Review Category : Health

Medical Errors May Result in More Than 200,000 Deaths, Study Finds

iStock/Thinkstock(NEW YORK) — Medical errors may be responsible for far more deaths than previously realized, according to a new study published Tuesday in the BMJ medical journals.

Researchers from Johns Hopkins University School of Medicine found that deaths from medical errors may be responsible for more than a quarter of a million deaths annually. Data in the studies was taken from a combination of Medicare and 13 other hospitals, which researchers examined to determine that the estimated annual rate of deaths from medical errors is 251,454 in the U.S.

That number would make it the third leading cause of a non-violent death in the U.S. ahead of chronic lower respiratory disease which leads to 147,101 deaths annually, according to data from the U.S. Centers for Disease Control and Prevention.

Dr. Martin Makary, lead author of the study and professor of Surgery and Health Policy and Management at Johns Hopkins University, said he hoped the study would reveal how much needs to be done to address patient safety.

“I like many doctors have been aware that people die from fragmented care, diagnostic errors, preventable complications and the problem is serious,” Makary told ABC News. “The concern I had was ‘Why is this not a national funding priority…why does it receive a comparable fraction of the funding” for cancer or heart disease?

Makary pointed out that identifying medical errors after a patient’s death is incredibly difficult. In most cases when a patient dies their cause of death is documented by a physician. That medical cause of death is then assigned a code used in billing and it is this code that the CDC uses to measure mortality statistics. These measurements can often miss complicated deaths according to researchers pointing to a case where a final cause of death was unsuccessful CPR but the patient had suffered a liver laceration during unnecessary testing days earlier.

To come up with their number researchers used information from four past studies and then extrapolated the mean number from that data to determine that more than a quarter of a million deaths were likely related to medical error.

Makary said there should be better measurements to identify medical error and said this was not a case of doctor being bad at their job.

“This problem should not be framed as we have bad doctors, it’s a system problem…a failure to impact normal human error,” said Makary.

The American Hospital Association released a statement in reaction to the study pointing out a decline in hospital-acquired conditions in recent years.

“No matter the number, one incident is one too many. Important progress has been made since 2008, the latest year the study examines,” association officials said in a statement. “Most recently, the Department of Health and Human Services estimated that through the hard work of hospitals, physicians and others, hospital-acquired conditions declined by 17%, saving 87,000 lives between 2010 and 2014. Hospitals are constantly working to improve patient safety. But there is more work to do and hospitals are committed to quickly adopting what works into every step of care provided.”

Dr. David Classen, patient safety expert and associate professor at University of Utah, said this large analysis comes after years of data estimating medical error deaths at more than 200,000 and pointed out some studies have estimated it to be closer to 400,000 people a year.

“If you had this many deaths in aviation industry…you’d shut it down,” said Classen. “It’s amazing that in all these other industries we never tolerate this kind of death.”

Classen said it’s key that this report lead to increased funding and research into patient safety and especially identifying when there are errors. Classen is currently developing ways of using electronic medical records to keep real time data of medical error and said he thinks self-reported errors represent just 10 percent of the actual problems.

“We’ve reached a point where an average patient comes in on 20 medications and has 10 different med problems and it’s hard for anyone human to sort it out,” said Classen. “We now deliver care not by an individual but by teams because it’s way too complicated.”

Both Classen and Makary say it’s key that patients advocate for themselves in the hopsital and both recommend having family members or other caregivers go to a hospital with a patient.

Mary Burton, vice president of Performance Measurement at National Committee for Quality Assurance, said standardizing data and national reporting of causes of death could be key in helping cut down on deaths or injuries related to medical error.

“We would be supportive of that kind of message either on death certificates or potentially in some other standardized place in a record because of course not every medical error…results in death,” Burton told ABC News.

Burton said these studies should drive the medical community to take action to protect patients and improve hospital care.

“Why if we’re the first world…then shouldn’t we be passionate about patients safety?,” said Burnton. “Shouldn’t we be vigorous and unrelenting in terms of developing system improvements in regards to safe guards?”

Copyright © 2016, ABC Radio. All rights reserved.

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Safe Space for Opioid Users Reveals Changing Views on Addiction

iStock/Thinkstock(BOSTON) — A Boston homeless center has started a new program allowing people who use opioids to be in a safe space where they can be supervised after taking the drugs. The program joins a growing number of places which aim to use “harm reduction” strategies — leading people toward treatment and reducing the risk of overdose — in the difficult fight against a rapidly growing opioid epidemic.

