See all posts on colonoscopies.
Unconscious patient's cell phone captures doctors mocking him during colonoscopy.
Sarah Fruchtnicht
Opposingviews.com
22 Apr 2014
A Virginia man is suing after his cell phone captured audio of doctors allegedly mocking him while he was under anesthesia for a colonoscopy.
The plaintiff, D.B., says doctors joked about firing a gun up his rectum and accused him of having STDs during his medical procedure.
"On April 18, 2013, during a colonoscopy, plaintiff was verbally brutalized and defamed by the very doctors to whom he entrusted his life while under anesthesia," the complaint says.
D.B. sued Safe Sedation LLC and Safe Sedation Management in Fairfax County Court for defamation, infliction of emotional distress and illegally disclosing his health records.
The patient said he left his phone on and recorded everything on accident. When he later drove home with his wife, they discovered the recording.
The doctors, Tiffany Ingham and Soloman Shah, are not named as defendants but are accused of mocking D.B. as soon as the anesthetic knocked him out.
"Tiffany Ingham, M.D. started to mock, and then continued to mock, the amount of medicine required to anesthetize plaintiffs," the complaint states. "Referring to plaintiff, Soloman Shah, M.D. commented that a teaching physician known to both him and Tiffany Ingham, M.D. 'would eat him for lunch.'
"Tiffany Ingham, M.D. agreed that plaintiff would be 'eaten alive' and also jokingly discussed a hypothetical of firing a gun up a rectum," it says.
"And really, after five minutes of talking to you in pre-op I wanted to punch you in the face and man you up a little bit," Ingham allegedly said to the patient while he was under.
Doctors allegedly discussed D.B.'s prescription medication and an irritation he had on his penis.
v
"A medical assistant at GMA touched plaintiff's penis during the colonoscopy," the complaint states. "Although plaintiff's penis is not involved in a colonoscopy, the medical assistant noted there was not 'much of a penile rash.' Tiffany Ingham, M.D. responded, 'No, you'll accidentally rub up against it. Some syphilis on your arm or something.' Solomon Shah, M.D. responded, 'That would be bad. That would be real bad.'"
"Tiffany Ingham, M.D. then stated to all present in the operating suite that, 'It's probably tuberculosis in the penis, so you'll be all right.'"
The lawsuit notes that the plaintiff has neither disease.
In a final remark on tape, Ingham allegedly said she would make a note in D.B.'s file that he had hemorrhoids even though he didn't.
He's seeking $1 million in compensatory damages and $350,000 in punitive damages.
COMMENTS
No need to anesthetize everyone
By: Publicgood
I did just fine during my colonoscopy with no anesthesia at all. I think doctors who anesthetize all patients are doing it for the same reason that they refuse to allow patients to have a DVD of the procedure: they don't want to listen to patient's questions either during the procedure or later on.
Colonoscopy souvenir DVDs
By: Publicgood
I am shocked that doctors across the US have stopped providing DVDs of colonoscopies in response to medical records requests. It's okay that they don't automatically give souvenir DVDs, but it's not okay to violate the law regarding patient's rights to access to their medical records. Doctors even claim that it's a cost-cutting measure; this is obviously false since digital memory is getting cheaper by the month and has always been cheaper and more compact than the VHS tapes on which colonoscopies used to be saved.
Wednesday, June 11, 2014
How Many Die From Medical Mistakes in U.S. Hospitals?
How Many Die From Medical Mistakes in U.S. Hospitals?
An updated estimate says at least 210,000 patients die
from medical mistakes in U.S. hospitals a year.
by Marshall Allen
ProPublica
Sep. 19, 2013
It seems that every time researchers estimate how often a medical mistake contributes to a hospital patient’s death, the numbers come out worse. In 1999, the Institute of Medicine published the famous “To Err Is Human” report, which dropped a bombshell on the medical community by reporting that up to 98,000 people a year die because of mistakes in hospitals. The number was initially disputed, but is now widely accepted by doctors and hospital officials — and quoted ubiquitously in the media.
In 2010, the Office of Inspector General for Health and Human Services said that bad hospital care contributed to the deaths of 180,000 patients in Medicare alone in a given year.
