Posted on 08/26/2019 4:17:24 PM PDT by grumpygresh
Johnson & Johnson ordered to pay $572M in historic opioid trial. In a landmark decision, an Oklahoma judge on Monday ordered pharmaceutical giant Johnson & Johnson to pay $572 million for its role in the state's opioid crisis.
(Excerpt) Read more at msn.com ...
When I lived near Savannah, a lawyer got something like a 9 million dollar judgement for a baby.
He paid the baby $100,000.00 and gave the rest to himself. Fortunately the Probate Judge caught it. He reversed the payments.
It sure is getting that way.
THE cause of the opiod crisis was the Obama administration making pain a part of vital signs.
Doctors had to describe these pills if anyone was in pain of face lawsuits and disciplinary actions.
Net worth = $360 billion.
The cause of the opioid crisis was the rise in illegal drug market which was facilitated by government bureaucracies, money laundering banks and the police state.
There weren’t hardly any lawsuits for inadequate pain control, you could list them on your hand.
Sessions was the scumbag that pushed this to the extreme; the leftists and statists in the doj went right along with it becuse they saw easy targets. It’s a lot harder to go after drug lords and gangs; they don’t have addresses and regular bank accounts. The people in these agencies are statists and leftists and don’t want to go up against hardened targets.
Yep, 25 TONS of Chinese fentanyl seized in Mexico recently. President Trump is attempting to get Chinese shipments of fentanyl stopped as part of a trade deal.
As far as I can tell J&J only makes 2 types of opioids, and one is a patch. (the other a pill). Duragesic and Nucynta. How many deaths due to those two prescribed Rx’s?!? Vs. fentanyl, oxycodone, heroin, etc., etc.. Bogus case and bogus ruling by the judge.
What a Racket, I hope Everyone of these Plaintiffs, Jurors, Lawyers and the Judge SUFFER from a Bad Accident or other extremely painful event, and they should ALL be put on a NO OPIOID LIST for the Rest of their miserable lives.
when I was 18 I had a Bad Accident and had a choice to go into a Medical Coma or Take ALL the Percodan(yesterdays oxycontin) I could eat for 3 months. I became very addicted, I went through withdrawls in the Hospital immediately after Surgery. All by CHOICE!!!
No doubt to be appealed.
I’m surprised that a conservative state with a Republican Governor and a Republican Attorney General were the ones to file this suit.
Oklahoma had previously sued and won against Purdue Pharma, Inc and got a $270 million settlement.
I hope Everyone of these Plaintiffs, Jurors, Lawyers and the Judge SUFFER from ... an extremely painful event, and ...be put on a NO OPIOID LIST ///
My sentiments exactly. J&J simply makes the drugs to relieve pain. Patient’s cannot obtain them without a MD Rx.
Though it would be hard on the public, I hope these companies respond to this govt thievery by going Galt’s Gulch on them. Fire thousands of workers, raze the manufacturing plants, and return it to the state “the way they found it.”
“Just notice the number of commercials being aired by law firms wanting to get their hands on the Monsanto Round Up lawsuits”
And yet you can still buy Round Up in Lowe’s or Ace Hardware. If it’s so dangerous, why can we still buy it? Seems a bit contradictory.
I agree
Judge probably paid off by someone in the state or Feds either offshore cash or promise of promotion. No doubt, the government crooks like the precedent.
Government is secret and dirty. I wish more people would wake up to this. I would have thought that the Page-Strzok e-mails should have woken a lot of people up. Government corruption is the rule not the exception.
It’s kind of like gun control, just demonize a medication instead of the misuse. Make it harder for law-abiding citizens to have Firearms or truly needy patients to receive pain relieving drugs. Statistics do show an increase of overdose on opioids, but it’s not prescription drugs that are the cause. It is the Street Fentanyl and the illicit drugs imported from China
In addition to the other actors in the opiod mess, the ACA, as enforced, coerced hospitals towards coercing their doctors to prescribe painkillers at high rates.
The same thing for the states who won millions of dollars from the tobacco industry while their state hired attorneys collected millions
THE cause of the opiod crisis was the Obama administration making pain a part of vital signs.
Doctors had to describe these pills if anyone was in pain of face lawsuits and disciplinary actions.
“the ACA, as enforced, coerced hospitals towards coercing their doctors to prescribe painkillers at high rates.”
Interesting if true. Do you have any sources, articles to back it up? I do know that hospitals were required at one point to list the pain score as a vital sign, but I am not aware of coercion to prescribe opiates by government or hospital administrators at least publically.
I do know that DEA increased the allowable opioid production in 2012 by about 40%. https://www.theguardian.com/science/2016/oct/05/opioid-production-us-epidemic-drug-enforcement-administration
But that being said, the increased overdoses is due to illicit drugs not prescriptions.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6369835/ and https://www.cato.org/blog/washington-post-revelation-pain-pill-distribution-only-helps-fuel-false-narrative.
