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The Uninsured Can Go To Health???

To download, read and dispel any rumors on the current health care bill facing a vote, here is a link to the full copy...

http://candicemiller.house.gov/pdf/hr3200.pdf

An Easy Way To Write Your Local Congress People On Health Care Reform Support:

http://salsa.wiredforchange.com/o/5831/p/dia/action/public/?action_KEY=489

Drugs Are Bad, nKay? So Don't Do Drugs. . .

But there is a time and a place for drugs and that's in college.

The above self defeating Aristotelean loop has taken a new twist.  Other than college, that place is MEXICO. . .  Viva Los Narcos!

So, in it's infinite wisdom and leadership role as essentially a third world country that has more drug cartel employees than the country has citizens and so much organized crime that almost anything can be target for a shakedown, the Mexican government has adopted the following pharmaceutical policy:

Legal Limit (what are we doing, going duck hunting?)

Marijuana: 5 grams

OK, is this weed or THC?   I am sure that Pi is used in calculating the conversion(THC, Pi, munchies. . .).  Imagine if you will, getting pulled over and the police finding 5.1 grams.  In Mexico, I am sure that cops can find enough 0.1 grams in their own pockets to toss into your car to put you over the legal limit so they can strong arm you into buying your way out of this one Joan Wilder.  Actually, probably driving with your windows down alone will do this.  What do you do when you get stopped stateside?  "Oh, that?  I just vacationed in Tiajuana officer, honestly."  Yeah, like that will get you off (sorry for the pun.)  This is not your grandma's bag of weed.  Woodstock anniversary as it may be, drugs are bad, nkay?  Especially drugs and Mexico used in one sentence.  In a recent article detailing the Sicarro in Mexico and one assasins attempt to get out of the organization, drug cartels are in it for the money.  Imagine that.  The assasin that was interviewed was admitted underage to the Mexican police where he was then sent to U. S. FBI and DEA schools to learn our procedures.  Knowing our tactics, no wonder our border patrol fails to catch less than 1% of incoming narcotics.  I did some math on an alternate point that border patrol checkpoints managed to confiscate over ... annually by "finding" cash from drug deals on it's way back to Mexico.  Since border enforcement gets to keep and apply found money to it's annual budget, well, then can do more with the cash than drugs so there seems to be motivation to be unmotivated.  Pot has gone from simple stoner humor to bad news.  Mexican law makers must have gotten into some bad liqour or testing samples when this bill was introduced and passed.  It is no longer a simple case of getting high and getting laid or whatever.  The line from Animal House will need to be rewritten as well.

On to harder drugs.  No, Viagra is not a hard drug nor am I throwing at you that minor drugs lead to more hard core drugs.  The Mexican lawmakers have made sure of that for us.

Additionally, the legal limits are as follows:

Cocaine   0.5 grams  (500 mg)

I thought this one went out of vogue before Miami Vice hit reruns?  

Now, it gets even screwier

Heroin

Yes, there is a legal limit for Heroin; 50 mg.  (That's 0.05 grams to keep it consistent.)  That's 10% of the cocaine allowance.  Though selling is still a crime, can you trade like we did with basebal cards as kids?

And last but not least: Meth

Meth???

The legal limit in Mexico is 40 mg. although you still won't be able to buy cold remedies easily to make it.  No wonder so many illegals keep sneaking into the U. S. to send remittances back home.

In terms of economics, in the U. S., expenditures for drug rehab as well as law enforcement cost for the war on drugs are included in calculating our GDP.  And, since we bring in more drugs from Mexico than we export some may argue that NAFTA has again created a trade defecit.  

Foreign aid to encourage cultivation of crops such as coffee will be scrapped for high value cash crops grown with U. S. dollars..  James, a friend at UF was doing his PhD thesis a few years back on this same concept.  James, you be at the State Department now?  Perhaps this is why former President "W" Bush bought over 100,000 acres in Uraguay earlier this year.

 

In terms of H1N1, or even bioterrorism, what a better way to spread the agent.  Didn't think about the saliva on the joint that has just been shared with you, did you?

