The following article is taken from the Houston Chronicle regarding the devastation experienced from the massive explosion in the city of West between Waco and Hillsboro, Texas. Click here to read the article and view additional pictures from the aftermath of this tragedy.

Investigators confirm ammonium nitrate led to West blast

But cause of fire preceding explosion still unknown

By Dug Begley | May 6, 2013 | Updated: May 6, 2013 8:38pm

A stockpile of ammonium nitrate at a fertilizer plant in West was the source of a deadly April 17 explosion, investigators said Monday.

The cause of the fire that preceded the explosion, however, remains undetermined.

Rachel Moreno, a spokeswoman for the Texas fire marshal’s office, confirmed that ammonium nitrate was stored in bins at the blast point, in a building that also included an office.

“We know (the fire) started in that building,” Moreno said, “but not in the bin.” The building was built in the 1960s, she said, although exact details of its construction were unavailable.

The explosion killed 14 people, mostly firefighters and others who rushed to contain the fire and evacuate nearby residents. Officials have focused on a 93-foot-wide crater at the site of the explosion. The fire also broke out in that vicinity.

Fire alone cannot cause ammonium nitrate, a chemical commonly used to make fertilizer, to explode. The investigation continues into other factors, such as intense pressure or extreme heat, that may have contributed.

The post Ammonium Nitrate, the cause for the blast in West appeared first on News Updates.

The following from the Texas Tribune, reports that a San Antonio woman is caught between the errors of medical staff and Texas legislation referred to as “tort reform” resulting in a punitive back-fire for seeking compensation for her losses. Read the following article by the Texas Tribune’s Becca Aaronson, dated January 25, 2013.

Despite Counsel, Amputee Hindered by Tort Laws

When Connie Spears arrived at a Christus Santa Rosa hospital emergency room in 2010 with severe leg pain, she told medical staff about her history of blood clots. Doctors sent her home with a far less serious diagnosis.

Days later, swollen and delusional, Spears was taken by ambulance to another hospital where doctors found a severe clot and extensive tissue damage. With her life on the line, they amputated both of her legs above the knee.

Nearly three years later, Spears says she is a victim not only of a medical mistake but also of Texas’ tort reform laws.

The massive tort reform package that Texas lawmakers approved in 2003 capped noneconomic damages a plaintiff can receive for medical malpractice at $250,000 and set a “willful and wanton” negligence standard — interpreted as intentionally harming the patient — for emergency care. It also required plaintiffs to find a practicing or teaching physician in the same specialty as the defendant to serve as an expert witness, and to demonstrate evidence of negligence ahead of a trial. Under the strengthened rules, if plaintiffs fail to produce adequate expert reports within 120 days of filing their cases, they are liable for defendants’ legal fees.

Spears said the laws obstructed her ability to find a malpractice lawyer and forced a judge to order her to pay thousands of dollars to cover some defendants’ legal bills.

Her lawyers plan to challenge the constitutionality of the laws.

“How can that law be?” Spears asked. “Maybe the law was too loose before, but they went way too far the other way.”

Tort reform proponents say that such restrictions are the only way to curb frivolous lawsuits against health care providers, and that they have drawn more medical professionals to a state with exploding population growth.

“Our purpose had never been to have a procedural hurdle,” said Mike Hull, a lawyer for the pro-tort-reform Texas Alliance for Patient Access. “It had been to have the plaintiffs really get the case reviewed.”

For two years, Spears struggled to get legal representation, because several lawyers said they feared her case did not meet Texas’ new negligence standards. Justin Williams, a Corpus Christi lawyer who eventually took the case, said he believed it was so strong it might challenge the state’s tort reform laws. “Her life has basically been ruined by all of this, and there was just no way I could turn her down,” he said.

But the case fell apart under the new expert witness rules. After the first attempt at an expert witness report failed to identify the proper defendants, Williams said, he was unable to find another expert witness in a time frame that would satisfy Texas’ requirements.

Tina York, an attorney for Christus Santa Rosa, said it is unusual for a case to get dismissed because of problems with an expert witness report. The rules are in the statute, she said, to weed out plaintiffs who “can’t legally support their claim” from the beginning.

York said Christus Santa Rosa did not pursue compensation for its legal fees out of sympathy for Spears. But Spears said other defendants in the case had. With her retirement savings tapped and her husband out of work, she is afraid they will lose their home.

The post Amputee Faces Hospital Legal Fees After Seeking Losses appeared first on News Updates.

Over a year ago, Johnson & Johnson announced a new head of their orthopedics division claiming a fresh start after recalls of their hip replacement. New information surfaces about the new head of orthopedics, Andrew Ekdahl, who is tied to the development and promotion of the failed implant in ways that raise questions about Johnson & Johnson’s choice for the position.

The following article is take from the New York Times, reported by Barry Meier on January 30, 2013.

