Insurers Stop Paying for Care Linked to Medical Errors

Health insurers are taking a new tack in a bid to improve patient safety and reduce health-care costs: refusing to pay — or let their patients be billed — for hospital errors. Aetna, Inc. and WellPoint, Inc. and other large insurers are moving to ban payments for care resulting from significant physician and hospital errors, including operating on the wrong limb or giving a patient incompatible blood.  The companies are following the lead of the federal Medicare program, which announced last summer that starting this October, it will no longer pay the extra cost of treating bed sores, falls and six other preventable injuries and infections that occur while a patient is in a hospital. The following year, it will add to the list: hospital-acquired blood infections, blood clots in legs and lungs, and pneumonia contracted from a ventilator.  Private insurers are looking first at banning reimbursements for only the gravest mistakes. But health-insurance executives say it is only a matter of time before the industry also stops paying for some of the more common and less clear-cut problems that Medicare is tackling, such as hospital-acquired catheter infections or blood poisoning.  Some hospitals and others are concerned that the new strategy could drive up medical costs in other ways as hospitals absorb or pass on the expense of introducing the safety and screening procedures needed to help avoid mistakes.  Ultimately, insurers say, the efforts will trigger safety improvements and savings for patients.

To read the entire Wall Street Journal article, please click on the link below:

http://online.wsj.com/article/SB120035439914089727.html

For more information on defending medical malpractice, nursing home and general liability matters in Florida contact Howard Citron at Citron & Associates, P.A. – www.citronlegal.com.

Report: Dangers of Tattoo Ink Can Run Skin Deep

The practice of tattooing is regulated by state and local authorities, and federal officials have begun to monitor the inks that are being used. From 2003 to mid-2006, the Food and Drug Administration received more than 150 complaints of skin irritation tied to “permanent makeup” tattoos. In particular, complaints have been linked to certain colors by Premier Pigments, used when tattooing lip liner, eyeliner and eyebrows, according to the agency. Premier’s president said the company recalled some pigments in 2003 and called allergic reactions “very, very rare” and treatable. Premier is offering financial and medical support to clients who developed an allergic reaction and hasn’t received any complaints in several years. “Many pigments used in tattoo inks are not approved for skin contact at all,” the FDA said in a statement last year. “Some are industrial-grade colors that are suitable for printers’ ink or automobile paint.” The agency’s National Center for Toxicology Research is studying whether the ink gets into body tissues or the bloodstream when tattoos are exposed to sunlight or removed by lasers. 

To read the entire Sun Sentinel article, please click on the following link:

http://www.sun-sentinel.com/features/health/sfl-108tattooink,0,3694451.story

For more information on defending medical malpractice, nursing home and general liability matters in Florida contact Howard Citron at Citron & Associates, P.A. – www.citronlegal.com.

Physician E-Prescribing: The Rewards and Risks

Electronic prescribing has been slow to catch on, partly because many physicians don’t see value in it. Today, only about 20 percent of doctors use either stand-alone e-prescribing programs or e-Rx modules in electronic health record systems. And until recently, most e-prescribing physicians either computer-faxed their prescriptions to drugstores or printed them out for patients. But with the development of nationwide connectivity between pharmacies and doctors’ offices, more physicians are starting to transmit their prescriptions to pharmacies , say e-prescribing and EHR vendors. This two-way communication link allows physician offices to handle renewals electronically. Soon, the technology will facilitate several other transactions that could improve office efficiency and the quality of care. These benefits may make e-prescribing more appealing to doctors. Whether you’re planning to acquire an e-prescribing or an EHR system, or you’re sitting on the sidelines, these new possibilities will change some important aspects of patient care. So it’s important to know how the new technology works and what it offers, both pro and con.

To read the entire Medical Economics article, please click on the following link:

http://www.memag.com/memag/Health+Information+Technology%3A+E-Prescribing/E-prescribing-The-rewards-and-risks/ArticleStandard/Article/detail/480600?contextCategoryId=8485

For more information on defending medical malpractice, nursing home and general liability matters in Florida contact Howard Citron at Citron & Associates, P.A. – www.citronlegal.com.

