Thursday, July 2, 2009

News Clipping Archives

Maryland / Regional

What will happen to the now closed Rosewood Center in Maryland? (media-dis-n-dat/blogspot.com)

Md. Medicaid expansion drawing more than expected (Salisbury Daily Times)

Inquiry continues into child's death in car (Baltimore Sun)

Man's Death Is Second Tied to Swine Flu in Va. (Washington Post)

Activists, pols residents join in rally for health care reform  (Frederick News-Post)

UM to acquire hospitals in Bel Air, Havre de Grace (Baltimore Sun)

Upper Chesapeake Health, Univ. of Md. Medical System to merge  (Daily Record)

2 Maryland health systems to merge by 2013 (Baltimore Sun)

Pharmacist accused of illegally selling pills (Baltimore Sun)

Faulty stoves blamed for carbon monoxide leaks (Baltimore Sun)

Census Bureau to employ 2,500 at data center in Baltimore Co.  (Baltimore Sun)

Cambridge woman accused of leaving baby in portable toilet tank  (Baltimore Sun)

Va. Man, 107, Finds Blessings And Burdens In Longevity (Washington Post)

 

National / International

Osteoporosis: Not just for women anymore (Baltimore Sun)

FDA requires Chantix, Zyban to have warning (Baltimore Sun)

Warnings Sought by U.S. on Drugs to Halt Smoking (Wall Street Journal)

FDA panel asks for painkiller restrictions (Baltimore Sun)

A Pitch on Health Care To Virginia And Beyond (Washington Post)

Falls Church Funeral Home Denies Mishandling Bodies (Washington Post)

Are we overdoing medical imaging scans? (The Beacon)

To Fix Health Care, Some Study Developing World (Wall Street Journal)

 

Opinion

What would be better than Rosewood? (Baltimore Sun Editorial)

Overdose stats show treatment beats jail (Baltimore Sun Editorial)

Accountability and health care reform (The Gazette Commentary)

Lower the drinking age (The Gazette  Letter to the Editor)

 

 

 

 

Maryland / Regional

 

 

What will happen to the now closed Rosewood Center in Maryland?

 

Baltimore Sun

By BA Haller

media-dis-n-dat/blogspot.com

Wednesday, July 1, 2009

 

The Rosewood Center, founded in 1888 as an asylum for the "feeble-minded," closes its doors for good today and awaits an uncertain future - with an expansion-minded college expressing interest in its space.

 

Stevenson University would like to take over most of the sprawling Owings Mills campus, now filled with dilapidated buildings contaminated with lead and asbestos, and many neighbors of the facility say they'd be pleased to see the school move in.

 

"It is a completely neglected time bomb and an environmental cesspool," said state Sen. Bobby A. Zirkin, a Democrat who represents the area. "Most of the buildings have to be torn down, and the cost of remediating is staggering."

 

Gov. Martin O'Malley ordered the center closed early last year after the latest in a series of reports about substandard conditions.

 

Most of the 166 people who lived in Rosewood at the time of the announcement have been placed in group homes - a move that prompted its own controversies - while 13 people with criminal histories were moved to a newer, secure unit at Springfield Hospital Center in Sykesville.

 

More than 500 employees have dispersed, some to jobs at other state facilities. Many retired or resigned and 97 were laid off, although state officials say they are still helping them find work.

 

Other than security guards, only three state employees will remain on the site, a maintenance crew for its 30 buildings.

 

Now about 200 acres but once more than three times that size, the site presents enormous environmental challenges before redevelopment can occur, and it could be months before the state decides what to do next.

 

The Department of Health and Mental Hygiene plans to offer the Rosewood property to all state agencies and seek comment from Baltimore County officials before considering proposals from the public.

 

For now, the campus remains vacant but for the ghosts of its troubled inhabitants. The once-stately stone-and-brick structures are overgrown with weeds and ivy and strewn with junked gurneys, file cabinets and wheelchairs.

 

Zirkin supports the proposal from Stevenson, whose campus next door has nearly doubled in physical size and enrollment in the past five years. The university, until recently known as Villa Julie College, is considering using the land for athletic fields that could help accommodate a football program being launched, a park, an amphitheater and a school of education.

 

It may renovate the newer buildings and use them for classrooms. There's no price tag yet, and the school would likely seek state and federal assistance for environmental work.

 

"This is the only plan out there, but it is a great one," Zirkin said. "All of a sudden, Owings Mills could become a college town. The university could create a heart here for this community and take what has been a major problem and turn it into a community resource."

 

Glenda G. LeGendre, a spokeswoman for Stevenson, said the university is "very interested" in using about 150 acres of the property, including setting aside some of the land as open space.

 

In a letter to state officials, James J. Angelone, president of the Greater Greenspring Association, wrote that the university's proposal "is by far the best solution proposed for this site."

 

Rosewood once housed more than 3,000 people, most of them severely retarded and completely dependent on others for their care. The long wards and echoing hallways were often their home for life, but the conditions and care were frequently judged to be substandard.

 

Over the course of decades, residents drowned in bathtubs when left unattended or froze to death after wandering out into the snow.

 

"It is a great thing for Maryland that this institution is closed," said Nancy Pineles, an attorney with the Maryland Disability Law Center, a watchdog group that promotes the civil rights of people with disabilities.

 

"It was a badly neglected facility that didn't serve any purpose any more."

 

In 2007, the law center called for state officials to shut down what it called "this flawed, outmoded institution," and noted findings by the state Office of Health Care Quality that conditions at Rosewood posed "immediate jeopardy to the health and safety of residents."

 

The 180-page survey noted abuses that included treating a deaf patient "with restraints to control his behavior" rather than a staff member skilled in American Sign Language, and found "sustained isolation of individuals with intellectual disabilities in rooms with no personal effects [that] shocks the conscience."

 

In December 2000, a resident died while being restrained, face-down on a floor, by Rosewood staff members "because he didn't want to go to the gym," said Pineles. She said the care quality office conducted a "limited investigation" but found no deficiencies and required no plan of correction.

 

Still, some family members fought to keep Rosewood open, hoping to preserve stability for patients. As it is, scores of patients are now adjusting to new environments.

 

Michael Jarowski, 61, lived at Rosewood for 32 years until January, when he moved to a group home in Carney that he shares with three others supervised by three staff members. Jarowski has a history of seizures and profound mental retardation. He wears a protective helmet, uses a wheelchair and does not speak.

 

"It is still a learning curve for his service provider," said his sister, Joan Druso.

 

The transition has been rough on Harry Yost, 81, who fought hard to keep Rosewood open. His 53-year-old son Larry, who cannot see, hear or speak, had lived there since childhood.

 

"Things starting going downhill this spring," Yost said, when the hospital lost all his son's clothes and replaced them with items that did not fit.

 

In April, Larry Yost was moved to a group home run by Catholic Charities. Officials at Rosewood had promised to send some of its staff to the home to help him with the transition, the same promise they made to Druso.

 

"They had laid off the people Michael was used to," she said. "They sent temps who really didn't care."

 

Harry Yost said his son "is doing all right, but I can't say he is better off."

 

Another former Rosewood resident, General Lee Oliver, 60, remains hospitalized after being severely beaten on June 10 by one of his caretakers at a group home in Windsor Mill, according to a Baltimore County police spokesman. The caretaker was arrested but has not been charged while the attorney general's office investigates the incident, Cpl. Michael Hill said.

 

While reports of beatings are uncommon, the level of care in some group homes has long worried relatives of the disabled.

 

"There is a great concern among Rosewood families that there will not be the kind of oversight and accountability a state facility provides," said Joelle Jordan, an advocate for a group of family members who were fighting last year to keep Rosewood open.

 

But the litany of incidents left state officials with little choice, they say.

 

"The magnitude of the problems there were such that to continue operations at Rosewood was inappropriate," said John M. Colmers, secretary of health and mental hygiene, who said the issue landed on his desk at the start of the O'Malley administration.

 

The group homes to which most of the Rosewood residents have been sent are being adequately supervised and monitored by visiting state inspectors, he said.

 

"Can we catch everything? No, we can't," Colmers said. "When bad things happen, the most important thing is to prevent them from happening again."

 

Copyright 2009 media-dis-n-dat.blogspot.com.

 

 

 

Md. Medicaid expansion drawing more than expected

 

Associated Press

Salisbury Daily Times

Thursday, July 2, 2009

 

ANNAPOLIS, Md. (AP) — Maryland health officials say state residents are using expanded Medicaid services in greater numbers than expected.

 

More than 44,000 additional state residents have enrolled as of this week, exceeding estimates that another 26,000 would enroll after income limits were relaxed. Officials say the economic downturn is the reason.

 

Last July, Maryland increased Medicaid eligibility to adults with children whose household income was 116 percent of the poverty level, or $20,500 for two parents with one child.

 

Tricia Roddy, director of Medicaid planning for the state health department, says the expansion is now expected to cost about another $144 million a year, $50 million more than originally estimated.

 

Copyright 2009 The Associated Press. All rights reserved.

