Pfizer may be in legal trouble after some lots of its oral contraceptives had the wrong medications. Now women who took the mislabeled medications have an increased chance of becoming pregnant.
Plaintiff attorneys wonder whether there will be class action lawsuits with hordes of women with unwanted pregnancies demanding justice.
The simple solution is that every person who files a lawsuit but who has not made arrangements to give their child up for adoption immediately upon birth should have their lawsuit dismissed. Adoption fees can go to the hospital to cover delivery costs. None of this horsepuckey about how Pfizer should pay every pregnant patient the costs of raising their children until the children turn 18. Either the women want the children or they don’t.

Then, according to the Pennsylvania Supreme Court, if your child doesn’t come out right and the doctor misreads an ultrasound, physicians can now be sued for a patient’s emotional distress.
In other words, “sorry, honey, but we would have aborted you if we had known what emotional distress your birth defects would have caused us.”

Patients gone wild. Michigan man going to trial after beating ED secretary on the head with a computer keyboard. According to this article, the accused “doesn’t recall anything.”
I have to wonder why this guy decided to go to trial. He doesn’t remember anything, but he’s going to get a jury to believe he didn’t do it? Were the imprints from the computer keys caused from some other source?

Plaintiff wins nothing at trial in a $1 million dollar lawsuit alleging that physician caused a patient’s death from drug resistant staph.
Keep taking your ZeePacks for coughs and runny noses, then demanding Levaquin when, for some odd reason, the ZeePacks don’t work. You could be the next one who dies from MRSA.

Blogger suggests repealing the unfunded mandate EMTALA as a means to cut health care costs, then gets blasted in the comments as a “moral degenerate” for doing so. Ouch. Give those commenters the best health care that someone else can pay for and give it to them now.

Study in the Journal of the American Academy of Child & Adolescent Psychiatry shows that most adolescents who come to the emergency department with self-harm don’t get mental health evaluations.
Do non-suicidal patients who cut themselves really need a mental health evaluation in the emergency department? Our job in the emergency department is to determine which patients are a threat to themselves or others. We can’t hold every patient who scratches their forearm with a sharp object for hours or days in the emergency department until a psychiatrist can see them.
If the AACAP has a problem with that, maybe it should tell its members to be more available for patient evaluations rather than trying to impose its will on other specialties.

What is the most common cause of infection outbreaks in US hospitals? Hospitals and cruise ships have a lot in common.
Also of note is that 35% of hospitals responding to the survey had at least one infection outbreak in the prior two years. Often these organisms are drug resistant. Those who want to be admitted to the hospital “just to be safe” may not be as safe as they think.
Also see this report about all the dangerous organisms present in pediatric ICUs.

What is the emergency department in China like? Everyone pays up front for the visit, for x-rays, and for medications or they don’t get care, x-rays, or medications. Then again, the doctor gets paid $13 for the visit and the total cost for reducing a dislocated shoulder was $150.

Cyberchondria. It’s catching. And it’s another reason that a free market and deregulation will cut down on medical expenses. You think your chronic back pain is a blown disk? Go to the walk-in MRI center, plunk down $3000 for an MRI and reading and prove yourself right … or wrong. When you’ve wasted many thousands of dollars in testing, then you can seek medical help to recommend other tests you can go purchase in order to quell your anxiety.

Moving to a different hospital is not quite the same as moving to a different a home. It involves police to man the routes between hospitals, 15 fully staffed ambulances dedicated just to the move, and a heck of a lot of crates.

Recent study by Deloitte (.pdf file) shows that most US physicians believe that health reform will increase costs, increase wait times in the emergency department, and change incentives to medical providers. Physicians believe that their incomes will decrease and that the increased demand for services by the newly “insured” will likely cause the scope of practice of midlevel providers to increase.
60% of physicians gave our healthcare system a “C” or “D” rating. Physicians were split on whether the Affordable Care Act is a step in the right direction. 78% of physicians would be comfortable with medical courts and binding arbitration as opposed to the current medical malpractice system.
Finally, most physicians are pessimistic about the future of medicine. 69% believe that bright students are being turned off to medicine, 57% think the practice of medicine is in jeopardy, and only 18% feel excited about the future of medicine.
Now of course the data are probably flawed because Deloitte didn’t survey any plaintiff’s attorneys, but, if you drink the Press Ganey Kool-Aid, data is valid regardless of the source, the bias, or the numbers.

Meth heads do the “shake and bake” … on their face. New process for making methamphetamines in a 2 liter soda bottle often backfires, causing explosion and burns to the junior chemist. Because most people suffering these burns don’t have insurance and because the mandated care from this activity averages $130,000 per person (60% more than other burn patients), the financial strains are contributing to the closure of several burn units across the country – leaving fewer resources available for everyone.

