Friday, November 27, 2009

British Meningitis victim wins £3.2m compensation after hospital turned him away for 'misusing emergency services'

Once again: "Diagnostic tests? Who needs 'em?"

The family of a man left severely brain damaged after being turned away from hospital were awarded £3.2million yesterday. Doctors failed to spot that a simple ear infection had spread to the brain of Mark Thomas when he was 12.

Antibiotics could have treated the illness, but they missed tell-tale signs of meningitis including a stiff neck and severe tiredness and sent him home. The blood test which flagged up the spread of the meningeal infection was only reviewed after Mr Thomas's parents took him back to the hospital the following week for a second opinion - by which time it had attacked his brain.

Before the eventual diagnosis, a nurse had lectured the family about ' inappropriate use of A&E services'.

Mr Thomas, now 20, has the mind of a child and virtually no short-term memory. He used to be a keen footballer, but now goes to fixtures and forgets the score within minutes of a match finishing. He suffered a stroke which damaged the right side of his body and will never be able to work, instead needing round-the-clock care from his parents Elaine, 49, and David, 51.

Mr Thomas, from Blakenhall, Walsall, suffered a series of ear infections which refused to clear up in the six weeks before contracting meningitis in February 2002. He saw his GP several times but by February 9 his condition deteriorated so much that his parents took him to Walsall Manor Hospital for a blood test. The schoolboy had the classic signs of meningitis, including a stiff neck, aversion to bright lights and extreme lethargy, which should have rung alarm bells for doctors. But he was sent home and the blood test results - which revealed the infection had spread to his brain - were not passed on to his parents.

Five days later his illness had worsened and his desperate parents took him back to A&E only to be told by a nurse his condition was not sufficiently serious and they were 'using emergency A&E servicesinappropriately'. But Mr and Mrs Thomas refused to take their son home and demanded a second opinion. It was only then that the blood test results from February 9 were reviewed and meningitis was finally diagnosed.

Bosses at Walsall NHS Hospital Trust admitted liability for the errors and a settlement was approved by the High Court in Birmingham yesterday. The £3.2million pay-out will fund a lifetime of future care for Mr Thomas.

Mrs Thomas, a housewife who cares full time for her son, said: 'My son had to learn to walk again, eat, it was just like having a baby again. If the doctors had done their job properly and acted more quickly, Mark would now be living a completely normal life.' Sue James, chief executive of the Trust, said: 'We wish to apologise again to Mark and deeply regret the delay in diagnosing his condition.'


Gifted Cambridge-bound student who died after two-year anorexia battle 'let down by NHS'

Anorexia is an OCD. She should have been given anti-psychotic drugs

A gifted teenager who died after suffering a severe eating disorder for two years was let down by health chiefs, an inquest heard today. Alice Rae, who scored 9 A*s in her GSCEs and had been offered a place at Cambridge University, was found dead in her bed by her mother on January 14. An inquest into the 18-year-old's death was told the 'highly intelligent and determined' college student was sent home from hospital within hours of her admission - and a chance to help her battle her condition was lost.

Her father, company director Peter Rae, told the coroner sitting at Winchester, Hants, that there were some occasions when his daughter 'simply ate and vomited all day every day.'

The inquest heard that just weeks before she died Alice, who suffered from anorexia and bulimia, had been admitted to hospital in December when her blood potassium levels were at life-threatening levels - she but was discharged within hours. The family turned to the NHS believing that experts would be able to help her out.

Mr Rae said: 'This was an obvious and clear point of possible intervention where the medical team saw that here was a girl with critically low life-threatening potassium levels. 'These were brought about by an illness and affecting behaviour. She was discharged in 20 hours and was given no advice other than to resume the treatment programme that clearly had not been working.' He added: 'We were told it would be quite some number of days (that she would be in there). We were surprised that she was discharged so quickly.'

