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Tag Archives: Patients Gone Wild

Healthcare Update — 10-13-2014

See more medical news from around the web at my other blog at EP Monthly. _________________ NEW SITE SPONSOR! Need to renew your BLS, ACLS, or PALS certificate? You can get your certificate the SAME DAY by taking an online course and passing the online test at Pacific Medical Training. By clicking on THIS LINK, you’ll also get a 15% discount on the course fees. That’s a $25 savings for your ACLS recertification! _________________ Straight out of Men in Black. UC Davis researchers have discovered that they can erase certain memories in mice by using flashes of light. China is cracking down on pharmaceutical price fixing. Some company executives received prison sentences of between 2 and 4 years for their actions – although unfortunately those prison sentences were suspended. Government department heads are also being investigated since they are responsible for and must be punished for law violations committed by their subordinates. Even the cats were amazed. 18 year old woman who had habit of chewing on her hair goes to doctor with abdominal pain and malnourishment. Rushed to surgery where a 9 pound hairball was removed. Yes, you read that correctly. A nine pound hairball. Like she had a baby Cousin Itt inside of her. The Limits of Friendship. How many friends can an average person realistically have in their social circle? Based on human brain size … about …. Oh go on and read the article. The discussion is pretty interesting. Baylor University Medical Center reportedly at risk of losing all federal funding if it doesn’t submit an acceptable action plan regarding psychiatric patient elopement. CMS inspectors recently found six cases in which psychiatric patients walked away from the hospital’s emergency department before treatment concluded and determined that those “elopements” put patients in “immediate jeopardy” of their health and safety. The Netherlands has a slightly different way to treat patients with severe psychiatric problems: Euthanization. The rate of death by lethal injection for patients with severe psychiatric problems tripled from 14 cases in 2012 to 42 cases in 2013. Counting “terminal sedation,” euthanasia accounts for one in eight deaths in the Netherlands. But at least the patients in the Netherlands have insurance – just like us. No more curly fries for me for a while. Woman puts potato in her vagina after being assured by her mother that doing so would be a fail-safe contraceptive method. Turns out mom was right. Guys tend to run the other way when they see roots growing out of your hoo hah. Fortunately, doctors were able to remove the budding spud without surgery. And if anyone makes any Mr. Potatohead jokes, I’m going to be sick. I just know it. The hormones from birth control pills found in sewage found to cause feminization of of male minnows. This caused the number of minnows in the Ontario waterways to decrease to 1% of the usual population. As a result, the number of lake trout decreased – lake trout are the minnow’s main predator. Also as a result, the number of insects in the area began increasing – insects are the minnow’s main source of food. When estrogen was removed from the water supplies, all of the changes reversed. Wait a minute. Obamacare requires that birth control pills be provided at no cost. That must mean that the government wants less fish and more insects in our country. What effect has the Affordable Care Act had on employment in the US? Mostly negative, according to this paper from the Mercatus Center at George Mason University. It creates financial incentives for employees to work less. Part ...

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Healthcare Update — 11-25-2013

Also see more healthcare related news from around the web at my other blog over on EPMonthly.com American College of Emergency Physicians threatens board certification of any physician who provides medical care in a non-emergency setting. If that fake headline left you scratching your head, so should this one: American College of Obstetricians and Gynecologists threatens board certification of gynecologist who treats men for anal cancer. Even though the diagnosis and treatment of anal cancer in men is similar to the diagnosis and treatment of cervical cancer in women, and even though ACOG’s decision will significantly affect studies on treatment of anal cancer, ACOG sees no “compelling reason” to change its mind. After all, ACOG has been “no Y chromosomes allowed” since 1935. All specialties should be outraged at ACOG’s decision. Most hospitals require board certification of their physicians, so physicians in many cases are forced to be members of the specialty societies in order to practice within hospitals. The more that physicians simply comply with misguided and arbitrary specialty society requirements, the more that we allow those special interests to control the medical care that we provide to our patients. ACOG’s decision not only usurps the determinations of state medical licensing boards, but it also smacks of misandry and homophobia. Did influenza vaccine kill this 19 year old? One day after getting influenza vaccination, the patient developed vomiting, headaches, chills and shaking. A week later he went into a coma and later died from “brain swelling” of undetermined etiology. Patients gone wild in a Long Island emergency department. The brawl in a parking lot wasn’t enough. When the victims were taken to Eastern Long Island Hospital, they went at it again and injured some of the emergency department staff in the process. Philip Howard from Common Good discusses in interview with Medscape how “crazy laws” trap physicians in malpractice system and how current system is not system of justice, but is instead a “system of extortion.” Pensacola Florida Naval Hospital closing its 21,000 visit per year emergency department and turning it into an urgent care center to save money. Will close at night and will no longer accept ambulance runs. Hospital spokesman justifies the move by stating that the emergency department has a “relatively low patient volume”. Tough Mudder race involves obstacle course where often wet and sweaty participants are shocked by live wires up to 10,000 volts. A race in the Philadelphia area resulted in 38 participants going to the emergency department – half of those visits were due to electrical shocks. Doctors at one hospital said that an 18 year old patient “essentially had a heart attack, inflammation of the heart” from receiving 13 shocks during the race. Taking things too far? ACEP’s @DrHowieMell is also quoted in the article. It was recently the 50th anniversary of President Kennedy’s assassination. One of the more captivating accounts of what happened when President Kennedy was brought to the emergency department was written by Jimmy Breslin. As patient volumes increase by 23%, UK’s St. Helier Hospital is telling patients to stay away from the emergency department unless they have a real emergency. Last year, the hospital treated a record number of patients, so it doesn’t look like the warning is going to work. $2.4 million verdict against emergency physician when gastric bypass patient complaining of abdominal and back pain is released from the emergency department and dies the following day from a bowel obstruction. Damages in medical malpractice claims continues to rise. Average payout for medical malpractice cases has increased from $300,000 to $500,000 between 2006 and 2012. Maryland, a ...