 

 

 

Inquiry continues into child's death in car

Ellicott City girl, 23 months, was left in car for nine hours

 

By Don Markus and Liz F. Kay

Baltimore Sun

Thursday, July 2, 2009

 

Howard County police are continuing to investigate the circumstances surrounding a child left forgotten in a car seat who died of hyperthermia in a stifling vehicle.

 

A neighbor found the 23-month old Ellicott City girl strapped in a car seat in a vehicle parked outside her home one week ago, police said Wednesday, apparently after her mother forgot she had left the toddler there about nine hours earlier. The identity of the child and her parents have not been released, but police said the girl was found in front of a home in the 3100 block of Edgewood Drive.

 

Child care experts say such tragedies may happen precisely because they're so horrifying a prospect that parents can't imagine it happening and don't take precautions that could help prevent it.

 

"It takes acknowledgment, and it is one of the things that parents least want to acknowledge," said Dr. Laura Jana, an Omaha-based pediatrician who wrote the book, Heading Home With Your Newborn: From Birth to Reality. "It's the last thing you ever want to imagine happening, and we push it away as if 'it could never happen to me.'

 

"I don't think our brains want us to be able to imagine us doing something like that to our child," said Jana, a spokeswoman for the American Academy of Pediatrics and the mother of three. "Denial is a very powerful thing."

 

In other cases in which children have died forgotten in parked cars, parents have been charged with neglect or even manslaughter. The Ellicott City mother has not been charged, and Howard County police spokeswoman Sherry Llewellyn said in a statement that she likely won't be if the incident is "determined to be accidental,"

 

Howard State's Attorney Dario J. Broccolino said the decision whether to file charges rests with the police. But he added that his office would review the findings to determine whether the incident needed further inquiry.

 

"It's so fact-specific," Broccolino said. "There are a million variables in these kind of cases."

 

Paraphrasing the famous remark of former U.S. Supreme Court Justice Potter Stewart, Broccolino added, "It's like pornography. I'll know it [if it's criminal] when I see it. I have to look at the report."

 

Police said Tuesday that a "a change in routine" in the parents' schedule led to the child being put in her car seat and left unattended for most of the day. Through Llewellyn, Police Chief William McMahon declined comment pending the outcome of the investigation.

 

Broccolino said that he heard from an officer in the department's child advocacy center that the couple also has an older child. "I was told that's where there was a mix-up," Broccolino said.

 

According to Lorrie Walker of Safe Kids USA, a Washington-based nonprofit group specializing in preventing injuries to children, this was the 15th death of a child in a locked car this year in the U.S.

 

Last July, a Bowie woman was charged with reckless endangerment after forgetting that she left her 14-month old in a locked car after dropping three other children off at the mall and going shopping with a fourth. The child was discovered a few hours later and survived.

 

Some are not so lucky. Last summer, a man in Northern Virginia left his toddler in the family car in the parking lot of a company where he worked. He returned later that day to find the child dead. He was charged with involuntary manslaughter, but a judge found him not guilty.

 

Jana and Walker urged parents to create routines that will serve as reminders that children are in the car - especially if they are in the back seat, which is where safety experts say they should be riding, although that also tends to make it more likely that a distracted parent will forget that they're there.

 

Walker suggests that parents, when putting a child in a car seat, also place a briefcase or important papers on the floor in front of the child.

 

While it is against Maryland law to leave a child under the age of 8 unattended in a car, parents are rarely charged with anything more than reckless endangerment in most cases, as long as the child survives.

 

"I can't imagine that any judge can hand down any sentence that is worse than what the parents are doing to themselves," Broccolino said.

 

Copyright © 2009, The Baltimore Sun.

 

 

 

Man's Death Is Second Tied to Swine Flu in Va.

 

By Clarence Williams

Washington Post

Thursday, July 2, 2009

 

An Arlington County area man whose health was already compromised has died after coming down with swine flu, becoming Virginia's second fatality related to the virus, state health officials said.

 

Virginia health officials declined to release details about the man, citing federal laws. But Health Commissioner Karen Remley said in a news release that although the cause of death has not been confirmed, the H1N1 virus appears to have been a factor. She declined to describe his underlying medical condition but said it increased his risk of complications from the flu.

 

The man had visited his doctor within the past week and was suspected at that time of having caught the virus, said Maribeth Brewster, a spokeswoman for the Virginia Department of Health.

 

"He was a confirmed case. Things progressed quickly, and he was hospitalized," Brewster said.

 

The case raises the number of swine flu-related deaths nationwide to 128, including one in Maryland, according to the Centers for Disease Control and Prevention's Web site. But the vast majority of cases are much less grave than initially feared. Virginia has 191 confirmed or probable cases of the virus. Maryland has 414, and the District has 33.

 

Brewster said officials will not try to trace where the man contracted the H1N1 virus, but they are looking for clusters of confirmed cases to track the virus's spread. Officials urged people to minimize their chances of contracting it by washing their hands thoroughly and frequently.

 

If people experience flu symptoms at this point in summer, it's likely that they have contracted the H1N1 virus, Brewster said.

 

"We know it's here, and it's widespread," she said. "If you experience flu-like symptoms currently, you do need to think about your co-workers or your neighbors, and you should stay home."

 

Copyright 2009 Washington Post.

 

 

 

Activists, pols residents join in rally for health care reform

 

By Nicholas C. Stern

Frederick News-Post

Thursday, July 2, 2009

           

The same day President Obama spoke at a town hall meeting in Annandale, Va., advocating for his health care agenda, several dozen residents, activists and politicians gathered at the C. Burr Artz Public Library in Frederick to rally support for national health care reform.

 

Vincent DeMarco, president of the Maryland Citizens' Health Initiative, was the keynote speaker.

 

Initiatives from Congress' expansion this year of a national plan to cover children, to Maryland's 2007 working families and small business health care act have helped thousands at the state level, DeMarco said.

 

Since last July, 1,157 adults in Frederick earning wages slightly above the federal poverty line -- about $22,00 per year for a family of four -- have gained coverage through the state's Medicaid expansion law, he said.

 

About 44,000 people have been helped by the law statewide, he said, elevating Maryland's ranking in coverage for adults from 44th in the nation to 21st.

 

"It's just a start," he told the audience.

 

More than 762,000 people in the state don't have health insurance, he said. DeMarco urged those present to contact state legislators, Congress and others to fight to expand health care reform.

 

DeMarco and the Maryland Citizens' initiative are supporting a health plan that would, in part, create an insurance pool to reduce premiums and expand on Medicare and Medicaid.

 

It would be paid for, in part, by maximizing federal matching funds, increasing cigarette and alcohol taxes and adding a 2 percent payroll tax for businesses, he said.

 

Guy Djoken, president of the Frederick branch of the NAACP, helped organize the rally.

 

He said the national NAACP is pushing for comprehensive health care reform this year.

 

"Poor and minority folks are falling behind due to health related issues," he said.

 

The problem of being able to obtain affordable health care has been exacerbated by tightening family budgets and rising jobless rates, Djoken said.

 

The NAACP supports the rationale behind Obama's health care proposal, he said.

 

"We would like to see comprehensive that extends health care to every person," he said. "We're flexible on how it happens."

 

Andrew Duck, a Democratic candidate for the 2010 Congressional race in Western Maryland, said health care reform is at the top of his political agenda.

 

Duck told the audience he and his family had once gone without health insurance, while having a young child and wife with another on the way.

 

He said he solved his personal health care crisis by joining the Army.

 

Duck mentioned the story he'd been told of a local business owner who had to sell his business to pay health insurance bills after he, and then his wife became ill with chronic conditions.

 

Reform is not about charity or give-aways to the poor, he said. He supports a public option for society's poorest individuals and a continuation of employer based health care.

 

"We can't fix the economy without fixing health care," he said.

 

Hampstead resident Casey Clark, another Democratic candidate for Congress in Western Maryland, also spoke at the rally.

 

He told the audience about a friend of his who was diagnosed with skin cancer at 34.

 

He was fired from his job, lost his insurance and moved in with his mother, who had to sell most of her possessions to pay for her son's treatment.

 

Clark's friend died at 35, just as the friend's mother lost her job and then had to sell her home, he said.

 

"Health care is a moral obligation, just like education," he said.

 

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UM to acquire hospitals in Bel Air, Havre de Grace

Deal would mean larger share of market for UM, more resources for Harford group

 

By Kelly Brewington

Baltimore Sun

Thursday, July 2, 2009

 

In a deal designed to address doctor shortages and bring new medical services to Harford County, the University of Maryland Medical System announced Wednesday that it will acquire Upper Chesapeake Health System, which owns hospitals in Bel Air and Havre de Grace.

 

Upper Chesapeake, the county's largest private employer, would be the latest example of hospital consolidation in Maryland, as large medical systems scoop up smaller hospitals that face competitive pressures. Also on Wednesday, executives marked the official takeover of Suburban Hospital in Bethesda by the Johns Hopkins Health System.

 

The consolidation trend continues to extend the reach of Central Maryland's medical powerhouses: the University of Maryland, Johns Hopkins and Medstar Health of Columbia.

