We detailed why the tort reform debate and the misconception of medical malpractice is a bunch of hot air earlier in this blog in the article “Tort “Reform”: The Big Payoff to Candidates That Support Malpractice Lawsuit Caps.” This article is here to explain how the Obama administration intends quell those concerns by pandering and throwing money at the issue.

Last week, Health and Human Services (HHS) Secretary Kathleen Sebelius announced that the Agency for Healthcare Research and Quality (AHRQ) has awarded $25 million in funding for programs to improve patient safety and lessen the number of malpractice lawsuits filed. The grants are part of a patient safety and medical liability initiative that President Obama outlined in an address last September to a joint session of Congress.

Medical Malpractice Grants

What this federal grant program intends to do is reduce preventable injuries, improve communication between doctors and patients, lower malpractice premiums, and “ensure that patients are compensated in a fair and timely manner for medical injuries, while also reducing the incidence of frivolous lawsuits,” according to an agency press release.

Most of the $25 mil (around $23 mil) will go to 20 separate programs and around $2 mil will be spent on conclusive research. The awards include 3 year grants of up to $3 mil to states and health care institutions for implementation and evaluation of patient safety and medical liability demonstrations, as well as 1 year planning grants of up to $300,000.

The grants are available to both institutions and individuals under the following guidelines:

• State governments, units of State governments, coalitions of State governments, established associations of State governments.
• Established health care systems.  Hsiao defines a health system as having capacities (e.g., hospitals, physicians), activities (e.g., health services), interconnections (e.g., financing, oversight, management), and purpose. Its components might include multiple States, localities, Tribal governments, universities, colleges, hospitals, nonprofit organizations, faith-based organization, community-based organizations, and Federal agencies.  Applicants to this FOA must share a long-established, legal entity as sponsor, and sufficient service volume to statistically power any proposed intervention.
• Organizations must also fit under AHRQ’s grant authorization under 42 USC 299c-5(c), which allows AHRQ to make grants to public and nonprofit entities.
• Any individual with the skills, knowledge, and resources necessary to carry out the proposed research as the PD/PI may work with their sponsoring organization to develop an application.  AHRQ encourages individuals from underrepresented racial and ethnic groups as well as individuals with disabilities to apply. AHRQ requires a minimum time commitment of 20% annual effort from the PD/PI or the Project Manager, depending upon how the applicant structures the project’s organization and work plan.

The grants are overall intended to streamline a process that the HHS views as hamstrung by complicated legal issues. The programs studied under the grants include a judge-directed legal negotiation program, “safe harbors” for state-endorsed evidence-based care guidelines, and early disclosure of medical errors by hospitals and clinics with offers of prompt compensation.

Essentially, the thinking here is the faster the process, the lower the legal costs, and thus the lower overall cost to insurance providers. The problem is that medical malpractice payouts haven’t risen since the 1980’s, but medical malpractice insurance has steadily risen consistently over the last decade with little to no explanation other than greed by the insurance companies.

Medical Malpractice Lawsuits

Yet skepticism can only go so far before it becomes unconstructive. Any system is not perfect and the medical malpractice system certainly is not. There are many states that have chosen to take medical malpractice lawsuits head on through legislation by capping the amounts paid out to plaintiffs. Unfortunately this has not lowered premiums and has only served to hurt patients with legitimate claims.

Our own home of Washington was one of those states that believed the hype. The state supreme court ended up repealing the medical malpractice law as unconstitutional. The same thing recently happened in Illinois and other similar lawsuits are making their rounds in other states that host caps as a solution.

The new grant initiative is hoping to take a different angle to a similar goal to lower costs and in turn lower premiums. In a White House blog entry, Ezekiel Emanuel, MD, PhD, special adviser for health policy at the Office of Management and Budget, noted, “As reviews by both the Robert Wood Johnson Foundation and AHRQ have revealed, we lack a solid evidence base for determining which practices will provide fair and prompt compensation to patients, reduce preventable injuries, improve the quality of care, and reduce liability premiums.”

We can only hope that Mr. Emanuel’s evidence comes out positive, but we fear that no matter how states or the federal government attempt to lower costs, insurance premiums will keep on rising until  state or federal bureaucracies offer medical malpractice insurance to compete with the market and stem the rising tide of unjustified profit.

Medical Malpractice Lawyers

The proponents and creators of these grants are, of course, trying to frame the system as benefiting the patients and the physicians equally, but what the system may turn out to be is a quick stopgap to lower settlement payouts on what are major medical errors.

“This new research is the largest government investment connecting medical liability to quality and aims to improve the overall quality of healthcare,” Secretary Sebelius said.

“The goals of the HHS Patient Safety and Medical Liability initiative are widely supported throughout the healthcare system, and we solicited broad-based input to ensure that it reflects the needs of stakeholders,” AHRQ director Carolyn M. Clancy, MD, said in a statement. “The projects we have funded help create measurable differences in the safety of healthcare for patients and help bring rationality and fairness to our medical liability system.”

We have the most sincere hope that this program works and will benefit both patients and the healthcare system as a whole. We also hope that the insurance industry will be honest about their business, recognize the lowered costs, and reduce premiums accordingly, but on this last point we will certainly not be holding our breath.

If you or a loved one have found that you have been injured or killed because of a medical error it is still your right to seek adequate compensation for your pain and suffering to assure that another patient will not have to go through what you are. Call the Medical Malpractice Lawyers at Phillips Webster for a free consultation.

Learn More About:

• Washington Medical Malpractice Laws
• Medical Malpractice FAQs
• Surgical Errors

Ronan Wilson had been born 12 weeks prematurely. This had left his immune system susceptible to illness, which seemed to often give in to ear infections and colds. Doctors expected that he would grow out of the phase like his older brother Gavin, who had also been born prematurely and had a series of health issues in early development.

Instead, at 4 years old, Ronan died April 8 at Doernbecher Children’s Hospital in Portland after his body was overtaken by E. coli O157:H7 bacteria, an infection that he had contracted at the Fletcher Daycare Center.

E. Coli Outbreak

The Centers for Disease Control and Prevention says E. coli O157:H7 is the most common toxin-producing bacteria in North America. The original source of an infection is often cow manure, which can enter the body in the form of undercooked hamburger or unpasteurized milk or fruit juices.