Alice had repeatedly said she was unhappy with the treatment at the NHS Eastleigh Eating Disorder clinic and had made no progress in her recovery. He said that treatment at the Eastleigh clinic had been 'completely useless' in tackling her condition. She would gorge on meals and throw them straight back up - and at her weakest was able to walk no more than 50 yards.

Mr Rae added: '(Staff at) the meetings would usually ask 'have you vomited this week?' and she saw this as how they were failing to understand her condition.' Mr Rae said that his daughter was overcome by her condition and unable to help herself.

Alice was a keen debater and horserider who had two older brothers - William and Tom - and a younger sister Georgina. However, she had battled with the eating disorder since 2006, the inquest was told.

Dr Carol Ward, the GP who saw Alice in the weeks leading up to her death, said that her condition had improved after her hospital admission - but that she was a very ill young woman. 'She was extremely bright and extremely intelligent and could discuss her care in great detail but this is a condition that is so devastating that it does affect your ability to make decisions about your care,' she said. 'Young girls with this condition are very, very difficult to help.'

She added that she expected Alice to be kept in hospital longer following her December 29 admission. 'I was surprised she was discharged as early - I did ring late morning (on December 30) and speak to medical admissions and there were no plans for her discharge,' she said.

A post mortem examination on Alice's body revealed no obvious cause of death - but it was ruled that on the balance of probabilities, low potassium levels were the most likely factor.

Dr Neil Joughin, a private consultant psychiatrist based in Chichester, West Sussex, saw Alice in the days before her death - and said she had a new motivation to get better after winning a university place. He said: 'If Alice had gone back into a general hospital or been sent to an eating disorder unit she would likely be alive today.'

She did not tell him about her hospital admission - and he would have treated her differently if she realised her problems.

Low potassium levels can cause the heart to beat irregularly - and doctors at the Royal County Hospital had suggested fitting a pacemaker in the hours before her hasty discharge. She was seen at the Eastleigh clinic by treatment co-ordinator Dr Isabel Lewsey for seven months of cognitive behavioural therapy at the start of 2008 - before it was discontinued because it was not working.

Coroner Sarah Whitby, the Assistant Deputy Coroner for Hampshire, recorded a narrative verdict. She ruled: 'Alice Rae died from an unascertained cause on the night of the 13 to 14 of January 2009 at her home. 'She had been suffering from anorexia from at least May 2006 for which she had been receiving treatment.'


Australia: Will they ever learn? Another government ambulance bungle over lack of street address

How many people do they have to kill before they get their act together? These phone helplines where some know-nothing just sits in front of a computer screen are a disaster. They usually fail completely when something non-routine comes up. I have experienced it many times with Telstra and have only got action by writing a letter to the Telstra boss. But writing letters is no help in an emergency. Emergency services should have somebody with local knowledge that they can call on if their computer data is inadequate. With Telstra, I have had arrogant and ignorant operators hang up on me too. That's just how computer-driven helplines deal with non-routine problems

Six months after an inquest found NSW triple-0 operators bungled a series of calls from a dying schoolboy lost in the Blue Mountains, the service has been accused of failing another person in need of help. Stuart Jamieson called the emergency line from a remote property near Boomi in far northern NSW on Monday to get help for a man who had become seriously unwell after working in the heat. An operator ended the call because Mr Jamieson could not provide a street number.

"I gave the road that went past [the location]," Mr Jamieson told Fairfax Radio network today. "They said they wanted a house number. I said there's no house number." Asked what road his property was on, Mr Jamieson said: "The Boomi-Goondiwindi Road. They couldn't find Goondiwindi on a map because ... it's in Queensland. "They said they could not find the Boomi-Goondiwindi Road."

AAP found the road in seconds, with two clicks on Google. Because the operator could not locate Mr Jamieson on a map, she terminated the call. "We were quite prepared to meet the ambulance at the road," Mr Jamieson said. An ambulance eventually arrived after he contacted a local stock and station agent who found help by knocking on the door of the Goondiwindi ambulance service, he said.

