Tag Archives: Milwaukee Journal Sentinel

Pushback against Medtronic’s Infuse hits boiling point

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.

Medtronic’s ongoing woes with its blockbuster spine fusion product Infuse have been a staple of Covering Health for as long as we can remember, but things have reached a crescendo this week.

spine
Photo by attila acs via Flickr

The first blow came with the publication of John Fauber’s in-depth report (read it at the Journal Sentinel or in MedPage Today) on the conflicts of interest and regulatory weak points that kept Infuse going strong despite serious questions about medical outcomes.

The next day, The Spine Journal made the unprecedented move of dedicating an entire issue to repudiating the failures of science and medical journal publication that made Infuse what it is today. For the record, both those links point straight to journal press releases. If you’re looking for more context, you’ll find it in Fauber’s followup to The Spine Journal‘s Infuse issue. HealthNewsReview editor and publisher Gary Schwitzer also blogged his take on the releases.

Fauber’s Medtronic coverage is a joint project between the Milwaukee Journal Sentinel and MedPage Today.

MJS finds attempts to improve infant mortality rates are fragmented

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.

This year, a team at the Milwaukee Journal Sentinel launched “Empty Cradles,” a yearlong reporting effort to find out why infant mortality is so high in the region and whether it must be that way. As we near the halfway point, their effort has already produced some powerful journalism and given new impetus to an issue that had been simmering, almost ignored, on the front burner all long.

Lakisha Stinson holds her newborn daughter, Rashyia, in their Milwaukee home. Stinson’s first daughter, Kelviana, died of sudden infant death syndrome in 2004. Infant mortality is a problem that plagues the Milwaukee area. Photo: Rick Wood/Milwaukee Journal Sentinel
Lakisha Stinson holds her daughter, Rashyia, in their Milwaukee home. Stinson’s first daughter, Kelviana, died of sudden infant death syndrome in 2004. Photo: Rick Wood/Milwaukee Journal Sentinel

In their latest major installment, in which they explore potential solutions to the crisis (and the recent lack thereof), reporters Crocker Stephenson and Ben Poston sum up the reason for their investigation in two damning paragraphs.

In Central Harlem, babies once died at a rate twice that of Milwaukee. But through a unified effort, the community has slashed its infant mortality rate by 78% since 1990. The rate there is now about 6 deaths per 1,000 births, lower than the state of Wisconsin as a whole.

In Milwaukee – where tens of millions of tax dollars have been spent in the past decade – 11 out of every 1,000 infants die before their first birthday. The city continues to have one of the worst infant mortality rates in the nation, especially for African-Americans, whose babies die at a rate about 2.5 times that of whites.

The problem, it seems, is that while the state supports 110  infant mortality reduction initiatives, they have so far failed to coalesce into a united public health effort.

Milwaukee and a few other urban areas are looking to change that, starting with the Lifecourse Initiative for Healthy Families which began in 2009. Modeled on successful programs in places like Harlem, the effort seeks to address the full spectrum of social factors that lurk behind high mortality rates.

In an earlier installment, reporters Mark Johnson and Tia Ghose looked at a medical mystery: African Americans in the United States are at a much higher risk than white Americans to have premature births, babies with low birth weights and infant mortality.

A married, college-educated African-American woman faces worse odds than a white, unmarried woman who dropped out of high school.

For more on how the series came together, see the background article editor Greg Borowski wrote for AHCJ this spring. It’s a great explanation of how to take a problem that everyone regards and common knowledge and report it into a deep, engaging, yearlong series. For more on previous installments in the series, see our coverage from January.

Drug-funded research group failed to disclose ties to makers of painkillers

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.

In his latest conflict of interest investigation, Milwaukee Journal Sentinel reporter John Fauber takes on a challenge that, even by his standards, is an ambitious one.

pills
Photo by somegeekintn via Flickr.

He attempts to show the effect pharmaceutical money and the local researchers who received it had on national opinions toward powerful prescription painkillers and how it all influenced the American epidemic of opiate abuse.

