Archive for September, 2011


Amid growing concerns about the spread of disease through organ transplant surgery, a Pennsylvania couple has filed two medical malpractice lawsuits against a hospital that transplanted a hepatitis C infected kidney from one partner to the other.

The organ transplant lawsuits were filed by Michael Yocabet, 50, and Christina Mecannic, 40, of Greene County. Surgeons at the University of Pittsburgh Medical Center transplanted a kidney from Mecannic into Yocabet on April 6, but the couple claims that they did so despite test results indicating that Mecannic had Hepatitis C.

One of the lawsuits accuses the hospital and a number of staff members of negligence in missing the blood test results months earlier and then failing to note the results on several occasions before the transplant took place. The other complaint claims that physicians asked Mecannic whether she cheated on Yocabet, charged her with having used cocaine and then gave her the option of keeping her infection a secret from Yocabet. The couple has been together for 21 years and have an 18-year-old son.

According to allegations raised in the lawsuit, blood tests indicated that Mecannic had Hepatitis C on January 26, but the hospital failed to notify her and did not disqualify her as a potential donor. Another test on April 22 also indicated Mecannic had the infection, but she was not notified until a month after her kidney had already been placed into Yocabet, at which point she claims she was then given the option of keeping it a secret.

The hospital has indicated that the transplant was a medical mistake and the result of human error. The kidney and liver transplant division of the University of Pittsburgh Medical Center was shut down for two months, a surgeon was demoted and a nurse was suspended as a result of the hospital’s investigation, officials claim.

Earlier this month, the U.S. Centers for Disease Control and Prevention (CDC) issued new draft guidelines designed to reduce the risk of HIV, Hepatitis B and Hepatitis C from organ transplants.  Among the additions to the updated guidance are recommendations for screening donors for hepatitis B and C, the use of more modern screening for organs slated to be transplanted and the use of a revised set of donor risk factors to provide a better idea of the risks associated with a donor’s organs.

Hepatitis C is an infectious disease that can cause liver damage, including liver failure, cirrhosis and liver cancer. It is technically incurable, but very effective treatment has been able to eradicate the disease in some of those who contract it.

The most common means of infection is through injection drug use. The CDC estimates that 60% to 80% of all recreational drug users in the United States have contracted hepatitis C from sharing dirty needles.

Mecannic says she most likely got infected through blood exposure while working as a licensed practical nurse in nursing homes.


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How Emergency Medicine Could Serve As An Inspiration To The Health Care Industry

How Emergency Medicine Could Serve As An Inspiration To The Health Care Industry  BY Ariel SchwartzMon Sep 26, 2011

It’s no secret that the health care industry is technologically backwards. With very few exceptions, patients are forced to navigate a system that lacks any kind of central coordination, and where records and test results are left to the mercy of fax machines. But there is one area in the health care industry where care is patient-centric, quick, and well-coordinated: the emergency room.

Minneapolis-based design firm Worrell debuted a video at last week’s Body Computing Conference that illustrates how principles from the ER can improve the patient care experience in the broader health care industry. One idea: a technology-based nurse line that allows patients to show–not tell–their symptoms using a diagnostic kit containing a camera, thermometer, blood pressure cuff, EKG, and more, all from the comfort of their home.

It’s the kind of idea that could cut down on emergency room visits (and accompanying costs), make health providers more effective, and empower patients to take control of their care. And the diagnostic kit could at least be partially paid for with savings from reduced ER trips. What are we waiting for? If any industry could use a design makeover, it’s health care.

[Images: Worrell]

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Cantaloupe Food Poisoning Death Toll Rises to Eight, May Go Higher: CDC

At least eight people are dead and 55 have become ill after eating cantaloupes contaminated with listeria, according to federal investigators who are monitoring cases of food poisoning caused by more than 600 pounds of recalled cantaloupe.

The U.S. Centers for DIsease Control and Prevention (CDC) said the number of listeria illnesses from cantaloups may continue to rise and there may be more deaths, despite on-going efforts to track down the potentially contaminated.

Listeria infections can live in the gut for up to two months before the carrier gets ill, and diagnosed cases of listeriosis are typically associated with a death rate of about 25%.

The cantaloupe food poisoning outbreak has already hit people in 14 states, with 43 of the 55 sickened requiring hospitalization. Most of the victims are over the age of 60 or have a compromised immune system due to health issues, the CDC reported. Of the eight deaths, two were in Colorado, one in Maryland, four in New Mexico and one in Oklahoma.

A Jensen Farms cantaloupe recall was issued on September 14, and subsequent inspections have found listeria strains associated with the illnesses on machinery and cantaloupes at Jensen Farms’ packing facility. The company already faces at least three listeria food poisoning lawsuits over the outbreak; two in Colorado and one in Texas.

