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March 31, 2007

Malpractice suit trial opens in Waco man's death

The adult children of a 75-year-old Waco, TX man who died five years ago after knee-replacement surgery are seeking up to $12 million in damages in the trial of a medical malpractice lawsuit that began March 26th. Kathy and David May and Suzanne Collier, claim that negligence on the part of four doctors who treated their father, Thomas L. May Sr., at Hillcrest Baptist Medical Center led to his death May 29, 2002. Drs. Nick Manitzas, Mark Mazzare, David Tuel and Todd Tyson have denied the allegations and say May received proper care and was preparing to go home when he got an infection that led to his death.

Dallas attorney Bill Zook, who is representing the May family with Ron McCallum, told jurors in opening statements that, despite his age and three prior surgeries to replace his left hip and left knee and to repair back problems, May was in relatively good health and enjoyed hunting, golfing and other outdoor activities. Zook told jurors that May’s knee-replacement surgery May 14, 2002, went well and that he and his family had expected him to be released from the hospital in about four or five days. Zook claims the doctors prescribed two types of pain medications, including one stronger than the recommended dose, and a blood thinner that formed a lethal cocktail when combined with blood-pressure medication that May already was taking. “We think it was an injustice the way these doctors cavalierly prescribed these medications, did not consider the interaction of them, and Mr. May died as a result,” Zook said. The doctors ignored a “black-box warning,” the most severe warning a drug manufacturer has to give a physician, that some of those drugs should not be combined, he said. May developed a condition known as sepsis, caused by inflammation, problems with blood clotting and low blood pressure. The sepsis led to respiratory problems, organ failure, pneumonia and an eventual heart attack, Zook said. He died from what is known as adult respiratory distress syndrome, Zook said.

Dallas attorney David C. McCue, who is representing Manitzas and Tuel, told jurors that, while May’s death was tragic, he was “not a glowing specimen of health” when he entered the hospital. He suffered from symptoms of asbestos exposure, had been a longtime, heavy smoker and had developed pneumonia after one of his previous surgeries, McCue said. He said the doctors had used all the drugs that they prescribed for May for years with no complications. May’s health took a turn for the worse when he ate a candy bar and aspirated it and some of his stomach contents got into his lungs, McCue said. An autopsy found E. coli in his system, which had to come from “bugs” from his intestines, McCue said. That led to the infection and pneumonia, not the combination of medications, he said. “It was bugs, not the drugs,” McCue repeated frequently during his opening, referring to bacteria from May’s intestines.

 


 

Florida women who ate tainted peanut butter file suits

Two Palm Beach County women who became ill after eating salmonella-contaminated peanut butter are suing its manufacturer, ConAgra Foods Inc. Brian Smith, a West Palm Beach attorney with Smith & Vanture, filed separate lawsuits Thursday in Palm Beach County Circuit Court on behalf of Ruby Reilly of Palm Beach Gardens and Gloria Deleo of West Palm Beach. There are close to 400 confirmed cases of illness that have been linked to the product in 42 states, FDA officials said. ConAgra is being sued for product defects, failure to warn consumers of the product's danger, and negligence. Each woman is seeking damages in excess of $15,000.

Seattle-based attorney Bill Marler, who in February filed a national class-action suit over the tainted peanut butter, said he represents 4,500 people who were sickened by the peanut butter. "Of that 4,500, there are close to 500 who had more than an emergency room visit. They had overnight hospital stays or days. We are looking at 10 possible deaths," Marler said.

ConAgra spokeswoman Stephanie Childs said Thursday it is working with the FDA to determine how the contamination occurred. "It concerns us greatly that any consumer may have been harmed by a product of ours," Childs said. The company has received 15 million calls from consumers about the recall, she said. "We are working with the FDA to finalize both the cause and the next steps," Childs said.

 


 

TBI Jail population presents new challenges

A jail is a reflection of societal problems. “It’s a little city, a complex society,” Hubbard County Chief Deputy Frank Homer said of a jail. “Everything that’s on the inside, is on the outside.” What’s being seen “on the inside” has evolved over the decades. Jail administrator Sherri Klasen joined the staff in 1986, when “alcohol was the main contributing factor” to those who were incarcerated. “Now it’s drugs,” she said. “And a huge part of it is methamphetamines.” In addition to the increase of inmates incarcerated for drugs and alcohol the Hubbard County Jail is seeing an increase in those with symptoms of mental health problems, as well. “We were warned of this in the late ’90s,” Homer said. State funding was “falling short.” State hospitals would be closing. The patients were to be given medication and sent “home.” Law enforcement was cautioned the impending problems could fall in their lap. As secure facilities disappear, the jail is dealing with more inmates with mental health issues for longer periods of time, Klasen said. Nationally, correctional facilities are seeing more mental health problems, UMMHC executive director Manfred Tatzmann said.

A recent survey by the federal Justice Department statistics bureau estimated a large percentage of prisoners nationwide reported treatment for or symptoms of major depression, mania or psychotic disorders such as hallucinations or delusions in 2006. Conditions faced by inmates may include fetal alcohol syndrome (FAS) or those who’ve suffered traumatic brain injury (TBI). TBI affects impulse control and memory. “They may forget to take their medications,” Tatzmann said. Offenders with TBI may suffer from depression, anxiety, cognition problems, violent thoughts, suicide attempts and discipline violations. The conditions may cause impulsive behavior and difficulties with the law, Tatzmann said. It’s been called the silent epidemic because there are no visible signs. “No two are alike,” Tatzmann said of patient symptoms resulting from TBI. People with brain injuries tend to self-medicate and domestic violence increases. The number of people with TBI has grown dramatically in the past 10 years because of medical advancements. Fifty percent of the people sustaining a TBI faced mortality previously, Tatzmann said.

