Variations in End-of-Life Care across England

I just noticed that England has a tool similar to the Dartmouth Atlas in the United States.  The National End of Life Care Intelligence Network (NEoLCIN) aims to improve the collection and analysis of information related to the quality, volume and costs of care provided by the NHS, social services and the third sector, to adults approaching the end of life. The Network's data and statistics “tool” allows the user to run various profiles.  For example, a quick search shows that in Newham 74% of the very elderly die in hospital.  In contrast, in Torbay, fewer than half of the very elderly (36%) die in hospital and fully one-half die at home -- where most people say they prefer to die.  This gap reminds me of similar gaps in the United States...

Effective Advance Care Planning: Are Your Advance Directives Worth the Paper They Are Written On?

ABA-CLE Home | Calendar | Web Store | ContactEffective Advance Care Planning: Are Your Advance Directives Worth the Paper They Are Written On?Live WebinarTuesday, January 31, 2012Event Code: CET2EACThis program will enhance practioners’ knowledge and skills withrespect to:the evolving components of advance care planning and how the emerging “Physician (or Medical) Orders for Life-Sustaining Treatment” (POLST or MOLST) will affect the process as theyemerge in virtually every state,effectively counseling clients and provide them with the tools they need for meaningful health decisions planning, anddrafting more practical...

New Pure Hydrocodone Pain Killer Drug Being Developed Talking to the FDA About Application-Targeting 2013 For US Market

This is kind of scary as to where we are going with pain killers.  One good thing though is that there are many new devices on the market coming out that distribute pain killer right to the affected area for recovery from surgery, wounds and so on and I would take that in a heartbeat versus taking pain killers.  I have had surgeries to where for a few days where I took Vicodin and I know what it does after a couple of days and that’s about all I am good for as I prefer being alert.  The case being made here is less liver damage from the acetaminophen found in combination drugs, like Vicodin, but it also puts the drug in a stronger...

Publish Ethics Committee Decisions pt III

A few weeks ago, I argued that ethics committees should publish their recommendations when those recommendations operate as binding decisions.  The complete argument for this position will appear in an article I have yet to write.  But I was encouraged to see this in the New York State Task Force on Life and the Law 1992 report When Others Must Choose (p169):"The committee should issue a statement of reasons for its decision, and unlike cases where the committee acts in an advisory manner, committee records of decisions about life-sustaining treatment should be subject to review . . . .  These procedures will afford openness and accountability . . ....

Christmas Wish Granted: Woman on Organ Support Given 1 More Day

                                  &nb...

Merry Christmas from the Medical Quack(s)

You didn’t expect to see anything else here did you?  Have a great holiday and posts will be a little fewer and less frequent in the next week before the new year.  Thanks again to all my readers for another wonderful year!  BD  Technorati Tags: Ducks,Christmas,holidays,Santa,New Years,hats,Merry Christmas,Medical Quack...

CEO and founder of the French Poly Beast Implant Prothese Wanted by Interpol

The implants are filled with an unapproved non-medical grade material said to be made for mattresses?  The article goes on to say around 40,000 women in the UK have the implants.  You wonder how does this go without notice for so long.  France stated that all women should have them removed and the UK was not as aggressive; however plastic surgeons in the UK felt a little different and said the suggestion from France was not at all out of line.  The company has been liquidated and the use of the PIP implants has been banned but when women have them removed I would definitely have the silicon tested to see exactly what is...

FDA Recalls St. Jude’s Riata Defibrillator Leads–Estimated 79,000 Patients in the US Implanted with the Device/Leads

Apparently they found the silicon covering on the leads is the issue and it could shock patients when they don’t need it or not work at all and have a higher failure rate than first anticipated.  St. Jude last year stopped selling the leads.  BD  St. Jude Medical Inc.’s Riata defibrillator leads, which the company stopped selling last year, were recalled by the U.S. Food and Drug Administration because of their potential to injure or kill patients The devices remain implanted in an estimated 79,000 U.S. patients. The company voluntarily sent a letter to doctors on November 28 informing them that the wires used to connect...

Family Requests 1 More Day of LSMT for Brain Dead Patient

                                  &nb...

Brain Dead Patient Wakes Up

                                  &nb...

