July 2006

News from Attorneys General Offices

  1. Delaware Attorney General Carl C. Danberg’s Medicaid Fraud Control Unit announced that its prosecution of Dr. Keith Sokoloff has led to the imposition of six month’s incarceration, followed by six months of home confinement. Dr. Sokoloff pled guilty to Felony Health Care Fraud, Delivery of a Schedule II Controlled Substance and Felony Conspiracy for selling drugs such as oxycontin and roxicodone. Numerous other individuals involved in the prescription drug ring supplied by Sokoloff have also been prosecuted.

  2. Kentucky Attorney General Gregory D. Stumbo’s office is developing a new booklet for consumers concerning the rights of patients in nursing homes the procedures to follow when these rights are violated. The office would like to contact other states with such booklets or information for consumers. States with such information pamphlets can contact Ruth Scott at mrascot0@uky.edu.

  3. Louisiana Attorney General Charles Foti Jr. announced that physician Anna Pou and two nurses have been arrested in connection with the deaths of four patients at a long-term care facility in the aftermath of Hurricane Katrina. They have been charged with second degree murder.

  4. Pennsylvania Attorney General Tom Corbett announced the formation of an Elder Abuse Unit with his office. The 26-member unit will be dedicated to investigating and prosecuting crimes involving senior citizens. The focus of the unit will be particularly on abuse by caregivers and fraudulent Internet and mail scams.

  5. Virginia Attorney General Bob McDonnell’s office has filed two amicus briefs in the case of a Virginia minor who, with the support of his parents, has refused to continue with chemotherapy for his Hodgkin’s disease. A juvenile court judge, finding the parents neglectful for allowing their son to pursue alternative treatments, had earlier ordered 16-year old Abraham Starchild Cherrix to report to the hospital to continue his treatments. General McDonnell’s briefs urged a stay of the lower court’s ruling until a new and full hearing could be held. The Accomack County Circuit Court also lifted the order awarding joint custody of the minor to his parents and social services officials.

Judicial Developments

  1. A Milwaukee judge is trying to find a way under Wisconsin law that a mother, Anastsia Schoenfield, can retain her parental rights while her son “Luke” can still be properly cared for. Schoenfield has limited mental abilities; Luke is dying of a rare genetic disease. The state has brought a lawsuit seeking to terminate her parental rights so that complicated issues regarding Luke’s care can be determined. The court suggested that guardianship be given the child’s foster parents without terminating Schoenfield’s parental rights. However, the district attorney’s office has noted that it is unclear whether, under state law, a biological parent may be able to override a guardian’s decisions as to end-of-life care. A further hearing was to be held late in July.

  2. A lawsuit has been filed in federal district court in Chicago challenging the new law that went into effect on July 1. It requires Medicaid recipients to prove their citizenship or legal status with documentation of that status or lose their public health coverage.

Legislative Developments

  1. The Maryland legislature passed a law to establish a drug repository in the state. The program will be regulated by the State Board of Pharmacy. It will allow people to donate medications no longer needed that can be, after being checked to ensure safety, donated to people who cannot afford such medication.

  2. Governor George Pataki has vetoed the bill passed by the legislature entitled the Palliative Care Education and Training Act. The legislation would have authorized up to $4.5 million annually to provide grants to medical schools and established centers for palliative excellence

Pain Management

  1. Dennis Kinch has finished his 2,400 mile walk from Chicago to Los Angeles to raise awareness of chronic pain and its treatment. The trip, sponsored by the National Pain Foundation, included stops at pain clinics and talk with pain patients. Kinch suffers from Paget’s disease and amkylosing spondylitis. In the course of trying to find treatment for his pain, he found that walking helped his pain.

  2. Joseph T. Rannazzisi, Deputy Assistant Administrator, Office of Diversion Control, at DEA, testified on July 26 before the house Government Reform committee’s Subcommittee on criminal Justice, Drug Policy, and Human Resources on what is being done to address prescription drug abuse. His testimony is available on the DEA website. At the hearing, Rep. Mark Souder (R.-Ind.) scolded the Administration for failing to curb the “epidemic proportions” of prescription drug abuse during a recent hearing of the House Drug Policy Subcommittee.

  3. According to the Pain & Policy Studies Group (PPSG), 26 states have adopted laws establishing Prescription Monitoring Programs (PMPs). These are Alabama, California, Colorado, Hawaii, Idaho, Illinois, Indiana, Iowa, Kentucky, Maine, Massachusetts, Michigan, Nevada, New Mexico, New York, North Carolina, Ohio, Oklahoma, Rhode Island, Tennessee, Texas, Utah, Vermont, Virginia, West Virginia, and Wyoming. The purpose of the PMPs is to monitor the presciptions of some controlled substances to detect illicit activity and to identify patients obtaining prescriptions from multiple sources. Documents, a trend graph, and other information are available on the PPSG website.

  4. Edward D. DeHaas, of Canton, Ohio, founder of PPMO in New Philadelphia, Ohio, has been charged with distribution of a controlled substance. The information alleges that ninety percent of the clinic’s patients came from out of state and that area chiropractors (referred by Dr. DeHaas) were used to act as these patient’s primary physicians who would then refer patients to DeHaas for pain management.

