Michigan doctor arrested for purposely misdiagnosing cancer
by Jen Hayden
Daily Kos
Aug 07, 2013
Greed knows no bounds. It pushes people to do unspeakable things. For Dr. Farid Fata, a Michigan oncologist, there were no limits:
Dr. Farid Fata, 48, of Oakland Township was arrested Tuesday and charged for allegedly submitting false claims to Medicare for services that were medically unnecessary, including chemotherapy treatments, Positron Emission Tomograph (PET) scans and a variety of cancer and hematology treatments for patients who did not need them. Dr. Fata owns and operates Michigan Hematology Oncology Centers (MHO) which has offices in Clarkston, Bloomfield Hills, Lapeer, Sterling Heights, Troy and Oak Park.
Dr. Fata was scamming Medicare to the tune of $35 million.
In the course of the scheme, prosecutors say Dr. Fata falsified and directed others to falsify documents. MHO billed Medicare for approximately $35 million dollars over a two-year period, approximately $25 of which is attributable to Dr. Fata, federal officials said.
The complaint further alleges that Dr. Fata directed the administration of unnecessary chemotherapy to patients in remission; deliberate misdiagnosis of patients as having cancer to justify unnecessary cancer treatment; administration of chemotherapy to end-of-life patients who will not benefit from the treatment; deliberate misdiagnosis of patients without cancer to justify expensive testing; fabrication of other diagnoses such as anemia and fatigue to justify unnecessary hematology treatments, and distribution of controlled substances to patients without medical necessity or are administered at dangerous levels.
Dr. Fata was prescribing painful and unnecessary treatments to patients:
The feds say he also deliberately misdiagnosed patients “as having cancer to justify unnecessary cancer treatment,” WXYZ reported.
Federal agents say Fata directed the “administration of chemotherapy to end-of-life patients who [would] not benefit from the treatment,” and deliberately misdiagnosed “patients without cancer to justify expensive testing.”
Thankfully, Dr. Fata isn't likely to get out of jail any time soon:
Dr. Fata faced a federal magistrate Tuesday afternoon. Assistant U. S. Attorneys assigned to the case argued Fata is a flight risk because he has access to about $14 million in liquid assets and a home in Lebanon. The magistrate is temporarily detaining Fata until another hearing can be held on Thursday. He faces up to 20 years behind bars if he’s convicted.
Twenty years? Not long enough. Not nearly long enough.
Monday, August 12, 2013
Tuesday, August 6, 2013
Patient: Kaiser Told Me 'Redheads Bleed More'
This patient was lucky that one person at Kaiser was looking out for her. This surgery might have had an even worse outcome if someone had tried to put her back to sleep when she awoke and saw a problem. I suggest an award for the staff member who insisted, "We can't give her any more medication."
Patient: Kaiser Told Me 'Redheads Bleed More'
(Click link to see documents)
By BARBARA WALLACE
Courthouse News Service
August 05, 2013
ROSEVILLE, Calif. (CN) - Kaiser staff dismissed "blood pouring uncontrollably out of" a woman's hand during surgery and "unbearable" pain afterward by saying "redheads bleed more," she claims in court.
Deborah Kossick woke up during surgery for carpal tunnel syndrome to see "blood pouring uncontrollably out of her hand and extremity, while there was chaos amongst the staff conducting the surgery, one of which kept yelling, 'we can't give her any more medication,'" she says in a complaint filed in Placer County Superior Court.
"Several days after the surgery, plaintiff was in unbearable and uncontrollable pain in her right hand," which was swollen and blackened, the complaint continues. Kossick says she "advised defendants that the pain was unbearable, and she believed that something had gone wrong during the surgery, as there was too much blood. Defendants advised plaintiff that she had nothing to worry about because 'redheads bleed more' than other patients."
At a follow-up appointment with her surgeon, Steven Hatton Ryder, M.D., a month after the operation, Kossick says she complained of continuing pain, swelling and discoloration of her hand. "Defendant showed no sympathy or concern whatsoever, and, instead, told her that there was nothing more he could do for her," the complaint says.
"To this date, plaintiff Deborah Kossick continues to be in an extreme amount of pain in her right hand, which is now permanent. The hand is also swollen and blackened, which will impact her ability to work and care for herself for the remainder of her life," according to the complaint.
Plaintiff seeks general, special and punitive damages, attorney's fees and costs of suit. Her husband, Robert Kossick, sued for loss of consortium. They are represented by David M. Poore of Brown Poore in Walnut Creek, Calif.
Patient: Kaiser Told Me 'Redheads Bleed More'
(Click link to see documents)
By BARBARA WALLACE
Courthouse News Service
August 05, 2013
ROSEVILLE, Calif. (CN) - Kaiser staff dismissed "blood pouring uncontrollably out of" a woman's hand during surgery and "unbearable" pain afterward by saying "redheads bleed more," she claims in court.
Deborah Kossick woke up during surgery for carpal tunnel syndrome to see "blood pouring uncontrollably out of her hand and extremity, while there was chaos amongst the staff conducting the surgery, one of which kept yelling, 'we can't give her any more medication,'" she says in a complaint filed in Placer County Superior Court.
