Injuryboard National News Desk

Ultrasound Finds More Breast Cancers Than Mammography

Jane Akre — Tue, 13 May 2008 19:25:15 GMT

LEARN MORE

IMAGE SOURCE: iStockPhoto/ breast covered/ author: Eric Hood

There is good news and bad news about using ultrasound to detect cancers in the breast.

First, it is more sensitive than mammography in finding cancer in dense breast tissue that in a mammogram can just appear white.

But ultrasound can also lead to more false positives meaning women have to undergo more biopsies.

Dr. Wendie Berg is a radiologist affiliated with Johns Hopkins Medical Center.

"With mammography, a woman has about a one in 40 chance that the biopsy will turn out not to be cancer. With the addition of ultrasound, it's one in 10" she tells U.S. News.

In this study 3,000 women with a higher-than normal risk of breast cancer were recruited from 21 centers. Their average age was 55. Some received mammography alone or mammography with ultrasound performed by a physician.

Within a year- mammography alone found 20 or half of the breast cancers that were eventually diagnosed. But the combination of ultrasound and mammography found 31 of the cancers.

Adding a single screening ultrasound to mammographywill yield an additional 1.1 to 7.2 cancers per 1000 high-riskwomen, the study concludes.

Using ultrasound in addition to standard mammography can lead to more cancers in high-risk women conclude the research funded by the Avon Foundation and the U.S. National Cancer Institute.

But don't expect to see it become the standard for evaluation. There aren't enough ultrasound technicians trained for it to be widely available. A doctor can perform only three to five ultrasounds an hour says Berg.

Compare that to as many as 50 mammograms that can be read in an hour.

MRI may also be more effective than mammography but the cost is prohibitive. It's up to the woman to talk to her doctor about her risk and screening options.

The results were published in the May 14^th issue of the Journal of the American Medical Association. #

Breast Feeding One Year Plus Reduces Rheumatoid Arthritis Risk

Jane Akre — Tue, 13 May 2008 18:32:39 GMT

LEARN MORE

IMAGE SOURCE: Wikimedia Commons/ rheumatoid arthritis/ U.S. Gov, NIH, author: arnavaz

As if there isn't enough good news about the positive results from breast feeding on children. Now comes word about an advantage for their mothers.

Women who breast feed for over a year reduce their risk of rheumatoid arthritis according to a Swedish study. The protection was not seen if the baby was bottle-fed, according to the researchers from Malmo University.

Women who breast fed more than a year saw a risk of rheumatoid arthritis (RA) cut in half.

It had been theorized that if a woman took oral contraceptives they had a similar protection against RA because they provide the hormone that is also elevated in pregnancy. But taking oral contraceptives did not have a protection factor.

The Malmo University Hospital study included 136 women with RA and 544 without.

Among the women who breast-fed for 13 months, they were half as likely to get RA when compared to women who had never breast-fed. Breast feed for one to 12 months and the protection against the disease dropped to 25 percent. While more women are breast feeding for longer there is also a corresponding decline in the number of women with RA.

RA is an autoimmune disease where the body attacks its own healthy tissues as it would a foreign substance.

Rheumatoid arthritis is a chronic inflammation of the lining of the joints. It can lead to painful long-term joint damage, loss of movement and disability. RA affects 1.3 million Americans and there is no cure but drugs to address the symptoms.

The study can be found in the May 13 issue of Annals of the Rheumatic Diseases. #

Blood Clots Linked To Air Pollution

Jane Akre — Tue, 13 May 2008 17:35:21 GMT

LEARN MORE

IMAGE SOURCE: WikiMedia Commons/ power plant before emission controls / author: National Parks Service

Tiny particles of pollution in the air, a fraction of the width of a hair, seem to increase the risk of deep vein thrombosis (DVT) or blood clots in the legs.

The study was done by Dr. Andrea Baccarelli while he as at the Harvard School of Public Health. "This is the first time that anyone has connected air pollution with deep vein thrombosis," he told the Washington Post.

Previously dirty air particulates have been connected to heart attacks. Dr. Baccarelli is now at the University of Milan.

Car exhaust, especially from diesel engines and burning of fossil fuels, pollute the air with particulate matter smaller than 10 micrometers in diameter.

That's about one-40^th the width of a hair. The researchers compared residents in the Lombardy region of Italy, measured at 53 sites, who had been diagnosed with DVT to more than 1,200 who had not. Where the particulate matter was high, that is 10 micrograms per square meter, the risk of DVT increased by 70 percent.

An editorial says this makes a very strong case that DVT is connected to air pollution. The burden of pollution may be greater than ever anticipated. More studies are needed to prove the theory.