During Trial, New Details Emerge About Hip Maker

When Johnson & Johnson announced the appointment in 2011 of an executive to head the troubled orthopedics division whose badly flawed artificial hip had been recalled, the company billed the move as a fresh start.

But that same executive, it turns out, had supervised the implant’s introduction in the United States and had been told by a top company consultant three years before the device was recalled that it was faulty.

In addition, the executive also held a senior marketing position at a time when Johnson & Johnson decided not to tell officials outside the United States that American regulators had refused to allow sale of a version of the artificial hip in this country.

The details about the involvement of the executive, Andrew Ekdahl, with the all-metal hip implant emerged Wednesday in Los Angeles Superior Court during the trial of a patient lawsuit against the DePuy Orthopaedics division of Johnson & Johnson. More than 10,000 lawsuits have been filed against DePuy in connection with the device — the Articular Surface Replacement, or A.S.R. — and the Los Angeles case is the first to go to trial.

The information about the depth of Mr. Ekdahl’s involvement with the implant may raise questions about DePuy’s ability to put the A.S.R. episode behind it.

Asked in an e-mail why the company had promoted Mr. Ekdahl, a DePuy spokeswoman, Lorie Gawreluk, said the company “seeks the most accomplished and competent people for the job.”

On Wednesday, portions of Mr. Ekdahl’s videotaped testimony were shown to jurors in the Los Angeles case. Other top DePuy marketing executives who played roles in the A.S.R. development are expected to testify in coming days. Mr. Ekdahl, when pressed in the taped questioning on whether DePuy had recalled the A.S.R. because it was unsafe, repeatedly responded that the company had recalled it “because it did not meet the clinical standards we wanted in the marketplace.”

Before the device’s recall in mid-2010, Mr. Ekdahl and those executives all publicly asserted that the device was performing extremely well. But internal documents that have become public as a result of litigation conflict with such statements.

In late 2008, for example, a surgeon who served as one of DePuy’s top consultants told Mr. Ekdahl and two other DePuy marketing officials that he was concerned about the cup component of the A.S.R. and believed it should be “redesigned.” At the time, DePuy was aggressively promoting the device in the United States as a breakthrough and it was being implanted into thousands of patients.

“My thoughts would be that DePuy should at least de-emphasize the A.S.R. cup while the clinical results are studied,” that consultant, Dr. William Griffin, wrote.

A spokesman for Dr. Griffin said he was not available for comment.

The A.S.R., whose cup and ball components were both made of metal, was first sold by DePuy in 2003 outside the United States for use in an alternative hip replacement procedure called resurfacing. Two years later, DePuy started selling another version of the A.S.R. for use here in standard hip replacement that used the same cup component as the resurfacing device. Only the standard A.S.R. was sold in the United States; both versions were sold outside the country.

Before the device recall in mid-2010, about 93,000 patients worldwide received an A.S.R., about a third of them in this country. Internal DePuy projections estimate that it will fail in 40 percent of those patients within five years; a rate eight times higher than for many other hip devices.

Mr. Ekdahl testified via tape Wednesday that he had been placed in charge of the 2005 introduction of the standard version of the A.S.R. in this country. Within three years, he and other DePuy executives were receiving reports that the device was failing prematurely at higher than expected rates, apparently because of problems related to the cup’s design, documents disclosed during the trial indicate.

Along with other DePuy executives, he also participated in a meeting that resulted in a proposal to redesign the A.S.R. cup. But that plan was dropped, apparently because sales of the implant had not justified the expense, DePuy documents indicate.

In the face of growing complaints from surgeons about the A.S.R., DePuy officials maintained that the problems were related to how surgeons were implanting the cup, not from any design flaw. But in early 2009, a DePuy executive wrote to Mr. Ekdahl and other marketing officials that the early failures of the A.S.R. resurfacing device and the A.S.R. traditional implant, known as the XL, were most likely design-related.

“The issue seen with A.S.R. and XL today, over five years post-launch, are most likely linked to the inherent design of the product and that is something we should recognize,” that executive, Raphael Pascaud wrote in March 2009.

Last year, The New York Times reported that DePuy executives decided in 2009 to phase out the A.S.R. and sell existing inventories weeks after the Food and Drug Administration asked the company for more safety data about the implant.

The F.D.A. also told the company at that time that it was rejecting its efforts to sell the resurfacing version of the device in the United States because of concerns about “high concentration of metal ions” in the blood of patients who received it.

DePuy never disclosed the F.D.A. ruling to regulators in other countries where it was still marketing the resurfacing version of the implant.

During a part of that period, Mr. Ekdahl was overseeing sales in Europe and other regions for DePuy. When The Times article appeared last year, he issued a statement, saying that any implication that the F.D.A. had determined there were safety issues with the A.S.R. was “simply untrue.” “This was purely a business decision,” Mr. Ekdahl stated at that time.

The post Questions Arise Regarding Handling of Defective Hip Replacement appeared first on News Updates.

