Liposuction Patients Donate Fat to Stem Cell Research at UCLA

This is a good idea, donate the fat for research, why not, as otherwise it’s just disposed of.  The fat is anonymous when donated, in other words there’s nothing that ties a donor to any type of recognition.  BD 

Dr. David Stoker is offering Los Angeles liposuction patients the opportunity to be a part of a ground-breaking research opportunity imagethrough the University of California, Los Angeles (UCLA). Women and men who have liposuction can choose to donate their excess fat to UCLA's stem cell research center, and help scientists develop a range of treatments for conditions such as diabetes and cancer.

"This is an excellent opportunity for women and men to reuse their fat to benefit medical research," notes Dr. Stoker. "Typically, when patients have liposuction, excess fat is disposed of as medical waste. Now, scientists from UCLA can use this fat to advance their stem cell research. After a patient has surgery, our services will anonymously donate the excess fat. Patients can benefit with the knowledge that they can both enhance their physical appearance and potentially help others lead healthy and active lives.

http://www.prweb.com/releases/2011/10/prweb8916203.htm

Dr. Oz Says “Enough is Enough” As He Volunteered at the CareNow Free Clinic In Los Angeles “Failure of Basic Morality in the US”

The CareNow Free Clinic got off to a rocky start but it looks like Dr. Oz had to be here as a consultant as California did not get the provisions implemented to allow doctors to travel over state lines to volunteer here.  The Medical Board messed up and had over a year to get this set up.  At any rate Dr. Oz was there and he wrote about his experiences with a couple of patients. 

“After more than 6,600 people overwhelmed volunteers at a free mobile health clinic in Los Angeles last year, California legislators passed a law making imageit easier for out-of-state medical personnel to assist with future events.
But just over a week before the massive clinic returns, the state has failed to adopt regulations needed for the additional volunteers to participate. As a result, only medical personnel licensed in California will be able to treat patients and some people could be turned away. It also means Mehmet Oz of "The Dr. Oz Show" won't be able to see patients at the clinic as planned, though he can serve as a consultant.”

Dr. Oz and the Uninsured Lose Again–Free Clinic Coming Next Week to Los Angeles–State Board Has Had Since September of 2010 To Implement Law To Allow Doctors To Cross State Borders to California to Volunteer-Failed

Dr. Oz concludes his comments making a couple good points, dignity and the chance to be healthy are vanishing in the US and it’s time to do something about it.  He also states his lack of confidence and disappointment in the politics and how it’s killing people like the woman he counseled with late stage breast cancer who had lost her job and had not been able to see a doctor for a couple of years.  What if this had been caught sooner? 

The insurance industry and the ability to cover and pay gets worse every day and I report it here on the Quack and do have to agree, time for single payor system as enough is enough.  BD 

The smell was unmistakable. I recognized it immediately – a fungating infection. It’s what happens when a cancer breaks through the skin and the puss oozes out and aerosolizes, producing an unsurprisingly foul odor. This is what late-stage cancer looks like if left unchecked, like many cancers were 100 years ago and still are today in the developing world. But I encountered this case this month, and Yvonne, the woman who sat crying before me, lives in Los Angeles. She lost her job two years ago, and when her insurance expired, she was too ashamed to seek help for a mass she felt in her right breast. Now the tumor had replaced her entire breast and blasted through the skin. Being cared for now — so late in her illness — was surely not what she would have wanted; and just as surely, it could have been avoided. How did we let this happen in America?

I was volunteering at the CareNow Free Clinic in the Los Angeles Sports Arena, where more than 700 doctors, nurses and health professionals had turned out to serve the local community. CareNow is a nonprofit founded to bring medical care to underserved communities, and the Los Angeles event was organized by Don Manelli, the indefatigable president of the group. He was aware of what we would see that day, as was I, having volunteered at similar clinics in Little Rock, Ark., and Moorsville, N.C. We also conducted our own clinic for The Dr. Oz Show in Houston in 2009 and saw more than 1,800 patients in one day. But simply having been down this road before does not mean you’re ever fully prepared for it.

It’s this tide of disease and despair that CareNow exists to fix. The group was informally established by a team of first responders who’d learned the art of swooping in to help after hurricanes, earthquakes, wildfires and tsunamis. In May 2009, they held the largest free clinic ever, also in Los Angeles, and a breathtaking 8,000 people showed up. After that, CareNow was formally founded, with the goal of providing care when there is no natural disaster. And on an otherwise unremarkable Friday afternoon in the fall, I was a small part of that effort, gently offering what encouragement I could to a weeping Yvonne.

But we’re not perfecting the law; we’re fighting over it. Politicians dither and people die. Lawyers argue the merits of this or that technical point, and more blameless Americans grow sick and slip away. This isn’t just a failure of politics and policy; it’s a failure of basic morality.

http://ideas.time.com/2011/10/31/enough-is-enough/

Microsoft Kinect Effect–Sensors Everywhere Including the Hospital OR- Video

This is a very cool commercial and has a little bit of everything in it with using in imagemany environments.  Earlier this year I met Microsoft/XBOX Corporate VP Ilan Spillinger  at the Israel Conference and heard his fascinating story on how the technology come to Microsoft and how it came across his path a couple of times before it got there.  Check out the part to where the surgeon stop and runs over and looks at his images. 

