Criminal actions against MD's further complicated treatment of Chronic Pain patients

MD be aware of treatment of chronic pain patients. In the emergency department (ED) we know all too well the presentation of a chronic pain patient who shows up on the weekend or after office hours complaining of pain and inability to reach their pain specialist or their primary care doctor.

Its hard to prove or disprove anything regarding chronic pain in the quick encounters we have in the ED. This story in the Sunday NY Times magazine is a frightening tale of one pain specialist who was sentenced to 30 years in prison for what appears to be treating chronic pain in a manner he deemed clinically appropriate. He was perhaps eccentric, disorganized in his record keeping, and unconventional is his dosing practices, but was he a criminal?

Click the link and read this engrossing cover story.

Ethylene Glycol poison in OTC med kills dozens of Haitian Children

Click on the link above for the second article in the NY Times regarding tainted glycerin exported from China to countries all over the world which over the past 10-15 years has resulted in many deaths (hundreds, perhaps thousands).

This series is frightening from the perspective of an emergency medicine physician. If this happened in my town would I be astute enough to pick up on it. Luckily the FDA has been applying some simple tests to pharmaceutical raw materials to test for dangerous ethylene glycol contamination. But for the international crowd or border crowd someone who walks in with a bottle of cough syrup purchased from outside the USA and signs of ethylene glycol toxicity then beware.

Doctor Foils A Malpractice Suit By Blogging

A pediatrician under a pseudonym posted blog entries about a malpractice suit. Reports state that the physician made derisive comments about the plaintiffs and jury. This ill considered blogging practice by the physician led to him being confronted on the stand about his blog entries and admission as to the pseudonym used.

Shortly after admitting to being the source of the blog commentaries the physician and his defense team were forced to settle the case for a significant sum. Moral: Think before you blog. Even if you think identities are protected.

Click on the link above to read the article in the Boston Globe.

Outbreak of Eye Infections Puzzles Officials

"Epidemiologists from the Centers for Disease Control and Prevention have linked the acanthamoeba keratitis outbreak to AMO Complete Moisture Plus Multi-Purpose Solution. Advanced Medical Optics of Santa Ana, Calif., manufactures the solution, which is used to clean and store soft contact lenses."

Lost Chances for Survival, Before and After Stroke

....Dr. Richard Burgess, a member of Dr. Warach’s stroke team, explained the situation: There is no particular penalty for not giving tPA. Doctors are unlikely to be sued if the patient dies or is left with brain damage that could have been avoided. But there is a penalty for giving tPA to someone who is not having a stroke. If that patient bleeds into the brain, the drug not only caused a tragic outcome but the doctor could also be sued. Few emergency room doctors want to take that chance....

Excerpt from the NY Times Article. Click link to read this article

Retail Clinics Acquired

National pharmacy chain Walgreen Co. has agreed to acquire retail clinic operator and partner Take Care Health Systems. The deal positions Walgreen to compete better with CVS/Caremark, which previously acquired retail clinic operator MinuteClinic. Take Care, which operates 50 clinics across the U.S., already runs some clinics at Walgreens locations. Walgreens will use the acquisition to power its upcoming retail clinic expansion. The chain plans to have more than 400 "Health Corner Clinics" running in its stores by the end of 2008.

While the deal's financial terms weren't announced, this probably didn't constitute a huge financial investment for Walgreens, which had 2006 sales of $47.4 billion. On the other hand, it suggests that Walgreen execs see retail clinics as strategic to the chain's future. Also, it suggests that savvy Hal Rosenbluth, chairman of Take Care, believes that retail clinics aren't going to be as successful going it alone. We would have predicted that Rosenbluth would grow Take Care further before selling it, but he may have decided that retail drug chains were going to control the business and cashed out while the getting was good.

Ethylene Glycol and mass poisonings in OTC meds

Globally contaminants in medications becomes a growing issue. This fascinating article in the NY Times explores the case of a Chinese factory which exported diethylene glycol tainted glycerin later used to make cough syrup. The result was tragic.

Its a good read. Click the title to link to the article.