Correlation or causation? Study shows that elderly patients who visit the emergency department are almost four times as likely to develop a respiratory or gastrointestinal infection in the following week as are elderly patients who do not visit the emergency department. The patients developing the infections were also “sicker” at baseline, though.
Interesting hypothesis, although I wonder whether this is similar to asserting that almost four times as many patients who die in the emergency department arrive by ambulance and therefore drawing an inference that ambulances cause patients to die.

Patients gone wild. Minnesota man arrested after “throwing items around the emergency room” then assaulting emergency physician and nurse.

Emergency department patient complaining of suicidal tendencies left alone for less than 5 minutes, some incident occurs, patient ultimately discharged from hospital, yet now Medicare is threatening to pull hospital’s funding. Did someone not buy all of the Joint Commission books before the inspection and upset the Joint Commission inspector? Notice how the hospitals are condemned for some heinous act yet how the Joint Commission doesn’t disclose what the acts were? Can’t find any mention of High Point Regional Hospital anywhere on its web site. Makes it a lot more difficult to question the judgment of the inspectors, doesn’t it?

Scranton area hospital closing its doors. Marian Community Hospital closing by mid-February. Community loses emergency department and behavioral health services.

Texas jury awards $1.9 million to patient who suffered complications after resident performed part of surgery on her without her knowledge and caused bowel perforation requiring permanent colostomy.

In the State of the Re-election, er, um, the State of the Union Address, how much was health care mentioned? Hardly at all. How often were unfulfilled campaign goals from 2010 and 2011 repeated almost verbatim? Quite a bit more.

Some people get jail time for pulling a tooth without a license. One man was awarded $22 million when he was locked up by a judge in solitary confinement for two years without a trial and had to pull his own tooth. The judge and the prosecutors who locked him up for so long should have to pay the verdict. But … negligence doesn’t apply to the judiciary.

Interesting article on why a government unfunded mandate has made Medicaid enrollment mandatory for most hospitals.

Covington, LA hospital sued for more than $600,000 when patient falls while trying to get up from the toilet. According to the article, the hospital was negligent for …
“failing to use consistent, coordinated, multi-disciplinary approach to fall precautions, for the failure among team members to effectively establish an individualized plan of care concerning fall precautions, failing to instruct the patient and her family regarding fall precautions, failing to adequately monitor the patient’s response to pain medications and failing to properly observe, supervise, and assist the patient with ambulation, failure to implement nursing measures required to monitor patients and to implement nursing considerations for a patient receiving narcotic analgesics”

When patients refuse to accept a settlement for an injury, some hospitals recommend malpractice attorneys to the patients. If the attorneys know that they are getting referrals from the hospitals, does this practice constitute a conflict of interest? Better yet, if the patient sues the hospital and loses, can the patient then sue the hospital for a negligent referral?

This malpractice attorney is a moron and a thief. Malpractice plaintiffs refuse to settle case for less than $350,000. New York attorney takes $70,000 settlement check, deposits it in his account and forges settlement papers. Now he’s facing 15 years in the Greybar Motel.

Woman gets 18 months in jail after trying to steal more than $250,000 from the medical malpractice settlement in her mother’s estate then lying to the probate judge about where the money went. Lawyer walks away with $450,000 of the $1 million settlement and nobody bats an eye.

Two emergency physicians in Granite City, IL hospital fired after patient death. According to a news report from KMOV in St. Louis (that was taken down shortly after being posted), Anthony Burkey entered the “Granite City Emergency Room” having hallucinations. He was being restrained by several people when he suddenly became unresponsive and later died. Gateway Regional Medical Center is the only hospital I can find in Granite City, IL. But why was the article pulled by the news station?

Funny description from a patient’s perspective of a “ruckus” taking place in room next door to his in the emergency department.

The story of “Dr. Douchebag” and why morale is declining in many of this country’s emergency departments. Even if you say “thank you, sir” for the abuse, your job may still be threatened because of bad Press Ganey scores.

More than 80% of medical mistakes go unreported by hospitals. Let’s just get this out of the way: Doctors kill every single patient that they treat and plaintiff attorneys should be paid even more money to sue our way to better health care. That should do it.

Indiana woman awarded $1.5 million after surgeon did not operate on abdomen soon enough. Two days after initial presentation, she required emergency surgery for ischemic bowel requiring that a large portion of her intestines be removed.

Sorry, Grandma, I know that your bone cancer is causing you excruciating pain, but you can’t have any more pain medication. As Florida cracks down on doctors who treat chronic pain patients, the patients are having more difficulty getting their medications. Where do the patients end up? In the emergency departments.
When pill abusing patients go to the emergency department and don’t get their medications, some become abusive and violent.
Now some Florida hospitals are implementing a “chronic pain management plan” which requires doctors to “help educate patients about the dangers of abusing prescription drugs and addiction.” Got that, Granny? You have bone cancer and you have six months to live, but abusing oxycontin is dangerous and can kill you.
As part of the “plan,” emergency physicians then will “refer the patient to a primary care physician” – who has already been “cracked down upon” and who won’t prescribe the pain medications, either.
End result? In an attempt to curb abuse by criminalizing the prescription of pain medications, Florida is now affecting the ability of patients who are legitimately in pain to receive necessary treatment. Cancer pain patients in Florida now more likely to get bounced around the system and die in pain.
And people blame the physicians instead of the legislators.

