A California hospital chain under investigation for allegations of overbilling the Medicare system has inaccurately diagnosed patients with a blood infection known as septicemia, a complex and deadly condition that hospitals are paid a premium to treat, a state investigation has found. California Department of Public Health inspectors examined records at four hospitals owned by Prime Healthcare Services and found that 22 of 120 patients diagnosed with septicemia showed few symptoms of the disease. At a San Bernardino County hospital, a patient was diagnosed with septicemia even though records showed "no sign of infection," inspectors found. At a Los Angeles County hospital, inspectors said seven patients diagnosed with septicemia showed signs of having urinary tract infections, a far less serious condition.
One of the first things we were taught in medical school was the pivotal role of thresholds in governing the human body. To trigger a nerve to fire or a muscle to contract, there must be a stimulus of electrical activity that exceeds a threshold value. If the threshold value is too low, muscles go into spasm and deadly rhythms develop in the heart. Low thresholds, however, aren't just a problem for an individual's health. They are increasingly a problem for the health of our medical care system. The threshold for diagnosis has fallen too low. Physicians are now making diagnoses in individuals who wouldn't have been considered sick in the past.
Women have had to wait dangerously long times for mammograms at several of New York's public hospitals, a city audit released on Wednesday found. The audit examined waiting times at nine health care facilities in the 2009 fiscal year and found that the worst were at Elmhurst Hospital Center in Queens, where women had to wait 148 calendar days for routine screening mammograms and 50 working days for diagnostic mammograms, when cancer is suspected. John C. Liu, the city comptroller, said in a statement accompanying the audit that the long waiting times "placed women in jeopardy" and violated the city's policies, which recommend waits of no more than two weeks for routine screening. He said women who had to wait long times for appointments were more likely to miss them.
Anything involving lasers seems modern and sophisticated, almost by definition. And surgery with lasers? That's got to be better, right? Maybe you've seen the ads for clinics offering laser spine surgery in airline magazines or on the Web. No hospital stays, quick recoveries and minimal incisions are part of the pitch. Well, Bloomberg News' David Armstrong reports that the booming business at for-profit outpatient laser surgery clinics comes at a high price for insurers and some patients. And the rate of serious complaints is higher than those for other outpatient procedures.
The Food and drug Administration should ban and order the recall of thousands of Bedside Assistant devices because they are blamed for the strangulation or asphyxiation deaths of four people and for entrapping a fifth patient in a hospital, says the health advocacy group Public Citizen.
"Data previously provided to the FDA demonstrates that these devices turn a bed into a death trap for patients who are physically weak and have physical or mental impairments," Sidney Wolfe, MD, and Michael Carome, MD, the group's director and deputy director wrote in a petition to U.S. Food and Drug Administration Commissioner Margaret Hamburg, MD.
The devices are bedside handles intended to help impaired patients get in and out of bed, sit up or turn over and as such are classified as medical devices requiring FDA approval.
What makes the issue of greater concern, Wolfe and Carome wrote, is that most healthcare providers and consumers may be unaware that the bedrails are classified as medical devices. As such, safety incidents related to the bedside handles should be reported to the FDA. The five incidents reflected in the FDA records go back to 1999.
"These devices are commonly used in the home setting without any involvement of a healthcare provider and family members of patients injured or killed by these devices likely are not aware of the procedures for reporting adverse events," they wrote.
The devices are more commonly used in nursing homes, assisted living facilities, and in private homes, and are sold by home healthcare medical supply stores.
Public Citizen's letter targets the devices by Bed Handles Inc. of Blue Springs, MO, but says similar devices made by other companies may be equally dangerous.
Bon Shaw, President of Bedside Handles, said in a telephone interview Wednesday that Public Citizen's claims are "incomplete, inaccurate, and misleading," because out of 200,000 bedside products sold, there have been only three incidents, not five.
He explained that the first incident, in 1999, was thought to be unique. But when the second one occurred in 2006, the company took steps to correct the problem.
"We added restraining straps with buckles to all our products across the board," Shaw says. Also, the company provided free straps and buckles to every customer using the products previously sold without them. "It is our belief that the problems occurred in instances where the products were being misused or the handles were improperly inserted."
"The attendant who put the person in bed pulled it out and then tried to jam it in after the person was on the mattress which is almost impossible to do correctly," he says.
Since the installation and distribution of the buckles and straps, there have been no adverse events caused by the products, he said.
Public Citizen also wants the FDA to investigate the association between the design and use of all bedhandle or rail devices made by any manufacturer.
The device is installed by sliding horizontal bars of the bed handles between the mattress and box spring of the bed, according to the package insert. "The bed handles can slip out of place, creating a gap between the edge of the patient's mattress and the vertical bars. The patient can then slip into this gap, becoming entrapped," Wolfe and Carome wrote.
The group's petition asks the FDA to consider the Consumer Product Safety Commission's 11 recalls in the last six years of "seven million drop-side baby cribs that posed a risk of death by strangulation or suffocation to infants and toddlers" in response to the deaths of 32 infants and toddlers between 2000 and 2010.
"It is important that federal agencies responsible for protecting the public health act consistently by safeguarding the health and safety of both young and old individuals alike," they wrote.
More than two years after thousands of veterans were put at risk of disease from lax sterilization practices at Department of Veterans Affairs hospitals, federal inspectors said Tuesday that weaknesses still existed, posing "potential safety risks to veterans." The Government Accountability Office report came as furious lawmakers at a House Veterans' Affairs Committee hearing pressed a top VA official for answers, accusing the agency of stonewalling Congress. The hearing came in response to continuing problems with improperly cleaned medical equipment at VA facilities across the country. In Miami, thousands of veterans were notified starting in 2009 that they might be at risk of disease after colonoscopies at the Miami Veterans Affairs Medical Center. Similar problems in VA facilities in Augusta, GA, and Murfreesboro, TN, brought the total of potentially affected veterans to more than 11,000.