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The school bus is one of the safest ways for children to travel to and from school. However, an average of 20 school-age children are killed each year in crashes involving school transportation, and more than half of the victims are killed in collisions between the bus and at least one other vehicle, according to the National Highway Traffic Safety Administration.
Drivers can help avoid crashes with school buses by following traffic laws and taking safety precautions during the school year. NHTSA reminds drivers of the following tips to help make the roads safe for buses and their youthful passengers:
- Slow down and obey the posted speed limit in school zones.
- Red flashing lights and extended stop arms—a stopsign shaped arm that extends from the left side of the bus— mean that the bus has stopped and that children are getting on and off. Motorists must stop their cars at least 20 feet away from the school bus. Move only when the red flashing lights turn off, the stop arm is withdrawn and the bus begins moving.
- Be alert, and watch for students, who may dart into the street without looking.
Parents can also help keep their children safe by teaching them these good habits:
- When waiting for the school bus, line up away from the street as the bus approaches.
- After entering the bus, find a seat and remain seated until the bus comes to a complete stop.
- When exiting the bus, always stop at the curb and wait for a signal from the bus driver before crossing the street.
Download the Fall 2008 Newsletter as PDF
Posted by admin at 9:55 pm on October 1st, 2008. No comments... »
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It’s common knowledge that driving recklessly is a factor in a number of highway deaths and that driving while under the influence is a leading cause of fatal crashes. But did you know that driving while drowsy also plays a big role in automobile wrecks?
The National Highway Traffic Safety Administration (NHTSA) estimates that more than 100,000 crashes reported to law enforcement agencies each year were primarily due to drowsiness or fatigue. What’s more, those crashes result in an estimated 1,500 fatalities and 71,000 injuries each year, and the annual monetary drain is estimated to be about $12.5 billion.
Contrary to what many believe, tired people usually can’t tell that they are about to fall asleep. And when it comes to staying awake behind the wheel, such common remedies as playing the radio loudly, chewing gum, slapping yourself and sticking your head out the vehicle’s window are not effective.
driving while fatigued is recognizing the warning signs of drowsiness and taking corrective action. You should consider pulling off the road into a safe place and getting some rest if:
• You can’t stop yawning.
• You have trouble keeping your eyes open and focused.
• Your mind wanders or you have disconnected thoughts.
• You can’t remember driving the last few miles.
• Your driving becomes sloppy— you weave between lanes, tailgate or miss traffic signals.
• You find yourself hitting the grooves or rumble strips on the side of the road.
Download the Fall 2008 Newsletter as PDF
Posted by admin at 9:50 pm on October 1st, 2008. No comments... »
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With the holiday shopping season approaching, parents are likely beginning to search for toys on their children’s wish lists. While nothing may seem more important than finding the perfect age-appropriate gift, it’s also advisable to make sure the toys you purchase for children aren’t made from materials that may be hazardous to their health.
Concerns about toy safety have surfaced in recent years, with manufacturers recalling millions of children’s products because they contained lead paint, toxic softening agents and other health hazards. The numerous recalls led some states to pass laws restricting or banning use of certain chemicals in the production of toys and other children’s products.
The good news? The recalls and new laws resulted in retailers across the nation tightening their standards. Several major retailers announced plans to significantly reduce the amount of lead in toys, while some manufacturers have eliminated the use of softening agents called phthalates, which tests have shown to be harmful to a child’s longterm health.
Concerned parents can find out about recent safety-related toy recalls or register a complaint about an unsafe toy by calling the Consumer Product Safety Commission’s hotline at (800) 638-2772 or by visiting its Web site at www.cpsc.gov.
Information about toys made with hazardous materials can be found at www.healthytoys.org, which has a searchable database that includes more than 1,000 toys.
Download the Fall 2008 Newsletter as PDF
Posted by admin at 9:47 pm on October 1st, 2008. No comments... »
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With millions of families facing the loss of their homes due to the nationwide mortgage crisis, officials are warning homeowners not to fall deeper in debt by paying a company that promises to solve their problems.
Some companies are pomising in television, radio and newspaper ads to immediately stop foreclosure of your home or to negotiate with your lender for better terms.
Officials at the U.S. Department of Housing and Urban Development warn that, while these may be legitimate businesses, they will charge you a hefty fee, often two or three months’ mortgage payment, for information and services your lender or a HUD-approved housing counselor will provide for free.