Drug addiction requires us all to subsidize rehab through taxes and social programs.  Unfortunately, most street dwelling addicts get a hospital stay via medicaid and therefore our pocketbooks as well.  You can tell the junkies.  They complain the most about their "pain."  To shut them up the physician orders xanax, percocet, fentanyl patches, dilaudid, morphine q 2 hours or on demand rather than practice good medicine and tell them to grow up and detox.  Doctors should not be catering to their addictions.  Some of these users are pretty hard core.  Aside from actually chewing their prescribed oxycontin to get a rush, one nurse caught a patient wringing out the fentanyl patch out to suck the juice.   On the positive side though, some recreational drugs have provided clinical treatment alternatives.  There is a THC derivitive called marinal being used in capsule form for naseau in cancer patients.  The FDA classifies drugs that have no known application withinin the grading scale C1 through 5.  This scale is done in roman numerals so those of you in school considering a career in health care better pay attention in third grade when the teachers cover this.

President Richard Nixon, historically one of our better president even with Watergate and the iconoclastic attacks of counter culture of that era initiated the war on drugs.  While the new law will impair such efforts, Mexican prosecutors view the new law passed in April '09 as a relief to having to prosecute small time users.  Sounds like Mexico just legalized selective prosecution.  They used to shake these guys down and hang them up for sacrifice while the big guys got to walk, now prosecutors could choose to focus on big time dealers but I wonder just what the life expectancy of prosecutors in Mexico is.  This drug war must be a republican thing.  Under the first Bush, Spin Magazine reported  the funds and weapons sent south of the border for the war on drugs was used for social cleansing.  Under "W" (pronounced "Dumb Ya" to those that also say "nucular"), surprisingly, the administration opposed such a change to the law.  This was yet another scenario where President Cheney set policy and Bush looked over his shoulder thinking "dude..."  The first Bush attacked the axis of evil, "W" attacked the axis of evil, if we were in 9th dimensional space, we could have 27 more axi!

As for the Democratic administrations, Under Obama, the current U.S. Drug Czar announced in July that he would adopt a "wait-and-see attitude."  DIdn't being a Czar used to be a bad thing?    The terms Caesar, Kaiser and King are interchangeable with King.  This proto EU WWI inter-marrying and inbreeding is what led to the first War.  Other than admission, the prior democratic administration was a little foggy on the pot issue.  I heard Bill Clinton is considering a run for President of Mexico.  

Learn from this: This was your President on drugs.  Any questions?

Does H1N1 Swine Flu Pose A Risk To Florida Hunters This Fall?

Everyone knows the generically correct swine flu as the politicall correct H1N1.  However, if being offensive to certain religous groups that consider pork unclean and therefore the contraction of the illness very bad unless it carries a nondescript name still does not change one mode of its transmission.  So, if a nun gets syphillis from a priest shouldn't plausible deniability force us to rename it as well?  This virus is a strain that exist in both humans and swine and it is communicable between the two.  Thankfully the more potent and often lethal bird flu does not share this pattern.  So, what we know: The news has often misreported facts on this disease.  In one case, after pigs contracting the disease in Canada after contact with a migrant worker other news services quoted that it does not jump back and forth between people and pigs.  It does.  Secondly, not all people are hygenically equal.  Ever notice a public restroom were the restroom was a wreck?  Forget puting the seat up, some think the floor is just as good as hitting the inside of the urinal.  Handwashing may not help if someone that hasn't bathed since he crawled out from under the turnip truck uses the same light switches, door knobs, fuel pumps (oh, didn't think of that one, eth?), tried your car door handles to see if they could steal anything, served you food or set your table in a restaurant: the list goes on.  In fact, I work in a hospital and have to continually tell nurses they cannot breathe on their finger to get the finger print scanner to work on the drug dispensing machine.  Yes, a nurse can be Miss Piggy too.  Watch our Kermit.  