Why let a little thing like a gangrenous appendix get between you and your wedding? Ceremony held in hospital. Both bride and groom wear “gowns.”

New York jury awards 18 year old patient $3 million for delay in c-section at birth that allegedly caused patient’s cerebral palsy.

Patients gone wild in Pennsylvania. Woman gives medical staff hard time in ED, pulls out IV, threatens to infect everyone around her with HIV, kicks a security guard in the cha-chas when trying to escape, then is wheeled out of the hospital by police kicking and screaming in a wheelchair. Initially charged with three felonies, but those charges were dropped by persecutors er, um prosecutors. Of course, if the security guard was an off duty police officer, the patient would be doing 20 to life in Leavenworth.

Patients gone wild then … police gone wild? Patient becomes combative in emergency department. Police called, then allegedly “strike the patient, place him in a headlock, pull and twist his head and forced handcuffs on him with force and violence.” Another officer allegedly “pushed the handcuffed man over a metal chair arm with the force of his weight pressing upon him.” The officers could face jail time and fines if found guilty.

Patients gone wild — Twilight Edition. Toledo woman allegedly tries to steal baby from hospital. When ED nurse approaches her, the woman turns around and bites her. Then she hisses, turns into a bat, and flies away.

The Medical Marijuana Advocates create even more safety policies. Now they’re recommending that health care organizations assess “fatigue risks” and develop a “fatigue management plan” which includes “strategic caffeine consumption.”
My kid kept me up last night. I’m a little fatigued. I want to come to work and sleep, then when I wake up, I want free double mocha lattes. OK, nanny?
The problem is that “fatigue” is determined in a retrospective manner and the Marijuana Advocates don’t tell anyone how to determine fatigue prospectively. Make people afraid of it and tell people who’s to blame for it. That’s how you win elections.
Of course, it didn’t take the plaintiff’s attorneys much time to jump on how providing services while “fatigued” is negligent and will kill people.

While many patients can’t afford health care at all, some hospitals cater to the ultra-rich, charging them between $450 and $4,500 per day in order to have a butler, swank hospital rooms, and an exclusive menu. Meanwhile, other patients wait in the emergency department for days before a hospital bed opens up. Oh, and medical residents aren’t allowed on the units, either — only attending physicians.

Kevin Pho from Kevin, MD wrote an article in USA Today providing some suggestions on how to reduce malpractice lawsuits. Some people commenting on the article demanded that physicians’ hours be cut back so that they aren’t overworked while trying to pay for their “expensive houses, cars, and boats” (see comments section).
I say “be careful what you wish for.”
In other countries, people are demanding that physicians work more hours because patients can’t get the care they need when the doctors work banker’s hours.

Florida teen wins a $12.6 million medical malpractice award after being given an expired vaccination and then contracting an infection which developed into sepsis, DIC, and gangrene resulting in amputations of all four limbs.
I’m sure the antivax crowd are having mind cramps over this concept. The vaccines are full of toxic waste and don’t work. The toxic waste is what caused the illness. They should be sued for giving it. Wait. The patient came down with an infection. Infections are good to build the immunity so we don’t need vaccines. That’s what we want. Then why did the teen win all that money? Wait. Maybe expired vaccines cause the infections. That’s it. Yeah. That’s our angle. Hey – will someone get Jenny McCarthy on the phone? Or Dr. Wakefield … does anyone know Dr. Andrew Wakefield’s number?

Speaking about crazy ol’ Florida …man in Naples, FL emergency department waiting room backs a female patient into a wall, gropes her breast, tries to unzip her pants, and then gets a patella to the cha-chas. Hobbles out of the hospital singing tenor and is arrested in the parking lot holding his crotch.

We’re not done yet … New bill requires that any accident victim in Florida must go to the emergency department to be checked out or risk losing personal injury protection benefits from their insurer. Because the emergency departments aren’t crowded enough without having to worry about patients going there because some brainiac legislator creates a law forcing them to do so.
Yet another reason not to live or practice medicine in Florida.
In fact, I just created a new page on my blog: the Top Ten Reasons Not to Practice Medicine in Florida. Permalink to the upper right. Add any reasons that I forgot to the comments section.

