Month: August 2013

Effectiveness and Reliability of the Drugs Presently Prescribed to Treat Hypothyroidism

According to a recent publication in the Wall Street Journal, some sufferers of hypothyroidism and several associated activist organizations are calling for more thorough screening tests and more effective treatment of the condition.
Though studies regarding alternative therapies and medications show conflicting results, Michelle Bickford, the 36 year old founder of the advocacy group, ThyroidChange, insists she experienced higher energy and less anxiety, depression and fatigue when she was prescribed a less commonly distributed, animal-derived medication. Bickford had been taking the popular levothyroxine prescription for hypothyroidism since the age of 11 but reports minimal alleviation of her symptoms until the switch.
Associate Professor of Medicine at Harvard Medical Center Jeffrey Garber, on the other hand, believes, “The vast majority of people are fine on the standard therapy.”

While thyroid patients and medical professionals may be at odds over what, if any, further research is needed, the complaints have called into question the effectiveness and reliability of the drugs presently prescribed to treat hypothyroidism.

Earlier this year, the brand Levoxyl recalled 52,000 bottles of levothyroxine due to a bad odor.
Uncertainty about stability and potency in a second batch of the drug led to another recall, potentially causing a shortage of the drug for the remainder of 2013.

Another levothyroxine brand, Synthroid has a long history of problems, including a class action lawsuit in the 1990s claiming millions of patients were overcharged for the drug, as well as more recent concerns over batch potency and stability.

Low potency of hypothyroid medication can cause serious harm to patients who depend on them, including little to no relief of symptoms and exacerbation of the condition. In such cases, patients may opt to take more than the recommended amount of the drug and an overdose is possible.

Thyroid disease affects 15 million people in the United States. The American Thyroid Association reports that approximately 50% of sufferers are not even aware that they have it, attributing it to other issues they are experiencing like aging, menopause or depression. The thyroid, a small, butterfly-shaped gland at the back of the neck, controls the body’s metabolism. It affects the functioning rate of cells, tissues and organs and controls heart rate, weight, temperature, energy level and muscle strength.
Thyroid malfunctions can happen in one of two ways.

The first, hypothyroidism, involves too little production of the thyroid hormone, causing the body to function at a lower rate.
Hypothyroidism is the most common type of thyroid disease, affecting 11 million Americans in 2012 according to the Center for Disease Control. Symptoms include:
• Fatigue
• Memory loss
• Depression
• Difficulty concentrating
• Coarse, dry skin and hair
• Intolerance to cold
• Constipation

Too much of the thyroid hormone (hyperthyroidism) causes the metabolism to function at a higher rate. Symptoms include:
• Nervousness
• Irregular menstrual cycles
• Weight loss
• Irregular heartbeat
• Increased metabolism
• Nervousness
• Perspiration

After the age of 35, The American Thyroid Association recommends anyone with a family history of testing positive for thyroid disease be evaluated every five years. Doctors can provide a definitive diagnosis with a simple blood test to measure the levels of thyroid hormones TSH, T-4 and T3. If a doctor fails to diagnose or improperly treats thyroid disease, the patient can experience severe consequences including heightened lethargy, depression, anxiety, weight gain, hair loss, bulging of the eyes, and hypoglecemia.

Sources:

http://online.wsj.com/article/SB10001424127887324635904578644532652110970.html

http://online.wsj.com/article/BT-CO-20130510-713949.html

http://nahypothyroidism.org/

Article by Shea Bergesen for Lavery Design Associates, Ltd. copyright 2013.
This article may not be reproduced without permission from the author.

Poor Hygiene and Inadequate Care in Nursing Homes

When a loved one is no longer able to live independently due to age or illness, many families decide to place them in the care of a nursing home. According to the Center for Medicare Services, approximately 3.3 million Americans will live in an elder care facility in 2013.

In the over 16,000 facilities nationwide, federal and state regulations are in place to protect nursing home residents from harm and ensure they are receiving proper care. However, a National Center for Elderly Abuse study of 2,000 nursing home residents in 2000 reported that 44% said they had been abused in some way and 95% reported witnessing or experiencing neglect. Instances of mistreatment may involve extreme abuse, including physical or sexual assault. However in many cases, neglecting personal hygiene and facility sanitation are the cause of illness, injury or even the death of a resident. Because many elderly patients are unable to take care of personal grooming without assistance, failure to maintain a consistent hygiene routine with residents — including not bathing them or changing dirty clothes/bed linens for hours or days at a time — can lead to serious physical and emotional problems.

Poor hygiene and inadequate care in nursing homes can result in:
• Bed sores
• Ulcers
• Skin and eye infections
• Internal parasites
• Ingrown fingernails/toenails
• Cataracts
• Kidney infections
• Malnutrition
• Oral pain and gum infections
• Dehydration
• Depression
• Lowered sense of well-being and self-esteem

Because their immune systems may already be compromised by preexisting medical conditions or advanced age, elderly people are more likely to develop infections from germs spread by poor hygiene. The US Department of Health and Human Services reports that infections are a leading cause of death in long term care patients, with an average of 1.5 to 2 million infections occurring in nursing homes each year. The risk of infectious and bacterial diseases such as colds and influenza can be significantly diminished by hygienic practices such as proper bathing, hand washing and oral care. Instead, these infections impact the health of thousands of people and cost billions of dollars in medical costs, with an estimated $1.4 billion spent each year.

While poor personal hygiene may seem minor compared to more egregious forms of neglect in nursing homes, it is a serious hazard that can result in severe medical conditions and even death. Nursing homes are required by law to maintain good hygiene for their residents.

