Wednesday, August 31, 2005
Turmoil in the FDA: A high-ranking official quits after the Plan B delay
"I can no longer serve as staff when scientific and clinical evidence, fully evaluated and recommended for approval by the professional staff here, has been overruled . . . The recent decision announced by the Commissioner about emergency contraception, which continues to limit women's access to a product that would reduce unintended pregnancies and reduce abortions, is contrary to my core commitment to improving and advancing women's health."
"I can no longer serve as staff when scientific and clinical evidence, fully evaluated and recommended for approval by the professional staff here, has been overruled . . . The recent decision announced by the Commissioner about emergency contraception, which continues to limit women's access to a product that would reduce unintended pregnancies and reduce abortions, is contrary to my core commitment to improving and advancing women's health."
Posted by Kevin |
link
| Comments (3)
| 
More doctors gone wild: A surgeon in Japan punched a patient in her 90's during surgery
"A doctor described as arrogant was suspended for three months for punching a patient in her 90s and hurling verbal abuse at her in the middle of surgery, officials said Tuesday.
The incident took place at Shiga Hospital in Higashiomi, Shiga Prefecture, on Aug. 1, according to officials at the Kinki regional office of the National Hospital Organization, which runs the hospital.
The doctor in his 30s started the surgery after the woman was put under local anesthesia.
But the patient continued to move and said she was in pain.
The doctor yelled at the patient, 'Don't move' and 'Shut up.' He then punched her on the right side of her forehead, according to the officials."
"A doctor described as arrogant was suspended for three months for punching a patient in her 90s and hurling verbal abuse at her in the middle of surgery, officials said Tuesday.
The incident took place at Shiga Hospital in Higashiomi, Shiga Prefecture, on Aug. 1, according to officials at the Kinki regional office of the National Hospital Organization, which runs the hospital.
The doctor in his 30s started the surgery after the woman was put under local anesthesia.
But the patient continued to move and said she was in pain.
The doctor yelled at the patient, 'Don't move' and 'Shut up.' He then punched her on the right side of her forehead, according to the officials."
Posted by Kevin |
link
| Comments (3)
|
Anger management: A doctor in Canada is disciplined for swearing at patients
"None of the complainants can be identified, but the daughter of one patient testified that, when she drove almost 20 kilometres to his office to pick up a prescription for her elderly father, Dr. Rathé came out of his office and said to her, 'Assholes like you and your parents I don't need.'
She told a college disciplinary panel that she was shocked by the remark, and when she questioned him about it, he told her that patients were a dime a dozen and he could always practise in the United States.
In another of a string of similar incidents, Mr. Sokolov described an office visit in which a daughter asked questions about the treatment the doctor was giving her 77-year-old mother. He said Dr. Rathé told her: 'This is my domain. You don't ask me questions in my domain.' And, as the two were leaving, he told them 'go and don't come back,' Mr. Sokolov said."
"None of the complainants can be identified, but the daughter of one patient testified that, when she drove almost 20 kilometres to his office to pick up a prescription for her elderly father, Dr. Rathé came out of his office and said to her, 'Assholes like you and your parents I don't need.'
She told a college disciplinary panel that she was shocked by the remark, and when she questioned him about it, he told her that patients were a dime a dozen and he could always practise in the United States.
In another of a string of similar incidents, Mr. Sokolov described an office visit in which a daughter asked questions about the treatment the doctor was giving her 77-year-old mother. He said Dr. Rathé told her: 'This is my domain. You don't ask me questions in my domain.' And, as the two were leaving, he told them 'go and don't come back,' Mr. Sokolov said."
Posted by Kevin |
link
| Comments (37)
|
Again, rising malpractice costs are hurting patients
"Just past Fredericksburg, Virginia's Northern Neck is increasingly becoming known among Washingtonians for its waterfront real estate, tiny fishing villages and a quiet, isolated rhythm that makes you feel like you're a million miles away.
But if you're a pregnant woman about to go into labor, isolation isn't necessarily a plus -- particularly if you're isolated from an obstetrician.
That has been the case for women on the Northern Neck since early last year, when the only two obstetricians on the 100-mile-long peninsula closed their 300-delivery-a-year practice because of rising malpractice insurance rates after decades in business.
Now, stories are common of women delivering babies in cars, parking lots and emergency rooms, getting their tubes tied and simply being panicky throughout their pregnancies, worried about getting to the nearest obstetrician -- at least an hour away." (via Common Good)
"Just past Fredericksburg, Virginia's Northern Neck is increasingly becoming known among Washingtonians for its waterfront real estate, tiny fishing villages and a quiet, isolated rhythm that makes you feel like you're a million miles away.
But if you're a pregnant woman about to go into labor, isolation isn't necessarily a plus -- particularly if you're isolated from an obstetrician.
That has been the case for women on the Northern Neck since early last year, when the only two obstetricians on the 100-mile-long peninsula closed their 300-delivery-a-year practice because of rising malpractice insurance rates after decades in business.
Now, stories are common of women delivering babies in cars, parking lots and emergency rooms, getting their tubes tied and simply being panicky throughout their pregnancies, worried about getting to the nearest obstetrician -- at least an hour away." (via Common Good)
Posted by Kevin |
link
| Comments (56)
|
Tuesday, August 30, 2005
The hospital scene in New Orleans
Washington Post: New Orleans Hospital Still Offers Care"The hospital is crowded and hot. Surgeries go on with the help of generators. A teen arrives by boat after giving birth in a hotel. And outside, a steady stream of homeless, frightened people seek refuge.
This was the scene Tuesday at New Orleans' Ochsner Clinic, the eye of the hurricane as far as medical care is concerned.
Federal officials said that 2,500 patients in the drowning city were being evacuated because at least seven hospitals in Orleans Parish were threatened by the loss of their power generators and other problems.
Perched a lofty 8 feet above sea level in Jefferson Parish, Ochsner is one of the few in the area still up and running."
Houston Chronicle: Power going out at New Orleans' VA hospital
"Gruner said plans are being made to move the ventilator patients to another facility within New Orleans or air evacuate them to another VA hospital. There are 154 patients at the New Orleans VA hospital, and about 700 people who have sought refuge in the building. The building is surrounded by water, Gruner said. VA officials are working to coordinate military aircraft support.
Tom Flanagan, director of Life Flight emergency transport at Memorial Hermann Hospital, said a patient in need of a liver transplant was on her way to Houston from Oschner Hospital in New Orleans this morning."
Times-Picayune: In a flood, hospitals become the rescued
"As floodwaters rose around Charity Hospital, nurses hand-pumped ventilators for patients who couldn't breathe. Helicopters landed on the garage to airlift critically ill babies. Doctors canoed supplies to and from Charity and three nearby hospitals . . .
. . . Charity held 300 patients, but its generator had failed and the backup generator was running out of diesel fuel. Police were working to get more generators to the hospital. The most critically ill were being evacuated Tuesday; the rest would go over the next five days.
Outside Charity, a boat pulled up carrying a man doubled over in pain.
'Where are we going to put him? We're the rescuee now. People coming in here, it's like running into a burning building looking for shelter,' nursing supervisor Ray Campo said.
Water was three to four feet deep in the street; in the hospital, halls were dark and a bit slippery. Top administrators carried supplies up and down darkened stairs. Everyone needed flashlights to get around."
