TOV Injury and Safety Blog

Cigarette companies underwrite research to put a better face on lung cancer

  Back in October of 2006, Dr. Claudia Henschke of Weill Cornell Medical College stunned the medical community with research and speculation suggesting that early CT scan screening could prevent eighty percent of lung cancer deaths.  Turns out, a tobacco company paid for the research.

If you grew up in Michigan, our courts say you must expect black ice in February

In Jennings v. New Attitudes Beauty Salon, two of the three judges disagreed with the trial court and held that a Michigan resident can never be surprised by black ice in February.

Leading cause of death for teens age 15 to 19

Motor vehicle accidents are the leading cause of death for teens between 15 and 20.  We have seen enough of this carnage over the past 30 years to anecdotally confirm this statistic.  The most dangerous time to ride with a young driver is after 10 pm, and a car with four teens driven by a sixteen-year old driver is more dangerous, statistically, than riding with a drunk.  Several states, including Michigan, have responded to these statistics with "graduated" drivers licenses that limit young driver's privileges.  These graduated programs have reduced teen deaths in the affected states by from 20 to 40 percent.

One-year back and third-party service providers

In Verbeke v. Innovative Rehabilitaton Systems, Allstate used the one-year back rule to take advantage of medical service providers.

Child trespassers and the attractive nuisance rule

After a child died while burrowning into a sand pile on the contractor's premises, the Court had to evaluate the duty owed children by the owner of the property.

The object must hit your car: your car can't hit the object

  In an effort to eliminate "phantom" uninsured motorist claims, most insurers require that there be some corroborating evidence of "physical contact" with the insured vehicle.  The "strict constructionists" in Seger v. Hartford read this requirement with such minute detail that striking a tree did not meet the contract terms and benefits were denied.

Serious impairment of shorter duration

In Donovan v. Metro Plant Services, the Court of Appeals recognized that an injury may meet the Supreme Court's interpretation of serious impairment, and thus be "life-altering", even though it may not be "life-altering" for more than a few months.

Preservation of evidence

Michigan's judges have adopted a rule that excludes from trial any evidence that was not preserved for the adversary to examine.  Unfortunately, that rule is not applied uniformly.

Effort to control "kickbacks" to doctors

  New Jersey's highly political U.S. Attorney, Christopher Christie, recently changed the focus of his investigation from the manufacturers of orthopaedic devices, to the doctors who are paid to endorse or install them.  His goal is to shed light on the significant "kickbacks" paid to some orthopaedic surgeons in return for using a particular company's product.

Life-saving drugs priced at $1,000.00 per day

   The manufacturers of Cerezyme, a drug essential to the treatment of Gaucher disease, a rare, sometimes fatal disorder, charge more than $300,000.00 per year for the drug, according to the New York Times.  By charging such high prices for a few patients (1,500 in the U.S., 5,000 total) the company generated revenues of 1.1 billion dollars in sales.  This price is driven by market forces-not the cost of development.  The company is exploiting a monopoly on the drug, despite the fact that most of the scientific research and development work on the drug was paid for by the federal government--which now pays again to purchase its own work product.

Study shows pain commonly lasts for a year post-trauma

  A recent study published in the Archives of Surgery showed that significant pain commonly remains more than one year after trauma.

Southwest Airlines grounds part of its fleet

  Last week, Southwest was fined more than 10 million dollars to penalize inspection lapses; days later it found another inspection problem and grounded 38 jets.

Michigan's "Gang of Four" acts again to protect insurers

  The arch-conserviative Justices hand-appointed by Governor Engler years ago struck again on March 7, denying health care providers the right to apply insurance payments to their oldest bills.

Hospital not responsible for anesthetist who assaulted patients during surgical procedures

  The Court of Appeals recently held that  no one else was responsible for damages when a certified registered nurse anesthetist (CRNA) sexually assaulted patients undergoing surgery.

Are we getting our money's worth for medical care?

    Guess where the U.S. ranks in life expectancy?  45th, according to recent data, behind Bosnia and Jordan.

    In infant mortality?  We're last among developed countries.