Now for the hunting season.  There is about half a million mix of domestic roaming and wild hogs in Florida.  Florida is hot and moist.  Usually a prime breeding ground for any tyoe of infection.  A lot of people go hunting.  Hunting legally and illegally.  Some people have no respect for hygeine, and some have no respect for laws.  Simply put, the vast hog population and some of the pigs that hunt them will more than likely only serve to spread a virus that has some lethality.  In particular, while deaths overall have been few in the general population, in pregnant women, the case is different.  Pregnant women seem to have more complication and more deaths per capita than the general population.  Hunters beware.  You can contract swine flu form contact from infected hogs.  If you take your kids hunting, they can as well.  And, you can bring it home to your wife.  Kinda sounds like the clap, eh guys?  You don't know where those hogs have been.  More than likely, processed pork (notice that commercially processed pork carries a religous marking on the packing to certify the pork is OK even though you may not be practicing that religion) and wild game that has been butchered and cured and cooked is also not a threat to your health.  

So, this hunting season, be extra careful handling your wild live game. Scientist are not sure how dead a hog has to be to not be contagious.  Secondly, aside from cleaning your guns mechanically clean contact surfaces aseptically.  This includes your gun case handles.  And as mentioned before, be careful at the gas pumps, vending machines, commercial door handles, light switches, restrooms and that funky stick that holds the key to the restroom.  It's bad enough you can;t even cut your foot in the Gulf without contracting cellulitis or get a kiss from your dog without getting MRSA (medicine resistent staph aureus due to the over use of antibiotics in our society,) but now our enjoyment ot the great outdoors will have one more thing to watchout for this fall.  Happy hunting.

Research notes on 2009 H1N1

"You might be a Redneck if you think "Swine Flu" if the past tense of "Pigs Fly."

James Robert Fellabaum

                        As of:  4PM   29 April  2009

Pandemic Flu/2009 H1-N1 Flu Info:

Association of State and Territorial Health Officers (ASTHO)

Flu State Updates:

http://www.astho.org/templates/display_pub.php?pub_id=3797&admin=1

BBC World Map (H1-N1 progress)

http://news.bbc.co.uk/2/hi/americas/8021547.stm

DHHS (US Department of Health and Human Services)

Public Health Emergency Declaration:  http://www.hhs.gov/secretary/phe_swh1n1.html

DHHS/Agency for Healthcare Research and Quality (AHRQ)

Tools and Resources for Influenza Preparedness   http://www.ahrq.gov/prep/swineflu.htm

DHHS/Centers for Disease Control and Prevention (CDC):

Main H1-N1 Flu Web Link:   http://www.cdc.gov/swineflu/

Case Counts:  http://www.cdc.gov/swineflu/investigation.htm

Guidance and Recommendations:  http://www.cdc.gov/swineflu/recommendations

Influenza General Resources    http://www.cdc.gov/flu/pandemic/

Info Phone Line:   1-800-CDC-INFO (1-800-232-4636)

Key Facts:  www.cdc.gov/swineflu/key_facts.htm

Media Brf Transcripts:  http://www.cdc.gov/media/transcripts/2009/t090426.htm

Seasonal Flu Overview    http://www.cdc.gov/flu/weekly/

Travel Updates/Guidance.   http://wwwn.cdc.gov/travel/contentSwineFluTravel.aspx

“Widgets” (Including Swine Flu Widget).   http://www.hhs.gov/web/library/index.html

DHHS/Food and Drug Administration (FDA)

Emergency Use Authorization Summary. http://www..fda.gov/bbs/topics/NEWS/2009/NEW02002.html

DHHS/National Library of Medicine

Swine Flu Resources.  http://sis.nlm.nih.gov/enviro/swineflu.html

DHHS/Pandemic Flu.Gov    

http://www.pandemicflu.gov/index.html

Federal and world response stages:  http://www.pandemicflu.gov/plan/federal/fedresponsestages.html

H1-N1 Frequently Asked Questions:

http://pandemicflu.gov/faq/swineflu/

Use of Pneumococcal Vaccine   http://www.pandemicflu.gov/vaccine/pneumococcal.html