MedPage Today: Hospitals Evacuate in Wake of Rising Waters From Katrina
While most of New Orleans headed for high ground as Hurricane Katrina roared toward this city, the staff at Tulane University Hospital, anticipating flooding, also moved the emergency department to higher ground -- the second floor. Not enough. Not nearly enough . . .
. . . 'We've now lost one of our backup generators,' Troyer-Carawy said in a television interview as the day wore on, 'so we have, you know, enough portable generators to provide the critically needed care for our patients, but if the water continues to rise, we will lose all of our backup generator power in the building. We've already lost air, suction, and water.'"
Posted by Kevin |
link
| Comments (1)
|
Crossing the line? The NH Board goes public on Dr. Bennett
The Union Leader: Board sets hearing for Dr. Bennett"One complaint charges he spoke to an obese female patient about her condition in a way that caused her distress and embarrassment. The other complaint, which was filed in 2001, said Bennett advised another female patient to buy a pistol so she could commit suicide to end her physical suffering.
Bennett’s attorney Chuck Douglas said the bigger issue is “how much under the First Amendment (of the Constitution) can government intrude into a doctor’s office . . .
. . . The notice released yesterday quotes Bennett as telling the woman, 'You need to lose weight. Let’s face it if your husband were to die tomorrow who would want you. Well, men might want you but not the types that you want to want you. Might even be a black guy.'
'The racial undertone gave rise to concern by the board the complaint might need further investigation,' Head said."
Boston Globe: State investigates doctor accused of racial remark to obese woman
"In a telephone interview Tuesday from Rochester, Bennett defended his message to her, saying he has read polls that say black men prefer overweight women.
Bennett, who treated members of the bin Laden family while practicing in Saudi Arabia from 1974 to 1981, denied wrongdoing Tuesday. He also said he is angry the board is reconsidering the 2001 complaint.
'That patient is currently in a nursing home completely demented, tied to a chair drooling on herself and doesn't recognize anybody,' said Bennett, 67. 'She was in pretty nearly that condition at the time she filed that complaint.'
As for the obese woman, Bennett said he gives the same -- admittedly harsh -- lecture to every obese female patient, and feels it would be bad medicine not to. He said he is sorry the woman was offended, but that he has apologized.
Charles Douglas, Bennett's lawyer, said his client is being attacked by the board, which, by its own rules, does not discipline doctors for bedside manner. 'If a patient does not like the message, go to another doctor,' Douglas said."
Posted by Kevin |
link
| Comments (14)
|
Richard Epstein takes on Mark Lanier about the Vioxx verdict on CNBC
"You're a bully, Mr. Lanier, and you're not going to get away with it now." (via PointofLaw.com)
"You're a bully, Mr. Lanier, and you're not going to get away with it now." (via PointofLaw.com)
Posted by Kevin |
link
| Comments (1)
|
A juror talks about being on a medical malpractice case
This blog does not tend to give jurors on malpractice cases very much credit. Here's one who sounds pretty reasonable - and I'm not just saying this because they found in favor of the physician:
This blog does not tend to give jurors on malpractice cases very much credit. Here's one who sounds pretty reasonable - and I'm not just saying this because they found in favor of the physician:
Obvious attempts to play on our sympathies (chemotherapy side effects listed repeatedly; three young children introduced to the jury; the horrific first-person account of a stage four cancer diagnosis; fears of reoccurence and secondary cancers; a lawyer struggling not to burst into tears at the end of a closing argument) didn't make for easy listening. It didn't help with meeting the burden of proof, either. Even though the threshold is lower in civil cases ("by a preponderance of the evidence" - more likely than not, instead of beyond a reasonable doubt) it still needs to be met.(via Universal Hub)
The case boiled down to a single question: was a doctor negligent because he failed to order a chest x-ray?
This is the question that took three weeks, multiple expert witnesses, subpoenaed doctors, dozens of medical records, copies of phone bills, and a couple of hours of deliberation to answer . . .
. . . This makes me think most cases aren't about punishing bad actors, they are about a broken system. They have very little do to with science but a lot to do with the modern practice of medicine, because they are about money.
Turns out the doctor we didn't find negligent has made two malpractice payments in the past ten years. The expert witness peripherally involved in treating the plaintiff (and who was called by the plaintiff to testify) made four.
Posted by Kevin |
link
| Comments (11)
|
Grand rounds 49 is up
Come get the weekly best of the medical blogosphere.
Come get the weekly best of the medical blogosphere.
Posted by Kevin |
link
| Comments (0)
|
A doctor in Vietnam builds an endoscope himself using cheap parts and a home computer
Posted by Kevin |
link
| Comments (0)
|
HIPAA, water-cooler talk, and the whole patient
"Studies show that multidisciplinary rounds improve every facet of patient care, from length of hospital stay to infectious complications and even mortality. But it still means that medical privacy is becoming a very relative concept. No longer can you offer up your gallbladder to the system, and keep the rest of yourself tucked safely away.
The walls between medical providers and the outside world are tall and thick now, bolstered by custom and the law. Nothing much gets out.
Inside the castle keep, though, the tongues are wagging, and it's all for your own good. From marital problems to drug and alcohol dependence to that odd habit of paying for your medical care from a wad of crisp new $100 bills, there is no such thing as "none of their business" anymore.
Everything is becoming our business now."
"Studies show that multidisciplinary rounds improve every facet of patient care, from length of hospital stay to infectious complications and even mortality. But it still means that medical privacy is becoming a very relative concept. No longer can you offer up your gallbladder to the system, and keep the rest of yourself tucked safely away.
The walls between medical providers and the outside world are tall and thick now, bolstered by custom and the law. Nothing much gets out.
Inside the castle keep, though, the tongues are wagging, and it's all for your own good. From marital problems to drug and alcohol dependence to that odd habit of paying for your medical care from a wad of crisp new $100 bills, there is no such thing as "none of their business" anymore.
Everything is becoming our business now."
Posted by Kevin |
link
| Comments (0)
|
Monday, August 29, 2005
The health problems left behind by hurricane Katrina
Posted by Kevin |
link
| Comments (0)
|
Inside a fake Viagra factory
"It may look like any building site, but it is the squalid factory where counterfeit Viagra is produced. The fake pills are stored on dirty plastic sheeting, while the cement mixer is used to dye them blue.
Most people who buy drugs over the internet will be unaware that they could easily come from somewhere such as this." (via Blog Plate Special)
"It may look like any building site, but it is the squalid factory where counterfeit Viagra is produced. The fake pills are stored on dirty plastic sheeting, while the cement mixer is used to dye them blue.
Most people who buy drugs over the internet will be unaware that they could easily come from somewhere such as this." (via Blog Plate Special)
Posted by Kevin |
link
| Comments (0)
|
A roundabout diagnosis of C Difficile
It seems like it took a lot of work to come to a simple C Difficile diagnosis in a 15-year old girl: "She and her family are angry at doctors they allege did not think she was ill, removed her appendix because they wrongly believed she had appendicitis and accused her of being pregnant before finally making the right diagnosis . . .
. . . Doctors claimed she had either severe constipation, appendicitis, was pregnant - or, it is further alleged, was faking. Her appendix was removed at Pendlebury Children's Hospital in Manchester, but that was found not to be the problem . . .
. . . It was also feared she might have Crohn's Disease, a chronic inflammatory disease of the intestines. C difficile was eventually diagnosed after extensive tests."
