Tuesday, October 13, 2009

Grandmother, 72, has leg amputated after British hospital wrongly diagnoses cancer

Sheer negligence

A 72-year-old grandmother had her leg amputated after being told she had cancer only to find out her leg was healthy all along. Doreen Nicholls underwent the surgery in 2007 and now needs a wheelchair to get about. According to the Sunday Telegraph, the grandmother was wrongly diagnosed with an extremely rare form of cancer and was told that without a leg amputation, she would die. Tests carried out after the operation revealed that her left leg, which had been cut off below the knee, was in fact healthy.

Mrs Nicholls told the newspaper that the misdiagnosis, at Birmingham's Royal Orthopaedic Hospital, has destroyed her life. Despite refusing to accept it was negligent in its treatment of Mrs Nicholls, the specialist hospital has agreed to pay her an out of court settlement which her lawyers described as a 'substantial six-figure sum'. Since being awarded the money, Mrs Nicholls has been able to buy a new prosthetic leg.

Mrs Nicholls, of Halesowen, near Birmingham, told the Sunday Telegraph: 'I shall never forgive the hospital for what they've done to me. 'I just want my leg back, money doesn't mean a thing.'

Mrs Nicholls told how the hospital called her to go back after the operation and said they had made a mistake and she didn't have cancer. She told the BBC: 'They called me back after the operation and the surgeon said: "I've got a bombshell to tell you - I'm very sorry, but we shouldn't have taken the leg off." 'I cried for days. It really was the worst part, worse than being told I had cancer, because I couldn't do anything, there was no treatment I could try,' she told the Sunday Telegraph. 'Every night I look back down and it's never going to change. 'It's ruined my life, I used to be active, go swimming, do gardening and walk a lot, now I can't do that any more. 'My little granddaughter asked me when it's going to grow back so we can dance and play together again, but it never can.'

Mrs Nicholls was referred to the Royal Orthopaedic Hospital in August 2007 due to a swelling on her left foot. A biopsy was carried out and the pathology results appeared to show the grandmother had an aggressive tumour. It was thought to be an extremely rare soft tissue cancer, sclerosing epithelioid fibrosarcoma. According to the newspaper, other clinical signs did not suggest cancer and the hospital team treating Mrs Nicholls was not unanimous in the diagnosis. But on October 10, 2007, her left leg was removed below the knee. Tests done after the operation showed that she was in fact suffering from a rare benign condition, pigmented villonodular synovitis.

Mrs Nicholls told the Sunday Telegraph: 'I still get so much pain. It's like pins and needles all the time at the stump where they cut the nerve endings. 'I've definitely lost faith in the medical profession. I'd never have another operation; I think I'd rather suffer the pain.'

A spokesman for the Royal Orthopaedic Hospital told the newspaper: 'The trust is deeply sorry about the outcome of Mrs Nicholls' treatment. 'We have been completely open and honest with Mrs Nicholls throughout and she has been fully informed of our findings. 'Our specialist teams are still regularly reviewing her progress.'


Amazing NHS bungle

They just don't care

A British Iraq War veteran has died after he was given a pair of cancerous lungs donated by a smoker as part of a lung transplant. Matthew Millington, 31, a corporal in the Queen's Royal Lancers, needed the transplant because he had an incurable lung condition. But he ended up with cancer after the organs donated to him came from someone who smoked 30 to 50 cigarettes a day, the Daily Mail said.

He died in February last year. At an inquest, coroner Ian Smith said he had died from "complications of transplant surgery". His widow, Siobhan, said: "All he wanted was another set of lungs. He said 'They've given me a dud pair.'"

Papworth Hospital in Cambridge, which performed the transplant, said early X-rays did not find any sign of cancer in Mr Millington's lungs, the Mail said. But the tumour had been missed. Drugs given to Mr Millington to help his body accept the new organs sped up the spread of the tumour, it said. The hospital defended its use of smokers' lungs in transplants and said all organs were screened rigorously, the Mail said.