 

Expected to be finalized in 2013, the merger offers the University of Maryland an opportunity to grab a growing share of the hospital market - and an entry to a county where military expansion is bringing thousands of new residents.

 

Upper Chesapeake, meanwhile, hopes to provide more specialized clinical services to meet growing demand in oncology, surgery and orthopedic services, and get easier access to capital to cover future expansion.

 

University of Maryland physicians already help staff Upper Chesapeake's emergency departments, a relationship that started two years ago.

 

It is part of Maryland's expanding reach. In 2006, it acquired Dorchester General Hospital in Cambridge and Memorial Hospital in Easton, and last year, it consolidated with Chester River Health System in Chestertown.

 

"Our strategy, our vision, has been to serve the state of Maryland," said John W. Ashworth III, a senior vice president at the University of Maryland Medical System.

 

While Maryland and Upper Chesapeake have been discussing the merger for years, specifics such as which services will expand, details on staff changes and possible construction projects are still being worked out.

 

For now, Upper Chesapeake is bracing itself for the military's Base Realignment and Closure process, estimated to add thousands of jobs to Aberdeen Proving Ground and as many as 40,000 new residents to Harford County and nearby.

 

Upper Chesapeake Medical Center in Bel Air and Harford Memorial Hospital in Havre de Grace employ a total of 3,000 people and have 286 beds.

 

"We had to ask, how do we position ourselves to respond to what we think will be that increased growth?" said Lyle E. Sheldon, president and CEO of Upper Chesapeake.

 

The physician shortage in Harford County is as acute as in rural areas on the Eastern Shore and Western Maryland which have trouble attracting doctors, said Sheldon.

 

Sheldon said a partnership with the University of Maryland, which trains half the state's physicians, can help entice doctors to practice in Harford County.

 

"We think it allows us to establish relationships with medical school students and physicians," he said. "We think this will open some doors."

 

While mergers have positive aspects for patients, such as access to large networks of top-notch doctors, not all mergers are beneficial for patients, analysts say. In some communities, new ownership means people may no longer have access to their longtime doctors and some jobs may be lost.

 

The outcome to patients depends on the hospitals, the location and how the merger is conducted, said Jeff Bauer, a hospitals mergers consultant based in Chicago.

 

Nevertheless, more hospitals are headed in this direction, as difficult economic times and uncertainties in national health care reform are on the horizon.

 

As hospitals try to bolster their finances, they are also trying to invest in technology such as electronic medical records and specialized clinical services to help set them apart from the pack, he said.

 

"Hospitals need money more than ever and small hospitals probably don't have it more than ever," Bauer said.

 

The financial incentives are on both sides, say merger experts.

 

Smaller hospitals gain access to more capital for building and expansion projects and technology improvements. And there are cost savings that come when doing business with a bigger organization, from better prices for supplies to the ability to cut redundant back-office services.

 

The University of Maryland Medical System at a glance

The University of Maryland Medical System, which has several hospitals in Baltimore, also includes these member hospitals:

 

•Baltimore-Washington Medical Center, Glen Burnie

•The Memorial Hospital, Easton

•Dorchester General Hospital, Cambridge

•Chester River Hospital Center, Chestertown

 

Source: University of Maryland Medical System

 

Copyright © 2009, The Baltimore Sun.

 

 

 

Upper Chesapeake Health, Univ. of Md. Medical System to merge

 

By Ethan Rothstein

Daily Record

Thursday, July 2, 2009

 

The Upper Chesapeake Health System and the University of Maryland Medical System Wednesday announced a merger that they hope to have completed by 2013.

 

Upper Chesapeake Health is the largest private employer in Harford County, and will join the third-largest private employer in the Baltimore metro area.

 

The first step of the merger will be the UMMS gaining control of two seats on Upper Chesapeake’s board of directors, which were previously held by St. Joseph Medical Center. St. Joseph had been a minority owner of UCH since 1998, but the UMMS will acquire St. Joseph’s ownership interest under the agreement.

 

The plan calls for the University of Maryland Medical System to provide funds for growth in services and clinical programs starting in October.

 

A key motivator in this agreement is the aging population of Harford County, Lyle E. Sheldon, president and CEO of UCH, said.

 

“As the population we serve grows and ages, the demand for specialty medical services will also grow,” Sheldon said in a news release. “Our goal with this agreement is to offer as many specialized services locally as possible.”

 

Upper Chesapeake Health, a not-for-profit health system, will add its two hospitals, Upper Chesapeake Medical Center in Bel Air and Harford Memorial Hospital in Havre de Grace, to make UMMS an 11-hospital system by 2013, in another move that will further consolidate health care in Maryland.

 

The reason behind health care consolidation could be traced to the health care reform that the Obama administration is demanding, and individual hospitals or small hospital systems may feel more secure as a part of a larger system, like UMMS or the Johns Hopkins Hospital and Health System, experts say.

 

“We feel that aligning with a dominant player in the state will position us to respond to what may happen with Obama’s health care reform in a better way,” said Sheldon.

 

Sheldon also said that a larger entity means dealing with skyrocketing expenses more easily.

 

“It wouldn’t surprise me that we end up with three or four large health systems in Maryland,” Sheldon said. “The expense associated with it will continue to grow. It seems to defy gravity.”

 

The University of Maryland School of Medicine was a large factor in the decision, Sheldon said. He said that students in their residencies would be assigned to Upper Chesapeake hospitals, providing physician recruitment that both he and John W. Ashworth III, senior vice president of network development for the UMMS and associate dean of the School of Medicine, said is key to the deal.

 

“We have found that they have been able to recruit physicians where we had difficulties before,” said Sheldon. “Through the School of Medicine, to work with their physicians, having this affiliation to the medical school that otherwise would not be there.”

 

Ashworth said that the demand for health care is going up twofold for Harford County.

 

“The demand curve is a combination of the baby boom generation and the growing population,” said Ashworth. “When Upper Chesapeake looked at their demand curve, that’s why they felt that we would be a good partner for them.”

 

The additional capital provided by the merger will help UCH continue to grow, said Sheldon, as the UMMS’ bond rating is very good.

 

“We’ve had a lot of success over the past 10 years with building a new hospital and seeing our market share grow,” Sheldon said. “We think that having this affiliation will allow us to sustain a very good performance, access to physicians and access to capital. Without them we just don’t think that those opportunities would be available to us.”

 

Copyright 2009 Daily Record.

 

 

 

2 Maryland health systems to merge by 2013

 

The Associated Press

Baltimore Sun

Thursday, July 2, 2009

 

The Upper Chesapeake Health System plans to merge with the University of Maryland Medical System.

 

The two health-care organizations announced a strategic affiliation Wednesday that they say will lead to a full merger by 2013.

 

UCH officials say the affiliation is in response to a growing and aging population in northeast Maryland that is seeking medical care close to home.

 

UCH says the agreement will give it access to financing to expand services, and will help attract physicians to Harford County because of UMMS's close relationship with the University of Maryland School of Medicine.

 

Upper Chesapeake Health includes the Upper Chesapeake Medical Center in Bel Air and Harford Memorial Hospital in Havre de Grace.

 

Copyright 2009 Associated Press. All rights reserved.

 

 

 

Pharmacist accused of illegally selling pills

Shop filled phony painkiller prescriptions, U.S. charges say

 

By Tricia Bishop

Baltimore Sun

Wednesday, July 1, 2009

 

A Reisterstown pharmacist was arrested Tuesday morning on federal charges claiming he illegally sold more than 23,000 prescription pills. The amount is the equivalent of 63 kilograms of cocaine or nearly 28,000 pounds of marijuana, federal authorities said.

 

A six-count indictment, unsealed Tuesday, alleges that Ketankumar Arvind Patel, 47, used his Medicine Shoppe Pharmacy at 11813 1/2 Reisterstown Road to fill phony prescriptions for the anti-anxiety medication Xanax, along with thousands of Oxycontin and Percocet pills, both of which contain oxycodone.

 

Such painkillers are responsible for more overdose deaths per year than heroin and cocaine combined, according to the Baltimore office of the Drug Enforcement Administration.

 

The regional agency also announced plans Tuesday to step up its efforts to fight prescription drug abuse through increased funding and multi-agency task force known as the Tactical Diversion Squad.

 

Carl J. Kotowski, assistant special agent in charge of the Baltimore office of the DEA, said the indictment was intended to send a "clear message" to pharmacists who would illegally sell prescription drugs.

 

"You'll be arrested and prosecuted like any other drug dealer," he said. "You will lose your license, and you risk losing your business and other assets."

 

Patel could receive a combined maximum sentence of 86 years in prison if convicted on all counts, and he and his business, Deepa Inc., could be subject to fines totaling more than $26 million.

 

The government is seeking forfeiture of $310,170 worth of alleged criminal proceeds, which could include Patel's Eldersburg house, his company and funds held in numerous bank accounts.

 

Officers already seized $50,000 in cash, two handguns and two cars from Patel's home: a 2008 Acura and a 2006 Porsche registered in his father's name.

