Archive for the ‘Medical Malpractice’ Category

Deceptive Marketing of Statins, Cholesterol Drugs

Thursday, August 26th, 2010

Our Chicago medical malpractice attorneys are, unfortunately, not shocked to learn that yet another class of drugs has been over-marketed and over-prescribed, to the financial benefit of the pharmaceutical companies and the harm of patients and the general public. This time it is statins that we have learned have been unnecessarily prescribed to millions of patients, causing untold harm. This overuse, and the marketing that led to it, trigger viable medical malpractice and products liability claims.

These drugs are marketed under a wide variety of brand names, the most commonly known of which include Lipitor, Crestor, Zocor, Pravachol, and Mevacor. They work by lowering a patient’s LDL, the so-called “bad cholesterol.” Statins can reduce fatty deposits in a patient’s blood, and may also reduce inflammation, which leads to plaque deposits breaking away from the walls of blood vessels, causing blocked arteries: heart attack or stroke. The problem, however, is that no one – not even our nations top research physicians – really understands the relationship between bad cholesterol, inflammation, and heart disease.

Statins arrived on the U.S. scene in 1997. They are now the world’s most prescribed medications. In the United States alone, about 24 million – that’s right, million – people take these drugs. At one time, these drugs were earning manufacturers over $26 billion dollars a year. That figure has dropped slightly, as statins are now available in generic form. The availability of generics, however, and the corresponding availability of cheaper versions of these medicines, has only increased the number of people using them. In 2009, the number of statin prescriptions filled in the U.S. was double that of prescriptions filled in 2001.

This class of medications was originally approved by the Food and Drug Administration for “secondary prevention,” or use in patients who had already suffered a heart attack or stroke – used to prevent recurring attacks.

But the rampant increase in use has been driven by “primary prevention,” the notion that statins should be used in patients who are otherwise healthy, but have high levels of LDL cholesterol. These primary prevention patients make up the majority of those on statins today – and it is these patients who are being placed at an unnecessary risk at risk, and may have valid medical malpractice or product liability claims in the future.

The latest round of the debate over statins appeared in late June in the Archives of Internal Medicine. The Journal published three studies, each looking at whether statins are all that they are cracked up to be. The first found that statins do not lower death rates among primary prevention patients. The second cast doubt on a key study used to justify primary prevention prescriptions. The third looked at the many conflicts of interest – ethical, clinical, and financial – that were present in that same study. Indeed, the principal researcher in that influential study (the JUPITER trial) had millions of dollars in royalties on the line. Our Chicago products liability attorneys believe that it will not be long before one – or many – class action suits are filed against the doctors and companies who conducted the JUPITER trial.

Conflicts of interest are simply at the heart of the booming popularity of statins. Indeed, primary prevention use skyrocketed after 2001, the year in which the National Heart, Blood and Lung Institute adopted guidelines calling for primary prevention prescriptions for as many as 36 million Americans with elevated cholesterol. But the National Institutes of Health has now acknowledged that of the nine physicians involved in crafting these guidelines, eight had “substantial financial ties” to drug companies that manufacture statins.

This over-prescription is not simply an academic matter: the side effects of statins, which untold numbers of Americans have suffered unnecessarily, are many and varied. At the tolerable end, the most common side effect of statins is simply muscle aches. Although this side effect is mild, somewhere between 5% and 20% of statin patient experience this effect. Some patient also experience headache, nausea, sleep disturbances, weakness, joint pain, memory loss, and diarrhea. Other side effects are not so manageable: tendon problems, depression, sexual dysfunction, peripheral neuropathy, and cataracts.

Then there are the larger problems: pancreatitis, osteoporosis, hemorrhagic stroke, even interstitial lung disease. Additionally, statins can cause muscles to actually break down, releasing a substance that damages the kidneys. They can also increase a patients liver enzymes. This particular effect is so common and serious that all statin patients are advised to have liver function tests after starting the medication and every year thereafter. Shockingly, if the increase in liver enzymes is present but low, the patient is often advised to remain on the medicine. But this increase can lead to permanent, irreversible liver damage. Frighteningly, Dr. James M. Wright of the University of British Columbia in Vancouver, sums up our understanding of the effects of statins with this statement: “I don’t think we know all the harms yet.”