Now comes a study in the current issue of the Journal of Patient Safety that says the numbers may be much higher — between 210,000 and 440,000 patients each year who go to the hospital for care suffer some type of preventable harm that contributes to their death, the study says.
That would make medical errors the third-leading cause of death in America, behind heart disease, which is the first, and cancer, which is second.
The new estimates were developed by John T. James, a toxicologist at NASA’s space center in Houston who runs an advocacy organization called Patient Safety America. James has also written a book about the death of his 19-year-old son after what James maintains was negligent hospital care.
Asked about the higher estimates, a spokesman for the American Hospital Association said the group has more confidence in the IOM’s estimate of 98,000 deaths. ProPublica asked three prominent patient safety researchers to review James’ study, however, and all said his methods and findings were credible.
What’s the right number? Nobody knows for sure. There’s never been an actual count of how many patients experience preventable harm. So we’re left with approximations, which are imperfect in part because of inaccuracies in medical records and the reluctance of some providers to report mistakes.
Patient safety experts say measuring the problem is nonetheless important because estimates bring awareness and research dollars to a major public health problem that persists despite decades of improvement efforts.
“We need to get a sense of the magnitude of this,” James said in an interview.
James based his estimates on the findings of four recent studies that identified preventable harm suffered by patients – known as “adverse events” in the medical vernacular – using use a screening method called the Global Trigger Tool, which guides reviewers through medical records, searching for signs of infection, injury or error. Medical records flagged during the initial screening are reviewed by a doctor, who determines the extent of the harm.
In the four studies, which examined records of more than 4,200 patients hospitalized between 2002 and 2008, researchers found serious adverse events in as many as 21 percent of cases reviewed and rates of lethal adverse events as high as 1.4 percent of cases.
By combining the findings and extrapolating across 34 million hospitalizations in 2007, James concluded that preventable errors contribute to the deaths of 210,000 hospital patients annually.
That is the baseline. The actual number more than doubles, James reasoned, because the trigger tool doesn’t catch errors in which treatment should have been provided but wasn’t, because it’s known that medical records are missing some evidence of harm, and because diagnostic errors aren’t captured.
An estimate of 440,000 deaths from care in hospitals “is roughly one-sixth of all deaths that occur in the United States each year,” James wrote in his study. He also cited other research that’s shown hospital reporting systems and peer-review capture only a fraction of patient harm or negligent care.
“Perhaps it is time for a national patient bill of rights for hospitalized patients,” James wrote. “All evidence points to the need for much more patient involvement in identifying harmful events and participating in rigorous follow-up investigations to identify root causes.”
Dr. Lucian Leape, a Harvard pediatrician who is referred to the “father of patient safety,” was on the committee that wrote the “To Err Is Human” report. He told ProPublica that he has confidence in the four studies and the estimate by James.
Members of the Institute of Medicine committee knew at the time that their estimate of medical errors was low, he said. “It was based on a rather crude method compared to what we do now,” Leape said. Plus, medicine has become much more complex in recent decades, which leads to more mistakes, he said. Dr. David Classen, one of the leading developers of the Global Trigger Tool, said the James study is a sound use of the tool and a “great contribution.” He said it’s important to update the numbers from the “To Err Is Human” report because in addition to the obvious suffering, preventable harm leads to enormous financial costs. Dr. Marty Makary, a surgeon at The Johns Hopkins Hospital whose book “Unaccountable” calls for greater transparency in health care, said the James estimate shows that eliminating medical errors must become a national priority. He said it’s also important to increase the awareness of the potential of unintended consequences when doctors perform procedure and tests. The risk of harm needs to be factored into conversations with patients, he said. Leape, Classen and Makary all said it’s time to stop citing the 98,000 number. Still, hospital association spokesman Akin Demehin said the group is sticking with the Institute of Medicine’s estimate. Demehin said the IOM figure is based on a larger sampling of medical charts and that there’s no consensus the Global Trigger Tool can be used to make a nationwide estimate. He said the tool is better suited for use in individual hospitals. The AHA is not attempting to come up with its own estimate, Demehin said. Dr. David Mayer, the vice president of quality and safety at Maryland-based MedStar Health, said people can make arguments about how many patient deaths are hastened by poor hospital care, but that’s not really the point. All the estimates, even on the low end, expose a crisis, he said. “Way too many people are being harmed by unintentional medical error,” Mayer said, “and it needs to be corrected.”
