Posts Tagged ‘HIPAA’

“No, Your Medical Records Are Not Private”

HIPAA or no HIPAA, a variety of government agencies might get a look at your personal medical records. “HIPAA allows federal bureaucrats to get patient records merely by issuing administrative subpoenas, or civil investigative demands.” The records may also find their way into the hands of private lawyers, such as those representing qui tam relators under the False Claims Act. “‘Everybody’s got horror stories for what happens when the relators get into their stuff,’ said Jonathan Diesenhaus, a former DOJ senior trial lawyer who now represents health care companies as a partner with the Hogan Lovells law firm, to TheDCNF. ‘It becomes an avenue for abuse.'” [Kathryn Watson, Daily Caller]

Medical roundup

  • Surprised this story of interstate lawsuit exposure hasn’t had national coverage: “Texas docs threaten to stop seeing New Mexico patients” [Hobbs, N.M., News]
  • More on the Daraprim episode and the fiasco of FDA generic-drug regulation [Watchdog, earlier here and here] More: Ira Stoll/N.Y. Sun;
  • Warrants, HIPAA be damned: Drug Enforcement Administration agents pose as Texas medical board to get at patient records [Jon Cassidy/Watchdog, Tim Cushing/TechDirt via Radley Balko]
  • Litigation finance and champerty: the reaction is under way [MathBabe, earlier on pelvic and transvaginal mesh surgery speculation]
  • No longer alas a surprise to see JAMA Pediatrics running lame, politicized content on topics like “youth gun carrying” [Jacob Sullum]
  • “Shame, blame, and defame”: in alcohol regulation as in other public health fields, government-funded research can look a lot like advocacy [Edward Peter Stringham, The Hill]
  • More adventures in public health: study finds dry counties in Kentucky have bigger problems with methamphetamine [Christopher Ingraham, Washington Post “WonkBlog”]

Medical roundup

  • Med mal something of a regional problem: nearly half of payouts are in Northeast, with New York alone paying out more than the entire Midwest [New Jersey Civil Justice Institute on Diederich Healthcare analysis] “Neurosurgeons were 50% more likely to practice defensive medicine in high-risk states compared with low-risk states” [Smith et al., Neurosurgery via NJCJI]
  • New Paul Nolette book on state attorneys general Federalism On Trial includes history of suits led by New York’s Eliot Spitzer to redefine as “fraud” widely known drug-pricing practices that Congress had declined to ban or otherwise address. The resulting lucrative settlements also earmarked money to fund private critics of the pharmaceutical industry;
  • City of Chicago signs on to one of the trial bar’s big current recruitment campaigns, suits seeking recoupment of costs of dealing with prescription opioid abuse [Drug & Device Law; earlier here, here, here]
  • We here in Washington, D.C. take very seriously any violations of HIPAA, the health privacy law. Just kidding! If a union supporter pulls information from an employee medical database to help in an organizing drive, that might be overlooked [Jon Hyman on National Labor Relations Board administrative law judge decision in Rocky Mountain Eye Center]
  • “Preferred Care defendants respond to New Mexico Attorney General’s lawsuit, argue it was filed at urging of Cohen Milstein law firm” [Legal NewsLine]
  • Philadelphia police run warrant checks of hospital visitor lists, and as a result many persons with outstanding warrants avoid going to hospitals. So asserts sociologist Alice Goffman in her book On the Run, but the evidence is disputed [Sara Mayeux last August, Steven Lubet in review challenging the book more broadly on ethical and factual grounds, Goffman’s response]
  • Making contraceptive pill available over the counter without prescription should please supporters of birth control access, right? Funny you should ask [Elizabeth Nolan Brown, Reason, earlier]

