Texas Hosts International Training Course

WACO - - Texas Parks and Wildlife Department is hosting the first Comprehensive Boat Accident Investigation course of 2014. This course provided by the National Association of State Boating Law Administrators (NASBLA) funded through a United States Coast Guard grant brings 60 law enforcement officers from all across the United States to one location to train on special techniques for investigating boating accidents.

"This course gives law enforcement officers the opportunity to develop their skills in boat accident investigation. The course also provides critical data to help shape boating safety regulations across the country," said Gary Haupt the Program Manager for the Accident Investigation Course for the NASBLA BOAT Program.

This class is being attended by a very diverse group from federal, state and local jurisdictions from states as far away as Alaska, Kansas, Oklahoma, Florida, and Virginia and one international attendee from Canada. The instructor cadre includes Marine Patrol Officers from Missouri, Wisconsin, Florida and Texas.

"The officers who complete this training receive a solid foundation in understanding the complexities of boating accident investigations. They'll have more confidence in conducting investigations because they'll have a better background. We are working towards a more consistent approach and this course provides a national training standard." said Assistant Commander Cody Jones, TPWD Texas Boating Law Administrator.

“In Texas, our game wardens will leverage this training within our STORM Team which conducts marine accident investigations and forensic reconstruction.” said Col. Craig Hunter, TPWD Law Enforcement Director. “The goal is to improve water safety and reduce water related fatalities. Networking and training with this group of officer’s helps us to improve what we do every day and we sincerely appreciate our partnership with the United States Coast Guard and NASBLA.”

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Source: The Gilmer Mirror (AP, 1/28)

Ford Recalls The 2013 Escape For Seventh Time

One of Ford Motor Company's most popular vehicles may also be one of its most troubled.

The company announced two more recalls Tuesday of its 2013 Ford Escape for problems that have caused at least 13 engine fires. The recalls affect 149,386 vehicles.

In documents filed with the National Highway Traffic Safety Administration, Ford officials said a "misinstalled fuel line could chafe and eventually leak fuel."

It's the latest in a string of problems for the '13 Escape, which has now been recalled seven times in roughly 17 months on the market. Ford said it knew of no deaths or injuries associated with the latest problem, but among 117 complaints filed on the car, several motorists told NHTSA they were afraid to drive their vehicles.

"The auto stalls randomly on occasion. I feel this is a dangerous situation, however, the dealer can't get a code so Ford will not fix," one vehicle owner wrote.

"We are concerned that we may get rear ended in a serious accident if the car stalls again, and the car/truck behind us doesn't stop in time, e.g. Harry Chapin on the LIE (Long Island Expressway)," wrote another. "We transport our two grandchildren two days a week from school and are extremely concerned."

The latest report of an engine fire arrived on Nov. 18, when a motorist wrote, "my car is still overheating after bringing it into the dealer 6 times."

NHTSA does not release the names of vehicle owners who file complaints.

The problems with fuel leaking, overheating and potential fires in the Escape is a vexing one for Ford. The company had issued three previous recalls to deal with the same problems on July 18, 2012, Sept. 4, 2012 and Dec. 3, 2012. It was not immediately clear why the first wave of recalls did not resolve the problem, and Ford did not return messages left seeking comment Tuesday.

The Escape remains a popular small SUV. Through October, Ford has sold 250,543 Escapes so far this year, trailing only the Honda CR-V in the crossover segment.

Among its crossover competitors, however, the Escape is the dubious leader among recalls by a wide margin for vehicles in the 2013 model year. The '13 CR-V has been recalled once. The Chevy Equinox, Toyota RAV4, Mazda CX-5 and Subaru Forester have not been recalled.

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Source: Aol Autos (Bigelow, 11/27)

'If drinking before five is wrong, I don't want to be right': Tweet 'posted by DUI driver hours before he crashed into kindergarten teacher and her son' killing them both

A kindergarten teacher and her son were killed following a car crash on Friday evening with a suspect -- who was found wearing only a towel and a BAC of 0.27%.

