Study urges CDC to add medical error to cause of death counts

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Physician and Nurse Pushing GurneyBy Marshall Allen and Olga Pierce ProPublica, May 3, 2016, 6:31 p.m.

A study by researchers at Johns Hopkins Medicine says medical errors should rank as the third-leading cause of death in the United States — and highlights how shortcomings in tracking vital statistics may hinder research and keep the problem out of the public eye.

The authors, led by Johns Hopkins surgeon Dr. Marty Makary, call for changes in death certificates to better tabulate fatal lapses in care.

Study estimates that more than 250,000 Americans die each year from medical errors.

In an open letter, they urge the Centers for Disease Control and Prevention to immediately add medical errors to its annual list reporting the top causes of death.

Based on an analysis of prior research, the Johns Hopkins study estimates that more than 250,000 Americans die each year from medical errors.

On the CDC’s official list, that would rank just behind heart disease and cancer, which each took about 600,000 lives in 2014, and in front of respiratory disease, which caused about 150,000 deaths.

Medical mistakes that can lead to death range from surgical complications that go unrecognized to mix-ups with the doses or types of medications patients receive.

But no one knows the exact toll. In significant part, that’s because the coding system used by CDC to record death certificate data doesn’t capture things like communication breakdowns, diagnostic errors and poor judgment that cost lives, the study says. Continue reading

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State health centers awarded $5m to expand capacity

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HHS awards over $260 million to health centers nationwide to build and renovate facilities to serve more patients. $5 million will go to centers in Washington state.

Washington MapToday, HHS Secretary Sylvia M. Burwell announced over $260 million in new funding to 290 health centers nationwide for facility renovation, expansion, or construction.

In Washington state, six centers will receive a total of $5,036,675.

The Washington state funding will make it possible for the centers to provide care to nearly 18,500 more patients.

Health centers will use this funding to increase their patient capacity and to provide additional comprehensive primary and preventive health services to medically underserved populations.

The funding comes from the Affordable Care Act’s Community Health Center Fund, which was extended with bipartisan support in the Medicare Access and CHIP Reauthorization Act of 2015.

There are nearly 1,400 health centers operating about 9,800 service delivery sites in every U.S. state, D.C., Puerto Rico, the Virgin Islands and the Pacific Basin. They provide care for nearly 23 million people each year.

6 awards totaling $5,036,675 to serve a projected 18,475 additional patients

Organization City Amount
COMMUNITY HEALTH ASSOCIATION OF SPOKANE SPOKANE   $1,000,000
COMMUNITY HEALTH CARE TACOMA   $648,675
COMMUNITY HEALTH OF CENTRAL WASHINGTON YAKIMA   $1,000,000
LEWIS COUNTY COMMUNITY HEALTH SERVICES CHEHALIS   $388,000
PENINSULA COMMUNITY HEALTH SERVICES BREMERTON   $1,000,000
YAKIMA VALLEY FARM WORKERS CLINIC TOPPENISH   $1,000,000
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First Zika case reported in King County

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2016 Cynthia Goldsmith Caption:This is a transmission electron micrograph (TEM) of Zika virus, which is a member of the family Flaviviridae. Virus particles are 40 nm in diameter, with an outer envelope, and an inner dense core. Additional Information:“Zika virus is spread to people through mosquito bites. The most common symptoms of Zika virus disease are fever, rash, joint pain, and conjunctivitis (red eyes). The illness is usually mild with symptoms lasting from several days to a week. Severe disease requiring hospitalization is uncommon.”For more information on the Zika virus, follow the link below.

From Public Health – Seattle & King County

The first case of Zika infection in a King County resident has been identified by Public Health – Seattle & King County. This Zika case does not pose a risk to the public in Washington state.

The types of mosquitoes that transmit Zika are not found in the Pacific Northwest so local health officials do not expect Zika virus to spread.

Zika virus is primarily spread through the bite of infected Aedes aegypti and Aedes albopictus mosquitoes, or less commonly, through sexual contact with a recently infected man.

The illness was identified in a man in his forties who had recently been in Colombia, a country that has Zika virus spreading actively and is on the list of Centers for Disease Control and Prevention’s (CDC) travel advisories.

This is the third case of Zika found in Washington state. All three cases were found in people who became infected while in countries that have current Zika outbreaks.

With ongoing widespread outbreaks in the Americas and the Caribbean including Puerto Rico, the number of Zika cases among travelers visiting or returning to King County and elsewhere in the mainland United States will likely increase.

This Zika case does not pose a risk to the public in Washington state. Zika virus is primarily spread through the bite of infected Aedes aegypti and Aedes albopictus mosquitoes, or less commonly, through sexual contact with a recently infected man.

