Featured Link – Healthcare Blue Book

Written On September 2, 2010 By Bob Kraft

The information at HealthcareBlueBook.com might be among the first of many such sites to come. It purports to tell consumers what the average fee should be for various medical procedures. Here is the description from the site:

Blue Book Information

The Healthcare Blue Book is provided free to consumers. The Healthcare Blue Book price represents a fair price to pay for a service or product when the patient is paying cash at the time of treatment. It represents a payment amount that many high-quality providers accept from insurance companies as payment in full, and it is usually less than the stated “billed charges” amount.

Unfortunately, it is difficult for consumers to determine fair pricing for healthcare. Prices are not generally published and the list prices (or billed charges) are higher than providers typically charge most of their patients with insurance. The Healthcare Blue Book is a free resource that shows a fair price for healthcare products and services to consumers.

Consumers with traditional health insurance frequently need to know how much healthcare services will cost. Average deductibles are increasing and can be $1000 or higher. Coinsurance rates, which are the percentage of the bill that the consumer must pay, range from 20 to 40%. Many consumers would prefer to use the doctor of their choice, instead of the one selected as “in-network” by their insurance company, as long as they knew they wouldn’t have to pay higher prices. There are also “non-covered services” that may not be covered by insurance. As health insurance companies shift more of the cost to consumers, consumers need to be able to choose healthcare services at fair prices.

About the Company

The Healthcare Blue Book has a single mission: fair, upfront pricing in healthcare.

In America, there are 47 million people without health insurance and 4.5 million with Health Savings Accounts (HSA). For those with health insurance, their deductibles and co-payments continue to increase each year. The result is that many people are directly paying for a large part of their healthcare. Unfortunately while consumers have to pay for healthcare services, it is difficult for them to find out what healthcare costs and, more importantly, what it should cost.

The Healthcare Blue Book was established to provide consumers with the knowledge they need to get fair prices for their healthcare. We invite all consumers to become members for free and to contribute to our project. We have created a cooperative environment where consumers can help each other find quality care at fair prices. While we work with many employers, providers and healthcare groups, the Healthcare Blue Book is a private and independently owned resource.

Posted in Consumer Information, Featured Link, Medical and Health Resources Comments (0)

Diabetes is Now the Most Commonly-Paid Disability of Vietnam Veterans

Written On September 1, 2010 By Bob Kraft

The Associated Press reports that diabetes is now the most common illness or injury among Vietnam veterans drawing compensation benefits. The reason is a link between Agent Orange and diabetes, even though that link is a bit questionable. In fact, side effects of Agent Orange account for a very large percentage of all disability benefits paid by the Department of Veterans Affairs. The list of illnesses tied to Agent Orange have continued to grow ever since the government finally broke down and admitted that the defoliant was indeed toxic to humans. Here are excerpts from the AP article:

By his own reckoning, a Navy electrician spent just eight hours in Vietnam, during a layover on his flight back to the U.S. in 1966. He bought some cigarettes and snapped a few photos.

The jaunt didn’t make for much of a war story, and there is no record it ever happened. But the man successfully argued that he may have been exposed to Agent Orange during his stopover and that it might have caused his diabetes — even though decades of research into the defoliant have failed to find more than a possibility that it causes the disease.

Because of worries about Agent Orange, about 270,000 Vietnam veterans — more than one-quarter of the 1 million receiving disability checks — are getting compensation for diabetes, according to Department of Veterans Affairs records obtained by The Associated Press through the Freedom of Information Act.

More Vietnam veterans are being compensated for diabetes than for any other malady, including post-traumatic stress disorder, hearing loss or general wounds.

Agent Orange was a dioxin-laden defoliant that was sprayed over jungles to strip the Viet Cong of cover. American forces often got a soaking, too, and Agent Orange was later conclusively linked to several horrific health ailments, including cancers. So Congress and the VA set up a system to automatically award benefits to veterans who needed only to prove that they were in Vietnam at any time during a 13-year period and later got one of the illnesses connected to Agent Orange.