Once a person contracts the E. coli bacteria, the infected person can spread the infection to another person through human stool, when people don’t thoroughly wash their hands after using the toilet or after diapering a child.

In an environment like a child care center it is very easy for this kind of infection to spread rapidly throughout the playground. No matter how clean the center was the bacteria is not only robust, but aggressive as in the case of Ronan Wilson.

A Family’s Tragedy

Ronan’s parents, Anthony and Bonnie Wilson, noticed that Ronan was sick. They took him to see the doctor. At first, the doctor thought that he had a severe case of the flu, which are the very first symptoms of E. coli bacterial infection. But Ronan’s condition deteriorated.

Anthony and Bonnie took Ronan back to Doernbecher on April 1, four days after the first visit. The staff noticed immediately that the E. coli had attacked Ronan’s kidneys, and he was put on dialysis. Then it attacked the lining of his colon, and on April 3 he had surgery to remove part of his colon. He would never wake up from the surgery.

Doctors conducted brain scans and they showed that the bacteria had destroyed critical parts of his brain. Hospital staff told the Wilsons that even if Ronan was to recover, he’d be physically disabled and brain-damaged. Bonnie inquired as to how mentally impaired Ronan would be. The doctor compared it to, “just [being] in the clouds all the time. He won’t even be there.”

The shock of what was happening was just setting in when Ronan’s brain began swelling. Anthony and Bonnie had to decide whether they wanted doctors to crack open Ronan’s skull to allow the brain room to keep swelling.

They knew that it was too risky and that Ronan’s quality of life had diminished. They knew that it was time to say goodbye.

Slow Reaction

The timeline of this outbreak is quite important. E. coli is very important to catch in it early stages to avoid spreading. The first child at the center tested positive March 19. Bonnie first took Ronan to see a doctor March 29. Even though she mentioned a child had E. coli, the doctor assumed Ronan had the flu and neglected to test him further.

Dr. Alan Melnick, Clark County health officer, said on April 9 in his first public announcement of the outbreak, that the details of the infection’s origin often remain a mystery. He explained that he didn’t shut down Fletch Family Daycare until April 2 out of concern that other parents who used the facility could take their children to different day cares and risk exposing others.

Yet there are other actions that Melnick may have taken such as investigating the incident immediately upon hearing of the outbreak and ordering mandatory testing of the children and the parents to avoid the spread of the infection over the wider community.

E. coli is the most detrimental to young children and the elderly. This outbreak could have spread to other children neighborhoods of other attendees of the daycare center. It could have easily also been spread to an elder care facility through grandchild visits and devastated the residents there. By waiting 3 weeks, Clark County could have put a lot more lives at jeopardy.

Misdiagnosis and Wrongful Death

Fletch Family Daycare has been operated by Dianne and Larry Fletch out of their Hazel Dell home for 20 years. While health issues have been resolved, the child care center remains closed while the state Department of Early Learning conducts an investigation.

Both Bonnie and Anthony Wilson said Saturday they wished the health department would have made a public announcement earlier so doctors and parents would have been more vigilant. “We don’t want this to happen to anyone else,” Bonnie said. “My goal is to tell Ronan’s story and make it known that he mattered.”

This is a sad story of parents being let down by the system on so many levels. The daycare seemed to do a good job of informing parents and Clark County, but that is where the wheels started to loosen. Clark County, by not taking action as to not alarm anybody, put thousands of lives in jeopardy.

Then there is the doctor in this situation that Ronan was initially taken to. Upon hearing of his exposure to E. coli, the doctor should have immediately realized that the infection first shows itself by manifesting in the patient “flu-like symptoms.” The test would have been simple and would have saved Ronan’s life rather than allowed it to grow and overcome his weak immune system, a weak immune system that one can only assume, the doctor was fully aware of. Taking precautions in patients such as Ronan would have been not only prudent, but expected and necessary.

This is the basis of medical malpractice. Avoiding taking a simple and necessary extra step that could have prevented the death of the patient is the one of the major causes of medical malpractice. By misdiagnosing Ronan the doctor may be partly responsible for his death.

Clark County could also be liable in this case. In a wrongful death lawsuit, the actions of the Clark County health officer may have been too passive. His fear of parents taking children to other daycares and spreading the infection may have discounted the lives, health, and welfare of the children attending the Fletcher facility. E. coli seldom just goes away on its own without claiming a life or inflicting severe personal injuries on one or two patients. As an example of this, Ronan would have been permanently mentally impaired by E. coli had he lived.

Either way, both Clark County and Doernbecher Children’s Hospital may be liable for the wrongful death of this young boy. If you or a loved one has been personally injured or killed due to medical negligence or the actions of an organization or governmental entity, then call Phillips Webster today for a consultation as to your legal options.

Learn More About:

• Washington Medical Malpractice Laws
• Medical Malpractice FAQs
• Surgical Errors

The warning letters go on to accuse the spas for misbranding Lipodissolve products. The spas have made unfounded claims that the drugs they use for their lipodissolve procedures are safe and effective. Yet, these procedures have neither been evaluated nor approved by the FDA.

The companies involved have been cited for a variety of regulatory violations, including making unsupported claims that the products have an outstanding safety record and are superior to other fat loss procedures, including liposuction.

The Spas Cited are:

• Monarch Medi Spas, King of Prussia, PA
• Medical Cosmetic Enhancements, Chevy Chase, MD
• IDinHealth, Edina, MN
• All About You Med Spa, Madison, IN
• Spa 35, Boise, ID
• Pure med Spa, Boca Raton, FL

Some of the letters indicate that the companies have said that lipodissolve products can be used to treat certain medical conditions. These include male breast enlargement, benign fatty growths known as lipomas, excess fat deposits, and some surgical deformities.

The FDA stated that they are unaware of clinical evidence to support any of those claims.

What is Lipodissolve?

Lipodissolve is touted to be fat dissolving procedure that is less invasive than liposuction, a surgical procedure that literally sucks the fat from the patient with a surgical vacuum. The Lipodissolve procedure has also been called “mesotherapy”, “lipozap”, “lipotherapy”, or “injection lipolysis”. Either way, it’s primarily all the same treatment.

