Thursday, July 11, 2013

FDA reconsiders generic drug warning labels

In a recent post, I noted the Catch-22 that the Supreme Court insists Congress created with its fast-track approvals for generic drugs. Those who are injured by a brand-name drug can win compensation from the manufacturer if they can show the drug was unreasonably dangerous or that its warning label didn't disclose the risks properly. But those injured by a generic medicine can't hold the manufacturer liable as long as the drug maker used the same active ingredients and displayed the same warnings as the brand-name drug.

The Food and Drug Administration has been considering changes to its labeling rules aimed at giving generic drug users more protection. And last week, the Obama administration filed notice that the FDA's efforts are coming closer to bearing fruit.

According to the notice, the FDA is working on a rule that would "revise and clarify procedures for changes to the labeling" of approved drugs, whether they be name brand names, generics or biologics. The change would either enable or require -- it's not clear from the limited information released by the FDA -- drug makers to make public possible changes to their warnings while the FDA was considering them. And it would make clear that both the brand-name and the generic versions of the drug would have to change their warning labels in the event that the FDA acted on a proposed change emanating from either camp.

The FDA is expected to formally propose its new rule sometime in September.

At issue is something called a "changes being effected" supplement. When drug makers learn of adverse reactions to their products or have new reasons to doubt the adequacy of their warning labels, they're obligated to inform the FDA. The makers of brand-name drugs can seek approval for new warnings and are allowed to alert the public about such developments through a "changes being effected" supplement before the FDA acts.

Generic drug makers aren't allowed to do that, however, even though they are required to tell the FDA about new evidence that might demand a change in their warning labels. They have to wait until the FDA formally decides that the warning label for that drug -- and its brand-name counterparts -- must be changed. If the brand-name version is no longer being marketed, the FDA has some flexibility to work with the makers of generic versions to update their labels, a spokeswoman for the FDA said.

The notice filed Wednesday says the FDA's new rules "would create parity" between brand-name and generic drug makers "with respect to submission of [changes being effected] labeling supplements." That strongly suggests generic drug makers would be able to make unilateral changes to their warning labels too.

The implication of the new rule is that it would reopen the door to lawsuits by such victims as Karen Bartlett, who was disfigured and nearly blinded by an adverse reaction to a generic anti-inflammatory drug. The Supreme Court overturned a New Hampshire jury's decision to award Bartlett $21 million, saying that as long as the drug manufacturer complied with federal requirements to use the same formulation and warning label as the brand-name product, it could not be held liable under New Hampshire law for selling an unreasonably dangerous drug. Justice Samuel A. Alito Jr. said the state law put generic drug makers in an impossible bind because the only way they could avoid liability for products that prove to be unreasonably dangerous would be to change the warning labels that federal law forbids them to alter.

The FDA's new approach, however, may permit generic drug makers to give supplemental warnings about new or heightened risks before the agency formally approves changes to the label for the brand-name and generic versions of the drug. That, in turn, would invite lawyers for injured patients to argue in court that generic drugs were unreasonably dangerous if they could have carried such an extra warning but didn't.

The trade association for generic drug makers sounded a cautious note about the FDA's minimally detailed proposal. "Our members have a long history of working closely with FDA to ensure that Americans have access to safe, affordable generic medicines, and we look forward to working with FDA on this important issue," said Ralph G. Neas, head of the Generic Pharmaceutical Assn.

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Source: Opinio L.A. (Healey, 7/08)

Monday, July 8, 2013

The human cost of drunk driving in Texas

Approximately every 20 minutes, there is an alcohol-related car crash in Texas. Each one of the 1,170 deaths caused by drunk driving in Texas last year were represented by an individual flag in front of the Gerald D. Hines Waterfall by Williams Tower Wednesday, June 26, as the Texas Department of Transportation held a press conference announcing the launch of facesofdrunkdriving.com, a website that shares the stories of more than a dozen people whose lives and families were irreparably altered by a person who chose to get behind the wheel after consuming alcohol, as well as the agency’s support of the “no refusal” activities conducted by law enforcement across the state this holiday weekend.

“There were more than 25,000 alcohol-related crashes in our state in 2012,” said TxDot Spokeswoman Raquelle Lewis during opening remarks. “The numbers alone can’t describe the impact of these crashes on individuals and their families.”