The accident took place at about 11.15pm in Northwest Austin.

Peggy Howard, 60, was declared dead just before midnight, the channel adds. She was a kindergarten teacher at Steiner Ranch Elementary School.

Worried about late-night driving, she had earlier dropped off son Cale Howard, 18, at the movies with a friend and had just picked him up.

Howard, a senior at Vandegrift High School, later died at Round Rock Medical Center several hours after the accident, Four Points News reports.

The deadly accident involved three vehicles.

Nicholas Michael Justin Wyzycowski, 21, drove a Chevrolet Avalanche when he rear-ended the Toyota Prius with Peggy and Cale Howard inside, the channel reports. An official said both cars moved into oncoming traffic, hitting a nearby Toyota Camry.

Witnesses at the scene told police the person driving the Avalanche fled from the scene without checking on the other victims, KXAN reports. He is described as only wearing a towel at the time of the accident.

Wyzykowski, witnesses added, was reportedly driving between 80 and 100 miles per hour. He reportedly was 'uncooperative, indifferent and cocky' with the investigating officer and refused to take a sobriety test, KXAN reports.

Wyzykowski's blood alcohol content (BAC), taken for medical purposes, was 0.27% -- more than three times the legal limit in Texas. He faces 19 felony charges, including 2 counts of intoxication manslaughter.

Three female passengers in the Toyota Camry had broken bones, statesman.com reports. One woman had a broken neck and another had a broken back.

Howard's friend in the Prius was sitting in the backseat and survived the crash, but had a broken femur, Four Points News reports.

The accident has left friends of the victims stunned.

Jim Freid and wife April, whose daughters went to school with Cale Howard, pulled up Wyzykowski's Twitter page on Saturday. Wyzykowski's account has since been removed, but Freid saved the posts.

Eight hours before the crash, Wyzykowski allegedly tweeted 'If drinking before 5 is wrong, I don't want to be right.' Another tweet, posted around 9pm, said 'Swangin.'

'Devastation, just absolute sadness,' Steiner Ranch Principal Susan Fambrough told KVUE. 'Because how do you explain to a 5-year-old that their teacher is gone?'

In a letter published online, Fambrough said the school has 'a plan in place' for students when they return to school on January 6.

Counselors will also available for all Vandegrift High School students needing support, principal Charlie Little wrote in a separate letter published on Sunday. A student support event was held on Sunday at 2pm, as well.

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Source: Daily Mail (Szathmary, 12/29)

Teen Who Killed Four People Got Off On Probation Because He's Rich

A 16-year-old boy who drunkenly killed four people got probation this week because the judge — with no apparent irony — agreed with the boy's defense that he was a victim of "affluenza," whose parents taught him wealth and privilege shield consequences. The teen had faced up to twenty years in prison.

Sixteen-year-old Ethan Couch admitted to four counts of manslaughter after he and seven other boys stole alcohol from Walmart, piled into his car and struck and killed four pedestrians while going 70 miles per hour in a 40 zone. One of his passengers remains in the hospital with severe brain damage, and nine other bystanders were also injured.

Couch's BAC was a .24 and he also had Valium in his system. According to reports, he was belligerent at the scene, at one point saying, "I'm outta here." Prosecutors were hoping to get up to 20 years.

Couch's defense was that he was a victim of his parents' wealth and privilege; in that he never had to face consequences, which an expert summarized prior to sentencing.

He said Couch got whatever he wanted. As an example, Miller said Couch's parents gave no punishment after police ticketed the then-15-year-old when he was found in a parked pickup with a passed out, undressed 14-year-old girl.

Miller also pointed out that Couch was allowed to drive at 13. He said the teen was emotionally flat and needed years of therapy. At the time of the fatal wreck, Couch had a blood alcohol content of .24, said Tarrant County Sheriff Dee Anderson. It is illegal for a minor to drive with any amount of alcohol in his or her system.

The victims' families sort of agree with the reasoning, in that they too feel that Couch's privilege helped him avoid consequences.

