Conflict-of-Interest Reporting Serves to Replace Fact With Fiction in Vaccine Injury Cases

PRNewswire-USNewswire - Monday, June 25, 2007

WASHINGTON -- With the Autism Omnibus Proceedings now in the second week of testimony in the US Court of Federal Claims, advocates for vaccine-injured children are calling the bulk of media accounts biased against families.

Often presented as ironclad in many media accounts, the misinformation parents and advocacy organizations note as appearing most frequently in mainstream news include:
-- the 2004 IOM report suggesting that research involving thimerosal be discontinued, even though the committee considering the research presented disregarded clinical investigation in favor of epidemiology conducted in Europe and funded primarily by drug companies and public health agencies
-- the assertion that the autism rate of one in 150 children is attributable to better diagnosing, while the symptoms associated with autism are profound, and according to parents and professionals alike "can't be missed"
-- the claim that the mercury-based preservative thimerosal has been removed from all vaccines, although most flu shots and several other vaccines still contain 25 micrograms mercury, an amount considered unsafe by government guidelines for anyone weighing under 550 lbs.

(See Vaccines Safety for a current list of vaccines and thimerosal content.)

-- that there is no science linking vaccines to autism, even though many peer-reviewed published studies confirm the link between mercury and neurological injuries with symptoms nearly identical to autism spectrum disorders (

View some of the relevant studies.

The use of spokespersons with ties to drug companies in news accounts has also been cited as form of bias. Dr. Paul Offit has been quoted frequently in defense of the practice of injecting mercury into pregnant women and young children. Dr. Offit's work has been funded for over 15 years by pharmaceutical giant Merck, with whom he is co-patent holder of the RotaTeq vaccine. The FDA announced last week that RotaTeq will now carry a label warning for pediatricians and parents about the vaccine's link to Kawasaki Disease, considered one of the leading causes of acquired heart disease among children in the US.
During the first week of the hearings, an NBC Today show segment featuring former Johnson & Johnson vice president Dr. Nancy Snyderman drew further criticism when Snyderman suggested that parents involved in the autism hearings were motivated by financial gain.

"Apparently, Dr. Snyderman is either completely ignorant of the emotional and financial devastation to families of children suffering from vaccine-related injuries or she's speaking on behalf of her former employer. Either way, it's unacceptable,"

commented NAA president and parent Wendy Fournier. Dr. Snyderman's former employment with Johnson & Johnson was not disclosed to viewers.
Johnson & Johnson subsidiary Ortho Clinical Diagnostics is involved in litigation for injuries, including autism, associated with its thimerosal- containing Rh immune globulin product, RhoGAM.
For more information, or contacts: Wendy Fournier (Portsmouth, RI) 401-632-7523 Rita Shreffler (Nixa, MO) 401-632-6452
National Autism Association or see National Autism Associates Website.

Staph Superbug May Be Infecting Patients

By MIKE STOBBE – Associated Press - Monday, June 25, 2007
ATLANTA - A dangerous, drug-resistant staph germ may be infecting as many as 5 percent of hospital and nursing home patients, according to a comprehensive study.
At least 30,000 U.S. hospital patients may have the superbug at any given time, according to a survey released Monday by the Association for Professionals in Infection Control and Epidemiology.
The estimate is about 10 times the rate that some health officials had previously estimated.
Some federal health officials said they had not seen the study and could not comment on its methodology or its prevalence. But they welcomed added attention to the problem.

"This is a welcome piece of information that emphasizes that this is a huge problem in health care facilities, and more needs to done to prevent it,"

