Personal Injury and Social Security Disability Blog

Millions Of Older Americans Use Risky Drug Combinations

This report is from the Associated Press. Note the Web site at ConsumerMedSafety.org that will let you check for dangerous drug combinations. Here are excerpts from the story.

At least 2 million older Americans are taking a combination of drugs or supplements that can be a risky mix - from blood thinners and cholesterol pills to aspirin and ginkgo capsules - a new study warns.

Among older men, the numbers are particularly alarming - one in 10 are taking potentially harmful combinations, according to the study.

The results aren't always disastrous, but older people are more vulnerable to side effects and drug-to-drug interactions. And patients need to know that just because lots of medicines and supplements don't require prescriptions doesn't mean they're harmless. Nor are some of these safe to take when you're prescribed other medications.

Experts say the take-home advice is to ask about any side effects of prescription drugs, and tell your doctor before taking other medicines.

Virtually every medicine can have side effects, and with so many being used by so many older adults, the potential for harm is high.

For example, warfarin, a potent prescription clot-fighting drug, was often taken with aspirin. Both increase the risk of bleeding, so the odds are even higher when both drugs are taken. The researchers said these risks also occur when warfarin is taken with garlic pills, which some studies have suggested can benefit the heart and help prevent blood clots.

Signs of bleeding problems include bruising easily, hard-to-stop bleeding from the gums or from cuts and blood in the urine.

Other commonly used and risky combinations included:

-Aspirin taken with over-the-counter ginkgo supplements, increasing chances for excess bleeding.

-Lisinopril, a blood pressure drug, taken with potassium, which combined can cause abnormal heart rhythms. Potassium is often prescribed to restore low levels of this important mineral caused by certain blood pressure drugs.

-Prescription cholesterol drugs called statins taken with over-the-counter niacin, a type of vitamin B that also lowers cholesterol. This combination increases risks for muscle damage.

Michael Cohen, a pharmacist and president of the Institute for Safe Medication Practices, called the study an important snapshot of medication use in older Americans. But as someone who takes at least five medications himself, Cohen said the widespread prevalence isn't surprising.

Cohen said his group recently launched a new Web site, http://www.consumermedsafety.org that will allow consumers to enter names of their medications to check for any potentially dangerous interactions.

Dallas Drivers, If You Don't Have Insurance, Your Car May Get Towed After A Traffic Stop

I've written many times about the problems Texas has with uninsured motorists. More than 25% of Texas drivers have no auto insurance, even though it's required by state law. Finally, beginning January 1, 2009, the Dallas police will start towing cars driven by people with no insurance. This new policy will disproportionately affect poor people, who find it harder to afford insurance. But the law is the law - even poor people are required to carry insurance, and I don't think poverty is a good excuse to drive uninsured. Here are excerpts from a Dallas Morning News article today about the new Dallas police policy:

Beginning Thursday, a new city ordinance gives police the power to tow cars of uninsured drivers who are stopped for traffic violations.

Though the law passed in late May, the City Council chose to delay implementation until the new year so a state database of insured motorists could get up and running. That database isn't up yet but is expected to be available for Dallas police after the new year, Lt. Harvey said.

The council split 10-5 in passing the new ordinance, with all three Hispanic council members and two of the council's four black members voting against it. The opponents said they feared that the poor, particularly minorities, would suffer the brunt of the new ordinance.

"In these tough economic times, it's not just going to be immigrant families who are affected. It's going to be a lot of families going through hard times," said council member Steve Salazar.

Technology, Disability, And The Americans With Disabilities Amendments Act

The disabled, under Social Security, must generally prove they are unable to perform their prior jobs going back 15 years. To do this, individuals must show they cannot perform those jobs as they actually performed them or as the jobs are generally performed. Technology can make certain jobs easier to perform. For those who cannot adjust to their past work, or other work in the economy, disability is available.

Suzanne Robitaille writes about technology and its role in assisting those with disabilities in the workplace and general lifestyle. Her recent article “For the Disabled, More Power for Play” appears in BusinessWeek. She notes in her introduction that the new Americans with Disabilities Amendments Act that goes into effect in 2009 expands the number of disabilities previously recognized:

“Assistive technologies are prevalent in the workplace, but when people with disabilities gear up to have some fun their options are more limited. This may seem like an oversight, but it's not: Disability protections have mostly focused on boosting jobs for this group, and employer demands for computers, mouse alternatives, and similar assistive technologies have soared over the last decade.

With the New Year, the landscape will be altered—for the better—for the nation's 56 million disabled Americans. President Bush in September signed the Americans with Disabilities Amendments Act, which will go into effect Jan. 1, 2009. The act will expand on the original 1990 law to include more disabilities that affect "one or more major life activity," such as learning disorders, among many others. It will also clarify that a major life activity doesn't just include work. The act expands this definition to include communicating, reading, and other activities of central importance—such as plain old fun. The new requirements for businesses have not yet been spelled out."