  5. According to a story in the on-line Portland Press Herald, a federal jury has convicted Dr. Mark Shinderman of forging prescriptions for patients at a Westbrook, Maine, methadone clinic. Shinderman’s attorney alleged that the controversy over methadone treatment was the backdrop of the prosecution against his client. Shinderman testified that he thought he had the authority to use the name and registration number of a doctor when prescribing medications to patients both men saw.

  6. A Technology Review report describes the procedure being used to attempt to alter brain activity through MRI feedback, thereby helping to control pain. In December, researchers reported the efficacy of this methodology in the Proceedings of the National Academy of Sciences. The author of the article tried this technique to see if she could control her own back pain. She reports that, although she could not tell if her pain was any better, she did seem to be able to control select parts of her brain.

  7. CBS News reported in its on-line Healthwatch section that accidental deaths from prescription painkillers have risen and show no signs of slowing down. The Centers for disease Control’s Leonard Paulozzi, M.D. checked the CDC death certificate date in making this finding and published the results in the journal Pharmacoepidemiology and Drug Safety. Commentators caution, however, that aggressive action against painkiller abuse must be balanced so that patients in pain will not suffer. A commentary by David E. Joransen of the University of Wisconsin noted that the study did not establish a causal connection between the increase in prescriptions for opiod painkillers and the increase in overdose deaths from them.

  8. Guilty verdicts were returned against a Tulane University-trained physician, Suzette Collins, and a registered nurse, Cherlyn Armstrong, for illegal diversion of controlled substances. Part of the prosecutors’ case included testimony by Dr. Joseph Guenther, who had earlier pled guilty to similar charges, that he had complained to Armstrong that patients with outdated or falsified medical imaging test results, or with no medical reports at all, were being granted appointments at pain clinics in Metairie, Gretna, and Slidell, Louisiana. Ac

  9. The new issue of the Journal of Practical Pain Management contains an article reporting the results of a recent study by Michigan Pain Consultants in Grand Rapids, Michigan, liking a vitamin D deficiency to joint and muscle pain.

  10. A national phone survey conducted on behalf of the American Society of Interventional Pain Physicians and Smith & Nephew, a manufacturer of medical devices, found that one in five had sought help from a medical professional for lower back pain in the past seven years.

  11. A new book, Pain and Depression: An Interdisciplinary, Patient-Centered Approach, contains ten chapters authored by senior clinicians and researchers in the field. It was edited by two doctors from the John Hopkins Pain Center.

Other Developments

  1. The July/August issue of CA: A Cancer Journal for Clinicians features a review of the current approaches to helping children cope with the death of a parent. Focusing on three different age groups: 3-5, 6-8, and 9-11, the article notes the importance of children being included in the dying process as appropriate for their age.

  2. An article in the St. Petersburg Times highlighted the launch of the Legacy Program at the Hernando-Pasco Hospice in Florida.

  3. The July 21 issue of the Wall Street Journal carried an interesting article regarding one family’s struggles to maintain treatment for their father. Titled “How Faith Saved the Atheist,” the author reports that, after the family told the staff that the patient was an Orthodox Jew (even though he is not), efforts to get the family to halt treatment stopped.

  4. The new issue of Journal of General Internal Medicine carries an article noting that one-third of married individuals choose someone other than their spouse as a surrogate for medical decision making. Women—mothers, sisters, and daughters—are more often chosen as surrogates than are men.

  5. The American Society of Pain Educators will launch a month-long calendar of educational events focused on pain management education as part of Pain Awareness Month in September. A national conference in Las Vegas, Nevada, September 6-9, will provide education for the frontline practitioner who treats patients in pain.

  6. The on-line publication of the National Active and Retired Federal Employees Association is carrying a lengthy article, titled “Evolution of the Living Will,” that explains the various documents one can prepare to ensure one’s wishes are met at the end of life.

  7. The current issue of the Annals of Family Medicine includes an article regarding the results of a trial in which patients received information tailored to their pain problems. Patients with pain and psychosocial problems received telephone coaching from a nurse who helped them develop skills in problem-solving and pain management. The study showed that such a tailored information program was effective.

  8. A Rockford, Illinois, woman, Jennifer Morrow-Ostergard, has been battling a nursing home concerning the care of her father, Jeffrey Morrow, who has been in a coma for ten years. She gained guardianship over him after her grandmother died. Her grandmother’s wishes were that measures be kept to keep Morrow alive. His daughter wants him transferred to another facility that will honor her request to reduce his daily calorie intake and stop giving antibiotics to treat his frequent infections.

  9. A new Mayo Clinic study, reported in the July issue of Mayo Clinic Proceedings, found that older people and those with chronic illnesses have the highest rates of end-of-life intensive care unit use. The study’s authors conclude that, given the country’s aging population, the ICU may be treating more and more people at the end of life.

  10. Two upcoming conferences are highlighted at the Hospice Foundation of America’ website. The first is the 16th International Congress on Care of the Terminally Ill to be held in Montreal, Canada, on September 26-29. Approximately 1200 participants from around the world will come together to share information on end-of-life care in different cultures and the latest developments in research. The other, to take place in Tampa, Florida, on October 27-28, titled “Building Bridges” will bring folks together to learn about research and practice in end-of-life care, particularly as it relates to persons with end-stage hear disease, cancer, and dementia.

  11. The Center for Death Education and Bioethics at the University of Wisconsin, LaCrosse, has donated its 3,000 item collection, including books, periodicals, and recorded interviews, to the university’s library where it will be more accessible to researchers.

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