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Nobel Prize for marketing. “Robotic surgeries are on the rise, fueled by aggressive marketing by doctors, hospitals and Intuitive Surgical Inc. (ISRG), which manufactures the $1.5 million robot.  Advertising on hospital and doctor websites, YouTube videos, billboards, and on radio and television has hyped the advantages of robotic surgeries, often claimed fewer complications without proof, and ignored contradictory studies finding no advantage in some cases.”

“Robot operations haven’t been proven in randomized trials to offer significant health benefits compared to standard, less-invasive surgery and multiple studies show they can cost thousands of dollars more.”

“A 2011 study by doctors at Johns Hopkins School of Medicine also found that 164 hospital robot-surgery websites surveyed “overestimate benefits, largely ignore risks and are strongly influenced by the manufacturer,” according to research in the Journal for Healthcare Quality.”

Excerpted from: Robot Surgery Damaging Patients Rises With Marketing by Robert Langreth, Bloomberg, Oct. 7, 2013

A hero in more ways than one. “What can the healthcare industry learn from “Miracle on the Hudson” pilot  “Sully” Sullenberger?”

“These were some of the intriguing questions explored last week at the inaugural Forum on Emerging Topics in Patient Safety, jointly sponsored by the Johns Hopkins Armstrong Institute for Patient Safety and Quality and the World Health Organization.”

“Sullenberger talked about how the same critical skills of team communications, simulation-based training, and documented procedures that saved many lives that day can and should be applied to the healthcare industry to help improve patient safety.  He indicated that one person’s heroic efforts aren’t enough and that a “team of experts” needs to be replaced by an “expert team.”

“Each of the speakers described safety-related challenges in their own fields, and encouraged discussions as to how they might be applied to the clinical environment, with a focus on:

  • Designing safe and highly reliable systems of care delivery
  • Ways to quickly disseminate and incorporate best practices in the areas of safety and quality
  • Developing performance measures that are meaningful to patients, providers, payers, and regulators”

Excerpted from:  Captain 'Sully' Sullenberger and Johns Hopkins Tackle Patient Safety by Robert J. Szczerba (Contributor) Forbes 10-2-13


Persistent, important public health problem. “About 150 Americans die a year by accidentally taking too much acetaminophen, the active ingredient in Tylenol, federal data from the CDC shows.”

“Acetaminophen has a narrow safety margin: the dose that helps is close to the dose that can cause serious harm, according to the FDA.”

“Over more than 30 years, the FDA has delayed or failed to adopt measures designed to reduce deaths and injuries from acetaminophen. The agency began a comprehensive review to set safety rules for acetaminophen in the 1970s, but still has not finished.”

Excerpted from: Use Only as Directed by Jeff Gerth and T.Christian Miller, ProPublica, Sept 20, 2013

Third-leading cause of death in America.  “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.”

“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.”

Excerpted from: How Many Die From Medical Mistakes in U.S. Hospitals? By Marshall Allen, ProPublica 9-19-13

HB 4: Violence to our system of justice. “Ten years later, patients continue to struggle with high cost, low access health care, corporate wrongdoers are allowed to divert and evade responsibility for their actions, and our most vulnerable are acutely impacted by the negative affect of limits on individual legal rights.”

Excerpted: Ten Years Later - How House Bill 4 Has Harmed Texans, a report by the Texas Watch Foundation, August 2013

One out of 20. “Americans could save billions of dollars in health care costs each year if hospitals did a better job of curbing preventable infections, according to a new study.”

“Research released today by JAMA Internal Medicine found that infections acquired during the course of medical treatment cost $9.8 billion annually. Researchers reviewed published data from 1998 through April 2013 and adjusted the costs for inflation in 2012 dollars.”

“The problem is so common that it has its own acronym: healthcare-associated infections, or HAI.”

Excerpted from: Study: Hospital infections cost $9.8 billion a year, CBS News 9-2-2013


Well, sure – it concerns us too. “Five facilities in Texas with large quantities of the same fertilizer chemical that fueled the deadly plant explosion in West have turned away state fire marshal inspectors since the blast, investigators said Monday.”