"Several days after the surgery, plaintiff was in unbearable and uncontrollable pain in her right hand," which was swollen and blackened, the complaint continues. Kossick says she "advised defendants that the pain was unbearable, and she believed that something had gone wrong during the surgery, as there was too much blood. Defendants advised plaintiff that she had nothing to worry about because 'redheads bleed more' than other patients."
At a follow-up appointment with her surgeon, Steven Hatton Ryder, M.D., a month after the operation, Kossick says she complained of continuing pain, swelling and discoloration of her hand. "Defendant showed no sympathy or concern whatsoever, and, instead, told her that there was nothing more he could do for her," the complaint says.
"To this date, plaintiff Deborah Kossick continues to be in an extreme amount of pain in her right hand, which is now permanent. The hand is also swollen and blackened, which will impact her ability to work and care for herself for the remainder of her life," according to the complaint.
Plaintiff seeks general, special and punitive damages, attorney's fees and costs of suit. Her husband, Robert Kossick, sued for loss of consortium. They are represented by David M. Poore of Brown Poore in Walnut Creek, Calif.
Monday, August 5, 2013
A safe, effective vaccine for cancer that some insurance companies don't cover
A safe, effective, cancer-fighting vaccine shunned
By Katy Waldman
Slate.com
August 5, 2013
Why aren't more teenage girls getting vaccinated against the human papillomavirus?
The New York Times reported recently that vaccination rates for the disease, the most common sexually transmitted infection and “a principal cause of cervical cancer,” failed to improve from 2011 to 2012.
This despite the fact that the rates at which people get “new vaccines typically increase by about 10 percentage points a year,” according to Thomas Frieden, director of the Centers for Disease Control and Prevention. And despite that experts have recommended since 2007 that girls receive the triptych of shots at age 11 or 12.
Every year, HPV causes about 19,000 cancers in women (mostly cervical) and close to 8,000 cancers in men (mostly throat). Yet, reported the Times, “only 33 percent of teenage girls finished the required three doses of the vaccine in 2012 ... putting the United States close to the bottom of developed countries in coverage.”
This distressing news launched a fleet of theories: that teenage girls go to the doctor less frequently than toddlers, leading to fewer opportunities for vaccination; that patients — or their parents — are embarrassed to ask for a vaccine for sexually transmitted infections, and doctors are reluctant to broach the topic; that neither doctors nor patients are well-versed enough in immunization literature to get the ball rolling.
A study in the (delightfully named) Morbidity and Mortality Weekly Report, however, rules out hypothesis No. 1. Teenagers are receiving plenty of other inoculations. (“If HPV vaccine had been administered during health-care visits when another vaccine was administered,” the authors of the study wrote, “coverage. ... could have reached 92.6 percent.”)
The vaccination flat line may flow from a combination of underinformed families and inconsistent doctors. “Providers give weaker recommendations for HPV vaccination compared with other vaccinations recommended for adolescents,”
researchers found. Plus, “the HPV vaccine is controversial,” says Tai Warren, a receptionist at Washington Pediatric Associates in Washington, D.C. “A lot of parents don't want them for their children.”
Warren couldn't say whether parents most often object to the vaccine because they perceive it as a license to have sex, because they are concerned about safety, or for some other reason. (More than seven years of study can attest that the procedure is safe, as well as effective.)
Sadi Bhattarai, a nurse at Chevy Chase Pediatrics in Washington, D.C., was not aware of any stigma surrounding the HPV vaccine. The procedure does prove slightly inconvenient.
“We often have to call after the first round and remind families to get the second and third shots,” she said.v Still, “at our practice, everybody gets vaccinated — boys and girls — when they come in for a physical and if they're the right age.”
Bhattarai ventured that plateauing rates “are both doctor- and patient-driven,” since not all clinics have adopted the immunizations as a standard part of their procedure, and not all families know to ask.
But Chris Griffiths of the Columbia, Mo., Health Department, said institutional lethargy is not wholly to blame. She senses a lingering wariness.
“As a nurse, I bring (the vaccine) up to people, and they associate it with promiscuity,” she said.
While her clinic makes a point of recommending the shots, other facilities in the state do not. Funding plays a role — to administer vaccines, a practice needs a separate locked refrigerator kept at a specific temperature and may rack up other expenses — but it is only part of the story. Patients and their families may also be dissuaded by insurance policies that fail to cover HPV inoculation. (The triplicate shot can cost up to $140 per dose.) Doctors may not want to incur a backlash by suggesting the vaccine.
Whatever the reason, we've trekked too far into the 21st century to be dithering over safe, easy, cancer-blasting vaccinations for children. Though the explanations behind the plateau may be complicated, the solutions are simple: Insurance companies should cover HPV shots. Doctors should promote them. Patients and their families should embrace them.
By Katy Waldman
Slate.com
August 5, 2013
Why aren't more teenage girls getting vaccinated against the human papillomavirus?
The New York Times reported recently that vaccination rates for the disease, the most common sexually transmitted infection and “a principal cause of cervical cancer,” failed to improve from 2011 to 2012.
This despite the fact that the rates at which people get “new vaccines typically increase by about 10 percentage points a year,” according to Thomas Frieden, director of the Centers for Disease Control and Prevention. And despite that experts have recommended since 2007 that girls receive the triptych of shots at age 11 or 12.
