Director of Oregon health care group arrested for sexual assault of dog

Examiner.com

February 27, 2015 

Yamhillmugshots.com

The executive director of a Bend, Oregon health care organization was arrested on Monday on suspicion of sexual abuse in the first degree, sodomy in the first degree, and sexual assault of a dog.
The Bend Bulletin reported today that John Williams Ryan, 47, was arrested after police investigated a co-defendant, Casie Lynn Nelson, 29, who was arrested on Tuesday. According to investigators, the catalyst behind the arrests was the couple's (still unspecified) illegal computer activity.
Oregon State is particularly strong in its animal welfare laws. According to the Animal Legal Defense Fund, Oregon ranked #2 for cracking down on animal abuse in 2013.
In 2014, Oregon's Supreme Court ruled that nonhuman animals can be victims - just like humans can. The landmark ruling, which afforded animals the same basic protection as humans, should enable authorities to help animals in need without obtaining a warrant.
Under Oregon State Law 167.333, sexual assault of an animal is a Class A misdemeanor.
Ryan was placed on leave from his position after his arrest by McMinnville Police detectives. RyanThe organization that Ryan directed, which is comprised of 600 providers and physicians, is currently being helmed by interim executive director Stephen Mann, who stated simply:

Effective Monday, February 23rd, COIPA Executive Director, John Ryan, was placed on administrative leave due to events unrelated to Central Oregon IPA."

According to the Yamhill County jail, Ryan was being held in lieu of $517,000 bail yesterday. Nelson is also in Yamhill County jail, in lieu of $142,500 bail.
McMinnville Police Capt. Dennis Marks stated that the Oregon Department of Justice, McMinnville Police Department, and Bend Police Department are all investigating this case. Updates to this story will be posted as they occur.
...You can also follow along on Facebook and Twitter!

Kaiser forces delay for heart attack patients when every minute counts

Delays in Important Treatment?

Paramedics are supposed to take heart attack patients to the closest, medically appropriate, hospital. But, NBC7 Investigates found this is not always happening.

By Mari Payton

Source: http://www.nbcsandiego.com/news/local/Delays-in-Important-Treatment-292806231.html#ixzz3SLf12YF6
Follow us: @nbcsandiego on Twitter | NBCSanDiego on Facebook

Updated at 7:26 AM PST on Friday, Feb 20, 2015

If you're having a heart attack, cardiologists say getting to the right hospital within 90 minutes is key for survival.

“If you are able to open that artery within 90 minutes, the chances of that patient having a good outcome is excellent,” interventional cardiologist Dr. Vimal Nanavati said.

If you're having the most serious kind of heart attack, called an ST elevation myocardial infarction (STEMI), where your heart artery is completely blocked, getting to a STEMI receiving center is critical.

“Every minute counts,” said Nanavati.

Thirteen San Diego County hospitals have STEMI receiving centers with catheterization labs that can unclog the blocked arteries in a patient's heart.

Robert Quittner has been a paramedic for over 10 years with San Diego Rural/Metro. He said a contractual agreement between two local hospitals is making him question the profession he loves.

"We became paramedics to take care of people," he said. "We're delaying their care. We're causing more damage to the heart."

Quittner is referring to a 30-year cardiovascular partnership between Kaiser Hospital in Grantville and Scripps Memorial Hospital La Jolla.

Kaiser Hospital does not have a STEMI receiving center, so its STEMI patients are transported to Scripps Memorial Hospital La Jolla for treatment.

Seven of the county's 13 STEMI receiving centers are closer to Kaiser Hospital than Scripps La Jolla, including Scripps Mercy, Alvarado, Sharp Memorial and UCSD Medical Center. Naval Medical Center is also included in the 13 facilities and has a STEMI receiving center...