Last month, the Boston Healthcare for The Homeless Program (BHCHP) started their initiative called Supportive Place for Observation and Treatment (SPOT) where people in the midst of an opioid high can go for support. Up to eight people will be allowed in the space at a time and they will be closely monitored by officials on site so that they don’t overdose.

“Currently, we are responding to 2-5 overdoses at our main site each week, and our lobby and clinic waiting room are already places where people rest safely in the midst of recent use of substances,” the center wrote in a recent statement on their site. “The street corners nearby are similarly filled with people who are also at high risk of overdose, and who may not be engaged with providers of health care or addiction services.”

“SPOT is one part of our larger response to lessen the impact of the opioid crisis on our patients, staff and the neighborhood,” officials from BHCHP said in a statement, adding that deaths from suspected opioid overdoses have increased by 50 percent, between 2014 and 2015, in Boston.

As overdose deaths have increased dramatically in recent years, mostly attributed to an epidemic of prescription painkiller addictions that can lead to intravenous heroin use, some health officials have advocated for simply reducing the immediate dangers for addicts.

In Ithaca, New York Mayor Svante Myrick has proposed a major initiative aimed at combating the opioid epidemic and hopes to open a supervised injection site — an option that currently exists in other countries, but not in the U.S. — so that addicts can use drugs in a safe space, to help diminish overdose cases and transmission of HIV or hepatitis through intravenous drug use. Seattle is considering a similar space.

Daniel Raymond, Policy Director at the Harm Reduction Coalition, said the spike in opioid drug use in recent years has lead to a major change in how some public health officials approach drug policy.

“A lot of these proposals reflect the state of crisis we’re in,” said Raymond. “The distinct thing with opioids and heroin is the immediate risk of overdose, the lethality. We’ve got the highest overdose numbers in the country that the CDC has ever seen.”

He pointed out that federal money is currently allocated to one of the early forms of harm reduction: needle exchange programs. These programs provide clean needles to drug users to cut down on HIV and other diseases transmitted through dirty needles. Many of these programs have informal policies to monitor addicts who are using drugs, as way to safeguard their health.

The changes at sites across the country, Raymond added, show an overall acknowledgement that more services need to be provided to people who are not yet fully sober or are looking for help to stop their drug use.

“As we learn more about addiction and treatment there’s a greater recognition that it’s not a magic bullet,” said Raymond. “Treatment is important and not magic.”

“We’ve got to something for people in the middle, that’s the space that harm reduction occupies,” he added.

Since 1999, the rate of overdose deaths involving opioids (including prescription opioids and heroin) almost quadrupled, with 78 Americans dying every day from an opioid overdose, according to the CDC.

Earlier this year, President Barack Obama proposed $1 billion to expand access to treatment for prescription and heroin use.

Copyright © 2016, ABC Radio. All rights reserved.

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Rescued Cat with Broken Jaw Learns to Smile Again

Duchess- the Miracle Kitty/Facebook(EL PASO, Texas) — Meet Duchess the “Miracle Kitty,” a cat with a broken jaw who’s learning to smile again and whose epic tale of survival is making the rounds on Facebook.

The young Siamese cat was originally rescued after being hit by a car last October, according to her owner, Crystal Tate, who works as a veterinary assistant at Adobe Animal Hospital and Veterinary Clinic in El Paso, Texas, the animal hospital that took Duchess in.

“The impact from the car broke her jaw, and seeing the condition she was in, most other places probably would’ve chosen to euthanize her,” Tate, 20, told ABC News Tuesday. “But the doctors here thought we she should give her a chance, so they attempted surgery to repair her jaw.”

Though Duchess’ “chances of survival were slim, she was a fighter and pulled through,” Tate said. “The day I first met Duchess, her mouth was just beginning to heal and the feeding tube had just been removed. She was very thin.”

Though the young cat’s “eyes showed so much sadness, her purrs showed so much love and hope,” she said, adding that she immediately fell in love with Duchess and took her home within a few weeks.

Duchess “has improved so much,” Tate said, explaining that whereas Duchess was once “lethargic and low energy,” she is now “spunky and playful.”

Tate added that Duchess loves playing and planning mischief with her other cat and two dogs.

“Duchess’ jaw is still crooked and it will be for the rest of her life, but it hasn’t crushed her spirit,” Tate said. “We are still learning her quirks and helping her live her new life, but we wouldn’t have it any other way.”

You can follow Duchess and her latest adventures on her Facebook page.

Copyright © 2016, ABC Radio. All rights reserved.

