Overdosing on pain reliever acetaminophen

Acetaminophen, the active ingredient in Tylenol, is one of the most popular pain relievers in the United States, but a new report by ProPublica finds acetaminophen may have caused the deaths of more than 1,500 people over 10 years.

The parents of a 12-year-old boy, Davy, told ProPublica that they took him to the hospital after treating him for a sore throat for a week with maximum strength Tylenol sore throat medicine. The hospital found that Davy had liver damage from the acetaminophen, and was declared brain dead a few days later.

"The key issue with acetaminophen is really what they call the narrow margin of error. It's the narrowest margin of error between the dose that can (help) you and the dose that can harm," said T. Christian Miller.

If users take the recommended daily dose, it's a pretty safe medicine.

"If you go over that and not too far, you can get in trouble," said Miller. When taken in larger than recommended doses, acetaminophen can damage or destroy the liver.

"What makes Tylenol unique is it's really a pretty safe medicine at the recommended doses, but if you go over two pills, four pills, six pills, eight pills over a number of days, depending on your condition, you can get into trouble with things like liver damage and even death," said Miller.

The U.S. Food and Drug Administration is still struggling to identify the number of pills over the recommended dose that could be seriously detrimental to users.

"The number they put out right now is studies show that anywhere from about four pills over, to eight pills over of extra strength, taken over several days, can get you into trouble.," said Miller. "A one-time dosage of about four times (over the recommended dose) can also get you into trouble in terms of liver damage and fatality."

Another couple Miller and his ProPublica colleague spoke to were the parents of 5-month-old Brianna Hutto, who was given Tylenol.

"The doctor then comes in and says I figured it out. It's acetaminophen poisoning. She's been poisoned by Tylenol. Her liver is failing. Her enzymes are high," Brianna's mother told ProPublica.

"How did this happen? How did she get poison or whatever from medicine that's always given, that we were told to give?" said Brianna's father.

The unfortunate story of Brianna underscores the dangers of Children's Tylenol versus Infants' Tylenol. Counter intuitively, Infants' Tylenol has a higher concentration of acetaminophen.

"What happened is the major manufacturers of acetaminophen, like Tylenol and others, were selling two different concentrations of infants' and children's, and the infants' was three times more concentrated than the children's," said Miller.

"So if you mixed up the dosage, in other words, if you gave your infant baby Infants' Tylenol at a Children's Tylenol level, you could end up poisoning them completely accidentally. That happened a number of times over 15 years, and that's what happened with the Hutto's."

CNN's medical team points out that if taken in its recommended doses, users are safe to take Tylenol, and this is not just a Tylenol problem. Acetaminophen is in hundreds of other medications, and Tylenol has a new cap that warns users about the ingredient, and to use it safely.

Tylenol said in a statement to CNN:

"As the makers of tylenol®, we understand that consumers have a need to know about the medicines they take and we have a responsibility to help them make informed choices, including helping them to understand both the benefits and the risks. When taken as directed, acetaminophen (the active ingredient in tylenol®) has one of the most favorable safety profiles among over-the-counter pain relievers. However, when an overdose is taken, it can result in serious liver damage. Consumers should always read the label on the medicines they take, never take more than the recommended dose, and talk to their doctor if they have any questions or concerns. Visit us at http://www.getreliefresponsibly.com for more information."

For people at home with Tylenol, with Infants' Tylenol and Children's Tylenol,

"If you're a parent, the number one thing is to follow what the label says. And as of now, that label is: If you have a kid under 2, call your doctor for recommendations. So that's what parents should do right now, is follow the label as it's labeled, and be careful when administering doses to their kids," said Miller.


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Source: CNN (Tapper, 9/23)

Police say woman's death at Texas climbing gym a tragic accident

GRAPEVINE, Texas –– Police say the death of an experienced climber at a Grapevine climbing gym was an unfortunate accident.

According to Grapevine police, 52-year old Susan Mailloux likely forgot to clip herself into the safety rope system provided by the gym. If Mailloux’s Facebook page is any indication, she loved rock climbing. It is covered with pictures of her on the wall.

Yesterday, police say, she was climbing with her boyfriend and his son, at Summit Climbing. At the top, 25 to 30 feet up, police say Mailloux let go, as if she thought she was tied in. She was not.

“Once she got to the top of that road ladder she simply released as if she was attached to it and then she fell to the ground,” said Sgt. Robert Eberling with the Grapevine Police Department.

The gym requires climbers to sign a waiver warning against all types of possible injury or death, including “freakish accidents which cannot be forseen.” Police say Mailloux failed to clip into, what’s called an auto-belay, an automatic harness system that lowers a falling climber, slowly, to the ground.