Every year, HPV causes about 19,000 cancers in women (mostly cervical) and close to 8,000 cancers in men (mostly throat). Yet, reported the Times, “only 33 percent of teenage girls finished the required three doses of the vaccine in 2012 ... putting the United States close to the bottom of developed countries in coverage.”
This distressing news launched a fleet of theories: that teenage girls go to the doctor less frequently than toddlers, leading to fewer opportunities for vaccination; that patients — or their parents — are embarrassed to ask for a vaccine for sexually transmitted infections, and doctors are reluctant to broach the topic; that neither doctors nor patients are well-versed enough in immunization literature to get the ball rolling.
A study in the (delightfully named) Morbidity and Mortality Weekly Report, however, rules out hypothesis No. 1. Teenagers are receiving plenty of other inoculations. (“If HPV vaccine had been administered during health-care visits when another vaccine was administered,” the authors of the study wrote, “coverage. ... could have reached 92.6 percent.”)
The vaccination flat line may flow from a combination of underinformed families and inconsistent doctors. “Providers give weaker recommendations for HPV vaccination compared with other vaccinations recommended for adolescents,”
researchers found. Plus, “the HPV vaccine is controversial,” says Tai Warren, a receptionist at Washington Pediatric Associates in Washington, D.C. “A lot of parents don't want them for their children.”
Warren couldn't say whether parents most often object to the vaccine because they perceive it as a license to have sex, because they are concerned about safety, or for some other reason. (More than seven years of study can attest that the procedure is safe, as well as effective.)
Sadi Bhattarai, a nurse at Chevy Chase Pediatrics in Washington, D.C., was not aware of any stigma surrounding the HPV vaccine. The procedure does prove slightly inconvenient.
“We often have to call after the first round and remind families to get the second and third shots,” she said.v Still, “at our practice, everybody gets vaccinated — boys and girls — when they come in for a physical and if they're the right age.”
Bhattarai ventured that plateauing rates “are both doctor- and patient-driven,” since not all clinics have adopted the immunizations as a standard part of their procedure, and not all families know to ask.
But Chris Griffiths of the Columbia, Mo., Health Department, said institutional lethargy is not wholly to blame. She senses a lingering wariness.
“As a nurse, I bring (the vaccine) up to people, and they associate it with promiscuity,” she said.
While her clinic makes a point of recommending the shots, other facilities in the state do not. Funding plays a role — to administer vaccines, a practice needs a separate locked refrigerator kept at a specific temperature and may rack up other expenses — but it is only part of the story. Patients and their families may also be dissuaded by insurance policies that fail to cover HPV inoculation. (The triplicate shot can cost up to $140 per dose.) Doctors may not want to incur a backlash by suggesting the vaccine.
Whatever the reason, we've trekked too far into the 21st century to be dithering over safe, easy, cancer-blasting vaccinations for children. Though the explanations behind the plateau may be complicated, the solutions are simple: Insurance companies should cover HPV shots. Doctors should promote them. Patients and their families should embrace them.
Saturday, August 3, 2013
Health exchange releases new small business rates
"In San Diego County, four companies will offer SHOP plans: Sharp HealthCare, Health Net, Kaiser Permanente and Blue Shield."
Health exchange releases new small business rates
Says San Diego companies with fewer than 50 employees could save 12 percent
By Paul Sisson
Aug. 1, 2013
San Diego County small businesses will be able to save 12 percent on health insurance premiums for their employees if they buy coverage next year from the state’s newly created health exchange, officials announced Thursday.
Covered California, the state agency tasked with creating and running the new health insurance exchanges mandated by the Affordable Care Act of 2010, released selected rates for many California regions that it says are less expensive than those now available to businesses with 50 or fewer employees.
Federal health reform calls for each state to create a Small Business Health Options Program, often called SHOP, which will operate alongside a larger exchange tailored to individuals and families.
Both exchanges must be running by Oct. 1 to provide enough shopping time before Jan. 1, 2014, the date when most uninsured Americans must purchase coverage or pay a small penalty.
Small business rates are separated into 19 different geographical regions. In San Diego County, four companies will offer SHOP plans: Sharp HealthCare, Health Net, Kaiser Permanente and Blue Shield.
Covered California did not provide a full list of potential premiums for each company but instead compared prices for a single 40-year-old employee.
Sharp, the only local company offering its own plan in the health exchange for individuals and families, said in a statement that serving businesses made sense because the health system has “long been active in serving the small group market in San Diego.”
In San Diego County, the average of the three lowest premiums offered in the exchange was $290, a rate that the state claims is 12 percent less than an average of $324 for “comparable” small group plans sold this year.
Scott Hauge, president of Small Business California, a nonprofit advocacy group that lobbies in Sacramento on issues that affect small businesses, lauded the rates as a step toward controlling costs.
“It’s a good first step. It adds competition to the market, and any time you add competition, it’s a positive,” Hauge said.
But not everyone was so impressed. Bill Hammett, a San Diego area insurance broker, said there was no way to tell how the state selected a comparable plan to make its cost comparison. He said that, overall, there is just not much difference in costs between companies offering plans on the exchange and those operating in the open market.v “I have no ax to grind with the SHOP exchange, but I just don’t think it’s going to be the huge splash they were hoping for,” Hammett said.