Dennis Pennywell was the first to speak after Lewis, accompanied to the podium by his wife Kae and son Jack. The Pennywells know the toll that drunk driving takes on families as well as anyone. On June 25, 2011, 20-year-old Aaron Pennywell was driving home through Cypress from a late-night dinner at Whataburger when a drunk driver with a blood .241 alcohol level — over three times the legal limit — slammed into his car. The drunk driver survived; Aaron did not.

The totaled Mustang Aaron was driving that night was on display in front of Williams tower, serving as a grim reminder of drunk driving’s dire consequences.

Since investigators couldn’t conclusively determine who ran the red light where the crash occurred, Michael Giacona, the drunk driver, received only about 90 days in jail for a second offense DWI charge. He received shock probation on the condition that he spend four consecutive Saturdays on a street corner bearing a sign stating, “I killed Aaron Coy Pennywell while driving drunk.” After one Saturday, Giacona argued that holding the sign put his personal safety at risk, and the judge remanded him back to jail. After another few days he was released, Pennywell said.

“The truth is though, he’ll have to live with knowing that he killed an innocent young man because of driving drunk,” Pennywell said. “As a result of the crash, we had to immediately organize and pay for a funeral, something a parent shouldn’t have to do. There is enough disease and enough other reasons for parents to have to bury their child; drunk driving is 100 percent preventable. We had to learn a whole lot more about our justice system than we ever cared to know. We’ve spent a lot more time in the courthouse than we ever cared to spend. And we have to see that empty space at special occasions — Christmas, Thanksgiving, Fourth of July, birthdays — Aaron’s not there, it’s an empty chair.”

Will Womble, chair of the Mothers Against Drunk Drivers (MADD) Houston chapter, took the podium to praise the benefits of the “no-refusal weekend” a program that gives law enforcement the authority to force suspected drunk drivers to submit to intravenous blood-alcohol testing if they refuse a breathalyzer.

“MADD supports the no refusal program,” Womble said, “and is proud to say that statistics show that over the last few years with the incorporation of no refusal programs in and around our community, the effects of drunk driving have gone down.”

Harris County Sheriff Adrian Garcia spoke next, flanked on both sides by deputies to accentuate the point that the crime of drunk driving is taken extremely seriously by his office. He said his staff will be on the lookout this holiday weekend, as well as year-round, for anyone unwilling to abstain from alcohol consumption before operating a vehicle.

“We have a jail cell ready for you if … you’re too proud to have a designated driver,” Garcia said. “We have plenty of designated drivers at the Harris County Sheriff’s Office to drive you to jail. And we will. Because the faces of drunk driving can’t be made any more clear than what you heard from the Pennywell family [or] from the fact the MADD had to come into existence.”

HPD Capt. Larry Baimbridge expanded upon Garcia’s remarks, elaborating on the activities of HPD traffic enforcement division officers whose sole target are drunk drivers.

“These guys are tasked with looking for, detecting and arresting drunk drivers,” Baimbridge said. “That’s their sole job, that’s their sole goal in the Houston Police Department … and they do a very good job of it. So the message here is clear: drive sober, find a safe ride home. It’s simply not worth the risk.”

Jeff Kaufman, the Houston-Galveston Area Council’s transportation program coordinator, told those in attendance how H-GAC received a step grant for smaller law enforcement agencies in the area to qualify for funding to conduct their own drunk driving enforcement efforts, a task force which Kaufman said has now grown to 15 agencies.

“As of Memorial Day weekend, we’ve conducted three waves,” Kaufman said. “This is a pilot project, this is something that hasn’t been done regionally or for the state, but we’ve made 115 arrests for suspected DWIs over these three weekends. DWI is easily avoidable, just don’t’ drink and drive. Get a designated driver, don’t overdo the celebration, just be responsible. Because it’s really not worth risking other people’s lives, it’s not worth risking time in jail.”

Though the efforts of these different agencies won’t bring back Aaron Pennywell — whose story is one of many on facesofdrunkdriving.com — his parents are hoping that by relating the senseless and tragic nature of their eldest son’s death, at least something positive will come from the abrupt end to Aaron’s life.

