Medical Malpractice News

Many Doctors Don't Report On Addicted Colleagues
A new survey finds that many American physicians fail to report troubled colleagues to authorities, believing that someone else will take care of it, that nothing will happen if they act or that they could be targeted for retribution. A surprising 17 percent of the doctors surveyed had direct, personal knowledge of an impaired or incompetent physician in their workplaces. One-third of those doctors had not reported the matter to authorities such as hospital officials or state medical boards. The findings are based on a 2009 survey of 1,891 practicing U.S. doctors. The American Medical Association an other professional groups say doctors have an ethical obligation to make such reports, and many states require doctors to tell authorities about colleagues who endanger patients because of alcoholism, drug abuse or mental illness. Despite that, many doctors do not know what to do or where to start.

'Octomom' Doc Accused of Implanting Seven Embryos
The fertility doctor of "Octomom" Nadya Suleman implanted too many embryos in one patient, resulting in the death of a fetus, and failed to refer another woman to a cancer specialist after finding cysts on her ovaries, the state licensing board said. The new allegations by the Medical Board of California bolster its ongoing negligence case against the doctor. The board said a 48-year-old patient was implanted with seven embryos in 2008 - several months after Suleman had embryos implanted. Implanting more than two embryos in a patient over age 35 meant the doctor "placed the patient at great risk for high-order gestation, which was confirmed by a quadruplet pregnancy that ended with catastrophic results," the filing said. Four of the seven embryos implanted in the patient became viable; she lost one during pregnancy and gave birth to triplets, one of whom has profound developmental delays. In another similarity to the "Octomom" case, the doctor is accused of failing to refer the same patient to receive appropriate mental health counseling prior to undergoing fertility treatments. The doctor is also accused of failing to refer another patient for cancer screening, despite her history of the disease and his discovery of cysts on her ovaries in an ultrasound. After her fertility treatments failed, she visited two more specialists, who recommended surgery to rule out cancer. Following surgery, she was diagnosed with metastatic, stage III bilateral ovarian cancer and had to have her uterus, cervix, ovaries and fallopian tubes removed. The doctor is scheduled for a hearing before the medical board later this year to determine if his license should be revoked or suspended.

Hospitals' Death and Readmission Data Offered
New information about the quality of outpatient and emergency care in U.S. hospitals is now available on the federal Centers for Medicare and Medicaid Services Web site. At the site, patients can now find data gleaned from Medicare claims about how well hospitals do in preventing infections in outpatient surgical patients and whether hospitals are using proven therapies, as well as other information. CMS has been posting similar information on inpatient care on a Web site since 2005, and that site has now been updated to include 30-day mortality and readmission information for patients admitted for heart attack, heart failure or pneumonia. The new outpatient information points out possible instances of excessive care, as well as inadequate care. For example, CMS officials say one-third of Medicare patients complaining of lower back pain underwent magnetic resonance imagining "rather than trying more recommended - and potentially safer - treatment first, such as physical therapy."

Pittsburgh Hospital Suspends Lung Transplants
Allegheny General Hospital has deactivated its lung transplant program and is referring the six patients on its waiting list to other centers. The hospital says it deactivated its program "while we focus on adding some additional components to the service." Since the program began in 2008, surgeons at the hospital have performed four lung transplants. In January, the Centers for Medicare & Medicaid Services certified the hospital's three-year-old liver transplantation program so Medicare and Medicaid patients could have the procedure done there. Recently, the hospital hired a kidney and pancreas transplant surgeon. The United Network for Organ Sharing said there had been eight other voluntary inactivations for transplant programs nationwide in the past 18 months, including one other lung program. According to the hospital, the deactivation was not related "in any way" to staff departures or the hospital's financial problems from years of operational losses.

Heart Tests Add to U.S. Radiation Dose Concerns
Heart imaging procedures can deliver a significant amount of radiation to patients, U.S. researchers found, urging patients and doctors to weigh the risks against the benefits. They said nearly one in 10 adults under the age of 64 had a heart procedure involving radiation over a three-year period in five major healthcare markets. An advanced type of heart stress test called myocardial perfusion imaging, in which doctors inject a radioactive tracer in patients to test blood flow, accounted for 74 percent of radiation exposure from heart scans. Heart catheterization and stenting - procedures in which thin tubes are fished through blood vessels to open blocked arteries - were the second biggest contributor to radiation exposure. More than half of the heart proceedings using radiation were done in the doctor's own office, researchers found. While doctors disagree over how much, most agree that radiation can cause cancer, and researchers are growing concerned that an explosion in the use of medical imaging is making it more likely that patients may develop cancer.

Lancaster Hospital Sued in Fatal Leap
The family of a man who died after he jumped out of a window at a Lancaster hospital is suing the hospital and two doctors who cared for him. During his hospitalization for mental health problems, he was agitated and paranoid and repeatedly threatened to throw himself out his eighth-floor window. During his stay, numerous medical notes documented his increased anxiety and desire to commit suicide; however, his doctors felt that he suffered from underlying dementia rather than psychosis and recommended against moving him to a secure "psych unit." His injuries and death, the lawsuit alleges, were the result of "the negligence, carelessness, recklessness and gross negligence of all named defendants."

Doctors Amputated Wrong Leg
Authorities are investigating the amputation of a 91-year-old woman's healthy leg in an Austrian hospital. The investigation was launched after the hospital alerted authorities about the incident. Local media reported that the woman ended up losing both legs since doctors later also had to amputate her sick limb - the one that should have been removed initially.

Getting a New Knee or Hip? Do It Right the First Time
In the United States in 2007, surgeons performed about 806,000 hip and knee implants - double the number performed a decade earlier. Though these procedures have become routine, they are not fail-safe. Implants must sometimes be replaced, and a study in 2007 found that 7 percent of hips implanted in Medicare patients had to be replaced within seven and a half years. The percentage may sound low, but the finding suggests that thousands of hip patients eventually require a second operation, forcing those patients to endure additional painful recoveries and increased medical expenses. The failure rate should be lower, and experts cite Sweden's failure rate to be a third of that in the United States. While considering replacing a deteriorating knee or hip, choose or request a referral to an experienced surgeon at a busy hospital. Also seek out an experienced physician, as a 2004 study found that patients receiving knee replacements from doctors who performed more than 50 procedures a year had fewer complications than patients whose surgeons did 12 procedures or fewer a year.

Hundreds of Veterans at Risk from HIV from Dirty Dentist Tools
Officials in Washington have promised a full investigation and disciplinary action after they admitted that more than 18,000 veterans in the St. Louis area were put at risk for HIV and other diseases from dental tools that had not been properly cleaned between patients. The 1,812 veterans who received dental care at the St. Louis VA Medical Center between February 2009 and March 2010 were sent letters telling them of the sanitation mistake and offering free testing for HIV, hepatitis B and hepatitis C. The center was found - during a routine, unannounced visit - to have failed to clean dental handpieces with a specialized detergent before they were sterilized. After the discovery was made, dentistry services were suspended for about three weeks while officials investigated and ordered the retraining of staff, along with a redesign of the procedure for cleaning dental equipment. The center's response to the failure was that "a growing number of veterans had been utilizing dental services and that the organization simply got 'too busy.'"

Victims' Families Appeal Killer Nurse Case
Eight families who gained a $95 million civil judgment against a killer nurse are appealing a Lehigh County judge's decision to drop a hospital from their lawsuits. The move sheds light on why the families went through with their civil trial against the penniless nurse, knowing they'll probably never see a dime of the judgement they obtained. According to the appeal, a court order prevented them from appealing the judge's decision to dismiss a hospital from their suits until they completed their cases against the nurse. The families are now asking the court to reverse the judge's 2009 order granting summary judgment for the hospital. If the hospital is thrown back into the case, it wouldn't be on the hook for the $95 million. A new trial between the plaintiffs and the hospital would be held, barring a settlement or other resolution. The judge had dismissed the hospital from the wrongful death lawsuits because the nurse didn't admit killing the eight patients named in the suits and because the medical expert for the plaintiffs couldn't say whether the nurse killed them. The nurse has subsequently admitted killing 29 people in Pennsylvania and New Jersey, telling prosecutors he injected patients with lethal doses of prescription medications; however, he has never been charged criminally with killing the eight patients cited in the civil case. The families claim the hospital was "negligent and reckless in the operation of its facilities, including hiring and oversight of" the nurse.

Bad Surgeon Guilty of Killing Three Patients
An American doctor accused of botching a string of operations while he was the chief surgeon at an Australian hospital was found guilty of killing three of his patients and grievously harming another. The trial came more than 25 years after questions were first raised about his competency and marks a milestone for many former patients who have waited years to face the man they accuse of irreparably damaging their lives. The doctor had been banned by U.S. authorities from carrying out some of the procedures he undertook when he moved to Australia, and he failed to inform his new employers. Prosecutors argued that he was a "bad surgeon motivated by ego" who tried to restore his reputation by carrying out surgery he was not competent to perform.

Want to Know What Hospitals Charge? Good Luck
Consumers - especially the uninsured - face significant challenges when they try to shop for the best price or negotiate. More than 30 states require hospitals to disclose at least some of their charges. Congress included such a provision in the new health overhaul law and similar proposals are pending in the House. But many experts say these efforts don't help much. Publicized hospital charges are "useless for consumers," largely because hospital prices are moving targets, varying with patients' needs and doctors' treatment strategies. Patients can't depend on estimates because they're often based on a hospital's average charges for treatments. For instance, a Tampa hospital charged as little as $48,631 and as much as $89,969 for gallbladder removals between 2008 and 2009. And when bills come in above the estimate, patients have little recourse.

9 in 10 Docs Blame Lawsuit Fears for Overtesting
Ninety percent of physicians surveyed said doctors overtest and overtreat to protect themselves from malpractice lawsuits. That sentiment is more common among male doctors than female doctors, according to the survey, which asked two questions: "Do physicians order more tests and procedures than patients need to protect themselves from malpractice suits?" and "Are protections against unwarranted malpractice lawsuits needed to decrease the unnecessary use of diagnostic tests?" Overall, 91 percent of the 1,231 doctors surveyed agreed with both statements. Defensive medicine is estimated to cost the U.S. health care system billions of dollars each year, and many doctors worry they could be sued even when they follow standard-of-care guidelines. Patient advocates argue that overtesting is easy and profitable for doctors and preferable to spending time with a patient.

Pennsylvania Health Department Reports On Hospital Infections
The Pennsylvania Department of Health issued its most complete report to date of hospital infections, finding that a disproportionate number of poor-performing facilities were in Philadelphia. Those with high infection rates included some of the city's most storied hospitals, such as Children's Hospital and the Hospital of the University of Pennsylvania. Executives at both institutions claim they have made progress since 2009 - the year the report focused on - and experts cautioned against using the report to compare hospitals, because the methodology to track infections is evolving. Nevertheless, the report will now be used to benchmark hospitals, giving them a baseline from which they must improve or face sanctions if they do not. Hospital infections cause a vast amount of harm, which experts say can often be prevented. Across the country, an estimated 1.7 million patients get infections during care, and 99,000 die each year as a result. Several hospitals in the Philadelphia region fared poorly in two areas: those involving urinary catheters, the thin tubes placed in a bladder to drain urine, and those involving central lines, IVs threaded into large blood vessels to deliver nutrients and medicines.

Is Your Doctor Addicted?
Doctors and nurses, unlike airline pilots, truck drivers and other professionals whose performance impacts public safety, are not required by law or regulation to be randomly screened for drug use. As a result, patients have no guarantee that surgeons, nurses or even dentists aren't quietly hooked on substances that could inhibit - or completely annihilate - his or her ability to treat you safely and effectively. Scanning recent news accounts shows case after case of drug-addled health care workers endangering innocent and completely unknowing patients, including: a surgeon hooked on pain pills who poked a hole in the colon of a patient, causing so much damage that 12 inches of the man's colon would later have to be removed; a dermatologist, addicted to hydrocodone, was arrested after her staff told investigators that she was sometimes so inebriated that she had trouble finishing surgeries, leaving on patient with part of her nose hanging free because the doctor missed a stitch; and a nurse who was convicted of siphoning pain medication from bottles and replacing it with saline, leaving numerous patients with watered-down, ineffective drugs after surgery.

Reports Urges More Curbs On Medical Ghostwriting
A new Congressional report calls on medical journals, medical schools and even the National Institutes of Health to take additional measures to ensure the integrity of the scientific articles many doctors rely on to make treatment decisions for their patients. The report focuses on medical ghostwriting, in which prominent researchers sign on as authors to articles for scientific journals that have been developed by third-party medical education companies at the behest of drug or medical device makers. "Manipulation of medical literature could lead physicians to prescribe drugs that are more costly or may even harm patients," the report said. Over the last few years, industry documents made public in government investigations and product liability lawsuits against drug makers have shown medical ghostwriting to be widespread, and in response, many medical journals have tightened their policies requiring authors to disclose industry funding and editorial assistance.

CT Scans Pose Growing Danger to Americans
From long-term cancer risks to radiation overdose mistakes, CT scans pose a growing danger to the American public and need more regulation to improve their safety, imaging experts have announced. CT scans are super-sharp X-rays that have transformed medicine by helping doctors quickly diagnose or rule out injuries and diseases - but they use far more radiation than ordinary X-rays, and too much radiation raises the risk of cancer over time. The Food and Drug Administration and Congress are considering new measures to help prevent medical mistakes - relatively rare cases where some people are accidentally given radiation overdoses. However, far more people face potential long-term harm from ordinary scans that are done correctly but that are overused, repeated or simply unnecessary. Annually, 10 percent of the U.S. population gets a CT scan, and use of this imaging is growing more than 10 percent per year.

Doctors in Training May Get Shorter Shifts
Patients will be told when they're being treated by rookie doctors, who would get shorter shifts and better supervision under proposed work changes for medical residents. The draft regulations aim to promote patient safety and reduce medical errors by enhancing work conditions for sometimes sleep-deprived junior physicians. The proposal slightly revises regulations adopted seven years ago and would have the biggest impact on interns - new doctors in their first year of residency training programs in hospitals after graduating from medical school. They would be more closely supervised by experienced doctors and the maximum length of their work shifts would be cut from 24 horus to 16 hours. Maximum work shifts would remain 24 hours for residents in their second year and beyond. Maximum work weeks would remain at 80 hours for all hospital residents. All residents and their supervisors also would be required to explain their roles to patients and explain that supervisors are ultimately in charge of their care.

Debate Over Industry Role in Educating Doctors
In the latest effort to break up the often cozy relationship between doctors and the medical industry, the University of Michigan Medical School has become the first to decide that it will no longer take any money from drug and device makers to pay for coursework doctors need to renew their medical licenses. University officials voted to eliminate commercial financing for postgraduate medical education, a practice that has come under increasing scrutiny from academics, medical associations, ethicists and lawmakers because of the potential to promote products over patient interests. While the financing in question amounts to as much as $1 million a year in Michigan, commercial payments for industry speakers and courses nationwide come to about $1 billion, nearly half the total expenditure for such courses.

Judge's Innovation May Offer Malpractice Fix
Curiosity about medical matters led a New York City judge to become a specialist in resolving wrenching cases that involve life-changing harm to patients. Taking note, the Obama administration is spending $3 million to see if his methods and insights resolving medical liability cases can work on a broader scale. The New York state court system is one of 20 recent recipients of federal grants to find answers to such problems as getting hospitals and doctors to acknowledge mistakes - rather than cover them up - and protecting clinicians who follow best practices and still have something go wrong. The goals are preventing errors that injure patients, reducing lawsuit costs by avoiding lengthy trials and discouraging the wasteful practice of defensive medicine, which occurs when doctors order costly but usually unnecessary tests more to protect themselves than to aid the patient.

Lawsuit Fears Can Lead to Overtesting in ERs
The fear of missing something weighs heavily on every doctor's mind, but the stakes are highest in the ER, and that fear often leads to extra blood tests and imaging scans for what may be harmless chest pains, run-of-the-mill head bumps and non-threatening stomachaches. Many ER doctors say the main reason is fear of malpractice lawsuits. ER physicians are among the top 10 specialists most likely to be sued for malpractice. The Physicians Insurers Association of America, which represents almost two-thirds of private practice doctors, lists more than 600 lawsuits against ER doctors nationwide between 2006 and 2008, which represents about 3 percent of their clients. The results of overtesting can be harmful - side effects from unneeded drugs and increased chances for future cancer from excessive radiation.

High Rate for Deaths of Pregnant Women in New York
More mothers die during pregnancy or soon after in New York than in almost every other state, and according to recently released reports, social factors like poverty, obesity and lack of insurance may be responsible. While the total number of maternal deaths are small - an average of about 40 a year across the state - city health officials said their analysis showed that maternal mortality was being driven by environmental factors like poor nutrition that could be changed through public policy. New York City's analysis found that 49 percent of the women who died were obese. Black women, who were more likely to be obese, were seven times as likely to die in pregnancy as white women. Hispanic and Asian women were twice as likely to die as white women. The death rate was highest in the Bronx and Brooklyn, which have large poor and minority populations.

Red Cross Fined $16 Million Over Blood Screening
Federal health regulators have fined the American Red Cross $16 million for sloppy screening of donated blood, the latest in a series of violations that have cost the group millions of dollars. The Food and Drug Administration said the group failed to take precautions to assure the safety of blood donations. Despite those oversights, the FDA says the U.S. blood supply appears to be safe. Regulators fined the group nearly $10 million for mismanagement of blood products - including red blood cells, plasma and platelets - and over $6 million for faulty manufacturing practices. The violations occurred in 2008 and 2009. The FDA has cited the Red Cross a dozen times already and fined the group over $21 million since 2003.

Hospital: Problems Fixed in Transplant Program
After an inspection of a Pittsburgh hospital's transplant program found serious violations of federal documentation regulations, state Health Department inspectors re-inspected the world-renowned facility and found the problems rectified. The hospital still hasn't yet gotten final recertification. That won't take place until officials at the Centers for Medicare and Medicaid Services have a chance to review the state's report. Though the hospital deemed the three areas of serious violations as easily rectified paperwork problems, if the state found they weren't corrected within 180 days of receiving the state's report on the violations, it could have lost its Medicare reimbursements. The report, performed during an unannounced visit earlier this year, found documentation problems with everything from failure to inform people of their patient rights, to not documenting that blood compatibility matches were done before a transplant, to not properly counting everyone who died from a transplant-related death.

Harlem Hospital Ends Review of Unread Heart Tests
Harlem Hospital Center has completed an investigation of 7,000 heart tests going back five years, most of which had never been reviewed by doctors. The investigation found that 14 patients might have been misdiagnosed because their tests had not been handled properly. Twelve of the patients had been contacted, and none of them were found to have suffered adverse effects from the failure to properly read their tests. All 7,000 patients whose heart tests were investigated will get letters explaining the situation in about a week. The tests that were investigated included 5,000 that had never been seen by doctors. Another 2,000 tests had been seen by doctors but had not been signed by them, as required by hospital protocol. The tests dated to 2005.

Doctors Gets 8 Years for Fraud
A Lancaster physician has been sentenced to eight years in federal prison for fraud and ordered to pay $7.1 million in restitution. Earlier this year, the neonatologist pleaded guilty to one count each of health care fraud and mail fraud. He was charged with submitting millions of dollars in fraudulent medical bills to 23 different health care benefit programs, including Medicaid, between 2003 and 2009. The restitution will be returned to state Medicaid programs and insurance companies that were defrauded.

Woman Received Lungs of a 30-Year Smoker
The family of a 28-year-old British woman who unknowingly received a lung transplant from a smoker says she would have been "horrified" and have lodged a complaint. Earlier this year, the cystic fibrosis sufferer received a double lung transplant from a donor who had smoked for three decades. She died recently of pneumonia. Britain's top transplant official defended the decision and said patients should be told they are not getting a "brand new" organ.

Some Early Cancer Overtreated
It is an unthinkable notion for an American generation raised on the message that early cancer detection saves lives, but specialists say more tumors actually are being found too early. That is raising uncomfortable questions about how aggressively to treat early growths - in some cases, even how aggressively to test - along with a push for more use of informed-choice programs. A recent study found that mammography is increasing diagnoses of tumors deemed genetically very low risk. Today's cancer screenings can unearth tumors that scientists say never would have threatened the person's life. The problem is there aren't surefire ways to tell in advance which tumors won't be dangerous - just some clues that doctors use in prescribing treatment.

Uninsured More at Risk Even in Hospitals
Uninsured Americans often have difficulty getting care and paying for medications, but what happens once they are admitted to a hospital with a life-threatening illness? A new study finds that even after they have heart attacks or strokes and are admitted to hospitals, the uninsured are more likely to die than those who carry private insurance. A gap persisted even after the researchers adjusted for disparities in the patients' underlying health, socioeconomic status and other factors. The study found that uninsured patients who had heart attacks were 52 percent more likely to die in the hospital than the privately insured, and those who had a stroke were 49 percent more likely to die in the hospital. One reason may be that patients who have trouble getting care may have more advanced disease.

Medical Scans Biggest Radiation Threat
Americans get the most medical radiation in the world, even more than people in other rich countries. The U.S. accounts for half of the most advanced procedures that use radiation, and the average American's does has grown sixfold over the last couple of decades. Too much radiation raises the risk of cancer. That risk is growing because people in everyday situations are getting imaging tests far too often. For example, New Hampshire teen was about to get a CT scan to check for kidney stones until a radiologist discovered he'd already had 14 powerful X-rays for previous episodes. Adding up the total dose, the radiologist was "horrified" at the cancer risk it posed.

Defect Risk Higher for Assisted Fertility Babies
Babies born to couples who had fertility treatment have a greater risk of birth abnormalities and doctors should be prepared to warn potential parents about these risks, French scientists have concluded. Couples considering undergoing assisted reproductive technology, or ART, treatment should be told that the risks of birth defects is around twice that of babies conceived naturally. Researchers found major congenital malformation in 4.24 percent of ART children, which is around double the rate seen in the general population. A similar study published in 2009 found that the number of babies born worldwide through ART rose to 246,000 annually in 2002 from 219,000 in 2000.

Infected Organs Pose Deadly Transplant Risk
Organ recipients are unusually likely to develop life-threatening illnesses from such infections because the transplant drugs they take suppress their immune systems dramatically. And as demand for transplants grows, concern about safety is rising, too. Many transplant experts are calling for better screening and tracking of donors, even as others worry that extra steps will slow down transplants and risk wasting urgently needed organs. No one knows how many diseases are transmitted through infected organs, and the U.S. does not have a national surveillance system in place to monitor disease transmission after donation. A landmark report last year suggested that the nation's periodic monitoring is patchy at best.

Pittsburgh Hospital Settles in Roof Death
The University of Pittsburgh Medical Center and relatives of an 89-year-old woman who froze to death on a hospital roof have reached a confidential settlement in the family's wrongful death and malpractice case. The settlement averts a trial and potential battle with state and federal regulators over access to records of inspections conducted in late 2008, just after the woman was found dead of exposure on the roof. The woman, who suffered from dementia and a heart condition, wandered unnoticed from her hospital room in 2008. She passed through a door that investigators said should have been locked and walked up a stairway to the roof, where she was found dead in 25-degree weather the next morning. Wearing only a nightgown and slippers, she died of hypothermia. Throughout the case, the hospital denied wrongdoing or negligence and accused the plaintiffs' lawyers of trying to prejudice potential jurors with false allegations. State health officials who investigated the death cited the hospital for violating state and federal regulations and imposed a $17,000 fine.

Lawsuit Claims Dosage Error at Pittsburgh Hospital Led to Death
The daughter of an 82-year-old woman who died at a Pittsburgh hospital last year is suing the hospital and three physicians, charging that her death was caused by a mistake in recording her medical history, resulting in her getting doses of a drug seven times higher than prescribed. The lawsuit claims the patient suffered fatal internal bleeding because of the overdose of a drug to treat her rheumatoid arthritis. Her daughter claims a doctor incorrectly recorded her mother's medical history to include a dosage of 12.5 milligrams of methotrexate per day. The correct dosage was 12.5 milligrams per week. As a result of the overdose, she suffered hemorrhaging and began aspirating blood.

Hospital Patients Return
One-fourth of Pennsylvanians hospitalized in recent years with common chronic conditions had to be readmitted within a year, contributing significantly to the estimated $1 billion-plus in hospitalization costs for treating those conditions. Readmissions accounted for nearly 30,000 additional hospitalizations from 2004 to 2008. In many cases, hospitalization for common chronic conditions - such as asthma, chronic obstructive pulmonary disease, diabetes and heart failure - could have been prevented through lifestyle changes as well as earlier intervention and better disease management.

Bringing Comparison Shopping to the Doctor's Office
Americans comparison-shop for items as small as groceries and as big as cars, but they rarely compare prices on their health care. When a doctor recommends a test or a procedure, most patients simply go where the doctor tells them to go. Even if a patient does want to comparison-shop, there is no easy way to obtain complete and useful information. It is a hole in the market that some companies see as an opportunity, especially because many Americans will soon have to pay more attention to what they are paying for, rather than count on insurance to cover everything. But there has been no easy way for consumers to shop for the best deal on a colonoscopy or blood test. A start-up financed by prominent venture capitalists aims to change that by building a search engine for health care prices. Patients can use the service to search for doctors that offer a service nearby and find out how much they will charge depending upon their insurance coverage.

Safety Features Planned for Radiation Machines
Manufacturers of radiation therapy equipment said at a patient-safety conference that within the next two years their new equipment and the software that runs it would include fail-safe features to help reduce harmful radiation overdoses and other mistakes. Two associations representing the biggest manufacturers of radiotherapy equipment said their equipment - including linear accelerators, which generate high-powered beams of radiation - will shut down if it does not detect that the treatment plan had been checked, that beam modifying devices were correctly placed and that the patient was properly positioned. Most machines are currently configured so that quality-assurance checks are at the discretion of the user.

Syringe Reuse Failed to Surface in Hospital Records
State inspectors over the past five years failed to uncover a doctor's practice of reusing syringes on different patients at Pittsburgh's Children's Hospital outpatient clinic, state records show. Inspection reports show Children's Hospital was found to be in compliance with rules the state Department of Health imposed. The Health Department inspects and licenses the center every year. Officials at Children's Hospital recently said they identified one doctor at its spasticity clinic who reused syringes on cerebral palsy patients. The patients received injections of the drug Botox to relax their muscles. Between 250 and 400 patients received care at the center and syringes were reused "very occasionally." So far, no patient has been infected.

Poor Infection Control at Many Surgery Centers
A new federal study finds many same-day surgery centers - where patients get such things as foot operations and pain injections - have serious problems with infection control. Failure to wash hands, wear gloves and clean blood glucose meters were among the reported breaches. Clinics reused devices meant for one person or dipped into single-dose medicine vials for multiple patients. The findings suggest lax infection practices may pervade the nation's more than 5,000 outpatient centers, experts say. The study was prompted by a hepatitis C outbreak in Las Vegas believed to be caused by unsafe injection practices at two now-closed clinics. It's the first report from a push to more vigorously inspect U.S. outpatient centers, a growing segment of the health care system that annually performs more than 6 million procedures and collects $3 billion from Medicare. Procedures performed at such centers includes exams of the esophagus, colonoscopies and plastic surgery.

Nurse Charged with Taking Pain Medication
A registered nurse has admitted to taking home a patient's pain medication and using it herself, according to police. She has been charged with acquiring Hydromorphone by misrepresentation, fraud, forgery or deception, illegally possessing a controlled substance, refusing to furnish the record of her dispensing the drug to a hospital patient and theft. Investigators allege the nurse obtained a dose of Hydromorphone, a schedule II controlled substance, from an automated dispensing machine at the hospital. She indicated in the system's record the drug was to be administered to a patient not assigned to her at the time. Later, she documented in hospital records that she had administered the drug to the patient. After her shift was over, her supervisor determined the patient had not received the drug.

Back Pain Widely Overtreated in U.S.
By one recent estimate, Americans are spending a staggering $86 billion a year in care for aching backs - from MRIs to pain pills to nerve blocks to acupuncture. However, researchers have found little evidence that the population got better as the bill soared over the past decade. The reality is that time often is the best antidote. Most people will experience back pain at some point, but up to 90 percent will heal on their own within weeks. In fact, for run-of-the-mill cases, doctors aren't even supposed to do an X-ray or MRI unless the pain lingers for a month to six weeks. Yet a study last year found nearly one in three aching Medicare patients get some kind of back scan within that first month? Those scans can be misleading, because people in middle age who don't even have pain nonetheless have degeneration of their disks. When someone does have pain, pinpointing that a particular black spot or bulge on a scan is the true cause is tricky.

Free Latte for Docs? Not Without Disclosure
New limits on free gifts to doctors have hit the ubiquitous free lattes and coffee seen at major medical meetings like the one for the American Society of Clinical Oncology. The conference exhibit floor still features massive information booths from cancer drugmakers, though the days of shopping bags laden with pricey goodies are long gone. Many drugmakers still offer coffee or candy with no strings attached; but Pfizer requires doctors to swipe their registration cards and warns that physicians from Minnesota and Vermont are prohibited from imbibing. Pfizer, which agreed last year to a $2.3 billion fine in a drug marketing case, also warns in a sign in front of the coffee machine that it may provide the names of coffee-drinking doctors to regulators. Earlier this year, Pfizer disclosed that it had paid $35 million to become 4,500 doctors and researchers for the last six months of 2009 for such services as speaking fees and work on clinical trials.

Findings May Alter Care for Early Breast Cancer
For many women with early-stage breast cancer, treatment may become considerably less arduous, researchers say. A new study found that certain women getting a lumpectomy may not need an operation to remove underarm lymph nodes, a procedure that can leave them with painfully swollen arms. Compared with not removing the nodes, the surgery did not prolong survival or prevent recurrence of the cancer. And a second study found that a single does of radiation, delivered directly to the site of the tumor right after a woman has a lumpectomy, was as effective as the six or so weeks of daily radiation treatments that most women now endure.

Too Much Care? Up to 1 in 3 Tests Unneeded
More medical care won't necessarily make you healthier - it may make you sicker. Anywhere from one-fifth to nearly one-third of the tests and treatments we get are estimated to be unnecessary, and avoidable care is costly in more ways than the bill: It may lead to dangerous side effects. Overtreatment means someone could have fared well or better with a lesser test or therapy, or maybe even none at all. Avoiding it is less about knowing when to say no, than knowing when to say, "Wait, doc, I need more information!" And efforts are underway to help doctors ratchet back avoidable care and help patients take an unbiased look at the pros and cons of different options before choosing one.

Hospital and Doctor Face $2.9 Million Payout in Case of Alleged Cancer Misdiagnosis
The Pennsylvania Supreme Court has denied an appeal by a Pennsylvania hospital in a malpractice suit filed by a woman who claimed her cancer went undiagnosed - a ruling that could cost the hospital $2.9 million. The woman, who died of breast cancer in 2009. first sued the hospital and her doctor in 2006. She claimed she was concerned about a bump on her chest, but was told by her doctor that it was only a cyst. The bump returned a year later and was found to be cancer. A jury awarded a verdict of $3,973,000, which was reduced to $2,582,000 because the jury found the doctor partially at fault. Though a judge reversed the verdict, the state Superior Court reinstated it and the Supreme Court upheld it.

Free Dental Clinic May Have Spread Hepatitis B
Nearly 2,000 people in five states and Washington, D.C., were urged to get hepatitis B tests after patients and volunteers at a free dental clinic in West Virginia contracted the blood-borne disease. Officials say the risk of widespread illness is low, but they are concerned that low-income people who can't afford medical care may not know they are sick and could pass the disease to others. Letters recommending testing are being mailed to 1,137 patients who received care at the clinic last year. Another 826 volunteers are getting similar letters. Three patients and two volunteers developed acute hepatitis B last year. While the agency says it's not certain they caught the disease at the clinic, tests show four were probably infected by the same source.

Scope of Unread Heart Tests in Harlem Hospital Widens
New York City hospital officials announced that the problem of unread echocardiograms at a Harlem hospital was bigger than they had initially believed, and that a review of thousands of records had found six patients who might have been deprived of necessary medical treatment because the results of their heart tests were not read by doctors. Initial reports suggested that the unread echocardiograms totaled nearly 4,000 and went as far back as 2007. Officials revealed recently, though, that the problems can be traced back to 2005 and includes nearly 5,000 unread echocardiograms. An additional 2,000 tests were read by doctors, who made notations in the medical records; however, those doctors did not sign the records, as required by medical protocol, so those tests were being reread as a precaution. The tests are currently being reviewed by a team of doctors recruited from hospitals across the city as part of an expansive investigation into what went wrong and in an effort to mitigate any harm to patients.

Hospital Wins Suit After Man Got Uterine Cancer
A prominent organ transplant hospitals wasn't to blame for the death of a man who became riddled with cancer after getting a kidney from a donor who unknowingly had uterine cancer, jurors found. The jury found for the hospital in the medical malpractice case surrounding the man's 2002 death. Experts have said it may be the only case of uterine cancer being transmitted by transplant, though the hospital has suggested he died of another form of cancer derived from the transplant. The man's widow had sought more than $3 million in damages. The hospital had argued that after belatedly learning about the cancer, its doctors did their best to assess the unusual situation and give him good advice. The man, a 37-year-old diabetic who had been on dialysis for four years, got a kidney transplant in 2002. The donor had died of stroke, and his surgeon didn't learn about her cancer until about six weeks after the transplant. The man decided to keep the kidney after his surgeon concluded there was only a slim chance he'd be sickened by the feminine cancer. He ultimately had the kidney removed but died the next month of a cancer his autopsy said came from the donor. His widow argued that the hospital should have urged him to have the organ removed immediately.

Syringes Reused at Pittsburgh Children's Clinic
At least 250 patients at Children's Hospital of Pittsburgh received injections with syringes that were used on other patients, prompting state health authorities to investigate. The syringes were not sterilized between uses, but sterile needles and tubing were used on all patients, which significantly minimizes any chance of transmitting infections. Injections with reused syringes were mostly given to children with cerebral palsy who have trouble walking. At least one physician gave the injections dating to 2005, but hospital officials are reviewing patient records to determine an exact timeline and whether more doctors were involved. The problem surfaced when a nurse noticed a doctor using the same syringe. Because the risk of infection is low, it is not believed that the practice compromised patients' health, but the hospital will offer them counseling and testing for blood-borne illnesses, including the hepatitis C virus, HIV and other infections. 

Man Dies of Uterine Cancer Linked to Transplant
A man who waited five years for the kidney that was supposed to change his life was instead killed by it. The kidney came from a woman who had uterine cancer, but she and doctors didn't know it. Once her disease was discovered after the transplant, his doctors highly doubted it could spread to him. But in seven months, he was killed by cancer that his autopsy linked to the transplant. His death, which is now the subject of a medical malpractice trial, is believed to be the only reported instance of uterine cancer apparently being transmitted by transplant, medical experts say. The case has reignited questions about the sometimes hidden risks carried by transplanted organs, risks that transplant experts say they have worked to minimize but can't eliminate - but are worth taking for many patients.

Who Pays for Medical Complications?
In 2007, officials at the Centers for Medicare and Medicaid Services announced that Medicare and Medicaid would no longer pay for the treatment costs of "conditions that could reasonably have been prevents" in an effort to improve patient safety and rein in health care costs. Instead, hospitals and physicians would have to take responsibility for these errors and cover their own costs. The group's decision was based in part on work previously done by a national coalition of health care safety and quality experts. These experts had assembled a list of complications so egregious that they called them "never events," as in they should never occur. "Never events" included complications stemming from operating on the wrong side of the body to leaving instruments in a patient after a procedure. WHile the CMS' list has always included several of the original "never events," it has since grown to include complications that were "never" mentioned by the health care experts. Over time, too, other insurers have begun adopting similar policies of refusing to pay for treatment costs of certain complications, cobbling together their own versions and definitions of "never events."