Physical Virtue Solution To Assess and Train Neck Disorders, Microsoft Kinect And More As Shown This Week at the Israel Conference

The Kinect Effect

Here’s a couple more videos showing Kinect in Healthcare.  We have a very expensive million dollar piece of surgical equipment working with a $150 X-box device, amazing. BD

Kinect And daVinci Surgical Robot Do Simulated Surgery Suturing Together (Video)
Microsoft Kinect Working with a PACS Server-Images on Steroids Via Gestures (Video)

One year ago this week, Xbox 360 set out to change the way we interact with games and entertainment with the launch of Kinect for Xbox 360. Sales immediately soared with more than 10 million Kinect sensors sold, setting the Guinness World Record as the fastest-selling consumer electronics device in 60 days along the way. But people were inspired not just to play; but also to discover, innovate and create. We call this "The Kinect Effect."

http://www.youtube.com/watch?v=diy7rkWkDtU

Occupy San Francisco Participant - Denied Coverage for Life Saving Procedure for Cancer–Insurer Said It Was Pre-Existing When She Was 14 Years Old Now Is 18

This is very sad as she is not 18 years old and imagine if she could have had that bone marrow transplant 4 years ago!  This is why the the Occupy movements are there with corporate greed alive and well.  This is a big ethics problem by all means.  image

ALGORITHM SAYS YOU HAVE A PRE-EXISTING CONDITION

She at least has care from the San Francisco Hospital who monitor and give her pain pills.  You may get tired of that word, but I’m here to drill it into your head as to how these decisions are made.  I have written 3 posts about the Killer Algorithms and here’s one that is currently killing a person.  I really didn’t mean it to actually be killing but rather denying care, but I guess you can wrap the two together and that is what you have.  At 14 years old this is sad as now she is 18 and considered an adult. 

“Attack of the Killer Algorithms” Part 3–Vatican Doesn’t Like It Either–Occupy Wall Street Belongs in New York As They Don’t Do Code or Algorithms in Washington–Only Find time To Talk Abortions

Here’s an example of a state governor who is so digitally illiterate that she let people die who needed organ transplants. This is cold and you know what goes around someday comes around I think.  You have to know how to work with reports and analytics and use them wisely and we don’t seem to see this at all. We have some horrible folks out there who completely lack ethics and the smarts to do anything about doing a better job too.  No that I expect elected officials to be the great while hope but we have today is pathetic and this is how they get grouped as cold and greedy when making decisions as such.  BD 

Arizona Governor Jan Brewer-Rootin’ Tootin’ IT Illiteracy Riding High Lacking Digital Literacy With Budget Algorithmic Solutions to Find Funding for Transplant Patients

As Miran Istina puts it, she has been living on borrowed time since she was 14. Diagnosed with cancer, she was given just months to live after her health insurer refused to provide her with life-saving surgery.

Now 18, Istina, from the city of Sisters in Oregon, has spent the past three weeks living in a tent at the Occupy San Francisco protest and says she will stay there indefinitely, despite her illness.

She was inspired to take part in the protest by the refusal of her insurance company to pay for treatment for her chronic myelogenous leukaemia.

She said: “They denied me on the terms of a pre-existing condition. Seeing as I had only had that insurance for a few months, and I was in early stage two which meant I had to have had it for at least a year, they determined it was a pre-existing condition and denied me healthcare.”

Treatment would require a bone marrow transplant and extensive radiation therapy and chemotherapy, at a cost of several hundreds of thousands of dollars. Coming from an ordinary middle-class background, her family has no way of paying for the surgery that would save her life.

Following her insurer’s refusal, she spent three years travelling the US looking for a healthcare provider who would give her a chance at life.

Health professionals from the San Francisco General Hospital are providing round-the-clock care for Istina, who needs strong pain killers and constant monitoring of her condition. Earlier in the month she suffered a kidney malfunction which required urgent hospital treatment.

http://www.healthcare-now.org/occupy-san-francisco-the-teenager-who-was-refused-cancer-treatment/

Prime Healthcare Responds to Billing Practices–Flawed Data and Algorithms Once Again-Who Got Sold a Bill of Goods as Kaiser, Stanford & Other Hospitals Had a Ton of Kwashiorkor Malnutrition Billings

I kind of like stories like this as it’s yet one more reminder to clean up the math we use today and a good reason to check out the bill software that is sold to both imagedoctors and hospitals.  I’m not a big fan of Prime Healthcare as they buy hospitals on their last leg with no money and cut out a ton of services and create “Cadillac ER” rooms but on this one I think they made their point.  What are these hospital buying today for risk assessments?  The EHR gets certified but not the rest of it.

Bad Algorithms in Healthcare Payment Systems and Risk Assessments–Did the Hospital Bill Fraudulently or Were They Sold Formulas That Did Not Conform

Kwashiorkor is the big diagnosis case here and heck even Kaiser and Stanford had a bunch of these at one of their facilities.

Prime Healthcare Billing Processes Under Question as 25% of Medicare Patients are Showing Malnutrition- Profit Algorithms?

It’s the software and the algorithms that do this based on matching clinical input, but duh folks!    Nobody wants to talk math and algorithms and instead we get stories as such in the news that “dances” around math and tries to tell a story, pathetic by all means but it starts in Congress with the digital illiterate pace they set.  You can read on to where a hospital had the same issue with too many of these types of diagnoses in Maryland…If we had just a few more folks that would entertain math we would be miles ahead! 

Duh!  It’s the software and the algorithms folks…want me to repeat this one more time???  In this case it appears to be the software from 3M at the heart of most of the issues.  Here’s another good example, rely on those Doctor rating sites…well look again at the flawed data…

HealthGrades And Other MD Rating and Referral Sites List “Dead Doctors” on Their MD Information Pages And Even Include the Insurance Plans the “Dead Doctors” Honor

I’m not going to fault California Watch as they are just using flawed information given to them as they are here to watch out for us over all, but I bet they might just join in on this issue of “flawed data” as it creates conflict where it should not exist. As a matter of fact if you are still one of those naïve folks out there that believes every report and all the statistics today, listen in to the audio below and get up to snuff here as marketing and algorithms for profit have diluted using math for being 100% available to prove accuracy.  There’s a ton of healthcare addressed here.