“Mainly it’s to tell these [people to] make choices when you are going to drink,” Kae Pennywell told Houston Community Newspapers. “Get a cab, call a friend to come pick you up, sleep it off, have a designated driver.


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Source: The Rancher (Haverkamp, 7/2)

Monday, July 1, 2013

Victim of DWI accident shakes hands of officers making a difference

SMITH COUNTY, TX - On Friday, fourteen East Texans were awarded for their dedication to putting an end to drunk driving in Smith County.

The award ceremony took place at the Holiday Inn off of South Broadway in Tyler.

Mothers Against Drunk Driving of East Texas handed out five different types of awards: judiciary and prosecutorial service, leadership, DWI education and outstanding service.

At the end of the banquet, Amie Jo Robinson shook the hands of law enforcement officers recognized for their commitment to the fight against drunk driving.

In 2000, Robinson said she and her two-and-half year old daughter were hit by a drunk driver in Gladewater.

"She passed away while I was holding her. My daughter ShiAnn. That wasn't fair, basically. So, if we can stop it then that's a good thing," Robinson said.

Among those officers was Sergeant Blake Lockhart with the Tyler Police Department, awarded by MADD for his leadership in the county.

He said he cannot begin to count how many people he knows who have been affected by drunk driving.

"No, I couldn't even begin to estimate. It's something that's so preventable and that's why we need to work harder to tackle the issue," Sergeant Lockhart explained.

And as law enforcement, prosecutors, and judges work diligently to take unsafe drivers off the streets, these mothers work to get through each day.

For Robinson, part of that healing process was visiting the man who took the life of her little girl.

"I actually visited him last summer in the prison and he, for the first time, he said he was sorry and I forgave him," Robinson said.

With a holiday along with "No Refusal" weekend right around the corner, Sergeant Lockhart wants to remind drivers of one thing.

"The worst thing that can happen if you drink and drive is not that you get a DWI, the worst thing that can happen is not that you kill yourself, the worst thing that can happen is that you kill a family of four and you live," he said.

Several East Texas police departments have declared this July 4th, a "No Refusal" holiday. That means, if you are stopped for drunk driving and refuse to provide a blood sample or breathe sample, an immediate search warrant will be sought and a blood sample will be obtained through that warrant.

For participating departments, "No Refusal" will run through July 6th.

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Source: KLTV (Sanders, 6/28)

Monday, June 24, 2013

Construction accident at Texas A&M equestrian complex injures four

COLLEGE STATION, Texas — Four workers were hurt, three critically, after a barn frame collapsed Saturday at an $80 million Texas A&M University equestrian complex that’s under construction.

The collapse happened on university property about a mile from the main campus, Texas A&M spokesman Lane Stephenson said.

College Station and Bryan fire departments, campus police and Texas A&M emergency medical personnel all responded to the accident, which happened shortly before 11 a.m. Saturday.

The accident involved an approximately 300-foot barn, according to the College Station Fire Department. Twisted metal beams could be seen at the site, where ground was broken last fall.

The injured workers were transported to hospitals. Their names and further details on their conditions were not immediately released. Nobody else was hurt.

For a time, emergency responders had to halt the search for the four because of concerns about another collapse.

“After that time search and rescue efforts were suspended until the remainder of the structure that was still standing could be stabilized,” according to a statement from the College Station Fire Department. “After the structure was secured a secondary search of the area was conducted to ensure that all patients had been located.”

Texas A&M police officials were trying to determine what caused the collapse. University police did not immediately return messages Saturday afternoon.

Conditions at the time were cloudy with temperatures in the mid-80s and winds gusting just above 10 mph, the National Weather Service said.

The first phase of the equestrian center was set for completion in 2014. The facility will include locker rooms, offices, a concessions building, a 50-stall barn, plus practice arenas and two covered competition arenas, according to the university.

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Source: Daily News (AP, 6/22)

Thursday, June 20, 2013

Texas DA convicted of DWI not tied to hit-and-run

AUSTIN, Texas- Investigators have concluded there is no evidence tying a Central Texas prosecutor convicted of driving while intoxicated to a hit-and-run accident that happened on the same night she was arrested.

Travis County District Attorney Rosemary Lehmberg was arrested April 12 following a report of a vehicle swerving in traffic. Her blood-alcohol level was nearly three times the legal limit for driving. She pleaded guilty to driving while intoxicated and served about half of a 45-day jail sentence.

