Ignoring your heart scan is medical negligence

I continue to be dumbfounded that many doctors continue to pooh-pooh or ignore CT heart scans when people get them.

I can't count the number of people I've seen or talked to through the Track Your Plaque program who've been told to ignore their heart scan scores. The most extreme example was a man whose physician told him his heart scan score of nearly 4000 was nothing to worry about!


A real-life story of a retired public defense attorney whose heart scan score of 1200 was ignored, followed two years later by sudden unstable heart symptoms and urgent bypass prompted us to write this fictitious lawsuit. Though it's not real, it could easily become real. To our knowledge, no single act of ignorance about heart scans has yet prompted such a lawsuit, but it's bound to happen given the number of scans being performed every year and the continued stubbornness of many physicians to acknowledge their importance.



Major Malpractice Class Action Lawsuit Looms for Doctors Who Ignore Heart Scan Tests

It's been several years since new medical discoveries have debunked old theories regarding heart disease and heart attack and have verified the efficacy of CT heart scans for detecting both early and advanced heart disease. Doctors who fail to keep apprised of these finding or refuse to change their practice for financial reasons put themselves at risk for becoming defendants in a major malpractice class action lawsuit. The plaintiffs will be a growing class of persons who were debilitated by avoidable heart attacks and heart procedures and the heirs and estates of those who have died.
Milwaukee , WI (PRWEB) November 29, 2005 -- This press release outlines a template for a potential class action lawsuit that may be on the horizon for the medical industry. The class of plaintiffs for this theoretical action remains latent but is growing on a daily basis. However, it requires only one such plaintiff to find an attorney who recognizes the scale and magnitude of the potential damages and move forward on a contingency basis. In real terms, this class could include 80% of those who had a heart attack, underwent a heart procedure, or subsequently died. According to the latest American Heart Association statistics, this number is estimated to be a least 865,000 persons and the entire class could easily be 10 times that number. Using a conservative estimate of $500,000 in damages per class member, the total damages could exceed $400 billion.

The plaintiffs, defendants, third parties, and facts surrounding the following moot complaint represent an actual incident. The names, specific health information, and dates have been changed to protect potential litigants.

Plaintiff, through his attorneys, brings this action on behalf of himself and all others similarly situated, and on personal knowledge as to himself and his activities, and on information and belief as to all other matters, based on investigation conducted by counsel, hereby alleges as follows:

NATURE OF THE ACTION

1.Plaintiff brings this class action on behalf of himself and all other persons who suffered physical damages or mental distress as a result of receiving a medical diagnosis indicating they had no identifiable heart disease, elevated risk for heat attack, or who were prescribed medications not suited to treat their heart disease once detected.

2.Substantial and irrefutable medical evidence has established that cardiac stress testing is an ineffective method for detecting heart disease of the type that is the root cause in over 90% of all heart attacks and other complications of heart disease that result in death or debilitating injury. A readily available and well-publicized test known as “CT heart scanning” is capable of detecting virtually all heart disease of this nature. It has also been established that simple cholesterol testing often fails to detect persons like likely to develop serious heart disease and prevents them from receiving common treatments capable of reducing or eliminating the source of their undetected heart disease. Readily available blood testing techniques exist that are capable of detecting non-cholesterol related sources of heart disease.

3.The medical community has made significant investments in outdated methods of detecting and treating heart disease. They rely on the revenue streams generated by providing these treatments to persons whose heart disease has progressed to the stage that intervention is required to prevent death or debilitation. Any change in diagnostic or treatment methods resulting in the prevention of heart disease would require substantial investments in new technologies and would severely reduce the market for current treatments. Plaintiffs believe this is a motivating factor in the neglect and willful suppression of readily available technology capable of detecting and preventing heart disease and represents gross medical malpractice.

SUBSTANTIVE ALLEGATIONS

On January 23, 1999, Plaintiff underwent a CT Heart Scan which was interpreted by a cardiologist at the ABC Scan Center . Plaintiff received a report from the Scan Center cardiologist indicating that his “calcium score” placed him in the top 1% for heart attack risk among men in his age group. The report also included the comment “Patient has a high risk of having at least one major stenosis (50% or greater blockage) in his Left Anterior Descending (LAD) artery and is urged to consult with a physician regarding this finding.”

On March 3, 1999 Plaintiff presented Defendant with the results of the January 23, 1999 CT Heart Scan. Defendant told Plaintiff to disregard the CT Heart Scan Results and ordered a physical including a stress test and cholesterol blood test.

On April 1, 2005, Plaintiff had a heart attack and a subsequent coronary angiography that confirmed multiple obstructive coronary plaques in his LAD. Plaintiff received an emergency balloon angioplasty to relieve his acute condition. Substantial damage to plaintiff's heart was incurred before emergency angioplasty could be instituted.

