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Medical Establishment Conspiracy To Conceal Lethal Risks Of Common Medical Procedure!

Marg

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After finding out that she had fibroids, this female doctor also found out that she had uterine cancer.

This is a harrowing story of the aftermath of her specific treatment, and her physican husband and her personal crusade to draw attention to the risks involved with the non-invasive treatment; and how the establisment retaliated against these two doctors for going public.

Https://www.nytimes.com/2017/05/24/...hone-share&referer=http://m.facebook.com&_r=1

I don't know why this link is not working.

If you want to search this story, her name is Dr. Amy Reed Noorchashm. She had 6 children and has unfortunately passed away at age 44.
 
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Queequeg

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Wow that's a powerful story.
In this longer version they make a little more clear as to how bad the doctors screwed up. No wonder the Husband was so pissed off.

What Are the Chances?
"“I said, ‘Did you get it out in one piece?’” Hooman says. “I assumed—the way you treat any mass, you take it out in one piece. You never chop it up. She said, ‘No, we morcellated it.’”" Regarding the second operation, conversation between husband (Hooman) and the surgeon
 

haidut

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I want to bump this thread and provide some more details, not only because of the powerful story but because it provides direct evidence of the great lengths the medical establishment will go at in order to silence dissent, even when coming from established and respected insiders like these two nice doctors. I would ask @Marg to maybe even consider changing the thread title to something like "Medical establishment conspiracy to conceal lethal risks of common medical procedure". The morcellation is still commonly used in most hospitals precisely because the corrupt political acrobats at FDA did not issue a ban on the procedure but simply worded it as a "safety" alert, which carries no regulatory power.
I get hate mail every day saying I promote conspiracy theories about the medical profession that do not exist in reality. Well, this article shows just how real these evil practices are and how united the medical gang is. Remember, both the woman and men doctors were part of the establishment and rising stars in the medical field!! If the medical establishment can do that to two of its own can you imagine what it would do to the average unsuspecting Joe who goes in for a "routine" medical procedure and experiences complications!?!?

https://www.nytimes.com/2017/05/24/...t-who-fought-morcellation-procedure.html?_r=0

"...Dr. Reed and her husband fought for years to ban the use of a surgical tool called a power morcellator, which has a spinning blade that slices up tissue so it can be extracted through small incisions. Though the device is regarded as a great boon to minimally invasive surgery, if a patient has cancer, as Dr. Reed did, morcellation can spread the disease."

"...Dr. Reed, an anesthesiologist and the mother of six children, underwent surgery involving morcellation in 2013, when, at 40, she had her uterus removed because of fibroids. The operation was performed at Brigham and Women’s Hospital in Boston, which is affiliated with Harvard Medical School, where both Dr. Reed and Dr. Noorchashm had teaching positions. A biopsy after the operation found that Dr. Reed had a hidden leiomyosarcoma, an aggressive type of cancer."

"...As physicians, Dr. Reed and Dr. Noorchashm knew at the time that her morcellation procedure could be a death sentence. As a surgeon himself, Dr. Noorchashm was outraged at the idea of shredding potentially cancerous tissue inside a body cavity. He had been trained to cut around tumors whenever possible, not through them, precisely because slicing into them could spread the cancer cells. Dr. Reed quickly embarked on a series of aggressive treatments, but she still suffered one recurrence after another, in her abdomen, lungs and spine. She had several major operations and received arduous courses of chemotherapy, radiation, immunotherapy and experimental treatment."

"...The couple fought the medical establishment as fiercely as they did the cancer, seeking to ban morcellation. They sent thousands of emails to the F.D.A., device makers, hospitals, legislators, professional societies and individual doctors, and they reached out to news organizations to publicize their cause."

"...Their activism, alienating some colleagues and aggravating administrators, came at a price. Dr. Noorchashm had been a rising star in cardiothoracic surgery at Brigham and Women’s, where his wife had the operation, but as he continued to criticize its gynecology department, his career there began to stall. He and Dr. Reed were both hired by the University of Pennsylvania, and moved there in 2014. Both had extended family in and around Philadelphia. They had apparently burned their bridges at Harvard. At one point, when Dr. Reed needed to return to Brigham and Women’s for a medical procedure, she and Dr. Noorchashm were stunned to find that the hospital had assigned a guard to inspect their bags and escort them at all times, for security reasons. Dr. Noorchashm called a lawyer. A judge put a stop to the escort, issuing a restraining order against the hospital."