One producer of peanut butter who supplies many food stores is linked to several salmonilla outbreaks and resultant recalls. FDA orders plant production to be suspended. People from 20 states have been affected by salmonilla linked to food product from this single source. This is the first instance of the FDA using its newly granted power to shut down a facility as granted by the Food Safety Modernization Act. Read this article posted by Schuyler Velasco, Staff writer for  The Christian Science Monitor, November 27, 2012.

FDA shuts down peanut butter factory after salmonella recalls

The FDA has suspended production at Sunland, Inc. after batches of the manufacturer’s peanut butter was linked to a widespread salmonella outbreak and led to an expansive recall of Sunland nut products. The shutdown marks the first time the FDA has used new shutdown powers granted by the Food Safety Modernization Act.

Nearly two years ago, President Obama signed a bill into law giving the Food and Drug Administration the authority to shut down food producers in the name of public health. Monday, the FDA wielded that power for the first time.

The agency has suspended production at Sunland, Inc., a large manufacturer of peanut butter, nut spreads, and hundreds of other nut-based products distributed in grocery stores throughout the United States. The company has issued ever-widening recalls of its wares throughout the fall, starting with peanut butter and growing to include 240 products sold at grocery stores nationwide.

Peanut butter produced by the New Mexico-based facility was linked to a widespread salmonella outbreak that sickened 41 people in 20 states. That,  “coupled with Sunland’s history of violations led FDA to make the decision to suspend the company’s registration,” the FDA’s statement on the shutdown reads.

Sunland’s troubles started in September, when the FDA issued a limited recall of certain batches of Trader Joe’s brand Valencia Creamy Salted Peanut Butter Made With Sea Salt. The recall expanded in subsequent weeks to include everything that came out of Sunland’s nut butter production facility between March 1, 2010 and September 24, 2010.

The FDA launched an investigation, and a review of the company’s records found salmonella in 11 batches of product over a span of three years: between June 2009 and December 2012. Sunland distributed products in spite of these findings, the FDA contends.

“Between March 2010 and September 2012, at least a portion of 8 product lots of nut butter that Sunland Inc.’s own testing program identified as containing Salmonella was distributed by the company to consumers,” the FDA statement reads.

“Additionally, during its inspection of the plant in September and October 2012, the FDA found the presence of Salmonella in 28 environmental samples (from surfaces in production or manufacturing areas) and in 13 nut butter product samples and one product sample of raw peanuts.”

Then on Monday, the FDA suspended Sunland’s Food Facility Registration, prohibiting the company from distributing food until it 1) requests an informal hearing from the FDA, and 2) takes corrective measures to make its facilities safer. “The FDA will reinstate Sunland, Inc.’s registration only when the FDA determines that the company has implemented procedures to produce safe products.”

“Consumers can be assured that products will not leave this facility until we determine they have implemented preventive measures that are effective to produce safe products,” Michael Taylor, the FDA’s deputy commissioner for foods, told the Associated Press.
The FDA’s power to halt production comes from the Food Safety Modernization Act, signed into law by President Obama on Jan. 4, 2011. The law required food handlers and distributors to register with the FDA and maintain food safety records. It also gave the FDA the power to suspend registration if a company’s products had a “reasonable probability” of posing health risks to consumers. Before, the FDA would have to go through court to suspend a registration.

You can find the expansive list of recalled Sunland products on the FDA’s website. Customers with affected products should throw them away or return them to stores for a full refund.

The post Extensive Salmonilla Recalls Spur Plant Shut Down appeared first on News Updates.

The following report from Bloomberg Businessweek informs us how study after study, all over the world, demonstrates health hazard caused by exposure to ultra violet rays produced by tanning booths, beds, etc. Any exposure to UV rays causes a weakening of the immune system spurring susceptibility to all types of cancer, especially to the three main forms of skin cancer including the number one danger, melanoma. Read the entire report below posted by  Jason Gale on December 03, 2012.

Teenage girls trading the risk of deadly melanoma for a year-round tan have helped spur a global backlash against the sunbed industry.

Health officials from Brasilia to Sydney are banning tanning salons amid evidence that they cause malignant lesions. Use of tanning beds causes all three types of skin cancer, especially for people younger than 25 years, a study published in October from the University of California, San Francisco said.

Doctors say the research, published in the British Medical Journal, should prompt tougher warnings on ultraviolet radiation-emitting tanning machines. The salons support $5 billion in U.S. annual economic activity, according to the Food and Drug Administration. In May, Vermont followed California, banning teens under 18 from indoor tanning. In Europe, laws prohibiting teens from tanning beds have been enacted in 22 countries, 18 of them since 2009. Age limits in Australia may have forced the closing of a third of sunbed operators there.

“We’re seeing an uptick in melanoma cases and deaths among young women,” said J. Leonard Lichtenfeld, deputy chief medical officer with the Atlanta-based American Cancer Society. “Are we going to look back in 15-20 years from now and wish we’d been more forceful about moving this process forward?”