 


 

March 30, 2007

Parkinson's Drug Causes Heart Damage, is Pulled from Market

At the request of the FDA, the Parkinson's drug Permax (generic: pergolide) has been voluntarily removed from the market by its maker, Valeant Pharmaceuticals, because of its link to heart valve damage.

"The reason for the withdrawal is because of the high rate of damage to the heart valves in users of pergolide," said Dr. Robert Temple, director of the Office of Medical Policy at the FDA's Center for Drug Evaluation and Research (CDER). "The damage causes the heart valve to become leaky. The drug is called a dopamine agonist and is used as stating therapy for Parkinson's patients."

Pergolide has been available since 1988, but heart valve damage wasn't reported until 2002. The drug's label was changed in 2003 to reflect the risk of heart valve damage, but the FDA upgraded the warnings to a "black box warning," the strongest warning it can mandate, in 2006. In January, the New England Journal of Medicine published two studies that showed a fivefold increased risk of heart valve damage from taking pergolide. One of the studies reported that 23 percent of patients on the drug develop heart valve prpoblems, and that's what led to the FDA's request for withdrawal.

The voluntary withdrawal will not take place immediately, because patients taking pergolide need time to consult with their doctors and make appropriate treatment decisions. "We are telling these patients not to stop the drug abruptly," Dr. Temple noted. "If the patients, with their physicians, conclude they need a dopamine agonist, there are ways to switch."

 


 

Illinois state proposal could revive medical malpractice debate

">An Illinois House committee hearing could bring back the medical malpractice debate that for several years dominated Metro East politics. Supporters and critics who have strong opinions on a bill that would establish a pretrial hearing on the merits of any expert witness in a civil trial. Supporters, in particular, say they plan to go before the House judiciary committee on civil law when it hears the bill. Though the bill, numbered HB1896, would apply to all civil litigation, the debate is likely to cast a spotlight on ">medical malpractice trials, which routinely involve the use of outside expert witnesses such as doctors evaluating the case of a plaintiff. In addition to allowing for a hearing on any expert witness, the bill would also allow the hearing to be appealed before a trial proceeded. Lawyers who are backed by tort reform groups criticize such measures, as a way for defendants to boost expenses for plaintiffs and stall a verdict.

Doctors blame lawyers for filing what they see as frivolous lawsuits. Lawyers fault insurers, saying the companies raise rates and then blame the civil justice system. Many doctors still have qualms about the issue and particularly criticize the credibility of expert witness testimony, according to the results of a study released by Illinois Lawsuit Abuse Watch, a watchdog group that supports the bill. In a mail survey of 176 Illinois physicians, 97 percent said they believe at least some problem exists with the system. And 65 percent said they had personally seen or heard inaccurate or questionable statements by a medical expert witness.

East St. Louis plaintiffs’ attorney, Rex Carr, said that the additional appeal process could delay a case for years. He said any defense attorney can already file a motion that appropriately bars questionable testimony. "This is just another way to add cost to the bringing of lawsuits. It wouldn't prevent any lawsuits," said Carr. "We get experts that are competent because we want to win our cases." The medical malpractice issue has cooled in recent years, as the Legislature in 2005 passed a compromise bill, signed by the governor, limited damages a plaintiff could receive and also made changes to the malpractice insurance industry. That measure now faces a constitutional challenge in court.

 


 

Health care bill raises consumer concerns

Attorney General Paul Morrison of Topeka Kansas, victims of medical malpractice and plaintiff’s lawyers criticized legislation that would exempt health care professionals from the law that allows consumers to sue over deceptive practices. “This bill would prevent my office from investigating the most deceptive and unconscionable acts committed by anyone in the health care industry,” Morrison said. House Bill 2530 would exempt professional services by a physician or health care provider from the Kansas Consumer Protection Act. Opposing sides of the legislation squared off before the Senate Judiciary Committee who which took no action on the bill but the measure was approved by the House, 109-14.

Rep. Mike O’Neal, R-Hutchinson, and health care professionals defended the measure, saying it would limit lawsuits while there were other legal remedies that could be used for patients who allege they were wronged in their health care. “This is not about exempting doctors from claims against them,” O’Neal said. He argued that patients could still sue for medical malpractice if their health care or treatment were botched by a health care professional.

Jerry Slaughter, executive director of the Kansas Medical Society, said the bill was needed because the Kansas Supreme Court in a recent decision expanded the scope of the Kansas Consumer Protection Act to include deceptive acts by health care professionals. “Our intent is not to immunize or protect physicians, but to return to where the law was,” he said. However, Morrison, plaintiff’s attorneys and advocates for the elderly and patients disagreed. They said medical malpractice laws allow patients to sue for poor treatment or care, while the Kansas Consumer Protection Act allows for lawsuits against doctors who make false claims in advertising or in their claims about certain treatments. The recent court ruling simply stated the parameters of the act and didn’t expand its reach.

 


 

Charges may be filed in CME van wreck

The Colorado State Patrol is seriously considering recommending felony charges be filed against the driver of a Colorado Mountain Express van that crashed into a parked snowplow Sunday morning, sending the driver and all eight passengers to the hospital, Capt. Ron Prater said Monday afternoon. Prater said two passengers remained in critical condition on Monday and at least one other person needed surgery for injuries sustained in the crash.

The ski shuttle was on the way from Vail to Denver International Airport around 8 a.m. the morning of March 25th when the driver collided with a Colorado Department of Transportation snowplow parked on a portion of the interstate that had been closed so crews could clean up a prior accident. The snowplow involved in the crash was parked across two eastbound lanes of traffic to provide a barrier for workers mopping up a fuel spill caused when a semi-truck jackknifed about four hours earlier, said Colorado Department of Transportation spokesperson Mindy Crane. "It was a safety precaution to protect the workers from traffic," Crane said. CDOT warned drivers of the upcoming accident and asked them to slow down via messages on numerous electronic boards starting on the approach to the Eisenhower Tunnel on the Summit County side, Crane said.