 

Patel appeared in Baltimore U.S. District Court Tuesday afternoon, dressed in jeans and sneakers. His wife, son and father sat in the front row behind him. They declined to comment. Patel was held overnight, pending a detention hearing scheduled today.

 

According to the DEA, nearly 7 million Americans are addicted to prescription medications, often obtained through forged documents, the Internet, theft or by "doctor shopping."

 

Abusers are often white-collar professionals or "soccer moms" who perceive the pills as somehow less harmful than street drugs, said Dr. Lee Tannenbaum of the Bel Air Center for Addictions.

 

"There's totally a different perception that these are safe and OK to be used," he said. But, he added, "it's exactly the same type of addiction as heroin. … These are super-potent drugs that really need to be much more tightly regulated."

 

The investigation into Patel's activity began in March after a confidential source admitted to buying fraudulent prescriptions from him for more than a year, authorities said. The source set up more buys on behalf of law enforcement, acquiring $12,000 worth of drugs with federal money.

 

Copyright © 2009, The Baltimore Sun.

 

 

 

Faulty stoves blamed for carbon monoxide leaks

8 at Cove Village hospitalized for gas poisoning in past week

 

By Brent Jones

Baltimore Sun

Wednesday, July 1, 2009

 

Managers of an Essex townhouse community troubled by carbon monoxide leaks say the complex should be rid of the dangerous gas by week's end, after stoves are adjusted.

 

Baltimore County officials and firefighters set up a temporary command center at the Cove Village complex Tuesday, and workers will spend two days investigating what they say are faulty stoves in several of the 299 units. Officials say the management company has agreed to replace gas stoves with electric models over time.

 

Carbon monoxide poisoning sent three residents to the hospital on Sunday; five others were treated in Maryland Shock Trauma Center's hyperbaric chamber last week. In July 2005, three people at the complex died of gas poisoning.

 

The security director for Sawyer Realty Holding LLC, a College Park-based company that owns the complex, said the company plans to meet tonight with tenants.

 

"The one thing we've said was that we shared the residents' frustrations," said Chris Davis, the security director.

 

With no federal or state regulations governing carbon monoxide levels, county officials say there is little for them to do other than respond to the steady flow of exposure calls, which peak during the summer and winter months.

 

Two years ago, state lawmakers mandated alarms for the odorless gas in all newly constructed public housing buildings. But the law does not address buildings built before 2008, or sanction owners of complexes that have frequent carbon monoxide calls. The owners of Essex Cove, built in the 1970s, installed gas alarms after the 2005 deaths of a 48-year-old man and his two teenage stepdaughters.

 

Timothy M. Kotroco, director of the county's Department of Permits and Development Management, said Cove Village produces the greatest number of gas incidents. In a one-month span last year, the Fire Department was called to the complex on 20 occasions in response to carbon monoxide alarms. But Kotroco said there is little his agency can do to punish the owners.

 

"Every time something flares up, they fix it immediately," he said. "It's not like we have ongoing code problems. And it's not like I can bring them into court."

 

Officials from Kotroco's department, Baltimore Gas & Electric Co. and the county Fire Department met with the owner of the complex Tuesday. Kotroco said stoves emitting high amounts of the deadly gas - formed when natural gas burns incompletely or appliances are not properly vented - will be readjusted.

 

Denise Stemple, a 21-year-resident who said she was a close friend of the man who died, said the latest rounds of gas scares have convinced her that she needs to leave.

 

"We need more maintenance men," Stemple said. "They do a lot but they need to do more. I'm scared to death. I have two children and a husband, and I'm concerned. It's time for me to move on."

 

Brittany Longbottom lives on the same block of High Seas Court as Stemple and said that news of the repeated calls "affects our friends and family, because then they start calling to make sure we're all right. I had my mama calling after what happened Sunday night."

 

Carbon monoxide remains one of the leading causes of accidental deaths in the United States. At low doses, fatigue and chest pain in people with heart disease can occur. At higher concentrations, people may experience impaired vision and coordination, headaches, dizziness, confusion and nausea.

 

State Del. Ben Barnes, a Prince George's County Democrat and a sponsor of the alarm requirement for new construction, said the measure was a good first step but that "all dwellings need to be equipped, much like they are with smoke detectors. It's just common sense."

 

Observers say drafting legislation punishing repeat offenders may be problematic. Carbon monoxide deaths are relatively rare, and the issue has not gained much national traction.

 

David G. Penney, a physiology professor at Wayne State University in Ohio and author of three books on the dangers of carbon monoxide, said it generally is up to local public health departments or fire departments to police repeat violators.

 

Several states have adopted mandatory detector laws, he said, but tenants who suffered from inhalation could also seek legal remedies against landlords.

 

"Of course, somebody can take them to court and sue them," Penney said. "These are all possibilities."

 

Carbon monoxide safety tips

 

• Keep gas appliances properly adjusted.

• Consider purchasing a vented space heater when replacing an unvented one.

• Use proper fuel in kerosene space heaters. Install and use an exhaust fan vented to outdoors over gas stoves.

• Open flues when fireplaces are in use.

• Choose properly sized wood stoves that are certified to meet EPA emission standards.

• Make certain that doors on all wood stoves fit tightly.

• Have a trained professional inspect, clean, and tune-up central heating system (furnaces, flues, and chimneys) annually.

• Repair any leaks promptly.

• Do not idle the car inside garage.

• Information supplied from the Environmental Protection Agency

 

Copyright 2009 Baltimore Sun.

 

 

 

Census Bureau to employ 2,500 at data center in Baltimore Co.

 

By Gus G. Sentementes

Baltimore Sun

Tuesday, June 30, 2009

 

The U.S. Census Bureau opened a new data center in Baltimore County on Monday that will generate more than 2,500 temporary jobs and process millions of questionnaires for the 2010 Census.

 

The new 236,500-square-foot facility – called the Baltimore Data Capture Center -- is in Essex, in the 8400 block of Kelso Drive. It will be managed by Lockheed Martin, a major federal government security contractor based in Bethesda, and subcontractor Computer Sciences Corp.

 

Beginning in September, temporary workers will be recruited from the Baltimore area to staff the center; a Census official said, and a dedicated Web site will be available that month to assist job seekers.

 

Fronda Cohen, a spokeswoman for the county Department of Economic Development, said the jobs, though temporary, can help act as a bridge for people who are out of work in a tough economy. The county's unemployment rate was 7.2 percent in April, the most recent month that figures were available, but the jobs – ranging from forklift operators to data processors -- will draw workers from the greater Baltimore area.

 

"The timing works out well, given the economic cycle that we're in," Cohen said.

 

About 40 percent of the 180 million census forms that will be completed is expected to be handled at the center, which was used before in 2000 by the Census Bureau for data processing, Cohen said. Two other data centers -- in Jacksonville, Ind., and Phoenix, Ariz., -- will process the remaining forms. The Phoenix facility is scheduled to open in November, according to Census officials.

 

Census forms will be mailed to the public in March and most of the data processing will occur between that month and July 2010, according to the agency. Next year's census will be one of the shortest in history, the agency said, with 10 questions that will take about 10 minutes to complete. The census is taken once every 10 years.

 

Operations at the Baltimore center are expected to cease in August 2010.

 

Copyright © 2009, The Baltimore Sun.

 

 

 

Cambridge woman accused of leaving baby in portable toilet tank

 

Associated Press

Baltimore Sun

Thursday, July 2, 2009

 

CAMBRIDGE - Cambridge police say a 44-year-old woman gave birth in a portable toilet at a park, then dropped the newborn girl into the waste holding tank.

 

According to charging documents, a witness at Long Wharf Park called 911 Monday morning after Candy Vigneri asked for a cigarette, then said she had just had a baby and the baby was in the toilet.

 

When police arrived, they found Vigneri holding the baby covered in blue chemical similar to the liquid inside the tank.

 

Police say the newborn was left in the waste tank for about three minutes. Vigneri and the baby were taken to the Memorial Hospital at Easton for treatment.

 

Vigneri was released Wednesday and charged with first- and second-degree child abuse and reckless endangerment. The infant was listed in stable condition on Wednesday.

 

Copyright 2009 Associated Press. All rights reserved.

 

 

 

Va. Man, 107, Finds Blessings And Burdens In Longevity

 

By Emma Brown

Washington Post

Thursday, July 2, 2009

 

Ask Larry Haubner for the secret to living 107 years, and the Fredericksburg man flexes his biceps, flashes a mostly toothless smile and growls. "Nutrition!" he bellows. "Exercise! I think we should all exercise more than we do."

 

But the self-described health nut's longevity means he's outlived his savings -- twice.

 

Two years ago, supporters raised $56,000 to help Haubner stay at Greenfield, the assisted living center he calls home. "I was sure that was going to be sufficient," said Carol Ewing of Bridges Senior Care Solutions, who holds power of attorney to manage Haubner's affairs.

 

Today Haubner seems as vigorous as ever. He takes no medication and can lift his walker over his head. But his funds are expected to run out again in November. Without more help, he will have to apply for Medicaid and move to a nursing home. So friends are mounting a second campaign. They've raised more than $7,000, enough to pay his bills for three months.

