Med errors kill more folks in U.S. than breast cancer or AIDS

There were 2 articles in the Tribune Tempo section last Tuesday that caught my eye (actually they caught my wife’s eye and she pointed them out to me). (Sorry no links)
Interestingly they were on opposed pages:

One article, titled “Doctors’ math errors can be dangerous”, reported that “Doctors make the same arithmetic mistakes the rest of us make, but the consequences can be considerably more serious.” Looking at a single drug dose calculation the Annals of International Medicine published study found drug dosage calculation errors by a “factor of 10”. Thank goodness between us and the drug being given or taken there is often a pharmacist allowing for checking and error remedy. But wait:

The other article was titled “Errors by pharmacists”. It cited an Ohio State University study that found that pharmacists “make an estimated 5.7 errors per 10,000 prescriptions processed…more than 2.2 million dispensing errors a year.”

Makes you feel safe, doesn’t it?

Coroner system on death bed?

While this bit from Minnesota Public Radio seems to have a bit of an anti-coroner bent to it, it does bring up some interesting points.

As is pointed out, “28 states still primarily use coroners to determine the cause of death.” (although I disagree with the second sentence in that paragraph) However, Medical Examiners discuss problems with the Coroner System in place around the country (as a member of the National Association of Medical examiners I get to listen in). State and local government officials and regular folks around the country have discussed problems.

Will the coroner system be replaced in this country? I doubt it, but likely it will hybridize into some sort of mixed system as exists in some states. There are not enough Forensic Pathologists to cover the entire country, “there should be 1000 medical examiners, but only half of that are practicing now”. We need to be certain that all areas of the country have access to trained forensic pathologist to lend their expertise to medicolegal death investigations and for autopsy.

But more importantly, we must ensure (and this is indeed where the coroner system comes up short in certain areas of the country) that we have trained and experienced folks in the field. Not just anyone can be a coroner or coroner’s deputy or a medicolegal death investigator. We must be sure that the medicolegal death investigation system is strengthened by any changes that are proposed or occur. We must ensure that a separate death investigation is done in every homicide or questionable death (Coroner’s case), in balance with and in parallel to law enforcement.

As stated on MPR:

“…it's important to have a trained death investigator at every death scene.
Somebody who understands the combination of the forensic issues, the medical issues, the evidentiary issues," .... "Somebody who can address things like the rigor mortis of the body, the position of the body, who can then give those clues back to the forensic pathologist in a way that would be meaningful to him or her."

That is our goal in every case and always will be. We take very seriously our duty of thorough medicolegal death investigation for determination of the cause and manner of death and pursue it professionally in every case, as should every office whether coroner or medical examiner.

Lake County Strategic Plan Community Outreach

Lake County, IL Strategic Plan Community Outreach Schedule

An open house from 6 to 7 and the meeting begins at 7 p.m.

Lake County Community Forums:

CENTRAL LAKE COUNTY
Monday, March 10 @ Division of Transportation, 600 W. Winchester Road,Libertyville

SOUTHEAST LAKE COUNTY
Tuesday, March 18 @ Highland Park Country Club, 1201 Park Avenue West, Highland Park

NORTHWEST LAKE COUNTY
Wednesday, March 19 @ Lake Villa Public Library, 1001 E. Grand Ave, Lindenhurst

SOUTHWEST LAKE COUNTY
Monday, March 31 @ Ela Area Public Library, 275 Mohawk Trail, Lake Zurich

NORTHEAST LAKE COUNTY
Tuesday, April 1 @ Warren Newport Public Library, 224 N. O’Plaine Rd., Gurnee

Is obesity killing our kids and can we ameliorate it?

I was at a meeting yesterday (I have had quite a run of meetings lately, including one in Bloomington Tuesday) of a new group/task force out to prevent death and promote healthy lifestyles. It is a group of various folks from our county coming together to “tackle the single most critical health concern facing Americans today”. I’m not so sure their target is the “most critical health concern”, but it is a serious concern and one worth tackling and that is obesity.

This effort got its start from the national YMCA “Activate America” initiative.

Another slogan from their PowerPoint presentation was “We want you to get Lake County active and fit”. That is, I think, a better (and more reasonable) target. Encouraging folks to get and stay active (and “fit”) and to see what we can do to aid folks in eating healthier stuff. This effort will include special emphasis on kids, likely their behavior is a bit easier to change/impact, but also because of some recent studies demonstrating that early obesity is shortening the life expectancy of our future generations. The first such studies came out in 2005 (see this New York Times article)

For the first time in two centuries, the current generation of children in America may have shorter life expectancies than their parents, according to a new report, which contends that the rapid rise in childhood obesity, if left unchecked, could shorten life spans by as much as five years.

and the New England Journal has again published similar studies the latter part of last year (see USAToday article).

Taken together, doctors say, the studies provide new evidence that excess weight does affect a child's long-term risk of heart disease and life expectancy.

Pushing activity (and fitness) is a great goal and would likely have a great impact on this and so many other health issues. Creative thought and attention needs to be directed at special problems experienced by folks in lower socioeconomic strata, those in neighborhoods not conducive (for many reasons) to outside, local activity, and other special populations, but it is doable for all.

I look forward to participating in this effort. Working to promote health and forestall death by many avenues is my “most critical…concern”.

Morgue: punishment community service and I work there

Punishment community service in the morgue.

I guess our court-mandated tours for certain groups of youths aren't too far out of the mainstream.