Source: http://www.nbcsandiego.com/news/local/Delays-in-Important-Treatment-292806231.html#ixzz3SLf9id4R
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Kaiser Cost a Man His Penis, He Claims

Kaiser Cost a Man His Penis, He Claims By BARBARA WALLACE  Courthouse News Jan. 21, 2015      NAPA, Calif. (CN) - An elderly patient's penis eroded because Kaiser would not let care providers remove his catheter, he claims in Napa County Superior Court.      Rupert Collins sued Kaiser Foundation Health Plan, Inc. for elder abuse, negligence and unfair business practices.      In his lawsuit, Collins says he was a patient at nonparty Napa Valley Care Center when he developed problems with his catheterized penis.      On July 21, 2013, a nurse sent a fax to Collins' insurer, Kaiser, according to the complaint.      "The fax stated that Rupert's penis was red and swollen with what was described as a cut. Rupert had a Foley catheter inserted into his penis. Monica's fax said: 'May we have a trial of no Foley to give the area a rest.' Despite this request, Kaiser denied the request to remove the Foley. Despite the fact that Kaiser was notified that Rupert's penis was red and swollen and cut, there is no documentation to show that any physician from Kaiser ever bothered to personally examine Rupert's penis," the complaint states.      "As a direct result of this reckless neglect by Kaiser, the Foley was left in Rupert's red and swollen and cut penis, and his penis began to erode further and further each day," it continues.      Two days later, there was a care conference about Rupert Collins' care, but no Kaiser representative showed up, according to the complaint.      "As a direct result of Kaiser's failure to participate, there was no meaningful communication or ongoing assessment and the dire need to remove the catheter from Rupert's eroding penis continued to be ignored," the complaint states.      On July 30, another nurse sent another fax to Kaiser requesting permission to remove the catheter, but the request was again denied, according to the complaint.      The next day, Collins' daughter had a look, according to the complaint.      "When Diana examined Rupert's penis, she was horrified at what she saw. Rupert's penis was split completely in half from the tip of his penis all the way down to the scrotum sac," the complaint states.      Collins' daughter had a third nurse contact Kaiser, but Kaiser told the nurse, "The penis erosion is normal and will heal on its own," the complaint states.      Collins' daughter pressed the issue and got him seen by a Kaiser urologist on Aug. 2. The doctor "stated that if Rupert had been treated earlier, the penis could have been saved but that the penile erosion was now complete, Rupert's penis would never heal and that reconstructive surgery was not a viable option," the complaint states.      "Rupert's penis and urethra is permanently eroded away and Rupert has suffered permanent genital mutilation," it continues.      Collins blames Kaiser's business practices for his injuries.      "The conduct of defendants is part of a general business practice at Kaiser conceived and implemented by Kaiser and Does 1-10, inclusive. This practice exists in part because defendants unreasonably expect few adverse consequences will flow from their mistreatment of their elderly, demented, disabled and vulnerable clientele, and said defendants made a considered decision to promote profit at the expense of their moral, legal and ethical obligations to their resident-patients," the complaint states.      Rupert Collins seeks general and special damages, treble damages, attorneys' fees and costs, restitution of all funds paid to Kaiser on his behalf and injunctive relief. He is represented by Rebecca J. Freeman of Freeman & Freeman in Santa Rosa.

Serving a claim against UC Regents

This is how you serve the UC Regents. You don't need to serve a tort claim.

Should you always trust an Ivy-Leage doctor? Will they sometimes lie to you for financial gain?

There's more than one way for doctors to make profits by concealing facts from patients.   Not all the products they promote are sold through the media, as seen in the story of Dr. William Taylor at UCSD.

Real-world doctors fact-check Dr. Oz, and the results aren't pretty

By Karen Kaplan 

LA Times
Dec. 19, 2014

Only one-third of claims made on 'The Dr. Oz Show' can be backed by medical evidence, study says

11% of the recommendations made by Dr. Oz or his guests contradict medical facts, researchers say

Viewers of 'The Dr. Oz Show' should be skeptical about advice given on the program, experts conclude

What do real-world doctors have to say about the advice dispensed on “The Dr. Oz Show”? Less than one-third of it can be backed up by even modest medical evidence.
If that sounds alarming, consider this: Nearly 4 in 10 of the assertions made on the hit show appear to be made on the basis of no evidence at all.
The researchers who took it upon themselves to fact-check Dr. Oz and his on-air guests were able to find legitimate studies related to another 11% of the recommendations made on the show. However, in these cases, the recommendations ran counter to the medical literature.

