Articles Posted in Health Alerts

For more than 40 years, CT scanning has been an essential tool in medical diagnostics. While the imaging technique has allowed doctors to obtain images of a patient’s heart, brain, abdominal organs, and vasculature, its effectiveness is reduced whenever a patient moves during the imaging process–even the slightest movement can cause blurriness in the images. GE’s new Revolution CT now allows doctors to image the entirety of a patient’s organ structures literally within the span of a single hearbeat. This remarkable feat is made possible using high-resolution cameras and motion correcting technology similar to image stabilization features in personal cameras. This innovation was announced by GE last week at the 99th annual Radiological Association of North America conference, and will soon be made to hospitals all across the country.

Source: GE Reports at: www.gereports.com/inside-knowledge/.

We routinely advise clients here at the Alaska Personal Injury Law Group about their legal rights concerning their medical records. We do this to encourage them to become knowledgeable consumers of medical services. Essentially, the more informed the client is as a patient, the better services they can receive from their health care provider. So, it was with some surprise that I was informed by my own doctor that “by the letter of the law” he was not permitted to provide me with the reports he had received from a specialist (mind you, I had requested that the specialist send him the records in the first place). I agreed to request the records from the specialist instead, and made a mental note to review the applicable law, thinking that perhaps there was some new provision about which I was unaware.

The short answer is my doctor has been misinformed. The “letter of the law” is that a patient is entitled to receive a a complete copy of their medical records held by their physician. This has always been the law in Alaska, and remains so today. Most states have laws addressing this right. Further, federal heath care law has recently articulated a federal right of access to one’s own medical records.

Alaska’s statute, passed in 1978, sets out a broad right of access in A.S. 18.23.005: “a patient is entitled to inspect and copy any records developed or maintained by a health care provider or other person pertaining to the health care rendered to the patient.” There are no articulated exceptions here, and the right of access would plainly reach to all records in the file, including lab reports, imaging studies, or the evaluations of other doctors since these are used by the physician in providing care.

A new MRI muscle imaging technique has been developed that allows detailed large scale 3-D images of the body’s complex muscle structures. It also provides a means of detecting muscle damage precisely. Expanding further on the utility of diffusion tensor imaging, the technique captures the movement of water molecules within muscle fibers to detect changes in fiber directions. Moreover, the technique allows reliable 3-D imaging to be captured so that the images can be viewed from different directions. It is expected that the imaging will be useful in the treatment of chronic conditions, such as post-polio syndrome and diseases causing muscle atrophy, sports injury rehabilitation, and trauma.

Source: Eindhoven University of Technology, News Release, 10/30/2012.

Christmas is the time for toys. Parents expect that toys have been designed and manufactured with safety in mind. That is not a safe assumption. Ninety five percent (95%) of the toys sold in the United States are now manufactured overseas, mainly in China. In the last 10 years, the number of toy-related injures has increased 54%. In 2008, more than 235,000 children were treated at U.S. emergency rooms for toy-related injuries, and at least 19 children died. The causes of these injuries and deaths have included choking hazards from small detachable or easily broken parts; lead and cadmium contamination, particularly in children’s jewelry; toxic chemicals in candy; and a variety of additional dangers such as igniting batteries, broken straps, and exploding parts. Small, powerful magnets swallowed by young children present a particularly insidious danger. If multiple magnets are swallowed, they can attract each other through the intestinal walls pinching, blocking or eroding the intestinal wall resulting in infections, blood poisoning, and even death. The undermanned Consumer Products Safety Commission is only able to check a tiny fraction of the toys imported into this country every year. Many of the dangers in modern toys are either latent or intentionally concealed. Even careful parents need to know that profits, and not necessarily safety, are the first priority for a number of toy manufacturers.

Source: http://www.justice.org/cps/rde/xbcr/justice/PlayingWithSafety.pdf

The Journal of the American College of Cardiology has just published a review of 44 years of research and has concluded that herbal products can contribute to cardiovascular morbidity and mortality. The risks noted include increased bleeding, and reducing or increasing the effect of a patient’s cardiovascular medications, Many of the ingredients used (aloe vera, ginkgo biloba, ginseng, and green tea) can interact with a patient’s heart medications and lead to serious adverse reactions. For example, some ingredients increase the blood levels of statins, calcium channel antagonists, and several anti-arrhythmic drugs. Another herbal ingredient is known to inhibit platelet aggregation and can lead to increased bleeding risk when the patient is also taking anti-coagulants such as aspirin, Plavix, or Coumadin. Some ingredients (garlic, ginkgo biloba, ginseng, saw palmeto) can have their own cardiovascular effects, and some can induce arrhythmias on their own. The authors, all Mayo Clinic physicians, have called for increased regulation of the products.

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“Use of Herbal Products and Potential Interactions in Patients With Cardiovascular Diseases,” Journal of the American College of Cardiology, 2020; 55:515-525.

The USDA has recalled 17,235 pounds of Daniele International salami because it is suspected of being contaminated with salmonella. To date, over 203 individuals have been sickened in 42 states, including one here in Alaska. Costco, a local retailer, is one of the retailers that has sold the company’s products.