An updated estimate says at least 210,000 patients die
from medical mistakes in U.S. hospitals a year.
by Marshall Allen
ProPublica
Sep. 19, 2013
It seems that every time researchers estimate how often a medical mistake contributes to a hospital patient’s death, the numbers come out worse. In 1999, the Institute of Medicine published the famous “To Err Is Human” report, which dropped a bombshell on the medical community by reporting that up to 98,000 people a year die because of mistakes in hospitals. The number was initially disputed, but is now widely accepted by doctors and hospital officials — and quoted ubiquitously in the media.
In 2010, the Office of Inspector General for Health and Human Services said that bad hospital care contributed to the deaths of 180,000 patients in Medicare alone in a given year.
Now comes a study in the current issue of the Journal of Patient Safety that says the numbers may be much higher — between 210,000 and 440,000 patients each year who go to the hospital for care suffer some type of preventable harm that contributes to their death, the study says.
That would make medical errors the third-leading cause of death in America, behind heart disease, which is the first, and cancer, which is second.
The new estimates were developed by John T. James, a toxicologist at NASA’s space center in Houston who runs an advocacy organization called Patient Safety America. James has also written a book about the death of his 19-year-old son after what James maintains was negligent hospital care.
Asked about the higher estimates, a spokesman for the American Hospital Association said the group has more confidence in the IOM’s estimate of 98,000 deaths. ProPublica asked three prominent patient safety researchers to review James’ study, however, and all said his methods and findings were credible.
What’s the right number? Nobody knows for sure. There’s never been an actual count of how many patients experience preventable harm. So we’re left with approximations, which are imperfect in part because of inaccuracies in medical records and the reluctance of some providers to report mistakes.
Patient safety experts say measuring the problem is nonetheless important because estimates bring awareness and research dollars to a major public health problem that persists despite decades of improvement efforts.
“We need to get a sense of the magnitude of this,” James said in an interview.
James based his estimates on the findings of four recent studies that identified preventable harm suffered by patients – known as “adverse events” in the medical vernacular – using use a screening method called the Global Trigger Tool, which guides reviewers through medical records, searching for signs of infection, injury or error. Medical records flagged during the initial screening are reviewed by a doctor, who determines the extent of the harm.
In the four studies, which examined records of more than 4,200 patients hospitalized between 2002 and 2008, researchers found serious adverse events in as many as 21 percent of cases reviewed and rates of lethal adverse events as high as 1.4 percent of cases.
By combining the findings and extrapolating across 34 million hospitalizations in 2007, James concluded that preventable errors contribute to the deaths of 210,000 hospital patients annually.
That is the baseline. The actual number more than doubles, James reasoned, because the trigger tool doesn’t catch errors in which treatment should have been provided but wasn’t, because it’s known that medical records are missing some evidence of harm, and because diagnostic errors aren’t captured.
An estimate of 440,000 deaths from care in hospitals “is roughly one-sixth of all deaths that occur in the United States each year,” James wrote in his study. He also cited other research that’s shown hospital reporting systems and peer-review capture only a fraction of patient harm or negligent care.
“Perhaps it is time for a national patient bill of rights for hospitalized patients,” James wrote. “All evidence points to the need for much more patient involvement in identifying harmful events and participating in rigorous follow-up investigations to identify root causes.”
Dr. Lucian Leape, a Harvard pediatrician who is referred to the “father of patient safety,” was on the committee that wrote the “To Err Is Human” report. He told ProPublica that he has confidence in the four studies and the estimate by James.