The FDA has been reviewing its classification of tanning beds since 2010. The machines are subject to general controls such as establishment registration requirements and quality system regulation, Michelle Bolek, a spokeswoman said.

Important Issue

“This is an important public health issue and we’re committed to providing consumers with an update soon on the agency’s next steps on tanning bed regulation,” she said.

For the moment, however, the FDA ranks tanning machines as class-I devices– as safe to use, in other words, as elastic bandages. Few other health groups share that position. The World Health Organization’s International Agency for Research on Cancer in 2009 added ultraviolet radiation from tanning machines to a danger category of carcinogens that includes radon and plutonium.

Indoor tanning before age 35 increases the risk for melanoma by 75 percent, the U.S. Centers for Disease Control and Prevention said in a report in May.

Brazil banned cosmetic tanning three years ago. Two Australian states have enacted legislation to ban salons by 2015 and a third plans to introduce a similar bill within months.

Royal Philips Electronics NV (PHIA), Europe’s largest maker of medical equipment behind Siemens AG (SIE), was a major supplier of products for UV tanning until recently. The Amsterdam-based company discontinued its product portfolio between 2009 and 2010, said Jeannet Harpe, a spokeswoman for Philips Lighting.

‘More Tainted’

“The business is becoming more and more tainted as the evidence becomes clearer,” said Craig Sinclair, head of the WHO’s Collaborative Centre for UV Radiation in Melbourne.

The number of indoor tanning operators in the city plunged 67 percent since a law in 2008 restricted access to adults 18 years and older. Shutting down solariums completely would avoid one in six melanomas in Australians ages 18 to 29, according to Victoria state’s Cancer Council.

At Body Bronze, a chain of 22 salons in Melbourne, a casual 8-minute session in a tanning bed costs A$15 ($16), while a package of 50 sessions goes for A$450, according to a pricelist available at an outlet in Prahran, an inner-city suburb.
Every day in the U.S., tanning beds are used by more than 1 million people, mostly Caucasian women ages 16 to 29, according to the American Academy of Dermatology. Of the 28 million Americans who go to a tanning salon at least once a year, 2.3 million are teens.

Beating Mother Nature

More than 3.5 million skin cancers in 2 million people are diagnosed annually in the U.S., according to the academy, a doctors group in Schaumburg, Illinois. This year, 81,240 melanoma cases will be diagnosed and 12,190 people will probably succumb to the malignancy, the American Cancer Society estimates. Women have a 1 in 377 chance of melanoma by age 39. For men, it’s 1 in 677.

Ninety percent of all skin cancers are associated with radiation exposure mainly from the sun, according to the International Skin Cancer Foundation in New York. The use of tanning beds compounds the impact of sun exposure because the radiation they emit is stronger than the long-wave UVA and shortwave UVB rays that reach the earth naturally.

UVA output from indoor tanning devices is four times higher and UVB output is twice as high as noon sunlight in Washington D.C. during summer, the CDC said in its May report.

“Every bit of extra UV exposure increases risk,” said Bruce Armstrong, professor of public health at the University of Sydney.

Burn Capital

Both types of radiation can weaken the immune system, increasing vulnerability to cancer as well as to other diseases, according to a study in the British Medical Journal in July. Tanning lamps induce the types of DNA damage to the skin associated with cancer, the researchers said.

“Each person has a certain amount of capital that protects them from cancer,” said Beatrice Secretan, a scientist at the WHO’s cancer-research agency. “If you burn that capital too quickly, you are in danger of developing cancer. The lighter the skin, the more at risk you are.”

A 2010 survey found 5.6 percent of American adults had used indoor tanning in the previous 12 months. Use was highest among young white women, with almost one in three in the 18-to-25- year-old age group having tanned indoors during the prior year. A 2010 study of 1,167 melanoma cases in Minnesota found indoor tanning use was common among 63 percent of patients.

Squamous Cell Carcinoma

Catherine Olsen, a senior research officer with the Queensland Institute of Medical Research in Brisbane, Australia, reviewed the research in the British Medical Journal in October in which scientists analyzed pooled data from 12 studies and found exposure to indoor tanning increased the risk of developing squamous cell carcinoma by 67 percent and basal cell carcinoma by 29 percent.

The so-called meta-analysis yielded “irrefutable” evidence that sunbeds caused all three types of skin cancer, not just the most aggressive one known as melanoma, she said.

The emerging research on the harm from indoor tanning is beginning to resonate in the U.S., where in cities such as San Diego, sunbed salons outnumber Starbucks Corp. (SBUX) coffee outlets and McDonald’s Corp. restaurants. Thirty-three U.S. states have laws restricting access to indoor tanning under a certain age — typically 14, 16 or 18 years, the CDC said in May.

“It’s a hodge-podge across the United States,” said Martin Weinstock, chief of dermatology at the Providence VA Medical Center in Rhode Island.

