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ALLENTOWN, Pa. — Federal prosecutors have ratcheted up their pursuit of two former Pennsylvania judges accused of taking $2.8 million in kickbacks to place youth offenders in private detention centers.

[. . . ]

The indictment accused Ciavarella and Conahan of extorting kickbacks from the former co-owner of PA Child Care LLC and its sister facility, Western PA Child Care.

Conahan shut down Luzerne County’s existing juvenile detention facility in 2002, saying it was unsafe. In 2004, the county entered a 20-year, $58 million agreement with PA Child Care to lease its new Pittston Township facility.

The indictment said that Ciavarella, as juvenile court judge, sent youths to PA Child Care and later to its sister facility while he was accepting payments. To keep the prison beds full, Ciavarella routinely deprived young defendants of their right to counsel, ordered juveniles into detention even when probation officers didn’t recommend it, and pressured probation officials to change their recommendations, the indictment said.

[ . . . ]

Former PA Child Care owner Robert Powell, a lawyer, pleaded guilty July 1 to paying kickbacks to the judges. Prominent construction company owner Robert K. Mericle, who built the detention centers, pleaded guilty earlier this month to a charge of withholding information on a crime.


Former Pa. judges indicted in kids-for-cash scheme

3 hours ago

(from Associated Press)


[And, there’s the US health care system / prison for private profit / mental health and “behavioral” health modification systems / pharmaceutical based cooperation cocktails for behavior modification systems at work as it has been for the last thirty years – and they want to make that more pervasive, rather than less, rather than fixing it, rather than making it right? Apparently.]


My Note –

I listened to the President and the Congressional address about health care last night at least three times to hear it all. I listened to it carefully and it is obvious that both the President and the Legislature are overstepping the bounds of their authority. But, apparently –

They plan to extort a required tax against every living, breathing citizen of the United States, exempting illegal immigrants of course who gets to keep all of the money they make here. And, that tax will be put into the profit glut of every insurance company in America – that’s what it means to require every citizen to have health insurance. It denies the freedom of choice, it is unfair taxation going into private hands, it is illegal and it will require each and every citizen, business and child born into this country to pay to be alive in the United States of America.

At the same time, doctors and hospitals and pharmaceutical companies will be exempt from accountability when their all too typical malpractice occurs. And yet, we all must be registered with some health care insurance provider and pay each month for each member of our families, our children, ourselves and our businesses to be covered by their services without recourse, simply because we are alive and citizens of the United States. They may as well have just taken 50% of everyone’s income off the top in the first place and provided something in return for it. That would be less than the percentage we are paying now, to get virtually nothing but corruption and Nazi Germany style oppressions and tyrannies across virtually every state and every administration regardless of political party.

It seemed a little off to me that, the people in politics whose funding comes directly from the big insurance companies, health industries and pharmaceutical companies, would be pursuing “health care reform.” Well, now it is obvious that there is no reform in it. The only pursuit they have been making is to charge a tax per head extorted from the freedoms of our citizenship here in order to line the pockets of their campaign contributors.

Now, when any person gives birth to a child in the United States of America, they will be registered and stamped for citizenship with a required registration to a health insurance provider which will legally require those parents and that individual to pay to those insurance revenue streams for every day that they are alive in the United States of America or elsewhere as long as their membership as a citizen of the US is maintained.

And, there will be no recourse against a health system, doctors and industries that have been pervasively known for causing more harm than good on a regular basis, so consistently, in fact as to be unimaginable. Every day across America, health care industry professionals cause harms which were preventable and inexcusable. Nothing in this bill fixes that. The members of Congress and the Administration have no intention of fixing that.

Apparently, their only intention was to jeopardize our freedoms, our rights, our inalienable rights, our basis of freedom and our basis of citizenship. Also, apparently they don’t like the limitations of their power guaranteed by the Constitution to prevent their overstepping the bounds of that oath of office they took. It certainly overstepped those bounds when they decided to impose a privately profitable “tax” called “health care insurance” on every citizen and every business by virtue of their existence.

And then, it begs the question – just as with auto insurance which is required of every vehicle and driver but is no more than a tax on the right to drive in a world that demands personal transportation in order to work, to have a business, or to make a living – what happens when people don’t have the money to continue paying those health insurance premiums? Then do they lose the right of citizenship in the United States, despite being born here, taken the oath of citizenship here, being a consummated and valuable member of the citizens of the United States and despite being guaranteed that citizenship by the Constitution?

Will that be done in the same way the car insurance companies send license and personal information to the State Office of No Insurance to legally dismiss our drivers’ license, as is done now? Will they take away the rights to our own children and to our own citizenship, beyond what they’ve already been doing in that arena through health and human services / social services, simply because they are born without the required registrations and payments to the health insurance industries and we failed to “sign them up for it” and remit those payments to them?