GruntDoc commented on this earlier, but I had to mention it now since it was just released as one of the top 10 articles on Medscape. The FDA has given approval to a device called an “Infrascanner” to detect intracranial bleeding. The device can detect “nearly 75%” of hematomas detected by CT scan. Hematomas don’t include deeper bleeding, so I’m assuming that these results don’t include subarachnoid hemorrhages or intraparenchymal bleeds. The device also excludes hematomas 82% of the time, meaning that the unfortunate 18% of patients are going to get a burr hole drilled in their head for bleeding that the Infrascanner says is present when it is really not. Or they’ll just get a CT scan which makes the whole Infrascanner thing a waste of time and money.
However, I am developing a similar device for predicting intracranial hematomas which I will soon seek approval from the FDA. A prototype is pictured at the right.

Greek financial crisis having effect on patient health care. Pharmacists plead manufacturers to ship aspirin. Manufacturers say “show me the money” first.

New strain of bird flu infects twelve people around country – most of whom have been in direct contact with animals. No word yet on the transmissibility of the H3N2 strain (how easily it spreads from person to person) but it was not included in this year’s vaccine, so if the transmissibility is high it is likely to spread quickly.

OK, OK, the previous article was swine flu, not bird flu. I just wanted to get onto Homeland Security’s “watch list.” Big Brother’s Department of Homeland Security is now monitoring and retaining information on a slew of social media sites including Drudge, HuffPo, and other “blogs that cover bird flu; several blogs related to news and activity along U.S. borders.”
Facebook, MySpace, Hulu, Youtube and Flickr also make the list, as do other “publicly available online forums, blogs, public websites and message boards.”
As Glenn Reynolds says on Instapundit, “How’s that Hopey Changey thing woking for ya?”
P.S. Bird flu, bird flu, bird flu, bird flu.

One third of medical costs … in Florida … attributable to defensive medicine costs. 88% of Florida physicians practiced some form of “defensive medicine” in the past 12 months to protect themselves from lawsuits. The other 12% are either teaching or lying.

Defense of frivolous lawsuits is costing the healthcare system a lot of money. It cost an average of $47,000 to defend a malpractice claim in 2010. Almost two thirds of claims against physicians were dropped, withdrawn, or dismissed without payment and cost an average of almost $27,000 to defend – totaling more than one-third of all defense costs for the year.
In addition, physicians are having to pay for larger malpractice policies. The number of policies with limits more than $1 million increased from 28 percent in 2001 to 41 percent in 2010.
If you want to review the actual reports, they are at this link. You have to be a AMA member to access them, though.

Rich doctors? A lot of them are going broke … and leaving practice … and leaving patients with fewer options for medical care.
And I keep going back to that discussion I had with with one of my clinical professors long ago. Boy am I glad that I’m a doctor.

Man … from Florida … runs out of emergency department … naked … and runs into a retirement resort. There he armed himself with knives and waited until he got a smackdown from a security guard.

Patients gone wild. New Jersey tough guy punches emergency department physician in face, breaking his nose. Now awaiting sentencing which may be as long as 18 months in state prison.

Patients gone wild … International Edition. English chap was so drunk he couldn’t stand, but had enough energy to spit at staff and urinate in a consultation area. Tries the same routine with police and is hauled away in a paddy wagon.

“Culture of tolerance” perpetuates violence against health care workers. Sixty six percent of nurses didn’t report physical abuse and 86% of nurses didn’t report verbal abuse. “If a police officer is assaulted, it’s a crime. To a nurse, it’s just part of the job. Don’t get in that mindset. Workplace violence goes up when a culture of tolerance is promoted.” Couldn’t have said it better myself.

That hospital needs an enema. Health Sciences North Hospital in Sudbury, Ontario has 100 patients waiting in limbo for nursing home placement. As a result, elective surgeries are being canceled, the emergency department is packed with 35 patients waiting for beds on the medical floor, and wait times are going up.
But the care is free.

So … back to the regularly scheduled updates, and the regularly scheduled update Satellite Edition.

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He should have just called a Bambalance. After running into deer in the road, drunk driver in New York arrested for trying to take deer to the emergency department for medical care.

Is loser pays a solution for frivolous medical malpractice lawsuits? Absolutely.

Speaking about “loser pays,” Glenn Reynolds from Instapundit brings up a very good point regarding using loser pays in criminal cases. Why shouldn’t government attorneys have to pay for defense attorneys’ fees if the jury finds a defendant not guilty? As it stands right now, a defendant can pay hundreds of thousands of dollars in legal fees to defend himself against criminal claims with the only solace being “hey, at least you’re not going to jail.”

Family of 85 year old patient on Coumadin awarded more than $200,000 when radiologist misses a 7mm subdural hematoma after patient fell and hit her head. Emergency physician and hospital were also sued, but were found not liable.

Patients gone wild returns. Florida man refuses to leave emergency department without being fed a meal. When police arrive to escort him out, he whips out his Willy and urinates on the floor. Then he goes to a phone and repeatedly dials 911 to ask for a ride to another hospital. Officer complains because the guy was passing “unbearable” gas when being patted down.