Exactly
Just a couple of quick searches:
the three questions in the original survey were:
During this hospital stay, did you need medicinefor pain?
During this hospital stay, how often was your pain well controlled?
During this hospital stay, how often did the hospital staff do everything they could to help you with your pain?
On October 1, 2017, the Centers for Medicare & Medicaid Services (CMS) announced they will no longer use results from the pain management portion of the Hospital Consumer Assessment of Health Providers and Systems (HCAHPS) survey to impact reimbursement rates from the Hospital Value-Based Purchasing (VBP) program*. The Department of Health and Human Services (HHS) determined pain management questions may financially incentivize inpatient hospitals to over prescribe opioids in an effort to eliminate pain and improve survey results.
HHS intends to replace the current questions with questions targeted toward pain management communication similar to those in the Outpatient and Ambulatory Surgery (OAS) CAHPS. HHS will have public comment periods available during development and prior to implementation of the new pain management questions for the HCAHPS. The President’s Commission on Combating Drug Addiction and the Opioid Crisis supported this decision as part of their 56 recommendations released on October 31, 2017.
…
*For now, the pain management questions will continue to remain a part of the survey sent to patients and will be used when determining scores for the Hospital IQR program, HCAHPS star ratings, and Hospital Compare overall ratings. However, the scores will not impact reimbursements through the VBP program.
Case
A hospital’s Committee on Patient Quality meets monthly to discuss a strategic plan to address deficiencies in scores on its Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey results. Dr. Anderson begins the meeting by proposing a new pain management protocol to the group. He references the plateau in pain management scores in the HCAHPS report, warning that the organization will sustain substantial financial penalties by failing to improve in the “patient experience of care” domain. As Dr. Anderson begins to explain the new protocol for pain management and how it will bring about an upward trend in scores, Dr. Parker interjects.
“Can we take a step back for a moment? I understand that patient satisfaction surveys can provide a lot of useful information to our hospital system. But a low rating on—let’s say pain control—doesn’t mean the patient received low-quality care.”
“I agree with what you’re saying, but this is the reality of pay for performance. Plus, there is value in considering patient satisfaction—happier patients are more likely to adhere to our recommendations and return in the future. As you mentioned, we can learn a lot from these surveys—like how helpful it was to have extra volunteer greeters in the lobby to assist patients with finding their way in the hospital,” explains Dr. Anderson.
“I still don’t think it makes sense for Medicare to tie the survey results to our reimbursement,” Dr. Parker counters. “Financial penalties for hospital-acquired infections and preventable readmissions make sense. Public reporting of morbidity and mortality encourages systemic improvements and patient empowerment. But all of these are objective measures. Patient satisfaction just isn’t an objective measure of care quality.”
…
Now, as part of the ACA’s Hospital Value-Based Purchasing Program [1], CMS is withholding 1 percent of Medicare payments—30 percent of which is tied to HCAHPS scores—to fund the incentives of the program [4]. The proportion of the payouts that is withheld from hospitals will undoubtedly increase over time. There are similar incentive components in the Physician Quality Reporting System (PQRS). Overall, measurement of and incentives linked to patient experience are increasing [5].
https://www.medscape.com/viewarticle/875980
Pain management specialist Ralph laraiso, MD, commented that patients don’t use the Visual Analogue Scale in the way it was originally developed, “while others have learned to manipulate that scale to obtain the maximum amount of narcotic medications.”
Dr Iaraiso said he relies more on functional status. “Many of these patients have psychosocial issues that will not be relieved by pain pills, but they will not admit to that nor seek appropriate professional services on their own, or, when referred, they are resistant,” he said.
…
Pressure to Prescribe?
Survey participants were asked how often they feel pressure to prescribe pain medication in order to keep patient satisfaction levels high.
For physicians, 28% said often; 29%, sometimes; and 6%, always. About a third said they never or rarely felt that pressure. Nurses felt similar pressure. Thirty-percent said they often felt a need to prescribe; 23%, sometimes; and 12%, always. Thirty-five percent said they never or rarely felt pressured to prescribe.
Mary Mavraganes, a registered nurse, said, “often we are forced to give pain medicine per family or patient request.” This can be the wrong move in the elderly, as they “become very confused, which results in falls,” said Mavraganes.
Another registered nurse, Debra Bork, said, “Since the opioid epidemic hit the fan, people want narcotics for every little pain they have and expect to get them.”