In the face of the statin craze, true experts continue to remind us that the best way to prevent heart disease, heart attack, and stroke is to exercise, refrain from smoking and excessive drinking, and eat a healthy “Mediterranean” diet. Perhaps the problem was best summarized by Dr. John Abramson of Harvard Medical School, a vocal critic of the over-prescription of statins. “There’s a conspiracy of false hope. The public wants an easy way to prevent heart disease, doctors want to reduce their patients’ risk of heart disease and drug companies want to maximize the number of people taking their pills to boost their sales and profits.” Indeed, the drug companies have sought every avenue to increase the use of statins, testing their effectiveness (with negative results) on everything from Alzheimer’s and rheumatoid arthritis to prostate and breast cancer, from kidney disease to macular degeneration and even diabetic neuropathy

It is important to note that these new studies do not call into question the effectiveness of statins for those who have already had a heart attack. For those patients, statins are a proven and effective weapon for fighting off additional attacks.

For a free consultation with an experienced Chicago medical malpractice lawyer at Passen Law Group, call us at (312) 527-4500.

Dangers of Electronic Medical Records: Need for Regulation

Monday, August 16th, 2010

electronic medical records 300x214 Dangers of Electronic Medical Records: Need for RegulationMany have expressed satisfaction at the recent trend towards electronic medical recordkeeping.  At Passen Law Group, our Chicago medical malpractice attorneys still have some reservations, however, about these new systems.

The possible privacy issues with electronic health records have received considerable press.  But the security of electronic health records is not the only potential issue.  There are also the problems inherent in all computer systems:  software defects and user errors.

Software bugs are the only of these concerns unique to electronic recordkeeping.  As any computer user knows, almost all computer programs, especially new ones, have flaws.  If these flaws cause problems, such as improper medication or dosage, etc., the results for any one patient could be catastrophic, even fatal.

The complete lack of oversight for such programs can only exacerbate the problem.  Our Chicago personal injury lawyers understand that not only is there no set of standards or requirements for electronic health records programs, but there are no obligations imposed upon the manufacturers vis a vis the purchasers and patients.  At present, no federal regulation requires the disclosure of software problems or issues to purchasers.  Indeed, some vendor contracts actually prohibit such disclosures.

This is why a recent article, published in the Berkeley Technology Law Journal, calls for federal regulation of electronic health records.  The article was written by two professors from Case Western Reserve University who have, in the past, called for federal oversight and regulation of systems used to maintain electronic health records.  These professors note that until a set of requirements is imposed, patients are at risk.  Our Chicago medical malpractice lawyers agree.

In addition, electronic health records systems are highly susceptible to problems also present in more conventional recordkeeping.  For example, any recordkeeping system can experience dangerous errors if it is overly complicated.  But electronic recordkeeping is particularly prone to this problem because electronic systems are generally more complicated to access and manage than paper-based systems.  These complicated systems can then lead to errors and omissions, which in turn can lead to dangerous misdiagnoses or treatments:  in short, medical malpractice.

Likewise, electronic health records systems can be problematic if any one of the many users is not given adequate system training.  Unlike paper-based recordkeeping, which is generally largely straightforward, electronic recordkeeping can be rather complicated.  But every user who will have responsibility for inputting patient data must be fully and completely trained in the new system, or the patients may suffer the consequences.  Again, this problem may be present in traditional recordkeeping, but is more pronounced in the new electronic systems because of their inherent complexity.

The lawyers at Passen Law Group join with others in urging the federal government to take control of electronic health records.  Although the use of such recordkeeping provides many benefits, including patient convenience and easier sharing of critical data between healthcare providers, there are also many dangers.  Appropriate regulation must be put in place to protect patients.