He focuses on the University of Wisconsin Pain and Policy Studies Group, which has received millions from painkiller manufacturers while publishing drug-friendly research and warning against increased regulation of OxyContin and its ilk. Many of these millions, Fauber found, appear not to have been disclosed in relevant publications even as the group was paving the way for the rapid rise of painkiller prescriptions in America.

The drugs had initially been approved for a very narrow range of uses, but became extremely popular as off-label use for the management of chronic pain spread like wildfire. It’s not easy to draw clean lines between the Wisconsin group and off-label use, but Fauber’s deft investigative work and careful sourcing make a strong case.

Related

Read more of Fauber’s work

Faltering Wis. transparency law has national lessons

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.

Journal Sentinel reporter Guy Boulton’s investigation of Wisconsin’s ongoing failure to properly implement a statewide health care transparency law that went into effect on Jan. 1 covers the local details well, but is really set apart by Bolton’s careful explanation of why hospital pricing transparency is so tricky. You’ll have to read straight through to the last paragraph to get the full effect, so be patient.

The law in question is an “incremental” measure that was all legislators could push through in the face of industry lobbying. It requires hospitals to “provide price information on request,” but Boulton writes that there’s a problem with that, namely, “That information just doesn’t have any relation to what you and your health insurance plan will actually have to pay. Rather, it requires disclosing the equivalent of a sticker price or manufacturer’s suggested retail price – a price that almost no one pays.”

The law does require physician practices with four or more doctors to disclose prices that are closer to what commercial health plans actually pay, on average, for 25 conditions. But compiling that information proved impractical in the time allotted.

The Department of Health Services didn’t even try implementing the law’s provisions for other health care providers this year, concluding that it wasn’t practical.

As Boulton points out, “price information also has become more important as more people have health plans with high deductibles,” but setting prices in health care is tricky and varies widely. To compound the problem, “prices negotiated by health plans and health systems are confidential.”

Wisconsin may provide a cautionary tale about what could happen in other states or nationally.

Reporter looks at black infant mortality in Wis.

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.

The Milwaukee Journal Sentinel‘s Crocker Stephenson took a look at disparities in infant mortality in that area and explored both their cases and ramifications. In Wisconsin, black babies die at twice the rate of white babies, a finding which may just be the tip of the iceberg. For national and international comparisons, see the companion infographic. According to Stephenson, infant mortality rates are an early indicator of a community’s degeneration. When mortality rises, so do other dire indicators.

The bottom third – the group of ZIP codes with the most poverty and lowest college graduation rates – had the highest infant mortality rate.

It also had the highest premature death rate, chlamydia rate, HIV rate and teen birthrate.

It had the greatest percentage of low birth weights; preterm births; uninsured adults; people who hadn’t seen a dentist in a year; births to mothers who received no prenatal care during their first trimester; smokers; pregnant smokers; obesity; violent assaults within the past year; single-parent households; and children who tested positive for lead poisoning.

Milwaukee’s health commissioner called it a “crisis,” one that Stephenson found is as much a social matter as it is one of access to proper care. For more, see the “Problem Areas” section of the story.

Flawed approval process led to flawed jaw implants

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.

In the Milwaukee Journal Sentinel, reporter John Fauber proves that it’s possible to do cutting-edge reporting on conflicts of interest and tie those conflicts to clinical trials of devices that hit the market a few decades ago.

His targets? Jaw joint devices that were initially grandfathered in, and for which newer treatments were approved in the late ’90s and early 2000’s. These trials, Fauber found, were too small, too conflicted and too inconclusive to provide real data, yet the devices were approved anyway. Now, he has found, patients are paying the price.

I’ll just include the first sentence here, as I’m confident that nobody will be able to resist reading the rest of Fauber’s story.

Before implanting a third artificial jaw joint in Heidi Clark’s head, doctors had to remove particles of plastic from the second failed joint that had broken apart and become embedded in muscle.