By PAULINE W. CHEN, M.D.

In his 60s, overweight and in a wheelchair, the patient had been seeing doctors and nurses regularly for his diabetes. Only recently had they discovered a pressure sore after someone had finally, as he put it, “wanted to examine at my backside.”

The oversight struck me as unimaginable. Until I watched another doctor try.

My colleague, a strapping man in his 30s, wrapped his arms around the man’s torso to lift him onto the examining table but could hardly budge the patient. A few members of the clinic staff came in to help, each taking a limb. Several minutes later, one of the nurses called for security. Two burly men in dark blue uniforms joined the fray, grunting as they finally extricated the patient from his chair.

A nurse lunged forward to unbuckle the patient’s belt while a medical student began yanking on his sneakers, but with each tug and jerk, the guards’ grip on the patient’s torso loosened. Feeling himself slipping, the patient grabbed at the shirt of one of the guards to break his fall. The guard lost his balance and reached for the wheelchair, but its brake was not engaged. The wheelchair spun, hitting the medical student and nurse and knocking over the other guard as the patient, pants half off and one shoe missing, collapsed back into its seat.

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By JIM DWYER
Published: May 23, 2013

From age 12 on, Teofilo Ramos had been a great worker: delivery boy, day laborer, soup kitchen chef, reliable hand at drywall, trusted caretaker in a Hasidic village. So it was no surprise that he wound up at midlife behind the counter of a deli on Rockaway Beach Boulevard in Far Rockaway, Queens — 12 hours a day, six days a week, drawing coffee from an urn, and slicing meat and swabbing floors.

Nor could it be taken as a shock, really, that he was slipping packets of heroin to certain customers.

“I’d have them come around the store and order a sandwich or something, and stuff it in the sandwich when I wrapped it,” Mr. Ramos said this week. “Or when I gave a book of matches. Be creative when giving it to them, instead of just being obvious.”

Mr. Ramos, 54, who grew up in East Harlem, has used drugs for nearly his entire life, spinning the hamster wheel of addiction alongside a ferocious work ethic.

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State officials today pulled the plug on its controversial plan to shut down Brooklyn’s Long Island College Hospital.

The decision has hailed as huge victory by health-care professionals and local activists who fought hard to retain the cash-strapped 506-bed Cobble Hill facility that provides the closest emergency-room access for the borough’s Brownstone Belt. Opponents claimed its closure would put North Brooklyn residents lives in jeopardy and successfully put pressure of local pols to help in their fight.

SUNY Downstate Medical Center, which acquired Cobble Hill-based LICH in 2011 after the state approved a merger to save the 155-year-old facility, said in a statement it would seek a new hospital operator or other “healthcare services” provider to run money-losing LICH.
“This is great news,” said Cobble Hill Association President Roy Sloane. It gives us an opportunity to turn LICH into the type of institution that this part of Brooklyn truly needs.”

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Eugene Evans, long time Jamaica, Queens resident, has formulated an exploratory Committee to investigate the feasibility of participating in the upcoming election for City Council District 28. The council position is presently held by Ruben Wills.

Eugene Evans is the son of Rochdale Village resident, business owner, and Vice President of the Board of Directors Joe Evans and younger brother of CWCOA’s President Dr. Robert Evans. Eugene Evans has an eclectic background in business ownership, community activism, and professional sports.

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EXCLUSIVE: Missing cab driver found in Jamaica Hospital bed days after cracked skull, memory loss

(Original article can be found here)

Despite the bank card and checkbook in Israel Nunez’s pocket that revealed both his name and address, the livery cab driver was incorrectly identified by emergency responders as “Daniel Nunez.” While his family frantically searched for him, Nunez’s pleas about his real name were ignored by Jamaica Hospital workers, he said.

Livery car driver Israel Nunez of Hollis, Queens, in his hospital bed at Jamaica Hospital. Nunez, 47, disappeared after being attacked and bludgeneoned in the head but was later found along the curb and misidentified by the hospital for six days while his friends and family frantically searched for him.
A seriously injured livery car driver lay in a Queens hospital for nearly a week before his family — who feared he was dead — finally was notified of his whereabouts, the Daily News has learned.

An ambulance took Israel Nunez to Jamaica Hospital at 3 a.m. on March 29, after he was found sitting on a curb with a cracked skull — apparently the victim of a brutal assault. He still has no idea what happened.

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by Dr. Robert Evans & Richard Wildzunas

“Diabetes is a killing disease in the African American community, but a disease that may be controlled, according to James R. Gavin III, MD, chair of the American Diabetes Association’s African-American Program. “By keeping fit, eating right and getting regular exercise, we can decrease our risk for diabetes quite substantially,” he said. “This is a disease about which we can do a great deal, but only when those affected are informed and empowered to take the kind of control of this disease that is now possible”

INTRODUCTION

The NYC Department of Health and Mental Hygiene report, dated November 10, 2010 “Public Health in Jamaica, Queens that “Diabetes” is a primary health concern in that the death rate due to diabetes is higher in Jamaica than in Queens and NYC overall.

Additionally, the NYC DOH has reported that diabetes is epidemic. Diabetes is a serious illness that is increasing rapidly in New York City and around the country and In just the past 10 years, the number of people with diabetes has doubled with 1 in 8 adult New Yorkers (about 800,000 people) have diabetes and a third of them don’t know it yet.