Continue reading

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Americans want more action against drug abuse, poll

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By Lisa Gillespie
Kaiser Health News

The fight against the growing abuse of prescription painkillers and heroin is not robust enough at any level — not federal and state governments’ efforts or those of doctors and users themselves, according to most Americans in a new poll out Tuesday.

Lack of access to care for those with substance abuse issues is a major problem, said 58 percent of those surveyed by the Kaiser Family Foundation. (KHN is an editorially independent program of the Foundation.)

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The poll found that Americans had somewhat different views of heroin and prescription drug abuse. More than a third called heroin abuse an extremely serious health problem in the U.S., while just over a quarter of those surveyed said the same about the abuse of strong prescription painkillers. In contrast, fewer than a fifth regarded alcohol abuse in the same way.

The fight against opioid abuse has generated heavy news coverage in recent months, as well as government concerns. President Barack Obama recently proposed adding $1 billion to the federal budget for treatment programs. Yet more than 60 percent of respondents generally faulted federal efforts as too little. Similar shares were dissatisfied with state governments’ actions and those of doctors who prescribe painkillers, the Kaiser poll found.

But more than 70 percent believed drug users themselves aren’t doing enough. Continue reading

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CRF Frozen Foods of Pasco Washington issues massive recall of its frozen vegetables due to Listeria concern

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Recall includes approximately 358 consumer products sold under 42 separate brands sold in all fifty U.S. states and the Canadian Provinces of British Columbia, Alberta, Manitoba, Saskatchewan.

Screen Shot 2016-05-03 at 3.38.59 PMAs a precaution, CRF Frozen Foods of Pasco, Washington is expanding its voluntary recall of frozen organic and traditional fruits and vegetables.

We are performing this voluntary recall in cooperation with the Food and Drug Administration (FDA) and the Centers for Disease Control and Prevention (CDC) because these products have the potential to be contaminated with Listeria monocytogenes.

The organism can cause serious and sometimes fatal infections in young children, frail or elderly people, and others with weakened immune systems.

Although healthy individuals may suffer only short-term symptoms such as high fever, severe headache, stiffness, nausea, abdominal pain, and diarrhea, Listeriainfection can cause miscarriages and stillbirths among pregnant women.

This expanded recall of frozen vegetables includes all of the frozen organic and traditional fruit and vegetable products manufactured or processed in CRF Frozen Foods’ Pasco facility since May 1, 2014.

All affected products have the best by dates or sell by dates between April 26, 2016 and April 26, 2018. These include approximately 358 consumer products sold under 42 separate brands, the details of which are listed below.

Products include organic and non-organic broccoli, butternut squash, carrots, cauliflower, corn, edamame, green beans, Italian beans, kale, leeks, lima beans, onions, peas, pepper strips, potatoes, potato medley, root medley, spinach, sweet potatoes, various vegetable medleys, blends, and stir fry packages, blueberries, cherries, cranberries, peaches, raspberries, and strawberries. For a complete list of affected products go here. Continue reading

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More young children with ADHD could benefit from behavior therapy, CDC

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Behavior therapy recommended before medicine for young children with ADHD

More young children 2 to 5 years of age receiving care for attention-deficit/hyperactivity disorder (ADHD) could benefit from psychological services – including the recommended treatment of behavior therapy.

ABC blocks stacked in a pyramidThe Centers for Disease Control and Prevention’s (CDC) latest Vital Signs report urges healthcare providers to refer parents of young children with ADHD for training in behavior therapy before prescribing medicine to treat the disorder.

ADHD is a biological disorder that causes hyperactivity, impulsiveness, and attention problems. About 2 million of the more than 6 million children with ADHD were diagnosed before age 6.

Children diagnosed with ADHD at an early age tend to have the most severe symptoms and benefit from early treatment.

The American Academy of Pediatrics recommends that before prescribing medicine to a young child, healthcare providers refer parents to training in behavior therapy.

However, according to the Vital Signs report, about 75% of young children being treated for ADHD received medicine, and only about half received any form of psychological services, which might have included behavior therapy. Continue reading

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States urged to reduce pregnancy-related deaths

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Blue Pregnant BellyBy Michael Ollove
Stateline 

The relatively high percentage of American women who die as a result of pregnancy, which exceeds that of other developed nations, is prompting a new national prevention campaign that is relying on the states to take a leading role.

The key element in that effort is to encourage all states to go beyond the information provided on a typical death certificate by having mortality review panels investigate the causes behind every maternal death that occurs during pregnancy or in the year after delivery.

The hope is the investigations will reveal systemic causes for at least some of the deaths and lead to preventive measures to save the lives of more would-be or new mothers.

