Friday, February 04, 2011

Medication Errors are a Major Killer! (Part 1)

Many High-Tech Health Interventions Unnecessary and Wasted
Posted By Dr. Mercola
February 15 2011
In recent years, over 20 percent of patients who received an implantable cardioverter-defibrillator (ICD, a device that regulates heartbeats) were not actually good candidates for the device.
Researchers looked at more than 111,000 patients who received ICD implants. More than 25,000 did not meet evidence-based criteria for receiving the device -- and the risk of dying in the hospital is significantly higher for patients who receive an ICD but do not meet the criteria.
According to CNN:
"... ICDs often are recommended as a primary prevention tactic for patients who are at high risk for a cardiac arrest or life-threatening arrhythmia, but who have not yet suffered from these symptoms. However, the Centers for Medicare and Medicaid Services (CMS) ... has issued a 'decision memo' stating that only people having certain serious heart conditions or cardiac histories are suitable candidates for ICDs."
Dr. Mercola's Comments:
An implantable cardioverter-defibrillator (ICD) is a device placed in your chest that uses electrical shocks to help control irregular heartbeat, including the type that can cause sudden cardiac death.
When used properly, the devices can and do save lives, but they are not without risks. The procedure to implant the ICD can lead to infection, vein damage or bleeding around your heart or through your heart valve. Allergic reactions to medications can also occur. In short, receiving an ICD is major surgery, and they should only be used when absolutely necessary …
Unfortunately, as with so many areas of modern medicine, a new study found ICDs are being used excessively and improperly -- and may ultimately be causing many patients more harm than good.
Over 20 Percent of Implantable Defibrillators May be Unnecessary and Harmful
Research from Duke University revealed that more than 20 percent of people who received an ICD between 2006 and 2009 were not good candidates for the device.
Many physicians recommend ICDs for people who are at high risk of cardiac arrest or life-threatening arrhythmia, even if they haven't had prior symptoms. But a new memo from the Centers for Medicare and Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services, described that only people with certain specific heart conditions should be given the devices.
The memo also details a long list of other qualifications that must be met before a person is deemed a good candidate for ICD.
What happens when someone who did not meet evidence-based criteria for receiving the device received an ICD anyway?
Their risk of dying in the hospital was significantly higher than those who were good candidates, and one out of 121 experienced complications from the implant, the new study found.
So why are so many patients being implanted with defibrillators even when there's no solid evidence that they will help, and now new research suggests the procedure itself could increase death risk and complications in poor candidates?
Dr. Sana Al-Khatib of Duke University School of Medicine in Durham, N.C., lead author of the study, told USA Today:
"It's lack of knowledge. It's ignorance. It's not keeping track of the guidelines. And we may have some physicians who don't agree with the guidelines or don't think the guidelines apply to their patients."
In reality, there are likely only a select few who will truly benefit from an ICD to reduce sudden death risk. However, everyone should be proactive about reducing this risk, as the most common "symptom" of heart disease is actually sudden death. To reduce your risk of sudden death without an ICD or other "high-tech" intervention, you can read my top tips.
When the Latest Technology Does Not Equal Better Medical Care …
There are many instances where high-tech medical procedures are not always your best solution from a health and healing standpoint. For instance:
Radiation-Based Diagnostic Scans (CT scans, etc.)
More than 70 million CT scans per year are now performed in the United States, including at least 4 million on children. This is up from just 3 million in 1980.
While high-tech imaging can be beneficial in certain cases, it must be used SPARINGLY because it exposes your body to dangerous radiation that is proven to cause cancer. According to a study in the Archives of Internal Medicine, CT scans alone will cause nearly 30,000 unnecessary cancer cases (about 2 percent of cancer cases), which will lead to about 14,500 deaths.
A New England Journal of Medicine study from 2007 also estimated that overuse of diagnostic CT scans may cause up to 3 million excess cancers over the next 20 to 30 years. Unfortunately, CT scans continue to be widely overused, including in children, when in most cases MRIs can provide similar imaging results and at this time appear to be far safer.
Prescription Drugs
Medications are often touted as among the latest innovations in modern medicine, but taking drugs is clearly not the route to optimal health that the modern medical system would have you believe it is.
More than 700,000 people visit U.S. emergency rooms each year as a result of adverse drug reactions. And, according to the U.S. Food and Drug Administration (FDA), adverse drug reactions from drugs that are properly prescribed and properly administered cause about 106,000 deaths per year, making prescription drugs the fourth-leading cause of death in the U.S.
Compare this to the death toll from illegal drugs -- which is about 10,000 per year -- and you begin to see the magnitude of the problem that the pharmaceutical industry is propagating.
Keep in mind, too, that many drugs are designed to create life-long dependency.
