For example, an underwriter for USAA who served 13 months in Afghanistan described how, while riding in a car his wife was driving, he momentarily mistook the steady bump of tires on a rumble strip for machine-gun fire. His story certainly resonates in Kentucky and with residents of Louisville, with its high concentration of military service members. Other returning troops have reported making defensive moves around tunnels and underpasses to avoid insurgents and following the car ahead closely, as if in a military convoy.
The study examined at-fault car accident data for 180,000 USAA military policyholders who served overseas between 2007 and 2010. It compared accident records in the six months before troops were deployed and the six months after they returned to the U.S.
Source: Bloomberg, "Vets' car-crash risk rises after deployment, USAA says," Noah Buhayar, April 24, 2012
]]>The appropriate balance is sometimes hard to strike in some medical cases, with strong evidence in recent years that doctors across the country and in virtually all specialties often engage in what has been termed "defensive medicine."
What that encompasses is perhaps made clearer by another description of the practice: "overuse of medical resources."
A growing group of medical experts is saying that some doctors too quickly and sometimes inappropriately resort to a battery of diagnostic tests and procedures - CT scans, X-rays, blood draws, specialty referrals - when they are unnecessary. The reasons why are various, but centrally include fear of medical malpractice charges, financial incentives for doing more rather than less and simple ingrained habit.
]]> That type of overtreatment, with its potential to bring about medical harm, is the focus of a recent report and recommendation from a group of doctors in a campaign called Choosing Wisely, which is releasing lists of frequently overprescribed tests and procedures in a number of medical specialties.Nine sub-specialty doctor groups representing about 375,000 physicians have currently weighed in, including groups representing family practice, kidney specialists, oncologists and cardiologists. They are working with a foundation that is seeking to widely disseminate findings to the public through a partnership with groups like AARP and Consumer Reports.
Later this year, eight more medical specialty groups are expected to have finished compiling their lists of tests and procedures that they believe should be questioned more often by patients when recommended by their doctors.
Commonly mentioned tests include EKGs ordered for low-risk patients without any symptoms of heart trouble, imaging tests for patients complaining of simple lower back pain, and CT scans on children, which can result in excess radiation.
Source: Albany Times Union, "5 questions you should ask to avoid overtreatment," May 4, 2012
]]>Ray LaHood, U.S. Transportation Secretary, recently announced the new standard that will require professionals to be trained and more knowledgeable concerning the specific physical qualifications needed to operate a commercial truck or bus on nationwide interstates, including in Kentucky.
Health professionals who complete the certification process will be added into a national registry of DOT-approved physicians and professionals allowed to conduct the exams for drivers. The government effort is aimed at doctors and other professionals gaining a better understanding of certain physical requirements needed to operate a commercial vehicle.
]]> The Federal Motor Carrier Safety Administration will oversee the registry, with officials voicing strong hopes that the rule will help to prevent 18-wheeler accidents and fatalities. The rule will require commercial truck and bus drivers to obtain their required proof of medical examination from a certified examiner who is listed on the national registry. Examiners who fail to complete the certification or maintain federal standards will be removed from the approved list of professionals.Currently, medical examiners perform about three million physicals each year on commercial drivers. The DOT-required exam scrutinizes driver fitness, vision, hearing, muscular conditions, respiratory health and any cardiovascular problems. Beginning in June 2012, the FMCSA will post the testing and training standards for examiners online on its government website.
Source: Occupational Health & Safety, "DOT announces final rule on training for medical examiners," April 19, 2012
]]>Facility negligence or abuse charges occur far less often, understandably, in regard to what befalls residents in a home during and/or following a natural disaster, such as a flood, tornado or hurricane.
]]> Less often does not equate to not at all, though, as is profoundly evidenced by the vivid pictures in the minds of many people concerning fallout from recent calamities such as Hurricane Katrina. In that incident, many hundreds of nursing home residents were inadequately cared for and, in some cases, abandoned altogether. In others, they were misplaced or failed to receive necessary medications. Some were stranded without food or water.The potential for a dire outcome is always present, especially in a locale such as Kentucky, which, owing to its capricious weather, has been designated a top-10 disaster-prone state.
A recent federal report on emergency care in nursing homes stresses the overt concerns of regulators that not many homes are following through adequately on federal requirements concerning implementation of emergency plans. Most homes have one or, more commonly, a multitude of deficiencies in their plans concerning required relevant information, contact data, sufficient onsite medications, water and other essentials.
That worries safety officials, especially given the approximately three million people who spend time in a home in an average year.