Dr. Oz doubles down on bogus weight loss products at Senate hearing

 

“Consumers should be skeptical about any recommendations provided on television medical talk shows,” the researchers wrote in a study published this week in BMJ. “Viewers need to realize that the recommendations may not be supported by higher evidence or presented with enough balanced information to adequately inform decision making.”

Critics of Dr. Mehmet Oz, an accomplished cardiac surgeon with degrees from two Ivy League universities, complain that his show is little more than an hour-long infomercial for weight-loss fads like green coffee bean extract. (The Federal Trade Commission has sued the company that hawks this dubious product.) A spokesman for the Center for Inquiry accused him of selling “snake oil.” In June, a Senate subcommittee took him to task for telling his viewers (who number 2.9 million on any given day) things like: “I’ve got the No. 1 miracle in a bottle to burn your fat. It’s raspberry ketones.”

“I don’t get why you need to say this stuff because you know it’s not true," Sen. Claire McCaskill (D-Mo.) said during the hearing...

Deep sedation for colonoscopy might not be safe
Consumer Reports
Nov. 19, 2014

Getting knocked out during a colonoscopy might seem like a good idea. After all, being awake as your doctor uses a long, flexible tube to get an inside view of your lower intestines doesn't sound very appealing. To avoid that problem, many doctors now routinely use the drug propofol (Diprivan) during colonoscopy to cause deep sedation in their patients.

But beware: That drug, which was reportedly given to Joan Rivers  soon before she died, might not be the healthiest choice and could put you at risk for some serious complications.

Don’t get the wrong idea: Colonoscopies are usually safe (about 3 out of every 1,000 people suffer a serious complication). And the procedure is proved to prevent colon cancer deaths. So if you’re ages 50 to 75, you should be screened (see our guide, "The Cancer Tests You Really Need," to find out how often you should be screened). 

But deep sedation isn't necessary. Colonoscopy can be done using conscious sedation or even none at all. “You should always try to aim for the lightest level of sedation that you need,” says Consumer Reports' medical adviser, Orly Avitzur, M.D. “The trend toward deep sedation is worrisome because it increases risk.”

For example, propofol increases your risk of aspiration pneumonia (caused by inhaling particles such as vomit, mucus, or saliva) by almost 50 percent, according to a study by Gregory Cooper, M.D., in the journal JAMA Internal Medicine. And it can cause a host of other side effects, including confusion, seizures, irregular heart beats, and potentially deadly allergic reactions.  

“For the general population there’s not a lot of good data saying patients have a better outcome with propofol when there’s not a medical indication,” says Cooper, a professor of medicine at Case Western Reserve University in Cleveland. “It’s overkill.”

Instead, Cooper says he uses the narcotics fentanyl (Duragesic and others) or meperidine (Demerol) combined with midazolam (Versed) to induce light sedation during colonoscopies.  

And propofol is expensive. Colonoscopies using anesthesia cost about 20 percent more than those done without, according to Cooper. And a 2013 research letter in JAMA Internal Medicine titled, "Propofol for screening colonoscopy: Are we paying too much?" said that the use of propofol typically added $600 to $2,000 to the price tag.

Screening colonoscopies are covered by insurance plans, thanks to the Affordable Care Act, although you might have to pay for part of the anesthesiologist’s fees, bowel prep kit, pathology costs, and a facility fee. But even so, “Somebody’s got to pay for it, whether it’s the insurance company or the patients,” Cooper says, adding that the current system provides a financial motivation for using more anesthesia.

Read more about how to protect yourself from surprise out-of-network medical bills.

But the rising tide of propofol use could be about to ebb. Beginning Jan. 1, 2015, Medicare is changing how it pays anesthesia professionals for colonoscopy care. Gastroenterologists will be paid a set amount that will cover the anesthesia cost, even if an anesthesiologist, for example, administers it. Doctors will then have to decide whether to recommend expensive anesthesia, which could include hiring a nurse anesthetist or anesthesiologist and pay them out of the same pot, or choose a less pricey option. “There may be a financial disincentive for Medicare doctors to recommend deep sedation,” Avitzur says.

