HEPATITIS C OUTBREAK IN VEGAS AFFECTING 40,000--OUT OF NEGLIGENT PRACTICES

So today we learn that there is a Hepatitis C outbreak that has been caused by the Endoscopy Center of Nevada, putting 40,000 at risk. If you have ever met someone with a severe case of hepatitis C, you know that what they are going through is literally a fight for their life. At times they are walking dead. Hepatitis C damages the liver. It is important to know that 80% of people with the disease do not have symptoms. In those who do, symptoms may not appear for 10-20 years, or even longer. Even then, the symptoms usually come and go and are mild and vague. Unfortunately, by the time symptoms appear, the damage may be very serious. What went wrong in Vegas will not stay in Vegas. Look for major legal fallout.


* A minority of people have symptoms during the early acute phase of the infection. These symptoms typically develop 5-12 weeks after exposure to HCV. Some people describe the symptoms as being flulike. The symptoms may last a few weeks or months.

o Nausea
o Vomiting
o Diarrhea
o Loss of appetite
o Fatigue
o Pain over the liver (on the right side of the abdomen, just under the rib cage)
o Jaundice - A condition in which the skin and the whites of the eyes turn yellow
o Dark-colored urine (may look like cola or tea)
o Stools become pale in color (grayish or clay colored)

* Prolonged nausea and vomiting can cause dehydration. If you have been vomiting repeatedly, you may notice the following symptoms:

o Fatigue or weakness
o Confusion or difficulty concentrating
o Headache
o Not urinating
o Irritability

* Chronic hepatitis C can lead to cirrhosis of the liver in many people, a condition traditionally associated with alcoholism. Cirrhosis is a condition in which healthy liver tissue is replaced by fibrous tissue, followed by scarlike hardening. As this happens, the liver gradually begins to fail, or lose its ability to carry out its normal functions. Eventually, symptoms develop. Symptoms of cirrhosis include the following:

o Fluid retention causing swelling of the belly (ascites), legs, or whole body
o Persistent jaundice
o Fatigue
o Disturbances in sleeping
o Itchy skin
o Loss of appetite, weight loss, wasting
o Vomiting with blood in the vomit
o Mental disturbances such as confusion, lethargy, extreme sleepiness, or hallucinations (hepatic encephalopathy)


THE LAS VEGAS SUN REPORTS THE STORY HERE:

Endoscopy Center of Southern Nevada doctors Sanjay Nayyar, left, and Clifford Carrol flank fellow doctor Eladio Carrera as he reads a statement during a news conference at the health district Wednesday, February 27, 2008. The Southern Nevada Health District is notifying about 40,000 former patients of the Endoscopy Center of Southern Nevada that they may have been exposed to hepatitis C.

Southern Nevada Health District officials announced today they have identified six cases of hepatitis C, five of which stemmed from procedures occurring on the same day that involved anesthesia at the Endoscopy Center of Nevada.

Following a joint investigation with the Nevada State Bureau of Licensure and Certification (BLC) and with consultation from the Centers for Disease Control and Prevention, the health district determined that unsafe injection practices related to the administration of anesthesia medication might have exposed patients to the blood of other patients.

The health district is recommending 40,000 patients who had procedures requiring injected anesthesia at the clinic between March 2004 and January 11, 2008, contact their primary care physicians or health care providers to get tested for hepatitis C as well as hepatitis B and HIV.

And here is the company’s response:

On behalf of the Endoscopy Center of Southern Nevada, we want to express our deep concern about this incident to the many patients who have put their trust in us over the years. As always, our patients remain our primary responsibility and we have already corrected the situation.

The recent events related to the Southern Nevada Health District study mark the first time anything like this has ever happened at our facility. We have already taken steps to ensure that it will never happen again.

The health district began its investigation in January, and we have been fully cooperating with them. We were officially notified by the health district on February 6, 2008 and submitted our detailed Plan of Correction on February 15, 2008. All concerns noted by the health department were addressed immediately. We continue to work closely with the Southern Nevada Health District and other health agencies during this ongoing review. We want to be sure that every patient who may have been exposed is informed and tested.

To help us with these issues, we have engaged the services of nationally renowned experts who have extensive epidemiological experience and that have worked closely with the Centers for Disease Control in the past. They include Dr. Janine Jason, CEO of Jason and Jarvis Associates. She is a Harvard Medical School-trained physician, epidemiologist, and immunologist who served as a medical scientist and senior epidemiologist at the Centers for Disease Control and Prevention and was on the Emory Medical School faculty for 23 years prior to becoming a private consultant. Dr. Jason has authored more than a hundred peer-reviewed medical and epidemiologic scientific articles.