NRC Finds Apparent Violations at 13 VA Hospitals
The Nuclear Regulatory Commission has found the Department of Veterans Affairs in apparent violation of three federal regulations involving radiation use at 13 VA hospitals across the country, including the Philadelphia VA Medical Center. While the action could result in a fine, the bigger issue is that the commission could strip the VA of its ability to oversee radiation services at all 153 hospitals nationwide. The commission would then take on those duties or assign them to states such as Pennsylvania and New Jersey that have that capability. The violations cited involve failing to develop procedures to ensure that care is carefully laid out; failing to verify that the procedure goes according to plan in at least four medical centers; and not reporting one incident of improper closing within 24 hours as required.

New Way Bacterium Spreads in Hospital
Health care workers and patients have yet another source of hospital-acquired infection to worry about, British researchers are reporting. Clostridium difficile, a germ that causes deadly intestinal infections in hospital patients, has long been thought to be spread only by contact with contaminated surfaces; however, a new study finds that it can also travel through the air. The researchers emphasized that there is no evidence that C. difficile can be contracted by inhaling the germs. Rather, they float on the the air, landing in places where most people can touch them. The bug is commonly spread by contact with infected feces, and the British scientists said the new study made it even more urgent to isolate hospital patients with diarrhea as soon as possible - even before tests confirm a C. difficile infection.

Women with Cancer Sues Wilkes-Barre Hospital and Doctors
Attorneys for a Pennsylvania woman with terminal cancer have filed a medical malpractice lawsuit against Wilkes-Barre General Hospital and several area doctors, claiming a curable kidney cancer was allowed to spread because doctors tested the wrong kidney for cancer several times. Earlier this year, doctors gave the women five months to live. The suit claims she was being treated for blood in her urine for years and a mass was detected on her right kidney in 2007. A biopsy was ordered on her right kidney, however doctors mistakenly performed a biopsy and CT scan on her left kidney, which was cancer-free. It took 20 months for doctors to discover their mistakes and properly diagnose the cancer as transitional cell carcinoma in the right kidney. "As a result, she now faces a certain death sentence," the suit says.

9 California Hospitals Fined for Endangering Patients
Nine hospitals in California face a combined $550,000 in penalties for endangering patients through medication errors, leaving sponges inside patients after surgery and other problems. One hospital was fined twice for a total of $125,000. In one instance there, a surgeon performing a hip replacement reported discovering dried blood on an instrument being used on a patient. Since 2007 when the fines were enacted as law, a combined $4.8 million in fines have been assessed, and $2.9 million have been collected.

Pittsburgh Hospice Cited After Man Burned
The state Health Department has cited a Pittsburgh-area hospice for safety violations after a patient who was on oxygen set himself on fire while smoking. Employees told inspectors they first became aware of the emergency when they heard a beeping noise and detected a strange smell. State inspectors reported seeing a charred area on the patio where the patient was smoking. Though not seriously injured, the patient went first to the hospital's emergency room and then to a nearby burn unit. State inspectors cited the facility for placing patients in immediate jeopardy and failure to implement a policy "to maintain a safe physical environment." The violations cited by inspectors included failure to develop an individualized care plan for patients, including the burn victim, who had been admitted the day before. Other violations included failure to have a one-to-one monitor on patients who smoke while on oxygen and "pervasive problems with the oversight of patients who were permitted to smoke."

Court Throws Out "Wrongful Life" Suit Over Birth of Brain-Damaged Child
A Brooklyn appellate panel has thrown out a "wrongful life" action filed by a mother who alleged that her doctors' failure to adequately advise her of the significance of ultrasound results, which indicate the potential presence of severe birth defects, prevented her from seeking an abortion. The case turned on the fact that signs of the defects - which left the now five-year-old boy blind, brain-damaged and unable to speak - were not discovered until about the 27th week of the plaintiff's pregnancy, which is beyond New York's 24-week limitation for legal abortions. The court found that because New York law only permits abortion after 24 weeks unless necessary to prevent the life of the mother - and the mother did not allege that her life was in danger - her doctors could not have done anything. The mother's suit sought coverage of her son's medical care, and she alleged that both facilities that treated her had failed to advise her of the significance of ultrasounds, to order further tests or to counsel her regarding abortion.

Medical Malpractice Filings Fall in Lackawanna County
Lackawanna County's medical malpractice case filings in 2009 dropped 53 percent over the last eight years, a change many experts say is the result of reforms meant to weed out frivolous lawsuits and limit hefty jury awards. Throughout the state, medical malpractice case filings fell almost 42 percent since 2000; but even as state officials hail the successes, some experts say more needs to be done. Medical malpractice insurance premiums remain twice as expensive as they were in 2000. In part because of that, many areas across Pennsylvania are seeing a shortage of doctors that could reach crisis proportions in the next 15 years.

Needle Error Puts 50 People at Risk in New Mexico
A group of New Mexico medical students failed to properly change needles on devices used for blood glucose testing, and now officials say a few dozen people might be at risk for contracting serious diseases. University of New Mexico School of Medicine officials made the announcement in hopes they could locate those who participated in free testing. Between 51 and 55 people were tested. The center learned about the testing mistakes nearly a month after. Officials have said the devices should not have been used at a public event and not all of the students were properly trained to use them. The devices, similar to home glucose testers, contain six lancets - or needles - that can be triggered to draw a blood sample. With each use, the device must be advanced manually to load a new lancet. While some volunteers were safely and properly tested, officials said some failed to change the lancets, resulting in potential exposure to other's blood.

Lifesaving Devices Can Cause Havoc at Life's End
Defibrillators are a modern medical miracle, small implants that save lives by sending an electrical jolt to interrupt a potentially fatal heart rhythm and restore normal beating. But with a rapidly growing number of patients getting the devices, they are increasingly posing a bionic challenge near life's end for both patients and their families. Specialists say that a failing heart often begins to beat in the same type of wildly erratic rhythm that a defibrillator is programmed to recognize and intercept with a jolt. And though doctors and patients routinely discuss end-of-life issues like withdrawing medications and resuscitation attempts, studies suggest that what to do about a defibrillator rarely comes up. The Heart Rhythm Society, a professional group representing cardiologists who implant heart devices like defibrillators, plans to issue guidelines in an effort to promote such talks. Among other things, the guidelines, which were developed with other medical organizations, emphasize that doctors should discuss possible device deactivation with patients at the time of implantation and periodically afterward.

Food Poisoning Suspected in Hospital Deaths
A health officials says food poisoning perhaps from an ingredient in chicken salad could be what killed three Louisiana mental health hospital patients and sickened 40 others. Officials say patients showed signs of gastrointestinal stress. The three deaths happened a few hours after the symptoms developed.

Lighter Load for Nurses May Aid Patients
A state law in California requires hospitals to maintain certain minimal levels of nurses on duty. Now a study suggests that the requirement may be saving lives. The study compares the outcomes of 1.1 million general surgery patients in more than 800 hospitals in three states - California, where nurses in medical surgical units are limited to five patients at a time and New Jersey and Pennsylvania, where nurses' patient loads averaged more than six. Researchers concluded that 225 hospitals deaths or 13.9 percent of all deaths in general surgery in New Jersey and 200 deaths or 10.6 percent in Pennsylvania that could have been averted with rules similar to California's.

Pittsburgh Transplant Center to Rectify Violations
The state Health Department appeared to take a Pittsburgh hospital's world-renowned transplant program to task recently, releasing the results of a report that showed it was not compliant with federal regulations in 30 areas. After a four-day inspection by 14 state inspectors, the report found documentation problems with everything from failure to inform people of their patient rights, to not documenting that blood compatibility measures were done before a transplant, to not properly counting everyone who died from a transplant-related death. Hospital officials countered that the report's findings were really nothing more than easily resolved differences over paperwork, and that many of the violations sound worse than they are.

Grand Jury to Probe West Philly Abortion Doctor
A local grand jury is investigating an embattled Philadelphia abortion doctor who has been linked to the deaths of two patients. The doctor has not yet been charged with any criminal wrongdoing, despite separate investigations by state, federal and local officials into his practice. He is also scheduled to appear at a disciplinary hearing before the state Board of Medicine, which will consider whether to permanently revoke his medical license. State officials found his clinics to resemble a house of horrors, complete with bloodstained floors, unlicensed workers who tended to patients and jars of fetus remains. Numerous patients have come forward and recalled disturbing tales of botched abortions. Some of their allegations were backed up by court documents from 10 malpractice lawsuits filed against the doctor over the years. He is also accused of doling out pain prescriptions illegally.

Mistrial Declared in Malpractice Case After Doctor Faints
The medical malpractice trial of a Pennsylvania doctor ended when the judge presiding over it declared a mistrial following the physician's fainting in the courtroom. After fainting, the doctor was taken to the hospital on a stretcher. Though the judge ended the trial, he gave the plaintiff the option of retrying the case. The victim's estate filed the lawsuit in 2006, alleging the doctor was liable for her death in 2004 at age 53. She died after suffering cardiac arrest two days earlier, and her estate alleged the doctor's improper prescription of medications had led to her death.

State Tries to Shut Philadelphia Abortion Clinic
State health officials are seeking to permanently shut down a West Philadelphia abortion clinic because the doctor who ran it has not responded to their charges. The clinic has been closed since a raid by federal drug agents and state authorities. At the same time, the doctor's medical license was suspended by the state Board of Medicine, which called his clinic's "deplorable and unsanitary" conditions "a clear danger to the public." After the raid, the Pennsylvania Department of Health elaborated on those conditions, citing the clinic for more than a dozen violations of state law, including a lack of equipment and drugs for emergency resuscitation, no easy way to get patients on stretchers out of the building, no backup physician and an under-reporting of second-trimester abortions. The doctor is also accused of delaying a report to the state of a patient who went into cardiac arrest last year and died. Each violation in of itself is grounds for revoking the clinic's approval to do abortions and for imposing fines. 

Pittsburgh Doctor Gets Jail Time for Fraud
A Pittsburgh internist hailed for treating local homeless people and the destitute in Haiti but dogged by health care fraud complaints as far back as 1980 will spend the next year behind bars for ripping off Medicare and private insurers by submitting more than $1 million in false claims. He had previously paid $3.3 million to the government as part of a guilty plea. He also shut down his office and will most likely lose his medical license. Federal prosecutors said the doctor submitted false claims for services he never rendered between 2003 and 2008. He was also accused of similar conduct in the past, which led to a federal conviction in 1991.

Unplugged Veterans Affairs Computer Affected Treatment of Cancer Patients
It took officials at a Veterans Affairs Department hospital in Philadelphia more than a year to learn that a computer used to assess patient's response to treatments for prostate cancer had been unplugged, delaying assessments, according to a recent inspector general report. The computer ran an application which oncologists use to focus radiation treatment on cancer hotspots - but the computer was disconnected from the hospital's network in 2006 when a vendor and a VA information technology technician unplugged it from a jack that linked it to the main network. That year, VA clinicians performed 17 procedures to insert radioactive seeds that treat prostate cancer. Without the network connection, X-rays showing the location of radioactive seeds could not be transferred to the computer, making it difficult for doctors to determine the patients' response to treatment. No patient was injured by the error. Nearly 40 veterans or their wives have filed claims against the hospital for alleged injuries. Two of those have filed federal lawsuits.

Hospital Cited for Violating Transplant Regulations
State Health Department inspectors cited a Pittsburgh hospital's highly touted transplant program for multiple violations of federal regulations, including failure to disclose and analyze two patients' deaths. The report also cites the hospital for failing to document that required organ and blood matches were performed before transplant procedures began. Inspectors also questions the hospital's claims that it experienced only one adverse medical event in more than a year. In actuality, in the same time period, one patient was returned to surgery because of internal bleeding, another multi-transplant organ recipient developed acute internal bleeding and died, and the final multi-transplant organ recipient developed acute bleeding the hospital could not control before the patient died 23 days later. Surgeons at the hospital performed 536 organ transplants last year.

New Jersey Court Considers Hospital's Right to End Treatment for Vegetative Patient
A New Jersey appeals court heard arguments over whether a hospital can end life-sustaining treatment for a patient in a persistent vegetative state contrary to his family's wishes. A year ago, a judge said no, granting an injunction requested by the comatose patient's guardian despite hospital doctors' opinion that further treatment would be futile. The hospital appealed, and though the patient has since died, the state Appellate Division proceeded to invite briefs and schedule arguments in the case. The hospital insists judicial guidance is needed because the case's circumstances are not uncommon and a similar situation is bound to recur. Equally interested are amici representing disabled patients, who fear a ruling in the hospital's favor would pave the way for caregivers to freely pull the plug in the interests of expedience and cost savings.

Teaching Physicians the Price of Care
Doctors in training have traditionally been insulated from information about the costs of tests and treatments they order for patients - in fact, for decades, the subject was virtually taboo when professors and trainees discussed treatment decisions during hospital rounds. During four years of medical school, students learn to order tests and treatments based on their knowledge of diseases and of scientific evidence. Until recently, most schools included little information on financial factors, like how the insurance system works and how treatment costs affect patients' behavior. As a result, most physicians enter practice with little sense of how to make the most cost-effective choices for patients, or how their own decisions affect the patient's medical bills. But escalating costs and the national debate over the health care overhaul are forcing medical schools and residency programs to grapple with teaching about the financial side of their profession. Accrediting organizations now require such teaching, and students and residents recognize that they need to understand finances as well as blood tests.

Hospital and Doctor Sued After Patient's Fatal Car Crash
A hospital failed to diagnose and treat the neurological symptoms of a Scranton man who died in a car crash hours after he was released from the hospital, according to a lawsuit filed by the man's family. He died in 2008 when his car lost control and flipped, landing on another car. His family is suing the hospital for $100,000, claiming wrongful death. The man suffered from dizziness, nausea, vertigo, ataxia and an unstable blood pressure when he sought treatment at his primary care physician's office. His doctor deemed him unable to drive, so her personally took him the hospital's emergency room. He was examined and released later that day.

Records Fight in Hospital Patient's Death Thickens
In a showdown over records in the death of an 89-year-old woman on a hospital rooftop, a federal prosecutor told an Allegheny County judge he didn't have the authority to order the state to turn over the names and notes of state inspectors. Government lawyers contend that under a 2008 federal regulation, state health inspectors are considered federal employees when enforcing federal rules. The regulation bars the release of those inspection records in most circumstances. The lawyer wants the names and notes of state health inspectors who investigated the 2008 death of a woman who, suffering from a heart condition and dementia, died of exposure atop the hospital after wandering unnoticed from her room. Her family sued the hospital, and their lawyers subpoenaed the inspection records. As a result of the inspection, the state Health Department cited the hospital for multiple violations and imposed a $17,000 fine.

Pricey Heart Screening May Not be Worth It
Examining patient records to pick out those at high risk of developing heart disease is cheaper and just as effective as screening all adults aged between 40 and 74, a British study has found. The research raises doubts about a $387 million a year screening program launched by the British government in 2008 and suggests funds may be better spent on high-risk patients. The lead researcher said, "A universal screening program for cardiovascular disease might prevent an important number of new cardiovascular events, but it may be unrealistic to implement in increasingly resource-constrained health systems." 

Philadelphia Doctor Facing Drug Crimes
A Philadelphia doctor has been charged with drug crimes after he allegedly bought and prescribed thousands of narcotic pills while both his state license to practice and his Drug Enforcement Agency license were expired. The 70-year-old doctor was arrested and charged with prescribing outside a patient relationship, delivery of a controlled substance and possession of a controlled substance. His lawyer said that he "is now totally compliant with all aspects of his licensure," and that the matter was dealt with in 2007. While his licenses were expired, he allegedly ordered thousands of pills from a pharmaceutical company and dispensed them to patients. During the same time, he also prescribed medications for himself, and at one pharmacy, only 10 of 491 prescriptions and 349 refilled he wrote were valid.

Health Department: 'A Lot' of Complaints from Temple
The deputy secretary of the Pennsylvania Department of Health says her agency has investigated "a lot" of complaints about Temple University Hospital since 1,500 nurses and allied health workers went on strike there. But because of reporting delays she blames on federal regulations, potential patients will not be able to see what those investigations found until at least the middle of next month. Asked whether this timetable serves the public, especially those who need to decide soon where to go for medical care, the health department said, "It serves the public the way the system is designed to serve the public. It is what it is. We're following our process."

New Doctor Code Curbs Industry Sway and Swag
No more letting industry help pay for developing medical guidelines. Restrictions on consulting dealt. And no more pens with drug company names or other swag at conferences. These are part of a new ethics code that dozens of leading medical groups recently announced, aimed at limiting the influence that drug and device makers have over patient care. It's the most sweeping move ever taken by the Council of Medical Specialty Societies to curb conflict of interest - a growing concern as private industry bankrolls a greater share of medical research. One of its most controversial rules: requiring top leaders of any medical society and top editors of its journals to have no consulting deals or financial ties to industry.

Malpractice Lawsuits Decline in Pennsylvania
In 2009, the number of new medical malpractice lawsuits filed in Pennsylvania courts fell for the fifth straight year, according to a report released by Pennsylvania's chief justice. The report provides new evidence that the malpractice climate in Pennsylvania has cooled since the early part of the decade, when rising costs led many doctors and hospital administrators to worry that the state's medical malpractice system might collapse. Philadelphia - long considered the center of the state's malpractice crisis because of the large number of generous verdicts here - saw the most dramatic declines in new suits and in large jury awards, as well as a rise in defense verdicts. The number of new malpractice suits in 2009 fell to 1,533 from 1,602 cases initiated in 2008. That marked a 47 percent decline from the 2,904 suits filed in 2002. And in Philadelphia, new malpractice suits fell even more dramatically to 491 from 1,365 in 2002 - a 64 percent drop. Moreover, doctors and hospitals who took cases to trial in 2009 did well, winning 85 percent of the cases statewide and 79 percent in Philadelphia. That compared with defense victory rates of 73 percent statewide and 59 percent in Philadelphia from 2000 to 2003.

More Nurses, Less Death
Ten to 13 percent fewer surgical patients in New Jersey and Pennsylvania would die if hospitals in those states had as many nurses as California law requires, according to a recent University of Pennsylvania study. The study of 1.1 million patients in 2005 and 2006 found that the nurse-to-patient ratios mandated in California could have saved the lives of 468 patients in New Jersey and Pennsylvania over a two-year period. The study was based on reports to states of deaths within 30 days of surgery and surveys completed by 22,336 nurses. Published in the journal Health Services Research, the study was meant to survey the 18 states, including Pennsylvania, that are considering legislation on nurse-staffing levels. California became the first, and only, state to enforce minimum nurse-to-patient standards in 2004. For example, it says one nurse can be responsible for no more than five patients on a medical-surgical unit and two in an intensive-care unit. The study found that, on average, nurses in California medical-surgical units cared for two fewer patients than nurses in New Jersey and 1.7 fewer than in Pennsylvania. It also found that nurses in California liked their jobs better and were less likely to feel burned out, an important finding because of the projected shortage of nurses.

Lung Cancer Scans Often Lead to False Alarms
Screening smokers for cancer with lung scans can lead to a high rate of false alarms, unneeded tests and biopsies, a new study suggests. Some hospitals are promoting lung cancer screening with a special X-ray called a CT scan. And some advocacy groups encourage current or former smokers to get tested. However, there's no convincing evidence that such tests save lives, and no doctors group recommends routinely screening smokers who don't have symptoms of lung cancer. Government researchers are studying whether the scans could save lives. While researchers are still waiting for the answer to that, they do have results on just how often scans are wrong. Scientists with the National Institutes of Health say doctors and people considering lung scans should take into account the high risk of false alarms in their study of 3,200 people. For those who got CT scans, the risk of a "false-positive" - finding a harmless spot - was 21 percent after one scan and 33 percent after two. For chest X-rays, the risk was 9 percent after one, and 15 percent after two. Anything suspicious detected through screening often needs to be followed up with more tests, biopsies and even surgery to find out if it really is cancer. Complications can include lung collapse, bleeding and infection.

Pediatrician Charged with Rape Once Cleared by Hospital
Officials at a Delaware hospital say that they investigated a 1996 complaint against a pediatrician now charged with sexually abusing more than 100 patients, but that the doctor was cleared of any wrongdoing. A nurse at the hospital reported in 1996 that the pediatrician might have inappropriately touched young girls in his care. After he was arrested last year, hospital officials said they were not aware of any past problems with him. They have since acknowledged that he was investigated by the local police in 2005, though no charges were filed. The officials said in a statement that they were revealing the 1996 complaint now because they could do so "without jeopardizing the criminal case." The pediatrician faces 471 counts of rape, sexual exploitation of a child and other charges. He is being held on $4.7 million bail. Authorities also say he videotapes some of the assaults, which involved infants and toddlers. The recordings date to 1998.

Hospital Investigations Hard to Gauge
The Pennsylvania Department of Health will soon release its first full-year's worth of hospital-by-hospital data showing how many bloodstream, urinary tract and other infections patients contracted during hospital stays in 2009. But even though the state has been collecting similar data since 2005, and anecdotal evidence indicates that at least some hospitals have made significant progress, it won't be possible to say how the state has done over the past half-decade in its nationally celebrated effort to reduce hospital-acquired infections. That's because the way infection reporting has been collected and analyzed has changed so much year to year - and agency to agency - that drawing long-term conclusions using the state's data is impossible, state officials and experts say. After all the work in the past decade that went into making Pennsylvania the first state in the country to publicly report hospital-acquired infection data, it's galling to those involved that the state is, in essence, starting all over again.

$1.5 Million Awarded for Lost Thumb in Wake of Overturned Medical Malpractice Caps
Four days after the Georgia Supreme Court unanimously struck down the state's damage caps in medical malpractice cases as unconstitutional, a jury has awarded $1.5 million in pain and suffering damages. It was a fortuitous stroke of timing, and a hefty verdict for an already disabled client who then lost a thumb when an IV needle leaked into his tissue. The 47-year-old plaintiff suffers from diabetes and chronic pancreatitis and was fully disabled when he was admitted to a Georgia hospital in 2005, seeking treatment for complications from his pancreatic disease. According to court documents, a nurse inserted an IV containing Phenargen, an anti-nausea drug, and Demerol, a painkiller, into his right wrist. A few hours later, the site of the insertion was "painful and swollen," and the needle was removed 45 minutes later. Almost nine hours elapsed before his doctor examined him and discovered that the drugs had leaked into surrounding tissue. The physician elevated his hand but he continued to complain of pain. He was then transported to another hospital where an orthopedic surgeon performed surgery on his wrist but was unable to save the thumb. He spent another 24 days in the hospital where he underwent "multiple additional surgeries to save his hand," according to his complaint filed in 2007, naming the original hospital and five nurses as defendants, asserting that the nurses had allowed the drugs to infiltrate the tissue surrounding the IV needle. He was ultimately awarded $53,026 in medical expenses and $1.5 million for pain and suffering.

Hospital Infection Problem Persists
the nagging and largely solvable problem of hospital-acquired infections remains as resistant to cure as the germs that contribute to an estimated 100,000 deaths a year, according to an annual government study recently issued. Despite a renewed focus on prevention and threats of governmental sanctions, hospitals continue to see increased rates of post-operative bloodstream infections and catheter-associated urinary tract infections, the Agency for Healthcare Research and Quality reported. The rates increased by 8 percent for bloodstream infections and 4 percent for urinary tract infections over the year before. There was no change in the incidence of bloodstream infections caused by the placement of catheters in central veins. The only positive news came from a 12 percent reduction in the rate of post-operative pneumonia.

Doc Deficit? Nurses' Role May Grow in 28 States
A nurse may soon be your doctor. With a looming shortage of primary care doctors, 28 states are considering expanding the authority of nurse practitioners. These nurses with advanced degrees want the right to practice without a doctor's watchful eye and to prescribe narcotics - and if they hold a doctorate, they want to be called "doctor." For years, nurse practitioners have been playing a bigger role in the nation's health care, especially in regions with few doctors. With 32 million more Americans gaining health insurance within a few years, the health care overhaul is putting more money into nurse-managed clinics. Those newly insured patients will be looking for doctors and may find nurses instead. The medical establishment is fighting to protect turf. In some statehouses, doctors have shown up in white coats to testify against nurse practitioner bills. The American Medical Association, which supported the national health care overhaul, says a doctor shortage is no reason to put nurses in charge and endanger patients. Nurse practitioners argue there's no danger. They say they're highly trained and as skilled as doctors at diagnosing illness during office visits. They know when to refer the sickest patients to doctor specialists. Plus, they spend more time with patients and charge less.

Mother Seeks Answers in Son's Death at Pittsburgh Hospital
Nearly four years later, the mother a late Pittsburgh man still wonders why her son died after routine surgery in a local hospital, and why hospital officials later disclosed his medical records to strangers. She is seeking answers even as the City of Los Angeles prepares to honor the memory of her son, perhaps best known locally as host of Pittsburgh's first Spanish-speaking television show. His mother believes he was served soup too soon after an appendectomy. She has received support from Rep. Charles Rangel, a powerful Harlem Democrat. He wrote a letter to the hospital in 2009, stating that the man died from asphyxiation "from his choking on food that was served him at lunch" and cited allegations on negligence in his care - negligence the letter said resulted from the hospital "using an unreliable and insufficiently tested" computer system. The hospital has responded to the letter, alleging that a physician who was recently fired was the source of the negligence allegations.

Study Shows Nursing Strikes Erode Patient Care
Do strikes kill? That is the provocative title of a study that examined the quality of care in New York hospitals during 50 nursing strikes over two decades, and the answer appears to be yes. The authors found that in-hospital deaths rose by 19.4 percent and readmissions by 6.5 percent for patients treated during strikes. The authors also estimate that, out of 38,228 patients admitted during the New York strikes, 138 patients died because of the strikes and 344 more had to return to the hospital after release. The increases occurred whether or not replacement workers were hired. The change was greatest in "nursing intensive services," like intensive care units.

UK Reveals 800,000 Organ Donor List Errors
Britain's transplant authority is investigating several hundred thousand errors in its organ donor list stretching back about a decade. The National Health Service Blood and Transplant Organization said a proportion of its 14 million-strong organ donor list has been affected by technical errors since 1999 - and that as a result a small group of people may have had organs removed without proper authorization. The programming error meant that, for example, people who wanted to donate organs such as their lungs or their skin were incorrectly identified as people who wanted to donate their corneas or heart. The glitch may have affected about 800,000 people - 45 of whom have since died and donated organs. Just under half of those are thought to have made donations based on the erroneous data. The revelations comes at an awkward time for the government, which has been pushing to increase Britain's rate of organ donation, one of the lowest in Europe. Officials have poured millions of pounds into an awareness campaign and floated the idea of automatically designating every person a donor unless they or their survivors opt out.

Pittsburgh Doctor Accused of Running Prescription Drug Mill
A Pittsburgh doctor ran a prescription drug mill that provided millions of doses of painkillers to patients who didn't need them. A grand jury investigation determined the doctor distributed prescriptions to patients he did not examine, according to state authorities who arrested him and 11 patients on drug-dealing charges. He charged about 500 patients monthly fees last year, refusing to accept health insurance and taking payment by cash, checks or money orders. The patients from four counties were "major traffickers and suppliers of OxyContin, Roxicodone, methadone, Endocet, fentanyl, Percocet and Valium. The doctor is charged with 21 counts of prescribing or dispensing controlled substances, and seven counts of prescribing drugs to a drug-dependent person.

Medical Radiation Complaints Spur FDA Action
The U.S. Food and Drug Administration has received nearly 1,200 complaints in the last decade about devices that deliver radiation treatments to cancer patients and has called on manufacturers to help improve safety. The FDA sent letters to 93 makers of radiation treatment devices, urging them to attend a workshop to address concerns about patient exposure to excess radiation from medical treatments and procedures. Radiation exposure became a major concern last year after the FDA said it was investigating 206 cases of patients being exposed to toxic doses of radiation during CT scans of the brain at Cedars-Sinai Medical Center in Los Angeles. The FDA also held a meeting with makers of diagnostic imaging equipment to gather ideas about how to protect patients from excess radiation exposure. High doses of radiation can cause skin burns, cataracts and other injuries - and, in extreme cases, cancer and death.

FDA Toughens Process for Radiation Equipment
The Food and Drug Administration is taking steps to reduce overdoses, underdoses and other errors in radiation therapy by strengthening the agency's approval process for new radiotherapy equipment. In a letter to manufacturers, the FDA said its action was based on a recent analysis of more than 1,000 reports of errors involving these devices that were filed over the last 10 years. The FDA will no longer allow new radiotherapy equipment to enter the market via a streamlined approval process that sometimes involved the use of outside, third-party reviewers. That process was instituted in the 1990s to reduce the agency's workload and speed approval time. Most of the reported problems - 74 percent - involved linear accelerators, computer-controlled machines that generate high-powered beams of radiation that target and destroy cancer cells. Problems with computer softward were most frequently cited as a cause for the errors.

Unneeded, Riskier Spinal Fusion Surgery On Rise
A study of Medicare patients shows that costlier, more complex spinal fusion surgeries are on the rise - and sometimes done necessarily - for a common lower back condition caused by aging and arthritis. What's more alarming is that the findings suggest these more challenging operations are riskier, leading to more complications and even deaths. Add to that the expense for patients whose problems after surgery send them back to the hospital or to a nursing home and "that's not a trivial amount of money" for Medicare. The cost to Medicare, just for the hospital charges for the three types of back surgery reviewed is about $1.65 billion a year, according to researchers. All the patients in the study had stenosis in their lower backs, a painful squeezing in the spine that's most common in people over 50. The researchers compared the risks for three different types of surgery for the condition: decompression, simple fusion and complex fusion.

Doctors Face 'Expiration Dates' of Specialties
The next time you're at the doctor's office, take a peek at those certificates hanging on the wall. Like gallons of milk, some of them are expiring. For the first time since leaving medical school, many doctors are having to take tests to renew board certification in their fields - 147 specialties from dermatology to obstetrics. Any doctors can deliver a baby, treat cancer or declare himself a cardiologist. Certification means the doctor has special training in that field and passed an exam to prove knowledge of it. They used to do this once and be certified for life. That changed in the 1990s - doctors certified since then must retest every six to 10 years to prove their skills haven't gone stale. For some specialists, like the doctors who push tubes into heart arteries to unclog blockages, this is the first year many are going through retesting. Older doctors are feeling the heat. More than a quarter of a million of them were "grandfathered" with lifetime certificates, but are being urged to retest voluntarily to show they still know their stuff. 

Judge Removes $105. Million Default Judgment in Lawsuit Against Hospital
A Dauphin County judge has removed a $10.5 million default judgment against a hospital in a lawsuit filed by a woman claiming she received faulty cheek implants during a 1990 operation. He found that the hospital "sets forth a meritorious defense." The woman, who sued the hospital and two surgeons, moved for default judgment, claiming the hospital did not respond to her amended complaint. According to her lawsuit, two years before her surgery at the hospital, the company that made the implants removed them from the marketplace. Six months before the surgery, the FDA sent a safety alert about the product, and two months after her surgery, the FDA recalled the implants. 

Attorneys: Mother's Counseling Not an Issue
A mother tried to accept the death of her 11-year-old son as "God's will." But nearly a year after his death, when she found herself still struggling emotionally, she sought mental health counseling. That counseling was the topic of a brief hearing in Lancaster County Court. Attorneys for a nurse convicted of killing the boy with a lethal dose of morphine, had raised it as an issues. Her attorneys suggested that information about her counseling might have been relevant during her trial. The judge addressed the evidentiary issue after the boy's mother agreed to allow the judge, defense and prosecuting attorneys to review her mental health records. After the judge read the records, he asked the defense attorney is there was anything that would have benefitted his client. He did not.

Mom's Mental State an Issue in Nurse's Appeal
Records of a mother's mental health treatment after her son's death will be discussed  in a Lancaster County court. Attorneys for a licensed practical nurse convicted of killing an 11-year-old has filed an appeal, raising several issues, including questions about the mother's mental health treatment. The defense charged that during the nurse's trial, the judge made a mistake when he did not direct a local mental health facility to release records relating to the admission of the boy's mother. The nurse had been hired by the boy's mother to care for her son, a cerebral palsy patient. The next morning, he was dead, and pathologists determined the child died from a lethal dose of morphine. More than six years later, the nurse was arrested, charged and convicted.

Pfizer Gave Docs $35 Million in Last Half of 2009
Pfizer Inc. paid doctors and teaching hospitals a total of $35 million in the last half of 2009 for services ranging from speaking to other doctors about the company's products to running studies of its experimental drugs. The world's biggest drugmaker by revenue disclosed details of its payments to about 4,500 doctors and other health professionals. Unlike rivals who have made some disclosures, Pfizer included figures on the considerable payments made to doctors running human tests of its drugs. The information was released a little more than a year after Pfizer promised to do so. Patients can search the new database to see whether their doctor has received payments for consulting services, giving speeches or participating in drug testing, as well as free meals or travel reimbursement.

Pfizer Details Payments to Doctors and Researchers
Pfizer, the world's largest drug maker, said that it paid about $20 million to 4,500 doctors and other medical professionals for consulting and speaking on its behalf in the last six months of 2009, its first public accounting of payments to the people who decide which drugs to recommend. Pfizer also paid $15.3 million to 250 academic medical centers and other research groups for clinical trials in the same period. While other pharmaceutical companies have disclosed payments to doctors, Pfizer is the first to disclose payments for the clinical trials. Pfizer said most of the disclosures were required by an integrity agreement that the company signed last year to settle a federal investigation into the illegal promotion of drugs for off-label uses.

$10.5 Million Judgment Filed in Suit
A $10.5 million default judgment has been entered against Pinnacle Health for allegedly failing to respond to an amended lawsuit filed by a woman claiming she received faulty cheek implants during a 1990 operation. The woman had the judgment entered in county court after she claimed Pinnacle Health did not respond to her amended complaint. However, an attorney for Pinnacle Health said the default judgment should never have been entered and the company is continuing to fight the lawsuit. According to the woman's lawsuit, two years before her surgery, the company that made the implants removed them from the marketplace. Six months before the surgery, the FDA sent a "safety alert" about the product, and two months after her surgery, the FDA recalled the implants. According to her lawsuit, the two surgeons used the implants despite knowing of their danger. She claims doctors failed to warn her as new information about the implants emerged, and in 2007 falsely claimed they had used a different implant. She blames the implants for a multitude of health problems, including loss of facial sensation, limited jaw movement and considerable pain.

Man Who Sued Hospital and Doctor Over Surgery Died
A Pittsburgh man who filed a lawsuit against a hospital its doctor over a gauze sponge allegedly left inside him during back surgery has died. He filed suit the day before against the hospital and a doctor who operated on him in 2008. He alleged the sponge caused a severe and life-threatening infection. The doctor found the sponge three months later in a follow-up procedure, according to the suit.

Scientists Say FDA Ignored Radiation Warnings
Urgent warnings by government experts about the risks of routinely using powerful CT scans to screen patients for colon cancer were brushed aside by the Food and Drug Administration, according to agency documents and interviews with agency scientists. After staying quiet for a year, the scientists say they plan to make their concerns public at a meeting of experts called by the FDA to discuss how to protect patients from unnecessary radiation exposures. The meeting is part of a growing reassessment of the risks of routine radiology. The average lifetime dose of diagnostic radiation has increased sevenfold since 1980, and an estimated 70 million CT scans are performed in the United States every year, up from three million in the early 1980s. As many as 14,000 people may die every year of radiation-induced cancers as a result, researchers estimate.