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Experts Find Insufficient Evidence to Recommend for or Against Routine Testing for Celiac Disease

iStock/Thinkstock(WASHINGTON) — The nation’s top experts on preventive health do not recommend for or against routine testing for celiac disease, unless symptoms suggest it.

Celiac is an autoimmune disease in which the body reacts to gluten, a protein found in wheat. This disease affects approximately 0.40 percent to 0.95 percent of adults in the U.S., and the symptoms include diarrhea, abdominal pain, weight loss and malnutrition.

Although blood tests exist to screen for celiac disease, proper diagnosis relies upon biopsy — an invasive procedure.

The United States Preventative Services Task Force (USPSTF) concluded that there wasn’t enough evidence to recommend for or against routine screening for people without symptoms.

For those with no symptoms, there is little evidence on the short- and long-term impact of a gluten-free diet for those with or without the disease.

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Deceased Toddler’s ‘Tip Jar’ Inspires, Collects Thousands

Jessy Nahmias(NEW YORK) — Brandon Nahmias died when he was just 2 years old, but his life continues to have meaning, his mom Jessy Nahmias says.

She sold empanadas for years at food markets, and next to her empanadas, a simple tip jar stood with a picture of Brandon.

Brandon was born with Down syndrome and a heart condition that could not be corrected completely, despite surgery. Shortly after he turned 2, Brandon caught a virus.

“His heart couldn’t take it,” the New York woman said.

After his death, his mom said she “went numb for about two years. I didn’t want to live.”

But Jessy has two other children, and life had to go on. She wanted some way to honor Brandon.

“People would leave tips but I didn’t feel right about that,” Jessy said of her empanada stand. “So I put out the tip jar instead to try and raise money for other kids with Down syndrome.”

She collected thousands of dollars and donated it all to Gigi’s Playhouse NYC, a Down syndrome achievement center. “Brandon’s Tip Jar,” as it has come to be known, has improved the lives of many other children, said Benny Kaufman, program director at Gigi’s Playhouse NYC.

The tips, Kaufman said, “support free academic and recreational programs for other individuals with Down syndrome so that they can explore and define their potential. It’s helped kids like Brandon learn to read and make life-long friends, it’s helped parents receive the support they need, and it’s helped create welcoming communities and change New York’s perception of Down syndrome.”

The organization was so inspired by the enormous effect of Jessy’s simple jar that they created an online “virtual tip jar” in Brandon’s memory.

And Brandon’s short life continues to make a difference. Nahmias just opened her own shop, called Jessy’s Pastries, in Oceanside, New York.

She plans to hire people with Down syndrome to work there.

“That was my goal all along, to have a storefront and continue to help people with Down syndrome,” Nahmias said. “Brandon came here to show us all what we’re supposed to do.”

Copyright © 2016, ABC Radio. All rights reserved.

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Experts Recommend Against Routine Testing for Celiac Disease

iStock/Thinkstock(WASHINGTON) — The nation’s top experts on preventive health do not recommend routine testing for celiac disease, unless symptoms suggest it.

Celiac is an autoimmune disease in which the body reacts to gluten, a protein found in wheat. This disease affects approximately 0.40 percent to 0.95 percent of adults in the U.S., and the symptoms include diarrhea, abdominal pain, weight loss and malnutrition.

Although blood tests exist to screen for celiac disease, proper diagnosis relies upon biopsy — an invasive procedure.

The United States Preventative Services Task Force (USPSTF) concluded that there wasn’t enough evidence to recommend routine screening for people without symptoms.

For those with no symptoms, there is little evidence on the short- and long-term impact of a gluten-free diet for those with or without the disease.

Copyright © 2016, ABC Radio. All rights reserved.

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“Biggest Loser” Winner Said Regaining Weight Felt ‘Shameful’

Photodisc/Thinkstock(NEW YORK) — A former Biggest Loser winner said he felt “shameful” for regaining weight until a new study shed light on the difficulties of long-term weight loss.

Danny Cahill, a contestant on season eight of the weight-loss reality show The Biggest Loser, weighed 191 pounds at the conclusion of the show, dropping more than 200 pounds in 30 weeks.

After Cahill returned home and resumed his life, the weight started to creep back on. A study published Monday in the medical journal Obesity Biology and Integrated Physiology followed 14 Biggest Loser contestants after their remarkable weight loss and found that all but one had regained weight after the show ended. Nearly all of them had slower metabolisms than before their appearances on the show.

Cahill said he gained back 100 pounds and now has to work out three to four times as much as he did before he joined the show.