…
“Government involvement in healthcare, especially HCAHPS, has no real value, but utilizes subjective measures and no outcome data to hijack hospital reimbursement,” commented Allen Coleman, MD, an anesthesiologist. “Pain scores are entirely subjective and leave us treating numbers, which is something good medical students learn not to do in clinical rotations.”
https://www.ashp.org/news/2013/04/26/pharmacists_work_to_boost_patient_satisfaction_scores
“We have an acute pain steering committee [that] is charged with looking at ways to improve pain management,” Ghafoor said. “And they had asked pharmacy specifically to look at some of the medication issues and try to see if there are ways to improve the medication administration up on the floors.”
During a two-month pilot program on the hospital’s oncology and medical–surgical units, Ghafoor reviewed medication administration records for each patient whose pain score was at least 5 out of 10. During multidisciplinary rounds, she recommended ways to maximize these patients’ pain therapy with opiates and other analgesics.
Important to the process was a review of each patient’s medication history, including data on controlled substance use obtained from the state’s prescription drug monitoring program.
“If the patient is missing a medication that they were on [at home], we want to make physicians aware of that so they can order that, because that, a lot of times, contributes to the pain,” Ghafoor said.
In the hospital’s oncology unit, Ghafoor’s efforts resulted in 84% of patients saying the staff always did everything they could to control pain, a 14-percentage-point increase on that HCAHPS measure. On the medical–surgical unit, the score rose from 78% before the pilot program to 91% afterward.
https://www.practicalbioethics.org/files/pains/PAINS-policy-brief-8.pdf
[This article is actually pro 5th Vital Sign]
Unfortunately, in conjunction with embracing Pain as the 5th Vital Sign, many hospitals established standardized protocols with different doses and formulations of pharmacological therapies based on narrowly focused pain scores alone.
https://www.mayoclinicproceedings.org/article/S0025-6196(17)30923-0/fulltext
Abstract
The opioid crisis that exists today developed over the past 30 years. The reasons for this are many. Good intentions to improve pain and suffering led to increased prescribing of opioids, which contributed to misuse of opioids and even death. Following the publication of a short letter to the editor in a major medical journal declaring that those with chronic pain who received opioids rarely became addicted, prescriber attitude toward opioid use changed. Opioids were no longer reserved for treatment of acute pain or terminal pain conditions but now were used to treat any pain condition. Governing agencies began to evaluate doctors and hospitals on their control of patients’ pain. Ultimately, reimbursement became tied to patients’ perception of pain control. As a result, increasing amounts of opioids were prescribed, which led to dependence. When this occurred, patients sought more in the form of opioid prescriptions from providers or from illegal sources. Illegal, unregulated sources of opioids are now a factor in the increasing death rate from opioid overdoses. Stopping the opioid crisis will require the engagement of all, including health care providers, hospitals, the pharmaceutical industry, and federal and state government agencies.
Side article, but interesting:
https://www.theatlantic.com/health/archive/2015/04/the-problem-with-satisfied-patients/390684/
The vast majority of the thirty-two-question survey, known as HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) addresses nursing care. For example, in a section about nurses, the survey asks, “During this hospital stay, after you pressed the call button, how often did you get help as soon as you wanted it?”
This question is misleading because it doesn’t specify whether the help was medically necessary. Patients have complained on the survey, which in previous incarnations included comments sections, about everything from “My roommate was dying all night and his breathing was very noisy” to “The hospital doesn’t have Splenda.” A nurse at the New Jersey hospital lacking Splenda said, “This somehow became the fault of the nurse and ended up being placed in her personnel file.” An Oregon critical-care nurse had to argue with a patient who believed he was being mistreated because he didn’t get enough pastrami on his sandwich (he had recently had quadruple-bypass surgery). “Many patients have unrealistic expectations for their care and their outcomes,” the nurse said.
In fact, a national study revealed that patients who reported being most satisfied with their doctors actually had higher healthcare and prescription costs and were more likely to be hospitalized than patients who were not as satisfied. Worse, the most satisfied patients were significantly more likely to die in the next four years.
...
How far will a hospital go to satisfy a patient? Recently, some have rushed to purchase extra amenities such as valet parking, live music, custom-order room-service meals, and flat-screen televisions. Some are offering VIP lounges to patients in their “loyalty programs.”
And because almost every question on the survey involves nurses, some hospitals are forcing them to undergo unnecessary nonmedical training and spend extra time on superfluous steps. Perhaps hospitals’ most egregious way of skewing care to the survey is the widespread practice of scripting nurses’ patient interactions. Some administrators are ordering nurses to use particular phrases and to gush effusively to patients about both their hospital and their fellow nurses, and then evaluating them on how well they comply. An entire industry has sprouted, encouraging hospitals to waste precious dollars on expensive consultants claiming to provide scripts or other resources that boost satisfaction scores. Some institutions have even hired actors to rehearse the scripts with nurses.
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