Articles Posted in Medicines / Drugs

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hospital-corridor-2-65904-m.jpgIf you are hurt by a professional’s negligence, you may be wondering what evidentiary rules apply to the professional’s apologies or expressions of sympathy. Can they be used to prove that the professional was negligent? In the recent Maine appellate case Strout v. Central Maine Medical Center, the Maine Supreme Court considered the effect of an apology in a medical malpractice case. The medical center appealed a verdict in favor of the plaintiff. The case arose when the plaintiff sought treatment in the ER for pain in his abdomen. A lesion was found on his liver. A surgeon evaluated his CAT scan and decided he was most likely suffering from cancer.

Days later, the plaintiff went to the office for a follow-up. The doctor telephoned the pathologist in charge of testing the tissue. The pathologist said he would send it for more testing, but that he believed the cancer to be of hepatic or pancreatic origin. He also told the doctor he needed more tissue to finish the assessment.

The doctor told the plaintiff that he was waiting for final results but believed he had liver or pancreatic cancer. He also told the plaintiff that if this was so, the cancer would be inoperable due to the location of the lesion and that even with chemotherapy, patients with these types of cancer usually had less than one year to live.
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operation-1389104-m-5.jpgThe government is cracking down on hospitals with the highest rates of infection and complications by docking Medicare payments. Those hospitals with the worst rates of infections and complications are going to lose 1% of each Medicare payment for one year starting this fall. Federal officials have released a preliminary analysis that identifies 761 hospitals that may be assessed based on poor performance. The estimated sanctions total $330 million over the year, although there may be some changes to assessments before the end of the year. Infections at hospitals are on a decline, but they are still extremely common.

The penalties will hit some types of hospitals especially hard. Penalties are more likely to be imposed on hospitals that are publicly owned or that treat substantial numbers of low-income patients. Major teaching hospitals will likely also be affected.

In calculating a hospital’s infection rates, the government will consider the hospital’s size, location, and affiliation with any medical school. One of the factors that contribute to a high scores were high rate of urinary and bloodstream infections among Medicare patients being treated in intensive care. Another factor is a high rate of surgery-related complications. Certain type of hospitals, such as rehabilitation clinics, children’s hospitals, psychiatric facilities, cancer centers, and critical-access hospitals are exempt from the penalties, as are hospitals with too few patients to be properly evaluated.
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passenger-traffic-122999_640.jpgHemodialysis is like taking off in a commercial airliner-over and over again, twice a week, every week, for years on end. Because when you’re on dialysis you have to have blind faith in the process. The patient is the passenger, and someone else is flying the plane.

Fresenius Medical Care, a powerful corporation based in Germany that specializes in kidney dialysis supplies, is the maker of dialysis additives GranuFlo and NaturaLyte, and the largest operator of hemodialysis clinics in the U.S. Last year, the FDA issued an alert and recall related to GranuFlo, a potentially dangerous acid concentrate product.

The product has been administered to some kidney patients in connection with hemodialysis, a procedure that cleans or filters toxins from the blood when a kidney patient’s kidney is too diseased or impaired to do the same task.
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Istock.com, Mikhail Mishchenko.jpgWhat’s the difference between a “heart attack” and sudden “cardiac arrest”? Did you know that your heart runs on electricity? And why does that fact matter anyway, to someone whose loved one died while receiving GranuFlo, or shortly thereafter?

Cardiac arrest is a stoppage of the pumping action of the heart. In a sense, everyone dies from cardiac arrest. However, not everyone has a cardiac arrest from a “heart attack” caused by the blockage of a blood vessel to the heart. Other causes of cardiac arrest may include intense physical activity, major blood loss, severe lack of oxygen and electrical changes in the heart from electrolyte imbalances.

Yes, everyone’s heart runs on electricity. The tiny electric charge that makes the heart beat–each and every beat–is from electricity from “electrolytes” the chemicals Potassium, Sodium, Magnesium and Calcium circulating in the blood in all of us. These chemicals are “The Big Four”. If they are not in the blood in the right balance, the electrical impulse that triggers each beat of the heart can go haywire and then stop. Cardiac arrest.

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0.jpegMaine may seem like an out of the way place to vacationers who visit our rugged coastline, hike Mount Katahdin or kayak across a quiet lake in the Maine woods. But according to the Centers for Disease Control and Prevention, Maine’s 12.3 per 100,000 drug overdose rate is higher than that of Massachusetts (11.8), Connecticut (10.8), New Jersey (8) and Washington DC 9.4). (http://www.cdc.gov/HomeandRecreationalSafety/rxbrief/states.html) “Pill mills” contribute to Maine’s drug overdose rate.