It seems like it took a lot of work to come to a simple C Difficile diagnosis in a 15-year old girl: "She and her family are angry at doctors they allege did not think she was ill, removed her appendix because they wrongly believed she had appendicitis and accused her of being pregnant before finally making the right diagnosis . . .
. . . Doctors claimed she had either severe constipation, appendicitis, was pregnant - or, it is further alleged, was faking. Her appendix was removed at Pendlebury Children's Hospital in Manchester, but that was found not to be the problem . . .
. . . It was also feared she might have Crohn's Disease, a chronic inflammatory disease of the intestines. C difficile was eventually diagnosed after extensive tests."
Posted by Kevin |
link
| Comments (8)
|
Capitol murder charges for late-term abortions?
"Texas doctors who perform abortions without parental approval or after the third trimester could face capital murder charges because of a new law that takes effect this week, a prosecutors group says."
"Texas doctors who perform abortions without parental approval or after the third trimester could face capital murder charges because of a new law that takes effect this week, a prosecutors group says."
Posted by Kevin |
link
| Comments (3)
|
A drug store dispensed Diazepam (Valium) instead of Ditropan to a 5-year old girl
"Kayla had two doses of liquid Valium.
'She got very hyper, she kept laughing and laughing,' Ferranti said.
After another dose, Kayla started to complain that she felt dizzy and her stomach hurt.
'I couldn't stop being silly,' she said.
CVS attributed the confusion to the similar spelling of the drug names. The child was given Diazepam, the wrong drug, a liquid Valium. The doctor prescribed Ditropan.
By all accounts, the doctor's prescription was clearly written. When he leaned of the error, the Ferranti's doctor called CVS."
"Kayla had two doses of liquid Valium.
'She got very hyper, she kept laughing and laughing,' Ferranti said.
After another dose, Kayla started to complain that she felt dizzy and her stomach hurt.
'I couldn't stop being silly,' she said.
CVS attributed the confusion to the similar spelling of the drug names. The child was given Diazepam, the wrong drug, a liquid Valium. The doctor prescribed Ditropan.
By all accounts, the doctor's prescription was clearly written. When he leaned of the error, the Ferranti's doctor called CVS."
Posted by Kevin |
link
| Comments (6)
|
Michael Kinsley on Vioxx
"Foreigners look with amazement at a society that gives Carol Ernst $16 million or so in trade for her 59-year-old husband -- more than he's worth to anyone else and yet almost insultingly inadequate to her -- gives tens of millions each to a few lawyers like Mark Lanier, and is about to institute a transparently phony plan to provide prescription drugs that do work to people who need them, with no money to pay for it." (via PointofLaw.com)
"Foreigners look with amazement at a society that gives Carol Ernst $16 million or so in trade for her 59-year-old husband -- more than he's worth to anyone else and yet almost insultingly inadequate to her -- gives tens of millions each to a few lawyers like Mark Lanier, and is about to institute a transparently phony plan to provide prescription drugs that do work to people who need them, with no money to pay for it." (via PointofLaw.com)
Posted by Kevin |
link
| Comments (0)
|
"If we get angry at our doctors for nagging us, it's because we don't want to do the hard work of getting rid of those pounds."
More support for Dr. Bennett.
More support for Dr. Bennett.
Posted by Kevin |
link
| Comments (16)
|
Several nursing home residents died during the Gulf Coast hurricane evacuation
Dehydration is suspected.
Dehydration is suspected.
Posted by Kevin |
link
| Comments (1)
|
Sunday, August 28, 2005
Dr. Bennett on MSNBC's Countdown
"I think it is about 70 percent of adult practitioners will write in your chart morbidly obese and not mention it to you, because, if they do, their 15 minutes expands to 20 or 30, they have got you unhappy and they may get a complaint, as I have had. Well, that's a brave new world.
I mean, if a doctor can't tell you the truth and expect to be defended in his right to do that, you can always change doctors. It's not like I hold a gun to people's heads and make them come see me.
They need to get value when they come to see me, in my view.
I have a lot of knowledge. I have spent 40 years at this. I have a prepared spiel that incorporates all these horrible facts. And I tell them, look, this is going to be horrible. This is what's going to happen, OK? The future is clear. If I can get to you believe, we choose a different future and you get to walk through the tulips with somebody that you love for a lot further in this life.
Those are the choices. It's that important. If I can't do it, what do I do? Talk about the weather? . . .
. . . If I have it my way, and if the patients — there's more than 100 patients that have signed a petition to the governor that he should fire our attorney general. The attorney general could have shut this off at any point in time.
There's no crime here. I have broken no law. You cannot say that I have done anything offensive in the greater scheme of things. Certainly, I'm not an addict. I'm not an alcoholic. They've tried to make me admit that I'm a disruptive physician. Not true. Not happening. Thanks."
"I think it is about 70 percent of adult practitioners will write in your chart morbidly obese and not mention it to you, because, if they do, their 15 minutes expands to 20 or 30, they have got you unhappy and they may get a complaint, as I have had. Well, that's a brave new world.
I mean, if a doctor can't tell you the truth and expect to be defended in his right to do that, you can always change doctors. It's not like I hold a gun to people's heads and make them come see me.
They need to get value when they come to see me, in my view.
I have a lot of knowledge. I have spent 40 years at this. I have a prepared spiel that incorporates all these horrible facts. And I tell them, look, this is going to be horrible. This is what's going to happen, OK? The future is clear. If I can get to you believe, we choose a different future and you get to walk through the tulips with somebody that you love for a lot further in this life.
Those are the choices. It's that important. If I can't do it, what do I do? Talk about the weather? . . .
. . . If I have it my way, and if the patients — there's more than 100 patients that have signed a petition to the governor that he should fire our attorney general. The attorney general could have shut this off at any point in time.
There's no crime here. I have broken no law. You cannot say that I have done anything offensive in the greater scheme of things. Certainly, I'm not an addict. I'm not an alcoholic. They've tried to make me admit that I'm a disruptive physician. Not true. Not happening. Thanks."
Posted by Kevin |
link
| Comments (17)
|
Saturday, August 27, 2005
Response from the NH Board of Medicine in the Dr. Bennett case
"Dr. Cynthia S. Cooper, a member of the Board of Medicine handling the dispute who has recused herself because Bennett has referred patients to her Dover practice, said she sticks to national guidelines when telling patients they are obese and need to lose weight.
'We never try to belittle patients or ridicule patients because of their weight,' she said. 'I think no matter what advice you give patients you have to try to communicate in an appropriate way.'
Cooper said she doesn't think doctors will hold back on what they tell patients.
'It may cause doctors to think of how they can approach sensitive topics ... however the advice should be the same,' she said.
She added that doctors are obligated to tell their patients to lose weight if that person needs to.
'I can tell you the Board of Medicine does not discipline physicians for telling patients to lose weight, or they'd be disciplining most of us,' Cooper said."
"Dr. Cynthia S. Cooper, a member of the Board of Medicine handling the dispute who has recused herself because Bennett has referred patients to her Dover practice, said she sticks to national guidelines when telling patients they are obese and need to lose weight.
'We never try to belittle patients or ridicule patients because of their weight,' she said. 'I think no matter what advice you give patients you have to try to communicate in an appropriate way.'
Cooper said she doesn't think doctors will hold back on what they tell patients.
'It may cause doctors to think of how they can approach sensitive topics ... however the advice should be the same,' she said.
