Erroneous Death Certificates: The True Epidemic Exposed …..Direct From The Disgusted Doctors

There is a blogger here in our WordPress family that I have great admiration and respect for. You see, she is a Mom whose adult son died under very suspicious circumstances. She firmly believes her son was murdered and is looking for justice to be done in his name. But the medical examiner did not rule his death  a possible homicide or even suspicious. The police report states UNATTENDED DEATH, and six sentences of explanation.  The case was closed in 1.5 hours.  No investigation into cause of death.

She reports, “It has been five years and still the local coroner refuses to release all of the autopsy report or allow an investigation into the strange circumstances surrounding his death – or the poison that was in his blood.It has taken all these years to discover that NO ONE oversees the coroner, they are not required to have a medical degree (only high school diploma or equivalent) and do not have to account for their findings to anyone.

It is because of her courageous, exhausting, and unrelenting fight to find answers into the death of her beloved son that I paid very close attention to the article below posted on the exclusive website Medscape. Shirley, this one is for you. Yet, it really concerns us all.

 

Cause of Death: 50% of Medical Residents Fib

by Diedtra Henderson

Some 48.6% to 58.4% of residents from more than half of the residency programs in New York City have knowingly entered the incorrect cause of death on death certificates — errors that have implications for epidemiology, public health research, and disease surveillance — according to result from a recent study.

Barbara A. Wexelman, MD, MBA, from St. Luke’s–Roosevelt Hospital Center, Columbia University College of Physicians and Surgeons, New York City, and coauthors report their findings in an article published in the May 9 issue of Preventing Chronic Disease, published by the Centers for Disease Control and Prevention.

As fewer autopsies are performed, Dr. Wexelman and coauthors note, death certificates have become even more important sources of information about how Americans die. Public health researchers rely on death certificates to gauge the leading causes of death and to identify disease outbreaks, and the certificates also influence funding policies and research priorities.

In most teaching hospitals, it falls to resident physicians to complete the forms. To examine their experiences and opinions, the researchers conducted an anonymous, Internet-based, 32-question survey of New York City’s 70 internal medicine, emergency medicine, and general surgery residency programs in May and June 2010. Some 521 residents from 38 residency programs responded to the survey; 178 of the residents were termed “high-volume” respondents, meaning they had completed 11 or more death certificates in the previous 3 years.

Forced to Do It

“Almost half of all respondents (48.6%) and 58.4% of high-volume respondents reported they had identified a cause of death on a death certificate that did not represent the true cause of death. More than half of the residents (54.0%) reported they were unable to list what they felt to be the correct cause of death after guidance from the admitting department in their hospital,” Dr. Wexelman and colleagues write.

“Of all respondents, 70% believed they were forced to identify an alternate cause of death when the patient died of septic shock (compared with 83.5% of high-volume respondents), and 34.2% believed they were forced to identify an alternate cause when the patient died of acute respiratory distress syndrome (compared with 44.3% of high-volume respondents),” the researchers continue.

Only 20.8% of respondents knew they could hedge the death determination by calling it “probable,” “presumed,” or “undetermined.” When the death certificate system would not accept the true cause of death or hospital admitting staff overruled them, 64.6% of respondents reported cardiovascular disease, 19.5% pneumonia, and 12.4% cancer as the cause of death.

Study participation was voluntary, and residents with stronger feelings about the accuracy of death certificates may have been more interested in participating. Other study limitations include the potential for recall bias.

“Residents routinely reported diagnoses on death certificates that did not match their medical judgments. These errors may have lasting effects on the public health priorities of the community. Reform is needed both in the training and education of residents and in the system itself,” the authors conclude.

 

What! Seriously!

Okay, so as a PhD candidate for a Doctorate of Natural Medicine, I find this sickening and disturbing. But what about all the doctors, nurses, administrators, and other licensed healthcare practitioners who deal with this on a frequent and regular basis? What do they think about all this? Below are just a small handful representative of  the comments received about this finding. I have tried to present a wide cross-section of respondents from various locations in the US and even a few international. These comments blow my mind, and I hope they give you pause for thought.

Lane Longo|  Health Business/Administration

 1 day ago
 “Dear Sirs,
Let me say, at the outset, that the  the title of this article would be more properly worded by removing the innocuous sounding euphemism “fib” with the  correct word  “lie”.  That is, to deliberately mislead by falsehood.
Further, the article stated that residents were “forced” by hospital admitting staff or because the program would not accept he actual cause.  While I do not have direct knowledge of the death certificate program used, I assure you that the program did not design the criteria.  Some governing board, after throwing out any sense of .ethics,  weeded out any possible incriminating causes which might redound to the hospital or physicians account. Do you imagine that because the patient is dead that the cause doesn’t matter to the family or the state?