Mr Millington had served in the army since he was 16, but started to struggle with his breathing while in Iraq in 2005. A year later he was told he would die in two years unless he had a transplant.


Hospitals across Australia forcing ambulances to wait for hours to unload seriously ill patients

With Westmead in Sydney again singled out

SERIOUSLY sick patients are queuing for hours to be unloaded from ambulances at busy hospitals across Australia. "Ramping" of patients is so common at major Sydney hospitals that ambulance officers routinely order pizza while they wait, ambulance union officials claimed yesterday.

In Queensland, more than 25,000 patients a year have had to wait at least half an hour to be unloaded from a waiting ambulance, Ambulance Service statistics reveal.

And in Melbourne this past winter, nearly 1000 patients had to wait more than an hour on an ambulance trolley. In 145 cases between May and July, patients waited more than two hours, according to data submitted by the ambulance union to a Victorian parliamentary inquiry.

The National Council of Ambulance Unions secretary, Jim Arnuman, yesterday said ramping was a growing problem in Queensland, NSW, Victoria and Western Australia. Ambulance officers attending Sydney's Westmead Hospital routinely ordered pizza because delays were so long, he said. "Unfortunately, the hospitals are using the ambulances as a labour pool to look after patients because of their own staff shortages," he said. "On bad nights in various areas of NSW, we have 40 to 70 per cent of our on-shift ambulances tied up in hospitals. "It is impairing the ability of ambulance services across the country to respond urgently to serious cases."

In Queensland - where the state government is probing the death of a critically ill elderly man when his ambulance was diverted from a busy hospital this month - new statistics reveal that more than 25,000 patients had to wait longer than half an hour to be unloaded from an ambulance in 2007-08. The figures, furnished by the Ambulance Service as part of an industrial arbitration, reveal 7 per cent of patients had to wait more than half an hour.

Liquor Hospitality and Miscellaneous Union spokesman Kroy Day said it was a "daily event" for ambulances to be diverted from the nearest hospital. "In the past 12 months, two patients died on ambulance stretchers waiting for a hospital bed," he said, adding this did not include the elderly man who died in transit this month. "It's an absolute tragedy, a disgrace and unacceptable."

Mr Day said ambulances had been forced to wait three hours to unload patients at Royal Brisbane Hospital, and up to four hours at the city's Princess Alexandra hospital. "It's a systemic problem and indicative of a system in crisis," he said. "The doctors and nurses and paramedics are doing a great job but they don't have the resources."

Steve McGhie, the general secretary of Ambulance Employees Australia, said he knew of up to 11 ambulances queuing outside a Melbourne hospital. "If your ... paramedics are all lined up for three or four hours waiting to offload their patients, you need more ambos to respond to the waiting emergencies," he said.


Limiting medical lawsuits could save $41B

Limits on medical malpractice lawsuits would lead doctors to order up fewer unneeded tests and save taxpayers billions more than previously thought, budget umpires for Congress said Friday in a reversal that puts the issue back in the middle of the health care debate.

The latest analysis from the nonpartisan Congressional Budget Office estimates that government health care programs could save $41 billion over ten years if nationwide limits on jury awards for pain and suffering and other similar curbs were enacted. Those savings are nearly ten times greater than CBO estimated just last year.

"Recent research has provided additional evidence that lowering the cost of medical malpractice tends to reduce the use of health care services," CBO Director Douglas Elmendorf wrote lawmakers, explaining the agency's shift. Previously, CBO had ruled that any savings would be limited to lower malpractice insurance premiums for doctors, saying there wasn't clear evidence physicians would also change their approach to treatment.

On Friday, Elmendorf essentially acknowledged what doctors have been arguing for years: fear of being sued leads them to practice defensive medicine. Some doctors will order a $1,500 MRI for a patient with back pain instead of a simple, $250 X-ray, just to cover themselves against the unlikely chance they'll be accused later of having missed a cancerous tumor.

