Editor in Chief Dr KK Aggarwal, Padma Shri Awardee
Dated: 4th June, 2019
$2.2M in medical negligence case
Clinton Herald: A Whiteside County judge has ordered a local hospital, two doctors, and a medical organization to pay $2.2 million as the result of a civil lawsuit verdict issued in May.
Whiteside County Judge Patricia Senneff on Friday entered the civil judgment totaling $2,022,195 against all named defendants, Dr. Zewdu Haile, Dr. Duncan Dinkha, Acute Care, Inc. and the Morrison Community Hospital District.
The judgment incorporates a Whiteside County jury’s verdict in favor of a 2-year-old boy who was the subject of a medical negligence lawsuit.
November 2011: The toddler sustained injuries after a physician applied a wrap to his wrist following a fall down the stairs.
Haile applied a wrap that was too tight on the child’s arm, cutting off circulation to the arm, hand and wrist and causing permanent injuries to the child.
Dinkha then failed to remove that wrap when the child was later returned to the emergency room.
Fasting may not be necessary before lipid test
In a post hoc prospective follow-up of a randomized clinical trial in which fasting and nonfasting lipid levels were measured in the same patients before randomization, researchers compared the association of each type of measurement with coronary and vascular outcomes.
The primary endpoint of the original trial, the Anglo-Scandinavian Cardiac Outcomes Trial-Lipid Lowering Arm (ASCOT-LLA), was major coronary events, defined as nonfatal myocardial infarction and fatal coronary heart disease, and participants were randomly assigned to receive atorvastatin calcium, 10 mg/d, or placebo.
The results of the current study were published May 28 by JAMA Internal Medicine.
Overall, 8,270 patients from the ASCOT-LLA were included in the current study, 6,855 of whom had no previous vascular disease. Most of the patients (82.1%) were men; the mean age was 63.4 years.
Nonfasting and fasting lipid levels were measured four weeks apart. ASCOT-LLA was terminated early after a median 3.3 years of follow-up because the risk reduction with atorvastatin calcium versus placebo was highly significant. Triglyceride levels were slightly higher in nonfasting samples than fasting samples, and cholesterol levels in both types of samples were similar.
Associations between coronary events and nonfasting lipid levels were similar to those seen with fasting lipid levels. Among all patients, adjusted hazard ratios were 1.32 per 40-mg/dL of LDL cholesterol with nonfasting levels and 1.28 for fasting levels. When patients with preexisting vascular disease were excluded, adjusted hazard ratios were 1.42 and 1.37 respectively.
Most patients in their study were white and that the inclusion criteria might limit the findings' generalizability. However, they concluded that the association with cardiovascular risk was similar with nonfasting and fasting lipid levels and that measurements of lipid levels were highly correlated with category of cardiovascular risk regardless of patients' fasting status.
Recent changes in U.S. guidelines have recommended broader adoption of nonfasting lipids for routine assessment of cardiovascular risk.
Current Temperature Status and Warning for next 24 hours
Heat Wave and Temperature Observed Yesterday (Past 24 hours from 0830 hrs IST of 03rd June to 0830 hrs IST of 04th June, 2019)
Severe Heat Wave conditions observed in many parts over West Rajasthan and at isolated pockets over Madhya Pradesh & East Rajasthan. Heat wave conditions observed at many places over Vidarbha and East Rajasthan; over some parts of Madhya Pradesh and at isolated pockets over West Rajasthan.(Annexure1-2)
Maximum Temperature more than 45.0°C were recorded in most parts over West Rajasthan; in many parts over East Rajasthan and Vidarbha; in some parts over Madhya Pradesh and in isolated pockets over Haryana, Chandigarh & Delhi.