Dana Howard, deputy director of media and public relations for Covered California, said prices are only one aspect of the SHOP exchange. He said the exchange is designed to allow small companies to act like their bigger competitors by allowing flexibility in the plan selected.
The SHOP exchange, he said, allows a company to “anchor” their coverage on a certain plan and allocate a set amount of money, say 50 percent, that they want to spend on an employee’s premium. But employees can decide on their own to go with a different insurance company offered on the exchange if they don’t like the one their employer selected. That ability [for employees] to move to different plans, Howard said, is usually an expensive option that most small companies can’t afford...
Health exchange releases new small business rates
Says San Diego companies with fewer than 50 employees could save 12 percent
By Paul Sisson
Aug. 1, 2013
San Diego County small businesses will be able to save 12 percent on health insurance premiums for their employees if they buy coverage next year from the state’s newly created health exchange, officials announced Thursday.
Covered California, the state agency tasked with creating and running the new health insurance exchanges mandated by the Affordable Care Act of 2010, released selected rates for many California regions that it says are less expensive than those now available to businesses with 50 or fewer employees.
Federal health reform calls for each state to create a Small Business Health Options Program, often called SHOP, which will operate alongside a larger exchange tailored to individuals and families.
Both exchanges must be running by Oct. 1 to provide enough shopping time before Jan. 1, 2014, the date when most uninsured Americans must purchase coverage or pay a small penalty.
Small business rates are separated into 19 different geographical regions. In San Diego County, four companies will offer SHOP plans: Sharp HealthCare, Health Net, Kaiser Permanente and Blue Shield.
Covered California did not provide a full list of potential premiums for each company but instead compared prices for a single 40-year-old employee.
Sharp, the only local company offering its own plan in the health exchange for individuals and families, said in a statement that serving businesses made sense because the health system has “long been active in serving the small group market in San Diego.”
In San Diego County, the average of the three lowest premiums offered in the exchange was $290, a rate that the state claims is 12 percent less than an average of $324 for “comparable” small group plans sold this year.
Scott Hauge, president of Small Business California, a nonprofit advocacy group that lobbies in Sacramento on issues that affect small businesses, lauded the rates as a step toward controlling costs.
“It’s a good first step. It adds competition to the market, and any time you add competition, it’s a positive,” Hauge said.
But not everyone was so impressed. Bill Hammett, a San Diego area insurance broker, said there was no way to tell how the state selected a comparable plan to make its cost comparison. He said that, overall, there is just not much difference in costs between companies offering plans on the exchange and those operating in the open market.v “I have no ax to grind with the SHOP exchange, but I just don’t think it’s going to be the huge splash they were hoping for,” Hammett said.
Dana Howard, deputy director of media and public relations for Covered California, said prices are only one aspect of the SHOP exchange. He said the exchange is designed to allow small companies to act like their bigger competitors by allowing flexibility in the plan selected.
The SHOP exchange, he said, allows a company to “anchor” their coverage on a certain plan and allocate a set amount of money, say 50 percent, that they want to spend on an employee’s premium. But employees can decide on their own to go with a different insurance company offered on the exchange if they don’t like the one their employer selected. That ability [for employees] to move to different plans, Howard said, is usually an expensive option that most small companies can’t afford...
Babies die; hospital halts heart surgeries
Babies die; hospital halts heart surgeries
By Elizabeth Cohen, Senior Medical Correspondent
(CNN)
August 3, 2013
Connor Wilson was born February 13, 2012. He had his first surgery at Kentucky Children's Hospital a week later and a second surgery on May 11. On August 3, 2012, his heart stopped, but doctors got it beating again. "He never got better," says his mother, Nikki Crew. Connor Wilson was born February 13, 2012. He had his first surgery at Kentucky Children's Hospital a week later and a second surgery on May 11. On August 3, 2012, his heart stopped, but doctors got it beating again. "He never got better," says his mother, Nikki Crew.>
>
Tabitha and Lucas Rainey were beginning to get suspicious.
The staff at Kentucky Children's Hospital kept telling them their infant son, Waylon, was recovering well from surgery. There had been a few bumps in the road, to be sure, but they said that was normal for a baby born with a severe heart defect.
Months passed. Waylon remained in the intensive care unit. More complications arose.
"Is everything OK?" the Raineys would ask.
Yes, the doctors and nurses assured them. Everything was fine.
Baby heart surgery concern
Then one day, Tabitha Rainey says a cardiologist took her aside.
"She said, 'If I were you, I would move him,' " Rainey remembers. "She told me we should take him somewhere else.'"
A few days later, the Raineys arranged to have Waylon sent by helicopter to the University of Michigan. By then their son, not quite 3 months old, was in heart failure.
Secret data
If Waylon Rainey had been born 30 years ago, he almost surely would have died a few days or weeks after birth. He has a condition called hypoplastic left heart syndrome, which means the left side of his heart is so malformed it can't pump blood.
Today, surgeons perform a series of three operations on babies like Waylon. They're high-stakes surgeries -- cutting into an organ the size of a newborn baby's fist is tricky, to say the least. The blood vessels can be thinner than a piece of angel hair pasta, and one wrong move, one nick, one collapsed artery or vein can be deadly.