The emergency services operator who disconnected his call has since been stood down, The Daily Telegraph reports.

The incident followed an inquest earlier this year into the death of Sydney schoolboy David Iredale. The 17-year-old became separated from his two classmates on Mount Solitary during a three-day trek in 2006. The inquest found three triple-0 operators bungled a series of calls for help he made to them before he died - because they did not have a street address.


Opposition to health care legislation dominant

As the debate over a health care bill enters a critical stage, a new USA TODAY/Gallup Poll finds Americans inclined to oppose congressional passage of the legislation this year. The survey, taken Friday through Sunday, finds 42% against a bill, 35% in support of it. Despite nearly a year of presidential speeches, congressional hearings and TV ad campaigns by interest groups, more than one in five still doesn't have a strong opinion.

When pressed about how they were leaning, 49% overall said they would urge their member of Congress to vote against a bill; 44% would urge a vote for it.

The findings underscore the difficult battle ahead as President Obama presses Congress to enact the legislation by the end of the year. The House passed its version this month, and Senate debate on its health care bill is slated to start in earnest next week. A sharp partisan divide in public opinion helps explain the mostly party-line votes in Congress.

Those Democrats surveyed were overwhelmingly in favor of a bill: 76% to 17%. By an even wider margin, 86% to 12%, Republicans were opposed. Independents were against it by 53% to 37%.

Obama has seen his approval rating on handling health care policy slide a bit since the summer. Now, 40% approve, 53% disapprove, down from a 44% approval rating in July.


Damn the deficit: Full speed ahead on health care

Double-digit. That hyphenated adjective has been used most often recently to describe October's 10.2 percent unemployment rate. But it can also be used to describe the federal budget deficit as a percentage of the gross domestic product. That precise number is not yet known, but it may turn out to have a more dire effect on our national life than October's unemployment rate.

In the fiscal year just ended, federal spending was nearly 25 percent of GDP while federal revenues slipped below 15 percent because of the financial crisis and recession. We have not seen a budget deficit of this magnitude since World War II, which surely was a greater challenge than recent economic troubles.

Apologists for the Obama administration argue that some 2009 spending, like that on financial bailouts, is nonrecurring. True, but as the Congressional Budget Office has reported, the trajectory of administration spending and revenue is pushing the annual deficit toward $1,000,000,000,000 -- that's $1 trillion -- for the next decade.

Congressional Democrats' health care bills threaten to add to that. The bill currently before the Senate is advertised as costing less than $1 trillion. But significant spending doesn't kick in till 2014 and over the ensuing 10 years adds up to $1.8 trillion, nearly double that.

Thanks to current low interest rates, servicing the debt costs the government only $200 billion this year. But the White House estimates that debt service will exceed $700 billion in 2019. "In a few years," the Economist editorializes, "the AAA rating of Treasury bonds, the world's most important security, could be in jeopardy."

It's not only Republicans who decry this prospect. Examining the Democrats' health care proposals, William Galston, domestic policy adviser in the Clinton White House, writes, "We're already facing an unsustainable fiscal future."

Looking further ahead, Scott Winship notes in the Progressive Policy Institute's blog that federal spending is on course to exceed 40 percent of GDP because of scheduled spending on entitlements -- Social Security, Medicare, Medicaid -- within the lifetime of today's children.

Yet the congressional Democrats who are pressing to expand federal health care spending do not seem much fazed by the prospect that, as Winship writes, "the level of taxation it would require to meet projected spending needs is far higher than anything the country has ever seen-slash-tolerated."

That suggests that, at least for some Democrats, huge looming budget deficits are not a bug but a feature.Just as Ronald Reagan hoped that cutting taxes would force politicians to cut spending, these Democrats hope that increasing spending will force politicians to increase taxes to levels common in Western Europe. Never mind that those economies have proved more sluggish and less creative than ours over the long haul.