Until now DVT has been found in air travelers who sit for extended periods of time. That is due to impaired circulation. It's advised to get up and move on a plane.

The findings are published in the May issue of the Archives of Internal Medicine. #

Public Health Too Quick To Dismiss Autism Parents, NIH Director Says

Jane Akre — Tue, 13 May 2008 12:31:59 GMT

LEARN MORE

Injuryboard on Vaccines
Injuryboard on Autism
Monica Bice web site
CBS Online Interview

IMAGE SOURCE: ©National Library of Medicine/ Dr. Bernadine Healy

"Public health has been too quick to dismiss concerns of families."

That stunning admission from the former director of the National Institutes of Health, Dr. Bernadine Healy, as the federal vaccine court listens to two more cases linking autism and vaccines.

Dr. Healy is the first well-known public health voice to break with her mainstream colleagues who dispel any link.

In a major turnaround, Dr. Healy says that public health needs to do a better job of identifying children who may be particularly susceptible and vulnerable to vaccines and perhaps should not receive them or receive them on a different schedule.

She tells CBS's Sharyl Attkisson in an exclusive online interview:

"This is the time when we do have the opportunity to understand whether or not there are susceptible children, perhaps genetically, perhaps they have a metabolic issue, mitochondrial disorder, immunological issue that makes them more susceptible to vaccines plural or to one particular vaccine or to a component of vaccine like mercury."

"So we, now in these times, have to take another look at that hypothesis, not deny it."

Dr. Healy says we have the tools today that we didn't have 10 or 20 years ago to find out if there is a susceptible group. A susceptible group does not mean vaccines aren't good, she says. Instead thee maybe a group of children who shouldn't have a particular vaccine or shouldn't have vaccine on the same schedule.

In January, the vaccine court concluded that vaccines did cause the autism-like symptoms of Hannah Poling, the Georgia girl who became mentally disabled with autism-like symptoms after her vaccines. She was later found to have an underlying and undiagnosed rare genetic mitochondrial, or cellular disorder that was aggravated by the vaccines.

Tampa Bay, Florida mom and support group founder, Monica Bice, is also in line for vaccine court. She says her daughter has been diagnosed with a condition they share, immunodeficiency. That means the four-year-old should never have received a live vaccine as is contained in MMR and chicken pox, because the virus over replicates and infects the child. Monica's daughter began showing signs of autism three weeks after being vaccinated.

Children like Poling and Bice would fall into the sub-set described by Dr. Healy who should either not receive vaccines, or receive them on an alternate schedule.

Dr. Bernadine Healy does not believe that knowing there is a sub-set of susceptible individuals, would discourage other parents from vaccinating.

"I do not believe the public will lose faith in vaccines. I think people understand a polio epidemic, I think they understand a measles epidemic, I think they understand congenital rubella, I think they understand diphtheria. Nobody's going to turn their back on vaccines."

Healy says it's the job of the public health community and of physicians to be out there and find a way to make vaccines safer. That the public would respect, she says. And what about the public health community that denies a cause and effect between vaccines and autism?

"I think you can't say that." Dr. Healy is quick to say.

Has the government been too quick to dismiss out of hand that there was a possibility of a link between vaccines and autism? Attkisson asks.

"I think the government or certain public health officials in the government have been too quick to dismiss the concerns of these families without studying the population that got sick."

She said she hasn't seen any major studies of 300 kids who got autism within few weeks of vaccine. And Dr. Healy believes public health has been too quick to dismiss in animal laboratory studies in mice that do show some concerns of vaccines and the mercury preservative, thimerosal in vaccines. The only way to determine cause and effect is in the laboratory setting, not in the population where you can only determine associations.

As a member of the Institute of Medicine, Dr. Healy says a 2004 report by the group concerned her.

"A report in 2004 basically said do not pursue susceptibility groups. Don't look for those patients. Those children who may be vulnerable. I really take issue with that conclusion."

The reason they didn't want exploration further, Dr. Healy says is because afraid if they found them that would scare the public away.

"You should ever turn your back on any scientific hypothesis because of your afraid of what it might show. I don't think the truth ever scares people."

She still believes vaccines are safe for the bulk of the population.

"If you know that there is a susceptible group you can save those children. If you turn your back on the notion there is a susceptible group that means you are... (hands up) what can I say."