In addition to our corrective actions, we are on a mission to maintain the trust our patients have had in us during our years of service to southern Nevada.

We wish to emphasize that the actual risk of anyone being affected by this is extremely low, but as a precaution, anyone who has undergone procedures at the Endoscopy Center who required anesthesia should be tested.

As I’m sure you understand this situation brings with it a number of complex elements including patient privacy and regulatory guidelines. At this time, our counsel has asked that we limit our comments to this statement, and we are unable to take questions.

Thank you.

CORRECTION: Earlier this blog said “Health officials say that practitioners were routinely using the same syringe on more than one patient, which is widely known to pass on infection.” Actually, the same syringe was not being used on multiple patients. But single dose vials of medication, which had become infected through their initial use, were being used again. Health officials say this is widely known to pass infection.

More Lantern, Less Bus in the Ditch

History in the United States is short and still moving outward. It is still being written as it expands. I knew a couple of my Great Grandmothers growing up. They were born in the late 1800's. Their parents were alive when Lincoln was President. My Great, Great, Grandfather was alive during the War of 1812. His father saw the birth of our nation.

One of my favorite places to visit is Boston. Not only is it where my oldest daughter Laura lives and attends college, it is where you can walk into living spaces that played and still play out a roll in the founding of our country. Take Christ's Church, better known as the Old North Church, for instance. This is where a young twenty-three year-old Episcopal Sexton, named, Robert Newman, had been directed by Paul Revere and the Sons of Liberty, to climb the tall steeple where he briefly hung two burning lanterns, signaling the direction independence would take. It was by water. Newman climbed a narrow dark stairwell to reach the top. Liberty demands as such. Once the two lanterns were lit, his friends across the Charles River in Lexington and Concord, readied themselves as they knew the British regulars were coming by boat as opposed to marching by land.

It may be an over simplification, but as I understand it, an argument had arisen between the Crown and its colonial subjects over who would represent the voice of the people. Would it be a distant Parliament separated by an ocean or left to the various individual legislatures found in the colonies at that time? The Crown took a hard position because it was powerful and felt it was the best parent for a rebellious child. In fact, Great Britain was the most powerful country at that time. There would be no negotiation. Ben Franklin was sent to England over a period of several years to work a compromise on behalf of the various individual colonies to try to keep the Empire together. After hitting his head against a wall, even he, perhaps one of the greatest minds of the last 400 years, saw the futility of trying to work a solution with the deaf Crown.

What ultimately happened was a revolt. But not in the sense of what has been or would become a revolution as we have seen in other parts of the world. No, it was a revolution of a very slow burn--one, that some would argue, still continues today. Slow was its genius. It gave time for the people to awaken and be touched by the light of liberty that was burning. It gave time to lighten the darkness. This slow paced revolution continues in our founding document the Constitution. It has the component of Federalism, reserving certain rights to the states. The boundaries are meant to be discussed and constantly shift. It is not meant to be an absolute rigid measuring stick. It's soft and malleable to avoid breakage. Different people will interpret it differently. There is no black and white. There are checks and balances.

People are born with the potential to make a difference if they involve themselves in the flow of the revolution. It is not the end that matters. It is the progress of the process. Although the lanterns of the night only burned a short while so not to be given away to the enemy, that light is still expanding out into the dark night.

The Silly Season

Plagiarize : to steal and pass off (the ideas or words of another) as one's own (Merriam-Webster Dictionary).

I think I must have plagiarized sometime today. I don't keep track, but that's the point. I know I said something to my friend at lunch. I know I spoke to my office mate. Not too long ago, I read the book "Mayflower" by Nathaniel Philbrick. Being excited to tell someone about Bradford's wife, being so distraught, due to her young child being left behind in England (after being told to do so by her overbearing husband) that she jumped to her death into the icy waters below once it anchored of the Cape; and that it was clear to me that the Mayflower Compact was a forerunner to the U.S. Constitution and the Declaration of Independence in that it provided limited government, I think I forgot to give the author of "Mayflower" credit. But then again, were did he get that idea? Then again, where did Thomas Jefferson get his idea?

