Tag Archives: Marshall Allen

Project looks at problems in how deaths are investigated

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism, and he has blogged for Covering Health ever since.

The results of a yearlong joint investigation of the American autopsy system by ProPublica, Frontline and NPR show that problems in the death investigation system throughout the country have led to innocent people being sent to prison, “allowed the guilty to go free and left some cases so muddled that prosecutors could do nothing.” When autopsies aren’t done, diagnostic errors go undetected and opportunities to learn more about medicine are lost.

One story of patient rights and legal wrangling sports the remarkable headline “Why Can’t Linda Carswell Get Her Husband’s Heart Back?” It hinges, among other things, on the simple fact that “Even though the Institute of Medicine has reported that medication errors affect an estimated 1.5 million patients per year, it is not typical to conduct toxicology tests as part of clinical autopsies. They are routine in forensic autopsies.”

Another piece takes a broader view, exploring the reasons behind and consequences of the fact that autopsies are performed on only about one in 20 patients who die in hospitals when, 50 years ago, the rate was one in two.

Hospitals aren’t required to perform autopsies – the Joint Commission hasn’t included autopsy rates in its accreditation process since 1971 – and neither Medicare nor private insurers reimburse hospitals for the procedures, which Allen found cost about $1,275 each. The implications of these financial disincentives, combined with related factors such as some physicians’ confidence that new diagnostic tools such as MRIs and CT scans provide such accurate results that they obviate the need for postmortem work, are far-reaching.

Diagnostic errors, which studies show are common, go undiscovered, allowing physicians to practice on other patients with a false sense of security. Opportunities are lost to learn about the effectiveness of medical treatments and the progression of diseases. Inaccurate information winds up on death certificates, undermining the reliability of crucial health statistics.

Furthermore…

A 2002 review of academic studies by the federal Agency for Healthcare Research and Quality found that when patients were autopsied, major errors related to the principle diagnosis or underlying cause of death were found in one of four cases. In one of 10 cases, the error appeared severe enough to have led to the patient’s death.

Other stories in the project report that suspicious deaths of the elderly are rarely investigated and that the deaths of children “pose special technical challenges for forensic pathologists.”

Watch the full episode. See more FRONTLINE.

ProPublica’s Allen opens window into screening business

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism, and he has blogged for Covering Health ever since.

In an investigation co-published with his old friends at the Las Vegas Sun, ProPublica’s Marshall Allen offers a revealing investigation into Heart Check America, a company whose high-pressure sales tactics and dubious quality record have earned it reams of consumer complaints and attention from state authorities.

Allen’s first-person anecdotal opener alone is enough to make the story worth reading, and the fact that he backs it up with thorough investigative work that appears to have already launched probes in two states is just the icing on the cake.

Heart Check America’s business model is eerily similar to that of the time-share industry, which is exactly where manager David Haddad earned his business stripes before being forced out by a state attorney general. Patients are lured in with the promise of free tests, then subjected to high-pressure sales tactics until they fork over thousands of dollars for long-term medical screening packages which they likely didn’t need in the first place.

It’s a classic investigation with evidence unearthed from a legion of sources; here’s just a sample of what Allen has assembled:

Colorado regulators checked Heart Check America’s Denver center. They found a litany of deficiencies, including no proof that staffers operating the scanner were qualified, no controls to ensure patients received as little radiation as possible, and that tests were being conducted without doctors’ orders.

Inspectors also found that the clinic was not supervised by a physician licensed in Colorado and that test results weren’t being read by a qualified radiologist or delivered to patients in a timely manner.

Allen’s work plays right into the debate over the efficacy of various screening procedures, especially those applied to low-risk patients, which makes one paragraph at the end of the story particularly ominous.

Haddad said he is continuing to look for opportunities in the imaging business. He has formed a new company, Cancer Check America, in Hilton Head, S.C, to focus on cancer screening.

Related

Pulitzer nods demonstrate breadth of health beat

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism, and he has blogged for Covering Health ever since.

This week’s Pulitzer announcements demonstrated just how far health journalism spread its wings in 2010, with health-related stories snagging wins and nominations for work related to everything from business to commentary to feature writing. Several AHCJ members were among the nominees, and Covering Health readers will recognize a significant number of the bylines and storylines. We’ve pulled the health-related award text below straight from Pulitzer.org and linked to related content when possible. Winning entries are in bold.

Explanatory Reporting

Editorial Writing

Investigative Reporting

Public Service

Local Reporting

National Reporting

Feature Writing

Allen looks at present, future of Nev. transparency

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism, and he has blogged for Covering Health ever since.

