Childhood Disease Rates Rise
Sources: U.S. Center for Disease Control and Prevention; National Institutes of Health
Childhood Disease Rates have been kept low with the advent of vaccination programs. Childhood disease is common in the early months and years of life. Some upper respiratory viral or bacterial infections—colds, bronchitis, or croup—are quite common. Also common are ear infections, sinusitis, impetigo (skin infection), and conjunctivitis (pinkeye). However, there are diseases which used to kill large numbers of children before they reached adulthood. Vaccines have been incredibly effective in preventing childhood diseases and improving child mortality rates.
Childhood diseases such as Diphtheria lead to breathing problems. Pertussis is another name for whooping cough, and it hinders breathing and eating. Tetanus is a serious bacterial infection that can be fatal if not prevented or treated. Vaccinating your child against diphtheria, tetanus, and pertussis can be done in a single dose (DTP Vaccine). Thanks to a vaccine, the United States is one of the only places in the world where polio is completely eradicated. One shot is all it takes to prevent this paralyzing condition. Getting a flu shot and a pneumonia vaccine are also recommended for infants six months or over. A certain strain of pneumonia can lead to blood infections and meningitis, which is covered in the vaccine. Similarly, the MMR vaccine protects against measles, mumps, and rubella, viral infections that cause serious symptoms. Measles and mumps often can lead to chronic conditions, such as deafness, brain damage, and reproductive problems. Rubella (also known as the German measles) and causes a high fever.
Why?
The childhood diseases of Pertussis and Measles have been seen more frequently than expected in the United States as parents “opt out” of vaccination programs because of misplaced fears regarding the safety of vaccines. More than 41,000 cases of pertussis were reported to CDC during 2012. 18 pertussis-related deaths during 2012 were been reported to CDC as of January 5, 2013. The majority of deaths continue to occur among infants younger than 3 months of age. The incidence rate of pertussis among infants exceeds that of all other age groups. The second highest rates of disease are observed among children 7 through 10 years old. Rates are also increased in adolescents 13 and 14 years of age.
The CDC reports several important milestones already have been reached in controlling vaccine-preventable diseases among infants and adults worldwide. Vaccines have drastically reduced infant death and disability caused by preventable diseases in the United States. In addition:
- Through immunization, we can now protect infants and children from 14 vaccine-preventable diseases before age two.
- In the 1950s, nearly every child developed measles, and unfortunately, some even died from this serious disease. Today, few physicians just out of medical school will ever see a case of measles during their careers.
- In March 2005, CDC announced that rubella is no longer a major health threat to expectant mothers and their unborn children, thanks to a safe and effective vaccine, high vaccine coverage.
- In September 2010, CDC announced that childhood immunization rates for vaccines routinely recommended for children remain at or near record highs.
- Yet, the CDC reports, “without diligent efforts to maintain immunization programs in the United States and to strengthen them worldwide, vaccine-preventable diseases will remain a threat to children. As illustrations, it’s only necessary to consider the 2010 California outbreak of whooping cough where over 8,000 cases were reported in the state and where there were 10 infant deaths, or measles, which takes the lives of more than 100,000 children globally each year.”
- Over the last two years, Pennsylvania has had one of the highest rates of pertussis outbreaks in the US.
For more information search for “childhood immunization” or “shots” on medlineplus.gov. Or visit the Centers for Disease Control and Prevention at www.cdc.gov/vaccines for more about vaccination schedules.
The Lewis Law Firm has a long history of representing children, and their families in Philadelphia and New Jersey. If your child has been diagnosed with preventable childhood disease, contact the Lewis Law Firm for a FREE consultation and review of your case, today.
Childhood Cancer, Common.
Sources: Centers for Disease Control and Prevention (CDC); Jemal A, et al., Cancer statistics, 2009. CA: A Cancer Journal for Clinicians 2009;59(4):225–249; U.S. Cancer Statistics Working Group Department of Health and Human Services, Centers for Disease Control and Prevention, and National Cancer Institute; 2009.
CANCER is the second most common cause of death among children between the ages of 1 and 14 years in the US, surpassed only by accidents. More than 16 out of every 100,000 children and teens in the U.S. were diagnosed with cancer, and nearly 3 of every 100,000 died from the disease. The most common cancers in children were leukemia (cancer of the bone marrow and blood) and brain and central nervous system cancers.
Lukemia
In 2005,* 4.1 of every 100,000 young people under 20 years of age in the U.S. were diagnosed with leukemia, and 0.8 per 100,000 died from it. The number of new cases was highest among the 1–4 age group, but the number of deaths was highest among the 10–14 age group.
