Category: Business

HTC Legend Mobile Phone Reviews

HTC Legend Mobile Phone Reviews

The initial type of programs to bear in mind in regards to increasing your living output is apps linked to operating and obtaining your path around. These are GPS applications, and they primarily turn your cell phone into a little lightweight GPS device. These programs enable you to only select in your local area and you will have a way to see nearby eateries as well as the addresses of your pals and family.

Google Routes Navigation is a great program that can help you accomplish only that. This is generally an intelligent telephone edition of the very popular web site on the web that enables persons plug in recommendations and look for locations. Google’s Routes Program presents satellite and street opinions that different portable applications do not provide.

Business applications for the LG Joy will also be very important because they could support us remain arranged and make living much easier for us. Organizational programs may include apps that allow you to with scheduling and conference appointments and deadlines, in addition to apps at that help you add up calendars and also create your personal to accomplish lists through the touch screen and writing performance of the phones. It is now more challenging to remain on top of things these days in contemporary life, because so many individuals have so many different obligations to have a tendency to, so when you can change your cell phone into an friend to help you remain related and up to date with modern living, then it’s worth taking advantage of.

Cellular Buying has also become remarkably popular and that is why there are numerous shopping programs for sale in the App Market. These kinds of apps can provide you with recommendations and addresses and entries to the closest centers, sites, food markets, and other aspects of modern living that you could be interested in finding in the real world. You can even use such programs to learn a number of opinions of shops that can help you find out which store you’re thinking about visiting or buying things from.

As you can see, you will find numerous aspects concerning the LG Thrill may be beneficial to day-to-day coping with several programs, including apps for operating, shopping, and work. On the way, it may perhaps not be considered a poor thought to appear into some extras such as a information wire, a case, monitor guard, and a Bluetooth headset. With a information cable you will have the ability to transfer documents from your own PC to your telephone and the Wireless headset allows you talk hands-free while you travel which can be really advantageous to your safety.  Shycocan

their property to review if the garage home closed. Acquire some bit of mind and don’t worry about turning every thing down before you leave. You can change every thing down without even being there. Connect with an individual screen, shut garage door and check every other components you may have forgotten. A good house will also support keep you on-time.

Simplify your property and work the House Theater audio, movie, and various other components all from remote control. One remote control is an easy and convenient method to enjoy audio in virtually any room at anytime. If you prefer music, utilize the multi-room music feature and balance out the acoustics in your home. You can be eco-friendly and enjoy the right feel in every room with lighting control. Dimming your lights employs less energy, therefore helping you save money. Appreciate get a handle on from anywhere with a good phone or net connection. Get some bit of brain and monitor your house security while on the road.

Looking for the Car Insurance Estimate?

Looking for the Car Insurance Estimate?

Can you actually wonder why different vehicles cost you different amounts for auto insurance premiums? Why is it that a new Corvette might cost you $1,600 dollars per month in auto insurance and an older Buick Noble might just cost you $90 each month? The newest Car insurance charge versus the previous car insurance charge is just a issue that you should review before you decide any car. Evaluation insurance costs before you decide and you will not get caught in an economic trap.

New vehicles charge more to ensure than previous vehicles for three reasons. First, an automobile robbery of a new and exotic car costs a great deal more compared to the auto robbery of an older and normal fashion car. This is due to the big price huge difference of the brand new car versus previous car. Like, a new Chevy Caprice is much more costly to ensure than an older Chevy Caprice. It really costs additional money to displace a new, costly car than an older, less costly car.

2nd, the price to fix a new car is much more than the price to fix a vintage car. Therefore, that reality will also increase your insurance advanced charge for a new car. Like, if your new Chevy Caprice is broken in an incident, the auto repair shop may charge you significantly additional money for fixes than if the subject car were a ten-year previous Chevy Caprice. Because of this, your insurer may charge you a great deal more insurance premiums on a new car than an older car due to such fix costs.

Next, the fashion and form of car also will considerably influence the cost of car insurance premiums your car insurance organization may charge you. Insurance organizations use actuarial statistic platforms which show them yesteryear reduction knowledge on unique models and kinds of cars. They choose these platforms, to simply help assess what premiums to charge their clients in the future. Mathematical platforms display these insurance firms that homeowners of certain models and kinds of vehicles, such as for instance activities vehicles, take part in more risky driving conduct than homeowners of vehicles which can be of normal form and style.

Like, insurance organization statistical platforms show that the insurer has skilled more deficits with activities vehicles than with normal cars. It is really because the master of a Corvette will likely travel such car quicker and riskier than the master of a Toyota Camry. With such pace and chance also arrives more deficits for the insurance companies. With such chance and reduction improve, the insurance organization should then improve their reunite and charge more for auto insurance premiums.

Another example of how the sort and type of car might provide an insurance organization with increased chance may be the off-road fashion vehicles such as the Hummer distinct vehicles. These vehicles are designed to accomplish in the off-road form environment. They’re raised up down the ground more than normal automobiles for less than carriage clearance. Furthermore, they also have four-wheel travel capability.

With such design features, the statistical platforms show that the insurance organization has skilled more deficits with these kinds of vehicles than normal cars. This is because the homeowners of such vehicles may take part in off-road driving that is both risky to the car and driver. In fact, some insurance organizations might bar recovery for such damages, when the master of the protected car was broken while any doing risky, off-road driving. Again, with increased chance, the insurance organization increases reunite and thus auto insurance premiums. Given that you know that certain models and kinds of vehicles charge more to ensure than others, you need to be wise about what kind of car you are going to buy.