By Jefferson's own admission, the ideas contained in the Declaration of Independence were commonly expressed throughout the 17th and 18th centuries. I remember studying about Locke and Hobbes in College and seeing that much of what Jefferson said was lifted to some degree. John Adams claimed that Jefferson also borrowed from Samuel Adams. I'm surprised John Adams didn't claim he wrote it. Perhaps they were friends. I recently learned that the Scottish philosophers in the 17th and 18th century probably came up with just about everything. The Irish undoubtedly will be shocked to hear this since they saved civilization in a time when the Romans were failing and medieval Europe was on the rise. Ireland had monks that liked to copy down everything. Oh, and then you can't forget the Dutch and their Oath of Abjuration. It basically discusses the idea of a people's right to denounce and overthrow their leaders should they fail to respect the people's laws and traditions. I got that from Wikipedia. Thomas Paine's pamphlet, Common Sense had in it the line, "life, liberty, and the pursuit of property," as well as the line, "the pursuit of happiness."

So here's the deal: Sometime along time ago when language began, someone said something. It was overheard and someone else liked it. They repeated it. After a few mellenia I repeated it in some from. I apologize that I can't remember her name so as to give her credit. I think it was Ilene. Nonetheless, I didn't mean not to give her credit. Don't get me wrong, if someone is guilty of copyright infringement or if they pass off an idea or analysis as their own without giving proper credit they should be held accountable. Politics, inherently, is nothing but a form of plagiarism. We take something that has hopefully worked in the past and, with a few minor changes, appropriate it and call it our own. The Mayflower and it's passengers mattered. The People watching them from behind the forest cover mattered. Words matter. I think I just plagiarized again. I'm sorry.

Just Being There

Don't ask where this idea comes from. Sometimes I'm of the impression that we are not the source of an idea. The idea exists in and of itself. We are just the receptacles of that thought. If we are open to it, it will arrive. If it arrives, it's up to us to listen to it.

There seems to be the thought that being first at something is the preferred method. It is entrenched in our psyches from birth, whether it's little league sports, being the head of the class or making the most money. It is the pursuit to get ahead at all cost no matter what. You can find it at home, at work, on the ski slopes and on CNN as you watch certain candidates and their spouses this season.

In this Machiavellian model, to progress to an end result at any cost, to achieve more knowledge, more power, more this, more that, we ultimately lose. We lose ourselves. Sometimes taking a breath and doing nothing is the best thing to do. Sometimes getting in your car and taking a scenic drive while listening to Rachmaninov, Shostakovich, Chopin, Miles, or Bill Evans is the best thing you can do. But the reality is, is that the people that get this already do this. And most likely the ones that don't are at this very moment thinking of ways to get on top. Their egos, or lack thereof, don't allow just being there--being in the moment. In my experience, there is no top.

My son is just 16 years old. The fact is, is that he will be a better musician than I am. He has a better temperament than I do. He is gifted with balance. Being first is not that important to him. He's more interested in clarity and understanding. For him happiness will come more easily as he is a better container for bliss. He plays in a band that occasionally asks me to play back-up percussion. I add "color" or so they say. I've learned I don't mind being second fiddle. It gives you the opportunity to look around and observe what's going on around you. It gives you more time to step back and contemplate what your part is and how you can best contribute to the whole.

You need that down time, you need to have a place to go and think. If all you are doing is trying to catch up and ultimately win--whatever that is-- you will most likely miss the point of what the universe is trying to whisper to you. If you want to see a person and what they stand for you have to understand what it is they are doing when no one is watching them. Hard to do, but for yourself.

Perhaps that's why there is a Camp David. Perhaps that's why Lincoln had a cottage that he would ride to about 3 miles North of Washington, D.C. As he rode to that Victorian cottage to find refuge, he would have undoubtedly seen the scores of Union troops encamped for a cause he believed deeply in, a cause to which thousands were dying and would continue to die. Quietly, and by himself, and away from the confusion of the White House he drew up the plans of how to unite a divided country, mourn the death of his son Willie, and dream up the Emancipation Proclamation. He understood the necessity of space and just being there.

Nationwide Recall of Beef being Fed to Our Children

The USDA has ordered the Nation's Largest Beef Recall. Based on what I'm reading and hearing don't be surprised if the Fed's don't bring additional criminal charges against the company Westland/Hallmark. If they don't, they're not doing there job. People should be outraged. Is it not outrageous that food not fit for human consumption is being fed to our children at school? What group of money focused idiots thought this would be a good idea and would go unnoticed? It also clearly calls into question what our government is doing about inspection. Obviously the inspection program at the USDA is soundly asleep at the wheel while our kids are eating beef from sick "downer" cattle. Yet another reason to write your member of congress and tell them to stop hearings that are a waste of time (see blog on Clemens below) and do something for our nations food supply.