Maximum temperature departures as on 03-06-2019: Maximum temperatures were markedly above
normal (5.1°C or more) at most places over West Rajasthan; at many places over East Rajasthan; at a few
places over West Madhya Pradesh; at isolated places over East Madhya Pradesh; appreciably above normal
(3.1°C to 5.0°C) at many places over Marathwada and Vidarbha; at isolated places over Telangana and South
Interior Karnataka; above normal (1.6°C to 3.0°C) at many places over Himachal Pradesh and Madhya
Maharashtra; at a few places over Arunachal Pradesh, Assam & Meghalaya, Jammu & Kashmir, Haryana,
Chandigarh & Delhi, Gujarat Region, Konkan & Goa Kerala and Tamilnadu, Puducherry & Karaikal. They were
markedly below normal (-5.0°C or less) at isolated places over Odisha and Chhattisgarh; appreciably
below normal (-3.1°C to -5.0°C) at many places over Bihar; at a few places over Jharkhand and Nagaland,
Manipur, Mizoram & Tripura; below normal (-1.6°C to -3.0°C) at many places over East Uttar Pradesh; at a
few places over West Uttar Pradesh, Gangetic West Bengal, Coastal Andhra Pradesh, Rayalaseema and
South Interior Karnataka and near normal over rest parts of the country.
Heat Wave Warnings for Next 24 hours (From 0830 hrs IST of 04th June to 0830 hrs IST of 05th June 2019):-
Heat Wave conditions in many parts with severe heat wave in isolated pockets very likely over East Madhya Pradesh and Vidarbha. Heat Wave conditions in some parts with severe heat wave in isolated pockets very likely over West Madhya Pradesh and West Rajasthan. Heat wave conditions in many parts over East Rajasthan and in isolated pockets over Haryana, Chandigarh & Delhi, Uttar Pradesh, Madhya Maharashtra, Marathwada, Chhattisgarh and Telangana.
Healthcare News Monitor
The Times of India- Chaitanya Deshpande
The Maharashtra Registered Pharmacists Association (MRPA) has claimed that many online shopping portals are openly selling scheduled drugs for pregnancy termination without prescription. To prove this, MRPA members across the state ordered the pregnancy termination drugs from a famous shopping website. Members from Mumbai and Pune received their orders over the past three days while a member from Nagpur received it on Monday. None of these buyers was asked for a prescription from a registered obstetrician or gynecologist, which is a must to buy these drugs. Moreover, they were given more than 20% discount on its printed price. MRPA president Kailash Tandale claimed that the international online shopping company has already stopped sales after they came to know about MRPA’s campaign. “MRPA members have receipts as well as the medicine we received from the shopping website. However, the website has taken the hint and stopped sale of this drug from June 2,” said Tandale. While a leading website has stopped sale, some small websites and online pharmacies are still selling it. While most of them insist on free pre-registration of the user, only a few of them ask to upload prescription and submit age proof.
Financial Express- Jyoti Joshi
The widespread use of antibiotics over the last 75 years has dramatically reduced illness and death due to infectious diseases. Unfortunately, their indiscriminate use has come at a grave cost, that of antimicrobial resistance (AMR)—the ability of microbes to adapt to drugs that act against them and become resistant to their effects in fighting disease, thus creating ‘superbugs’. The alarming rate at which bacteria are becoming resistant to existing antibiotics has led the WHO to identify AMR as one of the top-10 threats to global health. As per estimates, 700,000 persons die every year worldwide due to AMR and inaction in containing this menace is likely to cause, by 2050, over 10 million deaths every year, more than those caused by cancers and road accidents combined.
Business Standard- Vinay Umarji
Facilities of Cadila Healthcare Ltd. (Zydus Cadila)'s US arm, Nesher Pharmaceuticals (USA) LLC, have received 11 observations from the US Food & Drug Administration (USFDA), the Indian pharma company stated on Monday. Nesher Pharma, a 100 per cent subsidiary of Zydus Pharmaceuticals USA, saw USFDA inspection at its two facilities located at St. Louis, Missouri from May 13 to May 31, 2019. Apart from three observations at one facility and eight at another, Nesher Pharma also bagged a 'voluntary action indicated' (VAI) recommendation from the regulator, as per Cadila Healthcare's filing on BSE. "This was a product specific pre-approval inspection with general cGMP and there were no Data Integrity (DI) related observations. The company is confident of addressing these observations and responding to the USFDA at the earliest," Cadila Healthcare stated in its BSE filing on Monday.