The VA, interpreting that 1991 law and studies that indicated potential associations, has over time added ailments that have no strong scientific link to Agent Orange. The nonprofit Institute of Medicine’s biennial scientific analysis of available research, to which the VA looks for guidance, has repeatedly found only the possibility of a link between Agent Orange and diabetes, and that even a chance of a correlation is outweighed by factors such as family history, physical inactivity and obesity.

Disability benefits are a lot like workers’ compensation, providing income to veterans who incurred ailments from their active-duty service. The benefits can last a lifetime even if the veteran holds a full-time job. They often transfer to surviving family members when a veteran dies of the disability. They are paid in addition to any medical, education and pension coverage that veterans receive.

Many veterans have a combination of ailments that are crunched in a formula to determine their benefits. This makes it difficult to determine how much is being spent solely on diabetes.

Most veterans get a 20 percent disability rating for diabetes, which amounts to about $3,000 per year if it is their only ailment. Others get up to 100 percent. If each of the 270,000 Vietnam veterans got the minimum compensation for their diabetes, it would add up to $850 million every year.

Congress gave the VA the ability to deem ailments “presumptive” — automatically awarded — because of exposure to Agent Orange. The VA did that for five illnesses for which the Institute of Medicine found “sufficient evidence of an association,” such as leukemia, non-Hodgkin’s lymphoma and soft-tissue cancers. Those illnesses have risen dramatically in both Vietnam and the U.S. since the war.

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Hospital Fights Claims of Unnecessary Stents

Written On August 31, 2010 By Bob Kraft

Here’s an interesting story out of Baltimore — a hospital admitted that one of its cardiologists unnecessarily placed stents in hundreds of heart patients. But now that some of those patients have retained lawyers, the hospital seems to be changing its story and may deny any negligence. At first thought you might say, so what if people got stents they didn’t really need. After all, a stent is a simple device designed to keep an artery open. But people who do have stents usually have to take expensive blood-thinning medication, and may run increased risk of clotting in the future.

The situation was described in detail in the Baltimore Sun, and is an eye-opener for anyone who might need to go to a cardiologist. Here are excerpts from the article:

St. Joseph Medical Center has repeatedly said it wants to do right by its coronary stent patients.

After a complaint last year that star cardiologist Mark Midei was placing stents in the arteries of patients who didn’t need them, the Towson hospital removed him from duty, reviewed thousands of medical records and sent letters to nearly 600 people whose stents appeared unnecessary, telling them to go see a doctor. When asked if the hospital bore any legal liability, CEO Jeffrey K. Norman replied: “I suppose we do.”

But now that the lawyers have arrived, bearing the threat of hundreds of lawsuits, some say the message has changed. Even as some St. Joseph employees continue to suggest wrongdoing — including its chief of cardiology, who has told at least two patients that his former colleague falsified their records — the hospital’s attorneys appear to be girding for a fight.

In its legal filings, the hospital said it “generally denies all allegations of liability.” And medical malpractice attorneys preparing cases against St. Joseph say hospital lawyers are gathering experts to argue that Midei did nothing improper, despite the hospital having revoked his practice privileges.

After complaints about Midei were lodged by a patient early last year, reviewers for the hospital looked at X-ray images from the medical files of his stent patients to determine if their arteries had enough blockage — generally at least 70 percent — to justify the procedure. In many cases, they concluded that Midei had recorded significantly more blockage in written records than was revealed in the films, leading officials to send those patients letters.

For some of Midei’s patients, even unnecessary stents might have improved their quality of life, at least for a time, by taking away heart pain caused by blockage that didn’t meet the 70 percent threshold, cardiac specialists say. But those patients also must live with an increased risk of sudden clotting and other complications, the need to take drugs they otherwise wouldn’t, and a general fear that something could go wrong at any point.