And the final insult…”Study participation was voluntary, and residents with stronger feelings about the accuracy of death certificates may have been more interested in participating.”  This implies that there are many more who do not give a damn about the truth.  Who are you people?

One would think that the much vaunted medical community would eschew debauched ethics.  If you do it in the smaller things, you will blunt your conscience to the larger ones.”

 

Dr. WOOD DEMING|  Cardiology, General

 2 days ago
 “It does not sound like a resident training problem , but rather administrators bent on falsifying records to make billing more enriching or to portray the hospital in a different light .  I would also guess that this issue is discussed openly at meetings for hospital managers..”
Sal Campo|  Other Healthcare Provider

 11 days ago
 “I believe this is happening much more due to hospital errors and trying to avoid law suits. More inspections should be used for larger institutions and the state should not just shrug off family complaints when there family member dies.”
Dr. stephen c

 12 days ago
 “Why does no one mention the elephant in the room? When older patients are admitted with known pathology it is all too easy to let them die of iatrogenic causes such as acute respiratory failure due to over prescription of opiates. When my mother was admitted in light coma with a moderate middle cerebral bleed at 83, I arrived 24 hours later to find she was on regular morphine and already cheyne-stokeing. Apparently, she had groaned on being turned and a relative had asked for pain relief. I got the morphine stopped, she woke up and is now at home with no neuro deficit and only mild confusion enjoying her grandchildren for another year or two. Her death certificate would have read “Cerebro-vascular Accident”. It would have been a lie.”
 

Dr. Raymond Vergne|  Cardiology, Interventional

 12 days ago
 “For the living, medical “coders” love “NSTEMI” and “congestive heart failure”.  NSTEMI is the choice diagnosis for anyone with a minimal elevation of troponin levels, regardless whether it is due to sepsis, stroke, acidosis, respiratory failure,  pancreatitis, pulmonary embolism or atrial fibrillation.  Congestive heart failure is preferred over COPD, acute lung injury, thyroid storm, acute bronchitis or idiopathic pleural effusion.  NSTEMI and CHF yield better reimbursement from Medicare.  One learns fast not to argue with the coders.”
Dr. Anton-Lewis Usala|  Pediatrics, General

 13 days ago
 “This is an excellent description of what happens in the absence of quality systems.  Medicine is the last major industry that doesn’t have quality system assurance built into the delivery of its service.  While pharmaceutical companies are required to have design-reviewed processes in place, with point-of -process quality systems to assure they were completed as intended, the only part of drug development that does NOT require quality system enforcement is the clinical trial portion involving human subjects.  Many hospitals have quality departments, but they review after the fact events, and are not the same as industry quality systems that assure each step in process occurs as intended to prevent an unqualified product at the end.  I think such an approach would be initially difficult to implement (as they are when first applied to any service or industry) but would have profound beneficial effects for our patients, our institution, and our profession.”
Dr. Michael Dubriwny

 May 13, 2013
 “Aside from public health priorities, inaccurate reporting of cause of death is related to health grades and ultimately hospital reimbursement.”
 

I could go on and on, with many more comments, but I think you see the pattern and general consensus emerging. For anyone who wants to view all 79 and counting comments, let me know and I will send them to you. See, I can’t just post the link and have you look it up yourself because it is part of a private, members by subscription only site. All I can do is “Select All”, then ” Copy”, and then “Paste”. What does this mean? Well for one thing it means the news media and ethical investigative journalists of this world probably do not have access to this information to bring it to the public’s attention. And what does this revelation mean when it comes to all the data collected by various organizations that track the rise and or fall in the number of deaths related to a certain disease? Or to biologic family members that might be left in the dark about a possible genetic time bomb in their lineage that was inaccurately stated as the cause of death? The system is broken folks. How are we going to fix it?

 

 

 

 

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Bursting At The Seams! Part 1

Second Exploding Head

Second Exploding Head (Photo credit: Dru!)

I have been inhaling books and articles so quickly over the past few weeks. Like an addiction, I want more, more, more. Give it to me now. Another link, another email, another e-zine, research papers, scholarly journals, GoodReads, StumbleUpon, blog posts. I love it all.  I finally forced myself to stop today because I think my head just might explode! But what great information, intriguing points of view, and inspiration for me to step into the next phase of my cycle and write, write, write.

I am humbled by the receipt of some nominations and acknowledgements from fellow members of our WordPress family. I apologize for waiting so long to post some of these and properly thank those who sent them to me. Carey Mann, the scientifically brilliant author of The Bridge, nominated me for One Lovely Blog award a while back. Thank you Carey and a personal note to tell you I am jonesing for a new post by you. Hope to read a post of yours soon.