Ex-Nurse Gets 7 to 20 Years in Boy's Death
A former central Pennsylvania nurse convicted of giving an 11-year-old cerebral palsy patient a lethal dose of morphine has been sentenced to seven to 20 years in prison. A jury convicted her of third-degree murder, drug delivery resulting in death and delivery of a controlled substance. Prosecutors say she gave the boy a fatal dose of morphine at his home in 2002 because she was tired. She was a private duty nurse working the boy's home for the first time on the morning he died. She testified at trial that she never gave the boy any medication and her attorney said she had no reason to kill the child.

Top U.S. Psychiatrist Calls for Ethics Cleanup
American psychiatrists need to break away from a "culture of influence" created by their financial dealings with the drug industry, the head of the National Institute of Mental Health has said in a leading medical journal. He stops short of calling researchers corrupt or asking them to stop taking money from drug companies, but he highlights a "bias in prescribing practices" that favors brand name drugs over cheaper generics and non-drug treatments. He says the situation must change with new standards for transparency and full disclosure of psychiatry's collaborations with industry. His efforts also got a boost with the signing of the health care overhaul legislation which requires drugmakers and others to file annual reports to the government on their financial ties to doctors. The law requires reporting of gifts, entertainment, food, research money and other fees and grants. Consumer advocates applaud the "sunshine" provision because it also requires a database the public can search for their own doctors' ties to industry.

Ruling Strikes Down Georgia's Cap On Malpractice Awards
The Georgia Supreme Court has ruled that the state legislature may not limit the amount of money that juries award to victims of medical malpractice. The ruling struck down a 2005 state law, championed by state Republicans, that capped jury awards at $350,000 for the pain and suffering of malpractice victims. The court held that the cap improperly removed a jury's fundamental role to determine the damages in a civil case. The ruling was praised by victims' rights groups and plaintiffs' lawyers and was condemned by doctors and Republican lawmakers. Thirty states have placed caps on jury awards in malpractice cases; however, since the late 1980s, such caps have been struck down by many courts.

Friends and Patients Come to Doctor's Defense
Though she's an outpatient psychotherapist and he's a veteran family doctor, friends and patients are describing a Lancaster couple foremost as friends who were deeply hurt by the death of their son. Tragedy struck the couple in 2008 when their 14-year-old son died unexpectedly while recovering from knee surgery. A few months later, the husband acknowledged that he gave his son pain-killing medication he'd originally prescribed for someone else. Friends contend that the physician has been unfairly maligned for engaging in what they says is a widespread medical custom that few know is illegal.

Stanford Medical School to Expand Ethics Rules
The Stanford University School of Medicine plans to introduce new rules that would prohibit its volunteer teaching staff - called adjunct faculty - from giving paid speeches drafted by the makers of drugs or medical devices. Stanford already has one of the most comprehensive policies in the country governing the interactions between academic faculty and the medical industry. The policy, enacted in 2006, is intended to limit potential industry influence on day-to-day clinical practice and medical education. The policy prohibits faculty members from participating in industry speakers' bureaus in which drug and medical device makers pay a physician to give company-prepared speeches to doctors about company medical products. It also prohibits Stanford faculty members from accepting free gifts, including drug samples for patients. Soon the 660 community physicians who volunteer their time to teach at Stanford will also have to abide by the same policy - or give up their Stanford titles.

Unusual Damages Set in Philadelphia Bedsores Case
In a highly unusual step for such a case, a Philadelphia jury leveled $5 million in punitive damages against a hospital and a nursing home in the death of a man who developed ultimately fatal bedsores while at both facilities. The damages - $1.5 million against the hospital and $3.5 million against the nursing home - came almost immediately after the same jury awarded $1 million in compensatory damages in the case. The damages were awarded to the man's widow. While compensatory damages are not unexpected in such cases, punitive damages are. The man went into the hospital in 2006 after suffering weakness and confusion. he was 74 at the time and was thought to have suffered a stroke. Doctors then failed to properly diagnose a urinary-tract infection that, as a result, worsened and left him susceptible to the bedsores that ultimately killed him. After a week in the hospital, he was transferred to the nursing home, where he stayed two weeks until his condition worsened and he was returned to the hospital. He was released to his home after three days. Workers at both hospitals allowed the bedsores to fester as their patient became malnourished to the point that he lost 28 pounds. After he returned home, he was cared for by his wife until he died from the bedsores two years later.

Jury Awards Plaintiffs More Than $700,000 Against Area Doctor
A Pennsylvania jury has found against a physician in a civil lawsuit, awarding the plaintiffs $724,932. The jury found in favor of two plaintiffs, who both filed suit against the doctor in 2006 for an incident that occurred in 2002. One plaintiff claimed she was a patient of the doctor's who recommended she undergo a hysterectomy, anterior and posterior repair for the "discomfort caused by her symptoms, bleeding, pressure, constipation, urinary incontinence, dyspareunia..." The plaintiffs contended in their lawsuit that she did not have those conditions. In 2002, she underwent the total hysterectomy, and during the surgery, the doctor removed her left ureter. "The negligent, reckless or otherwise tortious conduct of the defendant" included failing to adequately diagnose, failing to take his patient's past history into account, misrepresenting her symptoms to justify unnecessary surgery and performing unnecessary surgery. The plaintiff claimed injuries that included pain, incontinence, depression and anxiety. She suffered and continues to suffer a number of problems due to the operation, which left her unable to perform certain daily activities.

When is the Worst Time to Go to the Hospital?
Analyzing the records of almost 40 hospitals and nearly 175,000 patients, researchers at the University of Michigan found that four factors - high hospital occupancy, weekend admissions, nurse staffing levels and the seasonal flu - can affect a patient's risk of dying in the hospital. But while those factors universally influence in-hospital mortality, they can also interact with one another in such a way that each hospital ends up with its own particular threshold of risk. The key is identifying not some universal cutoff point, but an individual hospital's limits.

V.A. Fined Over Errors in Radiation at Hospital
The Nuclear Regulatory Commission has announced its second-largest fine ever against a medical institution - $227,500 - after finding that the veterans hospital in Philadelphia had caused an "unprecedented number" of radiation errors in treating prostate cancer patients. NRC fines for medical errors involving radiation rarely exceed several thousand dollars, but commission officials said the size of the fine was justified by the magnitude of the failure at the hospital. Federal investigators said the hospital made significant errors, misplacing radioactive seeds, in 97 of 116 procedures involving patients with prostate cancer from 2002 to 2008. The fine was levied against the hospital's parent agency, the Department of Veterans Affairs. According to the commission, the veterans agency has been reluctant to acknowledge all the errors. While it initially concurred with the commission's findings, it has since changed its position, disputing both the nuclear agency's definition of a medical error and the number of mistakes at the Philadelphia hospital.

Dentist Used Paper Clips in Root Canals
A former Massachusetts dentist is accused of putting paper clips in patients' mouths during root canals, then billing Medicaid for the stainless steel posts he should have used. A grand jury has indicted the dentist on charges that include assault and battery, larceny, submitting false claims to Medicaid, and illegally prescribing drugs. Prosecutors say he was suspended by Medicaid in 2002 for allegedly hiring other dentists for his clinic and filing claims under their numbers for two years. He's also accused of illegally prescribing drugs to staffers who returned medications to him.

Georgia Court Upholds Key Medical Malpractice Law
A sharply divided Georgia Supreme Court has upheld a key part of a sweeping 2005 law that made it more difficult for patients to win medical malpractice cases involving emergency health care providers. The court's 4-3 ruling was a blow to plaintiffs' attorneys and other critics of the legislation who argued the higher standard of proof required by the law made it almost impossible for patients injured by emergency room workers to win malpractice claims. Critics of the law took another hit when the court released a separate ruling, this one by a 5-2 vote, that upheld a provision that allowed one side in a lawsuit to pay the other side's legal fees in some cases. They had argued the practice could discourage many victims from bringing legitimate claims to court. The court will likely issue a third ruling on a lawsuit that challenges the law's $350,000 limit on jury awards for malpractice victims' pain and suffering damages.

Woman Sues Doctor Over Botched Boob Job
An Ohio woman claims in a lawsuit that a Pennsylvania plastic surgeon used the wrong kind of breast implants on her and then kept her knocked out longer than necessary and continued with the botched operation on the advice of her fiance. She is seeking more than $300,000 in damages to have the surgery corrected and for physical and emotional discomfort. She contends she decided on silicone implants because her doctor told her they were more durable and less likely to ripple or deflate than saline. However, the doctor's office only had saline implants available at the time of the surgery, the lawsuit says. She claims she was then left under anesthesia for at least two hours as the doctor tried to "unravel this mistake." She claims the doctor kept her under while she told her fiance about the mistake. Under pressure to provide an immediate response, he told her to go ahead, even though her treatment plan didn't empower him to make such decisions. The lawsuit accuses the doctor of medical battery, medical malpractice, intentional infliction of emotional distress and false imprisonment for allegedly keeping her unconscious longer than necessary while trying to resolve the problem. The doctor allegedly refunded $1,050 to the woman, apologized and tried to persuade her that saline implants were a superior option.

Diabetes Heart Treatments May Cause Harm
Three aggressive treatment strategies doctors had expected would prevent heart attacks among people with Type 2 diabetes and some who are on the verge of developing it have proved to be ineffective or even harmful, new studies show. The results are surprising and disappointing, heart and diabetes experts say. An estimated 21 million Americans have Type 2 diabetes, the kind once known as adult-onset, and they are at enormous risk for heart disease. The only measure proved to reduce their chances - avoiding cigarettes and taking medication to lower bad cholesterol and blood pressure - still leave diabetics with a heart attack risk equivalent to that of a nondiabetic who has already had a heart attack. So doctors began trying other strategies they hoped would help: getting blood pressure to a normal range; raising levels of good cholesterol and lowering levels of dangerous triglycerides; or modulating sharp upswings in blood sugar after a meal. It is not known how many doctors have been encouraging patients to take these measures, but medical specialists say it seemed reasonable and tempting to do so.

Manslaughter Convict Worked as Nurse at Hospital After Lying On Application
A 44-year-old Pennsylvania man who killed his former lover by lethal injection worked three years at a Lehigh Valley hospital and even obtained a Pennsylvania nursing degree before the hospital caught on to his 14-year-old conviction. All the while, he hid the fact that a jury in North Carolina had convicted him in 1994 of involuntary manslaughter. He served about two years in prison. At the time of his conviction, he was a fourth-year medical student at the University of North Carolina. He injected a man with a lethal cocktail of medications in 1992 after being rejected by him in favor of another man. The hospital hired him in 2005 as a data entry clerk and later as a registered nurse. The hospital claims he lied about his criminal history on his employment application.

Americans Overtested and Overtreated, Experts Say
Too much cancer screening, too many heart tests, too many caesarean sections. A spate of recent reports suggest that too many Americans are being overtreated. Is it doctors practicing defensive medicine? Or are patients so accustomed to a culture of medical technology that they insist on extensive tests and treatments? A combination of both is at work, but now new evidence and guidelines are recommending a step back and more thorough doctor-patient conversations about risks and benefits. Experts dispute how much routine cancer screening saves lives. It also sometimes detects cancers that are too slow-growing to cause harm, or has false-positive results leading to invasive but needless procedures - and some risks. Treatment of prostate cancer that may be too slow-growing to be life-threatening can mean incontinence and impotence. Angiograms carry a slight risk for stroke or heart attack.

Jury Awards $95 Million in Damages to Plaintiffs Alleging Nurse Killed Their Loved Ones
A civil jury of seven women and five men awarded $95 million the decedents of eight people a serial killer nurse allegedly murdered from 2000 to 2002 while working at a Pennsylvania hospital. It was the first civil judgement against the nurse, who admitted to killing 29 people and attempting to kill six others by administering lethal doses of medication during a 16-year career at hospitals across Pennsylvania and New Jersey. The nurse, who did not participate in the civil trial, is serving a life sentence and has no tangible assets with which to pay such a monumental verdict. Compelling the nurse to pay may not have been the point of the civil trial. A lawyer for the plaintiffs told the jury that the monetary damages meant more than money; he wanted the jury's award to resonate.

Learning to keep Patients Safe in a  Culture of Fear
Over the last decade, hospitals have increasingly made patient safety a priority. Incorporating the lessons learned in high-risk industries like aviation and nuclear energy, medical centers across the county have begun promoting protocols, procedures and checklists to prevent healthcare errors. Chief among these initiatives has been a push for greater disclosure and transparency - and less far. A recent study indicates that current doctors-in-training may still be hesitant to document errors. The Joint Commission Journal on Quality and Patient Safety recently reported that the majority of residents have never written up an incident report. According to another study from a committee of leading experts in medical education and health care, young doctors are still going out into practice with little education or training in patient safety. Changing a healthcare culture that undermines some of the most important principles of error reduction - trust, teamwork and communication - has proved to be much more difficult than a safety checklist would lead one to assume.

Too Mangy Patients Get Invasive Heart Tests
A troublingly high number of U.S. patients who are given angiograms to check for heart disease turn out not to have a significant problem, according to the latest study to suggest Americans get an excess of medical tests. The researchers said the findings suggest doctors must do better in determining which patients should be subjected to the costs and risks of an angiogram. The test carries a small but real risk - less than 1 percent - of causing a stoke or heart attack, and also entails radiation exposure. Every year in the United States, more than a million people get an angiogram, in which a thin tube is inserted in the arm or groin and threaded up to the heart to check for blocked arteries that could lead to a heart attack. Dye is injected through the tube to make blockages show up on X-rays. Angiograms are often given to patients who might be having a heart attack or have symptoms that suggest a serious blockage. They are also sometimes done on people who may have some less clear-cut symptoms, like shortness of breath, or no symptoms but some risky traits like high cholesterol and an abnormal result on another heart test. This group accounts for about 20 to 30 percent of angiogram cases. In the study, nearly two-thirds of the patients in this second group were found to have no serious blockages. Though researchers could not establish why so few proved to have heart disease, some think the problem arises because doctors are afraid of missing something and getting sued.

Panel Urges New Look at Caesarean Guidelines
A panel of medical experts has recommended steps to reverse a trend that has dismayed many pregnant women: the increasing difficulty of finding doctors and hospitals that will let a woman try to give birth normally if she has had a Caesarean section in the past. The new recommendations came at a conference held by the National Institutes of Health to examine why the rate of vaginal birth after Caesarean, or VBAC, has plummeted to less than 10 percent from 28.3 percent in 1996. The repeat operations are feeding the nation's overall Caesarean rate of 31.8 percent, which has been rising steadily for the last 11 years. In the past, the rule was "once a Caesarean, always a Caesarean" because of fears that the scar on the uterus would rupture during labor, which can be life-threatening for both the woman and the child. The thinking changed gradually as it became clear that women could safely have normal births after Caesarean, and an expert panel in 1980 declared vaginal birth safe for many women who had Caesareans. The panel urged two medical groups to "reassess" guidelines that are widely believed to have had a chilling effect on doctors' and hospitals' willingness to allow vaginal birth after Caesarean. The guidelines require that surgical and anesthesia teams be "immediately available" during labor if a woman has had a prior Caesarean.

Web Searches for Doctors Complicated by Conjecture and Misleading Information
Web-savvy patients might be tempted to check out the myriad sites rating physicians, but for the present, say experts, don't. Many sites are well-intentioned but lack the response numbers to be accurate reflections. Others can be downright misleading. Doctors and health care professionals say it's best to take such ratings with a prescription-strength grain of salt. A 2009 poll estimates that 67 percent of American adults report looking for medical information online. The types of physician ratings sites vary. Some were established by physicians and provide a forum for patient feedback. Others will provide you with bare-bones information but will promise more in-depth information for a price. A phone call or Web visit to your state medical board will generally yield the same information for free.

Senate Panel to Investigate Deaths at Long-Term Care Facilities
The Senate Finance Committee has opened an investigation into patient deaths and allegations of substandard treatment at long-term care hospitals, small specialty medical centers that treat chronically ill patients. The investigation focuses on the Select Medical Corporation, a for-profit corporation that runs 89 long-term care hospitals, more than any other company. Senators have demanded that Select provide records about staffing levels and quality at its hospitals. Recent articles have detailed poor treatment and patient deaths at long-term care hospitals, which treat 200,000 seriously ill patients a year nationwide, but rarely have full-time physicians on staff. In one incident at a Select hospital in Kansas, a dying patient's heart alarm sounded for 77 minutes before nurses responded. Select has said that it conducted an appropriate clinical review in the case and terminated a clinician involved in the patient's care. The articles prompted the investigation, which Select claims it will cooperate with fully. The senators have asked Select to disclose its policies for patient monitoring, emergency situations and staffing, including physician involvement at its hospitals and staff turnover. Former employees of Select have said that the company's hospitals are understaffed and rely heavily on temporary nurses. The senators also requested the Select disclose information about its discharge policies. Former employees allege that the company presses to keep patients for 25 days and then discharge them almost immediately, because patients are most profitable if they stay exactly 25 days under government reimbursement rules. At some Select hospitals, the 25th day is called the "magic day," ex-employees say.

State's Malpractice Data Offer Ammo for Both Sides
In 2008, the latest year for which statistics are available, 1,602 medical malpractice lawsuits were filed in Pennsylvania, a drop of nearly 40 percent since 2000. The decline began after the state passed reforms intended to weed out frivolous lawsuits in 2002. These included obtaining a certificate of merit form a medical professional before filing a case, and a ban on "venue shopping" to find sympathetic juries. The peak occurred in 2002, when 2,904 suits were filed. Much of the surge was attributed to lawyers rushing to file cases before the new law took affect. Doctors and lawyers disagree over the significance of the deadline. Some argue that threats of frivolous lawsuits and large verdicts remain, continuing to spur defensive medicine and making Pennsylvania less hospitable for doctors than states that cap malpractice awards. Others argue that the new rules further stack the deck against patients, forcing lawyers to turn away many legitimate cases.

Childbirth Deaths in U.S. Rare But Too Frequent
Pregnancy-related deaths appear to have risen nationwide over the past decade, nearly tripling in the state with the most careful count - California. And while they're very rare - about 550 a year out of 4 million births nationally - they're nowhere near as rare as they should be. The maternal mortality rate is four times higher than a goal the federal government set for this year. Maternal mortality gets little public attention in the U.S., aside from last year's worry over the swine flu that killed at least 28 pregnant women. Among the leading preventable causes are hemorrhage, DVT-caused pulmonary emboli and uncontrolled blood pressure. It's not clear what's fueling the overall increase, although better counting is playing some role. Some suspects are a jump in cesarean deliveries that now account for almost a third of births. One in five pregnant women is obese, spurring high blood pressure and diabetes. More women are having babies in their late 30s and beyond.

Jury Awards Woman $2 Million in Verdict Against Hospital
A Northampton County jury has awarded a woman $2 million in a medical malpractice lawsuit against a hospital after knee-replacement surgery led to the amputation of her left leg. The jury found an orthopedic specialist not negligent in a two-week trial but found the hospital 40 percent negligent and a former nurse, who oversaw the patient, 60 percent negligent for not alerting the doctor to her deteriorating condition. Another nurse named in the lawsuit settled before the trial. The plaintiff was admitted in 2005 for a replacement of her arthritic left knee. The next day, after her surgery, she complained of numbness in her foot and an inability to move it. The surgeon was called in and suggested that the medical dressing was too tight. Nine experts testified during the trial that the plaintiff was suffering from a vascular problem and not enough blood was getting to her foot. Later that day, a rehabilitation doctor was consulted and found her leg white, cool to the touch and without feeling. Emergency surgery later that day revealed an undiagnosed blood clot. Following a bypass surgery and a month of care, gangrene set in and the surgeon had to amputate her leg below the knee. Later she had to have more of the leg removed, this time above the knee.

Sanctions Against State Sought in Hospital Lawsuit
Attorneys for the family of a woman who died atop a Pittsburgh hospital urged a judge to impose sanctions against the state Health Department for refusing to turn over inspection records. The attorney for the family said the department is withholding 11 sets of records. The attorney general's office argued that federal regulations bar release of the records, which include notes of state inspectors taken just after the incident. The 89-year-old woman died in the winter of 2008 when she wandered from her hospital room to the roof and died of hypothermia. The family is suing the hospital for wrongful death.

68 Fatal Overdoses Linked to Kansas Clinic
A new federal indictment implicates a Kansas doctor and his wife in nine additional patient deaths, bringing to 68 the number of fatal overdoses the government contends are linked to illegal prescription writing and a moneymaking conspiracy at their clinic. The doctor and his wife, who is a nurse, and unnamed others are accused of scheming to illegally dispense prescription drugs and defraud health insurance programs and patients through their clinic. They also are accused of money laundering. The couple is directly charged with contributing to 21 deaths. The indictment paints a chaotic picture of the couple's clinic, saying medical records often were missing or incomplete, patients were given prescription refills after previously overdosing on the same drugs and inexperienced physician assistants received little supervision. Prosecutors also allege the doctor left blank pads of signed prescriptions and accuse his wife of forging her husband's signature on some scripts. The couple was arrested in 2007 on charges they unlawfully prescribed drugs, overbilled for medical services and committed money laundering. The government alleges that from 2002 through 2007, patients who died of drug overdoses accounted for 18 percent of all such deaths in the county and surrounding areas. The new indictment also includes three deaths that occurred while the couple was imprisoned.

Possible Prostate Case Error at Philadelphia Hospital
The Hospital of the University of Pennsylvania reported a possible radiation error involving the treatment of a man for prostate cancer. The patient underwent a prostate brachytherapy procedure to implant 65 radioactive seeds to kill cancer cells in the acorn-size gland. When he returned for a follow-up scan a month later, doctors saw that the seeds were "outside the intended target." The incident seems to echo some of the problems at the Penn-run brachytherapy program at the Philadelphia VA Medical Center. From 2002 to 2008, 97 veterans got incorrect radiation doses. The incident at Penn was reported to the state Department of Environmental Protection, which oversees the medical use of radioactive materials in Pennsylvania for the U.S. Nuclear Regulatory Commission. The report noted that the incident may have been caused by a malfunction in a new ultrasound unit, which guides the needles used to place the radioactive seeds.

Hospital Sued Over Failure to Admit Patient
The Hospital of the University of Pennsylvania has been sued in federal court for allegedly refusing to accept a patient because he lacked health insurance. The lawsuit claims Penn initially said it would accept the transfer of a man from another hospital for emergency surgery to treat a tear in a major artery. Penn then refused after learning he had no health insurance. The suit also named a Penn cardiothoracic surgeon and its emergency room doctor on the case. It alleged that the surgeon failed to properly diagnose the man's condition and did not transfer him to a hospital capable of dealing with his problem soon enough. A nurse's note in the man's records stated that Penn "refused to accept patient due to no medical insurance." The man was eventually transferred to a hospital in Delaware. He now suffers brain damage and is blind as a result of the lack of timely care and the delay in getting him treatment caused by Penn's about-face. Penn initially billed the man $297, but waived those charges after his lawyers contacted the hospital. According to the suit, "the 'reverse dumping' section of EMTALA states that 'a participating hospital that has specialized capabilities or facilities...shall not refuse to accept an appropriate transfer of an individual who requires such specialized capabilities of facilities if the hospital has the capacity to treat the individual." The statue was enacted in 1986 to protect public access to emergency medical services regardless of the ability to pay. The act requires hospitals that participate in Medicare to provide stabilizing treatment and transfer the patient to a hospital with the capabilities to treat the problem.

Serial Killer Nurse's Civil Trial to Begin Soon
Jury selection is expected to begin for a civil trial in which eight families are suing a serial-killer nurse for wrongful death and other damages, court records say. The jury will determine what amount, if any, he owes to the family suing him. The nurse preyed on critically ill patients in Pennsylvania and New Jersey hospitals during a 16-year nursing career. He pleaded guilty to 29 murders and is serving life sentences in New Jersey for those crimes. A hospital was initially named as a defendant in the lawsuits, but a judge dismissed the claims because an expert witness could not conclude with certainty the patients were killed by the nurse. In his opinion, the judge cited the nurse has neither admitted to killing any of the people in these cases, nor has he specifically denied the allegations. The nurse has not responded to the complaints brought against him and has declined to be interviewed as part of a court-ordered deposition.

Killing Prompts Review of Mental Health Services
The torture and slaying of a western Pennsylvania woman has triggered a top-to-bottom review of the mental health system that the victim and at least three of her alleged killer navigated. Mental health officials said they will comb records from the months and years preceding the slaying for clues about whether the system failed and how it could have protected her. The woman, who family members said was mentally challenged, was beaten, stabbed and forced to drink urine and other substances before she was wrapped in Christmas lights and stuffed in a residential trash can. Police say her friends turned on her, taunting and torturing her for more than 33 hours, stabbing and beating her. The mental health system has emerged as a common thread linking the victim to the suspects. They all apparently used the same mental health and social services during the same time.

Two Medical Aides at Philadelphia Abortion Clinic Aren't Doctors - As Advertised
State authorities who attempted to verify the licenses of two people listed as medical doctors at a West Philadelphia abortion clinic soon found that neither is licensed to practice in the state. The clinic's owner and administrator has come under harsh scrutiny after his clinic was linked to the deaths of two women who received abortions there. One woman died after she was heavily medicated by an allegedly unlicensed employee before an abortion last year. Since state investigators suspended the doctor's license and labeled his clinic "deplorable," numerous women have come forward with tales of botched abortions and severe injuries that they claim they suffered at his hands. One woman claims the doctor left the arm and leg of a fetus inside her after he performed an abortion on her in 1999. She later sued the doctor and was awarded $5,000 in 20003. In all, 46 civil lawsuits have been filed over the years against the doctor, although not all have been related to medical malpractice.

At Hearing On Radiation, Calls for Better Oversight
A dozen witnesses, including representatives of virtually all of the leading professional groups in medical radiation, told a House subcommittee that more needed to be done to make sure that radiation continues to help, not harm, patients. The call for a more standardized, comprehensive method of overseeing medical radiation, both diagnostic and therapeutic, came from radiation oncologists, radiologists, therapists, researchers, medical physicists and equipment manufacturers. Saying that recent news reports about radiation accidents had "raised huge concerns for me," Frank Pallone, Jr., the New Jersey Democrat who is the chairman of the Energy and Commerce subcommittee on health, said he was shocked that the people who operate radiological devices need not be licensed in many states and that "the requirements to report errors and the penalties for making errors are basically nonexistent or not enforced." A man also described his son's death from a radiation overdose at a New York City hospital. His son's minimally invasive radiation treatments for tongue cancer quickly turned into a nightmare when his son became blind and deaf and had constant pain and vomiting.

Surgery Technician in Hepatitis Case Gets 30 Years
A 27-year-old Colorado surgery technician who infected three dozen people with hepatitis C has been sentenced to 30 years in prison. She received the sentence in federal court in Denver after pleading guilty to some of the charges in the case. Prosecutors had previously recommended that she get 20 years in prison, but a judge rejected the plea agreement. Some of the victims said it was not enough time. She had worked at two medical centers in Colorado, where she infected patients after she injected herself with painkiller-filled syringes and replaced them with ones filled with saline.

Catholic Directive May Thwart End-of-Life Wishes
An elderly woman taken last year to an Oklahoma medical center had suffered a massive stroke and could no longer speak, eat or drink. Although she had an advance directive specifying no artificial hydration or nutrition if she weren't going to recover, local health officials said, her nephew insisted the local bishop's directive on use of feeding tubes required the Catholic hospital to install one. Her doctors debated how to proceed, struggling with ethically charged issues that hundreds of Catholic hospitals and nursing homes could face under new doctrine. Last year, the U.S. Conference of Catholic Bishops approved a revised ethical and religious directive similar to that of the Oklahoma bishop. It states in part that Catholic health facilities have "an obligation to provide patients with food and water, including medically assisted nutrition and hydration for those who cannot take food orally." The bishops wrote that "this obligation extends to patients in chronic and presumably irreversible conditions," such as persistent vegetative state, who might live for many years if given such care. A feeding tube is not required, however, if it wouldn't prolong life, would be "excessively burdensome for the patient," or would "cause significant physical discomfort." The directive raises fresh questions about the ability of patients to have their end-of-life treatment wishes honored - and whether and how a health care provider should comply with lawful requests not consistent with provider's religious views. Hospitals and nursing homes do not have to comply with requests that are "contrary to Catholic moral teaching," according to longstanding policy that, as in the case of the revised directive, applies to non-Catholic patients as well. If a patient or family didn't want a feeding tube "and the reason they don't want it is they basically want to die, then the Catholic institution would explain to them they can't cooperate with that and they would have to go to another institution."

1 in 4 States Cut Back On Mammograms
A survey has found that some U.S. states have begun using controversial new breast cancer screening guidelines to stop offering routine mammograms for uninsured women in their 40s. The survey of more than 150 breast cancer health educators and providers from 48 states and Washington, D.C. found a quarter of the states have either cut or eliminated screening mammography and other early detention services for women under 50. The survey renewed concerns that the guidelines from the U.S. Preventive Services Task Force, which raised the recommended age for women to start getting screened for breast cancer to 50, might be used to deny health coverage for women. Issued last year, the guidelines sparked an outcry from cancer doctors and advocacy groups who said the changes would mean more women would die from breast cancer, and from lawmakers who said they could be used to ration healthcare.

Philadelphia Doctor's License Suspended Amid Abortion Concerns
State authorities have suspended the medical license of a West Philadelphia doctor whose practice was raided by federal drug agents. The suspension came after a hours-long search of the doctor's practice. The suspension order says the conditions of the clinic were "deplorable and unsanitary," and documented "blood on the floor, and parts of aborted fetuses were displayed in jars." The order calls the doctor's continued practice of medicine "an immediate and clear danger to the public health and safety." The suspension order also alleges that last year, a patient died after being treated at the clinic by an unlicensed employee. The woman was given 10 mg of Demerol and 12.5 mg of promethazine. When the patient began experiencing cramping, she asked for more pain medication, and the doctor told the unlicensed employee to administer it. The woman allegedly was given 75 mg of Demerol, 12.5 mg of premothazine and 10 mg of diazepam, and later more anesthetic in preparation for the abortion. After the abortion, the woman "started to have arrhythmia and then went into V-fib" (ventricular fibrillation). She was taken to an unnamed hospital, where she was pronounced dead.

Report Shows Hospital Infections Killed 48,000
Pneumonia and blood-borne infections caught in U.S. hospitals killed 48,000 patients and cost $8.1 billion in 2006. A recent report is one of the first to put a price tag on the widespread problem, which is worsening and which some experts say is adding to the growing cost of healthcare in the United States. Sepsis - a blood infection - killed 20 percent of patients who developed it after surgery. Researchers studied hospital discharge records from 69 million patients at hospitals in 40 U.S. states between 1998 and 2006, looking for two diagnoses - hospital-acquired pneumonia and sepsis. Patients who developed sepsis after surgery had to stay in the hospital on average nearly 11 days extra, at a cost of $32,900 per patient, they found. Just under 20 percent of them died. Pneumonia patients stayed an extra 14 days after surgery, at a cost of $46,400 and more than 11 percent of them died.

Massachusetts Doctor Pleads Guilty to Faking Research
A doctor accused of faking research for a dozen years in published studies that suggested after-surgery benefits from painkillers including Vioxx and Celebrex pleaded guilty to one count of federal healthcare fraud. The anesthesiologist will have to repay $361,932 in research grants and forfeit assets worth at least $50,000 as penalty for his conduct following a plea hearing. Prosecutors alleged the former chief of acute pain sought and received research grants from pharmaceutical companies but never performed the studies. They said he fabricated patient data and submitted information to anesthesiology journals that unwittingly published it. He took leave last year after a routine review found that some of his research was not approved by an internal hospital review board. Further investigation found 21 papers published in anesthesiology journals between 1996 and 2008 in which he made up some or all of the data.

Doctor Training Aided by Drug Industry Cash
More than half of the nation's medical residency programs to train doctors in internal medicine accepted financial support from the drug industry, even though three-fourths of the programs' directors said accepting the aid was "not desirable," a survey found. At issue are potential conflicts of interest as the residency programs accept drug company support to help train tens of thousands of new doctors at a point in their careers when they are beginning to prescribe drugs. The survey, conducted in 2006 and 2007, found that drug companies paid for educational materials like pocket guides in 83 percent of the programs that accepted support, meals in 90 percent, office supplies in 68 percent and drug samples in 57 percent. Medical residency programs in the southern United States were much more likely to accept the industry largess than those in the Northeast - 72 percent to 47 percent. The overall rate of accepting drug industry financing was 55 percent, but that was down from the 88 percent level reported in a 1990 survey.

Wrongful Death Suit Filed Against Western Pennsylvania Hospital
A Fayette County woman has filed a wrongful death lawsuit against Uniontown Hospital, alleging its emergency room misdiagnosed a heart condition that resulted in her mother's death. In the lawsuit, she indicates that her mother died of a myocardial infarction in May, five days after she visited the hospital's emergency room with chest pain. She alleges that the hospital discharged her mother from its emergency department, despite having conducted a diagnostic test that found irregularities with her heart. The test, an ECG, was conducted after she complained of chest pain that radiated to her left arm and shortness of breath. The lawsuit alleges the hospital knew she had risk factors for heart disease that included smoking and the death of her mother from a heart attack at a young age. Instead of admitting her for more tests, the lawsuit alleges the hospital discharged her from the emergency room with a diagnosis of non-cardiac chest pain.

Foot-Long Surgical Tool Left Inside Czech Patient
It took five long months for a Czech woman to discover the reason for her pain: Doctors had left a foot-long medical tool inside her abdomen. Doctors at a clinic in the southeastern town of Ivancice discovered their colleagues had forgotten to remove a spatula-like surgical instrument from the woman following a gynecological surgery earlier this year. The head of the clinic blamed "a series of individual failures" and said four employees had been punished. The woman, who complained repeatedly to her doctors about the pain, plans to sue.

Doctor-Patient Divide On Mammograms
Confusion reigned last year after the United States Preventive Services Task Force changed its recommendations on mammography, suggesting that most women start routine scans at age 50 rather than 40 and reduce the frequency to every two years, from once a year. Some women were relieved; others were angry and worried that insurers would cut back on coverage for screening. Now, an editorial in the Annals of Internal Medicine, the medical journal that first published the new guidelines, suggests that a divide has emerged between doctors and patients - with the doctors more inclined to accept the new recommendations and the patients wanting to stick to early and annual screening. The editorial was based on responses from patients, doctors and other health care workers to the journal's request for online comments on the new guidelines. Most of the 345 doctors who responded said they would stop offering routine mammograms to women in their 40s, and most said they would advise women 50 to 74 to have mammograms only every other year. By contrast, most of the 241 patients who responded said they did not believe in giving up routine mammograms in one's 40s - even if the doctor recommended a change - and were not likely to switch to an every-other-year routine.

Results Unproven, Robotic Surgery Wins Converts
On one level, robot-assisted surgery makes sense - a robot's slender arms can reach places human hands cannot, and robot-assisted surgery is spreading to other areas of medicine. But robot-assisted prostate surgery costs more - about $1,500 to $2,000 more per patient. And it is not clear whether its outcomes are better, worse or the same. One large national study, which compared outcomes among Medicare patients, indicated that surgery with a robot might lead to fewer in-hospital complications, but that it might also lead to more impotence and incontinence. But the study included conventional laparoscopy patients among the ones who had robot-assisted surgery, making it difficult to assess its conclusions. It is also not known whether robot-assisted prostate surgery gives better, worse or equivalent long-term cancer control than the traditional methods, either with a four-inch incision or with smaller incisions and a laparoscope. And researchers know of no large studies planned or under way.