“Numbers Don’t Lie, But People Do”–Radio Interview from Charles Siefe–Journalists Take Note, He Addresses How Marketing And Bogus Statistics Are Sources of Problems That Mislead the Public & Government

Actually this was a good response for Prime Healthcare in bringing this out into the open as it seems like of late the Medical Quack is doing a lot of talking about “flawed and unethical use of data and the algorithms” out there today.  Somebody needs to do it so I guess this blog is the place.  I just keep seeing it so that is why of late it’s in the headlines here a lot as we don’t live in denial around this blog and those who do will not feel comfortable reading for long sadly as they will miss the education process.  BD 

ONTARIO, Calif., Oct. 24, 2011 /PRNewswire/ -- California Watch has once again relied on faulty data, illogical comparisons, and baseless conclusions in its attempt to smear Prime Healthcare by comparing certain billing practices at Kernan Hospital, alleged (but not proven) in United States v. Kernan Hospital, to the billing practices of Prime Healthcare's hospitals.

There is no logical basis for any claim that the billing practices of Kernan Hospital parallel Prime Healthcare's billing practices. For example, the lawsuit alleges that Kernan put in place its own computer system. Prime Healthcare's hospitals utilize coding software developed by 3M, which is widely used across the United States and accepted by Medicare, and have not modified this software in any way. Likewise, Prime Healthcare's hospitals utilize practices that are consistent with the principles adopted by AHIMA including those related to physician queries.

Comparing billing practices of Maryland hospitals and California hospitals compares apples to oranges because Maryland relies on a different reimbursement methodology system than utilized in California (i.e., APR-DRG versus MS-DRG). Also, Maryland's APR-DRG methodology applies to both Medicare and Medicaid reimbursement in Maryland. Medi-Cal (California's Medicaid program) does not utilize a DRG reimbursement methodology.

In addition, as Prime Healthcare advised California Watch on March 3, 2011, the publicly available data for California tells a much different story:

  • According to the 2009 OSHPD Data, Eisenhower Medical Center in Rancho Mirage, California (an area with an average age of 56) reported 240 cases of Kwashiorkor in 2009 with 89.58% of the cases occurring in patients 35 years old or older and 62.1% (or 149 out of 240) of the cases occurring in patients 65 years old or older.
  • According to the 2009 OSHPD Data, Kaiser Foundation Hospital – Anaheim reported 146 cases of Kwashiorkor with 96.58% of the cases occurring in patients 35 years old or older and 58.2% (or 85 out of 146) of the cases occurring in patients 65 years old or older.
  • According to the 2009 OSHPD Data, St. Joseph's Hospital – Orange reported 138 cases of Kwashiorkor with 89.86% of the cases occurring in patients 35 years old or older and 61.6% (or 85 out of 138) of the cases occurring in patients 65 years old or older.
  • According to the 2009 OSHPD Data, Stanford University Hospital reported 70 cases of Kwashiorkor with no less than 87.14% (61 out of 70) of the cases occurring in patients 35 years old or older and 34.3% of the cases occurring in patients 65 years old or older.

http://www.prnewswire.com/news-releases/prime-healthcare-responds-to-california-watch-legal-comparison-132488353.html

Challenging the Surrogate - Daniel Sanger Hearing on Nov. 2

Maryland resident Daniel Sanger has been hospitalized since suffering brain damage after a heart attack in July. For the past month, he has been at Frederick Memorial Hospital, where he receives food and water intravenously.  A week ago today, hospital staff members removed his feeding tube with the permission of Sanger's wife, Leta Sanger.  (Frederick News-Post)


But Daniel Sanger's mother and brother challenged that decision.  Phyllis Sanger filed a motion for an emergency injunction, asking for the tube to remain and for her and son Mark Sanger to be granted temporary custody.  On Wednesday, Chief Judge Peter Krauser of the Maryland Court of Special Appeals ordered the tube be restored pending the outcome of Thursday's hearing.  (TRO Order from ADF)  The matter will return to Circuit Court on Wednesday, Nov. 2, when a preliminary injunction hearing is scheduled.


At the heart of the dispute lies Phyllis Sanger's claim that Daniel Sanger told her that he wanted to live.  But Leta Sanger takes issue with that claim and said her husband has never made a similar statement to her.  She said Daniel Sanger told her when his father was in a similar situation before his death that he wouldn't want to live in such a condition.


Practical Guide to End-of-Life Care in ICU

On this blog and in my law, medical, and bioethics journal articles, I usually focus on legal and policy issues concerning end-of-life treatment.  In my airplane reading, yesterday, I read a nice article that has a different, more practical and bedside focus.  In "End-of-Life Care in ICU: A Practical Guide" (in the Sept/Oct J. Intensive Med) , Irene Spinello provides: (1) a review of key concepts, (2) seven rules of communication, and (3) three steps for removing life-sustaining measures.



Arizona Pain Specialists First US Pain Clinic To Begin Stem Cell Clinical Trials To Regenerate Deteriorating Discs To Reverse Damage to the Spine & Relieve Back Pain

Back in June of this year the FDA approved the trial to treat chronic lower back pain with stem cells.  Mesoblast is sponsoring the trial and the company is located in Australia.  

Mesoblast Gets FDA Approval to Begin Advanced Clinical imageTrials Using Stem Cells to Treat Chronic Lower Back Pain 

Mesoblast in September was given European approval for another clinical trial for treating major heart attack victims.

Europe Gives Mesoblast Approval for Clinical Trials of “Off the Shelf” Stem Cell Treatments for Major Heart Attack Victims

The team at Arizona Pain Specialists (http://www.arizonapain.com) has been selected for an FDA-cleared adult stem cell study on advanced treatment for chronic low back pain. The study will offer this promising alternative to patients at the Arizona Pain Specialist’s clinic in Scottsdale, Arizona.

The treatment offered through the trial study may unlock a vital solution for many people suffering from debilitating pain. Approximately 15% of people in industrialized countries have chronic back pain lasting more than six months. Patients with pain from degenerative discs may now be able to avoid major back surgery. This new treatment involves a single stem cell injection administered into a degenerative disc through the use of adult donor bone marrow stem cells (not derived from embryos).

