INdiana Systemic Thinking

April 29, 2010

Seroquel Slap-down

Filed under: Healthcare,Legal/Law,Pharmacology,psychiatry,schizophrenia,Seroquel — kurtglmft @ 10:28 am

According to the Associated Press, via the Fort Wayne Journal Gazette, drugmaker AstraZeneca will have to pay 520 million in fines to resolve “allegations of illegal marketing of the company’s antipsychotic drug Seroquel.”

“AstraZeneca allegedly marketed Seroquel for off-label uses — those not approved by federal drug regulators — including insomnia and psychiatric conditions other than schizophrenia and bipolar disorder.”

In addition,

“U.S. Attorney Michael Levy of Philadelphia, where the settlement was filed, said that the company had “turned patients into guinea pigs in an unsupervised drug test.”

AstraZeneca, which has its U.S. headquarters in Wilmington, Delaware, faces more than 25,000 product liability lawsuits over Seroquel, with most alleging that the drug caused diabetes. Seroquel has been on the market since 1997.

The government said AstraZeneca paid kickbacks to doctors recruited to serve as authors of articles by Astra Zeneca and the company’s agents about the unapproved uses of Seroquel.

The company also made payments to doctors to travel to resort locations to advise AstraZeneca about marketing messages for unapproved uses of the drug, the government stated.

AstraZeneca denied the allegations leveled by the government in the civil case settled Tuesday, saying it wanted to avoid the delay, uncertainty and expense of a protracted legal battle.”

The story goes on to state the drug is the second best seller for the company, generating sales of 4.9 Billion dollars.

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March 16, 2008

DOC Makes Improvements At Girls School

Remember back in December when I posted this about St. Joseph County Judge Peter Nemeth? The story then was he refused to send female juveniles to the Indiana Girls School for a variety of complaints.

Well, today’s South Bend Tribune is reporting the Department of Corrections is making some staffing changes that are encouraging to Nemeth. Specifically;

The DOC has announced it will end a two-year-old arrangement to house boys and girls at the same Indianapolis Juvenile Correctional Facility by moving the boys to a recently renovated section of the Logansport Juvenile Correctional Facility.

Nemeth said he was encouraged by the DOC’s announcement that a “staffing plan for the facility is being developed to ensure the appropriate deployment of staff.”

“If they are actually doing a staffing plan … if it means more than just words, I think that is real progress,” the judge said. “I applaud them for that.

Girls will be moved into the unit being vacated by the boys. The unit will house girls in single rooms that lock from a central control location, along with a special management unit specifically programmed for girls struggling with mental health issues.

“It looks like they are going to do what we want them to do,” said Bill Bruinsma, executive director of the St. Joseph County Juvenile Justice Center. “We’ll have to see what staffing they’re going to add in and what kind of programming they’re going to put into it … It’s a step in the right direction.”

However, Nemeth doesn’t appear completely sold on the changes…

Nemeth said he still will avoid sending girls to the Indianapolis facility until he knows more details about the changes, especially whether staff-to-child ratios improve. Instead, he said he is sending girls who are the most difficult to rehabilitate to a private juvenile detention facility in Vincennes, at a daily cost to the county of $138, compared to $60 a day at the Indianapolis DOC girls school.

February 27, 2008

2004 Indiana Health Insurance Law Misses Mark

The Indianapolis Star Business section has a great in-depth story on the 2004 insurance change in Indiana that allowed insurance companies to either deny insurance policies for pre-existing conditions, or waive coverage for 10 years for those conditions. At the time, it was touted as a way for more people to be covered, at a lower price, because the insurance companies would not have to cover “high risk” patients. In addition, in 2004, Indiana was only one of two states requiring insurance companies to cover these “high risk” patients. When the law was being discussed in the legislature, the insurance companies told our representatives they were in support of this measure, because it would help more of the citizens of Indiana get coverage, at a lower cost.

Well surprise, surprise. We now find more people are not covered, and, in fact, there are less people covered and the insurance companies continue to make record profits.

Here are some quotes from the story:

Sen. Patricia Miller, R-Indianapolis, sponsored the change in Indiana law and hoped it would reduce the number of people denied health insurance.

She also wanted to limit the increasing number of people who had no choice but to seek insurance through the state’s high-risk insurance pool, which covers people who can’t get insurance from any other source. The pool was facing insolvency.

“We believed having some insurance was better than having none at all,” Miller said.

Miller said she’s had no complaints.

Rep. Craig Fry, D-Mishawaka, opposed the measure and still thinks it benefits only insurance companies. He called the measure just an effort by the insurance industry to “take advantage of people who need health insurance.”

Rich Collins, chief executive of Golden Rule Insurance Co., an Indianapolis-based subsidiary of UnitedHealth Group that sells individual policies, said Hoosiers have access to a strong and competitive health insurance market.

Collins said his company offers coverage to more than 89 percent of applicants.
“The fundamental issue is that health care is expensive,” he said.