 


 

Soldiers with brain injuries could develop epilepsy

Epilepsy experts worry that veterans arriving home with traumatic brain injuries are at risk for seizures and these electrical storms could be subtle and develop months to several years following their initial injury. "Epilepsy is very common following head injury," said Dr. Marc Dichter, professor of neurology and pharmacology at the University of Pennsylvania. "We are concerned that we will have a growing number of young people with head injuries who may develop epilepsy." Right now, there are no treatments to prevent epilepsy. Trauma and brain infection increase the risk for seizures. "As the brain tries to repair itself, it may take time to ripen into seizures," said Dr. Dennis Spencer, an endowed professor of neurosurgery at Yale School of Medicine in Connecticut.

Experts say it is hard to know exactly how many injured troops could later develop epilepsy. U.S. Army and other officials have said better medical care in Iraq has meant that more severely injured soldiers have been saved, only to return home with serious injuries, Dichter said. Severe brain trauma can trigger epilepsy in as many as 30 percent to 50 percent of the brain-injured soldiers, he added. Early warning signs for epilepsy can include subtle changes in behavior, lapses in memory, strange sensory auras, attention problems and depression.

Dichter is conducting a pilot study on head injuries, focusing on people who arrive at emergency rooms with gunshot wounds or wounds from accidents. These people are at greater risk of developing epilepsy over the next year or two. Funded by the Department of Defense, scientists also will test the effectiveness of short-term use of anti-seizure medicines to ward off seizures.

 


 

March 29, 2007

Injured patients want new rules for chiropractors

When Brittmarie Harwe woke up with a sore neck and shoulder in 1993, she sought help from a chiropractor recommended by a friend. At her second visit, something went terribly wrong. "When he did the first (adjustment), I felt it, like a rushing noise in my head, dizzy," recalled Harwe. "He looked me in the eye and realized I was in distress. I was having a stroke, right then and there." Harwe, 26 at the time, was rushed to the hospital, where she learned that her left vertebral artery had been crushed. In the days and years that followed she suffered from paralysis, vision loss, weakness and coordination problems, a paralyzed vocal cord and an inability to swallow. Today, she still uses a feeding tube.

Harwe plans to tell state lawmakers Monday that she had no idea stroke was one of the risks of cervical manipulation by a chiropractor. The legislature's Public Health Committee is considering legislation that would require chiropractors to inform patients, both in writing and verbally, of the risks and possible side effects of their treatments. State chiropractors say the legislation is unnecessary and unfairly punitive. They argue that a state law requiring a patient to give informed consent before a procedure is excessive given the statistically remote risk of injury and death. The bill was proposed by Sen. Leonard Fasano, R-North Haven, who has a constituent who suffered a stroke after a chiropractic visit. While he agrees many people benefit from visits to chiropractors, Fasano said consumers should have as much information as possible. "What is so bad about saying here are the potential risks?" Fasano said.

Janet Levy of Woodbridge, Fasano's constituent, formed the group Victims of Chiropractic Abuse last June. Five years ago, she woke up with a stiff shoulder ache and went to a chiropractor recommended by a friend. She immediately got a headache, but the chiropractor said it was only a reaction to the treatment. Days later, she went to the hospital and learned she had had a mini-stroke caused by a torn artery and needed emergency brain surgery. At the time, she was 48 and ran five miles a day. After the surgery, she was told she wouldn't walk again. But Levy persevered and went through two years of physical and occupational therapy, seven hours a day. Today she can walk, but still has balance problems and other neurological defects. Levy said she could have saved herself from those two years of suffering if she had known about the risks she faced.

 


 

Advocates Hope Lawmakers Will Take Initiative to Help TBI Victims

The Neurotechnology Industry Organization (NIO) met with lawmakers in Washington this week to discuss the many obstacles faced by companies and organizations working to help traumatic brain injury (TBI) victims. NIO members proposed federal research and developmental initiative programs to accelerate discoveries in the brain injury field.

"The economic burden our nation faces due to brain and nervous system disorders is $500 billion and climbing," said NIO Executive Director Zack Lynch. "Despite the large and growing unmet markets, massive economic cost, and untold human suffering, there are few effective treatments that delay, prevent and cure chronic neurological and psychiatric diseases. The NNTI provides the means for the United States to secure leadership in neurotechnology and improve countless lives."

NIP is a non-profit organization that represents companies involved in neurotechnology, neuroscience, and brain disease advocacy all over the world. The organization's mission is to accelerate cures for brain and nervous system diseases by promoting the neurotechnology industry's progress, advocating the industry's position to government officials, and providing business development services to their members.

In related news, Sen. Hillary Rodham Clinton announced at a press conference today that she will be introducing new legislation to improve the treatment of soldiers with TBI's. Her initiative calls for better TBI screening methods, more support systems for families of victims, and new treatment options and programs.

 


 

March 28, 2007

Pesticide Caused TBI 10 Years Ago

On March 26, 2007, 16 year old Christian Ward was rushed to the hospital after being exposed to the pesticide diazinon. Ward was exposed to the pesticide when her hair was washed with it to treat hair lice. She cried in pain immediately after diazinon was poured into her hair and went into cardiac arrest shortly thereafter. After being admitted to the hospital, Christian Ward remained in a coma for 5 days. Doctors told her family that she suffered a traumatic brain injury so severe that she would probably be in a vegetative state for the rest of her life.

Miraculously, 10 years later Christian is just a normal 16 year old girl. Doctors said that she would probably never be able to even breath on her own but now Christian is getting ready to learn to drive - like all regular teens her age. Christian's mother is thankful that her daughter had such a miraculous recovery and has spoken out about the misuse of household products over the years.

