The push to develop a vaccine against the Ebola virus is on, and vaccination is going to be an important part of controlling this contagious disease. Phase 1 trials are slated to begin soon in the United States. Even if adequate safety and immunogenicity are demonstrated in the phase 1 studies, vaccines will not be available in substantial quantity until the first quarter of 2015 at the earliest. Even if an effective vaccine can be produced, it is not likely to be 100% effective to succeed in stemming the current or future outbreaks. There are different strains and the virus continues to mutate. While I agree that an Ebola vaccine is an important of the global strategy to control the virus, I do not agree that Americans should receive an Ebola vaccine and be subjected to the risk a serious adverse event or death, unless they are traveling to an endemic area. So why are we doing these Phase 1 trials on Americans?
More than 12,000 women a year get cervical cancer, yet up to 93% of these cancers are preventable. The Centers for Disease Control reports that up to 8 million American women have not been screened for cervical cancer in the last 5 years, which is approximately 10% of all women who are at risk for the disease. The Papanicoolaou (Pap) test screens for abnormal cells and is a time tested screening method for detecting cervical carcinoma. More recently, testing for HPV infection to identify women at high risk for the disease has also been added to the screening and detection process. HPV vaccination is also another important part of the cervical cancer reduction public health program; however, vaccination does not prevent against all cervical cancers, and screening is critical to early diagnosis.
William Sage, MD, JD recently wrote an editorial in JAMA that malpractice claims are not currently causing disruption of the healthcare system, and the number of claims and average payout for claims is lower today than 10 years ago. Paid claims declined from 18.6 to 9.9 claims per thousand physician, and median payments declined from $218,400 to $195,000. However, statistics show that the number and frequency of medical errors has increased over the same period, with up to 400,000 negligent deaths a year from malpractice not including severely injured patients. The article goes on to discuss the need to compensate injured patients, the use of dispute resolution methods, the Medicare and Medicaid liens that impact settlement costs and the time delay in resolving claims. The article goes on to comment negatively on the significant contingency fee compensation that plaintiff attorneys receive when representing injured patients.
As fall approaches, flu vaccines are being administered to young and old to avoid the seasonal flu which comes every year. People need to know that although vaccines have eradicated many diseases, they are not without risk. While most will receive their flu vaccine without event, there are those rare occasions where individuals may suffer serious injuries associated with the vaccine. In 1986 Congress enacted the National Childhood Vaccine Injury Compensation Act. It is now called the National Vaccine Injury Compensation Act (the Program), because it covers adults as well as children to compensate those who suffer serious injuries following the receipt of vaccines as part of preventive care. The flu vaccine is one of the vaccines covered under the program.
Parents need to guard against medication errors when treating their children at home with prescription medications. According to an article in Pediatrics, about 70,000 medication errors occur annually in children under 6 years of age, with more than 17,000 occurring in children under 1 year of age. Although most drug administration errors do not result in serious medical injuries, there are approximately 400 serious injuries and an average of 2-3 deaths each year. The most common error was inadvertently giving the medication twice.
Using a power morcellation tool to remove uterine fibroids creates an unnecessary risk of spreading uterine cancer throughout the body, causing some women to rapidly develop advanced cancer. There is no reliable method for predicting whether a woman with fibroids may have a uterine sarcoma. When a power morcellator is used to break uterine fibroid tissue into small pieces for easy removal, any cancer cells within the tissue can become detached from the underlying mass and circulate through the bloodstream causing hematogenous spread of cancer throughout the body. The FDA discouraged the use of laparoscopic power morcellation during hysterectomy or myomectomy for uterine fibroids earlier this year and Ethicon, a Johnson & Johnson company, finally issued a global recall of all power morcellators on Wednesday July 30, 2014.
The controversy about whether breast cancer screening with mammography increases survival or only causes anxiety and healthcare costs for women contniues. A recently published Norwegian study on mammography screening and breast cancer mortality looked at all Norwegian women aged 50 to 79 between 1986 and 2005. Norway provides an ideal setting to evaluate the effects of breast cancer screening because of the well-defined population and access to medical records. The study shows that breast cancer screening with mammography reduces deaths from breast cancer by 28%.
Physical examination is becoming a lost art and used less and less as technology driven medicine replaces clinical assessment. A recent article in the Washington Post highlighted the waning ability of doctors to use physical examination to make an accurate diagnosis. Over the past few decades, the physical diagnosis skills of physicians has decreased while the use of a dizzying array of sophisticated expensive tests has increased dramatically. Many healthcare organizations downplay the physical exam and think it superfluous compared to medical testing. Often, however, when technology is used without bedside skills, it takes the physician down a path where tests cause more tests to be ordered and, at the end after all the delay, the patient either sees a surgeon, a lawyer or an undertaker.
CT Lung Cancer Screening Guidelines could detect 54,900 more lung cancer cases during a 5 year period if covered by Medicare. Most cancers would be diagnosed at an earlier more treatable stage. In fact, the number of early stage cancer diagnoses would double from 15% to 33%, while the number of patients diagnosed with advanced cancers would decrease from 57% to 40%. Seventeen percent (17%) fewer patients died from lung cancer in the screening group compared with the non-screening group. Medscape Medical News reported thatJoshua A. Roth, PhD, MHA told attendees at the 2014 Annual Meeting of the American Society of Clinical Oncology of these cost estimates. However, Medicare has yet to decide whether or not to cover the new screening guidelines from the United States Preventive Services Task Force (USPSTF)
Before E. Drew Britcher began leading the trial practice of Glen Rock's Britcher, Leone & Roth, LLC, he needed to learn how to effectively represent his clients' interests. However, it did not take this talented attorney long to achieve victory in the courtroom.
In the most recent issue of the New Jersey edition of Super Lawyers, Britcher talks about his very first court case. In Out to Right the Wrongs, Britcher explains that a woman who had suffered a stroke and later was forced to submit to an emergency amputation of her leg was told by other attorneys that she did not have a case. However, the author of the piece explores how Britcher's Hallmark style of "looking beneath the surface of a case to find its truest and most compelling liabilities," led his client to be awarded $1.2 million at the conclusion of her case.