The night she was arrested, Jeff Van Gorp reported that an SUV had clipped the side of his car, popped his tire and damaged the fender before driving away. Lehmberg was driving a Lexus four-door sedan. Van Gorp in later statements said it could have been a Lexus.

But the Austin American-Statesman reported that the Travis County sheriff's office has ended its investigation in the case after concluding Lehmberg could not have hit Van Gorp's car.

"There is no way her car could have jumped high enough to put the damage on the other car," said sheriff's office spokesman Roger Wade.

Senior Deputy Paul Cossette, who investigated the collision, wrote in an email to the newspaper that several factors led officials to come to that conclusion, including damage to Lehmberg's car not matching the height of damage to Van Gorp's car and no paint transfer on either vehicle that would suggest they came in contact with each other.

Lehmberg's claim that she scraped the rock wall in front of her home seems to match the damage on her car, Cossette said.

Lehmberg has faced mounting pressure to quit since her arrest. Gov. Rick Perry on Friday vetoed funding for the state's Public Integrity Unit overseen by Lehmberg because of her refusal to step down.
Rick Reed, an attorney behind one of the efforts to oust Lehmberg from office, initially claimed in court filings that Van Gorp called 911 after the collision to report that "his vehicle was struck by an oncoming silver-colored Lexus" with a license plate that matched Lehmberg's.

However, in the 911 call the Travis County sheriff's office released Wednesday, Van Gorp is recorded saying that a newer, midsize SUV hit his car.

"If the Sheriff's Office expects the citizens of Travis County to give any credence to Deputy Cossette's findings and conclusions it should release all records relating to his investigation immediately, if it has not already done so," Reed said.

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Source: KRGV (AP, 6/15)

Tuesday, June 11, 2013

Daughters say patient safety compromised at Dallas VA Hospital

Patient safety at the Dallas Veterans Administration Hospital is again being called into question.

Considered to be the agency's worst facility in 2004, the Dallas VA Hospital has received more than 30 certification agency complaints in the last three years.

And now, there are two more.

Two daughters agreed to discuss the deaths of their fathers and the conditions they say no veteran should have to endure.

The Veterans Administration is the largest health care system in the nation, serving more than eight million veterans a year. VA officials in Washington D.C. pledge “to never compromise the safety, security or well-being of veterans."

Sydney Schoellman says the government has shattered that pledge.

Her father, Korean War veteran Gary Willingham, trusted his care to doctors at the Dallas VA hospital. In November 2010, Willingham went to the VA for what his daughter believed would be a short operation to remove a tumor from his neck.

But six hours after surgery began, Schoellman said two doctors finally emerged. "They never really admitted that anything went terribly wrong,” she said. "They kind of just padded around that."

Schoellman said what they did tell her is that her father had lost a lot of blood, and that they had accidentally clamped off his carotid artery for six minutes.

When she and her family were allowed to see Willingham, she said she was in shock.

"What we saw wasn't the man we grew up with," Schoellman said. "That wasn't the man that we'd seen how many hours earlier." With his carotid artery clamped and his brain starved of oxygen, Willingham had, in effect, suffered a debilitating stroke. Schoellman's once-energetic father was now bedridden and would spend the next year before he died unable to eat or drink on his own. Outraged, Schoellman started to dig, asking for the detailed surgical notes from the day of the operation.

"I was informed by one of the employees at the Dallas VA that I should get those records before they disappeared," she said. Deep in the surgical notes Schoellman said she found a disturbing revelation: The carotid artery had been clamped not for six minutes — as she said she was told — but for 15 minutes.

"If we had known it was 15 minutes, we wouldn't have allowed the things that went on. We would have let him end his life with dignity and the grace he lived it with before the surgery," Schoellman said.

Willingham's family has since filed a formal complaint and a legal claim against the Dallas VA for improper care. Tammie Wilson has also filed a complaint with the Dallas VA, saying her father — decorated Vietnam vet Gary McGrew — was stripped of his dignity as well.

Admitted to the Dallas VA this past February with two broken arms, Wilson said her father agonized for hours without pain medicine. "They just dawdled and dawdled, and it might have been six hours in-between," Wilson said. "I would just keep going out to the nurses' station saying, "Please, please!' They would respond slowly, if at all."

