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A Modern Diagnosis

Mrs. Smith goes to the doctor's office to get her husbands test results. The lab technician says to her, "I'm very, very sorry Mrs.Smith, but we've had a bit of a problem.”


“You see, at the same time we sent your husbands samples to the lab, the lab also received samples from another Mr. Smith, and now, we're not sure which results are your husband's. Frankly, we simply mixed up the test results which are either bad news or terrible news!"


"What on earth do you mean?" said Mrs. Smith.


"Well, one Mr. Smith tested positive for Alzheimer's, and the other Mr. Smith tested positive for AIDS. We just can't tell which is your husband's test."


"This is terrible!" cries Mrs. Smith. "Can't we do the damn test over?"


"Normally, yes," says the technician, "but your insurer,  Legacy Health Care, won't pay for these expensive tests more than once."


"Well, what are we supposed to do now?" asked Mrs. Smith.


Legacy recommends that you drop your husband off in the middle of town. If he finds his way home, don't sleep with him."


Surgical Tools Washed in Hydraulic Fluid

3,800 patients at two Duke University Health System hospitals were operated on last year with instruments that were washed in hydraulic fluid instead of detergent! Click here to read full story.


Now That's a Severe Headache!

This X-ray picture shows a 5-centimeter nail stuck in an unidentified South Korean patient's skull Thursday, Dec. 2, 2004. According to a Seoul hospital, doctors found the nail after the man came to the hospital, complaining about a headache. They speculate that the nail stuck in the man's head four years ago in an accident but the man didn't know about it. The nail was removed in a surgery.


Most Doctors Aren't Pursuing Quality Improvement Efforts

A majority of physicians are not actively engaged in quality improvement practices and are reluctant to share information about the quality of care they provide with patients or the public, says a new Commonwealth Fund survey.   Read Survey Results.

To date, Quality Improvement has not permeated the culture of professional medicine, say the authors of "Measure, Learn, and Improve: Physicians' Involvement in Quality Improvement" (Health Affairs, May/June 2005).    Drawing upon data from the Commonwealth Fund National Survey of Physicians and Quality of Care, Anne-Marie J. Audet, M.D., and her colleagues found that only one-third of doctors have been involved in any redesign efforts aimed at improving performance. Just a third, moreover, have access to any data about the quality of their own clinical performance, while seven of 10 physicians do not feel the public should have access to quality-of-care data. The survey also revealed surprisingly low use of electronic medical records (EMRs): only about a quarter (27%) of doctors reported using an EMR routinely or occasionally.


Seven Years After Operation, Towel Found in Woman's Body
Singapore Press Holdings, 08/08/2004

Seven years ago, former nurse's aide Bonnie Valle went in for lung surgery. A heavy smoker for many years, she suffered from emphysema - where the lungs become swollen with air making breathing difficult - and needed a constant supply of oxygen. After her surgery at the Cleveland Clinic in Ohio, she often complained about an odd feeling in her chest, according to her family members. The doctors dismissed it by saying that it was just her emphysema becoming worse. The truth only came out after her death in 2002 when she donated her body for medical research. During dissection a faculty member of the Northeastern Ohio Universities College of Medicine found a green surgical cloth the size of a large hand towel behind her left lung. Now Ms. Valle's relatives have filed a lawsuit against the clinic.


Routine Head Injury Treatment Found To Increase Risk of Dying

A routine treatment for patients with head injuries, used for 30 years, may in fact be increasing their risk of dying, an international trial involving more than 10,000 patients has revealed.

The results are likely to lead to big changes in the use of corticosteroids delivered by drip - an anti-inflammatory treatment designed to prevent potentially lethal swelling of the brain. The results of the study, involving patients from more than 50 countries, were published in the Lancet.

Researchers found that 21% of patients treated with corticosteroids died within two weeks, compared with 18% of those on dummy treatments. There was no difference in outcome depending on the severity of injury or how quickly the corticosteroids, delivered via drips, were administered.

The trial was undertaken by the Medical Research Council. Ian Roberts, of the London School of Tropical Medicine, who was its clinical coordinator, said: "Obviously, we would have preferred to find out that corticosteroids improve patients' chances of surviving head injury, but our results are important because they will improve patient care and protect thousands of future patients from increased risk of death from corticosteroids."

Gee, what about those who were killed over the last 30 years?

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To Reduce Errors, Cut Here

New Rules Require Doctors to ID Patients, Take 'Time Outs' and Sign Their Work

Sandra G. Boodman, Washington Post
In 1998, 16 wrong-site cases were reported to JCAHO, compared with 75 last year. Cases included the removal of the wrong breast and a noncancerous kidney, a biopsy on the wrong side of the brain and surgery on the wrong patient.

While wrong-site surgery constitutes only a fraction of the estimated 98,000 medical errors that kill hospitalized patients annually or of the approximately 60 million surgeries performed in the United States, medical experts say it is indefensible because it is so easy to prevent. Click here to read full story.


In Good Standing?

Katherine Bibeau went to South Carolina in March, looking to slow her physical decline from multiple sclerosis. Ms. Bibeau, a 53-year-old laboratory technician from Minnesota, met Dr. James Shortt, who practices alternative medicine. He is, according to a sign on the front of the building, a “longevity physician.” “Hydrogen peroxide would be very good to kill whatever's in there,” Dr. Shortt had told Ms. Bibeau over the phone in February, according to a transcript of his taped recording of the call, “because, right now, we don't know what it is.” On March 9, Dr. Shortt administered the hydrogen peroxide, intravenously. Over the next five days, Ms. Bibeau bled to death.

The coroner has called Ms. Bibeau's death a homicide, her family has filed a civil suit and law enforcement officials have raided Dr. Shortt's office and seized his files. But the website of the South Carolina Board of Medical Examiners has this to say about Dr. Shortt: "The above Licensee is in good standing." Click here to read full story.

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Last update on: 7/13/05

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