"When I first heard there was a link between autism and vaccines I said that was silly. The more you delve into it, when you look at the basic science and research done on animals and also look at individual cases and the evidence that there is no link, what I come away with is the question has not been answered!" #

Vaccine Court Considers Boy's Autism Cases

Jane Akre — Tue, 13 May 2008 11:20:00 GMT

LEARN MORE

Injuryboard on Vaccines
Injuryboard on Thimerosal
Injuryboard on California Law Banning Thimerosal
Injuryboard on Hannah Poling
Injuryboard on Autism
CBS interviews Dr. Bernadette Healy on susceptible group
Moms Against Mercury
Institute for Vaccine Safety- on Thimerosal-Free Formulations
FDA on thimerosal free vaccines

IMAGE SOURCE: Wikimedia Commons/ Autistic boy ducks in a row/ author: andwhatsnext

The autism explosion in this country is center stage in U.S. Federal Court in the second of three hearings to determine whether vaccines led to thousands of children becoming autistic.

The families of two 10-year old boys from Oregon and their attorneys are arguing that the children developed the brain disorder autism, only after receiving childhood vaccines. Before that they were developing normally.

The special court is trying to determine if there is a cause between autism and a mercury- based preservative called thimerosal, which may build up on the brains of some children unable to process it out.

Government sponsored studies find no link but that argument runs in the face of millions of parents who have observed profound change in their child's behavior and development following inoculations for childhood MMR or measles, mumps rubella, that may or may not have contained thimosal.

Thimerosal was used in multi-dose vials until a phase out began in 1999 largely led by the manufacturers. Today mainstream media, including the New York Times in today's edition, insist that "Thimerosal was removed from all routinely administered childhood vaccines by 2001."

That follows a recommendation by the American Academy of Pediatrics (AAP) to remove thimerosal from vaccines. But the government did not mandate the removal. Because of that, no one is certain how many thimerosal-preserved vaccines stayed on shelves.

Earlier this year when a California health department study failed to showed an expected reduction in incidents of autism, critics pointed out that a state law mandating the removal of thimerosal didn't go into effect until 2006.

Lawyers for the boys and more than 5,300 other families believe whether vaccines are a cause, a complicating or environmental factor, the boys should be able to receive compensation under the National Vaccine Injury Compensation Program.

That was set up by Congress 20 years ago to prevent litigation from crippling the vaccine industry. The program is funded by a 75-cent tax on vaccinations and pays out in some cases $1 million.

It does not lay fault but helps compensate parents for the cost of raising special needs children, now estimated to be 1 in 150 in this country with autism or the related disorder Asperger's syndrome.

On Monday the court began listening to the autism cases of the 10-year-old boys, William Mead and Jordan King, both of Portland, Oregon.

Attorney Tom Powers told the court "What we will conclude. is that thimerosal-containing vaccines belong on the list of environmental factors.when one is evaluating what might have caused autism in a child when all of the other theories have been ruled out."

He told the court the boys had conditions that made them vulnerable to the mercury in thimerosal.

It is the same argument that won a case for an autistic Athens, Georgia girl, Hannah Poling.

In the Poling case, the government conceded that the vaccine caused autism-like complications stemming from a rare genetic mitochondrial disorder. Lawyers for the government argue that her case was rare and should not set a precedent.

Florida-based mom, Monica Bice will be making a similar argument when she and her daughter have their day in vaccine court.

Monica only found out that she has immune-deficiency after her daughter was vaccinated. Not only did the girl develop an extreme fever, encephalitis and autism-like symptoms following the vaccines, but the family has since found out she, like her mother, has an immune deficiency.

Bice says that means she should have never received vaccines with a live virus contained in childhood vaccines.

Monica tells IB News, " Many children have pre-conditions and should be weeded out for vaccines. If her pediatrician knew it should have been a red flag not to vaccinate."

Both cases support the general theory of causation and are leading public health officials to reconsider whether a certain susceptible and vulnerable group of children should either not be vaccinated or vaccinated on a different schedule. (See related story on NIH s Dr. Bernadette Healy).

The boy's claims should last two to three weeks but a decision will not be heard until next year. Bice does not expect to be before the court until next year.

Autism is seen in sever social avoidance, repetitive behavior, inability to speak or hold eye contact and a compulsion to stack or put items in a line.

There is general agreement that a genetic link exists but so might conditions in the womb that cause the child's brain effects.

To be additionally cautious, pregnant women are warned to avoid a flu vaccine containing thimerosal.

And parents can seek out thimerosal-free vaccines for the children which will come in the single-dose vials.

Next summer in another test case before the vaccine court, lawyers will argue that the measles, mumps and rubella vaccine caused autism. #

Trooper, Illinois Facing $24 Million Lawsuit in Death of Teen Sisters

Jane Akre — Mon, 12 May 2008 15:43:14 GMT

LEARN MORE

Injuryboard on Citizen Groups on Police Pursuits
Injuryboard on Pursuit Safety
Injuryboard on Pursuit Watch
Uhl Family remembrance web site
Illinois State Police
KSDK TV report on the accident
Ron Kelley's Driving course

IMAGE SOURCE: Courtesy: AttorneyTom Keefe/ Uhl Mazda

A $24 million lawsuit has been filed in the Illinois State Police Trooper crash that killed two sisters.