said Dr. John Jernigan, an epidemiologist with the U.S. Centers for Disease Control and Prevention.
At issue is a superbug known as Methicillin-resistant Staphylococcus aureus, which cannot be tamed by certain common antibiotics. It is associated with sometimes-horrific skin infections, but it also causes blood infections, pneumonia and other illnesses.
The potentially fatal germ, which is spread by touch, typically thrives in health care settings where people have open wounds. But in recent years, "community-associated" outbreaks have occurred among prisoners, children and athletes, with the germ spreading through skin contact or shared items such as towels.
Past studies have looked at how common the superbug is in specific patient groups, such as emergency-room patients with skin infections in 11 U.S. cities, dialysis patients or those admitted to intensive care units in a sample of a few hundred teaching hospitals.
It's difficult to compare prevalence estimates from the different studies, experts said, but the new study suggests the superbug is eight to 11 times more common than some other studies have concluded. The new study was different in that it sampled a larger and more diverse set of health care facilities. It also was more recent than other studies, and it counted cases in which the bacterium was merely present in a patient and not necessarily causing disease.
The infection control professionals' association sent surveys to its more than 11,000 members and asked them to pick one day from Oct. 1 to Nov. 10, 2006, to count cases of the infection. They were to turn in the number of all the patients in their health care facilities who were identified through test results as infected or colonized with the superbug.
The final results represented 1,237 hospitals and nursing homes - or roughly 21 percent of U.S. inpatient health care facilities, association officials said.
The researchers concluded that at least 46 out of every 1,000 patients had the bug.
There was a breakdown: About 34 per 1,000 were infected with the superbug, meaning they had skin or blood infections or some other clinical symptom. And 12 per 1,000 were "colonized," meaning they had the bug but no illness. Most of the patients were identified within 48 hours of hospital admission, which means, the researchers believe, that they didn't have time to become infected to the degree that a test would show it. For that reason, the researchers concluded that about 75 percent of patients walked into the hospitals and nursing homes already carrying the bug. "They acquired it in a previous stay in health care facility, or out in the community," said Dr. William Jarvis, a consulting epidemiologist and former CDC officials who led the study.
The infection can be treated with other antibiotics. Health care workers can prevent spread of the bug through hand-washing and equipment decontamination, and by wearing gloves and gowns and by separating infected people from other patients.
The study is being presented this week at the association's annual meeting in San Jose, Calif., but has not been submitted for publication in a peer-reviewed medical journal.
See also:
Association for Professionals in Infection Control & Epidemiology
The CDC's Web page on MRSA
Source: Associated Press/AP Online

New drug approved for Fibromyalgia patients

By MACIE JEPSON - WFAA-TV - Friday, June 22, 2007
As many as 13 percent of women in America have a neurological condition called Fibromyalgia and for the first time, the FDA has approved a drug that can help. It's called Lyrica.

Pamela Kennedy struggles everyday to take care of her toddler son.

"With Fibromyalgia, I've had pain for 15 years in all my joints," she said.

For many of those years, she's gotten relief from mind-altering pain pills that ease the muscular discomfort that she wakes up and goes to bed with everyday.

"If they could think of something I could take and be lucid all day and be a mom, that would be good."

The drug company Pfizer thinks it has. In clinical trials Lyrica was found to reduce pain, without the dangers of pain medication.

Lyrica decreased the release of neurotransmitters in the brain linked to the pain, fatigue and cognitive problems associated with Fibromyalgia. The disorder typically causes muscle pain, insomnia and stiffness.

Dr. John Harney already sees improvement in his patients.

"In about 200 of my patients over the last year and a half, I've found they have more energy, get into their exercise program more and pain drops about 50 percent. It's great news,"

he said.

Lyrica was already approved for treatment of tremors, migraines, muscular sclerosis and other neurological disorders.
Lyrica website

Two FW hospitals among nation's deadliest for heart patients

Baylor All Saints, Huguley say they respect U.S. study, but numbers may mislead
By JASON ROBERSON - The Dallas Morning News -Friday, June 22, 2007
Fort Worth is home to two of the nation's deadliest hospitals for patients being treated for heart failure: Baylor's All Saints Medical Center and Huguley Health System, according to a report from the U.S. Department of Health and Human Services.

After reviewing data on 4,500 hospitals across the country the department's Centers for Medicare & Medicaid Services division released a list of hospitals it said are performing either better or worse than the nation's average mortality rate for patients treated for heart attacks or for heart failure. The report did not list the national averages, nor did it reveal how far off a hospital was from those averages.

All Texas hospitals performed at the national average for heart attacks while five Texas hospitals made the Health and Human Services list for heart failure.
Hendrick Medical Center in Abilene and Christus St. Michael Health System in Texarkana also performed worse than average.

Meanwhile, Houston's Memorial Hermann Healthcare System was the only Texas hospital to do better – with a lower mortality rate than the national average.

The mortality numbers were based on a year's worth of hospital admissions, from July 1, 2005, to June 30, 2006.

The Centers for Medicaid & Medicare Services says it will use the report to help motivate hospitals to improve their quality.