The selection of Arizona Pain Specialists for this study strengthens the organization’s reputation as leaders in pain management. Physicians at the practice are thrilled to have been chosen to research this innovative biotech treatment.

A global regenerative medicine company, Mesoblast Limited will sponsor the trial study.
Mesoblast’s recent preclinical results indicated that their technology reverses the degenerative process and regenerates disc materials. Mesoblast is world renowned for developing novel regenerative medicine therapies with the aim of improving quality of life and increasing survival of patients with major, unmet clinical needs.

http://www.prweb.com/releases/2011/10/prweb8917784.htm

Hawaii Medical Center Searching for Buyers–If Not Center Could Close As Early as November-Only Hospital in the State Capable of Performing Transplant Surgeries

The center is aggressively looking for a buyer to keep the doors open.  If a buyer is imagenot found they could begin moving patients to other facilities in November.  The hospital is also turning to the government for potential help with emergency actions. 

The hospital has already gone bankrupt and there is too much debt so the reorganization won’t work.  BD

HONOLULU -- Hawaii Medical Center West treats a population stretching across Leeward Oahu and the Ewa plain, with patients also traveling to HMC East in Liliha. The financially ailing hospitals are aggressively looking for a buyer to take over from Saint Francis Healthcare System. Sen. Will Espero said if the hospital isn't sold by early November, it is in jeopardy of shutting down.

Jerry Correa, chief operating officer of St. Francis Health Care System released this statement to KITV4, saying:

“This was one of the most difficult decisions we’ve had to make. We were all hoping for a better outcome, but taking on these financial responsibilities would put our current programs and services at risk and become a burden on our mission of creating healthy communities in the Spirit of Christ’s healing ministry.”

http://www.kitv.com/news/29607115/detail.html

United HealthCare in New York to Disclose More Data Used to Justify Premium Increases–But You Can Almost Bet We Won’t See the Algorithms That Create the Data

This is getting to be such a hot topic today as you can no longer 100% rely on math to prove accuracy as with algorithmic formulas it can be marketed, flawed, you name it.  This is great that consumers will have additional access but think of the marketing too, it’s done to help them have consumers feel that they somehow deserve and needs these increases.  The marketeers of the web are getting smarter all the time. 

Even in the financial industry, people want to see those algorithms to find out how reports and analytics are calculated and this for good reason as you can’t touch, see or feel one of them, much less talk to one and the algorithms work on servers 24/7 every day making decisions and providing information on your computer screen.  Most of them are good guidance for decision making processes but again we have those created for profit and it’s hard sometimes to tell the difference.  This brings me around once again to my favorite NYU professor and his talk about “Numbers don’t lie, but people do”. Not saying that anyone is lying here but when you look back at the 15 year lawsuit to where doctors were paid less based on the United data base for out of networks services, this tells us to ask questions and to not assume when it comes to math and algorithms, in other words ask questions and ask about the math as 15 years of payments on flawed data was a long time before the math issues were finally resolved with the low balling rates that were used and that the other insurers also subscribed to.

“Numbers Don’t Lie, But People Do”–Radio Interview from Charles Siefe–Journalists Take Note, He Addresses How Marketing And Bogus Statistics Are Sources of Problems That Mislead the Public & Government

If you need a reminder on skewed numbers and algorithms, here’s the case that was settled in 2010 due to the work of Andrew Cuomo.  He found the flawed data so when more information comes available we need to ask questions and not be naïve and gullible.  BD

AMA Announced Settlement of Class Action Suit of $350 Million with Ingenix (United Healthcare)
Ingenix Data Base Has Some Long Reaching Legal Tentacles with Aetna, Blue Cross, Blue Shield, Humana

ALBANY, N.Y. — New York's largest health insurance company agreed Tuesday to publicly disclose more data used to justify premium increases.

The agreement with UnitedHealth Group is part of a statewide effort by state Financial Services Superintendent Benjamin Lawsky to make rate increase filings public for review by policy holders and consumer advocates. That could result in reducing the number of requested hikes and provide a better chance for consumers to challenge the requests.

Lawsky is now seeking greater disclosure from all companies operating in the state.

"We got here and said, 'This is crazy,'" Lawsky told The Associated Press. "We are supposed to be getting comment from consumers and they don't understand what's in the filing.

http://online.wsj.com/article/AP1f19c82204f44201bab80ad73fdc8933.html

Brooklyn Hospital Sells Off Its HMO To Amerigroup –They Need the Money for Health IT Updates and Pensions–All Four Brooklyn Hospitals Could Face Bankruptcy

Is this Health IT expense going to burst one day?  Time will tell but we have the sale again of yet another HMO and they need the money to keep the doors open so the imageMedicaid HMO was sold for $85 million.  In addition the state is looking to figure out how to handle the 4 Brooklyn hospitals that are in the red, fix the finances somehow or let all go bankrupts. 

Smaller HMOs are being acquired by larger HMOs in the US, either than or they are being bought by insurance companies.  We had one large purchase as such in Orange county California not too long ago.  It’s funny how we keep hearing on the other side of the coin that Health IT companies can grow rich quickly, but look at the clients, doctors and hospitals who’s incomes are shrinking so is this possible?  How long will the money last?  BD 

United Healthcare To Buy Huge Chunk of Orange County, California Managed Care Business with the Purchase of Monarch Healthcare–Subsidiary Watch

Some of the insurance companies now have a large number of Health IT subsidiaries and so with one company they cut compensation and then march in with the Health IT subsidiary to sell them more software to keep what business they have left.  United with all the various subsidiaries is one carrier that fits into that scheme in many areas as they own so many Health IT firms.  BD 

Subsidiary Watch-Corporate Conglomerate Insurers Reduce Compensation Contracts Using One Subsidiary Then Market Same MDs With Another Subsidiary in Health IT

A Brooklyn charitable hospital that's also one of New York's largest Medicaid HMO's is selling off its managed care business to a for-profit company.