I’ll let the reader make up their own mind as to what was really going on back in 2004, but I thinking it’s pretty clear this turned into a huge bonus for the insurance industry at the expense of citizens regardless of the intent.

Mr. Collins also got my dander up as he hit on a pet peeve of mine. “Health care” is not the same as health insurance. While “health care” may be expensive, health insurance is generally 30% higher to cover administering the policies, and paying his salary. Making health insurance much more expensive than health care.

February 24, 2008

Straight Talk

Filed under: IN Judiciary,Indiana,Legal/Law — kurtglmft @ 9:04 am
Tags: , , , ,

This little tidbit is too good to pass up. Unfortunately it was buried way down at the bottom of this article. You have to like it when someone bypasses all the politically correct diplomacy and says exactly what they mean and want:

Fielding special requests is just part of the job when it comes to holding public office — just ask Gov. Mitch Daniels.

The governor spoke Tuesday at the Outlook 2008 economic luncheon in Carmel.

He recalled receiving an especially flowery introduction before another recent address. Daniels said he stood up on that day to say first that he appreciated the kind words.

“I got up and said, ‘Bob, I don’t know how to thank you,’ ” Daniels recalled.

“He jumped up and said, ‘I do — I want to be a Superior Court judge.’ ”

The governor appoints county judges when there are vacancies.

Niiiiiiiice.

February 16, 2008

Follow Up: Lennington Gives Up Tax Court

Following up on my posts here and here, the Muncie Star Press is reporting:

Delaware County Circuit Court 5 Judge Wayne Lennington has relinquished jurisdiction over all cases related to tax sales, a week after acknowledging he was the target of a criminal investigation that involves his personal investments.

All five Delaware Circuit Court judges, including Lennington, signed an order Wednesday that transferred tax sale cases to the other four courts, and allowed the re-assignment of criminal cases from Lennington’s court at Delaware County Prosecutor Mark McKinney’s discretion.

February 13, 2008

Health Blog Roundup: Step-dads, Chelsea Clinton, Statins Make Women Stupid, etc…

Here are some of the posts I found interesting this morning from the list of national health blogs I keep track of:

From the Wall Street Journal Health Blog:

Do statins “make women stupid“?

Blue Cross of California wants doctors to help them cancel patient policies.

Dr. Grohol’s World of Psychology:

Making sense of suicide and drugs.

On the Radar:

Chelsea Clinton hates her health insurance.

Hidden Agenda in CDHPs

From MSNBC:

It’s tough being a step-dad!

February 9, 2008

Delaware Judge Now Says He is Extortion Victim

In a follow up to my post yesterday, Delaware County Circuit Court Judge Wayne Lennington now says he was a victim of an extortion plot, according to the Muncie Star Press:

Judge Wayne Lennington said Friday he believed an extortion attempt might have kindled an already existing investigation into his business affairs.

“If I would have paid him, I’m sure it wouldn’t have gone anywhere,” said the Delaware Circuit Court 5 judge. “But I wasn’t going to do that.”

On Friday, Lennington provided The Star Press with a copy of an e-mail whose author threatened to deliver to federal investigators information that was damaging to Lennington and a business partner, Joseph Gray, unless the men paid him $250,000.

The judge said he believed his extortionist was an Ohio man he had met once through Gray.

In a May 30, 2007 e-mail to Gray, the man purportedly wrote, “My attorney assures me that the material in my possession are sufficient to have Judge Lennington removed from the bench, and the both of you criminally prosecuted.”

Furthermore, the e-mail stated the man would be willing to turn over to investigators:

  • Taped conversations between himself and Gray about Gray’s relationship with Lennington.
  • Faxes to him from Lennington’s home.
  • “Copies of prints from the golf course,” which Lennington believes is a reference to an aerial photograph Lennington provided Gray of a Delaware County golf course they were considering buying.
  • Information about “unfettered access” to tax sale information.Sometime after receiving the e-mail, Gray showed the message to Lennington, the judge said.Lennington told The Star Press he had never done anything illegal so he felt comfortable sharing the extortion message with state police and Delaware County Prosecutor Mark McKinney’s office.
  • The judge could not provide a precise timeline concerning when Gray first provided him the e-mail and when he notified authorities.

    Lennington said he has not heard back from the police or prosecutor.

    While Lennington was under investigation before the extortion attempt, the fact that he refused to cooperate with the extortionist might have indirectly “intensified” investigators efforts to bring him down, the judge suggested.

    He questioned whether the extortionist, embittered by Lennington’s resolve, was feeding authorities false information that the judge conspired with Gray in illegal scams.

    An effort to reach the alleged extortionist through the e-mail address provided by Lennington was unsuccessful.

    Lennington didn’t mention the extortion letter during the Thursday interview in which he confirmed he was being investigated. The judge said he wasn’t comfortable with releasing the letter until a second conversation with a reporter on Friday.

