Fentanyl Hidden in Cocaine; Missed Breast Cancer Diagnoses; Calling Out Racism

— This past week in healthcare investigations

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INVESTIGATIVE ROUNDUP over an image of two people looking at computer screens.

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

Deaths from Fentanyl Mixed in Cocaine

On March 17, 2021, three "high-achieving" New Yorkers received cocaine from "a DoorDash-style" delivery service. Within hours, all three had died because illicit fentanyl had been mixed in with their cocaine, according to the .

The Journal's story about the three overdose deaths detailed the final hours of three New Yorkers with advanced educations and jobs who fell victim to a supposed scheme to lace cocaine with fentanyl to make it more addictive.

One of the victims, Ross Mtangi, was a trading executive at Credit Suisse Group AG. He had checked into a Manhattan hotel for work that morning, and texted the cocaine delivery service. After a man "wearing a baseball cap, cross-body bag and face mask" supposedly delivered the cocaine to Mtangi, he missed a work meeting. His sister and her partner found him dead in the hotel the following day, according the Journal.

Police found "translucent black baggies that contained lethal fentanyl mixed in with the cocaine" in his hotel room, according to the article.

Another victim, Amanda Scher, who was a social worker, died in her Greenwich Village apartment after contacting the same delivery service.

The third victim was Julia Ghahramani, a first-year lawyer, who texted the delivery service the same day and died shortly after receiving the cocaine, according to the Journal.

The Journal noted that fentanyl has become common among drug traffickers, who find it easy and inexpensive to produce. This also led many dealers to add illegal forms of the drug to other recreational drugs, like cocaine, according to the Journal.

Authorities were able to trace the seller of this lethal cocaine-fentanyl combination to a man named Billy Ortega, according to the Journal. According to the article, Ortega pleaded not guilty to causing the three deaths or to distributing drugs. He is awaiting trial.

Hospital Missed Two Dozen Breast Cancer Diagnoses

An Arizona hospital missed breast cancer diagnoses in some two dozen women, according to an investigation.

The hospital, part of the North Arizona Healthcare (NAH) system, asked its radiology group to review more than 6,000 screenings after cancer was found in several women who had been evaluated by a certain radiologist, according to NBC News.

The missed diagnoses were discovered by Beth Dupree, MD, who had recently joined the hospital to establish a state-of-the-art breast center at NAH.

"These were misses that were not subtle," Dupree told NBC News.

The radiology group, Northern Arizona Radiology, had an exclusive contract with the hospital system. The group hired breast cancer screening specialists to review the screens and found 25 additional missed cancer diagnoses.

NAH released a statement saying it had acted "quickly to address these concerns" and that it had "ensured these mammograms were re-read specifically by a team of breast fellowship-trained radiologists." It added that "very few required any follow-up."

One of the new specialty radiologists, Michael Ulissey, MD, said he had requested the review be expanded to other breast cancer screening cases, but the radiology group declined to do so.

Black Doctors Pushed Out Due to Racial Discrimination

Three black doctors have spoken out about the role racial discrimination played in their decisions to leave their former institutions, according to .

The doctors, including a former resident and a hospital executive, claimed they were systemically pushed out of their prior institutions, and one alleged being fired without any justification, according to ABC News. Ultimately, all three highlighted the ongoing experience of discrimination and racial bias in medicine for black individuals.

One of the doctors, Chris Pernell, MD, recently rose to fame during the early days of the COVID-19 pandemic after she became a leading voice calling attention to the disproportionate effect of the disease on people of color, according to the article. Pernell was also the "inaugural chief strategic integration and health equity officer" at her hospital.

Along with her rise in the media, Pernell was also considered to be a top choice for the CEO opening at University Hospital in Newark, New Jersey.

But instead of winning that job, she left the hospital last month. She noted that the main reason for her departure was the persistent presence of discrimination and racial bias, according to ABC News.

Pernell also highlighted the larger issue of racial bias in medicine as evidenced by the underrepresentation of black doctors, who make up around 5% of all practicing physicians in the country. Nationwide, Black people make up 12% of the total population, according to ABC News.

In another example of the role racial bias plays in marginalizing black doctors, the article noted that Black residents make up around 5% of all residents but accounted for almost 20% of residents who were dismissed in 2015.

Pernell told ABC News that she knows many other black doctors have dealt with her experiences as well.

"My story is not unique across the larger field of healthcare and life in general," she said.

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    Michael DePeau-Wilson is a reporter on ’s enterprise & investigative team. He covers psychiatry, long covid, and infectious diseases, among other relevant U.S. clinical news.