Diazinon is an organophosphorous pesticide used to control insets in soil, plants, and crops. Since the Wards' incident the U.S. Environmental Protection Agency has banned the use of diazinon from residential use. It is now illegal to sell diazinon products (outdoor and non-agricultural) in the US. Further investigation found that diazinon affects the nervous system - no matter what part of the body is exposed to the harmful pesticide.

 


 

Sleeping Pill Helps Individuals in Vegetative States

In 1996 Louis Viljoen was struck by a truck while riding his bicycle in South Africa. He sustained a severe traumatic brain injury (TBI) and has been in a persistent vegetative state ever since. In 1999 Viljoen's primary doctor prescribed the sleeping pill Zolpidem to cure his restlessness.
After giving her son the first dose of Zolpidem Vilojoen's mother did not expect anything out of the ordinary to occur. Instead she was surprised by the sound of her son's voice 20 minutes after his first ingestion of the pill. For 2 hours, Louis remained completely lucid and spoke to his mother before falling back into a vegetative state.

Dr. Ralf Clauss, a nuclear medicine physician in the UK, was intrigued by this phenomenon and flew to South Africa to scan Vilojoen's brain. He found that before the pill was given to Vilojoen, 30% of his brain was abnormal and did not light up during the scan. After the pill was administered the abnormal parts of Vilojoen's brain lit up like a normal brain. Since this miraculous discovery there have been numerous other similar cases in the UK, South Africa, and the US.

Zolpidem is still classified as a sleeping pill and cannot be prescribed to cure comatose patients until more research is done. It has taken eight years of research for Dr. Clauss to reach a hypothesis of how Zolpidem affects brain injury. "The drug is a GABA agonist, which means in normal tissue it stimulates GABA receptors and normally they put you to sleep," he explains. "But in Louis's brain, for example, these GABA receptors are abnormal and overactive. They keep Louis's brain in a sleeping or dormant state all the time. The drug distorts these abnormal receptors which put Louis to sleep, dormancy is switched off and the brain returns back to normal."

Zolpidem's manufacturer says that even more studies must be done before the drug can be used specifically for brain injury and comatose patients. Experts in the field do not expect Zolpidem to be used for brain injuries for another several years.

 


 

Brain Injuries Have Far-Reaching Effects

A year after a motor vehicle accident, a Maryland woman struggles to regain what she lost. Last year, Dawn Seminuk was a mother and nurse when a drunk driver changed it in an instant. March 30 marks one year since the horrific car accident that dramatically altered Dawn's life. "She'd see people and say don't ever let me get like that, and now she's there," said Kristine Bacon, Dawn's sister. Dawn lives at the Spa Creek Nursing Home in Annapolis. The former emergency room nurse now depends on around-the-clock care. When Dawn's car was struck by a drunk driver, her brain sustained irreversible injury. "Not only was her brain shaken up in her skull, her skull also hit the windshield and created multiple damage," said Diane Triplett with the Brain Association of Maryland.

Traumatic brain injury affects more than a million Americans every year. In Maryland, about 6,000 people have an injury serious enough to be transported to a trauma center. Most cases are caused by falls, motor vehicle accidents and being struck. "It's not just the injury, but period of time that follows during and after, that there's damage to the brain," Triplett said. Triplett said some brain injury patients like TV newsman Bob Woodruff make a significant recovery. Many are not as fortunate.

Dawn's family says they lack the insurance and resources to provide daily therapy. Without it, the improvements she initially made are quickly fading. "It's very frustrating as a mother to see your child going backwards," Barbara Seminuk, Dawn's mother, said. Dawn's mother says her goal is to bring her daughter home in two years when she can retire. Her main concern is that during that time Dawn will decline ever farther.

 


 

New Technology for Traumatic Brain Injury Detection in the war zone

Guardian Technologies International, Inc., a leading technology developer of intelligent imaging informatics solutions, for the homeland security and healthcare industries, has submitted a $3 million research and development proposal request to the U.S. Government for grant funding to expand the current capabilities of Signature Mapping™ and to engage in a customization initiative of its Signature Mapping™ technology for battlefield applications.

Acceptance of the proposal would provide the research and development funding necessary to improve detection of traumatic brain injury (TBI) on the battlefield. The War on Terror has yielded a radical change in the type of battlefield injuries U.S. soldiers are likely to sustain and has significantly complicated the field doctors' ability to accurately diagnose and triage patients in the field. Most of the soldiers wounded in action and subsequently evacuated are injured by explosions. Between 2003 and 2005, 28% of all battle injuries included TBI. The majority of those injuries were closed TBI (the injury was not surface detectable). Closed head injury is often difficult to identify in the field, particularly when it is combined with other serious and more obvious and sometimes life-threatening injuries. Confronted with this new medical problem, the Army through the Department of Defense is searching for technologies to address these clinical battlefield challenges.

http://www.redorbit.com/news/health/876828/guardian_technologies_signature_mappingtm_technologies_for_traumatic_brain_injury_detection/index.html?source=r_health">Using Signature Mapping™ generates many advantages over other image processing methodologies, particularly with TBI detection in the field, such as: 1) it is capable of differentiating and detecting brain hemorrhages with a high degree of certainty -- high sensitivity with a low rate of false positives; 2) the technology is able to detect small amounts of brain hemorrhage which may go undetected by normal trained observers; 3) it successfully differentiates very difficult-to-distinguish or difficult-to-classify image object types within the same image, such as blood versus x-ray artifacts (known as bone-hardening artifacts); 4) it can also detect cerebral spinal fluid and has been shown to accurately measure the size and shape of the ventricles; 5) it can provide quantitative measurement tools to track targeted defects or changes over time; and, 6) it does not rely solely on prior knowledge of an object's shape, volume, texture or density to be able to locate and identify bleeding in an image.

