Monday, November 30, 2015

Archive: November, 2009

POSTED: Monday, November 23, 2009, 2:00 AM
Gary Kao, the University of Pennsylvania radiation oncologist who directed the prostate program, appearingat a Senate hearing in June. At right is Gerald Cross of the Veterans Health Administration. (APRIL SAUL / Staff Photographer)


The slow reaction by the Department of Veterans Affairs to a flawed cancer-treatment program in Philadelphia suggests an agency that would rather forget its mistakes than learn from them.
Problems in treating nearly 100 veterans with prostate cancer began with the earliest cases, in 2002, The Inquirer has reported. But seven years later, and more than a year after this newspaper uncovered the substandard care, the VA and other institutions involved in the program have done little to hold anyone accountable.
The University of Pennsylvania doctor who performed most of the faulty procedures, Gary Kao, lost his job when the Philadelphia VA Medical Center shut down the program in June 2008. He’s on leave from his research position at Penn. Another doctor agreed to a three-day suspension.
And that’s about it for penalties to date. It’s a disappointing statement about the absence of oversight and responsibility by the VA, the university, and others.
A total of 98 veterans with prostate cancer were treated in the program, using a procedure called brachytherapy. The treatment involves placing radioactive seeds in the prostate gland to kill cancerous cells.
The procedure works well when done correctly. But veterans treated at the Philadelphia VA received incorrect doses of radiation, often because the seeds were implanted in the wrong locations.
Eight veterans have been sent to Seattle for further treatment, and at least five patients have filed claims with the VA. More are expected.
It’s bad enough to give substandard medical care to people who sacrificed for their country. But the injury is compounded by the apparent reluctance of various agencies to face up to the episode and to ensure that similar problems don’t happen again.
The Nuclear Regulatory Commission, which oversees the medical use of radiation, has reached disturbing conclusions in a report on the program. It said the Philadelphia VA staff didn’t know when to report mistakes. And the cancer-treatment team didn’t even check radiation doses for more than a year because a computer wasn’t working.
The VA’s own review of the program contained errors, the NRC said. And the VA didn’t compile a complete list of the overdoses and underdoses of radiation until last month.
The NRC will hold a public meeting Dec. 17 to decide what, if any, action to take against the VA Medical Center. The possible penalties range from a reprimand to stiff fines. The Department of Veterans Affairs’ inspector general is conducting a separate investigation.
Veterans and the taxpaying public deserve a full accounting of how these mistakes in the program occurred, why it took so long for the problems to come to light, and who wasn’t doing his job.
The Department of Veterans Affairs also needs to explain how it intends to ensure better safeguards for its medical care going forward.
Inquirer Editorial Board @ 2:00 AM  Permalink | 0 comments
POSTED: Sunday, November 22, 2009, 2:05 AM

One by one, the obstacles to a once-unimaginable overhaul of the nation’s $2.5 trillion health care system are tumbling by the wayside.

The Senate’s deliberation this weekend over its prescription for expanding health insurance coverage to most Americans represents, as President Obama noted, another milestone on the road to health-care reform.

Despite the entrenched and increasingly shrill opposition from congressional Republicans to any and all comprehensive reform, there is growing reason to hold out hope for success.

Inquirer editorial board @ 2:05 AM  Permalink | 0 comments
POSTED: Sunday, November 22, 2009, 2:00 AM
Gov. Rendell wants to clean up Harrisburg. (SHARON GEKOSKI-KIMMEL / Staff Photographer)

In the wake of another round of indictments alleging corruption in the legislature, Harrisburg is again embracing “reform.”

House Minority Leader Sam Smith (R., Jefferson), whose name appeared frequently in the grand jury’s report despite not being charged, proposed an “ethics officer” to field complaints of misconduct. He also wants rules to bar staffers from campaigning on state time, or using government equipment for campaign work.
Both practices already are illegal — hence the heavy workload of Attorney General Tom Corbett these past two years.