    February 8, 2008

    Delaware County Circuit Court Judge Under Investigation

    From the Muncie Star Press:

    Delaware Circuit Court 5 Judge Wayne Lennington acknowledged Thursday he is under criminal investigation for his connection to investment properties but denied any wrongdoing.

    Lennington, 77 — a local attorney for four decades before his 1998 appointment to the bench — said he was guilty only of associating himself with an Ohio man he now describes as a scam artist.

    “I didn’t do nothing except get screwed,” the judge said. Lennington said he believes he is under investigation by Indiana State Police and the Delaware County prosecutor’s office for his business ties to ESS Investments LLC, which is operated by Joseph Gray and chartered out of Westerville, Ohio.

    ESS has owned at least five properties on the south side of Muncie and in the northeastside Whiteley neighborhood since 2004. Those five properties account for more than $32,000 in delinquent real estate taxes and city sewage bills, according to the Delaware County treasurer’s office.

    Lennington said he never had ownership interest in ESS Investments, which despite its Ohio charter maintains a South Carolina address and a disconnected South Carolina phone number.

    He admits, however, to lending Gray $20,000 shortly after ESS bought the local houses to finance their restoration.

    “I thought we could fix them up and flip them and make some money,” Lennington said, adding most homes went unrestored and he never saw a return on his investment.

    Being a gullible investor and knowing a slumlord, however, are not illegal. Instead, evidence suggests investigators are interested in Lennington because of his longtime role as administrator of Delaware County’s tax court.

    Staci Schneider, a spokesman for Attorney General Steve Carter, would not confirm Thursday night whether their office was conducting an investigation into Lennington, nor would ISP Sgt. Rod Russell, the public information officer for the Redkey post.

    Lennington said he never acted improperly as tax sale judge nor did he use his authority for financial gain.

    February 5, 2008

    Big Insurance: “and throw a little sand in there too…”

    I don’t know if everyone will get the reference in the title, but I thought it was fitting.  In another example of Big Insurance trying to prop up their already fat bottom line, comes this from the Wall Street Journal’s Health Blog.  By the way, this is what happens when MBA’s make medical decisions instead of MDs.

    Aetna is about to cut back on its coverage of a popular but expensive form of anesthesia for patients undergoing colonoscopies, the AP reports. Docs aren’t pleased.

    Doctors say the fast-acting drug propofol makes colonoscopies more comfortable (or at least less uncomfortable). But its use often requires that an anesthesiologist be present, and boosts the cost of the procedure by $200 to $1,000. Insurers argue that “moderate sedation,” which combines painkillers and a sedative, works equally well for most patients and doesn’t require the presence of an additional specialist.

    WellPoint cut back on its coverage of propofol a few years back. As of April 1, Aetna will pay for an anesthesiologist to be present during a colonoscopy only in cases where the patient would be at high risk without one. UnitedHealthcare covers propofol during colonoscopy, according to the AP.

    Some gastroenterologists and anesthesiologists are working with lawyers to fight the change. “To the extent litigation is an option, we’re looking at all options,” said John Fanburg, counsel for the New Jersey State Society of Anesthesiologists and the New Jersey Gastroenterology and Endoscopy Society.

    I have an idea, lets have the “insurers” who made this decision undergo the procedure the way they want everyone else to.  Wonder if that would change their mind. 🙂

    February 2, 2008

    Britney Spears: Father Knows Best

    Filed under: Legal/Law,Misc,Uncategorized — kurtglmft @ 6:15 pm
    Tags: , , , , ,

    Alright, I wasnt going to blog on this, but I’ve been a little hard on Spears.  Besides, its that or mop the kitchen!

    WTHR is reporting that following her involutary committement to a Los Angeles hospital for an unknown condition, Britney’s father was awarded temporary “conservatorship” of Britney.  The father, James Spears, and an attorney were awarded co-conservators of Britney’s estate.  The court also proptly issued a restraining order against Britney’s “manager” and friend, Sam Lufti.

    From the story:

    A court creates conservatorships when a person cannot care for themselves or handle their affairs. Commissioner Reva Goetz said Spears would be under conservatorship until Feb. 4, at which time another hearing will be held.

    “It is in the best interests of the conservatee to have conservatorship over her person,” Goetz told a packed courtroom.

          The conservator will have the power to “restrict visitors,” have around-the-clock security for Spears, and have access to all medical records, Goetz said.

          Goetz said conservatorship over the estate was “necessary and appropriate.” She gave approval for the conservator to “take all actions to secure all liquid assets including credit cards.”

    The reason I wanted to blog on this was to point out how serious her condition must be.  In all the years I’ve practiced I’ve only run into two or three cases where the person’s conditon was so serious they could not make decisions for themselves or their estate.  So, while I originally thought much of this was for publicity, her condition must be very serious indeed.  Goes to prove the point no-one should evaluate another from afar, or through media reports.

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