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Healthcare Update — 11-14-2013

See more updates over at my other blog at EPMonthly.com Jury finds cardiologist and hospital liable for performing unnecessary cardiac stenting in patient. Patient wanted $50 million in damages, jury can’t agree on damage award. Judge throws out case against cardiologist during jury deliberations leaving hospital as only defendant. Veteran’s hospitals paying out record amounts in settlements and court judgments for medical malpractice claims. Some of the claims include – a 20-year Marine Corps veteran paralyzed after a routine tooth extraction – an Air Force veteran who died after a surgeon burned a hole in his heart with a laser – an Army veteran who died after doctors repeatedly failed to diagnose and treat a cancerous growth that was present on the patient’s chest x-rays for more than three years – another veteran who bled to death after being left in a room after a liver biopsy and never re-evaluated The payments for VA negligence come from the Treasury budget … meaning from our pockets. One State rep notes “We focus so much on sending our soldiers to war. But when they’re coming back, we don’t have the same focus on taking care of them.” Another article in the Dayton Daily News gives more details about several of the cases. Association or causation? After drug companies voluntarily withdrew many pediatric cold medications and recommended against using others until patients reach 4 years of age, the percentage of ED visits for adverse events from such medications decreased from 4% to 2.5%. Dr. Melvyn Flye arrested for perjury when he made untrue statements as an expert witness at trial. How often do you see that happen? Actually, I think it should happen more. Arrest incidentally occurred in July, but the article just came across my newsfeed this week. Patients gone wild. Patient upset because emergency physician won’t refill his Norco prescription leaves hospital emergency department and stabs emergency department greeter in the neck on his way out the door. The greeter is in serious condition. Godspeed to her. The patient is in the Greybar Motel. Hope he doesn’t even get Tylenol. Another article on the incident courtesy of Scott DuCharme – thanks! Popular Science calls this a “rare new bacterium.” Tersicoccus phoenicis is found in NASA “cleanrooms” and is resistant to chemical cleaning, ultraviolet rays, and other sterilization procedures. Interesting questions develop in my mind. First, I doubt that the bacterium is “new,” but suspect that it is just that no one has ever looked for or found it yet. Perhaps “newly discovered” would be a better term. Second, if chemicals and sterilization don’t kill it, then what does? If the only thing absent from clean rooms is bacteria, then likely the growth of other bacteria somehow hold the growth of this bacterium in check. Hat tip to Instapundit for the link. Will the Unaffordable Insurance Act (if you were wondering, I refuse to call it the “Affordable Care Act” because it isn’t “affordable” and it doesn’t provide medical “care”) provide more reimbursement for emergency department patients? If Medicaid payments stay the same (which they won’t), then this study suggests that receipts for previously uninsured patients will increase by 17-39%. Great save. Orlando emergency physicians perform needle cricothyrotomy on an infant with a pacifier tightly lodged in his throat. Patient went to surgery and an ENT surgeon had to remove the pacifier in pieces. Why don’t newspapers ever publish the names of the doctors that do great things like this? Seems like almost all of the publicity is for malpractice and other allegations of badness. Alicia Gallegos, former medical legal reporter extraordinaire for the ...

