Leisure, Lifestyle & Wellness
Popular Blood Thinner Causing Deaths, Injuries at Nursing Homes
Some facilities fail to properly oversee Coumadin. Too much can cause bleeding; too little, clots. Nursing homes are “a perfect setup for bad things happening,” one expert says 
 
This story was co-published with The Washington Post.
 
When Loren Peters arrived in the emergency room in October 2013, bruises covered his frail body, and blood oozed from his gums.
 
The 85-year-old had not been in a fight or fallen down. Instead, he had been given too much of a popular, decades-old blood thinner that, unmonitored, can turn from a lifesaver into a killer.
 
“My goodness, I’ve never seen anything like it,” recalled Lorna Finch, Peters’s daughter, of the ugly purple bruise that sprawled from the middle of her father’s stomach to his hip. “It was just awful.”
 
Peters took Coumadin at his Marshalltown, Iowa, nursing home because he had an abnormal heart rhythm, which increases the risk of stroke. It’s a common precaution, but the drug must be carefully calibrated: too much, and you can bleed uncontrollably; too little, and you can develop life-threatening clots.
 
When nursing homes fail to maintain this delicate balance, it puts patients in danger. From 2011 to 2014, at least 165 nursing home residents were hospitalized or died after errors involving Coumadin or its generic version, warfarin, a ProPublica analysis of government inspection reports shows. Studies suggest there are thousands more injuries every year that are never investigated by the government.
 
“It’s an insidious problem,” said Rod Baird, president of Geriatric Practice Management, a firm that creates electronic health records for physicians working in long-term care facilities. Because it’s so easy to get wrong, “Coumadin is the most dangerous drug in America.”
 
Nursing homes around the country are routinely cited for lapses that imperil residents, from letting those with dementia wander off to not stopping elders from choking on their food. For years, advocates, researchers and government officials have worried about the overuse of antipsychotic medications that can put elderly patients into a stupor and increase their risk of life-threatening falls. A national initiative helped reduce the use of such drugs among long-term nursing home residents by 20 percent between the end of 2011 and the end of 2014.
 
But the dangers of the widely used Coumadin have drawn relatively little scrutiny, perhaps because the drug has clear benefits. Still, improper use has caused some patients incalculable suffering and, in some cases, greatly hastened deaths.
 
Dolores Huss, an 89-year-old grandmother of eight, died from internal bleeding after a San Diego facility gave her an antibiotic that multiplies the effects of Coumadin then didn’t alert her physician that she needed additional blood tests to measure how long it was taking her blood to clot.
 
Shirley Reim, recovering from hip surgery, was hospitalized with blood clots in her legs after a Minnesota nursing home failed to give her Coumadin for 50 days in a row and also didn’t perform the blood test ordered by her doctor. She suffered permanent damage. Details of the cases come from government inspection reports and lawsuits filed by the patients’ families, which were settled confidentially.
 
Periodic inspections document hundreds of additional errors that were caught early enough to prevent serious harm, but the real toll is likely much higher, experts say.
 
A 2007 peer-reviewed study in The American Journal of Medicine estimated that nursing home residents suffer 34,000 fatal, life-threatening or serious events related to the drug each year. North Carolina data shows more medication errors in nursing homes involving Coumadin than any other drug.
 
Despite such evidence, Coumadin deaths and hospitalizations have drawn only limited attention from the Centers for Medicare and Medicaid Services, the federal agency that regulates nursing homes. Federal officials haven’t tallied Coumadin cases to see the full extent of the damage or identify common problems involving the use of the drug. Neither has the American HealthCare Association, the trade group for nursing homes.
 
The government investigates incidents like the one involving Peters that trigger complaints or surface in routine inspections. Sometimes, CMS slaps homes with “immediate jeopardy” citations, fining them and threatening to cut off federal funding if quick action isn’t taken. Villa del Sol, where Peters lived, received such a citation related to his care and was fined $33,345.
 
More commonly, though, homes are not fined and are simply asked to... Continue Reading…
 
Courtesy: ProPublica

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22 pilgrims killed in Andhra stampede
At least 22 pilgrims, mostly women, were killed and 20 others injured in a stampede during Godavari pushkaralu in Rajahmundry in Andhra Pradesh on Tuesday, officials said.
 
The tragedy occurred when a large number of pilgrims rushed towards one of the gates and tried to scale it at Kotagummam pushkar ghat on the banks of Godavari river to take the holy dip.
 
Chaos prevailed at all the three gates at the bathing ghat in Rajahmundry, a town in East Godavari district.
 
The toll may further go up as some bodies were still believed to be lying at the spot.
 
The bodies of victims were shifted to Rajahmundry government hospital. The injured were also brought to the hospital, where the condition of some of them is stated to be critical.
 
Tragedy struck couple of hours after Godavari maha pushkaralu, a once in 144-year event, began on Tuesday morning.
 
The 12-day pushkaralu, described as Kumbh mela of the south, began in both Telangana and Andhra Pradesh.
 
Chief Minister N. Chandrababu Naidu, who had a holy dip in Rajahmundry Tuesday morning, rushed to a control room to monitor the situation.
 
He appealed to people to follow queues to entry and exit points. He also requested the pilgrims to move to other ghats.
 
The failure of authorities to anticipate the huge crowds at the ghat and lack of proper arrangements to regulate the pilgrims led to the tragedy.

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SC notice on PIL for committee to appoint poll panel

A bench of Chief Justice HL Dattu, Justice Arun Mishra and Justice Amitava Roy issued notice after counsel Prashant Bhushan told the court that appointment process of the CEC and ECs needed to be made independent and free from government control

 

The Supreme Court on Monday issued notice to the central government on a PIL seeking the appointment of the chief election commissioner and election commissioners by a committee in a transparent manner, replacing the existing system of government naming them.
 
A bench of Chief Justice HL Dattu, Justice Arun Mishra and Justice Amitava Roy issued notice after counsel Prashant Bhushan told the court that appointment process of the CEC and ECs needed to be made independent and free from government control.
 
Appearing for PIL petitioner Anoop Baramwal, he told the court that a three-member committee being sought by the petitioner for the appointments should comprise the prime minister, the chief justice of India, and the leader of opposition.
 
The Law Commission, Administrative Reforms Commission and Committee on Electoral Reforms had all recommended that a broad-based selection committee be constituted for appointment of CEC and ECs, the court was told.
 
The PIL assumes significance as a constitution bench of the apex court is considering a batch of petitions whether the executive's role in NJAC compromises independence of the judiciary.
 
The court sought the government's response in this case in four weeks.

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COMMENTS

J Pinto

2 years ago

Sorry, that should read Bajrang Janata Parishad ?

J Pinto

2 years ago

According to yesterday's press reports, Amit Shah, reflecting the highest authority in the present government has indicated that they would like to stay in power for (at least?) 25 years to bring in Achche Din.

The nation should be on alert against any blatant attempt by the Bajrang-Janata Party to subvert the electoral system and destroy the democratic fabric that CON-gress respected all these years.

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