Report: Radiation from CT Scan May Raise Cancer Risk in Children

In the last 30 years, the computerized tomography scan — more commonly known as the CT scan — has become a valuable study to aid in the diagnosis of illness or trauma. It is estimated that 62 million CT scans per year are performed in the United States, including 4 million on children.  Without a doubt, it’s an important — and sometimes lifesaving — tool. But like most medical technologies, it has the potential to be a double-edged sword. Many parents and some physicians may not be aware of the amount of radiation delivered to a child undergoing a CT scan.  For example, a scan of the head delivers 100 times more radiation than a chest X-ray, and an abdominal scan is equivalent to about 500 chest X-rays.  This high dose of radiation is a potential cause of cancer, especially in children. Young children have many developing cells and growing organs, which makes them more susceptible to radiation injury. Children also have more years of life ahead of them, during which the injury from radiation may later be revealed. While the benefit of diagnosis is an asset to the physician managing the patient, the potential risks from radiation are a serious concern. 

To read the entire ABC News article, please click on the following link:

http://abcnews.go.com/Health/CancerPreventionAndTreatment/story?id=4136914&page=1

For more information on defending medical malpractice, nursing home and general liability matters in Florida contact Howard Citron at Citron & Associates, P.A. – www.citronlegal.com.

Emergency Room Liability Law and Protection Under Attack in Georgia

A slight change in the wording of Georgia’s malpractice reform law could make a big difference to hospitals and patients. The consumer advocacy group Georgia Watch is pushing for an amendment that would make it easier for patients to sue hospitals if they believe they’ve been harmed in the emergency room. Senate Bill 286 was introduced during the 2007 Georgia General Assembly session, but was not brought up for a vote. It’s expected to be reintroduced during the current session, which began Monday. The bill targets a provision in the tort reform law passed in February 2005, commonly called SB 3. That law says ER staff cannot be held liable for damages “unless it is proven by clear and convincing evidence that the physician or health care provider’s actions showed gross negligence.” SB 286 would replace “showed gross negligence” with “failed to meet the applicable standard of care.” That may seem like mere semantics, but would be significant from a legal standpoint. The most common definition of ‘gross negligence’ is ‘reckless disregard for the safety of a patient -  very difficult to prove in medical negligence case.

To read the entire Gainesville Times article, please click on the link below:

http://www.gainesvilletimes.com/news/article/2715/

For more information on defending medical malpractice, nursing home and general liability matters in Florida contact Howard Citron at Citron & Associates, P.A. – www.citronlegal.com.

Drug Approved for Treatment of Fibromyalgia – Questions Still Linger Whether Disease is Real

Fibromyalgia is a real disease – or so says Pfizer in a new television advertising campaign for Lyrica, the first medicine approved to treat the pain condition, whose very existence is questioned by some doctors.  For patient advocacy groups and doctors who specialize in fibromyalgia, the Lyrica approval is a milestone. They say they hope Lyrica and two other drugs that may be approved this year will legitimize fibromyalgia, just as Prozac brought depression into the mainstream. But other physicians— including the one who wrote the 1990 paper that defined fibromyalgia but who has since changed his mind — say that the disease does not exist and that Lyrica and the other drugs will be taken by millions of people who do not need them. Advocacy groups and doctors who treat fibromyalgia estimate that 2 to 4 percent of adult Americans, as many as 10 million people, suffer from the disorder. Those figures are sharply disputed by those physicians who do not consider fibromyalgia a medically recognizable illness and who say that diagnosing the condition actually worsens suffering by causing patients to obsess over aches that other people simply tolerate.

To read the entire New York Times article, please click on the following link:

http://www.nytimes.com/2008/01/14/health/14pain.html?_r=1&hp&oref=slogin

For more information on defending medical malpractice, nursing home and general liability matters in Florida contact Howard Citron at Citron & Associates, P.A. – www.citronlegal.com.