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Healthcare Update — 09-04-2013

Find more updates on my other blog at EPMonthly.com University of Iowa settles malpractice lawsuit after plaintiff attorney obtains confidential documents about why a neurosurgeon left the hospital system. Point to remember is that those confidential settlements aren’t as confidential as you might believe. Not sure whether this is a good or bad announcement. On one hand, emergency department closures across Nova Scotia are down by 21% and 25 of 38 hospitals had no ED closures over the prior year. On the other hand, emergency departments were still closed 5% of the time and one commenter notes that the professionals staffing the emergency departments to keep them open are paramedics and LPNs, not physicians. So is some care better than no care at all? Is this a model that should be replicated in the US? Another study showing how gut flora may play a large part in weight control. Swiss study shows that patients gained an average of 5 pounds after they stopped smoking – even when their diet went unchanged. While gut flora of control patients who smoked and who didn’t smoke remained the same, there was a significant shift in the intestinal bacteria of those patients who stopped smoking — including an increase in Proteobacteria and Bacteroides. Small community hospital in Florida closes its doors and residents lose nearby emergency services – although with only 3-4 inpatients per day this week and 25 beds, it likely didn’t have a large ED volume. Rural North Carolina’s Blowing Rock Hospital also closing its emergency department effective October 1. Oh, and add Flint River Hospital in Montezuma, GA to the list of hospitals closing their emergency departments. Yet another hospital closes. Chicago’s Sacred Heart Hospital is now closed and some of its physicians are being sued by the feds for performing “unnecessary” tracheostomies on poor and elderly patients. Criminal charges could also be filed. Multiple patients in Denver area hospitals are having bad reactions from synthetic marijuana, including Black Mamba and Spice. Reactions include hallucinations where patients jump off buildings and cessation of breathing requiring ventilator support. Jury awards $6.4 million to patient who had mitral valve prolapse and who was never referred to a cardiologist. More than 10 years after the diagnosis was initially made, the patient became “very ill”, complaining of fatigue, loss of appetite and abdominal pain. He was sent to several consultants, but none apparently evaluated his heart. Two months after symptoms began, patient suffers a stroke due to bacterial endocarditis. Patients gone wild … er, um … vampire? Unresponsive patient wakes up when medics trying to draw his blood and bites one of them on the back. Police officer punches patient in back of head to get him to let go. Blah! But they vere taking MY blood! Blah! Blah! Just another day in the ED … Georgia’s Floyd Emergency Department having a lot of patients going wild. First a patient gets upset with staff, throws a cup of urine on a staff member, then begins cursing. He gets arrested and charged with multiple crimes. Then, in a separate incident, another inked patient gets arrested for swearing at hospital staff and then fighting with an officer called to the scene. Same town, different story – woman arrested for DUI and unlawful conduct during a 911 call after trying to get a friend with an asthma attack to the Floyd ED. Rocking times in Rome, GA. The latest rage: “Foam parties”? Go out dancing and end up with three feet of bubbles all around you on the dance floor. All fine and dandy until someone loses an ...

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Healthcare Update — 06-26-2013

See more updates at EP Monthly.com In cats they are called hair balls and are considered a bad thing … New fad has fashion models dipping cotton balls in orange juice and eating them in an attempt to suppress their appetites and lose weight. I can’t even come up with a pithy comment for that one. $4 million settlement in New York after mother seeks care for UTI symptoms at 26 weeks gestation, doesn’t receive antibiotics, and child is born 11 days later with neonatal sepsis. Florida Governor Rick Scott is now backing legislation to crack down even further on expert witnesses in medical malpractice cases. The legislation was sparked by one doctor who misrepresented his credentials under oath when testifying as an expert witness. Now plaintiff attorneys are crying foul because the restrictions will “benefit doctors and corporations at the expense of injured patients and consumers.” In other words, “bwwwwaaaaaaaaaah, our contingency fees are going to dry up.” Could Governor Scott’s interest in improving expert witness standards possibly be because Florida is one of the suckiest states in which to practice medicine and he’s trying to make a turd smell a little more like a rose? Chicago-area hospital adding a “Telestroke Program” to its facilities. Now neurologists can view patients over computer cameras to determine whether they need to be transferred to a higher level of care. Will be interesting to see how much benefit the web cams will have. Not like you can do strength testing over the internets. Anyone out there use a video link to neurologists? Not to be outdone, the University of California at San Diego is instituting a study on use of telemedicine for emergency department patients. The principal investigator for the study, Dr. David Guss, states that “underutilized physicians” during lulls in patient volumes are an “unneeded expense.” Ahhhhh, the emergency department of the future … one doctor running around frantically performing procedures on critical patients while a bunch of other doctors write work notes and Norco prescriptions from the comfort of their home offices. New York’s Long Island College Hospital blocks ambulances from bringing patients to emergency department. One neonatologist threatens to “call the cops” if the hospital attempted to move her patients out. Tough to run incubators without electricity. The hospital is losing $1 million per week, but a judge ordered the hospital to maintain staffing levels anyway. Maybe they can use Monopoly money to pay the staff.. One less hospital to care for Brooklyn patients in an emergency. New York isn’t the only place where judges make idiotic rulings. Ontario Court of Appeal rules that obstetrician was negligent for relying on the treatment plan of a consultant specialist who misdiagnosed a patient’s aortic rupture as a pulmonary embolism. Obviously, the obstetrician should know more about medicine than every other specialist. If he agrees with the specialist and there is a bad outcome, he’s liable. If he disagrees with a specialist and there’s a bad outcome, he’s still liable. Ultimate effect of Ontario Court of Appeal’s ruling: Physicians are responsible for knowing everything about medicine and will be liable for misdiagnosis regardless of what a consultant says. Does Canada have a problem with defensive medicine yet? According to a Mayo Clinic study, we are officially The United States of Pill Poppers. Seven in ten people in this country are on at least one prescription medication. Half are on at least two prescription medications. Twenty percent are on 5 or more medications — most of those patients come to my emergency department. Antidepressants and opioids were tied for second place on the ...