Couch is now being sent to a $500,000-a-year counseling center. There are apparently five civil wrongful death suits pending against him totaling tens of millions of dollars.

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Source: Gawker (Bluestone, 12/10)

Insurance industry worries about older drivers with smartphones

In any conversation about distracted driving – especially texting behind the wheel – it is almost always in the context of youthful drivers. After all, they're the ones addicted to their smartphones, right?

Not so fast. Increasingly it appears that a growing number of those heads glancing down at smartphone screens behind the wheel have gray hair. Older drivers are quickly catching up with young drivers when it comes to staying connected while driving.

And it's not just texting. A July 2013 survey by State Farm Insurance found a big jump in the percentage of drivers who own smartphones, particularly among drivers age thirty and older. At the same time the percentage of drivers who access the Internet on their phone while driving has nearly doubled over the past five years, going up from 13% in 2009 to 24% in 2013.

More hands-free talking

The survey results also showed the use of hands-free cell phones while driving has increased, while the percentage of people talking on a hand-held cell phone or texting while driving has become stagnant over the past three years.

This may be due, in part, to the growing number of new cars that have a Bluetooth connection. With this system, a driver may answer a call and carry on a conversation simply by pushing a button on the steering wheel, without removing the phone from a pocket or a purse.

While there has been research that suggests talking on a hands-free phone is also distracting, the same could be said for a driver conversing with passengers. It's all a matter of degree. But it's the growing presence of electronic gadgets among drivers that keeps insurance agents up at night.

Multiple distractions

"As smart phone ownership increases for all age groups, the safety community must ensure we are keeping pace with our understanding of the types of distractions drivers face," said Chris Mullen, Director of Technology Research at State Farm. "Much attention is paid toward reducing texting while driving, but we must also be concerned about addressing the growing use of multiple mobile web services while driving."

While 86% of drivers age 18-29 have smartphones, the new data shows 64% of drivers age 50 to 64 do as well, a 20% jump in two years. Even 39% of drivers 65 and older now have smartphones, the survey found.

Distracted driving is a major concern for the insurance industry, which profits when there are fewer accidents. But while most concede that texting while driving is very dangerous, it's less clear that simply talking and driving is.

Questioning conventional wisdom

Another study from Carnegie Mellon University and the London School of Economics and Political Science, also conducted this year, finds that talking on a phone while driving does not increase the risk of a crash.

For the study, Carnegie Mellon's Saurabh Bhargava and the London School of Economics and Political Science's Vikram S. Pathania examined calling and crash data from 2002 to 2005, a period when most cell phone carriers offered pricing plans with free calls on weekdays after 9 p.m. They compared data from mobile network operators and accident reports and found that there was no direct correlation between the number of phone calls made during a certain time period and the number of crashes during the same time.

"Using a cell phone while driving may be distracting, but it does not lead to higher crash risk in the setting we examined," said Bhargava, who is an assistant professor of social and decision sciences at CMU. "While our findings may strike many as counterintuitive, our results are precise enough to statistically call into question the effects typically found in the academic literature. Our study differs from most prior work in that it leverages a naturally occurring experiment in a real-world context."

For its part, State Farm is encouraging government agencies to continue their high profile campaign against distracted driving, which specifically targets electronic gadgets.

"State Farm continues to support a multi-pronged approach to encouraging more engaged driving," Mullen said. "Legislation, enforcement, education and technology all have a role to play in making our roads safer for all who share them."

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Source: Consumer Affairs (Huffman, 11/13)

NTSB faults parade plans in fatal train collision

WASHINGTON — An oncoming freight train sounded its warning, and track guard gates started to descend. But the crowd was cheering, a marching band was playing, the lights of a police escort were flashing and a truck driver towing a parade float of wounded veterans and their wives in Midland, Texas, advanced heedlessly into the crossing.

The train rammed the float at 62 mph, killing four veterans and injuring 11 other veterans and their wives.

The National Transportation Safety Board on Tuesday faulted parade organizers and city officials for their lack of safety planning, not the truck driver towing the float.