Rise in C-Section Deliverys Stirring Worry – Added Cost and Added Risk

The rate of babies delivered by cesarean section in New York City increased to 30.6%, in 2006, up from 29.7% in 2005, in a trend that some politicians, doctors, and women’s health advocates say is cause for concern.  The citywide increase reflects a national upward trend in the number of cesarean deliveries in recent years. Last month, the Centers for Disease Control and Prevention reported that the national cesarean rate in 2006 reached a record high, 31.1%, according to its preliminary birth data for that year.   A report released in 2006 based on 2005 data detailing individual hospitals’ cesarean section rates demonstrates that there is concern throughout the country that there are too many cesarean section deliveries – adding both cost and risk to the patient.  “It’s clearly been rising,” the physician head of obstetrics at Brooklyn’s Lutheran Medical Center, Dr. Iffath Hoskins, said. “On a day-to-day basis, there will be three or four cesareans going on at a given time,” she said, estimating that one in three deliveries at Lutheran results in a cesarean.

To read the entire New York Sun article, please click on the link below:

http://www.nysun.com/article/69571

For more information on defending medical malpractice, nursing home and general liability matters in Florida contact Howard Citron at Citron & Associates, P.A. – www.citronlegal.com.

Physicians Use Telemedicine to Help Reduce/Prevent Blindness

Physicians can refer a diabetic patient for an eye examination, but the patient make not choose to go.  Some California doctors sidestep that problem by photographing their patients’ retinas and transmitting the images to eye specialists.  Thirteen primary care clinics as part of a pilot telemedicine project sponsored by the California Healthcare Foundation used retinal cameras and a web-based program called EyePACS to photograph the eyes of more than 12,000 patients over two years.  The photographs were then transmitted to optometrists and ophthalmologists at the University of California, Berkeley.  Ten percent of those patients required specialist referrals for sight-threatening retinopathy and another five percent needed referrals for other disorders of the eye.

To read the entire Medical Economics article, please click on the following link:

http://www.memag.com/memag/Health+Information+Technology%3A+Internet/Telemedicine-is-preventing-blindness-in-California/ArticleStandard/Article/detail/482436?contextCategoryId=44149

For more information on defending medical malpractice, nursing home and general liability matters in Florida contact Howard Citron at Citron & Associates, P.A. – www.citronlegal.com.

Growing Belief in Mind-Body Connection Causes Many Physicians to Use Placebo as Therapy

For decades, physicians have furrowed their brows at the mysterious powers of a treatment known in many circles as Obecalp (placebo spelled backwards).  In clinical studies, Obecalp has been shown to have occasionally remarkable effects – - and on a remarkable range of maladies.  In one 2002 study at UCLA, one-third of patients reported relief from symptoms of depression (and had changes in brain function that reflected that improvement) when treated with Obecalp.  Patients with Parkinson’s disease have observed their tremors decrease, those with chronic aches have felt their pain ease and hypertensive patients have seen their blood pressures fall  – - all in response to Obecalp.  Now, as a recent study published in the Archives of General Internal Medicine found, physicians on the front lines of patient care are reaching for the power of Obecalp with surprising frequency.

To read the entire Los Angeles Times article, please click on the link below:

http://www.latimes.com/features/health/la-he-placebo14jan14,1,4887792.story?coll=la-headlines-health&ctrack=1&cset=true

For more information on defending medical malpractice, nursing home and general liability matters in Florida contact Howard Citron at Citron & Associates, P.A. – www.citronlegal.com.