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Toyota Recalls Corolla and Matrix Models as NHTSA Investigates Engine Stalls

Written On August 30, 2010 By Bob Kraft

The AP reports, “Toyota recalled 1.33 million Corolla sedans and Matrix hatchbacks in the US and Canada Thursday because their engines may stall,” noting that this is one of the largest Toyota recalls since its safety crisis began last year. Meanwhile, GM “is recalling 200,000 Pontiac Vibes in North America due to the same problem, GM spokesman Alan Adler said. The Vibe is similar to the Matrix and was built under a joint venture between Toyota and GM at a now-closed factory in Fremont, Calif.” The AP adds that NHTSA “has been investigating the possibility of engine stalling in the Corolla and Matrix models since late November.”

Bloomberg News reports that NHTSA has said that the defect “could cause stalling ‘at any speed without warning.’” The recall covers model years 2005 to 2008, and follows “at least three reported accidents linked to the defect. The action adds to record recalls in the past year by Toyota City, Japan-based Toyota, including more than 8 million vehicles worldwide for flaws related to unintended acceleration.” Bloomberg notes that NHTSA “upgraded its investigation of the defect to an engineering analysis,” last week, “a step that can lead the agency to demand a recall. The regulator said cracks in engine control units could occur if improperly cured coating was applied to circuit boards.”

The New York Times notes that this is Toyota’s 15th recall this year, adding that NHTSA opened its investigation into the issue in December. “On Thursday, Toyota attributed the problem to improper manufacturing of the vehicles’ engine control modules, which allowed cracks to develop at certain solder points or in a protective coating on the circuit board. Dealers will replace the control modules, which were made by the Delphi Corporation, a process expected to take about 40 minutes for each vehicle, Toyota said.”

From the American Association for Justice news release.

(In an unrelated note, I read that in Afghanistan, 90% of all automobiles are Toyota Corollas! There is a long explanation having to do with a reluctance to be seen in U.S. or European vehicles, and with the endurance of Corollas. Whatever the reason, that’s an astonishingly high percentage for one model from one manufacturer.)

Posted in Consumer Information, Product Liability or Medical Devices, Vehicle Law or News Comments (0)

Circuit Breaker Model is Defective and Potentially Dangerous

Written On August 27, 2010 By Bob Kraft

Here is a very short summary of a very important article from the Dallas Morning News. If you live in an older home in North Texas you need to check your circuit breaker box to make sure it’s not a Federal Pacific Stab-Lok model. I checked ours, and we’re safe, but if you do have one of these models you are in risk of losing your home to a fire. Read the article for details and go check your breaker box.

The Dallas Morning News reports on “Federal Pacific Stab-Lok, a type of circuit breaker in thousands of North Texas homes that is now widely thought by engineers, electricians and house inspectors to be defective – and dangerous.” Concerns began to surface about the circuit breakers thirty years ago, but “after testing the devices for about two years, the Consumer Product Safety Commission said the government lacked sufficient data to warrant a recall.” More recently, however, “engineers studying them independently have found that the circuit breakers can overload and cause fires.” According to one expert, there may be as many as “20 million homes nationwide” that still use the Stab-Lok circuit breaker. “If your house was built during the ’60s, ’70s or ’80s, it probably has one of these breakers. About 90 percent of houses we see from that time have them,” said one inspector.

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Friday Fun

Written On August 27, 2010 By Bob Kraft

Can you have a play on words without using words? Yes. This is a marvelous “visual poem” from NPR:

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Compatibility of Hospital Tubes Creates Danger for Patients

Written On August 26, 2010 By Bob Kraft

I just wrote yesterday about hospital errors causing injuries and deaths needlessly. Now an article from the New York Times brings up a point that most hospital patients would never even consider — you can die because a nurse or aide hooks up your feeding tube to your medication IV, or vice-versa. The article is important reading for anyone about to enter a hospital or who has a friend or relative in the hospital.