Brain and Central Nervous System Cancer
In 2005,* 2.9 of every 100,000 people 0–19 years of age were found to have cancer of the brain or central nervous system, and 0.7 per 100,000 died from it. These cancers were found most often in children between 1 and 4 years of age, but the most deaths occurred among those aged 5–9.
Deaths from Childhood Cancer Declining
During the past 25 years, there have been significant improvements in the five-year relative survival rate for all of the major childhood cancers. The five-year relative survival rate among children for all cancer sites combined improved from 58% for patients diagnosed in 1975–1977 to 80% for those diagnosed in 1996–2004. A CDC study found that from 1990 to 2004, childhood leukemia death rates fell by 3.0% per year, childhood brain and other nervous system cancers by 1.0% per year, and all other childhood cancers combined by 1.3% per year, likely reflecting better treatment of childhood cancers. (2005 is the most recent year for which statistics are available)
The Lewis Law Firm has a long history of representing Women and Children in Philadelphia and New Jersey. If you or a child have been diagnosed and treated for cancer, contact the Lewis Law Firm for a free consultation.
Tort Reform -The Big Lie
Source: Public Citizen Report -Congress Watch Division (Public Citizen is a national non-profit consumer organization with more than 300,000 members and supporters).
Medical malpractice payments were at their lowest level on record in 2011
In contrast to the hundreds of thousands of annual avoidable adverse events (and tens or hundreds of thousands of deaths) that major studies attribute to medical mistakes, only 9,758 medical malpractice payments were made on behalf of doctors in 2011. However, policymakers and leaders of physician groups have spent the past two decades championing efforts to restrict patients’ legal rights, calling for Tort Reform and arguing of a crisis. There is no evidence that patients have received any benefits in exchange for ceding their legal remedies. Instead, the evidence suggests that litigation restrictions have suppressed meritorious claims, forcing malpractice victims and ordinary patients to absorb the costs of treating injuries caused by uncompensated medical errors.
Despite suggestions by those seeking to reduce patients’ legal rights that medical malpractice lawsuits are largely “frivolous,” the vast majority of payments compensate for extremely serious harms. 80% of the money paid for medical negligence in 2011 compensated victims or their surviving family members for harms defined by the NPDB as significant permanent injuries; major permanent injuries; quadriplegia, brain damage, or injuries requiring lifelong care; or death. The latter two categories (quadriplegia, brain damage, or injuries requiring lifelong care; and death) accounted for 44 percent of the dollars spent to compensate victims of medical malpractice.
Declines in Litigation Do Not Translate into Lower Costs for Consumer
Between 2000 and 2011, the value of medical malpractice payments fell 11.9 percent while healthcare spending nearly doubled, increasing 96.7 percent (both calculations in unadjusted dollars). These figures debunk claims that medical malpractice litigation is responsible for rising healthcare costs, as well as promises that patients should expect savings from litigation restrictions.
There Is No Evidence that the Decline in Medical Malpractice Payments Is Due to Safer Medical Care
For years, observers of healthcare safety issues referred to the 1998 Institute of Medicine (IOM) report, “To Err Is Human,” for guidance on the prevalence of medical errors. That study concluded that 44,000 and 98,000 patients were dying every year because of avoidable medical errors. In 2010 and 2011, three major studies reached conclusions on medical errors at least as shocking as those in the IOM report. The administrator of the Centers for Medicare and Medicaid Services (CMS), found that the number of adverse events could be 10 times greater than originally thought.
Comparing the well-recognized prevalence of medical errors with the relatively small numbers of malpractice payments leads to the inescapable conclusion that the overwhelming majority of medical errors do not lead to litigation. Harvard School of Health’s Michelle M. Mello and her co-authors in 2007 wrote in analysis of existing literature that only “2 to 3 percent of patients injured by negligence file malpractice claims … The findings of our analysis indicate that the overwhelming proportion of the costs of hospital medical injures are shifted to parties other than the hospital.”15
Uncompensated Medical Errors Are Costing Both Victims and Taxpayers Significantly
To put this figure in perspective, the total number of payments made in 2011 equaled only a little more than 1 percent of the number of Medicare patients that the Department of Health and Human Services estimates to suffer serious, avoidable injuries in a given year—and that’s just Medicare patients. This demonstrates that the vast majority of medical malpractice errors are not resulting in malpractice compensation payments for patients.