Members of the Institute of Medicine committee knew at the time that their estimate of medical errors was low, he said. “It was based on a rather crude method compared to what we do now,” Leape said. Plus, medicine has become much more complex in recent decades, which leads to more mistakes, he said. Dr. David Classen, one of the leading developers of the Global Trigger Tool, said the James study is a sound use of the tool and a “great contribution.” He said it’s important to update the numbers from the “To Err Is Human” report because in addition to the obvious suffering, preventable harm leads to enormous financial costs. Dr. Marty Makary, a surgeon at The Johns Hopkins Hospital whose book “Unaccountable” calls for greater transparency in health care, said the James estimate shows that eliminating medical errors must become a national priority. He said it’s also important to increase the awareness of the potential of unintended consequences when doctors perform procedure and tests. The risk of harm needs to be factored into conversations with patients, he said. Leape, Classen and Makary all said it’s time to stop citing the 98,000 number. Still, hospital association spokesman Akin Demehin said the group is sticking with the Institute of Medicine’s estimate. Demehin said the IOM figure is based on a larger sampling of medical charts and that there’s no consensus the Global Trigger Tool can be used to make a nationwide estimate. He said the tool is better suited for use in individual hospitals. The AHA is not attempting to come up with its own estimate, Demehin said. Dr. David Mayer, the vice president of quality and safety at Maryland-based MedStar Health, said people can make arguments about how many patient deaths are hastened by poor hospital care, but that’s not really the point. All the estimates, even on the low end, expose a crisis, he said. “Way too many people are being harmed by unintentional medical error,” Mayer said, “and it needs to be corrected.”
Tuesday, June 10, 2014
Do you want a souvenir DVD of your colonoscopy? So did I.
See all posts re UCSD.
I was scheduled for a routine colonoscopy at UCSD last month. Nothing controversial about that, right?
I had had a bizarre experience at Kaiser three years ago when I paid Kaiser $10 for a DVD of the digital video of my VUCG (or "VCUG"). Then suddenly the radiology imaging department claimed that there were no digital images of the procedure--even though the X-rays were done at the brand new Garfield Specialty Center advertised as having all-digital X-rays. Kaiser said that it only had a few odd thermal paper images of the June 15, 2011 procedure.
So naturally I wanted to make sure that the same thing wouldn't happen at UCSD. A couple of days before my colonoscopy I called to make sure that I would be able to get a DVD of the procedure.
UCSD's gastroenterology department told me that they don't save any of the digital data generated during colonoscopies.
This is what UCSD claims:
1. The patient can't get a second opinion from any doctor who wasn't watching the computer monitor during the procedure.
2. UCSD is very vulnerable to lawsuits; it can't prove that it wasn't negligent if the patient develops colon cancer that was missed.
3. UCSD can't learn from its mistakes. It can't go back and see what it was they missed so they can do a better job in the future.
4. A few seconds after the patient leaves, the doctor (and patient) are out of luck if the doctor suddenly thinks, "Hey, what was that I was looking at? Maybe that was something important. I'd like to see that again." Nope. No chance. According to UCSD, the images have been flushed from its computers.
5. UCSD says they don't save the images because it takes up too much space on the hard drive.
Yeah, right. Digital memory is getting cheaper by the month, so why would UCSD have suddenly stopped saving digital data recently? They used to give patients DVDs, and before that they gave VHS tapes of colonoscopies. Those tapes were a lot more expensive and bulky than digital memory.
I asked if I could pay extra to get my procedure saved, but they said NO. The procedure costs $1300 minimum. You'd think that would cover a bit of space on the hard drive, wouldn't you? Well, of course it does. They just don't want patients to see the images.
These days many doctors in the US are so dead set against patients seeing the images that they sedate everybody, even people who've had colonoscopies before without sedation and didn't have any problem. They'd rather take the risk of a bad reaction to drugs than to let patients see the video. I watched doctors on You Tube showing the whole process, and the first thing they asked patients when they woke up was, "Do you remember anything?" The patients all said NO.
When I suggested that I didn't believe that UCSD flushed the digital data, UCSD suggested that I go somewhere else if I wanted a DVD.
So I found a doctor who would give me a DVD of my colonoscopy.
The new doctor wants me to get some lab work done, so I went to UCSD today to get blood drawn.
The nurse who drew my blood was very sweet, but it quickly became clear that she had been tasked with finding out who had agreed to give me a DVD of a colonoscopy. Why would UCSD want to know that?
"Where are you going for your colonoscopy?" she asked.
I didn't want UCSD calling up the doctor and demanding that he not give me a DVD.