In fiscal year 2008, ending September 2008, poor performing hospitals must show improvement in order to receive full Medicare and Medicaid reimbursements. Health and Human Services will tighten the "pay for performance" incentive measures it has used since 2003.

Executives and spokespeople at Texas' losing hospitals spoke of their hopes to do better. No one disputed the findings.

But a Huguley Health System spokesman said the numbers are somewhat misleading. After receiving news of their mortality ranking on June 11, Huguley hospital administrators pulled the files of deceased patients submitted for the study.

Of the 29 deaths occurring during the study, 10 people were already in hospice care before their heart failure, suggesting they were expected to die, while one was 100 years old and another 98 years old, said Huguley spokesman Kurt Adamie.

"What's weird is that we just received an award from the Texas Medical Foundation two weeks ago for clinical excellence," Mr. Adamie said. He added that Huguley, by just two deaths, missed the bell curve separating average performing hospitals from those performing worse than the national average.

The largest Texas hospital with a higher mortality rate than average is Baylor All Saints.

"Patients should be reassured that there is oversight; people are concerned and we're working to make the necessary improvements," said Dr. Clyde Yancy, medical director of Baylor's Heart and Vascular Institute. "I respect the overall study. Obviously we have to take a look internally."

In a letter obtained by The Dallas Morning News, the Centers for Medicare & Medicaid Services gave hospitals the following disclaimer to its report:

"It is important to note that while your hospital, your state and the national crude mortality rates are all reported here for your reference, they are not directly comparable as they have not been risk-adjusted to account for patient differences, nor have any hospital adjustments been made to account for differences in sample sizes."

In an interview, Dr. Yancy said that adjusting for patient risk factors (such as the number with complicated cases) might have altered the findings.

Still, the report helped identify which areas of heart care need improvement at All Saints, he said.

Since the Fort Worth hospital was on par with the nation for heart attack treatment, Dr. Yancy said he targeted heart failure care with comprehensive educational programs for nurses in February.

Heart failure is the result of any number of diseases that prevent the heart from pumping blood normally. A heart attack is a type of heart failure where too little blood reaches the heart, resulting in damage to the heart's muscle.

Baylor's All Saints Medical Center has scored high in some state quality rankings. According to recent data from the Texas Department of State Health Services, Baylor All Saints' overall in-hospital mortality rate is the fourth lowest among more than 60 Dallas and Fort Worth area hospitals.
At the Hendrick Medical Center in Abilene, which also performed below average, marketing director Karen Brittain said patients should look at a variety of quality indicators. She added that her hospital was recognized as a Blue Distinction Center of Cardiac Care by Blue Cross/Blue Shield of Texas.

"But we certainly welcome any data sources that help us get better," Ms. Brittain said.

Houston's Memorial Hermann Healthcare System, which the Department of Health and Human Services ranks as one of the nation's best, was the only Texas hospital to have a lower than average mortality rate for heart failure patients.

"We as a hospital system are so focused on clinical quality for our patients that we take every guideline endorsed by cardiology societies to heart and work on those every day, so that every patient with a heart attack, every patient with heart failure, gets every known beneficial therapy,"

said Dr. Michael Shabot, chief quality officer.

Dr. Shabot said officials at the hospital were not surprised by their high ranking, having come to expect accolades. "In some ways we're competing with ourselves," he said.

Dr. Shabot did not take issue with the report's assessments.
Read more

STC board passes state resolution opposing health insurance cuts

By Daniel Perry - The Monitor - June 21, 2007

McALLEN — South Texas College leaders want to send a message to Gov. Rick Perry that his decision to cut off $154 million in health insurance funding for the state’scommunity colleges is a bad idea.

College trustees approved Thursday night a resolution sponsored by the Texas Association of Community Colleges objecting to Perry’s line item veto in the two-year state budget going into effect in September.

Trustees also decided to write their own resolution against the cuts and ask area cities, economic development corporations and chambers of commerce to lend their support.

“We should not be bashful to tell the governor that what he did was wrong,” board member Mike Allen said.

College President Shirley Reed said she wanted the college to work with Perry and area legislators rather than burn bridges with them regarding the issue. The state requires community colleges to pay all medical insurance premiums, but in the past this has traditionally been handled with Legislature-approved funding.

