Archive for Patient Safety

Why Rob a Bank When You Can Make More Money by Counterfeiting Drugs?

Want to make millions of dollars quickly while risking only a few months in prison if (and that’s a big IF) you’re caught?  It’s not difficult at all. Just set yourself up as a distributor of counterfeit drugs in the United States.

This week’s announcement by the FDA that a counterfeit version of Avastin, a chemotherapy drug that is used for several kinds of cancers and tumors (lung cancer, kidney cancer, colon and rectum cancers – but no longer for breast cancer since approval was removed last year) has been found across the country, infused into the national drug supply, raises plenty of questions about how that could possibly happen.

It was followed by an interesting article in USA Today which partially answers the question.  Counterfeiting is a multi-billion dollar business that is on the rise because it’s so lucrative, and because the penalties are so… well… inconsequential.  I mean – would you be willing to spend no more than six months in jail if you could make millions of dollars for use when you got out?  (Even if you would answer no! I don’t want to go to jail!…  I’ll ask you this…. what if your child had treatable cancer and you had no insurance?  Just sayin’ …)

Avastin isn’t the only drug that may be counterfeited.  Any high cost drug that can be watered down, or manufactured to “look” right even if it is manufactured without its expensive ingredients, is a target for counterfeiters.  Lipitor and Viagra are probably the most apt to be counterfeit, but others like drugs used to treat HIV and AIDs, or diabetic drugs, or weight loss drugs, are likely targets for counterfeiters, too.

So what happens if you are somehow treated using a counterfeit instead of the real drug?  Maybe nothing. Or maybe you die. Or anything in between. The problem is, for the most part, we patients have very few ways we can detect whether a drug is real or fake.

Katherine Eban, in her book, Dangerous Doses, tells the stories of people who died from receiving infusions of counterfeit Procrit.  The conventional wisdom on this most recent discovery of fake Avastin is that there was nothing in the counterfeit version that was dangerous, and it’s difficult to tell within a regimen of 18-20 doses a cancer patient might receive over six months whether one “missed” infusion of the active ingredients has a long-term effect.

The bigger picture problem is that our drug supply is not being well enough protected by the FDA, which is tasked with protecting us. The FDA has no backbone when it comes to protecting us from bogus, counterfeit drug distributors who appear to be selling “real” drugs, but target greedy doctors, pharmacies and hospitals that are so willing to buy “discounted” drugs for their patients, knowing that there will be more profit in their reimbursements.  Experts estimate that about 1% of our drug supply is counterfeit.  That means that 1 out of every 100 administered drugs may be counterfeit, too.

One answer to this is an electronic pedigree system, meaning, from the time the drug is manufactured, until it is given to the patient, it is followed and logged using a bar code type system. If such a system was in place, then even us patients would have a way to double check that the drugs being given to us are the real drugs they are supposed to be.

So why doesn’t the FDA insist on the development of such a system?  Well, actually, they have. But again, they have no teeth, and so far, no backbone.  Every time they raise the issue, the drug companies and drug distributors begin to wail about the added cost to the system.  (Surprise!  Follow the money!)  And so, nothing gets done.

Like other issues in healthcare, it looks like little will happen to improve this system until something horrible befalls someone famous; someone who can actually override the special interests in Washington and insist on development of this electronic pedigree system.

Until then, here is information to help us patients do what we can to protect ourselves from counterfeit drugs.

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Posted in: Follow the Money, Health /Medical Consumerism, Healthcare Quality, Hospitals, Media, Patient Empowerment, Patient Safety, Patient Tools

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10 Patient Empowerment Tips to Post on Your Refrigerator Door

The information center in many homes is the refrigerator door.  From family photos, to postcards to magnets from pizza shops, to phone numbers and kids’ artwork – the important ephemera of our lives can be found on refrigerator doors.

So today I thought I would share some advice that is worth cutting out and sticking to your refrigerator door – 10 empowerment tips that will keep you healthier and help you get the great medical care you deserve.

And if you like them, I invite you to download them (in the form of a small poster) to stick on your refrigerator door! (although – maybe you prefer to stick them on your bathroom mirror or medicine cabinet?  That’s OK too.)