State-by-State Pandemic Planning and status:  http://www.pandemicflu.gov/plan/states/index.html#stateplans

Department of Homeland Security (DHS):

Flu Updates.  http://www.dhs.gov/xprepresp/programs/swine-flu.shtm

DHS/FEMA:

FEMA Assistance for Pan Flu:  http://www.fema.gov/government/grant/pa/9523_17.shtm

Google Maps Swine Flu Tracking Tool:  http://maps.google.com/maps/ms?ie=UTF8&hl=en&t=p&msa=0&msid=106484775090296685271.0004681a37b713f6b5950&ll=32.639375,-110.390625&spn=15.738151,25.488281&z=5

International Association of Emergency Managers (IAEM)

Spanish Language reports/resources/information.  http://www.iaem.es/index.php?option=com_content&task=view&id=616&Itemid=208

Masks and PPE:

http://www.osha.gov/dsg/guidance/stockpiling-facemasks-respirators.html

http://www.cdc.gov/swineflu/guidance_homecare.htm

http://www.fda.gov/bbs/topics/NEWS/2007/NEW01630.html

http://www.cdc.gov/swineflu/guidelines_infection_control.htm

http://www.cdc.gov/swineflu/masks.htm

Society of Critical Care Medicine. 

Guidance/Tng Documents for Hospital PPE Issues.

http://www.sccm.org/Public_Health_and_Policy/Disaster_Resources/Pages/default.aspx

Mexican Department of Health:

http://portal.salud.gob.mx/

Office of Personnel Management (HR and US Govt personnel Issues):

www.opm.gov/pandemic/

www.opm.gov/oca/compmemo/2008/2008-09.asp

Advice to Federal Employees and Agencies on Preventing the Spread of the Current Flu and Maintaining Readiness to Use HR Flexibilities if Necessary

http://www.chcoc.gov/Transmittals/TransmittalDetails.aspx?TransmittalId=2227

http://www.chcoc.gov/Transmittals/Index.aspx

Pan American Health Organization:

Main Site:  http://new.paho.org/hq/index.php?lang=en

Flu Page:  http://new.paho.org/hq/index.php?option=com_content&task=blogcategory&id=805&I temid=569

Public Health Agency of Canada

PHAC Swine Flu information:

http://www.phac-aspc.gc.ca/alert-alerte/swine_200904-eng.php

Travel Health Warning:

http://www.phac-aspc.gc.ca/tmp-pmv/2009/hsf-mexico-090427-eng.php

Information on Government of Canada actions:

http://www.phac-aspc.gc.ca/media/nr-rp/2009/2009_0427_a-eng.php

General Influenza Information:

http://www.fightflu.ca/index-eng.html

US Dpt of Agriculture

Swine Flu FAQs.

http://www.usda.gov/wps/portal/usdahome?contentidonly=true&contentid=2009/04/0131.xml

US Dpt of Labor/Occupational Safety and Health Administration (OSHA):

Healthcare workers and workplace guidance.  http://www.osha.gov/Publications/OSHA_pandemic_health.pdf

Workplace Guidance.   http://www.osha.gov/Publications/influenza_pandemic.html

World Health Organization:

Pandemic Alert System/Levels:   http://www.who.int/csr/disease/avian_influenza/phase/en/index.html

Swine Flu Page:  http://www..who.int/csr/disease/swineflu/en/index.html

UPDATE: Did Non Profit Hospital Admit Fraud In Court?

Forwarded by the Plaintiff...

Case Number 2:06-cv-681 Meidinger ex Rel versus Lee Memorial Health System.

 

I thought I would bring you up to date on the case.

 

The case involves Lee Memorial Health System of submitting false claims to the Medicare/Medicaid Program.

 

All claims submitted to these programs are false because the amounts listed on the beneficiaries claims are wrong. LMHS has been submitting claims based on the "usual and customary" charges used for the private pay patients (insured and un-insured) rather than the "customary charge" as defined in the Social Security Law. The Social Security Law defines the "customary charge" as the actual amount collected from the private non-Medicare patients.