In the present biennium the college received more than $7.7 million from the state for health coverage. The college is estimated to get $3.9 million for the 2007-08 and 2008-09 academic years, but must find a way to fund the remaining $4 million the state is taking away.

Reed said the money was in the governor’s proposed budget when the legislative session began in January. And the funding stayed in the Senate and House versions throughout the session.

“Now what happened between January and June, I don’t know,” Reed said. “I believe there is a difference in philosophy (between the governor and the community colleges). And with community colleges, we are not addressed in state statutes very well. Sometimes the law applies to us and universities, sometimes to school districts and us, or specifically us.”

Randy Jarvis, a sociology instructor, said he felt “blindsided” when he heard earlier this week about Perry’s funding rejection. Jarvis said the funding cut would be easier to accept if the state were in a dire financial crunch.

“It’s obvious it will fall on the backs of our students,” he said.

Jarvis said the Faculty Senate would take the issue up when it reconvenes in August after its summer break.

College leaders have some tough decisions to make in the near future if Perry’s decision stands.

Reed said tuition could be increased for the 2008-09 academic year, but this could hurt student enrollment and mean less money comes from the state through funding formulas. There is also a chance some services and programs could be cut to save money.

She said the college could ask voters in Hidalgo and Starr counties to approve increasing the current tax rate of 0.11 cents per $100 of assessed property value. “I do not see that happening,” Reed said.
Read More

Texas House honored registered sex offender as Doctor of the Day

By Associated Press - Houston Chronicle - June 22, 2007
DALLAS — A Fort Worth-area physician twice recognized by the Texas House of Representatives as its "Doctor of the Day" is a registered sex offender, according to a broadcast report.

"I don't like the idea that I introduced a sex offender," Rep. Leo Berman, R-Tyler, told Dallas-Fort Worth television station KTVT. Berman introduced Dr. Nilon Tallant to the House on Jan. 12.

"He should have told whoever selected him to be the doctor of the day that he is a registered sex offender and not try to appear before the Texas House of Representatives and make himself look legitimate before the entire state," Berman said.

Tallant was one of 90 doctors who volunteered for the Physician of the Day program run by the Texas Academy of Family Physicians in the last session.

Physicians who participate in the program treat patients at the Capitol for the day, including visitors, legislators, their families and staff members.

Republican Rep. Phil King of Weatherford was to have introduced Tallant, as he had in 2006. But he was away from the floor and Berman happened to be standing near the podium when House Speaker Tom Craddick called for the introduction, the station reported.

Tallant was indicted on 19 counts of sexual performance by a child in 1996, the television station reported, citing Hays County court records. The victim was a 17-year-old female patient of the doctor, who was then 64 and practiced in San Marcos. Tallant pleaded guilty to a second-degree felony and was given 10 years' probation. He also lost his medical license for four years, the station reported.Republican Rep. Jerry Madden of Plano told KTVT that he received a complaint about Tallant's criminal record from the Council on Sex Offender Treatment shortly after the 2006 Doctor of the Day appearance. Madden said he told House officials, but the Texas Academy of Family Physicians says it was not told of Tallant's sex offender record. It said he would not have been invited to participate in 2007 if the academy had known about the record.

"It's horrendous and I want to make sure that this never happens again," Berman said. "I'm sure now we will have a close check on not only who comes in as the doctor of day but also as our chaplain of the day."

A telephone call placed by The Associated Press to a number listed for Tallant went unanswered late Thursday.

Tom Banning, with the physicians academy, said doctors for the program are screened on the Texas Medical Board's Web site.
KTVT reported that Tallant's online physician profile didn't reflect a criminal history and that Tallant did not disclose his criminal record to the board for the past three years, according to records it obtained under the Texas Public Information Act.
Banning said the Academy regretted that Tallant served as Physician of the Day and blamed the Legislature for holes in information because it has "historically starved down the Medical Board by diverting physician licensure fees to state general revenue. The TAFP supports using physician licensure for the purpose for which they are collected, to fully fund the Texas Medical Board so that it can carry out its mandate to protect the public safety."

Surgeon sues UT Southwestern under whistle-blower act

He says medical school demoted him after he aired Parkland concerns
By KIM BREEN / The Dallas Morning News - Tuesday, June 19, 2007

Trauma residents at Parkland Memorial Hospital have performed surgical procedures without proper supervision, a surgeon and former division chair at UT Southwestern Medical Center alleges in a lawsuit filed last week.