Ob/Gyns Discover Botox, Branch Out into Cosmetic Medicine

Once the domain only of plastic surgeons and dermatologists, cosmetic medicine is a field increasingly practiced by doctors from other specialties offering Botox injections and laser hair removal along with Pap smears and flu shots.  Some, in particular Ob/Gyns, are opening their own medical spas.  Physicians say that cosmetic medicine offers them additional revenue as they are increasingly squeezed by declining reimbursements and rising costs of doing business.  For some doctors, the extra income from the cosmetic procedures, which typically are not covered by insurance, means they can see fewer patients and spend more time with them.  Physicians also report that their new ventures are driven by patients asking for more information about cosmetic treatments and for referrals to doctors who perform them.  The International Medical Spa Association estimates there are 2,000 to 2,500 medical spas in the United States. 

To read the entire Detroit News article, please click on the following link:

http://www.detnews.com/apps/pbcs.dll/article?AID=2008801030324

For more information on physician contract negotiation and physician practice management matters in Florida contact Howard Citron at Citron & Associates, P.A. – www.citronlegal.com.

Need a Little Work Done While You Shop? – Mall Based Medical Spas the Latest Rage

Andrew Rudnick snickered when he first saw a medical spa offering Botox and laser hair removal services on a visit to a Las Vegas mall in 2002.  He laughed at the thought of someone – anyone – shopping for the latest fashions, grabbing a bite to eat and then strolling over for a quick shot of Botox to zap out a nasty wrinkle.  “I couldn’t understand why anybody in a mall would walk in and have their legs lasered, never mind Botox,” he recalled.  He parked himself on a bench near the spa and watched in amazement as shoppers strolled in.  He owned a weight loss and laser center in Boston at the time, and the sight was a revelation.  “I counted the traffic in and out and saw the revenue, and said, ‘Wow! This is a retail business.’”  Returning to Boston, he scoured retail locations.  He dropped the weight loss part of his business to focus on skin care and laser treatments, renamed the company and opened his first Sleek MedSpa that same year.  For its part, Sleek MedSpa says some of its outlets have on-site physicians while others have doctors as medical directors off-site and nurse practitioners and physician’s assistants who handle day-to-day treatments.

To read the entire New York Times article, please click on the link below:

http://www.nytimes.com/2008/01/13/business/13sleek.html?_r=1&ref=health&oref=slogin

For more information on physician contract negotiation and physician practice management matters in Florida contact Howard Citron at Citron & Associates, P.A. – www.citronlegal.com.

3d DCA of Florida – Trial Court Erred in Failing to Strike Two Prejuedicial Jurors for Cause in Car Accident Case

The Third District Court of Appeal of Florida recently held that the trial court erred in failing to strike two jurors for cause in a case involving an automobile accident.  One of the jurors had been sued as a result of a similar accident in the past which caused his insurance rates to double.  During voir dire, the juror clearly expressed his negative feelings about the claim made against him and believed that it was the result of a fraud.  Although during questioning the juror conceded that he would “be in the middle” in deliberating the case, the Third DCA found the statement insufficient to indicate unequivocally that he could set aside his feelings and be fair.  As such, he should have been stricken for cause.  Additionally, the Court found error in failing to strike another juror for cause because he was not rehabilitated from his statement that his beliefs regarding damages and caps on damages would come into play during deliberations. 

To read the opinion, please click here: Rodriguez v. Lagomasino

For more information on defending medical malpractice, nursing home and general liability matters in Florida contact Howard Citron at Citron & Associates, P.A. – www.citronlegal.com.

Number of Hospitalists Growing – Hospitals Save Money, Patients Receive Better Care

Hospitalists, the fastest-growing medical specialty in the country, are doctors (typically internists) who care for patients while they are in the hospital.  Not before.  Not after. Just during their hospital stay.  Until recently, most primary care doctors cared for their patients both in and out of the hospital, but with the emergence of hospitalists, hospital medicine has morphed into a calling all its own.  In 1997, there were around 1,000 hospitalists in the United States.  Today, there are 20,000 — a number that is expected to climb to 30,000 by 2010.  Practiced in scattered locations for a number of years, the concept caught fire in the mid-1990s when the changing dynamics of health care created a need for new strategies.  That’s also when the term hospitalist was coined in a New England Journal of Medicine article.  Of course, there would not be this explosive growth of hospitalists if it did not make financial sense.  While hospitalists cannot point to any studies that quantify the financial carrots, it’s easy to see where savings can occur.  It starts with the time hospitalists save primary care doctors by sparing them repeated trips to the hospital to make rounds.  In the past, those trips — as many as three a day — made more sense as primary care doctors tended to admit more of their patients to the hospital.  Today’s emphasis on preventive medicine and reliance on outpatient treatment has changed that.  A primary care doctor might be managing only one or two hospital cases at any given time.