A “pill mill” is a clinic, pain – management center or other facility used as a front for dispensing pain pills inappropriately or without a sound medical reason. The pill mill is not like your typical doctor’s office or drugstore chain pharmacy. Unlike a legitimate doctor’s office or pharmacy, many pill mills treat pain with pills only, provide pills without performing a physical exam or asking to see prior medical records, accept cash only and allow patients to select their own medication. As a result of the increased number of pill mills, many Americans have easy access to prescription pain killers for non-medical use resulting in addiction, emergency room treatment, loss of productivity and death.

There are many reasons why a Mainer would start down the path to using prescription pain killers, sedatives and stimulants without a prescription. Chronic pain that is not relieved by non-prescription pain killers in combination with limited access to an appropriate pain management system in rural areas is one common scenario. Cognitive or behavioral psychotherapy that could alleviate anxiety and depression may not be available in isolated rural areas. Poor state government oversight of health care providers acting outside the limits of accepted medical practice for prescribing controlled substances exposes unsuspecting Mainers to the risk of addiction and overdose. Insufficient public-school education about the dangers of prescription drugs means that peers share drugs without appreciating a lethal risk.

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Thumbnail image for yellowdot.jpgIn the moments after a serious car crash EMTs face a huge dilemma: Treat you without knowing anything about you, or waste precious time tracking down your medical history.

In the lingo of first responders, the “Golden Hour” is the time period lasting from a few minutes to several hours after a car crash when there is the greatest chance that prompt medical treatment will prevent death. During that time, the life of an unconscious, unresponsive or confused crash victim hangs in the balance. Now there is an easy and effective way to make the best use of the golden hour.

The Yellow Dot Program, which started in southern Maine in October 2012, is part of a nationwide push to help first responders get critical medical history information about crash victims on the scene. A bright yellow sticker (the Yellow Dot) placed on the rear window of a car alerts EMTs to look in the glove compartment for a yellow plastic sleeve that has a picture, identify, emergency contacts, life-saving medications, such as insulin or coumadin, and serious medical conditions an EMT would need to know to avoid making a bad situation worse.

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995871_chemicals sxchu username pottasche.jpgFollowing a recent precautionary drug recall, the Maine Board of Pharmacy has requested that Massachusetts-based Ameridose Sterile Admixing Services relinquish its license to do business in the state within 30 days. The Westborough, Massachusetts compounding pharmacy reportedly issued a recall for approximately 2,200 drug products and stopped all manufacturing operations pending both state and federal inspections.

Compounding facilities are specialized pharmacies that normally create custom drug formulations on a case-by-case basis. Such pharmacies typically remove potential allergens, alter drug dosage, or modify the physical format of a drug. The Ameridose drug recall occurred not long after another Massachusetts compounding facility, the New England Compounding Center (NECC), made national news for distributing injectable steroids that were allegedly tainted with fungal meningitis. At least 29 people died and hundreds more were reportedly sickened by the contaminated drugs. In that case, all products manufactured at NECC’s Framingham facility since May 2012 were recalled. Additionally, NECC’s license to operate was suspended in Maine and revoked in Massachusetts as a result of the rare disease outbreak. Both NECC and Ameridose are reportedly owned by the same individuals.

According to Ameridose, none of the drugs manufactured by the company have tested positive for contamination and the recall was issued out of extreme caution. The company also claims no adverse events were reported by patients who used Ameridose products. The recall reportedly occurred after the nation’s Food and Drug Administration expressed concerns regarding drug sterility measures undertaken at Ameridose’s Westborough facility.

Although it is unclear how much of the drug market in Maine is supplied by Ameridose, the company is allegedly a major supplier of injectable medications throughout the nation. According to Barbara Crowley, Executive Vice-President at MaineGeneral Health, organization hospitals in both Augusta and Waterville have removed all Ameridose products from use. Although the company is reportedly not a major supplier for MaineGeneral Health, alternative medications may be used by hospital physicians in order to compensate for those drugs that are no longer available. Likewise, a spokesperson for Bangor’s Eastern Maine Medical Center, Jill McDonald, stated all Ameridose products were removed from the hospital’s shelves. According to McDonald, the hospital will now begin performing all drug compounding in-house.

Each year, nearly 800,000 people suffer illness or other adverse effects after taking prescription medications. Problems may be caused by patient or caregiver error, allergic reactions, and healthcare provider, pharmacist, or manufacturer negligence. If you or a family member was hurt by a prescription medication, you should contact a competent Maine personal injury attorney.
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818437_injection_1 sxchu.jpgAccording to the nation’s Food and Drug Administration at least 30 Maine health care facilities reportedly received drug products manufactured at the Massachusetts compounding facility that was linked to a nationwide fungal meningitis outbreak. Originally, only 14 Maine medical facilities were suspected of receiving pharmaceuticals manufactured at the New England Compounding Center (NECC). In response to the deadly fungal meningitis outbreak, NECC issued a recall for all products manufactured by the company including three lots of the injectable steroid suspected of being contaminated with the disease. At this time, none of NECC’s other recalled drug products have been linked to a patient’s illness.