Dr. Larry Gentilello, former chair of the Division of Burn, Trauma and Critical Care, is suing UT Southwestern under Texas' whistle-blower act. He alleges he was demoted and stripped of an endowed position after raising concerns about patients receiving improper care at the county hospital.

"Because this is pending litigation, we cannot discuss these allegations at this time," said John Walls, assistant vice president for public affairs at UT Southwestern.

Parkland is the primary training site of residents affiliated with the UT Southwestern Medical School. Parkland officials declined to comment on the pending lawsuit.

Visiting Judge Richard Davis issued a temporary restraining order prohibiting UT Southwestern from filling Dr. Gentilello's former positions. The order expires June 29. A temporary injunction hearing has been scheduled for June 28.

According to the lawsuit, Dr. Gentilello, a tenured professor of surgery, became aware of problems with patient care, resident supervision and operating room and patient treatment protocols that violated Medicare and Medicaid requirements and procedures.

"Plaintiff observed that the patients at Parkland were being treated by residents with no attending physicians present and were undergoing surgical procedures with no attending physicians in the operating room during critical phases of surgery," the lawsuit states.

Parkland patients are typically indigent and primarily minority, it continues.

At UT Southwestern University Hospital's Zale Lipshy building, where patients are not indigent, the lawsuit states, attending physicians are present during treatment and procedures.
The lawsuit alleges Dr. Gentilello was stripped of his positions in March after notifying a superior about the alleged problems.

Dr. Gentilello did not return a call for comment. His attorney, Charla Aldous, said in a prepared statement that Dr. Gentilello has dedicated his professional life to caring for trauma victims, and that his distinguished career is what led UT Southwestern to recruit him.

"But when he tried to correct the gaps in emergency surgical services by ensuring that residents were being appropriately supervised by faculty, certain powers at UTSW stopped him and demoted him in retaliation."

She added:

"We want to make it clear that this suit does not allege any wrongdoing on the part of Parkland but rather seeks to ensure that Parkland patients are receiving the medical services they deserve."

The whistle-blower act prohibits government entities from retaliating against public employees who report a violation of law.

Dr. Gentilello is seeking reinstatement to his positions, attorney fees and damages.

WFAA NEWS

Studies say Texas lags in health care access

With high number of uninsured, state ranks 49th in one study
By JASON ROBERSON and ANGELA SHAH - The Dallas Morning News - Thursday, June 14, 2007

To many people, Texas has a strong reputation for quality health care.

Retirees who move to the state cite good hospitals as a key attraction. Dallas' Baylor University Medical Center and UT Southwestern Medical Center are renowned for churning out top-notch doctors. The University of Texas M.D. Anderson Cancer Center in Houston attracts patients from around the world.

But among the 50 states, Texas' health care system ranges from average to poor,

according to two reports released this week.

Industry experts say

the low rankings are explained largely by the widening gap between Texans who have health insurance and those who don't.

The large immigrant population and a high number of small businesses that don't offer health benefits to employees make Texas highest in the nation in the percentage of uninsured residents.

That helped rank Texas 49th out of 50 states and the District of Columbia for the overall performance of its health care system, in a study by the Commonwealth Fund, a nonprofit health care advocacy group. The study measured access to health care, quality of health care, avoidable hospital costs and deaths per 100,000 residents.

"We have too much pride in this state, and too much good economy, for us to sit back and tolerate this kind of rating," said Ladon W. Homer, immediate past president of the Texas Medical Association.

If Texas improved to the level of Hawaii, the best-performing state in the Commonwealth study, 2.7 million adults and 900,000 children would be insured, and the state would save $250.3 million a year, the study's researchers concluded.

A study released Monday by the U.S. Department of Health and Human Services pegged the state as average for health care quality, based on 129 indicators.The department began publishing the annual study in 2005 as a way to help state health leaders better recognize their strengths and weaknesses in providing quality care.

"Texas on overall quality is about average," said Ed Kelley, supervisor of the department's study.

"There are some things Texas is doing well and challenges that can be improved."

For example, the study found that Texas scored strongly for early colorectal cancer diagnoses and having a low percentage of nursing home residents who are depressed or anxious but poorly in areas such as full vaccination of children and avoidable hospitalizations for diabetes.