The mother of the teenage girls, Kimberly Dorsey, says the wrongful-death suit is about holding the officer and the state responsible and accountable for the crash. The suit charges the state of Illinois and State Police Trooper Matt Mitchell.

Her attorney, Thomas Q. Keefe says it was his choice to seek $12 million for each girl.

In March, a St. Clair County grand jury indicted Mitchell on two counts of reckless homicide and aggravated reckless driving.

Last November, sisters Jessica, 18 and Kelli Uhl, age 13, were killed when 30-year old Trooper Matt Mitchell, cross the median of I-64, just east of St. Louis and hit the sisters' Mazda head-on. They were killed instantly.

The jury found that Trooper Mitchell was traveling 126 mph in his police-issued 2006 Impala just before the crash. The officer was responding to an accident that was already resolved about 15 minutes away and was reportedly "multi-tasking," talking on the cell phone and the shoulder radio at the same time.

Jessica Uhl was a student at Southern Illinois University, Edwardsville. Kelli was an eight-grader. The girls had just attended a holiday photo session at their grandmother's home. They were reported to be best friends.

Attorney Thomas Q. Keefe says the lawsuit was filed, in part, to find out what happened moments before the deaths.

"What really drove me nuts about this case first and foremost was the Illinois State Police were so arrogant to believe they could investigate themselves," he tells IB News.

Keefe says the state owes his clients the truth instead of what he calls a "white wash" of the accident during which they blamed the collision on, what Keefe calls a "phantom" white car that caused Trooper Mitchell to go out of control.

Keefe says the speed the trooper was traveling only became apparent when information was down loaded from the car's black box. Also not clear is why his car's video camera was not operating moments before the collision.

Keefe says when the attempt to obfuscate the truth didn't work the Illinois State Police decided to "throw Trooper Mitchell under the bus."

"He bears responsibility but the Illinois State troopers do as well."

An accident reconstruction expert finds that the trooper was traveling 102 mph at the time of impact and the girls were traveling at 65 mph.

But the accident report detailing the crash and the speed was never handed over to the public. The impact literally drove the police cruiser through the sisters' car.

Additionally, Mitchell had been told the accident he was responding to was already under control and the injured passenger was in the ambulance.

This is not the first incident for Trooper Mitchell. A case previously was settled against him for $1.7 million and he was involved in two previous on duty crashes.

Mitchell reportedly last received high-speed driving training in 2001 when he was in the State Police Academy. There cadets take 26 weeks of courses before becoming troopers. After that, all of their driving training is on the road.

Ron Kelley says that's not surprising. He is a retired deputy sheriff from Osceola County, Florida who goes around the country training officers how to drive in emergency situations, or when not to pursue, an even more important lesson.

He says he gets the call from law enforcement after an accident or an officer is injured. "It's reactive" he tells IB News.

Following the Uhl case, Kelley asked a police chief friend from Illinois how much training in emergency vehicle operations is mandated for the troopers after they leave the academy.

"His email was short, 'we are currently reviewing that for revisions,' " Kelley says he was told. While officers receive refresher training in weapons, the fact that they drive for a living is often thought to be enough training.

"Who trains you to drive 126 mph?" he asks.

"Ideally, the bare minimum is you put them through a reoccurring training once a year for eight hours and show them the devastating videos of people seriously injured. It kinds of get their attention," Kelley says.

In Illinois as in many other states, there are no specific guidelines as to how fast officers can travel in pursuit of the public good- the speed limit is dictated by the situation.

Trooper Mitchell has pled not guilty to the two charges of reckless homicide as well as two charges of reckless driving filed in connection with injuries received by a Fayetteville couple who were hurt in the same collision.

But the case will not go before a jury. Because the claim is against the state, the lawsuit will be heard before the Illinois Court of Claims. Seven justices, appointed by the governor will listen to the evidence.

A pre-trial conference is set for next month. Each homicide count carries up to five years in prison and reckless driving counts up to three years. #

Government says Teen Depression Worse With Marijuana

Jane Akre — Mon, 12 May 2008 11:14:03 GMT

LEARN MORE

White House Report on Teen/Pot Use
Actual Report PDF
CNN video of news conference
Injuryboard on Marijuana use and Employment
Injuryboard on Antidepressants

IMAGE SOURCE:© iStockPhoto/dark angel series/ depression

The White House Office of National Drug Control Policy says that pot and depression are a bad combination and can lead to further mental health issues such as schizophrenia, anxiety and even suicide.