 

The attorney for LMHS has admitted, in another case the amounts not collected from the insurance companies is the consideration given to the insurance companies for referring the patients to LMHS. Everyone knows this is a kickback scheme, actually a fee splitting scheme, use to broker patients and is illegal. There are many tax question also involved in this illegal operation.

 

The Government has the legal right to know the actual amounts collect for medical services, this is covered by the Social Security Law and The Truth in Negotiations Act. The government is supposed to get the most favored nation prices, which is the lowest prices charged by a health care provider. That is why it made it mandatory for the the health care provider to put the actual amounts collected, known as the customary charge on the the beneficiaries claims. You must know their is a difference between the billed amount charged to insured patients and the actual amounts collected for the services given to insured patients.

 

The case is at a critical point. The Defense attorneys have never denied the allegations. If you know an attorney ask them what this means. In Federal court the allegations have to be denied or they are admitted to. It is like asking a defendant in a criminal case are you guilty or not guilty. It requires an answer.

 

Since the defense did not deny any of the allegations, because the defense attorney knows the law, I asked the Court for a Summary Judgment, rather than wait to go to trial. The Court said it would grant a summary judgment and asked the defense attorney to deny the allegations. The defense attorney did not deny the allegations. The defense attorney would not perjure himself.

 

We are now waiting on the court to make a summary judgment. The process normally takes six months. We have just completed the third month.

 

The question I have is whether the Board of Directors will be bringing criminal charges against the management of LMHS if the Court rules against LMHS?

 

 

 

Roy J. Meidinger Plaintiff

 

 

 

Damages sought for this case is Four Billion Dollars.

Health Insurance, Health Care: And Not The Two Be The Same.

Health insurance is like Communism, both look good on paper but are always perverted from their intent by human greed.

In the mid 1990 I spent a great deal of time negotiating enrollment for provider access to groups via managed care list.  The rank corruption of health insurers was abundantly clear.  Whether flat refusal for inclusion in local provider listing for our group even though the only other provider had passed away leaving a vacancy in the geographic area or middle management abscounding with funds that should have been reserved for patient care, the system of insurance for care fails to pass on maximum benefit to the patient.  On our side of the fence we neither could afford nor wanted to fund the bar tab and hooker fees for county commissioners in exchange for "consideration for list appointment".  Likewise, I observed the feeding freenzy of many intermediate coverage groups, the groups that exist between underwriter and end plan that were bought, sold, merged with a good forty percent of funds aside from salaries being diverted to anything but providing patient care.  Insurance execs looked more like Wall Streeters than concerned health insurers.  In the era of the dismal Clinton health initiatives where the flaws and failures of insurance controlled coiffers became apparent, we should have learned that Clinton-Care and insurance based provider systems is not the answer.  The so called Clinton proposal even went as far as to have two groups or levels that forbade doctors from accepting private pay without fines or jail time in the interest to preserve equality.  Where is the free market?  The poor or working poor in this country in the long term subsidize regular and elective care for the rich.  No plan will ever ensure equality.  And the rich have the option to go elsewhere.  Anti abortion is politiclally correct but alot of cash and a drive across the border means access to care unavailable here as well as discretion for prominent figures.  However, if you are poor you get to have the kid.  And, if you are a congressman... well, you have no worry about coverage or the level of care you receive.  This is why we need one system.  To contain cost, it should be a simple system.  A system similar to a debit card that can be swiped and the doctors can have access to their funds without waiting nine months and employing five extra employees to continually call and be stalled by the insurance companies.  Then care will once again be affordable for the consumer, easier for the provider and cost effective for the administrator.

James Robert Fellabaum

City Water Quality And Drugs Found...

