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The CMG Voice

New transport technology keeps livers warm and alive – not on ice in a cooler

Posted Thursday, April 26, 2018 by Tyler Goldberg-Hoss

As you may know, we as a society have not figured out the best system for organ transplantation. I have already written on the problem of too little organs and at least one solution for it. Additionally, some have advocated for legalizing the ability to sell your organs.

Within that context, medical researchers continue to find ways to make our organs last longer, make transplantation less necessary, and increase the likelihood that an organ will be viable for transplantation.

This includes hearts and now livers. A new study finds that instead of traditionally keeping livers “on ice” during the transport process, livers actually prefer to be warm.

The new technology, called an OrganOx device, replicates a liver’s normal environment, including keeping livers functioning during transport. This resulted, according to the study, in a greater chance the organ will actually be used in transplantation due to less injury to the liver as it “lives” outside the body.

You can read more about the results of the study here:

A ‘breakthrough in organ preservation’: Study shows keeping livers warm helps preserve them for transplant

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Radiologists watch out – Artificial Intelligence is coming

Posted Monday, April 23, 2018 by Tyler Goldberg-Hoss

Recently the FDA approved the marketing of a device that uses Artificial Intelligence (AI) to screen patients for the eye disease diabetic retinopathy.

The software, called IDx-DR, uses AI to analyze images taken of the retina. It is marketed toward health care professionals such as primary care doctors who may not normally be involved in the eye care of their patients.

Someone in the office takes a picture of the retina with a special camera. Then the images are uploaded to a server where the IDx-DR software is installed. Then IDx-DR does it’s thing. First, it determines whether the images are good enough quality to analyze. Next, if the images are good enough, it analyzes them, producing one of two results: either (1) “more than mild diabetic retinopathy detected: refer to an eye care professional” or (2) “negative for more than mild diabetic retinopathy; rescreen in 12 months.”

IDx-DR is not perfect: in the FDA study, it correctly identified more than mild diabetic retinopathy 87.4% of the time, and correctly identified those patients without more than mild diabetic retinopathy 89.5% of the time. However, considering how diabetic is the most common cause of vision loss among diabetics in the US, early detection of disease is important in halting its progress, and about ½ of all diabetics don’t see their eye doctors on a yearly basis. The software promises to improve detection and prevent vision loss for a significant number of people.

As an attorney who handles claims against medical providers, it will be important for any such provider to make sure each patient is appropriate for the screening software (some patients, such as those with underlying eye conditions, should not be screened with IDx-DR). And patients should be aware that the software is not perfect; they should go to their eye doctor if they begin having any vision symptoms.

Although this is a baby step in terms of using AI to screen for abnormalities in medical imaging, it does not take much effort to imagine AI interpreting x-rays and other imaging in the future. How long will it be before we are able to use our smartphones to take pictures of our bodies and allow AI to diagnose us?

You can read the FDA release here to learn more:

FDA permits marketing of artificial intelligence-based device to detect certain diabetes-related eye problems

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UberHealth launches. Perhaps more patients will make their medical appointments.

Posted Thursday, April 19, 2018 by Tyler Goldberg-Hoss

Nearly a year ago, I wrote about how, with the advent of ride sharing companies, some people have elected to use Uber or Lyft to take them to the Emergency Department instead of calling an ambulance.

It appears that Uber was paying attention. It has recently launched UberHealth, focused on helping patients get rides to medical appointments they might otherwise not make.

The UberHealth service is different than the traditional ride sharing apps in that the medical provider arranges the rides for the patient. The patient doesn’t need an app, or even a smartphone.

The benefit to the patient is obvious. For many, just getting to the doctor can be burdensome, particularly for those with limited means and/or without reliable transportation. This service will hopefully provide better access to healthcare.

For medical providers, this service aims to reduce the amount of no-shows, which cost providers money. In addition, with patients receiving better healthcare, hopefully they will in turn be healthier, and need less health care. Consider a patient who doesn’t make it to a doctor’s appointment, or fails to follow through on prescribed treatment plans, including physical or occupational therapy. That patient is less likely to have control over their medical condition, and more likely to need costly care in the future as a result.

You can read more about this new service here:

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Director of shuttered Seattle Pain Centers keeps license after clinics found to have caused or contributed to 16 deaths

Posted Monday, April 16, 2018 by Tyler Goldberg-Hoss

In September of 2016 I wrote about the suspension of Dr. Frank Li, director of a number of Seattle Pain Center clinics in the Puget Sound area.

Dr. Li’s medical license was suspended pending an investigation surrounding deaths associated with patients of his clinics. As a result, a number of opioid dependent patients were suddenly without a medical provider to prescribe them medication. Many scrambled to find other providers willing to do so, often encountering significant difficulty.

Recently, following the investigation conducted by the Washington Medical Commission, an agreement was reached whereby Dr. Li’s license remains suspended for at least another year. Further, once his license is reinstated, his ability to prescribe pain medication will be limited.

You can read a Seattle Times article on the recent agreement here:

In wake of deaths, Seattle-area pain doctor agrees to face a lifetime of restrictions

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The litigation process is particularly hard on wrongful death claimants

Posted Thursday, April 5, 2018 by Tyler Goldberg-Hoss

Hopefully, if you are reading this, you have never contemplated bring a lawsuit alleging that some person or entity wrongfully caused a loved one to die.

For those unlucky few who have and have not yet decided, it is worth a detailed discussion with your prospective attorney about how the process may negatively impact you.

Wrongful death litigation is not a particularly fun endeavor. For starters, the reason you are in such a position is because you have lost someone close to you; a spouse, a parent, maybe even a child. Not only that, the death often times is unexpected, adding another layer of feelings to process.

Through litigation, claimants can feel victimized all over again. The discovery process includes both written questions and often a deposition, where you are compelled to attend, swear before a court reporter to tell the truth, and then you are interrogated about the decedent, your relationship with him or her, and other areas of inquiry. Often such questions can involve delicate or sensitive matters. All of this can be difficult emotionally.

You may learn through the process that the defendants are blaming your loved one – or maybe even you – for causing the death.

Through it all, you are constantly reminded of your loss. It is perhaps primarily because of this that many wrongful death claimants have found that their process of grieving became stunted until the litigation was over.

Finally, claims are not always successful. You could slog through all of the above, and at the end of the trial, you end up with nothing.

Still, most of my wrongful death claimants have also told me, regardless of the outcome, that they were glad to have done it. Bringing a civil lawsuit does not bring a person back to life, but it is one of the few ways we as a society have figured out to hold someone accountable if a jury has decided he or she is responsible for a death.

Although often the focus of the result of a lawsuit – money – is on the family being compensated, don’t forget that the money serves a dual function - compensating the decedent’s family while simultaneously creating a deterrent effect on future negligent conduct. It is always my hope that, through this process, we as a society are safer.

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