Current Events in August 2004

The "HealthGrades Patient Safety in American Hospitals" looked at the mortality and economic impact of medical errors and injuries that occurred during Medicare hospital admissions nationwide from 2000 to 2002.

The number of deaths was nearly double that found iin the 1999 Institute of Medicine study To Err is Human, with an associated cost of more than $6 billion per year. At the time the study was issued, the IOM said the rate of in-hospital deaths should be considered a national epidemic.

The latest study applied the mortality and economic impact models developed by Dr. Chunliu Zhan and Dr. Marlene R. Miller in a research study published in the Journal of the American Medical Association (JAMA) in October of 2003.

Whereas the IOM study extrapolated national findings based on data from three states, Zhan and Miller looked at 7.5 million patient records from 28 states over one year, HealthGrades looked at three years of Medicare data in all 50 states and D.C. This Medicare population represented approximately 45 percent of all hospital admissions (excluding obstetric patients) in the U.S. from 2000 to 2002.

The HealthGrades study shows that the IOM report may have underestimated the number of deaths due to medical errors, and, moreover, that there is little evidence that patient safety has improved in the last five years, said Dr. Samantha Collier, HealthGrades vice president of medical affairs.

The equivalent of 390 jumbo jets full of people are dying each year due to likely preventable, in-hospital medical errors, making this one of the leading killers in the U.S., Collier said.

The HealthGrades study was released in conjunction with the companys first annual "Distinguished Hospital Award for Patient Safety," which honors hospitals with the best records of patient safety. Eighty-eight hospitals in 23 states were given the award for having the nations lowest patient-safety incidence rates. A list of winners can be found at www.healthgrades.com.

HealthGrades examined 16 of the 20 patient-safety indicators defined by the Agency for Healthcare Research and Quality (AHRQ) from bedsores to post-operative sepsis omitting four obstetrics-related incidents not represented in the Medicare data used in the study.

Of these sixteen, the mortality associated with two, failure to rescue and death in low risk hospital admissions, accounted for the majority of deaths that were associated with these patient safety incidents. These two categories of patients were not evaluated in the IOM or JAMA analyses, accounting for the variation in the number of annual deaths attributable to medical errors. However, the magnitude of the problem is evident in all three studies.

If we could focus our efforts on just four key areas failure to rescue, bed sores, postoperative sepsis, and postoperative pulmonary embolism and reduce these incidents by just 20 percent, we could save 39,000 people from dying every year, said Dr. Collier.

Study Highlights

Among the findings:

• About 1.14 million patient-safety incidents occurred among the 37 million hospitalizations in the Medicare population over the years 2000-2002.

• Of the total 323,993 deaths among Medicare patients in those years who developed one or more patient-safety incidents, 263,864, or 81 percent, of these deaths were directly attributable to the incident(s).

• One in every four Medicare patients who were hospitalized from 2000 to 2002 and experienced a patient-safety incident died.

• The 16 patient-safety incidents accounted for $8.54 billion in excess in-patient costs to the Medicare system over the three years studied. Extrapolated to the entire U.S., an extra $19 billion was spent and more than 575,000 preventable deaths occurred from 2000 to 2002.

• Patient-safety incidents with the highest rates per 1,000 hospitalizations were failure to rescue, decubitus ulcer and postoperative sepsis, which accounted for almost 60 percent of all patient-safety incidents that occurred.

• Overall, the best performing hospitals (hospitals that had the lowest overall patient safety incident rates of all hospitals studied, defined as the top 7.5 percent of all hospitals studied) had five fewer deaths per 1000 hospitalizations compared to the bottom 10th percentile of hospitals. This significant mortality difference is attributable to fewer patient-safety incidents at the best performing hospitals.

• Fewer patient safety incidents in the best performing hospitals resulted in a lower cost of $740,337 per 1,000 hospitalizations as compared to the bottom 10th percentile of hospitals.

Driving with a cracked or broken windshield is not only annoying, it can also put both drivers and their passengers at risk. In fact, insurance companies in some states are required by law to waive the deductible for damaged or broken windshields in an effort to encourage vehicle owners to make the appropriate repairs.

However, Doug Ashbridge, Director of Special Investigations for Farmers Insurance Group, says some glass companies are using that loophole to persuade consumers that they can have new windshields for free, since they are fully covered by their insurance company. While the rationale appears logical to the consumer, the practice is illegal.

According to Ashbridge, replacing a windshield that is not damaged, and then charging the insurance company on the grounds that it is damaged, is considered insurance fraud and, he says, "is a growing problem nationwide."

