CBS News' "60 Minutes" recently ran an excellent piece exposing the corruption and greed of some in the drug industry.  Trasylol (aprotinin injection) is used to stop bleeding during heart bypass surgery.  It was approved by the Food & Drug Administration in 1993. 

     A January 2006 New England Journal of Medicine article linked the use of Trasylol (aprotinin) to kidney damage, heart attacks and strokes. In addition, the same researchers completed a February 2007 study published in the Journal of the American Medical Association, which found patients on Trasylol were at greater risk of dying over the next five years than those given two other medications.

    In an interview for the "60 Minutes" story, Dr. Dennis Mangano said the FDA should have pulled Trasylol following his NEJM study. "Between my study and November 5, when it was taken off the market, there were approximately 431,000 patients who received the drug. As I calculated, 22,000 lives could have been saved. It's about a 1,000 lives saved per month delay in taking that drug off the market," he said in the interview.

   The most disturbing part of this is that not until November 2007 did Bayer Pharmaceuticals Corp., the manufacturer of Trasylol, agree to a marketing suspension. The marketing suspension came two weeks after a major Canadian drug trial was terminated because of an increase in deaths for cardiac surgery patients using Trasylol.

    The "60 Minutes" story also pointed out there are several other less expensive and safer alternative medications. 

        

The New York Times reports on the largest meat recall in history.  Here is an excerpt from the story:

A California meatpacker accused of animal cruelty is making the largest U.S. meat recall on record -- 143 million lbs, the U.S. Agriculture Department said on Sunday.

Most of the meat, raw and frozen beef products, probably has already been consumed, said USDA officials at a briefing. Some 37 million lbs were bought for school lunches and other federal nutrition programs. USDA said there was only a minor risk of illness from eating the beef.  Hallmark/Westland Meat Packing Co voluntarily recalled all of its beef produced since February 1, 2006. USDA said Hallmark violated rules against the slaughter of "downer cattle" -- that is, animals too ill to walk.

"This is the largest beef recall in the history of the United States, unfortunately," said Agriculture Undersecretary Richard Raymond.  Based in Chino, California, Hallmark/Westland has been closed since early February. Company officials were not immediately available for comment.

The Humane Society of the United States showed videotapes on January 30 showing workers at the plant using several abusive techniques to make animals stand up and pass a pre-slaughter inspection. These included ramming cattle with forklift blades and using a hose to simulate the feeling of drowning.

    According to USDA reports, the meat-packing company has processed “non-ambulatory cattle,” creating a risk of contaminating meat products with bovine spongiform encephalopathy (BSE), which affects nervous tissue.  It is also known as mad cow disease. 

    The USDA said that there is a “negligible” risk of contracting BSE from eating any of the recalled beef.  Let's hope they are right because even one victim is one too many. 

    There is also an increased risk of E. coli O157:H7.  "Downer" cows have approximately three times more E. coli o157:H7 than other cows. 

A UTAH CONNECTION:

    The Salt Lake Tribune today confirmed that some of the recalled beef was distributed to school lunch programs in Utah and consumed by Utah school children.  Utah schools have put a hold on ground beef from the Westland/Hallmark Meat Packing Company.   Luann Shipley of the Utah State Office of Education said all 29 school districts in the state had been notified of the hold. See the full story here:   origin.sltrib.com/ci_8295732 

    Again, health officials are saying the risk to human health is low.  For some reason, I don't feel completely reassured. 

        

    The Centers for Medicare and Medicaid Services (CMS) on Tuesday added more names to its list of under performing nursing homes, known as "special focus facilities."   One of them is in Ogden, Utah.  This questionable distinction belongs to the Mount Ogden Health and Rehabilitation Center.  It will now be inspected by state officials twice as often as those not on the list.  By releasing the list, the CMS hopes to get nursing homes to do the job right or get out of the business. 

    Kerry Weems, acting administrator of CMS, briefed the media stating that all the SFF facilities are "chronic under performers" that "have caused actual harm to residents at some point."

    Of course, just because a nursing home is not on the list doesn't mean it is safe.  I recently represented a family in a claim against another nursing home in Utah where an elderly man with Alzheimer's disease was allowed to wander unattended.  He fell out of a second story window to his death, only to be found hours later.  The necessary safeguards were obviously not followed. 

    As a Utah attorney, I have also seen cases involving decubitus ulcers (bedsores), falls, medication errors, and other abusive and negligent behavior in Utah nursing homes.  Our elderly loved ones deserve better.  Reporting substandard care facilities is clearly a step in the right direction, but my experience shows there continues to be room for improvement. 
 