The Times reported that “hundreds of deaths or serious injuries” have occurred due “to tube mix-ups” in hospitals. To prevent this problem, “experts and standards groups have advocated since 1996 that tubes for different functions be made incompatible.” The failure to make the change is due to “resistance from the medical-device industry and an approval process at the Food and Drug Administration that can discourage safety-related changes.” Dr. Kevin McBryde, an FDA reviewer, is among several agency employees who have argued that some of these tubes are unsafe, but was “overruled” by a supervisor. Meanwhile “an international standards group is seeking consensus on specific designs on how tubes for different bodily functions should differ, but the group has been laboring for years and its complete recommendations will take years more.” Here are the opening paragraphs:

Thirty-five weeks pregnant, Robin Rodgers was vomiting and losing weight, so her doctor hospitalized her and ordered that she be fed through a tube until the birth of her daughter.

But in a mistake that stemmed from years of lax federal oversight of medical devices, the hospital mixed up the tubes. Instead of snaking a tube through Ms. Rodgers’s nose and into her stomach, the nurse instead coupled the liquid-food bag to a tube that entered a vein.

Putting such food directly into the bloodstream is like pouring concrete down a drain. Ms. Rodgers was soon in agony.

“When I walked into her hospital room, she said, ‘Mom, I’m so scared,’ ” her mother, Glenda Rodgers, recalled. They soon learned that the baby had died.

“And she said, ‘Oh, Mom, she’s dead.’ And I said, ‘I know, but now we have to take care of you,’ ” the mother recalled. And then Robin Rodgers — 24 years old and already the mother of a 3-year-old boy — died on July 18, 2006, as well. (She lived in a small Kansas town, but because of a legal settlement with the hospital, her mother would not identify it.)

Their deaths were among hundreds of deaths or serious injuries that researchers have traced to tube mix-ups. But no one knows the real toll, because this kind of mistake, like medication errors in general, is rarely reported. A 2006 survey of hospitals found that 16 percent had experienced a feeding tube mix-up.

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Preventable Errors Killed 32 Patients in Oregon Hospitals Last Year

Written On August 25, 2010 By Bob Kraft

This article from OregonLive.com is specific to Oregon, but I have no doubt that it would apply to the entire country, probably in proportion to the number of hospital beds in each state.

Hospitals are trying to improve their safety records, partly because of the work of medical malpractice trial lawyers, partly because of high insurance premiums, and of course partly because they do care about their patients. Still, as more than one doctor has told me privately “a hospital is a dangerous place for a patient.” My personal doctors always recommend outpatient services when possible and hospitalization only when absolutely necessary because too many bad things can happen to a patient while in a hospital. Here are excerpts from this informative article:

At least 32 patients died as a result of preventable errors in Oregon hospitals last year, according to a report released Thursday by the Oregon Patient Safety Commission. The commission, created by the Legislature in 2003, represents a collaborative effort between the state and the health care industry to reduce serious medical errors. Fifty-six of Oregon’s 58 hospitals are participating in the voluntary program.

Hospitals reported 136 incidents in 2009. In 22 percent of cases, patients suffered minimal or no detectable harm. But half of the incidents resulted in serious injury or death. In nine cases, a surgical team operated on the wrong body part or the wrong patient. Surgeons accidentally left objects in patients 21 times – despite the commission setting a target of eliminating this type of error.

Oregon hospitals made progress in three other patient safety targets set by the 17-member commission: establishing electronic medical records, adopting evidence-based safety practices, and promoting a workplace culture of safety. According to the report, 61 percent of Oregon hospitals have developed electronic medical record systems with built-in error checking and decision support, significantly more than the national average of 51 percent.

And 87 percent of Oregon hospitals met targets for giving surgical patients antibiotics on time, up from 75 percent compliance at the beginning of 2008. Oregon’s performance is about equal to the national average on this measure, the report noted.

“There’s lots to point to that says people are taking this serious,” said Jim Dameron, administrator of the patient safety commission. “People are making a good faith effort to improve quality and make care safer for patients.”

Reports of objects accidentally left in surgical patients have declined from a high of 50 in 2007, but the number has persisted at around 40 incidents a year since 2002, leading the commission to conclude that hospitals have not made meaningful progress in reducing such errors. ”There is no indication that it’s going down, which is frustrating,” Dameron said. “Oregon is not unique there. It’s a stubborn problem.”