As opposed to take a suppose at everything you think a vehicle’s insurance costs are, call your vehicle insurance organization and ask your insurance agent for a free car insurance estimate for the precise form of car that you are interested in buying. You may get a certain reply to your problem of whether or not you are able to afford both the automobile and the insurance premiums necessary to cover your vehicle against protected losses.

Enough time to make such examination isn’t after you acquire a vehicle. When this occurs in time, it is too late. Enough time to make such examination is way before your getting an automobile. You actually desire to be able to make both car payments along with insurance advanced payments. Get a free auto insurance estimate ahead of time and avoid financial problems.

Are You Really the Patient? Medical Identity Theft Facts You Didn’t Know

Are You Really the Patient? Medical Identity Theft Facts You Didn’t Know

The public has become more armed against the threats of identity theft. While identity thieves can steal individuals’ money, ruin their good credit and cause years of aggravation and stress, an alternative form of identity theft, medical identity theft, can actually threaten lives.

Medical identity thieves steal and misuse other people’s personal information including their name and insurance card account numbers without the person’s consent and usually without their knowledge.

The Scary Truth about Medical Identity Theft

Your medical and insurance records follow you and when false information is added to your medical records, you can be at risk when you are treated in the future. Doctors may make decisions about your treatment and medications based on a fictitious medical history and this can put your health at risk. Not to mention that the insurance companies will have noted false “pre-existing conditions.”

As more and more medical communities rely on electronic records, the information is more likely to follow you on a larger scale and some believe this trend makes it easier more medical records to be compromised.

What can a thief do with your medical identity?

Medical identity thieves may use other people’s information to obtain medical care, prescription items or to make fraudulent medical claims.

A medical identity thief without insurance who wants a surgery or prescription drugs can use your information, get what they want and leave knowing you and your insurance company will get the bills.

Some medical identity thieves are motivated purely by money. Thieves can collect large amounts of money, even millions of dollars, by making these false medical claims.

Don’t Ignore a Medical Billing or Insurance Statements

Don’t assume a medical bill or insurance statement for services you didn’t get is just a mistake. It could be the first sign that someone has stolen your medical identity.

Joe Ryan, a Colorado resident, got a hospital bill for over $40,000 for surgeries and treatments he never received. This wasn’t a billing error. An ex-con had used Ryan’s medical identity to check into the hospital and obtain extensive medical care. Two years later, Ryan was still trying to undo the damage to his medical records.

You may not learn about a medical identity theft from a bill. Brandon Reagan, who stationed in California, learned that his medical identity had been stolen and used in South Carolina when his mother called and told him he was the lead suspect in a car theft. Reagan had lost his wallet in South Carolina and a thief used his military i.d. and license to test drive cars and then steal them. In addition to getting Ryan on a wanted list, the thief also used Ryan’s medical identity to go the hospital on several occasions to get treatment for injuries and kidney stones. The medical bills were close to $20,000.

Even though the identity thief was finally arrested, Reagan was left with a nightmare. His medical records in South Carolina were full of false information and his tax refund check was withheld due to the unpaid hospital bills still in his name.

Sketchy Law and Statistics on Medical Identity Theft:

Laws dealing with medical identity theft are still not thorough or consistent from state to state. Many Federal laws that were intended to protect confidentiality actually make it more difficult for you to access and correct your own medical records.

Wide scale investigations into medical identity theft are just beginning but in 2005 there were over 8 million victims of identity theft and three percent, 249,000 of those involved medical identity theft.

Pam Dixon, executive director of the World Privacy Forum warns, “Medical identity theft causes terrible harm, both financial and physical.”

How can you protect yourself from medical identity theft?

-Get a copy of your medical records for comparison in case they are compromised in the future.

– Annually request a list of payments made for your medical services from your insurance company.

-Review your Explanation of Benefits (EOB) as they are provided by your insurance carrier to determine their accuracy.

-Check your credit report at least once a year for any unusual unpaid charges.

-Research and report any suspicious medical bill or insurance statements.

Why You Need to Understand Medication Management

Why You Need to Understand Medication Management

Early in my mom’s tenure in assisted living, I noticed her monthly bill had a significant expense labeled as “medication management.” As someone who rarely takes any medication, I realized I needed to understand the process better.  I’ll be dedicating several posts in near future to this topic, as I believe family involvement in medication management is critical.

Medication is a Major Issue According to a 2006 study by the three leading non-profits – ACHA, NCAL and MEFC, medication is often a major component of an older person’s life, making it a major issue for assisted living facilities. The role of medication and medication assistance (called “medication management” by assisted living administrators) is surprising:

 

  • 77.5% of residents needed assistance with medications
  • Residents were taking an average of 13 medications

 

In an assisted living setting, residents rely heavily on staff to assist with the timely and correct delivery of medication.  But in the United States alone, nearly two million Americans experience adverse drug reactions from prescription medication each year.

What can you do to protect your loved one? A better understanding of medication management can help.

Where to Get Medications Families have several options for filling prescriptions on behalf of loved ones.  They are:

 

  • Mail order. Most health insurance and Medicare plans provide options for mail order delivery of medications.  Prescriptions are usually filled in 90-day quantities. Price discounts are usually offered over that of pick-up or local pharmacies. Unfortunately, mail order makes urgent medications challenging.
  • Pick-up. You guessed it?!  You or a family member pick up prescriptions and deliver them to the facility. For a small number of medications, this may be feasible.  But it doesn’t work for multiple prescriptions on multiple delivery schedules.
  • Local pharmacy delivery. Prescriptions are filled and delivered by a local pharmacy 1-2 times daily. Since assisted living facilities usually contract with a single pharmacy, rush orders and other conveniences are widely available. I recommend this option for all but the most hands-on families.