A report that analyzes about a dozen studies on pot use entitled "Teen Marijuana Use Worsens Depression: An Analysis of Recent Data Shows "Self-Medicating" Could Actually Make Things Worse," finds about two million teens felt depressed at some point during the past year. These are the kids more likely to use marijuana.

The intention of the report is to dispel two assumptions -first - that teen depression is not a problem and that marijuana is safe.

"Marijuana is not the answer. Too many young people are making a bad situation worse by using marijuana in a misguided effort to relieve their symptoms of depression," said John P. Walters, Director, National Drug Control Policy in a statement.

The White House reports that while pot use among teens is down about 25 percent, it still represents the most frequently used drug, more than all other illicit drugs combined.

Larry Greenhill, president-elect of the American Academy of Child and Adolescent Psychiatry, said at a news conference that "Marijuana available to teenagers in this country has increased tenfold in potency since the 1960s."

Others in the field point out that that is a long-standing myth.

The report says:

Teens who smoke marijuana at least once a month are three times more likely to have suicidal thoughts than non-users;
Using marijuana can cause depression and other mental illnesses;
The percentage of depressed teens is equal to the percentage of depressed adults, but depressed teens are more likely than depressed adults to use marijuana and other illicit drugs;
Teen girls who use marijuana daily are more likely to develop depression than girls who do not use marijuana;
Depressed teens are also more likely than non-depressed teens to engage in other risky behaviors such as daily cigarette use and heavy alcohol use.

Dr. Drew Pinsky, television host of VH1's Celebrity Rehab, and an addiction expert, appeared at a White House news conference announcing the report.

He says "Don't be fooled into thinking that pot is harmless. People are looking for solutions, the solutions become a problem. They are looking for a way to regulate depression and that ends up amplifying their depression. Abuse of marijuana does have consequences; it can increase instability and thought disturbances such as psychosis."

In his clinical experience he says there is a priming experience of the drug. After about three times, teens then say they love and want to reproduce the experience. That's when they use for years and then turn to other drugs to amplify the experience.

"With parents, don't ever say not my kid. You must stay vigilant," says Pinsky during the news conference.

Because it's marijuana means many parents don't take it seriously. "Our generation of parents has to cast off the anachronism of our experience. Our kids want our help and guidance, they would like our guidance."

But Bruce Mirken, director of communications at The Marijuana Project, which hopes to remove criminal penalties for marijuana use, says the report is deliberately confusing.

He tells U.S. News & World Report, "We agree that kids shouldn't smoke marijuana, but we simply have to be honest to teens and parents. This very week the British government's official scientific advisors on illegal drugs issued a report saying they are 'unconvinced that there is a causal relationship between the use of cannabis and any affective disorder,' such as depression."

Mirkin says the report omits any warning about alcohol and depression which is much more likely to be a teens drug of choice.

Interestingly girls are more likely than boys to experience sadness and hopelessness in the year surveyed, and three times as many girls as boys expressed depression in the year.

"Girls who smoke marijuana daily are significantly more likely to develop symptoms of depression and anxiety: Their odds are more than five times higher than those of girls who do not smoke marijuana," the report says.

No matter what the drug, substance abuse and teen depression often go hand in hand and should not be dismissed as a "phase".

Parents should be mindful of the signs of depression in teens. They include:

Behavior-moodiness may signal depression or drug use
Careless with grooming, changes in behavior and friends, loss of interest in daily activities and withdrawal

Parents must talk to their children if they see signs of drug use or depression. You are advised to stay involved in your teen's activities and get to know their friends.

Ask questions and know how he or she spends time; make sure there are parents present in the homes your teen visits; set limits about drug use with clear rules and consequences for breaking them.

Family history is the biggest risk factor for mental health problems and substance abuse.

Comments below the U.S. News Report by many teens say they self-medicate with pot to "feel better," gain an introspective look and make positive changes. #

How to Predict Next Seasons Flu Vaccine

Jane Akre — Mon, 12 May 2008 08:38:51 GMT

LEARN MORE

Injuryboard on Influenza
Injuryboard on Flu Drugs
The CDC
CDC Table of Flu Vaccines and thimerosal

IMAGE SOURCE: iStockPhoto/ flu vaccine given/Millanovic

Next year's flu season will be the topic in Atlanta this week at the annual influenza vaccine summit meeting.

Both the Centers for Disease Control and American Medical Association will begin making preparations for the 2008-2009 season which begins in the fall.

Top on the agenda- how to make a better educated guess as to which strains of influenza to prepare against.

