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The Right to Health and Information

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An interesting article is written by Trudo Lemmens and Candice Telfer titled “Access to Information and the Right to Health: The Human Rights Case for Clinical Trials Transparency,” which appeared in the 2011 issue of the American Journal of Law and Medicine (vol. 38, pages 63-112). In the article the authors argue that information about clinical trials should be recognized as a fundamental component of the right to health. The authors make a mention of two controversies in recent years. The first is of GlaxoSmithKline and its use of the antidepressant Paxil for treatment of depression in the pediatric population. In 2004, the Attorney General of New York prosecuted GSK for allegedly hiding negative data, selective publishing of positive data, and use of skewed publications to promote off-label prescriptions. The second case is the mention of Vioxx in which the … Read more

Defense Expenses and their role in Medical Malpractice Claims

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An interesting article titled “The Impact of Defense Expenses in Medical Malpractice Claims” written by Aaron E. Carroll, Parul Divya Parikh, and Jennifer L. Buddenbaum appears in the Spring 2012 issue of the The Journal of Law, Medicine & Ethics (vol. 40, issue 1, pages 135-142). The authors state “Multiple factors go into the determination of medical professional liability insurance premiums including return on investments, reinsurance costs, claims frequency, average amount paid out on malpractice claims, defense expenses, and administrative costs such as underwriting expense. These factors all interact with each other and, in general, evidence exists that each of these factors has played a role in the escalating cost of medical professional liability insurance.” The authors go on to describe tort reform efforts and state “These reform efforts include caps on damages, abolition of punitive damages, eliminating mandatory prejudgment interest, … Read more

Oral Surgeon Investigated for Reusing Needles and Syringes

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The Colorado Department of Public Health has released a lengthy document regarding an oral surgeon regarding unsafe injections. The document is from July 20, 2012, and is located over at http://www.cdphe.state.co.us/dc/Epidemiology/dentistFAQs.pdf. The document states: “Between September 1999 and June 2011, syringes and needles were re-used for multiple patients to give intravenous (IV) medications, including sedation. The IV medications were given during oral and facial surgery procedures. Needles and syringes were used repeatedly, often for days at a time. Because there can be a small amount of blood that remains in syringes and needles after an injection through an IV line, there is a risk of spread of bloodborne viruses, such as HIV, hepatitis B, and hepatitis C, between patients.” Patients who saw the oral surgeon in question were sent a mailing if they could be identified via medical records and … Read more

Third Molars (aka Wisdom Teeth): Kandasamy vs White and Proffit

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Like usual there are often heated exchanges over the management of wisdom teeth (third molars). Back in November 2011, in the American Journal of Orthodontics and Dentofacial Orthopedics (vol. 140, issue 5)  there was an exchange regarding two previous articles that had appeared and consequent exchange (White RP Jr, Proffit WR. Evaluation and management of asymptomatic third molars: lack of symptoms does not equate to lack of pathology. Am J Orthod Dentofacial Orthop 2011;140:10-6; and Kandasamy S. Evaluation and management of asymptomatic third molars: watchful monitoring is a low-risk alternative to extraction. Am J Orthod Dentofacial Orthop 2011;140:11-7) The articles in question I am referring to here are “Third molars” by Raymond P. White, Jr, and William R. Proffit in the American Journal of Orthodontics and Dentofacial Orthopedics (vol. 140, issue 5, pages 600-601) and Author’s response by Sanjivan Kandasamy … Read more

Review of the Wisdom Behind Third Molar Extractions

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Back in 2009, an article titled  The wisdom behind third molar extractions” by “S Kandasamy and DJ Rinchuse appeared in the Australian Dental Journal (54. pages 284-292. 2009) I discussed some of the provocative comments in this article in the post Bringing About Healthcare Change. To reiterate he states “…in the 21st century, the routine removal of asymptomatic pathology- free third molars has become a dated practice that is rapidly running out of valid excuses, and it has no justification in contemporary dentistry and medicine.” Earlier this year an article titled “Patient Specific Variables are a Consideration in the Decision to Extract Asymptomatic Third Molars” by Katerine W. L. Vig appeared in the J Evid Base Dent Pract. (2012 12 pp. 92-94) The conclusion of this article is “The removal of third molars to avoid lower incisor crowding is not justified. … Read more