Pending state approval, Lutheran Medical Center will get $85 million from the sale of Health Plus, which serves 320,000 patients on Medicaid and Medicare. CEO Wendy Goldstein said the hospital needs the money for workers' pensions, technology updates and the overall balance sheet.

"We very much needed an infusion of capital to stabilize the medical center and the whole system," Goldstein said, "and capital is very difficult to come by for safety net providers."

Lutheran is selling Health Plus to Amerigroup, a publicly traded company from Virginia that already has a small presence here. New York State Health officials regularly score Amerigroup "below average" in various categories — such as "Adults Access to Preventive Care" — often several points below Health Plus, the HMO AmeriGroup is acquiring.

Lutheran is one of several Brooklyn hospitals that is struggling to keep its doors open — though at least it’s slightly in the black.

http://www.wnyc.org/blogs/wnyc-news-blog/2011/oct/25/brooklyn-hospital-sells-hmo/

California Stem Cell Company in Irvine Takes Over Cancer Program Developed at Hoag Hospital in Orange County For Treating Skin Cancer

The company is focused on working with stem cells and also has another division that creates tools for predictive toxicology screening, in other words drug imagescreening.  The company also has partnerships with Johns Hopkins, UC Irvine and a few other healthcare organizations. 

California Stem Cell (CSC) is a privately held company focused on the manufacture of high-purity human cells for therapeutic development and clinical application.  CSC is currently developing stem cell based therapies for spinal muscular atrophy (SMA) and amyotrophic lateral sclerosis (ALS, or Lou Gehrig's Disease).”

This particular treatment seeks out the the worst type of melanoma and destroy the cells that break away from the initial tumor and are found elsewhere in the body.  This is the first time the company has acquired a treatment program that was developed at a hospital.  BD 

An Irvine stem-cell company is taking charge of a Hoag Hospital cancer program that trains its patients' own immune systems to attack tumors.

The program, acquired by California Stem Cell Inc., specializes in treating malignant skin cancer by targeting the stem cells of the cancer itself -- that is, the part of a cancerous tumor that is active and growing.

Hoag Memorial Hospital Presbyterian has been developing the treatment over the past 20 years.

The patient's own tumor stem cells, as well as immune cells, are purified from their blood.

The immune cells are then "taught" to recognize the cancer stem cells, and injected back into the patient's body.

The treatment targets the worst type of skin cancer, malignant melanoma. And it can seek out and destroy "seed" cells that break away from the initial tumor and lie dormant elsewhere in the body -- out of reach of traditional cancer treatments.

UC Irvine researcher Hans Keirstead, who developed the first human embryonic stem-cell treatment for spinal cord injuries to be tested on patients, is chairman of the company's science advisory board, Airress said.

The company also has applied to the U.S. Food and Drug Administration to begin a treatment for spinal muscular atrophy, a disease that typically kills its victims in their first years of life.

http://www.ocregister.com/news/stem-323592-cells-cancer.html

Xigris Drug for Treatment of Sepsis Being Withdrawn the Market–Failure to Show Survival Benefits

The results of a clinical trial showed the results compared to the use of a placebo and benefits were not attained.  It is the only drug on the market to treat Sepsis in imagethis manner.  The drug was approved back in 2001 so it has been around for a while and thus I’m sure many were given the drug.

All treatments currently being given to patients should be halted and the product returned to where it was purchased and no new patients should be given the drug.  I have to agree with another blogger, the Happy Hospitalist on his statement below:  BD

“I would personally like to take this opportunity to request the FDA and Eli Lilly remit payment for all hospital expenses previously incurred by using this apparently worthless $10,000 per 72 hour infusion drug.”

Eli Lilly has announced that the medicine Xigris is being withdrawn from the market because a study conducted showed that, after treatment with Xigris, no statistically significant reduction in mortality among patients with severe septicemia was noted. Xigris is still the only medicine approved for the treatment of severesepticemia. The recently concluded study was launched by Eli Lilly in 2008 andsought to help improve the selection of patients with severe septicemia fortreatment with Xigris; this was not achievable, possibly due to the selectionmethod used. We are not aware of any use of BioPorto's selection method (theAPC-PCI assay) in the study conducted by Eli Lilly.

The results of the published study, and the withdrawal of Xigris from themarket, show there is a very great need for a selection method to selectpatients with severe septicemia for treatment. BioPorto's APC-PCI (ActivatedProtein C/Protein C Inhibitor) test, which in a smaller study was demonstratedto be suitable for the selection of septicemia patients for treatment, willtherefore be even more relevant for the correct selection of patients withsevere septicemia, either in terms of bringing Xigris back to the market orwith a view to developing new methods for the treatment of severe septicemia.Several noteworthy studies are currently in progress with a view to developingnew treatments of severe septicemia, and accurate patient selection will bedecisive in connection with the development of new therapies.

http://www.cisionwire.com/bioporto--a-s-g/r/withdrawal-of-the-medicine-xigris-from-the-market,e268440

Nurses And Other Healthcare Professionals Occupy Wall Street With Make Shift Clinic

The protesters are now getting help from professionals that have set up a clinic to help the protesters with common medical needs/ailments.  Back in June of this year the nurses also held their own demonstration on Wall Street. 

Nurses Demonstrate on Wall Street Discussing Wages, Working Conditions - Addressing the Sad State of Healthcare Created by Financial Greed (Video)image

In addition there are plans to target the health care industry as it has been an algorithm risk assessment payment business that is not always fair.  As far as what I have also read, the tent is pretty well stocked with donations coming in from all over the country. 