Carolyn Page over at ABC of Spirit Talk had tagged me so….big thank you to Carolyn. Her blog is a must read for true spiritual inspiration and down to earth soul soothing.  There are rules to this game of tag, actually a lot of rules so here goes…..

RULES OF THE GAME:

1. Post these rules.

2 Post a photo of yourself and eleven random facts about yourself

3.Answer the questions given to you in the tagger’s post

4. Create eleven new questions and tag new people to answer them

5. Go to their blog and let them know they have been tagged.

Here is my pic      🙂

Baby girl aged 2

 

 

 

 

Random facts about me: I refinished a piece of furniture for the first time and it looks great; I made custom window treatments for my apartment for under $15.00 including hardware; One of my guilty pleasures is eating cherry pie filling right out of the container; I swear my veins contain sweet tea instead of blood; I love my neon pink high heels; Relaxing in a hot tub with a glass of wine=heaven; Walking through the grass barefoot is calming to me; I was an emancipated minor; I need a camera; My sense of smell is all but gone; Taking a hot air balloon ride is on my bucket list.

Carolyn’s questions for me:

1. If life was ‘just a bowl of cherries’… which fruit would you rather be..? Pineapple

2. Who is your favourite singer? Prince

3. Snow or Beach? Snow

4. Did you have a favourite toy when growing up? Did it have a name? Did you take it with you everywhere you went? Yes, Dolly…..poor thing went bald from my lugging it everywhere by the hair.

5. What are your favourite things to do on weekends? Same as every other day, make the best of every moment.

6. Did you have a hobby when you were a kid? Barbie dolls….does that count?

7. Are you a sporty type, or more the studious type?  Maybe you are both…! Studious now that I have had multiple hip replacements

8. If you were in a raft in the middle of the ocean, who would you like for company? My guardian angel

9. Do you keep your birthday cards? Never got any awww

10. Is life what you expected as a child? No, but thankfully I am not a child anymore

11. Do you have a pet? Nope

Here are my questions for my nominees:

1. What’s your lucky number?

2. What was your last dream about?

3. What is your shoe size?

4.Can you solve a rubix cube?

5. Do you think you are psychic in any way? If so, how?

6.If you had to do one…..Bungee jumping or sky diving?

7. Where would you go on your ultimate vacation?

8.What is your favorite holiday and why?

9. Bath or shower?

10.Hamburger with….. Ketchup, mustard, or mayonnaise?

11. Can you curl your tongue or wiggle your ears?

 

And my nominees are:

Wayward Spirit

JT Weaver

Cristian Mihai

Kate is Rising

The Hawk’s Tail

The QBox

Spread Information

You have all been TAGGED…..you’re it! Please don’t feel obligated to play or respond…..this is all for fun, so if it makes you giggle then go for it!

Wow! I have three more special people to thank for three more special awards so PART 2 will be posted soon. Stay tuned for more.  Then an exposé or two, updated evidence based practices for optimal health, some soul-searching posts…..Whew! I warned you I was bursting at the seams!

 

Advice? Prayers? Help Needed And Requested Please.

Live surgery webcast from Christiana Care Cent...

Live surgery webcast from Christiana Care Center for Advanced Joint Replacement (Photo credit: Christiana Care)

So, my WordPress friends and family, I am facing  a daunting problem. As reported in an earlier post this week, I was experiencing some severe mouth pain that I felt was connected to unpleasant memories and feelings. I actually was feeling better and thought I was out of the woods. But I am not. Today I was informed, and shown radiological proof that I have osteomyelitis in my jaw that is unresponsive to antibiotics. A portion of my lower  jaw needs excision, removal and replacement with cadaver bone. And because of my artificial joints being highly susceptible to a migrating infection, this needs to happen quickly. Okay. Breathe.

Surgery is scheduled for next week on the condition that I obtain cardiovascular clearance, hematological oncology clearance, and orthopedic clearance in addition to the standard pre-surgery screenings. And it is a short work week here in the US due to Labor Day. Whew. On the bright side, since this is now a medically urgent problem and not a dental one, medicare health insurance will cover a large part of it.

Here is where I ask for much-needed help.  In addition to the typical trepidation one feels when they face surgery, I have the added mental health terrors. Already, I am struggling to BE with my urges to dissociate and horrific combination flashback body memories of having my nose and mouth covered from childhood abuse. I have reached out to all my treating practitioners and my small…..okay teeny, tiny…..support system, but I am feeling very overwhelmed. So, I am asking all of you for your thoughts, prayers, advice, and good wishes because I believe very strongly in the power of collective thought energy. I thank you all in advance for your support and empathy.My usual resolve (which I have worked very hard at) is crumbling now. But I am trying to get back to a space of peace and acceptance.  I will keep on going…..somehow.