This review did not include Florida waterways and the Mote Marine findings of anti depressants in sharks.  Mote is proceeding to now test for more.  Here is how some of America's cities stack up:

Here's the list of metropolitan areas, grouped by categories — those with positive test results, including the number of pharmaceuticals detected and some examples of specific drugs found, locations where tests were negative, locations where tests were not conducted and a location with pending results:

TESTED POSITIVE

Arlington, Texas: 1 (unspecified pharmaceutical)

Atlanta: 3 (acetaminophen, caffeine and cotinine)

Cincinnati: 1 (caffeine)

Columbus, Ohio: 5 (azithromycin, roxithromycin, tylosin, virginiamycin and caffeine)

Concord, Calif.: 2 (meprobamate and sulfamethoxazole)

Denver: (unspecified antibiotics)

Detroit: (unspecified drugs)

Philadelphia: 56 (including amoxicillin, azithromycin, carbamazepine, diclofenac, prednisone and tetracycline)

Portland, Ore.: 4 (acetaminophen, caffeine, ibuprofen and sulfamethoxazole)

Riverside County, Calif.: 2 (meprobamate and phenytoin)

San Diego: 3 (ibuprofen, meprobamate and phenytoin)

San Francisco: 1 (estradiol)

Southern California: 2 (meprobamate and phenytoin)

Tucson, Ariz.: 3 (carbamazepine, dehydronifedipine and sulfamethoxazole)

Las Vegas: 3 (carbamazepine, meprobamate and phenytoin)

Long Beach, Calif.: 2 (meprobamate and phenytoin)

Los Angeles: 2 (meprobamate and phenytoin)

Louisville, Ky.: 3 (caffeine, carbamazepine and phenytoin)

Milwaukee: 1 (cotinine)

Minneapolis: 1 (caffeine)

New Orleans: 3 (clofibric acid, estrone and naproxen)

Northern New Jersey: 7 (caffeine, carbamazepine, codeine, cotinine, dehydronifedipine, diphenhydramine and sulfathiazole)

Washington, D.C.: 6 (carbamazepine, caffeine, ibuprofen, monensin, naproxen and sulfamethoxazole)

Chinese Companies Continue To Kill Americans

Apparently in the pursuit of profit, the Chinese have again conspired to increase their profit margin by hair splittingly substituting a remarkably close substitute...

Mystery substance in Baxter's heparin

FDA: Tampering possible in China

By David Greising and Bruce Japsen | Tribune staff reporters

11:08 PM CST, March 5, 2008

A significant amount of an unidentified foreign substance contaminated Baxter International Inc.'s blood-thinning drug heparin, the U.S. Food and Drug Administration said Wednesday, raising the possibility of intentional tampering in a supply chain that begins with pig farms in China.

The mysterious substance, which has a chemical makeup similar to heparin, comprises as much as 20 percent of the active ingredient in nine suspect lots produced by Baxter since September, the FDA said Wednesday. The suspect lots are connected to at least four deaths reported nationwide since Baxter noted a spike in adverse reactions to the drug in late December.

The FDA on Wednesday said heparin is connected to as many as 19 deaths and 785 serious illnesses since Jan. 1, 2007. But the FDA timeline extends well beyond the period from September to November, when Baxter's Cherry Hill, N.J., plant produced the heparin connected to the recent rash of serious allergic reactions. The suspect active ingredient in heparin originated at a Changzhou, China, plant owned by Scientific Protein Laboratories, a Baxter supplier based in Waunakee, Wis.

Flood of drugs, little oversight by regulators

"We don't know whether the introduction of the contaminant was accidental, as part of the biological process, or if it was deliberate," said Dr. Janet Woodcock, acting director of the FDA's center for drug evaluation and research.

At least one former top FDA official who helped lead the fight against counterfeit drugs indicated that some Chinese suppliers in the past have introduced foreign substances to boost production when supplies are tight. That's what happened in the early 1990s with an antibiotic known as gentamicin sulphate, which produced adverse reactions and some deaths in the U.S.

"The obvious question is, 'Are these plants back-dooring their supply in order to supplement their capacity?' " asked Benjamin England, who chaired the FDA's Counterfeit Drug Working Group before leaving for a private law practice in Washington, D.C., in 2003.

