Issue link: https://www.epageflip.net/i/35639
6A Daily News – Monday, July 4, 2011 Vitality & health CHICAGO (MCT) — The medical error that killed Gen- esis Burkett began with the kind of mistake people often make when filling out electronic forms: A pharmacy techni- cian unwittingly typed the wrong information into a field on a screen. Because of the mix-up, an automated machine at Advo- cate Lutheran General Hospital prepared an intravenous solution containing a massive overdose of sodium chloride — more than 60 times the amount ordered by a physician. When the nutritional fluids were administered to Genesis, a tiny baby born 16 weeks prematurely, the infant's heart stopped and he died, leaving behind parents stunned by grief to this day. Although a series of other errors contributed to the tragedy, its origin — a piece of data entered inaccurately into a computer program — throws a spotlight on safety risks associated with medicine's advance into the information age, a trend being pushed aggressively under health reform. The federal government is aiding the shift with $23 bil- lion in incentives to medical providers who buy electronic medical records or computerized systems that automate drug orders and other medical processes. The hope is that these technologies will enhance access to vast amounts of infor- mation now tucked away in paper files and meaningfully improve medical care. Doctors should be able to see test results quickly and communicate more easily with each other, for example. And electronic safeguards also can remind physicians about recommended medical practices or alert them to harmful interactions between medicines. Yet with these sizable potential benefits also come poten- tial problems. Hospital computers may crash or software bugs jumble data, deleting information from computerized records or depositing it in the wrong place. Sometimes, com- puters spew forth a slew of disorganized data, and physicians can't find critical information about patients quickly. Mean- while, different electronic systems used in hospitals may not be able to communicate, and the alerts built into these sys- tems are often ignored because they are so frequent and often are not especially useful, physicians and other experts report. Technology vendors tend to dismiss incidents like the death that occurred at Advocate Lutheran General in Park Ridge as arising from human errors, not product deficien- cies. But other experts say health information technologies can lead to mistakes when they aren't in sync with the way medical providers work. "We see problems much more often than we would like" because many health information systems are poorly designed and difficult for doctors and nurses to use, said Dr. Rainu Kaushal, chief of the division of quality and medical informatics at Weill Cornell Medical College in New York City. Exactly how often safety concerns arise is not known. The U.S. Food and Drug Administration in December acknowledged getting 370 reports of problems involving health information technology since January 2008, including several dozen patient injuries and deaths, but those numbers are likely to be low because such reports are voluntary. Some examples: • A patient died after a computer network problem caused delays in transmitting a critically important diagnostic Support the Tehama County Branding Project Baby's death spotlights safety risks fitness Lozenges unavailable to treat Spasmodic Dysphonia MCT photo Fritzie and Cameron Burkett lost their infant son to a sodium overdose. image. • Vital signs from patient monitors disappeared from electronic medical records after being viewed by hospital staff. •A patient died after getting therapy meant for someone else after a wrong name was entered electronically on a scan performed by radiologists. • Data about patients' allergies were eliminated from medical records during an automatic computer update. "(These) technologies can be enormously helpful, but what is emerging is that when implemented poorly, they can be harmful," said Dr. Ashish Jha, associate professor of health policy at Harvard University's School of Public Health and a member of an Institute of Medicine committee appointed late last year to study safety concerns associated with health information technology. That panel's recommen- dations are expected to be issued in 2012. Carla Smith, executive vice president of HIMSS, the industry's largest trade group, based in Chicago, said that "safety concerns are on our radar screen" and "we want to make sure we have checks and balances in place (in vendor systems) to prevent unintended harm." The story of Genesis Burkett's death at Advocate Luther- an General last October underscores the potentially devas- tating consequences of a single wrong piece of data put into a software system. The infant's parents, Fritzie and Cameron Burkett of Chicago, said they were overjoyed when their son, born four months early and weighing 1 pound 8 ounces, survived and began to improve under the hospital's expert care. For about six weeks, the Burketts and other family members said, they were at the baby's side, singing Christ- ian music softly at his bassinet. Having endured two previ- ous miscarriages, the couple said they named the baby Gen- esis, signifying a new beginning. Genesis emerged from a heart operation on Oct. 15 with- out any clear complications, said the Burketts' attorney, Patrick Salvi. Yet later that day, Fritzie Burkett said she got a call from the hospital telling her to come in immediately. When she arrived, Burkett said, medical staff were perform- ing CPR on Genesis, and about 40 minutes later they pro- nounced him dead. The problem could have been identified by automated alerts on the IV compounding machine, but those were not activated when the customized bag was prepared for the baby, according to the hospital. This event sponsored by the Job Training Center, Tehama EDC, Red Bluff Daily News, Rolling