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UNC and Duke LifePoint hospitals face potential EMTALA violations
The Friday Pulse Check
Good morning and happy Friday. Welcome to the Friday Pulse Check. I hope all of our friends in Florida are safe and that the region experiences a speedy recovery.
In the news:
Johns Hopkins anesthesiologist and Army doctor conspired to share Army medical records with Russia
This story was a bit of a shock this morning when I heard it on the radio. Anna Gabrielian, an anesthesiologist at Johns Hopkins University, and her husband, US Army Major Jamie Lee Henry, attempted to share medical information of US Army personnel with someone who they believed worked with the Russian government. That individual was an FBI agent. While the indictment only identifies Gabrielian’s employer as “medical institution 1,” her LinkedIn profile lists her as an employee of Johns Hopkins Hospital, and earlier today, the Hopkins Medicine website listed her as an instructor in anesthesiology. Major Henry had a “Secret” level security clearance and was stationed at Ft. Bragg, North Carolina. Allegedly, Gabrielian told her husband he was a “coward” when he raised ethical concerns posed by the HIPPA violations they were committing. Gabrielian was apparently motivated by a “patriotism” toward Russia and wanted to aid their war effort in Ukraine. Read more from CBS News.
New ALS drug approved despite concerns about effectiveness
Earlier this year, Ron discussed a new Alzheimer’s drug called Aduhelm that was approved by the Food and Drug Administration but would not be covered by Medicare. Aduhelm is very expensive and not very effective at treating Alzheimer’s, hence CMS’ decision to not cover it. This week, the FDA approved a new drug to treat ALS called Relyvrio; like Aduhelm, the decision is being criticized by watchdogs and physicians who question its efficacy. The FDA said “regulatory flexibility” was necessary for this instance because of the seriousness of the disease. Amylyx Pharmaceuticals, the manufacturer of Relyvrio, promised the FDA that if a large, ongoing study does not turn out to be promising, they will pull the drug from the market. Those results are expected in 2024. Read more from ABC News.
Duke LifePoint hospital and UNC Medical Center under scrutiny for potential EMTALA violations
Wilson Medical Center in Wilson, North Carolina, a Duke LifePoint hospital, had a brush with CMS this summer after regulators found a number of issues, including violations of the Emergency Medical Treatment and Labor Act, which placed the health and safety of patients in “immediate jeopardy.” One patient died after being sedated and left unattended, another patient died after his heart monitor was disconnected, and a third patient locked himself in an emergency room lobby bathroom and threatened to overdose on his medication. UNC Medical Center in Chapel Hill, North Carolina also faced a similar investigation from CMS after a patient committed suicide after being released from the emergency room. CMS gave both hospitals until the end of September to make corrective changes or lose their Medicare contracts; both hospitals, as of today, say they have. CMS has removed the “immediate jeopardy” designation but they are now reviewing the changes the hospitals have made to decide the next steps they will take. Duke LifePoint owns fourteen hospitals in mostly rural areas of North Carolina, Tennessee, Virginia, Pennsylvania, and Michigan’s Upper Peninsula and is affiliated with Duke University. Read more from the News and Observer.
Is the independence of physicians under attack?
As I wrote on Twitter this week, no it is not, despite what COVID-19 deniers might claim. We discussed that in detail this week on the FLATLINING Podcast. I can understand how casual observers might think that this might be the case though, particularly those who don’t understand how healthcare works (fact-free zone?).
It may look as though doctors with dissenting opinions were silenced, pushed off to the side, or ridiculed by the media when they had ideas that counter to the public health narrative about COVID-19. Combine that with the extremely political environment the pandemic fell into, it further entrenched people/voters/patients/citizens into believing there was a grand political scheme out to get them.
Just yesterday, I saw a LinkedIn post by someone who was proudly showing off his certificate saying he survived the “greatest scare campaign in the history of the universe.” I understand why some people might believe that, people who don’t understand how science and medicine are done.
This person would likely point to the changing guidance of the Centers for Disease Control and Prevention, the National Institutes of Health, Dr. Anthony Fauci, or anyone remotely related to medicine in the public eye throughout 2020 and 2021. What people like him fail to grasp, though, is that is how science is done.
