share of our non-insurance federal budget. That leaves what is now being called the medical-industrial complex. And between insurance companies, pharmaceutical manufacturers, healthcare providers and hospitals they seem bound and determined to take the rrest of that budget – and our life savings.

Teen access to Plan B uneven – either from ideology or ignorance

Since 2009 the Food and Drug Administration has mandated that Plan B and other emergency contraceptives be available without a prescription to women age 17 and up. In reality, a new study suggests, a 17-year-old’s access to these drugs can be uncertain.

In the study, two female research assistants at Boston University called every commercial pharmacy in five major cities and asked whether emergency contraception was available to them that day. If the answer was yes, they followed up with the question “If I’m 17, is that okay?”

At that point, 19% of the pharmacy workers told the young women that contraception would not be available to them. When researchers posing as doctors called the same pharmacies on behalf of a (fictional) 17-year-old patient, however, just 3% of pharmacies said the drugs weren’t available.

Pharmacies, moreover, incorrectly reported the age guidelines for over-the-counter access to 43% of the “girls” and 39% of the “doctors,” according to the study — which appears in the April issue of the journal Pediatrics…

Timely access to these drugs is important, Wilkinson and her colleagues say, since they’re most effective in the 24 hours following unprotected sex or a contraception failure. The odds of getting pregnant rise by about 50% every 12 hours after the event, according to the study…

The faulty information about age recorded in some of the other calls might be due to a combination of “confusion, misinformation, and maybe personal beliefs,” Wilkinson says, although she and her colleagues stress that the study is silent on this matter. A pharmacy’s location and whether or not it was part of a chain did not appear to play a role…

The “misunderstanding among the public, pharmacists, and doctors about this being an abortion pill” is an “ongoing dilemma,” Dr. Jean Amoura says… Ignorance in America is an ongoing dilemma.

“It’s unclear if the pharmacy workers who provided incorrect information to the study callers were simply unfamiliar with the law, but one of the unfortunate results of the age restriction is that it requires drugstores to keep emergency contraception behind pharmacy counters,” Dr. Deborah Nucatola said in a prepared statement. “As the research shows, that restriction creates access barriers for women of all ages and these barriers can in turn result in preventable unintended pregnancies.”

“Preventable unintended pregnancies” still is a panic button for Americans whose education, awareness, concern for themselves and others is trapped in the Dark Ages. It is part of a simple answer to a question of being responsible for your own decisions. As a starter.

Add in additional causes of unintended pregnancies – like rape – and the posturing of religious fundamentalists is criminal.

Phony pharmacies tied to price gouging drug wholesalers


Rep. Elijah Cummings [D-MD]

Lawmakers are investigating three shadowy pharmacies in Maryland and North Carolina for diverting critical but scarce drugs from patients to wholesalers, who are then able to resell the medicine at sometimes big markups.

Elijah Cummings, the senior Democrat on the House Committee on Oversight and Government Reform, began a probe in October to discover why certain companies were selling cancer drugs at more than a hundred times their normal cost.

Shortages of hundreds of drugs including cisplatin, a highly effective treatment for testicular cancer, and fluorouracil for colon and other cancers have helped create a lucrative shadow market…

According to preliminary details of Cummings’ investigation, made public on Wednesday, some wholesalers opened their own sham pharmacies to obtain drugs in short supply and re-sell them. One wholesaler increased the price tenfold from the pharmacy cost.

“It’s shocking to the conscience that anyone because of their greed would deny medicines to patients, who are in many instances in critical condition,” Cummings said in an interview. “If it’s not illegal, we need to make it illegal…”

The inquiry found cases of the pharmacy and wholesaler being headed by the same person, or by a husband and wife pair

Most of the nation’s drug supply passes from manufacturers like Hospira Inc and Teva Pharmaceuticals to three leading wholesalers – AmerisourceBergen Corp, Cardinal Health Inc and McKesson Corp – who distribute them to doctors, hospitals, clinics and pharmacies.

Smaller distributors help fill in the gaps in areas where larger companies may not operate or cannot meet the full demand. In recent years, a new crop of small players has surfaced, as the problem of drug shortages has worsened.

“Any time there’s a severe shortage of some critically needed good, invariably there are going to be folks who seek to exploit that,” said Jay Campbell, executive director of the North Carolina Board of Pharmacy.

The sleaziest of the profiteers they’ve uncovered – so far – was Jessica Hoppe, the president of a drug wholesaler called International Pharmaceuticals. State regulators discovered Hoppe operated the pharmacy from her wholesale office in Durham, North Carolina.

Cripes. How and why would the Federal Trade Commission need new regulations to deal with hustlers like this?

Pillheads putting pharmacies under siege

Less than two hours after picking out a man in a police lineup who held up his drugstore, pharmacist Mike Donohue was being robbed. Again…

Like the other five robbers who had held up Donohue’s store before, the man demanded OxyContin, a popular painkiller known for its high abuse potential.

“My technician came back and showed me the note that said, ‘Give me your OxyContin. I have a gun,’ ” Donohue said.

Instead of handing over the drugs, Donohue unholstered the Glock 19 handgun he wore beneath his white lab coat and sprinted to the front of the small pharmacy…

The would-be robber dashed out the door, with the pistol-packing pharmacist giving chase. Surveillance video cameras captured the entire incident.

The man got away, only to be arrested that day. He later pleaded guilty to attempting to rob Donohue’s store and to robbing another drugstore…

On the front window of his pharmacy, Mike Donohue lists the names of the men who have robbed him of drugs.

They were all eventually caught, he said, because of a simple truth: They couldn’t stop. But that’s little solace for the pharmacist who fears he is pitted against a new, more dangerous strain of criminal…

When he started his career two decades ago, Donohue said, he never imagined having to wear a gun or put bullet-resistant glass on his store windows to keep any shots he fires at robbers from breaking through and hitting someone walking by.

The pharmacist’s methods may be unorthodox but he says they are working: Since Donohue pulled a gun, the robbers have not come back.

RTFA. There are more tales of robbery and violence committed against the neighborhood pharmacist. Even if it’s a chain store, the guy dispensing prescriptions is still the same.