New Texas law: Paramedics can do blood draw on scene for DWI suspects

Starting Sunday, a new state law has taken effect in Texas to make it easier for the long arm of the law to catch up with drivers who have had too much to drink.

The new law, passed this spring by the Texas Legislature, says that if officers think alcohol played a factor in a crash, paramedics at the scene can draw your blood.

The law comes just in time for Labor Day weekend, a holiday when many folks are going to drink -- and some may try to drive.

"In the last legislative session, the legislation addressed an issue of whether EMTs could take blood in relation to intoxication behind the wheel, be it an accident issue or an arrest," said Susan Reed, Bexar County district attorney.

The change came from a state court opinion from years ago.

"Now in Bexar County, what that means is we have already established a system of taking blood and doing blood warrants and DWIs."

Now, add paramedics to that.

"We could develop a system of mobile units, using EMTs to do that," she said. "But remember, it is still the circumstance of having the sanitary place."

But at the end of the day, the DA says it's a good move -- especially for Labor Day weekend.

"It actually gives us more options and more ability to do warrants and do blood draws in relation to DWI."

The new law will allow 6,000 paramedics across the state to draw blood if the police at the scene ask for it.

More patrols will be out looking for impaired drivers for the holiday weekend. The Texas DPS is increasing DWI patrols through Sept. 9.

Last year, DPS troopers made nearly 2,000 DWI arrests.

___________________________________________
Source: KVUE (Cooper, 9/1)

Injured 'Texas' dancer's condition improves

The “Texas” company member who was injured in an accident north of Dumas last week that killed five people has improved, Northwest Texas Hospital Caytie Martin spokeswoman said.

Timothy Johnson, 30, of Portland, Ore., now is in satisfactory condition at the hospital, said Caytie Martin of Northwest.

About 11:30 p.m. Aug. 12, after leaving a “Texas” end-of-summer party, a Ford Taurus carrying six cast and crew members in the production ran a stop sign at the intersection of Farm-to-Market Road 119 and U.S. Highway 287 and was struck by a tractor-trailer.

Authorities said the rig’s load toppled onto the driver’s side of the car.

Clint Diaz, 20, of Amarillo; Andrew Duncan, 20, of Wichita Falls; Amanda Starz, 20, of Timonium, Md.; Julian Arredondo IV, 24, of Haltom City; and Eric Harrison, 21, of Fort Worth died in the crash.

Johnson and the driver of the tractor-trailer — Theron Arthur McSay, 70, of Fort Collins, Colo. — were injured in the accident and transported to Northwest.

McSay was released from the hospital this week.

Department of Public Safety officials said officers found alcoholic beverage containers in the Taurus, and Texas Alcoholic Beverage Commission authorities are investigating the party attended by the “Texas” company members, which was held at Coldwater Ranch, owned by former Texas Panhandle Heritage Foundation board member Joe Batson.

“We’ve held the party there for the last 22 years,” said Kris Miller, executive director of the foundation and a “Texas” cast member.

Miller, who said he attended the party, said no alcohol was being served to minors, but attendees 21 and older were allowed to bring their own beverages.

Two of the final week’s performances of “Texas” were canceled, but the final three shows of the musical’s 48th season went on as scheduled.

_________________________________________
Source: Amarillo (Bryant, 8/23)

After West Blast, Chemical Stockpiles Scrutinized

NEW BRAUNFELS — Off a dirt road connected to ever-flowing Interstate 35, a little metal sign on a wooden fence is the only indication of what lies ahead. Nearby, Buckley Powder, a mining and construction supply company, stores large quantities of ammonium nitrate, the source of the explosion at fertilizer depot that killed at least 14 people and injured hundreds more last month in West.

In 2012, according to state records, Buckley Powder had as much as 90,000 pounds of ammonium nitrate in bins at this Central Texas plant — stored, according to Howard Wichter, Buckley’s chief financial officer, under conditions in which “nothing can happen to it.”

At a Country Fare restaurant tucked inside a truck stop not far from the bins, Lisa Slickerman, a waitress, said people who lived in the community nearby knew little about what was stored at the plant, but perhaps should have, especially after the West explosion.

“Nobody talks about it,” she said.

“I thought they just sold rocks and dirt,” another waitress chimed in.

The facility is one of more than 110 across the state that report storing 10,000 pounds of ammonium nitrate or more at a time. Some companies hold it in powder form, like the depot in West, which in 2012 reported storing 540,000 pounds of the chemical. Others store it in a liquid solution, which is a much less volatile form, said Charles Mitchell, a professor of soil sciences at Auburn University.