 

Introducing the Med Room So where do they store all that stuff? It’s called a “med room.”  The med room is a restricted-entry office that holds all resident medication, dosage records and prescription histories.

If you’re looking into assisted living for the first time, you should ask to see the med room.  From an audit perspective, if you already have a loved on in assisted living, you should periodically ask to see the med room.

Your goal in visiting the med room is to validate the following:

 

  • Medication is stored in a well-organized manner like that seen in hospitals
  • Files are well-organized and clutter is at a minimum
  • The staff can quickly share with you your loved one’s medication and prescription history
  • There is a supply of pudding or apple sauce for those residents that have trouble swallowing pills
  • Contact information for your loved one’s doctors is readily available
  • The door is kept locked (verified by staff unlocking the door when they let you in)

 

Who Administers Medication Medications are provided to residents by a medical aide (called “med techs” by administrators).  Med techs are responsible for the maintenance of the med room and for administering medications correctly and in a timely manner.

Med techs typically lay out all medications on a labeled delivery tray and deliver medication to each room. Their role is to ensure residents take their medications, although they will often leave medications with caregivers, if they are present.

In the unfortunate event of hospitalization, the med tech will also provide a copy of all current medications to paramedics or the individual taking your loved one to the hospital.

Keeping Track of It All As a family member, you should stay well informed of the medications your loved one is taking. The dosage record is the easiest way to do this.

A dosage record is kept for each patient and resembles the graph paper we all used in grade school.  Along the left side of the page is a list of medications. Across the top are days of the month. Every time a medication is given, the med tech is required to sign the box corresponding to that medication and date.

The best way to spot-check medication management is to randomly request copies of the dosage report.  Secondarily, ask the staff to notify you when medications are added or discontinued, so that you have a real-time understand of the medications being consumed.

Implementing the AMA’s Guidelines For Medical Tourism

Implementing the AMA’s Guidelines For Medical Tourism

In June 2007, the American Medical Association (“AMA”) released a report entitled “Medical Travel Outside the U.S.,” that tried to explain why people are going abroad for medical care. According to the AMA, the primary reasons that Americans are traveling for treatment are the ever escalating-cost of healthcare and the lack of affordable health insurance.

On June 16, 2008 the AMA re-entered the conversation with Guidelines on Medical Tourism. These guidelines address important issues of patient safety, transparency, financial incentives, after care, and legal liability. The AMA’s contributions to the medical travel industry at such an early stage is notable and important. Many American doctors strongly disapprove of patients who seek care abroad and few will agree to provide follow-up care for returning medical travelers. Those doctors are understandably concerned about incurring liability for another physician’s malpractice.

Widespread resistance in the medical community led many to believe that the AMA would either ignore or actively oppose the development of the medical travel industry. Instead, most were surprised by the AMA’s desire to get out in front of the issue and announce guidelines that some view as a traveling patient’s bill or rights.

As the health insurance industry and employers begin to explore the cost savings and benefits of medical travel, the AMA’s contributions promote patient safety and protection. The AMA has legitimized a nascent industry with only limited support from mainstream healthcare networks. Since the AMA entered the discourse, more and more health insurers are evaluating whether medical travel makes sense today, tomorrow or sometime soon.

At this stage, AMA does not seem intent to stamp out medical travel. This may be due in part to the movement’s consumer-driven nature and the reality of restricted resources at home. Instead, the organization of medical professionals will propose model legislation to all states that protects patients who go abroad for treatment.

2. The Guidelines and Who Will be Impacted

The AMA’s Guidelines on Medical Tourism are enumerated below. Each addresses important components of patient decision-making, safety, protection and recovery.

a. Medical care outside of the U.S. must be voluntary.

b. Financial incentives to travel outside the U.S. for medical care should not inappropriately limit the diagnostic and therapeutic alternatives that are offered to patients, or restrict treatment or referral options.

c. Patients should only be referred for medical care to institutions that have been accredited by recognized international accrediting bodies (e.g., the Joint Commission International or the International Society for Quality in Health Care).

d. Prior to travel, local follow-up care should be coordinated and financing should be arranged to ensure continuity of care when patients return from medical care outside the US.

e. Coverage for travel outside the U.S. for medical care must include the costs of necessary follow-up care upon return to the U.S.

f. Patients should be informed of their rights and legal recourse prior to agreeing to travel outside the U.S. for medical care.

g. Access to physician licensing and outcome data, as well as facility accreditation and outcomes data, should be arranged for patients seeking medical care outside the U.S.

h. The transfer of patient medical records to and from facilities outside the U.S. should be consistent with HIPAA guidelines.

i. Patients choosing to travel outside the U.S. for medical care should be provided with information about the potential risks of combining surgical procedures with long flights and vacation activities.

Generally, these guidelines appear to be directed to health insurers and employers incorporating foreign providers into healthcare plans and to a lesser extent medical travel experts coordinating the patient travel experience. The Guidelines seek to protect patients from being pressured by healthcare payers to accept lower quality care without recourse in the event of a bad outcome. The AMA repeatedly stresses the importance of informing patients of their rights and recourse, the hospital and doctor’s credentials, and potential risks associated with combining travel activities with surgical procedures.