Another area of stalled progress is notifying affected patients in writing about every serious adverse event. Doing so is a requirement of participating in the patient safety program. Last year, hospitals provided written notification about half of the time, 43 out of 80 cases in which it was required, according to the commission’s report.

“Most hospitals do a pretty good job of oral disclosure, but clearly they don’t do the written notification,” Dameron said. Diane Waldo, a registered nurse and director of quality and clinical services for the Oregon Association of Hospitals and Health Systems, said hospital leaders worry that written notifications could alienate patients.

“They’ve made a big effort to address this and meet with patients and families,” Waldo said. “They believe a letter could be received as cold and wonder, is it helpful at all to the relationship?”

It’s possible that hospital leaders are concerned about exposing their institutions to greater legal liability.

Eight hospitals have shown that compliance is possible. They’ve notified patients of adverse events in writing for every serious harm event since reporting began in 2006, according to the commission.

The reporting system may underestimate the extent of preventable errors. For instance, hospitals reported eight health-care-associated infections to the commission last year — far less than the number identified in the state’s independent infection reporting program. Among intensive care patients alone, that program identified 75 central-line-associated blood stream infections. The patient safety commission asks hospitals to report “serious harm” infections only, which could account for part of the discrepancy. But the commission asserts that hospitals probably underreport serious infections in the patient safety program.

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Texas to Require Insurers to Justify “Unreasonable” Premium Increases

Written On August 24, 2010 By Bob Kraft

Will Texas really start to crack down on insurance company abuses, or is this just more empty talk from the Texas Department of Insurance? An article in the Dallas Morning News this week quotes state officials as saying they will now question “unreasonable” rate hikes from insurance companies. This change is being forced on the state by new federal legislation.

In Texas, carriers can raise their rates by any amount (up to 50%), at any time, without having to get permission from the state. Not surprisingly, this system has led to large, frequent rate increases by some insurance companies. We can hope for change. Here are excerpts from the article:

The Texas Department of Insurance is about to change its longtime policy of allowing uncontested insurance rate increases of up to 50 percent without interference, officials said.

State regulators will require insurance companies to justify “unreasonable” premium rate increases under the new federal health care overhaul, the Austin American-Statesman reported. State officials say they have always had that authority but have used it sparingly, the newspaper reported.

“In the past, we’ve looked at rate increases above 50 percent, and we’ve looked at complaints. That’s mainly what we’ve done as a watchdog,” said Katrina Daniel, senior associate commissioner of the department’s life, health and licensing program.

She said Texas lacks the resources, including staff and data, to perform regular rate reviews and comparisons.

However, under the new federal law, insurance companies will be required to justify to federal and state regulators “unreasonable” rate increases before imposing them. Companies also will have to post that information on their websites.

The federal government has yet to define what it regards as “unreasonable,” Daniel said.

Last week, federal officials distributed $46 million of $250 million in grants to the states. The $1 million Texas received was expected to go toward developing data required for more rate reviews.

“We will be reviewing more rates, for sure,” Daniel said.

Insurance companies have argued that rising health care costs have forced their rates to increase.

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Bill Introduced to Provide One-Time $250 Payment to SS Recipients

Written On August 23, 2010 By Bob Kraft

The Chairman of the House Ways and Means Social Security Subcommittee, Rep. Earl Pomeroy (D-ND), has introduced H.R. 5987, The Seniors Protection Act of 2010, that would provide a one-time $250 payment to retired and disabled Social Security and SSI beneficiaries (and to veterans) if there is no cost-of- living adjustment (COLA) announced for 2011.

Any COLA for 2011 will be determined in October by comparing the change in the Consumer Price Index (CPI-W) from the third quarter of 2009 to the third quarter of 2010. It is likely that there will be no increase. There was a large increase in energy costs in the summer of 2008, which resulted in a 5.8% COLA, paid starting in January 2009. However, prices dropped in the fall of 2008 and have not regained the level of the third quarter in 2008. As a result, there was no COLA for 2010 because there was no increase from the third quarter of 2008 to the third quarter of 2009.