Here is more from an article in the Deseret News:

"Being the sole Utah nursing home on the list doesn't mean it is or isn't the worst in the state, said Greg Bateman, long-term-care survey manager for the Utah Department of Health. CMS gave Utah a list of 15 facilities based on an undisclosed formula and asked it to pick one for consideration as an SFF program facility.

"Even though its most recent recertification survey was not very adverse, its history in the past three years included two surveys which cited 'immediate jeopardy,"' Bateman said -- including "one that showed actual harm to residents."

In its last full survey last May, Mount Ogden, 375 E. 5350 South in Ogden, was cited with several lower-level deficiencies "posing a potential for harm." Those all were corrected, he said. No facility "can go beyond six months in noncompliance" without being decertified.

Mount Ogden administrator Sam Hickcox said the serious deficiencies contributing to its poor three-year survey average occurred in 2005 and were one of the reasons Ensign Group, which owns and operates 64 facilities, bought it in July 2006. The company buys facilities "that are underperforming clinically and turns them around. That is our business. We feel like we're in the business of improving our industry," he said.

The new owners have made significant improvements, he said, including new equipment, beds and floors. The nursing home also has new management and upgraded clinical care and communication. Its census has risen from 49 to 61.

Each state is asked to look at certain facilities and suggest for the SFF list, "but that doesn't mean all of them make the list," says CMS regional spokesman Mike Fierberg. In cases where there's immediate jeopardy to a resident, it all goes out the window. Nursing homes are put on immediate termination track and are "toast unless they get this done. Stop what you're doing and fix this issue," he said.

Larry Minnix, president of the American Association of Homes and Services for the Aging and a strong advocate of pointing fingers at facilities that fail to perform well, hopes all the facilities on the list will be able to graduate.

"We're in favor of this effort," he said. Of nursing homes previously identified as poor providers, "a number have gotten better and stayed better for a period of time. There are some that haven't, and I hope CMS will cancel their contracts. We think they should be even more aggressive."

        

 

     This is another tragic, and avoidable, accident.
        
     It is reported that nine people are dead and as many as 20 injured after a charter bus rolled several times on wet and snowy roads in Utah's Four Corners area. The crash happened Sunday, January 6, 2008, on U.S. 163 about 5 miles north of Mexican Hat, Utah.  The Salt Lake Tribune reported the following:

  "Utah Highway Patrol troopers are trying to determine what caused the driver to veer off the rain-slicked State Road 163 about 5 miles north of Mexican Hat about 7:30 p.m. and down a 40-foot embankment. Weather forecasters reported light rain in the area at the t  "It could be speed, it could be fatigue, it could be distractions," said UHP Lt. Todd Peterson, who spent the morning investigating at the crash site. "I couldn't say for sure at this point which one it was."
    The roof of the bus tore apart as it rolled, ejecting almost all of the roughly 50 passengers and killing three people on impact, Peterson said. Four others died while being treated on the scene or transported to hospitals, and one more died while being treated at a hospital in Moab, according to UHP.
    The ninth victim, a woman, died Monday at Saint Mary's Hospital in Grand Junction, Colo., Trooper Cameron Roden told the Associated Press.
    The bus driver survived with minor injuries

   Speed.  Fatigue.  Distractions.  In my view, these are entirely unacceptable actions for a professional common carrier such as Corporate Transportation 'N Tours, an Arrow Stage Lines subsidiary, the owner/operator of the bus at issue. 

     Under Utah law, common carriers, such as Arrow Stage Lines, have a special relationship with their passengers.  This arises because they assume responsibility for another's safety and deprive the other of his or her normal opportunities for self protection.  Because of this, common carriers are held to a heightened standard of care which is  “predicated on the principle that '[p]ersons using ordinary transportation devices, such as elevators and buses, normally expect to be carried safely, securely, and without incident to their destination.” Lamb v. B & B Amusements Corp., 869 P. 926 (Utah 1993).   

    This tragedy did not need to happen.

        

Attend to Injuries

Get medical attention immediately and tell your doctors exactly how the injury occurred. Make sure to describe all symptoms and complaints.

It is best to seek attention quickly, even if you are not sure that you need it. You may be in shock and not notice your own injuries.

Make sure to follow-up with additional concerns and follow the advice of your doctor. 

Be Careful About What You Say

When talking to the police or highway patrol about the accident, it is important to be truthful, but to also keep your comments minimal. Limit yourself to asking if anyone was hurt. You should NOT:

• Apologize
• Admit it was your fault
• Say "I didn't see you" or anything of the kind

Comments like these could be taken as an admission of fault. At this stage, it is often too early to determine fault, and you do not want to risk damaging your case down the road.

Talk to no one about the accident or injuries except the police, your doctor, or lawyer.

Report the Accident

       Call 911 to report the accident. Utah law requires accidents be reported immediately to law enforcement.  See Utah Code Annotated §  41-6a-401.  and 41-6a-401.7.  This is not only required by law, it also creates written evidence of the accident and helps document fault. 