The Lipodissolve procedure involves a doctor or technician injecting the patient with a drug and herbal mixture intended to dissolve and permanently remove small pockets of fat from isolated parts of the body. The most commonly injected drugs are phosphatidylcholine and deoxycholate, usually in various combinations with one another.

Phosphatidylcholine – This is considered part of the Lecithin group of fatty acids that occurs in many animal and plant tissues. It is a vital substance that is in every cell in the human body. It depletes considerably in our cells as we age and its depletion has been speculated by some in the science community to contribute to the aging process.

Deoxycholate – This acid is one of the secondary bile acids, which are metabolic byproducts of intestinal bacteria. It helps the body absorb fats into the intestine and generally helps the patient pass them naturally. It usually comes in a white powdery substance.

Herbal Combinations – These can be a vast variety from harmless to marginally helpful. These combinations are more than likely specific to the spa offering the treatment and should be listed in procedural materials as to avoid allergic reactions.

What Are Lipodissolve Side Effects?

As with any relatively new procedure the side effects take time to realize. As this is essentially untested by the scientific establishment and the FDA, a comprehensive list has not been able to be compiled.

Through research done in this blog we have been able to comprise a list of possible side effects from medical data, FDA reports, and customer comments. Please note that this list is not scientific research or part of a medically endorsed research project.

Some of the side effects include:

• Post Procedure Lightheadedness – Reports are that this passes relatively quickly, within minutes to hours.
• Post Procedure Nausea – The causal effect is unknown at this time.
• Tenderness and Pain in the Treated Area – This has been reported to last up to several days to several weeks after the procedure.
• Bruising – There have been concerns that the discoloration lasts for a disproportionate amount of time.
• Scarring – Scars are permanent signs of the procedure that may require further plastic surgery to remedy or may have no remedy at all.
• Skin Deformation – These are areas of either sagging, wrinkled, or stretched patches of skin in the treatment areas that may require further plastic surgery to remedy.
• Hard Nodules in the Treated Area – There was not specific data or follow up as to the nature of these nodules.
• Serious Infection – There is a possibility of serious infection of the procedure area. It has been recommended that patients should avoid tight or restrictive clothing around the treatment areas during the healing period. These internal infections can get into the blood stream quickly and cause a series of other non-procedure related complications. If not caught soon enough these infections could cause death.

Explanations

The FDA has requested written responses from the spas within 15 business days of receipt of the warning letters. They as that the companies state how they intend to correct these violations and prevent future violations. Each warning letter stated clearly that failure to comply with the request and promptly correct the violations may result in legal action.

“We are concerned that these companies are misleading consumers,” said Janet Woodcock, M.D., director of the FDA’s Center for Drug Evaluation and Research. “It is important for anyone who is considering this voluntary procedure to understand that the products used to perform lipodissolve procedures are not approved by the FDA for fat removal.”

Protecting the Patient

These elective cosmetic procedures are very popular and growing in popularity everyday. They are generally run by trained and certified medical staff. Yet, since Lipodissolve is not an approved procedure by the FDA or the larger scientific medical community, there is no certification for the procedure. This means that there have been no standards set to assure the maximum care and protection of the patient.

The standards of the mixture used to conduct the procedure is also not standardized or approved. This means that effectiveness and side effects could vary greatly from one facility to the next. This also makes claims of effectiveness almost impossible.

We recommend that you only subject yourself to FDA approved and fully researched procedures that have a proven track record of their effectiveness. Approved procedures have standardized methods and drug mixtures that both protect the patient and give a clear set of results and side effects.

If you or someone you know has had one of these “fat dissolving” injection treatments under any name, and have found that they have suffered from adverse side effects, permanent disfiguration, or serious personal injury due to infection it is important that you find council that is experienced in Medical Malpractice lawsuits. Call Phillips Webster for a consultation as to your legal recourse.

Learn More About:

• Settlements in Medical Malpractice Lawsuits
• Filing a Medical Malpractice Lawsuit
• Causes of Medical Malpractice

Now we’ve taken it a little further. Many people don’t know how to figure out what hospital to go to. Out of the 74 hospitals, medical centers, and emergency care clinics that report to the US Department of Heath and Human Services (HHS) and the Washington State Hospital Association (WSHA) in the state of Washington, the data is 1) extremely hard to find, and 2) harder to quantify. So we’ve taken the time to help you figure out what hospitals NOT to go to.

Our list of the 10 Lowest Rated Hospitals in Washington State as according to two criteria – Patient Satisfaction Surveys & the WSHA Hospital Infection Study. The list was formulated from an examination and cross reference of the 2008-2009 data provided by the HHS hospital comparison database and various WSHA studies and consumer surveys that comprise their hospital ranking system. We put more weight on the hospital infection study and used patient satisfaction as corroborating evidence of the ranking. Generally, they matched with only a couple of exceptions.

10 Lowest Rated Hospitals in Washington State:

Please Note: National average on the Infection Study is 91.1% (Washington Average is 93.3%) and the national average for patient satisfaction is 68.6% (Washington Average is 67.6). National Avg = 91.1%/68.6%, Washington Avg = 93.3%/67.6%, the individual facilities ranking numbers are listed below the same way.

*charts provided by HHS database.

#1) Auburn Regional Medical Center – 82.1%/53.1% – This facility consistently received bad grades from both HHS and WSHA across the board. In an HHS comparison with some of the low overall statistics of the list below, their numbers were as far as 8-10 percentage points below. They also conquered the lowest patient satisfaction marks. From all of the data we studied, Auburn Regional Medical Center is the lowest rated hospital in the state.

#2) Kennewick General Hospital – 84.66%/63.1% – Kennewick is hot and doesn’t get a ton of rain so people from west of the mountains like to go there to lap up some rays on the rainy summer days. You may want to limit your activities to lying down, sitting, and lying down again, because you don’t want to get hurt. They came in a close #2 worst in the WSHA Hospital Infection study and a robust #6 worst in patient satisfaction.

#3) Valley Medical Center – 84.8%/67.7% – You may have seen Valley Medical Canter’s ads on local and regional television patting themselves on the back and inviting people to come see their new facility. We agree, consider going to the new one, because the old one’s infection study numbers are as mediocre as the patient satisfaction ratings from WSHA. At least HHS has them listed as only slightly below the national average. So congratulations to Valley Medical Center for being extremely average in their national average-ness.