HUD officials also warn that promises made by some companies could be scams. If any firm claims it can stop your foreclosure immediately if you sign a document appointing it to act on your behalf, you may well be signing over the title to your property and becoming a renter in your own home.
You should never sign a legal document without reading and understanding all the terms and getting professional advice from an attorney, a trusted real estate professional or a HUD-approved housing counselor.
HUD maintains state-by-state lists of housing counselors approved by the agency. Visit www.hud.gov/ foreclosure or call (800) 569-4287 for a list of approved counselors in your area.
HUD officials recommend that you take
the following steps if you are falling behind
on your monthly mortgage payments:
Don’t ignore the problem. The further behind you become, the harder it will be to keep your loan and your house.
Contact your lender as soon as you realize you have a problem.
If you receive a delinquency letter from your lending company, do not ignore it. Contact your lender immediately. Such letters may include important notice of pending legal action, and failure to open the mail will not be an excuse in foreclosure court.
If you feel you need outside assistance, contact a HUD approved housing counselor in your area. These counselors provide services free or for a modest fee.
Know your mortgage rights. Find and read your loan documents so you know what your lender may do if you can’t make your payments.
Download the Fall 2008 Newsletter as PDF
Posted by admin at 9:43 pm on October 1st, 2008. No comments... »
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With large numbers of Americans expressing unhappiness with the nation’s direction, the fall 2008 elections for president and members of Congress are shaping up to be some of the most important in recent history.
Public opinion polls are finding Americans pessimistic about many important issues ranging from the economy to the war in Iraq. Surveys are also finding voters concerned about corporate misconduct, excessive CEO compensation and HMOs denying needed medical treatment. Voters say they prefer candidates who defend the civil justice system over candidates who attack “frivolous lawsuits” and push for “tort reform.”
The 2008 presidential election will be held on Tuesday, Nov. 4, but states are holding primary elections prior to that date for a variety of positions including U.S. House of Representatives and U.S. Senate seats. Heavy voter participation in the presidential primaries earlier this year indicates there likely will be an above-average turnout for the Nov. 4 election.
To vote this fall, you must be 18 years or older and a registered voter. The 1993 National Voter Registration Act—often called Motor Voter Act—simplified the process for registering to vote. The act makes it possible for you to register to vote at the same time you apply for or renew a driver’s license. You can also register at many other state offices, at armed forces recruiting offices and by mail.
There is no fee for registering to vote. Most states require voters to be registered for a certain amount of time prior to an election, so it’s important to register well in advance of the next election.
A large voter turnout in this year’s presidential election would continue a recent trend toward increased participation in elections. Seventynine percent of registered voters actually voted in the 2004 presidential election—an increase from 76 percent in 2000. However, large numbers of Americans continue to be excluded from the election process because they are not registered.
Voting is one of the most fundamental and important rights provided to American citizens. Today most Americans 18 years or older are eligible to register to vote, but that hasn’t always been the case. When George Washington was elected as the nation’s first president, only white men who owned land could vote.
In 1870, the 15th Amendment to the U.S. Constitution extended voting rights to adult male citizens of all races. It wasn’t until 1920 that the 19th Amendment gave female citizens the right to vote. The 24th Amendment and the Voting Rights Act in 1964-65 removed a number of obstacles that were used to deny voting rights to minority citizens.
For more than 200 years, the American form of democracy has been used as a model by people of other countries who fought wars for the right to govern themselves through elections. Unfortunately, many Americans take the right to vote for granted and do not participate in the electoral process.
The late President Franklin D. Roosevelt emphasized the importance of voting when he said: “Nobody will ever deprive the American people of the right to vote except the American people themselves and the only way they could do this is by not voting.”