3. Implementing Key Guidelines

a. Patient Safety

The majority of the AMA’s Guidelines are aimed and ensuring patient safety. The Guidelines call for treatment abroad to be voluntary and for financial incentives to not restrict treatment options. This measure is meant to avoid patient coercion and withholding important information about available alternatives. The AMA also requires that institutions treating patients be accredited by recognized international accreditation bodies. This rule tries to ensure that patients are treated in safe and clean facilities that meet international standards of patient care, infection control and hygiene. The AMA also requires that patients be informed of the risks of combining surgical procedures with travel activities. The Guideline’s proscription against transferring patient medical records in violation of HIPAA aims to reassure patients that their privacy rights will continue to be safeguarded abroad.

Medical Terminology – First Step on a New Career Path

Medical Terminology – First Step on a New Career Path

In these days of economic uncertainty, career change is a hot button issue. As baby boomers retire and leave the work force, employers are concerned about the shortage of skilled workers. In addition, corporate cost cutting, off-shoring, layoffs, and forced career changes leave many workers with difficult choices. Gone are the days of one job and one employer for life. Following a career path today can mean maneuvering many twists and turns, setbacks, side roads, and blind alleys. Where is the roadmap to a new career that provides enrichment, stability and growth potential?

One of the best ways to ease some of the uncertainty and increase your marketability quotient is to broaden your skill set. Since continuing education is often required to maintain licenses and certifications, make those education hours do double duty. The right training can mean more opportunities in your current field, and serve as a stepping stone to a new career. But which industries offer the best chance for job stability and advancement?

It is predicted that expanding healthcare and healthcare-related industries will require many additional skilled workers in the coming decade. According to Forbes Magazine, “As well-heeled baby boomers age, look to the health care industry… (B)etween 2004 and 2014, seven of the 10 fastest-growing jobs in the U.S. will be in health care.” In addition to careers directly involved in patient care, demand for support professionals such as medical records and health information technicians, therapists, counselors, and medical transcriptionists will increase.

A basic requirement for entry into almost any healthcare-related career is a command of medical terminology. The ability to recognize, understand, spell, and pronounce basic medical terms, identify medical abbreviations, and decipher unfamiliar words using roots, suffixes and prefixes is a necessary tool to perform well in any medical setting. Medical terminology courses are widely available in online, home study and instructor-led formats. Because medical technology advances rapidly, medical terminology evolves to keep pace. To stay on top of new terminology, consider taking the course again if you’ve taken it in the past.

The Department of Labor database lists seven nontraditional careers that require medical terminology:

Medical Transcriptionists – To understand and accurately transcribe dictated reports, medical transcriptionists must understand medical terminology, anatomy and physiology, diagnostic procedures, pharmacology, and treatment assessments. They also must be able to translate medical jargon and abbreviations into their expanded forms.

Medical Records and Health Information Technicians – In addition to general education, coursework requirements for medical records and health information technicians includes medical terminology, anatomy and physiology, legal aspects of health information, health data standards, coding and abstraction of data, statistics, database management, quality improvement methods, and computer science.

Surgical Technologists – Surgical technologists receive their training in formal programs offered by community and junior colleges, vocational schools, universities, hospitals, and the military. In 2006, the Commission on Accreditation of Allied Health Education Programs (CAAHEP) recognized more than 400 accredited training programs. Programs last from 9 to 24 months and lead to a certificate, diploma, or associate degree. Programs provide classroom education and supervised clinical experience. Students take courses in anatomy, physiology, microbiology, pharmacology, professional ethics, and medical terminology. Other topics covered include the care and safety of patients during surgery, sterile techniques, and surgical procedures. Students also learn to sterilize instruments; prevent and control infection; and handle special drugs, solutions, supplies, and equipment. Most employers prefer to hire certified technologists.

Occupational Therapist Assistants and Aides – There were 126 accredited occupational therapist assistant programs in 2007. The first year of study typically involves an introduction to health care, basic medical terminology, anatomy, and physiology. In the second year, courses are more rigorous and usually include occupational therapist courses in areas such as mental health, adult physical disabilities, gerontology, and pediatrics. Students also must complete 16 weeks of supervised fieldwork in a clinic or community setting.

Medical Transcription Introduction

Medical Transcription Introduction

Medical Transcription is the process of converting voice dictation (typically either cassette or digital format) into a permanent written record utilizing word processing equipment and software.
Each day in hospitals all over the country, thousands of patients are admitted and discharged. Examinations are conducted, procedures are performed and recommendations are made. It is not uncommon for multiple physicians to be involved in a simple procedure for a single patient. Radiologists, Pathologists, Anesthesiologists, Surgeons, and a host of other medical specialists must all coordinate their efforts to ensure that patient care is both adequate and appropriate.

Underpinning all of these activities is a complex web of medical and patient information. Each patient-related activity and procedure must be meticulously documented and then added to the patient’s permanent record. Physicians and medical record handlers alike must be extremely careful to ensure that detailed patient identification information accompanies each procedure and examination report to avert potentially disastrous mix-ups. Over time, all of this information accumulates in a centralized medical records repository where it serves as a critical resource for patient care – facilitating accurate diagnoses and appropriate treatments. Indeed, timely patient care often hinges on the ability of Radiology, Pathology, and other specialty departments to quickly conduct their examinations and report their findings.

Evolution and History of Medical Transcription

In the past, patient medical charts consisted of a series of abbreviated handwritten notes that were funneled into the patient’s file for interpretation by the primary physician responsible for diagnosing ailments and prescribing treatment. Ultimately, this hodge-podge of handwritten notes and typed reports was consolidated into a single patient file and physically stored along with thousands of other patient records in a wall of filing cabinets in the medical records department.