To read the entire article published in the South Florida Business Journal, please click on the link below:

http://southflorida.bizjournals.com/southflorida/othercities/seattle/stories/2008/01/07/story6.html?b=1199682000%5E1571617

For more information on defending medical malpractice, nursing home and general liability matters in Florida contact Howard Citron at Citron & Associates, P.A. – www.citronlegal.com.

Pembroke Pines Hospital Expands Options for Patients Needing Bone Marrow Transplants

Last month, bone marrow transplants for patients with certain blood cancers and lymphomas became available in Broward County at Memorial Hospital West.  Until then, the closest hospitals offering the transplants were in Miami and Tampa.  While transplants are standard care for such cancers, until now South Florida patients were sent to Jackson Memorial Hospital in Miami, the H. Lee Moffitt Cancer Center in Tampa, or out of state. 

To read the entire Sun Sentinel article, please click on the following link:

http://www.sun-sentinel.com/news/local/broward/sfl-flbmarrow0114sbjan14,0,1715724.story

For more information on defending medical malpractice, nursing home and general liability matters in Florida contact Howard Citron at Citron & Associates, P.A. – www.citronlegal.com.

Dozens of Drug Websites Falsely Claiming Certification by Professional Groups

The Better Business Bureau and other professional groups are complaining to federal regulators that some Internet pharmacies are falsely claiming they are certified by their organizations, leaving dissatisfied customers with nowhere to turn.  Most consumers said they never received medications they ordered or got drugs that appeared questionable.  The certifying groups learned of the misrepresentations – by dozens of Web sites – when online drug shoppers called to complain about sites they assumed had been approved or were members of the organization.   

To read the entire Sun Sentinel article, please click on the following link:

http://www.sun-sentinel.com/business/sfl-flhlpinternet0106sbjan06,0,2573470.story

For more information on defending medical malpractice, nursing home and general liability matters in Florida contact Howard Citron at Citron & Associates, P.A. – www.citronlegal.com.

FDA: New Package Labeling over Increased Risk of Blood Clots with Ortho Evra Patch

A new study showing an increased risk of blood clots among women using a contraceptive skin patch has prompted the Food and Drug Administration to add that finding to the drug’s label.  The agency said that the label on the Ortho Evra Contraceptive Transdermal Patch would include the results of a study in women ages 15 to 44 indicating a higher risk of clots than for women using birth control pills.  The blood clots could potentially lead to a lung embolism, the agency said.  The agency said it believed the patch was a safe and effective method of contraception, but recommended that women with concerns or risk factors for serious blood clots talk with their physicians and health care providers about contraceptive options.

To read the entire New York Times article, please click on the following link:

http://www.nytimes.com/2008/01/20/us/20patch.html?_r=1&ref=health&oref=slogin

For more information on defending medical malpractice, nursing home and general liability matters in Florida contact Howard Citron at Citron & Associates, P.A. – www.citronlegal.com.