 

"He doesn't have anyone," said Connie Miller, Greenfield's director, "so we've become his family."

 

Virginia is one of eight states that do not allow Medicaid -- a program to help low-income people obtain health care -- to be used for assisted living services, according to the Assisted Living Federation of America.

 

In most cases, said Cindi Jones of the Virginia Department of Medical Assistance Services, assisted living residents who run out of money and qualify for Medicaid move to nursing homes or move in with family. Maryland and the District allow Medicaid payments for assisted living services, although there is a waiting list in Maryland.

 

For most people, worries about life after 100 are theoretical. The Social Security Administration estimated in an actuarial study that one in every 25,000 men born in 1900 would live to 107.

 

Haubner, who was born June 14, 1902, is blue-eyed and bald and answers to the nickname "Curly." He lived alone in a Fredericksburg apartment until he was 102. Locals knew him as the older fellow often seen cycling around town. But in 2004, he fell off his bike and was taken to a hospital.

 

Social workers determined that he could not safely return to his apartment. They found a place for him at Greenfield, a private-pay facility. The 36 residents personalize rooms with photographs, pets and their furniture.

 

Haubner's room is spare, furnished mostly with donations. A recliner is flanked by ancient exercise equipment, including a homemade weight -- an eight-kilogram lead ball inside a basket -- that he lifts at least 20 times a day. "That's what I do. If you want to do it," he cautioned a visitor, "start with five times."

 

Robert Prasse, a physician who treats Haubner for free, said he is in good health. "I don't see anything that's going to take him away from us in a hurry," he said.

 

Haubner never married and has no surviving family or friends. Other residents' families have adopted him, Miller said, bringing him Christmas and birthday gifts.

 

In his first two years at Greenfield, Ewing said, Haubner covered the $3,500 monthly bill with savings and $1,200 in monthly pension and Social Security payments.

 

But it became clear by 2007 that Haubner's bank account was shrinking even though he showed no signs of slowing down. Supporters launched savelarry.org to solicit donations, Ewing said, and media attention helped bring in 375 contributions.

 

Ewing has not told Haubner that he again faces the possibility of moving. "I don't want to worry him," she said.

 

Greenfield and eight other assisted living facilities are run by Greenfield Senior Living, based in Falls Church. Company spokeswoman Olga Soehngen said Greenfield charges Haubner a reduced fee and cannot promise he will be able to live out his life there.

 

Moving to a nursing home would be hard on Haubner, his supporters said. It's not that nursing homes are bad. But at 107, Ewing said, "he's earned the right to stay where he is."

 

Details of Haubner's past are sketchy, gleaned from stories he tells. He was born in Dubuque, Iowa, and grew up in Tacoma, Wash., where his father worked on the railroad. "You might say we never had any money," he said.

 

He worked at a Tacoma lumberyard before enlisting in the Army in his late 30s, then moved to New York to work as a doorman and pursue a dream of singing opera. He had a teacher who believed in him. "She said I had a voice that could make it," he said. But he never sang professionally.

 

Haubner moved to Virginia to live with his sister when her husband died. Fredericksburg resident Dianne Bachman said she often saw Haubner cycle to the Rappahannock, dismount and croon to the river. "He didn't have to have an audience," she said.

 

Haubner still breaks into song now and then, with a warbly voice. He's fond of sitting on the front porch at Greenfield. And he remains vigilant about exercise and diet.

 

"Well, I ate the cake," he said of his latest birthday celebration. "But I don't believe cake is a good food."

 

Copyright 2009 Washington Post.

 

 

 

National / International

 

 

Osteoporosis: Not just for women anymore

 

By Stephanie Desmon

Baltimore Sun

Thursday, July 2, 2009

 

OsteoporosisLong known to be a concern of aging women, osteoporosis turns out to be nearly as common in older men, a new study suggests.

 

Doctors routinely screen women in their sixties for thinning bones. But there are no guidelines for checking the bones of male patients. Physicians tend to look for osteoporosis in men only after a problem -- like a suspicious fracture -- occurs.

 

Dr. Sherita H. Golden, a Johns Hopkins epidemiologist and the author of the new study in the Journal of Clinical Endocrinology and Matabolism, said she and her colleagues were surprised by the findings.

 

Falling estrogen levels contribute to thinning bones in women and low testosterone levels have been linked to bone loss, Golden said, so it does make sense that the hormonal changes of aging, regardless of gender, could lead to osteoporosis. Osteoporosis makes bones fragile and more likely to break, which can leave sufferers debilitated and deformed.

 

Another surprising finding: Osteopenia, a less severe form of bone loss, is actually more prevalent in aging men than in aging women.

 

Golden would like to see the study of men duplicated. If the results match up, she thinks the answer is clear: Men should be screened just as carefully for bone loss as women.

 

Copyright 2009 Baltimore Sun.

 

 

 

FDA requires Chantix, Zyban to have warning

 

Associated Press

Baltimore Sun

Thursday, July 2, 2009

 

NEW YORK - The Food and Drug Administration will require two smoking-cessation drugs, Chantix and Zyban, to carry the agency's strongest safety warning over side effects including depression and suicidal thoughts.

 

The new requirement, called a "Black Box" warning, is based on reports of people experiencing unusual changes in behavior, becoming depressed, or having suicidal thoughts while taking the drugs.

 

The antidepressant Wellbutrin, which has the same active ingredient as GlaxoSmithKline PLC's Zyban, already carries such a warning.

 

The FDA is also requiring an additional study on Chantix and Zyban to determine the extent of the side effects. Pfizer Inc., which makes Chantix, said it is still discussing the potential study design with the FDA. The study could include patients with and without psychiatric conditions to determine the true incidence rate of psychological side effects, Pfizer officials said.

 

Pfizer had already updated its labeling following the beginning of an FDA investigation into the potential side effects in 2007. That investigation was sparked by several reports of psychiatric problems in patients.

 

Despite the new, stricter warnings, the FDA said consumers and doctors still have to weigh the benefit versus the risks when taking the drug.

 

"The risk of serious adverse events while taking these products must be weighed against the significant health benefits of quitting smoking," said Dr. Janet Woodcock, director of the FDA's Center for Drug Evaluation and Research. "Smoking is the leading cause of preventable disease, disability, and death in the United States and we know these products are effective aids in helping people quit."

 

Last fall, the FDA also began looking into scores of patient reports about blackouts and injuries while taking Chantix. The Federal Aviation Administration later banned use of Chantix by pilots and air traffic controllers. The drug's label also warns that patients may be too impaired to drive or operate heavy machinery.

 

Chantix was approved in 2006. Sales reached $846 million in 2008.

 

"The labeling update underscores the important role of health care providers in treating smokers attempting to quit and provides specific information about Chantix and instructions that physicians and patients should follow closely," said Dr. Briggs W. Morrison, senior vice president of the primary care development group at Pfizer.

 

Pfizer said it made the revised label warnings in agreement with the FDA and is immediately making the information available to health care providers and patients.

 

Shares of Pfizer fell 11 cents to $14.89 in afternoon trading, while shares of GlaxoSmithKline rose 79 cents to $36.13.

 

Copyright 2009 Associated Press. All rights reserved.

 

 

 

Warnings Sought by U.S. on Drugs to Halt Smoking

 

By Alicia Mundy and Jared A. Favole

Wall Street Journal

Thursday, July 2, 2009

 

Federal regulators, worried about potential links to suicides and hostile behavior, ordered tough new warning labels for Chantix and Zyban, the two most popular prescription smoking-cessation pills.

 

The move by the Food and Drug Administration could discourage smokers who want to quit the habit since the two drugs are widely considered among the most effective antismoking medications.

 

Chantix, made by Pfizer Inc., has been dogged by concerns that the once widely popular medicine is associated with suicidal behavior, mood swings, seizures, accidents, and most recently to an unusual skin allergy.

 

The issues began to surface in 2007, just a year after the drug had been approved by the FDA. By the end of 2008, the publicity about the possible side effects and a national alert to doctors by the FDA on possible psychiatric disorders caused Chantix sales to slump.

 

Zyban, sold by GlaxoSmithKline PLC, hasn't garnered as much negative news as Chantix but has been linked to many of the same mental-health disorders. It is marketed under the brand name Wellbutrin and generic buprophion as a treatment for depression.

[chantix and fda warning] Landov

 

Chantix, made by Pfizer, has been dogged by concerns that the once widely popular medicine is associated with suicidal behavior, mood swings and seizures.

 

Both companies say there is no evidence that their drugs actually cause suicides or mood swings. And along with the FDA, they both note that smokers trying to quit often experience depression, anger and other psychiatric side effects.

 

Some consumers have attempted to use a "Chantix defense" in court to explain bizarre behavior. Last month, a Pennsylvania man blamed the drug for a sudden outburst of rage against his wife, during which he drove his Bobcat lawn tractor into the side of their house and threatened to bring it down on her.