For a free consultation with an experienced Chicago personal injury lawyer at Passen Law Group, call us at (312) 527-4500.

Hospital Bloodstream Infections Caused by Negligence

Monday, August 2nd, 2010

Every year in the United States, an astounding 80,000 patients in American hospitals develop bloodstream infections related to the use of catheters. Catheter-related bloodstream infections, or CRBIs, are related to the small medical tubes which are inserted for a variety of reasons, including to administer medication and nutrition, and to monitor a patient’s blood flow. Depending on many things, including the condition and overall health of the patient, these infections can be anywhere from simple-to-treat to life-threatening. Indeed, of the 80,000 patients infected annually, 30,000 die from the infection. Our Chicago medical malpractice lawyers find these figures completely unacceptable, especially in light of the new evidence that almost all such deaths can be prevented.

CRBIs often occur when a catheter is left in too long, or is improperly prepared in the first place. Now, a new study has shown that almost all CRBIs are caused by the negligence of hospitals and staff. Indeed, CRBIs would be virtually wiped out if hospital workers would only follow a startlingly simple set of five basic rules: (1) Wash their hands with soap prior to inserting or treating the catheter; (2) clean the patient’s skin with an effective antiseptic prior to inserting the catheter; (3) put sterile drapes over the entire patient before inserting the catheter; (4) wear a sterile mask, hat, gown and gloves; and (5) after insertion, put a sterile dressing over the catheter site.

The study, part of a federally-funded program, looked at the effects of these measures in the intensive-care units of Michigan hospitals. When these simple measures were put in place, the rate of CRBIs dropped by two-thirds. It is estimated that in the 18-months of the study, these measures saved 1,500 lives and an astounding $200 million.

There requirements are hardly complicated. Indeed, many of them, such as the simple expedient of handwashing, are no more than common sense. Our Chicago medical malpractice attorneys are surely not the only ones to note that the failure to follow such simple and common-sense measures is almost certainly actionable negligence. And the same study shows that CRBIs, and the fatalities from them, can also be greatly reduced by evaluating, on a daily basis, whether the benefits of the catheter justify an additional day of risk, and using electronic monitoring to quickly identify CRBIs and aggressively treat them.

Not only is it no more than humane to adopt these measures, should hospitals need more persuasion they should note that it is also cost-effective. Peter Pronovost, a professor at Johns Hopkins University School of Medicine who helped to oversee the study, estimates that implementing the safety program described above costs around $3,000 per infection. Treating these infections, however, costs the hospital between $30,000 and $36,000. Thus, he estimates that most hospitals could save around $1 million per year.

So, why hasn’t this occurred? The Association for Professionals in Infection Control and Epidemiology just released a survey which may contain the answer, and it does not reflect well on the leadership of American hospitals. It appears that ignorance and neglect, in short, medical malpractice, are all that has prevented these simple measures from saving money and lives.

The survey received 2,075 responses, largely from hospital infection-control nurses. The responses identified a number of obstacles to the implementation of infection-prevention measures. A startling seven out of ten respondents said that they were simply not given adequate time for training, so hospital workers were unaware of the infection-control procedures. Almost one-third of the respondents said that enforcing the procedures, not educating workers about them, was the biggest challenge. And twenty percent of respondents said that their hospitals’ administrators (in what is surely a short-sighted position) are unwilling to spend the necessary funds.

Hospital administrators must be awakened to the folly of their inaction. If the simple facts have not done it, the time has come for harsher forms of persuasion. Especially in light of the new evidence that virtually all such infections are the result of negligence, the victims of CRBIs, and their families, must take legal action against the hospitals and staff whose negligence has caused their suffering. Perhaps jury verdicts and punitive damages will persuade these hospitals to protect their patients. If you or a loved one has been the victim of a CRBI, we urge you to talk to a top medical malpractice attorney about whether you might have a claim. Your action might not only bring you justice, but save lives.

For a free consultation with an experienced Chicago personal injury lawyer at Passen Law Group, call us at (312) 527-4500.