Unidentified since death in 1981

I am going to use this as a “test case”. I had conversations recently with an individual wondering if we could put together a “local” website (i.e. for Illinois specifically) to make available information about unidentified Coroner’s cases to seek help with identifying them from the local public and police jurisdictions not in the immediate area (in our case, outside Lake County). This does make sense in that unidentified folks may not travel all that far before death and local folks may recognize them. Information could/would still be submitted to data bases like NamUs and the Doe Network, but a more local listing site could be helpful. That is keeping in mind that nationwide only 20% of Coroner and Medical Examiner offices regularly report their unidentified to the FBI National Crime Information Center.

[I am going to post one here to check the Blogger format and search capabilities as a test to see if this sort of placement would work. I will be considering other website deliveries as well.]

Case in point (in reviewing our older cases, this gentleman came to our attention recently):

This individual died March 5, 1981, 8:11 a.m., after being struck by a northbound freight train at the Deerfield, IL train station. He had no ID with him.

The individual was a white male approximately 60 to 68 years old. The individual was approximately 5 foot 10 inches tall and weighed about 195 pounds. He was balding with gray hair and brown eyes. He had a 10 inch abdominal scar from his sternum to his waist, as well as 2 surgical drain-type scars laterally. He had been observed to walk with a limp or shuffling gait. He seemed to have an inability to use his left middle, ring, and little fingers. He was also described as, at least somewhat, disheveled in appearance.

His clothing consisted of a white T-shirt, brown cardigan sweater, brown polyester warm-up jacket with white stripes, orange socks, and brown dress pants with brown belt and shoes. He also wore a gold-colored Hilton wristwatch.

“John Doe” was buried April 22, 1981, he continues with that appellation to the present.

If you have any information on this individual call our office (847 377 2200) or email (coroner@co.lake.il.us).

If you are an Illinois Coroner and want to participate in such a project, let me know.

Learning more about insects

I ran across this article today, it reminds me of some of the Anthony Bourdain TV shows. (Have you seen the one where the octopus tentacles were still moving as he ate them? There has also been a show or two where he ate insects.) This article not only recommends eating insects but includes 4 receipts:

…they taste good. Plus insects are high in protein and have essential fatty acids and important vitamins.

Bon Appetite

Insects are indeed so fascinating.

There are always drug-related deaths

I received this as a comment to a previous post, but in looking at it I thought I would move it up to the level of a primary post. It seemed particularly pertinent as we worked through our case conferences last Wednesday with 5 overdose deaths (out of the 12 deaths we discussed). Those deaths were due to a variety of drugs, sometimes singly and sometimes poly-pharmacy, but drug-related deaths none the less. The individuals ranged in age from 18 to 69 and came from various places across the county and various socioeconomic strata.

Here is a mother’s heartfelt note:

My son Timothy Galvin was 18 years old and died of a methadone overdose.
Timothy is my son. He was my life. He was going to begin classes at Rogers State University in January 2008. He was a soldier in the National Guard and would have been deployed for Iraq in November 2007, but he had scored a 56 on his ASVAP test for enlistment. His Sergeant said this was one of the highest scores he had seen in 6 years. Therefore, he was eligible fro the college first program. He would not have to be deployed if he was enrolled in college. He was at a party on November 7 2007. I was told that he had been drinking liquor and Tim was not in his right mind if he was drinking anything other than a few beers. Somebody "gave him" or "let him take" a deadly dose of Methadone and by the next morning his best friend had to be the one to find him dead in his bed. This was a tragic & unfortunate accident that I pray no other family will have to go through, but I know that it will happen again. That is why, I don't know how & I don't know what it will take, but i am starting to gather more information on Methadone availability and find out what regulations the government is actually enforcing. Then I will call every Senator, State Representative, Pharmacy Boards, Clinic and mother that has lost their child to this drug and maybe we can change something. If you have lost your child from a methadone overdose and would like to e-mail me:
timarajmeeks2006@yahoo.com

God Bless,
Timara Jean Meeks

Alzheimer’s cure?

Although I am a firm believer that exercising your brain, like exercising your body, will keep it fit, it is nice to know that there is hope if Alzheimer’s ever strikes.

Reversal Of Alzheimer's Symptoms Within Minutes In Human Study

Coroner fascinated by insects

Insects will rule the world? Or have they? Do they already?

I have written before about insects being crucial to decomposition and at times I have been concerned about insects serving as a vector for a variety of diseases. As a matter of fact, I was reading recently about concerns that as global warming progresses we will see a spread in insect-vectored illnesses out of typical subtropical regions and spreading in this country. Another thing that came up recently was a discussion of cysticercosis. While I saw several cases as an ER physician and working at HealthReach, apparently more areas of the country are finally seeing cases.

With these things recently in my head, I was intrigued by this brief article. It reports a hypothesis (reasonable in my estimation) from a recent book by some folks in Oregon. They posit that the fall of the dinosaurs was due to insects. The insects spreading reptilian disease and pollinating flowers, so that they proliferated and replaced plants they were more used to eating, spelled the doom of the dinosaurs.The mighty thunder lizards brought low by lowly insects.

Bug spray or pledges of peace? You decide.

The Ada County, Idaho Coroner asked "Human or Not"?

Larger Decedents Impact Equipment Purchases

We have budgeted for a new lifting device for the office to lift and move bodies in the office, to ensure that it is robust enough for the larger folks we are seeing through the office. We have purchased body bags that will be big enough for some of the folks we are seeing these days. We are making certain that the new transport gurneys we are buying are tough enough.

I hadn’t thought about this, but we do need a new autopsy table, so I will think about this now:

The Orange-Osceola Medical Examiner's Office has a new addition: An autopsy table that can support 1,000 pounds.