 


 

ConAgra reports 3Q profit despite peanut butter recall

ConAgra Foods Inc. earned $192.6 million in the third quarter despite a massive recall of all of its peanut butter products after they were linked to a salmonella outbreak, the company reported. This year's results were considerably better than a year ago, when ConAgra posted a loss of $25.2 million because of one-time charges related to restructuring. The Omaha, Nebraska based company said its earnings amounted to 38 cents per share in the quarter that ended Feb. 25, versus a loss of 5 cents a share a year ago. Its latest results included one cent a share from discontinued operations.

ConAgra has yet to resume production at its only peanut butter plant, in Sylvester, Georgia. The company has said the recall would cost between $50 and $60 million dollars. Chief Executive Gary Rodkin said Thursday that about $48 million of the recall costs, or 5 cents per share, were included in the third quarter.

 


 

March 27, 2007

Oklahoma officials testing whether man's death linked to peanut butter

State officials in Tulsa Oklahoma are trying to determine whether a salmonella outbreak traced to the peanut butter recall played a role in a Tulsa man's death. Assistant laboratory director for the Oklahoma Department of Agriculture, said a peanut butter sample provided by the man's wife was tested and matched to Salmonella Tennessee (the strain that caused illnesses in hundreds of people across the country. The state is conducting more tests to determine whether the suspected organisms found in the peanut butter were present in the man's body. The director told the state Board of Agriculture the man was already suffering from an undisclosed illness before his death this month.

Although federal officials have received reports that hundreds of people became ill and dozens were hospitalized after consuming the contaminated peanut butter, there have been no documented deaths. Oklahoma had 12 confirmed cases of peanut butter poisoning between October and February, but no deaths, said director of the state Health Department's Communicable Disease Division. Oklahoma's cases include 10 women and two men ranging in age from 1 to 80. The most recent case involved a 53-year-old man in Jefferson County in early February.

 


 

Majority of brain traumas called preventable in Utah

On average, across Utah, there are five nonfatal traumatic brain injuries a day and one that kills, according to the Utah Department of Health. They result primarily from motor vehicle crashes and falls, and the majority are preventable. Wednesday Mar 21, the department released a study of traumatic brain injuries that occurred from 2000 to 2003. It found that TBIs were nearly twice as common among males as females and that the rate of TBIs in rural Utah is 53 percent higher than in urban Utah. "We don't believe the numbers are any different today than the study period," said Kevin Condra, a spokesman in the Violence and Injury Prevention Program. "The most common are motor vehicles, centering on seat belt use and having children in proper restraints. The next most common is hazards," he said. Among Utahns 60 and older, the common cause of TBI is a fall, usually at home. Condra cited loose rugs, clutter around stairways and poorly lighted pathways as among factors contributing to the falls and subsequent brain injuries.

Among younger Utahns, the brain traumas are most common in the 15-24 age group and typically involve a motor vehicle. That includes injuries to motorcyclists who didn't wear helmets and drivers and passengers who were not properly restrained, including children. For the study period, 4,403 males and 2,612 females were hospitalized because of TBIs. Another 1,047 males and 287 females died before being admitted. Those admitted to an emergency department, the report said, are not considered a "hospital inpatient." The report excluded patients treated and released from the emergency department. In cases where hospital discharge information was known, most went home to care for themselves or receive assistance. "Also, approximately one-fifth (24.3 percent for males and 15.5 percent for females) of all TBI subjects died before admission or during hospitalization because of the injury," the report said. The department's goal, said Condra, is to raise awareness and reduce the number of preventable injuries.

 


 

Indianapolis traffic fine could help disabled

In Indianapolis a fine you pay for your next speeding ticket might be a few dollars higher, but advocates for the disabled say the increase ultimately could bring hope to Hoosiers who suffer from spinal cord injury or traumatic brain injury. Tucked deep within the House budget bill is a section creating the state's first spinal-cord and head-injury research fund. Increased fines motorists pay for speeding, driving while intoxicated or other violations would fund the research, conducted in Indiana.

To persuade senators to approve that section in the House budget, a group of Hoosiers in wheelchairs sat outside the state Senate, handing out leaflets and lobbying Thursday. Greg Bedan who suffered paralysis in a high school football injury in 1976 but went on to work in state government, noted that the injury-research funds would boost Indiana's life sciences industry. Additionally research has the potential to help disabled Hoosiers re-enter the work force. "There's a lot of servicemen coming back with traumatic injuries, not just to the head, but amputees and spinal cord injuries," Bedan said. "It will improve their lives as well." Derek Deckman, who was injured in an auto accident two weeks before his 18th birthday, was on Medicaid for 10 years until he completed his education and could support himself through employment. Now he is an account representative for a technology firm. "The biggest challenge is breaking down the stereotype that people with disabilities don't have value to add to the work force," he said.

Although she does not use a wheelchair, Darcy Keith is a survivor of a traumatic brain injury again, from an auto accident. "We're called the walking wounded," Keith said, because her injury is not immediately apparent to others. She hoped that having a group of disabled advocates lobby for the proposal would register with legislators considering the bill. The advocates noted motor vehicle accidents are the leading cause of spinal cord injuries and of traumatic brain injuries for those ages 16 to 24. Lifetime medical costs for such patients can reach $2 million, and many end up on Medicaid. In light of the correlation between certain traffic violations and injuries, the proposal calls for increasing fines by $18 for speeding, driving while intoxicated, running a red light, and failure to yield, for example. Motorcycle registration fees also would go up by $10, to $27, the proposal says. Together, that would generate an estimated $19.1 million a year in motor-vehicle fees for the injury research fund. Indiana University and Purdue University each would get $500,000 a year for spinal cord and brain injury research. And a nine-member board would screen research projects and award grants from the remaining funds.

 


 

Nationwide class action lawsuit against ConAgra Foods, Inc.