“Permanent hospital residents” costing billions in care because they are illegal immigrants and have no place where they can be discharged. Total cost is several million dollars per year just for one struggling New York hospital.
How should the patients be managed more efficiently? Perhaps being flown to their country’s consulate and dropped off there?
Thanks to DefendUSA for the link.

Teens try to get high overdosing on Coricidin cold medication. Instead end up in hospital. Time for the American Academy of Pediatricians to get out their pitchforks and torches to lobby for removal of another drug from the market. JCAHO would probably be all over it, but unfortunately, the overdoses didn’t occur inside a hospital.

While you’re waiting to see the doctor … would you mind doing chest compressions? Remember last year when Royal Columbian Hospital in British Columbia set up treatment beds in an adjacent coffee shop? This year, overcrowding has forced the same hospital emergency department to set up patient beds in the hospital lobby.
On one hand, I applaud the emergency department staff for having the guts to do what they have to do in order to provide care to patients. On the other hand, what in the heck is wrong with the healthcare system that providers are forced to take such measures?

Are all those rashes that people get when they take medications really “allergies”? This study says that they aren’t. About 25% of the time, the rashes are due to something else. From my experiences, I’d say that 25% is an underestimate.

The government comes up with an updated version of the emergency severity index to determine which patients need immediate care and which do not. Anyone in “severe pain” (can you say “10 out of 10”) or having “emotional outbursts” in triage should be considered for immediate treatment. Does anyone else see a problem with where this is heading?

Texas nurse sues Emerus 24 HR Emergency Room for wrongful discharge after being accused of stealing/diverting drugs from the emergency department and then reporting defamatory information about her to the Texas Board of Nursing.

In Pakistan, one hospital’s emergency department x-ray machine has been broken for 2 months. Patients are upset over the inconvenience of having to go to the outpatient department for x-rays. Oh, by the way, patients have to pay for outpatient x-rays while those obtained in the emergency department are free.

What’s the best medication to treat clostridium difficile colitis? The jury is still out. No antibiotic has been proven superior to the others. However, Flagyl is a heck of a lot cheaper than vancomycin.

Calling all Americans: Blood donations needed. Every two seconds a patient needs a blood transfusion. Pay it forward.

People living in houses near Virginia hospital warned to stay inside after intoxicated patient flees the emergency department. The patient is so dangerous that we have to hide women and children when he’s in public, yet when he gets to the emergency department, staff gets scrutinized if he is restrained and staff gets threatened with job loss if he isn’t satisfied with his visit. Yep, that’s about right.

Medical malpractice reform losing physician support? Give me a break. I work for a hospital. Who in their right mind would suggest I or any other employed physician is any less interested in whether we are named in a frivolous lawsuit? Sure, take my 401k and my house keys. Really. No interest in all. In addition, it seems as if Dr. Kirsch hasn’t heard of the National Practitioner Data Bank.

Some hospitals either close their emergency departments during the holidays, such as these in British Columbia or keep them open with nurses only such as these in Australia.

81 year old Canadian patient has abdominal surgery postponed 4 times in past 18 months. This time, busy emergency department and insufficient ICU beds was cause for cancellation. Wife asks if the government can add a “smidge” more money to hospitals so that sick people can at least have a chance of surviving. But don’t forget – the care is free.

A man after my own heart. And here’s his blog.

In 2010, dental problems caused 115,000 emergency department visits in Florida alone. That’s about 0.1% of all the emergency department visits in the whole country.

Illinois psychiatric patient waiting in emergency department for 6 hours becomes agitated and combative prior to being transported to room. When restrained, becomes unresponsive and dies. Preliminary cause of death is “excited delirium.”

Money well spent? Medicare has forked over nearly a quarter BILLION dollars in the past 10 years for … external penis pumps. That doesn’t even include implantable devices or pills like Viagra.

As North Dakota oil industry booms, so does medical care. Doctor appointments are not available for several months, the wait time in the emergency department has doubled, orthopedic surgeries have tripled, oh yeah, and STDs have reached an all-time high as well.
When waitresses in the area make $100/hour including tips and nurses … don’t, one nurse also considers whether to stay in health care.

Good ruling or not? Ohio Supreme Court rules that medical malpractice claims must be supported by expert testimony before they can proceed to trial. Although the issue in the case was whether informed consent claims are considered medical malpractice claims for purposes of the law, were a lot of attorneys trying to win med mal trials without medical expert testimony before the ruling?

Patients gone wild? Texas man walks into emergency department, says that he’s “taken something” and then passes out. Then wakes up and begins fighting throwing punches. After staff undressed him and called the police, they found a bleeding chest wound as well.

New Zealand hospital says “enough is enough.” Patients who abuse medical staff will be prosecuted.