"I don't think I should say, since UCSD doesn't approve of patients getting DVDs," I told her.
"Oh, no," she said. "It's not that. It's just that we don't do DVDs."
Fine, I thought. So we're all happy and relaxed about this situation. I sat back in my chair and the nurse put a pillow on my lap.
"So are you getting it done at a hospital?" she asked. It seemed that my nurse was not so happy and relaxed about the situation after all.
I didn't want to say YES and I didn't want to say NO. I didn't want to tell the truth or tell a lie. So I didn't say anything.
I was afraid she'd be mad at me and poke me painfully with the needle, but she was very careful. I only felt a tiny pinch. And then we said friendly good byes.
Message to UCSD: she tried. She really did try. But I had planned ahead of time that I wouldn't spill the beans. So don't blame the very sweet girl who couldn't get the information out of me.
I was scheduled for a routine colonoscopy at UCSD last month. Nothing controversial about that, right?
I had had a bizarre experience at Kaiser three years ago when I paid Kaiser $10 for a DVD of the digital video of my VUCG (or "VCUG"). Then suddenly the radiology imaging department claimed that there were no digital images of the procedure--even though the X-rays were done at the brand new Garfield Specialty Center advertised as having all-digital X-rays. Kaiser said that it only had a few odd thermal paper images of the June 15, 2011 procedure.
So naturally I wanted to make sure that the same thing wouldn't happen at UCSD. A couple of days before my colonoscopy I called to make sure that I would be able to get a DVD of the procedure.
UCSD's gastroenterology department told me that they don't save any of the digital data generated during colonoscopies.
This is what UCSD claims:
1. The patient can't get a second opinion from any doctor who wasn't watching the computer monitor during the procedure.
2. UCSD is very vulnerable to lawsuits; it can't prove that it wasn't negligent if the patient develops colon cancer that was missed.
3. UCSD can't learn from its mistakes. It can't go back and see what it was they missed so they can do a better job in the future.
4. A few seconds after the patient leaves, the doctor (and patient) are out of luck if the doctor suddenly thinks, "Hey, what was that I was looking at? Maybe that was something important. I'd like to see that again." Nope. No chance. According to UCSD, the images have been flushed from its computers.
5. UCSD says they don't save the images because it takes up too much space on the hard drive.
Yeah, right. Digital memory is getting cheaper by the month, so why would UCSD have suddenly stopped saving digital data recently? They used to give patients DVDs, and before that they gave VHS tapes of colonoscopies. Those tapes were a lot more expensive and bulky than digital memory.
I asked if I could pay extra to get my procedure saved, but they said NO. The procedure costs $1300 minimum. You'd think that would cover a bit of space on the hard drive, wouldn't you? Well, of course it does. They just don't want patients to see the images.
These days many doctors in the US are so dead set against patients seeing the images that they sedate everybody, even people who've had colonoscopies before without sedation and didn't have any problem. They'd rather take the risk of a bad reaction to drugs than to let patients see the video. I watched doctors on You Tube showing the whole process, and the first thing they asked patients when they woke up was, "Do you remember anything?" The patients all said NO.
When I suggested that I didn't believe that UCSD flushed the digital data, UCSD suggested that I go somewhere else if I wanted a DVD.
So I found a doctor who would give me a DVD of my colonoscopy.
The new doctor wants me to get some lab work done, so I went to UCSD today to get blood drawn.
The nurse who drew my blood was very sweet, but it quickly became clear that she had been tasked with finding out who had agreed to give me a DVD of a colonoscopy. Why would UCSD want to know that?
"Where are you going for your colonoscopy?" she asked.
I didn't want UCSD calling up the doctor and demanding that he not give me a DVD.
"I don't think I should say, since UCSD doesn't approve of patients getting DVDs," I told her.
"Oh, no," she said. "It's not that. It's just that we don't do DVDs."
Fine, I thought. So we're all happy and relaxed about this situation. I sat back in my chair and the nurse put a pillow on my lap.
"So are you getting it done at a hospital?" she asked. It seemed that my nurse was not so happy and relaxed about the situation after all.
I didn't want to say YES and I didn't want to say NO. I didn't want to tell the truth or tell a lie. So I didn't say anything.