National and State of New York reports support CWCOA healthcare initiative for developing an integrated delivery model including a “Diabetes Center of Excellence”, and establish a continuum of care program for the early detection and treatment of diabetes.

Community Wellness Centers of America, LLC (CWCOA) goal in developing a “Diabetes Center of Excellence” is to bring into the community an integrated private sector and government approach that significantly improves current health disparities throughout the community and addresses the chronic diabetes health issues prevalent with Queens County.

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Cheryl Clark, for HealthLeaders Media, March 18, 2013  (original article)

For the first time, providers, payers, and patients now have an enormous searchable database containing documents detailing about 8,000 serious federal safety rule violations—many of which have caused serious patient harm or death—at about 1,000 U.S. hospitals since January, 2011.

The documents, which resulted from federally authorized complaint investigations and are called “2567s,” were released over the weekend by the Centers for Medicare & Medicaid Services after a long-standing request from and collaboration with the Association of Health Care Journalists. The AHCJ has organized the document files on a searchable website on its site, hospitalinspections.org.

AHCJ president Charles Ornstein, a senior reporter at ProPublica in New York, made the announcement about the database during a news conference Saturday at the organization’s annual meeting in Boston. He said the documents “show deception, fraud, falsification, and medical errors that are inexcusable.”

Also, he said, now members of the public can find out not only which hospitals in their cities or regions had incidents serious enough to prompt such investigations, but how often errors of a particular type occurred in any facility to receive such a federal investigation report in the last 26 months.

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For Immediate Release (original article)
March 18, 2013

Contact:
Robert Zirkelbach
202-778-8493

Data Shines a Spotlight on Hospital Price Trends for Specific Procedures and in States and Metropolitan Areas

Washington, D.C. – A new study published in the March issue of the American Journal of Managed Care (AJMC) provides new data on trends in hospital prices across the country. The report, conducted by researchers at America’s Health Insurance Plans (AHIP), found that from 2008 to 2010 inpatient hospital prices increased 8.2 percent per year with wide variation in price levels and growth rates across states and localities.

The new study, “Trends in Inpatient Hospital Prices, 2008 to 2010,” addresses a critical gap in the ongoing health care cost debate. “Despite the keen interest in US health care costs, there is surprisingly little detailed public information available on one of its key components: transaction prices paid by commercial insurers for inpatient hospital care,” according to the study’s authors.

Using claims data from the commercially insured population under 65, the authors developed estimates of price levels and growth rates based on admissions (service), state, and locality. The authors concluded that unadjusted prices for inpatient hospital care rose 8.2 percent per year during the 2008-2010 period. Taking into account the complexity of treatment and the number of procedures performed, the authors estimate that 1.3 to 1.9 percentage points of this increase could be attributed to increased intensity per admission. Thus intensity-adjusted price increases ranged from 6.2 to 6.8 percent annually during this period.

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By ANAHAD O’CONNOR (original article)

THE FACTS Old prescription habits apparently die hard.

Studies have suggested that most doctors say they would prescribe an antibiotic if a child with sinus symptoms also had green nasal discharge. The habit stems from the notion that green indicates a bacterial infection.

But other studies show that green is no more common in a bacterial infection than a viral one, for which antibiotics are ineffective.

In a definitive study from 1984, scientists put 142 children with green nasal discharge into groups, including one that was treated with antibiotics and another that received a placebo. They found that the drugs had no effect on “potentially pathogenic organisms” or on symptoms. About 35 percent of subjects treated with antibiotics showed improvement, compared with 31 percent in the placebo group. More recent studies have bolstered that conclusion.

According to the Centers for Disease Control and Prevention, when cold viruses infect the respiratory tract, the body makes clear mucus that helps wash away germs from the nose and sinuses. After about three days, the body’s immune cells fight back, changing the discharge to a white or yellow color. “As the bacteria that live in the nose grow back, they may also be found in the mucus, which changes to a greenish color,” the agency says. “This is normal.”

The only time antibiotics are needed for a runny nose, experts say, is when the diagnosis is bacterial sinusitis.

THE BOTTOM LINE The color of nasal discharge should not dictate the medicine.

by Barry Meier (original article)

An internal analysis conducted by Johnson & Johnson in 2011 not long after it recalled a troubled hip implant estimated that the all-metal device would fail within five years in nearly 40 percent of patients who received it, newly disclosed court records show.

The company’s analysis also suggests that the implant is likely to fail prematurely over the next few years in thousands more patients in addition to those who have already had painful and costly procedures to replace it.

The internal Johnson & Johnson analysis is among hundreds of internal company documents expected to become public as the first of over 10,000 lawsuits by patients who got an A.S.R. prepares to go to trial this week. The episode represents one of the biggest medical device failures in recent decades and the forthcoming trial is expected to shed light on what officials of Johnson & Johnson’s DePuy Orthopaedics division knew about the device’s problem before its recall and the actions they took or did not take.

The trial, which is expected to begin Friday in California Superior Court in Los Angeles, may also provide a guide to the consequences of the A.S.R. episode to Johnson & Johnson, both for the company’s finances and its reputation. Last year, the company took a $3 billion special charge, much of it related to medical and legal costs associated with the device. DePuy has offered to pay patient costs for replacement procedures.

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