Man being prosecuted in NM under federal fetus law

Date: 12/30/2008

ALBUQUERQUE, N.M. (AP) — Federal prosecutors in New Mexico believe they may be the first to use a 2004 law to charge someone with killing a fetus while causing the death or injury of the mother.

Charges against Frederick Beach, accused of beating his pregnant girlfriend to death, include one under the Unborn Victims of Violence Act. U.S. Attorney Greg Fouratt said his office's research found "no other case in the country in which that section (of law) has been charged," the Albuquerque Journal reported Tuesday.

Attorneys for Beach, 37, said they expect to pursue any available legal challenges.

"We may be breaking ground on a new area of law," said defense attorney Amy Sirignano. "We're not sure where that will lead us."

Beach pleaded not guilty last week to killing a fetus and to first-degree murder and child abuse charges.

He is accused of beating to death Verlinda Kinsel, 29, in September and killing the fetus she had said was his. Authorities say the victim's 9-year-old son witnessed the assault.

If convicted, Beach faces life in prison.

The case is being prosecuted in federal court because Kinsel was killed on the Navajo reservation.

The Unborn Victims of Violence Act stemmed from the abduction and murder of a pregnant woman, Laci Peterson, in California in 2003. The law makes it a crime to kill a fetus in utero at any stage of development while committing another federal crime; it does not require the perpetrator to know the woman was pregnant.

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Information from: Albuquerque Journal, http://www.abqjournal.com

Copyright 2008 The Associated Press.

Nursing home industry worries about new ratings

Date: 12/18/2008 6:42 AM

By KEVIN FREKING
Associated Press Writer

WASHINGTON (AP) — Rating systems help people decide which restaurants to go to or hotels to stay at. So why not something similar from the federal government for the nation's 16,000 nursing homes?

Such a simple rating for so complex a task as caring for the elderly is leading to much anxiety in the nursing home industry. Home operators worry about the ramifications for their business if they get one or two stars — when five is the best.

The Centers for Medicare and Medicaid Services was to let everyone know Thursday just how many stars each home is getting. Already the industry is questioning the validity of the rankings. To operators, the five-star system is a great idea whose time has not yet come.

The system "is poorly planned, prematurely implemented and hamhandedly rolled out," said Larry Minnix, president and chief executive officer of the American Association of Homes and Services for the Aging, an industry trade group.

Federal officials say the rankings will put nursing homes "on the path to improvement" because they know family members will think twice before putting someone in a one-star home.

The ratings are based on state inspections, staffing levels and quality measures, such as the percentage of residents with pressure sores. The nursing homes will receive stars for each of those categories as well as for their overall quality.

Consumer groups like the concept, but they agreed there are some potential problems with the data. For example, the staffing data is self-reported just before state surveys and is widely recognized as unreliable.

"From a consumer viewpoint, it's not stringent enough," said Alice H. Hedt, executive director of the National Citizens' Coalition for Nursing Home Reform. "It's basically taking information already available on Medicare's Nursing Home Compare Web site and pulling it into an easier system for consumers to use, and that is a good thing."

Hedt said consumers should consider the star ratings, but not solely rely on them when comparing facilities. Her organization also issued a press release warning that nursing homes may appear in the ratings to give better care than they actually do.

"Our initial reaction is that consumers should probably avoid any facility with a one- or two-star rating and even a three-star rating unless people they trust convince them that the rating is inaccurate or unfair," she said.

But, in Indiana, eight nonprofit nursing homes have reported they got one star for staffing even though they have some of the highest staffing levels in the states, said Jim Leich, president and chief executive officer of the Indiana Association of Homes for the Aging. He believes the one-star rating is the result of a records glitch particular to any nursing home that is part of a campus that includes housing for residents with less intensive care needs.

"It's really going to be an injustice for some of our best facilities," he said.

The Jennings Center for Older Adults in Garfield Heights, Ohio, got four stars for its nursing home, said Martha Kutik, the center's president and CEO. Still, she's worried that the rating system relies on surveys that measure cracks in the ceiling but don't measure patient and family satisfaction.

"Any system that's going to measure quality for consumers should keep satisfaction high on the list," Kutik said.

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On the Net:

Medicare's Nursing Home Compare Web site: http://Medicare.gov/NHcompare

Copyright 2008 The Associated Press.

Medicare Rewarding Doctors for Paperless Prescriptions

The question we all must ask as we contemplate the below story on paperless prescriptions: do we trust doctors' computers more than we trust electronic voting machines? One of the most treacherous areas for medical mistakes are prescription foul-ups. Will this eliminate or create more problems? Do we trust our health to our health to the efficiency experts who thunk this one up? Why do I get the sense that it may take the trial lawyers to bring sanity back to this process?