In many cases, glass companies will rent parking lot space from auto repair facilities, convenience stores, gas stations or car washes, and prey upon those business' customers. The glass company representatives -- also called "glass claims harvesters" -- will approach vehicle owners, inspect their windshields and offer to fix or replace them for free even if the glass is not damaged.

Once the vehicle owner agrees to the deal, the harvester will subcontract the windshield replacement with another, less expensive glass company and turn a profit from the consumer's insurance claim. Some of the more aggressive harvesters even offer vehicle owners incentives, such as free car washes, free steaks or cash to replace windshields that are not in need of repair.

Once they obtain the vehicle owner's policy information, some harvesters impersonate the insured and submit multiple glass claims. Others repair windshields and then claim them as replacements, or claim more repairs than were actually done.

Ashbridge points out that the "free" windshield could ultimately cost vehicle owners their preferred status rating with their insurance company, resulting in rate increases, and possibly more severe penalties.

He warns that vehicle owners who agree to unnecessary windshield repairs or replacements from these types of glass company representatives could end up facing criminal charges.

Ashbridge notes that most glass companies are honest, so it's hard for consumers to know if the offers are dishonest. He advises them to contact their insurance agent before giving glass companies their policy information and letting them submit glass claims.

According to Ashbridge, industry studies show that property casualty insurance fraud costs consumers about $20 billion each year. In some states, it adds as much as $240 per year to every auto policy.

Britax is recalling 355,516 child seats because a harness can come loose, federal safety officials said.

Britax is recalling all Marathon, Husky, Wizard and Snug Seat Traveler Plus seats. The seats were made between August 2002 and this July and have the model numbers E9L06, E9L30, E9L07 and E9L32, the National Highway Traffic Safety Administration said.

The defect was discovered during company testing. Britax found that the adjuster strap could slip within the metal buckle that controls the tightness of the shoulder harness. If the strap slips far enough, the harness could loosen and the child could fall forward in an accident.

No injuries have been reported as a result of the defect.

Britax will provide consumers with a free kit that will allow them to fix the problem by replacing the adjuster strap. Registered owners should receive the kit by Sept. 30. Consumers who did not register should call 800-683-2045 to receive a kit.

In the meantime, Britax said consumers should check to see if the strap is slipping and should use a different seat if it is.

Britax said seats made after Aug. 1 are not affected. The company also said it is recalling all seats not yet purchased and retrofitting them with the new strap. A spokeswoman for the company could not immediately say how much the recall will cost.

Everyone has heard horror stories about home remodeling contractors, and increasingly, many of them seem to be coming from Texas. Consumer advocates say there's a reason for that -- Texas law does very little to hold contractors accountable, and all too often it's the homeowner left in the lurch.

A recent report in the Houston Chronicle detailed reports from homeowners who've had bad experiences with a contractor, and discovered they have few rights when they looked for recourse.

Criminal cases against contractors are almost impossible to make under current Texas law. When homeowners file civil suits, unscrupulous contractors file for bankruptcy, or seek other clever manipulations of the law.

Part of the problem, say consumer advocates, is that Texas has almost no licensing requirements for home remodeling contractors, making it very difficult for homeowners to tell the good ones from the bad ones. The situation has gotten so bad that frustrated homeowners formed a chapter of Homeowners Against Deficient Dwellings, which tries to offer some education to consumers before they get in a jam.

The group says it would like to see Texas adopt some of the safeguards other states have, like performance bond requirements, a guaranty fund for victims and more thorough licensing procedures.

The Texas Attorney General's Office reports receiving more than 700 reports from homeowners about their contractors since 2002. The Better Business Bureau of Metropolitan Houston said it's received more than 4,000 such reports in the last three years.

Two Common Scams

The attorney general's office says there are two very common home improvement scams it deals with on a repeated basis. In one case, a contractor says he was in the neighborhood and noticed something on your home that is in need of repair. In the other, the contractor knocks on your door and says he's just completed a job for one of your neighbors, and has leftover materials, and can do the same job for you at a "today only" low price. In both cases, the contractor shows up uninvited. That, says attorney general Greg Abbott, should send up a red flag.

While consumer education and vigilance is all well and good, Texas consumer advocates say putting teeth into the state's consumer laws is a better answer. They point to a recent case in which disgruntled homeowners were successful in bringing criminal fraud charges against their contractor. In court, the contractor denied he committed fraud and claimed he simply took on more work than he could handle.

The case was tossed out because the court held that contractors have no fiduciary duty to homeowners under state law. Consumer advocates say, until that changes, Texas homeowners will continue to be at the mercy of home repair rip-off artists.