In both studies, Midwestern and Northeastern states such as Wisconsin, Minnesota, New Hampshire, Vermont and Maine performed the best. Those states have higher percentages of residents with health insurance and don't have the same impact from immigration as Texas does.

Many uninsured

In a state with 23.5 million people, more than 5.5 million – including 1.4 million children – lack health insurance,

according to the Texas Medical Association. Texas'

uninsured rates are about 1.5 times the national average.

Texas stands out for the ethnic makeup of its uninsured,

said Anil Kumar, an economist with the Federal Reserve Bank of Dallas.

Hispanics make up a third of the state's population – much larger than the 13 percent for the U.S. as a whole. More than half of the uninsured in Texas are Hispanic, compared with 25 percent for the nation.

Many Hispanics, particularly laborers, work at small businesses, said Roger C. Rocha Jr., state director of the League of United Latin American Citizens.

"Low-income people who cannot afford health insurance are in jobs that don't offer health insurance,"

he said.

"And then with CHIP programs being cut or not being funded adequately, there is a big segment out there not covered."

Only 55 percent of Texans have access to employer-sponsored insurance, below the national average of 63 percent, according to the Texas Medical Association. For small businesses – which provide about half the state's nonfarm, private-sector jobs – coverage drops to 37 percent.
...
Strain on hospitals

The strain of supporting uninsured Texans pressures hospitals financially and in the quality of care, experts say.

Total uncompensated care – including bad debt from people who can't pay their bills and charity care that hospitals agree to provide – increased 78 percent, from $5.6 billion in 2001 to $10.1 billion in 2005,

according to the Texas Hospital Association.

Uninsured patients are more likely than their insured counterparts to forgo or delay treatment for acute illnesses or injuries, to go without needed treatment for chronic conditions or illnesses and to die prematurely.

Besides the dangers to those who go without insurance, the situation also creates a drag on the state's economy,

said Nancy Williams, president of the Health Industry Council of the Dallas-Fort Worth Region.

Uninsured patients create higher health care costs for everyone as a result of the inherent cost shifting.

"The uninsured is an issue because the insured can't handle it,"

Ms. Williams said.

A study by Families USA, a Washington-based nonprofit group that advocates for universal health care, found

in 2005 that employer-sponsored family coverage in Texas costs $1,551 more per year as a result of the uninsured.

The problem of the uninsured is again getting attention from politicians. Presidential candidates are floating proposals to increase the ranks of insured Americans and even to provide universal health coverage.

Massachusetts is rolling out a plan that will cover nearly all of its residents. Politicians in California, New York and Pennsylvania are talking about doing the same.

In Texas, solutions have come in a more piecemeal fashion.

In the recent legislative session, lawmakers restored many of the funding cuts made in 2003 to the Children's Health Insurance Program. CHIP is designed for children of families who earn too much for Medicaid but not enough to buy private health insurance.

Since the cuts, CHIP enrollment had dropped from a high of 529,000 in May of 2002 to 300,800 this month,

according to the Texas Health and Human Services Commission.

Lawmakers also agreed to settle a Medicaid-related lawsuit by spending $707 million to increase dentists' payments by 50 percent and physicians' 25 percent, and to dispatch up to 40 mobile labs into inner-city neighborhoods and impoverished colonias.

Mr. Homer, the former TMA president, said

the state was funding two-thirds of the actual cost of Medicaid – "which means many physicians opt out of this program, which means more people don't have access to health care."

Read more

Three Heroes in Mesquite

By Steve Blair - Grassroots News U Can Use - June 5, 2007

Monday, June 4, 2007, three Registered Nurses’ employment by Health Management Associates at Dallas Regional Medical Center in Mesquite was terminated. Why?

They complained that their nurse to patient ratio was being raised critically high, so as to possibly endanger patients.

Normally, the nurse to patient ration in an Intensive Care Unit (ICU) would be 1:2. They were being ordered to increase that ratio to 1:5. Patients in ICU are in critical peril, and increasing the ratio only means that each critical patient will get less necessary attention.

Michael B. Rothburg, M.D., MPH, assistant professor of medicine at Tufts University and a physician at Baystate Medical Center, Springfield, Massachusetts, conducted a cost effectiveness study that seems to apply to the Mesquite case.