This year's flu vaccine was largely ineffective because new strains of the influenza virus were not predicted. Two of the three strains escaped the target of the flu shot making it about 44 percent effective and one of the worst years for flu cases and pneumonia among adults.

An FDA committee met in February to select the influenza virus strains for the 2008-2009 season. Based on samples gathered from laboratories around the country, the panel recommended that vaccines for next season should contain the:

an A/Brisbane/59/2007 (H1N1)-like virus;
an A/Brisbane/10/2007 (H3N2)-like virus; *
a B/Florida/4/2006-like virus. #

* A/Brisbane/10/2007 is a current southern hemisphere vaccine virus.
#B/Florida/4/2006 and B/Brisbane/3/2007 (a B/Florida/4/2006-like virus) are current southern hemisphere vaccine viruses.

Five flu vaccine makers plan to produce a record number of doses next year - 143 million doses for 2008-2009, compared to 140 million doses produced for 07-08.

CSL Biotherapies is planning on tripling its production to six million doses hedging its bets that people will not be less likely to get a flu shot because of last year's miscalculation.

Sanofi Pasteur Inc. will make 50 million doses and Novartis Vaccines will manufactur 40 million. GlaxoSmithKline PLC will produce from 35 to 38 million doses. They should be ready by the fall.

In addition there should be about 12 million doses of the nasal spray, FluMist, which contains the live virus. It is approved only for health people, but there is concern that a live virus might infect those with compromised immune systems.

By the fall expect to hear a more aggressive ad campaign urging inoculations in children as young as six months, down from age five. That could boost the demand an additional 30 million doses.

Annual vaccination against influenza is recommended for all persons including school-aged children; all children aged 6-59 months; everyone 50 and older; children and adolescents (aged 6 months-18 years); and women who will be pregnant during the influenza season, among others.

Pregnant women may want to seek sources of influenza vaccine that are thimerosal-free.

Thimerosal-free vaccines are available in limited quantities each year. Thimerosal is an ethylmercury-based preservative which may have an effect on children leading to autism.

The CDC reports the number of vaccines and their thimerosal content for each influenza season on its web site each year.

Handwashing is still considered among the top preventative to spreading and contracting the flu.

Every year hundreds of thousands are hospitalized and about 36,000 are killed in the U.S. from the flu. #

85 Now Identified With Hepatitis C in Las Vegas Investigation

Jane Akre — Sun, 11 May 2008 00:04:43 GMT

LEARN MORE

Picture of Dr. Desai Las Vegas Sun
Southern Nevada health district
Southern Nevada Health District Hotline 702-759-4636
CDC infection control
CDC on needles and syringes
White Meany Wetherall LLP
Attorney Steve Klearman blog

IMAGE SOURCE: WikiMedia Commons/ colonoscopy illustration/ author: Euchiasmus

The most expansive public health investigation in U.S. history has added more names to the list of patients who've contracted hepatitis C from the reuse of syringes and vials at Las Vegas area clinics.

Now health officials say 77 more people treated at the Endoscopy Center of Southern Nevada have been diagnosed with hepatitis C.

It's unclear how they were infected, though all have visited the center and none had hepatitis C or any risks factors before they were a patient there between March 2004 and
January 11^th of this year.

Risk factors for hepatitis C include IV drug use, sharing needles, an organ transplant or blood transfusion before 1992, dialysis for kidney failure or having sexual contact with a known carrier of hepatitis C.

The latest cases identified are among 400 former patients of the Endoscopy Center and another clinic on Shadow Lane who have recently tested positive.

The remaining may have had a risk factor for exposure. It's estimated about three to four percent of the population carries hepatitis C but is asymptomatic.

Brian Labus, senior epidemiologist for the Southern Nevada Health District tells the Las Vegas Review-Journal, "We can't say for certain that they got it at the clinic; however, the clinic is the obvious source of infection considering they had no other risk factors," Labus said.

Genetic testing can be useful to identify the source of the disease in clusters, but Labus says that the virus mutates rapidly making it difficult to identify the source.

Altogether there are now 85 confirmed cases of hepatitis C linked to the Endoscopy Center and the Desert Shadow Endoscopy Center also run by majority owner, Dr. Dipak Desai and his partner Dr. Eladio Carrera. The medical licenses of both men have been suspended pending a hearing by the Nevada State Board of Medical Examiners.

Health officials say at least 40,000 patients and thousands more of their exposed loved ones are being tested for hepatitis C, B and HIV. The origional exposure at the clinic came through the reuse of syringes and single-use vials of sedative.

Reportedly, 10,000 former patients cannot be located.

There is no cure for hepatitis C, a blood-borne disease that can cause cirrhosis of the liver, liver cancer and death.

