Sleep deprivation insanity

I recently settled a case in which a young contestant was required to go without sleep and keep his hand flat on a Nissan truck until the last contestant was standing. The contest was called "Hands on a Hardbody"  He eventually left the contest, broke into a K-Mart, forced the trigger lock out of a shotgun and committed suicide. There was no effective exit strategy to assure safety for contestants although many instances had taken place over the years concerning insane behavior. One woman jumped the fence and ran out in traffic. She had to be tackled by her boyfriend. One contestant argued with his father because he thought he was in Oklahoma although the contest was in Longview Texas. One contestant thought he was pushing daisies down on the hood of the pickup. The examples are endless. Simply put, I argued that minimal protection should have been provided to the contestants to assure they were not a danger to themselves or others. This result of sleep deprivation has been known for decades and studied at length by scientists. The North Koreans used sleep deprivation and stress to break down soldiers in the Korean conflict. It wasn't that the soldiers just got tired, they went into a mental breakdown.

Sleep deprivation combined with stress and stimulants have been used casually in contests as well as work environments. It is simply dangerous and negligent to do so.

Studies have shown:

Patients suffering from insomnia reported a four-fold higher rate of attempted suicide.

The risks of only 24 hours of sleep deprivation are substantial and render an individual in a state of impairment comparable to being intoxicated

More than 80% of people are suffering from hallucinations by 48 hours of sleep deprivation

An important recent study done by the University of California, Berkeley, and Harvard Medical School was published in Current Biology showing objective radiological findings correlating with symptomatic changes in subjects who are sleep deprived. The emotional part of the brain (amygdala) is dramatically different in the images. The amygdala , which alerts the body to protect itself in times of danger, goes into overdrive on no sleep, according to the study. This consequently shuts down the prefrontal cortex, which commands logical reasoning, and thus prevents the release of chemicals needed to calm down the fight-or-flight reflex.

The study showed that sleep deprivation excessively boosts the part of the brain most closely connected to depression, anxiety and other psychiatric disorders.

Trial for a Terrorist


So this is it? For years the world has seen Gitmo photographs of naked men being tormented and stories of torture techniques for which the United States prosecuted and executed Nazi war criminals. Our argument has been: “That’s what 24’s Jack Bower would have done to save us from terror. Surely the guys we have been holding without hope of release, or even a trial, were the really bad guys who were responsible for planning and carrying out bombings and acts of mutilation.” Then the guy we try first is a car driver/mechanic employee, father of two and possessor of a fourth grade education, who hasn’t killed or mutilated anyone. He has been a prisoner for five years and only received a trial after many attempts by our President stop it. A jury of six military officers found him guilty of supporting al-Qaeda by driving bin Laden and carrying weapons in the car he drove, but found him not guilty of terror conspiracy. His sentence is about the same length of time as the time he has served but Bush is arguing that he should be kept locked up for an indeterminate amount of time anyway. Wasn’t there someone at Gitmo the government could have tried who did something really evil? Is there some way the critics of the United States could have gotten any more political ammunition against us than this guy being the first example of the Gitmo prisoners we didn’t want to give a trial? Jack Bower would have never messed with a driver/mechanic who obviously was outside the terror loop.

Digitek

The Texas Supreme Court has made it almost impossible to bring a suit for damages against a pharmaceutical company. It has determined that if the FDA approves a drug there should be a defense of pre-emption. The United States Supreme Court is considering doing the same nation wide. Digitek (digoxin) is different because it was manufactured defectively and contained twice the dose approved by FDA. Victims of this drug still have a fighting chance for justice in the court system. Continue Reading...

Railroads and workplace safety

Plaintiff must prove the following essential elements to sustain a claim for FELA negligence, causation and personal injury defendant: (a)Negligent maintenance of safety at the work place (b)Causation—no matter how slight—between that negligence and damages (c)personal injury damages.

Railroad companies continually use public and private property to organize work crews and park trucks and equipment. They do this without paying for the use or getting permission. This might save the company money but subjects the workers that can not be properly supervised or assured to be safe.