Hills Casino, the Tehama County Branding Project, and the Red Bluff/Tehama County Chamber of Commerce This is your opportunity to be part of creating the future of Tehama County. Thanks to your support and generosity, Roger Brooks returns August 2nd Rolling Hills Casino 8am to Noon (Breakfast Provided) Pre-registration required Cost: $25 per person September 2nd August 5th & July 2ND Visit www.destinationtehama.wordpress.com Upcoming Fundraising Events Rolling Hills Comedy Night Doors open at 7:30pm Show starts at 8:30pm All proceeds to benefit the branding effort! Branding Swap Meet 8am to 2pm Tehama District Fairgrounds Fee: $30. Register at Business Connections Tehama District Fairgrounds or Red Bluff/Tehama County Chamber of Commerce DEAR DR. GOTT: I have been diagnosed with spas- modic dys- phonia, which is not on your list of health reports. I have to wait another five months for an appointment with an ENT specialist. In the meantime, I must contin- ue talking, as I am a teacher of FSL (French as a Second Language) and my work means I talk all day long. I’ve tried getting slippery elm lozenges, which are sup- posed to help the voice, but they are presently unavail- able in Canada. So what can I do, short of not talking, to reduce or relieve symptoms? DEAR READER: Spas- modic dysphonia (SD) is a neurological disorder of the larynx, or voice box. When a person speaks, air from the lungs is forced between the vocal cords (referred to as vocal folds). This airflow causes the vocal cords to vibrate, which in turn pro- duces the voice. In the case of spasmodic dysphonia, the muscles within the vocal folds can spasm, interfering with these folds and prevent- ing the occurrence of a nor- mal voice sound. Instead, these spasms give the voice a strained quality, often making it extremely difficult for others to understand what a person is saying. The condition commonly begins when a person is in his or her 30s to 50s and may progress from mild to serious. It is more common in women than in men and can last a lifetime. There are several forms of SD. The most common one, accounting for almost 80 percent of all cases, occurs when the vocal cords hit together and stiffen dur- ing speech, causing the indi- vidual to speak in a breath- less, strained manner. The person will likely run out of air when attempting to talk. A less common form involves the forceful closure or spasm of the voice box during speech. Still another possibility, while rarer still, is when a person has both conditions. Symptoms may begin with the observation of strained voice tones that might be attributed to other causes. Several specialists, including an ear-nose-and- throat physician and perhaps a neurologist, may be con- sulted for an appropriate diagnosis. The cause of SD is Dr. Peter Gott unknown but may be linked with an abnormality of the central nervous system and basal ganglia — the cluster of nerve cells within the brain that coordinates move- ment of muscles throughout the body. The voice can appear completely normal or near normal at times but not at other times. SD may be hereditary; however, this is a rare disorder, and that makes genetic studies difficult. While there is no cure, therapy is available and might involve the services of a speech pathologist or botu- linum toxin (Botox) injec- tions to temporarily weaken or paralyze the muscles to eliminate spasms. Unfortu- nately, the BOTOX route is a temporary one and may require repeat injections up to four times a year. Other possibilities include cutting one of the smaller branches of the nerve leading to the larynx or adjusting the framework of the larynx; these latter procedures are reserved for the patient who fails to respond to BOTOX injections. Other than BOTOX, I am reluctant to recommend such therapy as acupuncture, tai chi, or over-the-counter remedies. I don’t want to mislead you into thinking alternatives might stabilize your situation, but five months is a long time to wait. Ask a friend from the U.S. to send you some lozenges. Readers who would like related information can order my Health Report “Medical Specialists” by sending a self-addressed, stamped No. 10 envelope and a $2 U.S. check or money order to Dr. Peter Gott, PO Box 433, Lakeville, CT 60039-0433. Be sure to mention the title when writing, or print out an order form from my web- site’s direct link: www.AskDrGottMD.com/o rder_form.pdf. Dr. Peter H. Gott is a retired physician and the author of several books, including “Live Longer, Live Better,” “Dr. Gott’s No Flour, No Sugar Diet” and “Dr. Gott’s No Flour, No Sugar Cookbook,” which are available at most bookstores or online. His website is www.AskDrGottMD.com. For nutrition, frozen fruits (MCT) Right now you can use farm-fresh local strawber- ries to make smoothies. Blueberries and peaches will follow in due course. But smoothies can be enjoyed year-round thanks to frozen fruit. In fact, frozen fruit can make an even better smoothie than out-of-season fresh fruit. Here's why: Fresh fruits destined for the market are usually picked before they are fully ripe because a dead-ripe fruit can turn into a bruised fruit or a rotten fruit long before it reaches the store. But fruits destined to be frozen can be harvested at peak ripeness since they only need to travel from the field to the freezing plant. Frozen fruits are every bit as nutritious as their fresh coun- terparts, if not more so, since the longer fruits and vegetables "stay out," the more nutrients they lose. Vitamin C, for instance, is destroyed by light, air and oxygen. The one downside to freezing is that the texture of the fruit usually suffers. A defrosted strawberry could never be mistaken for fresh. But in a smoothie, everything is pureed into a uniform smoothness. When shopping for frozen fruit, select packages that are clean, dry and fresh-looking. When you shake the package, the fruit should rattle; if it doesn't, it may have thawed and been refrozen.