#4) Island Hospital – 85.5%/75.4%– Between #3 and #4 there seems to be a gap where the numbers jump higher and the standards start to raise. Island Hospital still doesn’t rank wonderfully on the Infection Study, but in both WSHA and HHS the patients seem to love them. Particularly the staff. Island actually ranks as one of highest in the state for patient satisfaction, and the recommendations are consistent across the board. They also tout on their website as being one of the top 100 hospitals in the country. So if you survive your experience with them you are guaranteed to be happy.

#5) Sunnyside Community Hospital – 86.8%/67.7% – This teeny-weeny Yakima community hospital averages 6-10 patients per day. Not much. Their intensive care unit only has four beds. Needless to say, don’t get into a wreck on a crowded bus wreck near Sunnyside. The infection study and patient satisfaction show that their numbers for both WSHA and HHS remain just below mediocre.

#6) Lincoln Hospital – 88.3%/67.4% – The medium sized Lincoln hospital in Lincoln county was trated much more nicely by HHS than WSHA. The patient satisfaction numbers on the HHS charts below are 6-10 percentage points higher than the WSHA numbers. Regardless, their infection risk can still be improved. So can their wesite.

#7) Valley General Hospital – 88.6%/64.9% – Valley General Hospital is a hospital. They serve Eastern Snohomish County. They have people wearing white clothing and comfortable shoes. They are competent at treating ailments in most humans. If you’re getting the idea the they are almost boringly average, it shows in their numbers. They’re average to WSHA and slightly below average on HHS. But they did implement what they call the Emergency Department Process Improvement Plan in 2009. They say it was successful and that patients were satisfied. Excited? No. Satisfied? Yes. But from check in to discharge the shaved off almost a whole hour. BAM! Medical care! I’m not quite sure if that’s good, but kudos…I guess.

#8) Lourdes Medical Center – 89.3%/ n/a – Lourdes is located in Pasco, Washington and according to their website they are awesome. Unfortunately, there is no patient satisfaction data from either the HHS or WSHA so I guess we can only take their word for it. And the fact that they didn’t rate very well in the infection study, that might say volumes. Healthgrades.com, a healthcare rating and finding website (who contributed no information to this list because their rating methodology is unknown) says that they rated Lourdes far below the national average.

#9) MultiCare Good Samaritan Hospital – 89.5/60.7 – This Pierce County non-profit hospital seems to be ever expanding. They state on their website that they have 98 locations for people to be dissatisfied with them in. The have multiple types of care listed amongst their many facilities that cover Allenmore Hospital, Good Samaritan Hospital, Mary Bridge Children’s Hospital & Health Center, and Tacoma General Hospital. They are the largest private employer in Pierce county with almost 9000 employees. They are by far the largest organization on this list. Does their size give them a pass? No. Most of the large hospitals were at the top of the list. This might be an administrative problem.

#10) Greys Harbor Community Hospital – 90.7%/68.5% – This small Grays Harbor County hospital serves a fairly large community. Their patient satisfaction numbers have gone down from 75% in 2008. This may have something to do with being the only game in town or it could be the fact that the bad economy has hit Aberdeen especially hard and people are just down in general. It also could be a funding issue or a turnover issue. Whatever it is, they have the potential to bump into the above average category with a little work.

Things to consider

This list was compiled of hospitals in Washington State that actually report to the WSHA in some capacity. Out of their members, about 25 percent of the hospitals offered limited to no data. This left them off of this list. It may be because they are too small and lack the resources or a matter of low self esteem.

Either way, their lack of reporting has kept them off of this list but should raise scrutiny. Check the WSHA website for their membership and criteria.

The biggest concern that these numbers raise is the risk of infection. There have been other studies conducted to be able to gauge the overall efficiency and effectiveness of a hospital by measuring instances of lung and staff infections not related to the original wound or illness. There was even a study to measure the volume of various cleaners used by the facilities as according to the number of beds and patient volume to determine exposure to infections and cross contamination within facilities.

Medical Malpractice

These studies show that no matter what the person’s injury or ailment, their ability to fight infection lowers during the healing process. That’s why it is important that the facility protect the patient and not expose the patient to further harm through lax policies, understaffing, or profit-centric administrative policies.

As a patient it is your right to expect and receive the proper care that you need so that you can heal and once again lead a healthy productive life. If you or a loved one has an ailment that has gotten worse or has died due to the policies of the medical facility or health care providers within the facility the only thing protecting your rights is the legal system. Call Phillips Webster for a consultation as to your legal rights.

Learn More About:

• Medical Malpractice
• Wrongful Death Lawsuits
• Settlements for Medical Malpractice Lawsuits
• Wrongful Death Statute of Limitations

The interesting thing is that this is not the only legal discrepancy nor the least blatant that Omnicare has gotten into. You see, as they have grown to dominate the market they have had a history of abusing and defrauding the American Medicare system, and thus the American tax payers, for their own profit.

Omnicare Defrauds Medicare for Millions

An example of this was in 2008. The case was brought in front of the DOJ that marked the first time that a United States Attorney’s Office had joined forces with the National Association of Medicaid Fraud Control Units (NAMFCU), to conduct a joint health care fraud investigation.

They found after two years of investigation that Omnicare had deliberately bilked Medicare out of $49.5 million by falsifying records. It seems that they were charging the American people for one type of pill, but giving out much cheaper types of pills to patients. Merely pennies or fractions of pennies on a pill by pill basis, but it equates to millions in the long run of Omnicare’s profit margin.

The DOJ settlement covered Omnicare’s submission of reimbursement claims to Medicaid programs in 43 states for three prescription drugs from April 2000 through 2005: Ranitidine (generic Zantac), Fluoxetine (generic Prozac) and Buspirone (generic Buspar).

Omnicare, Johnson & Johnson, and Kickbacks

Though Johnson & Johnson is still in the throws of the lawsuit involving kickbacks given to Omnicare for the distribution of Riperdal and other pharmaceuticals in its nursing home network, Omnicare’s involvement is still slightly fuzzy. You see, in DOJ documents describing the settlement, it’s alleged that it was Omnicare that started the ball rolling on the crime in the first place.

