A few weeks ago, we posted a blog about the connection between doctors and prescription sales. In that article, financial data was used to show that doctors who worked with a pharmaceutical company, giving presentations and speeches, were more likely to prescribe a drug that the company had marketed.

In a similar tale of big pharma influence, one St. Louis company has been entangled in a lawsuit under the False Claims Act. John Prieve, the whistleblower who brought forth the suit, worked at Mallinckrodt LLC. In his suit, he claims that Mallinckrodt defrauded the government because they used financial incentives to increase the number of doctor prescriptions their drug got. In doing so, many of the prescriptions were paid by Medicare and Medicaid, essentially placing the added cost on the government. The suit alleges that the company ‘targeted doctors’ who prescribed similar drugs in an attempt to increase sales of the less effective and more expensive antidepressants and sleep aids that Mallinckrodt made. The company is settling the suit for $3.5 million.

Philip and Morris Esformes have been accused of taking over a million dollars in kickbacks from Omnicare Inc. during its purchase of Total Pharmacy. The whistleblower, Maureen Nehls, filed the suit under the False Claims Act. The Esformes, as operators of nursing homes, are accused of switching their facilities to Total Pharmacy, which Philip had a 40% stake in, and receiving donations from the company, which may or may not be considered a kickback.

The trial will start today in Chicago. Omnicare Inc., the company accused of ‘donating’ to the Esformes had previously settled with the government for $17.2 million. See article at McKnight’s.

Two years ago, Medicare recipients who couldn’t pay for prescriptions were able to get their medications thanks to a deal with drugmakers to lower prices, reports USA Today. Discounted drugs were the savior then, and the benefits of that decision could be saving the program now. Since that initiative, Medicare has saved $5 billion and allowed patients to receive vital medications, which ultimately led to less hospitalizations. The initiative helped stabilize patients who had previously been taking their medications only as they could afford them. The program may have long lasting ramifications in cutting down on the number of hospitalizations and may boost the sale of name-brand drugs. The overall statistics on the program are positive, but there is still conjecture over the long term effects of the initiative.

Deep brain stimulation or DBS is basically a pacemaker for the brain. For many debilitating neurological or psychiatric conditions which are the result of the brain’s irregular neurological response, DBS acts as a pacemaker, using electricity to set the brain’s rhythm in much the same way as a pacemaker would for the heart. In this article from Motherboard and Vice, questions about DBS are answered.
Basically, DBS is comprised of two leads placed in the brain which are wired to a battery in the chest. The leads, which are small electrodes, are wired to the battery in the chest, which is what sends the current. The leads act as conductors, sending the electricity into the brain, and managing the brain’s neural pathways. For more on DBS, including a video that shows its effects, see the article here. See article at MotherBoard.

The possible answer: Both.

In an article in the Chicago Tribune, the question of whether bedrails are a safety precaution or a threat to the elderly is explored. Since 1985, the Food and Drug Administration “has received 901 reports of patients caught, trapped, entangled, or strangled in hospital bed rails, including 531 deaths.” Some say that the rails provide support, and prevent falling. Others note that falls do not increase without the rails, and that the rails can often provide obstacles which increase injuries from falls.

In addition, rails used as restraints, with the maximum number of siderails, two at the top and two at the bottom, can be incredibly dangerous to the elderly. Elderly persons are often small and frail, and they can become trapped between the rail and the mattress, which compresses their lungs, suffocating them, and it can break bones in the neck. Many times, the person can’t even scream because their lungs are being compressed. Child bedrails and elderly bedrails don’t have the same safety standards. Child bedrails are safer by far, but there is a growing advocacy movement for safer elderly bedrails. As a result, ASTM International will create voluntary guidelines for adult bed rails. Officials say that if these voluntary guidelines do not decrease deaths, then other steps will be looked into.

…Or at least gives second degree burns. Daniel Lynch, a patient at Slate Belt Nursing and Rehabilitation Center, recently lit up a cigarette, intending to enjoy a smoke. However, Mr. Lynch was wearing an oxygen machine, with a tube that led to his mouth. The oxygen ignited, giving Mr. Lynch second-degree burns over his face, neck and hands. Authorities say that the flame was caused by the oxygen’s pressure. At this time, it’s unsure if the nursing home is at fault for letting Mr. Lynch smoke while receiving oxygen. See the full article here.

Americans may be living longer, but that doesn’t mean we’re living healthier. American longevity has increased, but so have the number of years living with chronic disability. In a report by the Wall Street Journal, a study from the Journal of the American Medical Association, JAMA, is reviewed to see why Americans living longer doesn’t mean that we’re living healthier.

The study found that deaths from obesity related illnesses like diabetes and kidney disease were increasing, along with neurological conditions like Alzheimer’s. America has made some medical advances to combat cancer and HIV, but our later years are frequently plagued with avoidable diseases which could be controlled through weight loss and better diet, an increase in physical activity, and better management of stress—which includes not smoking.

The things that are plaguing Americans, and decreasing the quality of our longevity are things that we have control over. Some say that until we begin taking this issue seriously, the situation will only get worse.

Herlinda Garcia was diagnosed with Stage IV terminal breast cancer in 2009.  She underwent seven months of horrible chemotherapy, gave away a life’s worth of belongings, and arranged for hospice care for when she became too ill to care for herself. There’s only one problem.

Garcia did not have cancer.

Her doctor, Dr. Qadri, had misread the PET/CT scan. Garcia was misdiagnosed and did not find out that she was cancer-free until 2011.  Because of the malpractice from Dr. Qadri, a jury awarded Garcia only $367,500 in a medical malpractice lawsuit, which will then be lowered to comply with the state’s arbitrary cap on damages at $250,000.

See article at Houston Chronicle.

The Supreme Court’s recent decision regarding arbitration in American Express Co. v. Italian Colors Restaurant shows how far the Conservative Majority will protect the inteests of the monied class. The ruling was very technical, but it boils down to this:

Italian Colors Restaurant contended that American Express had a monopoly when they charged more for their credit cards than other cards. Because of Express’ arbitration contract, Italian Colors couldn’t come together with others affected by the monopoly, and couldn’t fight the contract because of limited resources.  The cost of each arbitration would outweigh the benefit so the monopoly would continue.  In effect, by upholding the arbitration contract, the Supreme Court nullified the restaurant’s right to a jury, due process, equal protection, and a fair compensation.

Justice Kagan correctly called the decision a “BETRAYAL” of the Court’s previous decisions regarding mandatory arbitration. In doing so, they found that it was okay for the company to make it impossible for the restaurant to vindicate their statutory rights. The conservative Court’s decision was a blatant violation of rights in favor of corporate interest.

In a follow-up from a previous post, Attorney General Mike DeWine upholds his commitment to cracking down on nursing home abuse and neglect. In Ohio, DeWine is using 21st century technology to capture crimes that are as old as time. Complaints in the past month have increased significantly since the incident at Zanesville was discovered. DeWine is committing to aggressively pursuing claims of substandard care in nursing homes, and the people of Ohio already seem to be positively responding. See article at The Intelligencer.