The responsibility for overseeing these facilities varies. Some, like Buckley, which supplies materials used for blasting at rock quarries and construction sites, are inspected by the federal Bureau of Alcohol, Tobacco, Firearms and Explosives. Others, like Adair Grain, which owned the West storage site, are subject to inconsistent scrutiny by a long list of state and federal agencies, said Neil Carman, director of the clean air program at the state’s chapter of the Sierra Club.

As the authorities continue to investigate the cause of the West explosion, and state and federal lawmakers discuss whether new regulations and greater oversight are needed, stockpiles of chemicals stored in communities across the state are the subject of intense concern.

A patchwork of regulations, generated by municipal, state and federal authorities, has led to almost exclusively local control over disaster preparation. “If I have a plant near my house, do I know that they have a plan?” said state Rep. Joe Pickett, D-El Paso, the chairman of the House Homeland Security and Public Safety Committee. “The public needs to know who to go to and who to ask for a plan, so it brings attention to these facilities.”

“It’s just ludicrous. I think it’s a pattern of lax regulation in Texas," Carman said, "and it’s surprising, given the number of industrial plants.”

At the federal level, safety and accident prevention falls to the Occupational Safety and Health Administration, which according to an agency fact sheet oversees more than seven million workplaces and last inspected the West depot in 1985. The Environmental Protection Agency requires companies to report their methods of handling certain dangerous chemicals, but not ammonium nitrate. And the Department of Homeland Security keeps track of facilities that hold ammonium nitrate, but the agency did not know about the West facility, which had not reported to it. According to a department spokesman, Peter Boogaard, the agency is currently investigating whether the West facility should have submitted documentation of its ammonium nitrate.

At the state level, the Texas Commission on Environmental Quality focuses on pollution and air quality, not accident prevention. The Office of the State Chemist checks the composition of feed and fertilizer for consumers, and whether explosives are behind fences and locked doors. The primary responsibility for tracking potentially dangerous chemicals in Texas falls to the Department of State Health Services, but Commissioner David Lakey told lawmakers at a hearing this month that the agency did “not have authority related to the regulation of these chemicals.” Its role is as a data depository, Lakey said, suggesting that regulations are the responsibility of local officials like fire chiefs and city councils in the form of fire and safety codes.

Those local officials are also responsible for preparing communities for disaster prevention, Steve McCraw, the director of the state’s Department of Public Safety, testified at the same hearing. “There’s no orchestrated, overarching effort to educate people about what’s in their areas,” he said. “It’s local level, not state down.”

McCraw’s department oversees a statewide network of 270 local emergency-planning committees, which operate differently in every county, and bring together public officials and industry leaders to develop safety plans. “The best experts are on the ground,” said W. Nim Kidd of who oversees emergency management for the DPS.

Amarillo knows the importance of local involvement in disaster planning firsthand. High on the Texas plains, the city is home to several heavy industry and petrochemical facilities — including the largest repository of ammonium nitrate in the state — and has adapted to the risk. The city’s fire department includes a hazmat team, which drills to prepare for specific threats. Sonja Gross, a community relations coordinator for the city, said the regional planning committee met quarterly to work on disaster preparation and prevention.

A fertilizer depot in the northeast quadrant of the city, owned by the multinational company Gavilon, reported an average daily stockpile of more than 2.1 million pounds of a liquid ammonium-nitrate mixture in 2012.

The fertilizer at the Gavilon facility is stored as a liquid with the organic chemical urea, which experts say ordinarily poses little combustion risk. But while the solution is much safer than ammonium nitrate stored in a powder form, explosions at similar facilities — as a consequence of spills or misused equipment — are not unheard of.

In Amarillo, as in New Braunfels, many who live in the industrial area near the fertilizer facility say they had no idea about the chemical stockpile next door and are concerned, even if the risks were comparatively low.

“They should have let us know" in some way, said Judy Watson, manager of the Red Rock Saloon, a bar down the street from the plant. “A lot of people live here. A lot of homeless people sleep here, too.”

The neighborhood isn’t unfamiliar with industrial accidents; in March, a warehouse containing propane tanks — less than a third of a mile from the Gavilon facility — erupted in flames when an employee spilled flammable liquid near an open-flame portable heater, according to the Amarillo Fire Department. Casey Essery, who lives on the same block as the warehouse, recalled watching the crackling flames multiply from his house.