Visitors gone wild? Vancouver perv walks into patient room and sexually assaults patient waiting to be checked for pelvic pain. Later arrested and charged. Patient plans to sue hospital for letting the man walk through the emergency department.

Personally, I’ll take my chances with the nasal washes. Two Louisiana people die from amoebic meningoencephalitis after irrigating nasal cavities with Neti Pot.

Get your flu shot before its too late. Montreal Children’s Hospital has been seeing 80-90 additional patients each day due to influenza and other respiratory illnesses.

More Medicare patients are going in for their “free” annual physicals under new health care reform law. However, as Michael Cannon from the Cato Institute notes, there is no such thing as a “free” lunch. In other words, current taxpayers are picking up the tab for the “free” physicals.

I’d feel a little unsafe watching eight little same-aged kids running around the mall. Court rejects fertility doctor’s appeal to have his medical license reinstated. Doc who made “Octomom” famous loses license after medical board concluded that revocation of license was “necessary to protect the public.”

No, this isn’t a drive through emergency department. In a scene straight out of the first Terminator movie, an Australian teen drives his car straight through an emergency department wall, bursting a water main.

Spirited medical malpractice debate takes place over at Point of Law. Ted Frank hits a home run dispelling a visiting professor’s regurgitated trial lawyer claim that lack of the threat of medical malpractice makes sloppy doctors.
“Professor Svorny’s students are not allowed to sue her for any alleged educational malpractice, another cap of zero. I trust that Svorny’s lack of incentives created by liability do not reduce her efforts in teaching ….”

Illinois hospital/surgeon settle malpractice case for $17.5 million after patient suffers multi-system organ failure and other complications after hernia surgery.

Whooping cough resurgence in New York. More than double the number of cases than occurred in the next-largest outbreak in 2006.
I renew my assertion that vaccinations should not be mandatory, but that parents who fail to vaccinate their children should be charged with endangering the welfare of a child and should incur civil liability if their children contract preventable communicable diseases or transmit those diseases to others.

Now from the “how else can we justify our existence” department. JCAHO is considering whether to regulate “overuse” of health care treatments, procedures, and tests. That’s right, boys and girls, soon the clipboard brigade will descend upon hospitals and start throwing out citations if too many CT scans or surgeries are performed.
You’ll have to click on the “read more” link at the above site to read about it. I avoided pasting into the story the unique URL that the link generates.
That got me thinking. When is someone going to do a study showing how JCAHO is a threat to patient safety?

Patients gone wild. Illinois man gets a twofer. First he’s arrested for breaking a car door at a bowling alley parking lot. Then he is arrested again after going to the emergency department and attempting to punch out a female emergency physician, hitting her in the ribs.

Who are you freaks and what did you do with Bullwinkle? Flying squirrel gets loose in emergency department, repeatedly jumps from light head-on into glass window.
In other news, PETA is now considering whether to pursue an EMTALA action against the hospital for failing to perform a proper screening exam before releasing the animal into the wild.
And in still other news, JCAHO is considering whether to declare glass windows a threat to patient safety because patients *could* make the same mistake and run head-on into glass, killing or seriously injuring themselves.
Hat tip to hashmd for the story.

Double double toil and trouble. New York woman criminally charged for “self-abortion” after drinking herbal concoction allegedly intended to cause abortion, then aborting her fetus.

Chicago area hospital system settles birth injury case for $7.5 million.

Navy SEAL dies in hospital from “preventable causes.” Family awarded $4 million. Overdose of painkillers was suspected, but Maricopa Medical Center in Phoenix was able to keep the records secret under Arizona quality assurance law.

The problems with government “insurance.” When federal payments don’t cover the cost of care, states seek to decrease payments to providers … which decreases the number of providers willing to provide medical care at a loss … which decreases access to care.
Arizona hospitals sue to block cuts in Medicaid reimbursement. They argue that the cuts will shift cost of care to insured patients who have to pay more money for their care.
Meanwhile, California is planning to cut Medi-Cal payments to providers by 20%, which will impact the access to medical care for more than 7 million California residents. If the cuts are enacted, “half the state’s hospitals that run skilled-nursing units said they would close them” and “another 35 percent said they would reduce beds or end service to Medi-Cal patients.”

Yet another reason not to practice medicine in Florida — it has three of the top ten “saddest” cities in the US. I’d be sad, too if I could lose my license after three successful malpractice cases, with criminal charges against physicians and pharmacists, with high malpractice rates, if lawyers forced me to sign a contract invalidating statutory contingency fee caps before they took my malpractice case, state investigators cite physicians for failing to save a 13 week old fetus, etc, etc, and so on.

Scary trend. Another patient drives to the hospital emergency department then shoots himself dead.