Conclusion
The juxtaposition of declining medical malpractice payments, skyrocketing medical costs, and consistent findings of rampant medical errors discredit the underlying promises of those who have campaigned to reduce patients’ access to legal remedies. The only sensible response is for policymakers and physicians to dedicate themselves to pursuing patient safety measures with the same vigor they have applied to limiting patients’ legal rights. That is a solution we could all live with.
The Lewis Law Firm has a long history of standing up for injured patients and their families. If you or a loved one have been the victim of physician or hospital malpractice, please contact the Lewis Law Firm for a FREE consultation and case review, today.
~Posted by: Gayle R. Lewis, Esquire
Surgical Malpractice Ureteral Injury From Obstetrical/Gynecologic Surgery Common Cause of Lawsuits
Source: Danish Medical Journal -Acta Obstetricia et Gynecologica
DANISH researchers, in connection with the Department of Anesthesia of the University of Copenhagen and the Insurance Association of Denmark, have studied reports of 136 ureteral injuries which constitute surgical malpractice in gynecological and obstetrical surgeries which resulted in litigation and insurance claims. Their findings? Failure to dissect and identify the ureter was the most common negligent act of the docotor. Patients were compensated for 54% of these claims for which 44 of the njuries were clearly caused by negligence.
We will restate that point, according to these researchers, Iatrogenic (doctor-caused) ureteral injury or surgical malpractice during pelvic surgical procedures is a well-known complication and important cause of morbity (further harm). The authors investigated the circumstances surrounding registered ureteral injuries in order to identify potential opportunities to prevent such injuries. In a study which could never happen in the US, the researchers were permitted to closely evaluate some 136 medical insurance claims spanning a 10 year period (here 1996 to 2006). They found that Laparotomy procedures (where the belly is opened) were associated with 107 injuries (79%) and 29 injuries (21%) were caused during laparoscopic procedures. 34 patients continued to suffer from chronic renal dysfunction. Significantly, only 17 of the ureteral injuries were discovered during the procedure.
Conclusions: 44 of the ureteral injuries could potentially have been avoided using established surgical practices, most importantly, by exposing the ureter via dissection when indicated. Most of the ureteral injuries were discovered postoperatively. Under Danish Law, patients may file a claim if their medical treatment results in an injury or an unexpected side effect, and the independent Danish Patient Insurance Association (DPIA) will consider these claims. The DPIA operates on a no-blame basis and does not take any legal action beyond assessing damages. As a result, patients can file a claim with the DPIA free of charge with the purpose of seeking financial compensation. In general, financial compensation may be granted under any one of the following conditions: (i) an experienced specialist would have acted differently, whereby the injury could have been avoided, (ii) defects in or failure of the technical equipment were of major concern with respect to the incident, (iii) the injury could have been avoided by using alternative treatments, techniques or methods if these were considered to be equally safe and potentially offer the same bene fits and, finally, (iv) the injury is rare, serious and more extensive than the patient should be expected to endure. Compensation is calculated based on the extent of pain and suffering, reduced income, reduced ability to work and medical expenses. Here in the US, patients can only receive fair compensation for injuries caused by medical malpractice through litigation.
The Lewis Law Firm has a history of representing women who have sustained ureteral, bladder and kidney injuries from improperly performed obstetric and gynecologic surgery or surgical malpractice. If you or your loved one has suffered a ureteral or other injury following c-section or hysterectomy or fibroid surgery, contact the Lewis Law Firm for a Free consultation and case review, today.
Posted by: Gayle R. Lewis, Esquire
A Cheap Plastic Ring May Prevent Premature Birth
Sources: The Lancet online, BBC Health
They aren’t entirely new, however, in one of the first radomised and controlled studies, women with a short cervix (identified by transvaginal ultrasound at 20-23 weeks) had a simple silicon pessary device inserted to determine if this might reduce the risk of preterm labor.
A Brief Background
Being born prematurely (before 34 weeks) during pregnancy is linked to a host of health problems, including: breathing problems; blindness or poor vision; infection; and, death. Over 13 million babies are born prematurely every year. One reason for premature births is a short cervix, defined as a length of 25 mm or less. Physiologically, a short cervix does not accomodate a growing baby to term.
The Study
The Pesario Cervical para Evitar Prematuridad (PECEP) trial followed 11,875 pregant women (aged 18-43) in five hospitals in Spain. The women were randomly assigned to have a cervical pessary placed or to continue their pregnancy without one. Unlike placebo studies, the control and study groups were known.
Results
Spontaneous delivery before 34 weeks of gestation was significantly less frequent in the pessary group than in the expectant management group. How significantly? In the group of women without the pessary, 27% of babies were born prematurely. In the group with the pessary. the rate of premature birth was 6%. No serious adverse effects with the use of a cervical pessary were reported.