They were the ones that allegedly solicited the kickbacks and then received kickback money from Johnson & Johnson in exchange for agreeing to recommend that physicians prescribe Risperdal, a J&J antipsychotic drug, to nursing home patients. At the time, and perhaps even now, Omnicare has an 80% success rate with their recommendations to physicians, which means that physicians will prescribe their recommended drug 80% of the time.

This is not just an isolated incident, it seems that this was a well thought out act developed by executives at Omnicare. The evidence of this is that Johnson & Johnson weren’t the only pharmaceutical giants Omnicare approached for kickbacks. The government also alleged that Omnicare solicited IVAX Corporation, and IVAX paid, $8 million in kickbacks in exchange for Omnicare’s agreement to purchase $50 million in drugs from IVAX. IVAX is now a subsidiary of Teva Pharmaceuticals Industries, Ltd, bought in 2006.

Johnson & Johnson’s kickbacks to Omnicare took multiple forms, including rebates that were conditioned on Omnicare engaging in an “Active Intervention Program” for Risperdal and payments disguised as data purchase fees, educational grants, and fees to attend Omnicare meetings. These are just imaginative ways that companies shuffle around money in an attempt to hide its true source, a method called “laundering”. You may have heard of it.

The government allegations didn’t stop there. They said that Omnicare regularly paid kickbacks to nursing homes by providing pharmacist “consultant” services at rates far below the company’s cost and well below the fair market value in order to induce the nursing homes and their medical staff to refer their patients to Omnicare for pharmacy services. Essentially, this was a form of kickback to the home itself. No wonder they had an 80% recommendation rate.

Michael Loucks, Acting U.S. Attorney for the District of Massachusetts, said after the settlement was reached, “[This] settlement provides a strong message to these pharmacies, as well as to pharmaceutical companies and nursing homes, that the government will not tolerate the payment of kickbacks which can distort proper medical judgment and put profits ahead of good medical care.”

Unfortunately, none of the nursing homes providing advice to their patients and residents were punished with the exception of two large chains in Atlanta, GA. Yet the DOJ was confident that they had adequately punished Omnicare, even though, this may not even come close to the profit that they actually accrued from the crime itself.

“These defendants broke the law to take advantage of our nation’s most vulnerable citizens, the elderly and the poor,” said Tony West, Assistant Attorney General for the Civil Division of the Department of Justice. “Illegal conduct like this can undermine the medical judgments of health care professionals, lead to patients being prescribed medications they do not need, and drive up the costs of health care.”

Omnicare Still Profiting in Washington State

Another major problem that hasn’t been addressed is Omnicare’s handling of the drug Risperdal. The federal lawsuit details an elaborate program by J&J and Omnicare to allegedly convince resident physicians in nursing homes to prescribe Risperdal saying that the drug was superior to older and cheaper antipsychotics.

Under subpoena, Johnson & Johnson were forced to release 5000 documents related to the case. Within the documents was found a 1999 email in which Omnicare offered J & J’s sales team a list of nursing home physicians who had been resistant to prescribing the antipsychotic.

“These names were provided to the sales force in an effort to increase the call frequency on these resistant prescribers and to eventually influence them to use more Risperdal in the elderly demented patient,’’ the e-mail said.

Also alleged was that the drug was touted by both Johnson and Johnson, but also Omnicare, to be effective on other non-label ailments such as treating dementia. Yet the FDA warned, and other studies have shown specifically, that the drug could drastically lower the life expectancy of dementia patients. On top of that, Riperdal has a subduing effect that considerably lowers the patient’s quality of life, essentially acting as an invisible restraint and could be construed as abusing a patient.

Riperdal is an antipsychotic that is used for treating severe schizophrenia, not the natural mental lapses associated with aging. Regardless, company representatives selling off label treatments is very illegal.

Medical Malpractice

The large companies are not the only ones who are to blame for this blatant abuse of the system and the patients. The medical practitioners of the facilities specifically prescribed drugs to their patients as result of the money saving incentives given by a pharmaceutical provider and could have put thousands if not millions of elderly patients at risk.

Just because a patient has dementia does not mean that they don’t enjoy and absorb the environment around them. Many dementia patients have creative and productive lives. They enjoy taking walks and spending time with others. When they are drugged into a catatonic state they are denied these simple pleasures and their lives being shortened strips away the time their loved ones have with them.

If you suspect that your loved one was affected by the activities of Johnson & Johnson or the physicians at your loved one’s care facility may have been influenced by the manipulations of Omnicare resulting in nursing home abuse or medical malpractice related to the untimely death, then it is important that you find out your legal rights immediately. Call Phillips Webster for a consultation and to find out your legal options.

Learn More About:

• Defective Drugs Litigation
• Misdiagnosed Medication
• Failure to Diagnose

This month two healthcare professionals faced strict discipline charges for substance abuse. When one thinks of substance abuse in healthcare professionals it generally brings to mind prescription drugs that seem to be readily available, but these cases do not involve the obvious.

Showing that healthcare professionals are vulnerable humans just like the rest of us, the Department of Health has cracked down on these individuals for alcohol abuse. This ailment can be highly detrimental to their patients by hampering their decision making skills, affecting essential motor skills, and potential misdiagnosis.

If a doctor is diagnosing and operating, even after a drinking binge, it could lead to serious personal injury and medical malpractice lawsuits.

DUI Doctor

When a doctor gets a DUI it is an issue of bad decisions and usually affects their career and reputation, but rarely impacts their license to practice medicine. In the case of Dr. Sarah S. Reade, who is a specialist and surgeon who specializes in internal medicine, a DUI was a sign of a larger problem, a serious mental problem.

The Medical Quality Assurance Commission and Department of Health revoked Olympia physician Sarah S. Reade’s license after she was charged with driving under the influence of drugs and/or alcohol in December.

The suspicions began with Reade having a terrible Christmas Day in 2009. Reade was arrested for DUI and spent a solemn Xmas night in the Nisqually jail, according to Department Of Health documents.

Her father called Thurston County Sheriff’s deputies the next day and told them he was concerned about his daughter’s mental state. When deputies responded by going to her home, where they reported they found it “cluttered and strewn with clothing, disrupted furnishings, household garbage, animal feces and bottles of liquor,” the documents say.

The doctor admitted she had been drinking.