In Rome, Georgia Plaintiffs' counsel Kathryn E. Barnett announced that 32 consumers, including the parents of nine children that became seriously ill after eating Peter Pan or Great Value peanut butter, spanning 16 states filed an amended class action complaint against the international food conglomerate ConAgra Foods, Inc. The proposed class consists of all persons nationwide that contracted Salmonella Tennessee from eating ConAgra's contaminated peanut butter

"This case shows that the number of 425 persons made ill from eating Salmonella tainted peanut butter as reported by the Center for Diseases Control constitutes a gross underestimate," stated Kathryn Barnett of the national plaintiffs' law firm Lieff Cabraser Heimann & Bernstein, LLP. "We believe thousands of consumers have been made sick over the past two years. Since the recall was announced in February, our law firm alone has been contacted by over a thousand persons that have reported symptoms of Salmonella poisoning, including fever, stomach cramps and severe diarrhea which in many cases required hospitalization."

"My husband and I were terrified when our son became so sick. We called our pediatrician and raced to the Emergency Room with him," stated plaintiff Kelli Hamman of Flomaton, Alabama. "I never dreamed it could have been caused by peanut butter. I don't understand why my son and other children had to suffer like this, and I hope ConAgra will take responsibility and answer to every family that has suffered." Ms. Barnett advised consumers: "If you have suffered symptoms of contaminated peanut butter, do not discard the evidence; instead mark the peanut butter with 'Do Not Eat' or 'Contaminated' and make certain the jar is stored in a safe place that is beyond the reach of children. The peanut butter can be tested for the presence of Salmonella."

 


 

March 26, 2007

Doctors ask Nevada lawmakers to pass 'I'm sorry' law

Doctors asked Nevada lawmakers to pass a law that would let them say they're sorry for medical mistakes. Doctors are usually told not to because of fears an apology could be used against them later in court. Several doctors and the head of the Nevada State Medical Association asked the Senate Judiciary Committee to pass SB174, an "I'm sorry" measure to prevent any expression of compassion, regret, or fault for what happened to a patient from being used as evidence in any civil court proceedings. Sponsored by Sen. Joseph Heck, R-Henderson, who is also an osteopathic physician, the bill is similar to laws already passed in 29 other states.

Doctors often are told by medical educators and attorneys not to apologize to patients for medical errors out of fear that the apology will be seen as an admission of negligence, Heck said. "This advice, which has been heeded by many physicians, results in a chilling and straining of the patient-physician relationship at the very time when the patient is most in need," said Heck. Apologies can actually reduce the chances of a lawsuit being filed, some doctors testified. What most patients and their families really want is to understand what happened when mistakes are made, said Dr. David Fiore, a Reno family physician. "What we really need this for isn't so much the malpractice," said Fiore. "We need it for the healing." Larry Matheis, executive director of the Nevada State Medical Association, said passing the bill is vital now that medical schools are increasingly stressing communication skills. "This absence of communication has to be bridged," said Matheis. "Most of it is going to have to be bridged by people being free to talk to each other, and talk to each other frankly."

Bill Bradley, a Reno medical malpractice attorney, testified against the bill. If an apology is retracted when litigation begins, it could be even more devastating to a patient than not receiving an apology, he said. "Any sincere attempt to reconnect with the victims should start with a thorough explanation of the event," said Bradley. "If litigation follows, the thorough and accurate explanation those patients got should be able to stand in court, because the truth is the truth." Heck agreed that withdrawing an apology in court would do harm, but said that's exactly why his bill should be passed. If the doctor's earlier apology is inadmissible, there's no need to deny the apology took place, he said.

 


 

Malpractice victim uses grief and anger to assist others

When Tresa E. Speer died, her daughter, Mary Crabtree, didn't know where or to whom to turn. In March 2003, Speer, 75, went into the hospital for a routine knee replacement and never came out. Crabtree sued the doctor for malpractice and the case was settled out of court. Crabtree found little solace in the money, however. Crabtree didn't allow herself to wallow in her misery. Channeling her grief, she created a lasting, living tribute to her mother. Crabtree has created The Tresa E. Speer Medical Malpractice Support Group for Malpractice Survivors and Families. It's a Web site devoted to offering support and information about medical malpractice.

For those contemplating surgery or already a victim, the site raises public awareness on how to become proactive in making better health-care choices. It has tips on what to look for when choosing a surgeon and how to investigate their backgrounds. It allows victims to share personal stories of medical malpractice and offers resources that enable easier navigation through the justice system. There are also resource referrals and an on-line support system connecting other people who are going through similar situations. Victims can tell their stories knowing there are others out there facing similar confusion and emotional pain.

 


 

Majority of Medical Malpractice Claims in Seven States Closed Without Compensation Payments

The majority of medical malpractice claims in a study of seven states were closed without any compensation paid to those claiming a medical injury, the Justice Department's Bureau of Justice Statistics (BJS) announced. BJS conducted a study of medical malpractice insurance claims that were closed from 2000 through 2004 in Florida, Illinois, Maine, Massachusetts, Missouri, Nevada and Texas. These states were identified as having comprehensive medical malpractice insurance claims databases, some of which extend back to the early 1990s.

About one-third of the medical malpractice insurance claims closed in Maine, Missouri and Nevada resulted in a payout. In Illinois about 12 percent of closed claims ended in a payout. Few medical malpractice insurance claims produced payouts that exceeded $1 million. Less than 10 percent of the claims in Florida, Maine, Missouri and Nevada had payouts of $1 million or more. In Florida, Maine and Missouri, about two-thirds of the claims were closed with insurance payouts of less than $250,000. Among persons receiving compensation, insurance payouts were highest for claimants who suffered lifelong major or grave permanent injuries. In Florida and Missouri, claimants with these types of injuries received median payouts ranging from $278,000 to $350,000. Insurance payouts were lowest for claimants who suffered temporary or emotional injuries. In Florida and Missouri, claimants who suffered these types of injuries received median payouts ranging from $5,000 to $79,000.