It gets worse. Under Texas law, if a subcontractor doesn't get paid, they can place a lien on the property. Many a Texas homeowner who has paid their contractor in full has found themselves in that situation.

The National Fire Protection Association (NFPA) says the number of fires started by cigarettes increased 19 percent in the most recent year studied. It's urging more states and cities to follow New York's lead in requiring that cigarettes be designed to stop burning when they're not being actively smoked.

New York is the only state that has passed the cigarette safety law. Starting in June 2004, cigarettes sold in New York must be self-extinguishing and all cigarette brands must be tested to make sure they self-extinguish at least 75 percent of the time.

"Cigarette fires are a major cause of death that we know how to address,'' said James M. Shannon, NFPA president and chief executive officer. "A cigarette touching something combustible can take significant time to produce a fire. Cut down the burning time of cigarettes and you can prevent fires."

NFPA's analysis sheds light on how cigarettes lead to fatal fires. Contrary to the popular image, most victims of smoking-material fires did not fall asleep smoking. Many are not even smokers. Rather, these fires typically started when someone abandoned or improperly disposed of smoking materials.

Most victims were in the room where the fire started, and most had some condition that limited their ability to get out. Often they were asleep, but a significant number were impaired by drugs, alcohol, disability or old age. Indeed, people older than 64 are more likely to die in smoking-material fires than younger people, even though they are less likely to smoke, accoording to the NFPA.

In 1999, smoking-material fires increased 19 percent over the previous year to 167,700, resulting in 807 civilian deaths, 2,193 civilian injuries, and $559.1 million in direct property damage. Deaths and injuries both decreased by 11 percent from 1998 to 1999, but property damage costs, adjusted for inflation, increased by 33 percent.

The effort to prevent deaths from cigarette-caused fires has a long history. In 1979, after a fire started by a cigarette killed five young children in a Boston suburb, the late U.S. Rep. Joseph Moakley (D-Mass.) introduced a bill that would have required the Consumer Product Safety Commission (CPSC) to regulate cigarettes as a fire hazard.

In 1987, a federally-mandated study found that it was possible to manufacture cigarettes that would be less likely to start fires.

Some versions of the popular Ford Explorer and Mercury Mountaineer SUVs are among the worst on the road for rollover risk, according to the latest rankings from the National Highway Traffic Safety Administration (NHTSA).

The Explorer Sport Trac two-wheel drive posted the single worst rating for rollover risk among all 2004 vehicles analyzed -- including cars, vans and SUVs. DaimlerChrysler's Pacifica four-wheel drive was the top rated SUV, with a 13 percent rollover risk.

The Explorer Sport Trac four-wheel drive, the Explorer four-door, two-wheel drive, and the Mountaineer four-door, two-wheel drive were in the bottom six of the SUV class, which as a group posted the lowest scores.

NHTSA has for years used a five-star safety rating system, assailed by safety experts as incomplete and misleading. With today's release, NHTSA began assigning a percentage risk for rollover to the star ratings.

The ratings are determined by a mathematical calculation based on a vehicle's measurements and on a road test that includes extremely sharp "fish-hook" turns.

Cars and minivans generally did well in the tests, with most outperforming SUVs. Pickups were mostly in the SUV class, with worse ratings than most vans and cars.

The safest vehicle overall was the Mazda RX-8 four-door. It has an 8 percent chance of rolling over. By comparison, the two-wheel drive Explorer Sport Trac has a nearly 35 percent chance of rolling over in an emergency maneuver, the government said.

2004 Model Year Rollover Testing
Passenger Cars

Pickup Trucks

Sport Utility Vehicles (SUV)

Vans

1. Corporate Twin of Chevrolet Silverado 4x2
2. Corporate Twin of Chevrolet Silverado 4x4
3. Corporate Twin of Chevrolet Trailblazer 4x4
4. Corporate Twin of Chevrolet Trailblazer 4x2
5. Corporate Twin of Ford Escape 4x4
6. Corporate Twin of Ford Explorer 4x4
7. Corporate Twin of Ford Escape 4x2
8. Corporate Twin of Chevrolet Tahoe 4x4
9. Corporate Twin of Chevrolet Tahoe 4x2
10. Corporate Twin of Ford Explorer 4x2
11. Corporate Twin of Ford Freestar

A nationwide consumer class action lawsuit against the manufacturer and distributor of CortiSlim charges that the company's claims are false and misleading.

The CortiSlim pitch goes something like this: when you're under stress, your body releases a hormone called cortisol, which does a lot of things, including increase your appetite. Not only that, we're told that cortisol actually influences where the fat from all that stress-related eating goes - straight to your belly.