Here's the story:

AP Greg Risling
Posted: 2008-02-17 22:31:57

LOS ANGELES (Feb. 17) - The U.S. Department of Agriculture on Sunday ordered the recall of 143 million pounds of frozen beef from a California slaughterhouse, the subject of an animal-abuse investigation, that provided meat to school lunch programs.

In what officials said was the largest beef recall in U.S. history, the Department of Agriculture on Sunday ordered the recall of 143 million pounds of frozen beef from a California slaughterhouse that provided meat to school lunch programs. The recall will affect beef products that came from the Westland/Hallmark Meat Co.
Officials said it was the largest beef recall in the United States, surpassing a 1999 ban of 35 million pounds of ready-to-eat meats. No illnesses have been linked to the newly recalled meat, and officials said the health threat was likely small.

The recall will affect beef products dating to Feb. 1, 2006, that came from Chino-based Westland/Hallmark Meat Co., the federal agency said.

Secretary of Agriculture Ed Schafer said his department has evidence that Westland did not routinely contact its veterinarian when cattle became non-ambulatory after passing inspection, violating health regulations.

"Because the cattle did not receive complete and proper inspection, Food Safety and Inspection Service has determined them to be unfit for human food and the company is conducting a recall," Schafer said in a statement.

A phone message left for Westland president Steve Mendell was not immediately returned.

Federal officials suspended operations at Westland/Hallmark after an undercover Humane Society video surfaced showing crippled and sick animals being shoved with forklifts.

Two former employees were charged Friday. Five felony counts of animal cruelty and three misdemeanors were filed against a pen manager. Three misdemeanor counts — illegal movement of a non-ambulatory animal — were filed against an employee who worked under that manager. Both were fired.

Authorities said the video showed workers kicking, shocking and otherwise abusing "downer" animals that were apparently too sick or injured to walk into the slaughterhouse. Some animals had water forced down their throats, San Bernardino County prosecutor Michael Ramos said.

No charges have been filed against Westland, but an investigation by federal authorities continues.

Officials estimate that about 37 million pounds of the recalled beef went to school programs, but they believe most of the meat probably has already been eaten.

"We don't know how much product is out there right now. We don't think there is a health hazard, but we do have to take this action," said Dr. Dick Raymond, USDA Undersecretary for Food Safety.

Most of the beef was sent to distribution centers in bulk packages. The USDA said it will work with distributors to determine how much meat remains.

Federal regulations call for keeping downed cattle out of the food supply because they may pose a higher risk of contamination from E. coli, salmonella or mad cow disease because they typically wallow in feces and their immune systems are often weak.

About 150 school districts around the nation have stopped using ground beef from Hallmark Meat Packing Co., which is associated with Westland. Two fast-food chains, Jack-In-the-Box and In-N-Out, said they would not use beef from Westland/Hallmark.

Jack in the Box, a San Diego-based company with restaurants in 18 states, told its meat suppliers not to use Hallmark until further notice, but it was unclear whether it had used any Hallmark meat. In-N-Out, an Irvine-based chain, also halted use of the Westland/Hallmark beef. Other chains such as McDonald's and Burger King said they do not buy beef from Westland.

Raymond countered a claim leveled by Humane Society President and CEO Wayne Pacelle, who said a USDA inspector was at the Westland plant for about two hours each day. USDA inspectors are there at slaughterhouses "continuously," Raymond said.

Federal lawmakers on Thursday had called for the Government Accountability Office to investigate the safety of meat in the National School Lunch Program.

Upon learning about the recall, some legislators criticized the USDA, saying the federal agency should conduct more thorough inspections to ensure tainted beef doesn't get to the public.

"Today marks the largest beef recall in U.S. history, and it involves the national school lunch program and other federal food and nutrition programs," said U.S. Sen. Tom Harkin, chairman of the Chairman of the Senate Committee on Agriculture, Nutrition and Forestry. "This begs the question: how much longer will we continue to test our luck with weak enforcement of federal food safety regulations?"

Advocacy groups also weighed in, noting the problems at Westland wouldn't have been revealed had it not been for animal right activists.