Download the Fall 2008 Newsletter as PDF
Posted by admin at 9:35 pm on October 1st, 2008. No comments... »
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An Important Lesson for Physicians By Shirin E. Harrell, BA, RN, MBA, JD The United States Attorney in Boston recently announced the settlement of a health-care-fraud case involving five urologists and TAP Pharmaceutical Products, Inc., a major American pharmaceutical manufacturer. The government alleged that the urologists received illegal inducements from TAP to prescribe the drug Lupron in the 1990’s. 1 The physicians pleaded guilty to health-care fraud, and TAP agreed to pay $875 million to settle allegations of fraudulent drug pricing and marketing of Lupron.TAP markets Lupron for the treatment of advanced prostate cancer. The U.S. Attorney initiated an investigation into TAP’s pricing and marketing of Lupron in 1997, after a urologist employed by an HMO reported to law-enforcement authorities that he was offered an educational grant to reverse a decision he had made on behalf of the HMO to exclude coverage for Lupron.To induce physicians to prescribe Lupron instead of a cheaper alternative, TAP gave physicians free samples of the drug, worth as much as $40,000, as a form of volume discount. The average cost of a monthly dose of Lupron was $400 to $600. Because Lupron must be injected under the supervision of a physician, Medicare, which normally does not reimburse for medication, reimbursed physicians 80% of their administration cost. The remaining 20% was reimbursed by the patient as a co-pay. TAP fully intended and expected the physicians to prescribe the free Lupron to their patients and then bill the patients and their insurers the average wholesale price of the drug. That is precisely what the physicians did.
As a further incentive to encourage physicians to prescribe Lupron, TAP offered them free consulting services, free trips to golf and ski resorts, and money disguised as “educational grants,” that the physicians used to pay for cocktail parties, office Christmas parties, medical equipment, and travel expenses. The Government described these items as kickbacks and bribes used to influence the physicians to prescribe Lupron.
The TAP case is likely to have a significant impact on the marketing practices of not only pharmaceutical companies, but on all health-care vendors. For physicians, the message should be loud and clear.
First, physicians need to carefully examine some of the perks they are used to receiving from health care product and service vendors. The Federal government cited as illegal inducements many of the marketing practices typically utilized by pharmaceutical companies and other health care vendors, including: free products, free consulting services, trips to golf and ski resorts and money purportedly for “educational grants” but used for other purposes. Thus, physicians who accept free services, free products, or money from vendors risk criminal charges and civil liability.
It is a felony under the Medicare-Medicaid Anti-kickback statute (42 U.S.C. 1320a-7b) to receive or solicit payment in exchange for ordering an item, such as a prescription drug, reimbursable by Medicare or Medicaid. This statute was expanded to apply to all federal health care programs under the Health Care Portability and Accountability Act (HIPAA).
In terms of civil liability, physicians who knowingly submit false claims for reimbursement by the federal government can incur civil penalties of up to $10,000 per claim, plus treble damages, under the Federal False Claims Act (31 U.S.C. 3729-3732). At $10,000 per claim, civil monetary penalties often reach millions of dollars. For example, TAP’s $875 million penalty included over $559 million to settle its federal civil False Claims Act liability in the Lupron case.
Second, physicians need to realize that the Government is paying close attention to their interactions with manufacturers and vendors of health care products and services. The TAP case highlights the government ’s increased vigilance in investigating and prosecuting violations of the fraud and abuse statutes. In a six-month period (April through September 2001), the Government recouped more that $1.22 billion through both Civil Monetary Penalty Law and False Claims Act civil settlements. 2
Physicians should stay tuned to further developments in this area.
This publication is intended for general information purposes only and does not and is not intended to constitute legal advice. I f you have specific questions or concerns consult your legal advisor. For additional information please contact:
Shirin Harrell, Esq.
HARRELL & NOWAK, LLC
650 Poydras St., Ste. 2107
New Orleans, La 70130
504-522-7885
sharrell@harrell-nowak.com
Shirin E. Harrell represents individuals injured by the negligence of physicians, hospitals and other health care provider. She founded the law firm of HARRELL & NOWAK in New Orleans, Louisiana.
1 Information obtained from press releases of October 3, October 15, and December 6, 2001, United States Attorney, District of Massachusetts.
2 U.S. Department of Health and Human Services, Office of Inspector General, Semiannual Report to Congress, April-September, 2001.
Posted by admin at 11:21 pm on August 25th, 2008. No comments... »
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It’s hard to believe that operations on the wrong body part or on the wrong patient still happen. Yet, according to the Joint Commission on Accreditation of Health Care Organizations (”JCAHO”), surgeons have operated on the wrong leg, eye, kidney or other body part 150 times since 1996. 1 Most of the time these cases are quietly settled, but sometimes they become headline news.