The just-issued study by the Health and Human Services Department recommends that federal guidelines be given greater clarity and force. The report tasks Medicare and Medicaid officials with helping homes develop more comprehensive and meaningful emergency plans through specific planning and training protocols.
The need is proven to be dire. In a recent summary inspection by federal regulators at 24 nursing homes across the country, not one facility had any protocol to advise staff members on how to deal with residents' illnesses during an evacuation.
Source: USA TODAY, "Big gaps found in nursing homes' disaster plans," Ricardo Blonso-Zaldivar, April 16, 2012
]]>The technology works by allowing each vehicle to monitor the location of other vehicles and objects on the roadway. If the system's information transmitters detect slowing traffic or dangerous conditions ahead, they can warn the driver through audible sounds, seat vibrations or tightening the driver's seatbelt. The driver can then slow down or take other precautionary actions to avoid a potential car crash.
]]> Another feature of the transmitter system is the ability to control the vehicle automatically. If the system senses another vehicle that is too close or traveling at a dangerous rate of speed, the system may activate one or more of the vehicles' braking systems to avoid a car crash. Unfortunately, in order for this system to work on a universal level, all vehicles will need to have the wireless communication device installed.Although industry experts anticipate that it may be several years before all vehicles in Kentucky and across the nation are equipped with the safety prevention sensors, new cars that are equipped with the wireless technology will provide car owners with additional benefits.
For instance, these systems will also be capable of sensing traffic congestion and communicating with traffic signals. Therefore, drivers will be able to get traffic updates and alternative routes in real time, which will allow them to reach their destination sooner and waste less fuel while sitting in traffic.
Source: Washington Post, "The not-so-distant future of driving: When cars can talk, crashes may be avoided," Ashley Halsey III, April 10, 2012
]]>That would be surgical sponges and operating tools that are sometimes inadvertently left behind in patients' bodies following a medical procedure. Although it is estimated that such outcomes occur in only about one in 6,000 surgeries, everyone involved -- patients certainly, as well as doctors and medical administrators duly concerned with adverse publicity and medical malpractice allegations -- agrees that any surgical outcome that leaves behind an unintended surgical artifact is one too many.
]]> The celebrated Mayo Clinic in Minnesota is acutely focused on the matter, with a chief medical officer for that health system noting that, "The consequences of a sponge left behind can be huge."That said, the clinic has introduced new technology to minimize the possibility of left-behind outcomes. Specifically, surgical teams operating at select hospitals now use bar-coded surgical sponges that are scanned by nurses at the end of an operation. Surgical nurses routinely count all sponges manually, but quality assurance experts say that scanning "reduces the chances of human error by one more step."
Proof of success with such an innovation is obviously in the counting, and officials note that, since the SurgiCount system debuted in 2009, more than one million sponges have been scanned without one ever having been left inside a patient.
That contrasts starkly with outcomes in operations where the bar-coded sponges are not used. Health officials note that there were nearly 40 cases of sponges left inside patients last year in Minnesota in surgeries not using the bar-coded system.
The cost of using the sponges adds only about $2 to a surgery and little added effort required by a surgical team. That should make it attractive to hospitals nationwide, say those who point to its proven efficacy.
Source: The Free Press, "Bar-coding sponges safeguards against surgery mishaps," Robb Murray, March 16, 2012
]]>The news is very relevant as the riding season gets in full swing in Kentucky and other parts of the United States. With warm weather underway, more and more motorcyclists will be hitting the roadways, some for the first time.
]]> During the first 30 days of riding, a rider is four times more likely to experience a motorcycle crash occur than during the entire second year of riding, according to the Highway Loss Data Institute. Twenty-two percent of insurance claims between 2003 and 2007 came from riders whose policies had been in effect for 30 days or less.More than half of the claims coming from owners of supersport bikes were received within the first three months of ownership. Supersport bikes have very high power-to-weight ratios and can hit 200 miles per hour, making them especially dangerous.
Experts say one of the big problems leading to motorcycle accidents, along with excessive confidence and risk-taking behavior, is that riding a motorcycle requires a number of functions to be performed all at once, placing demand on the rider's brain in several different ways.
Another concern is that licensing courses designed to expedite the licensing process may not be effective in reducing accidents. Some evidence suggests that, because of their pace, they may even be detrimental and increase the risk of accidents, disproving their value in preventing motorcycle injuries and fatalities.