Last week, Dr. Desai was stopped by a car dealer from shipping his two Mercedes out of the country to Dubai.

The FBI, local police and State Attorney's office is also conducting criminal investigations into Dr. Desai who is alleged to have told his medical personnel to reuse syringes and other equipment in a cost-saving move.

Those inside the investigation say he also over-billed Medicaid for services.

Several hundred people have joined into class-action lawsuits against Dr. Desai and his clinic.

Lawyers for Dr. Desai want plaintiffs to fill out a 27-page questionnaire detailing information about their sex lives and drug use. Lawyers for plaintiffs say it is a designed to embarrass and humiliate those who have filed suit. Dr. Desai's lawyers believe it's necessary to determine whether those who are suing have any additional risk factors.

On Friday the Nevada State Board Medical Examiners refused to turn over to the District Attorney's office complaints against Dr. Desai.

Chief Deputy District Attorney Scott Mitchell told the Las Vegas Sun, "I think they are so far removed from what they're supposed to be doing that it hasn't occurred to them that they're protection for the public, not interference for the doctors."

Dr. Desai, one of the most prominent doctors in the state, was previously one of the nine board member and many believe his friendships with other board members as well as Gov. Jim Gibbons is the only reason he is not in jail now.

The doctor has already paid the city $500,000 in fines. #

Public Calls For Rational Police Pursuits - 2 Officers Charged

Jane Akre — Fri, 09 May 2008 10:50:01 GMT

Ashley McIntosh

LEARN MORE

Dr. Robyn online petition
Pursuit Watch
Candy Priano and Voices Insisting on Pursuit Safety
Injuryboard on High-Speed police chases
Injuryboard on Hot Pursuits
Injuryboard on police chases Nebraska
Injuryboard on Pursuit Watch
Police Driving web site
KSDK video on Trooper Matt Mitchell
NHTSA 1982-2006 pursuit fatalities by state

IMAGE SOURCE: Ali Carter Memorial Web site Courtesy: Leigh Griffis; Website of Dr. Robyn Silverman on Ashley McIntosh; Sarah Phillips Courtesy, John Phillips, PursuitWatch.org

A Fairfield County, Virginia police officer has been charged with reckless driving for crashing her cruiser into a citizen's car and killing the driver.

It's one of the rare times a police officer - in charge of protecting the public - has been charged with putting the public in danger.

Fairfax Commonwealth's Attorney Raymond Morrogh said that 22-year-old Officer Amanda Perry showed a "momentary lapse of judgment" deserving of a criminal misdemeanor not a manslaughter charge.

The family of the victim, 33-year-old Ashley McIntosh, thinks otherwise.

Sister, Meredith Heller, tells the Washington Post, "I guess Ray Morrogh finds a momentary lapse of judgment, which results in an officer killing my sister, acceptable. Whereas I, as a citizen, cannot. I would be curious to know, if the roles were reversed, what charges would my sister have faced."

Last February, Officer Perry was driving north on Route 1 in response to a reported fight.

Perry's emergency lights were on, as dictated by policy, but she was not using her siren, according to witnesses, when she drove into an intersection against a red light.

The police cruiser hit a Toyota Corolla pulling out of the Mount Vernon Plaza shopping center. The driver, McIntosh, a kindergarten teaching assistant, had the green light and was turning north when her car was hit on the driver's side.

McIntosh was thrown from her car. The teacher, who was engaged to be married this summer, died the next day.

Officer Perry, who had been on the force for a year, was not injured.

The police union president, Officer Marshall Thielen, told the paper "I'm concerned that this type of charge could have a chilling effect on our officers in the future, in their decision-making process, as we attempt to serve the public."

In charging the officer, Morrough said she was supposed to have her lights and siren on and proceed cautiously when entering an intersection against a red light. Perry had not met those standards.

In a separate case, Illinois State Trooper Matt Mitchell is facing two counts of reckless homicide and two counts of reckless driving in an crash that killed Jessica Uhl, 18 and her sister Kelli, 13, the day after Thanksgiving last year.

Just after noon, Trooper Matthew Mitchell was travelling at 126 mile per hour and was talking on his cell phone and radio at the same time while responding to a wreck in which the injured passenger was already in the ambulance. He had reportedly been told not to hurry.

This was Trooper Mitchell's third crash with citizens, among them one that resulted in a $1.7 million judgment.

"It's a pretty high standard to being charged," Professor Geoffrey Alpert tells IB News. He's been studying police pursuits for 25 years and is with the University of South Carolina's Criminal Justice Department.