Whenever the need arose to review the records of a specific patient, the patient’s file would be retrieved from the filing cabinet and delivered to the requesting physician. To enhance this manual process, many medical record documents were produced in duplicate or triplicate by means of carbon copy.

In recent years things have changed considerably. Walls of filing cabinets have given way to desktop computers connected to powerful mainframe systems where patient records are prepared and archived digitally. This digital format allows for immediate remote retrieval by any physician who is authorized to review the patient information. Reports are stored electronically and printed selectively as the need arises.
While the transition from a paper based to an electronic format will take years to complete, considerable progress has been made. Handwritten reports are largely a thing of the past. Verbal dictation is now by far the most common method for documenting and reporting the results of examinations and procedures. Physicians generally use either a cassette based voice dictation system or a digital voice dictation system to record their findings. Dictating reports verbally not only allows physicians to be more thorough in their reporting, it also saves them a great deal of time. The Wall Street Journal recently reported the results of a study conducted by the Association of Legal Administrators suggesting that verbal dictation is the fastest way to create a document. The study states that “a 245-word document takes 9.34 minutes to create with an electronic dictaphone, compared with 16.46 minutes on a personal computer and 16.49 minutes by hand.” (WSJ, Tuesday, October 22, 1996, page A1, column 5). Given the salaries of most physicians, the cumulative productivity savings associated with these technological enhancements is considerable.

The process of converting voice dictation to a typewritten format is known as transcription. Traditionally a staff of skilled medical transcriptionists working in the medical records department of the hospital has accomplished the work of transcribing medical records. In the early years of medical transcription it was not uncommon for very large hospitals to have staffs of 40 or 50 medical transcriptionists working one or more shifts. A transcription supervisor, who in turn reported to the Medical Records Director, generally oversaw these transcriptionists.

The Medical Transcription Outsourcing Trend

Increasingly, traditional hospitals are coming under competitive attack by more efficient managed care organizations. In an effort to remain competitive, many hospitals have turned to outsourcing as a means of cutting costs. Many of the processes that were previously performed internally are now being contracted out to third parties. Medical transcription is no exception. The outsourcing of transcription and other functions relieves hospitals of the administrative headaches and overhead burdens associated with internal production and allows them to focus their attention on improving service and lowering costs.

This new competitive climate has driven many hospitals out of business. Those organizations that have survived have done so by becoming more efficient and cost-conscious. There is considerable evidence to suggest that contracting out medical transcription is a much less costly alternative to producing reports internally. Most savvy healthcare providers today understand this and are responding appropriately. The significant cost-cutting pressures which continue to drive the industry toward consolidation, managed care and capitation virtually guarantee that the outsourcing trend will not only continue but accelerate in coming years.

This proliferation of outsourcing agreements has spawned a new generation of small medical transcription companies intent on carving out a piece of the pie. Interestingly, in spite of its rapid growth, the medical transcription industry is still considered a cottage industry. While there are a few truly national players, the industry is at this point still dominated by the hundreds of small local transcription companies located wherever hospitals are found.

Opportunities in Medical Transcription

The outlook for quality medical transcriptionists have never been greater. Lucrative opportunities abound today in hospitals, clinics, HMO’s, and in the hundreds of Medical Transcription contracting companies located throughout the country.

The Dangers of Expired Medications

The Dangers of Expired Medications

Expired medications are commonplace and inertia notwithstanding, many of us tend to rely on an intuitive sense of their value in continuing to store and use them. Such drugs can be harmful to health in several ways; they can be unpredictable in effectiveness, simply ineffective, or even toxic.

The formal way of classifying a medication as having expired is through it’s labeled expiry date. This date is often set based on a combination of the common properties of the dosage form as well as the stability and expiration studies of the product that have been conducted by the manufacturer. Importantly, this expiry date is contingent on specific storage conditions of the product. Although a medication may pass it’s labeled expiry date, it may not necessarily be any less effective or dangerous to consume depending on the product itself, the storage conditions and the circumstances leading up to expiry.

When most medications pass their expiry date under appropriate storage conditions, they are generally taken to have become so variable in effectiveness as to have become unsuitable for use. This often comes about as a result of the degradation of the active ingredients of the medication with exposure to physical, chemical or microbiological variables like temperature, pressure, humidity, light, bacteria as well as other components of the product known as excipients.

Creams may “crack” once their expiry date is passed, leading to a separation of the components and hence provide a non-uniform delivery of active ingredients. This can lead to the poor control of conditions like eczema or acne. Tablet medications can mechanically “powder” off, change in consistency with exposure to water vapor or even experience the contained drug itself becoming ineffective on prolonged exposure to air as occurs with glyceryl trinitrate, an emergency medicine that can easily become ineffective in relieving acute symptoms of chest pain. With common injections, should the acidity change to fall outside a fairly narrow range, significant pain and tissue damage can result from use. With most eye drops, an expiry date of one month after opening is accepted to minimize the potential for dangerous bacterial contamination.

With any medication, once a specific threshold of remaining active ingredient is passed, the medication can no longer be relied upon to deliver accurate doses. This loss of reliability is often exacerbated by the fact that the active ingredients can degrade into various combinations of active, inactive or toxic breakdown products. The common aspirin is for instance, known to react with moisture to breakdown into salicylic acid, which is active, and acetic acid, which is inactive and can lead to toxicity in excess.