“A railway operator that hauls hazardous materials across Texas was also said to have rebuffed a state request to share data since the April explosion at West Fertilizer Co. that killed 15 people and injured 200 others. The company denied that Monday.”

“Regulators and state lawmakers at a hearing about the still-unsolved explosion were intrigued by the lack of cooperation. State Fire Marshal Chris Connealy said "well, sure" when asked whether those facilities refusing to admit inspectors raised concern.”

Excerpted from: Fire marshal: Inspections refused since West blast by Paul J. Webber, Associated Press 8-26-13

If the board had moved faster, my daughter would still be alive. “Dr. Greggory Phillips was a familiar figure when he appeared before the Texas Medical Board in 2011 on charges that he'd wrongly prescribed the painkillers that killed Jennifer Chaney.”

“Over a decade, board members had fined him thousands of dollars, restricted his prescription powers, and placed his medical license on probation with special monitoring of his practice.”

“They also let him keep practicing medicine.”

“Despite years of criticism, the nation's state medical boards continue to allow thousands of physicians to keep practicing medicine after findings of serious misconduct that puts patients at risk, a USA TODAY investigation shows. Many of the doctors have been barred by hospitals or other medical facilities; hundreds have paid millions of dollars to resolve malpractice claims. Yet their medical licenses — and their ability to inflict harm — remain intact.”

Excerpted from: Dangerous doctors allowed to keep practicing, by Peter Eisler and Barbara Hansen, USA TODAY 8-20-13

No talking. “Two young children are forbidden from speaking about Marcellus Shale or fracking for the rest of their lives. The court action stems from a settlement in a high-profile Marcellus Shale lawsuit in western Pennsylvania.”

The two children were 7 and 10 years old at the time the Hallowich family settled a nuisance case against driller Range Resources in August 2011. The parents… had been outspoken critics of fracking, saying the family became sick from the gas drilling activity surrounding their Washington County home.

According to court testimony … the parents were desperate to move and reluctantly agreed to a gag order that not only prevents them from speaking of Marcellus Shale and fracking, but also extends to their children.

But she [the mother] said she didn’t fully understand the lifelong gag order on her children.
Judge Polonsky didn’t have an answer for her. And the family’s attorney… questioned whether the order would be enforceable.

Excerpted from: Lifelong Gag Order Imposed on Two Kids in Fracking Case, by Susan Phillips, StateImpact PA August 1, 2013

Hats off to Sully!  “Capt. Chesley “Sully” Sullenberger in 2009 coolly landed his jet safely on the Hudson River in what was dubbed as the Miracle on the Hudson. He has refashioned himself as an expert on reducing medical errors, which by some estimates kill up to 200,000 people a year — “the equivalent of 20 jetliners crashing per week,” he told POLITICO.”

“If tens of thousands of people died in plane crashes, he says, “There would be a national ground stop. Fleets would be grounded. Airports would close. There would be a presidential commission. The NTSB would investigate. No one would fly until we had solved the problems.”
“But patients die needlessly every day, and it’s barely a blip on the national radar.”

“Sullenberger has become a fixture on the health care circuit, where comparisons to airline accidents and calls for pilot-like safety checklists have become clichés. He crisscrosses the country, pleading with policymakers to embrace practices to reduce medical errors and save lives.”

Excerpted from: ‘Miracle’ pilot on mission against medical errors, by KYLE CHENEY, Politico, August 1, 2013.

JULY 2013

When a ride brings death. “Friday’s death of a roller-coaster rider at Six Flags Over Texas appears to have one of two likely causes: Either some kind of negligence on the part of ride operators caused a Dallas woman to plummet from the Texas Giant, or there was some kind of security restraint malfunction. Either way, the public deserves clear answers about what happened and why.”

“The decision by Six Flags to offer minimal information and to keep its investigation in-house, instead of seeking an independent review, strikes us as self-serving and unlikely to put the public at ease. Neither Texas nor the federal government has agencies charged with amusement park accident investigations.”