 

FDA officials said the label changes -- a so-called black-box warning --aren't intended to stop people from using the drugs, just to prod patients and doctors to closely monitor behavior. Chantix has been praised by many anti-smoking advocates and physicians. Steven Schroeder, a physician and director of the Smoking Cessation Leadership Center at the University of California, San Francisco, said, "I suspect what this means is [Chantix] will be less and less a first choice." He added, however, that he hopes Chantix remains a choice because the burden of trying to quit smoking is high.

 

About 100 suicides in patients taking Chantix have been reported to the FDA since 2006, said Curtis Rosebraugh, an FDA official. By comparison, there have been 14 reports of suicide in patients taking Zyban.

 

Robert Temple, director of the FDA's office of drug evaluation, said the numbers don't mean one drug is more prone to cause suicidal thoughts or adverse reactions than another. Chantix has more market penetration and has been covered extensively by the media, meaning people are more aware of problems associated with it and more likely to file reports with the FDA.

 

Chantix had U.S. sales of $701 million in 2007 but last year after the news about concerns with psychiatric side effects, sales plunged to $489 million. For the first quarter of 2009, Chantix sales dropped 36% year over year to $177 million and company executives cited the negative information in warnings already on the label. It is unclear what impact the new stronger black-box addition will have.

 

Zyban sales totaled $574 million in 2008.

 

The FDA wants Glaxo and Pfizer to conduct clinical trials to determine how serious the side effects are with their products.

 

Jonathan D. Rockoff contributed to this article.

 

Printed in The Wall Street Journal, page A5

 

Copyright 2009 Dow Jones & Company, Inc. All Rights Reserved.

 

 

 

FDA panel asks for painkiller restrictions

FDA panel recommends ban on some drugs, warnings and, new dosage limits for others

 

Associated Press

Baltimore Sun

Thursday, July 2, 2009

 

ADELPHI - Government experts say prescription drugs like Vicodin and Percocet that combine a popular painkiller with stronger narcotics should be eliminated because of their role in deadly overdoses.

 

A Food and Drug Administration panel voted 20-17 Tuesday that prescription drugs that combine acetaminophen with other painkilling ingredients should be pulled off the market.

 

The FDA has assembled a group of experts to vote on ways to reduce liver damage associated with acetaminophen, one of the most widely used drugs in the U.S.

 

Despite years of educational campaigns and other federal actions, acetaminophen remains the leading cause of liver failure in the U.S., the FDA says.

 

Panelists cited FDA data indicating 60 percent of acetaminophen-related deaths are related to prescription products. Acetaminophen is also found in popular over-the-counter medications like Tylenol and Excedrin.

 

"We're here because there are inadvertent overdoses with this drug that are fatal and this is the one opportunity we have to do something that will have a big impact," said Dr. Judith Kramer of Duke University Medical Center.

 

But many panelists opposed a sweeping withdrawal of products that are widely used to control severe, chronic pain.

 

"To make this shift without very clear understanding of the implications on the management of pain would be a huge mistake," said Dr. Robert Kerns of Yale University.

 

In a separate vote, the panel voted 36-1 that if the drugs stay on the market they should carry a black box warning, the most serious safety label available.

 

The FDA is not required to follow its panels' advice, though it usually does.

 

Lynette Bradley-Baker, an assistant professor at the University of Maryland School of Pharmacy, said the FDA hearings shed light on what has long been a problem: the excessive use - often inadvertent - of acetaminophen.

 

"Having some constraints in place," she said, "is a good start." She hopes the FDA will look at research under way into the true safe dose of acetaminophen. She also hopes that the FDA decision will jump-start patient conversations with physicians and pharmacists about how much to take of the popular painkiller.

 

"It's all done in the interest of public safety," she said. "That's the No.1 goal."

 

The FDA convened the two-day meeting to ask experts to discuss and vote on a slew of proposals to reduce overdoses with acetaminophen. The drug has been on the market for about 50 years and many patients find it easier on the stomach than ibuprofen and aspirin, which can cause ulcers.

 

Earlier in the day, panelists took aim at safety problems with Tylenol and other over-the-counter painkillers. In a series of votes, the panel endorsed lowering the maximum dose of those products.

 

The FDA's experts voted 21-16 to lower the current maximum daily dose of nonprescription acetaminophen, which is 4 grams, or eight pills of a medication like Extra Strength Tylenol.

 

The group was not asked to recommend an alternative maximum daily dose.

 

Baltimore Sun reporter Stephanie Desmon contributed to this article.

 

Copyright © 2009, The Baltimore Sun.

 

 

 

A Pitch on Health Care To Virginia And Beyond

Obama Hears From Guests and Twitter

 

By Michael D. Shear and Jose Antonio Vargas

Washington Post

Thursday, July 2, 2009

 

President Obama offered a wonkish defense of his embattled health-care reform effort during an hour-long town hall meeting in Northern Virginia yesterday that featured seven questions, including one sent via Twitter and several from a handpicked audience of supporters.

 

With the president's health-care ambitions meeting a cool reception on Capitol Hill, the administration is increasingly seeking to pressure lawmakers with evidence of the public's desire for action as well as proof that the health-care industry is a stakeholder in -- not an opponent of -- the effort.

 

"The naysayers are already lining up," he said in remarks before taking questions. The challenge for opponents, he said, is: "What's your alternative? Is your alternative just to stand pat and watch more and more families lose their health care?"

 

Obama made his pitch before an audience of about 200 people at Northern Virginia Community College's Annandale campus, including students, administrators, professors and local residents. But the real targets of the message were far beyond Annandale, and the White House is hoping to use social media sites such as Twitter and Facebook to reach constituents across the country.

 

"This is a moral imperative, and it is an economic imperative," he told the live and online audience as he waded through health-care financing statistics.

 

Even as he spoke, the Republican Party live-blogged its opposition. "Obama says our economy is in crisis because of health care costs," wrote Matt Moon, deputy research director at the Republican National Committee. "But his government-run plan will make it even worse, putting our country further into debt."

 

In the stage-managed event, questions for Obama came from a live audience selected by the White House and the college, and from Internet questions chosen by the administration's new-media team. Of the seven questions the president answered, four were selected by his staff from videos submitted to the White House Web site or from those responding to a request for "tweets."

 

The president called randomly on three audience members. All turned out to be members of groups with close ties to his administration: the Service Employees International Union, Health Care for America Now, and Organizing for America, which is a part of the Democratic National Committee. White House officials said that was a coincidence.

 

The most dramatic moment came from Debby Smith, 53, of Appalachia, Va., who was near tears as she described for Obama her fragile health, including a recently discovered tumor for which she cannot get treatment.

 

Obama waved her over and hugged her, saying, "I don't want you to feel like you're all alone." He promised to "find out what we can do within existing law" and called Smith the "perfect example" of the kind of person his health plan is intended to help.

 

Afterward, Smith seemed less than satisfied with Obama's reassurances, telling reporters that it was still unclear how she would get the treatment she needs before she becomes eligible for government aid in nine years.

 

Obama's other audience questions came from a union worker who asked what she could do to help him, and another from a health-care activist who urged him to talk about how to make health care more affordable.

 

One Twitter user asked whether it makes sense to tax people's health-care coverage as a way to pay for reform. That led Obama to offer a long explanation of the various financing proposals, including his own for limiting deductions for the wealthy.

 

"This is something that's going to be debated in the House and the Senate," he said.

 

A Texas physician -- later proudly identified by the White House as Rep. Michael C. Burgess (R) -- challenged Obama to support caps on medical malpractice awards, something the president has refused to do.

 

Another video question came from someone named Steve, who wondered why the president does not simply advocate a "single-payer" plan that would involve the government insuring all Americans.

 

Obama was ready for the question. He launched into an explanation of the evolution of the American health-care system, calmly describing how difficult he thinks it would be to shift it to one based on a European model.

 

"For us to transition completely from an employer-based [system] . . . could be hugely disruptive," he said. "We should be able to find a way to create a uniquely American solution to this problem."

 

Copyright 2009 Washington Post.

 

 

 

Falls Church Funeral Home Denies Mishandling Bodies

 

By Josh White

Washington Post

Thursday, July 2, 2009

 

A Falls Church funeral home that allegedly mishandled numerous bodies over the past year has denied wrongdoing. Its attorneys wrote to a Virginia regulatory board that the company has not violated any laws or industry standards and that it treats all remains with "the utmost dignity and respect."

 

Attorneys for National Funeral Home, which serves as a regional embalming and storage facility for Houston-based Service Corporation International, wrote that allegations of impropriety were unfounded. They said an internal investigation has turned up "credible, independent evidence that refutes the principal allegations" that surfaced when current and former employees and customers complained publicly this year.

 

The complaints, first reported in The Washington Post in April, centered on allegations that National Funeral Home was overwhelmed with bodies from six area funeral homes and that supervisors there resorted to storing bodies in hallways, a back room and on unrefrigerated storage racks in a garage.

 

Whistleblower Steven Napper, a former Maryland State Police trooper who worked at the facility as an embalmer, documented unsanitary conditions there. Photographs Napper took in December showed bodies balanced on biohazard boxes, and the remains of decorated military officers scheduled to be buried at Arlington National Cemetery being stored in the garage.