Reade’s downward trajectory continued into the weekend. Two days later, she called 911 and warned that she was going to slit her wrists with a scalpel. When the deputies showed up, she sprayed them with a garden hose and shouted profanities at them.

This is not the first disciplinary action against her. The Olympia native had her license suspended in 1998. She fought that suspension and won. Then in 2005, the commission put Reade on probation due to another DUI in which she crashed into a tree. She was required to complete an alcohol-treatment program. She was not working as a doctor at the time.

Narcotic Nurse

The state Department of Health is disciplining Karen Marie Erickson, a licensed practical nurse, whose urinalysis came back positive for traces of oxazepam, a prescription drug used to treat anxiety and acute alcohol abuse.

Though she seemed to be taking a drug to treat her alcohol abuse, her urine also register for marijuana and cocaine, the DOH statement sent March 9^th said.

A DOH investigator sent Erickson two letters in July to her last known address, asking Erickson to explain her conduct. Both letters came back with a note that she had moved and left no address.

Her license expired that same month, but the Nursing Care Quality Assurance Commission is still considering sanctions.

Department of Health Discipline

Upon examination of the DOH disciplinary database, the agency has been clamping down on substance abuse as of late. There was no indication of a formal announcement of these actions, but it is very good for patients.

Every month for late 2009 & 2010 there seems to be at least two or three disciplinary actions around the state regarding non-prescription substance activity. The personal problems and conduct of healthcare workers can adversely affect the health and welfare of patients. This is serious for institutions also who take the brunt of medical malpractice lawsuits associated with this conduct.

Medical Malpractice

It is important that the institutions monitor their staff also. Before the Department of Health steps in, the signs of substance abuse, inappropriate or unusual behavior, or erratic moods are clear to their managers and coworkers. Some of the signs that a coworker is abusing alcohol are:

• Excessive sick time
• Disengaged or distracted behavior
• Lateness and bad schedule maintenance
• Erratic mood swings
• Sleepiness or excessive fatigue
• Excessive drinking during work parties
• Bottles in personal storage areas
• Drinking during breaks
• Drunkenness during shift
• Smelling of alcohol during shift

If the institution does not recognize these signs and engage in some sort of discipline prior to DOH action then they could be putting patients at risk.

If you or someone you know suspect that your healthcare provider has misdiagnosed you or has inhibited care through inappropriate behavior or substance abuse it is important that you find an experienced attorney to inform you of your legal rights. Call Phillips Webster for a consultation.

Learn More About:

• Damages Covered by Medical Malpractice Awards
• Anesthesiology Mistakes
• Surgical Errors

Upon further investigation they found out that Michael James Shannon, 38, was the alleged groper.

Shannon was placed on administrative leave shortly after the complaint. He was returned to duty after claiming he was examining the woman’s shoulder and did not touch her within several inches of her “privacy areas,” according to court documents.

A Pattern Arises

They thought that the matter had been settled until authorities say a second patient came forward two weeks later claiming an identical violation. That’s when the authorities were brought in.

“This time, there was no indication that Shannon should have been assessing that area of the patient’s body,” a Seattle detective noted in documents.

“Shannon’s supervisor did not find Shannon’s account credible and was concerned that ‘there may well be a pattern (of) patient abuse,” she added.

In the documents charging him, King County prosecutors say that he groped two patients and lied to each by telling them that his groping was part of their therapy.

Legal Wrangling

Following the allegations Shannon was immediately fired from Swedish Hospital as their legal team swung into action trying to salvage this mess.

Along with the Swedish Hospital and state investigations, the two women’s complaints prompted a Department of Health investigation. The DOH investigation has resulted in a preliminary injunction against Shannon. While he’s still allowed to work as a physical therapist, he’s barred from contact with female patients under the terms of the Department of Health order.

These kinds of allegations are very serious and can ruin an individual’s reputation and career, particularly when under the employment of perhaps the largest medical facility in the State of Washington. That’s probably what prompted Shannon on March 2 to request an administrative hearing be held by the Department of Health regarding matter. That hearing has not yet been scheduled.

Prosecutors, on the other hand, asked King County Superior Court Judge Sharon Armstrong to order that Shannon be barred from work as a physical therapist until the case against him is concluded.

Shannon is charged with two counts of indecent liberties. He has not been jailed in the case.

The Defendant Flees the Country

Embarrassing situations make people do the oddest of things.

According to court documents, apparently Shannon had left the country “with his wife for her job” prior to charges being filed or the Department of Health action.

The documents do not reveal what country they fled to and if Shannon has agreed to return for the state hearings and the DOH hearings regarding the matter.

“The defendant reported to the Department of Health that he is working as a physical therapist, but he refused to divulge where he is working,” Senior Deputy Prosecutor Carol Spoor told the court. “Thus, he continues to have access to patients, where he may continue his offense pattern.”

Medical Malpractice

A physical therapist is a medical practitioner that has the trust of his patients literally in their hands. Many patients are coming out of serious accidents, spinal cord injuries, burn injuries, brain injuries, and amputation. Many times they turn to their physical therapist for inspiration and hope. The therapist helps them overcome their tribulations and celebrates their triumphs. Many times they form a very close bond. When that trust is broken it severely hampers or even sets back a patient’s recovery. It can cause them to do avoid therapy or attempt to do it on their own which can cause serious personal injuries.

If you or a loved one have found that you’re a victim of medical misconduct by a health care professional be it sexual or otherwise, it is imperative that you find experienced legal council to help you through this trying time. Call Phillips Webster for a consultation on your legal options.

Learn More About:

• Washington Medical Malpractice Laws
• Medical Malpractice FAQs
• Surgical Errors

Often times the nursing home will hide these important documents amongst an overwhelming stack of legal documents that can confuse an elderly patient that may already have a diminished ability to comprehend these documents.

Marlene Owen is one of the women who successfully challenged an arbitration Agreement signed by her delusional elderly stepfather in 2003. She said, “It gives the nursing home carte blanche to abuse these elderly people because they won’t have to answer to it”

Owens’ stepfather, John J. Donahue, died at age 93. She alleges that his death was directly related to the injuries he suffered at a Brockton, Mass nursing home in 2005. In 2007, Owens filed a lawsuit claiming abuse and neglect. That’s when she found out about the arbitration agreement.