Most recently I tried to successful conclusion a FELA (federal employers liability act) case  for a Maintenance of Way worker who fell into a man hole partially obscured by snow. The unsupervised property under a bridge, owned by a small town, was not supervised or watched. The railroad company merely instructed its employee to pick up a truck left there by another crew. In the interum some vandals stole the man hole cover...an act that would not have happened on guarded railroad property.

Continue Reading...

Bad medicine

“I have come to understand that money from the pharmaceutical industry can shape the practices of nonprofit organizations that purport to be independent in their viewpoints and actions,”  is a statement by Republican Senator Grassley written to the Psychiatric Association. My response is "Oh really?" The age old axiom of politics is Follow the Money. I'm glad someone in charge is stumbling across the impact of big money on the medicine we take every day based on nothing but child-like faith of the pharmaceutical and medical industry. 

In 2006 money from the pharmaceutical industry accounted for about 30 percent of the association’s $62.5 million in financing. About half of that money went to drug advertisements in psychiatric journals and exhibits at the annual meeting, and the other half to sponsor fellowships, conferences and industry symposiums at the annual meeting.

As obviously wrong is this situation is, it is a small sin compared to the comedy of FDA approval of new drugs on the market. The FDA doesn't have the resources to study the effects of new medications. It uses the studies of the companies who stand to gain billions of dollars and are under intense pressure to beat a competing company to make it to the market with a similar product. Many of the scientists and medical doctors go to work for these companies after a tenure with FDA.

The Texas Supreme Court, financed in great part by pharmaceutical companies, has held that if the FDA approves a drug, a consumer can not sue for injuries from using the drug no matter how harmful it turns out to be. The United States Supreme Court is considering the same pre-emptive law to disadvantage victims of unreasonably dangerous drugs. Attorneys for those hurt are fighting to find legal theories around these roadblocks.

The drug giants have produced good products for us but it is immoral for them to use their wealth to take advantage of the fiduciary relationship to the patients they make a profit to protect.

So, what's the answer?

Continue Reading...

politics and energy

The American people are up in arms about the cost of fuel. Actually, it is fortunate, in a way that our personal short-term needs are beginning to coincide with our long-term duties as stewards of Earth. Candidates feed us clichés rather than hard truth and leadership. Cutting gas taxes for the summer will rob funds for highway and bridge maintenance and repair with no lasting relief. Drilling off shore and in the Alaskan wildlife preserve might lower gas prices by a few cents a gallon in ten years but will provide no meaningful or timely remedy to this crisis. Taking away the sweetheart tax deal from oil companies may be a good idea for other reasons but not for energy independence. All of this political rhetoric is nothing more than a distraction.

Intermediate relief can be provided by our new President by pulling out of a war crippling our ability to address concerns including energy costs. Additionally, our government can create real tax incentives and grants for private and academic research into alternate energy and energy conservation.

Short term relief is in the citizens’ hands. It is time for a leader who will mimic the inspiration of Churchill promising “…blood, sweat and tears.” in World War II and Kennedy telling Americans to ask not what our country can do for us but what we can do for our country. Americans are willing to sacrifice if we know that it is necessary and fair. This is a classic opportunity for our politicians to actually lead with truth and inspiration. The cumulative effect can be staggering. It is within our ability to do such things as install energy light bulbs and insulation. We can turn off lights and electronics; raise the thermostat a few degrees; ride the train or bus; carpool; etc.

Our next car can be kinder on gas mileage and we can drive slower. Many of us push our 70 MPH speed limit to near 80 on our highways, (Mia Copa). Each increase in miles per hour decreases miles per gallon with greater impact as speed continues to grow.

Coincidentally, most serious injuries and death increase by multiples at the higher speeds. Stopping distance is 304 feet at 60 MPH; 388 feet at 70 MPH; and 481 feet at 80 MPH. A car traveling at 60 MPH covers 88 feet per second; 70 MPH, 103 feet per second; and 80 MPH, 117 feet per second.
Continue Reading...