"This terrible collision between a fast-moving freight train and a slow-rolling parade float of veterans and their loved ones should never have occurred," said NTSB Chairman Deborah Hersman at a board meeting to conclude a yearlong investigation of the accident. "Parade and event organizers must identify and manage hazards in advance to ensure a safe outcome for participants and spectators."

Citing other fatal accidents at parades and special events in Bangor, Maine; Edmond, Okla.; and Damascus, Va., the five-member board also made a series of safety recommendations to cities and counties regarding the need for permits and safety plans.

The parade had been an annual event in Midland, a transportation and commerce hub in the West Texas oilfields, for nine years. A local charity had invited the veterans for a three-day weekend of hunting and shopping in appreciation of their service, including a parade timed to fall near Veterans Day.

Led by three police vehicles and a marching band, two floats with veterans and their spouses were en route to a banquet in their honor on Nov. 15, 2012 when the collision occurred. One float had just cleared the highway grade crossing, and a second flatbed truck was edging across the tracks when it was struck by a Union Pacific train. Several veterans and their wives managed to jump from the float before the collision.

NTSB investigators described to the board how safety precautions for the annual parade had melted away over the years.

After the first few years that the parade was held the route was changed from one that didn't cross Union Pacific's tracks to a route that did cross the tracks. For several years after the route change, parade organizers would alert the railroad to their plans and police were stationed at the highway grade crossing. But even those precautions were dropped by last year.

In the early years of the parade, organizers also obtained parade permits from the city. But last year, no permit was obtained in violation of city regulations, investigators said. Even if a permit had been issued, city regulations didn't require parade organizers to submit a safety plan, they said.

"It seems things got lax in the planning," highway safety investigator Gary Van Etten told the board. "There was no (safety) plan."

Midland officials, responding to the board's findings, said in a statement that while they've already implemented significant changes in the city's process for handling special events, they said they also realize there is more work to be done.

"The review and upcoming one-year anniversary of the accident bring back many painful emotions and memories, and our hearts continue to go out to the families who relive the accident every single day," the city's statement said. "Our hope is that those who have followed our story are still listening so that these recommendations can also help them hold safe, successful events in the future."

The railroad crossing warning system was activated the required 20 seconds before the accident, and the guardrail began to come down seven seconds after that, but the truck's driver was unaware of the danger because circumstances of the parade had created an "expectation" of safety, investigators said.

Police were stationed at intersections along the parade route and the truck driver had been allowed to proceed for 34 minutes through a series of red lights before the accident, investigators said. By the time the driver arrived at the grade crossing, he had reason to assume he could proceed through a red light there as well, they said.

"I think he was led down the primrose path, he was invited across these railroad tracks," said NTSB board member Robert Sumwalt.

The truck driver didn't recognize the warning bells that sounded as the train approached because of noise from the crowd, the marching band and motorcycles in the parade, investigators said.

The driver told investigators that he did not see the flashing lights of the grade-crossing warning system or detect the presence of the train until the float was on the tracks because he was looking at his side-view mirror to make sure float passengers weren't being jostled as he negotiated a dip in the roadway on approach to the grade crossing.

The train's engineer sounded the locomotive's horn and pulled the emergency brake seconds before the collision, but was unable to stop in time. The first truck towing a float, which was in front of the truck that was struck, was fitted with a train horn that had been sounding throughout the parade, yet another reason why the driver of the truck that was struck didn't register the danger until it was too late, investigators said.

Show of Support, the group that organized last year's parade, is holding a banquet this year, not a parade, Midland spokeswoman Sara Higgins said.

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Source: Merced Sun Star (Lowy, 11/05)

Mother angry over handling of school playground accident

PASADENA, Texas -- A first grader from Fisher Elementary is nursing a broken wrist and her mom believes the school didn't do enough after it happened.

Herminia Castillo fell off the monkey bars.

"She landed really, really hard on the floor,' said Herminia's mom Rosalinda Garcia. "Not one of the teachers had gone to go and check on her or see if she was okay."