Business Standard- PTI
Swiss pharma company Actelion Pharmaceuticals Ltd has filed a petition in a US court alleging that Natco Pharma and its US partner Syneos Health LLC are attempting to come out with generic version of its patented drug Tracleer (Bosentan) tablets for oral suspension (dispersible tablets) of 32 mg. In the petition on May 28, Actelion alleged that the Indian drugmakers proposed generic Bosentan 32 mg will infringe upon the patent and requested the court to pass an injunction order against manufacturing, importing and selling that drug in the USA.
ET Healthworld- Reuters
The U.S. Food and Drug Administration said on Monday it approved expanded use of Merck & Co Inc's antibiotic to treat hospital-acquired pneumonia in patients 18 years and older. The approval is based on the treatment's late-stage trial results, which showed that Merck's drug, Zerbaxa, was as effective as another antibacterial drug. Hospital-acquired pneumonia occurs in patients at least two to three days after being admitted or in those who are on mechanical breathing machines and have life-threatening lung infections with high mortality rates. These infections are typically treated using antibiotics, but the growing problem of antibiotic resistance has rendered some of the most commonly prescribed treatments ineffective.
ET Healthworld- Tamara Mathias
An experimental drug developed by Seattle Genetics Inc and Astellas Pharma Inc led to significant, rapid tumor shrinkage in patients with advanced bladder cancer who had been previously treated with immunotherapy and chemotherapy in a mid stage trial, according to data presented on Monday. In the 125-patient study of the drug, enfortumab vedotin, the overall response rate was 44%, meaning tumors were at least 30% smaller for those patients. That included a complete response, or no detectable cancer, for 12% of patients.
The Janssen Pharmaceutical Companies of Johnson & Johnson announced results from the phase 3 CASSIOPEIA (MMY3006) study, an Intergroupe Francophone du Myelome (IFM) study in collaboration with the Dutch-Belgian Cooperative Trial Group for Hematology Oncology (HOVON) and Janssen Research & Development, LLC, showing that the addition of Darzalex (daratumumab) to bortezomib, thalidomide and dexamethasone (VTd) before and after autologous stem cell transplantation (ASCT) resulted in deeper responses and longer progression-free survival (PFS) compared to VTd alone in patients with newly diagnosed multiple myeloma who are transplant. The data, being presented for the first time as part of an oral session at the 2019 American Society of Clinical Oncology (ASCO) Annual Meeting in Chicago, have also been simultaneously published in The Lancet. Additionally, the US Food and Drug Administration (FDA) granted Priority Review to the supplemental Biologics License Application (sBLA) for Darzalex in combination with VTd in this patient population earlier this week following the March 26 submission.
Pharmabiz- Peethaambaran Kunnathoor
Various associations of pharmacists across the country are planning to approach the Supreme Court for an order to make 'Dr' prefix only for those who successfully complete their Ph D in a subject. The associations have already taken objection to Indian Medical Association (IMA) stand against Pharmacy Council of India’s (PCI) letter to universities recommending for adding 'Dr' prefix to the names of Pharm D graduates. The associations of pharmacists will first approach the prime minister and the union health minister to resolve the dispute amicably with the medical practitioners. If the practitioners of medicine do not reach an agreement in favor of the pharmacy practitioners, the pharmacist bodies will file suit in the apex court against the demand of the medical practitioners and convince the court that Pharm D is a professional doctorate degree in pharmacy. Further, they will argue that 'Dr' prefix should be permitted to use only by Ph D holders or by any other doctoral program passed out.
Moneycontrol- Viswanath Pilla
The withdrawal of the Generalized System of Preferences (GSP) benefits by the US could have an impact of 4-5 percent on margins of Indian pharmaceutical companies exporting drugs to the country. GSP is preferential duty-free access given by developed nations to developing countries. As many as 3,500 products are eligible to get GSP concessions but India exports about 2,000 items including pharmaceuticals. “It does impact pharmaceutical, but very marginally,” said Dinesh Dua, Chairman of Pharmaceuticals Export Promotion Council (Pharmexcil) – the agency under Department of Commerce for promotion of pharmaceutical exports.