 

Several current and former employees have backed Napper's allegations, as did Ronald Federici, a doctor who witnessed the facility's conditions late last year when his father's body was sent there. Federici said the facility was "disgusting, degrading and humiliating."

 

As part of an investigation by the Virginia Board for Funeral Directors and Embalmers, the funeral home was given an opportunity to respond, leading to the company's letters Friday.

 

Emily Wingfield, the funeral board's deputy director, said state laws prohibit her from commenting on the case.

 

In the letters, which SCI released yesterday, National Funeral Home officials "vehemently disagree" with Napper's claims. While denying unclean or unsanitary conditions, funeral home officials acknowledge that they stored bodies on the garage racks in coffins "during exceptionally busy times" and never for an extended period.

 

"Mr. Napper's allegations have no merit and are plainly contradicted by objective, irrefutable evidence," wrote William G. Broaddus, a Richmond attorney representing the funeral home who also claimed Napper never raised concerns with superiors. "National Funeral Home treats all remains with the utmost dignity and respect. It has acted in accordance with all laws, regulations and industry standards at all times."

 

Napper said yesterday that he stands by his complaints and noted numerous conversations with his managers about problems at National Funeral Home.

 

"There is no doubt in my mind that what they were doing was wrong and that they knew about it," Napper said.

 

Officials for SCI said they conducted an internal review of the allegations and hired a law firm to do an independent investigation. Citing pending litigation, SCI spokeswoman Lisa Marshall said she could not provide a copy of the investigation report or discuss its contents.

 

"We took these allegations seriously and did an internal review," Marshall said. "We found no credible evidence that supports the allegations in the complaints."

 

Marshall emphasized that there is no law in Virginia requiring funeral homes to refrigerate embalmed bodies, even if they are to be stored over long periods. Marshall said that storing bodies on the garage racks is a legal "option available to us."

 

Two families, one of which has sued SCI, said they were ensured that their loved ones would be held in refrigerators before burial and were shocked to learn how the bodies were handled. Kim Brooks-Rodney, an attorney who represents the family of an Army colonel whose body was stored at National, said it does not surprise her that SCI has denied wrongdoing.

 

"We fully expect the photographs taken by Mr. Napper, his testimony and the testimony of other current and former National Funeral Home employees to expose the hideous treatment the remains kept at National Funeral Home received," Brooks-Rodney said. "People deserve dignity in life and in death, and for some reason National Funeral Home does not seem to understand this basic principle of common decency."

 

SCI plans to spend more than $200,000 to make improvements to National Funeral Home's facilities, including adding a third storage cooler, the ability to control the garage's temperature and new flooring and lighting. Marshall said the funeral home is developing written protocols and procedures for bodies scheduled for burial at Arlington.

 

The Virginia state board is considering new regulations that would require funeral homes to tell families where bodies are being held and the method of storage. The board is also considering regulations requiring that any body stored for longer than 24 hours be embalmed or refrigerated.

 

Copyright 2009 Washington Post.

 

 

 

Are we overdoing medical imaging scans?

 

By QContent

The Beacon

Thursday, July 2, 2009

 

The economy is in a downturn, but these are boom times for medical imaging. Old-fashioned film X-rays have their place. Doctors still X-ray bones to see if they’re broken, and order chest X-rays to diagnose pneumonia.

 

But now radiologists — doctors who specialize in making diagnoses from med­ical imaging — have plenty of other ways to peek inside the human body to get a pic­ture of what’s going on.

 

Magnetic resonance imaging (MRI) pro­duces brilliant images of the brain, spine and soft tissues around joints. Positron emission tomography (PET) scans are emerging as a way to detect cancer and brain abnormalities.

 

And the number of computed tomogra­phy (CT) scans done annually in the Unit­ed States has almost doubled since the late 1990s, so there are now some 60 million CT scans done each year.

 

All this imaging has put the art of diag­nosis on a more objective footing and in­creased its speed and accuracy.

 

It may also occasionally save money, for example, helping rule out coronary artery disease in emergency room visitors with chest pain, thus avoiding an expensive hospital admission for observation.

 

But the more common view, in and out­side of medicine, is that American health­care has gone overboard with imaging.

 

There are well over 10,000 CT scanners in the U.S., and imaging equipment is ex­pensive. A CT scanner can cost over $1 million, an MRI machine even more. So when a hospital or a clinic buys one, there’s a strong incentive to keep it busy.

 

A team of Stanford University and Har­vard University researchers estimated that each additional CT scanner in a city results in more than 2,200 additional CT scans among Medicare beneficiaries.

 

A CT scan costs several hundred dollars (the actual charge depends on the hospital and the patient’s health insurance) so the expense fromall thatCT scanning begins to add up.

 

By some tallies, up to 30 percent of imaging tests are unnecessary. If that’s true, then we could save billions by cutting back on them.

 

Risks from radiation

 

Overdoing CT scanning isn’t just a pock­etbook issue. CT scans use radiation, just like X-rays, and radiation exposure can cause cancer.

 

Like a conventional X-ray, the CT scan in­volves sending radiation through the body to create images of structures inside. Denser tissues, such as bone, block or weaken this radiation, so they show up as white on the scan, just as they do on an X-ray.

 

But instead of creating one image on film from a single burst of radiation, the CT scan­ner creates many cross sections at once (tomos is the Greek word for cut or section,  See CT SCANS, page 8.

 

Copyright (c)2009 The Beacon ~Baltimore~ Jul 2009.

 

 

 

To Fix Health Care, Some Study Developing World

Cost-Effective Medical Practices Deployed in Poor Nations Deliver Good Results, but Can They Work in the U.S.?

 

By Amy Dockser Marcus

Wall Street Journal

Thursday, July 2, 2009

 

When doctors running the AIDS clinic at the University of Alabama at Birmingham wanted to increase the number of patients who showed up for treatment, they turned to an unusual place for help: southern Africa.

 

"Project Connect" is based on a program used in AIDS clinics in Zambia. In the Alabama program, patients were given appointments with doctors within five days of calling the clinic. Blood tests were taken during the first visit. A social worker did an interview, trying to identify and address any issues that might prevent patients from coming back. The no-show rate dropped from 31% in 2007 to 18% through June 2009.

 

"We recognized that we had a problem and that Zambia had already come up with an affordable solution that could work here," says Michael Saag, a pre-eminent AIDS doctor and founding director of the Alabama clinic.

 

With health-care costs soaring in the U.S. and more than 50,000 new HIV infections every year, many are starting to ask: If it can be done over there, why can't we do it here?

 

The obstacles range from the complexities of insurance reimbursement to regulations designed to protect patients. Another hurdle is cultural: There is a deep-seated reluctance to accept that simpler and less expensive treatments like those used abroad might be good enough.

 

"We're building Cadillacs, and they're offering us VW Beetles," says William Vodra, who drafted U.S. Food & Drug Administration rules while working at the agency, and now specializes in regulatory issues involving medical products as a lawyer at Arnold & Porter in Washington, D.C.

 

Bruce Walker, director of the Partners AIDS Research Center at Massachusetts General Hospital, worries that imported practices -- and possibly lower standards -- would be adopted only for disadvantaged patients in the U.S. But Dr. Walker believes it will be too costly for the U.S. to continue to rely on current practices. "You have to find a way of changing the approach slightly while still providing outstanding care," he says.

 

That is why solutions deployed in developing countries are getting more attention. "We learned from Africa that in a very resource-limited setting, you can do very effective chronic care delivery that doesn't have to be overmedicalized," says Mark Dybul, who was the U.S. Global AIDS Coordinator under President George W. Bush. "These are models we can learn a lot from."

 

For Heidi Behforouz, it has been an education. Dr. Behforouz started running the Prevention and Access to Care and Treatment Project in Boston based on a program first used successfully in rural Haiti. PACT trains community health workers to persuade AIDS patients to adhere to treatment regimens. The hope is this will reduce rates of emergency-room use and hospitalizations, big drivers of health costs.

 

The strategy appears to work; according to data PACT collected, total medical expenses for 20 patients fell 40%. But PACT, which is expanding to sites in New York, still pays for the program out of private donations and fund raising, since insurers don't cover it.

 

Dr. Behforouz presented data to an advisory council that recommended to the Massachusetts State Legislature that community health workers be trained and reimbursed, but the process for approval is likely to take years before it is implemented, if ever. "This is still a nascent field," Dr. Behforouz says. "They don't wear white coats. Their training is different than doctors or nurses. It's hard to get them recognized as health-care workers."

 

Similar barriers exist for low-cost health technologies, which are easier to launch in the developing world than in the U.S. Daktari Diagnostics in Cambridge, Mass., developed a hand-held, $8 device that takes a critical blood test in six minutes to determine when to start AIDS treatment.

 

That is much faster and cheaper than the more sophisticated version of the test performed in the U.S., which can cost more than $50, requires an expensive machine and takes a couple of days to get results back. Daktari will begin rolling out the device next year in India, Brazil, Rwanda, Botswana and South Africa -- but not in the U.S.