Excerpted from: Editorial: Six Flags’ credibility at risk after roller coaster death, Dallas Morning News 7-22-13

Most alarming. “The Texas Medical Board has temporarily suspended the license of a Plano neurosurgeon whose practices have led to "significant risk of harm and resulted in at least two patient deaths" over the past 18 months.”

“The order issued this week against Dr. Christopher Daniel Duntsch, 42, cites numerous mistakes in four surgical cases, from diagnostic breakdowns to failures to recognize and respond to complications. It also said he is unable to practice medicine with "reasonable skill and safety due to impairment from drugs or alcohol."

“Duntsch, who was practicing at University General Hospital Dallas… injured one patient earlier this month after he demonstrated "poor judgment and insufficient knowledge of the regional anatomy'' involving a spinal procedure, the order said.”

Excerpted from: Plano neurosurgeon suspended after patient deaths by MILES MOFFEIT, The Dallas Morning News 6-28-13

Alive and Well and Tipping the Scales.  "For decades, ALEC has been a conduit for the oil, tobacco, and pharmaceutical industries to push legislation that changes the rules to limit accountability when a corporation’s products or actions cause injury or death."

"In just the first six months of 2013, seventy-one ALEC bills that advance these "tort reform" goals have been introduced in thirty states."

“[The bills] are carefully crafted to provide relief and protections for the industries who wrote them," said Joanne Doroshow, Executive Director of the Center for Justice & Democracy.

"By pushing these "tort reform" bills, ALEC is not advocating for "free markets" and "limited government," but instead protecting corporate interests from any form of accountability to consumers or the public."

Excerpted from: Justice Denied: 71 ALEC Bills in 2013 Make It Harder to Hold Corporations Accountable for Causing Injury or Death, by Brenda Fincher, Center for Media & Democracy, July 10, 2013.

ALL TALK, NO ACTION. “West stands as a testament to the consequences when our elected officials allow politics to cloud their judgment on public safety. The victims of this disaster are dealt a double blow when political feuding blocks their ability to recover damages and get the assistance they need. At some point, common sense and simple compassion must come into play.”

“When industry fails to police itself, people die and livelihoods get destroyed. That’s why it’s time to put politics aside and get to work on laws with teeth to minimize the possibility of another West in our lifetimes.”
Excerpted from: Editorial: Expert advice ignored on West, Dallas Morning News 7-1-13

JUNE 2013

Common sense: Fewer distractions on the road will ultimately save lives.  "Texas could be among the worst in the country in having motorists run red lights because of distracted driving, according to a new report.”

“A study released Tuesday by the National Coalition for Safer Roads and FocusDriven estimates that there were 7.3 million red light violations nationwide last year because of distracted driving.”

“And a breakdown of the report’s state-by-state figures shows Texas with the second highest rate last year of intersection violations per licensed driver: one such violation for every 25 drivers.“

“All of the findings point to a clear conclusion: distracted driving increases red-light running and puts lives at risks,” the report’s executive summary says. “Fewer distractions on the road will ultimately save lives.”

Texas is one of nine states that doesn’t completely ban texting while driving, although the state does prohibit the activity for school bus drivers and younger motorists. Efforts during this year’s legislative session to enact a complete ban went nowhere.

Excerpted from: Report - Texas could be among nation’s worst in red light violations caused by distracted driving, by Tom Benning, Dallas Morning News 6-11-13

Don’t say a word.  “Chris and Stephanie Hallowich were sure drilling for natural gas near their Pennsylvania home was to blame for the headaches, burning eyes and sore throats they suffered after the work began”.

“The companies insisted hydraulic fracturing…wasn’t the cause. Nevertheless, in 2011, a year after the family sued, Range Resources Corp (RRC). and two other companies agreed to a $750,000 settlement. In order to collect, the Hallowiches promised not to tell anyone, according to court filings”.