For instance, acid-reducing medications actually induce acid-related symptoms like heartburn and acid regurgitation once treatment is withdrawn. Headache drugs can also cause "medication overuse headaches" leading you to seek another drug to relieve the pain caused by the first one.
It's all too common to have to take one or more additional drugs solely to treat side effects caused by your initial drug treatment, so the more you can stay away from this warped system, the better.
Mammograms are often touted as a "life-saving" form of cancer screening, responsible for reducing breast cancer death rates by 15-25 percent. But this reported benefit is based on outdated studies done decades ago …
The New England Journal of Medicine published the first recent study to look at the effectiveness of mammograms in years and revealed that mammograms may have only reduced the cancer death rate by 2 percent -- an amount so small it may as well be zero.
If mammograms were completely safe and capable of reducing your cancer death risk even a small amount, you might be able to make an argument for their use. But mammograms are not only ineffective … they're unsafe as well, as you can read about the risks in-depth here.
The Most Overused Medical Tests and Treatments …
In 2007, Consumer Reports published a list of the 10 most overused medical tests and treatments, and not much has changed since then. Their list includes not only implanted defibrillators as discussed above, but also:
Back surgery
Heartburn surgery
Prostate treatments
Implanted defibrillators
Coronary stents
Whole body screens
High-tech angiography
Virtual colonoscopy
Now, if you're like most people, when you're faced with an ailment or disease and your physician "sells" you on a particular surgical procedure or drug treatment, you probably expect it to solve your problem, improve your health, or, at the very least, live up to its advertised ideals.
But in the United States this is, sadly, expecting too much. American medical care is the most expensive in the world, and for this "price" Americans get:
A maternal mortality rate that is 13.3 maternal deaths for every 100,000 births -- over four times the U.S. government's 2010 goal of 3.3.
A premature birth rate that is higher than that of most other developed nations, and rose 36 percent between the early 1980s and 2006.
Ranked second-to-last out of rich countries for measures of child well-being.
Ranked 41 places behind other countries in infant mortality.
Ranked 49th in life expectancy worldwide, putting it lower than a dozen other developed nations.
So please understand that if you live in the United States, your health is not safe in the hands of the conventional medical system. The current medical paradigm, with its focus on a drug, surgery or other high-tech solution for every symptom, actually creates a mind-boggling amount of needless suffering and premature death.
Low-Tech Solutions to Stay Well
There are cases when modern medicine and new technology save lives, and you should take advantage of these options when they're truly warranted -- which typically is only after you're already very sick or injured. But the latest technology is NOT what will give you energy, vitality and well-being, nor will it help you to prevent the chronic diseases like heart disease, cancer and diabetes that are currently plaguing the nation.
In short, high-tech solutions will not keep you well (and in some cases may make you worse) … the very low-tech and very simple strategies below, however, will:
Address your emotional traumas and manage your stress
Optimize your vitamin D levels
Drink plenty of clean water
Limit your exposure to toxins
Consume healthy fats like animal-based omega-3 fats from krill oil (as an aside, it's been found that consuming omega-3 fats may prevent more sudden deaths than defibrillators)
Eat a healthy diet that's right for your nutritional type (paying very careful attention to keeping your insulin levels down by avoiding sugar (especially fructose) and grains)
Eat plenty of raw food
Optimize your insulin and leptin levels
Exercise -- I also encourage you to incorporate Peak 8 exercises to really maximize your health benefits
Get plenty of good sleep
Remember, relying on high-tech medical interventions and drugs will not give you the healthy body and mind you desire. You can use modern medicine's solutions as Band-Aids, temporarily suspending a symptom or two, but there will be side effects … Your body will try to compensate and heal, but the more medical interventions you throw at your system, the more off-kilter your body gets and the more ill you ultimately become.
What WILL give you optimal health requires just a bit of work on your part -- to eat well, exercise, and relieve stress -- in short all of the things I detail, for free, on the tens of thousands of pages available on my site.
Please also take advantage of the search feature located at the top of this page to learn even more strategies you can use to support your body's innate ability to stay well and heal, naturally.
Nearly 250,000 Deaths From ONE Common Mistake: Here's How to Protect Yourself
Posted By Dr. Mercola
February 04 2011
It's been seven years since I posted the comprehensive, footnoted research article, Death by Medicine, on this website.
Authored in two parts by Gary Null PhD, Carolyn Dean MD ND, Martin Feldman MD, Debora Rasio MD, and Dorothy Smith PhD, it described in excruciating detail how the modern American medical system had bumbled its way into becoming the leading cause of death and injury in the United States.
From medical errors to adverse drug reactions to unnecessary procedures, heart disease, cancer deaths and infant mortality, the authors took statistics straight from the most respected medical and scientific journals and investigative reports by the Institutes of Medicine (IOM), and showed that on the whole American medicine caused more harm than good.