‘Political Power’

“The tanning industry does have a lot of a money and, apparently, political power,” said Weinstock, who is chairman of the American Cancer Society’s skin cancer advisory committee. “Though they don’t have much in the way of scientific argument, they do their best to obfuscate.”

One example came earlier this year after researchers at England’s Leeds Institute of Molecular Medicine wrote a letter to the editor of the International Journal of Cancer in June saying they had found no statistically significant evidence that sunbeds increase melanoma risk in a study. The research wasn’t designed to register a small association between the two, only a large one, said co-author Timothy Bishop, chairman of the Leeds Cancer Research UK Centre.The Tanning Shop, a U.K. chain of 80 salons, responded to the findings by releasing a statement hailing “definitive results from clinical research” that proved “there is no link between sunbed use and melanoma.”

The Leeds researchers don’t support that interpretation of their findings, said Bishop, adding that he was “extremely disappointed” with the way the study had been portrayed.

Conflicting reports mean “there’s still the perception out there that it’s safer” to tan in a salon, according to Olsen from the Queensland Institute of Medical Research. “But it’s not the case at all.”

The post Research Worldwide Shows Tanning Beds Present Risk of Cancer appeared first on News Updates.

Federal Agents from the Food and Drug Administration raided the NECC (New England Compounding Center) which is linked to the recent outbreak of meningitis in several states. Fifteen are dead and hundreds sickened. Read the following article from Reuters’ Greg McCune as news floods the media about this serious health incident.

New England Compounding Center, Pharmacy Tied To Meningitis Outbreak, Raided By Feds

The post Meningitis Death Toll at 15 – Company Under Intense Scrutiny appeared first on News Updates.

Some local pharmacies offer compounding services to meet special needs of patients. However, some pharmacies are acting as miniature drug companies replicating products already available on the market to compete with large pharmaceutical companies. This has created an element of risk that is talked about in this Editorial from the New York Times which calls on Congress to enact legislation to give increased regulatory power to the F.D.A. This health risk is responsible for repeated incidents such as the recent outbreak of meningitis and thousands who were exposure to tainted steroids. Read below:

Editorial

Out-of-Control Compounding of Drugs

Published: October 9, 2012
The meningitis outbreak that has sickened at least 119 people and killed 11 of them has laid bare a disturbing lack of regulatory oversight of pharmacies that mix drug compounds and ship them around the country. Unless Congress passes legislation to strengthen the hand of the Food and Drug Administration, the public will continue to be at risk from contaminated products.

The outbreak has been linked to a steroid made by the New England Compounding Center in Framingham, Mass., that was shipped to 23 states. The steroid was almost certainly contaminated by a fungus, although final laboratory results are not yet in. Some 13,000 patients may have had the tainted steroid injected near their spines to ease back or neck pain. The center has shut down, surrendered its license and recalled all of its products, not just the steroids, while state and federal investigations try to pin down exactly what went wrong.
How could this happen? As Denise Grady, Andrew Pollack and Sabrina Tavernise explained in The Times, these pharmacies fall into a legal no man’s land between the Food and Drug Administration and 50 state pharmacy boards, most of which have little expertise and limited resources to ensure the safety of these products.
Years ago, compounding pharmacies were small-scale operations that mixed ingredients to meet the special needs of patients who couldn’t take the standard drugs, perhaps because they were allergic to a particular ingredient or couldn’t swallow a pill and needed a liquid form instead. Such pharmacies still exist, often inside a hospital, where they custom-make mixtures in accord with prescriptions written by the patients’ doctors.
Over the past decade or more, however, some pharmacies have morphed into miniature drug companies that compete with big pharmaceutical firms and produce compounds that essentially mirror drugs already on the market. Doctors and hospitals have turned to these pharmacies because their prices are often much lower than those charged by major manufacturers or because the standard drugs are in short supply.
Therein lies an element of risk. Compounded drugs have not gone through the same rigorous tests for safety and effectiveness required of standard drugs and are not made in plants inspected by the F.D.A. to ensure good manufacturing practices. There have been several incidents in recent years in which compounded drugs have caused injury. Some critics complain that the F.D.A. and state regulators should have intervened in this case sooner and more forcefully, which may well be true. But conflicting court decisions have left unclear what powers the F.D.A. has to regulate these pharmacies.
Congress can and should clarify matters with legislation. The legislation ought to grant the F.D.A. any powers it thinks it needs to inspect compounding pharmacies, monitor their nationwide sales and judge the safety or effectiveness of their products. It should also empower the F.D.A. to block pharmacies from making drugs (such as injectable steroids) that require a higher degree of sterility than many of them can meet. The goal is to ensure that there are no further calamities in this lightly regulated market.

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For vehicle owners who have had their airbags serviced during the past three years at repair facilities other than new car dealerships, the Obama Administration suggests taking their cars to have their airbags inspected to be certain they are safe. This is termed an “extreme safety risk” as some airbags are failing to deploy and in some cases exploding on deployment with flying debris and shrapnel. Please read this article from the Asssociate Press dated October 9, 2012.