Hospital Type May Play Role in Decision On Feeding Tubes
When nursing home residents with advanced dementia are sent to the hospital, many are given feeding tubes, even though the practice is not believed to help them live longer. Now a new study finds that it is much more prevalent at some hospitals than others. The study analyzed more than a quarter of a million admissions of nursing home residents to thousands of hospitals from 2000 to 2007. Some hospitals inserted feeding tubes in as few as one of every 100 patients with advanced dementia, others in as many as one of three. Large hospitals and for-profit hospitals were more likely than others to insert the tubes, as were hospitals deemed aggressive about providing end-of-life care. The findings suggest that such decisions are more likely to be based on hospital practices than on the wishes of patients and their families.

Big Changes Proposed in Psychiatric Diagnoses
The American Psychiatric Association is proposing major changes to its diagnostic bible, the manual that doctors, insurers and scientists use in deciding what's officially a mental disorder and what symptoms to treat. In a new twist, it is seeking feedback via the Internet from both psychiatrists and the general public about whether the changes will be helpful before finalizing them. The manual also suggests some new diagnoses. Gambling so far is the lone identified behavioral addiction, but in the new category of learning disabilities are problems with both reading and math. Also new is binge eating, distinct from bulimia because the binge eaters don't purge. Sure to generate debate, the draft also proposes diagnosing people as being at high risk of developing some serious mental disorders - such as dementia or schizophrenia - based on early symptoms, even though there's no way to know who will worsen into full-blown illness. It's a category the psychiatrist group's own leaders say must be used with caution, as scientists don't yet have treatments to lower that risk but also don't want to miss people on the cusp of needing care.

Lawmaker's Death a Reminder of Surgery Risks
Gallbladder surgery is usually a very safe operation, but a powerful congressman's death is a reminder of the known risks. Well over half a million people have their gallbladders removed annually, most of them minimally invasively just as the late Rep. John Murtha of Pennsylvania. Complications are rare, but they include nicking the intestine, liver or bile ducts as doctors struggle to squeeze an inflamed gallbladder through a tiny opening in the abdomen. If an intestine of bile duct is perforated, spotting it quickly can mean the difference between survival or death from massive infection. Moreover, the risk of complications rises with age, and when doctors must remove what they call a "hot gallbladder," one already inflamed or diseased. Murtha, 77, was first hospitalized with gallbladder problems in mid-December and eventually had his gallbladder removed. However, at the end of January, he came to another hospital's emergency room with a fever and infection. He died at the hospital from "major complications from surgery." Sources say Murtha's large intestine was damaged during the gallbladder removal, triggering the infection.

Long-Term Care Hospitals Face Little Scrutiny
More than 400 long-term acute care hospitals have opened nationwide in the last 25 years. Few of them have doctors on staff, and most are owned by for-profit companies. Lawsuits, state inspection reports and statistics deep in federal reports paint a troubling picture of the care offered at many of these hospitals. In 2007 and 2008, one company's hospitals were cited at a rate of almost four times that of regular hospitals for serious violations of Medicare rules. Other long-term care hospitals were cited at a rate about twice that of regular hospitals. Long-term care hospitals also had a higher incidence of bedsores and infections than regular hospitals in 2006, the most recent year for which federal data is available. Unlike other specialized hospitals, long-term hospitals do not treat specific types of patients or offer services unavailable in regular hospitals. They are defined solely by the fact that they keep patients longer than other hospitals. They are also smaller than a typical hospital, averaging about 60 beds. Many patients at hospitals that specialize in long-term care are very sick. While usually in stable condition, they may be on dialysis, need a ventilator or have wounds that will not heal. If patients need surgery or suffer serious medical emergencies, they are usually transferred back to general hospitals.

FDA to Increase Oversight of Medical Radiation
The federal Food and Drug Administration announced it will take steps to more stringently regulate three of the most potent forms of medical radiation, including increasingly popular CT scans, some of which deliver the radiation equivalent of 400 chest X-rays. With the announcement, the FDA puts its regulatory muscle behind a growing movement to make life-saving medical radiation - both diagnostic and therapeutic - safer. Recently, the leading radiation oncology association called for enhanced safety measures, and a congressional committee was set to hear testimony on the weak oversight of medical radiation. The FDA has for weeks been investigating why more than 300 patients in four hospitals were overradiated by powerful CT scans used to detect strokes. The overdoses were first discovered last year at Cedars-Sinai Medical Center in Los Angeles, where patients received up to eight times as much radiation as intended. The errors occurred over 18 months and were detected only after patients lost their hair.

Illinois Supreme Court Uncaps Medical Malpractice Damages Again
The Illinois Supreme Court has once again shot down a state law capping non-monetary damages in medical malpractice lawsuits, finding that such a statute violates the separation of powers between the judicial and legislative branches. The high court said that the limit on non-monetary damages, such as those for pain and suffering, interferes with "the authority of the judicial branch to reduce verdicts." While four justices backed the decision, two concurred in part and dissented in part, and one didn't participate. Health care industry defenders and trial lawyer opponents of the 2005 law squared off in the case, which alleged medical malpractice against a hospital, doctor and nurse involved in the delivery of a brain-damaged baby. The new law would have capped damages in such cases at $1 million against hospitals and their personnel and $500,000 against individual doctors.

Nurse to Stand Trial for Reporting Doctor
When a nurse wrote a letter informing state regulators that a doctor at her hospital was practicing bad medicine, she considered that she might lose her job. Instead, she was indicted and threatened with 10 years in prison for "misuse of official information," a third-degree felony in Texas. The prosecutor in the case claims he can show that she had a history of making "inflammatory" statements about the doctor and intended to damage his reputation when she reported him to the Texas Medical Board. She claims that, as an administrative nurse, she had a professional obligation to protect patients from what she saw as a pattern of improper prescribing and surgical procedures - including a failed skin graft that he performed without surgical privileges. He also sutured a rubber tip to a patient's crushed finger for protection. When the medical board notified the doctor of the anonymous complaint, he protested to his friend, the county sheriff, that he was being harassed. The sheriff obtained a search warrant to seize the two nurses' work computers and found the letter.

Two Accuse Pittsburgh Hospital and Surgeon of Malpractice in Transplant
A California man and his brother have sued a Pittsburgh hospital and its former chief of transplantation over allegations of medical malpractice connected to a liver transplant. One brother served as a live organ donor for the other, who suffered from liver disease. Their lawyer claims that neither the surgeon nor the hospital gave the brothers all of the information concerning the dangers of live liver transplantation. Both men are suffering complications from the surgeries. A local study on liver transplants in the region detailed a higher-than-expected rate of complications in surgeries performed at the hospital that use organs donated by a living person. Another review found that 66 percent of 121 live-donor liver transplant recipients experienced significant complication. The surgeon being sued performed all the surgeries cited in the study.

Medical Group Urges New Rules On Radiation
The leading professional organization dedicated to radiation oncology has called for enhanced safety measures in administering medical radiation, including the establishment of the nation's first central database for the reporting of errors involving linear accelerators - machines that generate radiation - and CT scanners. The American Society for Radiation Oncology's six-point plan aims to improve safety and quality and reduce the chances of medical errors. Even though the group says serious radiation accidents are rare, it says it will work toward a stronger accreditation program, expanded training and an enhanced program to ensure that medical technologies from different manufacturers can safely transfer information. The group began a comprehensive review of existing policies after two articles in The New York Times reported on the harm that can result when powerful and technologically complex machines go awry and when basic safety procedures are not followed.

Executive: Hospital Ignored Policy in Death
A senior executive from Aria Health, owner of the Philadelphia hospital where a man died last year as he waited for emergency treatment, admitted that staff did not follow company policy requiring periodic checks on patients in the waiting room. The official said the hospital had since trained staff to keep better tabs on waiting patients. She also said it had added a second full-time security guard in the 25-seat waiting room where the man's watch was stolen after he died. The official's statements were made during a hearing with Philadelphia City Council, the first public forum devoted to the incident when a 63-year-old man walked into the waiting room at the hospital. Security video showed that the man died 11 minutes after he arrived, complaining of pain in his left side. A triage nurse first called his name 14 minutes after he arrived, though an earlier investigation suggests his name was called after 18 minutes. For someone with nontrauma chest pain, an EKG is recommended within 10 minutes, and the man was not examined until nearly 50 minutes after he had slumped in his chair.

Late Steeler Player's Family Sues Hospital and Doctors
The family of the late Pittsburgh Steelers star Dwight White has filed a malpractice and wrongful death lawsuit against a Pittsburgh hospital and its top neurosurgeon. In the complaint, his widow and his daughter charged that doctors and other staff failed to properly diagnose and treat the player when he suffered a pulmonary embolism after routine back surgery. The player underwent surgery for a herniated disc in 2008 and was discharged the next day, but the suit alleges that steps could have prevented his death had been delayed or omitted. Soon after he returned home, "his symptoms and weakness progressed to where he was essentially bedridden." Attempts to reach his doctor failed because he was out of town. Other doctors only prescribed over-the-counter medications and laxatives. After a few months, he was taken back to the hospital, where he was diagnosed with a pulmonary embolism, which his family alleges was "eminently treatable as long as he received proper care." His wife and daughter claim that physicians prescribed a blood thinning agent, but failed to monitor its effects in violation of the hospital's own protocols. The complaint alleges that his condition worsened and efforts to save his life through surgery failed.

Doctor Pleads Guilty to Bilking $8 Million from Patients and Insurers
A former Lancaster County doctor has pleaded guilty in federal court to bilking patients and insurance companies out of $8 million. Under a proposed plea agreement, the physician is facing eight years in federal prison. He was also ordered to pay $7.1 million in restitution to Medicaid and several insurance companies under the proposed plea agreement. So far, he has paid nearly $1 million. Authorities discovered that the doctor was submitting bills to insurance companies for work he was not performing. From 2003 to early last year, the doctor participated in a scheme to defraud public and private insurance companies.

FDA Aims at Doctors' Drug Pitches
The FDA recently sent a warning letter to a well-known dermatologist and clinical researcher, citing the doctor for expressing premature enthusiasm in the media about Dysport, an injectable antiwrinkle drug the agency had not yet approved. Her comments in the media in 2007 violated restrictions on drug promotion, and the agency asked the doctor to explain how she intended to prevent similar violations in the future. Under the Obama administration, the FDA has stepped up scrutiny of drug advertising, dispatching many warning letters about misleading commercials and online marketing efforts, but this is believed to be the first time the agency has warned an individual investigator - a medical researcher who oversees a clinical trial - for apparently promoting an unapproved drug. The doctor is far from the only cosmetic doctor to have jumped the gun. Some talk show hosts and beauty editors have often turned to clinical investigators for news of the latest cosmetic medical treatments. Now, some industry experts say the FDA warning may curb the media enthusiasm of certain cosmetic doctors who until now have provided scoops about coming medical products - or have talked up the latest unapproved cosmetic uses for drugs and devices that the agency had approved only for other purposes.

Doctor Cleared in Malpractice Lawsuit
A jury has ruled that a Luzerne County man should not receive any money from a doctor he allegedly had committed malpractice in 2002. The man received nothing from the jurors who deliberated less than an hour before deciding that the doctor, an emergency room physician, was not responsible for his contracting osteomyelitis, a bone infection, in his left thumb. The doctors saw the man in 2002 in the emergency room of a local hospital after the man's thumb had been bitten. The doctor prescribed antibiotics and instructed the man to see a specialist. However, the man claimed he could not afford the antibiotics and that the doctor had not told him that delaying his surgery would matter. Months later, the man went to another emergency room when the bone of his thumb started protruding.

As Technology Surges, Radiation Safeguards Lag
In New Jersey, 36 cancer patients at a veterans hospital were overradiated - and 20 more received substandard treatment - by a medical team that lacked experience in using a machine that generated high-powered beams of radiation. The mistakes, which have not been publicly reported, continued for months because the hospital had no system in place to catch the errors. In Louisiana, a man received 38 straight overdoses of radiation, each nearly twice the prescribed amount, while undergoing treatment for prostate cancer. He was treated with a machine so new that the hospital made a miscalculation even with training instructors still on site. In Texas, a man now wears two external bags - one for urine and one for fecal matter - because of severe radiation injuries he suffered after a medical physicist who said he was overworked failed to detect a mistake. The overdose was never reported to the authorities because rules did not require it. These mistakes and the failure of hospitals to quickly identify them offer a rare look into the vulnerability of patient safeguards at a time when increasingly complex, computer-controlled devices are fundamentally changing medical radiation, delivering higher doses in less time with greater precision than ever before.

Mom Fights Legal Ruling Keeping Her in Hospital
Though a woman wanted to leave the hospital, her doctor strongly disagreed - enough to go to court to keep her there. She smoked cigarettes during the first six months of her pregnancy and was admitted on a false alarm of premature labor. Her doctor argued she was risking a miscarriage if she didn't quit smoking immediately and stay on bed rest in the hospital, and a judge agreed. Three days after the judge ordered her not to leave the hospital, she delivered a stillborn fetus by cesarean section. Six months after her pregnancy ended, the dispute over the legal move to keep her in the hospital continues, raising questions about where a mother's right to decide her own medical treatment ends and where the priority of protecting a fetus begins.

Hospital Sued for Paying Kickbacks to Doctors
A Pennsylvania hospital is being sued in federal court for alleged fraud and paying kickbacks to two doctors for referring all their patients to the hospital. The lawsuit was filed in 2004 by four doctors and is still pending. The doctors are suing under the Federal False Claims Act, as well as the Stark Law and Medicare anti-kickback statute. The Stark Law prohibits a physician from referring patients to a medical facility where he holds a financial relationship. The anti-kickback statute prevents a physician from being compensated for referrals. The false claims portion alleges that the defendants perpetuated a scheme where they presented claims for reimbursement to government agencies for services rendered to patients who were illegally referred to the hospital. The plaintiffs allege the scheme arose out of an equipment sublease that the hospital entered into with two defendants. The defendants decided to expand their practice by leasing a nuclear cardiology imaging camera and performing related diagnostic services for patients in their office. After learning of their plans to obtain a nuclear camera, the hospital adopted a policy preventing physicians from having competing interests with the hospital, which was then used as leverage to get the defendants into a sublease arrangement.

New Report Compares Pennsylvania Hospital Infection Rates
Pennsylvania hospitals reported more than 13,000 preventable infections in the second half of 2008, according to a report released by the Pennsylvania Department of Health. The report compared two types of hospital-acquired infections on a hospital-by-hospital basis: catheter-associated urinary tract infections and central line-associated bloodstream infections. An analysis of the numbers was not immediately available, and experts warn against using the statistics to compare hospitals. Future reports will be published annually.

Radiation Offers New Cures and Ways to Do Harm
Americans today receive far more medical radiation than ever before. The average lifetime dose of diagnostic radiation has increased sevenfold since 1980, and more than half of all cancer patients receive radiation therapy. Without a doubt, radiation saves countless lives, and serious accidents are rare. But patients often know little about the harm that can result when safety rules are violated and ever more powerful and technologically complex machines go awry. To better understand those risks, The New York Times examined thousands of pages of public and private records and interviewed physicians, medical physicists, researchers and government regulators. The Times found that while this new technology allows doctors to more accurately attack tumors and reduce certain mistakes, its complexity has created new avenues for error - through software flaws, faults programming, poor safety procedures or inadequate staffing and training. When those errors occur, they can be crippling.

Plea Rejected in Case of Hepatitis Infections
Suggesting that 20 years in prison was not enough punishment for the crime, a federal judge rejected a plea agreement for a former hospital technician and drug user who admitted that she exposed hundreds of patients in her care to hepatitis C. The judge said the agreement with the former hospital worker inordinately restrained his discretion and did not take into account the views of victims, many of whom submitted anguished written statements. It is unusual for a judge to reject a plea agreement. The technician admitted to the police that while working at Rose Medical Center in Denver in 2008 and 2009, she stole pain-medication syringes from operating room trays, replacing them at times with needles she had already used to inject herself with heroin. Seventeen Rose patients have so far been found to have a strain hepatitis C linked through genetic sequencing to the strain in the technician's blood.

Hospital at Fault as Dying Man Robbed in ER
A Pennsylvania Health Department report says a nurse twice called the name of a Philadelphia man who died of a heart attack in a hospital waiting room but never went to look for him. The report found that hospital staff called the man's name 17 minutes after he arrived, but he had already stopped moving. Hospital personnel checked on him an hour after he arrived only when another patient alerted staff he wasn't moving. Police say the man's watch was stolen after he lost consciousness. Hospital officials say they have taken steps to avoid similar incidents, and two employees have been suspended.

Pennsylvania State Laws Requiring AED Training Few and Far Between
While working the nigh shift as a custodian at Capital BlueCross, a central Pennsylvania woman suffered a heart arrhythmia. Her final cause of death was a presumed cardiac arrhythmia; however, no one knows for sure if a jolt from an automated external defibrillator, or AED, could have saved her - because no one used one. Capital BlueCross has at least one AED in each of its local offices in case of emergencies, and the central Pennsylvania branch was no exception. The devices deliver a shock to a patient suffering from cardiac arrest, and a number of people were trained to operate an AED. But the woman's co-worker claims she never received training. Pennsylvania doesn't have any specific laws requiring businesses to train their staff on their AED machines. In fact, the state doesn't require they buy AEDs at all. Federal buildings across the nation must provide access to the machines, but beyond that, it's been largely up to local businesses, schools and public places to make decisions about AEDs for themselves. AEDs have become so commonplace that the Red Cross has begun including AED training in any First Aid or CPR sessions unless specifically asked not to.

Docs Seek to Stifle Patients' Rants On Web Sites
Dozens of physician rating Web sites have sprung up in recent years, offering anyone with access to a computer the chance to rave - or rant - about the treatment received from a doctor. Most of the testimonials are glowing, but the bad ones can be brutal: Doctors are routinely branded as rude, incompetent - or worse. "He insisted on doing a pelvic exam on me...For a sore throat," wrote one post. Some doctors, worried about their reputations, are trying to fight back against negative reviews, requiring patients to sign contracts - critics call them "gag orders" - promising not to post comments to public sites. Others ask patients to sign over copyright to future comments, hoping for leverage to have any nasty tags removed. Such contracts haven't been tested in court, and Internet law experts say they're unlikely to prevail. Still, proponents argue that the waivers are necessary to protect doctors hamstrung by medical ethics and privacy laws. Critics say they're nothing short of censorship.

Pittsburgh Doctor Guilty of Health Care Fraud
A Pittsburgh doctor has pleaded guilty to a federal health care fraud charge. The doctor received more than $1 million from fraudulent Medicare and private health insurance claims between 2003 and 2008. As part of the plea agreement, he has agreed to pay three times the amount, $3.3 million, to the government. His sentencing is scheduled for later this year.

Popular Blood Therapy May Not Work
The treatments has become so popular that patients with orthopedic injuries are demanding it, willing to pay $1,000 or more out of their own pocket. Its appeal only soared higher when professional athletes reported that it cured them. It is a new procedure, based on an idea that once seemed revolutionary: Inject people with their own blood, concentrated so it is mostly platelets, the tiny colorless bodies that release substances that help repair tissues. However, the first rigorous study asking whether the platelet injections actually work finds they are no more effective than saltwater. In the study, researchers recruited 54 people with Achilles' tendons that had been hurting at least two months. The participants were randomly assigned to have an injection of platelets or saline. Six months later, patients in both groups had improved. Their pain was average, and two-thirds to three-quarters had returned to their sport. There was no difference between saline and platelet injections.

Deal Made to Monitor Brooklyn Hospital
New York City, the Justice Department and lawyers representing mentally ill patients at Kings County Hospital Center in Brooklyn where a 49-year-old woman died in 2008 while waiting for treatment said that they had reached an agreement allowing a federal judge to monitor conditions at the hospital. The proposed settlement comes after two and a half years of bitter litigation over conditions at the hospital. The lawsuit, filed in 2007, called the psychiatric unit of Kings County a "chamber of filth, decay, indifference and danger." The suit gained momentum in 2008 when a Jamaican immigrant who had worked as a caretaker for children and the elderly died about 24 hours after arriving by ambulance at the psychiatric emergency room, where doctors said she was schizophrenic and ordered that she be committed. She was left in the waiting room, where she eventually collapsed and died because of blood clots that began in her legs and traveled to her lungs. A surveillance video showed her lying on the floor for more than an hour. During that time, a guard went in to check on her by wheeling his chair across the floor while still sitting in it, and another staff member prodded her with a foot. Notes in her chart claimed she had been sitting quietly in the waiting room which the surveillance video showed that she had been lying on the floor. Investigators soon found the unit to be a nightmarish place, where suicidal behavior was left untreated, patients sexually abused one another and the emphasis was on subduing patients through drugs and physical restraints, rather than on giving them individualized treatment. The city has since paid the woman's family $2 million.

Arrest of Pediatrician Followed Years of Complaints
The Delaware pediatrician who prosecutors say may have molested more than 100 patients showed a pattern of inappropriate touching that led to multiple complaints from patients and co-workers, but the police were unable to get enough evidence to charge him. Starting in 2005, police investigators received complaints about the pediatrician from eight patients accusing him of abuse as far back as 1999. At least one complaint was sent to a state medical group, but no action was taken to suspend his license and he was not charged. The pediatrician has been charged with 32 criminal counts relating to the rapes of at least seven girls, ages 3 months to 13 years. At the time, the authorities said they had received multiple complaints about the doctor roughly a year ago, however new reports, which include the accounts of three doctors and a nurse, indicate that concerns were raised far earlier. In 2005, police tried to charge him with offensive touching after a 3-year-old patient told her parents about his kissing her too much in at least one office visit. No arrest was made, because officials decided they could not win the case. A former office manager for the pediatrician told investigators in 2005 that she filed a complaint earlier that year with the Medical Society of Delaware, which is a professional organization that does not license doctors. Officials at the society, as well as at the Delaware Board of Medical Practice, which grants doctors' licenses, said they never received any complaints from patients or alerts from the police.

Hospital Cuts Dialysis Care for the Poor in Miami
To chip away at an overwhelming budget deficit, Miami's public hospital system has stopped paying for kidney dialysis for the indigent, leaving some patients to rely on emergency rooms for their life-sustaining treatments. A total of 175 patients were affected by the decision. The situation is similar to that at Atlanta's public hospital, which closed its outpatient dialysis clinic last year to curb costs. In Miami, officials said patients could come to the emergency room for treatment, and eight have this week. Federal law requires that emergency rooms treat patients in serious medical jeopardy, regardless of their ability pay. For patients with end-stage kidney disease, going without dialysis can prove fatal in as little as two weeks. To be treated in an emergency room, however, dialysis patients often must show up in severe distress. Dialysis provided through an emergency room admission is considerably more expensive than routine treatment at a clinic, but while the hospital was not reimbursed for treating uninsured patients at private clinics, it can receive emergency Medicaid payments for dialysis provided through emergency rooms. The hospital's decision has shifted the financial burden from Miami taxpayers to the state and federal government.

Hospitals Could Stop Infections by Tackling Bacteria Patients Bring In
Hundreds of thousands of patients each year suffer from infections after surgery, and experts say more than half of those infections stem from bacteria the patients themselves are carrying in their nose or on their skin. Otherwise harmless bacteria can enter the body through surgical incisions and cause infections that can require expensive treatment, slow recovery or even cause death. But two new studies suggest relatively simple ways hospitals can prevent many infections by killing the bacteria on the patient before surgery, with methods of screening, scrubbing or pretreating the patient that many hospitals do not typically use. The studies examined infections that develop at the site of surgery, often around the incision, and afflict more than 300,000 patients a year in the United States. While experts are increasingly trying to stop hospital-acquired infections by approaches including stepped-up hand-washing by doctors and nurses, the new studies looked at the bacteria patients may be carrying before entering the hospital, especially the common bacteria staphylococcus aureus. Researchers tested patients for the bacteria using nasal swabs. They treated about 500 who carried the bacteria for five days with an antibiotic ointment on their noses and showers treated with chlorhexidine, an antiseptic. After surgery, which sometimes occurred during the five-day treatment, those patients were 60 percent less likely to develop infections than patients receiving a placebo of ointment and soap.

Dousing Patients in Antiseptic Curbs Infections
Bathing patients in an antiseptic and squirting medicated ointment up their noses dramatically cut the rate of dangerous staph infections afterwards, researchers found. A second study found the antiseptic did a better job of preventing infections than the reddish-brown iodine solution that's been used for decades to swab the skin before an operation. Infections are a vexing problem for hospitals. Some 30 million surgical procedures are done each year, and up to a half million Americans develop surgical-site infections, mostly from staph bacteria. While attention has been focused on ways to stop health care workers from spreading bugs, patients can also contaminate themselves with the germs they harbor in their noses or on their skin. Two new studies tried different approaches to killing those bacteria to see if that reduced the number of post-surgery infections. Researchers tested a newer antiseptic against the iodine solution commonly used to prep surgery patients and found it cut all surgical-site infections by 40 percent. A study in the Netherlands, where the new antiseptic prep is already used, treated patients who had staph bacteria to see if there was any additional benefit. Treatments with nasal ointment and antiseptic baths reduced staph infections by nearly 60 percent compared to dummy treatments.

Judge Slashes Neurosurgery Expert's $7,000 Fee in Automobile Injury Case
Neurosurgeons might be able to charge more than other experts for their deposition testimony, but $7,000 for two hours is "near to being extortionate," a New Jersey judge has ruled. As a consequence of her ruling, the defendants in the case will not have to pay more than $600 per hour when they depose the plaintiff's medical expert, leaving the plaintiff to pick up the difference unless the expert agrees to lower his rate. The expert typically charges $5,000 for the first hour of deposition and $2,000 for every hour thereafter. His court appearances are even more expensive at $12,000 per day and rising to $15,000 when he has to go out of state. The plaintiff in the case claims he was rear-ended by an ambulance in 2007, resulting in myelopathy and loss of spinal function. He was treated by the expert. The defendants want to depose the expert, but under the Federal Rules of Civil Procedure, the party seeking discovery is the one who has to pay for the deposition; however, the rule requires discovery seekers to pay only "a reasonable fee for time spent."

Octuplet Mom's Doctor Accused of Negligence
The California Medical Board is accusing a fertility doctor of negligence and violating professional guidelines in the case of a woman who conceived octuplets. The state licensing body said that the fertility doctor acted beyond the reasonable judgment of a treating physician by repeatedly providing fertility treatment to a woman identified only by her initials in the documents.

Half of Depressed Americans Get No Treatment
About half of Americans with major depression do not receive treatment for the condition, and in many cases the therapies are not consistent with the standard of care, according to a new study. The study also showed that ethnicity and race were important factors in determining who received treatment, with Mexican Americans and African Americans the least likely to have depression care. Of those surveyed, 8.3 percent had major depression, and about 50 percent of those with the condition received at least one type of treatment. However, only about 21 percent had therapies that followed accepted treatment guidelines from the American Psychiatric Association. For example, a situation in which a patient took antidepressants for only one week instead of 60 days and was not monitored by a physician would be against the standard of care. The study also showed that counseling was used more than drug therapy overall.

Abdominal Surgery Risk May Rise with Age
Common abdominal surgery like removal of the uterus or the gallbladder may pose a greater risk to older patients than generally reported. A new study finds that 5 percent of those 65 and older died within 90 days of surgery and that 17 percent developed complications. The risks increased with advancing age: 2.5 percent of patients in their 60s died after surgery, compared with 6 percent of those in their late 70s, 12.6 percent in their late 80s and 16.7 percent in their early 90s. The rate of postsurgical complications also increased with age, to 22 percent for patients in their late 80s and early 90s, from 14.6 percent for those in their late 60s.

Harvard Teaching Hospitals Cap Outside Pay
The owner of two research hospitals affiliated with the Harvard Medical School has imposed restrictions on outside pay for two dozen senior officials who also sit on the boards of pharmaceutical or biotechnology companies. The limits come in the wake of growing criticism of the ties between the industry and academia. Medical experts say they believe the conflict-of-interest rules at the institutions go further than those of any other academic medical center in restricting outside pay from drug companies. The rules impose limits specifically on outside directors who guide some of the nation's biggest companies. Senior officials at the two hospitals must limit their pay for serving as outside directors to what the policy calls "a level befitting an academic role" - no more than $5,000 a day for actual work for the board. Some had been receiving more than $200,000 a year. Also, they may no longer accept stock. Criticism has been mounting in recent years as the conflicting roles of some medical leaders have been disclosed through Congressional investigations, lawsuits and reports in the news media. Those disclosures have raised questions about bias and the cost and quality of patient care at the nation's medical institutions. The institutions are also forbidding speaker's fees from drug companies for any employee, including nearly 8,000 with Harvard faculty appointments. Some other medical schools have taken similar actions in prohibiting faculty members from being paid by drug companies to speak about their products.

The New Katrina Flood: Hospital Liability
More than 100 deaths occurred in New Orleans-area hospitals and nursing homes after Hurricane Katrina when emergency backup power systems failed and patients languished for days awaiting transport. About 200 lawsuits have been filed in Louisiana alleging that these institutions are liable for the deaths and for the suffering of other patients who survived because of corporate failure to plan adequately for flooding and implement evacuation constituted negligence or medical malpractice. One of these cases is set to go to trial soon. The family of a 73-year-old patient who died in what her family alleges was sweltering heat after nurses spent hours pumping air into her lungs by hand in the pitch dark has sued the hospital, alleging that the hospital was negligent in her death for not  ensuring that their generators were resistant to flooding.

Officials Re-Examining Organ Transplant Rules
The plight of two kidney transplant patients who contracted a brain infection from an organ donor is prompting health officials to re-examine their policies on using people with certain neurological conditions as donors. The organ donor had had seizures and a brain disorder initially thought to be an autoimmune disease and not transmissible. The real cause of his illness turned out to be a rare, usually fatal infection, but the mistake in diagnosis was not recognized until the transplants were done and the two recipients had become critically ill. The case highlights the lack of a national policy on whether to bar people with poorly defined neurological disorders as donors. For now, the decision is up to individual transplant centers. Disease transmission from transplants occurs in 1 percent of cases involving deceased donors, according to data the organ network began collecting in 2005. But reports are increasing as centers become aware of the network's database. Recipients have contracted West Nile virus, rabies, H.I.V., tuberculosis, a rodent virus, parasitic worms and other infections. In a few cases, donors have even transmitted cancers. Transplant patients are especially vulnerable because the drugs needed to prevent organ rejection work by suppressing the immune system.

Attorneys for Dead Woman's Family Wants State Agency Sanctioned
Attorneys for the family of a woman who froze to death on the roof of an Oakland hospital are asking an Allegheny County judge to sanction the state Health Department for refusing to turn over notes written by inspectors who found violations at the facility after her death. Although the state is not a party to the lawsuit against the facility, attorneys for the woman's family contend the notes include the identities of key witnesses to the events leading to her death last year. The notes the family seeks were taken days after her death and resulted in a critical 22-page inspection report. The Health Department imposed a $17,000 fine on the facility. The dispute over reports stems from a rule change the U.S. Department of Health and Human Services enacted in late 2008. Attorneys say the change deprives them of key evidence once available in wrongful death and negligence suits against hospitals and nursing homes. Health Department attorneys said that the regulation, which took effect weeks before the woman's death, bars them from releasing state inspectors' notes. The woman wandered from her 12th floor room at the hospital dressed only in a hospital gown and slippers. She was found dead from hypothermia more than 12 hours later on the roof. She suffered from dementia and a heart condition, and her medical records indicated that she had a tendency to wander.

Deadly Amoeba Passed On by Mississippi Organ Donor
Medical officials say an extremely rare organism has been passed from an organ donor to at least one recipient in what is thought to be the first such transfer of the amoeba. University of Mississippi Medical Center officials announced that four people in three states received organs from a patient who died earlier this year after having neurological problems. Two of the recipients are critically ill, but the others haven't show symptoms. Doctors say they test for known harmful diseases in organ donors, but there's no way to test for every possibly ailment.

Holding Doctors Accountable for Medical Errors
Ten years ago, a national panel of health care experts released a landmark report on medical errors in the American health care system. "To Err is Human: Building a Safer Health System" estimated that as many as 98,000 people died in hospitals each year as a result of preventable mistakes. Being hospitalized, it turned out, was far riskier than riding a jumbo jet. While the report offering comprehensive strategies to improve safety, its main conclusion was that medical errors were primary a result of "faulty systems, processes and conditions that lead people to make mistakes or fail to prevent them." Spurred by this finding, health care leaders across the country addressing errors believed to be a result of systemic flaws. They instituted more rigorous hospital accreditation standards and procedures, increasing public reporting and transparency and established systemwide safety changes like the mandatory use of checklists, the placement of hand sanitizing gel dispensers throughout hospital wards and the regulation of physician duty hours. For nearly a decade, this paradigm of systems failure defined the national movement to improve patient safety. But more recently, some health care safety experts have begun questioning the assumption underlying the report's conclusions: that only health care systems, and not individual clinicians, could be held accountable for medical mistakes.

Immigrants Lose Lawsuit Against Atlanta Hospital
Efforts to force a public hospital in Atlanta to continue providing free dialysis treatment to a group of immigrants, most of them illegal, suffered a setback when a judge dismissed a lawsuit challenging the recent closing of the hospital's outpatient renal clinic. When the struggling hospital closed the clinic for fiscal reasons in October, it agreed to pay for three months of dialysis for the patients at private clinics, either in the United States or in their home countries. That reprieve has nearly expired, and most of the patients have not taken steps to seek treatment elsewhere. Three of the patients have died since the clinic's closing, two of them in Mexico and one in Atlanta; however, none of the deaths appeared related to inadequate access to dialysis. An Atlanta judge provided little reasoning for granting the hospital's request to dismiss the patients' lawsuit. Their lawyer contended among other claims that the hospital had illegally abandoned the patients. However, a lawyer for the hospital argued that the patients were asserting a constitutional right to medical care that does not exist in law.

26 Arrested in Three States in Medicare Fraud Schemes
Federal agents arrested 26 suspects in three states, including a doctor and nurses, in a crackdown on Medicare fraud totaling $61 million. Arrests in three separate cases in Brooklyn, Detroit and Miami included a Florida doctor accused of running a $40 million home health care scheme that falsely listed patients as blind diabetics so he could bill for twice-daily nurse visits. The Department of Justice and the Department of Health and Human Services said 32 indicted suspected lined up bogus patients and otherwise billed Medicare for unnecessary medical equipment, physical therapy and infusions for H.I.V. The doctor in Miami, along with 14 people with whom he worked, was accused in an indictment of running a scam to tap a Medicare program that pays high rates to care for the sickest patients. The doctor referred about 1,250 Medicare beneficiaries for expensive and unnecessary home health and therapy services, and bribed the owners of two clinics in Miami to join the scam. He also faked medical certifications. The raids come only one week after Miami-Dade County received more than half a billion dollars from Medicare in home health care payments intended for the sickest patients in 2008, more than the rest of the country combined, even though only 2 percent of those patients nationwide live there.