She added that doctors are obligated to tell their patients to lose weight if that person needs to.
'I can tell you the Board of Medicine does not discipline physicians for telling patients to lose weight, or they'd be disciplining most of us,' Cooper said."
Posted by Kevin |
link
| Comments (4)
|
Friday, August 26, 2005
More medical blogosphere podcasts
Soundpractice.net continues its podcasts around the medical blogosphere by interviewing Dr. Robert Centor of DB's Medical Rants and Dr. Joe Stirt of bookofjoe.com.
Posted by Kevin |
link
| Comments (0)
|
The Chicago Tribune talks about the abortion bias of the fetal pain article
" A research article about when fetuses feel pain is sparking a heated debate over the nexus between science and politics and what information authors should disclose to scientific journals.
The report, published Wednesday in the Journal of the American Medical Association, analyzed previously published research and concluded that fetuses probably don't feel pain until 29 weeks after conception because of their developing brain structures.
Undisclosed was the fact that one of the five authors runs an abortion clinic at San Francisco's public hospital and another worked temporarily more than five years ago for an abortion-rights advocacy group.
Several ethicists said they consider those points regrettable omissions that left readers without important information. Other experts consider the authors' background irrelevant."
" A research article about when fetuses feel pain is sparking a heated debate over the nexus between science and politics and what information authors should disclose to scientific journals.
The report, published Wednesday in the Journal of the American Medical Association, analyzed previously published research and concluded that fetuses probably don't feel pain until 29 weeks after conception because of their developing brain structures.
Undisclosed was the fact that one of the five authors runs an abortion clinic at San Francisco's public hospital and another worked temporarily more than five years ago for an abortion-rights advocacy group.
Several ethicists said they consider those points regrettable omissions that left readers without important information. Other experts consider the authors' background irrelevant."
Posted by Kevin |
link
| Comments (7)
|
They are considering malpractice review panels in Wyoming
Posted by Kevin |
link
| Comments (0)
|
An editorial on Dr. Bennett: I couldn't have said it better myself
Reprinted from the New Hampshire Union Leader.Doctor’s orders: Don’t replace them with lawyer’s orders
ROCHESTER DOCTOR Terry Bennett told an obese patient she was fat and should lose weight, and for that the state board of medicine is trying to discipline him. Sounds like board members need to see a doctor themselves — to have their heads examined.
Dr. Bennett said his patient was merely overweight when he first told her to drop some pounds. Because she didn’t listen to him, she eventually became obese and developed diabetes, gastroesophageal reflux and chest pains, he said. Then he really got stern with her.
“I told a fat woman she was obese,” he said. “I tried to get her attention. I told her you need to get on a program, join a group of like-minded people and peel off the weight that is going to kill you.”
Rather than thank the doctor for trying to save her life, the patient filed a complaint with the New Hampshire Board of Medicine. That in itself was absurd. But the real lunacy came when the board objected to a subcommittee’s recommendation simply to send the doctor a letter of concern and instead asked the Attorney General’s office to investigate.
Imagine. With all the real crime the Attorney General’s office has to handle, the board of medicine thought it would be a good use of a state attorney’s time to investigate whether a doctor was too harsh when he told a patient her obesity would kill her.
If the board succeeds in disciplining Dr. Bennett, then every physician in the state will think twice before giving unhealthy patients the advice they need. Some might even feel the need to run their advice by an attorney before giving it. Such a chilling effect would endanger people’s lives, and it cannot be allowed to happen. Doctors must be able to speak freely to their patients, even if it means hurting their feelings.
The board of medicine consists of eight members appointed by the governor to five-year terms. At the first opportunity, Gov. John Lynch should replace any member who voted to have Dr. Bennett investigated by the Attorney General’s office and officially wrist-slapped by the board. Anyone who thinks that sternly warning a patient to lose weight is a no-no for a doctor does not belong in a position of authority over the state’s physicians.
Posted by Kevin |
link
| Comments (45)
|
A Cape Cod physician loses his license over OxyContin
"At yesterday's hearing in Boston, officials said, the board investigator presented evidence that Brown was the single leading prescriber of OxyContin in the entire state, with his prescriptions accounting for 288,859 of the 922,985 OxyContin tablets sold through pharmacies in 2004. In an affidavit presented at the closed-door disciplinary hearing, the investigator said almost all of Brown's prescriptions were 40-milligram tablets, which are known for having a higher value for illegal resale."
"At yesterday's hearing in Boston, officials said, the board investigator presented evidence that Brown was the single leading prescriber of OxyContin in the entire state, with his prescriptions accounting for 288,859 of the 922,985 OxyContin tablets sold through pharmacies in 2004. In an affidavit presented at the closed-door disciplinary hearing, the investigator said almost all of Brown's prescriptions were 40-milligram tablets, which are known for having a higher value for illegal resale."
Posted by Kevin |
link
| Comments (0)
|
Thursday, August 25, 2005
The editor-in-chief of JAMA is receiving hate mail after publishing the article on fetal pain
"The editor of a medical journal that published an article this week saying fetuses likely don't feel pain until late in pregnancy said Thursday she has received dozens of angry e-mails from abortion opponents.
Dr. Catherine DeAngelis, editor in chief of The Journal of the American Medical Association, said she had to take a walk around the block after receiving dozens of 'horrible, vindictive' messages.
'One woman said she would pray for my soul,' DeAngelis said. 'I could use all the prayers I can get.' DeAngelis said she is a staunch Roman Catholic and strongly opposes abortion, though she also supports women's right to choose.
'Your license should be stripped,' DeAngelis said, reading aloud from the 50 or so e-mails that came to her office. 'You're hypocrisy,' 'You should get a real job,' 'Eternity will definitely bring justice for you,' others wrote."
"The editor of a medical journal that published an article this week saying fetuses likely don't feel pain until late in pregnancy said Thursday she has received dozens of angry e-mails from abortion opponents.
Dr. Catherine DeAngelis, editor in chief of The Journal of the American Medical Association, said she had to take a walk around the block after receiving dozens of 'horrible, vindictive' messages.
'One woman said she would pray for my soul,' DeAngelis said. 'I could use all the prayers I can get.' DeAngelis said she is a staunch Roman Catholic and strongly opposes abortion, though she also supports women's right to choose.
'Your license should be stripped,' DeAngelis said, reading aloud from the 50 or so e-mails that came to her office. 'You're hypocrisy,' 'You should get a real job,' 'Eternity will definitely bring justice for you,' others wrote."
Posted by Kevin |
link
| Comments (2)
|
The blogosphere responds to Dr. Bennett calling a patient fat
Peevish . . . I'm Just Saying:"Doctors tell you what you need to hear, whether you want to hear it or not and this woman's in some serious denial if she thinks filing a complaint is going to change her health risks.
It's about as smart as me filing a complaint about my doctor telling me to quit smoking, wouldn't you say? Quitting smoking or not quitting smoking is my personal choice, but it's my doctor's duty to point out the health risks to me."
The CultureGhost:
"He suggested in a professional manner it would be in her best interest to lose some weight. And her feelings got hurt. WTF? This guy does not sound like some malicious surreal Monty Python physician who spends his mornings plotting ways to verbally abuse his patients. And her feelings got hurt. WTF? She files a complaint because a doctor, a man with a medical degree and years of experience, states she might have a health problem. What next, pray tell . . .