Epidemic in China

Heparin is produced from an enzyme in the mucous lining of pig intestines. The suspect lots of heparin were made beginning in September, just after the peak in an epidemic of an often-fatal disease known as "blue ear" that afflicted more than 250,000 pigs throughout China. More than half those pigs died or were exterminated.

An FDA official at the press conference said it is possible supplies of the adulterated ingredient came from pig intestines. But FDA officials emphasized they have not pinpointed the source.

Conventional quality and safety testing typically does not discover a foreign substance, England added, because the tests are not designed for that purpose.

The FDA in its press conference Wednesday said conventional tests performed by Baxter and Scientific Protein did not show any variation because the contaminant is so similar to heparin.

"It acts like heparin in this test, so it looks like everything is fine in the test," Woodcock said.

Only after further testing, using nuclear magnetic resonance spectroscopy, did the differences in chemical makeup become apparent, the FDA said.

Scientific Protein's plant obtains heparin from bulk providers of raw material. From its plant in Changzhou, Scientific Protein ships raw heparin to the company's headquarters outside Madison, Wis., then on to Baxter's Cherry Hill plant for final processing, packaging and shipping.

Pointing fingers

Baxter, in its own press conference, sought to point the investigative spotlight back to China. Baxter executives said the active pharmaceutical ingredient sourced from its China-based supplier is the focus of the company's investigation.

"Either the problem lies further back in the supply chain, somewhere before the material gets to the processing plant, or there's something in the processing before it comes to Baxter," said Peter Arduini, president of Baxter's medication delivery business.

Arduini said the company's Cherry Hill manufacturing plant, where multidose vials of heparin are finished and filled before shipment to hospitals and dialysis centers, recently passed an FDA inspection.

Arduini said Baxter's investigation centers further into the "supply stream" in China. There could be "process issues" associated with Scientific Protein's Chinese manufacturing plant, he said.

Baxter also took issue with the numbers provided by the FDA, which said heparin has played a role in 19 patient deaths since Jan. 1, 2007. Baxter insists that four deaths so far may be connected to adverse reactions to the suspect heparin.

For its part, Scientific Protein disagreed with the FDA's interpretation of test results that seems to focus the investigation on a possible adulterated material being added during Scientific Protein's production process.

"During the call with the media, FDA speculated that the source of the adverse events may be a contaminant," Scientific Protein said in a statement. "It is important to note that this theory is speculation at this point, and [Scientific Protein] is participating actively in working with the FDA to pursue this theory as well as others so that we can understand the cause of the adverse events."

Scientific Protein's Changzhou plant, owned in a joint venture with a Chinese partner, is preparing a response to an FDA inspection report last week that criticized the plant's record-keeping, reporting and processes. "It is important to emphasize that the root cause of the heparin adverse events has not been tied to any of the agency's observations," Scientific Protein said in a statement.

FDA inspections

Dr. Andrew C. von Eschenbach, commissioner of the FDA, declined to say whether the FDA physically inspects the more than 700 Chinese facilities that ship pharmaceutical ingredients and drug products to the U.S. The FDA has deployed a "risk-based" system that seeks to focus inspection on plants that might potentially cause the most harm to U.S. consumers.

Von Eschenbach said the agency is beginning to reallocate resources to better address the problems presented by the huge growth in foreign-made drugs. "We recognize that the number of sites that we must pay attention to that are beyond our borders are going to require us to address this systematically," he said.

The FDA plans to increase the number of inspectors, base inspectors in key foreign cities, and build stronger working relationships with foreign regulators, Von Eschenbach added.

dgreising@tribune.com

bjapsen@tribune.com

Copyright © 2008, Chicago Tribune  (SEE ORIGINAL ARTICLE)

Doctor, Did You Kill My Mother?