By JOAN LOWY, Associated Press

WASHINGTON (AP) — Thousands of motorists may be driving cars and trucks installed with dangerous counterfeit bags and they should have them replaced at their own expense, the Obama administration warned Wednesday.

Most at risk are motorists who have had their airbags replaced over the past three years by a repair shop other than a new car dealership, the National Highway Traffic Safety Administration officials said.

Only 0.1 percent of the U.S. vehicle fleet — about 250,000 cars on the road — are makes and models for which counterfeit airbags are known to be available, NHTSA said. Auto industry officials briefed by the agency said they were told that tens of thousands of car owners may be driving vehicles with counterfeit airbags.

In government tests last month of 11 counterfeit bags, 10 didn’t inflate or failed to inflate properly. In one test, a counterfeit bag shot flames and shards of metal shrapnel at a crash dummy instead of inflating, said NHTSA Administrator David Strickland, who showed a video of the test at a news conference.

“It is an extreme safety risk,” he said.

NHTSA is asking car owners to check a government website, www.Safercar.gov, for information on how to contact auto manufacturer call centers to learn if their vehicle model is among those for which counterfeit airbags are known to have been made.

No deaths or injuries have been tied to the counterfeit bags, NHTSA said. But it’s unclear whether police accident investigators would be able to identify a counterfeit bag from a genuine one, industry officials said.

About 1.5 million airbags are deployed each year in police-reported tow-away crashes, Clarence Ditlow, executive director of the Center for Auto Safety, said.

“Airbags save several thousands of lives annually. But they can’t save lives if they have not been repaired properly,” he said.

NHTSA has compiled a list of dozens of vehicle makes and models for which counterfeit airbags may be available, but the agency cautioned that the full scope of the problem isn’t clear yet and the list is expected to “evolve over time.”

If a car model is on the list and has had its airbags replaced during the past three years by a repair shop other than a new car dealership, NHTSA is asking owners to take the vehicle into a dealership or repair shop to be inspected at their own expense to determine whether the replaced airbags are counterfeit.

Fees for checking out airbags — a complex and technical process — could run between $100 to $200, said Bailey Wood, a spokesman for the National Automobile Dealers Association, said. The cost of replacing a driver’s side center column airbag is $750 to $1,000, he said. Other airbags may be more, he said. Some types of cars have as many as eight airbags.

The problem isn’t the result of a manufacturing defect by automakers and isn’t a recall, NHTSA and industry officials said.

“The bad actor here is the counterfeiters,” Wood said. “Because of that, the cost to have an airbag evaluated and possibly replaced is going to be borne by the consumer.”

The counterfeit bags typically look like airbags made by automakers and usually include a manufacturer’s logo. Government investigators believe many of the bags come from China, an industry official said.

The bags are marketed to auto repair and body shops as the real deal, industry officials said. Auto dealerships that operate their own body shops are usually required by their franchise agreements to buy their parts, including airbags, directly from automakers and therefore are unlikely to have installed counterfeit bags, industry officials said.

But only 37 percent of auto dealers have their own body shops, according to the automobile dealers association. Many consumers whose vehicles have been damaged are referred by their insurance companies to auto body shops that aren’t affiliated with an automaker.

Consumers who bought replacement airbags online or who have purchased a used car that may have its airbags replaced in the past three years were also asked to check NHTSA’s list.

Counterfeiting of a wide variety of auto parts has long been a well-known problem, industry officials said. But recent incidents have escalated concern by government officials. In August, federal agents confiscated nearly 1,600 counterfeit airbags and arrested a North Carolina auto mechanic, according to a report by the Charlotte Observer. The mechanic was tied by federal officials to another counterfeit airbag case last year in Tennessee, the report said.

Dai Zhensong, a Chinese citizen, pleaded guilty and was sentenced in federal court in Chattanooga, Tenn., last February to 37 months in prison for trafficking in counterfeit airbags, according to a statement made at the time by the U.S. Attorney’s Office.

Zhensong was a part owner and manager of the international department of Guangzhou Auto Parts, which made a variety of auto parts, many of which were counterfeit, the statement said. In 2010, he traveled from China to Chattanooga to sell additional counterfeit airbags and other auto parts.

The counterfeit airbags were manufactured by purchasing genuine auto airbags that were torn down and used to make molds to produce the counterfeit bags. Trademark emblems were purchased through Honda, Toyota, Audi, BMW and other dealerships located in China and affixed to the counterfeit airbags. The airbags were advertised on the Guangzhou Auto Parts website and sold for approximately $50 to $70 each, far below the value of an authentic airbag, the statement said.

About 2,500 counterfeit airbags have been seized by law enforcement authorities so far this year, John Morton, director of U.S. Immigration and Customs Enforcement, told reporters. Investigations are under way in several locations around the country, and further arrests and seizures are expected, he said.