Republicans immediately called for liability limits to be incorporated in the health care overhaul legislation advancing in Congress. The Senate Finance Committee bill now gives a nod of recognition to doctors' concerns, but little more. Heeding a call from President Barack Obama, the legislation calls for promoting state experiments with programs to resolve cases before they go to court. "The more federal health care programs spend on unnecessary tests, the less money is available for necessary patient care," said Sen. Charles Grassley of Iowa, the ranking Republican on the Finance Committee. "Cutting medical liability costs would help preserve patients' access to care." Tens of billions of dollars in savings is "not chump change," added Grassley. "It's a no-brainer to include tort reform in any health care legislation."

However, Republicans were unable to pass malpractice limits when they controlled Congress and the White House, and it's unlikely that Democrats would do so now. For one thing, trial lawyers who file malpractice lawsuits have traditionally been heavy contributors to Democratic politicians.

But also, patient advocates argue that fixed limits on jury awards as in California and some states are unfair to those who have suffered the most harm because of a doctor's negligence. A patient who was given the wrong drug and had to spend several days in the hospital recovering from a bad reaction would likely be able to collect adequate compensation. But a family whose youngster was left brain damaged by an anesthesiologist's mistake probably would not be able to offset all the costs of lifelong care.

Obama has tried to straddle the argument, siding with the doctors on defensive medicine and agreeing with the lawyers who say limits on jury awards are the wrong remedy. He wants to promote alternatives to litigation; studies have shown anger over cover-ups by doctors is a principal reason that families sue.

Trial lawyers said Friday the projected malpractice savings have to be viewed in the context of the $2.5 trillion a year the U.S. spends on health care.

"Medical malpractice claims have almost no effect on overall health care spending," said Anthony Tarricone, president of American Association for Justice, which lobbies for lawyers. "The vast majority of empirical evidence suggests that there are only minuscule savings to be found in reforming our nations civil justice system."

But the CBO report means the malpractice issue will stay alive as the health care debate in Congress builds to a climax this year. The budget scorekeepers estimated the total effect of malpractice curbs could reduce the federal deficit by $54 billion over 10 years, once $13 billion in new tax revenues from economic ripple effects are taken into account.

Even in the health care debate, that's real money.


Liberal Health Care Ideas: DOA

It’s one of the biggest myths in Washington, a powerful idea that hangs around year in and year out no matter how hard we try to kill it. It’s the claim that liberals offer ideas and conservatives merely oppose them.

Even the brightest conservatives can fall for it. “Republicans have to join the battle of ideas,” Louisiana Gov. Bobby Jindal wrote recently in The Washington Post. Jindal went on to outline 10 conservative ideas for health care reform.

But he’s incorrect to say conservatives have yet to “join” the battle of ideas. In fact, we’ve been mostly going at it unopposed.

Consider health care, the hot topic these days. Conservatives favor expanding competition by allowing insurance plans to compete across state lines. We favor policies to give individuals more control of their health spending. And we support ending federal tax breaks, so individuals can buy health insurance as they buy auto, life and homeowners insurance.

What’s the liberal response? Create a massive new entitlement that would, eventually, lead to a single-payer system.

“We’re looking at the possibility of universal health care by about 2010,” New York Times columnist and economics professor Paul Krugman announced on the TV show “Democracy Now!” two years ago. Discussing the plans floated by then-presidential candidates Hillary Clinton and Barack Obama, Krugman added they, “are not single-payer, but they can evolve into single-payer,” an outcome that would lead to something such as Medicare, which Krugman calls “the cheapest, most efficient plan.”

Is it? “The fact is that, in recent years, Medicare administrative costs per beneficiary have substantially exceeded those costs for the private sector. This despite the fact that, as critics note, private insurance is subject to many expenses not incurred by Medicare,” wrote industry expert Robert Book in a paper from The Heritage Foundation. “Moving millions of Americans from private insurance to a Medicare-like program will result in program administrative costs that are higher per person and higher, not lower, for the nation as a whole.”