Laurel Nokomis On Women's Health Issues

Lauel may be reached at Freelancenewsreport@juno.com

20FEB2008

"The only good patient is a dead one..." was the comment overheard by a pharmaceutical rep at a Naples Florida hospital.  With the advent of DRGs (diagnosis related groupings) used to pay a flat fee by U. S. Medicare a trend has been noted of late to get the patient out of the hospital as fast as possible to maximize profits.  If a patient is admited for a stroke and dies a day later in ICU or several days later in general care, the hospital get's reimbursed the same amount of money.  With the WWII generation passing away at the current rate of 1,000 people a day I wonder just how jaundiced physician intensivist are becoming?  At the ICU of another Florida hospital, an Intensivist M.D. was confronted on the phone by the family of a patient that had been moved to a hospice setting.  "She's still alive... you said she wouldn't make it this long" was the comment the physician had to deal with.  To the nurse he later confided "Here's how I like to do it... I keep them in ICU until their kidney's fail, the narcotics do the rest."

Recently, a friend from high school lost his mom.  She was a hard working robust fighter that spent all her time incessently caring for others (she herself was a registered nurse for forty years) yet failing to take care of alot of her own health needs.  Issues aside, she eventually suffered a stroke.  From day one my friend got the impression that the doctors were just writing her off at age 87 and not willing to allow the family the "courtesy" of providing a standard of care.  After a brief improvement she relapsed and quickly passed.  When questioned on the admistration of the over use of narcotics the medical staff denied the use of any when removing her intubation.  And so, after 40 years of caring for others, caring for them in the very institution that was apparently pushing her death sentence. Mercy Hospital in Pittsburgh (under the auspices of the University of Pittsburgh Medical System) she was gone.  Her son, my friend of a long time was understandably upset.   Not only at the loss to the family of one held so dear, but at the calous disregard for "one of their own."  He relayed to me an episode from the past of a Halloween night where some local kids threw eggs on her home.  He remembers her standing outside crying and yelling into the night "I was always good to you kids, any of you, when you came over... how could you do this to me?"  This was one of those times that her feeling were hurt and there was nothing to be said or done but wait until the morning and hose off the front of the house.  ANd after caring for ailing parents and family members it came her turn.  However, in her defiance to not be a burden, at the same time my friend James wonders if she cried out silently at the custodial nursing care and loud blaring TV in her room set on channels the nursing staff would want with little concern for the mental outlook of the patient.  The insult added further as staff and even clergy referred to her professionally and in prayer as "Clara" with the inevitable interruption of "Clare... her name IS Clare."

Statistically, according to the literature, if you live to be 65, men expect to reach 85 and women expect 87.  Currently everyone from WWII  seems to be rushing the pearly gates.  In their wake, bereavement, and a glut of housing that few counted on in a down market.  And those that wished not to be a burden by maintaining independence inevitably created burden in the maintenance of estates that their heirs would have to manage along with their loss.

And what about "The only good patient is a dead one?"  Has the medical field become the holding tank of our last breaths only to urge your passing as someone else is waiting for your room?  I remember a dark horse candidate running for a city office and ruminating why the ruling class was unaware that they would some day meet their maker.  Joe Giffen left gainful employment to care for an ailing wife and live in public housing.  A move rarely seen in this present epoch.  While death is inevitable part of life, and extreme measures are sometimes that, extreme, what about the quality of the value of life.  Not the value of the quality of life, but the quality of the value.  Clare lost her mother to cancer when she was ten.  The next day she got scarlet fever and spent ten days in quarentine.  Then the depression cost the family their farm.  Clare had a rough life and she devoted hers to ensuring that others did not disparage or suffer of like.  To her, there was no "only good patient."  She cared for everyone regardless.

And as for mothers everywhere, mothers that want what's best for their children, don't they truly deserve the best?  The best of care and the best of respect?  Women have long been the forgotten souls of health care.  Probably the number one providers of such, but not necessarily the recipients.  Now health studies are underway to study women's health specifically.  And perhaps it is time that women start to demand a fullness and richness to this portion of their existance.

Fortunately my mom is still around and doing well.  I think I'll take her out for dinner this week.  All health care starts with the showing of respect.  And, after that, laughter is still the best medicine.

Laurel Nokomis

New York City, NY