Nurses at Saint Vincent Hospital in Worcester allege that cost-saving measures are causing pervasive lapses in care, including two patients dying after failing to receive potentially life-saving dialysis. The new assertions come nearly three years after nurses there settled the longest nursing strike in state history with the hospital's for-profit owner, Tenet Healthcare, a battle waged in part over staffing levels. Now, they say, the situation has grown even more dangerous, with stretched-thin nurses often struggling to do their jobs right. The Massachusetts Nurses Association, the union that represents about 600 nurses at the hospital, alleged more than 70 concerning incidents between April and November, from preventable bedsores to unsafe rationing of limited supplies, in an 18-page complaint filed in December with federal and state officials and shared exclusively with the Globe. Perhaps the most incendiary allegation is that two female patients in the intensive care unit on Sept. 29 died because there weren't enough nurses to provide them with continuous dialysis, the preferred form of care for critically ill patients with acute kidney failure. Unlike traditional dialysis, which takes three or four hours, this treatment lasts 24 hours and requires constant bedside supervision. "That was probably the worst night of my life," said one nurse, who has many years of experience and spoke to the Globe on condition of anonymity. "And I've had some pretty bad nights." Because six nurses were overseeing 12 patients that night, the union alleges, one of the two patients received traditional dialysis, and it had to be cut short by 30 minutes. The other patient didn't receive dialysis at all. Both died in the intensive care unit. While both patients were very sick to begin with and might have died anyway, the nurses said, understaffing prevented the women from receiving the care doctors had ordered.
By the time the maker of OxyContin pleaded guilty to a federal charge of misbranding the drug in 2007, Purdue Pharma had spent a decade selling opioid prescriptions through commercial health plans. Five years later, with restrictions tied to the plea deal expiring, Purdue saw a new sales opportunity in an "aging population with painful conditions," according to internal company documents. As the U.S. opioid crisis deepened, records show, Purdue sharpened its focus on the federal government’s Medicare prescription program for seniors. Between 2012 and 2013, Purdue deployed an email marketing campaign to healthcare providers, launched new advertising in a long-term-care medical journal, and armed its sales force with patient vignettes to share with doctors. Each effort emphasized OxyContin’s insurance coverage through what’s known as Medicare Part D. "Medicare Part D is the only significant and growing book of business for OxyContin," a McKinsey analysis for Purdue found in 2013. Telling doctors the opioid was covered by Medicare was only one part of the equation. To secure that coverage, Purdue had to negotiate terms with two corporate giants in the Medicare business, UnitedHealth Group and CVS Health. A Barron's investigation—the second in a series on pharmacy-benefit managers, or PBMs—found that Medicare coverage administered by arms of UnitedHealth was a top source of OxyContin sales, at a time when government watchdogs were raising alarms about opioid use and spending in the program. UnitedHealth and CVS wear multiple hats in Medicare Part D. They serve as so-called sponsors of drug plans that seniors can purchase each year. They also operate PBMs, the middlemen that negotiate between drugmakers and insurance companies.
Abbott Laboratories and DexCom said on Monday they have reached an agreement to settle all patent disputes between them related to continuous glucose monitoring devices. The agreement will dismiss all pending cases in courts and patent offices worldwide, along with a provision preventing legal action between the companies for patent and appearance disputes for the next 10 years.
Working with a line of colon cancer cells, Korean researchers figured out a way to throw a few genetic switches to cause the cells to revert back to a healthy state. The technique could have major implications in the way we approach cancer treatment.
In the universe of science, innovators are finding that A.I. hallucinations can be remarkably useful. The smart machines, it turns out, are dreaming up riots of unrealities that help scientists track cancer, design drugs, invent medical devices, uncover weather phenomena and even win the Nobel Prize. "The public thinks it's all bad," said Amy McGovern, a computer scientist who directs a federal A.I. institute. “But it's actually giving scientists new ideas. It's giving them the chance to explore ideas they might not have thought about otherwise." The public image of science is coolly analytic. Less visibly, the early stages of discovery can teem with hunches and wild guesswork. “Anything goes" is how Paul Feyerabend, a philosopher of science, once characterized the free-for-all. Now, A.I. hallucinations are reinvigorating the creative side of science. They speed the process by which scientists and inventors dream up new ideas and test them to see if reality concurs. It's the scientific method — only supercharged. What once took years can now be done in days, hours and minutes. In some cases, the accelerated cycles of inquiry help scientists open new frontiers.