A few notorious examples are illustrative of this point. A patient admitted to a Tampa, Florida, hospital in 1995 for an amputation of a gangrenous foot had the wrong foot removed. 2 In New York, a patient had surgery on the wrong side of his brain at Sloan-Kettering Cancer Center. 3 A surgeon, nationally recognized for his work with breast cancer patients, confused two patients and performed a mastectomy on the wrong patient in November 1998. 4
JCAHO, alarmed at the continued high incidence of surgical mistakes, issued a sentinel alert advising patients to become involved in ensuring that the surgical site is well marked before undergoing surgery. This alert, issued in December 2001, is the second sentinel alert on the same type of medical error. The first alert focused on wrong site surgery was issued in 1998, and included a review of 15 cases that had been reported to JCAHO. Of the150 reported cases in the current database, operations on the wrong body part accounted for 76% of the cases, while operations on the wrong patient accounted for 13% of the cases. The wrong surgical procedure was involved in 11% of the cases.
What is even more alarming is that JCAHO’s figure may actually understate the true incidence of wrong site surgery. Health care providers are not required to report sentinel events to JCAHO. They report these events voluntarily. In fact, of the 150 cases, only 81% were self-reported by providers. The Physician’s Insurance Association of America discovered 331 claims for wrong site surgery in the ten year period from 1985 to 1995 when it reviewed claims from 22 malpractice carriers representing 110,000 physicians. 5 And, even this number could be too low because not every case results in a claim.
Wrong site surgery can have serious consequences for both patients and health care providers. In response to the first alert in 1998, the American Academy of Orthopaedic Surgeons adopted the “Sign your Site” program of preoperative surgical site identification. Surgeons were encouraged to initial the intended operative site using a permanent marker. According to Dr. Terry Canale, past President of the American Academy of Orthopaedic Surgeons, the Academy discovered that after a two year period of this campaign only 60% of surgeons were marking their operative sites. 6
JCAHO is now encouraging patients to take an active role in assuring that surgeons operate on the correct site. According to JCAHO, patients should do two things: (1)discuss specifically what will be done during the surgery with both the surgeon and anesthesiologist, and (2) have the surgical site marked with a permanent marker in the presence of their surgeon, then have the surgeon initial the site.
The alert also offers concrete steps for providers to reduce the risk of wrong site surgery. The JCAHO recommends providers:
- require that the surgical site be marked.
- develop verification checklists.
- require each member of the surgical team to orally verify the identity of the patient, the planned surgical procedure and the site, with the patient, after the patient arrives in the operating room.
- call a “time out” for the surgical team before the actual surgery begins to verify the patient, procedure and site.
In 1975, the Louisiana legislature limited damage awards in medical malpractice actions to $500,000, exclusive of future medical expenses and legal interest. Despite multiple challenges to this limit on constitutional grounds, the medical malpractice cap remains in effect. But providers should beware. Wrong site surgery is clearly avoidable and can result in devastating consequences for patients. Thus, it is imperative that health care providers quickly adopt effective preventive measures designed to eradicate wrong site surgery, or face the real possibility of losing the medical malpractice cap. Continued wrong site surgery errors may provide opponents of the cap with enough ammunition to finally eliminate it, leaving providers vulnerable to unlimited damage awards. What the legislature giveth, the legislature can taketh away.
By focusing national attention on this issue, JCAHO hopes to eliminate these avoidable mistakes. Lets hope that a third sentinel alert on this subject will not be necessary.
This publication is intended for general information purposes only and does not and is not intended to constitute legal advice. I f you have specific questions or concerns consult your legal advisor. For additional information please contact:
Shirin E. Harrell, Esq.
HARRELL & NOWAK, LLC
650 Poydras St., Ste. 2107
New Orleans, La 70130
504-522-7885
sharrell@harrell-nowak.com
Shirin E. Harrell represents individuals injured by the negligence of physcians, hospitals and other health care providers. She founded the law firm of HARRELL & NOWAK in New Orleans, Louisiana.
1 JCAHO Sentinel Event Alert, Issue 24, December 5, 2001
2 ABC News.com, December 6, 2001, “Willie King” case, 1995.
3 New York Times, March 9, 1996, March 1, 2000, February 8, 2001.
4 St. Petersburg Times, June 1, 2001.
5 New York Times, January 5, 1999.
6 Teleconference Transcripts: Wrong Site Surgery and Sentinel Event Alert #24, December 5, 2001.
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Posted by admin at 11:00 pm on August 25th, 2008. No comments... »
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