The whole column is here. The short version: U.S. Sen. Jeff Sessions, an ardent advocate for tort reform, says the U.S. government need sto sue BP for trangressions that led to the Gulf of Mexico oil spill. From Milbank’s column writes:

Sessions, probably the Senate’s most ardent supporter of tort reform, found himself extolling the virtues of litigation — against BP. “They’re not limited in liability on damage, so if you’ve suffered a damage, they are the responsible party,” said Sessions, sounding very much like the trial lawyers he usually maligns.

Let’s see, a mechanism to redress grievances when government regulation fails. Where have we heard that before?

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The decision comes as the auto giant continues to grapple with a separate slate of troubles with its vehicle fleet involving sudden unintended accelleration that prompted a massive recall and government investigations.

The latest blow involved a single vehicle, the high-end Lexus GX 460 SUV. The consumer watchdog organization reported in an article posted on its website that the SUV would swerve badly while attempting to slow heading into a corner during routine tests at the magazine’s testing facility in Connecticut. For only the second time in a decade, Consumer Reports issued a “don’t buy” warning to its readers. 

In a video that accompanies the article, the SUV can been seen with its rear end swerving badly during the cornering manuever involving the driver lifting off the accelerator to reduce speed heading into a turn. The magazines editors say that in a real-world situation, such as a driver entering a freeway exit ramp at too high a speed, that sort of performance could lead to a potential rollover accident. Consumer Reports has notified the National Highway Traffic Safety Administration about the problem.

The “don’t buy” designation marked the first time since 2001 that the magazine has issued such a warning to consumers. The last car to be hit by that black mark was the 2001 Mitsubishi Montero Limited.

Toyota initially responded to the magazine’s report with an on-line statement expressing concern over the results of the test, but saying their engineers never encountered the problem when conducting similar tests. The statement said the auto giant would try to duplicate the test, quickly evaluate the results and “determine if appropriate steps need to be taken.”

In the meantime, the company statement said, “please keep in mind that the 2010 GX 460 meets or exceeds all federal government testing requirements.  Customer safety and satisfaction remain our highest priorities.  We take the Consumer Reports’ test results seriously and appreciate Consumer Reports bringing it to our attention.”

But later in the day, as a firestorm of media attention and cutomer complaints began to grow, Toyota took further action and pulled the SUV from the market until tests can confirm what changes might need to be made to ensure the safety of the vehicle.

“At this time we have asked our dealers to temporarily suspend sales of the 2010 GX 460,” Mark Templin, the group vice president and general manager, told the New York Times.

–Eric Bailey

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The cases will be handled U.S. District Judge James V. Selna, the Judicial Panel on Multi-District Litigation ruled today. It won’t be easy. More than 50 deaths have been attributed to problems with Toyotas, and the company has been under fire for its response to reports of the problems. Toyota eventually recalled more than 8 million motor vehicles, and around 80 of the filed lawsuits seek class-action status, according to the Wall Street Journal.

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That report ”arguably launched the modern patient-safety movement,” according to University of California, San Francisco, medical professor Dr. Robert Wachter.  The oft-quoted report estimated as many as 98,000 people die in U.S. hospitals each year as the result of preventable medical errors. That report recommended a “four-tiered approach” for better hospital safety. 

Ten years later, how are hospitals doing?

Wachter, who is associate chair of the UCSF Department of Medicine, gives safety efforts a grade of B- in a paper published in the January 2010 issue of Health Affairs.  That’s slightly better than the C+ Wachter gave on the fifth anniversary of “To Err Is Human” in 2004.  In the abstract to his latest paper, Wachter writes:

Relatively few health care systems have fully implemented information technology, and we are finally grappling with balancing “no blame” and accountability.  The research pipeline is maturing, but funding remains inadequate.  Our limited ability to measure progress in safety is a substantial impediment.

Wachter is especially disappointed in the lack of improvement in hospitals’ information technology, which he says has been “stunningly slow” with a “glacial adoption curve,” especially compared to the use of information technology in other areas.  He says only 2 percent of hospitals have fully integrated IT systems, including electronic medical records and electronic entry of treatment instructions (such as prescriptions) by physicians.

But Wachter says if you had asked him when “To Err Is Human” was published how much progress would be made over the next ten years, he would have underestimated what has actually been accomplished.  As he writes on his blog:

…as I wander around my own medical center, signs of progress are unmistakable.  Our safety enterprise is much more vigorous than it was five years ago (it was nonexistent 10 years ago).  Despite some major IT snafus, we are using an electronic health record, and it is a far better way of communicating information than via snippets of chicken scratch penned on dead trees.  During a weekly two-hour meeting, we analyze serious errors and review progress in fixing the unsafe conditions we uncover.  Our residents and students are (mostly enthusiastically) participating in new safety and quality curricula.  We are measuring safety outcomes such as healthcare-associated infections and reporting these results regularly at the highest levels of the organization.  All good stuff.

The estimate of as many as 98,000 deaths a year resulting from preventable errors has been described as “equivalent to two 737s crashing every day.”  Some health care executives have objected to that comparison, but Wachter embraces it.

Although some have critiqued the “crash-a-day” spin as hyperbolic, I continue to believe it was masterful.  Something was necessary to shake us out of our collective inattention, and it took the Jumbo Jet analogy to do it.  (And just consider what our response would be if, in fact, a commercial airliner crashed for “just” two or three days in a row!)

A story on the anniversary of “To Err Is Human” on the HealthLeaders Media web site says there are still many “significant challenges” to improving patient safety, among them reducing the number of medication errors.

Allen Vaida, a pharmacist and executive vice president of the Institute for Safe Medication Practices, says: “We have made great strides in understanding that medication errors are an issue, but we still have a long way to go.” Vaida says hospitals should implement barcoding of medications. 

“Only 5-20% of hospitals now do it.  We should be striving for 100%,” he says. Second, he says, “we have to do a better job learning from others.  Too many hospitals see tragic mistakes that happen elsewhere and say, ‘That happened in California.  I’m in Ohio.  It doesn’t happen here.’

“We need to realize we’re in a risky business, and ask the question, ‘Could that happen here?’ “

–J.G. Preston

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Short-term Halloween costume stores, novelty shops, flea markets, and seedy web sites don’t necessarily have consumer safety as their highest priority.  And if they’re selling contact lenses to a buyer who doesn’t have a prescription for them, they’re breaking the law…and putting the consumer at risk.

The man pictured above is not the result of some genetic experiment gone wrong.  He’s wearing “cosmetic contact lenses,” which, even if they don’t correct vision, are regulated by the Food and Drug Administration the same as standard contact lenses.  The Federal Trade Commission requires business that sell contacts to verify the buyer has a prescription from a medical professional.

Since variations of these lenses seem to be especially popular at Halloween, the California Board of Optometry recently issued a reminder that improper use of contacts can cause eye problems, including corneal ulcers that can in extreme cases lead to blindness without proper treatment.  Improper fitting and inadequate maintenance can create problems, and Board of Optometry officials say legal sellers will provide instruction in the care and use of contacts.

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