The ads for CortiSlim say it blocks cortisol, which helps you lose weight without a lot of diet and exercise.

The suit charges CortiSlim with using a series of misleading infomercials in which the human body's ability to regulate weight loss is allegedly linked to the body's production of a chemical substance called cortisol. Contrary to the company's advertisements, the suit charges the defendants' marketing claims are unsubstantiated and lack a valid scientific basis.

The official CortiSlim Website features a FAQ section that is somewhat vague about when consumers of the product will see results. However, it advises users to not weigh themselves for the first 30 days of using the product. In fact, the company recommends not using a scale to measure the product's effectiveness!

The lawsuit seeks a refund for all consumers who relied on the company's claims.

August 6, 2005
Pokmon plush dolls, beanbags, and key chains are being recalled. Tips of sewing needles have been found in the stuffing, posing a puncture hazard.

The recall involves 13 plush Pokmon characters shown below. All recalled toys have a sewn-in label reading TOMY. There also is a production code on the toys label that begins with a letter and is followed by two numbers. The following production codes are included in the recall: A04, B04, C04, D04, E03, E04, F03, F04, G03, G04, H03, I03, J03, K03, and L03. Any production code containing an S is not part of this recall.

The toys were sold at Pokmon Center NY, 10 Rockefeller Plaza, New York City and on the firms Web site at www.pokemoncenter.com nationwide from January 2004 through August 2004 for between $2 and $11. A limited number were given away as a promotional item.

Parents should take these toys away from children immediately and contact TOMY Company for information on receiving a refund or free replacement toy.

Consumer Contact: Call TOMY Company at (800) 691-8055 between 9 a.m. and 5:30 p.m. ET Monday through Friday.

The recall is being conducted in cooperation with the U.S. Consumer Product Safety Commission (CPSC).

A new study finds that drivers' reaction time, accuracy and consistency of speed improved significantly when they used a headset with their cell phone, compared with using a handheld phone.

The study is one of the few to analyze physical impairment experienced while driving and using a mobile phone; to date most other studies have focused solely on the mental distraction of using a mobile phone while driving.

The study was commissioned by Plantronics, which manufactures headsets. It was conducted by Design Science, an independent human factors research firm that has conducted other driving-related studies for a wide range of organizations including the U.S. Department of Transportation.

Many traffic safety experts contend that the use of any kind of cell phone -- hands-free or otherwise -- creates a dangerous distraction for drivers. Washington, D.C., New Jersey and New York have outlawed the use of hand-held cell phones while driving.

"Our study is not intended to address the issue of whether or not it is safe to talk on a mobile phone while driving, but rather what type of technology is safest for drivers to use while talking on their mobile phones," said Beth Johnson, Plantronics senior director of product marketing.

Researchers used a driving simulator to compare the driving ability of subjects using a mobile phone under two conditions -- one holding a mobile phone, and the other using a headset, leaving their hands free.

"The central question of our study was, 'For a person using a mobile phone, does driving improve if he or she uses a headset?' What the research showed is that, across all conditions, the answer is a resounding yes," said Stephen Wilcox, Ph.D., Principal of Design Science.

"Driving with both hands on the wheel is the safest option for motorists who use mobile phones, and headsets are tools to enable that improvement."

The driving performance of 24 subjects in three major categories was measured: steering accuracy, braking reaction time and speed variability. Key initial findings of the research found:

• 71% of the test subjects steered more accurately when using a headset;
• 100% of the test subjects had faster brake reaction times when using a headset;
• 92% of the test subjects maintained a more consistent speed when using a headset.

August 3, 2004
About one million Vornado portable electric heaters are being recalled. A faulty electrical connection can cause the heater to overheat and stop working, posing a fire hazard to consumers.

Vornado has received 24 reports of heater fires, though no injuries have been reported.

The recalled portable electric whole room heaters are designed for indoor use and have model numbers 180VH, VH, Intellitemp, EVH, and DVH. The model numbers are located on the bottom of each unit. Each heater is about 11 inches long, 9 inches wide, and about 12 inches tall; weighs about 6 lbs.; and has the Vornado name and symbol on the front.

Retailers and distributors nationwide, as well as Vornados Web site, sold the heaters from July 1991 through January 2004 for between $50 and $120.

Consumers should stop using the recalled heaters immediately and contact Vornado to arrange for shipping and a repair, free of charge.

Consumer Contact: Contact Vornado at (888) 221-5431 between 8 a.m. and 5 p.m. CT Monday through Friday or log on to the companys website at www.vornado.com.

The recall is being conducted in cooperation with the U.S. Consumer Product Safety Commission (CPSC).