Attorney Gordon Johnson
g@gordonjohnson.com
800-992-9447
©Attorney Gordon S. Johnson, Jr. 2008


Date: 12/15/2008 9:41 PM

BC-MED--HealthBeat-Paperless Prescriptions,2nd Ld-Writethru/855

Pushing more doctors to ditch the prescription pad

WASHINGTON (AP) — The push for paperless prescriptions is about to get a boost: Starting in January, doctors who e-prescribe can get bonus pay from Medicare.

For patients, the benefits are obvious — from shorter drugstore waits to increased safety, as pharmacists no longer squint to decipher doctors' messy handwriting.

But persuading U.S. doctors to ditch their prescription pads for electronic prescribing so far has been a long, uphill battle. Only about 10 percent of doctors are taking the plunge like Dr. Ted Epperly in Boise, Idaho, who's adopting the technology now.

Still, the movement is gaining steam as Medicare warns that its bonus payments are for a short time only: Holdouts still sticking to paper in 2012 will find their Medicare payments cut.

And continuing the push for medical information technology is a key part of President-elect Barack Obama's health-reform plans, in hopes that moving to computerized records — not just prescriptions, but all those troublesome paper charts that contribute to medical errors and wasted care — ultimately could save millions of dollars a year.

"We'd never go back," says Epperly, also president of the American Academy of Family Physicians. Patients "recognize that, 'Hey, Dr. Epperly's in the information age, and my safety is better and the quality of care is better.'"

What's a paperless prescription? When the doctor writes it by computer and sends it directly to the drugstore by computer, no little piece of paper to get lost or stolen anywhere along that trail.

Some doctors do write prescriptions via computer but then hand the patient a printout, or it arrives at the drugstore as a fax. Those don't count as true electronic prescribing.

In December 2007, 35,000 doctors were writing at least some paperless prescriptions, according to SureScripts-RxHub, which operates drugstores' e-prescription network.

The 2008 count isn't finished yet, but SureScripts estimates that number has doubled to more than 70,000. Moreover, the volume of prescriptions filled electronically grew about 15 percent a month since August, faster than the 5 percent to 8 percent monthly increase seen earlier in the year — presumably as doctors geared up for the Medicare incentive.

The biggest reason for the paperless push is to improve safety. More than 1.5 million Americans are injured every year by medication mistakes. Deciphering doctors' chicken-scratch — was that 100 milligrams or 100 micrograms? — does play a role. But perhaps more important, electronic prescribing systems can flash an alert if the dose seems wrong or patient records show use of another drug that can dangerously interact.

By avoiding unnecessary medication injuries, Health and Human Services Secretary Michael Leavitt has estimated that widespread e-prescribing could save as much as $156 million over five years.

It can save patients cash, too. Most insurance plans divide their formularies into tiers with escalating co-pays, and e-prescribing can let doctors debating which drug to recommend take patient cost into account. A study published last week found that Massachusetts doctors increased use of the cheapest drugs by 6.6 percent during their first year of e-prescribing.

Patients appreciate that price discussion, says Dr. Joe Heyman, chairman of the American Medical Association's trustees and a longtime e-prescriber. An obstetrician/gynecologist, he regularly discusses big contraceptive price differences.

While some patients may need Brand X instead of Generic Y, "in general any of the birth-control pills will do the job," Heyman says. "If when you e-prescribe, it tells you this is a Tier 3 drug and will cost the patient $50 instead of $10, somehow that can be more persuasive" than the ad the woman saw for a pricier version.

So why haven't more doctors joined?

There's definitely some upfront pain, as the office staff enters patient information into electronic prescription programs that can cost $3,000 per doctor. The Medicare incentive — an extra 2 percent in reimbursement rates in 2009 and 2010, and smaller bonuses the next three years — could offset the investment by earning the doctor an extra $1,000 to $1,500 a year, Epperly estimates.

A bigger barrier: Narcotic painkillers and other controlled substances that account for 20 percent of all prescriptions are banned from electronic prescribing. The Drug Enforcement Administration is working on rules to allow that switch.

Then there's the drugstore link. While almost all pharmacy chains are part of a national e-prescription network, smaller ones may not be — only 27 percent of independent pharmacies were in 2007 — and doctors also must use software recognized by the network. In Boise, Epperly says more drugstores still receive his e-prescriptions as a fax than as fully paperless, his biggest frustration.