Copyright © 2012 The Associated Press. All rights reserved.

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The New York Times’ writer Anahad O’Connor tells the story of complications due to oversights of surgical teams when all surgical objects aren’t accounted for after their job is done. Read these stories of foreign objects sent home with recovering patients and the troubles that follow…

On an overnight shift in 2005, Sophia Savage, a nurse in Kentucky, felt a crushing pain in her abdomen and started vomiting.

The next day she underwent a CT scan, which led to a startling diagnosis: A surgical sponge was lodged in her abdomen, left behind, it turned out, by a surgeon who had performed her hysterectomy four years earlier.

Ms. Savage’s doctor ordered immediate surgery to remove the sponge.

“What they found was horrific,” Ms. Savage said. “It had adhered to the bladder and the stomach area, and to the walls of my abdominal cavity.”

The festering sponge had spread an infection, requiring the removal of a large segment of Ms. Savage’s intestine. She sued the hospital where the hysterectomy had taken place, and in 2009 she won $2.5 million in damages. But the award has been appealed, and her life has been in tatters. Suffering from severe bowel issues and unable to work, Ms. Savage, 59, has been racked by anxiety and depression. Most days, she said, she cannot bring herself to leave home.

“I never dreamed something like this would happen to me,” she said.

Every year, an estimated 4,000 cases of “retained surgical items,” as they are known in the medical world, are reported in the United States. These are items left in the patient’s body after surgery, and the vast majority are gauzelike sponges used to soak up blood. During a long operation, doctors may stuff dozens of them inside a patient to control bleeding.

Though no two cases are the same, the core of the problem, experts say, is that surgical teams rely on an old-fashioned method to avoid leaving sponges in patients. In most operating rooms, a nurse keeps a manual count of the sponges a surgeon uses in a procedure. But in that busy and sometimes chaotic environment, miscounts occur, and every so often a sponge ends up on the wrong side of the stitches.

In recent years, new technology and sponge-counting methods have made it easier to remedy the problem. But many hospitals have resisted, despite the fact that groups like the Association of Operating Room Nurses and the American College of Surgeons have called on hospitals to update their practices.

As a result, patients are left at risk, said Dr. Verna C. Gibbs, a professor of surgery at the University of California, San Francisco.

“In most instances, the patient is completely helpless,” said Dr. Gibbs, who is also the director of NoThing Left Behind, a national surgical patient safety project. “We’ve anesthetized them, we take away their ability to think, to breathe, and we cut them open and operate on them. There’s no patient advocate standing over them saying, ‘Don’t forget that sponge in them.’ I consider it a great affront that we still manage to leave our tools inside of people.”

All sorts of tools are mistakenly left in patients: clamps, scalpels, even scissors on occasion. But sponges account for about two-thirds of all retained items.

When balled up, soaked in blood and tucked inside a patient, a 4-by-4-inch cotton sponge is easy to miss, especially inside large cavities. Abdominal operations are most frequently associated with retained sponges, and surgeons are more likely to leave items in overweight patients.

Hospitals traditionally require that members of a surgical team, usually a nurse, count — and then recount, multiple times — every sponge used in a procedure. But studies show that in four out of five cases in which sponges are left behind, the operating room team has declared all sponges accounted for.

Now hospitals have a more technological approach at their disposal. They can track sponges through the use of radio-frequency tags. In a study published in the October issue of The Journal of the American College of Surgeons, researchers at the University of North Carolina at Chapel Hill looked at 2,285 cases in which sponges were tracked using a system called RF Assure Detection. Every sponge contained a tiny radio-frequency tag, about the size of a grain of rice. At the end of an operation, a detector alerts the surgical team if any sponges remain inside the patient. In the U.N.C. study, the system helped recover 23 forgotten sponges from almost 3,000 patients over 11 months.

Created by a thoracic surgeon at Weill Cornell Medical Center in New York, the RF Assure system adds about $10 to the cost of a procedure, roughly the cost of a single suture used in surgery.

“It’s a small price to pay to enhance patient safety,” said Dr. Leo R. Brancazio, the medical director of labor and delivery at Duke University Hospital in North Carolina, which adopted the RF Assure system about 18 months ago, after a sponge was left inside a patient during a Caesarean delivery. “It’s one extra step that takes 12 seconds at the end of a procedure.”

Another tracking system relies on bar code technology. Every sponge receives a bar code, which is scanned before use and scanned again as it is retrieved.

Electronic tracking can be a safety net when manual counting fails. Yet nationwide, fewer than 1 percent of hospitals employ it, said Dr. Berto Lopez, an obstetrician-gynecologist and the chief of the safety committee at West Palm Hospital in West Palm Beach, Fla.

Dr. Lopez became an advocate for electronic tracking after he was sued in 2009 for leaving a sponge inside a patient — an error that occurred, he said, after two nurses assured him that all sponges had been accounted for. He now refuses to operate in any hospital that does not use electronic tracking.