Of course, the usual caveats apply, it is thought that only a small portion of women have a short cervix and “more studies are needed.”
If you or a loved one had a child born prematurely and you beleive that you were not provided with appropriate obstetrical care, contact the Lewis Law Firm for a free consultation. The Lewis Law Firm is committed to the health of women and children.
Posted by: Gayle R. Lewis, Esquire
Test Predicts Pre-Eclampsia
Source: American Society of Nephrology; the Preeclampsia Foundation
Pre-eclampsia is a heart condition that occurs only during and after pregnancy which can affects both the mother and baby. It occurs in at least 5-8% of all pregnancies. Pre-eclampsia is a rapidly progressive condition commonly starting with high blood pressure and the presence of protein in the urine. Swelling, sudden weight gain, headaches and changes in vision are important symptoms, however, some women report few or no symptoms. Pre-eclampsia and other hypertensive (high blood pressure) disorders of pregnancy are a leading cause of maternal and infant illness and death. Pre-eclampsia is thought to lead to 76,000 maternal and 500,000 infant deaths each year. Risk factors include: multiple pregnancies; obesity; diabetes; teen pregnancy; first pregnancy
Researchers at the esteemed Mayo Clinic have reviewed the develoment of a simple test which can be performed during pregnancy and which could predict which women will develop pre-eclampsia. The test detects specific kidney cells in a woman’s urine. Out of 15 women studied, all of whom developed pre-eclampsia, all tested positive for the cells, called podocytes. Although carried out on a very small number of women, the researchers say the test is highly accurate for predicting pre-eclampsia and could alert doctors early to the problem.
Ann Marie Barnard, chief executive of Action on Pre-Eclampsia, was quoted as commenting, “A large number of the 1,500 women who call our helpline each year are terrified of becoming pregnant again because they have suffered pre-eclampsia, often with tragic results” and “Any test which can predict whether they are going to get it again has to be welcomed – while it cannot stop the disease occurring, it would enable services to be more closely focused on them and more alert to signs of the disease developing.”
According to numerous sources on this subject, the current tests for prediciting which women might develop pre-eclampsia are still not reliable enough for recommended use. If the results of this study can be repeated in larger groups of women, this could be a game changer.
Posted by: Gayle R. Lewis, Esquire
Smoking while pregnant increases birth defects!
Sources: BBC Health; Journal Human Reproduction; US Department of Health & Human Services
New Research from the UK suggests that women who smoke while pregnant are increasing the chance their baby will be born malformed. The risk for having a baby with missing or deformed limbs or a cleft lip is over 25% higher for smokers.
In England and Wales 17% of women smoke during pregnancy. That number is higher in the US. For women under 20, the figure is 45%. While most mothers will have a healthy baby, smoking can cause considerable damage to the unborn child.
Each year several hundred babies are born with a physical defect directly caused by their mother’s smoking. “Pregnant smokers will be shocked to learn that their nicotine habit could cause eye or limb deformities in their baby,” says Amanda Sandford of Action on Smoking and Health. The chance of a baby being born with missing or deformed limbs is 26% higher, and cleft lip or palate is 28% more likely.
Similarly, the risk of clubfoot 28% greater, and gastrointestinal defects 27% more. Skull defects are 33% more likely, and eye defects 25% more common. The greatest increase in risk – of 50% – was for a condition called gastroschisis (parts of the stomach or intestines protrude through the skin).
Professor Allan Hackshaw, who led the research, believes that, “Women should quit smoking before becoming pregnant, or very early on, to reduce the risks.” Statistics from the US show that only 18% to 25% of all women quit smoking once they become pregnant. Professor Hackshaw adds the risk was likely dose-related – or the more a woman smokes, the greater the risk to her unborn child.
All of the research suggests that If you are pregnant or are trying to conceive, the best thing you can do is limit or stop your smoking entirely.
Post: David M. Schwadron, Esquire
FDA approves the first vaccine to prevent meningococcal disease in infants and toddlers
The U.S. Food and Drug Administration today approved the use of Menactra in children as young as 9 months for the prevention of invasive meningococcal disease caused by Neisseria meningitidis serogroups A, C, Y and W-135. Menactra already is approved for use in people ages 2 through 55 years.
Meningococcal disease is a life-threatening illness caused by bacteria that infect the bloodstream (sepsis) and the lining that surrounds the brain and spinal cord (meningitis). Neisseria meningitidis is a leading cause of meningitis in young children. Even with appropriate antibiotics and intensive care, between 10 percent and 15 percent of people who develop meningococcal disease die from the infection. Another 10 percent to 20 percent suffer complications such as brain damage or loss of limb or hearing.