    The Commonwealth Fund, a health-care research group, ranks the U.S. last among major industrialized nations in health care quality, access and efficiency.  We've talked in other weblog entries about how the lack of universal coverage affects even those who have excellent insurance:  for just one example, the average waiting time in US emergency rooms for potential heart attack patients has almost tripled in the past ten years, as ERs  have become clogged with uninsured patients with inadequate primary care and hospital beds are allocated to remunerative elective surgery.

     While many have blamed malpractice litigation for the cost of medical care in the U.S., knowledgeable experts know that malpractice litigation is only a small part of the equation:  they blame the system of remuneration we use to compensate for medical services.  As third-party payors keep ratcheting down the payment for various services, the only way for an ambitious health care provider to increase his or her income is to provide more services.  As a result, experts like Dr. Sandeep Jauhar, a cardiologist on Long Island, argue that physicians succumb to the demands of patients or their families' to turn over every stone-- to find answers or exclude potential problems--even if additional testing or care is neither necessary nor appropriate.  Universal health care systems pay for results--or for "showing up", you could argue.  Our market system pays for activity--whether it is useful or not--and efforts by auditors to assure that the activity is appropriate merely add an additional significant layer of expense to the entire system.

When does a drug cost too much?

Recent approval of the drug Avastin by the FDA raises ethical and financial questions that we all need to consider.  Avastin was recently given "accelerated approval" for treatment of advanced breast cancer on the basis of a single clinical trial that showed that when used with a second drug, it:

1.  does not extend overall survival rates;

2.  causes serious side effects, including a reported half-dozen deaths; and

3.  holds tumor progression at bay for about 5 and 1/2 months.

The British National Health Service refuses to pay for Avastin for advanced breast cancer, citing the above limitations, and the cost:  $92,000.00 per year, per patient.  This is the kind of health care issue that should be discussed by our politicians and by all of us.  What will we pay and what risks will we take, not to live longer, but to control our cancer better for six months?  Are we willing to pay higher taxes or insurance premiums in order to afford this kind of expense?  Are we willing to ration health care so it is available only to the wealthy?  By refusing to consider  and discuss these issues, that is precisely what we are doing.

We should note, too, that while Avastin is expensive, it is not unusually expensive:  many drugs are priced comparably.

Senate considers product safety laws

  The U.S. Senate recently adopted legislation, though watered down, that would improve product safety for American families.

Insurance limits, inflation and "reform"

Most Michigan citizens would think that with all of the "reform" championed by the Republicans in the last twenty years, our no fault law would be "up-to-date".  Boy, would they be mistaken.

Controversy over vaccination safety and autism

  The government's recent decision to pay compensation to a young girl who apparently suffered brain damage after being inoculated against childhood disease, has added to the controversy over whether a previously-used preservative causes autism.

A clearing house for dangerous products is proposed

    Mark Pryor, an Arkansas Democrat, has sponsored a bill to create an easily accessible database for dangerous products.  Given the ineptitude and inadequate resources of the Bush-led Consumer Product Safety Commission, the difficulty of supporting any government entity through tax revenue, and the practical ineffectiveness of product recalls, this is an excellent idea that would help consumers to protect themselves and their children.

Tie protects the victims--temporarily

The US Supreme Court voted 4-4 to give the drug industry complete immunity for drugs approved by the FDA, despite fraudulent actions by the manufacturer  that hid or distorted data to secure approval.

Tracing the heparin problem

About half of the nation's heparin supply--a blood thinner essential to kidney dialysis, many surgeries, and other medical procedures, has apparently been contaminated at its source in China.  Efforts to trace the source of the problem have been stymied by China's mass of small producers and by lack of regulation and record-keeping.

Father of baseball player killed in bus crash campaigns for improved bus safety

    John Betts, father of David Betts, the Bluffton College baseball player who was killed when a bus collision on an Atlanta freeway overpass decimated his team, has devoted considerable energy to a campaign to improve the safety of interstate and charter buses.

More crib recalls

  The AP reported that safety officials recalled 24,000 cribs last Thursday.  They were manufactured in Indonesia, and are supplied with inappropriate brackets that don't allow their mattresses to be lowered to the proper level.  As a result, children would be able to crawl over the railing and fall out.  The cribs recalled were imported by Munire Furniture, Inc., and sold under the names Majestic Curved Top, Majestic Flat Top, Essex, Brighton-Sussex and Captiva.