“When something bad happens to you, you get religion,” he said. “I’ve been rampaging ever since this happened. You study the subject, and you realize that this happens to a lot of people.”

Dr. Lopez, who said he had no financial interest in tracking systems, said that even though radio-frequency tracking is relatively cheap, many hospitals do not want the added expense.

“In my heart, I think it comes down to hospitals not wanting to spend the 10 bucks,” he said.

But Dr. Gibbs, of NoThing Left Behind, said technology should be only an adjunct to manual counting. Some hospitals now use inexpensive “counter bags” that resemble the shoe storage bags that hang from closet doors. Each sponge has its own compartment. If a compartment is empty at the end of an operation, a nurse can see that a sponge is missing. Then, Dr. Gibbs said, an electronic tracking system can help find the missing sponge.

At the same time, she added, sponge counts should not be the sole responsibility of nurses: Everyone in an operating room must share accountability. Surgeons can tell nurses where sponges are being placed, for example, and conduct thorough wound exams to look for sponges before stitching up a patient.

“Technology is but an aid,” Dr. Gibbs said. “The way that safety problems are corrected and fixed is by changing the culture of the O.R.”

The post Tools and Supplies Left Behind After Surgery appeared first on News Updates.

Errant euthanasia of pets will be reviewed by the Texas Supreme Court for “sentimental damages”, i.e. valuation beyond the replacement price of the pet. Please read this interesting article from the Fort Worth Star Telegram’s Elizabeth Campbell. Springer Lyle will post any updates to the court’s decisions as this case progresses.

By Elizabeth Campbell of the Fort Worth Star Telegram

Texas Supreme Court will hear case regarding sentimental value of pets lost due to errant euthanasia.

The Texas Supreme Court will weigh in on a case to determine whether pet owners can claim damages for the sentimental value rather than the market value of their animals.

Last week, the state’s highest civil court agreed to hear oral arguments after a former Fort Worth animal shelter employee appealed a landmark ruling out of the 2nd Court of Appeals in Fort Worth that said owners can claim sentimental value for their deceased pets, overturning a 120-year-old state Supreme Court decision stating that a person can only sue for the market value of a pet.

The case is being watched by animal advocates, pet product manufacturers and veterinary groups, said Randy Turner, an attorney who is representing a Fort Worth family who sued the animal shelter employee after their dog, an 8-year-old Labrador mix named Avery, was mistakenly euthanized three years ago.

“Veterinarians are terrified of this case. They think it’s going to result in huge jury verdicts and skyrocketing malpractice insurance premiums,” Turner said.

Controversial ruling

John Cayce, an attorney and retired chief justice of the Fort Worth appeals court who is representing the former animal shelter employee, Carla Strickland, in her appeal, said pet owners can already sue for reasonable damages if their animal is killed accidentally.

“The lower court ruling expands the law for pet owners to recover unlimited emotional damages, which is more than someone can recover for a parent or grandparent,” Cayce said.

Cayce said the Fort Worth appeals court ruling would also have a “devastating” effect on the economy, forcing veterinarians to pay more for malpractice insurance and pet owners to pay more for vet visits.

Although dogs are beloved companions, Cayce wrote, “They should not be placed into this intimate familiar category as a matter of public policy.”

Because cities are generally immune from lawsuits, the former shelter employee was sued. However, the Texas Supreme Court ruled that government employees can also claim immunity in most cases.

Turner said Texans can sue for sentimental value on property from photos to their grandmother’s wedding veil, and that it does not make sense to exclude pets.

“A pet is the most sentimental piece of property you own,” he said. “You can recover the sentimental value of the photo of your dog, but not the dog,” Turner said.

Mistakenly euthanized

The debate over whether a the loss of a pet falls under sentimental value began when Avery escaped from Kathryn and Jeremy Medlens’ back yard during a thunderstorm.

The next day, Jeremy Medlen went to the animal shelter to get his dog, but found out he had to pay $80 in order for the shelter to release Avery. Medlen didn’t have the cash on hand but was told he could come back to claim Avery.

He returned to the shelter the next day, but matters were complicated even more when he learned that a veterinarian would have to implant a microchip in Avery’s ear.

A “hold for the owner” sign was placed on the dog’s cage to prevent the dog from being put down.

But when Medlen returned to the shelter with money to claim Avery, he learned that his pet had been euthanized by mistake.

The Medlens could not be reached for comment.

Initially, their lawsuit was dismissed in a Tarrant County civil district court because the family sued for the sentimental value and not the market value of their dog, but the Medlens appealed, and the Fort Worth appeals court issued its ruling in favor of the family.

“Dogs are unconditionally devoted to their owners,” the appeals court ruling stated. “We interpret timeworn Supreme Court law to acknowledge that the special value of man’s best friend should be protected.”

Elizabeth Campbell,

817-390-7696

The post Sentimental Value of Pets to be Heard by Texas Supreme Court appeared first on News Updates.