The death rate is significantly higher in the U.S. than in other developed countries. 

A number of studies suggest that one in three maternal deaths is preventable.

“It’s hard to do anything about a problem if you don’t have the problem fully defined,” said Cynthia Shellhaas, an associate professor in the division of maternal-fetal medicine at the Ohio State University Wexner Medical Center. Continue reading

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Opioid epidemic fueling hospitalizations, hospital costs

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Tablet Thumb BlueBy Shefali Luthra
Kaiser Health News

Every day, headlines detail the casualties of the nation’s surge in heroin and prescription painkiller abuse: the funeralsthe broken families and the patients cycling in and out of treatment.

Now, a new study sheds light on another repercussion — how this public health problem is adding to the nation’s ballooning health care costs and who’s shouldering that burden.

The research comes as policymakers grapple with how to curb the increased abuse of these drugs, known as opioids.

Hospitalizations related to use and dependence on opioids have skyrocketed, from about 302,000 in 2002 to about 520,000 a decade later.

State legislators in New YorkConnecticutAlaska and Pennsylvania have tried to take action by adding new resources to boost prevention and treatment.

In addition, President Barack Obama laid out strategies last month intended to improve how the health system deals with addiction. Continue reading

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Shortages of emergency drugs increase, study

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Vaccine SquareBy Michelle Andrews
Kaiser Health News

At some hospitals, posters on the wall in the emergency department list the drugs that are in short supply or unavailable, along with recommended alternatives.

The low-tech visual aid can save time with critically ill patients, allowing doctors to focus on caring for them rather than doing research on the fly, said Dr. Jesse Pines, a professor of emergency medicine and director of the Office for Clinical Practice Innovation at the George Washington University School of Medicine and Health Sciences, who has studied the problems with shortages.

The need for such workarounds probably won’t end anytime soon. According to a new study, shortages of many drugs that are essential in emergency care have increased in both number and duration in recent years even as shortages for drugs for non-acute or chronic care have eased somewhat.

The shortages have persisted despite a federal law enacted in 2012 that gave the Food and Drug Administration regulatory powers to respond to drug shortages, the study found. Continue reading

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Ovarian cancer mutations found in healthy women, UW study finds

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From the University of Washington

In a study of 36 women – 16 diagnosed with ovarian cancer and a control group of 20 with no cancer diagnosis – nearly all of the women were found to carry cancer-associated gene mutations.

“Cancer mutations are supposed to indicate the presence of cancer. This study suggests that if we sequence deeply enough, we will find cancer mutations in nearly everyone,” said Rosana Risques, a UW assistant professor of pathology, who led the study with Jeff Krimmel, a medical student.

This study suggests that if we sequence deeply enough, we will find cancer mutations in nearly everyone.

The study is a caution for scientists and clinicians trying to detect cancer based on mutations, said Michael Schmitt, a co-author of the study and co-inventor of duplex sequencing. He is an oncology fellow at UW Medicine and Fred Hutch Cancer Research Center.

Among cells stained for the P53 mutation, the brown dots are nuclei of high-grade serous ovarian cancer cells. The blue represents normal Fallopian tube epithelial cells. Photo: Courtesy of Rosana Risques

Among cells stained for the P53 mutation, the brown dots are nuclei of high-grade serous ovarian cancer cells. The blue represents normal Fallopian tube epithelial cells. Photo: Courtesy of Rosana Risques

“Because healthy tissue frequently carries low-frequency cancer-like mutations, we need exquisitely sensitive technologies to accurately define the mutational load and differentiate between truly cancerous changes versus age-associated mutations,” he said.

The study was an early test of the power of DNA duplex sequencing, a technology developed at the University of Washington. Duplex sequencing independently tags molecules along both strands of DNA. In terms of a prospective diagnostic, its accuracy is thought to be unmatched.

This research, marking the technology’s first published application in human cancer detection, was posted online today by the Proceedings of the National Academy of SciencesContinue reading

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Gov. Inslee issues directive aimed at reducing lead exposure

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Washington state Gov. Jay Inslee issued a directive Monday to the state Department of Health (DOH) and partner agencies to assist local communities with lead testing and take steps aimed at reducing lead exposure in Washington.

“While no imminent public emergency has been discovered, recent detections of lead in some water systems are highlighting the important roles our water utilities, schools, public health departments and the state play in ensuring we all have access to safe, clean drinking water,” Inslee said. “This directive will better ensure we’re working in coordination and leveraging resources effectively to tackle lead at all its primary sources, whether it’s water, paint or soil.”