Featured Link - HelpInsure.com

Texans have had the highest homeowner insurance rates in the country for years. And with our Republican government's pro-business priorities, that probably won't change anytime soon. But at least the State now offers a Web site where consumers can compare insurance rates for homeowner and automobile protection. The site is HelpInsure.com, and this is the explanation from there:

Compare Rates for Insurance

Helpinsure.com is a comprehensive resource to help you shop for auto and residential property insurance. You can view and compare sample rates provided by insurance companies, get information about companies and agents, and learn more about the types of insurance you need to protect your family and property.

This website is a free service of the Texas Department of Insurance (TDI) and the Office of Public Insurance Counsel (OPIC). TDI and OPIC are state agencies. We do not sell insurance, and we do not endorse any product, service, or company.

Getting Started

To view sample rates:

1. Select one of the tabs above to choose the type of insurance you're shopping for.
2. Provide some basic information about you and your situation. Insurers use this information to determine the rates they charge.
3. Compare sample rates.
4. Create custom worksheets to make detailed comparisons of sample rates, policy coverages, and companies.

PLEASE NOTE: The sample rates are estimates given to TDI by the companies listed. Your actual premium will be based on your individual circumstances and could be higher or lower than the sample rates shown. To get an exact premium quote, contact the company or an agent directly. Some companies may require you to meet eligibility requirements.

For more information contact: [email protected]

USA Today Argues Defensive Medicine Increases Healthcare Costs

From the American Association for Justice:

In its Opinion blog, USA Today (12/29) editorializes, "Healthcare costs are out of control," but "that doesn't stop sensible physicians from shunning the sickest patients or ordering needless hospitalizations, drugs, tests, and invasive procedures." In fact, "against their better judgment, physicians practice 'defensive medicine' -- actions designed to protect themselves from lawsuits rather than serve patients' best interests." The reason is because "the threat of being sued is pervasive, and doctors simply don't trust the legal system." The cost of practicing defensive medicine costs the US "$60 billion-plus, according to the Health and Human Services Department." USA Today argues that "change obviously is needed -- and aggressively resisted both by trial lawyers who profit from the system and by others who don't want to lose a deterrent to medical malpractice." USA Today concludes, "Reform would encourage doctors to focus on patient needs instead of what unnecessary tests might keep a lawyer away from their doors."

AAJ president contends reducing preventable medical errors will lead to fewer malpractice claims. In an opposing viewpoint, Les Weisbrod, president of the American Association for Justice, writes in the USA Today (12/29) Opinion blog, "The field of medicine is filled with doctors devoted to improving lives and protecting patients. Trial attorneys also are passionately committed to these identical principles." In fact, "America's fair and open legal system helps injured people seek recourse, and leads to improved safety methods and standards." Arguing that "98,000 people die every year from preventable medical errors," Weisbrod contends that "by reducing medical errors, fewer people will be injured, leading to fewer malpractice claims." He also asserts that a study conducted by Harvard's School of Public Health "found 97 percent of medical malpractice claims had merit, proving only those with real injuries seek any recourse." Weisbrod concludes, "If we want to reform healthcare, reducing the 98,000 preventable deaths is where progress is desperately needed." Meanwhile, the US "legal system provides justice for deserving, injured individuals while holding wrongdoers accountable."

Choosing A Home Health Care Agency

Many of our personal injury clients and Social Security disability claimants require home health care. One of the best companies providing this service in the Dallas and Fort Worth area is Nurses Today, owned and operated by Ms. Anita Porco, R.N. This information about choosing a home health care agency is from the Nurses Today Web site: 

Home health care can be defined as care brought to the home to maintain or restore a person's health and well-being. Home health care is provided through various private agencies (profit and non-profit), hospitals, (public and private) and public health departments.

The Department of Aging and Disability Services licenses the agency to provide home health care after meeting rigorous standards and criteria. A licensing survey is conducted regularly after the initial license is granted. Ownership of the agency by a health care professional may establish a higher level of care for the client.

Your phone calls to the agency need to be dealt with promptly and personally. When caregivers are employees of an agency rather than independent contractors, the agency has control of the employee as well as insurance and taxes for the employee. Supervisory visits by a Registered Nurse to evaluate care should be performed at least every 6 months. An agency that has been in business for several years should be able to provide references from clients (private individuals, hospitals, nursing homes or physicians).