How about this – what if we directly and immediately take to task those insurance companies as we should’ve done in the first place. They are the ones who have driven up the costs of health care beyond all measure. They are the ones who have tolerated shoddy health services, malpractice, incompetence, dispassionately destroyed the health of people for profit motives, paid themselves like kings and lobbied to get out of any accountability to the public and their customers. They are the ones that need to be changed. We sure don’t need to keep paying them to continue slaughtering us. They’ve done enough damage for several lifetimes and now they intend to further that profit machine to serve their own interests to an even greater and more oppressive extent. They are inherently evil – why give them even one more dime to use to do more damage?

– cricketdiane, 09-10-09


And, oh by the way, they plan on robbing over $500 Billion dollars from the social security system, Medicare and Medicaid funds that we have all paid into the government trusts for it, under the guise of this “health care reform.” That isn’t their money and is not free money, but every time they can find an excuse to get their hands on it – even paying the interest on the national debt out of it – there they go without anyone saying a word. And they are doing it again. It was written into the first bill and it will be found in the second one that will come to vote. Neither Congress nor the office of the President has any right given to them by the Constitution and by our laws, to levy a tax against every citizen for the right to be alive. And neither do they have the power offered to them which legislates health care to every person under their jurisdiction. It denies the fundamental rights and freedoms we are guaranteed.

Looking at how easily those judges in the story above, denied the rights and opportunities of those who were to be protected by them and did so with no more conscience about right and wrong than their insatiable desire for money could offer, I am horrified at the thought that more of that kind of power would be put into the hands of judges, insurance companies, government agency officials, states, health care businesses, prison for profit businesses, mental health agencies and industries or pharmaceutical companies / lawyers / academics / legislatures / state agencies / health and human services / hospitals / or in fact, anybody.


For the same reason that Congress could not legislate the salaries or bonuses of bankers and financiers, nor could limit or restrict them legally – they also cannot legally legislate health care. It is outside the authority of the President and the Congress, which constitutes a taking and assuming powers that do not legally belong to them. Anything they do in that process by exceeding their bounds of authority and doing it in that way will contest the foundation of authority they have been granted and break the validity of the legal and consensual premise of that authority.


It is a shame that so many shed their blood and gave their lives to insure our democracy, freedoms, individual rights and noble ideals when the real enemies of those tenets were in our businesses and seated in our own government all along, both of whom were so quick to disregard them, and found it painlessly easy to disavow the importance of those core foundations, then undermine them as a possibility guaranteed to everyone or, in fact, to anyone.

– cricketdiane


Medical malpractice cases from one law firm – these aren’t small negligence cases that are being pursued – it is obscene how far the health care system and health care industries have strayed away from offering health –

Notable Cases

  • Sued Woodstock Residence Nursing Home on behalf of one patient who died as the possible result of a morphine overdose.[3] The Illinois Department of Public Health found six mysterious deaths at the home and two employess face criminal charges.[4] [5]
  • $3 million awarded on behalf of woman who choked to death at a nursing home when her trachea tube got clogged. [6]
  • $7.62 million verdict against an HMO doctor who ignored a mother’s complaints of postpartum bleeding, resulting in her bleeding to death.[7]
  • $10 million settlement on behalf of a 5-year-old boy who, while playing in an open fire hydrant, was struck by a City of Chicago Fire Department truck and ultimately lost his leg and half of his pelvis.[8]
  • $14 million verdict on behalf of a patient who’s diagnosis of lung cancer was delayed after doctors ignored abnormal chest x-ray results. [9]



A 2004 study of medical malpractice claims in the United States examining primary care malpractice found that though incidence of negligence in hospitals produced a greater proportion of severe outcomes, the total number of errors and deaths due to errors were greater for outpatient settings. No single medical condition was associated with more than five percent of all negligence claims, and one-third of all claims were the result of misdiagnosis.[6]

A recent study by Healthgrades found that an average of 195,000 hospital deaths in each of the years 2000, 2001 and 2002 in the U.S. were due to potentially preventable medical errors. Researchers examined 37 million patient records and applied the mortality and economic impact models developed by Dr. Chunliu Zhan and Dr. Marlene R. Miller in a study published in the Journal of the American Medical Association (JAMA) in October 2003. The Zhan and Miller study supported the Institute of Medicine’s (IOM) 1999 report conclusion, which found that medical errors caused up to 98,000 deaths annually and should be considered a national epidemic.[7] Some researchers questioned the accuracy of the 1999 IOM study, reporting both significant subjectivity in determining which deaths were “avoidable” or due to medical error and an erroneous assumption that 100% of patients would have survived if optimal care had been provided. A 2001 study in JAMA estimated that only 1 in 10,000 patients admitted to the hospital would have lived for 3 months or more had “optimal” care been provided.[8]