On April 3, 2005, per Defendant's recommendation, Plaintiff underwent open heart surgery to insert three bypasses in his LAD to resolve substantial obstructive heart disease, the same artery identified as having likely obstructive heart disease over 5 years earlier via CT heart scan.

On July 7, 2005, Plaintiff independently obtained additional blood testing not ordered by Plaintiff and was found to have several additional blood abnormalities not discovered by Defendant that are known to contribute to the development of heart disease and were readily treatable using lifestyle changes, nutritional supplements, and prescription drugs.

As early as September, 1996, the American Heart Association (AHA) issued a “Scientific Statement” to health professionals acknowledging the strong link between heart attacks and high calcium scores in asymptomatic patients. Extensive studies and references have confirmed the ineffectiveness of stress testing to reveal early heart disease in asymptomatic patients.

Plaintiff alleges that Defendant failed to utilize readily available medical tests and protocols to identify, aggressively treat, and potentially delay, halt, or reverse advanced heart disease that later resulted in extensive physical and emotional trauma to the Defendant.

PRAYER FOR RELIEF

WHEREFORE, Plaintiff herein demands judgment:

A. Declaring this action to be a proper class action maintainable pursuant to Rule 23 of the Federal Rules of Civil Procedure and declaring Plaintiff to be a proper Class representative;

B. Awarding damages against each defendant, joint and severally, and in favor of Plaintiff and all other members of the Class, in an amount determined to have been sustained by them, awarding money damages as appropriate, plus pre-judgment interest;

C. Awarding Plaintiff and the Class the costs and other disbursements of this suit, including without limitation, reasonable fees for attorneys, accountants, experts; and

JURY DEMAND

Plaintiff hereby demands a trial by jury.
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Fractures and vitamin D

Fractures and vitamin D

This is a bit off topic, but it's such an interesting observation that I'd like to pass it on.

Over the past several years, there have been inevitable bone fractures: People slip on ice, for instance, and fracture a wrist or elbow. Or miss a step and fracture a foot, fall off a ladder and fracture a leg.

People will come to my office and tell me that their orthopedist commented that they healed faster than usual, often faster than anyone else they've seen before. My son was told this after he shattered his hand getting slammed against the boards in hockey; his orthopedist took the screws and cast off much sooner than usual since he judged that healing had occured early. (My son was taking 8000 units vitamin D in gelcap form; I also had him take 20,000 units for several days early after his injury to be absolutely sure he had sufficient levels.)

My suspicion is that people taking vitamin D sufficient to enjoy desirable blood levels (I aim for a 25-hydroxy vitamin D level of 60-70 ng/ml) heal fractures much faster, abbreviating healing time (crudely estimated) by at least 30%.

For any interested orthopedist, it would be an easy clinical study: Enroll people with traumatic fractures, randomize to vitamin D at, say, 10,000 units per day vs. placebo, watch who heals faster gauged by, for instance, x-ray. My prediction: Vitamin D will win hands down with faster healing and perhaps more assured fusion of the fracture site.

Comments (25) -

  • River Rat

    4/26/2010 11:18:16 PM |

    Just anecdotal, but I had an experience that confirms your theory.  In the middle of a 21-day trip down the Colorado through Grand Canyon, I fell and fractured my arm.  I decided just to splint it up and continue the trip, since the pain wasn't too bad.

    By the time I got to a clinic in Flagstaff, 10 days later, the doctor said everything had healed so well I didn't even need a cast.  

    Needless to say, there is lots of free Vitamin D in the Grand Canyon in summer!  We were in the sun all day long.  Maybe it made the difference.

  • ithink

    4/27/2010 12:18:12 AM |

    probably also has to do with the fact people are calcium deficient without vitamin d.

  • DrStrange

    4/27/2010 12:51:24 AM |

    Isn't there evidence that the blood level vs benefit curve reverse itself ("U" shape) above around 60 ng/ml?  Maybe just under or at that safer???

  • mongander

    4/27/2010 2:02:11 AM |

    Last fall I was happy with my blood level of vit D, 79 ng/ml, so I reduced my daily dose from 10,000 iu to 5,000 iu.   I just got my spring test result and my level dropped 23 points to 56 ng/ml.  I'm gonna go back to 10,000 iu, except maybe during the summer when I get a lot of sun.