Although the rates of meningococcal disease are low in the United States, infants and toddlers are more susceptible to getting this serious illness. Meningococcal disease is particularly dangerous because it progresses rapidly and can cause death within hours. Early symptoms are often difficult to distinguish from influenza and other common illnesses.
“The highest rate of meningococcal disease occurs in children under one year of age. With today’s approval, Menactra can now be used in children as young as 9 months of age to help prevent this potentially life-threatening disease,” said Karen Midthun, M.D., director of FDA’s Center for Biologics Evaluation and Research.
The safety of Menactra in children as young as 9 months was evaluated in four clinical studies in which over 3,700 participants received the vaccine. The most common adverse events reported in children who received Menactra at 9 months and 12 months of age were injection-site tenderness and irritability. Occurrence of fever was comparable to other vaccines routinely recommended for young children.
Menactra is given as a two-dose series beginning at 9-months, three months apart; and the study results showed the vaccine produces antibodies in the blood that are protective against the disease.
Menactra was originally approved on Jan. 14, 2005, for use in individuals ages 11 years through 55 years and was approved in October 2007 for children as young as 2 years. Menactra is manufactured by Sanofi Pasteur Inc. of Swiftwater, Pa.
Immediate Release: April 22, 2011
Media Inquiries: Shelly Burgess, 301-796-4651, shelly.burgess@fda.hhs.gov
Consumer Inquiries: 888-INFO-FDA
Low Apgar Scores and ADHD.
Source: Journal Pediatrics, 2011.
A recent study by Danish researchers of the Department of Epidemiology, School of Public Health, University of Aarhus, concludes that a low Apgar score is associated with an increased risk of ADHD in childhood. What does it all mean?
The Apgar score was devised in 1952 by Dr. Virginia Apgar (an anesthesiologist) to simply and repeatably assess the health of a newborn in the delivery room. While it has come under question in some circles as to whether an Apgar score means anything at all, the score is a subjective number assignment (0 to 10) of Appearance (color, etc.), Pulse, Grimace (facial movements or crying), Activity (movement) and Respiration (breathing). It is usually taken at 5 minutes of life. And repeated.
While it is clear that a score of zero is incompatible with describing life, it is debatable what a low Apgar score (say a 4) means to an infant’s future development. It is after all their first graded test.
Enter the Danes. The researchers decided to determine whether low Apgar scores at 5 minutes are associated with increased risks of attention deficit hyperactivity disorder (ADHD) in the future. The study was a nationwide (Denmark for the Euro-ignorant) population-based cohort study of 980,902 babies born in Denmark from 1988 to 2001. All children were monitored from 3 years of age until a first International Classification of Diseases diagnosis of hyperkinetic disorder, a first medication for ADHD, migration, death, or the end of 2006, whichever came first.
Their results? Compared with children with Apgar scores of 9 or 10 at 5 minutes, the risk for ADHD was 75% higher in children with Apgar scores of 1 to 4 (hazard ratio 1.75; 95% CI: 1.15-2.11) and 63% higher for those with Apgar scores of 5 to 6 (95% CI: 1.25-2.11). Consider that 5% of all children are diagnosed with the disorder.
But why? There the research is not as complete. Speculation includes: poor maternal nutrition and prenatal (prior to birth) medical care; asphyxia (lack of oxygen); small brain hemorrhage; shock or trauma -any one of which could result in a subjectively lower score by the observer.
Post: David M. Schwadron, Esquire
Antidepressants linked to preterm birth?
Source: Reuters Health; American Journal of Obstetrics & Gynecology, December 2009
Remember that post about the safety of prescription medications for pregnant women? http://www.medicalmalpracticelawyerblogphiladelphia.com/?p=528
Well, researchers in Washington (State not the Nation’s capital) have found in a study of 3,000 women, those taking selective serotonin reuptake inhibitors (SSRIs) into their 2nd and 3rd trimesters had an increased risk (14%) of giving birth prematurely.
Medications such as Zoloft, Paxil and Prozac were felt to have no appreciable impact during the 1st trimester, however benzodiazepines, such as Ativan and Xanax were linked with preterm labor, low birth weight, respiratory distress and low Apgar Scores.
Among the women in the study who did not take any such medications, only 9% gave birth prematurely as opposed to nearly half of the women taking benzodiazepines.
One might very well question why, with the prevalence of such prescriptions, studies such as this were not published earlier.
~Posted by D.M. Schwadron, Esquire.