Wilson said no one seemed to be aware that her father was in his final stages in a fight with cancer. She said nurses were still trying to feed him in the minutes he was taking his last breaths.

"Here comes this nurse, stirring up the same pills and the same apple sauce he had spit out the night before because he couldn't even take a drink of water," Wilson said.

Administrators at the Dallas VA have declined to discuss either of the complaints with News 8, saying they either can't due to pending legal action or to lack of proper authorization.

They also say the complaints filed against them with the Joint Commission, the hospital accreditation agency, have been investigated and closed. They said the VA "maintains a safe and sanitary environment" and "invite families to discuss their concerns and complaints ... through several means available to them."

Schoellman said the only means left for her family is the courts, along with her ability to speak out for the veterans who cannot. "These are some of the greatest national treasures that we have, and they walk in every day, and these families are blindsided by the pain and the agony of losing someone at the hands of people who are never held accountable," Schoellman said.

Last fall, News 8 investigated complaints about quality of care at the Dallas VA. The Inspector General with the Veterans Administration last fall also found excessive wait times and irregularities with referrals and appointments.

Rep. Eddie Bernice Johnson (D-Dallas) said her office has also received complaints.

"While I am unable to comment directly on any information I have received from my constituents, many of these complaints pertain directly to the quality and timeliness of patient care," Johnson said. "The VA’s own Inspector General reports — which are public record — bear out the delays and shortcomings in patient care."

“I have repeatedly expressed my concerns to the VA in Dallas and in Washington D.C., in direct response to those complaints," the congresswoman added. "The single most important responsibility of the VA is to meet the health challenges that our veterans face. While I have worked directly with [VA] Secretary [Eric] Shinseki's office on numerous occasions within the past year, the VA at the local and federal levels have not responded impartially to these complaints. It has always been my hope that the leadership at the VA would have taken their own initiative to address these issues. I will do everything necessary to address the concerns of my constituents and patients of the VA North Texas Healthcare System. So long as the VA’s ability to meet those challenges remains in question, I will not rest until these issues are resolved.”

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Source: WFAA (AP, 6/10)

Wednesday, June 5, 2013

The Texas Fertilizer Plant Explosion Wasn't an Accident

Almost everyone in America knows the names of the two young terrorists allegedly responsible for the April 15 Boston Marathon bombings, but few can identify the owner of the fertilizer plant that exploded in West, Texas, two days later. Both are culpable of killing innocent people, but the media, along with government regulators and law enforcement agencies, poured much more time and resources into finding the two Tsarnaev brothers than they did in investigating Donald Adair. Crime in the streets (particularly by terrorists) is big news but crime in the suites rarely makes headlines.

Why isn't the American public calling for the arrest, conviction, and imprisonment of Adair, the owner of the West Fertilizer Company in West, Texas, where an explosion on April 17 killed 14 people, left 200 others with injuries (including burns, lacerations, and broken bones), flattened houses and a 50-unit apartment building, destroyed a nursing home, damaged a local school, and left a crater 93 feet by 10 feet?

The explosion was so devastating that investigators, almost two months after the incident, are unable to definitively determine the exact cause of the explosion. But it is possible that Adair -- who also owns Adair Grain (the parent company of West Fertilizer) and Adair Farms, including about 5,000 acres of cropland and grassland in the area, worth several million dollars -- consistently flouted the law and common sense safety measures that put both his employees and the surrounding community at risk.

When 84-year-old Eula Bingham, OSHA chief under President Jimmy Carter, heard the news about the West, Texas, explosion, she thought, "Oh my god a fertilizer plant." According to Bingham, "fertilizer plants are well known as the most horrible, explosive places in the world." Adair had ample opportunity to know and follow the law and certainly knew the consequences of failure.

After 9/11 companies like Adair's were required to inform the government of chemicals that could be used in terrorist attacks. West Fertilizer stored large quantities of anhydrous ammonia and ammonium nitrate, in the middle of a small town. The company failed to tell the Department of Homeland Security that it was storing 270 tons of ammonium nitrate (the same chemical that Tim McVeigh used to bomb the Oklahoma city federal building in 1995, which left 168 people dead) as required by law.