Most persons infected with Salmonella develop diarrhea, fever, and abdominal cramps 12ā€“72 hours after infection. Infection is usually diagnosed by culture of a stool sample. The illness usually lasts from 4 to 7 days. Although most people recover without treatment, severe infections may occur. Infants, elderly persons, and those with weakened immune systems are more likely than others to develop severe illness. When severe infection occurs, Salmonella may spread from the intestines to the bloodstream and then to other body sites and can cause death unless the person is treated promptly with antibiotics.

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Researchers from the UK, Sweden and the US have established that using drugs purchased from the internet can kill and cause patients to bypass health systems that could diagnose life-threatening problems. They estimate that 90% of counterfeit drugs are sold via the internet, which has spawned global sales of over $75 billion, sales which have increased 92% in the last 5 years.

The findings are set out in an article in the International Journal of Clinical Practice. The researchers reviewed over 50 studies published since 1995. The data particularly focused on erectile dysfunction medication, and showed the over 44% of these drugs were fake. The consequences were dire for some, including 150 men admitted to hospitals after taking counterfeit tadalafil and herbal preparations that claimed to cure the dysfunction. Seven were comatose and four subsequently died. Two pregnant women died after being given injections of a counterfeit iron preparation for anemia. Fifty-one children died of kidney failure after taking paracetamol syrup contaminated with glycol, an antifreeze used in cars.

We have previously reported on the problem of herbal preparations being spiked with prescription medications here, here, here, here and here.

The Alaska Personal Injury Law Group recently posted an article about how the FDA and other federal agencies have systematically attempted to use preemption to make manufacturers immune from suit for injuries caused by their defective products. One point of discussion was how the FDA has weakened regulatory protection of consumers from dangerous, defective drugs. Now, just a few days later, an independent group of objective scientists has issued a new report chastising the FDA for its approval of bisphenol A, commonly referred to as BPA.

The new report was issued by the Science Board, a group of independent scientists that provides advice to the Commissioner of the FDA. The Science Board provided peer review of the FDA’s draft assessment of use of BPA in food contact applications. The Science Board concluded that the FDA position was seriously flawed.

BPA is an industrial chemical used to make polycarbonate plastic and an epoxy resin used in many consumer products. The FDA approved it for use in baby bottles and as a liner in food containers like baby formula cans. It is also used extensively in other food containers, in sport bottles such as Nalgene bottles, and as a liner in soda cans. In mid-2008, the National Toxicology Center issued an extensive report addressing the health risks resulting from exposure to BPA, including effects on brain and behavioral development in infants and small children, and the potential to cause cancer. In response, the FDA steadfastly maintained its position that BPA was safe.

The Science Board has now found multiple flaws in the FDA assessment. First and foremost, the FDA assessment failed to provide “reasonable and appropriate scientific support” for its finding that the public wasn’t at risk from BPA. Second, the FDA ignored many peer reviewed studies that found BPA presents serious health hazards. Instead, the FDA relied upon two studies funded by the chemical manufacturers’ association, only one of which was peer reviewed. The studies ignored by FDA show multiple risks, including impaired neural development, developmental changes in children, impaired reproductive tract development and diabetes. Third, the FDA assessment improperly analyzed the margin of safety (MOS) provided by the FDA standard for BPA exposure. The Science Board found extensive evidence that the FDA standard for allowable exposure levels was at least an order of magnitude too high, particularly for children.
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Just because an herbal product is advertised to be “all natural,” this does not mean that it is safe. “All natural” is a marketing term used to convince you to buy a product–it is code for “no side effects.” In fact, most diet supplements are untested as to both their safety and their effectiveness in treating any particular condition, although most consumers look at the packaging (which is designed to look like pharmaceutical packaging), and assume that someone with a white coat has tested the product. Not so. Moreover, herbal medicines can cause dangerous drug interactions, many of which are unknown to science, when herbals are taken along with prescription medications. If you are taking prescription medications and mixing them with diet supplements, you are taking the risk that your medication’s effectiveness may be blunted or substantially increased, either of which can cause significant injury.

The most recent warning is given to us by the Stollery Children’s Hospital in a release to the Canadian Cardiovascular Congress. Noting the inherent unpredictability of Warfarin treatment itself, the hospital warned that combining such therapy with herbal remedies increases the risks of clots and bleeding in patients. Remarkably, in a study of children taking Warfarin, researchers found 37% to be taking diet supplements, yet the parents had not informed their physicians about the supplement use.

Set out helow is a list of herbal products known to interact with Warfarin (Coumadin). Be sure to talk with your doctor about combining any of these products with your blood thinning treatment.

Eli Lilly and Co. has announced that it will now begin disclosing information about the money it pays to individual doctors for advice, speeches, and other services. The company is riding out ahead of legislators at the state and federal levels who have pushed disclosure bills that would impose a legal mandate upon drug manufacturers to make such payments public. Lilly will disclose payments above $500 made in 2009, but will not make disclosure about payments in past years.

A handful of states have legislated disclosure from drug manufacturers: Minnesota, Vermont, West Virginia, and Maine. No disclosure requirements have been imposed on medical device manufacturers, although the obvious ethical concerns apply there as well. ( See our previous posts here, and here.

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