If there is no COLA for payments in 2011, it will be the first time since automatic COLAs began that Social Security and SSI benefi ciaries did not receive a benefit increase for two consecutive years.

Posted in Social Security, Social Security Disability, Veterans Benefits Comments (0)

Friday Fun

Written On August 20, 2010 By Bob Kraft

What are you willing to do for $5.00? Oh, grow up — that’s not what I meant. What legitimate skill or talent would you share for five bucks? Find out what other people will do at Fiverr.com.

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FDA Raises Safety Concerns About Potential Fibromyalgia Drug

Written On August 19, 2010 By Bob Kraft

Wall Street Journal reports that the FDA revealed safety concerns about Jazz Pharmaceuticals Inc.’s potential fibromyalgia drug Rekinla (sodium oxybate), which faces a review on Friday from the FDA’s arthritis and drug-safety advisory committees. The drug is currently approved to treat narcolepsy under the brand name Vyrem, but would be dosed in a different way to treat fibromyalgia. Jazz also is proposing to sell the drug under a different restricted distribution program than currently used for narcolepsy, which would involve 15 specialty pharmacies, but the FDA said that two restricted distribution programs may create confusion among prescribers and be burdensome to the healthcare system. The FDA also said it was concerned about having two different brand names for the drug.

However, the AP reports that the FDA said the drug “effectively treated pain from fibromyalgia in two company-run studies,” though “regulators have concerns about the misuse and abuse of the drug, which has been used as an illegal stimulant and a date rape drug.” FDA reviewers also “cautioned that an approval for fibromyalgia would greatly expand the drug’s patient population, making it harder to control.”


Bloomberg News adds that according to a Jazz-sponsored study published last year in the Journal of Clinical Sleep Medicine, “Ten cases of abuse occurred among the 26,000 narcolepsy patients worldwide who received Xyrem from 2002 to 2008,” and the drug “also was linked to one death and two cases of sexual assault.” Reuters and NPR also cover the story.

From the American Association for Justice news release.

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Featured Link – Dallas County Criminal Background Search

Written On August 19, 2010 By Bob Kraft

Are you a little suspicious of that guy who just moved in across the street from you? There are several Web sites where you can do a criminal background search for a small fee, but now in Dallas County you can do a search for free. This is a service of the county, and you can find the search page on the official Dallas County Web site. And yes, I did check to make sure that no one in my family was listed before I posted this link!

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TxDOT Debuts New Travel Information Line

Written On August 18, 2010 By Bob Kraft

The Texas Department of Transportation has just set up a travel hotline to give drivers real-time information on traffic conditions throughout the state. The phone number is 800-452-9292. The system is based on interactive voice response, in which the caller asks questions, and the automated system responds.

This is an excellent idea, and I look forward to using it. It’s really still in beta test stage at this point, so it’s a little unfair to make fun of a “flaw” in the system. However, apparently no one seemed to consider the fact that a few of us around here speak with slight accents. And the automated system is not yet fine-tuned to handle Texas dialect yet, and is looking for testers with different regional accents. Here’s a quote from Steve Simmons, TxDot Deputy Executive Director:

“John Steinbeck wrote that Texas is ‘a nation in every sense of the word,’ and at times, we even seem to have our own language with accents from every corner of the state. Now we need callers with an East Texas twang and a Panhandle drawl. We want South Texans to help the system learn to understand ‘Refugio’ and Central Texans to teach the computer the number of times the letter ’s’ is in ‘New Braunfels’ or how to pronounce ‘Mexia’ or ‘Bexar.’”