The school let Garcia look at surveillance video from the playground and she noticed it was actually other students who helped Herminia over to the adults.

"They weren't supervising her properly to attend to her on time," Garcia said.

We asked Pasadena ISD for the video but they won't release it at this point.

However, district officials tell us that another child was injured moments before and since Herminia's injury didn't appear that serious, they went in order.

The first grader was eventually taken inside.

"The teacher took me to the nurse and then the nurse put ice on it and water on it," Castillo said.

Garcia says she got the call about what happened an hour later.

When they were reunited, the 6-year-old was taken to the emergency room. Her fractured wrist means no PE or recess for a little while.

Since Herminia's mom thinks some retraining is in order, district officials have agreed to meet with her next week to talk about it.

No one from Pasadena ISD would talk on camera about the incident but they did send us this statement:

We regret that this first grade student got hurt playing on the playground during recess. Teachers on the playground and the campus R.N. responded quickly and appropriately to this child’s injury. The supervising teacher who responded to the injured student got to her within 35 seconds.

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Source: KHOU (Craig, 10/24)

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)

State to Feds: We Won't Enforce Insurance Reforms

Though Texas will join 26 other states in defaulting to a federal marketplace for purchasing health insurance — a major component of the Affordable Care Act — it is one of only six that will not enforce new health insurance reforms prescribed by the law. It's a decision some say could lead to confusion over who's responsible for protecting Texas insurance consumers.

Because Texas did not create its own state-based marketplace, known as a health insurance exchange, under the Affordable Care Act, it must use a federally facilitated one instead. By federal law, the state must enforce provisions and regulations related to the insurance exchange and market reforms unless it notifies the federal government that it cannot or will not. If a state does not enforce those reforms, the federal Centers for Medicare and Medicaid Services will step in to do it.

Texas, Arizona, Alabama, Missouri, Oklahoma and Wyoming have all notified the federal government that they will not be policing the health law. John Greeley, a spokesman for the Texas Department of Insurance, said his agency cannot enforce regulations tied to the federal insurance exchange or market reforms because it is not authorized to do so.

"We can't act on anything that doesn't exist in state law," he said.

Officials with CMS, who sent a letter to TDI acknowledging the state's decision, declined to comment for this story.

Stacey Pogue, a health policy analyst with the liberal Center for Public Policy Priorities, said she doesn't believe TDI's hands are tied. In the past, she said, the agency has responded to federal laws by "taking actions that ensure that they do have oversight."

The practical effects of the state's decision are not entirely clear yet. In the first show of autonomy, Texas was not required to comply with a federal request for information about its insurance plans. Most states defaulting to the federal health insurance exchange had to submit that information by July 31.

In the states that will not enforce the exchange and market reforms, the federal government will have to review insurance forms and respond to consumer complaints about health insurance, said Kevin Lucia, an assistant research professor with the Georgetown University Health Policy Institute’s Center on Health Insurance Reforms. Those duties, he added, are “typically reserved for state insurance departments.”

Pogue said the state's decision could create an “administrative burden” for insurance plans and could result in confusion for Texans who purchase health insurance under the federal exchange. For instance, she said, if people worry their insurance providers are discriminating against them based on their gender — a practice banned by the federal reforms — they may not know whether to report a complaint to CMS or to TDI.

“There’s all this opportunity to be bounced back and forth, which is a burden for consumers,” she said. If consumers have to report insurance violations to the federal government, that could prevent TDI from having a complete picture of consumers’ experience with insurance providers, she added.

“Consumers can be experiencing a lot of problems on the market that the state regulator doesn’t know about,” Pogue said.

Greeley said TDI has worked to make sure “insurers understand what their responsibilities are” under the ACA. And he said even if the state does not enforce federal regulations, TDI will still work to protect insurance consumers.

“Anybody that buys an insurance policy in Texas — no matter what line or how they got to it — can come to the Texas Department of Insurance for their questions,” he said.