Medical roundup

  • Mississippi community rallies behind 88 year old doctor investigated by licensure board for practicing from his car [AP]
  • Pennsylvania: “Kill deal between Attorney General’s office and law firm, nursing homes ask court” [Harrisburg Patriot-News; earlier on AG Kathleen Kane; related on law firm of Cohen Milstein, on which earlier]
  • Hazards of overwarning in the wired hospital: “2,507,822 unique alarms in one month in our ICUs, the overwhelming majority of them false.” [Robert Wachter, Medium]
  • JAMS arbitrator, a retired California Supreme Court judge, resists subpoena seeking explanation of settlement allocation decisions among Prempro clients of Girardi Keese [National Law Journal; see also from way back]
  • Reports of VA-scandal retaliation raise question: do all the HIPAA laws in the world protect us from persons in high places wishing to pry into our medical records with ill intent? [J. D. Tuccille, Reason]
  • New York Attorney General Eric Schneiderman charged that 79% of herbal supplements lacked appropriate DNA, but that claim itself turns out to be hard to substantiate [Bill Hammond, New York Daily News]
  • Nurses’ gallows humor defended against That’s-Not-Funny Brigade [Alexandra Robbins, Washington Post]

Medical roundup

  • Down comes the pediatrician’s wall of baby pictures, another HIPAA casualty [Anemona Hartocollis/NY Times, resulting letters to the editor, earlier, NPR with somewhat different slant]
  • Had the Washington Post stayed on story of Maryland health exchange fiasco, it might have held power to account [my Free State Notes]
  • FDA rules requiring that certain drugs be kept out of hands of anyone but patients may inadvertently establish monopoly for some off-patent compounds [Derek Lowe via Alex Tabarrok]
  • Richard Epstein argues Hobby Lobby right result, wrong reasoning [new Cato Supreme Court Review, more]
  • Defensive medicine: so much easier to go ahead and order the ultrasound [White Coat]
  • Fate of melanoma-scanning device and the FDA [Alex Tabarrok via Elizabeth Nolan Brown] Can agency learn from European private certification? [more]
  • Seredipitous offshoot of study on rats helped premature infants; but would this have been quite as likely to appear in HuffPo if framed as “what we owe lab-animal research” rather than “what we owe federal research”? [Sam Stein; related, first volunteer given new trial Ebola vaccine, and a hat tip to lab-animal research on that too [Wellcome, U.K.]

Yale wants you to eat a hearty meal

The internet has lit up with the story of the 20-year-old, 92-lb. history major who says she’s been battling the Yale administration over its pressure on her to eat more. [New Haven Register]. Although much of the press coverage seems unaware of the issue, it would not be surprising if changing legal pressures on universities played a role here. Efforts both regulatory and liability-driven have been under way to hold universities accountable for not preventing student suicides, and as a result, many campuses have seen a shift toward more interventionist, rules-driven policies designed to show that the institution was not standing idly by when it knew or had reason to know of early signs of self-harm. (Our file on the topic goes back a decade.) If the list of self-harm behaviors includes eating disorders, you might have a formula for interventions in which very skinny students are placed under pressure to prove they are not anorexic. Evaluating cases like the current one, of course, is difficult for outsiders because of HIPAA and other privacy laws which broadly prohibit the sharing of health-related information, even on topics of public concern.

Jahi McMath’s “routine tonsillectomy”

In the season’s highest-profile case of alleged medical negligence, 13-year-old Jahi McMath, described as suffering from sleep apnea, went in to Oakland Children’s Hospital for surgery. After the surgery she began bleeding profusely, went into cardiac arrest and suffered brain death.

A hundred press accounts have described the procedure McMath underwent as a “routine tonsillectomy.” Not so, according to Brandon Peters, M.D. at About.com:

There is a paucity of known facts in this situation. The family and their lawyer have released few specific details. Oakland Children’s Hospital, bound by the privacy restrictions of the Health Insurance Portability and Accountability Act (HIPAA), has offered even less. Jahi underwent three surgical procedures for the treatment of her sleep apnea. This included a tonsillectomy, uvulopalatopharyngoplasty (UPPP), and removal of nasal turbinates. Though initially described as a “routine tonsillectomy,” this degree of surgery in children is not routine. It is extensive. When performed on a child, the risk is high.

More here and on uvulopalatopharyngoplasty (or “UP3”) and its indications and risks here. It should be apparent that with the sparsity of facts agreed on it is still extremely early to begin speculating what went wrong in McMath’s case and what kind of medical negligence if any might have been involved. (& Alkon)