Medical malpractice insurance payouts increased as the insurance claims advanced through the legal system. Payouts were typically lowest for claims closed prior to the filing of a lawsuit and highest for claims closed after trial. In Florida, Nevada and Texas, claims decided by trial resulted in median payouts that were at least two and a half times larger than claims that were settled. Claims closed after a trial also cost more for insurance firms to defend than claims settled at or prior to a trial. In Florida, Nevada and Texas, 95 percent or more of medical malpractice claims were settled prior to a trial decision before a jury or judge.

 


 

Increasing Rate of TBI's Alarms Medical Community

In 2004 statisticians found that nearly 204,000 Americans were admitted to hospitals for traumatic brain injuries (TBI's). This came with a $3.2 billion price tag. Of the 204,000 TBI sufferers surveyed in 2004, 40% were caused by accidental falls, 26% due to car accidents, 4% were caused by bicycle and other recreational accidents, and 2% were due to shootings. Most of the TBI sufferers were 65 or older or between the ages of 18-44. Only 15% of the TBI sufferers were children. The 2004 survey also found that 13% died in the hospital and nearly 30% were transferred to long-term care facilities.

These results also show that there has been a 38% increase in hospital admissions related to TBI's from 2001 to 2004. This is an alarming finding because previous research showed a steady decrease in the amount of TBI's for the past 10 years. Dr. Claudia Steiner of the Agency for Healthcare Research and Quality finds this information extremely troubling. She hopes that the release of the new information will urge TBI experts and lawmakers to further investigate the phenomenon and find the cause of this trend.

The findings of the survey do not account for war veterans treated at VA hospitals or any other military personnel. They also do not include information regarding individuals who died before they were admitted to the hospital

 


 

Senior Citizens Lead Hospitalizations for Serious Head Injury

Senior citizens led hospital admissions for the most serious category of head injury, Type 1 traumatic brain injury, which increased for all ages nearly 38 percent between 2001 and 2004 after a decade of decline, according to the latest News and Numbers from the Agency for Healthcare Research and Quality. People age 65 and older accounted for nearly 36 percent of hospitalizations for Type 1 injuries, followed by people age 18 to 44 (about 31 percent). People ages 45 to 64 comprised 19 percent of the cases and adolescents and children accounted for 15 percent.

In 2004, there were nearly 204,000 hospitalizations for traumatic brain injury at a cost of $3.2 billion, and seven of 10 of these involved patients with a Type 1 injury. Inpatient hospital care for these patients cost $2.7 billion. Forty percent of patients with Type 1 injuries were caused by falls, such as down stairs, off ladders, or on ice. Other common reasons for Type 1 injury hospitalizations included motor vehicle accidents (26 percent), being hit while playing sports or having a falling object hit the head (8 percent), bicycle or other transportation accidents (4 percent), and shootings (2 percent). About 13 percent of Type 1 patients died while hospitalized and nearly 28 percent were transferred to a nursing home or other type of rehabilitation facility. By comparison, less than 1 percent of other head injury patients died while hospitalized and about 8 percent were discharged to a nursing home or other type of rehabilitation facility.

This News and Numbers is based on data in Hospital Admissions for Traumatic Brain Injuries, 2004. The report uses statistics from the Nationwide Inpatient Sample, a database of hospital inpatient stays that is nationally representative of all short-term, non-federal hospitals. The data are drawn from hospitals that comprise 90 percent of all discharges in the United States and include all patients, regardless of insurance type as well as the uninsured.

 


 

Neuropsychiatric Aspects of Traumatic Brain Injury

Risk factors for TBI include substance abuse and psychiatric conditions associated with impulsive behaviors, such as bipolar disorder, cluster B personality disorders, and attention-deficit/ hyperactivity disorder (ADHD). These pre-injury psychiatric conditions are associated with high-risk behaviors that can lead to TBI. More than 50% of TBIs involve alcohol intoxication, and 30% to 60% of patients are intoxicated at the time of injury. An initial score on the Glasgow Coma Scale of 13 to 15 constitutes a mild TBI, while a score of 9 to 12 represents moderate TBI, and a score below 9 is severe TBI. Mild TBI accounts for about 80% of all cases, with moderate and severe cases each being responsible for 10%. The American Congress of Rehabilitation Medicine has further refined the definition of mild TBI, stating that it is any traumatically induced disruption of brain function with limited loss of consciousness (30 minutes or less) or post-traumatic amnesia for less than 24 hours.

Patients who sustain multiple head injuries over time appear to demonstrate increased irritability with each subsequent injury, particularly when the injuries are associated with loss of consciousness. Risk factors for aggression include a history of impulsive aggression, arrest and substance abuse. Aggression is also frequently encountered in post-TBI mania, which occurs in 7% to 9% of patients independent of severity of injury, cognitive impairment, or physical disability. While post-TBI manic syndromes may resemble the classic manic syndrome of euphoria, elation, increased energy, and grandiosity, a more common presentation is a mixed bipolar syndrome. Treatment of post-TBI aggression aims to reduce disruptive behaviors without negatively impacting other areas of functioning. Anticonvulsants appear to be effective and well-tolerated in treating these disorders, although cognitive impairment may occur at higher doses.

The prevalence of major depression following TBI ranges from 15% to 61%. Some investigators noted that fatigue, frustration, poor concentration, boredom, and distractibility were common in depressed TBI patients. However, feeling sad or blue was not as common. Additionally it has been found that feelings of depression and sadness did, in fact, discriminate between depressed and non-depressed patients and suggested that cognitive impairment and fatigue were not useful diagnostic symptoms. Treatment of post-TBI depression with antidepressants appears to be effective, as is psychotherapy and, when necessary, electroconvulsive therapy. Effective treatment is considered crucial to maximizing cognitive and psychosocial functioning, which are often compromised by depressive symptoms.