Now that the arbitration agreement has been nullified by a judge, she is now suing her elderly step father’s former nursing home over bad care and neglect.

Arbitration Agreements: More Profit and Worse Care

Nursing homes are becoming less and less accountable for their care specifically because of their arbitration agreements. They don’t have to pay out as much for settlements so even if their lawsuits go up by 25%, they still are increasing their profit. So that allows them to pay for lower skilled or less trained staff, because the consequences are worth it.

The Aon Corp. conducted a study in 2009 for the American Health Care Association, which represents 11,000 senior living and rehabilitation centers. The average nursing home lawsuit claim amount in the United States from $261,000 in 1998 to an estimated $116,000 in 2008.

This is during a time when tort reform and arbitration increased. Though victims of abuse, their families, and attorneys can fight arbitration it is a long expensive road that makes settlements look easier and less emotionally draining.

“Settlements are less costly,” with arbitration, said Chris Coleianne, an actuary with Aon.

Aon also found:

• Lawsuit payouts on average in arbitrated cases was $91,000, compared to $138,000 in nonarbitrated cases; 35% less.
• Nursing homes’ legal costs were around $33,000, compared to $56,000 in nonarbitrated cases; 41% less.

These numbers are significant over the long run.

“Nursing homes began offering arbitration agreements about nine years ago to rein in high jury awards and legal fees, and so far it’s working,” said Susan Feeney, vice president of public affairs for the American Health Care Association. “Payouts may be lower, but families pay a lot less in legal fees with arbitration,” she said.

Legislators Join the Fight

Governor Chris Gregoire has called on the Department of Social and Human Services to begin a significant crackdown on Nursing Homes in Washington State. She did this on the heals of the shocking article about nursing home abuse in Washington state by the Seattle Times.

That crack down has yielded some results, but has yet to address the serious problems found throughout the state that the Times alleges. The rampant abuse in such a blatantly profitable industry is something that both Gregoire and the Times recognizes needs to be curbed before it gets out of hand.

Even politicians on the federal level are mobilizing to protect seniors. U.S. Rep. Barney Frank (D-Mass) and U.S. Rep. William Delahunt (D-Mass) are among 28 sponsors of legislation banning arbitration agreements in nursing homes. The legislation has already been filed by California Rep. Linda Sanchez. It is pending in front of a House subcommitee.

Nursing Homes Fight Back

As one might guess the nursing home industry has mobilized against the bill so to retain their right to abuse seniors without accountability.

W. Scott Plumb, senior vice president at the Massachusetts Senior Care Association, representing 400 nursing homes throughout that state alone, defended the use of the agreements and said the nursing home industry has been singled out.

“They are quicker, less costly and they are very attractive alternatives to expensive, time-consuming litigation,” Plumb said. He makes arbitration agreements sound as enticing as a luxury car.

Yet, even the people who give the care in the nursing homes themselves agree that seniors need to retain legal protection. Arlene Germain, president of Massachusetts Advocates for Nursing Home Reform, said the agreements capitalize on vulnerable seniors.

“They should not lose the ability to hold nursing homes accountable in the event of abuse or neglect by signing away their constitutional right to have their cases heard by a judge and jury,” she said.

Protect Yourself and Loved Ones

There is this idea that if you allow nursing homes profit that they will somehow raise the level of care or give back to their residents somehow. Yet, trends have shown that the more profit a nursing home care corporation makes, the more facilities they open. Though the level of care in these facilities may be higher, the residents pay for it through higher leases and fees. Also, that doesn’t guarantee that the facility will retain the level of care or be maintained as the corporation moves on to their next more profitable venture.

As a normal citizen who cares for the health and welfare of your elder loved one it is important that you monitor their care for signs of nursing home abuse or nursing home neglect. Often they cannot communicate concerns on their own so it is also important that you examine them periodically for signs of abuse. If you see these signs you should find experienced legal council to find out your legal options. Call Phillips Webster for a consultation.

Learn More About:

• Causes of Medical Malpractice
• Washington Medical Malpractice Laws
• Medical Malpractice FAQs

The study was published in the Archive of Pediatrics and Adolescent Medicine. The study surveyed 141 parents who had lost their children to terminal illnesses like cancer. The nature of the study was to find out how many parents with a child in physical pain  due to a terminal illness like cancer, had considered drastic measures to end their child’s life early. A term generally referred to as euthanasia.

The Study

The 141 parents surveyed had had children who died in hospitals in Minnesota and Boston.

Thirteen percent of parents with children that were terminal considered hastening the process.  A few even acknowledged that they asked doctors to use fatal doses of medication to end the child’s suffering for good.

The study goes on to say that nine percent of the parents had brought the option up with a medical practitioner. In the study the parents of five children said they “explicitly requested” it from a doctor. Three sets of parents confirmed that the doctor had agreed to administer a lethal dose of morphine.

According to the study, in hindsight, 34 percent of the parents said they would have considered euthanasia for their child if the child had been suffering from “uncontrollable pain.”

Fifty percent of those surveyed supported the right for parents to make choices regarding the early death of their child in cases of an excruciating and imminent death.

“If there was absolutely no other option, and the patient is suffering, then why wouldn’t you” hasten death? said David Reilly, a Boston-area man whose 5-year-old son died of cancer 11 years ago.

The Study Authors Comment

The study refers many of these cases as “hastened death” rather than euthanasia. This can lead to serious medical malpractice charges in most states. Regardless of their name are officially opposed by the American Pediatric Society who have stated officially that they prefer palliative care (care to reduce pain by no longer treating the disease with painful methods).

“Desires for hastened death may represent an exit plan to be used if no other alternatives are recognized,” they write. “If physical suffering is identified, our results suggest that parents are willing to have an open discussion about existing options … such as proportionately intensive symptom management and palliative sedation.”

The study’s authors explicitly do not suggest that doctors were hastening death on any of their young patients. They lightly suggest that the parents may have misinterpreted the willingness of doctors to administer lethal doses of pain killers.

“I have no doubt that in a small number of cases, some physicians might cooperate with a parent’s desire to see a child’s suffering ended,” Dr. Douglas Diekema, a medical ethicist at Seattle Children’s Hospital, told The Associated Press. “This might include giving a drug for sedation or pain control that also suppresses the drive to breathe.”