This is really a big move and again as I have said before it comes down to the math, the bath created with computer formulas that forget ethics along the way and you have computer screens and programmed algorithms making decisions not humans, which is ok but what is lacking today is the knowledge of when a human needs to intervene to correct flawed data or to enhance areas of forgiveness so someone can get care they need. I call it the Attack of the Killer Algorithms and they have teeth as we have all found out.  You can see, touch or feel them but they are there every day on IT infrastructures running 24/7 and when ethics are crossed along with bad and deceptive marketing, you reach a point where enough is enough and I think that is exactly where we are today.  You can read part 3 and there are links back to parts 1 and 2 at the link below.  BD 

“Attack of the Killer Algorithms” Part 3–Vatican Doesn’t Like It Either–Occupy Wall Street Belongs in New York As They Don’t Do Code or Algorithms in Washington–Only Find time To Talk Abortions

Hypothermia, skin infections, sprained ankles, and the common cold — these are just some of the ailments treated by Occupy Wall Street’s volunteer medics who staff a makeshift clinic inside Zuccotti Park. And flu season is coming.

At the National Nurses United tent, there’s at least one registered nurse present around the clock. The encampment is also home, at times, to paramedics, herbalists, acupuncturists, a therapy dog and a veterinarian. There’s a self-service area where protesters can help themselves to vitamins.

http://blogs.wsj.com/metropolis/2011/10/25/occupy-wall-streets-nurses-face-coming-flu-season/

Forthcoming New Primer on Medical Futility

I just got the page proofs for my chapter on “Medical Futility," chapter 12, in Guidance for Hospital Ethics Committees forthcoming from Cambridge University Press (D. Micah Hester and Toby Schonfeld, editors).  My chapter, like the rest of the volume, is written to an audience of new, “inexperienced” members of an ethics committee.  This book will surely prove to be even more valuable than Hester's last guide for hospital ethics committees.  After reading my  chapter, the reader will be able to:
  1. Describe the three main definitions of “medical futility.”

  2.  Identify the key factors at the heart of disagreements between surrogates and providers concerning whether a treatment is beneficial.

  3. Distinguish six strategies that ethics committees can use to prevent and to resolve medical futility disputes.



New Bioethics Blog

Stephen Latham at Yale has a new bioethics blog.  It is not limited to end-of-life issues like this one.  But it is a valuable resource, being both superlatively informed yet written in a colloquial, accessible manner.



Cigna Buys HealthSpring Inc For $3.8 Billion, Who Bought Bravo Medicare HMO Who Had Profits of a Billion in 2010-Subsidiary Watch

Here goes another one with Medicare patients being a focus and this is yet one more acquisition to gain more patients from traditional Medicare coverage.  Members have restricted lists of doctors they can see and preventive care is a big part of the imageprogram too. 

HealthSpring To Pay $545M For Bravo Health Medicare Company With Profits of 1 Billion in 2009-Over 800 Million in 2010 Thus Far

In other recent Cigna news from a couple months ago we had this going on and I don’t know if it has been resolved yet.  Currently as it stands, the state of Delaware can demand payment from Cigna if they do not keep employees in Delaware and add more jobs.  An economic fix is being discussed for the issue and it will be interesting to see what comes out of this discussion,just one of many that appears today, again based on potential profit losses.  If one is a worker in the Delaware office, well you job could be at stake ant it comes right back around to rules, laws and contracts.  This grows out to where now it is taking an “economic development director” to examine and create a “fix”.

Cigna Wants Expatriate Plans Exempt from Medical Loss Ratios-Threatening to Dump 500 Employees in Delaware From Payroll

You might also want to look at some of their recent other efforts.  The former CEO of Cigna is now working for a medical tourism business who had a contract with a city in Connecticut and it was cancelled based on the partner in the business having a criminal background.  At any rate you can see where Cigna did buy a similar company.     BD

CIGNA Acquires Vanbreda International–To Service Expatriate Customers With Health Insurance Outside the US And Employer Benefit Packages–Medical Tourism

Cigna Corp. will buy fellow health insurer HealthSpring Inc. in a $3.8 billion deal as it becomes the latest managed-care company to snap up a bigger share of the fast-growing Medicare Advantage market.

Cigna, based in Bloomfield, Conn., also said Monday it raised its earnings expectations for 2011 and moved up its third-quarter earnings report to Friday from Nov. 3.

HealthSpring shares soared more than 33 percent, or $13.50, to $53.66 in afternoon trading, while Cigna stock slipped 10 cents to $44.60 and broader trading indexes rose less than 1 percent.

Cigna's acquisition is the latest in a series of deals made by health insurers to expand their Medicare Advantage businesses, which have grown increasingly popular with the managed care sector as baby boomers become eligible for them. In addition, big insurers like Cigna have reported strong results in recent quarters, and analysts have speculated that companies would start exploring acquisitions.

Last year, HealthSpring spent $545 million to buy another Medicare Advantage plan operator, Bravo Health Inc. HealthSpring, based in Nashville, Tenn., has about 340,000 Medicare Advantage customers in 11 states. It also has a Medicare prescription drug business with more than 800,000 customers.

The deal represents a major diversification for Cigna and the most significant move by Chief Executive David Cordani since he took the helm nearly two years ago. Cigna had focused its U.S. health insurance plans on businesses, though Cordani sought more international expansion.

http://www.latimes.com/business/la-fi-cigna-healthspring-20111024,0,2861843.story?track=rss&utm_source=dlvr.it&utm_medium=twitter&dlvrit=52116

“Attack of the Killer Algorithms” Part 3–Vatican Doesn’t Like It Either–Occupy Wall Street Belongs in New York As They Don’t Do Code or Algorithms in Washington–Only Find time To Talk Abortions

I don’t care whether you are Catholic or not, I’m not but this is a good statement and coming with recognition from the Vatican, it’s time to take note.  I have been writing about the bad of use of code and flawed data and poignant algorithms and its living imageamong us.  The is the sheer frustration of the Occupy Wall Street movement.  How do you do battle with an element you can’t see, you can’t touch and you can’t talk to it.  They are doing what they can as humans and we all live with the unethical use of math today and financial formulas, so in essence they represent all of use.