Ben Mann is also a climber at Summit, he did not know Mailloux.

“All of the rock walls are lined with ropes and about every five to ten feet there’s a sign that says don’t forget to clip in, or make sure you’re clipped in,” Mann said.

The manager of the Budget Suites in Irving, confirmed Mailloux had lived here for several years Former neighbors say she also has a son in the Navy. The owner of Summit said Mailloux came in once every week or ten days to climb and police confirm had experience climbing.

The gym was closed today and will also be closed tomorrow, the owner says, out of respect for Mailloux and her family.

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Source: Kens5 (Schechter, 09/24)

Drunk driving in Plano: Does Plano PD's no-refusal policy work?

This is one of three stories chronicling the Plano Police Department's efforts to eliminate drunk driving.

In 2012, nearly 1,100 people were killed in car accidents on Texas roadways involving a driver under the influence of alcohol, according to the Texas Department of Transportation.

To help decrease that number, police departments across the state often institute no-refusal policies during holiday periods. During such times, judges are on call to sign blood-draw warrants for drivers arrested on suspicion of drunk driving.

The Plano Police Department is working to eliminate drinking and driving in the city by utilizing a no-refusal policy.

However, some departments, such as Plano PD, have gone a step further and made the no-refusal policy permanent. The decision to use no-refusal tactics year-round came in mid-2012, but the department began the expanded policy in 2009 by having judges on call every weekend.

Now that the policy is in full effect, is it working? To answer this question, the Plano Star Courier looked at police records dating from 2007 to now.

The statistics show a correlation between the increased enforcement and a decrease in DWI arrests, but are unclear how the policy affected alcohol-related traffic accidents.

Arrests

In 2008, the year before the increased enforcement went into effect on weekends, 1,252 people were arrested for DWI or DUI in Plano. That number decreased slightly in 2009 to 1,235 arrests but decreased an average of 11 percent each year from 2010 to 2012.

Officer David Tilley said he believes the no-refusal policy serves as a strong deterrent to people who may consider drinking and driving in Plano.

"This is something that is important to our department and to our officers because our job is to protect the public," Tilley said. "Sometimes, unfortunately, that means protecting people from themselves. We are going to have additional officers out there on weekends doing DWI enforcement, and we are going to be arresting you if you have been drinking."

Accidents

In 2008, 212 alcohol-related accidents occurred, a number that decreased each year through 2011, when 174 occurred. The number of accidents rose to 248 in 2012 but is projected to decrease to 200 this year.

With no changes made to the department's accident reporting policy, Tilley said it is the belief of the department that the 2012 figure was an outlier and that the department's policies are working.

"That number was very much a concern," he said. "We looked at it and said, 'What did we do wrong?' We really didn't feel we did anything wrong, but we knew we could improve, and that is when we started trying to get more information out to the public."

Warrants

As expected, the number of blood draw warrants issued in 2012, the first year the policy was in effect year-round, increased; 258 warrants were issued last year, up from only 35 the year before. Through the first six months of this year, 169 warrants were signed by judges.

While getting a warrant may seem more complicated than conducting the standard field sobriety and breathalyzer tests, that is not typically the case, said Officer Mica Lunt, one of the department's DWI trainers. Lunt said drivers who refuse all tests are often easier for officers to deal with than those who don't.

"In the case of a total refusal, the officer makes a decision based on the driving that has led them to come in contact with the offender, the observations they make of the driver when they get to the vehicle, and the fact the person has refused the tests," Lunt said. "... If the officer believes the person is intoxicated, they simply make an arrest, take them to jail and apply for a search warrant."

The no-refusal policy has also proven popular with officers for a number of reasons, Lunt said. Chief among them is that it provides more evidence for the district attorney, which results in more cases pleading out rather than going to trial.

"That is good for officers in a number of ways since most of the officers who make these arrests work nights, and court happens during the day. When a case like that goes to trial, officers are up for more than 24 hours straight all the time," Lunt said, adding that officers who work nights are paid overtime if they must attend court during the day.

Since 2008, 504 blood-draw warrants were signed for Plano officers. In those cases, blood-alcohol results were available in 479 of them. Data from Plano PD shows that in these 479 incidents, the arrested person had a blood-alcohol content under the legal limit of 0.08 in only 15, or 3 percent, of the cases. The person's blood showed no alcohol in four of the 15.

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Source: Plano Courier (Conrad, 08/29)

Construction workers in West Campus apartment complexes allege mistreatment, unpaid wages

Of the three West Campus apartment complexes that opened to more than 1,000 students this fall, at least two were built by construction workers who claimed they were mistreated.