 


 

March 23, 2007

Ortho Evra Patch Caused Daughter’s Death

"My daughter took the Ortho Evra patch in 2004," says April. "She started to have chest pains but her doctor thought it was just an infection." Eryn was only 24 years old when she passed away. "Eryn went to the doctor a few times but he said it was an upper respiratory problem," says April (not her real name pending a lawsuit). Eryn had left the house to dog-sit for her brother on January 27th. Through a series of phone conversations I had with her that night, I knew that something wasn't right. When we found her at my son's house, she was pale white (I thought she was dead) and unconscious. I grabbed her and I yelled at her; she came to for a bit but not enough to know what was going on.

My fiancé and I drove her to the hospital only two miles away. When we got there, they immediately thought it was a drug overdose. They had a hard time finding a vein but started an IV. Then we watched her blood pressure go from 110/70 to 250/180 and they rushed her to a CAT Scan. They found two bleeds on her brain. The hospital didn't have a neurosurgeon or an ICU to handle her, so she was intubated. She fought like crazy, she didn't want the tubes down her throat, but that was the only way she could be flown out by helicopter. Eryn never woke up. She was in a comatose state for two weeks; she had a feeding tube in her stomach. She had two major strokes that left her paralyzed. She had MRIs and CAT Scans done daily. On February 8th, she was coded blue and had two heart attacks in front of us. The second heart attack left her brain dead because she was without oxygen for 15 minutes. Another CAT Scan was done the next morning and the hospital said that she couldn't be moved again because her body was riddled with blood clots. We sat with her the whole morning and at 10 a.m. the neurosurgeon said there was nothing more that anyone could do. At 6.30 that night they asked us to sign a DNR. By then we watched her fingernails turn blue and the rest of her body was shutting down. At 1 a.m. the following morning she had a cerebral fever: her arms were frozen stiff because there was no circulation. At 3 a.m. we spoke with the doctors again and they suggested we take her off the machine. We didn't know how long she would last -she was full of morphine. They shut the machine down at 4.12 a.m. and at 4.15 a.m. she passed away.

It was the second day of her hospitalization that we determined Ortho Evra was to blame. She wasn't on any other medication. They took the patch off her right away at the first hospital. The neurologist wasn't convinced at the time, thinking she had some rare brain disease. Tests were flown out everywhere but she had no infectious diseases. She never smoked and gave blood every few months. A couple of the nurses suggested that Ortho Evra was to blame. Then I found a lawyer and I sent him all of her medical records. He said that their pathologist, hematologist, cardiologist and neurologist all confirmed that her death was caused by the Ortho Evra Patch.

 


 

Long Island couple sues fertility clinic, citing toddler's complexion

After they saw a baby girl they had gone to a fertility clinic to conceive, her parents became convinced something was wrong, according to court papers. The girl's skin was darker than either parent's, a judge wrote in allowing the parents to proceed with a lawsuit that claims the clinic botched the insemination of the wife's eggs. "While we love Baby Jessica as our own, we are reminded of this terrible mistake each and every time we look at her; it is simply impossible to ignore," state Supreme Court Justice Sheila Abdus-Salaam's decision quoted parents Thomas and Nancy Andrews as saying. "We are conscious of and distressed by this mistake each and every time we appear in public," the judge quoted the Andrews' affidavit as saying.

The couple sued New York Medical Services for Reproductive Medicine, accusing the Manhattan clinic of medical malpractice and other offenses. The Andrews' court papers say that on the advice of Dr. Martin Keltz, the couple agreed to in vitro fertilization of the eggs with Thomas Andrews' sperm so they could have a child who was biologically their own. However, their court papers say, the clinic was negligent and used another man's sperm. Three DNA tests _ a home kit and two professional laboratory tests _ confirmed that Thomas Andrews was not the baby's father. The judge said the Andrews’ complain that they have been forced to raise a child who is "not even the same race, nationality, color ... as they are." The mother was born in the Dominican Republic "and has a complexion, skin coloration and facial characteristics typical of that region," while the father is Caucasian, the judge quoted the Andrews' papers as saying. Nancy Andrews asked Keltz about the "abnormality" of the child's complexion, the judge said, and the physician told her the condition was normal, that the in vitro fertilization was done properly and that the child would "get lighter over time."

The lawsuit, which seeks unspecified damages, came to light after the judge issued a decision that allows the Andrews’ to proceed with parts of the suit while dismissing other parts. The judge dismissed the lawsuit against Keltz, who had advised the procedure and had performed the embryo implantation. She allowed the case to proceed against Dr. Reginald Puckett as owner of the clinic but threw out the case against him as an individual. Puckett has already been found liable for the alleged blunder. In trying to have the lawsuit against Puckett personally and as clinic owner dismissed, his lawyer, Martin B. Adams, told the court that Puckett "did not examine, communicate with, care for or treat plaintiffs." The judge found Carlo Acosta, the non-physician embryologist who processed the egg and sperm for creation of an embryo, liable for the alleged blunder. She said his response to the Andrews' claims "could not be weaker _ it is nonexistent."

 


 

Anemia Drugs May Harm Some Cancer and Kidney Patients

New studies are raising questions about whether certain drugs which are used by millions of cancer patients are actually harming them rather than helping. The drugs are used to treat anemia caused by chemotherapy, reducing the need for blood transfusions and giving the patient more energy. The drugs in question are: Aranesp and Epogen, both sold by Amgen, and Procrit, sold by Johnson and Johnson. Also known as EPO drugs, all three are versions of erythropoietin, a substance made by human kidneys tha