"...The gynecology profession also fought back against Dr. Noorchashm and Dr. Reed, insisting that leiomyosarcoma was so rare that the benefit of morcellation — the ability to have minimally invasive surgery — far outweighed any risk."

"...In November 2014, the F.D.A. went further, recommending that power morcellators not be used in the vast majority of women having fibroid surgery. Using the device in women with undetected sarcomas, it said, “may spread cancer and decrease the long-term survival of patients.” The F.D.A. portrayed the statement as a “safety communication,” not as an announcement of a new regulation. Morcellator use dropped significantly, but many gynecologists still favored it, and the devices remained available. Dr. Noorchashm and Dr. Reed would not settle for less than a complete ban, and continued to agitate. They prodded legislators to ask the Government Accountability Office to investigate morcellation. In a report issued in February, the G.A.O. criticized the F.D.A.’s method of collecting data on problems stemming from morcellation, noting that the system was dependent on voluntary reports from doctors, who frequently fail to report bad outcomes."
 

Nokoni

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"the system was dependent on voluntary reports from doctors".

FDA oversight in action:
See__Hear__Speak_monkeys_Insert.jpg
 

Marg

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Haidut,

I opened up my original post to make changes to the title, but the "edit" at the bottom of my original post was not there so I could not make a revision.
 

haidut

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Haidut,

I opened up my original post to make changes to the title, but the "edit" at the bottom of my original post was not there so I could not make a revision.

It's OK, just a suggestion on my part. I think as long as we keep this thread active long enough to be seen by a few hundred people today the message will be heard loud enough.
 

Queequeg

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In reading the NYT it was unclear to me just what happened but after reading the Boston Mag article it was clear that the first error, though standard of care at the time, was to use a Morcellator on uterine fibroids. Dangerous because of a 1 in 350 chance of having a hidden cancer. In this case however the doctors did a second operation after finding that the patient definitely had cancer and still used a morcellator. That is criminal malpractice IMO.
 

haidut

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In reading the NYT it was unclear to me just what happened but after reading the Boston Mag article it was clear that the first error, though standard of care at the time, was to use a Morcellator on uterine fibroids. Dangerous because of a 1 in 350 chance of having a hidden cancer. In this case however the doctors did a second operation after finding that the patient definitely had cancer and still used a morcellator. That is criminal malpractice IMO.

Not a criminal malpractice legally speaking as there was no prohibition or warning from the FDA at that time on using morcellator on cancers. The real criminal maplractice is actually on FDA's end to even allow the approval of this procedure without a concominant "black box" warning as the common knowledge in the profession at the time was clearly that using a morcellator was dangerous without first checking for cancer through biopsy. Even now, after the FDA issued a safety warning, the industry completely voluntarily reduced the use of morcellators due to bad publicity. There is no ban on the procedure (even in cases of confirmed cancer) or anything of the sorts, which allows doctor to do still whatever they please, especially if the patient is considered "compliant" (read: less than informed) and is unlikely to find out or complain.
 

Queequeg

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Not a criminal malpractice legally speaking as there was no prohibition or warning from the FDA at that time on using morcellator on cancers. The real criminal maplractice is actually on FDA's end to even allow the approval of this procedure without a concominant "black box" warning as the common knowledge in the profession at the time was clearly that using a morcellator was dangerous without first checking for cancer through biopsy. Even now, after the FDA issued a safety warning, the industry completely voluntarily reduced the use of morcellators due to bad publicity. There is no ban on the procedure (even in cases of confirmed cancer) or anything of the sorts, which allows doctor to do still whatever they please, especially if the patient is considered "compliant" (read: less than informed) and is unlikely to find out or complain.
Because there is a relatively high risk of hidden cancer in uterine fibroids, the FDA is now warning against its use in that situation but I don't think there was ever a time that a morcellator was approved to be used on known cancer cells. That is just insane. As the husband said in the story, you always remove the mass as one piece and you never chop it up. Seems pretty sensible standard of care. It's well known that even biopsies can spread cancer so I really cant see how using a morcellator on known cancer was ever standard practice. I would be curious if you have some info that supports that claim. If so the FDA and the medical system is more ****88 than I thought.
 
