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Perils of Colonoscopy Prep, Electronic Medical Records Update, and Cold-hearted Insurers

Posted by Andrew J. Barovick | Dec 26, 2008 | 0 Comments

Nobody looks forward to a colonoscopy, but based on anecdotal evidence, the preparation is usually worse than the procedure.  Consuming large amounts of drugs that expel every last bit of waste from your colon so that your physician can get the unobstructed views necessary for the procedure is simply not fun.

But, did you know that the prep could be dangerous?  According to a May 5, 2006 FDA MedWatch Alert , a rare but serious reaction can occur when patients are given oral sodium phosphates (such as Fleet Phospho-soda or Fleet ACCU-PREP) for pre-colonoscopy bowel cleansing.  Acute phosphate nephropathy (renal failure) is a risk of the drugs, but individuals considered to have an increased risk are: the elderly, those with kidney disease or decreased intravascular volume, those using drugs that affect renal function or perfusion, ACE inhibitors, ARBs, and possibly NSAIDs.  Maybe you did not know this.  However, your doctor should know about it.  Since that alert was issued, any physician who instructed a patient in one of the risk groups to take the medications may be liable for medical malpractice, if the patient suffered kidney failure as a direct result.

More recently, the FDA announced , on December 11, 2008, that it is placing a Boxed Warning on the prescription oral sodium phosphate drugs Visicol and OsmoPrep alerting consumers to the risk of acute phosphate nephropathy.   The announcement recommended that patients no longer use over-the-counter OSPs for bowel cleansing.   (hat tip to my colleague, Thomas Valet, Esq., for alerting me to the OSP-related news)

Electronic Medical Records get a fresh, and decidedly American look in today's NY Times .  Reporter Steve Lohr  puts the spotlight on the Marshfield Clinic, in Marshfield, Wisconsin, to show how the instant accessibility of complete and regularly-updated electronic patient-care records improves the safety, and the delivery of healthcare to patients.

Mr. Lohr reports that President-elect Obama is on board with the idea of bringing further computerization to the American system of healthcare.  “Mr. Obama vowed to spend $50 billion over five years to spur the adoption of electronic health records and said recently that a program to accelerate their use would be part of his stimulus package.”

And finally, some depressing news with which to end the year.  Did you ever notice how your health insurer “loses” the claim sheets you send in, or finds nifty little ways to make sure you get little to no reimbursement for the medical procedures you need?  Well, consider yourself relatively lucky.  Or at least luckier than the family of a 17-year-old girl in California who was diagnosed with leukemia, and has since died, partly because the family's health insurer, Cigna , reportedly rejected valid claims and delayed acting on those they deemed legitimate, so that a potentially life-saving liver transplant was approved too late to do any good for the patient.  The story was reported by the AP in today's NY Times , at A-11.

Have a wonderful, safe and happy New Year.

About the Author

Andrew J. Barovick

Mr. Barovick is a graduate of Columbia College and Cardozo School of Law. He began his legal career at the Queens District Attorney’s Office, where he tried over 20 felonies to verdict, and argued an equal number of appeals before the Appellate Division, Second Department, the New York Court of Appeals and the United States Court of Appeals for the Second Circuit.


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