I was afraid she'd be mad at me and poke me painfully with the needle, but she was very careful. I only felt a tiny pinch. And then we said friendly good byes.
Message to UCSD: she tried. She really did try. But I had planned ahead of time that I wouldn't spill the beans. So don't blame the very sweet girl who couldn't get the information out of me.
Monday, June 9, 2014
UCSD Researchers Find Protein That Triggers Diabetes
UCSD Researchers Find Protein That Triggers Diabetes
The origins and steps of obesity-related
diabetes have been established for the first time, according to a
significant set of findings just published by researchers at the UCSD School of Medicine.
The researchers concentrated on a protein, called ANT2, that they believe causes diabetes in fat people.
“We’ve pinpointed the steps, the way the
whole thing happens,” said Jerrold M. Olefsky, associate dean for
Scientific Affairs and Distinguished Professor of Medicine at UCSD.
“The research is in mice, but the evidence
suggests that the processes are comparable in humans and these findings
are important to not just understanding how diabetes begins, but how
better to treat it and prevent it.”
In a study published this weekend in the medical journal Cell,
the UCSD researchers described a sequence that begins at the cellular
level, as cells react to high-fat diets. These high-fat diets can then
result in obesity- induced insulin resistance, and then diabetes.
Olefsky and others have previously shown that
obesity is characterized by low-grade inflammation in fat tissue, and
that this inflammation can become chronic and result in insulin
resistance and diabetes. In their most recent findings, the scientists
describe the earliest stages of the process which begin before obesity
manifests itself.
The scientists began by feeding mice a
high-fat diet. They noticed that the high levels of saturated fatty
acids in the diet activated a protein in the fat cell membranes, which
in turn caused increased oxygen consumption in the cells.
The increased oxygen consumption by the ANT2 protein left less oxygen for the rest of the cell.
Without an adequate oxygen supply, the cells
go through a process that ultimately launches the immune system’s
inflammatory response system. A sustained high-fat diet ensured that the
process continued unimpeded, and that led to obesity, chronic tissue
inflammation and insulin resistance in the mice.
The researches found that by controlling
certain aspects of the process, they could protect the mice from
inflammation, insulin resistance and elevated glucose levels that were
caused by the high-fat diet.
The researches suggest that by impeding two
specific steps in the sequence, they could blunt or even reverse the
damaging cellular sequence.
— City News Service
Friday, June 6, 2014
CDC confirms 4th U.S. case of mad cow disease after Texas man dies
Mad cow disease is still here, it turns out.
Los Angeles Times
June 6, 2014
Mad
cow disease -- the fourth confirmed case in the U.S. -- is responsible
for the death of a Texas man, the Centers for Disease Control and
Prevention said Friday.
The variant CJD, as it’s medically known, was confirmed by experts after a sample of the man’s brain tissue was analyzed.
No specifics on the victim or when he died were released.
“The history of this fourth patient, including extensive travel to Europe and the Middle East, supports the likelihood that infection occurred outside the United States,” the CDC said in a statement.
The disease is a rare, degenerative fatal brain disorder in humans that is believed to be caused by eating the meat of cows with the disease bovine spongiform encephalopathy, according to the CDC.
The disease in humans is more prevalent in Europe. The majority are in Britain, which has had 177 confirmed cases since the disease was discovered there in 1996, and France, with 27, the CDC reports.
CDC confirms 4th U.S. case of mad cow disease after Texas man dies
by Ryan ParkerLos Angeles Times
June 6, 2014
The variant CJD, as it’s medically known, was confirmed by experts after a sample of the man’s brain tissue was analyzed.
No specifics on the victim or when he died were released.
“The history of this fourth patient, including extensive travel to Europe and the Middle East, supports the likelihood that infection occurred outside the United States,” the CDC said in a statement.
The disease is a rare, degenerative fatal brain disorder in humans that is believed to be caused by eating the meat of cows with the disease bovine spongiform encephalopathy, according to the CDC.
The disease in humans is more prevalent in Europe. The majority are in Britain, which has had 177 confirmed cases since the disease was discovered there in 1996, and France, with 27, the CDC reports.
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