Tag Archives: Milwaukee Journal Sentinel

Top docs spar over Medtronic research, Iraq service

Following up on his work on the dangers of Medtronic’s Infuse spine fusion product and the conflicts of interest that appear to have facilitated its approval and adoption, the Milwaukee Journal Sentinel‘s John Fauber has the latest on high-profile sniping between two top orthopedic surgeons over the Spine Journal‘s recent Infuse issue devoted to the many complications and conflicts of Infuse.

The combatants in this case are frequent Fauber target and University of Wisconsin-Madison orthopedic surgeon Thomas Zdeblick, who has received $23 million from Medtronic since 2002, and Stanford orthopedic surgery professor and Spine Journal editor-in-chief Eugene Carragee, the Iraq veteran whose research helped spark the recent push against Infuse.

The showdown began with Zdeblick’s defiant response to the Spine Journal‘s Infuse research, a letter which included an apparent attempt to discredit Carragee’s review because the surgeon wasn’t performing the elective spine fusion surgeries while he was serving with the American military in Iraq. In response, Carragee says he took no extended leaves of absence during the period covered in his study. For the record, Carragee’s second tour of duty in Iraq was cut short in 2008 after he was injured in an attempted suicide attack.

The full text of Zdeblick’s initial letter and the response of Carragee and his co-authors has been published online, and the medical community has rallied around the decorated veteran.

In an email to the Journal Sentinel, Charles Rosen, president of the Association for Medical Ethics, was sharply critical of Zdeblick’s letter.

“Zdeblick’s assertions are so nonsensical that the whole letter strikes me more like the ravings of a guilty man who’s been cornered,” said Rosen, a clinical professor of orthopedic surgery at the University of California, Irvine.

Fauber’s review included a particularly tidy summary of the overall Medronic fracas, and I have included his wrapup below the fold in case anyone still needs to get up to speed on the issue.

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Pushback against Medtronic’s Infuse hits boiling point

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.

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

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

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.

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.


Read more of Fauber’s work

Faltering Wis. transparency law has national lessons

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.