番茄社区

Welcome to the latest edition of Investigative Roundup, highlighting some of the best investigative reporting on healthcare each week.

Patient Dies After COVID-Infected Lung Transplant

A woman in Michigan contracted COVID-19 and died last fall, two months after receiving a double-lung transplant from an infected donor, .

University of Michigan Medical School officials said that the fatality may be the first proven case of COVID-19 in the U.S. in which the virus was transmitted through an organ transplant, KHN reported. The case is an anomaly in some 40,000 transplants last year.

The donor had shown no signs of COVID-19 and initially tested negative, KHN reported. A surgeon who handled the lungs was also infected. The surgeon became ill, but recovered.

The case -- though isolated -- has prompted calls for more thorough testing of lung transplant donors, said Daniel Kaul, MD, director of Michigan Medicine's transplant infectious disease service, KHN reported. That includes samples taken from deep within lungs, and from the nose and throat.

"We would absolutely not have used the lungs if we'd had a positive COVID test," Kaul said, according to KHN. Kaul about the case in the American Journal of Transplantation.

Affluent Californians Jump the Vaccine Line

A California program intended to increase COVID-19 vaccine access in hard-hit communities of color is being misused by people who don't reside in the targeted neighborhoods, the .

Those unfairly taking advantage of the program are scooping up inoculation appointments intended for residents of Black and Latino communities, according to the Times.

Vaccine access codes -- used to make the appointments -- have been circulating in wealthier, work-from-home communities, the Times reported, as some 2,000 community groups have contacted the state about participating in the program. Many of those gaining illicit access are not yet eligible for the vaccine.

Problems with the program became apparent last week, the Times reported, prompting California Gov. Gavin Newsom (D) to say the state would be to the program.

Widely Used Hernia Mesh a Chronic Pain Culprit

As more patients report chronic pain following hernia repair operations, lawsuits involving physicians' use of a synthetic netting known as hernia mesh are on the rise, .

Since 2018, some 30,000 people have filed lawsuits in federal and state courts involving hernia mesh, Harper's reported, citing Brett Vaughn, a lawyer with the Hollis Law Firm outside Kansas City.

Harper's spoke with one of those individuals, Michael Ransford, a 60-year-old farmer from New York, who had an operation at Columbia Memorial Hospital in 2016 to repair both an umbilical and testicular hernia. Ransford -- whose physician used hernia mesh to make the repairs -- has since had two more surgeries to remove some of the mesh that had stuck to his bowel and then most of the rest of the mesh that was creating scar tissue and other pain-causing issues. In the process, Ransford had to have his right testicle amputated. And he still experiences pain.

"Ransford doesn't know whether he'll ever fully recover. Doctors who perform explant surgery -- removal of mesh that has degraded -- say that 75% to 80% of patients see an improvement, but that some continue to experience intermittent pain," Harper's reported.

In recent decades, mesh makers have hired doctors to promote the product, and lobbied others to promote it as the new standard of care, Harper's reported. A primary argument for mesh has been that it wards off hernia recurrence.

Though medical researchers have turned their attention to warnings about hernia mesh, the FDA's 510(k) process -- allowing companies to market new devices merely by claiming similarity to existing ones -- may have contributed to the problem, Harper's reported.

"Hospitals are also complicit in the continued prevalence of hernia mesh," Harper's added. "Many have teamed up with Intuitive Surgical, the leading seller of surgical robots."

The magazine cited Marty Makary, MD, MPH, editor-in-chief of 番茄社区 and professor of surgery and health policy at the Johns Hopkins University School of Medicine, on the issue of robots as an unnecessary expense. "It's an operation where the robot has no benefit and may introduce new risks," Makary told Harper's.

COVID ECMO Rationing

As public health experts in the fall warned of a surge of COVID-19 patients that could overwhelm hospitals, that's exactly what happened, prompting physicians -- including those in Los Angeles County -- to make difficult decisions in the process, .

The surge meant that critically ill patients who might have survived with extracorporeal membrane oxygenation (ECMO) could not receive the treatment, ProPublica reported.

"Doctors had to choose who received the therapy based on who they thought had the best chance to survive," ProPublica reported. "Some were approved, but had to be put on a waitlist. Many patients died waiting."

That included 53-year-old Miguel Fernandez, a COVID-19 patient at PIH Health Whittier Hospital. Fernandez was the beloved oldest sibling in a family of Mexican immigrants, ProPublica reported. Despite his family's pleas for him to be moved to a nearby hospital with ECMO machines and the highly trained staff needed to run them, his condition deteriorated and caused an eventual approval to receive the treatment to be rescinded.

"In some parts of the country, doctors can tap into centralized systems to quickly find any available bed for ECMO at any hospital in the region," ProPublica reported. But that isn't the case in Los Angeles. For Fernandez, his caregivers and family had to "hack through red tape and navigate an opaque, disconnected and sometimes unfair system to try to save his life."

Fernandez passed away in December after a 26-day hospital stay and never having received the treatment.

Comment