Nurses Hold One Day Strike at Long Beach Memorial and Miller’s Children’s Hospital

The nurses have been without a contract for a few months now and are also talking about working conditions and other items needing attention.  One thing I know about the hospital is that “its is busy” like all the time.  They did remodeling and shifting things around in the last couple of years to ease people waiting in the hallways that existed a couple years ago in the ER area.  What is odd here is that over 75% of the nurses showed for work though.  The Children’s Hospital is new and state of the art and I did a walk through interview with the CFO just before it opened a while back.  BD  Miller Children’s Hospital Long Beach – Brand New Pavilion Carries Focus on Patients and “Green” Hundreds of nurses from Long Beach Memorial Medical Center and Miller...

US Senator Doesn’t Want Us Ingesting Caffeine With Aeroshot Breathable Caffeine

The product says you get the same amount of caffeine as you would in a Starbucks cup of coffee which seems harmless enough.  Ok so you take 3 or 4 snorts, some like me drink that many cups daily anyway.  If you really like caffeine, you can bathe in it, suck it down in lollypops and more.  There are geek sites all over the web that sell caffeine in different types of products.   The product doesn’t need FDA approval the article indicates as it has some vitamin supplements included as well. Caffeine: Shower Shock Caffeinated Body Wash, Javapops Who can figure out what gets priorities today in Congress?  From reading...

Feed The Wards Video From ZDoggMD–His Christmas Wish Granted-Not On Call This Year!

The doctor no problem here with working on a second career!  This so funny and I think one of his best as he an entire collection.  Use the link at the bottom to go his site and see more of the rapping hospitalist.  Pumpkin colored ensure…Santa pulled his central line…<grin>.  BD img alt="" galleryimg="no" onload="var downlevelDiv = document.getElementById('d13e461b-069f-4580-99ba-8d8395e79891'); downlevelDiv.innerHTML = "";" src="//lh3.ggpht.com/-apOYVWzPDpU/TvPTbK7zCII/AAAAAAAA4uM/iouEVw_m5wE/video9b7d84d58ce0%25255B7%25255D.jpg?imgmax=800" style="border-style: none">Feed the Wards! But it is the Holidays,...

Shell Practices that Defraud Medicare–One Good Reason to Clean Up The Flawed Data on the Internet-Hunting Ground for Thieves

If you read the Medical Quack often enough this is fairly common topic that comes up for me to write about as it is such a big problem.  The “shell” practices as they are called can sometimes find provider IDs online, for “dead” doctors and then they go to work billing.  It really makes for a huge problem all the way around without some decent audit trails and checking.  It’s funny we have all the data being sold out there and they grab stuff for free and use it for all kinds of intelligence, but when it comes to simple verification we have little.  Chapter 7 of the Attack of the Killer Algorithms shows how flawed data hurts...

Rasouli Case - Call for Interveners

Now that the Supreme Court of Canada has granted leave to appeal, the appellants have 30 days to file a Notice of Appeal.  [Rule 58(1)(b)]  Within 12 weeks after that, the appellants must file and serve their factum, record, and book of authorities.  [Rule 35(1)].  And within 4 weeks after that, any person interested in the appeal may make a motion for intervention.  [Rules 55-56]   Given both the public policy importance of the issues in this case and the factual errors made by the Ontario court, I hope that relevant physician associations, hospital associations, and others will prepare motions for intervention.In a paper published in the Osgoode Hall Law Review last year, professors Alarie and Green concluded that 'interveners...

One more Johnson and Johnson Recall-Motrin That May Not Work-Where’s the BarCodes to Help Consumers, Drug Chains, Pharmacists, the FDA and So On…

Well they did do a trial on bar codes for baby wipes which give product information but in case of a recall, they information could be updated quickly.  I realize the company is delving deep into quality control but gee look at the other side with consumers and everyone else involved.  A collaborated effort with the FDA could work very well and make it easier for compliance too with a synchronized data base, but we just don’t seem to want to go there. Johnson and Johnson Puts Microsoft Tag Bar Codes on Baby Wipes But Can’t Do the Same to Give Consumers the Chance to Find Their FDA Recalls - BarCode Baby Steps? Here’s an image of...

Rasouli Case Will Be Heard by Supreme Court of Canada

Earlier today, the Supreme Court of Canada granted the critical care physicians' petition for leave to appeal from the Ontario Court of Appeal's June 2011 ruling in Cuthbertson v. Rasouli.  If the briefing is sufficiently robust, this could be the most significant judicial examination of medical futility - ever, in the world. &nb...