“Most physicians don’t intentionally push that drug to the point of stopping a child’s breathing, but some may be comfortable not intervening if a child stops breathing in the course of treating him or her for discomfort,” Diekema said.

The Euthanasia Debate

The debate of euthanasia has hit the status of pop culture with headline catching cases such as Terry Schiavo, Dr. Kevorkian, and the Oregon Legislation for assisted suicide. Internationally, the Netherlands is the only country where euthanasia is legal for infants and children. In all of these cases people had strong opinions, but in the case of a terminal child in pain there may be a little more contemplation.

The researchers in the study promote an open discussion between doctors and parents. They understand that the situation will never be simple and always painful.

The study goes on to suggest that parents and doctors voice their values regarding end-of-life decisions. After interviewing doctors in Oregon, where assisted suicide is legal, the study concluded that “these conversations are highly challenging.”

“Finding an equilibrium between their position and their willingness to relieve patient suffering does not come easily,” the study said.

Tough Decisions that Affect Whole Families

The pain of losing a child can be profound. The image of a child in pain hits the soul at its core empathetic level. The image also highlights a need for what the study calls “progressive thinking” with regard to the choices faced by parents of terminally ill children. They urge open lines of communication from doctors about options for pain relief.

Though the decision is left to parents and doctors as to the care of the child and ultimately what direction the care goes. There are of course exceptions where the state has stepped in. Some highly publicized cases include instances where the parents are refusing care on religious grounds causing their child great pain. Other cases include instances without clear lines of custody.

These are hard medical decisions that require a family to review their legal options particularly if they feel as if the medical practitioner is giving inappropriate advice that may affect the child’s comfort and passing. If you or a loved one find themselves in a situation of a life decision call Phillips Webster for a consultation on your legal options.

Republican leaders of the debate say that medical malpractice lawsuits are the reason why medical costs in America are rising. Just today Rep. John Boehner, the top Republican in the House, said, “Lawsuits have helped grow the size of health care costs.”

The problem with that assertion is that Beohner and the rest of his party have been proven wrong time and time again in this assertion.

The Reality of the Tort Reform Debate

As Tom Baker, a professor of law and health sciences at the University of Pennsylvania School of Law and author of the book, “The Medical Malpractice Myth,” told the New York Times in a recent interview:

“[Tort reform is] a red herring. It’s become a talking point for those who want to obstruct change. But [tort reform] doesn’t accomplish the goal of bringing down costs.” He goes on to explain, “As the cost of health care goes up, the medical liability component of it has stayed fairly constant. That means its part of the medical price inflation system, but it’s not driving it. The number of claims is small relative to actual cases of medical malpractice.”

This would insinuate that those who are in support of medical malpractice lawsuit caps are somehow fabricating the numbers (otherwise known as “lying”). We certainly don’t want to insinuate that, so Mr. Baker will elaborate for us:

“We have approximately the same number of claims today as in the late 1980s. Think about that. The cost of health care has doubled since then. The number of medical encounters between doctors and patients has gone up — and research shows a more or less constant rate of errors per hospitalizations. That means we have a declining rate of lawsuits relative to numbers of injuries.”

The Wrench Has Been Caste

In an ever effort to be bipartisan, President Obama has not taken the possibility of medical malpractice lawsuit caps off of the table. In a statement today he said, he wants to change how the United States deals with medical malpractice lawsuits, although he says Republicans are overstating its effects on the health care system.

Overstating its effects is an understatement. They have asserted that up to 20% of healthcare costs are due to medical malpractice lawsuits. In a speech at the summit yesterday Senator Dick Durban of Illinois, assistant to the Democratic majority leader, threw that assertion aside using simple math:

“The point that’s been made by the president is if we do believe the Congressional Budget Office, when Orrin Hatch asked them how much will we save if we implement the Republican plan on medical malpractice from the House, they said $54 billion over 10 years; $5.4 billion a year is a lot of money, except in the context of the $2.5 trillion bill that we pay each year for health care. It represents one-fifth of 1 percent of the amount of money we spend each year on health care.”

That would mean that Republicans are hundreds of billions of dollars off on their calculations. By our calculations, it amounts to being really, really, really wrong (to the tenth power).

The Medical Malpractice Contradiction

Here is where the supporters of medical malpractice lawsuit caps really lose their footing. They are not all Republicans, but since this is the sticking issue on the healthcare reform debate on the Republican side, there is one massive contradiction to their core philosophy that needs to be raised.

The main talking point for Republicans is government’s role in normal American’s lives. But yet if a patient is hurt by the negligence of the healthcare provider, it is government that dictates the amount of compensation, not the patient, not a jury of the patient’s peers. It’s the government.

As Durbin said in his speech:

“I will tell you that as far as the president is concerned, in his neighborhood there is a great hospital, which I will not name, and at this hospital a woman went in for a simple removal of a mole from her face. And under general anesthesia, the oxygen caught fire, burning her face. She went through repeated surgeries, scars and deformity. Her life will never be the same. And you are saying that this innocent woman is only entitled to $250,000 in pain and suffering.” He goes on to say, “I don’t think its fair. Our jury system makes that decision, and the states, 30 of them have made a decision on what to do.”

The Big Payoff

So why all of the deception? Campaign contributions and lots of them from the insurance agencies who made a record high $75 million on malpractice insurance last year without having to pay out more than they did in the 1980s.

According to the Washington Post, Health insurers and their employees contributed $2.2 million to the top 10 recipients in the House and Senate since 2005, while drug makers and their employees gave more than $3.3 million to top lawmakers during that period, according to an analysis of federal elections data by Consumer Watchdog, a California-based advocacy group.

Medical Malpractice Lawsuits are Essential

A patient cannot rely on politicians, government agencies, healthcare providers, insurance companies, or the government to be on their side when they are hurt or made sicker by medical mishaps done by healthcare workers or facilities. When a person is hurt they become more of a liability and more of an expense. That is the exact thing politicians, insurance companies, healthcare providers, etc. want to avoid and will do what they can to cut their losses at the patient’s expense.

Don’t let this happen to you. If you find yourself getting sicker or physically hurt by the negligence of a healthcare provider or healthcare facility you need experienced and professional representation. Call Phillips Webster for a consultation on your legal rights.