Although federal investigators do not believe any patients were injected with the possibly contaminated steroid solution at a Maine medical facility, 74 Maine residents are reportedly being monitored for possible fungal meningitis infection after receiving spinal injections in neighboring New Hampshire. Additionally, as many as 14,000 patients throughout the nation may have received tainted steroid injections for pain. While the injectable steroid is normally used to treat pain in a variety joints, those at highest risk for contracting the potentially fatal disease include patients who received contaminated spinal injections. At least 24 people have died and more than 300 patients have taken ill as a result of contracting the rare disease.

Meningitis causes the membrane that surrounds a victim’s brain and spinal column to become inflamed. Common symptoms include an intense headache, stiff neck, fever, and light sensitivity. Unfortunately, symptoms of fungal meningitis can take more than one month to appear. Those who are diagnosed with the disease must reportedly undergo months of treatment with intravenous antifungal drugs. Unlike other types of meningitis, the fungal strain cannot be transferred from person to person.

Compounding facilities are specialized pharmacies that normally create custom drug formulations. They are often used to remove potential allergens, alter dosage, or modify the physical format of a drug. Investigators reportedly believe products manufactured at NECC since May 21st are the most likely to place the public at risk for disease. Medical and other facilities throughout Maine are allegedly contacting all patients who were treated using drug products manufactured at NECC since that time. In addition, patients who may have been treated using an NECC product are being advised to remain on the lookout for symptoms of infection.

Although this particular type of outbreak is quite rare, about 770,000 people suffer illness or other adverse effects from prescription medications every year. Potential problems include allergic reactions, patient or caregiver error, and healthcare provider, pharmacist, or manufacturer negligence. If you or a loved one was sickened by or died after taking a prescription medication in Maine you should contact an experienced personal injury attorney.
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Thumbnail image for Codine1.jpg.pngCodeine is a commonly prescribed medication, of the opiate family, used for pain management in a variety of situations. It is widely used in combination with other drugs such as acetaminophen or ibuprofen, to treat everything from back pain to broken bones and to relieve post-operative discomfort. Codeine is also routinely used in combination with promethazine as a cough suppressant. However, its’ use post-operatively in young patients, has recently been called into question by the Food and Drug Administration after 3 deaths and one near death have been reported in children receiving a tonsillectomy and/or adenoidectomy to treat sleep apnea.

It is estimated by the American Sleep Apnea Association, that approximately 1 to 10% of the childhood population suffers from Obstructive Sleep Apnea Syndrome. This condition causes snoring and breathing difficulties or lapses, due to airway constriction during times of rest. If left untreated, it has also been linked to behavioral issues within young children. Often a tonsillectomy or adenoidectomy; considered to be minor surgeries, are used to treat this condition. Approximately 500,000 tonsillectomies are performed annually within the United States, making it the third most prevalent surgical procedure for children. Until now, codeine was often prescribed to relieve post-operative pain in these circumstances.

Following three deaths of pediatric patients, aged 2-5, the Food and Drug Administration has launched a safety review of the products’ use post-operatively for young children. Currently, it is unclear whether factors such as age, other anesthetics, or medical conditions also contributed to their deaths however; in each of these cases, initial testing indicates that these adverse reactions to codeine can be linked to a genetic condition that causes certain patients to metabolize codeine at a faster rate than their similar peers.

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1296420_81434190.jpgReports from both the federal and state governments show that hospitals may be under-reporting serious adverse events, known in Maine as “sentinel events,” to government agencies, despite statutes in many states requiring such reporting. Maine enacted a statute, which took effect in May 2003, requiring hospitals and other medical facilities to report such events to the state Department of Health and Human Services (DHHS). The statute defines sentinel events as those involving a patient’s unexpected death or permanent incapacitation, serious medication errors, or criminal acts involving or against a patient. DHHS officials have found that the number of sentinel events reported by Maine medical facilities is lower than the expected number based on national surveys.

Maine’s Mandatory Sentinel Event Reporting Statute applies to hospitals, outpatient surgical centers, end-stage renal disease facilities (ESRDs), and treatment centers for patients with mental retardation. The statute requires these facilities to report sentinel events to the DHHS’ Division of Licensing and Regulatory Services within twenty-four hours of the event or face fines. The facility has forty-five days, once the DHHS finishes its review, to identify the cause of the error and develop a plan for remedying any deficiencies and preventing future errors.

The DHHS’ report for calendar year 2011, issued in June 2012, identifies ten types of sentinel events:
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