David Gonzales, executive director of the Texas Association of Health Plans, said it’s unclear what impact the state's decision could have on insurance companies.

“I suspect it will be more of a burden for some plans than for others,” he said.

Pogue said inefficiencies could stem from the state’s refusal to enforce insurance reforms. TDI is the agency best equipped to regulate insurance plans in Texas, she said.

“Without a doubt they are the appropriate body,” she said.

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Source: Texas Tribune (Luthra, 8/07)

Elder abuse claim adds new liability risk for doctors

A physician who allegedly failed to refer a patient to a specialist can be liable for elder abuse, a California appeals court has ruled. The decision by the Court of Appeal for the State of California, 2nd Appellate District, said doctors can be sued for elder abuse for their outpatient treatment of seniors, regardless of whether they had “custodial obligations” to the patient.

Legal experts say the ruling broadens liability for doctors who treat older patients and exposes them to additional legal penalties when negligence claims arise. Plaintiff attorneys in states with similar elder abuse laws probably will use the California ruling as fuel to expand physician liability in their jurisdictions, legal analysts said.

“This is going to open the door for medical malpractice plaintiffs over the age of 65 to start pleading elder abuse in addition to medical malpractice,” said attorney Cassidy C. Davenport, who represents Pioneer Medical Group, the defendant in the case. “This is going to allow them to circumvent tort reform statutes” since elder abuse is not included in such medical liability reforms.

In the California case, Elizabeth Cox, 83, began receiving care at Pioneer Medical Group in Cerritos in about 2000, according to court documents. Several health professionals treated her for onychomycosis, which limits mobility and indirectly impairs peripheral circulation.

In 2007, Cox’s vascular issues worsened, and a Pioneer family physician diagnosed her with peripheral vascular disease, according to court documents. The patient’s condition continued to deteriorate, and she visited Pioneer Medical Group at least seven more times during the next two years complaining of various aliments associated with peripheral vascular disease. She was admitted to a hospital with gangrene in 2009, and her right leg was amputated. She died from blood poisoning in 2010, court documents say.

In 2011, Cox’s daughters sued Pioneer Medical Group and several staff members for elder abuse. The plaintiffs said the medical group’s continued failure not to refer Cox to a vascular specialist constituted abuse and neglect.

The medical group contended it was not liable for elder abuse because doctors treated Cox as an outpatient, and liability for elder abuse “requires assumption of custodial obligations.” The group argued the alleged conduct constituted only professional negligence and not the “reckless neglect” required for an elder abuse claim. A lower court ruled in favor of Pioneer, throwing out the case.

Appeals judges reversed. They sent the case back to the lower court, allowing the elder abuse claim to move forward against Pioneer Medical Group. Whether the defendants’ conduct was reckless is for a jury to decide, the judges said.

“The jury may view defendants failure to refer Mrs. Cox to a vascular specialist as deliberate indifference to her increasingly urgent medical needs without regard for the excessive risk to which they exposed her by their failure to seek appropriate specialized care,” the May 24 opinion said.

Pioneer Medical Group in July asked the California Supreme Court to review the decision. At this article’s deadline, the court had not said whether it would accept the case.

Investigations stem from adult protective laws

The California Medical Assn. was disappointed with the decision, saying it blurs the lines between conduct that falls under the state’s Medical Injury Compensation Reform Act and the Elder Abuse Act. The CMA issued a friend-of-the-court brief in support of Pioneer Medical Group.

“The opinion really will hurt the goals of both MICRA and the Elder Abuse Act,” said Alicia Wagnon, CMA legal counsel. “The facts of this case are so clearly professional negligence. That [these actions] can also be deemed elder abuse is simply wrong, and it really eviscerates MICRA’s definition and the purposes of MICRA.”

All states have some form of adult protective services statutes that authorize and regulate investigation of elder abuse cases. Generally, APS laws establish a system for the reporting and review of elder abuse claims and for the provision of social services to help victims, according to the American Bar Assn.’s Commission on Law and Aging. Most jurisdictions also have separate elder abuse laws that provide for civil or criminal damages in cases of elder abuse and neglect, either by individuals or institutions.