The U.S. Pipeline and Hazardous Materials Safety Administration fined the factory in 1985 for mishandling storage of anhydrous ammonia. In 2011, the same agency cited the firm for "not having a security plan" and for improperly planning to transport anhydrous ammonia and issued a fine of $5,250.

The federal EPA last inspected the plant in 2006 and assessed a fine of $2,300 for failing to update a risk management plan. The company responded in 2011 with an updated but misleading plan, stating that its chemicals did not pose a risk or fire or explosion, and claiming that the "worse-case scenario" was a 10-minute release of gas or a leak from a broken house, neither of them harmful to human.

The company also reported contradictory information to state agencies. It filed reports with the Department of State Health Services that it had not stored ammonium nitrate on site until 2012. Yet it reported to the Texas Commission on Environmental Quality that it had a "maximum annual through put" of 2400 tons, or 4.8 million pounds of ammonium nitrate after the department found that it was operating without a permit.

Adair ran a fertilizer company that stored tons of highly explosive ammonium nitrate, failed to follow government safety guidelines and -- laws or no laws -- shirked his basic responsibility to prevent a foreseeable, preventable and tragic disaster. Is he any less a killer than the Boston bombers?

If so, Adair shares that responsibility with others. There are at least 2,500 facilities around the country that could each put over 10,000 people at risk in the event of an accident, according to a recent Congressional Research Service memo. Last year alone, 1,270 people died in over 30,000 chemical spills and accidents.

Corporate lobby groups have consistently opposed common sense safeguards for our food, consumer products, environment, drugs, and workplaces. They've spent billions of dollars in campaign contributions, lobbyists and donations to conservative think tanks and front groups to oppose and weaken these and other safety laws and gut the budgets of government agencies set up to enforce them. Their resistance delayed life-saving protections for decades in some cases. The chemical industry has been one of the most effective lobby groups in this regard. In the 1970s, for example, the industry lobbied Congress to prohibit OSHA from regularly inspecting workplaces with fewer than 10 employees in industries with low reported injury rates. Fertilizer plants are included on the list of exempted industries. This may be why OSHA hadn't inspected the West Fertilizer plant since 1985.

The chemical industry opposed a 1981 OSHA "hazard communication" rule requiring employers to label toxic chemicals used by workers on the job. The common sense rules would have put "virtually unmanageable burdens on small manufacturers," according to Ralph Engel representing the Chemical Specialties Manufacturers Association. Engle claimed that "workers would be just as safe without this regulation." It's hard to imagine workers able to take proper precautions when they don't know about the dangers of the poisons they work with.

The chemical industry successfully delayed federal "right to know" legislation requiring disclosure of toxic chemicals to workers and nearby communities until a 1984 gas leak at a Union Carbide factory in Bhopal, India exposed 500,00 people to toxic gas that killed nearly 4,000 and disabled many more. The disaster created public demand for action that overwhelmed industry opposition and led to the Emergency Planning and Community Right to Know Act of 1986. Eugene Humphrey, representing the Organic Chemical Manufacturers Association, testified before Congress that disclosing the existence of dangerous chemicals would burden small business and wouldn't "significantly improve the protection of human health or the environment."

In 1992, the Fertilizer Institute, another trade group, successfully lobbied for a "retail exemption" rule that allows facilities storing large amounts of dangerous chemicals to avoid strict OSHA and EPA regulation if they sell more than half of their chemicals to "end users," including farmers. It is possible that West Fertilizer claimed this exemption, even though the amount of anhydrous ammonia stored at the facility would otherwise have required extensive precautions.

In 2009 the chemical industry -- joined by major business lobby groups such as the U.S. Chamber of Commerce and the American Farm Bureau -- spent $51 million pressuring Congress to oppose legislation that would have tightened security standards on chemical factories, fertilizer depots and water-treatment plants. The lobbying effort included "mining companies, refiners, paint makers, explosive fabricators and fertilizer plants," according to Bloomberg News. The industry -- including such giant firms as Dow Chemical and DuPont -- donated $34 million to political candidates in the last three elections, two-thirds of which went to Republicans. "If enacted, it could lead to disruption in our nation's food supply," the U.S. Chamber of Commerce and 25 other groups representing companies that mine, refine fuels, mill grains or make fertilizer, wrote in a letter to congressional leaders. The CEOs of these corporations, and the heads of their corporate industry lobby groups, don't intentionally want to see Americans killed or injured by unsafe workplaces, dangerous consumer products, and unhealthy toxic chemicals that destroy people's health. But by pushing Congress and state governments to weaken safety and health standards, and to slash budgets for inspection and enforcement, they make it inevitable that many Americans will needlessly die, suffer injuries, and ruin their health.