  • TedHutchinson

    4/27/2010 12:23:13 PM |

    How to Optimize Vitamin D Supplementation to Prevent Cancer, Based on Cellular Adaptation and Hydroxylase Enzymology" You can read Reinhold Vieth's justification for keeping 25(OH)D both high and STABLE here.
    In order to regulate any system there has to be a means of both increasing and decreasing responses.
    Where the upregulation and down regulation is performed by different substances both of which are derived from Vitamin D, it follows these have to be kept tightly controlled and always in balance.
    Sudden rise in 25(OH)D causes a period of imbalance between those forces, during which too much immunosuppression may occur.
    The further north people live the more extreme differences between Summer/winter status. It isn't surprising those flying to the tropics for short midwinter sun breaks end up catching something from recycled germs during the flight home.
    Making sure your Vitamin D needs are met daily throughout the year evens out the percentage change in levels as naturally more vitamin D3 is made in low 25(OH)D skin than when 25(OH)D is high.

    Correcting vitamin D deficiency BEFORE a winter sun break results in a lower increase in 25(OH)D.
    Less change in status = shorter period of imbalance.

    I don't have to remind readers here Ergocalciferol speeds up the catabolism of vitamin D Cholecalciferol has a longer half life. Using Vitamin D2 therefore promotes greater/faster swings in status and should be avoided.

    Using Vitamin D3 supplements daily at amounts no greater than UVB exposed skin would naturally produce, most nearly replicates the changes in status human DNA would have evolved with.

    Apologies to Dr Vieth for assuming the copy of the paper linked to above was non-copyright and putting it online.  I think it's important the public have access to the full text rather than just my garbled version of this important paper.

  • Ned Kock

    4/27/2010 1:17:02 PM |

    Thanks Dr. Davis for the post sharing you personal experiences.

    DrStrange:

    The relationship seems to follow a U-curve pattern, with very high levels being associated with hypervitaminosis D problems.

    The levels mentioned by Dr. Davis seem well below the ones that can lead to toxicity. For example, a farmer in Puerto Rico had a level of 225 nmol/L (90 ng/mL), and had no signs of toxicity:

    http://healthcorrelator.blogspot.com/2010/02/vitamin-d-levels-sunlight-age-and.html

    From the post above, toxic doses seem to start around 50,000 IU per day. That's way more than the 10,000 IU or so that we get from sun exposure.

    My only point of disagreement with Dr. Davis is about our ability to produce vitamin D from sunlight after age 40. There is research (post above too) showing that the elderly can produce as much as 80 percent vitamin D from sunlight as do 20 or 30 year olds.

  • homertobias

    4/27/2010 3:21:19 PM |

    Hi Dr.Davis.
    I just wanted you to know that THIS PRACTIONER is running her own open label trial on 5-10 people with lp(a).  I will let you know the outcome.
    I just read your trial on 45 CAC high scorers that you published in Am J of Theraputics last year.  I hear that the registration process to publish is a horrific process. I am glad you persisted,  I really wanted your raw data but...

  • Tom

    4/27/2010 6:58:50 PM |

    I hope I'm not diverting from the topic here....I'm confused about the Vit D-Calcium interaction.

    I believe I understand correctly that high Vit D levels allow the body to more effectively process calcium.

    I don't understand how calcium requirements change with increased Vit D levels.  I have a blood level of 72 (D3) and 3 (D2).  But I haven't paid attention to my calcium intake.

    Can anyone clarify the relationship between Vid D and calcium please?

    Thank you in advance.

  • DrStrange

    4/27/2010 7:00:05 PM |

    "The relationship seems to follow a U-curve pattern, with very high levels being associated with hypervitaminosis D problems."

    Not hypervitaminosis D but rather reversal of D's benefits.  I had read that above 60 ng/ml the risk of prostate cancer increased again.  Just now searching for the study found on D council site, a recent article showing the likelihood that this outcome was because the research subjects had all gotten their higher D levels from Cod liver oil and the vitiman A in that is what reversed the benefits of D, not the high levels of D!  So seems I could well have been misinformed about that.

    http://www.vitamindcouncil.org/newsletter/vitamin-d-vitamin-a-and-cancer.shtml

  • sonny

    4/27/2010 11:32:00 PM |

    Just threw out all multivitamins in the house after hearing about vitamin A interfering with vitamin D absorption.

  • TedHutchinson

    4/28/2010 8:27:12 AM |

    @ Dr Strange
    Tuohimaa's team claiming they have found a U shaped curve for Vitamin D is based in Tampere, Finland latitude 61N
    People at that latitude with high 25(OH)D levels have experienced a greater change in level from summer to winter or if they choose to take a winter sun break will experience further re-balancing of the immune system. Vieth argues it is the length and number of periods of imbalance that drive the effects Tuohimaa reports.