Smith sounded very much like former Democratic House leader Bill DeWeese (D., Unindicted) did 16 months ago. He professed shock and surprise that close colleagues in his party’s leadership, including former Speaker John M. Perzel (R., Phila.), allegedly spent public money illegally on political campaigns right under his nose.

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POSTED: Saturday, November 21, 2009, 2:00 AM

Whatever else you might think of him, Sen. Robert Byrd (D., W.<TH>Va.) reached an impressive milestone on Wednesday.

The adopted son of a coal miner became the longest-serving lawmaker ever in the history of Congress: 56 years and 319 days.

Byrd, who is in poor health and turned 92 yesterday, is in his ninth term in the Senate. He has served under 11 presidents, beginning with President Dwight D. Eisenhower in 1953.

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POSTED: Friday, November 20, 2009, 2:00 AM
AS THE setting sun creates a scarlet and golden reflective glow on the Schuylkill, tired rowers hoist their shell over their heads and turn toward their boathouse ... or, maybe they're just headed east to Jersey, getting an early head start on practice for the errant Dad Vail regatta. (Associated Press)

The 75-year-old Dad Vail Regatta hasn’t always been held in Philadelphia, but since 1953, the Schuylkill has been its home and that’s where it belongs.

Unfortunately, next May the Dad Vail crews will be rowing their boats down the Navesink in North Jersey. That’s where the tony New York suburb of Rumson outbid Philadelphia to host the races. Except the event wasn’t actually put up for bids. Rumson instead waved $250,000 under the noses of the Dad Vail’s organizers and they grabbed it. Philadelphia officials say they didn’t hear about the deal until it was done.

The Dad Vail folks certainly had no reason to believe this city would come up with similar cash, given its five-year doubling of fees charged for police, fire, and other services during the event. But would it have hurt to ask?
Rumson Mayor John E. Ekdahl said his town pounced on the opportunity to sponsor the nation’s largest college regatta, and expects big returns in what will be spent at local hotels, restaurants, and stores. Every dollar spent in the Monmouth County town will be a buck Philadelphia misses.

Inquirer editorial board @ 2:00 AM  Permalink | 0 comments
POSTED: Friday, November 20, 2009, 2:00 AM
A federal panel is recommending a radical change to mammogram guidelines, citing evidence that the potential harm outweighs the benefits. (Heather Charles/MCT/File)

The aim of medicine is above all else, to do no harm. But one must wonder if that will be the case with a new medical recommendation on the detection of breast cancer.

For years, experts widely agreed that mammograms beginning at age 40 provided the best way for early detection of breast cancer. But new guidelines released this week by an important federal task force recommend a drastic change and raise new questions about the benefits of testing and exams.

The panel says women don’t need mammograms until they’re 50 and then only every other year, not annually. The potential harm of annual testing outweighs the benefits, the panel found. It was the first breast-cancer reassessment since 2002 by the U.S. Preventive Services Task Force, which typically guides federal policy.

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POSTED: Thursday, November 19, 2009, 3:00 AM
Plans to widen Route 322 will put a five-lane road within feet of Marlene and Dewey Gray's front stoop in Richwood, Gloucester County. (April Saul / Staff Photographer)