Missouri hospital tries new tactic to shore up bad debt in the emergency department — holding prescriptions hostage. Patients will all be evaluated in the emergency department, but won’t get their prescriptions on discharge until they either pay their insurance co-pay or pay at least a $40 down payment toward the bill for their care. That policy will end as soon as the first asthma patient dies from no steroids and lack of access to a rescue inhaler after an asthma exacerbation.

You think it’s so easy, then YOU try to meet the guidelines. American College of Cardiology recommends that patients with acute MI be transferred to a hospital capable of performing PCI within 30 minutes. Study in the Annals of Internal Medicine shows that the median time to transfer is double that. Heck, just filling out all the paperwork takes 30 minutes. But just think about how safe that government regulations and lawsuit fears are making all of us …

Does this mean Congress should be held as a bunch of “enemy combatants” for passing that health care law? Secretary of Health and Human Services Kathleen Sebelius said Thursday that America’s health “really is a matter of national security.”

The dog must have been an Al Qaeda operative. Kentucky couple comes to emergency department with runny nose, burning skin, dizziness and headache after coming into contact with stray dog. Soon, hospital staff came down with same symptoms. Then hospital goes on lockdown while Haz-Mat crew investigates.

Finally, a video to get you feeling all kinds of Christmasy in this holiday season, courtesy of the Drudge Report. Homeless woman, when discussing her 15 children and how she isn’t getting enough social services to care for them all states “Somebody needs to pay for all my children,” and “somebody needs to be held accountable.” The video is apparently several years old, but has resurfaced as a “flashback” and now seems to have gone viral. As the great Glenn Reynolds says on Instapundit … “How’s that Hopey Changey thing working out for ya?”
As an update, this video was being discussed on a radio station in our area and one of the callers made a comment “Ma’am, it’s a uterus, not a clown car.” Ouch.

Emergency department haiku. This guy is good.

Australian government web site showing emergency department waiting times shown to post inaccurate information, not to update information for days, and alleged to be a “waste of resources.”
One leader opposing the site says that “people don’t go to emergency departments unless they need to be there. If they need to be there, they will go to the closest one. Not review a website first.”
Don’t worry. Nothing like this would ever happen in the US.

Another article on how hospital rankings are arbitrary. Feds’ Hospital Compare website measures outcomes one way, US News measures same outcomes an entirely different way. Patients or administrators who believe either set of rankings end up being the real losers.
A man with one watch always knows the time. A man with two watches is never sure. A man who reads a watch that measures time in ounces is just a dimwit.

Trying to avoid the “Code Zero.” Last year, 4000 patients waited at least 10 minutes to get a hospital bed after being transported by ambulance. During those waits, the paramedics aren’t available to take other calls. When all the ambulances are busy, it’s called a Code Zero. Hospitals blame the delays on crowding due to non-urgent patients.

What? Governmental requirements for faster care actually slow care down? You don’t say. Canadian requirement that emergency department patients should not wait more than 4 hours between arrival and admission “hits the target but misses the point.” Wait times after the cutoff was implemented actually went up and “activity in the last 20 minutes of the four-hour window grew every year since the rule was introduced.” When one patient is near the four hour mark and another is ready to be discharged at 1 hour, the 3.5 hour patient will attract much more resources in order to meet the cutoff. The 1 hour patient will wait much longer because the staff is worried about preventing waits from going over the 4 hour cutoff.
Like this wasn’t foreseeable?

Will the next pandemic influenza candidate please step forward. New strain of swine flu discovered. Combines previous H1N1 genetic material with rare H3N2 genetic material. Limited coverage afforded from current year’s vaccinations. Save up so that you can afford the Tamiflu prescriptions.

This week’s edition of patients gone wild. Georgia man becomes upset in emergency department, kicks holes in wall, then shouts obscenities. Now in jail on disorderly conduct charges.

More patients gone wild. Man shoots and kills former girlfriend in a Chicago hospital parking garage.

Another patient gone wild. Man kicks police officer in back of head in Hawaii emergency department.

Yup, there’s more. Prison inmate coming to the emergency department for a medical condition tries to steal guard’s gun. Shots go off. No one is hurt. Inmate gets moved to extended-stay Greybar Motel.

That wasn’t a donation, it was his deductible. Connecticut hospital gets a $1.4 million donation from a businessman who credited the hospital with saving him from septic shock.

It’s not the “ICU” anymore, it’s the “Eye See You.” Cameras over the sinks in one hospital’s ICU increase hand washing rates significantly. Whether washing one’s hands scores of times per day has any real effect on decreasing infection rates in hospitals … who cares? That’s irrelevant when a clipboard brigade can get highly educated health care providers to act like lab rats with a simple camera and LED display.