The recall was expanded on September 23 to include 594 pounds of Carol’s Cuts fresh cut cantaloupe. The recalled cantaloupe, supplied to Carol’s Cuts, LLC by Jensen Farms, was sold in 8-ounce clamshell containers labeled Fruit Medley and in 5-pound bulk trays. The cantaloupe was shipped to institutional food customers and restaurants in Overland Park, Kansas, Kansas City and Maryland Heights, Missouri, and Omaha, Nebraska. All of the recipients of the recalled cantaloupe have been notified.

The recalled Carol’s Cuts cantaloupe was sold in clamshell containers with an oval label sticker with the words “Fruit Medley” and a “Best If Used By” date of September 3, 2011 or September 19, 2011. The 5-pound bulk trays have lot numbers of 72361 and a Best If Used By date of September 3, 2011, and 72700 with a Best If Used By date of September 19, 2011.

Listeria infections, also known as listeriosis, pose a particular risk for children, the elderly and those with weakened immune systems. For pregnant women, illness from Listeria bacteria can cause miscarriages and still births.

Blood tests are usually required to diagnose listeriosis, which can be treated with antibiotics. Symptoms of listeriosis include muscle aches, abdominal pain, nausea, diarrhea, severe headaches and fever. If the bacteria spreads from the intestines to the bloodstream and nervous system, it could cause meningitis and other complications.

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Conditional Payment Alert: MSPRC Institutes $300 Recovery Threshold on Certain Liability Settlements

On September 6, 2011, the Medicare Secondary Payer Recovery Contractor (MSPRC) indicated that they will not seek recovery against a liability insurance settlement, in certain instances, if:

  • The total lump-sum settlement, award or other payment is $300.00 or less;
  • Involves only a liability insurance settlement (not no-fault/workers’ compensation);
  • The resolution of the claim is for alleged physical injuries (and not for ingestion, exposure or implantation;
  • There are no additional settlements related to the same claim; and
  • A demand has not been issued.

This is the first time that the MSPRC has implemented a low-dollar recovery threshold. As we had mentioned earlier this summer, a June Congressional hearing on MSP recovery practices highlighted concerns that CMS and the MSPRC were focusing energy on circumstances where the recovery would be too minimal.  This threshold is at least indirectly responsive to those concerns.

While any threshold is welcome, the $300 is unlikely to relieve much of the administrative burden for CMS, the MSPRC, plaintiffs and insurers.  In June, the RAND Corporation unveiled a study that articulately argued for a much higher recovery threshold – of $5,000.  A copy of that study can be found here, and should be required reading for the key decision makers at CMS and the MSPRC.  This announcement by the MSPRC is at least a step toward recognizing the concerns highlighted in the RAND study, as well as HR 1063.

The alert can be found below and on the MSPRC’s website.

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Cerebral Palsy Malpractice Lawsuit Verdicy of $29M Against U.S. Upheld

A federal appeals court has upheld a $29 million verdict for a family that filed a medical malpractice lawsuit over negligent treatment at a government-funded clinic that allegedly caused their son to develop cerebral palsy.

The cerebral palsy malpractice lawsuit was originally filed by the parents Christian Arroyo, who was born in 2003 at the Erie Family Health Center. He is a spastic quadriplegic due to cerebral palsy, which his parents’ lawsuit alleges was caused by a brain infection that should have been detected and treated.

According to the complaint, after he was born, Arroyo suffered from an infection for 12 hours, which was not properly treated because the clinic staff failed to diagnose the problem. Although the boy allegedly showed every symptom of a brain infection, including an inability to see, the medical staff missed those signs and failed to treat Arroyo with antibiotics, which the family claimed may have prevented him from developing cerebral palsy.

At trial, the family won the cerebral palsy lawsuit against the clinic last year, receiving an award of $29.1 million. Because the clinic is funded by the federal government, the case was against the United States government, which attempted to get the verdict thrown out on appeal.

The U.S. government argued that Arroyo’s parents filed the case after the statute of limitations, based on when they reasonably should have known that their son’s brain damage was caused by a medical mistake. However, the U.S. Court of Appeals for the Seventh Circuit rejected that argument last week, upholding the verdict.

Cerebral palsy can be caused by a brain injury that occurs before, during or shortly after birth. If the brain of a baby is deprived of oxygen, it can result in irreversible damage that leaves the child with developmental problems, loss of motor functions and other life-long injuries and disabilities associated with cerebral palsy.

Although cerebral palsy can occur without a medical mistake, when the exercise of the proper standards of medical care could have prevented the child’s brain from being deprived of oxygen, medical malpractice lawsuits over cerebral palsy are often filed to obtain compensation for the child.

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