The intent of such laws is to prevent custodians from abusing and taking advantage of elderly patients, Davenport said. She notes the majority of elder abuse claims arise in the nursing home context and involve repeated acts of ignoring an elderly patient’s basic needs such as adequate food and water.

“We have an aging population in nursing homes [who are at risk] for being abused physically and financially,” she said. Elder abuse laws are intended “as an incentive to go after those who are abusing these elders. It wasn’t to say elders get extra incentive to sue the physician for medical malpractice.”

The California ruling confirms that physicians should be held responsible for recklessly failing to provide necessary medical care, said Clay Robbins III, the plaintiffs’ attorney.

“Merely because a person withholding [medical care] also happens to be a physician should not have bearing as to whether that individual should be responsible for the enhanced remedies under the act,” he said.

Jury awards not covered by insurers

The ruling is concerning for physicians who treat elderly patients, said William E. Hopkins, a health law attorney and partner at Brown McCarroll in Texas.

“Physicians are now on notice that they’re not just being judged on a negligence standard; they’re now being judged on negligence and this other standard,” he said. “I would not be surprised if [elder abuse] is pled in most cases where there’s some level of medical negligence with elderly people.”

Hopkins said Texas has an elder abuse law similar to California’s, and that he can foresee a similar case playing out in his state.

“This is the kind of case that certainly will have plaintiffs lawyers’ minds working with regard to, “Is this something I should be pleading?’ ” he said. “They’re going to pull the elder abuse act in their state and see if this kind of argument applies.”

If the decision stands, physicians found liable of elder abuse would be forced to pay jury awards out of pocket, Davenport said. Insurance policies generally do not cover elder abuse claims. Fear of such payments probably would lead to more settlements, she said.

The decision jeopardizes doctors’ professional medical judgment and could negatively affect patient care, said Bret C. Perry, an Ohio medical liability defense attorney who defends physicians, assisted-living facilities and nursing homes.

“The practice of medicine and decisions made on a daily basis by physicians and health care professionals cannot be legislated, and those decisions clearly fall within the purview of professional judgment,” he said in an email. “If this ruling is permitted to stand, I can foresee a chilling effect and negative impact on the future of medical care for the elderly and potentially an exodus of professionals leaving the state due to this type of potential liability.”

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Source: Amed (Gallegos, 7/22)

Bone-Chilling Mistakes Hospitals Make And Why They Don't Want You To Know

Claire* was detained by security at the airport when the metal detector went off. Guards couldn’t figure out why. Eventually, they let her board the flight, but when she arrived home she immediately asked her doctor to order an X-Ray. The result: There in Claire’s abdomen, clear as day, was a retractor, a surgical instrument the size of a crowbar, somehow left behind from her recent surgery.

This story is not as unusual as we would all hope. Indeed, the story is instructive enough that it appears in the leading textbook on patient safety, “Understanding Patient Safety” by Bob Wachter. There’s even a well-vetted medical term for this kind of error: “foreign objects retained after surgery,” one among many scary mishaps labeled as “serious adverse events.” The Leapfrog Group, my nonprofit which represents employers and other purchasers of healthcare, has another name for these outrageous errors: “never events” – mistakes that should never happen, no excuses. Surgical never events – Claire’s experience, plus some other errors you don’t want to hear about during lunch, occur about 11 times a day, according to a study from Johns Hopkins. There is a host of grisly mishaps known to happen beyond the surgical suite in the walls of a hospital, from excruciating and fully preventable Stage 3 or 4 bedsores to collapsed lungs. When you count all the non-surgical and surgical never events, they happen about 200 times a day to Medicare beneficiaries alone.

Here’s the kicker: Though I don’t know Claire, I bet the offending hospital billed her for the surgery to remove the crowbar. They probably weren’t brazen enough to bill her to replace the missing retractor in the operating room, but stranger things have shown up on hospital bills.