"Change itself was a bit of a barrier," he says.

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On the Net:

Searchable list of e-prescribers: http://www.learnaboutEprescriptions.com

Copyright 2008 The Associated Press.

China says 300,000 babies sickened by tainted milk

Date: 12/2/2008

By GILLIAN WONG
Associated Press Writer

BEIJING (AP) _ China has dramatically raised the toll from its tainted milk powder scandal, saying six babies likely died and 300,000 were sickened, figures that back up months of complaints from parents and show the government is beginning to acknowledge the scale of the crisis.

The scandal has been met with public dismay and anger, particularly among parents who feel the government breached their trust after their children were sickened or died from drinking infant formula authorities had certified as safe.

The Health Ministry's revised death toll is twice the previous figure, while the new count of 294,000 babies who suffered urinary problems from drinking contaminated infant formula is a six-fold increase from the last tally in September.

"Most of the sickened children received outpatient treatment for only small amounts of sand-like kidney stones found in their urinary systems, while some patients had to be hospitalized for the illness," the ministry said in a statement late Monday.

The latest statistics show that China's communist leaders are slowly acknowledging the scale of China's worst food safety scare in years. During such crises, the government often deliberately releases information piecemeal in part to keep from feeding public anger.

Thousands of parents have been clamoring for compensation for their sickened and dead children. The release of the figures raises the question of whether the Health Ministry is getting closer to finalizing a compensation scheme.

"The new figures are more realistic and objective than previous figures. We knew the previous ones could not have been accurate," said Chang Boyang, a Beijing lawyer who has provided legal assistance to families of children who became ill.

Four of the six deaths were recorded in the provinces of Jiangxi, Zhejiang, Guizhou and Shaanxi, and the other two were in Gansu province in the northwest, the ministry said.

The ministry said it investigated 11 possible deaths related to melamine-tainted milk and ruled five of them out. Melamine poisoning could not be ruled out in the remaining six cases, it said but gave no further details or explanation. It also did not make clear whether three earlier reported deaths were included in the new total.

The ministry said it checked into babies who died before Sept. 10, and that between then and last Thursday, no new deaths were reported.

The ministry declined phone interviews Tuesday and did not respond to faxed questions from The Associated Press.

There are other families who say their children died from drinking milk powder made by Shijiazhuang Sanlu Group Co., the dairy at the center of the crisis, but their cases were apparently still not classified as caused by tainted formula.

Without the official verdict, families fear they will be refused compensation promised by the government through the Health Ministry, which has also said it would provide free medical treatment for children sickened by tainted milk. Some parents expressed pessimism about receiving compensation promised by the government.

"I've talked with a lawyer and at first we wanted lots of compensation, but later we agreed to settle for a much smaller amount, although I wasn't happy. But now even that seems impossible as nobody has ever talked to us about it," said apple farmer Tian Xiaowei of Shaanxi province, whose year-old boy died in August.

"The economy in this country is bad now, I don't think the Communist Party will take care of our problem," Tian said.

The health bureau of Ru'nan county where he is from first ruled his son died from tainted milk powder, but a higher authority said there was no proof his death was linked to infant formula, Tian said.

The attorney Chang said there was still no word of compensation, and the group of volunteer lawyers he belongs to was considering starting a fund to help the victims' families, with contributions from all sectors and the public.

"I assume that the government is worried about the situation of the dairies and is afraid the companies may fall if they have to pay for the compensation amid the current financial crisis," Chang said. "The government may be worrying about the interests of the companies first."

The scandal was first reported in September, but the government has said that Sanlu, the dairy, knew as early as last year that its products were tainted with melamine and that company and local officials first tried to cover it up.

Like a number of major dairies, Sanlu was said to have excellent quality controls that allowed it to enjoy a government-granted inspection-exempt status.

The scandal highlighted the widespread practice of adding melamine — often used in manufacturing plastics — to watered-down milk to fool protein tests. Melamine is rich in nitrogen, which registers as protein on many routine tests. Though melamine is not believed harmful in tiny amounts, higher concentrations produce kidney stones, which can block the ducts that carry urine from the body, and in serious cases can cause kidney failure.

The crisis prompted authorities to announce a complete overhaul of the country's dairy industry to improve safety. The scare badly hit dairy exports, which fell 92 percent in October from the previous year as snags in the supply chain forced a loss in orders, and importers became wary of Chinese food products, the official China Daily newspaper reported.

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Associated Press researchers Chi-Chi Zhang, Xi Yue and Yu Bing contributed to this report.

Copyright 2008 The Associated Press.