  1. Become the expert in your own medical challenges. Read everything you can about your symptoms or diagnosis, ask questions, study anatomy, acquire and review copies of all your medical records. Be the authority on YOU.
  2. Using your YOU expertise, partner with your doctors and other providers. While they may have a medical education and experience, YOU are the one who has lived in your body your entire life.  Be an active participant on your own healthcare team. If your provider won’t listen to you, or share in your decision-making, then find one who will.
  3. Pursue a second opinionwhenever you are diagnosed with a difficult disease or condition, or surgery, chemo, or long term treatment are prescribed. And if they disagree?  Then seek a third.
  4. Don’t be afraid to say NO.  Sometimes less is more. As the authority on YOU, you’ll know when NO is the right answer.
  5. Thank your doctors and their staff members when they have been collaborative and helpful.  They work in a tough environment.  Appreciation, when appropriate, can go a long way toward strengthening your partnership.
  6. Read and listen past the headlines.  Get the whole story, then pursue additional, objective resources to confirm their veracity and to determine how well they apply to YOU. In particular, be sure Internet health  information is credible.
  7. Review your medical bills. Experts tell us that up to 80 percent of medical bills contain errors.  Incorrect bills will eventually cost us all in higher premiums and taxes.
  8. Provide support to others. Shared experiences can help others who suffer the same medical challenges you do.  Refer them to good doctors, and support groups, and offer an ear when they want to share their joys, or need to vent.
  9. Accept support from others. Whether it’s a loved one, or a professional, sometimes it’s imperative to have an advocate by your side to keep YOU safe, or keep you from being railroaded.
  10. Finally, wash your hands regularly and cough or sneeze into your elbow.  Infections are dangerous and deadly whether acquired during a hospital stay, or brought home from school by the kids.  Hygiene can go a long way toward keeping infection at bay and keeping YOU healthy.

Don’t forget – if you like these tips, you can print them out as a small refrigerator poster – here they are.

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Posted in: Patient Empowerment, Patient Safety, Patient Tools, Pharmaceutical Drugs, Self Help

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Healthy Travel Tips for the Holidays

This column first appeared
in the Syracuse Post Standard
November 22, 2011

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You may be among the millions of Americans who will travel during the upcoming holidays. Travel takes you out of your normal environment and disturbs your routine. If you have health issues, like a chronic disease, an injury, or even a short-term illness, it’s smart to prepare ahead of time for those changes and accommodate for them where possible.  You’ll want to be sure your travel doesn’t upset your health, and your health doesn’t upset your travel.

Drugs, supplements and supplies:  Pack enough to cover the days you’ll be away, plus extra, in case flights are delayed or a blizzard closes the roads. If you fly, remember that airlines can lose checked bags, so keep all medical supplies with you in your carry-on bag. Any time difference at your destination may require an adjustment of your drug routine. Make yourself a chart ahead of time to keep your regimen on schedule.

Airport security:  The TSA has strict rules about what can, or cannot go through security.  Medications, oxygen, inhalers and other medical items must be packed in certain ways, and will be screened through x-ray machines. Go online before you fly to learn to learn how to get your medical equipment or materials through security.  http://1.usa.gov/TSAMedical

Foods:  Alert your host ahead of time if you have special dietary requirements, or if certain foods upset your digestion. Mention any food allergies you have or conflicts with drugs you take. Plans can be made to accommodate your needs when they are discussed ahead of time.

Contagious diseases:  Of course, holiday time is often cold and flu time, too.  Get your flu shot prior to travel. Wash or sanitize your hands as often as possible, and keep them away from your mouth, nose or eyes. If you are highly susceptible or your immune system is compromised, consider wearing a face mask to protect yourself from others who might be contagious. If you have a cold, then cough or sneeze into your elbow, not your hands, to prevent infecting others.

Long Distance Travel:  If you’ll be sitting for great lengths of time in a car or plane, you risk potentially deadly blood clots in your legs called DVT (deep vein thrombosis.). Keep your blood circulating by taking hourly breaks to walk around and stretch.

These travel preparations will keep you healthier and will make your visit more enjoyable, too.

Here are some additional resources for
making sure you stay healthy while traveling:

•  Tips for Healthy Travel
Before You Go, As You Travel, and At Your Destination

•  Tips for Healthy International Travel

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About.com Patient Empowerment

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Posted in: Health /Medical Consumerism, Health Insurance, Healthcare Quality, Medical Errors / Mistakes / Misdiagnosis, Patient Empowerment, Patient Safety, Patient Tools, Self Help

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Choosing a Safer Hospital

Please note that this column first appeared in the Syracuse Post Standard on September 27, 2011

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In my last column I shared an open letter to our local hospitals which resulted from my review of their most recent “report cards.”  These report cards score hospitals on their quality of service and safety records. Despite a few improvements, problems were exposed at all of them – problems that continue to put us patients in danger or simply make us miserable.

Think about that. Danger! Too many of us patients enter the hospital with an expectation that, whatever our medical problem is, it will be improved because we have been hospitalized.  Instead we find ourselves the victims of deadly infections, drug errors, falls, surgical mistakes, even crimes.

And think about the second part.  Misery!  When we are at our most vulnerable, perhaps unable to walk on our own, or even stay conscious, we may be at the mercy of staff who ignore our complaints about everything from intense pain, to the need to use the bathroom.