Antibiotics make you fat? Interesting correlation between states with the highest antibiotic use and states with highest number of deaths from strokes, highest number of patients with heart attacks, highest diabetes rates and greatest obesity rates.
Sounds wacky, but I think that the correlation needs to be given more study. We have a lot to learn about the effects of intestinal flora on our systems. I have long been a believer that dysbiosis is responsible for a lot of unexplained human ailments.

Bakersfield, California hospitals are so busy that the emergency departments often are overwhelmed to the point that they go on bypass to ambulances. Now, because some patients are getting sent to hospitals that aren’t covered by their insurance, the state is considering whether to do away with “closure” to ambulances and to force already overwhelmed departments to take even more patients.
Administrators say that such a policy will make hospitals “more creative.”
Instead, the policy will cause longer waits, fewer ambulances on the street (crews will have to wait with patients until the patients get a bed), and more deaths.
I think that California has now become the second suckiest state in which to practice medicine.

California legislators are embracing the expansion of Medicaid coverage in their state. That’s because they’re getting extra money from the federal government. Wait until the money dries up. Then they’ll be singing another tune. Think that emergency departments are overcrowded now?

What’s the suckiest state in which to be infected with the HIV? If you live there and are black, you’re ten times more likely to die than if you’re white.

Capitalism at its finest. Obama administration grants multimillion dollar contract to Siga Technoligies for smallpox vaccine.
Did I mention that the company’s controlling shareholder is billionaire Ronald Perelman – a longtime Democratic Party donor.
Oh, and the Obama administration blocked other corporations from bidding on the contract.
Oh, and the government paid $255 per dose for 1.7 million doses of the vaccine – well above the “reasonable” price for the vaccine.
Oh, and smallpox has been eradicated for more than 30 years.
Oh, and the government already owns $1 billion worth of smallpox vaccine at $3 per dose which would prevent death if given within 4 days of exposure to smallpox.
Oh, and the new drug cannot even be tested to see if it works because of ethical constraints.
In other words, our president funneled $433 million to a crony’s corporation for a medication we don’t reasonably need and that can’t even be tested to see if it works.
For all we know, it could be little $255 sugar pills.
We’re from the government and we’re here to help.

He swallowed WHAT? New book publishes pictures about foreign bodies in patients’ bodies — that have found their way into many orifices. Some picture excerpts from book included at this link.

More patients gone wild. Maine teenager high on bath salts busts up hospital room and damages monitoring equipment to the tune of $30,000. Gets discharged from hospital straight to the Greybar Motel and charged with “terrorizing.”

More patients gone wild. Man picked up by Chicago paramedics after car accident, then begins punching paramedic in the head after he gets into ambulance. Now the patient’s car is trashed and he’s charged with a felony.

Home Depot isn’t the place to get silicone for your butt augmentation. If the “doctor” performing the procedure in a hotel room is using a glue gun to inject the silicone, that’s probably a good sign that you’re going to have a complication … like death.

Oh, and if your “doctor” is using a trowel to finish your butt lift, that usually isn’t a good sign either.  Florida man charged with using mineral oil, cement and “Fix-a-Flat” to perform buttocks augmentation. I’ll leave the snarky comments to you all on this one. A picture of the perp is to the right.

The story of how one patient named Nicholas Cecil Leading Horse cost Washington State taxpayers nearly $2.5 million in medical costs related to alcoholism and drug abuse. Now he is sober and living a better life.

Another tragic suicide in the emergency department. New York man walks up to emergency department entrance and shoots himself in chest with shotgun.

Remember those Wisconsin doctors who were handing out sick notes on the streets during protests over Governor Scott Walker’s proposed changes to collective bargaining agreements for state workers? Seven of them have been sanctioned by the state medical board for sloppy record keeping.

What happens when the American public gets “insurance” instead of health care? The insurance companies raise rates whenever they want and increase deductibles at will. Now one insurance company is getting sued for raising rates too quickly and too often.

Former US Marine files $10 million lawsuit against government for failure to properly treat his post traumatic stress disorder which resulted in him breaking into a pharmacy to try to get the drugs that he needed. Unfortunately, the federal government is immune from suit for injuries related to combat. The patient and family are alleging that his injuries aren’t combat-related.

Florida woman awarded $6.3 million after suffering radiation burns during treatment for early stage skin cancer.

In England when there aren’t enough staff to keep hospitals open, Army medics are drafted to fill in the gaps.

Another emergency department closure. Wyoming hospital seeks state approval to close its emergency department.

Remember how the Congressional Budget Office predicted that so many more people would have health care “insurance” after health care reform was enacted?
A recent Gallup poll shows that the CBO is inept at making these predictions.
Instead of a 6 million people gaining health insurance as the CBO predicted, more than 4.5 million people LOST their health insurance.
And we already know that health care insurance doesn’t equate to health care access any more than automobile insurance means that you have access to a car.

What was voted the most hazardous technology in hospitals this year? It’s not what you would think. Finally an agency looks into the unintended consequences of “safety” measures.