Employers and other purchasers have long been outraged by these astonishing misadventures in hospitals, and they are tired of paying for them. In recent years, they’ve adopted a set of purchasing principles that include refusing to pay for never events and demanding an apology to the patient. It’s amazing that we even needed to establish such guidelines in the first place. But according to the Leapfrog Hospital Survey, while the majority of reporting hospitals committed to adhere to our guidelines, hundreds more refused.

A few years ago, after many battles, Medicare finally started requiring hospitals to publicly report on some of them, including the following nine events:

Foreign object retained after surgery

Air embolism

Pressure ulcers, Stage 3 and 4

Trauma and falls

Collapsed lung due to medical treatment

Breathing failure after surgery

Postoperative PE/DVT (a preventable and often deadly blood clot)

Wound split open after surgery

Accidental cuts or tears from medical treatment

We used these nine measures in our Hospital Safety Scores – letter grades assigned to more than 2,500 general hospitals warning consumers of their propensity for deadly mistakes. We found that some hospitals have many more of these never events than others. And the public deserves to know which hospitals protect patients best.

But the American Hospital Association (AHA) and its lobbyists disagree. They did not want hospital data on these never events, as well as some other terrible measures, publicly reported. They acknowledge these events happen, but they say the government wasn’t measuring them in a way that’s perfectly fair to hospitals.

Purchasers continually fight this effort to suppress reporting. The best-known and most well-respected national coalition of employers, unions and consumer advocates, the Consumer-Purchaser Disclosure Project, pleaded in a letter last year to Secretary of Health and Human Services Kathleen Sebelius, “When it comes to patient safety, we simply cannot afford – in either human or financial terms – to delay or derail progress toward greater transparency and accountability. Nor can we wait until the arrival of perfect measures before addressing patient safety gaps in our health care system.”

The hospital lobbyists nearly won suppression of never events. Last fall, the Centers for Medicare & Medicaid Services (CMS), the agency that runs Medicare, announced they would stop reporting the never events listed above, plus other key measures. However, the agency recently told us they do, indeed, plan to continue reporting these measures, at least through 2013, so we’ll keep working with them to continue the level of transparency the public deserves.

The good news is that the administration has taken steps to identify other measures of patient safety for public reporting and pledges to tie Medicare payment to performance on those measures in the future. These are new measures of infection, errors and accidents. Just last month, CMS put out for public comment a proposed rule to make a number of important new safety measures public.

Last week, the hospital lobby submitted a 58-page comment letter complaining (among other things) that these measures aren’t perfect enough, but consumer and purchaser organizations responded, saying the measures, in fact, meet the requirements of good science and give the public the information we need to protect ourselves and our families.

Our advocates ask for reporting on more critical measures, faster and with more detail. AHA asks for fewer measures, reported later instead of now, and reported in generalities so you can’t discern among hospitals using the data. For instance, Leapfrog wants to end the exemption of Maryland, Puerto Rico and Guam from public reporting. We ask for data to be reported for each and every facility that calls itself a hospital; currently, CMS only reports data by hospital system, and a system can have several hospitals in a wide geographical area. (Patients care about their individual hospital, not what corporate system it belongs to. And we have found major differences among hospitals in the same network).

Meanwhile, before the ink was dry on its letter to CMS complaining about the imperfection of measures and requesting delays, AHA was quick to submit testimony to the Senate about its commitment to public reporting — as long as it’s on its own terms. AHA’s testimony asks for fewer measures to be publicly reported, and although the lack of progress nationally on patient safety is well established, the testimony reports glowing achievements by some of its member hospitals in improving on several important measures of performance. Ironically, the important measures it touts to Congress are among the same ones it tells CMS aren’t good enough for public reporting.

We can only hope for bipartisan common sense to prevail when hospitals ask to suppress information from the public that they themselves use to improve their performance. While we’re hoping for the right response from Congress, consumer and purchaser advocates will need all the support we can get to protect patients — and protect our right to know.

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Source: Forbes (Binder, 7/15)