Business lobbies want to be free from government rules. Unfortunately, their freedom leads to tragedy for workers, families and communities.

Texas prides itself on the lack of rules for businesses. Texas is the only state that doesn't require companies to have workers compensation insurance. Houston is one of the few cities that have no zoning laws to create buffers between schools, homes and toxic chemical manufacturers. Texas doesn't have a state fire code and prohibits small counties from having local codes allowing fire marshals to inspect and prohibit the storage of highly flammable and explosive chemicals near homes and schools. According to the New York Times, some Texas counties even cite the lack of local fire codes as a reason for companies to move there.

Texas lawmakers have also recently sought to further weaken the state environmental agency that oversaw the West plant and reduced its budget by $305 million. Even after the explosion, Texas Governor Rick Perry claimed that more government oversight and more safeguards aren't needed.

The harsh reality is that none of the state or federal agencies has enough budget and staff to routinely inspect and enforce the laws on the books. For example, OSHA's tiny staff of around 2,400 inspectors is spread so thin that it would take more than 90 years to conduct even cursory inspections of all eligible workplaces in Texas.

We can't depend on government agencies to police every company and workplace to guarantee our safety and health. We have to expect businesses -- big and small alike -- to obey the law and take every precaution, whether required by government or not, to prevent the kind of needless death and destruction that happened in West, Tex. That is both their legal and moral responsibility, the social contract they agree to in order to stay in business and make a profit.

If they put profit before people, and allow greed or indifference to put lives at risk, they should be punished, even if an OSHA, EPA, or FDA inspector hadn't visited their operation for the past six months, year, or five years.

Corporate criminals rarely get caught. But even when they do, they rarely suffer sufficient consequences to deter them or their counterparts from routinely flouting health and safety laws. And even when they are found guilty, the fines are rarely big enough to make them change their ways.

Last year, for example, a serious violation of the federal Occupational Safety and Health Act drew an average penalty of $2,156. State-level OSHA agencies imposed an average $974 penalty for a serious violation. The median penalty in fatality cases investigated by federal OSHA was a meager $6,625. Corporations view these as just a cost of doing business, not a real deterrent.

Corporate lobbies routinely block laws that would impose stiffer penalties -- and would thusly serve as real incentive for businesses to change their behavior rather than cut corners, flout the law, and put human lives at risk.

America's criminal justice system operates on a double standard -- one for the rich and one for everyone else. According to federal law, someone caught using illegal food stamps goes to jail for one year. Senator Lindsey Graham, one of the architects of the bipartisan immigration bill, recently told reporters that employers who hire an undocumented worker will "get fined heavily, lose your business or may go to jail." It's hard to imagine Graham making the same argument about employers that flout workplace safety laws or the Clean Air Act.

By using their political clout to oppose and weaken health and safety laws, by violating laws because they don't think they'll get caught, and by viewing the small fines and sanctions they will face as simply a cost of doing business, America's corporate executives do more harm to society -- more deaths, more injuries, more chronic health problems -- than all the lunatics, sociopaths, and spouse abusers who kill and injure people by pulling the triggers of their guns.

Perhaps if corporate executives saw a significant number of their counterparts on the nightly news being handcuffed and sent to jail for violating laws meant to protect workers, consumers, and the environment, they would be more likely to make sure that their companies met the health and safety standards embodies in our laws.

Surely Donald Adair did not want to see his friends and neighbors in West suffer death and injury from explosion in his fertilizer plant. But he is culpable nonetheless for flouting the laws and shirking responsibilities that would make such explosions less likely. The explosion -- and thus the deaths and injuries -- was preventable. Perhaps people in West, Texas give Adair a pass because he's a local man who runs a small family-owned business. Does that make him any less of a killer?

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Source: The Blog (Dreier, 6/4)