Free Online Class - The Aging Population, Alzheimer’s and Other Dementias: Law & Public Policy

The University of Iowa's National Health Law and Policy Resource Center is offering a new course this spring (January - April 2012) titled "The Aging Population, Alzheimer’s and Other Dementias: Law & Public Policy."  It will be available free and online to anyone. Law students as well as graduate students from other colleges may enroll in the Colloquium for course credit or may audit the Colloquium.  Non-students may participate via the internet. This course is taught by an all-star cast of experts.  For example:Legal Needs of the Aging Population and the Practice of Elder Law - Lawrence A. FrolikLegal Approaches to Determination of Diminished Capacity and Assessing Clients with Diminished Capacity - Charles P. SabatinoAdult Guardianships - Erica F....

Audit Shows Medicaid Payments for the Dead

I have written about how public payers should not cover medical treatment for those in a persistent vegetative state or for those with an infinitesimal prospect of benefit.  But surely, an even easier case can be made that public payers should not pay for medical treatment for individuals who are dead.  Unfortunately, a non-insignificant amount of money is spent for the treatment of such individuals.The Maryland Department of Legislative Services' Office of Legislative Audits released an audit earlier this month showing that Maryland's Medicaid agency has not ended payment of Medicaid fees for all enrollees who die outside the state.  Auditors found that the state paid at least $426,403 in Medicaid fees between Jan. 1, 2008, and Aug. 31, 2011, relating to the...

POLST - Now in New Jersey Too

New Jersey Governor Christie has signed the revised POLST bill.  Of course, legislation is just the first step in the long, long journey of implementati...

Heartbeat Bills and End-of-Life Decisions

I do not regularly follow legal developments concerning reproduction.  But I have long been aware that the politics of end-of-life decision making and the politics of reproductive decision making are intertwined.  Reviewing some of the materials on pending "heartbeat bills" drives this home.  At least in a significant subset of cases, the rationales are parallel.  Just as decisions to withhold or withdraw LSMT at the end of life are driven by the patient's potential quality of life, many abortions are prompted by concerns about the fetus' potential quality of life.  The heartbeat bills elevate the intrinsic value of biological life above its quantity or quality.  I am concerned that the passage of such bills could create a dangerous vitalist wedge...

Massachusetts Nurses Association Protesting Private Equity Company Cerberus Who Operates Steward Healthcare With More Concern for Profits Than Care

Many nurses made the trip to the Cerberus offices in New York to promote an “Occupy” type demonstration with discontent over many working and pension conditions since Steward, who is owned by Cerberus took over and purchased several hospitals in Massachusetts. One item in particular pointed out was the skimping on bread and juice used to stabilize patients at Norwood Hospital and Good Samaritan Hospital.  There have been a greater number of private investments in healthcare and apparently it has become so large in number they had to create a “non profit” group to talk about how to “profit”…kind of an oxymoron?  BD  How Big Are...

Prestige Brands to Acquire 17 Consumer Over the Counter Brands From Glaxo

This seems to make sense as Prestige already had a large number of consumer products already and that appears to be their primary business.  The over the counter products seem to a bit of a mixed bag with both drugs and other types of consumer products.  BD  IRVINGTON, N.Y., Dec 20, 2011 (BUSINESS WIRE) -- Prestige Brands Holdings, Inc. (NYSE-PBH) today announced the signing of a definitive agreements with GSK to acquire 17 over-the-counter (OTC) pharmaceutical brands sold in North America for a total of $660 million in cash. The transactions are expected to be completed in the first half of calendar year 2012 subject to customary...

Hawaii Medical Center Closes Emergency Rooms As New Buyer for the Facility Fell Through And Facilities Will Be Closed When All Patients Have Been Transferred

Back in October the hospital stated they may have to close and the ER rooms are the first stage of this with paramedics stationed outside and there are no doctors on staff to see anyone.  About 1000 employees are affected and patients are being transferred to other hospitals.  As you can read below, no more transplant surgeries. 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 We are just about bleeding the hospitals dry of money in many area and with the next year it’s almost sad to say we will see more stories like this...

HealthVault Free Mobile App For Windows Phone Is Out from the Zune Store To Download & Got My Ducks Updated

This is pretty neat and loaded it up on my phone and off I go.  It’s pretty straight forward and works fine.  I didn’t have a lot of time to go through all of the screens yet but will do later one.  The screens are very similar to what you see on the computer just smaller and if you are used to mobile apps already, then you will get it.  It was very simple to sign in and so forth.  I have my mother on the account and all her information is available for me as well and actually she has more in there than I do.  Just yesterday I posted about a new MIT program that uses a $2.00 piece of hardware that uses the same...