Documents obtained from the City of Austin show complaints have been filed against the contractors who oversaw construction of 2400 Nueces and The Callaway House for lack of rest and water breaks for construction workers. Workers Defense Project, a nonprofit that strives to represent mistreated workers in Texas, has also taken legal action against owners of The Callaway House twice this year after learning of unpaid wages for construction workers who worked on the private off-campus dorm.

The City of Austin received a complaint, regarding breaks, against the construction project at the 2400 Nueces site. Construction workers who built the property have claimed they were not given rest or water breaks during day-long shifts of work. While Texas does not require breaks at the state level, a City of Austin ordinance requires a 10-minute rest break for every four hours on the job. A construction worker, who worked on 2400 Nueces and spoke to The Daily Texan on the condition of anonymity, said he was mistreated in several ways while working on the project.

Despite the conditions and not receiving overtime pay, the worker said he could not quit because he had to provide for his family and the work at 2400 Nueces was the only job he could get at the time.

Hensel Phelps, the general contractor for the project, did not return a request for comment, but city records show an inspector visited the site in response to the complaint filed in July 2012 and took pictures of rest stations, water coolers and the required city-issued signage about the policy. The land 2400 Nueces was built on is leased by UT to a private college student housing developer.

Around the same time the rest breaks complaint was filed, a construction worker at 2400 Nueces fell from the sixth floor injuring himself and the two other workers he fell on. They were all treated at a hospital for non-life-threatening injuries.

The worker interviewed by The Daily Texan — who was not one of the workers who fell — said he and other construction workers were not given any kind of health insurance or compensation while working on the site.

Greg Casar, a business liaison representative for Workers Defense Project, compared Texas’ construction industry to doping in sports.

“When it is so competitive, and there is really no enforcement or oversight, then it creates an incentive for everybody to cheat,” Casar said.

Texas is one of the nation’s most robust states for construction, with more than 950,000 construction workers in the state, according to the 2010 U.S. Census. Accompanying this massive amount of construction work is limited state government oversight and regulation. Unlike California and other states with large construction industries, Texas does not require breaks for workers or compensation for on-the-job injuries. The state also has no task force in place to monitor workplace fraud.

The allegations made by workers in West Campus are consistent with statewide worker mistreatment issues discussed in a report by UT.

Earlier this year, UT faculty — in partnership with Workers Defense Project and faculty from the University of Illinois at Chicago — released Build a Better Texas, a report that examined the construction industry in Texas. The report found 39 percent of workers surveyed said they did not receive rest breaks. Another issue many construction workers face is misclassification as contractors, because of which workers are often not paid for overtime, forced to supply their own safety equipment and are not given insurance.

Workers Defense Project alleges this occurs at most private construction projects like 2400 Nueces.

“The idea is you are completely on your own,” Casar said. “It totally severs any level of responsibility anybody has to that worker.”

Worker misclassification, or workplace fraud, is illegal nationwide but the way individual states handle and investigate these instances varies greatly. About 41 percent of workers surveyed said they were victims of workplace fraud, according to Build a Better Texas.

Further complicating the situation is the distant relationship between general contractors and construction workers, who are often hired and supervised by subcontractors.

“It’s not the general contractors that are cheating,” Casar said. “They have a direct working relationship at the developer level, and aren’t overseeing the labor at any phase. If you just build a building, and don’t ask questions, that’s what you get.”

In July, Workers Defense Project filed a lien — a legal maneuver that prevents the owners from selling the property and could lead to further legal action — against American Campus Communities, the owner of The Callaway House, after construction workers who worked on the project claimed $36,800 in unpaid wages. Earlier this week, The Callaway House’s general contractor, Harvey-Cleary, promised to pay the unpaid wages following the lien.

This is the second time Workers Defense Project has successfully advocated for unpaid workers against the owners of The Callaway House. In April, workers won a claim of more than $24,000 in unpaid wages.

Gina Cowart, vice president of investor relations and corporate marketing at American Campus Communities, said the company had instructed Harvey-Cleary to pay the workers for the full amount of unpaid wages. American Campus Communities is “rigorous” in paying its contractors and service providers, Cowart said.

“We do not believe we have been accurately portrayed by Workers Defense Project communications,” Cowart said in a statement. “However, we do respect the role they played in bringing the matter to our attention to foster resolution.”

Almost a quarter of construction workers surveyed by Build a Better Texas reported they had previously been denied wages.

The documents obtained from the city also revealed a complaint filed in May against The Callaway House construction project for violating the ordinance that requires rest breaks on construction sites.

City records show an inspector visited the site after the complaint and found the required city-issued signage about the policy was posted at the site. The inspector also reminded the management of the ordinance.

Harvey-Cleary did not return a request for comment.

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Source: Daily Texan (Blanchard, 9/06)