Saturday, March 15, 2014

Patient Safety in the News February 2014

In this story, NPR highlighted Senator Joe Manchin’s attempts to introduce legislation to force the FDA to ban a new painkiller, Zohydro, which was placed on the market this week. Zohydro is one of the most powerful prescription pain medications created and it is crushable, so that it can be abused by snorting it. The drug is so potent that swallowing one tablet could kill a child. 42 different public health organizations have called for the FDA to ban the drug, as well as attorneys general from 28 states. The FDA’s own advisory panel voted 11-2 against approving the drug, but top FDA officials over-ruled this decision, taking the position that the drug was needed. Emails later became public that showed that FDA officials participated in private meetings with pain drug companies that paid organizers thousands of dollars to attend, including Zohydro’s manufacturer.  Matthew Perrone wrote a similar story for ABC.  Huffington Post Live discussed this story in the context of the nation’s current hydrocodone abuse epidemic.

Yolanda Kennedy, for Medical Xpress, discussed a study appearing in the British Medical Journal Quality & Safety which demonstrated that by requiring hospital pharmacists to collaborate with health care providers during key points of a hospital admission, overall prescription errors were reduced 79% and  severely harmful medication errors were entirely eliminated. 

Errors due to the failure of junior physicians and nurses to speak up about concerns of patient safety were discussed in this article appearing on BMC Health Services Research.

Vineet Chopra, MD and Laurence F. McMahon Jr., MD, argued in JAMA that the rudimentary alarm systems in hospitals need to be updated with new technology that analyzes information and sends meaningful warnings to health practitioners.

Pauline W. Chen, MD discussed in the New York Times how  an emergency room’s goals of speed and efficiency conflict with caring for the elderly, how the aging population may exacerbate this problem in the coming years and how a “small but dedicated group of emergency medicine and geriatrics specialists have been working to improve this situation.”

Philip Levitt, M.D., a retired neurosurgeon argued in the L.A. Times that a systems approach to patient safety has inadequately reduced medical errors because most errors are not due to faulty systems, but the acts of individual practitioners.  Meanwhile, in an interview appearing in Forbes magazine, Ashish K. Jha, M.D., a professor at the Harvard School of Public Health, indicated that the focus of the patient safety movement on systems failures rather than individual physician mistakes was one of two areas of advancement in patient safety since 2000.  Nevertheless, Dr. Jha also characterized improvement in patient safety as “excruciatingly slow.”

Peter Orszag, former director of the Office of Management and Budget in the Obama administration, argued in this article appearing in the Insurance Journal that the appropriate route to malpractice reform is not to cap damages, but to protect doctors from liability when they follow national clinical decision guidelines.

The Florida Supreme Court held that legislation capping noneconomic damages against physicians who commit medical malpractice is unconstitutional because it violates the equal protection clause of the state constitution.

Nancy Chute with NPR reported that a recent study demonstrated that statins do not actually cause muscle aches, despite the fact that this is listed as a potential side-effect on most packages.

A second article by Ms. Chute discussed the increasing use of ADHD medications revealed in a study performed by Express Scripts, a pharmacy benefits management company. Between 2008 through 2012, the use of these medications rose 35.5 percent overall. Interestingly, while children’s use of ADHD medication rose 19 percent, the use of these medications by adults rose 53 percent during the same time period.

Arundhati Parmar wrote an article on MDDI Online that spotlighted how the Consumers Union through its Safe Patient Project is asking members of the American Academy of Orthopaedic Surgeons to demand warranties for joint replacement prosthetics.

Paula Span, writing for the New York Times addressed an article appearing in JAMA which the discussed the consequences of for-profit corporations taking over the provision of hospice care.  The article suggests that one of the consequences of this evolution is that for-profit hospitals are actually discharging patients from hospice care for economic reasons rather than consideration of patients’ well-being.

Inna Jaffe, writing for NRP discussed the February 2014 report of the Department of Health and Human Services  which indicated that approximately one-third of patients admitted to skilled nursing homes are actually harmed by the medical care that they receive.

Geoffrey Mohan pointed out in an article in the LA Times that one of the consequences of global warming is that drilling activities in previously dormant frozen areas may revive ancient viruses. 

 Finally, the Huffington Post featured an article by Jenn Savedge discussing a recent article appearing in the Journal of Medical Entomology about a new strain of super lice, resistant to traditional forms of treatment. 

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