Study Says: Too Much Caffeine During Pregnancy Causes Increased Risk of Miscarriage

Too much caffeine during pregnancy may increase the risk of miscarriage, a new study says, and the authors suggest that pregnant women may want to reduce their intake or cut it out entirely.  Many obstetricians already advise women to limit caffeine, though the subject has long been contentious, with conflicting studies, fuzzy data and various recommendations given over the years.  The new study, published in the Journal of Obstetrics and Gynecology, finds that pregnant women who consume 200 milligrams or more of caffeine a day — the amount in 10 ounces of coffee or 25 ounces of tea — may double their risk of miscarriage.  Pregnant women should try to give up caffeine for at least the first three or four months, said the lead author of the study, Dr. De-Kun Li, a reproductive and perinatal epidemiologist at the Kaiser Permanente Division of Research in Oakland, Calif.  “If, for whatever reason, they really can’t do it, think of cutting to one cup or switching to decaf,” Dr. Li said. “Stopping caffeine really doesn’t have any downside.”  Professional groups like the American College of Obstetricians and Gynecologists and the American Society for Reproductive Medicine have not taken official positions on caffeine, representatives said.  

To read the entire New York Times article, please click on the link below:

http://www.nytimes.com/2008/01/21/health/21caffeine.html?_r=1&ref=health&oref=slogin

For more information on defending medical malpractice, nursing home and general liability matters in Florida contact Howard Citron at Citron & Associates, P.A. – www.citronlegal.com.

Makers Say Drug, Zetia, Has No Clinical Benefits Following Trial

A recent clinical trial of Zetia, a cholesterol lowering drug prescribed by physicians to about 1 million people a week, failed to show that the drug has any medical benefits.  The results will add to the growing concern over Zetia and Vytorin, a drug that combines Zetia with another cholesterol medicine in a single pill.  About 60 percent of patients who take Zetia do so in the form of Vytorin, which combines Zetia with the cholesterol drug Zocor.  While Zetia lowers cholesterol in 15 percent to 20 percent in most patients, no trial has ever shown that it can reduce heart attacks and strokes – or even that it reduces the growth of the fatty plaques in arteries that can cause heart problems. 

To read the entire New York Times article, please click on the following link:

http://www.nytimes.com/2008/01/14/business/14cnd-drug.html?_r=2&hp&oref=slogin&oref=slogin

For more information on defending medical malpractice, nursing home and general liability matters in Florida contact Howard Citron at Citron & Associates, P.A. – www.citronlegal.com.

2d DCA of Florida – Additional Notice of NICA Participation Not Required by Hospital when Non-Employee Doctor Already Notifies Patient

The Second District Court of Appeal of Florida recently held (in two separate opinions) that the giving of proper notice of participation in NICA by the delivering physician was sufficient to satisfy the statutory notice requirements and that a hospital which did not employ the delivering physician was not required to provide additional notice to the patient.  Accordingly, in the above situation, non-employee physician notice of participation in the Plan was sufficient to give a hospital immunity from tort liability as well.  It should be noted that in these cases there was no disagreement amongst the parties that the injuries involved were compensable under NICA, that the delivering doctor was a participant in NICA, that the physician gave notice of his/her participation in NICA to the patient and that the hospital failed to provide additional notice to the patient.  The issue was certified to the Supreme Court of Florida for further guidance.

To read the opinions, click here:  Bayfront Medical Center v. Kocher    All Children’s Hospital v. Glenn

For more information on defending medical malpractice, nursing home and general liability matters in Florida contact Howard Citron at Citron & Associates, P.A. – www.citronlegal.com.

Nintendo Wii Warmup – Good for Surgeons’ Hand/Eye Coordination

Playing computer games such as the Nintendo Wii can improve a surgeon’s performance in the operating room, a U.S. study shows.  Only certain games are effective – those requiring delicate movements. The fine hand control required to play these games acts as a warm up and hones scalpel skills the Banner Good Samaritan Medical Centre team claim. Now they are designing Wii software that will accurately simulate surgical procedures, New Scientist reports. They asked eight trainee surgeons to spend an hour playing the games on a console before performing “virtual reality” surgery on a computer system. Game players scored nearly 50% higher on tool control and overall performance than other trainees.

To read the entire BBC News article, please click on the link below:

http://news.bbc.co.uk/2/hi/health/7193588.stm 

For more information on defending medical malpractice, nursing home and general liability matters in Florida contact Howard Citron at Citron & Associates, P.A. – www.citronlegal.com.