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Featured Link – Crohn’s and Colitis Foundation

Written On August 17, 2010 By Bob Kraft

Our Social Security disability department sees a lot of Crohn’s disease and colitis cases. There is an excellent resource site for people suffering from these diseases, by the Crohn’s & Colitis Foundation. Here is a description from the site:

About the Crohn’s & Colitis Foundation

The Crohn’s and Colitis Foundation of America is a non-profit, volunteer-driven organization dedicated to finding the cure for Crohn’s disease and ulcerative colitis. It was founded in 1967 by Irwin M. and Suzanne Rosenthal, William D. and Shelby Modell, and Henry D. Janowitz, M.D.

Four decades ago, the Crohn’s & Colitis Foundation created the field of Crohn’s disease and ulcerative colitis research. Today, the Foundation funds cutting-edge studies at major medical institutions, nurtures investigators at the early stages of their careers, and finances underdeveloped areas of research. Educational workshops and symposia, together with our scientific journal, Inflammatory Bowel Diseases, enable medical professionals to keep pace with this rapidly growing field. No wonder the National Institutes of Health has commended the Foundation for “uniting the research community and strengthening IBD research.”

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Study Puts Cost of Medical Errors At $19.5 Billion

Written On August 16, 2010 By Bob Kraft

Medical errors and the problems they can cause — including bed sores, post-op infections and implant or device complications — cost the U.S. economy $19.5 billion in 2008, according to the Health Blog of the Wall Street Journal, which cited a recent study by the Society of Actuaries based on insurance claims data. Here are excerpts from the article:

The cost estimate includes medical costs, costs associated with increased mortality rate and lost productivity, and covers what the authors describe as a conservative estimate of 1.5 million measurable errors. The report estimates the errors caused more than 2,500 avoidable deaths and over 10 million lost days of work.

A couple of things make this study stand apart from previous studies, Jim Toole, the chairman of the SOA’s project oversight group, who proposed the study a few years ago, tells the Health Blog. First, the sample size is bigger, starting with a dataset of 24 million people. It also used control groups to calculate the cost-of-care differential between a patient who sustained an error-caused injury and a similar patient who wasn’t injured. And finally, says Toole, these were neutral data, collected for another reason, which means they’re less subject to bias than data aggregated for the sole purpose of counting errors.

Bed sores — which are almost always considered to be the result of an error — produced the largest annual error cost, at almost $3.9 billion, followed by post-op infections ($3.7 billion), device complications ($1.1 billion), complications from failed spinal surgery ($1.1 billion) and hemorrhages ($960 million). To come up with those figures, researchers found the total cost of a given type of injury and estimated how often it was caused by an error. (Those assumptions, plus the possibility that some data were miscoded, represent the study’s biggest weaknesses, Toole says.)

“This is so important, and yet it’s so overlooked,” says Toole. “We have wonderful information in this country about automobile safety and how in the last 20 years we’ve reduced highway deaths by 35% … but we have no starting point for medical errors or injuries.”

He’d like to see better federal patient-safety efforts, including a mandatory national reporting system.

Clarification: A previous version of this post said that bed sores are always considered to be the result of errors; although the AHQR classifies them as “never events,” in this study 5% of the bed sore-related injuries were not counted as errors.

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Consumer Groups Ask FTC to Force Rental Companies to Fix Recalled Cars

Written On August 13, 2010 By Bob Kraft

Here’s one more thing for you to worry about on your next vacation or business trip — car rental companies are apparently not bothering to repair vehicles that have been recalled for safety defects. As reported in the ”Wheels” blog of the New York Times:

“Two consumer safety groups are asking the Federal Trade Commission to order Enterprise Rent-A-Car to start fixing every vehicle with a safety recall before renting them to consumers. The groups say the request highlights the lack of a requirement that rental companies must fix recalled vehicles before renting them.

The request comes about three months after Enterprise admitted in a California court that its failure to fix a Chrysler PT Cruiser was responsible for the deaths of two California women when it caught fire and crashed.”

There is no reason rental companies should be treated differently than car dealers, which are not allowed to sell recalled vehicles without first repairing them. Be careful next time you rent a vehicle, check to see if there’s been a recall on it. You can get that information from SaferCar.gov.