Dr. Rothburg found that the standard of an average ratio of 1:4 patients throughout the whole of the facility was maximum effective. Such a ratio could save 72,000 lives annually, and could result in fewer patient complications that increase patient stays by three to four days, “at a cost of $4,000 and $5,000 per day.” [“Study Finds Nurse-to-Patient Ratios Cost-Effective” by Christina Orlovsky, NurseZone, Wednesday, June 6, 2007]

Considering the health of the patients and even the cost efficiency, the three Registered Nurses took the correct position to complain to their Supervisor. However, they were terminated.

All Nurses take an Oath --The Florence Nightingale Pledge

I solemnly pledge myself before God and in the presence of this assembly, to pass my life in purity and to practice my profession faithfully. I will abstain from whatever is deleterious and mischievous, and will not take or knowingly administer any harmful drug. I will do all in my power to maintain and elevate the standard of my profession, and will hold in confidence all personal matters committed to my keeping and all family affairs coming to my knowledge in the practice of my calling. With loyalty will I endeavor to aid the physician in his work, and devote myself to the welfare of those committed to my care.

Obviously, the choice of these Nurses was a morally difficult one if they knew their employment might be jeopardized. They decided to uphold their own Oath, and now they will pay the price to Administrators who fail to understand that both patient care and bottom line economics share one decision. The three Nurses were right.

People who stand by their morals, even when risk is real, are Heroes.

AARP Texas Vote News Alert; Hutchison, Cornyn Vote to Block Senate Decision

Giving Medicare Power to Negotiate Lower Drug Prices
AARP Texas - Wed, 18 Apr 2007

AUSTIN, Texas, April 18 /PRNewswire/ -- Despite the support of a majority of the U.S. Senate and nearly 90 percent of surveyed Texans, Senators Kay Bailey Hutchison and John Cornyn voted to block consideration of legislation that would give Medicare the power to bargain for lower prescription drug prices -- S.3, The Medicare Fair Prescription Drug Price Act of 2007.

Similar legislation, H.R. 4, passed the U.S. House of Representatives earlier this year.

TEXAS VOTED TO BLOCK S.3 GIVING MEDICARE THE POWER TO BARGAIN FOR LOWER PRESCRIPTION DRUG PRICES John Cornyn X Kay Bailey Hutchison X

"Working Texans were poorly represented today in the U.S. Senate on this all
important issue," said AARP-Texas State Director Bob Jackson. "Score one for the pharmaceutical industry and the power of their lobby."

Jackson said the bill would have put downward pressure on Medicare drug prices. Given the overwhelming support in both Texas and the U.S. for giving Medicare the power to negotiate, he said AARP will continue working so that the will of the people will eventually be heard.

"We are particularly disappointed with Sen. Hutchison's vote as this is a reversal from her previous vote in support of negotiating drug prices. Nearly 11,000 Texans called her offices and another 1,400 sent e-mails or faxes urging her to support the bargaining for lower prescription drug prices," said Jackson.

David Sloane, AARP Director of Government Relations, added: "Pharmaceutical manufacturers have given more than $20 million in campaign contributions for the last two cycles alone. They followed that up over the last few months with misleading polling and disinformation aimed at scaring older Americans into preserving the exorbitant profits that pharmaceutical companies make on brand name drugs. Senators should know this issue is not going away. No amount of campaign money can trump the will of 90 percent of Americans."

AARP notified the 110th Congress that it was tracking roll call votes on key legislation important to its 38 million members, and reporting the outcomes of these votes back to its members. "We believe people make the right choices when they understand the issues and position taken by their elected officials. AARP intends to ensure that its members get that information," Jackson concluded.

BACKGROUND INFORMATION: Despite the outcome in the Senate today, prescription drug affordability remains a high priority for AARP and its members. Because an overwhelming majority of Americans support S.3, AARP is confident this issue will be back. The association will continue to fight to make prescription drugs more affordable for all Americans. While millions of older Americans and persons with disabilities have been helped by Medicare Part D drug plans, more should be done to put downward pressure on drug costs. AARP will continue to support legislation that would allow Americans to safely and legally import lower-priced prescription drugs from abroad, and legislation to help bring generic drugs to market sooner, including generic versions of biologic therapies. AARP is also working to pass legislation that would reduce the asset test that prevents low-income people from qualifying for extra help under the Medicare drug program.

AARP is a nonprofit, nonpartisan membership organization that helps people 50+ have independence, choice and control in ways that are beneficial and affordable to them and society as a whole.