. . . Not only have we become a nation of gluttons (recent report estimates 49% of the nation may be overweight), but we're getting dumber by the hour. Perhaps the most galling aspect is how this represents our inability to face the truth. We want to be lied to...often."
The Fifty Minute Hour:
"Ultimately, I don't think this doctor committed an ethics breach in need of remedy by the medical board. But I find it a little disturbing that he is unwilling to admit he made a mistake. Even if he believes that the medical evidence supports a conclusion that obesity is dangerous ceteris paribus, he offered his patient no actual medical assistance in reducing that danger. Instead, he made her angry and upset, and therefore (the anecdote from his other patient notwithstanding) less likely to follow any other important advice he needs to give her. The doctor's actions weren't unethical, they were just unhelpful. It would be great if other doctors could learn from this story what their patient's reactions to statements like these are likely to be so that they can phrase their advice in ways that are more likely to succeed in getting patients to take better care of themselves. Because no matter what the reason might be, 'you're fat, go on a diet,' is not likely to help matters."
Sugar Shock! Blog:
"What's the matter with this kind of honesty? Every single bit of it is absolutely true! In fact, if anything, Dr. Bennett wasn't painting a scary enough portrait of what could ensue as a result of being obese! Being obese could lead to so many kinds of health complications and even an early death.
Well, apparently this particular fat lady -- who saw the doctor five or six times -- just couldn't handle her doctor's honest approach. It seems that she'd rather get her physician in trouble than take responsibility for her own actions and join a support group or quit quickie carbs, etc."
Far Right Wing:
"When a fat woman can endanger a doctor’s license for doing his JOB by telling her his best advice on her health, that’s when we as a society has lost it. The liberal people who want to put everyone in some kind of sensitivity training like this fat woman in New Hampshire is what is wrong with America. They are filing compliant against a professional for his professional opinion because the professional’s advice isn’t sensitive. People don’t go to a mechanic, a stockbroker or a doctor for their emotionally sensitive advice."
Medpundit:
"When did rudeness become a matter for attorneys general? And judging from this version of events, he is routinely rude to obese women. His goal, no doubt, is to get their attention, but it's probably better to confine comments to medical risks and not to venture into romantic risks. Still not a matter worthy of an attorney general, though, or of a medical board for that matter."
Captain's Quarters:
"Bennett did apologize to the patient in writing for offending her, but he points out that mild, politically-correct language offers too many excuses for people to disregard the medical advice. His bedside manner may be a bit too blunt for some patients, but that gets addressed by the market and shouldn't cause the medical board to reprimand him for his honesty. Getting the New Hampshire Attorney General involved is far more ominous, and far more ridiculous."
DB's Medical Rants:
"Saw the physicians (sic) interviewed on TV today. He is obviously intelligent and well spoken. He described his 1 year of fighting this battle as a Big Brother scenario, and then as Kafkaesque.
I like the Kafka concept. He was “reported” for telling a patient the truth. If we cannot tell patients that they are obese - and that they should do something about it - then can we tell patients to stop smoking, or stop drinking - or what about crack cocaine?
This story continues to confuse me. I really cannot believe that it is a story. What is the board of medicine thinking? Who called the attorney general - and why did he not just laugh it off?"
Posted by Kevin |
link
| Comments (20)
|
The VA is being sued after a patient died minutes after being discharged
"The suit, filed by Attorney Leonard Fodera of Philadelphia, charges the VA with negligence and seeks unspecified damages, costs and expenses. Arthur Dumble was admitted to the hospital Feb. 3, 2001, after suffering from chest pains and underwent treatment and a series of tests before his discharge two days later, the complaint states."
"The suit, filed by Attorney Leonard Fodera of Philadelphia, charges the VA with negligence and seeks unspecified damages, costs and expenses. Arthur Dumble was admitted to the hospital Feb. 3, 2001, after suffering from chest pains and underwent treatment and a series of tests before his discharge two days later, the complaint states."
Posted by Kevin |
link
| Comments (1)
|
Wednesday, August 24, 2005
The death of VBAC
"For some women, birth has become the latest battleground for reproductive rights.
At a growing number of hospitals, women are being forced to schedule a repeat cesarean section just because they already had one. Doctors and hospitals say they fear lawsuits if they allow a patient to attempt a vaginal birth after a C-section - called a VBAC - and something goes awry.
'We think the risk is more of a legal risk than a medical risk,' acknowledges Bob Wentz, CEO of California's Oroville Hospital, which banned VBACs two years ago.
As the overall C-section rate in the USA continues to climb, so will the proportion of pregnant women who have already had one. C-sections hit an all-time high of 27.6% in 2003, the most recent year for which information is available." (via Overlawyered)
"For some women, birth has become the latest battleground for reproductive rights.
At a growing number of hospitals, women are being forced to schedule a repeat cesarean section just because they already had one. Doctors and hospitals say they fear lawsuits if they allow a patient to attempt a vaginal birth after a C-section - called a VBAC - and something goes awry.
'We think the risk is more of a legal risk than a medical risk,' acknowledges Bob Wentz, CEO of California's Oroville Hospital, which banned VBACs two years ago.
As the overall C-section rate in the USA continues to climb, so will the proportion of pregnant women who have already had one. C-sections hit an all-time high of 27.6% in 2003, the most recent year for which information is available." (via Overlawyered)
Posted by Kevin |
link
| Comments (11)
|
An SUV crashes into an operating room
"A sport utility vehicle rammed into the operating room toward the end of a cataract procedure.
No one was injured, but Dr. Bernard Spier said that if the accident had happened moments earlier, it could have hurt the patient's eye.
Spier had removed the cataract and had just used a plunger to implant a silicone lens when the crash threw him onto the partially sedated patient."
"A sport utility vehicle rammed into the operating room toward the end of a cataract procedure.
No one was injured, but Dr. Bernard Spier said that if the accident had happened moments earlier, it could have hurt the patient's eye.
Spier had removed the cataract and had just used a plunger to implant a silicone lens when the crash threw him onto the partially sedated patient."
Posted by Kevin |
link
| Comments (0)
|
A woman is suing Planned Parenthood for failing to prevent her pregnancy
"A Bay Point woman says Planned Parenthood and the Contra Costa Regional Medical Center are responsible for the costs of raising her child because they failed to keep her from getting pregnant.
In 2004, Planned Parenthood staff examined Kelly Horde, now 33, three times, and medical center staff members examined her once before she learned she was in her fifth month of pregnancy, she said in a complaint filed in Contra Costa Superior Court.
She is suing for an unspecified amount claiming negligence and medical malpractice. Horde is also alleging ``wrongful life'' -- a legal term that usually means a child should not have been born."
Depo Provera has an effectiveness rate of 99.7% in preventing pregnancy. The story states that they kept giving her the shots despite knowing she was already pregnant 5 months. Something isn't right here.
"A Bay Point woman says Planned Parenthood and the Contra Costa Regional Medical Center are responsible for the costs of raising her child because they failed to keep her from getting pregnant.
In 2004, Planned Parenthood staff examined Kelly Horde, now 33, three times, and medical center staff members examined her once before she learned she was in her fifth month of pregnancy, she said in a complaint filed in Contra Costa Superior Court.
She is suing for an unspecified amount claiming negligence and medical malpractice. Horde is also alleging ``wrongful life'' -- a legal term that usually means a child should not have been born."