These children are medically very fragile, and even the best surgeons lose patients. Surgeons track their deaths and complications and take great pride in the number of babies they save. Some are so proud they publish their success rates right on their hospital websites.
Kentucky Children's Hospital is not one of these hospitals.
Instead, Kentucky Children's Hospital has gone to great lengths to keep their pediatric heart surgery mortality rates a secret, citing patient privacy. Reporters and the Kentucky attorney general have asked for the mortality data, and the hospital has declined to give it to them. In April, the hospital went to court to keep the mortality rate private.
Parents of babies treated at Kentucky Children's say the hospital's effort to keep the data a secret, coupled with troubling events over an eight-week period last year, makes them suspicious something at the hospital has gone terribly wrong...
10 ways to get your child the best heart surgeon COMMENT
Jason Simpson • 12 hours ago
− I am a pediatric cardiologist.
Pediatric heart surgery is the most delicate/complex of any surgical procedure known to man. It is a hundred times more difficult to reconstruct a baby's heart than it is to do brain surgery or colon surgery.
This is why there is such widely divergent rates of mortality and complications between hospitals and between surgeons. There are only a handful of people in the world who have the technical expertise and judgment to do these surgeries well.
There are lots of other hospitals who advertise for pediatric heart surgery programs, but they use surgeons who haven't perfected their craft yet and are still basically in training. You want one of the top flight fully trained surgeons listed at the hospitals below.
The training of a pediatric heart surgeon is the longest training pathway of any doctor. 4 years med school, 5 years general surgery, 3 years adult cardiothoracic surgery, 2-3 years pediatric cardiothoracic surgery = 14-16 years AFTER you finish undergrad. Even surgeons who have completed that pathway still have a LONG way to go in order to be fully competent surgeons and practice at the top of their craft. Many pediatric cardiothoracic surgery fellows simply arent cut out for the job and they wash out and have to pick a different medical specialty. Most of them switch from pediatric to adult heart surgery, which is much less technically complex and far easier to do.
I've worked with dozens of pediatric heart surgeons at every level of their training, and from what I've seen it is impossible to tell for sure if they are going to be good surgeons until at least 3-4 years AFTER their fellowship is completed. So never pick a surgeon who is less than 4 years out from the completion of their fellowship.
IMHO, there are only a few places in the United States who are technically capable of pulling off these highly complex surgeries:
1. Boston Childrens
2. Texas Childrens Hospital (Houston)
3. UCLA
4. CHOP (Philadelphia)
5. Univ Michigan
6. Cincinnati Childrens
There are lots of other hospitals who advertise for pediatric heart surgery programs, but they use surgeons who havent perfected their craft yet and are still basically in training. You want one of the top flight fully trained surgeons listed at the hospitals above.
Places in Kentucky and other small volume centers have NO BUSINESS opening up a pediatric heart surgery program. If you live in the middle of the country, you need to take your child to one of these elite academic medical centers in order to get good care.
By Elizabeth Cohen, Senior Medical Correspondent
(CNN)
August 3, 2013
Connor Wilson was born February 13, 2012. He had his first surgery at Kentucky Children's Hospital a week later and a second surgery on May 11. On August 3, 2012, his heart stopped, but doctors got it beating again. "He never got better," says his mother, Nikki Crew. Connor Wilson was born February 13, 2012. He had his first surgery at Kentucky Children's Hospital a week later and a second surgery on May 11. On August 3, 2012, his heart stopped, but doctors got it beating again. "He never got better," says his mother, Nikki Crew.>
>
Tabitha and Lucas Rainey were beginning to get suspicious.
The staff at Kentucky Children's Hospital kept telling them their infant son, Waylon, was recovering well from surgery. There had been a few bumps in the road, to be sure, but they said that was normal for a baby born with a severe heart defect.
Months passed. Waylon remained in the intensive care unit. More complications arose.
"Is everything OK?" the Raineys would ask.
Yes, the doctors and nurses assured them. Everything was fine.
Baby heart surgery concern
Then one day, Tabitha Rainey says a cardiologist took her aside.
"She said, 'If I were you, I would move him,' " Rainey remembers. "She told me we should take him somewhere else.'"
A few days later, the Raineys arranged to have Waylon sent by helicopter to the University of Michigan. By then their son, not quite 3 months old, was in heart failure.
Secret data
If Waylon Rainey had been born 30 years ago, he almost surely would have died a few days or weeks after birth. He has a condition called hypoplastic left heart syndrome, which means the left side of his heart is so malformed it can't pump blood.
Today, surgeons perform a series of three operations on babies like Waylon. They're high-stakes surgeries -- cutting into an organ the size of a newborn baby's fist is tricky, to say the least. The blood vessels can be thinner than a piece of angel hair pasta, and one wrong move, one nick, one collapsed artery or vein can be deadly.
These children are medically very fragile, and even the best surgeons lose patients. Surgeons track their deaths and complications and take great pride in the number of babies they save. Some are so proud they publish their success rates right on their hospital websites.
Kentucky Children's Hospital is not one of these hospitals.
Instead, Kentucky Children's Hospital has gone to great lengths to keep their pediatric heart surgery mortality rates a secret, citing patient privacy. Reporters and the Kentucky attorney general have asked for the mortality data, and the hospital has declined to give it to them. In April, the hospital went to court to keep the mortality rate private.