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haidut

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Because there is a relatively high risk of hidden cancer in uterine fibroids, the FDA is now warning against its use in that situation but I don't think there was ever a time that a morcellator was approved to be used on known cancer cells. That is just insane. As the husband said in the story, you always remove the mass as one piece and you never chop it up. Seems pretty sensible standard of care. It's well known that even biopsies can spread cancer so I really cant see how using a morcellator on known cancer was ever standard practice. I would be curious if you have some info that supports that claim. If so the FDA and the medical system is more ****88 than I thought.

The risks have been known for at least 2 decades and the FDA still left the procedure entirely at the doctors' discretion. Just because some doctors know the risks is not enough, as the FDA's official stance was that the procedure was safe and that is what doctors follow and use for legal defense. The blackbox warning did not come until 2014, despite strong evidence against the procedure. So, FDA is a lot more culpable here than doctors. I can only imagine how many women got terminal cancer because of this procedure. But the even more messed up situation is that a blackbox warning is not a ban, and doctor still have discretion to use it as they see fit, provided they properly inform their patients of the risk, which of course is unprovable if they do or not. So, if a woman with fibroids is to have the procedure today a doctor can still choose to use morcellation and would be legally covered.

Morcellation-Cancer Controversy Still Unresolved
"...The findings by Wright and colleagues reopened a discussion that has made headlines, off and on, since late 2013. In December of that year, the SGO published a position statement advising caution in the use of morcellation to treat uterine fibroids. Several case reports had documented that the procedure unleashed cells from unrecognized leiomyosarcoma, which evolved into advanced uterine cancer. An editorial published in The Lancet Oncology in early 2014 noted that the cancer risk associated with morcellation had been recognized for at least two decades."

"...The FDA subsequently issued an advisory, discouraging use of power morcellators in association with hysterectomy or myomectomy procedures. An FDA advisory committee reviewed the evidence linking morcellation and cancer but came to no conclusions. Then, in July 2014, Wright and colleagues published the first comprehensive data on the issue, which showed a cancer risk of 1 in 368, derived from a review of 200,000 cases. In November 2014, the FDA issued an updated advisory, specifically "warning against the use of laparoscopic power morcellators in the majority of women undergoing myomectomy or hysterectomy for treatment of fibroids." A black box warning followed."
 

encerent

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@haidut

I don't get this part : "Only then were Dr. Reed and her husband told that her surgeon had used a power morcellator to slice up her uterus. The device allows doctors to work through small slits rather than big, open incisions, so that patients can heal faster and run less risk of bleeding and infection."

So an anesthesiologist goes into surgery and doesn't know that they're going to use a morcellator on her? You'd think she'd know exactly what they would be doing to her.
 

Queequeg

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The risks have been known for at least 2 decades and the FDA still left the procedure entirely at the doctors' discretion. Just because some doctors know the risks is not enough, as the FDA's official stance was that the procedure was safe and that is what doctors follow and use for legal defense. The blackbox warning did not come until 2014, despite strong evidence against the procedure. So, FDA is a lot more culpable here than doctors. I can only imagine how many women got terminal cancer because of this procedure. But the even more messed up situation is that a blackbox warning is not a ban, and doctor still have discretion to use it as they see fit, provided they properly inform their patients of the risk, which of course is unprovable if they do or not. So, if a woman with fibroids is to have the procedure today a doctor can still choose to use morcellation and would be legally covered.

Morcellation-Cancer Controversy Still Unresolved
"...The findings by Wright and colleagues reopened a discussion that has made headlines, off and on, since late 2013. In December of that year, the SGO published a position statement advising caution in the use of morcellation to treat uterine fibroids. Several case reports had documented that the procedure unleashed cells from unrecognized leiomyosarcoma, which evolved into advanced uterine cancer. An editorial published in The Lancet Oncology in early 2014 noted that the cancer risk associated with morcellation had been recognized for at least two decades."