The purpose of this was not to frighten you, but to help you make informed choices about your health, and to provide you with the tools you need to take control of your own health
Seven years after the original article was written, an analysis in the New England Journal of Medicine November 25, 2010 piqued my interest -- the researchers found that, despite efforts to improve patient safety in the past few years, the health care system hasn't changed much at all.
Instead, 18 percent of patients were harmed by medical care (some repeatedly) and over 63 percent of the injuries could have been prevented. In nearly 2.5 percent of these cases, the problems caused or contributed to a person's death. In another 3 percent, patients suffered from permanent injury, while over 8 percent experienced life-threatening issues, such as severe bleeding during surgery.
In all there were over 25 injuries per 100 admissions!
Shocked, I decided to do some research of my own on the state of American health care today.What I found is the grim picture that I'm sharing with you, as an update to the original Death by Medicine article.
Over 40,000 Mistakes EVERY Day!
Unfortunately, the NEJM article was just a reminder of something that the Thirteenth Annual HealthGrades Hospital Quality in America Study pointed out earlier this year.
HealthGrades has been studying the quality of care in the nation's hospitals since 1988. This year they analyzed approximately 40 million Medicare patients' records from 2007 through 2009, and found that 1 in 9 patients developed a hospital-acquired infection.
The HealthGrades report said that "the incidence rate of medical harm occurring is estimated to be over 40,000 each and EVERY day according to the Institute for Healthcare Improvement."
Another study, in 2008, by the Office of Inspector General for the Department of Health and Human Services, also reported grave evidence that something is amiss in the hospital setting in America: One in seven Medicare beneficiaries who is hospitalized will be harmed as a result of the medical care they receive in the hospital, the study said.
Authors of this study found that physician reviewers determined nearly half, or 44 percent of the adverse and temporary harm events "were clearly or likely preventable." The cost of these mistakes was estimated at $324 million in October alone. The mistakes equate to 3.5 percent of the Medicare budget.
Hospital-Acquired Infections
Another study, published in the Archives of Internal Medicine this year, showed that sepsis and pneumonia caused by hospital-acquired infections killed 48,000 patients and ramped up health care costs by $8.1 billion in 2006 alone. Both these infections are mostly preventable through better infection controls. The study also found that 20 percent of people who developed sepsis died; 11 percent of those who developed pneumonia died.
The authors noted that many hospital-acquired infections are super resistant to common antibiotics – and it's not just sepsis and pneumonia that they're talking about.
A different study in 2006 showed that "central-line-associated" bloodstream infections caused by catheters placed directly into veins resulted in a $26,839 loss for each patient that came down with this type of hospital-acquired infection. This same study estimated that 2 million people come down with hospital-acquired infections of any type in every year, and that approximately 100,000 die from those infections.
Medication Errors are a Major Killer
In 2000 the Institutes of Medicine reported that medical errors were the eighth leading cause of death in the U.S., killing between 44,000 and 98,000 people each year. While the number of errors today is said to
possibly be the fourth leading cause of death in a hospital, health officials agree that this type of death-by-medicine is still prevalent -- and preventable.
In a June 2010 report in the Journal of General Internal Medicine, study authors said that in looking over records that spanned from 1976 to 2006 (the most recent year available) they found that, of 62 million death certificates, almost a quarter-million deaths were coded as having occurred in a hospital setting due to medication errors. They also found that these errors spiked in July, and particularly in teaching hospitals.
There are four points in the medication use process at which errors may occur:
when the medication is ordered (written, electronic, or oral)
when the medication order is transcribed and verified
when it's dispensed, and
when it's administered
The June 2010 report narrowed the errors down to:
drug overdose
prescribing the wrong drug
taking the wrong drug, or
accidents involving medications during surgery or medical procedures
Older adults are at a higher risk of medication errors and have a greater propensity for experiencing harmful and fatal errors. The most common types of medication errors in older adults are omission and improper dose.
Nearly Half a Million Preventable Adverse Drug Reactions
An estimated 450,000 preventable medication-related adverse events occur in the U.S. every year.
A study published in the Journal of Gerontology in 2006 showed that adverse drug reactions are very common in frail elderly persons after a hospital stay, and polypharmacy and warfarin use consistently increase the risk.
The costs of adverse drug reactions to society are more than $136 billion annually -- greater than the total cost of cardiovascular or diabetic care. Adverse drug reactions cause injuries or death in 1 of 5 hospital patients.
The reason there are so many adverse drug events in the U.S. is because so many drugs are used and prescribed – and many patients receive multiple prescriptions at varying strengths, some of which may counteract each other or cause more severe reactions when combined.