But many are pragmatic about the risks. David Bernhardt, the owner of the Adult Video Gallery at the Paramount, across the street from the Gavilon depot, said he was unfazed by the tanks’ presence: “It’s one of those things that comes with being in an industrial part of town.”

An appreciation for the benefits and hazards of industry may explain why some, including state Sen. Kel Seliger, R-Amarillo, remain reluctant simply to call for more oversight of Texas’ industrial facilities.

“In our part of the state, because it’s been very heavy in oil and gas production and plastics and fertilizers,” Seliger said, "a lot of lessons have been learned” on the importance of setting and enforcing regulations to ensure safe practices.

In New Braunfels, home of Buckley Powder, Lynn Lindsay, the local emergency-management coordinator, said Comal County’s committee had little financing and did not meet regularly. “We are actively working to rectify the situation,” said Lindsay, who is also a courthouse administrator. “We have active relationships with first responders, but it’s a matter of tying it all together.”

Lindsay said New Braunfels residents had expressed more concerns since the West explosion, and he is trying to develop a database of chemicals in facilities across the county so first responders know what to do in case of an emergency.

He said the Legislature could consider creating standards for reporting or directing an agency to list best practices for first responders.

State Sen. Donna Campbell, R-New Braunfels, said there was “a point at which you can overregulate” companies that store dangerous chemicals and that many large manufacturing companies have their own emergency preparation plans.

“I think we’re doing a good job,” she said. “Just periodically something happens that’s not predictable.”

And whether heightened public disclosure will happen is already a subject of debate. "I have the right to know where these chemicals are in my community,” Rep. Pickett said at a recent hearing. "But 9/11 happened, and there’s a balance. I understand that.”

____________________________
Source: Texas Tribune (Hooks, 5/10)

Rogue Dentist May Have Exposed 7,000 Patients to HIV, Hepatitis

The Tulsa Health Department is warning 7,000 patients of a local dentist's office that they could have contracted HIV, hepatitis B or hepatitis C from poor sterilization practices.

Dr. Wayne Harrington, an oral surgeon with a practice in Tulsa, Okla., is being investigated by the state dental board, the state bureau of narcotics and the federal Drug Enforcement Agency because one of his patients recently tested positive for hepatitis C and HIV without known risk factors other than receiving dental treatment.

Upon hearing of the infected patient, the Oklahoma Board of Dentistry conducted a surprise inspection of Harrington's practice on March 18, allegedly finding numerous problems, including regular use of a rusty set of instruments on patients with known infections, and the practice of pouring bleach on wounds until they "turned white."

Calls to Harrington's office were directed to an operator, who told ABC News the clinic no longer took voicemails. The operator said patients were being referred to another clinic, but did not disclose the clinic's name.

Susan Rogers, executive director of Oklahoma's Board of Dentistry, called the incident a "perfect storm." On top of his many violations in sanitary practice, the dentist was a Medicaid provider, which means he had a high proportion of patients with HIV or hepatitis, she said.

Harrington and his staff told investigators that he treated a "high population of known infectious disease carrier patients," according to a complaint filed by the Oklahoma Board of Dentistry.

He allegedly allowed unlicensed dental assistants to administer medication, according to the complaint. These assistants were left to decide which medications to administer, and how much was appropriate.

Drug cabinets were unlocked and unsupervised during the day, and Harrington did not keep an inventory log of drugs, some of which were controlled substances. One drug vial expired in 1993.

"During the inspections, Dr. Harrington referred to his staff regarding all sterilization and drug procedures in his office," the complaint read. "He advised, 'They take care of that. I don't.'"

Harrington allegedly re-used needles, contaminating drugs with potentially harmful bacteria and trace amounts of other drugs, according to the complaint. Although patient-specific drug records indicated that they were using morphine in 2012, no morphine had been ordered since 2009.

The instruments for infected patients was given an extra dip in bleach in addition to normal cleaning methods, but they had red-brown rust spots, indicating that they were "porous and cannot be properly sterilized," according to the complaint.

The Tulsa Health Department said Harrington's patients will receive letters by mail notifying them of the risk and steps to obtain free-of-charge testing. While 7,000 patients may have been exposed, Joseph Perz, an epidemiologist with the U.S. Centers for Disease Control and Prevention, said it's "extremely rare" to see dental transmission of HIV and hepatitis B or C. In July 2012, 8,000 Coloradans were notified that their dentist had reused needles, potentially exposing them to the blood-borne viruses. But not a single case was identified, according to the CDC.