A 2006 follow-up to the 1999 Institute of Medicine study found that medication errors are among the most common medical mistakes, harming at least 1.5 million people every year. According to the study, 400,000 preventable drug-related injuries occur each year in hospitals, 800,000 in long-term care settings, and roughly 530,000 among Medicare recipients in outpatient clinics. The report stated that these are likely to be conservative estimates. In 2000 alone, the extra medical costs incurred by preventable drug related injuries approximated $887 million – and the study looked only at injuries sustained by Medicare recipients, a subset of clinic visitors. None of these figures take into account lost wages and productivity or other costs.[9]


Medical malpractice

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Medical malpractice is professional negligence by act or omission by a health care provider in which care provided deviates from accepted standards of practice in the medical community and causes injury or death to the patient. Standards and regulations for medical malpractice vary by country and jurisdiction within countries.


Medical error

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Medical error is an inaccurate or incomplete diagnosis and/or treatment of a disease; injury; syndrome; behavior; infection or other ailment.

In the U.S., medical errors are estimated to result in 44,000 to 98,000 unnecessary deaths and 1,000,000 excess injuries each year.[1][2] One older extrapolation suggests ‘180,000 people die each year partly as a result of iatrogenic injury, the equivalent of three jumbo-jet crashes every 2 days’.[3] It is estimated that in a typical 100 to 300 bed hospital in the United States, excess costs of $1,000,000 to $3,000,000 attributable to prolonged stays and complications just due to medication errors occur yearly.

However, medical error definitions are subject to debate, as there are many types of medical error from minor to major,[4] and causality is often poorly determined.[5] The Health Grades study statistics, based on AHRQ MedPAR data, were based on administrative records, not clinical records, and largely overlooked multi-causality of outcomes.[6]

Medical care is frequently compared adversely to aviation: while many of the factors which lead to errors in both fields are similar, aviation’s error management protocols are regarded as much more effective.[7]

Experts estimate that as many as 98,000 people die in any given year from medical errors that occur in hospitals. That’s more than die from motor vehicle accidents, breast cancer, or AIDS–three causes that receive far more public attention. Indeed, more people die annually from medication errors than from workplace injuries. Add the financial cost to the human tragedy, and medical error easily rises to the top ranks of urgent, widespread public problems.

In 2000, The Institute of Medicine released “To Err Is Human”, which asserts that the problem in medical errors is not bad people in health care–it is that good people are working in bad systems that need to be made safer.[8]



Examples of errors

  1. Misdiagnosis;
  2. Giving the wrong drug or (wrong patient, wrong chemical, wrong dose, wrong time, wrong route);
  3. Giving two or more drugs that interact unfavorably or cause poisonous metabolic byproducts;
  4. Wrong-site surgery, such as amputating the wrong limb.
  5. Gossypiboma, a surgical sponge left behind inside the patient after surgery.



My Note –

In medical journals and other statistical analysis portals / academics / study / dissemination – the terms can be Iatrogenesis, as above, or medical error, or pharmaceutical error or who knows how many other things. It seems to be divided up rather than placed in the same category by the same terms where an overview of the problem and of the pervasiveness of the problems would be self-evident.

cricketdiane, 2009


Adverse drug reaction

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An adverse drug reaction (abbreviated ADR) is an expression that describes harm associated with the use of given medications at a normal dose[1]. The meaning of this expression differs from the meaning of “side effect”, as this last expression might also imply that the effects can be beneficial.[2] The study of ADRs is the concern of the field known as pharmacovigilance.



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[edit] Classification

ADRs may be classified by e.g. cause and severity.

[edit] Cause

  • Type A: Augmented pharmacologic effects – dose dependent and predictable
  • Type B: Bizarre effects (or idiosyncratic) – dose independent and unpredictable
  • Type C: Chronic effects
  • Type D: Delayed effects
  • Type E: End-of-treatment effects
  • Type F: Failure of therapy

Types A and B were proposed in the 1970s,[3] and the other types were proposed subsequently when the first two proved insufficient to classify ADRs.[4]

[edit] Seriousness and Severity

The American Food and Drug Administration defines a serious adverse event as one when the patient outcome is one of the following:[5]

  • Death
  • Life-Threatening
  • Hospitalization (initial or prolonged)
  • Disability – significant, persistent, or permanent change, impairment, damage or disruption in the patient’s body function/structure, physical activities or quality of life.
  • Congenital Anomaly
  • Requires Intervention to Prevent Permanent Impairment or Damage

Severity is a point on an arbitrary scale of intensity of the adverse event in question. The terms “severe” and “serious” when applied to adverse events are technically very different. They are easily confused but can not be used interchangeably, require care in usage.

