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July 2010

Judicial Abuse Hits Health Care--Again

While it's hardly the only cause of out-of-control health care costs, absurd legal judgments are right up there, along with pointless layers of administrative bureaucracy. You've probably read articles by plaintiff's lawyers suggesting that this was a myth.

It's no myth. I grant you that if one considers only the value of the judgments themselves (as all the apologists do), the factor is not terribly large. But, that is a foolish and misleading analysis.

The real cost derives from the countless extra tests ordered on virtually every single patient, done solely to protect against future litigation. A hidden cost—and one that no doubt inflicts harm on many patients—is the tendency toward conventional therapies, as the risks inherent of trying something innovative are more legal than medical.

My latest HND piece describes an incandescently preposterous judgment in California, against a well-regarded nursing home operator, in which absolutely no patient harm was even alleged. The stars were definitely aligned for the ambulance chasers in this one.

A clueless jury, led by a more clueless judge put the worst possible bias on every aspect of the proceedings. And there was also a grotesquely inflated class, likely comprised of a majority of members who had no problem with Skilled Healthcare, and didn't even know that they were included.

Read the piece, and weep for the future of health care.

Wasn't it supposed to be "First Do No Harm"?

What would you think about a medical practice officially sanctioned by the American College Of Surgeons that supplants—for no reason other than greed—a non-surgical procedure that cures the condition 82% of the time?

And, what if this very surgery is actually the leading cause of the condition recurring again and again?

Welcome, friends, to the sad and convoluted world of Small Bowel Obstruction (SBO). Surprisingly, SBO accounts for 20% of all acute surgical admissions in the United States. Or, maybe I should have said "Not surprisingly," given that this very surgery begets more of the same surgery.

Nice work if you can get it, as long as you're not the patient. Read all about it in my latest HND article.

More infection control problems at the VA--not to mention a cover-up

My latest HND piece examines the current round of infection control breaches at certain Veterans Affairs medical facilities.

The glitches at the St. Louis VA are getting the attention at the moment, along with an announcement that 79 possible victims from breaches last year at a Miami facility were somehow not notified to come in for testing. But there is a bigger story that is being pretty effectively covered-up.

A series of much worse infection control breaches occurred at facilities in Mayagüez and San Juan, PR, only in these cases, the possible victims were never even notified. As identified by infection control expert Dr. Lawrence Muscarella, and originally reported by fearless Puerto Rican journo Jannette Rios...

These infection-control breaches are numerous and include the following:

  • Failure to disinfect transvaginal ultrasound transducers after each use
  • Improper cleaning of flexible laryngoscopes after each use
  • Failure to leak-test flexible endoscopes
  • The routine use of a damaged and misbranded flexible endoscope

Note that each of these breaches has been linked either directly to patient injury or, at the very least, poses an increased risk of transmission of such infectious agents as HIV and the hepatitis B and C viruses. More than that, there is the possibility of tuberculosis and even cervical and anogenital cancers.

Readers may not be aware that the VA medical system represents the purest example in the entire world of a government-controlled health care monopoly. The entire system was literally built from the ground up by the government. In European countries with completely socialized medicine, the infrastructure and most physical facilities were originally operated by others.

With the VA, however, even the original 54 facilities were part of the Public Health Service.

These massive infection control failures are a disgrace, and dishonor our brave warfighters. Worse, though, is that these debacles only portend the future for all of us under government-controlled health care.

Maybe that's why they are being covered up.

Make Way For Tomorrow (1937)

Many of you know that I like few things better than deflating overblown and inaccurate conventional wisdom.

Within the world of motion pictures there exist a small number of films that have a completely undeserved great reputation. In every case that I have investigated, this is because the film is said to illustrate some liberal political premise.

Make Way For Tomorrow has inspired nothing other than stellar reviews, despite its massive flaws.

By the way, Roger Ebert's review of this film is, not surprisingly, positive. However, as frequently occurs with Ebert's reviews, he gets major plot details wrong. I have no idea why he is never called on this, since he is—after all—being paid to write these reviews.

Wow! Deflating two sacred cows in one article. Read my complete review.

Yet another crummy secondhand smoke study, but it gets even worse...

Anybody still need convincing that smoking is bad for your health? Probably not, but in order to keep those research dollars coming in, academic "scientists" have had to become more creative.

However, this creativity has nothing to do with science, but everything to do with packaging. Evidently, it works for Stephen G. Grant, Ph.D., of the University of Pittsburgh.

Grant starts off with the most sympathetic cohort in the world—pregnant women and their newborns—and does some cool genetics. Unfortunately—for science, at least—the experimental design is seriously flawed.

Grant first looked at the effect of smoking by the mother, as well as environmental tobacco smoke (ETS) on this cohort, and concentrated on a particular gene—HPRT in the newborns. His results, published in 2005, showed mutagenic effects in both the active and passive smoking groups, and there was little difference between these two groups.

Moreover, even if a woman stopped smoking upon pregnancy, the effect was still present. Grant suggested that ETS was to blame. New work by Grant has confirmed these results with a different gene—glycophorin A.

The most disturbing finding of course, is that even if these women stop smoking, if they are "exposed" (and that is not well-defined) to ETS, they may as well not stop. The genetic damage will still occur.

Fear not! My latest HND article points out the many flaws in Grant's work, and suggests that with its atrocious public health implications, his funding agencies should think twice about supporting his work in the future.

Getting techie on Chinese drywall

That's the title of my latest HND article. We take a look at some good science—as done by the Consumer Product Safety Commission—and expose an overblown and now discredited approach.

"Overblown" and "discredited" would apply to the carelessly and perhaps cynically promoted use of x-ray fluorescence (XRF) spectroscopy as a magic bullet to discern tainted drywall. The theory was that any board with a strontium level higher than 1200 ppm (or mg/kg) would be tainted, and given the ease of using an XRF gun to make this measurement, XRF would be the way to go.

Then, the drywall test results from Lawrence Berkeley National Labs came in...

One sample, from Taian Taishan put out 185.14µg/m2/hr of hydrogen sulfide, and was rated as the second worst tested. But, its strontium content was a mere 273 mg/kg. Then there's a super-clean American board with no measurable hydrogen sulfide, with strontium at an eye-popping 2580 mg/kg.

How about one of the lowest emitting Chinese samples tested, with virtually unmeasurable sulfide emissions, and an astounding 5890 mg/kg of strontium?

Strontium APPEARED to be a marker for high sulfide, based on preliminary work, but it now seems as if the deck was stacked. Perhaps, board from particular mines with high strontium and high sulfur just happened to occur in many of the first homes tested.

I'm also inclined to believe that negative findings were suppressed. I wonder how long it will take for XRF instrument manufacturers to remove tainted drywall references from their websites—or at least acknowledge that XRF alone is not definitive?

Keep track right here:

Innov-X Systems

Oxford Instruments


Thermo Fisher Scientific

Right now, the best inspection method is still non-destructive evaluation, looking for signs of tainted drywall (corrosion to wires and HVAC components, usually accompanied by odor).

Read the complete article.