Obtain Information

• Obtain the name, address, insurance information, vehicle license number and driver's license number of everyone involved in the accident.
• Get the names, addresses and telephone numbers of all witnesses.
• Photograph the accident scene, including all vehicles involved (before repairing) and any visible injuries (e.g., cuts, bruises).

Contact an Attorney

     It is important to contact an experienced attorney immediately who specializes in personal injury claims.  Early legal representation can help preserve your claim and ensure the maximum recovery.  If you or a loved one has been injured in a car or truck accident, contact me today, and I would be happy to talk with you for free about how I can help. 

        

    One of my best clients, with a very strong case, recently told me that when she first called, she wasn’t even sure her case was worth pursuing.  In reality, she had a fantastic case.  This became apparent to her only after discussing the matter with me. 

    I review numerous potential Utah medical malpractice claims for each one I take.  Selecting the right cases is essential.  That’s why I’m more than happy to discuss potential cases with anyone for free.  I’m also not afraid to turn down cases that are just not viable.  Ultimately, pursuing a weak case results in frustration for everyone involved.  Of course it’s impossible to tell initially exactly how strong a case is prior to conducting discovery.  Sometimes things will be discovered that weaken or strengthen a particular case.  Nevertheless, careful initial screening is the key to success.  

    So what makes a great medical malpractice case?  In theory it is simple, but it becomes quite difficult in practice.  I look for:

• Strong Liability 

      This means the proposed defendants are legally responsible for your injuries.  A poor medical outcome or injury during a medical procedure, alone, is not enough to make a valid case.  In a medical malpractice claim, the health care providers involved must have “breached the standard of care.”  This is just a legalistic way of saying the doctors, nurses, or other providers failed to use reasonable care in treating you.  In general, the more unreasonable the actions are, the stronger the claim becomes.  The unreasonable care, or lack of care, must also be the cause of your injuries. 

      How do we determine what is reasonable in a medical context?  Generally, in Utah, it requires the use of an expert witness familiar with the type of medicine involved.  Occasionally, the mistake is so obvious even a lay person can tell there was medical malpractice.  In these rare cases, an expert is unnecessary. 

 

• Strong Damages 

      Even with a clear mistake, a medical malpractice case is still not viable unless there are significant damages.  A medical error that results in no harm or only slight temporary pain, is not enough to justify the cost and time involved in pursuing a claim. 

      How much damages are enough?  How bad does the injury need to be?  How many medical bills must be incurred?  These are all issues that must be considered.  Only an experienced medical malpractice attorney can answer these questions. 
 

• Other Factors

      By this I mean other, less defined, items that may improve the value of a case.  This can be things such as how likable the plaintiff is compared to the defendant.  Is there any comparative fault on the part of the plaintiff?  Is the proposed defendant a large corporation or a well-respected local doctor? Who are the insurance companies and defense attorneys involved? 

      THE BOTTOM LINE:
 

      Many factors come in to play in making a valid malpractice claim.  Strong liability and damages are essential as well as numerous other less defined factors.  Do not pre-judge your potential claim.  Only an attorney experienced in handling these types of cases can properly evaluate and advise you regarding a medical malpractice case in Utah. 

     

        

    Children under age 5 have been banned from most Utah public swimming pools in an attempt to stop the spread of cryptosporidium, a parasite that can cause severe diarrhea. 

    So far, the state has confirmed 422 cases of crypto, and, fortunately, no deaths.

    Cryptosporidium is found in soil, food, water or surfaces that have been contaminated with human or animal feces. 

    Cryptosporidium is protected by an outer shell that allows it to survive outside the body for long periods of time and makes it very resistant to chlorine, so regular levels of chlorine in pools will not kill it.  Officials have recommended  pools hyper chlorinate to destroy the parasite. 

    From a legal standpoint, of relevance is when the various pools knew or should have known about this problem?  If it was known, were any warnings given to swimmers and their families?  Is the advice of officials to hyper chlorinate and close the pools to young children being properly heeded? 

The number of cases continues to rise.  Let's hope it goes the other direction with the implementation of these safeguards.     

        

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Moore's latest documentary movie, "Sicko" opened last friday.  I haven't seen it yet, but it should be entertaining.  While Moore's tactics and style may be controversial, the movie promises, at the very least, to continue the national discussion of healthcare.  One such issue the movie highlights  is the World Healthcare Organization's ("WHO") 2000 survey which ranks countries from best to worst in terms of healthcare.  The U.S. ranks only 37th, two slots ahead of Cuba, and lower than Morocco, Oman, and many others.  WHO's criteria for the rankings were: 1) Good health: "making the health status ...<< MORE >>