The potential for even more danger and distress is growing, too.  The numbers of hospitalized patients are growing as baby boomers age, and as healthcare reform provides more patients with access to healthcare. As time goes on, the ability of hospital personnel to keep us safe and relatively comfortable will be taxed even further.

So how can we patients ensure our own safety and comfort?  We’ve previously looked at important safety precautions to take during a hospital stay. But the best approach is to begin with safety and satisfaction in mind.  That means reviewing hospitals’ track records before we ever need hospitalization, and making our best choice based on what a hospital has already demonstrated it can do.

Which is why those report cards mentioned in my last column are important.  They are tools we patients can use to help us choose the best hospital.

Let’s use them!

The latest New York Hospital Report Cards can be found at  http://www.myhealthfinder.com/newyork11/ .  Medicare’s website, http://www.hospitalcompare.hhs.gov also offers information about hospital safety and satisfaction levels.

Finally, if you’ve been hospitalized, there’s something you can do to help future patients make hospital decisions.  After a hospital stay, some patients are surveyed about the safety, communications and quality of their care.  By answering and returning the survey, you’ll be contributing to hospital ratings of the future, and providing valuable feedback to help our local hospitals improve their service, too.

……………… ADDITIONAL RESOURCES ON THIS TOPIC ………………

More Hospital Report Cards (more states)

How to Choose the Best Hospital for You

A Patient’s Guide to Hospital Infections

How to Prevent Hospital Infections

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About.com Patient Empowerment

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Posted in: Health /Medical Consumerism, Healthcare Quality, Hospitals, Medical Errors / Mistakes / Misdiagnosis, Patient Advocacy, Patient Empowerment, Patient Safety, Patient Tools, Self Help

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An Open Letter to Hospitals

Please note that this column appeared in the Syracuse Post Standard on September 13, 2011.  It addresses the recently issued New York State Hospital Report Card.  You don’t need to be a resident of Central New York, or even New York State to gain benefit from this column.  Resources for you are found below.

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Dear Central New York Hospitals:

It’s report card time.  That time when we patients get the opportunity to learn whether or not you’ve improved your patient care and outcomes since last year.

I was hoping to find glowing reports. After all, you know exactly what will be measured and what needs to be done to earn the highest grades.  No one’s expecting miracles; just safe and timely care, a clean environment, pain management and effective communications.

But did I find stellar reports?  No.

Granted, the report card says I have less of a chance of catching pneumonia at St. Joes.  And, Community General, congratulations on your infection rate which is lower than the average hospital in New York State.  Both St. Elizabeth’s and Faxton in Utica are doing quite well avoiding Pulmonary Embolisms and Deep Vein Thromboses.

But those are only three high grades among almost four dozen measurements.  My real concerns are for those that registered lower than statewide averages – so low that some patients are dying, acquiring infections, suffering pain, and leaving your facility in worse condition than when they were admitted.  Each one of you earned the lowest possible score in at least three categories.

According to news reports, one official blamed bad scores on outdated statistics. Sorry – that’s no excuse! Your patients are human beings, not statistics.  Perhaps their pain, debilitation or death took place a few years ago, but many of those patients are still in pain, still debilitated and yes, still dead today.

As you know, beginning next year, Medicare will take patient satisfaction survey scores into account when it comes to determining reimbursements. We patients don’t require much to score you highly on those surveys.  We expect only the basics: communicate with us respectfully, prevent infections, avoid mistakes, keep us as pain-free as possible, and send us home with instructions we understand and can carry out.

Put another way:  treat us the way you would treat your own loved ones. Provide for us what you would provide for them.

Such an approach is bound to land you in the top tier on next year’s report card.

Best regards,
Trisha Torrey
Every Patient’s Advocate

PS:  Patients can find New York State hospital report cards by linking to http://www.myhealthfinder.com/newyork11/. Pay particular attention to patient safety and satisfaction measures. Then use those scores to choose where you want to be hospitalized. Your life may depend on it.

……………… ADDITIONAL RESOURCES ON THIS TOPIC ………………

More Hospital Report Cards (more states)

How to Choose the Best Hospital for You

A Patient’s Guide to Hospital Infections

How to Prevent Hospital Infections

……………………………………………………………………………………

Want More Patient Empowerment?
Find Hundreds of Articles at:

Every Patient’s Advocate

About.com Patient Empowerment

…and…
sign up for 2x per month newsletters of
Patient Empowerment Tips

Posted in: Doctor Communication, Health /Medical Consumerism, Healthcare Quality, Hospitals, Medical Errors / Mistakes / Misdiagnosis, Patient Advocacy, Patient Safety, Patient Tools, Self Help, Surgery

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