Source: The Republic, "Motorcycle crash risk drops sharply after the first month on the road," Michael Virtanen, April 15, 2012
]]>Unseasonably warm weather has brought Kentucky motorcyclists out in force on state roads and highways in the early months of 2012. Many of them say they have been riding all year, when, in a typical year, they wouldn't be out on the roads until about May.
]]> Rising gas prices, too, have factored into a burgeoning biker population that now includes novice riders who are much more prone to become involved in accidents.That combination of warm weather and pain at the pump has resulted in what traffic authorities say is a prohibitively high number of motorcycle wrecks occurring around the state.
The crash-related numbers certainly tell the story. According to the KSP, there were 249 crashes through April 4, which is an accident rate that is up nearly 70 percent from last year. Nine people already died by that date, with an additional 167 incurring injuries ranging from minor to nearly fatal. Compared to 2011 figures covering the same period, the death rate from motorcycle accidents is up 44 percent. The injury rate is up a stunning 75 percent.
"Don't ride over your abilities," says a KSP trooper. "Know your limitations."
State police are actively using online social media sites to get out information on biking awareness and safety. The KSP states that it has more than 40,000 Facebook followers.
Source: Louisville Business First, "State police use social media to push motorcycle safety," Carol Brandon Timmons, April 9, 2012
]]>Statistics indicate more than 8,000 patients die each year from infections resulting from surgical error, which costs the nation's health care system more than $10 billion.
]]> The report, which was produced by Johns Hopkins University School of Medicine researchers and published recently in the Journal for Healthcare Quality, notes that the nation's hospitals are not currently mandated to report statistics for patients who suffer from errors or infections due to hospital negligence. Currently, only 21 states gather the data, and only eight make it available to the public. Kentucky is not one of those reporting states."People are shocked when they find out that simple health care metrics [such as readmission rates and infection rates] are being collected, but that they are not made available to the public," says Martin Makary, MD, lead author of the study.
The information that is released is often of poor quality and difficult for regulators and consumers to evaluate and compare. The Johns Hopkins report states that inconsistency in reporting among hospitals and states -- some which report surgical-site infections from only certain types of operations, others which don't report at all -- is a troubling nationwide problem.
The researchers believe that full disclosure by hospitals everywhere should be mandated to empower patients to make more informed decisions about their care.
"Full disclosure of hospital performance relative to national averages can come about by consumers insisting on it, insurers requiring it, or Medicare mandating it," Makary says.
As of September 2010, only these states publicly reported information on surgical-site infections to some degree: Colorado, Massachusetts, Missouri, New York, Ohio, Oregon, South Carolina and Vermont.
Source: Forbes, "Lack of national reporting mandate for hospital infections hurts consumers," Gergana Koleva, April 5, 2012
]]>That deal did happen, with a new entity -- Chrysler Group LLC -- emerging from a government-brokered restructuring in bankruptcy.
In the plan presented to the court in the negotiations, and with an eye on risks and liabilities going forward following the birth of the new company, Chrysler offered to take on future liability for claims involving car accidents only to the extent they involved compensatory (actual) and not punitive damages.
That plan, covering only Chrysler vehicles sold prior to the Fiat deal, was approved.
]]> Should that concern Kentucky and other motorists who, collectively, own close to 30 million vehicles covered in that agreement?Chrysler argued that the new company could only be viable going forward if it did not have to contend with massive uncertainty concerning "wildly unpredictable" punitive damages.
"It would have been irresponsible to accept that level of risk," says a company spokesperson.
Critics counter, though, that the cost to vehicle owners could be prohibitively high in that, without the threat of punitives, Chrysler lacks incentive to take especially problematic vehicles off the road. Again, the company has agreed to compensate victims of car crashes only for the costs of their actual damages.
The bankruptcy judge who approved the plan says that the parameters of the law flatly "allow for the cutting off of liability." Whether in fact preferential treatment in bankruptcy such as Chrysler received should be legally available, he says, "is a policy issue for Congress to address."
Source: Wall Street Journal, "Chrysler got legal shield in Chapter 11," Mike Spector, April 4, 2012
]]>General Motors introduced the compact Chevy Cruze in 2008. The Wrangler, a perennial favorite since the 1980s, is perhaps Jeep's best known model.
Source: New York Times, "Fires prompt investigations of 277,000 Chevy Cruzes and 100,000 Jeep Wranglers," Christopher Jensen, April 6, 2012
]]>That bill stalled out, however, following strong lobbying efforts from the nursing home industry, prompted by fears of malpractice suits. What ultimately defeated the legislation was a request for tacked-on language that would have mandated a person seeking to file a malpractice lawsuit against a nursing home to initially have the complaint reviewed and approved by a medical review panel.