Despite the fact that at least 400 innocent civilians are killed and 4,000 injured during police pursuits every year, Alpert says law enforcement is well aware of the dangers but some departments don't want to remove pursuits as a tool of law enforcement. "They don't care, they just want to count deaths on the freeway," he says.

Candy Priano hears from families around the country who have had loved ones killed in police pursuits.

Priano founded the citizen group, Voices Insisting on Pursuit Safety, after her daughter, Kristie was killed in the back of the family minivan on the way to her high school basketball game by a police car in pursuit.

Priano and Alpert both believe the national death toll may actually be at least twice the 400 estimated deaths because police don't count victims who die days after a collision, such as McIntosh, or pedestrians killed in the course of a pursuit.

It may be the sheer numbers of people being hurt across the country who are connecting with each other through the internet and creating a groundswell of citizens groups saying enough is enough and calling for responsible police pursuits.

Sarah Phillips

Ali Carter

John Phillips and his family formed the advocacy group, Pursuit Watch, after Phillips' 20-year-old sister Sarah, was killed by a police cruiser traveling 70 mph.

The mission of Pursuit Watch is to encourage pursuits only when there is an imminent and immediate danger to the public.

"We're not about police bashing," says Phillips who founded the group along with his late father, Jim.

Phillips has helped Orange County develop one of the most responsible and restrictive pursuit policies in the nation, which sometimes means there is no chase. Its adoption follows a similarly restrictive policy by the Orange County Sheriff's Office in the fall of 2003.

"There's been a groundswell but it takes time" Phillips tells IB News. At first his group met with resistance and the police had a mixed reaction, but he says over time the new policy has been accepted.

"Sometimes the police forget their job isn't to catch the bad guy but to protect the community," he says. "I don't doubt their sincerity but the public is starting to get it saying this happened in my neighborhood."

The turnabout in public attitude is being seen outside of Florida.

Just last month, a newspaper editorial said an "appropriate settlement," referring to the million dollar settlement reached by the city of Bowling Green, Kentucky and the family of 20-year-old Allison "Ali" Carter.

The Western Kentucky University student was killed instantly in April 2006 by an officer exceeding the speed limit and on call, without his lights or sirens on.

Family attorney, Phil Grossman (and IB member) says that editorial represents a turnabout in public opinion.

He tells IB News, "Bowling Green is a smaller city very protective of their police. The local news paper saying the results were appropriate can encourage better police practices that would prevent serious injury and death to innocent citizens of the city of Bowling Green."

Grossman says the attitude about police can be seen in focus groups. "Citizens are pretty angry over that conduct," referring to citizen's reactions when they see officers speeding past their cars.

While the officer in training has received remedial training, the Carter family has offered to contribute financially to establish a training program for city police officers to encourage safer practices.

The family has not heard back from the department, Grossman says.

Professor Alpert says he too has seen a shift in the public attitude. He found after conducting a public opinion study in Baltimore "the more the public knew about the consequences, the less they supported them."

Among those responding to the Washington Post newspaper article about the McIntosh case, more than half took issue with the police.

jw1123 wrote:

Too often, police officers think that they are above the law. Ms. Heller is right, the charges were too lenient. This kind of charge SHOULD have a chilling effect on officers in the future, they should exhibit discretion over how fast they drive, when they use their lights, and should abide by the same laws that they enforce on everyone else.

5/3/2008 12:25:33 PM

matrox wrote:

Cops always breaking laws they paid to uphold. How many times have seen speeding cops speeding from stoplight to stoplight? Tailgating and forcing drivers into the right lane? A few months ago a cop flew past me on a residential thorofare doing about 45 in 25mile zone only to find him pull into a 7/11 where about 5 or 6 squad cars were with cops at the far end of the lot standing around BS'ing drinking coffee. This about 11 or 12 at night.

5/3/2008 11:31:39 AM

clearthink wrote:

How much more tragic can anything be??

When an innocent life is extinguished by someone hired to protect us all -- well, the whole police department needs to be held accountable. The young officer who killed the motorist is an extension of an overall system (police, prosecutors, etc.) that is way too insulated and suspect. People naturally take notice of this and react accordingly.

5/3/2008 11:07:13 AM

McIntosh was a popular athlete and softball player at West Potomac High School. At Clermont Elementary she had bonded with her class of youngsters, friends say.

And what may have made police acutely aware of the sensitivity of the McIntosh case were the more than 1,000 names signed to a petition. Circulated online by Dr. Robyn Silverman, the aunt of one of McIntosh's students, among others, it called for Fairfax police to conduct a fair investigation of their own officer.

There's been no word so far on how fast Officer Perry was traveling at the time she drove her cruiser into McIntosh's car, but what is now known is that the incident she was responding to turned out to be two men apprehending a suspected shoplifter. #