If a resident has been injured or suffers premature death as a result of improper hygiene at a nursing home facility, a lawsuit may be the logical next step and can result in compensation awarded to the victim and/or their family. Contact Okun, Oddo & Babbat to arrange a consultation with one of our experienced attorneys.

Sources and Resources:
www.centeronelderabuse.org
www.ncea.aoa.gov
www.hhs.gov/ash/initiatives/hai/actionplan
www.cdc.gov/nchs/fastats/nursingh.htm
www.cms.gov/Medicare/Provider-Enrollment-and-Certification/CertificationandComplianc/NHs.html

Article by Shea Bergesen for Lavery Design Associates, Ltd.
copyright 2013. This article may not be reproduced without permission from the author.

Recent Johns Hopkins Study

Recent Johns Hopkins Study Links Certain Brands of Beer to Emergency Room Visits

A New York Times article by Anahad O’Connor titled “Beers Implicated in Emergency Room Visits” addresses some questions raised by a new study at Johns Hopkins Hospital in Baltimore which narrows down the five beer brands consumed most often by patents who ended up in the emergency room due to their consumption. The article cites Budweiser, Steel Reserve, Colt 45, Bud Ice and Bud Light, three of which are malt liquors, and contain more alcohol than regular beer. While alcohol frequently plays a part in many emergency room visits – causing car-related accidents, falls, injuries, homicides, drownings, shootings and domestic violence – this new study examines the brands, their consumption and how this could potentially influence labeling requirements on certain beers. It is important to note that the study relies on data collected from one urban treatment center. The complete study was published by the journal of Substance Use and Misuse and is available online.

Informed Consent: Premature Births

In 2010, the New England Journal of Medicine published the details of a 2004-2009 study of 1,300 severely premature infants at 23 medical institutions across the United States. The study, called the Surfactant, Positive Pressure and Oxygenation Randomized Trial (SUPPORT), was designed to address a longstanding issue in the care of premature babies: Oxygen, considered a crucial component in preemie care, administered to an infant in too high a dose can result in blindness while too low a dose can cause severe brain damage or death. Doctors hoped to discover what level of oxygen administration was best to prevent blindness without increasing the risk of neurological damage or death by randomly assigning the infants involved to receive different levels.

Considered ethically flawed by a number of federal officials, the study resulted in much negative feedback and a 2013 lawsuit against overseers of the study at the University of Alabama at Birmingham. The suit by parents of five Alabama children claims negligence and failure to properly inform the family of the risks involved. Along with questions about the ethics of medical experimentation, publicity around the study has raised the issue of informed consent processes as they pertain to premature infants.

Informed consent is a legal procedure to ensure that patients and caregivers are aware of all the potential risks involved in a particular medical treatment.

In the case of SUPPORT, the US Department of Health and Human Services acknowledged many of the parents would not have allowed their newborns to undergo the oxygen level tests had they been aware of the potential for serious harm or fatality.

It is a doctor’s responsibility to notify pregnant patients of the risks associated with carrying and delivering a baby – including factors that may increase their chances of premature labor. Some of the most common conditions that make a mother high risk for a premature birth are:

  • Multiple babies including twins and triplets
  • History of premature birth
  • Short intervals between pregnancies
  • Smoking, drinking and/or drug abuse during pregnancy
  • Poor nutrition
  • Infections of the amniotic fluid or lower genital tract
  • High blood pressure and diabetes
  • Stress
  • Unusual shape of the uterus
  • Physical injury or trauma
  • Age of the mother, with heightened risk for those under 18 or over 35

With 500,000 cases of premature birth in the US each year, it is not always possible for a doctor to arrest early labor and prevent injury to the infant. During and post-delivery, the premature child may experience bleeding in the brain, low blood sugar, infections, severe lung damage and breathing problems that require close post-birth monitoring in neonatal intensive care units. As the baby develops, they are more likely to show signs of cerebral palsy, intellectual disability, vision and hearing problems and learning difficulties.

Failure of hospital personnel to fully disclose the treatment options
available and the risk factors involved in premature birth
may be grounds for a medical negligence claim.

While it is up to the parents to assess the quality of life their child will lead and determine if further operations and life-sustaining treatment should be administered, it remains the doctor’s responsibility to help them make educated decisions in the child’s best interest and obtain their informed consent before carrying out or withholding treatment.

When a baby is born with unexpected brain damage or physical defects, it will alter the course of their life and create significant hardship for the family. According to a report published by the Institute of Medicine in 2006, the cost of medical care in the first year of life for premature babies is 10 times higher than for full-term infants. The resulting disabilities can cost millions of dollars over a lifetime in rehabilitation fees and special education. Failure of hospital personnel to fully disclose the treatment options available and the risk factors involved in premature birth may be grounds for a medical negligence claim. If a doctor fails to notify a patient of risk factors or performs a procedure without informed consent of the patient, they may be liable for damages sustained as a result.

Okun Oddo & Babat specializes in Medical Malpractice and Medical Negligence claims. Contact us today or call or call us at 212.642.0950 to arrange an appointment with one of our experienced New York attorneys.

Sources & Resources:
www.nejm.org/doi/full/10.1056/NEJMe1304996
www.ahrp.org/cms/content/view/921/81/
www.cdc.gov/reproductivehealth/MaternalInfantHealth/PretermBirth.htm
www.marchofdimes.com/mission/the-economic-and-societal-costs.aspx
www.mayoclinic.com/health/premature-birth/DS00137/DSECTION=risk-factors

Article by Shea Bergesen for Lavery Design Associates, Ltd.
copyright 2013. This article may not be reproduced without permission from the author.