In 2009 there were nearly 3.68 billion prescriptions filled in the U.S. That averages to almost 12 prescriptions for every person in the U.S. Other interesting drug statistics are:
Specialists give more than 2 prescriptions per visit
Just over 89 percent of Medicare patients take prescription medicine daily
46 percent take 5 or more prescriptions chronically
Nearly 54 percent take meds prescribed by more than one doctor
One thing that the drug companies don't tell you, and that your physician may not realize, is that premarketing drug safety profiles may be very narrow: most new drugs have 3,000 or less short-term patient exposures. Another fact the drug companies don't advertise is that some drugs have rare toxicity possibilities, meaning very bad side effects could occur in as few as 1 in 20,000 patients. To detect such rare toxicity, more than 60,000 patients must be exposed AFTER the drug is marketed.
49th in Life Expectancy, First in Health Care Costs
The latest study published in Health Affairs revealed that the United States now ranks 49th in the world for both male and female life expectancy, down from 24th in 1999.
In 1950, the United States was fifth among the leading industrialized nations with respect to female life expectancy at birth, surpassed only by Sweden, Norway, Australia, and the Netherlands. The last available measure of female life expectancy had the United States ranked at forty-sixth in the world. U.S. infants also are in the basement when it comes to mortality rates; according to 2009 data compiled by the World Bank, the U.S. is 41 places behind other countries in infant mortality.
Is American Medicine Working?
There's no doubt that government health care officials are worried about this country's reputation for safety in the hospital setting. If they weren't, they wouldn't have set up the Center for Quality Improvement and Patient Safety, a task force charged with developing plans and strategies for making American health care safer.
The problem is that, as it always with government, things move very slowly when change is needed, so the nation has yet to have a nation adverse event reporting system for hospital medical errors. We also don't have any federal standards regarding state systems. The question is whether living the status quo is going to make us any healthier or not, and if it doesn't, what are we going to do to make a better life for ourselves?
What about Preventive Care?
It doesn't take a genius to figure out that the American health care system is skewed toward treating illnesses and diseases, not preventing them. In 2003, my Death by Medicine report showed that judging by health care spending alone, the U.S. should be the healthiest country in the world with the best medicine available. But it wasn't.
And today, it still isn't.
One reason for that is because an obscure federal panel that most people never hear about not only defines what preventive medicine is, but decides what services your health care dollars will pay for. Historically that panel, the U.S. Preventive Services Task Force, has been accused of being ultra-conservative in the way of preventive care. But when it does approve it, the definition of preventive care means some kind of diagnostic test for a possible existing illness, not a strategy for staying well.
For example, if you take a look at the task force's website, you'll see lists of "preventive" medicine topics the group is considering that include such things as aspirin use and various types of disease screenings -- with only one mention of vitamin supplements as a possible upcoming preventive strategy.
If you click on the task force's A to Z topic guide of existing "preventive" health care, you'll see that almost every single one is some type of disease screening or counseling for a condition you already have.
And that's what's wrong with U.S. health care, whether it was seven years ago or today -- we are all too eager to embrace screenings for diseases or illnesses we may or may not have, and counseling and/or medical treatment in the form of pills and chemicals and surgeries for it, after we find out what disease it is we have.
According to the Kaiser Foundation and the CDC, the main drivers of health care costs in the U.S. are technology and prescription drugs; chronic disease; aging of the population; and administrative costs.
I agree that these are huge contributors to what is killing us as a nation financially and as a people. But I DON'T agree with the context in which they're presented. If you've followed all the information I've given you here, and even skimmed the 2003 Death by Medicine article, then I think you'll see why I think the major contributors have a slightly different paradigm -- and that the only way we are get healthier as a nation, and drive medical costs down too, is to change that paradigm.
That's because the foundational causes of what's driving health care costs in America are:
The emphasis on sickness and treatment, rather than health, fitness, and prevention which is primarily fostered by ultra-sophisticated marketing strategies employed by the drug cartel.
Fraud -- by both consumers and providers, including the drug industry.
Unnecessary procedures, medications, hospitalizations and screenings
Medical mistakes, hospital-acquired infections, and surgical and device errors
If we were only to address these issues, beginning with changing the emphasis of our well-being to health and fitness, and then following the healthy lifestyle that paradigm suggests, I promise that the issue of sickness in America and what it's costing us -- as well as the death-by-medicine events will begin to fade away very quickly.
It's time to quit bombarding your body with medical interventions and to reward yourself with the fit and healthy body that come from living fit and lean.
And until then -- until our health care system as a whole -- changes the emphasis of what we're doing to health and healthful living, exercise, proper nutrition and diet, and vitamin supplementation, we're not going to see anything in our health care system change, even if we wait another seven years to see how it's going.
Also See:
Hospitals are Hazardous to Your Health!
10 September 2010