Cadila Pharma recently received the Good Laboratory Practices Certification from National Good Laboratory Practice (GLP) compliance Monitoring Authority (NGCMA), Dept. of Science and Technology, Govt. of India, for their Pre-Clinical Department after an inspection was held from 4th to 6th February 2019. This certificate is for Dholka facility which is capable of conducting toxicity studies, mutagenicity studies, and analytical and clinical testing. Certificate no. GLP/C-135/2019 was issued on 6th May 2019. GLP is a data-driven system that establishes the use of industrial chemicals, pharmaceuticals, veterinary drugs, pesticides, cosmetic products, food products, feed additives products, etc. do not pose any hazards to human health and the environment.
Exchange4media- Neeta Nair
It is his first Cannes outing as a juror but he is no new face at Cannes. His agency Medulla Communications won India its first ‘Agency of the Year’ title, and he charmed audiences last year as a speaker there along with the late Pooran Isarsingh of the ‘Last Laugh’ fame. Praful Akali, Founder & Managing Director, Medulla Communications, India is judging the Pharma Lions this year. exchange4media caught up with Akali to understand what will he be looking for in the entries, the trends that he has noticed in the Health and Pharma category and more.
The Times of India-Ishita Mishra
Activists who accompanied the 9-year-old rape survivor from Tehri to the Government Doon Medical College & Hospital (GDMCH) have alleged that the chief medical superintendent (CMS) of the hospital visited the family in an inebriated state on Sunday night while another lady doctor misbehaved with them. The Uttarakhand State Commission for Protection of Child Rights (USCPCR) took cognisance of both the allegations on Monday. “The CMS was in an inebriated state. He stood watching while the female doctor was scolding the girl and her mother. When I objected to such behaviour, she asked me to leave the hospital,” said Jabbar Singh Verma, a social activist from Tehri. The survivor’s mother also confirmed that the incident had occurred. When contacted, the CMS, Dr KK Tamta said that he has not received any complaint about such misbehaviour. “When no one has filed a complaint, how am I supposed to act?” Usha Negi, chairperson of USCPCR, said that the doctors initially admitted the girl in the labour room and moved her to the ward only after her intervention. She also said that the gynaecological ward where the victim was kept has poor arrangements. “The ward was stinking when the victim was moved. She is already suffering from trauma and this will affect her health. We have also taken note of the allegations made by the girl’s family about the doctors’ misbehaviour. We will seek reply from the hospital administration on this,” she added
The Times of India
MP minister for public health and family welfare Tulsiram Silawat has ordered an inquiry into an incident wherein a pregnant woman gave birth to a baby on floor of a government-run JP hospital, here on Monday. Silawat reached the district hospital, after receiving the information about the incident. The mother, Sujita Rathore suffered from 27 week pre-emptive delivery and gave birth to the baby on floor on the way to the labour room. Describing the incident as sad, Silawat instructed the district civil surgeon to present the full report in two days. Silawat said that arrangements should be made in hospitals, so that such incidents do not recur. The minister also met Sujita Rathore, asked about her health. Silawat instructed that the patient should be treated well and given the best possible treatment. The mother of two had arrived at the hospital with painful contractions. It was alleged that patient was not attended. Silwat also inspected OPD, pathology lab, CT Scan, X-ray and emergency wings of the hospital. The hospital OPD timings have been increased from Monday.
The Times of India - Durgesh Nandan Jha & Paras Singh
Until last year, Ram Manohar Lohia (RML) hospital used to get around 200 patients daily for anti-rabies vaccination. This number has grown manifold over the last six months and on Monday it crossed 1,000. Hospital authorities blamed the unavailability of anti-rabies vaccine at state and municipal corporation-run hospitals for this surge and said if the vaccine wasn’t made available at all centres soon, it could lead to a full-blown crisis. “There is a limit to how much we can stretch our resources,” said Dr V K Tiwary, the medical superintendent of RML hospital. At Safdarjung hospital also, which is run by the Centre, officials said there has been significant increase in the rush of patients for the vaccination. Anti-rabies vaccine is needed to prevent the development of disease in persons who have been bitten by an infected animal, say a dog. The first dose of anti-rabies vaccine has to be injected within 24 hours of the bite — the sooner the better. However, people who had queued up at RML on Monday said they had been running from one hospital to the other in search of the vaccine but to no avail.
