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unnecessary Caesarean births is occurring".'° VanHam reported a Caesarean section postpartum haemorrhage rate of 7%, a haematoma formation rate of 3.5%, a urinary tract infection rate of 3%, and a combined postoperative morbidity rate of 35.7% in a high-risk population undergoing Caesarean section.'” The greatest cause of morbidity in vaginal births is anorectal tearing. In a study of 20,500 women, 5% required an episiotomy and 67 patients (.0033%) experienced wound disruption that required surgical correction resulting in a "satisfactory outcome".'"* We used a cost analysis from a 2000 study in which the increase in hospitalisation costs per patient suffering an adverse drug reaction was $5,483. Therefore, costs for the Lazarou study's 2.2 million patients with serious drug reactions amounted to $12 billion." Serious adverse drug reactions commonly emerge after Food and Drug Administration approval. The safety of new agents cannot be known with certainty until a drug has been on the market for many years. '"” _ Bedsores NEVER ENOUGH STUDIES Over one million people develop bedsores in US hospitals Scientists used the excuse that there were never enough studies every year. It's a tremendous burden to patients and family, and revealing the dangers of DDT and other dangerous pesticides to a $55 billion health care burden.’ Bedsores are preventable with ban them. They also used this excuse proper nursing care. It is true that 50% of around the issue of tobacco, claiming that those affected are in a vulnerable age group more studies were needed before they could of over seventy. In the elderly, bedsores be certain that tobacco really caused lung carry a fourfold increase in the rate of death. cancer. Even the American Medical The mortality rate in hospitals for patients Association (AMA) was complicit in sup- with bedsores is between 23% and 37%. * pressing results of tobacco research. In Even if we just take the 50% of people over {2 te Surgcon Generals repor.cet” | Today, scientists | 7. bitors adh vex morally refused to endorse it. What was their rea- continue to use the sores of 115,000. Q, wa searcl “tug itics j 69 ati ae seas son? They needed more researc| . Actually, excuse that they Critics will say that it was the disease or what they really wanted was more money . advanced age, not the bedsores, that killed and they got it from a consortium of tobacco need more studies the patient, but our argument is that an early companies that paid the AMA US$18 mil- A death due to being denied proper care lion over the next nine years, during which before they will deserves to be counted. It is only after the AMA said nothing about the dan- gers of smoking. '* The Journal of the American Medical Association (JAMA), "after careful consideration of the extent to which cigarettes were used by physi- cians in practice", began accepting tobacco advertisements and money in 1933. State journals such as the New York State Journal of Medicine also began to run Chesterfield ads, claiming that cigarettes are "Just as pure as the water you drink...and practically untouched by human hands". In 1948, A report from the Coalition for JAMA argued that "more can be said in Nursing Home Reform states that at behalf of smoking as a form of escape from tension than against least one-third of the nation's 1.6 million nursing home residents it...there does not seem to be any preponderance of evidence that may suffer from malnutrition and dehydration, hastening their would indicate the abolition of the use of tobacco as a substance death. The report calls for adequate nursing staff to help feed lend their support to restrict the inordinate use of drugs. counting these unnecessary deaths that we can then turn our attention to fixing the problem. Malnutrition in Nursing Homes The General Accounting Office (GAO), a special investigative branch of US Congress, gave citations to 20% of the nation's 17,000 nursing homes for violations between July 2000 and January 2002. Many violations involved serious physical injury and death.'" contrary to the public health".'” patients who aren't able to manage a food tray by themselves." It Today, scientists continue to use the excuse that they need is difficult to place a mortality rate on malnutrition and dehydra- more studies before they will lend their support to restrict the tion. This Coalition report states that malnourished residents, inordinate use of drugs. compared with well-nourished hospitalised nursing home resi- dents, have a five-fold increase in mortality when they are admit- OVERVIEW OF STATISTICAL TABLES AND FIGURES ted to hospital. So, if we take one-third of the 1.6 million nursing Adverse Drug Reactions home residents who are malnourished and multiply that by a The Lazarou study' was based on statistical analysis of 33 mortality rate of 20%,*'* we find 108,800 premature deaths due million US hospital admissions in 1994. Hospital records fot to malnutrition in nursing homes. A had m © Today, scientists continue to use the excuse that they need more studies lend their support to restrict the of drugs. OVERVIEW OF STATISTICAL TABLES AND FIGURES Adverse Drug Reactions The Lazarou study' was based on statistical analysis of 33 million US hospital admissions in 1994. Hospital records for prescribed medications were analysed. The number of serious injuries due to prescribed drugs was 2.2 million; 2.1% of in- patients experienced a serious adverse drug reaction; 4.7% of all hospital admissions were due to a serious adverse drug reaction; and fatal adverse drug reactions occurred in 0.19% of in-patients and 0.13% of admissions. The authors concluded that a projected 106,000 deaths occur annually due to adverse drug reactions. Nosocomial Infections The rate of nosocomial [i.e., hospital-related] infections per 1,000 patient days has increased 36%, from 7.2 in 1975 to 9.8 in 1995. Reports from more than 270 US hospitals showed that the nosocomial infection rate itself had remained stable over the pre- vious 20 years with approximately five to six hospital-acquired 26 = NEXUS before they will inordinate use www.nexusmagazine.com DECEMBER 2004 — JANUARY 2005