 

William Rodriguez, who founded Daktari after leaving his job as chief medical officer for the William J. Clinton Foundation, says that when he started to raise money for the venture, "the first question investors asked us is why we were not marketing this in the U.S."

 

One of the main reasons was that Daktari's test is less accurate, at 90% precision, than the version used in the U.S., which is as high as 97%. Even if a trial demonstrated that the test was accurate enough to offer good clinical care -- something Dr. Rodriguez and some AIDS doctors say is the case -- the company's founders worried that it would be too difficult and too costly to convince insurers, labs and doctors to switch to the Daktari test.

 

"In the developing world, people are willing to make the tradeoff in accuracy for simplicity and low cost," says Dr. Rodriguez. "In the U.S., that kind of trade-off is a hard sell."

 

In Alabama, Dr. Saag notes that the high rate of new HIV infections in rural parts of the state -- estimated 1% to 2% annually -- is lower than in Zambia. But it is on a par with some African countries, such as Niger and Benin. And the challenges of poverty and stigma associated with AIDS are the same in rural Alabama as they are in parts of Africa, he says. "There are spots here where you can't tell if it's Zambia or Alabama."

 

Bolstered by the success of "Project Connect," Dr. Saag began thinking about programs that worked in Zambia to address perceptions of AIDS. Stigma about the disease, he believed, was one of the main reasons why people refused to be tested for AIDS, spreading the disease and resulting in the need for more expensive health interventions.

 

This fall, a Zambian group that developed a novel program to increase AIDS testing will travel to Alabama. Dr. Saag wants his team to study their model to possibly adapt it in Alabama. He calls the project "Zambama."

 

Printed in The Wall Street Journal, page A9

 

Copyright 2009 Dow Jones & Company, Inc. All Rights Reserved.

 

 

 

Opinion

 

What would be better than Rosewood?

 

Baltimore Sun Editorial

Thursday, July 2, 2009

 

The Rosewood Center in Owings Mills is finally closed after years of reports of abuse and neglect of the mentally and physically disabled residents there. It was clear that the facility had massive maintenance and management issues and badly failed many of its extremely vulnerable residents. But it's also clear that the alternative -- housing the former residents in group homes -- is not an ideal answer for some.

 

The state has had problems overseeing them, too, and many of the residents have not known another home for almost their entire lives. The adjustment in many cases will be extremely difficult.

 

How should the state structure its care for this population? Can everyone be served in group homes, or is there still a need for an institution like this one?

 

Copyright 2009 Baltimore Sun.

 

 

 

Overdose stats show treatment beats jail

 

Baltimore Sun Editorial

Thursday, July 2, 2009

 

A generation ago, former Baltimore Mayor Kurt Schmoke urged lawmakers to consider abandoning the criminal justice model for dealing with the country's rampant drug problem and focus instead on treating people for their addictions. He was roundly criticized for the idea, and America went on to prosecute a fruitless "war on drugs" that two decades later it is still clearly losing.

 

But last week city health officials announced a small but significant victory in that struggle that may yet vindicate Mr. Schmoke's more humanistic approach to the scourge of substance abuse. Officials reported that deaths from alcohol and drug overdoses declined for the second straight year in the city and are now at their lowest levels in more than a decade. The reason? Expanded treatment opportunities for heroin users and programs that teach addicts how to avoid life-threatening overdoses even if they aren't able to completely break the cycle of dependence.

 

There's little doubt that treatment can save lives. Two years ago, a total of 281 people died of drug overdoses in Baltimore. That number dropped to 176 last year, a decline of nearly a third. Health officials say the improved statistics are directly attributable to more drug treatment slots made possible by a $1.1 million federal grant, and to education and outreach efforts such as the city's Staying Alive program, which instructs addicts how to spot the signs of overdose and intervene before it's too late.

 

The numbers would be even better if treatment were more widely available. Last year, a staggering 74,000 people in Baltimore required treatment for substance abuse by some estimates. Yet the city could only accommodate a fraction of that number -- some 16,000. Facilities that treat heroin addicts with buprenorphine, a semi-synthetic drug that health officials say can help decrease overdoses, have waiting lists of more than a year, and even addicts who have decided to seek help often can't get in.

 

Despite these limitations, the treatment model remains by far the more promising strategy for reducing the harm caused by substance abuse. Drugs and alcohol destroy families, communities and lives and drive most serious crime in the city. That's why Mr. Schmoke was right to insist that the only practical course lay in treating addiction as a public health problem rather than as a criminal justice matter. With addiction at epidemic levels -- nearly one in every six people in Baltimore struggles with a dependence on alcohol or drugs -- there's no way we're going to make a dent in this problem simply by locking more people up.

 

Copyright © 2009, The Baltimore Sun.

 

 

 

Accountability and health care reform

 

The Gazette Commentary

Thursday, July 2, 2009

 

As President Obama and Congress stand poised to engage this summer in a colossal debate over legislation to provide all Americans with quality affordable health care, citizens of our nation and state must stand on guard against attempts by insurance companies and the health care industry to exploit the health care debate to obtain additional legal protections from accountability for injuries caused by substandard medical care.

 

Avoiding accountability is nothing new to the health care industry. Although federal law requires hospitals to report physicians who have their admitting privileges revoked or restricted for more than 30 days to the National Practitioner Data Bank (NPDB), a recent report by Public Citizen reveals that hospitals not only are failing to adequately discipline errant doctors but also are "turning a blind eye" to the NPDB reporting requirement.

 

Prior to the opening of the NPDB, the Department of Health and Human Services estimated that 5,000 hospital clinical privilege reports would be submitted annually; however, the actual number of reports has averaged only 650 per year.

 

In the 17-plus years the NPDA has been in existence almost half of American hospitals have failed to report even one physician disciplinary action, according to the Public Citizen report. Thousands of hospitals (with collectively hundreds of thousands of doctors with admitting privileges) have never disciplined and reported even a single doctor in the 17 years that the reporting requirement has existed.

 

In 1996, the Health Resources and Services Administration (the HHS agency that manages the NPDP) held a conference with all the stakeholders (including medical and hospital associations) to examine the issue of the number of reports filed with the NPDB. The conference concluded "the number of reports in the NPDB on adverse actions against clinical privileges is unreasonably low, compared with what would be expected if hospitals pursued disciplinary actions aggressively and reported all such actions."

 

Public Citizen identified two categories or reasons for this "dangerously low number" of hospital based disciplinary reports: lax hospital peer review and arrangements with disciplined doctors designed to avoid reporting, such as granting a "leave of absence" in lieu of a "suspension" and imposing discipline of less than 31 days.

 

On the Maryland front, another recent report by Public Citizen disclosed that Maryland ranks near the bottom in the nation (45th) in serious doctor disciplinary actions taken by a state medical licensing board. This embarrassing distinction is nothing new for Maryland, which consistently has been associated with such states as Mississippi and South Carolina for poor doctor discipline.

 

These studies reflect a reality. Accountability for substandard medical care only exists inside the courtroom, when an injured patient can obtain full compensation from a health care provider if the patient can prove that his or her injuries were the result of medical negligence, and the payment on a judgment must be reported to the NPDP.

 

If the health care and insurance industries are allowed to use the health care debate as a Trojan horse to limit patients' access to justice in the courtroom, there will be no accountability at all for substandard medical care.

 

So when the health care reform debate rages this summer, those concerned about protecting patient safety and patients' rights must stand on guard to prevent diversion of health care reform into liability protection. Limiting justice to injured patients is not barter for winning affordable health care for all patients.

 

Wayne M. Willoughby is public information officer and immediate past president of Maryland Association for Justice (formerly the Maryland Trial Lawyers Association).

 

Copyright 2009 The Gazette.

 

 

 

Lower the drinking age

 

The Gazette Letter to the Editor

Thursday, July 2, 2009

 

Many people consider 18-year-olds to be grown adults. At 18, you can be tried as an adult by law, buy legal drugs, vote, serve in the military and do some sort of labor to support oneself. But given all these rights, an 18-year-old cannot legally consume or buy alcohol.

 

Many young men and women can enlist in the military to serve and sacrifice their lives at 18. They are trained to withstand some of the most dangerous scenarios and to not fear death. One must wonder why 18-year-olds cannot at least have a beer in public or in some social events. It is not fair for those young men and women that are expected to do things that are far worse than consuming an alcoholic beverage.

 

[People] fear that lowering the drinking age to 18 would increase the amount of fatalities or deaths due to driving while intoxicated. But why not then lower the drinking age and raise the driving age to 21? In some countries, people start drinking at a younger age. Yet they do not have as [many] accidents or deaths due to intoxicated drivers like we do. Maybe it is that they have more control or that they are well prepared or educated on the issue.

 

If 18 is the legal age when you are considered an adult, why can you not drink a beer? The amount of taxes one pays at 18 is the same amount of one who is 21.

 

The drinking age should become 18. It is not fair that one has to wait an extra three years when considered an adult at 18 to be able to have alcohol.

 

Mauricio Garcia, Bladensburg

 

Copyright 2009 The Gazette.

 

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