A classic scene in the 80s movie Crocodile Dundee was when a New York City thug pulled a switchblade on the Australian hunter and demanded his money. “Give him your wallet,” his frightened friend said. “He’s got a knife.”
“That’s not a knife,” Dundee says smiling as he pulls out a menacing hunting knife. “This is a knife!”
The thug and his accomplices quickly scatter.
I recalled that scene this morning while reading an investigative story in Kaiser Health News that revealed more than 10,000 patients last year were diagnosed with covid after being admitted for another condition. About 21 percent, or just over 2,000 of these patients, died between April and September, according to KHN’s analysis of public records.
The stats are alarming, but even more alarming are statistics released in September by the Society of Healthcare Epidemiology of America (SHEA), which revealed that hospital acquired infections (HAIs) soared in 2020, as much as 47 percent relating to some treatments. SHEA didn’t quantify the likely number of deaths resulting from the increased infections, but the CDC estimated in 2014 that about 70,000 people died annually because of HAIs. Although hospitals made great strides in recent years reducing infections, it stands to reason that the dramatic increase last year resulted in tens of thousands of patient deaths.
“Its mind boggling that covid gets all the attention when there are much more critical and prevalent issues like hospital infections that need to be addressed,” a hospital industry source said.
Likely, some of the patients who contracted covid after landing in the hospital are included in SHEA’s statistics. But industry experts tell me that hospital covid statistics are inflated because hospitals have a financial incentive to classify a patient as having covid. Hospitals treating a patient with garden-variety pneumonia – an ailment so common in elderly patients it’s known as “the old man’s friend” – receive a mere $5,000 from Medicare. But if they classify that patient as suffering from covid they get $13,000. And if they put the patient on a ventilator, they get $39,000.
It isn’t a conspiracy theory to suggest that “nonprofit” hospitals would cheat the government with bogus diagnoses. The National Health Care Anti-Fraud Association estimates that healthcare fraud represents as much as $300 billion, or 10 percent of America’s annual health care outlay. And much of this fraud is for costly treatments that weren’t medically necessary. At the height of the pandemic several hospital workers contacted me to say their hospitals were falsely classifying patients as having covid when they didn’t. One source said her mother’s death certificate listed covid as the cause when she died of cancer. The practice seems to be one of the worst kept industry secrets.
Another reason hospital covid deaths in 2020 were inflated was because many of them resulted from the treatment of covid, rather than the disease. According to the American Journal of Tropical Medicine and Hygiene, as many as 50 percent of the deaths could have possibly been avoided had hospitals used ventilators more sparingly.
Hospitals can dramatically reduce HAIs if they set their mind to it. Between 2016 through 2018, the latest available government data, the national rate of bloodstream infections after surgery was about five percent. Yet 12 hospitals managed to dramatically cut their infection rates to 2.85 percent or lower. One of those hospitals was Cleveland Clinic, whose CEO years ago set an internal HAI target of zero.
Speed is critical when it comes to administering antibiotics to patients with infections. A 2014 study posted on the National Institute of Health’s website revealed that outcomes for patients with sepsis, a condition when infections start attacking vital organs, dramatically improve if they receive antibiotics within three hours of the diagnosis. The mortality rate increases by over seven percent with every hour of delayed antibiotics.
Cocktails of antibiotics are typically administered through drug infusion pumps. It’s estimated that more than 60 percent of hospitals rely on Alaris infusion pumps, including 152 VA hospitals. The infusion pumps have been subject to more than a dozen FDA recalls, including some identified as “Class 1,” meaning they involve risk of death or injury. In addition to frequently breaking down, Alaris pumps have been known to administer incorrect drug doses, an especially dangerous flaw because they are often used in intensive care units to treat critically ill patients. The FDA has put Alaris pumps on “ship hold,” meaning that a hospital agrees to accept all liability resulting from use of the pump to accept delivery.
FDA filings reveal Alaris pumps have been linked to more than 60,000 reported malfunctions, including about two dozen deaths and hundreds of injuries. The actual numbers are likely higher since it’s estimated that less than 10 percent of all medical incidents in the U.S. are reported. Class action law firms aggressively solicit patients who have been harmed by Alaris pumps. The Department of Homeland Security last year issued an alert warning the Alaris pumps are highly vulnerable to cybersecurity breaches. A hacker accessing a drug pump can kill patients by altering the prescribed doses of medicines or simply shutting down the machines. Hackers have been known to disrupt critical patient treatments.
A reliable industry source confirmed for me that Cleveland Clinic uses drug infusion pumps manufactured by Baxter at most of its facilities. Baxter infusion pumps are considerably more reliable and safer, according to FDA filings.
In April, I reported for Deadline Detroit that a senior manager at Beaumont Health’s flagship hospital in suburban Detroit sent a text message intended for the manager of anesthesia and supplies advising him not to accept “anything in writing” from hospital nurse anesthetists relating to problems with Alaris pumps. The manager mistakenly sent the text to one of the hospital nurse anesthetists just after it became known his colleagues had garnered sufficient votes to unionize because of patient safety issues.
I will let you speculate as to why the Beaumont manager didn’t want any issues documented in writing.
Hospitals in Michigan, and perhaps in other states, don’t appear to be tightly regulated, if at all. At the height of the pandemic in Michigan, Beaumont temporary closed a hospital that was designated to treat only covid patients. The local ABC news affiliate reported that Beaumont transferred dozens of covid patients to the local VA hospital, including some on ventilators and one listed as too unstable for a transfer. That patient died during the transfer.
The station obtained a memo from a Beaumont hospital manager that said, “(CEO) John Fox went to (Governor) Gretchen Whitmer and said Beaumont health cannot sustain all the COVID patients because financially it will ruin our business … We are bleeding money out of our system.”
A spokeswoman for Michigan Attorney General Dana Nessel didn’t respond when I inquired whether the transferring of patients on ventilators would be investigated. Beaumont in 2020 added $1 billion to its already sizeable $2.5 billion reserve. Fox is a former chair of the Michigan Health and Hospital Association. He is paid more than $6 million a year to run an eight hospital system, which has markedly declined under his leadership.
Earlier this year a patient at Beaumont Royal Oak died from an intubation complication undergoing a routine colonoscopy within three weeks of a controversial outsourcing company taking over the hospital’s anesthesia functions. After the outsourcing contract was announced, the co-heads of Beaumont’s cardiology department warned the hospital’s chair they had “serious concerns” about the outsourcing firm’s capabilities. It’s not clear the chair bothered to read the warning because Detroit’s local business publication reported he had received so many complaints about CEO Fox that he stopped reading them. Beaumont denied that claim.
As for KHN’s report, the publication’s investigation efforts are admirable. But KHN did a disservice allowing the wife of a patient who contracted covid at Blake Medical Center in Florida and died to criticize the hospital for not mandating that its healthcare workers get vaccinated. KHN hopefully knows that vaccine mandates for healthcare workers are intended to reduce their severity of covid illness. A vaccinated healthcare worker can still transmit the virus.
Notably, the Cleveland Clinic initially resisted vaccine mandates, but reversed itself in September after President Biden issued his edict.
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