Deciding when a patient is stable enough to leave a hospital is difficult for any doctor, but some former employees of Prime Healthcare Services say the chain has gone to extreme lengths to keep patients at their medical facilities. Court testimony shows that Panch Jeyakumar, MD, former medical director at Prime's Desert Valley Hospital in Victorville, has accused the chain's founder and board chairman, Prem Reddy, MD, of overstating one patient's level of illness in "an economic decision." Jeyakumar testified that he and two other physicians, including a cardiologist, believed that one patient who came to Desert Valley had endured a fainting spell. But Reddy, who had practiced as a cardiologist, got involved in the case and wrote on a patient medical record: "post cardiac arrest – sudden death."
Millions of people across the globe die each year from medical errors and infections linked to healthcare and going into hospital is far riskier than flying, the World Health Organisation said on Thursday. "If you were admitted to hospital tomorrow in any country... your chances of being subjected to an error in your care would be something like 1 in 10. Your chances of dying due to an error in healthcare would be 1 in 300," Liam Donaldson, the WHO's newly appointed envoy for patient safety, told a news briefing. This compared with a risk of dying in an air crash of about 1 in 10 million passengers, according to Donaldson, formerly England's chief medical officer. "It shows that healthcare generally worldwide still has a long way to go," he said. Hundreds of millions of people suffer infections linked to healthcare each year.
When patients need a new heart valve, they can get an artificial one—if they're healthy enough for the conventional method, open-heart surgery. But a new artificial valve, inserted via catheter, doesn't require major surgery at all, and a group of heart experts is meeting Wednesday to weigh in on the device's safety. The artificial Sapien heart valve system, from Edwards Lifesciences, will be reviewed by an advisory panel to the FDA, which doesn't have to follow the panel's advice but usually does. Replacement valves are needed when the aorta, the main artery that carries blood away from the heart, becomes narrowed and prevents blood from flowing normally. The Sapien valve can be threaded through a leg artery to the aorta. In a clinical trial among patients deemed too sick for surgery, those who had the Sapien valve had better survival after a year than those who got other care, including using a balloon catheter to repair the valve.
Too many Americans weigh more than is good for them. What else is new, right? We learned less than two weeks ago that rates of obesity worsened in 16 states last year, and not one state showed improvement. Now, the Centers for Disease Control and Prevention is out with the latest analysis of its own nationwide survey data, collected by telephone since 1984. The figures are just a little different, but the trend is all too familiar. In the CDC's survey, people reported their own height and weight. Colorado, once again, was the best, sort of. Twenty-one percent of people there fit the criteria for obesity. In the other report we wrote about, Colorado was the only state to squeak under 20 percent, with an obesity rate of 19.8%. Obesity rates were highest in Alabama, Mississippi and West Virginia. Obesity is defined as a body mass index of at least 30.
Hospitals are changing how they care for premature infants amid growing evidence that some longtime practices, intended to keep the most vulnerable babies alive, may increase risks of serious and potentially deadly complications. Some neonatal intensive-care units are cutting back on the high levels of oxygen traditionally given to premature babies. The change is based on research indicating the high levels may contribute to a condition called retinopathy of prematurity, a leading cause of blindness. Hospitals also are cutting back on prescribing several medications, including antibiotics and anti-reflux drugs, for infants because studies show they confer few benefits and increase risk of adverse reactions. "Everything we do is a balance of risks and benefits for the infant, and we have to be vigilant to make sure we are not making things worse," says Dan L. Ellsbury, director of the Center for Research, Education and Quality at Pediatrix Medical Group, a large neonatal physicians group and a unit of Mednax Inc., of Sunrise, FL. Pediatrix doctors care for some 20% of premature babies receiving intensive care in U.S. hospital NICUs.
Are we outsmarting cancer? Or just ourselves? Over the past several years, scientists have begun looking not just for individual genes linked to cancer, but for collections of genes and molecules, like proteins, that form telltale patterns, or signatures, that can be used to identify a cancer cell and reveal what drugs might kill it. Signatures can be used to diagnose the disease, scientists hope, and to give a prognosis to patients who have cancer. But there have been few successes in this brave new world of cancer research, and some notable failures. Genetic tests devised at Duke University by researchers using the new methodology have turned out to be worthless, though they were once hailed as breakthroughs. Two new blood tests for ovarian cancer have also been abandoned. Despite the setbacks, researchers say they cannot give up on their quest for cancer signatures.