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Healthcare Update — 06-06-2013

See more updates over at EP Monthly.com Patients gone really wild. 45 year old patient falls asleep in Harlem Hospital emergency department then wakes to find another patient sexually assaulting her. Assailant then stopped and began to urinate on her. Comments to the article equate the incident to the future of health care in this country. Schools requiring doctor’s notes to apply sunscreen on kids due to “possible–but quite rare–risk of being allergic”? We should probably require doctor’s notes to eat lunch, also. Food allergies are a big problem, you know. It would be amusing to turn the tables on these moronic school officials. “Sunscreen of 30 SPF or higher must be applied exactly 27 minutes prior to anticipated sun exposure. Sunscreen should be applied to all exposed skin areas including scalp and also applied to a 3.5 inch area of skin buffering any and all exposed skin areas. Sunscreen must be reapplied to these same areas every 30 minutes or fraction thereof. Application of sunscreen, times of application, areas of application, and reapplication efforts should all be clearly documented, signed by school officials and returned to this office for filing with the State. Any variation from these directions should be considered medically contraindicated and unauthorized by this practitioner.” Hat tip to Instapundit for the article link. Are US doctors paid too much? When this Forbes article compares US physician salary to physician salary in other countries without comparing the legal atmospheres, the regulatory atmospheres, the costs of training, the costs of malpractice insurance, and the costs of licensure, the article doesn’t effectively answer the question – even though it concludes that US doctors are underpaid. Show me another country where a specialist has to pay $150,000 in malpractice insurance each year and then we’ll talk. Kentucky needs 3,790 more physicians than it currently has – and that’s before Medicaid expansion and the UnAffordable Insurance Act take effect. With 25% of Kentucky’s primary care physicians at risk for retirement in the next 5 years, the problem will only get worse. Now it is looking at allowing nurse practitioners to prescribe non-scheduled medications as one way to combat the problem. Don’t worry, Kentuckians. You’ll still have insurance! Connecticut hospitals have serious problems obtaining psychiatric medical care for children. On many days, more than half of the beds in the Connecticut Children’s Medical Center ED are occupied by behavioral health patients. Many sit in the department for days because there are “no psychiatric beds available in the state of Connecticut.” Chicago’s Roseland Community Hospital threatened to stop taking new patients unless Illinois paid it more than $6 million in back debts. On Wednesday, the hospital recanted and stated that Illinois did not owe it any money – and got $350,000 in funding. Black Disciples gang members protested the possible closing of the hospital, stating that they deserve to be saved and that closing the hospital would amount to “genocide.” Closures of other area hospitals increased the ED volume at Roseland by 40%. Many of those patients were uninsured. I predicted this scenario years ago. When hospitals close, uninsured patients don’t stop getting sick. They find care at other open hospitals. Oh, and don’t forget … the UnAffordable Insurance Act increases the amount of insurance coverage to young healthy adults. The Rand Corporation also commented on the study, stating that “private insurance was acting as it should.” That is until workers are fired or their hours are cut so employers no longer have to pay for coverage to them or their families beginning on January 1, 2014. Don’t worry, though. Our elected representatives ...

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