We’ll have to wait to find out if commercial insurers follow Medicare’s lead. If they do, says Cooper, “There will be less cost to the health care system since there won’t be another bill from the anesthesiologist.”

Until then, if you’re gearing up to have a colonoscopy, make sure you discuss your anesthesia options with your doctor before the procedure.

L.A. County Health Dept. Allegedly Falsified Nursing Home Records of Complaints

L.A. County Health Department Allegedly Falsified Nursing Home Probe Records

By Anna Gorman  
Kaiser Health News
November 10, 2014
 

The Los Angeles County Public Health Department falsified the dates it received complaints about nursing homes as pressure rose to meet state deadlines for launching investigations, according to two employees.
In a letter last month to county, state and federal officials,  inspector Kimberly Nguyen cited 11 cases in which she said the dates typed into the computer system were later than the dates the complaints were actually received. The cases mentioned in the letter involve alleged abuse, falls and pressure sores, she said.
“In my belief, falsification is a serious matter and unlawful and our department should know better to not manipulate paperwork to mislead others and the public,” Nguyen wrote in the Oct. 7 letter.

...Meanwhile, the state, which directly oversees nursing homes in every district except Los Angeles County, has had its own history of problems with timely investigations. A lawsuit by California Advocates for Nursing Home Reform, or CANHR, resulted in a 2006 order by a Superior Court judge instructing public health officials to follow the law regarding investigation timelines.
Geraneo noted that order in her e-mail to administrators, referring to a case involving a non-working generator in which the complaint year had allegedly been changed from 2013 to 2014. “We cannot change the initiation dates of these complaints because of the CANHR lawsuit!”
Geraneo declined to be interviewed.
Since Kaiser Health News began writing about the department’s health facilities inspection division in March, administrators have sent e-mails to staff telling them not to speak to the media and to forward all requests. Reached by phone, several inspectors have declined to talk, saying they feared retaliation.
Nguyen said  she has been she has been targeted for retaliation as a result of raising questions since July 2013 about the quality of nursing home oversight.
In May 2014, Nguyen was suspended for five days without pay because she allegedly failed to renew her nursing license. A department letter said her license expired on November 30, 2013 and that she worked for six days without a valid license.
But as the Board of Nursing later confirmed in writing, her license actually had been renewed promptly. The Board simply hadn’t entered the renewal on its website.

 

 

 

L.A. County Health Dept. Allegedly Falsified Nursing Home Records

California Health Line

November 10, 2014

Two Los Angeles County Public Health Department employees allege that the department falsified the dates it received nursing home complaints in order to meet state deadlines for launching investigations, Kaiser Health News reports.

Background

Under state law, investigations must be launched within 10 days of receiving a nursing home complaint -- or within 24 hours if the complaint involves the threat of death or serious harm.

The California Public Health Department requires inspectors to enter dates based on when the complaint was first received by phone, fax, email or letter.

Details of Falsified Records

In a letter sent last month to county, state and federal officials, Inspector Kimberly Nguyen cited 11 cases in which she found records with falsified dates.

The dates entered were much later -- as much as 79 days --than the dates the allegations actually had been submitted.

The cases involved complaints about:

• Abuse;
• Falls; and
• Pressure sores.

According to KHN, Nguyen said she believes the date manipulation was deliberate (Gorman, Kaiser Health News, 11/10).

Nguyen said her supervisor, Adewole Adegoke, has been aware of the record falsification since July but has made no effort to stop the practice (Nguyen Letter, 10/7). She wrote, "In my belief, falsification is a serious matter and unlawful, and our department should know better to not manipulate paperwork to mislead others and the public."

Meanwhile, Sharon Geraneo, an assistant supervisor at the department, sent a separate email in August about the department allegedly falsifying records.

Response to Allegations

The county Department of Public Health said it has "zero tolerance for intentional document falsification" and is not aware of any deliberate falsification.

Officials said that they had identified a data entry error by one individual that affected 35 cases but that "swift and appropriate corrective actions" were taken.

The California Department of Public Health said it is investigating the allegations (Kaiser Health News, 11/10).