Symptoms_of_lead_poisoning_(raster)

Illustration courtesy of Mikael Häggström via Wikipedia

Inslee’s directive charges DOH and other state agencies to take action to reduce the exposure to lead, not only in drinking water, but also in the state’s infrastructure and places children are proven to be most susceptible to exposure, such as older buildings that may have lead paint. Continue reading

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Even as birth rates fall, teens say they are getting less sex education

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By Michelle Andrews
Kaiser Health News

Teenage girls are catching up to teenage boys in one way that does no one any good: lack of sex education, according to a recent report.

The proportion of teenage girls between the ages of 15 and 19 who were taught about birth control methods declined from 70 to 60 percent over two time periods, from 2006-2010 and 2011-2013, the analysis of federal data found.

Meanwhile, the percentage of teenage boys in the same age group who were taught about birth control also declined, from 61 to 55 percent.

teensexedpressrelease_002

“Historically there’s been a disparity between men and women in the receipt of sex education,” said Isaac Maddow-Zimet, a coauthor of the study and a research associate at the Guttmacher Institute, a reproductive health research and advocacy group. “It’s now narrowing, but in the worst way.”

The study, which was published online in the Journal of Adolescent Health in March, analyzed responses during the two time periods from the Centers for Disease Control and Prevention’s National Survey for Family Growth, a continuous national household survey of women and men between the ages of 15 and 44.

In addition to questions about birth control methods, the study asked teens whether they had received formal instruction at their schools, churches, community centers or elsewhere about sexually transmitted diseases (STDs), how to say no to sex or how to prevent HIV/AIDS.

Overall, 43 percent of teenage girls and 57 percent of teenage boys said in the most recent time frame that they hadn’t received any information about birth control before they had sex for the first time. Continue reading

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Synthetic drugs send states scrambling

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By Sarah Breitenbach
Stateline

626a9a5d49384bf599c632587887dc1a (1)Vials of a confiscated synthetic amphetamine called flakka that killed 61 people in Broward County in a little more than a year. States have been reworking drug laws to make it easier to classify synthetic drugs as illegal.

It’s been four months since anyone in Broward County, Florida, has died from an overdose of alpha-PVP, known as flakka, a crystal-like synthetic drug meant to imitate cocaine or methamphetamine. But the drug has already taken a deadly toll, and left health and law enforcement officials scrambling to stem a new public health crisis.

In small doses, flakka elicits euphoria. But just a little too much sends body temperatures rocketing to 105 degrees, causing a sense of delirium that often leads users to strip down and flee from paranoid hallucinations as their innards, quite literally, melt. If someone survives an overdose, they are often left with kidney failure and a life of dialysis.

Because the drugs were largely unregulated when they first hit the market, some states have struggled to combat them.

Flakka is among a growing number of addictive and dangerous synthetic drugs being produced easily and cheaply with man-made chemicals in clandestine labs in China.

But because the drugs were largely unregulated when they first hit the market, some states have struggled to combat them. Now legislators, health professionals and police are trying to eradicate the drugs by making it easier to qualify them as illegal and ramping up the criminal penalties for selling them.  Continue reading

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Opioid treatment model spawns imitators

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Two white tabletsBy Christine Vestal
Stateline

BALTIMORE — Dr. Kenneth Stoller held court on the sidewalk outside the Broadway Center for Addiction on a sunny afternoon last week, chatting with a troop of lingering patients.

He beamed as he patted a young man on the shoulder and said he’d see him tomorrow.

“It’s important for patients to see this as a place that’s safe and accepting,” he said. “For some, it’s the first place they’ve gotten positive reinforcement in their lives.”

Operated by Johns Hopkins Hospital and located two blocks from its main campus, the Broadway Center — or “911” as it’s called because of its address at 911 N. Broadway — has provided methadone maintenance therapy for people with opioid addiction for more than two decades.

But unlike most of the roughly 1,400 methadone clinics across the country, the Broadway Center offers not only methadone, but the two other federally approved addiction medications, buprenorphine and naltrexone, and a full complement of mandatory addiction counseling and group classes. In most other places, addiction treatment is fragmented, leaving patients to shop around for the care they need or settle for whatever is offered at their local opioid treatment clinic.

Unlike most of the roughly 1,400 methadone clinics across the country, the Broadway Center offers not only methadone, but the two other federally approved addiction medications, buprenorphine and naltrexone, and a full complement of mandatory addiction counseling and group classes.

“If you went to a doctor for any other disease, you’d expect to be offered all available treatment options,” said Dr. David Gastfriend, scientific adviser at the Philadelphia-based Treatment Research Institute, which studies substance abuse treatment. “Addiction treatment should be no different.”  Continue reading

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