While the expiry date provides a useful gauge of when to stop using a medication, there are also many other factors that can informally accelerate the expiry of a medication and make it dangerous to use, chief among which is how the medication is stored. It is oftentimes not just the medication that is affected by storage conditions but also the storage container. Under inappropriate storage conditions, certain containers can leech material into liquid medication preparations, or medication particles can stick to the container rather than remain separated. On average, a 10 degree rise in temperature doubles the rate of chemical reactions that occur to a medication product and can accelerate the rate of bacterial contamination several fold. Just like an ice cream can simply melt or a loaf of bread becomes mouldy much quicker if not refrigerated, many medication products can easily expire much faster when not stored appropriately.

With oral liquid and topical medications, potentially dangerous changes associated with expiry can at times be detected by color or consistency changes, component separations, altered smell or taste (oral preparations). Should a suspicion of expiry arise, a medication expert should be consulted regardless of whether or not the labeled expiry date has been passed.

“Expiry” should also be understood to occur once a supply of medications is no longer used appropriately for it’s intended purpose. Consultation with a medication expert is always advised to prevent the inappropriate use of existing medication supplies. Inappropriate use can often occur with self-medication and is harmful. An unfinished supply of a previously used antibiotic may be tried to treat a new infection that is actually untreatable by or resistant to that antibiotic. This practice may not only delay recovery but can also encourage the proliferation of “super bugs” that have resistance to many antibiotics. Another incorrect purpose involves sharing medications and this can be especially harmful if another is allergic to the shared medication or a child or pet is medicated with an adult’s medication. Children often require dose adjustments to accommodate their size while many human drugs are often unsuitable for pets. Even a simple food like chocolate that we may enjoy can easily be toxic to a pet dog.

Another mechanism whereby medication expiry is dangerous occurs when an unfinished supply is used despite new information that points to increased precautions associated with the medication or that has led to it’s recall. An example is obtaining pain relief from a previous supply of a painkiller like Vioxx (rofecoxib) or Celebrex (celecoxib) in spite of an existing heart condition that is now known to relate to an increased risk of fatality under those circumstances of consumption.

Expired medications that are kept instead of discarded not only take up space but can actually discourage the appropriate use of new supplies in the treatment of illness. A medication cabinet, if not tended to regularly, could eventually contain more expired medications than viable ones and this can lead to the accidental consumption of an expired medication in place of a viable one. It is definitely advisable to clear the medication cabinet of expired medicaitons at least annually if not more often.

A further danger however, lies in how expired medications are disposed of. Expired medications and pharmaceutical byproducts can be harmful to the environment especially when they end up in our rivers and drinking water supply. Hormonal compounds like estrogen from birth control pills and patches as well as antibiotics have been linked to being flushed by individuals and institutions into sewage, draining largely unchanged and collecting in rivers and streams, then returning in tiny amounts into drinking water. Traces of antibiotics could worsen bacterial resistance while estrogens and other steroids are known to change the reproductive characteristics of fish. Even trace amounts of chemotherapy medications have emerged in tap water and this could be severely detrimental to the unborn babies of pregnant women who drink such water. The long-term impact on human health of medications in our rivers and drinking water is as yet unknown but no one would want to wait to find out. We can all play our part by inquiring on and using pharmacy or state-run programs for the disposal of expired medications instead of sending them down the sink or the toilet bowl.

A pharmacist is the expert of choice to approach in handling medication expiry and should be consulted if in doubt. As a general rule, it is always best to safeguard your own health and that of those around you by expeditiously and appropriately discarding all expired medications.

When to Take Your Medication

When to Take Your Medication

Timing your medication appropriately can be crucial to the success of any treatment regime whether it be to cure a life-threatening condition or simply to alleviate troublesome symptoms.

When best to take a medication depends on the active ingredient, what product form the medication is in, the nature and severity of the condition to be diagnosed, prevented or treated, as well as individual diet and lifestyle. The detailing that your doctor or pharmacist provides often centers on maximizing the effectiveness and safety of the medication.

Getting as much of the active ingredient to be absorbed into the body can be an important goal of correctly timing your medication. Some medication is better absorbed when taken with meals or specific foods while the absorption of others is inhibited when taken in the same way. Extremely little of an osteoporosis medication like Fosamax (alendronate) already ever gets into the body, let alone reaches the bones, under fasting conditions from a single dose. This medication needs to be taken with plain water and without food or other drink, weekly on the same day in an upright position upon first rising. Already more than 99% of a single dose will be excreted out of the body under such conditions and if the medication is taken with food or at other times during the day, the amount absorbed can be further reduced by half or more.

Some medications may be safer to take with food rather than on an empty stomach. In better assuring the long-term safety of a painkiller class of medications known as NSAIDs, it may be advisable to avoid taking the medication aspirin for instance, on an empty stomach and to either take the medication with or after food or together with an antacid.

Active ingredients can require a specific dose and timing strategy to be most effective. This is especially so for different types of antibiotics in treating infections. An antibiotic medication like cloxacillin may require four times a day dosing to maintain effective blood levels in treating a skin infection while ciprofloxacin, an antibiotic of a another class that acts differently, may only require once or twice a day dosing to treat a urinary tract infection.