Parents of babies treated at Kentucky Children's say the hospital's effort to keep the data a secret, coupled with troubling events over an eight-week period last year, makes them suspicious something at the hospital has gone terribly wrong...
10 ways to get your child the best heart surgeon COMMENT
Jason Simpson • 12 hours ago
− I am a pediatric cardiologist.
Pediatric heart surgery is the most delicate/complex of any surgical procedure known to man. It is a hundred times more difficult to reconstruct a baby's heart than it is to do brain surgery or colon surgery.
This is why there is such widely divergent rates of mortality and complications between hospitals and between surgeons. There are only a handful of people in the world who have the technical expertise and judgment to do these surgeries well.
There are lots of other hospitals who advertise for pediatric heart surgery programs, but they use surgeons who haven't perfected their craft yet and are still basically in training. You want one of the top flight fully trained surgeons listed at the hospitals below.
The training of a pediatric heart surgeon is the longest training pathway of any doctor. 4 years med school, 5 years general surgery, 3 years adult cardiothoracic surgery, 2-3 years pediatric cardiothoracic surgery = 14-16 years AFTER you finish undergrad. Even surgeons who have completed that pathway still have a LONG way to go in order to be fully competent surgeons and practice at the top of their craft. Many pediatric cardiothoracic surgery fellows simply arent cut out for the job and they wash out and have to pick a different medical specialty. Most of them switch from pediatric to adult heart surgery, which is much less technically complex and far easier to do.
I've worked with dozens of pediatric heart surgeons at every level of their training, and from what I've seen it is impossible to tell for sure if they are going to be good surgeons until at least 3-4 years AFTER their fellowship is completed. So never pick a surgeon who is less than 4 years out from the completion of their fellowship.
IMHO, there are only a few places in the United States who are technically capable of pulling off these highly complex surgeries:
1. Boston Childrens
2. Texas Childrens Hospital (Houston)
3. UCLA
4. CHOP (Philadelphia)
5. Univ Michigan
6. Cincinnati Childrens
There are lots of other hospitals who advertise for pediatric heart surgery programs, but they use surgeons who havent perfected their craft yet and are still basically in training. You want one of the top flight fully trained surgeons listed at the hospitals above.
Places in Kentucky and other small volume centers have NO BUSINESS opening up a pediatric heart surgery program. If you live in the middle of the country, you need to take your child to one of these elite academic medical centers in order to get good care.
Montana Experiment Brings NHS-Style Health Care to USA; Saves State Millions, Patients Delighted
"[D]ivision manager Russ Hill says it's actually costing the state $1,500,000 less for healthcare than before the clinic opened."
Montana Experiment Brings NHS-Style Health Care to USA; Saves State Millions, Patients Delighted
by james321
Daily Kos
Jul 31, 2013
Former Montana Gov. Brian Schweitzer has pledged his support for single-payer health care in the past, but his recent efforts to bring zero-cost sharing primary and preventive care to Montana government employees and retirees may be doing something that most progressives would only dream could happen in America: bringing NHS-style, socialized medicine to Montana.
This is a big deal and -- while currently limited to state employees and retirees -- could be laying the groundwork for America's most socially-just health care system. NPR has the details:
A year ago, Montana opened the nation's first clinic for free primary healthcare services to its state government employees. The Helena, Mont., clinic was pitched as a way to improve overall employee health, but the idea has faced its fair share of political opposition.
A year later, the state says the clinic is already saving money.
Pamela Weitz, a 61-year-old state library technician, was skeptical about the place at first.
"I thought it was just the goofiest idea, but you know, it's really good," she says. In the last year, she's been there for checkups, blood tests and flu shots. She doesn't have to go; she still has her normal health insurance provided by the state. But at the clinic, she has no co-pays, no deductibles. It's free.
That's the case for the Helena area's 11,000 state workers and their dependents. With an appointment, patients wait just a couple minutes to see a doctor. Visitation is more than 75 percent higher than initial estimates.v Yup, nobody is forced to visit this publicly-financed clinic run by a private operator. If they wish, they can take their big-profit, private health insurance and head to any doctor they want, but folks are recognizing that this, err... public option, provides better care. And, when patients do make this choice, both the state and patients save money.
The state contracts with a private company to run the facility and pays for everything — wages of the staff, total costs of all the visits. Those are all new expenses, and they all come from the budget for state employee healthcare.
Even so, division manager Russ Hill says it's actually costing the state $1,500,000 less for healthcare than before the clinic opened.
"Because there's no markup, our cost per visit is lower than in a private fee-for-service environment," Hill says.
Physicians are paid by the hour, not by the number of procedures they prescribe like many in the private sector. The state is able to buy supplies at lower prices.
Bottom line: a patient's visit to the employee health clinic costs the state about half what it would cost if that patient went to a private doctor. And because it's free to patients, hundreds of people have come in who had not seen a doctor for at least two years.
Take a second and let the words above sink in real deep. There you have exactly why the UK, Canada, Australia, Italy, Costa Rica, Cuba and other first-world -- and third-world -- countries are able to secure better health care outcomes than the United States with dramatically lower health care spending. Imagine what -- let's call it the Montana model -- could do for our national debt. And, you know, even more importantly, the health of our people and the wellbeing of our medical professionals.