The Times of India
The authorities of Atal Ayushman scheme sent a showcause notice to Nainital-based Brijesh Hospital for forgery and improper treatment of a patient that led to his death. The hospital has to revert within 15 days and until then it has been barred from admitting patients under the scheme. Abhishek Tripathi, director of Atal Ayushman Scheme (Uttarakhand) told TOI that a patient who was suffering from breathing difficulty and COPD was admitted to Brijesh Hospital. The doctors at the hospital were found to be lackadaisical in his treatment causing his death. The hospital also didn’t follow the ICU guidelines which is an offence. “The hospital is accused of forging reports of patients to unethically avail the monetary benefits under Atal Ayushman Scheme. The hospital was also found not treating poor patients, with ration card, for free which also violates rules,” he added. The authorities of Brijesh Hospital were issued notice to revert on why Rs 64,000 given under Atal Ayushman scheme, shouldn’t be taken back and why the hospital should not be removed from the scheme. As many as four hospitals have been fined or deempaneled from the scheme in Uttarakhand so far. Irregularities were found in as many as 10 hospitals under the scheme.
The Hindu-Bindu Shajan Perappadan
‘I am overworked’ campaign seeks to highlight unregulated duty hours and increasing cases of depression Demanding regulated working hours, and standardised working and living conditions, resident doctors across India have joined hands to start a unique campaign called - “I am overworked.” “As part of the campaign, the doctors will be wearing a band/badge with these words while doing their duty. There will be no strike or gathering but a silent appeal to the Union Health Minister Dr. Harsh Vardhan, who is a physician and knows exactly the stress and pressure resident doctors are under while working in India. We hope that justice will be done,’’ said ex-president of resident doctors’ association, All India Institute of Medical Sciences (AIIMS) Dr. Harjit Singh Bhatti. The campaign, meanwhile, is aimed at “highlighting the issues of unregulated duty hours, poor working and living conditions and increasing number of depression and suicides among resident doctors in the country,” noted the group of doctors.
Business Standard- IANS
The Supreme Court on Monday stayed a Madras High Court order that had permitted the demolition of five floors of a private hospital in Chennai. The hospital authorities had allegedly violated the approved building plan for the eight-storey building. The High Court had ordered the demolition to begin from June 16. A vacation bench comprising Justices Indu Malhotra and M.R. Shah on Monday also directed Billroth Hospitals Ltd to refrain from using the top five floors of the building for any activity. The Supreme Court issued notice and sought a reply on the issue from the Tamil Nadu government.
The New Indian Express-PTI
Three senior doctors of a civic-run hospital, arrested for allegedly abetting the suicide of a junior colleague by harassing and making casteist remarks against her, Monday approached a sessions court for bail. The three doctors -- Hema Ahuja, Bhakti Mehere and Ankita Khandelwal -- all attached to the B Y L Nair Hospital in South Mumbai, were arrested last week on charges of abetment to suicide of their junior colleague, Dr Payal Tadvi. After Tadvi ended her life on May 22, her family alleged that the doctors taunted and hurled casteist abuses at her as she belonged to a scheduled tribe. While Mehere was arrested last Tuesday evening, Ahuja and Khandelwal were taken into custody in the early hours of Wednesday. The accused were subsequently booked under provisions of the Scheduled Castes and Tribes (Prevention of Atrocities) Act, Anti-Ragging Act, Information Technology Act and section 306 (abetment to suicide) of the Indian Penal Code (IPC).