  Here’s a guy the SEC caught with using flawed software with his clients for 3 years knowing it was flawed.  How do you think his clients felt?  I mention this as these are the folks playing the game here and there’s nobody safe.  I have a ton more related links there too for additional reading if you are interested to see how insurers and others use their algos. 

SEC Sues Quant–Undisclosed Error in Trading Algorithm- Miscalculating “Risk”-Healthcare Software Evaluates This Factor Too

I’m going to recap 3 of my most popular posts in the last couple weeks here and they all have to do with this topic.  We get it in healthcare too.  Just this morning I read about a hero in the Joplin tornado, not getting any benefits even though he saved a number of people “Algorithm said No”.  This is flat out what it is and this is why the statement from the Vatican stands out today.  Never mind that he saved the lives of others (and we don’t know if they had insurance or not, only the algorithms know for sure) so they might be ok to get medical care.  Listen in to the radio cast below and you’ll get it. 

“Numbers Don’t Lie, But People Do”–Radio Interview from Charles Siefe–Journalists Take Note, He Addresses How Marketing And Bogus Statistics Are Sources of Problems That Mislead the Public & Government

In Washington, all they do is talk abortions as match seems to either off limits or over their heads today with keeping up with the modern world.  Heck they need big data capabilities to sort out information to make laws, but gee nobody will discuss that, abortions come first:)  Now granted we do have to look at cost but how the money is distributed and charged, well that’s another matter.  So again, the Occupy movement belongs on Wall Street where the algos are created. 

Digital Illiteracy Still Plagues Law Makers–Severe Focus on Abortion Rights Proves It–Is This Where Our Lawmaking Knowledge Leaves Off or Even Begins? Scary…

Insurers are buying up Health IT companies to sell the very expensive Health IT software, but on the other hand we have laws and rules that are cutting the incomes of doctors and hospitals who are their potential clients and they don’t seem to care, give us money for the shareholders is the tune there. 

WellPoint Creates Reimbursement Algorithm to Cut Down Hospital Annual Payment Increases and Reward Only Those Who “Score” Well–Analytics on Steroids

I wrote part one a couple weeks or so ago and lot’s packed into this post.  I asked that perhaps Michael Moore would consider this for his next movie as he is doing such a great job with awareness, now we need to find a method of attack to fight back against those algorithms we can’t see, feel or talk to.  The movie Capitalism got every stirred up for sure, self included, but again how do we fight “Killer Algorithms”?

Occupying Wall Street–It’s All About the “Attack of the Killer Algorithms”–The Unfair and Marketing Exploit of Ethics Using Math–This Could be a Subject for Michael Moore to Explore and Document In a Movie

I said back in August of 2009 we need a Department of Algorithms in a post I made after the Madoff affair hit the wires, but folk are still not into the fact that formulas and math is the battle ground.

“Department of Algorithms – Do We Need One of These to Regulate Upcoming Laws? 

How is the Supreme Court going to rule on the Healthcare Law without some big data capabilities?  They can rent this from the DOE or go sit over there in the House and talk abortions I guess with those members of Congress who see this as such a huge priority.  Guess what, the Healthcare Law has a lot of math in there too, so oh my now what? 

Supreme Court Likely to Rule on Healthcare Law Early Next Year–This Gives The Justices Time to Rent Some Computing Space from the DOE As They Will Need It

Now we have more algorithms making their way forward with credit scoring with an optional “tell all” analytical report.  Now granted these are not all bad it’s just the way they get used with “innocent” people who have “stuff” like we all do, some little tiny flaw that the digital illiterates use to judge us as bad people.  Nobody stands out bigger than Arizona Governor Brewer as far as digital illiteracy and not knowing imagehow to use analytics when she cut off funds for transplants and this is exactly what the Vatican is talking about with ethics.  Rootin Tootin Jan believing all the flawed reports and numbers she sees, it’s obvious when you look at her decisions and she should listen above to the radio show about “numbers not lying, but people do”.  That the whole problem with so much of this and the steroid marketing going on to convince us that 2 plus 2 equals 5.  You hear it enough and have it marketed to the fact that this is real math, some start believing it and no longer question what they know is wrong.  I had a couple heavy geeks recently totally agree with me on this that the gullible and naïve numbers in the US are growing.  The more they can sway the more flawed code arrives as they have victory with “duh”. 

Arizona Governor Jan Brewer-Rootin’ Tootin’ IT Illiteracy Riding High Lacking Digital Literacy With Budget Algorithmic Solutions to Find Funding for Transplant Patients

Dangerous decisions without ethics or any elements of “forgiveness” with data are being made every day and the folks who sit at screens and do customer service work are told not to ask questions and that your answers are on the screen.  They may get fired if they question those algorithms built by the officers of company that are strictly designed for profit and they will run them up the flag pole as fast as they can complete with “steroid marketing” to prove their points. With code and algorithms today, math is no longer 100% effective for proving truth and accuracy.  Go back the link above with the quant and re-read that one for edification

“Killer Algorithms: Part 2” Disturbing News for Consumers With Credit Scoring Adding New Data Analytics–Some of the Same Methodologies Used by Insurers With Flawed/Potential Erroneous Data–One More Reason to Continue Occupying Wall Street

Don’t you as a consumer just love to see marketing like this image below, problem is with this image is that “humans” are the “problem applications”…lovely huh..but that’s what’s out there.  If you do not fit, you are the problem, read between the “marketing” lines on this one.  What other message do you get as a consumer?  Obviously this message is not meant for us, even though we are the subject, it’s wording to attract insurers for profit. 