Imagine living in a home for 40 years, and one day waking up to discover that what used to be a two-lane country road was being widened to make way for a five-lane highway that will enable exhaust-belching cars and trucks to speed past your front door.
That’s what is happening to Marlene and Dewey Gray, a retired Gloucester County couple who have lived most of their adult lives in a house on Route 322.
The Gloucester County Highway Department purchased the Grays’ front yard to make room for the road expansion, but it wouldn’t buy their house.
That means the new highway will come within about 12 feet of their front door.
Talk about a lawn job.
Trucks that already shake the home when they rumble past will create and an even greater noise-and-safety issue for the Grays, who are in their 70s.
The county said it declined to purchase the Grays’ home because it didn’t need the extra land and wanted to keep a lid on the cost.
Only a brain-dead bureaucratic agency could come up with such a heartless decision.
Taxpayers want government to be good stewards of their money. But the road project is costing $10 million. How much more would the purchase of the Grays’ home add to the overall price?
By purchasing only the front yard, the county has created a real hardship for the Grays, who say they would be willing to move to make way for the road.
Beyond the safety-and-noise issue, the highway expansion may very well reduce the value of their home and make it difficult to sell.
A commercial developer had some interest in purchasing the property, but that went away as the economy slowed. There is no guarantee of when, or if, that interest will reemerge.
Regardless, the county owes it to the Grays — who have been paying property taxes on the land for 40 years — to treat them with some dignity and respect.
Building a five-lane highway that runs within a few feet of a homeowner’s front door isn’t the type of progress that anyone should expect.
Inquirer Editorial Board @ 3:00 AM  Permalink | 0 comments
POSTED: Thursday, November 19, 2009, 1:00 AM


Congressmen are getting cranky about the work of a new independent House ethics board, and that’s a good sign.
The nonpartisan Office of Congressional Ethics was created at the urging of Speaker Nancy Pelosi (D., Calif.) in March 2008 to look into complaints against lawmakers and, if necessary, refer them to the House Ethics Committee for possible discipline.
The new office was devised because the Ethics Committee wasn’t doing its job of enforcing standards of conduct. Along with the new office, private citizens for the first time would be allowed to file complaints against lawmakers, too.
You can tell that the OCE is already rubbing some lawmakers the wrong way. It was assailed by the Ethics Committee for what that panel called a “fundamentally flawed” probe of Rep. Sam Graves (R., Mo.) in a possible conflict-of-interest case. It was the OCE’s first public review of a lawmaker’s actions.
Graves had asked one of his wife’s business associates to testify at a congressional hearing. The OCE referred the case to the Ethics Committee, which cleared Graves. The exoneration came despite the OCE’s warning that lawmakers should avoid even the appearance of a conflict.
The caution irritated Republicans and Democrats on the Ethics Committee, who argued (erroneously) that there is no such requirement in House rules. They also criticized the OCE for failing to meet its own deadlines, and questioned whether the office should have been allowed to complete the investigation.
Clearly, the Ethics Committee doesn’t like others telling it how to do its job. But it’s just as clear that it needs the advice.
Before the creation of the OCE, the Ethics Committee was paralyzed by partisanship. At one point, the committee didn’t even meet for more than a year, much less consider action against any lawmakers.
While the panel was slumbering, House members of both parties were stealing all the silverware. There were numerous scandals, including the infamous corrupt lobbying network of Jack Abramoff when Republicans ruled the House, not to mention the FBI finding a $90,000 stash of bribe money in the freezer of Rep. William Jefferson (D., La.).
The preliminary work of the OCE indicates that there is no shortage of ethics issues since Democrats took control of the House. A confidential report leaked accidentally last month showed that the Ethics Committee had looked into at least 30 lawmakers this year as part of inquiries into possible violations of House rules.
Nobody has been accused of wrongdoing, but among the names on the list are Reps. Charles Rangel (D., N.Y.), powerful chairman of the House Ways and Means Committee, and Rep. John Murtha (D., Pa.), chairman of the defense appropriations subcommittee.
Murtha and other appropriators are under fire for their questionable relationships with defense contractors.
The Ethics Committee has begun full investigations into Reps. Maxine Waters (D., Calif.) and Laura Richardson (D., Calif.), probes that were recommended by the OCE.
The committee wants to know if Waters violated ethics rules by helping direct federal bailout money to a Boston bank connected to her husband, and whether Richardson got special favors in a real-estate deal.
The OCE’s role in ethics enforcement is important and should be preserved. It’s no accident that the House Ethics Committee is once again busy after a long, self-serving hibernation.
Inquirer Editorial Board @ 1:00 AM  Permalink | 0 comments
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