“… In cases from Wyoming to Arkansas, Pennsylvania to Texas, drillers have agreed to cash settlements or property buyouts with people who say hydraulic fracturing, also known as fracking, ruined their water, according to a review by Bloomberg News of hundreds of regulatory and legal filings. In most cases homeowners must agree to keep quiet”.
“The strategy keeps data from regulators, policymakers, the news media and health researchers, and makes it difficult to challenge the industry’s claim that fracking has never tainted anyone’s water”.

Excerpted from: Drillers Silence Fracking Claims With Sealed Settlements, By Jim Efstathiou Jr. and Mark Drajem, June 06, 2013.

MAY 2013

All we can say is, WASH YOUR HANDS! “At North Shore University Hospital…, motion sensors,… go off every time someone enters an intensive care room. The sensor triggers a video camera, which transmits its images halfway around the world to India, where workers are checking to see if doctors and nurses are performing a critical procedure: washing their hands.”“This Big Brother-ish approach is one of a panoply of efforts to promote a basic tenet of infection prevention, hand-washing, or as it is more clinically known in the hospital industry, hand-hygiene.”

“Studies have shown that without encouragement, hospital workers wash their hands as little as 30 percent of the time that they interact with patients.”

Excerpted from: With Money at Risk, Hospitals Push Staff to Wash Hands, By ANEMONA HARTOCOLLIS, The New York Times , May 28, 2013

Dangerous limbo.  “If the West Fertilizer Co. plant had been in Illinois, state regulators there likely would have inspected it annually…”

“Many states simply have more eyes looking at such facilities than Texas, where no state agency regulates any aspect of ammonium nitrate safety, either to protect workers or the general public.”

“Texas is also one of only four states that lacks a statewide fire code and associated rules on storage of the chemical. Those rules are perhaps the strongest protection against unsafe handling of ammonium nitrate, which authorities have long known can blow up catastrophically under certain conditions.”

“Texas doesn’t just lack a statewide fire code: It prohibits smaller counties from adopting fire codes even if they want to. McLennan County is among those without a fire code, and the West Fertilizer plant, which straddles the city and county line, might have fallen into a regulatory limbo as a result.”

Excerpted from: Texas behind the curve on regulating fertilizer plants by Jeremy Schwartz, Austin American-Statesman May 18, 2013

Do as I say – not as I do.  “Almost half of teenagers cop to texting while driving. And those texting teens are more likely to make other risky moves while in the car, too.”

“That includes not wearing seat belts, drinking and driving, and riding with a driver who's been drinking, a just published in the journal Pediatrics finds.”

“The CDC study asked 8,505 students across the country if they had texted while driving during the past 30 days. About 45 percent said yes. Those teens also admitted to more driving while drinking, not wearing seat belts, and riding with drivers who had been drinking than their peers who weren't texting.”

“That may mean there's a big group of risk-taking teenagers whose parents may need to take a different approach to keeping them safe.”

Excerpted from: Teens Who Text And Drive Often Take Other Risks by Nancy Shute, NPR May 13, 2013

Haphazard. “For the first time, the federal government will release the prices that hospitals charge for the 100 most common inpatient procedures. Until now, these charges have been closely held by facilities that see a competitive advantage in shielding their fees from competitors. What the numbers reveal is a health-care system with tremendous, seemingly random variation in the costs of services."

“A Washington Post analysis of the 10 most common medical procedures showed certain patterns by state. Hospitals in six states — California, Florida, Nevada, New Jersey, Pennsylvania and Texas — routinely had higher prices than the rest of the country.”

Excerpted from: One hospital charges $8,000 — another, $38,000 by Sarah Kliff and Dan Keating, Washington Post, May 8, 2013

APRIL 2013

You would think Texas would have learned its lesson from Galveston. “Texas’ environmental agency knew in 2006 that West Fertilizer Co. was handling 2,400 tons a year of potentially explosive ammonium nitrate in a warehouse near schools, houses and a nursing home, documents show.”