    Now we have greater availability of effective strength D3 it will be easier for people at that latitude to attain and maintain the levels that enabled the Inuit to survive long winters with over 6000iu daily vitamin D3 provided from traditional diet.

    @ Tom
    Video of Heaney explaining the calcium/vitamin D story

    The Vitamin D requirement in health and disease Heaney similar information in PDF form but in greater detail.
    Bear in mind when considering Vitamin D and Calcium absorption that other co-factors work in synergy with Vitamin D.
    Magnesium is required to power the  production of the active hormone Calcitriol that lowers PTH and magnesium also counterbalances the role of calcium as magnesium is a natural calcium channel blocker.
    Each Vitamin D Receptor requires zinc.
    Also Vitamin K2 mk4 is critical for healthy bone density transporting calcium from bloodstream to bone.

  • Kent

    4/28/2010 8:13:45 PM |

    There has been at least one study done. Here's one with guinea pigs.
    http://www.springerlink.com/content/w734p41874205516/

    This is another area where common sence and experience shouldn't really require a study to initiate this course of action. Example; I saw the other day there was a "study" done on children that proved that what they saw on TV affected their actions. I'm sure many parents are glad that study "finally" came through!

  • Jason

    4/28/2010 9:40:56 PM |

    New study on grains:

    http://www.lef.org/news/LefDailyNews.htm?NewsID=9615&Section=Nutrition

    "Published research shows eating two to four serves of wholegrain foods a day can reduce the risk of heart disease by as much as 40 percent - equal to the effect of cholesterol lowering drugs,"

  • Tom

    4/29/2010 1:03:42 PM |

    To TED,

    Thank you Ted for the information.  The Heaney video was very interesting and worthwhile.  It's interesting that he says optimal D3 for calcium absorbtion is between 80 and 120 nmol.  I'm at 70 nmol and thought I was fine!
    The video is well worth watching.

    nevertheless, I'm still trying to understand how much calcium I should be taking, assuming I get my D3 to 80 or so.

    Your remarks about Magnesium, etc. are helpful.  Thank you.  But again, I struggle with how much?  

    Tom

  • Daniel

    4/30/2010 4:23:49 PM |

    Ted,
    Another explanation, this one from Cannell, for the U curve found in Scandinavia is cod liver oil.  

    People with the highest vit D levels may be consuming enormous amounts of cod liver oil and, thus, vitamin A.

    Excess retinol may thwart the action of vit D by competing for certain nuclear receptors.

  • P90X Results

    5/3/2010 9:57:44 AM |

    This is very useful information of Obesity. You can find more information about how to prevent heart diseases. I am very excited about your post, it's really amazing.

  • Tom

    5/3/2010 10:45:10 PM |

    To Ted,

    Thank you once more for this information.

    I just read that calcium has been implicated in Prostrate cancer.  have you heard anything about this?

  • Anonymous

    7/28/2010 5:01:59 PM |

    Do you know if anything helps for soft tissue injuries? I am still not fully recovered from a foot injury 5 months after the acute phase. The orthopedist expected it to take 4 weeks to heal and I'm a little concerned about how long it will take.

  • Troy @ shipping quote

    12/31/2010 5:44:10 AM |

    The above blog post is quite informative. Having good information related to bones and its requirements. I was not knowing that Vit D is so important for our bones. But good to know about that. Want to ask what are the natural resources of Vit D in our daily diet?

  • CatinaAgilar6368@hotmail.com

    1/1/2011 12:48:29 PM |

    Quite an informative blog post. I know that inadequate amount of vitamin D in diet can lead to osteoporosis, which is a brittle bone disease. But are there any side effects of excessive intake of vitamin D.

  • Nevil - same day courier

    3/22/2011 12:13:49 PM |

    Great post William, my friend is really having some bone problem, so this information will be quite useful for him. Looking forward for more post on the same topic.

  • Hal

    5/7/2011 4:11:01 PM |

    I know someone who was in a car accident that resulted in very serious fractures of one arm and wrist.  He is in his late 60's and his injuries were not healing.  

    I came to know this person about 6 months after the accident.   He was taking about 2 grams of  calcium per day thinking that this would help his bones, perhaps because the doctor told him to talk more calcium, but no supplemental  Vitamin D.   I told him that the should be taking at least 5000UI D3  per day pointing out that Walmart has 5000UI gel caps for cheap ($5 per 100 at that time) and that he was likely taking too much calcium.  He started taking more D3 although I am not sure how much since I didn't want to be pushy.  

    It has been about 9 months now since he started taking more D3 and his injuries have healed and he has had surgery to remove most of the plates and screws that had been put in place.    Was D3 the reason for this?    I don't know but I am sure that it didn't hurt either.

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