Malpractice

Rare Q fever outbreak reported in American medical tourists

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Five Americans came down with an unusual illness after traveling to Germany for a controversial treatment involving injections with sheep cells, health officials reported Wednesday.

The treatment is not permitted in the U.S. The New York residents received the “live cell therapy” in May last year. About a week later, they developed fever, fatigue and other symptoms of a dangerous bacterial illness called Q fever.

Two told investigators that they were part of a group that, for the last five years, had traveled to Germany twice a year for the injections. They said they get them to improve their health and vitality. There is no published clinical proof the treatments work, health officials say.

The Centers for Disease Control and Prevention on Wednesday released a report on the outbreak, which included a Canadian case — another medical tourist who got the treatment in Germany at about the same time. The four women and two men ranged in age from 59 to 83.

Live or fresh cell therapy involves injecting people with fetal cells from sheep. It’s sometimes offered as an anti-aging therapy, but also has been touted as a treatment for conditions ranging from impotence to migraines to liver disease.

Q fever is caused by a hardy germ found in cattle, sheep and goats. People usually get it from inhaling barnyard dust — it’s an occupational hazard for farmers.

But cases in the U.S. are unusual — each year fewer than 200 are reported. It is treated with antibiotics and U.S. residents rarely die from Q fever; three or four deaths are reported in the worst years.

Errors kill 15,000 aged patients a month.

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http://mobile.reuters.com/article/idUSTRE6AF5SM20101116?irpc=932

Lifetime Risk for Malpractice Suit Might Exceed 75%

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But take comfort: There is not much chance of paying out.

For all our professional obsession about malpractice suits, we lack good data on recent patterns of risk and payment. U.S. researchers obtained access to a national insurer’s records from 1991 through 2005, which encompassed almost 250,000 physician-years of liability coverage.

Neurosurgeons and cardiovascular surgeons faced the highest annual risk for claims (almost 20%), and pediatricians and psychiatrists had the lowest (less than 5%). Overall, only 22% of suits resulted in payments to claimants, with patterns that did not correlate well with overall risk for suit. For example, gynecologists who do not practice obstetrics (a “medium-risk” specialty), faced the highest risk for payment if sued, whereas obstetrician–gynecologists were more likely to be sued but less likely to pay claims. Overall mean settlement amount was about US$275,000, but payments were often higher in infrequently sued specialties: The average payment amount for pediatricians, for instance, exceeded that for neurosurgeons.

The researchers estimated that, by age 45, 36% of physicians in low-risk specialties and 88% of those in high-risk specialties had faced their first claims. By age 65, these numbers became 75% and 99%, respectively. The practice of internal medicine — a medium-risk specialty — entailed an almost 90% risk of suit by age 65.

Comment: Although these results represent only one insurer’s experience and are not necessarily widely generalizable, they still point to a surprisingly high lifetime risk for suit, even among what have always been perceived as low-risk specialties. The researchers suggest their figures help explain the pervasive fear of malpractice suits and the practice of defensive medicine. Note, however, that this analysis apparently did not distinguish between early dismissal of a named physician from the case versus physician involvement all the way to settlement or trial.


source:  Journal Watch General Medicine