“Other agencies that knew about the dangerous stockpile also failed to pose such questions to their peers, records and interviews indicate. The explosion April 17 in the Central Texas town of West killed 14 people, including 10 volunteer firefighters, burned a school and destroyed or damaged buildings over a 35-block area.”

“There are no uniform federal rules for ammonium nitrate storage, and state rules vary. But fire safety experts have long expounded best practices such as structural fire protection, emergency drills, worker training and protective buffer zones between storage facilities and homes and schools.”

Excerpted from: Why didn't 2,400 tons of ammonium nitrate at West plant raise concerns? By RANDY LEE LOFTIS, Dallas Morning News 4-24-13

Why? “A Texas fertilizer plant (West, Texas) that exploded, killing up to 15 people, was required by the state to have sprinklers and other safety mechanisms, but told the U.S. Environmental Protection Agency it did not have such equipment.”

“The measures are required because the plant handles anhydrous ammonia, a flammable substance that can be used as a fertilizer.”

“But in a risk management plan the company filed with the EPA in 2011, officials said it did not have such systems.”

Excerpted from: Feds Told No Sprinklers In Texas Fertilizer Plant by Associated Press, KAKE 4-18-13

Riddled with hazards. “Like almost everything in the Texas, the construction industry in the Lone Star State is big. One in every 13 workers here is employed in the state's $54 billion-per-year construction industry.”

“...Years of illegal immigration have pushed wages down, and accidents and wage fraud are common. Of the nearly 1 million workers laboring in construction here, approximately half are undocumented.”

“…working Texas construction is a good way to die while not making a good living. More construction workers die in Texas than in any other state, the WDP-UT study finds. Within 2010, construction workers in the lightly regulated Lone Star State died at twice the rate as those in California."

“According to the study, 1 in every 5 Texas construction workers will require hospitalization because of injuries on the job. Texas is the only state in the nation without mandatory workers' compensation, meaning hospitals and taxpayers usually end up shouldering the cost when uncove red construction workers are hurt.”

Excerpted from: Construction Booming In Texas, But Many Workers Pay Dearly by Wade Goodwyn, NPR 4-10-13.

Enough is enough.  “Houston will consider an ordinance banning texting while driving if the Legislature again fails to enact a statewide ban, Mayor Annise Parker said…”
“Known as It Can Wait, Houston, the program will use social media, news media and community activism to get the word out, the mayor said.”

“In 2011, she said, 13 percent of more than 3,000 traffic fatalities across Texas could be blamed on texting while driving.”

Excerpted from: Houston considers ban on texting while driving By Carol Christian, Houston Chronicle 4-2-13

MARCH 2013

There's no MD in 'Team.'  “Despite all the work in the last decade to improve patient safety and raise awareness of preventable medical errors, physicians by and large have been slow to support the movement, a leader in patient safety said here.”

"The fact of the matter is a number of physicians are not involved, are a bit skeptical about it, and have really not participated as they should," Lucian Leape, MD, adjunct professor of health policy and management at Harvard University…”

“Recent studies … haven't been able to show a big drop in deaths.”

“One of the reasons why is the lack of doctor support, Leape said, suggesting several explanations for why such support is lacking.”

"Doctors tend to feel they have an individual veto over safe practices," said Leape, who is sometimes called the father of patient safety. "If they don't agree with something, they feel they don't have to follow it."

“In addition, most of the practices to increase patient safety are team-driven and involve nurses. "We don't do teams well," Leape said. "Doctors aren't trained to work in teams."

Excerpted from: Doc Support for Patient Safety Movement Lags, By David Pittman, MedPage Today March 19, 2013

What goes up must come down. Apparently not!  “Hospitals’ fast-rising sticker prices are adding to the financial burdens of the 49 million Americans without insurance…”
“So-called full charges at hospitals grew

an average 10 percent a year between 2000 and 2010, according to Gerard Anderson, a Johns Hopkins University professor who analyzed hospital financial reports. The charges went up at four times the pace of inflation, and faster than hospital costs, which Anderson said increased an average 6 percent a year.”