Dental transmission is not impossible, however. Perz cited a dental fair three years ago in which hepatitis B was transmitted between patients. In July 2012, more than 1,800 veterans who received dental care at a St. Louis VA Medical Center were warned that improper cleaning of dental tools may have exposed them to HIV and hepatitis.

__________________________________
Source: Good Morning America (Lupkin, 3/29)

Despite Counsel, Victim Is Hindered by Tort Laws

SAN ANTONIO — When Connie Spears arrived at a Christus Santa Rosa hospital emergency room in 2010 with severe leg pain, she told medical staff members about her history of blood clots. Doctors sent her home with a far less serious diagnosis.

Ms. Spears in a pre-surgery photograph. She has run into problems with the state’s expert-witness rule and its time frame.

Days later, swollen and delusional, Ms. Spears was taken by ambulance to another hospital where doctors found a severe clot and extensive tissue damage. With her life on the line, they amputated both of her legs above the knee.

Nearly three years later, Ms. Spears contends that she is a victim not only of a medical mistake but also of Texas’ tort reform laws.

The huge tort reform package that Texas lawmakers approved in 2003 capped noneconomic damages that a plaintiff could receive for medical malpractice at $250,000 and set a “willful and wanton” negligence standard — interpreted as intentionally harming the patient — for emergency care. It also required plaintiffs to find a practicing or teaching physician in the same specialty as the defendant to serve as an expert witness and to demonstrate evidence of negligence before a trial. Under the strengthened rules, if plaintiffs fail to produce adequate expert reports within 120 days of filing their cases, they are liable for defendants’ legal fees.

Ms. Spears said the laws obstructed her ability to find a malpractice lawyer and forced a judge to order her to pay thousands of dollars to cover some defendants’ legal bills. Her lawyers plan to file a motion that challenges the laws’ constitutionality.

“How can that law be?” Ms. Spears asked. “Maybe the law was too loose before, but they went way too far the other way.”

Tort reform proponents say that such restrictions are the only way to curb frivolous lawsuits against health care providers and that they have drawn more medical professionals to a state with exploding population growth.

“Our purpose had never been to have a procedural hurdle,” said Mike Hull, a lawyer for the pro-tort-reform Texas Alliance for Patient Access. “It had been to have the plaintiffs really get the case reviewed.”

For two years, Ms. Spears struggled to obtain legal representation, because several lawyers said they feared her case did not meet Texas’ new negligence standards. Justin Williams, a Corpus Christi lawyer who eventually took the case, said, “Her life has basically been ruined by all of this, and there was just no way I could turn her down.”

But the case fell apart under the new expert-witness rules. After the first attempt at an expert-witness report failed to identify the proper defendants, Mr. Williams said, he was unable to find another expert witness in a time frame that would satisfy Texas’ requirements.

Tina York, a lawyer for Christus Santa Rosa, said it was unusual for a case to be dismissed because of problems with an expert-witness report. The rules are in the statute, she said, to weed out plaintiffs who “can’t legally support their claim” from the beginning. (Christus Health is a corporate sponsor of The Texas Tribune.)

Ms. York said Christus Santa Rosa did not pursue compensation for its legal fees out of sympathy for Ms. Spears. But Ms. Spears said other defendants in the case had. With her retirement savings tapped and her husband out of work, she is afraid they will lose their home.

______________________________________
Source: The New York Times (Aaronson, 1/24)

Congress subpoenas co-owner of meningitis-linked pharmacy

BOSTON- The chief pharmacist at the company linked to the deadly meningitis outbreak has received a subpoena to appear before a congressional committee after he declined to appear voluntarily.

The House of Representatives Energy and Commerce Committee issued the subpoena to Barry Cadden, co-owner of the Massachusetts-based New England Compounding Center and its chief pharmacist before the compounding pharmacy surrendered its license in the wake of the outbreak.

"With more than 400 people infected and 30 deaths, it is critical that we hear directly from the head of the facility linked to the outbreak," said Committee Chairman Fred Upton and Ranking Member Henry Waxman in a statement. "Since Mr. Cadden has indicated he will not appear voluntarily, we are left with no choice but to issue a subpoena."

James Coffey, Director of the Massachusetts Board of Registration in Pharmacy, which regulates pharmacists in Massachusetts, has also been invited to testify at a hearing scheduled for November 14.

A spokeswoman did not immediately respond to a question as to whether Coffey had agreed to attend.

Margaret Hamburg, Commissioner of the U.S. Food and Drug Administration, is scheduled to testify.