Depo Provera has an effectiveness rate of 99.7% in preventing pregnancy. The story states that they kept giving her the shots despite knowing she was already pregnant 5 months. Something isn't right here.
Posted by Kevin |
link
| Comments (5)
|
A doctor committed suicide after missing a fatal diagnosis in a young female patient
"Father-of-two Dr Paul Goodson, 44, had examined new mother Alison Webster when she went to his surgery complaining of stomach pains. She returned home with painkillers but Alison, 23, was later admitted to hospital where she died of post-natal complications.
It is believed Dr Goodson took a fatal drugs overdose at a remote woodland beauty spot the next day . . .
. . . But care worker Alison began suffering severe abdominal pain and went to her local surgery in Pembroke Dock.
She was seen by Dr Goodson and then went home to her modern detached house in the village of Sageston. But her condition worsened and she was taken to Withybush Hospital in Haverfordwest, where she died on August 9.
An inquest was opened and heard the cause of death was severe abdominal infection puerperal sepsis which can affect women after childbirth."
"Father-of-two Dr Paul Goodson, 44, had examined new mother Alison Webster when she went to his surgery complaining of stomach pains. She returned home with painkillers but Alison, 23, was later admitted to hospital where she died of post-natal complications.
It is believed Dr Goodson took a fatal drugs overdose at a remote woodland beauty spot the next day . . .
. . . But care worker Alison began suffering severe abdominal pain and went to her local surgery in Pembroke Dock.
She was seen by Dr Goodson and then went home to her modern detached house in the village of Sageston. But her condition worsened and she was taken to Withybush Hospital in Haverfordwest, where she died on August 9.
An inquest was opened and heard the cause of death was severe abdominal infection puerperal sepsis which can affect women after childbirth."
Posted by Kevin |
link
| Comments (21)
|
Tuesday, August 23, 2005
Explaining statistics and non-significant relative risk to the Vioxx jury
"So how do you explain these issues to a Texas jury? Well, the defendants argued these 5 to 1 odds aren't statistically significant, to which the plaintiff's lawyer Mark Lanier offered this folksy rejoinder (hat tip: Newmark's Door):
"So how do you explain these issues to a Texas jury? Well, the defendants argued these 5 to 1 odds aren't statistically significant, to which the plaintiff's lawyer Mark Lanier offered this folksy rejoinder (hat tip: Newmark's Door):
Have you got $6 on you? I'm going to give you a dollar and you give me the six. It is not statistically significant in the difference. What do you think, are you in or out?Sure, Mr. Lanier, I'm in, though here's how the deal actually works-- you give me the dollar, but you don't know whether I give you $6 or I give you nothing. Or, to be a little more accurate, even if there actually is an elevated risk of the magnitude the studies suggest but can't prove, the question is whether I might want to accept a 1 in 4,000 risk of dying from a heart attack in order to get the only medication that makes my pain bearable and a mobile life livable. And if I say no to the Vioxx, I may end up taking something that is less effective for my pain but has risks of its own." (via PointofLaw.com)
Posted by Kevin |
link
| Comments (2)
|
"I didn't understand any of the medical evidence . . ."
. . . brags a Vioxx juror: "The same LA Times article has one juror singling out the fact that no senior Merck executives attended the trial; the Wall Street Journal ($) is even more explicit: 'The big guys didn't show up,' said [juror John] Ostrom. 'That didn't sit well with me. Most definitely an admission of guilt.' Is there a better demonstration how the verdict was the product of emotion, rather than reason? There are several thousand Merck lawsuits. Not even every senior Merck attorney can attend every single Merck trial. Is the company supposed to shut down so the executives can spend all their time as a full-time courtroom audience? Ostrom also proudly brags to the Journal how he didn't understand any of the medical evidence."
Update:
Catallarchy:
"That the jurors did not receive proper instructions (or didn’t listen to them) seems pretty clear to me. For one thing, jurors are allowed to ask questions of witnesses. If, as juror John Ostrom said, “We didn’t know what the heck they were talking about,” how could the jury find in favor of the plaintiff, especially for that amount of money, without asking questions until they did understand what Merck was talking about?
It’s ultimately the responsibility of the defendant’s attorneys and expert witnesses to make sure the jury understands their side of things. In this case it appears that neither did a very good job when it came to picking the jury, instructing the jury, or giving testimony."
The Republican:
"The seven men and five women on the jury that awarded $253 million to the widow of a Texas man who died from a heart condition that may or may not have been linked to the painkiller Vioxx didn't exactly focus on science during their deliberations.
They didn't, it would seem clear, focus on science during the trial, either.
'Whenever Merck was up there, it was like wah, wah, wah,' juror John Ostrom told the Wall Street Journal, mimicking the sounds made by the teachers on 'Peanuts' television cartoons. 'We didn't know what the heck they were talking about.'"
USA Today:
"Jurors are often swayed by sympathy or a slick presentation from an expert witness or attorney. Litigation becomes jury-by-jury roulette. An alternative worth considering is special health courts, where judges experienced in medicine try cases without juries. The judges would select impartial experts and write opinions that set precedent."
Jane Galt:
"This points up a larger problem, which is that even under the Daubert standard of scientific evidence, lay jurors are disastrously ill-equipped to cope with complex technical arguments. An acquaintance who is a securities litigator told me shortly before 9/11 that they try their damndest to keep cases out of court, because the issues are so complex that even the lawyers have a hard time getting a handle on them, and 'if you explain it to the jury, it takes six weeks, and they hate you more with every minute--and at the end, they still don't understand it.'"
TheAgitator.com:
". . . causality in liability cases often requires a grasp of science most lay juries simply aren't capable of, though in this case the problem seems to be that the jury didn't even feel like trying. Complex securities fraud cases can be even worse. And what do we do when a rash of suits moving ahead of the science forces a company to settle (settling making more economic sense than fighting mutliple suits in multiple venues) -- as Dow did in the breast implant cases -- and science later conclusively shows the company wasn't liable?"
ProfessorBainbridge.com:
"At the very least, this incident thus raises serious questions as to the competence of lay jurors to resolve technical issues. To be sure, there is some evidence that how technical evidence is presented matters a lot, and some suggestion in the press accounts that Merck's lawyers may not have done a very good job of presenting the evidence in a way that would maximize understanding. Even so, at the very least, this case confirms the urgent need for objective study of the ability of lay juries to understand and process scientific evidence. If it turns out that they cannot do so, perhaps it is time to take these sorts of issues out of their hands."
Update 2:
More ProfessorBainbridge.com:
"Setting up courts to specialize in technical medical and scientific issues, as McCaughey proposes, thus strikes me as a perfectly plausible compromise that retains the benefits of the jury system (if any) while still being likely to constrain bad science and bad arguments."
. . . brags a Vioxx juror: "The same LA Times article has one juror singling out the fact that no senior Merck executives attended the trial; the Wall Street Journal ($) is even more explicit: 'The big guys didn't show up,' said [juror John] Ostrom. 'That didn't sit well with me. Most definitely an admission of guilt.' Is there a better demonstration how the verdict was the product of emotion, rather than reason? There are several thousand Merck lawsuits. Not even every senior Merck attorney can attend every single Merck trial. Is the company supposed to shut down so the executives can spend all their time as a full-time courtroom audience? Ostrom also proudly brags to the Journal how he didn't understand any of the medical evidence."