Posted in Product Liability or Medical Devices, Vehicle Law or News Comments (0)

Drug Company Efforts to Outmaneuver the FDA Disturbingly Common

Written On August 13, 2010 By Bob Kraft

Time Magazine reports that the FDA panel’s recent decision to recommend keeping Avandia (rosiglitazone) on the market is “a move worth billions of dollars to GSK but that also may have put millions of patients at risk.” The move is also an example “of the drug industry’s outmaneuvering FDA regulators,” which is “disturbingly common, say both scientists and policymakers who follow drug approval and safety monitoring.” FDA critics and industry monitors “charge that the drug-approval process is too easy for pharmaceutical companies to game. It is in some ways an unsurprising development. The FDA serves a public insatiably hungry for new medicines. Yet the agency does not have responsibility for performing safety testing.”

From the American Association for Justice press release.

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Friday Fun

Written On August 13, 2010 By Bob Kraft

Why haven’t the airlines already thought of this…?

PAY & SIT: the private bench (HD) from Fabian Brunsing on Vimeo.

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Preliminary NHTSA Report Finds No New Defects in Toyota Electronic Systems

Written On August 12, 2010 By Bob Kraft

The Department of Transportation’s preliminary findings from investigation into the data records of 58 Toyotas involved in unintended acceleration incidents received heavy media coverage, including over two minutes of airtime, total, between segments on all three major networks, as well as articles in major national papers, including one front-page article. The reports focused on the report finding no evidence of defects with the electronic systems, but usually included investigators’ caveat that the results are preliminary and that additional investigations are needed. A minority of sources noted that the data recorders may be unreliable or inapt for determining the alleged flaws in the electronic systems.


ABC World News (8/10, story 8, 0:20, Stephanopoulos) reported, “Some rare good news for Toyota tonight. Safety experts at the Transportation Department say that so far they have not found any new defects with the electronic systems and no problems beyond the floor mats and sticky accelerator pedals.” The CBS Evening News (8/10, story 8, :30, Couric) reported, “A preliminary Federal report out today suggests that in many cases drivers, not the cars, are to blame. The drivers may have hit the accelerator instead of the brake.”


USA Today (8/11, Woodyard, O’Donnell) reports that the National Highway Traffic Safety Administration said “the only causes of ‘unintended acceleration’ continue to be those already identified – sticky gas pedals or floor mats that can become trapped under accelerators.” This is “significant because Toyota critics have alleged that electronics might be at fault in cases of unexplained acceleration,” and “Toyota seized on the report as further proof of what it has contended all along – that engine electronics are not to blame for runaway cars.” In fact, of the 58 data recorders investigators examined, in 35 cases drivers had not braked at all .


The Washington Post /AP (8/11, Thomas) reports, “Olivia Alair, a Transportation Department spokeswoman, said the review of the black boxes was ‘one small part’ of the investigation, which is expected to be completed later in the fall.” She added “that experts with NASA and NHTSA were ‘conducting research at labs across the United States to determine whether there are potential electronic or software defects in Toyotas that can cause unintended acceleration.’” Meanwhile, “Transportation Secretary Ray LaHood and NHTSA Administrator David L. Strickland briefed members of the House Energy and Commerce Committee on the findings of the government review.”


The Los Angeles Times (8/11, Bensinger) reports that LaHood and Strickland “told three members of Congress in the briefing that the agencies had drawn ‘no conclusion’ on the causes of sudden acceleration and noted that investigations by NHTSA, NASA, and the National Academy of Sciences were ongoing, with final results a year or more away.” Additionally, “the reliability of black box data has been questioned by automotive experts and even Toyota itself, and the officials were careful to point out that it is only a piece of the puzzle when it comes to analyzing sudden acceleration.”


In a front-page article, the New York Times (8/11, A1, Bunkley) reports that investigators studied data recorders from just 58 vehicles. Also, Sean Kane, a Massachusetts safety consultant working on behalf of plaintiffs in lawsuits against the carmaker, “said many of the reported crashes happened at low speeds, often in parking lots, and would not activate the data recorders.”


From the American Association for Justice press release.

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