If you have any concerns about the agency that you are considering you can call the Department of Aging and Disability Services for information at: (512) 438-3011

Here is your checklist of questions to help you determine which agency you may want to use:

1.  Is the Agency licensed by the State of Texas?

2.  Is the agency owned by someone who has a health care background?

3.  Does the agency carry worker's compensation and liability insurance and bonding?

4.  Are the care givers treated as employees or as independent contractors?

5.  Is there a medical person available 24 hours a day, 7 days a week to handle your concerns?

6.  How professionally does the agency respond to calls made to the agency?

7.  What are the qualifications of the care givers?
  A.  Are their references checked?
  B.  Is there a personal interview?
  C.  Is there a criminal history check for all employees?
  D.  Is the license verified with the Texas Board of Nursing for RN's and LVN's?
  E.  Is there verification of eligibility for employment?
  F.  Are there testing procedures to verify competency?
  G.  Are employees CPR certified?
  H.  Are employees verified as free of communicable diseases?
  I.  Are employees drug screened?

8.  Is there an evaluation process to determine the appropriate level of care?

9.  Can the agency provide continuity of personnel?

10. Are the charges for services made clear to you prior to services being rendered?

11. Does your physician have input into the care provided?

12. How is the care provided evaluated?

13. What references is the agency able to provide?

14. When was their last licensing survey?

15. How long has the agency been in business?

16. Does the agency specialize in any type of care?

Friday Fun

100 Movies, 100 Quotes, 100 Numbers

Merry Christmas!

Merry Christmas to each and all of you! My hope for you is that you spend a wonderful day today with family and friends, and that you remember the reason we celebrate this day.

For everything you would ever want to know about the history of Christmas, visit the Christmas page of the History Channel Web site.

Wal-Mart Settles Wage Claims With Workers

The New York Times (12/24, B1, Greenhouse, Rosenbloom) reports, "Wal-Mart said on Tuesday that it would pay at least $352 million, and possibly far more, to settle lawsuits across the country claiming that it forced employees to work off the clock" and some "lawyers described it as the largest settlement ever for lawsuits over wage violations." The "union critics of Wal-Mart, the world's largest retailer, saw the settlement as proof of their view that the company achieves its low prices in part by cheating workers." But Tom Mars, Walmart's general counsel and an executive vice president, said, "Many of these lawsuits were filed years ago, and the allegations are not representative of the company we are today." The settlement "involved hundreds of thousands of current and former hourly employees. It is unclear how much the average employee will receive but the sum could be several hundred dollars."

Bloomberg News (12/24, Fisk) reports, "The agreement comes five weeks before Mike Duke takes over from outgoing Chief Executive Officer H. Lee Scott, who has overseen a sales resurgence and sought to burnish Wal-Mart's image among environmentalists, politicians and labor groups. Wal-Mart may pay from $352 million to $640 million, potentially less than 0.1 percent of its $378.8 billion in revenue in 2008."

The AP (12/24) reports, "Last year, Wal-Mart said it would pay more than $33 million in back wages to thousands of employees after turning itself in to the Labor Department for paying too little in overtime over the past five years. A judge in Pennsylvania also ruled last year that Wal-Mart workers in that state who previously won a $78.5 million class action award for working off the clock will share an additional $62.3 million in damages."

News courtesy of the American Association for Justice.

FDA Chastises Coca-Cola Over "Diet Coke Plus" Labeling

From the news release of the American Association for Justice:

In an article appearing in some 30 papers and websites including the Washington Post, the AP (12/24, Perrone) reports that the FDA has "scolded" the Coca-Cola company "for placing inappropriate nutritional claims on its Diet Coke Plus soft drink." The label reads, "Diet Coke with Vitamins and Minerals," but "regulators said the beverage does not have enough nutrients to justify the use of the word 'plus' in its name. According to the agency, foods labeled 'plus' must have at least 10 percent more nutrients than comparable products." The FDA gave Coke ten days to respond with plans to correct the inconsistency. The Wall Street Journal (12/23, Rubenstein) Health blog added that the letter said "'the FDA does not consider it appropriate to fortify snack foods such as carbonated beverages.' The letter warning Coca-Cola that Diet Coke Plus violates federal law was dated Dec. 10, but was published online today."

However, Dow Jones Newswires (12/23, Favole) reported that "Coca-Cola believes the label complies with the FDA's policies and regulations, said Scott Williamson, a Coca-Cola North America spokesman. He said the company takes the FDA's concerns seriously, while noting that the warning doesn't involve any health or safety issues." Forbes (12/24, Reese, Rubillo) also reports on this story, noting that despite the initial dip in stock value on the announcement of the FDA's admonishment, it could become "a classic case of 'bad' publicity likely becoming good publicity. There will be plenty of consumers that may now be interested in trying the drink."