Hill says the facility is catching a lot, including 600 people who have diabetes, 1,300 people with high cholesterol, 1,600 people with high blood pressure and 2,600 patients diagnosed as obese. Treating these conditions early could avoid heart attacks, amputations, or other expensive hospital visits down the line, saving the state more money.
Clinic operations director and physician's assistant Jimmie Barnwell says this model feels more rewarding to him.
"Having those barriers of time and money taken out of the way are a big part [of what gets] people to come into the clinic. But then, when they come into the clinic, they get a lot of face time with the nurses and the doctors," Barnwell says.v Again, common sense that's not too common in these United States -- with the exception of Montana -- at the moment. High-deductible garbage plans -- promoted by big wigs at Aetna and Cigna who want patients to have more 'skin in the game' -- lead patients to delay putting off that chest pain until it becomes a heart attack...and open-heart surgery. When doctors aren't dealing with private health insurer bureaucracy and any sort of medical billing, the entire resources of the practice go towards taking care of human beings. When doctors are salaried instead of operating with a fee-for-service model, they emphasize quality over quantity. This is how medicine works in the UK, Canada and many other countries where protecting the wealth of hospital and insurance company CEOs is not the primary goal of the health care system.
Even Republicans -- who, you know, are naturally predisposed to hate the idea of patients seeing doctors without cost-sharing -- have a tough time faulting the new clinics.
"For goodness sakes, of course the employees and the retirees like it, it's free," says Republican State Sen. Dave Lewis.
...
Now, Lewis is a retired state employee himself. He says, personally, he does like going there, too.v "They're wonderful people, they do a great job, but as a legislator, I wonder how in the heck we can pay for it very long," Lewis says.
Well, Mr. Republican, they're saving the state millions -- you just won't admit it, but at least you admit you love the socialized medicine.
What's most exciting about these clinics? More are on the way.
Montana recently opened a second state employee health clinic in Billings, the state's largest city. Others are in the works.
And best of all? Schweitzer went right around the backs of Republicans to set up these life- and money-saving clinics. That's bold, progressive leadership. Let's do our best to spread the news far and wide about how the "Montana model" is proving what much of the rest of the world already knows: the ideal primary health care system should be free at point of use.
Montana Experiment Brings NHS-Style Health Care to USA; Saves State Millions, Patients Delighted
by james321
Daily Kos
Jul 31, 2013
Former Montana Gov. Brian Schweitzer has pledged his support for single-payer health care in the past, but his recent efforts to bring zero-cost sharing primary and preventive care to Montana government employees and retirees may be doing something that most progressives would only dream could happen in America: bringing NHS-style, socialized medicine to Montana.
This is a big deal and -- while currently limited to state employees and retirees -- could be laying the groundwork for America's most socially-just health care system. NPR has the details:
A year ago, Montana opened the nation's first clinic for free primary healthcare services to its state government employees. The Helena, Mont., clinic was pitched as a way to improve overall employee health, but the idea has faced its fair share of political opposition.
A year later, the state says the clinic is already saving money.
Pamela Weitz, a 61-year-old state library technician, was skeptical about the place at first.
"I thought it was just the goofiest idea, but you know, it's really good," she says. In the last year, she's been there for checkups, blood tests and flu shots. She doesn't have to go; she still has her normal health insurance provided by the state. But at the clinic, she has no co-pays, no deductibles. It's free.
That's the case for the Helena area's 11,000 state workers and their dependents. With an appointment, patients wait just a couple minutes to see a doctor. Visitation is more than 75 percent higher than initial estimates.v Yup, nobody is forced to visit this publicly-financed clinic run by a private operator. If they wish, they can take their big-profit, private health insurance and head to any doctor they want, but folks are recognizing that this, err... public option, provides better care. And, when patients do make this choice, both the state and patients save money.
The state contracts with a private company to run the facility and pays for everything — wages of the staff, total costs of all the visits. Those are all new expenses, and they all come from the budget for state employee healthcare.
Even so, division manager Russ Hill says it's actually costing the state $1,500,000 less for healthcare than before the clinic opened.
"Because there's no markup, our cost per visit is lower than in a private fee-for-service environment," Hill says.
Physicians are paid by the hour, not by the number of procedures they prescribe like many in the private sector. The state is able to buy supplies at lower prices.
Bottom line: a patient's visit to the employee health clinic costs the state about half what it would cost if that patient went to a private doctor. And because it's free to patients, hundreds of people have come in who had not seen a doctor for at least two years.
Take a second and let the words above sink in real deep. There you have exactly why the UK, Canada, Australia, Italy, Costa Rica, Cuba and other first-world -- and third-world -- countries are able to secure better health care outcomes than the United States with dramatically lower health care spending. Imagine what -- let's call it the Montana model -- could do for our national debt. And, you know, even more importantly, the health of our people and the wellbeing of our medical professionals.
Hill says the facility is catching a lot, including 600 people who have diabetes, 1,300 people with high cholesterol, 1,600 people with high blood pressure and 2,600 patients diagnosed as obese. Treating these conditions early could avoid heart attacks, amputations, or other expensive hospital visits down the line, saving the state more money.