Update:
Catallarchy:
"That the jurors did not receive proper instructions (or didn’t listen to them) seems pretty clear to me. For one thing, jurors are allowed to ask questions of witnesses. If, as juror John Ostrom said, “We didn’t know what the heck they were talking about,” how could the jury find in favor of the plaintiff, especially for that amount of money, without asking questions until they did understand what Merck was talking about?
It’s ultimately the responsibility of the defendant’s attorneys and expert witnesses to make sure the jury understands their side of things. In this case it appears that neither did a very good job when it came to picking the jury, instructing the jury, or giving testimony."
The Republican:
"The seven men and five women on the jury that awarded $253 million to the widow of a Texas man who died from a heart condition that may or may not have been linked to the painkiller Vioxx didn't exactly focus on science during their deliberations.
They didn't, it would seem clear, focus on science during the trial, either.
'Whenever Merck was up there, it was like wah, wah, wah,' juror John Ostrom told the Wall Street Journal, mimicking the sounds made by the teachers on 'Peanuts' television cartoons. 'We didn't know what the heck they were talking about.'"
USA Today:
"Jurors are often swayed by sympathy or a slick presentation from an expert witness or attorney. Litigation becomes jury-by-jury roulette. An alternative worth considering is special health courts, where judges experienced in medicine try cases without juries. The judges would select impartial experts and write opinions that set precedent."
Jane Galt:
"This points up a larger problem, which is that even under the Daubert standard of scientific evidence, lay jurors are disastrously ill-equipped to cope with complex technical arguments. An acquaintance who is a securities litigator told me shortly before 9/11 that they try their damndest to keep cases out of court, because the issues are so complex that even the lawyers have a hard time getting a handle on them, and 'if you explain it to the jury, it takes six weeks, and they hate you more with every minute--and at the end, they still don't understand it.'"
TheAgitator.com:
". . . causality in liability cases often requires a grasp of science most lay juries simply aren't capable of, though in this case the problem seems to be that the jury didn't even feel like trying. Complex securities fraud cases can be even worse. And what do we do when a rash of suits moving ahead of the science forces a company to settle (settling making more economic sense than fighting mutliple suits in multiple venues) -- as Dow did in the breast implant cases -- and science later conclusively shows the company wasn't liable?"
ProfessorBainbridge.com:
"At the very least, this incident thus raises serious questions as to the competence of lay jurors to resolve technical issues. To be sure, there is some evidence that how technical evidence is presented matters a lot, and some suggestion in the press accounts that Merck's lawyers may not have done a very good job of presenting the evidence in a way that would maximize understanding. Even so, at the very least, this case confirms the urgent need for objective study of the ability of lay juries to understand and process scientific evidence. If it turns out that they cannot do so, perhaps it is time to take these sorts of issues out of their hands."
Update 2:
More ProfessorBainbridge.com:
"Setting up courts to specialize in technical medical and scientific issues, as McCaughey proposes, thus strikes me as a perfectly plausible compromise that retains the benefits of the jury system (if any) while still being likely to constrain bad science and bad arguments."
Posted by Kevin |
link
| Comments (26)
|
Ted Frank takes a look at Vioxx spam in the wake of the verdict
Posted by Kevin |
link
| Comments (0)
|
Something is lost for husbands from the delivery room to the bedroom
"Whether the father is present in the delivery room is a couple's personal decision, of course.
But it is a decision that involves potential gains and potential losses, and too few couples realize that fact or are willing to talk about it.
Women may want to consider the risks as they invite their partners to watch them bring new life into the world. For some of the passion that binds them together may leave their lives at the very same time."
"Whether the father is present in the delivery room is a couple's personal decision, of course.
But it is a decision that involves potential gains and potential losses, and too few couples realize that fact or are willing to talk about it.
Women may want to consider the risks as they invite their partners to watch them bring new life into the world. For some of the passion that binds them together may leave their lives at the very same time."
Posted by Kevin |
link
| Comments (1)
|
Medical schools are not adequately preparing future physicians for real-life
"According to survey results, released today, physicians-in-training are receiving traditional education, but are not being offered curricula that keeps pace with the advances in the healthcare industry. As summer vacation ends and schools re-open, medical students wonder, am I receiving an education that will make me a competent physician? Results show that only 17 percent of students are very satisfied with their curricula . . .
. . . Respondents report their curriculum includes no classes/electives on:
- Business of medicine (47%)
- Technology advances in medicine (35%)
- Global HIV/AIDS (31%)
- Complementary and alternative medicine (26%)"
"According to survey results, released today, physicians-in-training are receiving traditional education, but are not being offered curricula that keeps pace with the advances in the healthcare industry. As summer vacation ends and schools re-open, medical students wonder, am I receiving an education that will make me a competent physician? Results show that only 17 percent of students are very satisfied with their curricula . . .
. . . Respondents report their curriculum includes no classes/electives on:
- Business of medicine (47%)
- Technology advances in medicine (35%)
- Global HIV/AIDS (31%)
- Complementary and alternative medicine (26%)"
Posted by Kevin |
link
| Comments (5)
|
Response supporting the doctor who told a fat woman she was obese
"I don't know about you, but to me this is a waste of resources and a waste of time. Doesn't the Medical Board of New Hampshire have some real issues to investigate, like physician incompetence or dishonesty? Do they really have nothing else to do that this is something they actually have time to pursue?
Have we as a society become afraid of the truth so much that we're willing to file complaints against doctors who tell us the truth, because the truth hurts our or someone else's feelings?"
"I don't know about you, but to me this is a waste of resources and a waste of time. Doesn't the Medical Board of New Hampshire have some real issues to investigate, like physician incompetence or dishonesty? Do they really have nothing else to do that this is something they actually have time to pursue?
Have we as a society become afraid of the truth so much that we're willing to file complaints against doctors who tell us the truth, because the truth hurts our or someone else's feelings?"
Posted by Kevin |
link
| Comments (6)
|
The British Medical Association is warning against inappropriate screening tests
"The British Medical Association report said patients should be particularly wary of tests which could be bought over the internet of via mail order.
And it warns ad hoc tests may do harm than good, either through false positive or inconsistent results.
The prostate cancer test and mammograms for women under 50 are two tests whose worth are questioned by the BMA.
An estimated £65 million was spent on private screening in the UK in 2004.
But while patients may pay for the initial screening, if a potential problem is discovered it is the NHS that picks up the bill for further tests, counselling and treatment."
"The British Medical Association report said patients should be particularly wary of tests which could be bought over the internet of via mail order.
And it warns ad hoc tests may do harm than good, either through false positive or inconsistent results.
The prostate cancer test and mammograms for women under 50 are two tests whose worth are questioned by the BMA.
An estimated £65 million was spent on private screening in the UK in 2004.
But while patients may pay for the initial screening, if a potential problem is discovered it is the NHS that picks up the bill for further tests, counselling and treatment."
Posted by Kevin |
link
| Comments (0)
|
Monday, August 22, 2005
Grand rounds is up at Straight from the Doc
Come get the weekly, meaty, best of the medical blogosphere, sans the fat.
Posted by Kevin |
link
| Comments (0)
|
Vioxx and Merck: Monday update
Forbes.com: How to defend Merck"One of Merck's main goals will have to be to limit the number of patients who can claim they are owed money. In clinical trials, Vioxx was linked to an increase in heart attacks, strokes and some other heart problems. But it never was linked to arrhythmias, the cause of death written on the death certificate of Robert Ernst, the victim in the first Vioxx lawsuit. By one line of logic, that should have made it easy for Merck to argue that Vioxx did not cause his death.