"On the one hand, I'm glad that the recall is taking place. On the other, it's somewhat disturbing, given that obviously much of this food has already been eaten," said Jean Halloran, director of food policy initiatives at Consumers Union. "It's really closing the barn door after the cows left."

Associated Press writer Jacob Adelman contributed to this report.

Sesame Seeds and Salmonella

The FDA just sent out the following press release regarding Nutri-Foods Organis Sesame Seeds due to possible salmonella contamination.

Recall -- Firm Press Release

FDA posts press releases and other notices of recalls and market withdrawals from the firms involved as a service to consumers, the media, and other interested parties. FDA does not endorse either the product or the company.
Nutri-Foods Recalls "Organic Sesame Seeds Natural - Unhulled" Because of Possible Health Risk

FOR IMMEDIATE RELEASE -- February 15, 2008 -- Nutri-Foods, Inc. ("Nutri-Foods") of Royal Oak, Michigan, is recalling its .50 pound packages of "Organic Sesame Seeds Natural - Unhulled" due to possible salmonella contamination, an organism, which can cause serious and sometimes fatal infections in young children, frail or elderly people, and others with weakened immune systems. Healthy persons infected with Salmonella often experience fever, diarrhea (which may be bloody), nausea, vomiting, and abdominal pain. In rare circumstances, infection with Salmonella can result in the organism getting into the bloodstream and producing more severe illness such as arterial infections (i.e., infected aneurysms), endocarditis and arthritis.

The recalled "Organic Sesame Seeds Natural - Unhulled" were sold at Nutri-Foods.

The product comes in a .50 pound clear plastic package with a product SKU #170 at the top and a "packed on" date of December 28. This product was sold from circa December 15, 2007 through January 28, 2008.

No illnesses have been reported to date in connection with this problem.

Production of the product has been suspended while the FDA and manufacturer of the product continue their investigation.

Write Congress and Tell Them You Don't Care About Roger Clemens' Injections in His Backside!

How much did we as taxpayers pay today to watch Roger Clemens and his former physical therapist talk before a committee of Congress to discuss whether the PT injected him with steroids and human growth hormone? Based on my experience, it was well into the seven figures. Here's a thought: Why doesn't Congress focus on what "we the people" sent them to do? Enact legislation and pass bills that help the economy, build bridges, roads, dams, schools, healthcare, pollution, global warming, poverty, etc, etc, etc.

Here's something you can do: The FDA recently published a report on the need to partner with Congress to make the changes necessary to transform the safety of the nation's food supply. They call it the Food Safety Plan. The Plan recommends legislative changes to strengthen the FDA's ability to continue to protect Americans from foodborne illnesses. In part, the plan will:

Authorize FDA to Accredit Highly Qualified Third Parties for Voluntary Food Inspections.
Require New Reinspection Fee From Facilities That Fail to Meet current Good Manufacturing Practices (cGMPs)
Authorize FDA to Require Electronic Import Certificates for Shipments of Designated High-Risk Products
Require New Food and Animal Feed Export Certification Fee to Improve the Ability of U.S. Firms to Export Their Products
Provide Parity Between Domestic and Imported Foods if FDA Inspection Access is Delayed, Limited, or Denied
RESPOND Rapidly to Minimize Harm.
Empower FDA to Issue a Mandatory Recall of Food Products When Voluntary Recalls Are Not Effective
Give FDA Enhanced Access to Food Records During Emergencies

See the full Plan here: http://www.fda.gov/oc/initiatives/advance/food.html

Although this Plan is by no means perfect, it does put focus on a too common problem in the United States--food poisoning. The CDC estimates that 76 million foodborne illness, or food poisoning, cases occur in the United States every year, which means that one in four Americans contract a foodborne illness annually after eating foods contaminated with such pathogens as E. coli O157:H7, Salmonella, Hepatitis A, Campylobacter, Shigella, Norovirus, and Listeria. Approximately 325,000 people are hospitalized with a diagnosis of food poisoning, and 5,000 die. The estimated costs in terms of medical expenses and lost wages or productivity are between $6.5 and $34.9 billion (Buzby and Roberts, 1997; Mead, et al., 1999).

Now ask yourself, why do "we the people" care about Roger Clemens and his injections? Write your member of Congress and tell them how you feel about it and, why you're at it, tell them you want a few things to change or you will vote them out. Then they will have plenty of time for America's favorite past-time--just make sure the hot dog is cooked and hot when you get it.