Hamburg, Cadden and others, including officials from the U.S. Centers for Disease Control and Prevention, have also been invited to testify about the outbreak before the Senate Health, Education, Labor and Pensions Committee at a separate hearing scheduled for November 15.

Meanwhile, NECC's legal team has been busy in federal court defending the company against a mounting number of lawsuits.

NECC lawyers, for example, say NECC did nothing wrong and have been caught in a crossfire of conflicting federal and state laws concerning specialty pharmacies. In addition, NECC lawyers argue various states have themselves enacted differing and in some cases conflicting regulations on the practice of pharmacies.

"Permitted practices in some states may be arguably impermissible manufacturing by FDA and other states," NECC lawyers said Monday in documents filed in U.S. District Court in Massachusetts.

But Peter McGrath said NECC and its attorneys are just buying time to plan how to contend with looming lawsuits and investigations.

Last month, McGrath, a former federal prosecutor, filed suit in state court in Massachusetts seeking to freeze the assets of NECC and its owners, including Cadden. His attachment, filed on behalf of an unnamed New Hampshire man, seeks several million dollars.

NECC wants that case moved to U.S. District Court because of the federal questions involved over what makes a drug manufacturer.

NECC said it expects a Judicial Panel on Multidistrict Litigation to rule within the next two to four months on whether to consolidate a number of lawsuits in one court. The decision could come soon after a hearing is held January 31 in Orlando, Florida.

____________________
Source: AP (Clarke, 11/7)

Company linked to meningitis scare besieged as deaths rise

CHICAGO (Reuters) - The company that produced contaminated medications linked to an unprecedented fungal meningitis outbreak faced mounting scrutiny on Saturday over whether it illegally sold drugs to medical facilities, as the death toll from the disease grew to 15.

The Centers for Disease Control and Prevention (CDC) said another person died from meningitis, the second death in Indiana. The number of cases of the disease reported reached 201 in 14 states, according to the CDC and state officials.

Illinois reported its first case of meningitis from a steroid injection and New Hampshire officials reported that state's first four confirmed cases from the outbreak, which showed no signs of abating.

Tennessee is the worst affected state with six deaths and 52 cases followed by Michigan with three deaths and 41 cases, including one case of an infection that has not been confirmed as meningitis.

As federal and state authorities scrambled to contain the outbreak, investigators were trying to determine how the medication produced by New England Compounding Center was contaminated and whether its sprawling drug supply business complied with licensing laws.

A series of emails between the company and a clinic in Mississippi reviewed by Reuters show that NECC sold drugs without requiring physicians to supply individual patient prescriptions. The customer confirmed that NECC supplied the clinic with drugs without patient names or prescriptions, which are required by a number of states including Massachusetts, where the company is based.

The emails also indicate that NECC referred business to a sister company, Ameridose LLC, despite a statement by Ameridose earlier this week that the two operated separately.

NECC has recalled the suspect product, surrendered its license to operate in Massachusetts and suspended operations. Ameridose also has temporarily suspended operations.

"NECC's intent has always been to operate in compliance with our licenses in the states where we do business," the company said in a statement.

FEDERAL CRITICISM

The U.S. Food and Drug Administration is investigating NECC and there have been calls from some in Congress for a criminal investigation of the company.

"FDA considers this to be one of our top priorities and we are dedicating many resources to this investigation," the agency said in a statement late on Friday. Federal regulators have come under criticism for failing to prevent the outbreak by closely regulating drug compounding companies such as NECC, which prepare medications for clinics and doctors largely outside federal oversight. The FDA has said the law does not give it adequate authority to do so, leaving regulation largely to the states. "This outbreak began at a compounding pharmacy and the Food and Drug Administration has very limited authority over what these facilities produce," said a spokesman for the Health and Human Services Department in Washington. "We urge Congress to give FDA the authority it needs to ensure these kinds of outbreaks do not happen again."

NECC faces mounting threats from states as well. Several states are investigating the company and at least two - Michigan and Massachusetts - have said the company violated their regulations, according to a Reuters survey.

Some 14,000 patients received the suspect steroid medications, which were shipped to 76 facilities in 23 states as long ago as May.

Meningitis is an infection of the membranes covering the brain and spinal cord. Symptoms include headache, fever and nausea. Fungal meningitis is a rare form and is not contagious.

Cases of meningitis have been reported in Tennessee, Michigan, Florida, Idaho, Illinois, Indiana, Maryland, Minnesota, New Jersey, North Carolina, Ohio, Texas, Virginia and New Hampshire.

________________________________
Source: Yahoo News (McCune, 10/15)