A bill focused on increased oversight of Kentucky's child welfare system also died, in the Senate, with several members of that body expressing concerns with some of the language in the would-be law. The bill -- which would have established an outside panel of experts to review serious injuries and potential wrongful death cases involving children -- did pass the House.
Legislators were able to agree on language concerning controls on medications containing pseudoephedrine, a main ingredient used in the production of methamphetamine. A bill that more tightly circumscribes consumers' ability to purchase medicines with that ingredient passed both chambers and will now go to Gov. Beshear for his signature.
Source: Louisville Courier-Journal, "War on meth: Bill curbing cold medicine purchases clears Kentucky legislature," Deborah Yetter, March 31, 2012
]]>These challenges can become even more daunting for teen drivers suffering from attention deficit hyperactive disorder, or ADHD. This condition affects teen drivers in Kentucky and across the United States, and it can drastically increase the risk of being involved in a car accident.
]]> A recent study found that teen drivers dealing with ADHD were two to four times as likely as other teen drivers to be involved in a car crash. This staggering accident rate makes teenage drivers with ADHD more likely to be involved in a car accident than legally drunk adult drivers.Although teen drivers with ADHD and other learning or attention problems can learn coping mechanisms and other methods to better manage their condition, doing so requires patience and persistence. It can sometimes take years of training and management in order for them to become the best drivers that they can be.
Drivers with ADHD struggle with being inattentive while driving due to various distractions in and outside of the car, as well as a predisposition toward becoming distracted easily. Inattention is the leading cause of car crashes among all drivers, but persons with ADHD are likely to become inattentive at a much higher rate than other drivers.
Persons with ADHD are also more likely to take risks when driving due to a tendency toward impulsiveness.
The study underscores the potential hazard that teen drivers with ADHD pose to themselves as well as other drivers, and it could trigger greater concerns and possible regulations and safety measures installed to improve roadway safety for these individuals.
Source: New York Times, "Study: ADHD teen drivers run higher crash risks," March 27, 2012
]]>The suit, which was filed last week in a Marion County civil court, also names the driver of the school bus owned by Miller Transportation as a co-defendant. The driver died in the accident that is the subject of the litigation.
]]> The accident occurred on March 12 as the bus was traveling with children to a school in East Indianapolis. The driver struck a pillar beneath an overpass, dying in the crash from what accident investigators say was blunt-force trauma.One child -- a 5-year-old girl -- also died in the accident, and it is her parents who have brought the complaint. Several other lawsuits have also been filed against Miller Transportation by families of other children who suffered injuries in the crash.
All the lawsuits contend that the bus was unsafe because it lacked seat belts.
"It's insane not to have these buses seat-belted," said a spokesperson for the families. "That bus became a clothes dryer with the kids being tossed around," he added.
A majority of states, including Indiana, do not have laws mandating that school buses have seat belts.
In addition to the child who was killed in the crash, another child sustained facial, neck and back injuries, a third broke her foot, and others are currently suffering from other injuries.
Although an Indiana police investigation concluded that the bus was in proper working order, the lawsuits allege that Miller did not properly inspect it for "defective and unsafe conditions."
Source: Indianapolis Star, "Several parents file lawsuit over school bus crash that killed two and injured several children," Bill McCleery, Alex Campbell, March 23, 2012
]]>"This is absolutely the mildest winter I've seen," says one long-time boater who spends months each year living on his boat and spending time in Kentucky river cities such as Louisville and Owensboro.
Of course, the annual arrival of boating season comes with necessary warnings and advice regarding vigilance on the water and the need to exercise all due caution to avoid boating accidents. Each year, water accidents cause a number of deaths and serious injuries on Kentucky rivers and lakes, with adverse outcomes owing to jet ski accidents and personal water craft misadventures to barge and other commercial traffic collisions, drug and alcohol use and other factors.
]]> Another recurring problem stems from strong currents and floating debris, as well as driftwood that gathers around river banks. Some boaters, too, get caught up on or forcefully hit submerged objects that are not readily apparent from the driver's seat.And the Kentucky Department of Fish and Wildlife Resources adds one more point to the list of things that boaters should be thinking about when they hit the water: drinking.
State officials note that about half of all deaths that occur on the water each year involve the use of alcohol, and they remind boaters that boating while intoxicated can bring fines and penalties every bit as stiff as for drunk driving convictions on roadways.
Source: Evansville Courier & Press, "Mild winter has boaters prepping for river season," Max Roll, March 24, 2012
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