The product form can play an important role in when and how often a medication is taken. Long-acting, delayed or sustained release preparations can work to release the active ingredients of a medication product differently or consistently throughout a day allowing the medication to be therapeutic despite being dosed only once instead of multiple times in a day. In managing blood pressure for instance, chronotherapeutic medication has been developed to work in tandem with the body’s natural circadian rhythms and in effect, to best tackle the peak blood pressure that tends to occur upon awakening. Innopran XL (propranolol) can be taken just once at night before sleeping. Technology allows the release of the medication’s active ingredient four hours after taking it, with resulting peak blood levels that coincide with the morning spike in blood pressure.

The nature of a medical condition can also help to determine when it is best to take a particular medication. Cholesterol is synthesized by the body, often during sleep in the night hence the arising notion that it may be most advantageous to dose cholesterol-lowering medication like Zocor (simvastatin) or Mevacor (lovastatin) in the evenings. Conditions like migraine, fever and gout may have acute symptoms that occur unpredictably and can often require medicating regardless of the time of day.

Incorporating individual diet and lifestyle patterns often facilitates compliance with taking medication and can be crucial to effectively treating a chronic condition like diabetes without unduly reducing quality of life. To best control the condition, insulin injections may be administered as well as oral medication taken before, with or after food to coincide with specific anticipated spikes in blood sugar levels. In consultation with the treating doctor, oral medication may be timed with meals or scheduled for consumption either consistently in the morning or the night to facilitate lifestyle and compliance.

When specific medications are used to moderate elements of diet and nutrition, taking these consistently with meals can be important to treatment success. A weight-loss medication like Xenical (orlistat) is often best taken with meals or times of food intake that involve the most consumption of fats as these get bound by the medication and are passed out from the body. The cholesterol-reducing medications colestipol and cholestyramine also act in a similar way and are best taken with meals.

Timing medication for best outcomes can be especially important when having to take five or more medications consistently. In such cases known as polypharmacy, it becomes increasingly important not just to match medicating with specific time slots before, with or after food, but also to space out the different medications appropriately so as to avoid negative interactions that could lead to ineffective medicating or even direct harm to health.

In timing your medication, discuss the various considerations with both your treating doctor and pharmacist. This will optimize a safe and effective medication regime and better your treatment outcomes.

Attorney’s Guide to Medical Malpractice For South Carolina (SC) Lawyers and Plaintiffs

Attorney’s Guide to Medical Malpractice For South Carolina (SC) Lawyers and Plaintiffs

Medical and health care providers – primarily hospitals, surgeons, doctors, pharmacists, physicians, nurses and emergency medical technicians (“EMTs”) — are expected to offer us care and support during our most critical moments. The vast majority of medical and health care providers do offer excellent care that will help us to recover from a personal injury or medical condition. However, some providers fail to meet the requisite standard of care, and, under such circumstances, may be guilty of medical malpractice.

COMMON TYPES OF MEDICAL MALPRACTICE

Medical malpractice, commonly called “medmal” for short, generally occurs when a negligent, careless or reckless act, mistake, error, or omission by a doctor or other medical professional causes damage or harm to a patient. It has been estimated that almost 98,000 people die in hospitals in the United States each year, and that medication errors injure approximately 1.3 million people per year. Medical malpractice errors or negligence typically occur in the diagnosis or treatment of a patient, and may include, but are not limited to:

>Failure to treat
>Wrong treatment
>Delay in diagnosis
>Failure to diagnose
>Failure to rule out causes or conditions
>Misdiagnosis
>Failure to test
>Failure to obtain informed consent
>Surgical injury
>Wrong prescription of drugs
>Patient abandonment
>Use of defective medical products

A patient’s right to recover compensation for medical malpractice is generally governed by common law as well as statutes and regulations which have been promulgated to protect patients who have been subjected to medical malpractice or medical negligence. Medical malpractice suits are usually complex, time-consuming, expensive to litigate, dependent upon expert testimony, and vigorously defended by health care providers and their insurers.

ELEMENTS OF A MEDICAL MALPRACTICE OR MEDICAL NEGLIGENCE CLAIM

The medical malpractice personal injury victim is commonly referenced as a “plaintiff” and the person or entity that caused the harm is commonly referenced as a “defendant.” The South Carolina Supreme Court has set forth the elements of negligence with regard to a medical malpractice personal injury claim that a plaintiff has to prove as follows:

>A physician-patient relationship exists
>The generally recognized and accepted practices and procedures that would be followed by average, competent practitioners in the defendants’ field of medicine under the same or similar circumstances >That the defendant departed from the recognized and generally accepted standards
>The defendant’s departure from such generally recognized practices and procedures was the proximate cause of the plaintiff’s alleged injuries and damages

Thus, the medical malpractice lawyer and his client must present evidence to meet each of the foregoing elements at trial.

A physician commits malpractice by not exercising that degree of skill and learning that is ordinarily possessed and exercised by members of the profession in good standing acting in the same or similar circumstances. Durham v. Vinson, 360 S.C. 639 (2004). A plaintiff and his attorney must proffer expert testimony to prove both the required standard of care and the defendant’s failure to conform to that standard, unless the subject matter lies within the ambit of common knowledge so that no special learning is required to evaluate the conduct of the defendants.

INFORMED CONSENT CLAIM

A physician’s failure to obtain a patient’s “informed consent” with regard to a procedure or treatment is a form of medical malpractice. The term “informed consent” means that a physician must tell a patient all of the potential benefits, risks, and alternatives involved in any surgical procedure, diagnostic procedure, medical procedure, therapeutic procedure, or other course of treatment, and must obtain the patient’s written consent to proceed. Under Informed consent law, a physician who performs a diagnostic, therapeutic, or surgical procedure has a duty to disclose to a patient of sound mind, in the absence of an emergency that warrants immediate medical treatment, (1) the diagnosis, (2) the general nature of the contemplated procedure, (3) the material risks involved in the procedure, (4) the probability of success associated with the procedure, (5) the prognosis if the procedure is not out, and (6) the existence of any alternatives to the procedure. Thus, the plaintiff and his lawyer must present evidence of the physician’s breach of the foregoing elements of an informed consent claim in order to prevail at trial.

