Arizona Medical Malpractice Lawyer Blog

Department of Gynecologic Oncology University of Texas M. D. Anderson Cancer Center, Houston, Texas recently provided data showing that the change in CA-125 test results for a patient over time may an effective screening tool for detecting the early stage of ovarian cancer. Diagnosing and treating ovarian cancer has long plagued science as it generally is not discovered until it has progressed to a fatal stage. With these new findings, it is hoped that the majority of ovarian cancer victims will be diagnosed early on and allow a far greater chance of survival.

SOURCE: University of Texas M. D. Anderson Cancer Center

AMA recently introduced The Health Insurer Code of Conduct Principles, designed in effort to get health insurers to commit to full transparency and accountability with respect to all of their clinical and administrative processes. The effort is focused on holding the health insurance industry accountable to physicians and patients.
The bill was signed by several societies, such as: the American College of Cardiology; American Academy of Orthopaedic Surgeons; American College of Emergency Physicians; American College of Rheumatology; American Gastroenterological Association; and Congress of Neurological Surgeons.
Posted on the Pediatric SuperSite on May 25, 2010; New AMA insurer's code of conduct highlights need to earn patient trust

Generally a disease arising in children, Type I diabetes is now suspected to be linked to enterovirus (EV) infections. Although the data at this point does not prove a causal link between EV and Type I diabetes, it is a significant biomarker of the early stage of Type I diabetes.

Enterovirus Infections Linked To the Early Stages of Type 1 Diabetes? A. Q. Toniolo, G. Maccari, G. Federico, A. Salvatoni, G. Bianchi, A. Baj;
Univ. of Insubria and Ospedale di Circolo, Varese, ITALY, 2Pediatric Endocrinology Unit, Univ. of Pisa Med. Sch., Pisa, ITALY, 3Pediatric Endocrinology Unit, Univ. of Insubria Med. Sch., Varese, ITALY

New York's Health commissioner has ordered a formal investigation into the city's public hospitals after hospital officials recently admitted that thousands of cardiac test results, many of which were abnormal, were never viewed by physicians. According to the officials, this has been an ongoing problem since 2007 because they allow technicians to read the test results.

New York Times (5/27, A24, Hartocollis)

Due to a dozen cases of severe liver damage believed to be from the new weight-loss drug, Orlistat, the FDA has required the manufacturer to include these recent findings in its labeling. Of the dozen reported cases of liver damage, two deaths occurred and three required liver transplants. According to the FDA they are not certain of the cause of liver damage but warn that patients taking Orlistat should report sings of liver damage to their doctors.

For additional information, go to: FDA MedWatch alert (Free)

Since 2008 a number of studies have shown that probiotics can prevent necrotizing enterocolitis (NEC) in preterm infants (JW Pediatr Adolesc Med Mar 26 2008). Recently this was confirmed in four recent clinical trials. Despite these findings, there remains no consensus on whether probiotics should become a standard practice with preterm infants.

Journal Watch Pediatrics and Adolescent Medicine May 26, 2010

According to a recent study of COPD patients conducted in the Netherlands, beta-blockers appear to reduce mortality and exacerbations. This is a dramatic shift from prior beliefs in the medical field that withheld beta-blockers from COPD patients due to fear of worsening symptoms.

Arch Intern Med. 2010;170(10):880-887.

The Warnings' section for Tramadol (opioid used to manage moderate chronic pain) have been strengthened to note the increased risk of suicide for patients who are addiction-prone, taking tranquilizers or antidepressant drugs. Additionally the warning now notes the risk of overdosage. The strengthened warning comes after several Tramadol-related deaths.
For additional information go to: Ultram (tramadol hydrochloride), Ultracet (tramadol hydrochloride/acetaminophen): Label Change

A recent study by BMJ demonstrates that metformin leads to vitamin B12 deficiency and that this deficieincy increases the longer a patient receives metformin. It is believed that metformin interferes with the absorption of B12.
BMJ article (Free)

Researchers in a U.K. hospital found C. difficile in the room air of 7 out of 10 patients with C. difficile. It is well known that C. difficile excretes a large number of spores. It is now postulated that these spores may be capable of infecting others who come in contact with the airborne spores.
Best EL, et al. The potential for airborne dispersal of Clostridium difficile from symptomatic patients. Clin Infect Dis 2010 Jun 1; 50:1450.
Medline abstract (Free)