"...The FDA subsequently issued an advisory, discouraging use of power morcellators in association with hysterectomy or myomectomy procedures. An FDA advisory committee reviewed the evidence linking morcellation and cancer but came to no conclusions. Then, in July 2014, Wright and colleagues published the first comprehensive data on the issue, which showed a cancer risk of 1 in 368, derived from a review of 200,000 cases. In November 2014, the FDA issued an updated advisory, specifically "warning against the use of laparoscopic power morcellators in the majority of women undergoing myomectomy or hysterectomy for treatment of fibroids." A black box warning followed."
I think we are speaking about two different things.
The first which you are addressing in the above link is the use of morcellation on tissue such as uterine fibroids that have a relatively high chance of containing hidden cancers. "Several case reports had documented that the procedure unleashed cells from unrecognized leiomyosarcoma, which evolved into advanced uterine cancer." The crux of the debate here is whether or not the benefits from laproscopic surgery and morcellation outweighed the risk that the patient may have an unknown cancer which would then be spread by morcellation.

The issue I am bringing up is completely different. It is the use of morcellation on tissue that has already been confirmed to contain cancer. I don't think anyone in medicine would think that is a good idea but that is exactly what happened to Dr. Reed in her second surgery. That is what I believe was criminally negligent.
 

encerent

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In reading the NYT it was unclear to me just what happened but after reading the Boston Mag article it was clear that the first error, though standard of care at the time, was to use a Morcellator on uterine fibroids. Dangerous because of a 1 in 350 chance of having a hidden cancer. In this case however the doctors did a second operation after finding that the patient definitely had cancer and still used a morcellator. That is criminal malpractice IMO.

Why would she consent to having a morcellator used on her twice? Or (as an anesthesiologist) did she not know? Or did she only find out after both surgies about the risks of morcellators?
 

Queequeg

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For the first surgery she didnt know she had cancer so it was a calculated risk. The bs at the time was that only 1 in 10,000 women had hidden cancers so she probably figured it was worth the risk.
What I cant figure out is what happened after they found cancer in her. The article indicates that the surgeon went back in to remove her now known cancerous ovaries but instead of carefully removing them in one peice, she chopped them up with a morcellator and therefore spread the cancer cells everywhere. It doesn't make any sense. I doubt the Doctor/patient knew that was going to happen. The only thing that makes sense is that the article got the timeline wrong and morcellation was only used in the first surgery.
 

haidut

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I think we are speaking about two different things.
The first which you are addressing in the above link is the use of morcellation on tissue such as uterine fibroids that have a relatively high chance of containing hidden cancers. "Several case reports had documented that the procedure unleashed cells from unrecognized leiomyosarcoma, which evolved into advanced uterine cancer." The crux of the debate here is whether or not the benefits from laproscopic surgery and morcellation outweighed the risk that the patient may have an unknown cancer which would then be spread by morcellation.

The issue I am bringing up is completely different. It is the use of morcellation on tissue that has already been confirmed to contain cancer. I don't think anyone in medicine would think that is a good idea but that is exactly what happened to Dr. Reed in her second surgery. That is what I believe was criminally negligent.

I agree, knowing that there is cancer and still doing the procedure is negligent/criminal. But given that the chance of hidden cancer inside the fibroid is not small, why would the FDA approve the unmodified procedure without either requiring biopsy first or the use of the so-called "surgical bag" on all cases of morcellation of fibroidal uterus? The use of surgical bag is a simple and cheap method that would minimize risk of spreading cancer, yet neither the biopsy nor the bag are requirements for the procedure. Look at what the medical authorities (same article) recommended on morcellation and the FDA still left the procedure approval unmodified.
"..."If you know there's cancer, don't morcellate the uterus," she said. "If you think there's cancer, don't morcellate the uterus. If you think that it's benign, go the extra mile to make sure it's not cancer. Once you're pretty sure there is no cancer there, I think it is a patient's right to choose between a higher complication rate versus a very, very low rate of morcellating cancer.""