Deccan Chronicle- Puli Sharat Kumar
A 55-year-old woman was allegedly declared dead by a hospital in Karimnagar when she was still alive, her family members claimed on Monday. They began making arrangements for her last rites when the woman, Kanakamma, stirred to life at Rangapet of Sarangapur mandal of Jagtial district on Monday. The hospital has denied the allegation. Ms Kanakamma, a resident of Rangapet, was seriously injured when she slipped and fell down on a stone at her home on May 31. She was admitted in a Surya Hospital at Karimnagar. On examining Ms Kanakamma, the doctors conducted a surgery after which she went into a coma. Her family members claimed that the doctors told them that she was in a serious condition and they were fighting to save her life. After a few hours, they declared that Ms Kanakamma was dead and asked her family members to take the body home, the family said.
ET Healthworld- IANS
At least eight infants died due to the alleged failure of the air-conditioning (AC) system in a hospital in Pakistan, officials said. Sahiwal Deputy Commissioner Zaman Wattoo had written a letter to the Punjab government's Specialised Healthcare and Medical Education Department recounting the chain of events allegedly leading to the infants' deaths, mainly due the failure of the AC system, reports Xinhua news agency. The official said that he received an emergency call late Saturday night from an attendant of a patient, informing him that infants had started dying due to non-functioning of the AC system in the paediatric ward of the District Headquarters Hospital Sahiwal.
The Hans India- Mahesh Avadhutha
About 134 specialist doctors working in Area and District Hospitals and CHCs (Community Health Centres) in various districts have been served show-cause notices for unauthorised absence from work for the last several months. Telangana Vaidya Vidhana Parishad (TVVP) will wait for their written explanations before initiating further action around June 15. Paper notification will be issued afterwards and those who fail to respond would be given termination letters, according to officials. The absentee doctors belong to different specialities including OBG (Obstetrics and Gynaecology), Paediatric, General Surgery, Ophthalmology, Pulmonology, Anaesthesia, Radiology etc.
A resident doctor in Rajasthan is an eye of a storm after he was videographed mercilessly thrashing what looks like a patient. The incident, according to news agency ANI, is from Sunday and took place at Sawai Man Singh (SMS) Medical College in Jaipur. In the video, the resident doctor, who is wearing a blue shirt and a surgical mask, is seen throwing punches at a man wearing a white vest. After a point the man at the end of the doctor's ire falls back on a hospital bed. At this point, the doctor climbs on top of the bed, holds the man down and proceeds to slap him multiple times. There are a few other doctors and patients present while the attack is taking place. However, none of them initially intervene.
It's a common practice for some homoeopathic doctors to prescribe and hoard allopathic medicines. The prime difference between the two is that allopathic medicines attempt to alleviate the symptoms of the disease by attacking or affecting the natural defence of the body whereas homoeopathy works majorly on the symptoms. Its effectiveness hasn't been proved yet, therefore, it is sometimes termed as 'pseudoscience'. The state government had recently granted permission for homoeopathy doctors to practice allopathy which would be a 6-month course, after which they have the authority to prescribe allopathic medicines. However, the course hasn't commenced yet.
A doctor is vicariously liable for the negligence committed by members of his team which was assisting in the treatment, held the National Consumer Disputes Redressal Commission while dismissing an appeal. The case was regarding the death of a three year old child named Arshiyai in 2004, while she was undergoing treatment for cancer at Mohan Dai Owal Cancer Treatment and Research Foundation Hospital, Ludhiana, under the supervision of one Dr. Raman Arora. A medicine used for treatment called 'Vincristine' had to be administered intravenously. However, this medicine was given intrathecally (through back bone injection) by Doctor Harjith Singh Kohli, with assistance of Doctor Vandana Bhambri, who were assisting Dr. Arora. After the injection, the situation of the patient worsened. Within two weeks, Arshiya breathed her last.
Doctor liable for acts of his assistants
A doctor is "vicariously liable" for his team, which assists him in rendering treatment, the apex consumer commission NCDRC has said while directing the treating doctors and hospital to pay Rs 16 lakh to a couple who lost their 3 year old daughter, a blood cancer patient, after she was administered injection wrongly.
People with borderline high QT interval in ECG should not consume energy drinks
A new clinical trial published in the Journal of the American Heart Association reports that energy drinks can prolong QTc interval in ECG and raise blood pressure in volunteers.