15,000 Projected to Die from CT Scans Done in One Year
Radiation from CT scans done in 2007 will cause 29,000 cancers and kill nearly 15,000 Americans, researchers announced. The findings add to mounting evidence that Americans are overexposed to radiation from diagnostic tests, especially from a specialized kind of Z-ray called a computed tomography, or CT, scan. "What we learned is there is a significant amount of radiation with these CT scans, more than what we thought, and there is a significant number of cancers," the researchers wrote. It is estimated that just from the CT scans done in one year, just in 2007, there will be 15,000 excess deaths. About 70 million CT scans were done on Americans in 2007, up from 3 million in 1980. The scans done in 2007 will cause an estimated 29,000 cancers. A third of the projected cancers will occur in people who were ages 35 to 54 when they got their CT, two-thirds will occur in women and 15 percent will arise from scans done in children or teens. The researchers estimated there will be an extra 2,000 excess breast cancers just from CT scans done in 2007.

Poor Turned Away from Free Cancer Screenings
As the economy falters and more people go without health insurance, low-income women in at least 20 states are being turned away or put on long waiting lists for free cancer screenings, according to the American Cancer Society's Cancer Action Network. In the unofficial survey of programs for July 2008 through April 2009, the organization found that state budget strains are forcing some programs to reject people who would otherwise qualify for free mammograms and Pap smears. Just how many are turned away isn't known, but in some cases, the women are screened through other programs or referred to different providers. For example, New York used to screen women of all ages, but this year the budget crunch has forced them to focus on those considered at highest risk and exclude women under 50. The Cancer Society doesn't have an estimate for what percentage of breast cancer diagnoses come from mammogram screenings, but says women have a 98 percent survival rate when breast cancer is caught during stage I. That shrinks to about 84 percent during stages II and III, and just 27 percent at stage IV - when cancer has reached its most advanced point.

Pregnant Woman Claims Hospital Ignored Her
A woman says she was ignored for so long at a Las Vegas hospital that she went home and gave birth to a premature baby that later died. Witnesses who were in the waiting room have corroborated accounts by the woman and her fiance, claiming that a nursing aide told them to mind their own business or they wouldn't see a physician themselves. The hospital chief has promised action against those responsible if the allegations are true. Meanwhile, the Nevada State Board of Nursing wouldn't provide specifics about the complaint stemming from the November 30 incident.

Ex-Inmate Receives $55,000 for Medical Claim
A former Pennsylvania inmate received $55,000 to settle a lawsuit against the county for his claim he was denied medical treatment until he was rushed to the hospital for heart surgery following a stroke. The inmate accused the jail of a misdiagnosis, believing he needed "detoxing" from an addiction to drugs or alcohol instead of taking him to the hospital for an illness. He filed a federal lawsuit in Pittsburgh against the county, the jail, the county prison and the health system that provides medical treatment at the jail. According to his lawsuit, he was arrested in 2006 on a bench warrant. One day after his arrest, he asked to be taken to a hospital because he felt ill, including complaints of lower back and internal pain, cold sweats and chills. The lawsuit claimed prison personnel told him the illness was a symptom of withdrawal. He was finally taken to the emergency room at a local hospital after a week, where he was tested for a urinary tract infection and returned to jail. Two days later, blood tests showed he had a bacterial infection. He was finally returned to the hospital where he was diagnosed with a left middle cerebral artery infarction which occurs when tissue dies because of a lack of blood supply, blood poisoning, a recent stroke and a bacterial infection. His lawsuit accused the county of failing to have any procedure or protocol in place for an inmate to be properly evaluated for his medical treatment. The lawsuit also states that the prison doctor was not readily available to examine prisoners.

Daughter Awarded $3 Million After Death of Mother Who Had Do-Not-Resuscitate Order
A 79-year-old woman who suffered from chronic obstructive pulmonary disease that caused her to briefly stop breathing once told her family and medical staff at a Georgia hospital that she did not want to be cured, but to simply keep her comfortable until she died. However, a jury has awarded her daughter $3 million for medical malpractice claims stemming from her mother's death in 2002 after she was given what a plaintiff's expert said was too much morphine too quickly. She had been in the hospital for more than a week when she suffered respiratory arrest. When a team arrived in her room, they began life-saving measures; they stopped when her physician informed them of her do-not-resuscitate order. They then changed her care instructions from "curative" to "comfort." She was subsequently given morphine to "keep her comfortable." She immediately fell into unconsciousness and died three hours later. In 2004, the woman's daughter and son sued the physician for medical malpractice. They alleged administering the amount of morphine that was given "was a violation of standard care." The daughter also testified that the woman was alert and watching television when she was given the morphine. The jury took three hours before awarding $3 million; the daughter had originally asked for $5 million.

Pennsylvania Woman Files Lawsuit Because Legs Partially Amputated
A Pennsylvania woman who underwent partial amputations because she sat with her legs folded under her for as long as 12 hours while passed out drunk claims a doctor overlooked an acute medical condition because she was intoxicated. The 20-year-old filed a medical malpractice lawsuit against a Fayette County hospital and an emergency room physician. According to her lawsuit, she "consumed an excess of alcohol" while celebrating her 20th birthday at a neighbor's house. She lost consciousness while "seated on the floor with her legs tucked under her." She remained in that position for up to 12 hours before a relative discovered her the following day. Disoriented and complaining of pain in her lower legs, she was taken by ambulance to the emergency room. She alleges that although she showed signs of a reversible condition known as "acute compartment syndrome," the emergency room physician waited nearly six hours before arranging for her transfer to another hospital. The transfer was done via ambulance, but a medical helicopter was dispatched while she was enroute because of her "deteriorating health." Within two hours of her arrival at the other hospital, she was diagnosed with acute compartment syndrome and had bilateral knee amputations. The lawsuit alleges that the physician "discounted" indicators of the syndrome because she was intoxicated. Instead she was diagnosed with acute alcohol toxicity.

Infections Lead to More Deaths in ICU
Just over half of all patients in intensive care units around the world have infections, and they are more than twice as likely to die in the units as patients who are not infected, a new study has found. The study surveyed the infection status of more than 13,000 patients from 1,200 noncardiac intensive care units in 75 countries on a single day in 2007. It found that 51 percent of patients had infections, most commonly of the lung, while 71 percent were being treated with antimicrobial agents. One-fourth of those with infections died, compared with just over one-tenth of infection-fee patients. The longer a patient spent in intensive care, the greater the risk of an infection: 32 percent for patients who had been in the I.C.U. for a day or less at the time of the survey, and 70 percent for those who had been there for more than a week.

More Exposed to Risky Scans in LA Hospital
Federal health regulators have identified 50 more patients exposed to dangerous radiation levels from brain scans at a hospital in Los Angeles. The Food and Drug Administration says more than 250 patients at Cedars-Sinai Medical Center have received dangerous CT scans in the last 18 months. The brain scans are used to diagnose strokes. The agency reported in October that more than 200 patients at the hospital had been put at risk, and officials say it is unclear whether the problems are being caused by human error or a problem with CT equipment. Apart from the Los Angeles hospital, federal health regulators are investigating reports of dangerous radiation levels at two more California hospitals.

The Doctors were Real, But the Patients Undercover
Posing as patients, three undercover observers got themselves admitted as patients to a locked psychiatric ward to investigate conditions inside. The project took place earlier this year at a psychiatric complex 40 miles from Amsterdam, and staff had been warned that they would be watched. The project came about following a pair of patient deaths last year in psychiatric facilities in Amsterdam - one involving a suicide, the other a man who choked on food while locked in an isolation cell. Among the findings of the project were that patients frequently found it difficult to get information on their treatment and medications and that the sound of a staff member's key chain jangling could be jarring to an already anxious patient.

Medical Schools Quizzed On Ghostwriting
Senator Charles Grassley wrote to 10 top medical schools to ask what they are doing about professors who put their names on ghostwritten articles in medical journals - and why that practice was any different from plagiarism by students. Mr. Grassley, the ranking Republican on the Senate Finance Committee, sent the letters as part of his continuing investigation of so-called medical ghostwriting. The term refers to publication of medical journal articles in which an outside writer - sometimes paid by a drug or medical devices company whose product is being studied - has done extensive work on the article without being named in the publication. Instead, one of more academic researchers may receive author credit. Mr. Grassley said ghostwriting had hurt patients and raised costs for taxpayers because it used prestigious academic names to promote medical products and treatments that might be expensive or less effective than viable options.

Widower Wins $6 Million in Medical Malpractice Trial
The husband and estate of a woman who developed blood clots and died shortly after undergoing outpatient knee surgery have been awarded more than $6 million. In 2003, an orthopedic surgeon performed less than an hour of arthroscopic surgery on the 42-year-old woman before her daughter took her home. The woman died less than 12 hours later. The cause of death was deep venuous thromboids that had formed at the site of the surgery and traveled to the lung causing a pulmonary embolism. The widower argued that the surgeon ignored several risk factors that should have indicated that blood clotting could be a problem: the patient was somewhat obese and was taking birth control pills; she also had a history of asthma, hypertension, heart disease and stroke. After three-and-a-half hours of deliberations, the jury awarded the woman's husband and estate $6 million.

Lingering Pain After Surgery for Breast Cancer
Breast cancer patients often experience pain that persists long after surgery, and a new Danish study has found that the problem affects a large proportion of women. Almost half the patients reported chronic pain two to three years after treatment, and more than half reported discomfort. The patients most likely to have these effects were those under 40, those who had undergone radiation treatment and those who had surgery to remove all of the lymph nodes in their armpit rather than a less invasive procedure called a sentinel biopsy, which can be used to determine whether the cancer has spread.

Many Doctors Perform Unneeded Pap Smears
Many doctors are performing unnecessary Pap smears, ignoring guidelines issued by major medical organizations and adding to healthcare costs, a survey of physicians has found. Of 1,212 primary care doctors who responded to a survey about cervical cancer screening, about one-fifth described practices that were consistent with the latest recommendations from groups including the American Cancer Society and the United States Preventive Services Task Force, the study found. Most had overused cervical cancer screening. The survey described four situations and asked physicians whether they would recommend Pap smears in each one. A vast majority said they would recommend annual Pap smears for at least three years for an 18-year-old woman who had recently become sexually active, which is consistent with the recommendations of major medical groups. But many of the doctors said they would also recommend the screening for a 35-year-old woman whose cervix had been removed but who had no history of cancer; testing in that situation would be inconsistent with guidelines.

Hospital Fined $150,000 for Wrong-Site Surgery
Rhode Island's largest hospital was fined $150,000 and ordered to take the extraordinary step of installing video cameras in all its operating rooms after it had its fifth wrong-site surgery since 2007. Rhode Island Hospital was fined a second time for wrong-site surgeries; the hospital was also fined $50,000 after brain surgeons operated on the wrong part of the heads of three patients in 2007. The latest incident involved a patient who was to have surgery on two fingers. Instead, the surgeon performed both operations on the same finger. Under protocols adopted in the medical field, the surgery site should have been marked and the surgical team should have taken a timeout before cutting to ensure they were operating on the right patient, the right part of the patient's body and doing the correct procedure. The surgical team allegedly marked the wrist, rather than each finger, and the surgeon did not mark the site himself. The team also did not take a timeout before the second surgery. When they discovered the error, they checked with the patient's family to see if they should perform the surgery on the correct finger. When they did the surgery on the correct finger, they also did not do a timeout, something observers call "amazing" given that they had just made such a serious error.

Court Applies Criminal Liability to Company for Workers' Actions
Following the conviction of five health care workers for failing to provide care to a patient in a persistent vegetative state and stating in company records that the care had been provided, a New York appellate panel has ruled that the workers' employer, a nursing home, also may be held criminally liable. At issue was whether a limited liability company, as opposed to a corporation, can be held criminally liable under New York law for acts its employees committed within the scope of their employment. The panel held that the principles that allow criminal liability for corporations in such circumstances apply to limited liability corporations as well. The charges against the home and its employees stemmed from an investigation by the New York Attorney General, which used video surveillance in the room of one of the facility's residents. The recording showed at least five healthcare workers failing to provide necessary services to a "total care" patient. The workers then falsified charts, claiming to have done the work.

License Revocation Over Doctor's Affair with Patient Upheld
A doctor's constitutional right to courtship and marriage was not violated by New York state regulators who, in revoking his license, faulted his consensual relationship with a patient who later became his fiance, an appeals court has ruled. The doctor had urged the court to consider an earlier ruling that the absence of a proscription in the law against any physical contact of a sexual nature between a physician and patient did not, ipso facto, constitute approval by the Legislature of such relationships involving medical professionals regulated by the Health Department. The appeals court found that a doctor's sexual relationships with patients "bears scrutiny for moral unfitness due to the potential for abuse of the confidential relationship between doctor and patient." Among the other charges facing the doctor were that he provided substandard care for several patients, including urging them to use alcohol and tobacco. He also pre-signed prescription pads in violation of state procedures. Finally, he was charged for misconduct for entering into sexual relationships with two women when they were his patients.

Hospital's 5th Wrong-Site Surgery Since 2007
Health officials are investigating how a surgeon at Rhode Island Hospital mistakenly operated on the wrong part of a patient's hand, the hospital's fifth wrong-site surgery since 2007. The hospital's president said that the mistake happened on a patient scheduled for surgery on two fingers. A joint on one finger underwent a procedure meant for another. The surgery was then performed on the correct finger, and the patient was discharged. The same  hospital was fined $50,000 after brain surgeons operated on the wrong side of patients' heads in three separate cases in 2007.

Many Doctors Ignore Heart Drug Guidelines
Most hospitalized heart failure patients are sent home without widely recommended inexpensive pills, despite a program to get more doctors to follow treatment guidelines. Only one-third of 12,565 patients eligible for the drugs got them - even though they were treated at 201 hospitals that had voluntarily enrolled in the American Heart Association's Get with the Guidelines program. Reasons why so few doctors "got with the program" are unclear. But the study offered some theories, from lack of marketing for the decades-old drugs to concerns about their safety.

Nurse Accused of Using Internet to Encourage Suicide
A nurse who authorities say visited suicide chat rooms on the Internet and encouraged depressed people to kill themselves in under investigation in at least two deaths and may face criminal charges that could test the limits of the First Amendment. Investigators say the nurse feigned compassion for those he chatted with, while offering step-by-step instructions on how to take their lives. The Minnesota Board of Nursing has since revoked his license, citing that he had told one person that his job as a nurse made him an expert on the most effective ways to die.

FDA to Study Negative Effects of Lasik Surgery
The Food and Drug Administration says it is launching a study into problems resulting from laser eye correcting surgery, which included blurred vision and dry eyes. The FDA says it will work with the National Eye Institute and the Department of Defense to determine the percentage of patients who experience negative side effects following surgery. The project includes a clinical trial tracking patients who undergo the procedure, which is expected to conclude by 2012.

Radiation Overdoses Point Up Dangers of CT Scans
At a time when Americans receive far more diagnostic radiation than ever before, two cases under scrutiny in California - one involving a large, well-known Los Angeles hospital, the other a tiny hospital in the northern part of the state - underscore the risks that powerful CT scans pose when used incorrectly. Recently, Cedars-Sinai Medical Center disclosed that is had mistakenly administered up to eight times the normal radiation dose to 206 possible stroke victims over an 18-month period during a procedure intended to get clearer images of the  brain. Hundreds of miles north, the other case - involving a 2-year-old boy complaining of neck pain after falling off his be - has led to the revocation of an X-ray technician's state license for subjecting the child to more than an hour of CT scans. The procedure normally takes two to three minutes.

Panel Finds Shortcomings in Bone Study
An academic panel investigating a former Army surgeon who performed a study of a Medtronic bone treatment study said in a report that it had found instances of research misconduct but failed to find proof that he had falsified data. The doctor conducted the research in question while a surgeon at Walter Reed Army Medical Center in Washington. He became a highly paid consultant to Medtronic when he joined Washington University in St. Louis in mid-2006. In a report last year, Army officials accused him of inflating the number of combat soldiers whose leg injuries had been successfully treated with the product. Officials also found that he had forged the names of four Army doctors before submitting the study to a medical journal for publication. After a lengthy review, the Washington University panel concluded that it had been possible for the doctor to support the number of leg injuries he reported if such injuries were defined broadly. The panel also raised the possibility that some of the data discrepancies had reflected problems in Walter Reed's patient record keeping system.

Active Duty Military Now Have Right to Sue for Medical Malpractice
In a move to partially reverse a controversial 59-year-old Supreme Court ruling, the House Judiciary Committee has approved a bill to give active duty members of the military the right to file medical malpractice suits against the government. Under the 1950 court ruling, active duty military personnel cannot file malpractice claims against the government, regardless of where the malpractice occurs. The bill recently approved would continue that ban for claims stemming from battlefield situations but allow suits for non-combat cases.

Subjective Test in Jail Death Dismisses Suit Against Nurse
The standard for assessing claims brought by pretrial detainees charging deliberate indifference to health and safety should be the same as that applied to cases of convicted prison inmates who contend that they have suffered cruel and unusual punishment, a federal appellate court has ruled. The 2nd U.S. Circuit Court of Appeals concluded that a nurse at the Albany County Correctional Facility, despite her mistaken judgments, could not be held liable for the death of a man while he was in custody because the evidence did not show that she had been aware of an "excessive" risk to the inmate's health and safety, which she had disregarded. The case was brought by the prisoner's estate, who was arrested in 2001 on a charge of harassment. He had been held at the county jail at least 27 times and had been treated for chronic alcoholism by the staff. The registered nurse testified that she smelled alcohol on his breath and that he told her he was "possessed." After conducting her assessment, she erroneously concluded that he was under the influence of alcohol. The inmate later told her he was going through alcohol withdrawal. She declined to enter the cell or ask him questions that would have detected signs of alcohol withdrawal. Instead, she called a doctor, told him the prisoner was drunk, and he advised her to be kept under investigation. He later went into a seizure, fell from his bed and died.

Researchers Look at Deaths After Surgery
Patients are much more likely to die from surgery in some hospitals than others, and conventional medical wisdom has long attributed the excess deaths to a higher rate of postoperative complications. But a new study contradicts that notion. Researchers looked at 84,730 people who underwent inpatient surgery at 186 hospitals from 2005 to 2007. They found that death rates varied widely from hospital to hospital, from 2.5 percent to 6.9 percent. But complication rates did not vary significantly: 24.6 percent of patients at the high-death hospitals experienced complications after surgery, compared with 26.9 percent of the patients at the hospitals with the lowest death rates. The apparent discrepancy suggests that how a hospital responds to complications may be even more important than the frequency of complications.

Addicted Doctor's License Revoked
A Pennsylvania dermatologist will lose her state medical license for at least 10 years after pleading guilty to writing more than 400 bogus prescriptions to feed her addiction to painkillers. She could also face penalties of more than 10 years in prison at her sentencing later this year. Revocation of her medical license is automatic because two of the offenses to which she pled are drug-related felonies. She came under investigation in 2006 after security officials at a pharmacy raised questions about prescriptions she was filling. The pharmacy claims she wrote fraudulent prescriptions for painkillers for herself, family members and patients and kept the drugs for her own use.

Jury Awards Plaintiff $9.5 Million for Permanent Damage from Erectile Dysfunction Treatment
An Atlanta man obtained a $9.25 million jury verdict in his lawsuit against a men's clinic after its erectile dysfunction therapy caused permanent damage to his penis. Both before and during the trial, the man settled with two of the three defendants. The Boston Men's Health Center Inc. was the defendant hit with the verdict. The jury found in favor of the plaintiff following a six-day trial, awarding $750,000 in compensatory damages. After further deliberations, the jury levied $8.5 million in punitive damages against the company and found that the defendant acted with an intent to cause harm. The man's attorney had requested $6.75 million in punitive damages. His lawsuit began when he responded to a radio advertisement that promised "sex for life" in 2006. The center diagnosed him with erectile dysfunction and premature ejaculation. They recommended injecting their medication, which contained a drug the FDA has warned should not be used to treat erectile dysfunction, into his penis. After injecting the medication himself, as the center had instructed, he experienced an erection that was painful and would not subside. The medicine had caused fibrosis and scar tissue to form. As a result, he is now unable to have a normal erection.

2 More Women File Suits Against Oral Surgeon
Two Pennsylvania women filed lawsuits against a Mt. Lebanon oral surgeon over allegations that he sexually assaulted them while they were under anesthesia. The women filed the civil lawsuits against the surgeon, who was recently acquitted by an Allegheny County judge of criminal charges of molesting 17 female patients. The lawsuits accuse the surgeon of sexually assaulting one woman in 2006 and the other later that year. The new suits mark four pending civil lawsuits against the surgeon, all with similar allegations.

Worker in Hepatitis Case Sentenced to 20 Years
A former hospital surgical technician who may have infected dozens of surgical patients with hepatitis C by stealing their pain medication and swapping back needles tainted by the virus she carried pleaded guilty to federal drug charges. The woman, who could have faced up to life in prison on the most serious charges, accepted a 20-year prison sentence in a plea agreement with federal prosecutors. Twenty-seven patients at two hospitals where she worked last year and this year, in Denver and Colorado Springs, have tested positive for a strain of hepatitis C and have been linked to her care. Her guilty plea does not end the legal saga or the continuing investigation into how exactly the infections were transmitted and who might bear further responsibility.

Many On Debilitating Dialysis Not Told About Transplantation Option
The failure of doctors at dialysis clinics to inform thousands of patients about kidney transplantation may be shortening lives and costing taxpayers millions of dollars a year. Kidney transplantation adds an average of 10 years to a patient's life, and a new kidney costs the federal Medicare program$50,000 less per patient than conventional dialysis. Yet thousands of patients started dialysis without hearing about transplant options. Some spend as long as five years on the debilitating treatments before they are placed on the nation's transplant wait list, while others who would benefit from the surgery are not even on the list. Those spending a year or longer on dialysis before being listed for a transplant include privately insured patients whose treatments are more profitable to clinics. The country's largest dialysis providers say they need those patients to offset lower payments from Medicare. Money plays a strong role when it comes to prescribing dialysis before transplantation, some experts say. Others point to ignorance, fear and insurance rules as reasons dialysis patients are not listed for transplantation.

Facebook Misconduct: Med Students Cross Line
From Facebook to YouTube to personal blogs, future doctors are crossing the line - and getting in trouble. A new study finds most medical school deans surveyed said they were aware of students posting unprofessional content online, including photos of drug paraphenalia and violations of patient privacy. Some infractions resulted in warnings, others in being expelled. The survey cited a handful of examples. In one, a student posted identifying patient details on Facebook. Another requested an inappropriate friendship with a patient. Others used profanity, including the deans. Most deans have said their schools didn't yet have policies to help students figure out what's allowed online and what can get them kicked out of medical school.

Medical Malpractice System Breeds More Waste
The direct costs of malpractice lawsuits - jury awards, settlements and the like - are such a miniscule part of health spending that they barely merit discussion, economists say. But that doesn't mean the malpractice system is working. The fear of lawsuits among doctors does seem to lead to a noticeable amount of wasteful treatment. A Harvard economist whose research is cited by both the American Medical Association and the trial lawyers' association sayd $60 billion a year, or about 3 percent of overall medical spending, is a reasonable upper-end estimate. If a new policy could eliminate close to that much waste without causing other problems, it would be a no-brainer. Medical researchers have estimated that only 2 to 3 percent of cases of medical negligence lead to a malpractice claim. For every notorious error, there are dozens more.

Value of CT Scans in Youths Questioned
Each year, hundreds of thousands of children who hit their heads undergo CT scans to rule out the possibility of serious brain injury, but a new study has found that many of the high-radiation scans are unnecessary. The study, one of the largest of its kind, enrolled 42,412 children ages 18 and younger who sought emergency care at dozens of medical centers after suffering mild head injuries in bike collisions, car crashes, falls and other accidents. Of the total group, 14,969 of the children, or just over one-third, had CT scans, but only 780 of the scans, or about 5 percent, picked up traumatic brain injuries. The paper also offered a list of six indicators that could be used to determine whether a child was at risk for a serious brain injury, with a separate list for children under 2. The highest risk factors for children of all ages are an altered mental state and signs of a skull fracture. Of the children under 2 who were scanned, one-quarter had none of the six predictors; 21 percent of the older children scanned had none of the predictors.

Patient Dies After Catching Fire During Surgery
A woman died after being severely burned in a flash fire while undergoing surgery, a rare but vexing dilemma in operating rooms. She died in Nashville six days after being burned on an operating table in Illinois. The Tennessee state medical examiner's office said she died from complications of thermal burns and classified her death as accidental. The hospital said in a statement only that "there was an accidental flash fire in one of the hospital's operating rooms," injuring a patient before being immediately extinguished. The hospital didn't said how the fire started, but it said that it was responding with "necessary and appropriate measures." Surgical flash fires are most often sparked by electric surgical tools when oxygen builds up under surgical drapes. They occur an estimated 550 to 600 times a year - a tiny fraction of the millions of surgeries performed in the U.S. annually - and only kill about one or two people each year. Concern over such blazes waned after the 1970s when highly flammable agents such as ether gave way to safer anesthetics. But worries have mounted in recent years with increased use of electrosurgical devices and the replacement of cloth hospital drapes with those made of more flammable, disposable synthetic fabric.

Medical Editors Push for Crackdown On Ghostwriting
The scientific integrity of medical research has been clouded in recent years by articles that were drafted by ghostwriters sponsored by drug companies and then passed off as the work of independent academic authors. Yet the leading medical journals have continued to rely largely on an honor system of disclosure to detect such potential bias, asking authors to voluntarily report any industry ties or contributors to their manuscripts. But now, in light of recently released evidence that some drug makers have gone to great lengths to turn scientific articles into marketing vehicles for their products, some influential medical editors are cracking down on industry-financed ghostwriting. And they are getting help from Congress. These editors are demanding that journals impose tougher disclosure policies for academic authors and that the journals enforce their own rules by actively investigating the provenance of manuscripts and by punishing authors who play down extensive contributions by ghostwriters. In medical journal circles, the exorcism of industry-financed editorial assistance even has its own name: ghostbusting.

Ghostwriting Called Rife in Medical Journals
Six of the top medical journals published a significant number of articles in 2008 that were written by ghostwriters, according to a study released by editors of the Journal of the American Medical Association. Among authors of 630 articles who responded anonymously to an online questionnaire created for the study, 7.8 acknowledged contributions to their articles by people whose work should have qualified them to be named as authors on the papers but who were not listed. In the scientific literature, ghostwriting usually refers to medical writers, often sponsored by a drug or medical device company, who make major research or writing contributions to articles published under the names of academic authors.

29 Hepatitis B Cases Tied to One New Jersey Doctor
New Jersey health officials are urging 2,000 more patients to get tested for hepatitis B and other blood-borne diseases following an outbreak linked to a single doctor's office. Earlier this year, the state told nearly 2,800 of the doctor's patients to get tested after several were diagnosed with hepatitis B. Officials say there are now 29 positive cases, plus 68 others who tested positive for antibodies that cannot be definitively linked to the outbreak. The doctor's medical license has been suspended, and his attorneys claim that there is no evidence that the outbreak is linked to his office.

Liver Transplant Study Finds Inequities
Women, African Americans and Medicare-covered patients hospitalized with liver-related conditions are less likely to be evaluated and referred for a liver transplant, according to a University of Pittsburgh School of Medicine study. The study looked at 144,507 patients hospitalized in Pennsylvania with liver-related conditions between 1995 and 2001 and tried to determine if any potential barriers existed at the referral stage. The study found that 4,361 of those patients underwent transplant evaluation. Of that group, 3,071 were wait-listed and 1,537 went on to have a transplant. Another 57,020 died during the study period. According to the study, 61 percent of men were evaluated for transplantation compared to 39 percent of women; 73.8 percent of whites were evaluated compared to 8.6 percent of African Americans; and 62 percent of patients with commercial insurance were evaluated compared to 4.7 percent with Medicare only. "What we found is that from the point of hospitalization, where people are diagnosed with liver-related conditions, gender, race and insurance status play a big role in who is evaluated and listed for transplant," researchers said.

Medical Malpractice Case Settled After 13 Years
The estate of a late Erie businessman is set to receive $806,714 in a medical malpractice case - 13 years after the state sued Hamot Medical Center and three years after the estate won at trial. The state Supreme Court finally denied Hamot's final appeal in the case. His estate sued Hamot in 1996 after he fell at the hospital and suffered a brain injury in 1994 and died at a residential rehabilitation center in 1996. The state argued that Hamot's level of nursing care for the man, who was admitted for complications from a stroke, fell below acceptable standards, a contention Hamot disputed. The estate prevailed against Hamot at a jury trial in 2006. The state Superior Court upheld the verdict in 2008, prompting Hamot to ask the state Supreme Court to hear an appeal, a request the Supreme Court turned down.

State Hospital Trainee Pleads Guilty to Giving Woman Nails to Swallow
A former psychiatric aide trainee at Allentown State Hospital who says she suffers from a mental illness has admitted giving a patient nails and teaching her how to swallow them. She pleaded guilty to reckless endangerment, a misdemeanor that carries a maximum sentence of two years in prison. Police say that she showed an 18-year-old female patient how to swallow nails. Four nails had to be removed from the patient's abdomen. The trainee, who says she has bipolar disorder, told authorities she swallows nails and other metal objects.

VA Will Compensate Veterans for Medical Error
The U.S. Department of Veterans Affairs now estimates that more than 600 veterans erroneously received letters telling them that they had been diagnosed with Lou Gehrig's disease. As a result of the panic the letters caused, the agency plans to create a more rigorous screening process for its notification letters and is offering to reimburse veterans for medical expenses incurred as a result of the letters. "That's the least they can do," said a former Air Force reservist who racked up more than $3,000 in bills for medical tests to get a second opinion after receiving the letter. Since acknowledging the mistake, the VA has increased its estimate on the number of veterans who received the letters in error. The VA has also refuted a Gulf War veterans group's estimate of 1,200, saying the agency had been contacted by fewer than 10 veterans who had been wrongly notified.

Hospital Sued Over Charges for Copies
A law firm has sued Magee-Womens Hospital, claiming the Pennsylvania hospital overcharges for providing copies of medical records. The 20-page class action lawsuit was filed in Allegheny County Common Pleas Court. The same law firm sued another hospital with similar allegations. The lawsuit claims that charges connected to the records must be cost based, but that Magee charges the maximum allowed by the state regardless of what it costs the hospital to provide the copies. The lawsuit is seeking refunds for everyone who has bought copies of records since 2005.

Study Finds Radiation Risk for Patients
At least four million Americans under age 65 are exposed to high doses of radiation each year from medical imaging tests, according to a new study. About 400,000 of those patients receive very high doses, more than the maximum annual exposure allowed for nuclear power plant employees or anyone else who works with radioactive material. The study did not estimate the number of cancer cases that the radiation might cause over the next several decades, but some doctors say it would probably result in tens of thousands of additional cancers. Each individual patient is at relatively minor additional risk from the tests, but because they are given to so many people, the cumulative risk is significant.

Acquitted Oral Surgeon Faces Civil Lawsuit
A Pennsylvania woman has sued a Mt. Lebanon oral surgeon over allegations that he sexually assaulted her while she was under anesthesia. The woman filed the civil lawsuit against the doctor, who was acquitted by a judge earlier this year of criminal charges of molesting 17 female patients. The lawsuit accuses the doctor of sexually assaulting the woman twice in 2007. The lawsuit seeks compensatory and punitive damages in excess of $25,000.

VA Investigates Errant Notices of Fatal Disease
The U.S. Department of Veterans Affairs will personally apologize to veterans who received erroneous letters saying they had been diagnosed with Lou Gehrig's disease. The veterans also will receive an explanation about how "this unfortunate and regrettable error" occurred and reassurances that the letters do not confirm diagnoses of the fatal neurological disease. VA employees were still thumbing through case files, trying to determine exactly how many veterans mistakenly received letters intended to inform sufferers of ALS, or Lou Gehrig's disease, of benefits available to them or surviving spouses and children. The VA mailed more than 1,800 letters and has been notified by less than 10 veterans who received the letters in error. However, a Gulf War veterans group that provides information, support and referrals about illnesses to military members estimates at least 1,200 veterans received the letters by mistake.

Study Finds Risk in Off-Label Prescribing
Physicians are allowed to use drugs in ways that are not specifically approved by the Food and Drug Administration, a practice called off-label prescribing. There is usually less scientific evidence to support nonapproved uses, and a new survey of physicians has found that many might not even know when they are prescribing off label. The average physician in the survey identified the FDA approval status correctly for only about half the drugs on a list provided by the researchers, according to a study. Confusion was greatest with psychiatric drugs, the survey of some 600 doctors found. Nearly one in five who prescribed Seroquel in the previous year thought it was approved for patients with dementia and agitation, even though it was never approved for this use and even carried a "black box" warning that it was dangerous for elderly patients with dementia. And one in three doctors who used lorazepam to treat chronic anxiety thought it had been approved for this use; in fact, the FDA warning advises against using it for this purpose.

What Your Doc Isn't Telling You Could be Deadly
As it turns out, no news is not always good news. A new study shows that in one out of 14 abnormal test result cases, the patient was not informed of the irregular result. Of nearly 5,500 patient records studied from 23 physician practices across the country, some doctors failed to let patients know of abnormal results 25 percent of the time. For some patients, that failure could be the difference between life and death. Nor should you assume that your doctor's computer system means the office is on top of things. Researchers found that groups that stuck with simple paper-based processes to manage test results were less likely to forget to inform patients of abnormal results. Electronic records didn't necessarily prove more successful, and offices using a mix of paper and electronic records had even higher failure-to-inform rates. To avoid errors, the study authors suggest all test results be routed to the proper physician, who then must sign off on the results. The office should contact patients with the test results no matter what the outcome, and then should document that the patient was called. As a backup, patients should be told to call within a certain time period if they haven't heard from the doctor's office.

Complaint Over Doctor Who Posted Inkblot Test
The doctor who helped Wikipedia publish the 10 inkblots of the Rorschach test is being investigated by his local doctors' organization after it received complaints that his actions were unprofessional. In a letter from the group, the College of Physicians and Surgeons of Saskatchewan, the doctor was notified that two psychologists had filed complaints. One of them complained that by including the inkblots on Wikipedia, the doctor was violating the test's secrecy and that if he were a psychologist, his behavior would be "viewed as serious misconduct." The other complaint echoed the same concern about the test's security, but added that the doctor "shows disrespect to his professional colleagues in psychology and disparages them in the eyes of the public."

Surgeon Tied to Bone Product Inquiry Resigns
A former Army surgeon accused of falsifying a study on a bone growth product used on severely injured Iraq war veterans has resigned his teaching post at Washington University. The surgeon was placed on leave earlier this year while the university investigated charges against him. Medtronic, the maker of the bone growth product Infuse, also suspended his consulting contract. The company paid him nearly $800,000 the last few years. An investigation by Walter Reed Army Medical Center, where the surgeon worked before joining the university, concluded that he had falsified parts of a study that claimed greater benefits than other Army surgeons reported for the Medtronic bone growth product. The Army reported its findings to the university and a medical journal the surgeon was also found to have forged the signatures of four listed co-authors, who told Army investigators that they did not approve the study.

Senator Moves to Block Medical Ghostwriting
A growing body of evidence suggests that doctors at some of the nation's top medical schools have been attaching their names and lending their reputations to scientific papers that were drafted by ghostwriters working for drug companies, articles that were carefully calibrated to help the manufacturers sell more products. Experts in medical ethics condemn this practice as a breach of the public trust. Yet many universities have been slow to recognize the extent of the problem, to adopt new ethical rules or to hold faculty members to account. Those universities may not have much longer to get their houses in order before they find themselves in trouble with Washington. A senator who helps oversee public funding for medical research signaled that he was running out of patience with the practice of ghostwriting. He has had a long-running interest in investigating conflicts of interest in medicine and is starting to put pressure on the National Institutes of Health to crack down on the practice.