I think the last part is the most damning. Even if there is pretty high confidence of no cancer present, the patient should still be allowed to choose. But the current procedure is for the patient to NOT be notified of what the procedure will entail. It's left entirely up to the doctor performing the surgery. I highly doubt the patient chose NOT to have morcellation and the surgeon still did it. In that case it would be a direct "assault with a deadly weapon" charge.
 

haidut

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@haidut

I don't get this part : "Only then were Dr. Reed and her husband told that her surgeon had used a power morcellator to slice up her uterus. The device allows doctors to work through small slits rather than big, open incisions, so that patients can heal faster and run less risk of bleeding and infection."

So an anesthesiologist goes into surgery and doesn't know that they're going to use a morcellator on her? You'd think she'd know exactly what they would be doing to her.

Yes, quite often you are not notified of all the procedures that will be performed during surgery. Some surgeries contain so many of them that explaining all of them and their risks/benefits is considered overwhelming for a lay person. The surgeon performing the procedure has a LOT of latitude of what goes and what doesn't. I am sure you all have seen Grey's Anatomy or ER shows. Quite a few episodes dealt with staff arguing during surgery if a procedure is medically necessary or not. In most cases the issue revolved around the patient not being informed prior about the risks, and in other cases it was about some surgeons being either too aggressive or doing things strictly to cover their **** legally to the direct detriment of the patient. I know these are shows but some of the situations they deal with are quite realistic. I have surgeon friends and if I told you half of the stuff they have to go through (ethically) during surgery you will probably never go for any elective procedure :): Such is the sad state of medical affairs - the vast majority of procedures are done based on the least legal risk for the performer and his/her employer. The patient is the least of their concern, unless it is somehow tied legally or financially to their bottom line.
 

Queequeg

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I agree, knowing that there is cancer and still doing the procedure is negligent/criminal. But given that the chance of hidden cancer inside the fibroid is not small, why would the FDA approve the unmodified procedure without either requiring biopsy first or the use of the so-called "surgical bag" on all cases of morcellation of fibroidal uterus? The use of surgical bag is a simple and cheap method that would minimize risk of spreading cancer, yet neither the biopsy nor the bag are requirements for the procedure. Look at what the medical authorities (same article) recommended on morcellation and the FDA still left the procedure approval unmodified.
"..."If you know there's cancer, don't morcellate the uterus," she said. "If you think there's cancer, don't morcellate the uterus. If you think that it's benign, go the extra mile to make sure it's not cancer. Once you're pretty sure there is no cancer there, I think it is a patient's right to choose between a higher complication rate versus a very, very low rate of morcellating cancer.""

I think the last part is the most damning. Even if there is pretty high confidence of no cancer present, the patient should still be allowed to choose. But the current procedure is for the patient to NOT be notified of what the procedure will entail. It's left entirely up to the doctor performing the surgery. I highly doubt the patient chose NOT to have morcellation and the surgeon still did it. In that case it would be a direct "assault with a deadly weapon" charge.
completely agree.
 

encerent

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Yes, quite often you are not notified of all the procedures that will be performed during surgery. Some surgeries contain so many of them that explaining all of them and their risks/benefits is considered overwhelming for a lay person. The surgeon performing the procedure has a LOT of latitude of what goes and what doesn't. I am sure you all have seen Grey's Anatomy or ER shows. Quite a few episodes dealt with staff arguing during surgery if a procedure is medically necessary or not. In most cases the issue revolved around the patient not being informed prior about the risks, and in other cases it was about some surgeons being either too aggressive or doing things strictly to cover their **** legally to the direct detriment of the patient. I know these are shows but some of the situations they deal with are quite realistic. I have surgeon friends and if I told you half of the stuff they have to go through (ethically) during surgery you will probably never go for any elective procedure :) Such is the sad state of medical affairs - the vast majority of procedures are done based on the least legal risk for the performer and his/her employer. The patient is the least of their concern, unless it is somehow tied legally or financially to their bottom line.

Oh yeah my dad was a doc as well as many other family members. The number one thing they have on their mind is legal liability, not the well-being of the patient. Of course theoretically the laws are there to constrain the physician to give the patient the best care. But in real life that's not the case. Doctors follow a treatment algorithm in medical and surgical settings, no more no less, in order to avoid being sued.
 

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