Trayslol

Trayslol, has been used to reduce bleeding, especially in heart bypass surgery. It is a medication that is administered to patients without their knowledge as part of the administration of drugs incident to their surgery. Trayslol is also known as aprotinin. Manufactured by Bayer, Traslol has been widely used since the 1990s . It was first revealed in January of 2006  that Trayslol administration increased the risk of renal toxicity. Trayslol has also been linked with increased risk of kidney failure, cardiovascular events (myocardial infarction or heart failure), cerebrovascular events such as a stroke, encephalopathy or coma. The FDA issued an alert  and warned physicians to monitor patients for problems. Bayer recently admitted that  a large study suggested that Trasylol increases the risks of severe side effects. It has removed the drug from the market.

A  New England Journal of Medicine study reported that patients given Trasylol had a more than 50 percent higher death rate than patients who got other, cheaper drugs. The patients receiving the drug were heart patients so it was not readily apparent to the treating physicians that the fatal outcome was related to the administration of Trayslol.
Continue Reading...

Bison and Harley Davisons

Recently my client was driving his Harley home at night and a Bison charged out on the dark road. My client has no memory of the accident. The result was the death of the Bison and my client almost losing his life. By courageous efforts, his physician saved his leg. In Texas livestock can roam on Farm to Market Roads with impunity unless there is an election in the county to change the law. Fortunately the dark road was not a Farm to Market Road. The distinction as to whether a Bison could be considered live stock as contemplated by the statute.  Next the question is whether a Bison is by its nature a wild ferocious beast, (ferae naturae). Strict liability law governs such situations. It was problematic to draw the Bison into this law since there was no evidence that the accident occurred due to the ferocious, wild nature of this Bison. Now one knows how long the beast was out or how it got out. The best logic for the plaintiff was a version of the special laws dealing with wild animals. The Bison is a great athlete. It can run faster and jump higher than a horse. The negligence for the landowner is that Bison could not be prudently be pastured in a pasture contiguous to a public road with marginal cattle fences. At the least the border fences should have been six feet or higher and reinforced. We settled while the jury was deliberating Continue Reading...

Fentanyl deaths

Fentanyl is a opiate 100 times more powerful than morphine. Originally this drug was put out as Duragesic®  made by Johnson & Johnson. Although originally it was used in operations, it later was applied in patches for patients with chronic serious pain. Numerous generic versions of the fentanyl patch, including Sandoz (manufactured by Alza), Mylan, Watson and Actavis hit the market. Although intended for only serious pain symtoms, some doctors prescribed it to those not needing such a potent medication. "Fold-over defects" and "stringer leakers" have caused leakage from the patches to over-medicate and kill patients.

A second Public Health Advisory regarding fentanyl pain patches has been issued, which stated that "reports indicate that doctors have inappropriately prescribed the fentanyl patch to patients for acute pain following surgery, for headaches, occasional or mild pain, and other indications for which a fentanyl patch should not be prescribed."

Johnson & Johnson recalled approximately 32 million patches because of possible leak defects. The recall includes Duragesic® and Sandoz brands. Actavis Inc., the United States manufacturing and marketing division of the international generic pharmaceutical company Actavis Group HF announced that 14 lots of fentanyl transdermal system CII patches sold in the United States are being voluntarily recalled.

Once again, patients have relied vainly on the FDA, pharmaceutical companies and their treating physicians for a good faith review of the medications prescribed.  

Continue Reading...

Heparin contamination

The FDA announced that onersulfated chondroitin sulfate has been found as a contaminant in Heparin, a bloodthinning drug distributed by Baxter Internation Inc. This contaminant  does not occur naturally. The question is how the Heparin became contaminated.

Hundreds have been injured, including 19 deaths.  Adverse reactions include: refractory hypotension leading to organ damage, organ failure, shock, and death. Baxter began recalling  Heparin in January .

Heparin is used before certain  surgeries, including coronary artery bypass graft surgery, and in kidney patients before they undergo dialysis. Heparin is often initiated using a high bolus dose given directly into the bloodstream.  This administration is the most risky for adverse effects.

Continue Reading...