Diabetes Case Shows Pitfalls of Treatment Rules
A plan embraced by insurers, health plans and Congress is coming under fire. The plan entailed drawing up guidelines on how to best treat a particular illness and then paying doctors to follow the guidelines. However, setting such guidelines may not be good for every patient and some experts are warning that a similar national plan will pose risks. A recent case involving diabetes treatments has illustrated the difficulties. A national guideline-setting group abruptly withdrew a controversial diabetes standard it adopted in 2006 that called for aggressive control of blood sugar. The change came after a large federal study indicated that lowering blood sugar levels too quickly or too much in some patients could harm or even kill them. Medical journals and diabetes experts have lashed out at the group's initial decision to approve the guideline, saying they warned back in 2006 that it was medically ill-advised for some patients.

Charges Against Chiropractor Dropped
Charges against a chiropractor who was accused of inappropriately touching four female patients were dropped. He was charged with four counts of indecent assault and four of harassment for allegedly reaching down the pants of the patients while giving them an "adjustment" to treat heartburn. At a preliminary hearing, the district attorney asked that all charges be dropped because the statute of limitations had expired. The statute is two years, and the alleged incidents occurred in 2004 and 2006. The credibility of the accusations was also called into question because the women, who police said all knew each other, filed charges against the chiropractor one month after he sued his former business partner, with whom one of the women has close ties.

Lawsuit in Death Ends with Settlement
A four-year court fight over a midstate woman's death from breast cancer has ended with a $1.35 million insurance settlement sanctioned by a judge. The case stems from the 2005 death of a 38-year-old woman from breast cancer. Her family contended that her cancer was misdiagnosed and not promptly and properly treated. In the suit, the woman's family claimed her cancer was misdiagnosed in 1999 after a biopsy was conducted on tissue from an area of concern on her left breast. Indications of cancer that should have been detected were not identified, though. Her family alleged that the woman had a history of breast cancer, therefore wasn't given appropriate guidance for treatment and that she could have survived with the appropriate care. Several insurers are to pay for the settlement between the family and doctors.

Surgery Tech in Hepatitis Case Pleads Not Guilty
A Colorado surgery technician who authorities say is linked to at least 19 cases of hepatitis C has pleaded not guilty to charges of stealing syringes of painkillers and replacing them with dirty needles. The technician appeared in court on charges of tampering and illegally obtaining a controlled substance. She could face life in prison if convicted. Prosecutors say she was addicted to painkillers and exposed up to 6,000 patients at hospitals in Denver and Colorado to hepatitis C, an incurable liver disease. Investigations have also been launched in New York and Houston, where she previously worked at hospitals.

Do Patients Share Blame When Doctors Miss Diagnosis?
Diagnostic failures, or diagnoses that are delayed or in error, are an increasingly popular topic of research in patient safety. While some researchers have focused on the role of doctors, others have looked at the steps involved in care, or the process of care. What has emerged most recently from this latter group of studies is that diagnostic failures are often due to missed steps, so-called "process of care lapses," that stem from both doctors and patients. Investigators from Harvard Medical School studied the records of over 100 women with breast cancer diagnosed late or at advanced stages and found that roughly a quarter of patients had experienced process of care lapses. Examples of such lapses included inadequate physical exams, delayed physician involvement and incomplete diagnostic and laboratory tests. But while the investigators discovered that nearly 20 percent of the women were missing as many as two or more steps in their care, they also found that doctors and patients contributed equally to the resulting diagnostic failures.

Quick Tests for Flu Often Inaccurate
As the swine flu spreads, many doctors and hospitals are turning to rapid tests that can determine within minutes whether an anxious patient has the flu, and sales of such tests are soaring. However, the tests have a severe limitation: They may fail more than half the time to detect swine flu infections, according to newly published studies and to experts in medical testing. The low sensitivity of the tests is becoming a concern to health authorities because a false negative reading might prompt a doctor not to prescribe antiflu drugs. It is also one of the big issues laboratory directors face as they prepare for what is expected to be a crush of flu testing this fall and winter. Numerous diagnostic companies are hoping to capitalize on demand for influenza testing.

Studies Question Using Cement for Spinal Injuries
Two new studies cast serious doubt on a widely used and expensive treatment for painful fractures in the spine. The treatment, vertebroplasty, injects an acrylic cement into bones in the spinal column to ease the pain from cracks caused by osteoporosis, the bone-thinning disorder common in older people. Doctors began performing it in this country in the 1990s, patients swore by it, and it soon caught on, without any rigorous trials to determine whether it really worked. The new studies found the cement no better than a placebo, but it remains to be seen whether the findings will change medical practice, because they defy the common wisdom and challenge a popular treatment that many patients and doctors consider the only hope for a very painful condition.

Medical Papers by Ghostwriters Pushed Therapy
Newly unveiled court documents show that ghostwriters paid by a pharmaceutical company played a major role in producing 26 scientific papers backing the use of hormone replacement therapy in women, suggesting that the level of hidden industry influence on medical literature is broader than previously known. The articles, published in medical journals between 1998 and 2005, emphasized the benefits and de-emphasized the risks of taking hormones to protect against maladies like aging skin, heart disease and dementia. That supposed medical consensus benefited Wyeth, the pharmaceutical company that paid a medical communications firm to draft the papers, as sales of its hormone drugs soared to nearly $2 billion in 2001. But the seeming consensus fell apart in 2002 when a huge federal study on hormone therapy was stopped after researchers found that menopausal women who took certain hormones had an increased risk of invasive breast cancer, heart disease and stroke. A later study found that hormones increased the risk of dementia in older patients. The ghostwritten papers were typically review articles, in which an author weighs a large body of medical research and offers a bottom-line judgment about how to treat a particular ailment. The articles appeared in 18 medical journals and did not disclose Wyeth's role in initiating and paying for the work.

Doctors Reap Benefits by Doing Own Tests
In 2005, doctors at a medical practice in Iowa ordered nine CT scans for patients covered by insurance. A month later, they ordered eight. After that, the numbers rose sharply, with the urologists ordering 35 scans, 41 scans and 55 scans each month. Within seven months, they were ordering scans at a rate that had climbed more than 700 percent. The increase came in the months after the urologists bought their own CT scanner. Instead of referring patients to radiologists, the doctors started conducting their own imaging and drawing insurance reimbursements for each of those patients. A host of studies and reports by academics and the federal government shows that physicians who own scanners order many more scans than those who do not. As a result, Americans pay billions of dollars in extra taxes and insurance premiums. Government panels have found that, across several areas of medicine, ordering more procedures does not improve health outcomes. In the case of medical scans, unnecessary imaging also creates a health risk; as many as 1 percent of all cancers in the United States appear to be caused by radiation from medical imaging.

Dozens Arrested in Health Care Scam Sweep
Federal authorities arrested more than 30 people, including doctors, and were seeking others in a major health care fraud investigation in New York, Louisiana, Boston and Houston. More than 200 agents worked on the $16 million case, which included 12 search warrants at health care businesses and homes across the Houston area, where the bulk of the arrests were made. Federal authorities say those businesses were giving patients "arthritis kits," which were nothing more than expensive orthotics that included knee and shoulder braces and heating pads. Patients told the authorities that the kits were unnecessary, and many never even received them. Health care clinic owners billed $3,000 to $4,000 for each kit. Another scam involved billing Medicare for thousands of dollars worth of liquid food like Ensure for patients who cannot eat solid food. The authorities said clinic owners never distributed food to patients. In some cases, clinic owners billed patients who were dead when they were said to have received the items.

Lax Hospitals May Foster Kidney Sales
A look-the-other-way attitude at some U.S. hospitals may be fostering a black market trade in kidneys, transplant experts say. Some hospitals do not inquire very deeply into the source of the organs they transplant because such operations can be highly lucrative. A single operation can bring in tens of thousands of dollars for a hospital and its doctors. Despite guidelines from various groups and Medicare, U.S. transplant centers are mostly free to write their own rules for screening donors to make sure they are not selling their organs. The questions they ask vary widely. Some hospitals require long waiting periods to weed out shady donors; others do not. The possibility that organ trafficking is going on in the U.S. and that surgeries take place at hospitals in this country was raised with the recent arrest of a New York man who was charged with plotting to buy a kidney from an Israeli and sell it to an American patients for $160,000. The man was recorded boasting that he had brokered "quite a lot" of transplants over 10 years.

FDA Deems Mercury Level in Fillings Safe
Silver dental fillings containing mercury are safe for use by adults and children ages 6 and above, the FDA says. Only people who are allergic to mercury should avoid that type of filling. After reviewing more than 200 scientific studies, the agency concluded that mercury vapor released by the filling was not enough to cause brain damage. Still, the agency for the first time classified the fillings as a Class II, or "moderate risk," medical device. The move acknowledges the risk for patients and allows the agency to impose tighter safety controls. The decision is somewhat of a change of heart for the FDA, which settled a lawsuit last year with groups opposed to mercury use by posting a warning on its Web site about the filling's potential risks for fetuses, breast-feeding infants and children younger than 6. The agency said the findings showed that the fillings do not expose those groups to mercury levels considered unsafe by the Environmental Protection Agency, but added that there were few studies on the effects of mercury in fillings on children under 6.

New Jersey Tosses $71.8 Million Medical Malpractice Award
The New Jersey Supreme Court overturned a $71.8 million medical malpractice award to the family of a brain-damaged infant, finding the trial judge's serious errors during jury selection and disparate treatment of counsel made the trial hopelessly unfair. The court unanimously found that the judge's voir dire process failed to screen for bias against the defendants and that her apparent favoritism toward the plaintiffs counsel further cast doubt on her fairness, so much so that she should not preside at the retrial. The plaintiff underwent successful spina bifida surgery in 1998 when he was four months old. During recovery, an endotrachial breathing tube moved, and he was without oxygen for five to 15 minutes. The boy was rendered a quadriplegic, is blind and cognitively delayed and will require around-the-clock care for the rest of his life. The lawsuit alleged that medical personnel failed to respond quickly enough, failed to administer the correct drugs and did not call for help. The court found that the way the judge conducted voir dire allowed jurors to develop prejudices against the hospital. Jurors were asked in open court, which allowed potential jurors to hear about others' negative experiences with the hospital.

Lab Coat On the Hook in the Fight Against Germs
The American Medical Association is studying a proposal made at its annual meeting that doctors hang up their lab coats for good. The group's Council on Science and Public Health is looking at the role clothing plays in transmitting bacteria and other microbes. The lab coat resolution reflects a growing suspicion that doctors may not always be as clean as they can be. One 2004 study found that 48 percent of neckties worn by a sampling of New York City doctors and clinical workers carried at least one species of infectious microbe. Two years ago, the British National Health System adopted a "bare below the elbow" hospital dress policy that bans long fingernails, ties, hand and wrist jewelry. Little data exists that definitively ties lab coats and other accoutrements to the infections that kill nearly 100,000 hospital patients in the United States annually.

Hepatitis C Case Found at 2nd Colorado Hospital
A patient infected with hepatitis C has been found at a second Colorado hospital that employed a surgery technician accused of swapping her dirty syringes for ones filled with painkillers meant for patients. State health officials said a patient at the second hospital may have contracted the blood-borne liver disease from the 26-year-old technician. Prosecutors have already linked 19 hepatitis C cases found at the first hospital. She faces multiple charges of tampering and fraudulently obtaining a controlled substance. She also worked at hospitals in New York and Houston, where health officials have launched investigations. Officials say up to 6,000 patients at the two Colorado hospitals may have been exposed to the disease. Thousands of former patients have been tested, with 1,818 negative results for the one hospital and 894 for the other.

Immigrant Deported by Florida Hospital Sues
The case of an illegal Guatemalan immigrant who was privately deported by a Florida hospital is at the center of a legal battle. The immigrant was flown from the hospital to Guatemala in 2003 after it had spent more than $1 million rehabilitating him from injuries suffered in a car crash. The case is now the focus of a civil trial in which his family members say the hospital sent him home illegally so it wouldn't have to pay to treat him.

Airman Loses Legs After Gallbladder Surgery
An airman lost parts of both legs and was in critical condition after routine gallbladder surgery at an air force base went horribly wrong. The airman was supposed to get his gallbladder removed laparoscopically, via a small incision. During the procedure, surgeons nicked or punctured an aorta, a large artery that carries blood from the heart throughout the body. The surgeons repaired the breach enough to save his life, but the repair began leaking and disrupted the blood supply to his legs. He was flown to a medical center where doctors told the family that damage from the lack of blood required amputation. He has since undergone 10 surgeries to remove dead tissue from his legs, leaving him without much of his right leg and the lower portion of his left. He still hasn't had his gallbladder removed because of the surgery complications. The case is under investigation by the base, a national hospital accrediting commission and the U.S. surgeon general.

Popular Heart Bypass Technique May Pose Risk
A common method used in heart bypass surgery spares patients pain and problems upfront but seems to raise their risk of dying or suffering a heart attack over the next three years, a worrisome new study finds. The results could have a big impact. About 450,000 bypass operations are done each year in the U.S. and 70 percent of them use the method at issue. It involves the way doctors remove a leg vein that is cut up and moved to the chest to create detours around clogged heart arteries. For decades, this was done with a long incision that left scars and often led to infections. About 13 years ago, doctors started trying a new way: making small "porthole" cuts and using a tiny scope and tools to tunnel along the vein and pull it out through the small openings. This method quickly became popular, but the study has found that people who had the small-incision method were significantly more likely to die, suffer a heart attack or need another artery-opening procedure in the following three years. The likely reason is that the vein suffers damage from being pulled out and doesn't hold up well over time.

New York Hospital Warns of Possible Hepatitis Risk
A hospital in New York is notifying about 2,800 patients of possible exposure to hepatitis C after learning that a former employee is suspected of exposing nearly 6,000 patients in Colorado to the disease. The New York State Health Department said that it's working with another hospital after learning that the worker in question worked at the hospital between 2007 and 2008. The agency is recommending that patients who had surgery then should be tested. Colorado health officials believe the worker may have exposed patients to hepatitis C while working as a surgery technician in Denver. She is accused of injecting herself with painkillers meant for patients, then filling the used syringes with saline solution, even though she knew she was infected. Ten cases of hepatitis C have been linked to the Denver hospital, where she worked until April.

VA Hospitals Inadequately Serving Women
Veterans Affairs Department hospitals and clinics aren't always making sure women veterans have privacy when they bathe and receive exams, government auditors have found. As thousands of women veterans return from Iraq and Afghanistan and enter the VA's health system, the Government Accountability Office reported that no VA hospital or outpatient clinic under review is complying fully with federal privacy requirements. GAO investigators found that many VA facilities had gynecological tables that faced the door, including one door that opened to a waiting room. It also found instances where women had to walk through a waiting area to use the restroom, instead of it being next to an exam room as required by VA policy. At four hospitals investigators visited, women were not guaranteed access to a private bathing facility. In two of those cases, there wasn't a lock on the door.

Study Cites Hormones as Cancer Risk
Women who took hormone replacement therapy after menopause had a sharply increased risk of ovarian cancer, researchers in Denmark have found. In a study of more than 900,000 Danish women ages 50 to 79, the scientists found 140 extra vases of ovarian cancer linked to hormone treatment over eight years. That translated to a 38 percent greater risk of contracting the disease compared with women who did not receive the therapy. Hormone therapy accounted for 5 percent of the cases of ovarian cancer in the study period. The findings were similar to those in a 2002 study, which was stopped early because it found an increased risk of ovarian cancer, breast cancer, strokes and other health problems from hormone therapy. Use of the treatment plunged after those findings were reported, and sales of some therapies have fallen 50 percent since 2001.

Medical School Says Former Army Surgeon Hid Ties to Medtronic
A former medical doctor and Medtronic consultant at the center of a research scandal did not tell his medical school employer for a year about his Medtronic ties even as he was conducting company-sponsored research. The new disclosure, which the medical school made in response to a Senate investigation, may intensify the controversy surrounding the physician. The Army has accused him of falsifying a medical journal study about the use of Medtronic bone-growth product on American soldiers with severe leg injuries, reporting more favorable results than other Walter Reed doctors found. The medical documents also shed new light on Medtronic's financial support of the doctor's research on those soldiers, who were treated with the company's bone-growth product, Infuse. Medtronic has denied supporting or knowing about the doctor's study of Infuse at Walter Reed. However, the documents show that for more than a year Medtronic financed a separate, unpublished study by the same doctor while he was teaching that also reviewed the use of Infuse on Walter Reed patients with combat-related leg injuries.

VA Putting Patients at Risk of Overdose
Two years after an Iraq war veteran overdose on medication at a Veterans Affairs facility, the problems blamed in his death have not been corrected at many of the VA's residential treatment sites, a government study found. The VA's inspector general ordered the review as part of legislation passed to fix problems after the 27-year-old veteran's death in 2007. The former Marine had surgeries for a groin injury he sustained during the war and was diagnosed with post-traumatic stress disorder. His father later testified that the day before his son died, he was given five different prescriptions in doses covering 14, 15 and 30 days. The father also said that his son had been in the treatment facility for six weeks, but had yet to see a psychiatrist. He son was also known to abuse prescription medications. The inspector general's review says fewer than half of sites visited had appropriate policies to screen patients. More than 10 percent of patients allowed to give themselves narcotics received more than a week's supply.

1 in 3 Breast Cancer Patients Overtreated
One in three breast cancer patients identified in public screening programs may be treated unnecessarily. Researchers analyzed breast cancer trends at least seven years before and after government-run screening programs for breast cancer started in parts of Australia, Britain, Canada, Norway and Sweden. Once screening programs began, more cases of breast cancer were inevitably picked up. If a screening program is working, there should also be a drop in the number of advanced cancer cases detected in older women, since their cancers should theoretically have been caught earlier when they were screened. However, the study found that the national breast cancer screening systems, which usually test women aged between 50 and 69, simply reported thousands more cases than previously identified. Overall, one third of the women identified as having breast cancer didn't actually need to be treated.

New York Hospitals Fare Poorly on Readmissions
Hospitals in New York are significantly worse than those elsewhere in the nation at limiting patients from having to return shortly after being treated for a major illness, according to federal data. Critics of hospitals with high readmission rates have long accused hospitals of having a financial motive for creating what they call a revolving door for patients. Generally, hospitals are paid for each admission, regardless of how long the patient stays in the hospital. So when patients return, the hospital is paid again for the new treatment. However, hospitals claim that they often treat poor and uneducated patients who may return because they do not have access to primary care nurses and physicians and so are regular users of the emergency room. Nationwide, about one in five Medicare patients end up back in the hospital within 30 days of being discharged.

Judge Allows Wrongful Death Suits Against Hospital to Proceed
Five wrongful death suits filed against a Lehigh County hospital by families of patients a former nurse has confessed to killing can proceed to trial. However, the same judge who allowed five suits to go to trial threw another 10 out because the nurse never confessed to the murders. The nurse, who is now serving a life sentence in Trenton, worked at the hospital as a nurse from 2000 to 2002. He pleaded guilty to killing 29 people and attempting to kill six others at hospitals in Pennsylvania and New Jersey. Five hospitals where he worked have reached undisclosed settlements with families of patients who he had killed.

Oral Surgeon Acquitted of Molesting Patients
Compelled by testimony of drug-induced sexual hallucinations, an Allegheny County judge acquitted an oral surgeon of all charges related to allegations he molested 17 female patients. The surgeon was cleared of assaulting patients in his offices from 2002 through 2007, when two patients went to police. The judge said he believed the women were truthful about what they thought happened, but he found compelling the testimony of defense experts who said the women could not have remembered anything because of drugs used to anesthetize them and the fact that the drugs can cause sexual hallucinations. The judge clarified that if the case were a civil matter rather than a criminal, his verdict might have been different. Two patients involved in the case have filed notices they intend to file civil lawsuits. The surgeon centered his argument around anesthesia drugs that can cause sexual hallucinations while preventing the patients from remembering anything real.

Psychiatrist's Trial Set in Jail Death
A federal judge presiding in a civil lawsuit stemming from an inmate's suicide in the Northumberland County Prison in 2006 has ruled that the medical malpractice and wrongful death case against the inmate's psychiatrist can proceed to trial. The judge dismissed several counts in the suit against Northumberland County, some of the claims against the psychiatrist and some of the psychiatrist's complaints against the county. The county has already agreed to pay $360,000 to settle its portion of the lawsuit. Contained in the order is extensive testimony that reveals that the inmate's suicide while in custody might have been avoided if the psychiatrist and prison workers had communicated more effectively. Several prison employees, including a shift commander, the prison nurse and at least one guard, misunderstood or never received an order from the psychiatrist indicating that the inmate was to be placed on suicide watch. The psychiatrist claims he didn't understand the difference between "close watch" and "constant watch" in the context of prison procedures. His order put the patient on close watch, which only required observation every 15 minutes. The psychiatrist believed that the inmate was suicidal and tried to have him transferred to a hospital. However, because there were charges pending against the inmate, the hospital would not accept him. The suit was brought by the inmate's grandmother on behalf of his estate.

Hospital Worker Held in Hepatitis C Case
A Denver hospital has asked every patient who had surgery there over a six-month period to come in for a blood test amid allegations that a former technician exposed up to 6,000 people to hepatitis C as she fed her painkiller addiction. The technician is accused of injecting herself with painkillers meant for patients, then filling the used syringes with saline solution. Thousands of patients at two hospitals where she worked were exposed, and nine have tested positive for hepatitis C. If convicted of all charges, she faces a maximum of 34 years in prison.

VA Silent on Patient Compensation
An attorney for veterans potentially exposed to HIV and other infections by colonoscopies at three Department of Veterans Affairs hospitals said his clients were waiting to hear if they will be compensated for mistakes that led to congressional hearings and new VA spending on patient safety. Of the more than 10,000 veterans who have been getting follow-up blood checks and have the option of filing a complaint in a claim just like other VA patients. Attorneys for the patients describe the claims process as cumbersome, particularly for veterans who have tested positive for HIV and hepatitis. Most recently, a seventh veteran has tested positive for HIV among the others exposed to mistakes with rigging or cleaning endoscopic equipment at VA hospitals in Tennessee, Miami and Augusta. Another 12 veterans among those who have heeded VA warnings to get follow-up blood checks have tested positive for hepatitis B and 36 others have tested positive for hepatitis C.

Few Survive Cardiac Arrest, Even with CPR
The odds of surviving a cardiac arrest after getting CPR in a hospital are slim and have not improved in more than a decade. Only about 18 percent of such patients live long enough to leave the hospital. Black patients fared worse than white patients, a disparity only partly explained by more of them being treated in hospitals that did a poorer job of CPR. Another study found that one-third of hospitalized patients do not get a potentially life-saving defibrillator shock within the recommended two minutes of suffering cardiac arrest. Even when CPR is given by these highly trained hospital staffers, chest compressions often are too slow or too shallow to be effective.

Oncologist Defends His Work at VA Hospital
The radiation oncologist whom regulators accuse of mishandling scores of radioactive seed implants at the Philadelphia veterans' hospital told a Congressional panel that while he "could have done better" with some implants, his patients over all received effective treatment for their prostate cancer. Speaking publicly for the first time, he said that he was not a "rouge physician" and that his academic credentials and an absence of malpractice lawsuits underscored that point. Investigators for the Nuclear Regulatory Commission and V.A. officials have identified him as the doctor who did all but a handful of what they say were 92 substandard seed implants out of 116 cases over more than six years. In some cases, most of the tiny metal seeds ended up in other organs. Investigators claims to have found that the errors resulted from a systemwide regulatory failure, in which none of the safeguards intended to protect veterans from poor medical care had worked.

Puzzling Disparities Found in Childbirth Injuries
A new government study turned up some unexpected and puzzling disparities in injuries to women and babies during childbirth. Women covered by Medicaid were less likely to be injured in childbirth than those with private insurance. Their babies, however, were more likely to experience complications, such as broken collarbones, head injuries and infections. A similar dichotomy was revealed when the researchers compared births in urban and rural hospitals: moms did better in rural hospitals, while their babies did worse. Overall, the news from the study was good; researchers found that childbirth complications have declined in the years between 2000 and 2006. But experts were perplexed by the disparities between the different groups of women and children.

Doctor and Patient Accused of Using False Prescriptions for Pills
A family practice physician and a painting contractor were charged with conspiring to obtain thousands of painkillers over a four-year period by writing and passing prescriptions in the names of the contractor, family members and employees. Authorities say the scheme started in 2005 and continued until state agents raided the doctor's office. Both men allegedly obtained thousands of pills in the names of their parents and wives, as well as two of the doctor's employees. In addition to writing those prescriptions, the doctor wrote and personally filled numerous prescriptions totaling more than 3,000 Oxycodone pills in the name of a mistress and his ex-wife without their knowledge or consent.

Medtronic Gets Subpoena Regarding Disputed Study
Medtronic disclosed that it had received a Justice Department subpoena seeking information about its ties with a company consultant, a former Army doctor accused of falsifying a favorable medical journal article about a Medtronic bone growth product called infuse. The medical device maker indicated in a filing with the Securities and Exchange Commission that it had received a subpoena in May from the United States attorney in Boston seeking information about its financial ties and other dealings with a former orthopedic surgeon at Walter Reed Army Medical Center in Washington. Recently, Medtronic, at the behest of a senator, disclosed that it had paid about $800,000 in consulting fees over the years to the doctor, with the vast bulk of those funds paid to him in the last three years. It was over that period that the doctor submitted his now-challenged Infuse study to a series of medical journals before it was published in 2008 in a British journal. It claimed Infuse performed "strikingly" better than a traditional bone graft when used to repair serious leg injuries suffered by American soldiers. In an investigation completed last year, the Army accused the orthopedist of forging the name of other military doctors on that Infuse article and citing patient data that did not match Walter Reed records.

False Test Results Seen in Maternal Screening
A massive effort to test pregnant women for a deadly germ they can spread to their babies had yielded a bad surprise: High rates of wrong test results that led some infants to miss out on treatment. A study found the test missed more of the infections than would normally be expected. If the mothers had tested positive for the Group B strep bacteria, they would have been given antibiotics during labor to cut the chances of infecting their infants. Group B strep is a common bacteria carried in the intestines or lower genital tract and can be spread to babies during delivery. It's harmless to most adults, but in newborns can lead to blood infections, pneumonia, meningitis, mental retardation or hearing and vision loss and death. It is a rare problem which occurs in less than 1 in 3,000 births, but the infection's terrible risks drove the Centers for Disease Control and Prevention and doctor groups in 2002 to recommend routine tests of all pregnant women. Possible explanations include problems with the collection of samples or the accuracy of the standard lab test used to check for the germ, experts said. Or perhaps the mother was infected after getting the test.

Surprise VA Inspections Show Continued Flaws
Fewer than half of Veterans Affairs centers given a surprise inspection last month had proper training and guidelines in place for common endoscopic procedures such as colonoscopies, even after the agency learned that mistakes may have exposed thousands of veterans to HIV and other diseases. The findings, from the VA's inspector general, suggest that errors in colonoscopies and other minimally invasive procedures performed at VA facilities may be more widespread than initially believed. The random inspections were conducted over two days at 42 VA medical centers around the country. They found that just 43 percent of the centers have standard operating procedures in place and have properly trained their staffs for using endoscopic equipment. The investigation comes months after the discovery of a mistake in Tennessee led to a nationwide safety campaign at the VA's 153 medical centers calling attention to potential infection risks from improperly operating and sterilizing the equipment.

Obesity Surgery May Thin Bones, Causing Breaks
Doctors don't yet know how likely patients' bones are thin enough to break in the years after surgery, but one of the first attempts to tell suggests they might have twice the average person's risk, and be even more likely to break a hand or foot. The Mayo Clinic's finding is surprising, and further research is under way to see if the link is real. But with bariatric surgery booming and even teenagers in their key bone-building years increasingly trying it, specialists say uncovering long-term side effects and how to counter them takes on new urgency. Simply taking today's doses of calcium supplements may not be enough.

Medtronic Paid Surgeon While in Army
Medtronic has acknowledged that it paid a former Army surgeon, who is now accused of falsifying research about one of its products, to give speeches and train other doctors on the company's behalf while he was in the military. The disclosure shows that the financial entanglements between Medtronic and the surgeon were more extensive than previously acknowledged. Army officials have accused the doctor of falsifying research about the benefits of a Medtronic bone growth product called Infuse in treating American soldiers who suffered severe leg injuries in Iraq. Until mid-2006, the doctor, an orthopedic surgeon, worked at Walter Reed Army Medical Center in Washington. Initially, Medtronic officials said that the company had supported some of the doctor's research through grants to a foundation but refused to say when the company had hired him as a consultant. That drew the attention of an Iowa senator, who had already been investigating Medtronic in connection with its marketing of Infuse.

Sexual Assaults Probed at Western Pennsylvania Psychiatric Clinic
The state is investigating separate claims of girls being sexually assaulted by other patients at Western Psychiatric Institute and Clinic on the heels of two lawsuits being filed against the facility. The most recent complaint alleges that a girl who was then 14 was sexually assaulted by a 16-year-old male patient. The other complaint includes claims that a 12-year-old girl was sexually assaulted in 2008 by a 15-year-old boy with a violent criminal record. The state Department of Health is conducting an investigation on behalf of the Department of Public Welfare. According to one lawsuit, the 14-year-old girl was admitted on referral after she was found to be socially withdrawn, depressed, having suicidal indications and engaging in self-harming behavior. Five days after she was admitted, she told a doctor that a male patient had been "intrusive" with her and that he had made inappropriate comments. She claimed that he assaulted her the next evening after sneaking into her room. Both lawsuits allege gross negligence in that the staff failed to properly supervise adolescent patients and allowed male and female patients to be housed in the same unit. It also includes a claim of corporate gross negligence. The other girl's attorney claims that the clinic tried to cover up her assault, claiming that her injuries were of her own doing. She was also moved to an area that housed patients ages 14 to 18, even though her mother had requested that she remain in an area for children under the age of 14.

Teen Files Sex Assault Case Against Psychiatric Clinic
A 15-year-old girl and her parents have sued Western Psychiatric Institute and Clinic over allegations that she was sexually assaulted by a male patient at the Oakland facility. The girl was admitted to the clinic for psychiatric care and evaluation. Six days later, the girl, who was 14 at the time, was sexually assaulted by an older male patient on the same floor as her. A similar lawsuit was filed against the clinic earlier this year. Another teenage girl claims she was sexually assaulted by a male patient.

Germs and Flu Up, But Infection Control Down
Even as the threat from drug-resistant germs continues to rise and the swine flu virus sweeps the country, U.S. hospitals are cutting back on staff and resources to battle potentially deadly patient infections. More than 40 percent of nearly 2,000 hospital infection workers responding to a professional association survey reported being hit by budget cuts in the past 18 months, mostly because of the troubled economy. The result has been layoffs, reduced hours, hiring freezes and diminished ability to detect, track and manage infections that can cost money. Reductions are short-sighted, because every new hospital infection adds an average of $15,275 in additional costs to a patient's care. Thirty-nine percent of infection control staffers who responded said they'd had layoffs or reduced hours in their departments and 35 percent had seen hiring freezes. Nearly a quarter said they'd reduced surveillance, meaning they weren't able to look as carefully or as often for evidence of infections. That includes detection and treatment of so-called superbugs such as methicillin-resistant staphylococcus aureus, or MRSA, and Clostridium difficile, known as C. diff, plus emerging threats from new infections.

Georgia Lawyers Pursue Family Values Vision with Abortion Case
An Atlanta-area abortion clinic is being sued on behalf of a teenager. The girl and her mother allege that the clinic violated the state's parental notification law and the Woman's Right to Know Act when it performed an abortion for the teenager without notifying her mother. Her attorneys claims she suffered mental and physical pain and suffering due to the "violence" of the abortion. The teenager gave the clinic a note signed by her then-boyfriend's mother, who represented herself as her mother.

Discredited Research Study Stuns Ex-Army Doctor's Colleagues
Army officials have uncovered an apparent case of falsified research by a doctor who had befriended the doctor when they both worked at Walter Reed, treating American soldiers severely injured in Iraq. The full report of that Army investigation provides an unusually detailed anatomy of a suspected case of medical research fraud, one all the more disturbing because it occurred at the nation's premier military research hospital. The Justice Department has opened an inquiry into the episode. The disputed journal article was written by a former Army orthopedic surgeon. The surgeon forged the signatures of other Army doctors on the study and never showed it to them before it was published. The British journal that published that study retracted it in March and has banned him from its pages. The incident has also shown how medical journals may fail to conduct adequate due diligence on the studies they publish, information that other doctors rely on for guidance. As happened in this case, they often deal only with a study's principal author, rather than all the credited contributors.

Hospital Tries to Separate from Lawsuit Over Patient Death
In an attempt to remove itself from liability for a patient's death, the University of Pittsburgh Medical Center claimed in a court filing this week that it doesn't run hospitals or employ any health care professionals. The family of the 89-year-old woman who wandered from her room and died on the roof of UPMC in December sued the health system, claiming its negligence caused the woman's death. The patient went missing from her room and was found dead the next morning on the hospital's roof, wearing only a hospital gown and slippers after a night in which temperatures dipped into the 20s. Defendant UPMC filed full answers to the family's complaint denying any negligence. UPMC took the position that even if there was wrongdoing on the part of its employees, it's not the health system's responsibility. The filing states that a fire exit door leading to the roof that the patient appears to have used was not required to be alarmed. Also, hospital staff did not discover a broken lock on a door to mechanical areas on the 13th floor until after her death. In addition, the response denies claims that hospital staff delayed in alerting police that the patients was missing or tried to remove evidence from the scene before authorities could investigate.

New Blood Tests for 920 Patients After Six Samples Mislabeled
A Bronx hospital has agreed to repeat blood tests for nearly 1,000 patients after an investigation found that some test results had been given to the wrong patients. State officials said that six patients being treated by outpatient clinics at the hospital had received inaccurate test results in 2008 because their blood samples had been mislabeled. The state said that as many as 920 patients, including some children, who had been tested at the clinics would be retested. The hospital claims that the inaccurate tests were "isolated incidents" affecting only six patients on six specific days, and that the hospital was "not aware of any adverse effects" on patients. Officials are still unsure, though, whether any patients had been given the wrong diagnosis or the wrong medication as a result of the testing errors. The State Health Department also faulted the hospital for failing to respond more quickly after it discovered problems with its testing.

Lawsuit Claims Psychiatrist Could Have Done More
A psychiatrist testified that a young man was the most suicidal individual he had ever seen in 30 years of practice, but that he did not tell Northumberland County Prison officials to place him under constant supervision, according to documents filed in a federal lawsuit. That breakdown in communications contributed to the 2006 suicide of the young man in his prison cell and led to a $360,000 settlement between the county and the dead man's grandmother. However, the wrongful death suit she filed against the psychiatrist is still pending. She alleges that the psychiatrist knew her grandson was suicidal, but failed to inform prison officials of his precarious mental and emotional state. The man had recently survived a fire that killed his mother, brother, his girlfriend and his mother's boyfriend, and he was arrested at his girlfriend's funeral for his disruptive behavior. He was evaluated by the psychiatrist that night and he ordered that the man be observed every 15 minutes. Because the psychiatrist did not order constant monitoring and did not tell prison officials he was suicidal, he was not placed in a suicide-proof cell or issued special suicide-proof clothing and blankets. The next day, a prison nurse took him off the 15-minute checks because she was not told of his suicidal tendencies. The man then hung himself with a bed sheet.