Young children presenting with fevers account for nearly 25 million medical visits each year. Determining whether the illness is viral or bacterial and deciding whether to treat with antibiotics can be challenging and many times incorrect. A clinical diagnostic model developed by pediatricians over a two-year study developed 26 signs and symptoms to determine whether to treat for bacterial or viral. The strongest predictors of serious bacterial infection were unwell appearance, elevated body temperature, reduced fluid intake, increased capillary refill time, and chronic disease.
Overall the diagnostic model proved more accurate at ruling out SBI than physicians.
Craig JC et al. The accuracy of clinical symptoms and signs for the diagnosis of serious bacterial infection in young febrile children: Prospective cohort study of 15 781 febrile illnesses. BMJ 2010 Apr 20; 340:c1594. (http://dx.doi.org/10.1136/bmj.c1594)

• Original article (Subscription may be required)
• Medline abstract (Free)

A recent study indicates that adolescents who smoke while pregnant are at an increased risk than pregnant adults who smoke. The risk of stillbirth is greater amongst adolescents than adults. This is a public concern that the medical community must address with adolescents who are pregnant. Smoking cessation must be developed and aggressively targeted at this high-risk group to avoid devastating outcomes.

J Pediatr Adolesc Gynecol. 2010 Jun;23(3):129-35. Epub 2010 Feb 11.

PMID: 20149977 [PubMed - in process]

Two lots of Metonidazole injection have been recalled because of sterility issues. The lot numbers being recalled are: A090742, A090743, A090744, A090745, A090746, A090769, A090770, A090771, A090772, A090773, A090774, A090775, A090776, A090968, A091014, A000013, A000016 and A000019, which were distributed to hospitals, wholesalers and distributors nationwide from February through May 2010. Metronidazole injection, USP is an intravenous antimicrobial product used to treat infections and is supplied in a single dose plastic container.
For more information go to:

Metronidazole injection 500 mg / 100 ml: Voluntary recall due to non-sterility

According to recent data, obese pregnant women are at a greater risk of surgical delivery (i.e., c-section) and protracted labor.

Archives of Gynecology and Obstetrics, 05/17/10

With all the focus on healthcare efficiency and reduced errors, the role of the primary care physician is once again getting due recognition for its importance in the overall scheme of healthcare delivery. The current proposition involves focusing patient care back to the primary care physician and reducing the multitude of specialists and sub-specialists in the overall patient care scheme. It's almost like times past where everyone went to the primary care physician for all their health concerns.

For more information go to: The Multi-Stakeholder Movement For Primary Care Renewal And Reform

Health Affairs

Recent data from a systemic review and meta-analysis show a strong correlation between low ABG pH and neonatal mortality, cerebral palsy, hypoxic ischemic encephalopathy (HIE), and intraventricular hemorrhage.

BMJ 2010;340:c1471

For further information go to: Strength of association between umbilical cord pH and perinatal and long term outcomes: systematic review and meta-analysis

The control board wiring on some of GE's Aisys and Avance Anesthesia Systems are defective and can lead to the machines shutting off without warning.
To report any adverse events associated with GE's Aisys or Avance Anesthesia Systems contact:

• Online: www.fda.gov/MedWatch/report.htm
• Phone: 1-800-332-1088
• Mail: return the postage-paid FDA form 3500, which may be downloaded from the MedWatch

  Download Forms page, to address on the pre-addressed form
  

• Fax: 1-800-FDA-0178

For additional information go to:

GE Healthcare Aisys and Avance Anesthesia Systems: Recall

A recent cross-sectional study by the Medical University of South Carolina demonstrate that super obese women are at a greater risk of gestational diabetes, large for gestational age baby, preeclampsia, c-section, and 5-minute apgar less than 7.

Maternal super-obesity (body mass index >/= 50) and adverse pregnancy outcomes, Acta Obstet Gynecol 2010 May 4. [Epub ahead of print]

According to Cardiology Today, results from over twenty trials from around the world indicate that people who consumed nuts experienced reduced chronic heart disease risk.

Researchers found that 2.4 oz of nuts daily reduced total cholesterol by over 5% while reducing LDL (bad cholesterol) by 7.4%.

For more information go to: Consuming more nuts key to heart-healthy diet

The FDA has issued a recall of Colleague Volumetric Infusion Pumps due to Baxter's failure to correct many serious issues with the pumps. Baxter must not only recall these pumps but also must destroy them. In addition owners of these pumps will receive a refund and assistance from Baxter in locating a replacement.
For more information go to: Baxter Colleague Infusion Pumps: FDA Ordering Recall

According to the FDA GnRH agonists may increase in the risk of diabetes and various cardiovascular diseases. Although the increased risk may be small, it is statistically significant. At this time the FDA is not making any conclusions as to the safety of these drugs. It also recommends that patients should not stop treatment with GnRH agonist unless instructed by their physician.
For more information go to: GnRH Agonists: Safety Review of Drug Class Used to Treat Prostate Cancer