Clinic operations director and physician's assistant Jimmie Barnwell says this model feels more rewarding to him.
"Having those barriers of time and money taken out of the way are a big part [of what gets] people to come into the clinic. But then, when they come into the clinic, they get a lot of face time with the nurses and the doctors," Barnwell says.v Again, common sense that's not too common in these United States -- with the exception of Montana -- at the moment. High-deductible garbage plans -- promoted by big wigs at Aetna and Cigna who want patients to have more 'skin in the game' -- lead patients to delay putting off that chest pain until it becomes a heart attack...and open-heart surgery. When doctors aren't dealing with private health insurer bureaucracy and any sort of medical billing, the entire resources of the practice go towards taking care of human beings. When doctors are salaried instead of operating with a fee-for-service model, they emphasize quality over quantity. This is how medicine works in the UK, Canada and many other countries where protecting the wealth of hospital and insurance company CEOs is not the primary goal of the health care system.
Even Republicans -- who, you know, are naturally predisposed to hate the idea of patients seeing doctors without cost-sharing -- have a tough time faulting the new clinics.
"For goodness sakes, of course the employees and the retirees like it, it's free," says Republican State Sen. Dave Lewis.
...
Now, Lewis is a retired state employee himself. He says, personally, he does like going there, too.v "They're wonderful people, they do a great job, but as a legislator, I wonder how in the heck we can pay for it very long," Lewis says.
Well, Mr. Republican, they're saving the state millions -- you just won't admit it, but at least you admit you love the socialized medicine.
What's most exciting about these clinics? More are on the way.
Montana recently opened a second state employee health clinic in Billings, the state's largest city. Others are in the works.
And best of all? Schweitzer went right around the backs of Republicans to set up these life- and money-saving clinics. That's bold, progressive leadership. Let's do our best to spread the news far and wide about how the "Montana model" is proving what much of the rest of the world already knows: the ideal primary health care system should be free at point of use.
Friday, August 2, 2013
Woman Blames Kaiser for Multi-Organ Failure
Woman Blames Kaiser for Multi-Organ Failure
By BARBARA WALLACE
Courthouse News Service
July 31, 2013
PORTLAND, Ore. (CN) - A Kaiser patient started to bleed internally during an elective surgery to remove a mass from her kidney, and within days she was debilitated due to Kaiser's slow response, she claims in Multnomah County Circuit Court.
Patricia and Joseph Moore sued Northwest Permanente, Kaiser Foundation Hospitals and Kaiser Foundation Healthplan of the Northwest dba Kaiser Permanente for $9.5 million for medical malpractice and loss of consortium.
Within hours of the surgery Moore's abdomen was distended. Other symptoms "consistent with acute hemorrhage" followed, but it was not until shortly after midnight the next day that Kaiser "initiated their rapid transfusion protocol," according to the complaint.
Over the next two days Moore's complications escalated, including falling blood pressure, increasing abdominal distention, rapid heart beat and breathing problems, the complaint says.
"Following numerous transfusions, Patricia Moore sustained respiratory failure and was intubated. During the intubation she aspirated abdominal contents into her airway."
The next morning, "Patricia Moore was diagnosed with acute renal failure," and this was followed by removal of her left kidney and three months on a ventilator, after which she was discharged to a care facility, according to the complaint.
Moore blames Kaiser's failure to timely diagnose and surgically correct the internal bleeding for a host of problems she has experienced, including hemorrhagic shock, multisystem organ failure, acute respiratory failure, gangrene of her left leg and foot, anoxic brain injury and prolonged ventilator dependence.
The plaintiffs are represented by Timothy J. Jones and Ken L. Ammann of Salem, Ore.
By BARBARA WALLACE
Courthouse News Service
July 31, 2013
PORTLAND, Ore. (CN) - A Kaiser patient started to bleed internally during an elective surgery to remove a mass from her kidney, and within days she was debilitated due to Kaiser's slow response, she claims in Multnomah County Circuit Court.
Patricia and Joseph Moore sued Northwest Permanente, Kaiser Foundation Hospitals and Kaiser Foundation Healthplan of the Northwest dba Kaiser Permanente for $9.5 million for medical malpractice and loss of consortium.
Within hours of the surgery Moore's abdomen was distended. Other symptoms "consistent with acute hemorrhage" followed, but it was not until shortly after midnight the next day that Kaiser "initiated their rapid transfusion protocol," according to the complaint.
Over the next two days Moore's complications escalated, including falling blood pressure, increasing abdominal distention, rapid heart beat and breathing problems, the complaint says.
"Following numerous transfusions, Patricia Moore sustained respiratory failure and was intubated. During the intubation she aspirated abdominal contents into her airway."
The next morning, "Patricia Moore was diagnosed with acute renal failure," and this was followed by removal of her left kidney and three months on a ventilator, after which she was discharged to a care facility, according to the complaint.
Moore blames Kaiser's failure to timely diagnose and surgically correct the internal bleeding for a host of problems she has experienced, including hemorrhagic shock, multisystem organ failure, acute respiratory failure, gangrene of her left leg and foot, anoxic brain injury and prolonged ventilator dependence.
The plaintiffs are represented by Timothy J. Jones and Ken L. Ammann of Salem, Ore.
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