BREACH OF CONTRACT OR WARRANTY CLAIM

While most health care providers will not guarantee or warrant a particular outcome, there are times when they do, and a failure to successfully provide the outcome may give rise to a breach of contract or breach of warranty claim. These type cases usually involve plastic surgery wherein the patient is told that his or her post-surgery physical appearance will be the same as demonstrated on a computerized enhancement of the patient’s photograph. Thus, much like a business breach of contract claim, the plaintiff and his lawyer must present evidence of the physician’s breach of the stated warranty or guarantee by the preponderance of evidence in order to prevail at trial.

COMPENSATION IN MEDICAL MALPRACTICE CASES

In a medical malpractice personal injury lawsuit, a victim seeks compensation for the injury or injuries he or she has suffered. Compensation can include past and future medical expenses, disability or deformity, loss of income, emotional and mental anguish, loss of a spouse’s comfort and society, past and future pain and suffering, and an amount which would be necessary to make the person whole as respects a permanent personal injury. McNeil v. United States, 519 F.Supp. 283 (D.S.C. 1981). In cases where the defendant acted recklessly, maliciously or willfully, punitive damages may also be awarded. Punitive damages in medical malpractice lawsuits are intended to punish the responsible party and deter others from committing the same acts. Gamble v. Stevenson, 305 S.C. 104, 406 S.E.2d 350 (1991). If a wrongful death results from the medical malpractice, the decedent’s beneficiaries are entitled to compensation.

CAPS ON MEDICAL MALPRACTICE DAMAGES

For medical malpractice cases arising on or after July 1, 2005, which placed caps on non-economic damages a patient could recover from a liable defendant health care provider. S.C. Code § 15-32-220(a) limits the civil liability for non-economic damages of the health care provider to an amount not to exceed $350,000 for each claimant regardless of the number of separate causes of action on which the claim is based. S.C. Code § 15-32-220(a) provides an exception to the foregoing cap where the health care provider is proven to be grossly negligent, willful, wanton or reckless and that conduct was the proximate cause of the claimant’s non-economic damages. S.C. Code 15-32-220(b) provides that the $350,000 cap is limited to each claimant. S.C. Code 15-32-220(c) allows a claimant to stack his claim, and provides that up to three health care providers may be subject to the $350,000 cap per claimant, for a total of $1,050,000 per claimant.

The non-economic damage cap of $350,000 per medical entity or practice or person does not apply to economic damages and does not apply to punitive damages. Effective for medical malpractice cases arising on or after July 1, 2005, S.C. Code 15-32-230 further limits liability with regard to emergency obstetrical or emergency department situations. This section eliminates liability on behalf of any person providing emergency care or emergency obstetrical care to a person in immediate threat of death or an immediate threat of serious bodily injury while in an emergency room, obstetrical or surgical suite, unless the health care provider is proven to be grossly negligent. Other caps or limitations may be applicable to a medical malpractice case as well.

STATUTE OF LIMITATIONS

The plaintiff’s attorney must timely bring a medical malpractice suit within the required timeframes. There are time limits on bringing a personal injury lawsuit in the state of South Carolina known as statutes of limitations. See S.C. Code 15-3-530(5); 15-3-535. While a medical malpractice personal injury suit is generally subject to a three year statute of limitations, there may be exceptions depending on the circumstances, such as a medical malpractice case where the negligent conduct may be covered by a concept known as the “discovery rule.” See S.C. Code 15-3-545; Wilson v. Shannon, 299 S.C. 512, 386 S.E.2d 257 (Ct. App. 1989).

The statutes of limitations are different for negligence suits against a South Carolina state government agency pursuant to the South Carolina Tort Claims Act (“TCA”) and the federal government pursuant to the Federal Tort Claims Act (“FTCA”). Under the TCA, a suit must generally be filed within two years, unless a verified claim is filed within a year of the injury, then the statute of limitations is three years. S.C. Code § 15-78-110. Under the FTCA, an administrative tort claim must generally be presented to the subject federal agency within two years. Once a timely administrative tort claim has been filed, there is no statute of limitations on bringing a suit unless the federal agency denies the claim, in which case a suit must be brought in federal court within six months after the denial. 28 U.S.C. 1346(b), 1402, 2401, 2675.

NECESSITY OF AN EXPERT

South Carolina Code 15-79-125 requires, on medical malpractice cases arising on or after July 1, 2005, that before a medical malpractice suit can be filed, a plaintiff has to simultaneously file both a notice of intent to file suit and an affidavit of an expert witness subject to the affidavit requirements established in 15-36-100 in a county in which venue would be proper for filing or initiating the action. Statutory mediation of any such medical malpractice case is required as well, and, there are time limits for filing suit should the attempted mediation fail. As noted above, an expert’s testimony is necessary at trial to prove a breach of the standard of care and proximate cause of the injury, and the medical malpractice lawyer should retain a medical expert early on to assess the case and to be prepared to testify at trial.

Medical malpractice suits in South Carolina are difficult to pursue. Before undertaking a med-mal suit, the injured client would be well advised to consult with a lawyer with medical malpractice experience.