A headache is severe, if it causes intense pain. There are scales like “visual analog scale” that help us assess the severity. On the other hand, a headache can hardly ever be serious, unless it also satisfies the criteria for seriousness listed above.

[edit] Overall Drug Risk

While no official scale exists yet to communicate overall drug risk, the iGuard Drug Risk Rating System is a five color rating scale similar to the Homeland Security Advisory System:[6]

  • Red (High Risk)
  • Orange (Elevated Risk)
  • Yellow (Guarded Risk)
  • Blue (General Risk)
  • Green (Low Risk)

[edit] Location

Adverse effects may be local, i.e. limited to a certain location, or systemic, where a medication has caused adverse effects throughout the systemic circulation.

For instance, some ocular antihypertensives cause systemic effects[7], although they are administered locally as eye drops, since a fraction escapes to the systemic circulation.


As research better explains the biochemistry of drug use, fewer ADRs are Type B and more are Type A. Common mechanisms are:

  • Abnormal pharmacokinetics due to
  • Synergistic effects between either
    • a drug and a disease
    • two drugs

Interactions with other drugs

The risk of drug interactions is increased with polypharmacy.


Abnormal pharmacokinetics

Comorbid disease states

Various diseases, especially those that cause renal or hepatic insufficiency, may alter drug metabolism. Resources are available that report changes in a drug’s metabolism due to disease states.[8]

Genetic factors

Abnormal drug metabolism may be due to inherited factors of either Phase I oxidation or Phase II conjugation.[9][10] Pharmacogenomics is the study of the inherited basis for abnormal drug reactions.


Monitoring bodies

Many countries have official bodies that monitor drug safety and reactions. On an international level, the WHO runs the Uppsala Monitoring Centre, and the European Union runs the European Medicines Agency (EMEA). In the United States, the Food and Drug Administration (FDA) is responsible for monitoring post-marketing studies.

Examples of adverse effects associated with specific medications

See also


  1. ^ Nebeker. Jonathan R. Clarifying Adverse Drug Events: A Clinician’s Guide to Terminology, Documentation, and Reporting. Ann Intern Med. 2004;140:795-801.
  2. ^ a b Nebeker JR, Barach P, Samore MH (2004). “Clarifying adverse drug events: a clinician’s guide to terminology, documentation, and reporting”. Ann. Intern. Med. 140 (10): 795–801. PMID 15148066.
  3. ^ Rawlins MD, Thompson JW. Pathogenesis of adverse drug reactions. In: Davies DM, ed. Textbook of adverse drug reactions. Oxford: Oxford University Press, 1977:10.
  1. ^ MedWatch – What Is A Serious Adverse Event?. http://www.fda.gov/medwatch/report/DESK/advevnt.htm. Retrieved 2007-09-18.
  2. ^ ‘Traffic-light’ medicine risk website to launch“. The Guardian. 2007-10-02. http://www.guardian.co.uk/business/2007/oct/02/7.

Medical Errors Costing U.S. Billions

Wednesday, April 9, 2008; 12:00 AM

TUESDAY, April 8 (HealthDay News) — From 2004 through 2006, patient safety errors resulted in 238,337 potentially preventable deaths of U.S. Medicare patients and cost the Medicare program $8.8 billion, according to the fifth annual Patient Safety in American Hospitals Study.


Of the 270,491 deaths that occurred among patients who experienced one or more patient safety incidents, 238,337 were potentially preventable, the researchers said.If all hospitals performed at the level of the top-ranked hospitals, about 220,106 patient safety incidents and 37,214 patient deaths could have been avoided, and about $2 billion could have been saved.

[ . . . ]

Starting Oct. 1, the federal Centers for Medicare and Medicaid Services will stop reimbursing hospitals for the treatment of eight major preventable errors, including objects left in the body after surgery and certain kinds of post-surgical infections.


My Note –

The health care reform being legislated currently only includes preventing people from suing doctors, hospitals, pharmaceuticals and to legally require every citizen to have health insurance which amounts to a tax per head levied and extorted from every American in order to exist anywhere in this country. Not only is it not going to solve the health care crisis in this country, it will continue to contribute to the problems we already endure and allow them to get worse. Medicine and profits are not compatible by any sensibilities of conscience and good health.

– cricketdiane, 09-13-09