Writing for the Las Vegas Sun, reporter Marshall Allen put a fitting cap on an award-winning investigative run at the paper with a story rounding up the state’s first steps toward transparency in medical error reporting. Through the lens of former Beth Israel Deaconess chief, transparency pioneer and blogger Paul Levy, Allen demonstrates just how much transparency in Nevada could benefit both hospitals and their patients. It’s potential that was created, in no small part, through the reporting that Allen and Alex Richards have done.

Over the course of the Sun’s two-year investigation, most Las Vegas hospitals refused to discuss patient safety issues. The Nevada Hospital Association has since 2002 lobbied against mandated public reporting of patient harm. But since the Sun’s investigation, and with legislation pending, the association has said it will begin posting patient injury and infection data on its hospital quality website.

Throughout the piece, Allen paints a sunny picture of a more transparent future, and uses examples from Massachusetts to dissolve any reservations readers might have.

Dr. Tejal Gandhi, Partners’ director of patient safety, said at first there was panic over posting on the hospitals’ websites the infections and injuries suffered by patients. People worried there would be a media frenzy or a rise in malpractice lawsuits, she said.

When the information became public, in 2009, The Boston Globe published one story but there was little other reaction, she said.

The hospitals have seen no increase in malpractice lawsuits. But it has brought a new focus on reducing certain infections and injuries, including the formation of task forces and establishment of standardized safety protocols.

Allen, who recently took a job with ProPublica, completed part of this series while on an AHCJ Media Fellowship on Health Performance, supported by the Commonwealth Fund. The series, which was reported with Richards, won a 2010 Award for Excellence in Health Care Journalism, the investigative reporting category in the 2010 Scripps Howard Awards, best in show for the print category of the National Headliner Awards and the 2011 Goldsmith Prize for Investigative Reporting.

‘Do No Harm’ team captures another award

Pia Christensen

About Pia Christensen

Pia Christensen (@AHCJ_Pia) is the managing editor/online services for AHCJ. She manages the content and development of healthjournalism.org, coordinates social media efforts of AHCJ and assists with the editing and production of association guides, programs and newsletters.

AHCJ member Marshall Allen and Alex Richards have won the investigative reporting category in the 2010 Scripps Howard Awards for the series they did for the Las Vegas Sun.

The Ursula and Gilbert Farfel Prize, given in cooperation with Ohio University’s Scripps College of Communication and the Farfel Endowment, carries $15,000 in prize money.

Allen, now at ProPublica, was a health reporter at the Las Vegas Sun, where he and Richards reported the series  about preventable errors in hospitals, for which they reviewed 2.9 million records. The pair also received the 2011 Goldsmith Prize for Investigative Reporting.

The award-winning series was partially completed while Allen was on an AHCJ Media Fellowship on Health Performance. The fellowship program, supported by The Commonwealth Fund, has assisted four reporters since last summer on significant projects exploring health systems. Allen’s focus for his fellowship year is on exploring whether transparency about hospital quality improves the quality of care for patients. In 2009, he was an AHCJ-CDC Health Journalism Fellow.

He won second place in beat reporting in the 2007 Awards for Excellence in Health Care Journalism. In 2008, he took third place in the medium newspaper category and second place in the limited report category. In the 2009 awards, he won first place in the beat reporting category.

Allen, who serves on AHCJ’s Finance and Development Committee, has contributed tip sheets and articles to the organization’s resources, including:

Las Vegas Sun’s Allen a finalist for Goldsmith Prize

Pia Christensen

About Pia Christensen

Pia Christensen (@AHCJ_Pia) is the managing editor/online services for AHCJ. She manages the content and development of healthjournalism.org, coordinates social media efforts of AHCJ and assists with the editing and production of association guides, programs and newsletters.

AHCJ member Marshall Allen, with Alex Richards, is a finalist for the 2011 Goldsmith Prize for Investigative Reporting for their two-year investigation into preventable infections and injuries in Las Vegas hospitals.

Marshall Allen

Marshall Allen

The Las Vegas Sun reporters reviewed 2.9 million records for the reporting of “Do No Harm: Hospital Care in Las Vegas.”

Allen recently wrote an article for AHCJ members about making some of those inspection reports available for readers to see, using DocumentCloud. The technology allows readers to see the breadth of inspectors’ findings, including those that may not grab headlines but are just as important to the public.

Allen reports on health care for the Las Vegas Sun. As a member of the inaugural class of AHCJ Media Fellowships on Health Performance, he is exploring whether transparency about hospital quality improves the quality of care for patients. He has won Awards for Excellence in Health Care Journalism for his body of work in 2007, in the limited report and medium newspaper categories in 2008 and for his body of work in 2009. He was a member of the 2009 AHCJ-CDC Health Journalism Fellowship Program.