July 28, 2014
Health Care Summertime Blues
By Michael D. Shaw
Readers of a certain age will remember the hit song referenced above from 1958, performed and co-written by the late rock legend Eddie Cochran. Like Eddie, “I’m gonna raise a fuss, I’m gonna raise a holler” about a two recent events in our wonderful world of health care.
Johns Hopkins Ob-Gyn Scandal
Among physicians, men who specialize in Obstetrics and Gynecology how long been viewed with some suspicion. This story, coming recently out of vaunted Johns Hopkins will do nothing to quell such thoughts.
As reported by multiple media outlets, Johns Hopkins Hospital has agreed to pay $190 million to settle claims from thousands of women who may have been surreptitiously recorded during pelvic exams by gynecologist Dr. Nikita A. Levy. The good doctor had some kind of sick fetish, and loved to record images of his patient’s genitals, using spy-cams, concealed in pens and key fobs. Moreover, he was accused of scheduling unnecessary pelvic exams, and occasionally performed them without a nurse or other professional in the examining room.
Hospital officials claim to have first learned of his misdeeds on February 4, 2013, even though court documents suggest that he could have been doing them for years. Indeed, plaintiffs’ attorneys estimate that more than 8,000 patients might have a claim. Hopkins did fire him on February 8, and after an extensive search of his office and home revealed more than 1,300 videos and images, Levy committed suicide on February 18, in his basement. His chosen method was suffocation, and in an elaborate turn, pumped helium into the plastic bag he put over his face. No word on whether he recorded the event.
Upon the settlement agreement, Donald L. Devries Jr., an attorney for Hopkins, sounded a trifle disingenuous. He spoke of a “colossal breach of trust,” while trying to stress that Levy was a “rogue employee,” apparently able to operate in stealth for so many years. “There was no inkling of it,” Devries said. “It’s one of those situations where no matter what rules or regulations or whatever you put in place, if somebody wants to violate it secretly as this physician did, there’s not a thing that institution is going to be able to do to know that.”
Sure thing, Donnie. Nikita Levy was in the Johns Hopkins Community Medicine system for 25 years. Yet, none of his co-workers ever noticed that the guy was a pervert. And, there were never any patient complaints over all that time. But then, how many women kept coming back, and recommending this clown, despite their own misgivings? My take is that Hopkins did have an inkling of it, but since Levy didn’t actually rape a patient, and was probably a good earner, they stood by him. Funny how quickly they canned him when the word got out, though.
Fatal Bacterial Outbreak at Greenville (SC) Memorial Hospital
Contrary to fashionable and stupid public opinion, getting everyone insured is not the biggest problem in health care. Vying for that title could be the astonishing number of hospital-acquired infections (722,000 such infections occurred in 2011 resulting in 75,000 deaths, in the US alone).
Since March, 2014, 15 patients at Greenville Memorial are confirmed to have been infected with Mycobacterium abscessus, with the death toll up to four. The organism is found in water, soil, and dust. According to the CDC, it has been known to contaminate medications and products, including medical devices. As noted by infection control guru Lawrence Muscarella, Ph.D, M. abscessus rarely infects patients in the health care setting, and it is not transmitted from patient to patient, meaning it is not contagious.
Rare it may be in these settings, but when infection does occur, it is usually caused by injections of substances contaminated with the bacterium or through invasive medical procedures employing contaminated equipment or material. And, since people in hospitals are often immunocompromised, the results can be devastating.
Initially, the hospital linked the infections to “a piece of surgical equipment,” which was subsequently taken out of service. At the time, officials declined to identify the device, saying that their investigations were preliminary. Three weeks later, though, they backed off from this assertion, focusing on the somewhat obvious contention that “water” was the source of the infection. Well…yeah, but how did this get to the affected patients?
On July 23, during its coverage of the story, WYFF-TV (Greenville) news anchor Carol Goldsmith poses the question “Are other hospitals safe?” The segment that follows features Dr. Matt Arduino from CDC, who does not provide an answer.
With 75,000 deaths from hospital infections per year in a total of 5723 US hospitals, you tell me.