We learn more every day from scientific discoveries at universities and drug manufacturers. We do studies to see what treatments work for what diseases and what treatments don’t. And before I’m criticized for being a Biden-voting sycophant, read my comments above about Relyvrio and Aduhelm.
Last week on the podcast, we discussed how some physicians facing prison time because of their over-prescription of opioids are hoping that a new Supreme Court decision raising the burden of proof on prosecutors - it requires them to prove malicious intent - will keep them out of jail. “I didn’t intend to harm my patients by over-prescribing opioids; it was in my medical opinion that it would help them” they are arguing.
I’m sure Governor Gretchen Whitmer and former Governor Andrew Cuomo didn’t intend to cause more nursing home deaths by sending COVID-19-positive patients to nursing homes. They still did though.
There isn’t a censorship crackdown on physicians who want to prescribe hydroxychloroquine to COVID-19 patients or people who opposed mask mandates or vaccines. New studies have shown that they are ineffective at treating COVID-19 and even can cause heart disease and more studies are showing that the vaccines are effective at preventing severe illness.
As I’ve mentioned before, there is no kabal of physicians who are out to subject millions of Americans to their tests (like a COVID-19 vaccine conspiracy says). Physicians are as diverse as any group of people in the United States, politically, religiously, ethnically, etc. Just because a majority of them agree with what the studies say about any given topic does not mean that the minority who don’t are being censored or oppressed.
For more detail, check out this week’s episode of the FLATLINING Podcast.
Let us know what you think in the comments below, email us at firstname.lastname@example.org, or tweet Matthew or Ron.
There was a report this week that Vladimir Putin’s health is deteriorating, which could supposedly explain his rash decisions in his war against Ukraine. Now, that report came from The Sun, a British tabloid, so who knows the veracity of their analysis? I supposed it is possible that the Russian president is on his last legs.
Stephen Biegun, former Deputy Secretary of State during the Trump administration and former Vice President of International Governmental Affairs at Ford Motor Company, wrote in the Detroit News this week about his other “last legs.” After shelling civilian populations for months, including hospitals and medical clinics, his allies in Uzbekistan and China have told him to end this. This week, to try and cut his losses, Putin is annexing parts of the Ukrainian territory that he still controls. As the World Health Organization and other non-profits try to prop up medical facilities in the war-torn country and the International Criminal Court in the Hauge starts to look at war crimes, including genocide, Putin could be on his last legs among the Russian people. Read more from the Detroit News.
Today ought to be a day of anticipation ahead of tomorrow’s celebration in border communities in the northern parts of the United States. Canada is finally dropping their COVID-19 entry restrictions, being one of the last countries in the west to do so.
Canada had some of the most restrictive policies. They required all travelers (including Canadian citizens) to prove they were vaccinated and present a negative PCR test to enter the country, although the testing requirement was dropped in March. Travelers had to put all of their information, including what their quarantine plan was if they tested positive in Canada, into their web portal and app.
All of that is going away tomorrow to the great rejoicing of major border communities like Detroit and Buffalo. Here is an example of why their policies were pointless:
There are many Detroit Lions fans who live in Windsor, Ontario. Last year, when the US required negative tests for foreigners to enter, a Canadian national could get a negative COVID-19 test on the Wednesday before Thanksgiving, drive over the Ambassador Bridge to Detroit on Thanksgiving day, go to Ford Field with thousands of other Lions fans, and then return to Canada using the same negative COVID-19 test they took on the day before.
As for proving you are vaccinated and filling out an app before you go to the border or the airport, it doesn’t save any time at immigration any more. As someone who has crossed the border a number of times before and after the onset of the pandemic, it is still a slow experience regardless if you tell them ahead of time that you’re coming.
Finally, the new order also removes the requirement to wear masks on airplanes, in airports, on trains, and on public transit.
As I mentioned in the podcast earlier this week, I am glad Canada has finally come to the same decision that the rest of the world came to months ago.
Have a good weekend,