Psychiatric Hospital in Washington County Settles Abuse Suit
A private psychiatric hospital in western Pennsylvania paid $150,000 to settle a suit alleging it over-medicated and abused juveniles the state Department of Public Welfare sent there in 2005. The settlement includes no admission of wrongdoing, but does contain an agreement outlining standards of care and oversight. The suit was filed by a Harrisburg-area psychiatrist who, while under state contract, monitored private facilities for fraud and abuse from 2001 until his firing in 2003. He alleged that the hospital held juveniles who did not require hospitalization, prescribed and administered unnecessary medication to increase government reimbursements and billed the government for care that was not provided. The facility is licensed as a school and hospital and houses as many as 132 boys between the ages of 6 and 18. The psychiatrist also claimed he was fired after he reported a pattern of rampant abuse in facilities in Pennsylvania, Florida, Texas, Oklahoma and Virginia. He also won a $374,000 civil rights whistleblower suit in 2007 for his firing.

State Clears Doctor to Practice After Drinking at Work
An optometrist accused of being intoxicated at work can continue to practice, as long as probationary conditions are met the next three years, a state board has ruled. The optometrist surrendered his license in April after a complaint was filed with the state Board of Optometry, alleging that he was intoxicated while attempting to treat two patients in March. He claims that the intoxication allegation was hearsay. He was not criminally charged, but in proceedings before a state board committee, he admitted to drinking before work to the point of impairment, as well as having an alcohol addiction. One of the patients he treated that day screamed for help and attempted to keep the doctor from passing out.

Lawsuit in Patient's Rooftop Death to Proceed
The family of an 89-year-old woman who froze to death on the roof of a Pittsburgh hospital will continue with its wrongful death lawsuit against the hospital despite an adverse ruling from an Allegheny County Common Pleas judge. The judge struck more than 100 paragraphs from the 215-paragraph lawsuit filed earlier this year on behalf of the family of the woman, a dementia patient who wandered from her room and was found dead in freezing temperatures the next morning. Stricken from the complaint were references to a critical state Health Department report on her death, charges that a newly installed computer system was a factor in the case, alleged staffing shortages and references to other cases in which patients wandered from the hospital.

Small Gifts Found to Influence Doctors
Can a little promotional gift like a pen or a coffee mug inscribed with a drug's name really make a difference in a doctor's prescription patterns? It can, researchers say. A study reports that students from a medical school where such gifts are allowed had a more favorable attitude toward a cholesterol drug than did students from a school where they are banned. Although hospitals have long discussed what restrictions to place on the more valuable offerings lavished by drug companies, the researchers suggest that no gift is too small. The researchers worked with 352 third- and fourth-year students at Penn, which bans most gifts, samples and meals from drug companies, and the University of Miami, which allows them. using a series of psychological tests, the researchers assessed whether the students had positive and negative associations with the cholesterol drug Lipitor and a competitor, Zocor, which is available generically for less money. Most students from both schools viewed Lipitor more favorably, but when the researchers sought to influence the students subconsciously by having them use promotional materials like Lipitor clipboards and notebooks, they found that the fourth-year students in Miami showed stronger positive feelings for the drug.

Senator Seeks Data on Doctor Accused by Army of Falsifying Product Study
A top Republican lawmaker has opened an inquiry into a former Walter Reed Army Medical Center doctor whom the Army has accused of falsifying a medical study involving a product made by Medtronic, a company for whom he works as a paid consultant. The Iowa senator released letters seeking information about the doctor. The letters were sent to Walter Reed officials, two medical journals and the head of Washington University, where the doctor works as an associate professor in the medical school. It was reported that a British medical journal had retracted an article by the doctor earlier this year after learning from Army officials that he had, among other things, forged the names of four other doctors he cited as the study's co-authors. Army investigators determined that his article had overstated the benefits of a Medtronic bone-growth product, Infuse, that was used at Walter Reed to treat American soldiers who had suffered severe lower leg injuries in Iraq. Army officials also cited discrepancies in the data he cited, saying he had described more injuries than Walter Reed records showed.

Judge Tosses Claims from Lawsuit in Patient's Rooftop Death
A judge tossed many of the claims in a lawsuit against the University of Pittsburgh Medical Center brought by the son of an elderly patient who died on the roof of the hospital last year. The judge granted many of the motions sought by lawyers for the hospital but stopped short of dismissing the case in its entirety. The patient, an 89-year-old woman who was suffering from dementia, died after wandering from her hospital room in December. Her body was found in subfreezing temperatures on the hospital roof the next morning. The lawsuit alleges that multiple failures at the hospital, including the lack of a functioning lock on a door that the patient apparently walked through, resulted in her death. The hospital, meanwhile, has denied claims that her floor was understaffed and that there was an attempt to cover up or tamper with evidence, such as a malfunctioning lock.

Miami VA: Steps Taken to Stop Contamination
The top Veterans Affairs official in Miami said she has taken steps locally to prevent the kind of problems that exposed patients to contaminated medical equipment at VA hospitals in three states. The director of the Miami VA Healthcare System said she has hired someone in Miami to supervise training, make sure biochemical equipment works properly there and ensure the problems aren't repeated. Five patients have tested positive for HIV, three of them in Miami, and 33 have tested positive for hepatitis since February, when the VA started notifying more than 11,000 people treated at three VA medical centers to get follow-up blood checks because they could have been exposed to infectious bodily fluids. The equipment is used for colonoscopies and ear, nose and throat procedures.

Lines Drawn On Comparing Medical Treatments
The Obama administration plans to spend $1.1 billion over the next few years on studies to compare the effectiveness of competing treatments for common conditions like back pain, heart disease and prostate cancer. The studies will be publicly released, to help doctors and patients decide which treatment options they want to pursue. Supporters include many medical researchers, consumer groups, unions and insurers. They say such studies are essential to curbing the widespread use of ineffective treatments and helping control health care costs, which totaled $2.2 trillion in 2007, or 16 percent of the nation's gross domestic product. But potential opponents, which include medical products companies, some doctors and their political allies, warn that the comparative effectiveness movement could lead to inadequate treatment for some patients and even the rationing of health care.

Institute of Medicine Calls for Doctors to Stop Taking Gifts from Drug Makers
In a scolding report, the nation's most influential medical advisory group said doctors should stop taking much of the money, gifts and free drug samples they routinely accept from drug and device companies. The report, by the Institute of Medicine, part of the National Academy of Sciences, is a stinging indictment of many of the most common means by which drug and device makers endear themselves to doctors, medical schools and hospitals. "It is time for medical schools to end a number of long-accepted relationship and practices that create conflicts of interest, threaten the integrity of their missions and their reputations, and put public trust in jeopardy," the report concluded. The institute's report is even more damning than a similar one released last year by the Association of American Medical Colleges, which proposed tough new rules governing interactions between companies and medical schools. In the wake of the association's report, many schools and medical societies toughened their policies. The institute's imprimatur is certain to accelerate this process. The report calls on Congress to pass legislation that would require drug and device makers to publicly disclose all payments made to doctors.

California Woman Sentenced for Illegal Abortions
A woman who posed as a doctor and performed unlicensed abortions at her clinic in Chula Vista has been sentenced to six years and eight months in prison. A San Diego Superior Court judge ordered her to serve the sentence concurrently with a three-year term handed down by a Los Angeles court for similar charges. She pleaded guilty last year to nine counts of practicing medicine without a license and one count of grand theft. One of her patients suffered severe complications, had to be hospitalized three times and eventually gave birth prematurely. Her attorney said she is a "get-things-done kind of woman" who recognized what she did was wrong. She also operated five other abortion clinics in California.

Civil Suit Against Hospital Dismissed
A judge has dismissed a civil lawsuit against the Behavioral Health Department of Altoona Regional Health System brought by the widow of a man who died after he fled the hospital's mental health wing more than two years ago. His widow was asking for damages on behalf of his estate. The man was in the process of being admitted to the hospital's mental health wing when he assaulted a crisis counselor and left the facility. He then boarded a train and made it to a railroad bridge. State police eventually found his body in the river. The lawsuit against the hospital claimed that employees were negligent in allowing him to flee. The hospital claimed that the state's Mental Health Procedures Act grants limited immunity to employees of a mental health facility.

Doctor Liable for Sleeping with Patient, But Fault Shared
A Long Island judge has upheld a $416,500 jury award in a malpractice action against a doctor accused of sleeping with a patient he treated for depression. However, the judge declined to strike the jury's 25 percent apportionment of responsibility to the plaintiff under the doctrine of comparable negligence. "Given the patient's age and experience and notwithstanding the defendant's professional status, it remained that the plaintiff was possessed of a will of her own and was not utterly bound by defendant's influence or choices, but free to exercise her judgment and to engage in such conduct as she chose," the judge held. The patient, a former model, filed the medical malpractice action in 2004. She alleged that she visited her family practitioner for anxiety and depression in 2000, shortly after her infant daughter was diagnosed with cerebral palsy. From 2001 to 2002, the patient and doctor engaged in a sexual relationship. She claimed the affair led to the deterioration of both her mental health and marriage: her husband filed for divorce, she lost full custody of her daughter and experienced severe mental distress. She alleged that her doctor violated his duty of care by engaging in a sexual relationship with her while also treating her for depression. She claimed she was unable to exercise independent judgment.

Three Patients HIV Positive After VA Clinic Mistakes
Three patients exposed to contaminated medical equipment at Veterans Affairs hospitals have tested positive for HIV. Initial tests show one patient each from VA medical facilities in Tennessee, Georgia and Miami has the virus that causes AIDS. The patients are among more than 10,000 getting tested because they were treated with endoscopic equipment that wasn't properly sterilized and exposed them to other people's bodily fluids. The VA also said there have been six positive tests for the hepatitis B virus and 19 positive tests for hepatitis C at the three locations. The VA has said it does not yet know if veterans treated with the same kind of equipment at its other 150 hospitals have been exposed to the same mistake before the department had a nationwide safety training campaign.

Psychiatric Not Liable to Patient's Victims, Rules California Appeals Court
After a 19-year-old California man killed two neighbors in 2005, the victim's survivors sued the murderer's psychiatrist, accusing him of causing the rampage by giving his client an unstable mix of antidepressents. California's 4th District Court of Appeal ordered summary judgment for the doctor, saying that the patient had a pre-existing mental disorder that "necessitated" treatment. One of the justices ruled, "As early as 2001, the man exhibited violent tendencies toward his parents, and when he became a patient, he already suffered from Asperger's syndrome. The doctor did not create the man's painful mental disorder." The justices also found that the man had never expressed an anger towards the people he later killed.

Two California Hospitals Settle Patient-Dumping Lawsuit
A $1.6 million settlement has been reached with two Southern California hospitals accused of improperly discharging and dumping psychiatric patients on Skid Row in Los Angeles. The settlement also bars College Hospitals in the Orange County cities of Cosa Mesa and Cerritos from transporting homeless psychiatric patients to downtown shelters. City officials allege that over two years, as many as 150 patients from the two hospitals were dumped on Skid Row, an area on the east side of downtown where thousands of homeless people live. Under the settlement, the hospitals agreed to give $1.2 million to charities that care for the mentally ill and homeless and to pay $400,000 in civil penalties. In once case, a bipolar schizophrenic was driven 40 miles to the Union Rescue Mission last year from the Costa Mesa hospital. The next day, the shelter contacted the hospital and asked them to pick him up, saying they were unequipped to treat him. A van from the hospital came for him, but simply dropped him at another Skid Row shelter. From there, he wandered the streets before ending up at a clinic that contacted his family and found a place for him to board and receive treatment.

VA Patient Tests Positive for HIV After Mistakes
The Veterans Affairs department says a patient has tested positive for HIV after being exposed to contaminated equipment at a medical facility. The VA reported previously that hepatitis has been found in 16 patients. But the agency says there is no way  to prove the patients contracted the illnesses because of treatment at their facilities. More than 10,000 veterans have been warned to get blood tests because they could have been exposed to contamination at facilities Tennessee, Georgia and Miami. All three sites failed to properly sterilize endoscopic equipment between treatments. The VA has said patients could have been exposed to body fluids from a previous patient.

New Jersey Warns 3,000 to Get Tested for Hepatitis
New Jersey officials advised nearly 3,000 people who share a doctor to get tested after five cancer patients who visited the physician were found to have hepatitis B. Ocean County health officials said two cases of hepatitis B were confirmed in late February as connected with a single oncologist. Health officials decided to send a letter to all his patients dating to 2002. The letter warns them of the risk and suggests they be tested for the liver diseases hepatitis B and hepatitis C and for HIV. State officials recently learned of three more cases, all in the same area. How the disease spread is unclear.

Nurse Charged in Death of 5 Patients
A nurse has been charged with murdering five patients at a clinic in Texas by injecting bleach into their veins while they were undergoing kidney dialysis, local authorities said. The arrest of the nurse appeared to resolve the mystery surrounding a spike in deaths and sudden illnesses at a dialysis clinic a year ago. State records show 19 people died at the clinic in the five months before the nurse was fired in late April of last year; that number was well above the state's average rate. The police claim they have found evidence linking the nurse to at least five of those deaths, including three which happened on a single day. She is also charged with sickening five other patients, who survived despite having doses of bleach added to their intravenous tubes during dialysis. If convicted, the nurse could face the death penalty. The nurse was fired from the clinic after a patient spotted her injecting an unusual fluid into the intravenous tube of another person undergoing dialysis.

Many Medicare Patients End Up Back at Hospital
One in five Medicare patients end up back in the hospital within a month of discharge, a large study found, and that practice costs billions of dollars a year. The findings suggest patients aren't told enough about how to take care of themselves and stay healthy before they go home, the researchers said. A few simple things, like making a doctor's appointment for departing patients, can help, they said. Patients often have a honeymoon notion about how things will be once they're home. Then when they get confused about how to take their medicine or run into other problems, they head back to the hospital because they don't know where to turn.

Doctors Urge End to Corporate Ties
A group of prominent physicians and researchers urged professional medical groups to "wean" themselves from industry support and move toward a complete ban on corporate money for things like souvenir pens, tote bags and the sponsorships of committees that develop clinically important guidelines and training programs. The recommendations are not binding and would have to be put in place by individual professional associations. Still, concern over industry support has been increasing among scientists, and several leading academic medical centers already are putting stringent policies in place.

Harvard Researchers Named in Subpoena
Federal prosecutors have issued a subpoena seeking information about the work and statements of three prominent Harvard researchers who have been the focus of a Congressional investigation into conflicts of interest in medicine. The researchers are named in the subpoena, which was sent to a lawyer who represents state attorneys general in lawsuits that claim makers of antipsychotic drugs defrauded state Medicaid programs by improperly marketing their medicines. The three researchers have advocated increased use of antipsychotic medicines in children and have accepted lucrative consulting agreements from the drugs' makers. An Iowa senator is investigating conflicts of interest in medicine and found that each of the researchers had failed to report much of their consulting income to Harvard. Two of the researchers may have also violated federal and university research rules. The subpoena was issued by the Federal District Court for the Massachusetts District and was sought by the United States attorney in Massachusetts.

VA Mum on Extent of Equipment Contamination
Thousands of military veterans across the south are waiting to find out if they were exposed to infectious diseases by government clinics that performed colonoscopies and other procedures with equipment that wasn't properly sterilized. Veterans Affairs officials won't say if mistakes that may have expose patients to infections at medical centers in Tennessee and Florida and a clinic in Georgia have been discovered elsewhere. The VA recently warned veterans who had colonoscopies as far back as five years ago at its hospitals in the south to undergo tests to make sure they haven't contracted serious illnesses.

Psychiatric Group Ends Industry-Sponsored Seminars
Amid increasing scrutiny of ties between doctors and drug makers, the American Psychiatric Association announced that it would end industry-financed medical seminars at its annual meeting. The association, the field's premier organization, said it would also phase out meals at the meeting paid for with industry money. Each year, psychiatrists must attend a set number of these seminars to fulfill state licensing requirements. But the seminars are often financed by drug or device makers and can be biased in favor of the sponsor's products. Over the years, the association has charged companies up to $50,000 for sponsoring a symposium, and some annual meeting have included 30 of them, for a total of $1.5 million. Total income from the meetings account for about 10 percent of the association's $50 million annual budget.

Medicaid Suit Could Determine Who Decides Care: Doctor or State
State governments and Medicaid plan administrators have shown keen interest in a case argued before Atlanta's federal appeals court that could determine whether doctors or state officials get to decide how much medical care a Medicaid recipient needs. A young disabled Georgia girl is at the center of the case. Neither side suggests the girl shouldn't have Medicaid-funded nursing care in her home; however, at issue is whether the state properly reduced the number of hours that she receives such care. Her mother filed suit in 2007 after the state told her it was reducing her number of paid nursing hours from 94 each week to 84. A judge ruled that the state should provide the amount of skilled nursing care that her physician deems necessary. Now states and Medicaid plan managers are up in arms, claiming that the ruling means that states won't have the flexibility they need and the discretion the law allows to allocate Medicaid resources fairly.

Jury Determines Doctor Negligent in Baby's Care
A doctor who formerly worked at an Altoona hospital was found negligent in his treatment of a baby suffering from a stomach problem. However, the civil court jury found that the doctor was not responsible for subsequent medical problems that resulted in the child being transferred to another hospital in Pittsburgh. The verdict meant that the boy's parents will receive no damages. Testimony during the five-day trial indicated that the youngster recovered from the serious medical problems that threatened his life, although he will need ongoing treatment at least into first grade. The boy's mother became concerned a few months after his birth because the child was not eating well and was regurgitating his food. He was diagnosed with a narrowing of the opening between the stomach and his intestine, and the doctor performed an operation to correct the condition. The doctor told the parents that during surgery he had nipped the stomach, but had repaired the cut. However, after his symptoms became worse, he was transferred to another hospital where they found a hole in his stomach.

Criminals in Medical School
A year ago, Sweden's most prestigious medical school found itself in an international uproar after it unknowingly admitted a student who was a Nazi sympathizer and a convicted murderer, then scrambled to find a way to expel him. But the case has gotten more bizarre. The 33-year-old student, having been banished from the medical school of the Karolinska Institute in Stockholm on the ground that he falsified his high school records, has now been admitted to a second well-known medical school. New twists in his and another case highlight the difficulties that three of the country's six medical schools have had in admitting and dismissing students with serious criminal offenses in just the past two years. The cases resonate far beyond Sweden, raising fundamental questions about who is fit to become a doctor.

Study Finds Prostate Test Saves Few Lives
The PSA blood test, used to screen for prostate cancer, saves few lives and leads to risky and unnecessary treatments for large numbers of men, two large studies have found. The findings, confirm some longstanding concerns about the wisdom of widespread prostate cancer screening. Although the studies are continuing, results so far are considered significant and the most definitive to date. The PSA test, which measures a protein released by prostate cells, does what it is supposed to do, indicates a cancer might be present, leading to biopsies to determine if there is a tumor. But it has been difficult to know whether finding prostate cancer early saves lives. Most of the cancers tend to grow very slowly and are never a threat and, with the faster-growing ones, even early diagnosis might be too late.

Air Force Nurse Charged in 3 Patients' Deaths
An Air Force nurse has been charged with giving lethal amounts of medication to three terminally ill patients in his care. He was formally charged in military court with deliberately giving three patients lethal amounts of medication and with conduct unbecoming an officer for allegedly changing a medical document. The Air Force began investigating after another staff member discovered irregularities in the nurse's administration of medications that may have resulted in the death of a terminally ill patient. The investigation revealed that two other patients in his care may have received lethal amounts of medication. He was removed from duty as soon as the irregularity was reported.

Ambulance Stethoscopes May Pose Risk
Stethoscopes carried by ambulance crews are not always cleaned as often as they should be, and as a result they may by exposing some patients to drug-resistant bacteria, a new study reports. Researchers who looked at stethoscopes used by emergency medical services workers in New Jersey found that a significant number carried MRSA, a bacteria resistant to standard drugs. Some of the ambulance workers could not recall the last time the instruments had been cleaned. Of 50 stethoscopes tested, 16 had the bacteria, which a simple alcohol swab is usually enough to kill.

Medical Malpractice Lawsuit Settled for $500,000
A Cumberland County judge has approved a $525,000 insurance settlement that will benefit a 12-year-old boy whose mother died while undergoing medical treatment for allergies in 2003. The deal came nearly five years after the boy's grandmother filed the malpractice lawsuit over the death of her 25-year-old daughter. In the suit, she claimed her daughter, who had allergies, died because of a lack of proper medical supervision by personnel at the medical center where she was being treated. The settlement was reached two days before the case was set to go to trial. More than $300,000 will go into a structured settlement for the boy and won't be available to him until he is an adult.

16 Patients Have Hepatitis in Army Needle Scare
Sixteen patients exposed to a mismanaged insulin needle program have tested positive for hepatitis C. The William Beaumont Army Medical Center patients were among more than 2,000 diabetics who may have been exposed to blood-borne illnesses between August 2007 and January 2009 because of the program that systematically gave multiple patients injections from the same insulin pen. It remains unclear if the infections came from the improper insulin injections or were previously undiagnosed infections. Either way, the 16 patients are being treated and their blood is being tested to try to determine how they contracted the virus. The hospital is also launching an epidemiological study to try to match the types of hepatitis C found among the 16 patients to those of 39 other patients who had been diagnosed with hepatitis C before being treated for diabetes at the Army hospital. But because not all of the patients who may have been affected have been screened, hospital officials may never know how many people have become ill from being treated at the hospital.

Doctor Admits Pain Studies Were Frauds, Hospital Says
In what may be among the longest-running and widest-ranging cases of academic fraud, one of the most prolific researchers in anesthesiology has admitted that he fabricated much of the data underlying his research. The researchers never conducted the clinical trials that he wrote about in 21 journal articles dating from at least 1996. The reliability of dozens more articles he wrote is uncertain, and the common practice, which is supported by his studies, of giving patients aspirinlike drugs and neuropathic pain medicines after surgery instead of narcotics is now being questioned. The drug giant Pfizer underwrote much of his research from 2002 to 2007, and many of his trials found that Celebrex and Lyrica, both Pfizer drugs, were effective against postoperative pain. The researcher's activities were spotted after questions were raised about two study abstracts that he filed last spring. Investigators determined that he had not received approval to conduct human research and that he had concocted data for 21 studies.

Hepatitis C Infections Found in Clinic Patients
At least nine kidney patients were infected with hepatitis C while being treated at a Manhattan dialysis center that was closed by state health officials last year, according to the results of an investigation by the Centers for Disease Control and Prevention. The viruses found in four of the infected patients were close generic matches to viruses in other clinic patients, the investigators said, indicating that the four were almost certainly infected by contaminated equipment at the clinic. The center was ordered closed after investigators found unsanitary operating conditions. According to the CDC's report, still other patients may also have been infected at the clinic. The patients whose infections were genetically traced to others came in for treatment on the same days of the week, and two had been hooked up to the same dialysis machines.

Attorney Sues Psychiatrist Over Rampage
A lawyer committed to a mental hospital for 20 years after shooting at a motorist is accusing his psychiatrist of misdiagnosing him and prescribing medication that made him paranoid and manic. He has since filed a lawsuit against the psychiatrist. Police say that the lawyer believed there was a conspiracy to kidnap his family when he fired a shotgun twice into a van driver in 2007 and broke into his ex-wife's home. No one was injured, and he was arrested and found not guilty by reason of mental disease or defect. Other psychiatrists have testified that his mental state was affected by the prescription drugs Adderall and Prozac.

Hospital Wants Suit in Death Tossed
Hospital attorneys want a judge to throw out a lawsuit filed by the son of an 89-year-old woman who wandered from her hospital room and was found dead in subfreezing temperatures on the hospital roof the next morning. The hospital alleges that many of the claims in the complaint are false, inadmissible or both, and claim that many of the allegations were designed to generate adverse publicity and "contaminate the jury pool." While the hospital claims that the floor was sufficiently staffed and that there was a functioning lock in place on the patient's door, the lawyer for the patient's family noted that the patient walked through three doors and past a nurses' station on her way to room unnoticed. The wrongful death and negligence lawsuit alleges that multiple failures at the hospital, including the lack of a functioning lock, resulted in her death.

Crackdown on Doctors Who Take Kickbacks
Federal health officials and prosecutors, frustrated that they have been unable to stop illegal kickbacks to doctors from drug and device companies, are investigating doctors who take money for using these products. For years, prosecutors rarely pursued doctors because they believed that juries would sympathize with respected clinicians. But within a few months, officials plan to file civil and criminal charges against a number of surgeons who they say demanded profitable consulting agreements from device makers in exchange for using their products. The move against doctors is part of a diverse campaign to curb industry marketing tactics that enrich doctors but increase health care costs and sometimes endanger patients. Taken together, the new measures are likely to transform the relationship between medicine and industry. Over the past year, for instance, prosecutors have greatly increased fines that are collected as part of plea agreements with drug and device companies charged with illegal marketing tactics. In January, Eli Lilly announced it would pay a record fine of $1.4 billion to settle federal criminal charges that it illegally marketed Zyprexa, an antipsychotic medicine. Two weeks later, Pfizer announced that it had set aside $2.3 billion to pay an expected fine over charges that it illegally marketed Bextra, a painkiller that has been withdrawn from the market.

Most Fertility Clinics Break the Rules
The California fertility doctor who implanted the octuplet mom with lots of embryos was no lone wolf: Fewer than 20 percent of U.S. clinics follow professional guidelines on how many embryos should be used for younger women. The furor over Nadya Suleman and her octuplets brought scrutiny to U.S. fertility clinics and how well they observe the guidelines, which are purely voluntary. The controversy has led to talk of passing laws to regulate clinics, something that has already been done in Western Europe. Fertility doctors say there are many reasons clinics skirt the guidelines: pressure from patients who want to use more embryos to improve their chances of getting pregnant; financial concerns from those who are paying for their treatment out of their own pockets; and the competition among clinics to post good success rates. And the only penalty for violating the guidelines is expulsion from some of the industry's professional organizations, though that can affect whether insurance companies will cover a clinic's treatment.

Dentist Overcame Loss of License by Moving to Maryland
A former Pennsylvania dentist lost his license following a drug conviction but managed to continue practicing by moving to Maryland, court records show. The Pennsylvania State Board of Dentistry automatically suspended his license after he pleaded no contest to charges related to prescription fraud. A year later, the dentist obtained a license to practice dentistry in Maryland on a five-year probationary period on the condition he undergo drug screening and treatment for his addiction. However, last week, he was indicted in Maryland on 169 charges related to prescription fraud. Aside from the criminal charges, he could face the loss of his license once again. While still in the probationary period, a former staffer accused him of knowingly employing unlicensed dental assistants to perform teeth cleaning and X-rays. When hearings on the claims were held, the dentist was reprimanded by the board and had his probationary period extended by three months. His most recent charges came to light when his stepson alerted authorities that numerous prescriptions for pain medication were written and filled by the dentist.

Beijing Investigates Transplants for Tourists
China is investigating whether 17 Japanese tourists received illegal kidney and liver transplants in China. China has banned all transplants for foreigners because an estimated 1.5 million Chinese are on waiting lists for transplants. China has warned that the hospitals and medical personnel who carried out organ transplants against the rules will be severely dealt with according to the law. The investigation comes after a newspaper reported that 17 tourists had spent $87,000 each for the operations. The price included travel, accommodations and 20 days of treatment in a hospital. Most of the patients registered under Chinese names and were between the ages of 50 and 65 years old. The newspaper also reported that most of the organs were likely from executed Chinese prisoners.

Massage Therapist Fired After Sexual Assault Charge
A massage therapist has been fired from a chiropractic center after being accused of sexually assaulting a female client. The masseur was arraigned on a felony count of aggravated indecent assault and released on $25,000 unsecured bail. He is accused of sexually assaulting a woman who came into Herman Chiropractic for a massage. When the woman asked what he was doing, he replied, "Massaging you. What? Don't you like that?" He then asked the client out on a date after the massage.

Son Sues Hospital Over Mom's Death on Roof
Rose Lee Diggs, the 89-year-old woman whose body was found on the roof of a Pittsburgh hospital in December, was the victim of a vast, impersonal hospital system that favored profit over patient care, claims a lawsuit filed by Diggs' son. The suit accuses the hospital of being "recklessly indifferent" in its handling of Diggs. The lawsuit also charges that the hospital, which has 50,000 employees and more than $7 billion in annual revenue, created a dangerous health care environment with inadequate staffing levels, poor security, a dismal records system and a patient population bursting at the seams. Diggs, who was admitted to the hospital for dementia and heart problems, was found on the hospital's roof more than 13 hours after she was last seen in her room. She was wearing only a hospital gown and slippers on a night in which temperatures fell into the 20s. The lawsuit also claims that there were at least 20 to 30 similar "elopement" cases at the hospital over the last two years.

Urine Injection Kills Bolivian Woman
A Bolivian woman has died from an injection of urine allegedly administered by her friend as a form of health therapy. A 35-year-old woman died of an "infection caused by urine that was injected by" her fashion designer friend. The friend is a practitioner of urine therapy, a form of alternative medicine using human urine for cosmetic purposes or to treat various diseases. Some people rub it on their skin, while others ingest or drink it. The fashion designer supposedly injected the urine into the woman's IV serum while she was being treated for an intestinal blockage. After she administered the injection, she was expelled from the hospital. The woman died shortly thereafter.

Acupuncturists Dropped from Suit Over Needle Shards in Patient's Heart
Surgeons removed two needle fragments from the inside of the right ventricle of a woman's heart in 1999. No one knows how the shards got there, but her legal team believes they entered her body while she received acupuncture treatments to her back, then traveled up an artery to her heart. An appellate court rejected that theory and threw out the woman's claims against two acupuncturists. However, the panel upheld the denial of a motion to dismiss the physician who allegedly misdiagnosed her symptoms. For about two years, the woman suffered from fatigue, pain in her arm and pain in her chest. Ultimately, a chest X-ray revealed what appeared to be a needle in her heart. She underwent surgery to remove the two pins, each over 1 inch in length. She then filed actions against a host of defendants, including two acupuncturists, her psychiatrist who had advised her that her symptoms were homesickness, and several physicians. The action against a physician who failed to consult a current X-ray and instead relied on an old X-ray was allowed to continue.

FDA to Place New Limits on Prescriptions of Narcotics
Many doctors may lose their ability to prescribe 24 popular narcotics as part of a new effort to reduce the deaths and injuries that result from these medicines' inappropriate use, federal drug officials announced. A new control program will result in further restrictions on the prescribing, dispensing and distribution of extended-release opioids like OxyContin, fentanyl patches, methadone tablets and some morphine tablets. These products are classified as Schedule II narcotics and already are restricted according to rules jointly administered by the FDA and the DEA. But the current restrictions have failed to fully meet the goals the FDA wants to achieve. Hundreds of patients die and thousands are injured every year in the U.S. because they were inappropriately prescribed drugs like OxyContin or Duragesic or they took the medicines when they should not have or in ways that made the drugs dangerous. The agency has issued increasingly urgent warnings about the risks, but the toll has only worsened in recent years.

Pfizer to Disclose Payments to Doctors Next Year
Pfizer Inc., the world's largest drugmaker, will begin disclosing all sizable payments it makes to doctors, including those who test experimental drugs in people, a first for the industry. The disclosures would begin early next year and are planned to include all payments to a doctor or other prescriber exceeding $500 in a year. The move comes after the introduction of legislation that requires such disclosures, and revelations of astronomical payments to some doctors that were not revealed to universities and hospitals that employed them. Consumer groups, politicians and others increasingly have been criticizing industry payments to doctors who promote a particular drug brand to colleagues, provide consulting services to drugmakers or work on human tests of experimental drugs, yet don't disclose that they are receiving tens of thousands of dollars, even millions, for those services. A handful of drugmakers, including Merck & Co. and Eli Lilly & Co., have recently announced plans to disclose payments for consulting, giving speeches and the like.

Doctor Found Not Negligent in Heart Attack Death
A Blair County jury struggled for more than five hours before finding a family physician was not negligent in the treatment of a 48-year-old woman who died of a heart attack. A civil court lawsuit, seeking more than $1 million in economic and personal damages, was brought against the doctor by the woman's son. Her death came within a day of the doctor releasing her from the hospital where she had been admitted with chest pains. The doctor concluded that the pains stemmed from a bruise on her chest caused by physical work she was performing. He told her to remain on medications he prescribed and to return in two weeks for a stress test. She died the next day of a heart attack. The jury first said they couldn't come to a verdict, but later ruled 10 to 2 in the doctor's favor.

Records Dispute in Rooftop Death Settled
A special master will determine how to divvy up disputes records in a three-way lawsuit over a patient's hospital rooftop death. Lawyers for the hospital, a former employee and the family of the deceased woman agreed to settle the matter after hours of negotiations. The appointment of the special master also ended a pending lawsuit against a former hospital security employee who was accused of taking confidential records. He was subsequently dismissed from his job and sued, while he sued the hospital for wrongful termination. The final lawsuit was filed by the family of an 89-year-old dementia patient who wandered from her hospital room and was found dead the next morning on the hospital roof.

California Medical Board Probes Octuplet Birth
The fertility doctor who helped a California woman have 14 children, including octuplets, is now facing a state investigation on top of harsh criticism from medical ethicists. The Medical Board has not identified the doctor who helped her become pregnant. The board is looking into the matter to see if they can substantiate if there was a violation of the standard of care. While there is now law dictating the number of embryos that can be placed in a mother's womb, doctors say the norm is to implant two or three at most. The mother of the octuplets had six embryos implanted. Doctors have also questioned why a fertility specialist who helped her conceive six children previously would then implant more embryos into her.

Hospital Ordered to Pay $5 Million in Lawsuit
An Allegheny County jury awarded a woman more than $5 million after determining that treatment errors at UPMC caused brain damage that left her unable to care for herself. The 59-year-old woman was disoriented when she checked herself into the hospital in 2006. Doctors found that she had a severely low sodium imbalance, but was given four times the prescribed amount of sodium. Though she was prescribed 250 cubic centimeters of saline over an hour, she was instead given 1,000 cubic centimeters of saline. The rapid increase of her sodium levels caused a condition that led to brain damage. The verdict is one of the 10 largest awarded in the county, and the woman plans to use the money to remain in her home rather than be moved to a nursing home.

60,000 Exposed to Hepatitis by Health Workers
Patients who got hepatitis from contaminated syringes and medicine vials are joining infection control advocates to warn Americans about a problem they say is more common than people think. A recent federal report found more than 60,000 people were exposed to hepatitis, and at least 400 people were infected with it in 33 U.S. outbreaks linked with blatant safety violations. Many involved reuse of syringes. Health workers likely thought they were being safe by discarding the syringes' used needles and snapping on sterile ones. They were apparently unaware that the plastic barrel part of a syringe can become contaminated as well. Though the number of reported infections isn't large for the time period, 1998 to 2008, authorities believe many more cases go unreported, and the lack of care and cleanliness that went on in medical clinics and doctors' offices is disturbing.

Lawsuit Filed Against Altoona ER Doctor
When a 48-year-old woman was taken by ambulance to Altoona Regional Health System for severe chest pains, a doctor concluded that the pains were a result of strenuous work conditions. She was then sent home with instructions to return in two weeks for a stress test. A day later, the woman suffered a fatal heart attack. Her estate is now suing the doctor who diagnosed her with a muscoskeletal condition rather than ruling her symptoms as the precursor to her eventual heart attack. The family claims that the doctor failed to provide appropriate treatment for her, which could have prevented her death. Two doctors plan to testify that the doctor did not take the steps necessary to properly diagnose her heart condition. Two other doctors will state that tests in the hospital were apparently normal and did not indicate that she was suffering from heart disease.