“I did feel like a million bucks for a couple years I kept the weight off completely. I wondered why others were gaining it back. I was working out two hours a day and riding my bike all over town to go where I was going,” Cahill told ABC News. “Once that stopped, the weight started creeping back on.”

The producers of the show responded to the study in a statement given to ABC News.

“We have comprehensive procedures and support systems in place which we routinely re-evaluate to ensure all contestants receive the best care possible. The lead medical doctor on the show, who has worked with the National Institutes of Health on initiatives in the past relating to The Biggest Loser, has been made aware of this most recent study and is in the process of evaluating its findings,” the statement read.

The study found that among those who lost an extreme amount of weight, their metabolism slowed greatly and they had less of a hormone called Leptin, which regulates hunger. The contestants now have to work harder to keep the weight off than someone of the same size.

Cahill admitted that his weight gain has taken a toll mentally.

“When you gain weight back, even when you’re in school it’s shameful,” said Cahill. “When you’re in front of America, then it’s 10 times as shameful.”

“When we found this out we were like, ‘Okay, some of it is not our fault.’ It is our responsibility but some of it has to do with this science,” he said, adding, “I’m going to do what David did when he tackled Goliath. I know there’s a bigger God out there that wants me to be well and I am going to do everything I can but I can’t do it all.”

Dr. Holly Lofton, assistant professor of medicine and the director of medical weight management program at NYU Langone Medical Center, told ABC News that she often prescribes Food and Drug Administration-approved weight-loss medications to patients after losing weight so they can control their hunger.

“Hunger is not a sign of poor willpower and it’s not a sign of cheating,” Lofton said. “There’s a lot of shame and guilt at the idea that they may not be able to keep the weight off on their own without medications or devices or surgery, because that is what the environment has taught us.”

Copyright © 2016, ABC Radio. All rights reserved.

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Doctors Advised to Treat Insomnia with Cognitive Behavioral Therapy

iStock/Thinkstock(NEW YORK) — People who suffer from chronic insomnia may be able to find relief without the help of drugs.

New guidelines published by the American College of Physicians (ACP) advise physicians to use cognitive behavioral therapy (CBT) as the first-line treatment for patients with insomnia. CBT is a combination of therapy, behavioral interventions and patient education, and it can be done in person (individually or in groups), via telephone- or Internet-based modules, or through books.

In trials, CBT significantly improved several aspects of insomnia in all ages. Some medications improved insomnia symptoms at least a small amount, but others did not show significant benefits, and some drug therapies were associated with adverse effects.

In addition to recommending CBT for insomnia, the new guidelines advise clinicians to discuss the possible benefits and harms of drug therapy with patients if they need to prescribe it to those who did not improve with CBT alone.

While there was not enough evidence to say which approach was most effective, CBT is less likely to cause harm, so the ACP felt that it provides better overall value than drug therapy.

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Your Body: Is Moderate Alcohol Intake Good for You?

iStock/ThinkstockBy DR. JENNIFER ASHTON, ABC News Senior Medical Contributor

Many studies lead people to believe that a glass of wine at dinner could lead to better overall health and even a longer life. But not so fast — this topic is really controversial.

Most reputable peer review studies do in fact show what we call a “J-shaped” curve with respect to alcohol intake. This means that most people who don’t drink at all and people who drink a lot have higher death rates than those who drink moderately.

On the positive side, alcohol — especially red wine — can be good for a Mediterranean lifestyle.

On the negative side, however, alcohol is known to be associated with an increased risk of numerous cancers and it is packed with calories.

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Study: Flu Shots for Pregnant Moms Protect Babies, Too

iStock/Thinkstock(SALT LAKE CITY) — In a study just published in the journal Pediatrics, researchers at the University of Utah School of Medicine have discovered that pregnant women who get the flu vaccine significantly reduce the risk for their baby to get the illness.

According to the scientists, infants 6 months and younger whose mothers were vaccinated when pregnant had a 70 percent reduction in confirmed flu cases and an 80 percent reduction in flu-related hospitalizations compared with babies whose moms skipped the shot.

What’s more, the study showed that 97 percent of laboratory-confirmed flu cases occurred in infants whose mothers’ weren’t immunized.

“Babies cannot be immunized during their first six months, so they must rely on others for protection from the flu during that time,” according to Julie H. Shakib, D.O., M.S., M.P.H., the University of Utah’s assistant professor of pediatrics. “When pregnant women get the flu vaccine there are clear benefits for their infants.”

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