The instrument they may have in mind is the value added tax, which operates as an invisible sales tax on goods and services. Back in May, Budget Director Peter Orszag's spokesman mentioned the VAT as a "credible idea" that he did not want to rule out. In June, House Ways and Means Chairman Charles Rangel suggested a VAT as "a point of discussion."

In September, John Podesta, head of the Obama transition team, spoke of how a VAT would "create a balance" with other economies, and White House adviser Paul Volcker cited a carbon tax and a VAT as ways to raise lots of revenue. In October, Speaker Nancy Pelosi said, "Somewhere along the way, a value added tax plays into this."

These statements are noteworthy, because American politicians are ordinarily skittish about saying we should imitate Europe's high-tax and high-spending policies. These policies seem more unpopular than ever 10 months into the Obama presidency. Pollster Scott Rasmussen reports that 53 percent of voters worry that the federal government will do too much in response to economic problems, while only 37 percent worry it will do too little.

That mirrors voters' current opposition to Democratic health care bills. Democratic leaders nonetheless want to jam one through before their current majorities are eroded, as they seem likely to be, in the 2010 elections. This is politically risky, but makes sense if your goal is to expand government.

So the battle over health care is not just about health care. It's about whether government will permanently gobble up more of the private-sector economy and slow it down in the process.


Will Medical Tourism Industry Realize Benefits From Passage of Government-Run Health Care Bill?

Bob McCarty is a touch cynical below

Recently, a friend shared a prediction that prompted me to wonder whether or not the medical tourism industry will experience a boom if government-run health care becomes a reality in the United States.

In case you’re not familiar with the concept of medical tourism, it typically involves people from one country traveling to an exotic foreign locale to have a medical procedure performed at a lower cost. The “medical tourist” label applies to those who opt to spend some of their procedure-related savings by incorporating sightseeing and leisure activities into post-operative travel plans.

Considering the possibilities, I conceived that the most likely ObamaCare-induced scenario would involve cruise ships that would otherwise have found themselves in dry dock as a result of Obama’s massive wealth-redistribution schemes pulling the plug on the domestic cruise industry.

Reconfigured as floating hospitals, the ships would cruise in international waters barely 12 miles off the coast of the United States. They would be staffed by skilled doctors, nurses and other professionals who see tremendous benefit in being able to make a decent living as health care professionals unencumbered by bureaucracy-choked government panels. Their patient rosters would be comprised of people hoping to realize both the financial benefits that stem from saving money and the psychological benefits that would result from avoiding an experience with a government-run health care system.

Seems simple enough until liberalism — or, more accurately, socialism — enters the picture. That’s when I concluded that it will not work — not for very long anyway — due to efforts the Obama Administration will launch to thwart their success. Those efforts will include the following:

* The Obama Administration will refuse cruise hospitals entry into U.S. territorial waters and, in turn, access to U.S. ports. Why? Because their operations do not comply with federal health care guidelines and regulations.

* The Department of Homeland Security will step up screenings of American citizens who attempt to travel outside of the United States while not in the best physical condition. I can just imagine Janet Napolitano saying, “We wouldn’t want to burden other nations with our sick or inform citizens.”

* Both the Coast Guard and the FAA will deny applications for operating permits made by land, air or sea transportation companies hoping to be able to ferry patients to or from cruise ships. Of course, President Barack Obama will describe the denials as being “part of a larger anti-terrorism effort about which I cannot offer more details.”

* Congress will raise the tax rate on income earned by medical professionals while working outside the United States to a level high enough to make it unprofitable for them to make a living. President Obama will describe this as “only fair to those who grew up poor and could not afford medical school.”

If the measures above fail to sink the niche cruise hospitals, I’m certain Obama Administration officials will seek international assistance — perhaps from the United Nations and/or the World Health Organization — to make them illegal and to make those behind them subject to prosecution from the International Criminal Court. Their justification: “Those ships are needed to serve as floating prisons to house the thousands of Americans who refuse to sign up for government health insurance.”


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