Most Hospital Patients Unable to Identify Their Physicians
Hospital patients are rarely able to identify their doctors by name or to describe their roles in the patients' care, a new survey has found. Researchers interviewed 2,807 adults over a 15-month period. The patients were asked about the roles of the various physicians attending to them and to name the doctors on those teams. Medical teams consisted of three to four people, including medical students, residents and attending physicians. Some 75 percent of the patients were unable to name a single doctor assigned to their care. Of the 25 percent who responded with a name, only 40 percent were correct. Those patients who claimed to understand the roles of their doctors were more likely to correctly identify at least one of their physicians. In the new study, patients able to name one of their physicians also were more likely to be unsatisfied with their care.

Law Firms Win Dismissal of Suit on Failure to File Medical Malpractice Action
A client may not proceed against his former attorneys for failing to sue two doctors who prescribed a pain medication that allegedly worsened his then-undiagnosed kidney disease, a Texas appeals panel ruled. The client did not present enough evidence showing a link between the drug Celebrex and his kidney disease. The panel also found no abuse of discretion in the trial court's exclusion of a medical expert's testimony because the expert provided no scientific data to support his conclusion that Celebrex worsened the plaintiff's condition. The plaintiff underwent surgery in 1998 for his back. Afterwards, his surgeon referred him to a pain-management specialist who prescribed Celebrex. After taking the drug for five months, he began experiencing swelling and exhaustion and was eventually diagnosed with kidney disease. He then sued, claiming that the specialist was negligent in prescribing or allowing him to take Celebrex because a urinalysis at the time of his back surgery showed an abnormality indicating possible kidney disease and that Celebrex worsened his condition. The appeals court found that the man had failed to prove that Celebrex worsened his condition and that his argument was not scientifically reliable.

More Delays for Women in Emergency Care
A new study has found surprising evidence of delays in getting women with heart trouble to the hospital. Researchers examined 5,887 emergency calls about suspected cardiac symptoms in Dallas. About half of those calls were made by women. Ambulances arrived just as quickly for women as for men. Patients of both sexes spent an average of 34 minutes in the care of emergency medical workers, including about 19.9 minutes of care on the scene and 10.3 minutes spent traveling to the hospital. But 647 patients, about 11 percent, were delayed, spending 45 minutes or longer in the care of emergency workers. Women were 52 percent more likely than men to be among the delayed. It is not clear what caused the waits, but other studies have suggested that heart problems in women are not recognized as readily by medical personnel.

New Rules on Doctors and Medical Firms Amid Ethics Concerns
Smith & Nephew, a leading maker of artificial hips and knees, has ordered their executives and sales representatives to steer clear of doctors after 5 p.m. and limit their interactions with doctors to business hours. Although it remains to be seen whether such steps will be worthwhile, such limits are signs of an ethical makeover under way within the medical device industry, a field that has been troubled by federal investigations and bad publicity over the volatile issue of frequently undisclosed financial ties between companies and physicians. Two senators recently increased the pressure by reintroducing legislation that would require device and drug makers to report all financial links with doctors on a federal Web site.

UPMC Suit Over Documents Ties to Woman's Death
Lawyers for the University of Pittsburgh Medical Center are seeking to block the family of a woman who died after wandering onto a hospital roof from accessing confidential security documents the hospital accuses a fired employee of taking. UPMC charges that the documents include sensitive information on patients and visitors, and that a security official fired in October took them without authorization. Court documents show that the former employee contends he was a whistleblower, let go from his job because he raised questions about "various security breaches." UPMC is seeking an emergency order to return the documents and overturn a subpoena for the records from lawyers for the deceased patient, who died on the roof of UPMC after wandering from her hospital room about 5 pm. A staff member found her the next morning. She was being treated for dementia and heart problems. Her family sued UPMC last month.

California Lawmakers Rush to Rescue Good Samaritans in Wake of Court Ruling
Lawmakers are rushing to introduce legislation that would offer greater legal protections to Good Samaritans in light of a recent California Supreme Court decision. Legislators from both parties have introduced three bills to address the decision, which held that a state statute only shields rescuers from liability if they provide medical care in an emergency situation. The ruling puts at risk aid-givers who inadvertently hurt victims while removing them from a burning building or other potentially dangerous scenarios. One lawmaker remarked, "It's ludicrous to suggest that if I dive into a swimming pool to rescue someone and I break their arm dragging them out that I'm liable for their injuries, but if I break their ribs while giving them CPR, I'm OK." The Supreme Court decision stems from a 2003 car accident, during which a passenger pulled her injured friend out of what she thought was a smoldering car at risk of exploding. The friend was left a paraplegic and sued the passenger as well as the car's driver for negligence.

Good Samaritan Defense Fails to Win Dismissal of Medical Malpractice Suit
A self-described student who was present at the birth of a stillborn child cannot use the "Good Samaritan" defense in her attempt to persuade the court to dismiss a medical malpractice claim against her. Citing deposition testimony of the parties involved in the July 2004 birth, a Supreme Court justice ruled that there was sufficient evidence to raise a question of fact as to the student's claims of lack of involvement. In January 2004, the plaintiff discovered she was carrying twins after a sonogram. Her and her husband were seeking a home birth and were under the care of a midwife, who is another defendant in the case. In June 2004, the midwife diagnosed one of the twins with a decelerated heart rate. After the mother was refused entry to a hospital because the midwife was not allowed to deliver there, the midwife returned home with the parents and her student, a registered nurse. After one of the twins was delivered stillborn, the couple sued. The student was arguing that she was simply a "law student observer" who was invited to the birth by the midwife. She claimed her duties were only to observe, take pictures and enter information on a chart. After the delivery, the student admits that she injected the mother with an anti-hemorrhaging agent. The mother, however, claims that the student became "actively involved" in the delivery procedures, with another midwife present agreeing that the student performed resuscitation efforts on the stillborn infant.

Doctor to be Tried for Failing to Report Abuse
The trial of a pediatrician charged with failing to report suspicions of child abuse in the death of a 6-month-old will begin soon. The baby's parents have been charged with homicide in her death, but the doctor, who allegedly examined the baby and noted bruises and bite marks, did not report suspicions of abuse to the state and is being charged with neglect. State law requires professionals, including doctors, to report suspected child abuse.

UPMC Alters Safety System in Wake of Death on Roof
University of Pittsburgh Medical Center executives announced a system-wide safety reform spurred by the case of a dementia patient who wandered away from her room and was found dead 14 hours later on the hospital rooftop. The new system, called "Condition L," will improve hospital searches the way Amber Alerts have in cases of missing children. UPMC revamped its search policies after the death of a patient, who walked away from her room on the 12th floor at 5:00 pm and was found on the roof of the hospital at 8:00 am the next day. The patient was found in her hospital gown and slippers after a night in which temperatures fell to the 20s. UPMC employees insist that they checked her room two other times during their search but found no sign of her. They claim she may have wandered through other parts of the hospital before going outside.

No More Goodies for Doctors from Drug Makers
Starting January 1, the pharmaceutical industry has agreed to a voluntary moratorium on branded goodies, such as Viagra pens, Zoloft soap dispensers and Lipitor mugs, that were meant to foster good will and, some would say, encourage doctors to prescribe more of the drugs. Some skeptics deride the voluntary ban as a superficial measure that does nothing to curb the far larger amounts drug companies spend each year on various other efforts to influence physicians. But proponents welcome it as a step toward ending the barrage of drug brands and logos that surround, and may subliminally influence, doctors and patients.

Child Psychiatrist to Curtail Industry-Financed Activities
A prominent Harvard child psychiatrist will curtail activities financed by the drug industry while Massachusetts General Hospital investigates his failure for years to disclose the consulting fees he received from drug makers. The psychiatrist, a world-renowned and controversial researcher on childhood mental illness, has agreed to stop participating in speaking engagements and other activities paid for by pharmaceutical companies. A Congressional investigation found that the psychiatrist had been paid at least $1.6 million in consulting fees by drug makers from 2000 to 2007, but had failed to report much of this income to Harvard officials for several years.

Doctor Cleared of Harming Man to Obtain Organs
A California transplant surgeon was acquitted of a charge that he had intentionally harmed a donor to speed extraction of the patient's kidney and liver. The verdict closed a case that had drawn widespread attention to the medical and ethical complexities of organ transplant. The surgeon was found not guilty of a single felony charge of abuse of a dependent adult after two other felony charges, which included administering harmful substances and unlawful prescription, were dropped. Prosecutors had argued that the doctor prescribed an excessive amount of drugs during a failed harvesting procedure on a brain-damaged donor. The doctor countered that he had been trying to ease the patient's suffering after other doctors failed to perform their duties.

Hospital May Face Lawsuit Over Woman's Death
The family of the 89-year-old woman who died on the roof of a Pittsburgh hospital has asked Common Please Court to give it access to reports from authorities regarding the woman's death. A writ of summons would allow the family to gather information to prepare a wrongful death lawsuit. The family is currently seeking subpoena power for investigative reports on the death prepared by the Allegheny County medical examiner, the district attorney's office, Pittsburgh police and the Department of Health. The woman, who suffered from dementia and heart problems and had a history of wandering, left her room through a fire exit. Her body was found the next morning by a maintenance worker with injures that suggested a fall. She was wearing only a hospital gown.

Colonoscopies Miss Many Cancers, Study Finds
For years, many doctors and patients thought colonoscopies, the popular screening test for colorectal cancer, were all but infallible. However, researchers have reported that the test may miss a type of polyp, a flat lesion or an indented one that nestles against the colon wall. The study found that colonoscopies missed just about every cancer in the right side of the colon, where cancers are harder to detect but about 40 percent arise. And it also missed roughly a third of cancers in the left side of the colon. Instead of preventing 90 percent of cancers, as some doctors have told patients, colonoscopies might actually prevent more like 60 percent to 70 percent.

Medical Malpractice Case Includes Rare Punitive Damages Claim
A Florida man who is suing two doctors for malpractice in a rare case allowing a punitive damages claim contends one of his surgeons left him on the table unconscious to be mutilated by the other doctor. The man, a former lawyer, claims his plastic surgeon later lied about his detached role in the botched surgery, creating two sets of medical records to hide the truth and still billed his insurance company for performing the surgery. The lawyers is suing because after an operation to remove small growths under his enlarged breasts ended with the complete removal of both breasts, leaving the man's chest disfigured.

Hospitals Face a New Epidemic: Bedsores
The number of hospital patients with bedsores has risen dramatically over a 14-year period, leading to longer, more expensive hospital stays. Some 503,300 patients admitted to U.S. hospitals in 2006 suffered from a bedsore that developed either before or during their stay. That figure is an increase from 281,300 in 1993, or 78.9 percent. By contrast, overall hospital admissions increased by just 15 percent between 1993 and 2006. Most of the patients who had bedsores were ages 65 and older.

The Pain May Be Real, But the Scan is Deceiving
Scans, more sensitive and easily available than ever, are increasingly finding abnormalities that may not be the cause of the problem for which they are blamed. It's an issue particularly for the millions of people who go to doctors' offices in pain. In what is often an irresistible feedback loop, patients who are in pain often demand scans hoping to find out what's wrong, doctors are tempted to offer scans to those patients, and then, once a scan is done, it is common for doctors and patients to assume that any abnormalities found are the reason for the pain. But in many cases it is just not known whether what is seen on a scan is the cause of the pain. The problem is that all too often, no one knows what is normal.

Weak Oversight Lets Bad Hospitals Stay Open
Unlike some other nations, including France, the United States has no federal agency charged with hospital oversight. Instead, it relies on a patchwork of state health departments and a nonprofit group called the Joint Commission that sets basic quality standards for the nation. Hospitals are rarely closed or hit with significant financial penalties for hurting patients. One of the reasons is that even troubled hospitals are major employers, and communities generally rally behind them when they face the threat of cuts.

Death on Roof Prompts Hospital Probes
The death of an 89-year-old woman on the roof of a Pittsburgh hospital is prompting several investigations, and the hospital could face fines, a change in its accreditation status and a lawsuit from the woman's family. Pittsburgh police, the state Health Department and the hospital itself will examine how the woman, who suffered from dementia and heart problems, was able to wander unnoticed from her room on the 12th floor to the roof. Her body was found there by a maintenance worker the next morning. She was wearing only a hospital gown and slippers in overnight temperatures that dipped to 23 degrees.

Does More Sleep Make for Better Doctors?
A national panel of health care experts recently released a report affirming the current mandate that limits the workweek for medical residents to 80 hours and offering additional recommendations to decrease fatigue for doctors-in-training. The report encourages graduate medical education programs to embrace a new culture of training, one that emphasizes patient safety and the importance of sleep.

New Doctors Still Too Tired for Safety
A new U.S. report finds that doctors-in-training are still too exhausted and recommends that hospitals let them have a nap. Regulations that capped the working hours of bleary-eyed young doctors came just five years ago, limiting them to about 80 hours a week. However, a panel recommended easing the workload a bit more: Anyone working the maximum 30-hour shift should get an uninterrupted five-hour break for sleep after 16 hours. The argument is that sleep deprivation can fog the brain and lead to serious medical mistakes. As an illustration of the fatigue residents may experience, the panel noted that researchers have shown that overworked doctors have an increased risk of being involved in traffic accidents or falling asleep at the wheel after an extended-duty shift.

Arrogant, Abusive and Disruptive Doctors
Surveys of hospital staff members, who blame badly behaved doctors for low morale, stress and high turnover, suggest that such behavior contributes to medical mistakes, preventable complications and even death. A survey of health care workers at 102 nonprofit hospitals from 2004 to 2007 found that 67 percent of respondents said they thought there was a link between disruptive behavior and medical mistakes, and 18 percent said they knew of a mistake that occurred because of an obnoxious doctor. Another survey found that 40 percent of hospital staff members reported having been so intimidated by a doctor that they did not share their concerns about orders of medication that appeared to be incorrect. As a result, 7 percent said they contributed to a medication error.

Cardiologists Debate Expensive Heart Scans
Cardiologists have opened another front in the rancorous debate over expensive medical technologies, questioning the conclusions of a new study finding that high-resolution computer scans of the heart are almost as effective as conventional angiograms. The debate reveals a deep rift among heart specialists over the use of 64-slice or CT angiography, which produces 3-D images of the heart and blood vessels. CT scans are faster and less invasive than conventional angiograms, but they expose patients to higher doses of radiation, which may increase the risk of cancer. Angiograms, on the other hand, require insertion of a catheter through a blood vessel in the groin, a longer procedure that carries a risk of more immediate complications.

Delay in Cancer Treatment Found to Raise Recurrence
One in five breast cancer patients ages 65 and older postponed radiation therapy or did not complete the full radiation regimen after breast-conserving surgery, and the lapses in care took a significant toll on their health, a new study reports. Researchers reviewed the medical records of nearly 8,000 patients with Stage 1 breast cancer. Those who waited eight weeks before beginning radiation therapy were 1.4 times as likely to have had a recurrence or to develop a new breast tumor, the researchers found. Patients who delayed radiation for 12 weeks or longer were four times as likely to have suffered a recurrence.

Vegas Doctor Convicted of Using Botox Knockoff
A doctor and his wife have been convicted of treating patients with a Botox knockoff at their Las Vegas clinic. Jurors returned the verdict with convictions on mail fraud and adulterating a drug while held for sale. Prosecutors claimed that patients thought they were getting Botox treatments to reduce facial wrinkles but got the cheaper TRItox instead. TRItox has yet to be cleared for human use and is only used in research.

Birth Defects Tied to Fertility Treatments
Infants conceived with techniques commonly used in fertility clinics are two to four times more likely to have certain birth defects than are infants conceived naturally, a new study has found. The findings applied to single births only and found defects including heart problems, cleft lips, cleft palates and abnormalities in the esophagus or rectum. Fertility treatments seemed to double the chance of such defects; whereas cleft lips occur in one in 950 natural births in the United States, the study found that the risk of cleft lips in fertility treatment births was one in 425.

Nasty Intestinal Bug Spikes in U.S. Hospitals
A virulent, drug-resistant gut infection that causes potentially deadly diarrhea, especially among the old and sick, is up to 20 times more common than previously though, a large survey of U.S. hospital and health care centers finds. Thirteen in every 1,000 patients were infected or colonized with Clostridium difficile, known as C. diff, according to surveys by nearly 650 U.S. acute care and other centers. That's between 6.5 and 20 times higher than previous estimates of the nasty bacterial infection tied to overuse of antibiotics and improperly cleaned hospital rooms. On average, there may be more than 7,000 infections and 300 deaths in U.S. hospitals on any single day from C. diff.

Off-Label Meds, Not Placebos, Should be the Real Worry
A newly released study showed that half of all American doctors who responded to a nationwide survey say they regularly prescribe placebos to patients. However, a study in 2001 found that American physicians wrote 150 million prescriptions off-label to treat conditions for reasons other than the ones for which the drugs were approved. That represents 21 percent of all prescriptions written for 160 of the most common medications used in the U.S. About three-quarters of all off-label prescriptions were written for conditions for which there was little or no scientific support to show that they worked.

114 Hepatitis C Cases Linked to Two Las Vegas Clinics
Investigators think they've identified almost everyone who may have contracted the potentially deadly hepatitis C virus at two Las Vegas outpatient medical clinics. Officials say nine cases of the incurable blood-borne liver disease are the result of the unsafe practice of reusing syringes and medicine vials at the clinics, both of which have been closed. While officials have not attributed any deaths to the outbreak, the widow of one of the clinic's former patients has filed a lawsuit blaming her 60-year-old husband's hepatitis C diagnosis and death on unsafe medical practices.

Half of Doctors Routinely Prescribe Placebos
Half of all American doctors responding to a nationwide survey say they regularly prescribe placebos to patients. The results trouble medical ethicists, who say more research is needed to determine whether doctors must deceive patients in order for placebos to work. The most common placebos the American doctors prescribed were headache pills and vitamins, but a significant number also reported prescribing antibiotics and sedatives. The American Medical Association discourages the use of placebos by doctors when represented as helpful.

Doctor and Family Dispute Cause of Lewisburg Man's Death
A Union County jury will decide whether a former Evangelical Community Hospital emergency room physician was negligent in failing to diagnose heart disease in a 53-year-old man who died three weeks after being treated in 2005. The family of the man filed a lawsuit against the doctor and the hospital alleging medical negligence led to his death. When he visited the emergency room with complaints of fatigue, neck and left shoulder pain and arm numbness, and high blood pressure, the doctor did not diagnose him with a possible heart condition, which was the correct move. Instead, she diagnosed him with neck arthritis and sent him home with painkillers. He died three weeks later.

Ties Between Doctors and Stent Makers Queried
Heart doctors and makers of medical devices meeting for their annual convention got a sobering piece of news: two senators are asking tough questions about financial ties between the doctors and the companies. The two lawmakers want answers regarding the financial relationship between doctors and device manufacturers and drug producers.

$10.7 Million for Woman Forced to Wait for Brain Scan
A jury has awarded nearly $11 million to a woman who became partially paralyzed after waiting two hours for a hospital brain scan. Jurors found a New York City hospital negligent in caring for the woman after she was brought to the emergency room with a fractured skull after a fall. Her lawyers argued that the woman was cleared for a brain scan two hours before she got one. She was subsequently neglected in the emergency room as she lapsed into a coma and now has no movement in her left side and must use a wheelchair.

Woman Who Didn't Know She was Pregnant Sues Hospital
A woman who arrived at an emergency room with abdominal pain subsequently gave birth to a child in a hospital restroom. She claims she didn't know she was pregnant and is now suing the hospital. She claims that the medical staff should have known that she was pregnant and missed obvious signs of labor. The baby went into respiratory arrest and suffered brain damage due to treatment providers' negligence, and the mother now wants the hospital to pay for the baby's lifelong medical care.

Top Psychiatrist Didn't Report Drug Makers' Pay
One of the nation's most influential psychiatrists earned more than $2.8 million in consulting arrangements with drug makers from 2000 to 2007, failed to report at least $1.2 million of that income to his university and violated federal research rules. The psychiatrist is the most prominent figure to date in a series of disclosures that is shaking the world of academic medicine and seems likely to force broad changes in the relationships between doctors and drug makers.

New York Court Applies Negligence Standard to Second Injury During Medical Exam
After filing a personal injury claim against a driver who rear-ended him in a fender-bender, a New York man was required to submit to a medical examination by a physician of the defendant's insurer's choosing. However, during the exam, the man suffered a second injury when the doctor grabbed his head, rotated his neck and pulled. This caused the man various neck and nerve injuries and a second suit. A New York court subsequently decided that the doctor's actions were negligent, rather than malpractice.

Attorney Claims Penis Amputation Medically Necessary
A lawyer for a Kentucky doctor being sued over the amputation of a patient's penis claims the procedure was "medically necessary" and authorized by the patient. When the man agreed to his initial circumcision surgery for inflammation, he gave his doctor permission to perform any medical procedure deemed necessary.

Oregon Hospital Tells Grandpa He's Pregnant
A 71-year-old grandfather treated for agonizing abdominal pain received this surprising news in the hospital's paperwork: "Based on your visit today, we know you are pregnant." Hospital administrators claim that an errant keystroke caused the hospital's computer to spit out the wrong discharge instructions for the man.

Kentucky Man Claims Penis Amputated Without Consent
A Kentucky man who claims his penis was removed without his consent during what was supposed to be a circumcision has sued the doctor who performed the surgery. The man was circumcised to better treat inflammation, but the doctor removed his penis without consulting either him or his wife or giving them the opportunity to seek a second opinion. The couple is suing for unspecified damages. The case is similar to a suit in which a man was awarded $2.3 million after his penis and left testicle were removed without his consent.

Nuclear Waste Piling Up at U.S. Hospitals
Tubes, capsules and pellets of used radioactive material are piling up in the basements and locked closets of hospitals and research installations around the country, stoking fears they could get lost or, worse, stolen by terrorists and turned into dirty bombs. For years, truckloads of low-level nuclear waste rom most of the U.S. were taken to a rural South Carolina landfill. There, items such as the rice-size radioactive seeds for treating cancer and pencil-thin nuclear tubes used in industrial gauges were sealed in concrete and buried. But a South Carolina law took effect on July 1 that ended all disposal of radioactive material at the landfill, leaving 36 states with no place to throw out the nuclear waste.

On Fire in the Operating Room
Surgical fires at least five times as common as once thought, affecting between 550 and 650 patients a year, including 20 to 30 who suffer serious, disfiguring burns. Every year, one or two people die this way. In Pennsylvania, fires occur in one in every 87,646 operations, according to the latest 2007 data. That amounts to 28 fires a year in Pennsylvania alone and allows researchers to estimate with greater certainty the incidents in the rest of the country.

Hospital Bracelets Face Hurdles as They Fix Hazards
New York's 11 public hospitals are at the forefront of a national movement to standardize color coding of hospital wristbands to designate patient conditions, such as "Do Not Resuscitate" or allergies. While the goal is to prevent potentially dangerous mistakes, some are concerned that the wristbands can also violate a patient's privacy. For instance, branding a patient by the end-of-life choices may inadvertently broadcast those choices to family and friends who have not been consulted.

Study Finds Few Pain Doctors Face Criminal Prosecutions
A new study has found that doctors are rarely criminally prosecuted or sanctioned in connection with the prescribing of narcotic painkillers. The study found that 725 doctors, or about 0.1 percent of practicing physicians, had been prosecuted or sanctioned by state medical boards between 1998 and 2006 on charges arising from illegally or improperly prescribing narcotics. Of that group, 25 doctors specialized in pain treatment. "The widely publicized chilling effect of physician prosecution on physicians concerned with legal scrutiny over prescribing opioids appears disproportionate to the relatively few cases," the study reported.

Consumer Ads for Medical Devices Subject of Senate Panel
As makers of medical devices like artificial knees and heart stents increasingly pitch their products directly to consumers, some lawmakers, medical groups and others are calling for restrictions on such advertisements, claiming they mislead patients. Experts maintain that the advertising of a medical device can have more of an impact on a patient's well-being than a drug, because devices often require surgery to implant and may remain inside the body for years. The Senate Special Committee on Aging plans to hold a hearing about direct-to-consumer promotions of medical devices. The chairman of the committee said he was holding the hearing because he thought that the Food and Drug Administration might have to increase its scrutiny of medical device promotions, much as it had done with pharmaceutical advertisements.

E.R. Patients Often Left Confused After Visits
A vast majority of emergency room patients are discharged without understanding the treatment they received of how to care for themselves once they get home, researchers say. And that can lead to medication errors and serious complications that can send them right back to the hospital. A new study found that 78 percent of patients did not understand at least two or more areas of their treatment or recovery instructions. The greatest confusion surrounded home care.

Small Patients, Big Consequences in Medical Errors
Medical mistakes, though common in adults, can have more serious consequences in children, doctors say. A study found that problems due to medications occurred in 11 percent of children who were in the hospital, and that 22 percent of them were preventable. Children are often victims of diagnostic errors, incorrect procedures or tests, infections and injuries. Medical errors also pose a greater threat to children than to adults for a number of reasons, including their smaller size and their kidneys, liver and immune system are still developing.

Defibrillators are Lifesaver, But Risks Give Pause
The implanted defibrillator, a device that can automatically shock an erratically beating heart back to a normal rhythm, has been proved to save lives. But in the last two years the number of patients receiving defibrillators has actually declined, as more doctors and patients decide the risks and uncertainties the devices pose may outweigh their potential benefits. What makes doctors and patients increasingly wary, though, is a string of highly publicized recalls in recent years, along with mounting evidence suggesting that a vast majority of people who get a defibrillator never need it.

Virginia Patients in Pennsylvania Given Inadequate Cancer Care
Some 55 prostate cancer patients were given too-low doses of radiation treatment at the local Veterans Affairs hospital in the past six years, and federal investigators want to know why. The Nuclear Regulatory Commission announced it is inspecting the Philadelphia VA Medical Center's facilities and procedures to figure out what went wrong and how to prevent it from happening again. Hospital officials had announced the possible underdoses in July. Officials said they were reviewing records of 114 cancer patients to see which ones might have received the wrong radiation doses. Two of the 114 patients have since died.

Hospital and Doctor Deals Up for Review
A sweeping overhaul of the government rules regulating financial arrangements between doctors and hospitals will likely force many of them to undo or restructure joint ventures, leasing deals and other contracts for medical services. The changes will bring doctors, doctor-owned entities and hospitals that use such services back to the negotiating table with their lawyers. The changes also raise barriers for doctors who want to invest in ancillary lines of business involving medical services such as testing.

Are the Mentally Ill Falling Through the Cracks?
The Kia Johnson case, in which a woman with mental illness was charged with killing a pregnant teenager and stealing her baby, drew worldwide news coverage this summer. That startling homicide, though, was just one of at least 10 serious incidents involving local residents with mental illness that have occurred in Allegheny County neighborhoods in less than a year. Incidents such as these have led people to ask: Are people falling through the cracks of the community health system? And what might be done to prevent such problems from occurring?

After Son's Death, Family Feels Deceived
After their son suffered a severe head injury, his family said that they declined several requests for permission by an organ donor program to donate his organs. However, the Gift of Life Donor Program, which connects transplant hospitals with potential organ donors, took his organs because he agreed to be an organ donor when he got his driver's license. The family claims that Gift of Life led them to believe that despite his organ donor status, they would be able to make the final decision on whether or not his organs would be taken. In the end, his organs were donated.

Court Calls $8-a-Day Medical Malpractice Award for Amputee a Miscarriage of Justice
In an unusual if not unprecedented parsing of a medical malpractice verdict, a New Jersey state appeals court ruled that a $100,000 award for pain and suffering was too low because it amounted to $8 a day for the rest of the plaintiff's life. The plaintiff, who was forced to wait for necessary surgeries as her condition worsened, eventually lost her leg. The judge ordered a new trial on the $100,000, finding it "grossly insufficient and a miscarriage of justice."

Transplant Study Revives Questions Over When to Declare Donors Dead
A report on three heart transplants involving babies is focusing attention on a touchy issue in the organ donation field: When and how can someone be declared dead? For decades, organs have typically been removed only after doctors determine that a donor's brain has completely stopped working. In the case of the three infants, all were on life support and showed little brain function, but they didn't meet the criteria for brain death.

Lawsuit Alleges Kickbacks Paid to Local Doctors
A medical supply company has filed suit against six out-of-state medical device companies, alleging they made kickback payments to several local doctors to gain a competitive edge. More than a dozen physicians also are mentioned in the suit, with a listing of payments allegedly made to them by the defendants. The payments ranged from less than $100 to more than $8 million. The lawsuit alleges that companies blocked them out of the market with inferior and more costly products by offering kickbacks "for the purpose of gaining exclusive access to the lucrative replacement hip, knee and joint industry and to the orthopedic industry in general."

More States Shred Bills for Awful Medical Errors
Hospitals in nearly half the states in the nation now say they won't bill patients for the worst kind of medical mistakes, including operating on the wrong body part or the wrong person, or giving someone the wrong blood. The list has more than doubled since February when hospital associations in 11 states urged their members to waive payment for specific errors dubbed "never events" because they should never happen.

Early Test for Cancer Isn't Always Best Course
For years, patients have been told that early cancer detection saves lives. However, a panel of leading experts recently offered exactly the opposite advice. They urged doctors to stop screening older men for prostate cancer, which will kill an estimated 28,600 men in the United States this year. The reality is that while some cancer screening tests clearly save lives, the benefits of other screening tests are less clear and may actually do harm.

Feds Warn Doctors Not to Perform Prostate Screenings After 75
The U.S. Preventive Services Task Force told doctors that they should stop routine prostate cancer screenings of men over age 75 because there is more evidence of harm than benefit. The task force found that evidence of the benefits of treatment based on routine screening of this age group are small to none, while treatment often causes moderate or substantial harm, including erectile dysfunction and bladder and bowel control problems.

Probe Focuses on Outpatient Services at a Psychiatric Clinic
Community mental health care provided to adults by the Western Psychiatric Institute and Clinic is the target of a state-ordered probe that includes a temporary halt on new referrals to those services. State officials are concerned about a series of deaths and other serious events involving local residents with mental illnesses who received care from the clinic.

Mother and Doctor Face Trials in Child's Death
The mother and a doctor of a 6-month-old girl who died in May have been charged with homicide and neglect. The girl's pediatrician was charged with neglect after police found that she failed to report suspicions of abuse to authorities as required by state law. The girl died after being brought to a local hospital. She was scalded, bitten and choked with bruises and cuts covering her body.

Government Intervenes in Psych Ward After Rash of Deaths
After a series of deaths and other serious events involving local residents with mental illness, a top state official has called a temporary halt to outpatient referrals to the Western Psychiatric Institute and Clinic. The clinic is being investigated after six out of 10 serious incidents that occurred in recent months in Allegheny County involved people who had received outpatient mental health services from the clinic.

Med Students Oversharing on Facebook
Researchers at the University of Florida found that the school's medical students had posted pictures and comments on their Facebook pages that they likely wouldn't want their future patients to see. They studied 800 profiles and found that nearly all of the pages contained offensive material that was available for public viewing.

Hospital Bullies Take a Toll on Patient Safety
The number of doctors who yell, curse, throw things, ignore questions, act impatient and insult colleagues is growing. A recent study has found that such disruptive behavior by doctors can cause medical errors that lead to patient harm. Beginning in January, a hospital accrediting agency will require hospitals to establish codes of conduct that define inappropriate behaviors and create plans for dealing with them.

Family Files Lawsuit Over Death in Psych Ward
The daughter of a woman who died unnoticed on the floor of a hospital psychiatric unit called for criminal prosecution of the workers who did nothing to help her. The woman had spent nearly 24 hours in the emergency waiting room before collapsing to the floor and being ignored for an hour before she died. The woman's family will also be suing the hospital, the city and the city's Health and Hospitals Corporation for $25 million.

Doctors Still Taking Drug Company Freebies
Four out of five doctors surveyed said they let drug and device makers buy them food and drinks despite recent efforts to tighten ethics rules and avoid conflicts of interest. The national survey also found that family doctors were more likely to meet with industry sales representatives, and that cardiologists were more likely to pocket fees than other specialists.

Video of Dying Mental Patient Being Ignored Spurs Changes at Brooklyn Hospital
A videotape recently surfaced showing a patient collapsing onto a floor in a Brooklyn hospital after waiting nearly 24 hours to be seen, and lying there for about an hour while hospital workers did nothing for her. The patient soon died.

WHO Issues Checklist to Make Operations Safer
The World Health Organization issues guidelines aimed at reducing complications and deaths from the rising numbers of operations now being performed. The guidelines are a list of simple safety checks that the health organization said could halve the rate of surgical complications. The list is intended to improve anesthetic safety practices, avoid infections and improve communication among members of surgical teams.

Doctors Say Medication is Overused in Dementia
The use of antipsychotic drugs to tamp down the agitation, combative behavior and outbursts of dementia patients has soared, especially in the elderly. Sales of newer antipsychotics totaled $13.1 billion in 2007, up from $4 billion in 2000. Part of this increase can be traced to prescriptions in nursing homes. Researchers estimate that about a third of all nursing home patients have been given antipsychotic drugs.

Doctors May Provide Addictive Drugs Online
Government regulators are preparing to allow highly addictive medications, including painkillers, to be prescribed online, a goal long-sought by health insurers and large employers. The concern is that patients are more likely to abuse these treatments, and their prescriptions should be monitored more closely. Supporters, however, claim that electronic prescriptions will actually avoid deadly medication errors.

Call for Crackdown on Docs Who Peddle Human Growth Hormones
Both doctors and legislators are joining the battle to regulate growth hormones, which doctors are prescribing at a rising risk. While it may seem odd that a doctor would prescribe a drug intended for older female cancer victims to a young man, it's currently standard operating procedure in some of the nation's anti-aging and weight loss clinics.

Infection Workers Battle Bugs and Bad Habits
Stopping the spread of a potentially deadly drug-resistant staph infection has riveted the attention of the nation's hospitals and nursing homes, especially after a year of headlines and public panic. But frontline experts gathered for a national conference said they wonder how they're supposed to beat MRSA when they can't get their colleagues to wash their hands.

Medical Litter: Device Debris Poses Serious Risk
Hundreds of patients are learning the hard way about a growing but under-recognized problem: medical devices that break or malfunction, leaving behind potentially deadly debris. Earlier this year, the federal Food and Drug Administration officials warned clinicians about the danger of devices that litter patients' bodies with broken stents, torn balloons, fractured wires and stray parts ranging from catheter tips to drill bits.

Italy Doctors Investigated for Needless Surgeries
Police have arrested 13 doctors form a clinic in Milan who investigators suspect performed needless and sometimes fatal operations to make more money. Three of the doctors were arrested on suspicion of murder for allegedly having performed on several patients "abnormal or invasive surgeries, without taking into consideration the fragility of the patients because of age or their medical condition." Police officials said five patients at the clinic are believed to have died after suspected needless surgeries.

New York Psychiatrist Settles Malpractice Lawsuit
A former psychiatrist who confided to a patient that he wanted to kill six people and asked the patient to help him find a handgun has settled a medical malpractice lawsuit with the man. Richard Karpf agreed to pay $365,000 to Dennis White, a former patient who called police in 2003 telling them of Karpf's intentions.

Malpractice Victims Out of Luck in Virginia
Virginia's cap on malpractice damages is unconscionable and unfair, and it will become ever more so when it tops out at $2 million. That $2 million is for all damages, medical expenses and lost income as well as pain and suffering, and other non-economic damages. With rising medical expenses, that cap will impact more victims of malpractice.

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