Unfortunately, Birnbaum says, getting science across to a jury can be incredibly difficult. 'It takes some very good lawyering to do that, because laypeople, it's hard for them to differentiate between arrhythmias and heart attacks,' says Birnbaum."
BBC: Widow 'encouraged' by Vioxx case
"A south Wales widow who alleges the painkiller Vioxx killed her husband has welcomed the £141m awarded by a US jury to an American woman.
Maureen Watt, from Bargoed, is one of hundreds in the UK hoping to take legal action against the US firm Merck."
NY Times: Vioxx Verdict Raises Profile of Texas Lawyer
"To jurors, Mr. Lanier's performance may have appeared unscripted, but he meticulously planned the trial's smallest details, down to his choice of wedding band. Outside the courtroom Mr. Lanier wears a heavy band engraved with Hebrew and Greek lettering, but in front of jurors he prefers a simple gold band so they will not be distracted. For the same reason, he wore the same blue suit each day. He also hired a private investigator to examine the jurors' criminal records in search of potential hidden biases.
With the help of a 13-member shadow jury that was paid to watch the trial and report to consultants hired by Dr. Robert Leone, his in-house jury psychologist, Mr. Lanier refined his arguments each evening in Suite 922 at the Four Seasons hotel in downtown Houston, where he and several members of his team stayed during the trial."
Corante: In the Pipeline:
"You would think, to hear the way some people talk, that no one at Merck ever took Vioxx. That they just launched it onto the market with an evil cackle and a shout of 'Caveat emptor', then sat back to watch the money roll in. Actually, employees of Merck very likely took Vioxx at a rate above that of their cohorts in the general population - employee discounts, you know. I've no doubt that this applies to Merck's marketing department, to their clinical development groups, and to their toxicologists. Why shouldn't they take their own company's drug if they're in need of a COX-2 inhibitor?"
Posted by Kevin |
link
| Comments (6)
|
A doctor is in trouble because he told a fat woman she was obese and the patient took offense
"He said he tells obese women they most likely will outlive an obese spouse and will have a difficult time establishing a new relationship because studies show most males are completely negative to obese women.
Bennett said he tells them their obesity will lead to high blood pressure, diabetes, heart disease, gastroesophageal reflux and stroke.
One patient who Bennett had seen five or six times took offense at the lecture and filed a complaint against Bennett about a year ago with the New Hampshire Board of Medicine.
Bennett says his former patient filed the complaint because 'I told a fat woman she was obese. I tried to get her attention. I told her you need to get on a program, join a group of like-minded people and peel off the weight that is going to kill you.'
He said he had discussed her obesity before with the woman, but she continued to put on weight, becoming diabetic with gastroesophageal reflux and chest pains."
"He said he tells obese women they most likely will outlive an obese spouse and will have a difficult time establishing a new relationship because studies show most males are completely negative to obese women.
Bennett said he tells them their obesity will lead to high blood pressure, diabetes, heart disease, gastroesophageal reflux and stroke.
One patient who Bennett had seen five or six times took offense at the lecture and filed a complaint against Bennett about a year ago with the New Hampshire Board of Medicine.
Bennett says his former patient filed the complaint because 'I told a fat woman she was obese. I tried to get her attention. I told her you need to get on a program, join a group of like-minded people and peel off the weight that is going to kill you.'
He said he had discussed her obesity before with the woman, but she continued to put on weight, becoming diabetic with gastroesophageal reflux and chest pains."
Posted by Kevin |
link
| Comments (35)
|
Sunday, August 21, 2005
Doctors as plaintiffs suing the insurance companies
(via CuriousJD and symtym)
(via CuriousJD and symtym)
Posted by Kevin |
link
| Comments (4)
|
The Boston Globe looks at the difficulty in balancing justice and medicine in the malpractice crisis
"According to Howard, one of the chief problems is that juries must make decisions about 'standard of care' (the accepted norm from which a negligent doctor may have deviated), an area about which most jurors know little. And jury decisions apply only on a case-by-case basis. As a result, pain and suffering awards for the same injuries vary widely, while studies show that even 'hard' economic damage awards (such as lost wages and medical costs) can differ substantially as well. 'There is a sort of lottery aspect to damage awards that is unfair to most plaintiffs,' says Howard. 'There's no horizontal equity across the line.'"
"According to Howard, one of the chief problems is that juries must make decisions about 'standard of care' (the accepted norm from which a negligent doctor may have deviated), an area about which most jurors know little. And jury decisions apply only on a case-by-case basis. As a result, pain and suffering awards for the same injuries vary widely, while studies show that even 'hard' economic damage awards (such as lost wages and medical costs) can differ substantially as well. 'There is a sort of lottery aspect to damage awards that is unfair to most plaintiffs,' says Howard. 'There's no horizontal equity across the line.'"
Posted by Kevin |
link
| Comments (5)
|
Vioxx and Merck: Sunday update
Susan's Scribblings"All the drugs advertised in print and on television bring out the side effects and possible risks, and no doctor should prescribe a drug without discussing the ups and downs of its use with the patient. Perhaps the unfortunate victim's heart attack was actually unrelated to Vioxx--heck, some of the healthiest people can drop dead for no apparent reason--but based on what I've read and seen, this recent lawsuit "victory" may well be the start of a reversal in our ability to study, develop and heal through the good efforts of the drug companies.
My sympathies go to the widow of the man who died, but I also grieve for Merck and hope they can continue to work to produce drugs that help and heal, for people who appreciate what medicine can and cannot achieve."
Greg's Opinion:
"As for the notion that this hurts more people than it helps by prohibiting companies from producing new drugs, color me doubtful. I just don't buy it when apologists for big companies claim we're all going to hell in a handbasket if we don't cave to said company's demands for maximum immunity. Nor do I accept it as a given that we should live with a statistical probability of X deaths per Y prescriptions. Apparently, the apologist crowd would stipulate this coldhearted reality as a necessity. It isn't. If a company can't find a means to survive in a business environment that says 'when you take shortcuts that cost people's lives, you pay for it' then they don't deserve to be in business. Last I checked, after all, there were ample cars on the streets today despite Ford being held liable for their disasterous Pinto design. Those of us who do cling to social responsibility as a responsible ideal aren't out to kill off all business ... rather to rid the ones who have no good cause to put people's lives and well-being at risk. Merck, ultimately, may or may not fall into that category ... they obviously have no problem producing numerous drugs that do the world a lot of good. And more power to them. But they may well need the wakeup call of this verdict (and it's successors) to ensure a better way to produce a safer product."
NY Times: For Merck, Vioxx Paper Trail Won't Go Away:
"As Merck examines its defeat in Texas, it may be tempted to blame its problems on the ineptitude of its lawyers, who committed basic mistakes like failing to prepare witnesses and badgering Mrs. Ernst, a sympathetic widow, for 90 minutes on cross-examination.
Merck may tell itself that the part of Texas where the case was heard is favorable to plaintiffs and that the trial might have turned out differently elsewhere. It might even say that W. Mark Lanier, the Houston lawyer who represented Mrs. Ernst, is so skilled that he won a case that most other plaintiffs' lawyers would not even imagine bringing."
Ideoblog:
"The verdict was hardly surprising. As reported here, the plaintiff’s case fe