Another reason Medicare seems more efficient is that it doesn’t spend much time or money cracking down on fraud. Instead, it just shells out for fraudulent claims it never determines to be fraudulent. Harvard Professor Malcolm Sparrow estimates that more than 20 percent of Medicare and Medicaid spending may be wasted through fraud. And Medicaid’s internal inspector admits the program has no way to track waste, fraud or abuse. No wonder Sparrow’s book is titled, “License to Steal.”

Medicare is already bankrupting states across the nation. So what’s the big liberal idea of the week? Expand the program. The Senate’s proposed Baucus bill (which isn’t really a bill, since the Finance Committee hasn’t bothered to write it down) would supposedly provide health insurance to millions more Americans. But nearly half of them would simply be dumped into Medicare. That’s not a solution; it’s merely a way to create a new problem. “Nobody’s going to put their state into bankruptcy or their education system in the tank” for Medicaid expansion, Democratic Tennessee Gov. Phil Bredesen told The Washington Post over the summer.

It’s ironic that liberals, who claimed to worry that George W. Bush wanted to use anti-terrorist FISA legislation to listen to their phone calls (all of them) and read their e-mail (even the spam) are eager to have the government-run health care.

After all, if the liberal dream comes true and the federal government becomes the sole provider of health care, it will have an interest in virtually every aspect of our lives. Look no further than North Carolina, which recently announced it will punish state employees who don’t take care of themselves.

“Tobacco use and poor nutrition and inactivity are the leading causes of preventable deaths in our state,” Anne Rogers, director of integrated health management with the N.C. State Employees Health Plan, told the Raleigh News & Observer. “We need a healthy workforce in this state. We’re trying to encourage individuals to adopt healthy lifestyles.” The state will “encourage” that by charging overweight individuals or those who smoke more for health insurance.

Once the government is in charge of health care almost everything you do -- what you eat, how fast you drive, whether you have a pet -- will be a federal concern. Denying care will be about the only way the government can hold down costs, so it’ll look for any excuse to do so.

Is that the goal of the liberal “thinkers?” Or is this potential outcome merely a happy coincidence? One suspects liberals really have no idea.


The truth about the Baucus bill

Obamacare advocates in the White House, Congress and the newsroom of the New York Times were elated this week when a Congressional Budget Office statement said the health care reform bill by Senate Finance Committee Chairman Max Baucus, D-Mont., would cut the federal deficit by $81 billion annually. Hallelujahs ensued all around, including a Times headline proclaiming "Health care bill gets green light in cost analysis." But two words in the CBO statement -- "Preliminary Analysis" -- demonstrate that such celebrations were not only premature, but fundamentally misleading.

CBO had to qualify its observations because it was not allowed to score the actual text of the Baucus bill but rather had to rely on a legislative summary provided by Senate committee staff. So not only were CBO's analysts forced to look at language that put the bill in the best possible light, they were also denied the concrete details and precise legal wording that quite possibly could change their conclusions entirely. Such "close enough for government work" analyses suffice for Baucus and the Times, but for everybody else, by labeling its assessment as preliminary, CBO was clearly waving yellow caution flags.

Reading further, other yellow flags were present in the CBO analysis. As The Examiner's Susan Ferrechio reported Friday, enactment of the Baucus approach will add approximately $900 billion to the federal budget. That money will have to come from somewhere. Half of it will come from massive cuts in Medicare Advantage, while the other half will be generated by new taxes on high-end insurance, higher income taxes, and new levies on drugs and innovative medical devices. We will address these additional yellow flags on this page on Tuesday in Part 2.

There is another reason why the CBO's preliminary analysis should be taken with a grain of salt, though this one wasn't mentioned in the report. Whatever the content of the Baucus bill once it is voted out of the finance committee, it will disappear into a legislative black hole as Senate Majority Leader Harry Reid, House Speaker Nancy Pelosi, and their key aides do what they did on the economic stimulus package back in February -- huddle together behind closed doors to write the final bill, which will then be presented as a fait accompli in the form of a conference report. Everything else is mere sound and fury signifying nothing until Harry and Nancy do their thing in the dark.


1 comment:

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Take care,