While the charges appear on hospital invoices across the U.S., the amounts people actually pay vary widely, depending on their health coverage. The system is so irrational that those without any insurance can get stuck owing the most money, said David Himmelstein, a professor at City University School of Public Health at Hunter College in New York.

“It’s unconscionable,” said Himmelstein, who co-authored a 2009 study that found illness and medical debt was a factor in more than 60 percent of personal bankruptcies. “It adds to the already grave suffering of the uninsured.”

Excerpted from: Uninsured Americans Get Hit With Biggest Hospital Bills By Charles R. Babcock, Bloomberg 3-11-13

Exactly.  “The bottom line is that when the law is left to lobbyists and politicians instead of judges and juries, everyday Texans are left holding the bag. So Weekley [Richard Weekley, TLR] and his cronies in the CEO set may be faring better because our state has shielded them from accountability, but the rest of us aren’t.”

Excerpted from: Letter-to-Editor: Texans fare better when there’s accountability by N. Alex Winslow (Texas Watch), Midland Reporter News 3-3-2013

This is going to hurt.  “Think getting into an auto accident is bad? It's about to get worse. Starting March 1, one Texas town will start charging drivers extra to respond to wrecks.”

“Cash-strapped municipalities across the country have started charging victims for responding to accidents and other emergencies. Sometimes a person's insurer will pick up the tab, but a growing number are refusing to -- that means on top of paying for vehicle damages and insurance hikes, motorists are now being slapped with thousands of dollars in additional fines.”

“In Missouri City, Texas, drivers involved in an accident will be charged up to $2,000 even if they don't call for help. According to Fire Chief Russell Sander, insurance companies will be forced to pony up the cash, not victims.”

“Sander… says drivers shouldn't be worried.… he doesn't "think they're going to see much difference in our services or their cost that's out of their pocket."

“But many argue that insurers will push the penalties onto their customers by increasing deductibles, premiums or limiting coverage.”

Excerpted from: Insult to injury? Texas town joins trend of imposing 'crash tax' on accident victims,, Feb 20, 2013

Poop deck. “What was supposed to be a four-day vacation cruise became a nightmare aboard "a floating toilet, a floating Petri dish, a floating hell."

“Maritime law experts say passengers waive most legal rights when they buy cruise tickets. The fine print in ticket contracts basically requires any lawsuits be subjected to arbitration in a federal court in Miami.

“What's more, Carnival's ticket contract… shows that passengers waive their rights to a jury trial and to joining in a class-action lawsuit. That means for most potential plaintiffs, the legal costs would exceed any amount they could reasonably hope to recover.”

“… the cruise industry has opted to insulate itself by requiring that passengers sign away their rights before they get onboard.”

“That leaves little recourse if you find yourself standing in human feces, waiting hours for a ration of spoiled food.”

Excerpted from: Column: Cruise passengers are sunk before they ever sue, by Loren Steffy, Houston Chronicle 2-20-13


Texas is #1 – again. “Texas homeowners are still paying the highest insurance premiums in the nation, although residents of two other Gulf Coast states are paying almost as much, new figures from the National Association of Insurance Commissioners show.”

“Texans pay sky-high premiums for policies that have more holes than a block of Swiss cheese,” said Alex Winslow of Texas Watch, a consumer group active in insurance rate issues. “Prices continue to climb while coverage is getting slashed.”

“Winslow said the Legislature needs to consider a proposal that would require insurers to offer a standard policy so homeowners can do comparison shopping.”

“It would give consumers a benchmark choice to make meaningful comparisons and determine which policy provides the best value for their hard-earned dollars,” he said.”

Excerpted from: Texas homeowners still paying nation’s highest insurance premiums, by Terrence Stutz, Dallas Morning News 12-18-12

Taking it back. “AAJ has launched an online, grassroots campaign called “Take Justice Back.” The campaign hit the ground running with an interactive website that educates Americans about the importance of the civil justice system, motivates the public through real stories of people denied justice, engages consumers through social media, and empowers activism.”

Access the website here.