So again in Washington we are just about screwed all the way around as gee why would they entertain tools that could help them make better laws and take of important issues when they can kill the days talking abortions?  As you can see bit business is all over this with using greater technologies, so again a wasted cause for the Occupy movement as they are so digitally illiterate in DC that there’s no glimmer of hope while the are outsmarted all the way around, and we elect these people, scarier yet so let’s all get smarter on who gets into office next time. 

WellPoint Hiring IBM Watson Technologies–Congress Needs to Wrap Their Heads Around Using Technology That Processes 200 Million Pages of Info in 3 Seconds to Make Lawsimage

I’m sure the Vatican didn’t make this statement…although they trust God there but it’s the algo folks that want the data who knows if they have a God or a superior being they worship.

“In God we trust; all others must bring data”

The Vatican can see widening inequality and thus they felt it was time to make a statement and again, I feel it was a good one and can be appreciated by anyone of any religion as all have ethics and this points out how they truly lack on Wall Street so the target for the protesters is right one.  Last week is saw other saying they should move to DC and just laughed at those articles as they doo are probably digital illiterates that don’t get it either.  BD 

VATICAN CITY — The Vatican called on Monday for an overhaul of the world’s financial systems, and once again proposed the establishment of a supranational authority to oversee the global economy, saying it was needed to bring more democratic and ethical principles to a marketplace run amok.

In a report issued by the Pontifical Council for Justice and Peace, the Vatican argued that “politics — which is responsible for the common good” must be given primacy over the economy and finance, and that existing multinational institutions like the International Monetary Fund had not been responding adequately to global economic problems.

The document grows out of the Roman Catholic Church’s concerns about economic instability and widening inequality of income and wealth around the world, issues that transcend the power of national governments to address on their own.

The language in the document, which the Vatican refers to as a note, is distinctively strong. “We should not be afraid to propose new ideas, even if they might destabilize pre-existing balances of power that prevail over the weakest,” the document states in its conclusions. The message prompted comparisons with the rallying cries of protest movements that have been challenging the financial world order, like the indignados in Madrid and the Occupy Wall Street protesters in New York City.

The report is highly critical of “an economic liberalism that spurns rules and controls” and fuels social injustice. International institutions must become “more representative, and with greater levels of participation and legitimacy,” Bishop Toso said, to achieve “free and stable markets regulated by an appropriate legal framework and working towards sustainable development and social progress for everyone.”

http://www.nytimes.com/2011/10/25/world/europe/vatican-calls-for-global-oversight-of-the-economy.html?_r=1&smid=tw-nytimesbusiness&seid=auto

Clinical Ethics Conference - Albany, NY (Nov. 18, 2011)

I will be speaking at the 2011 AMBI Clinical Ethics Conference on November 18, 2011.  It will focus on the role and function of hospital ethics committees.  Here is the agenda:



7:45-8:25am     Registration, Continental Breakfast
8:25-8:30am     Welcome, Introductions  Bruce D. White, DO, JD
8:30-9:30am     Ethics Committee Operation and Function: Current Challenges  
                           Thaddeus Mason Pope, JD, PhD
9:30-9:45am     Break
9:45-10:40am    Exceptional Families and How Ethics Committee and Nursing Champions Can  
                             Make a Difference Charlene Grove, RN, BSN, MS  Stephanie Strickland, RN,  
                             BSN, MS, CNRN
10:40-11:35am    Ethics Committee Liability Issues   Bruce D. White, DO, JD
11:35-12:30pm    Lunch
12:30-1:20pm      Breakout Session I      
                               Ethics Committee Function and Responsibilities    Steve R. Offord, MD
                               MOLST Education Module: The AMC Experience     Michael W. Dailey, MD
                               Ethical Issues in Discharge Planning     Jane Jankowski, LMSW, MSB
                               Difficult Conversations at the Bedside     Rev. Harlan Raymayer
1:20-2:05pm      Breakout Session II
2:15-3:15pm      “A Mock Ethics Consultation”
                            Heather Frenz; Sheila Otto, RN, MA    Wayne N. Shelton, MSW, PhD   
                            Bruce D. White, DO, JD        Jane Jankowski, LMSW, MSB
3:15-3:30pm      Concluding Remarks, Evaluation     Bruce D. White, DO, JD


Getting a Flu Shot Becoming Complicated–That Is If You Are Trying to Avoid Needles–You Can Snort Your Vaccine Instead

Painless needle free flu shots, the FDA says they may not work due to the fact that they have not approved “injector devices” for the shot.  If you got one of these from a drug store or elsewhere, you might need another one.  image

Pharmajet, the company who makes the device has FDA approval to use for delivery of other drugs, but apparently it’s not a delivery method for flu shots.  There could be something to this as a vaccine has different properties and is not like an antibiotic in the way it reacts as one simple example.  Kroger doesn’t know what to do now and is looking to the FDA, can we do it or not with flu shots.  There’s also another company Bioject who makes a similar device. 

When all else fails, snort it as there is one that you can inhale until this dispute is settled.  BD 

For this year’s flu season, many pharmacies are for the first time offering painless, needle-free shots to ward off the disease. But there’s one big problem: The FDA says they may not work.

The agency on Friday warned doctors, nurses and pharmacists “not to use injector devices to administer influenza vaccines.” The agency’s alert notes it has not approved any “injector devices” for use with the flu vaccine.

“The FDA has no data to support the safety or effectiveness” of flu vaccines delivered by jet injector, the alert reads.

So patients who already received the shot may need to go back and get a jab in the arm with a needle after all.

PharmaJet, a Colorado-based company, has been marketing its device as a proven flu-fighting tool.  In place of a needle, PharmaJet uses a high-pressure steam of liquid to pierce the skin and deliver the vaccine.

“PharmaJet’s needle-free injectors have received FDA marketing clearance for use with liquid medicines and vaccines and are available throughout the United States,” company president James Bowman said in a recent press release.

http://abcnews.go.com/blogs/health/2011/10/21/fda-warns-pharmacies-to-stop-pushing-needle-free-flu-vaccine/

 
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