Currently Unpublished
as of 2001

An Ounce of Prevention
Nan DeVincent-Hayes, Ph.D
5736 Royal Mile Boulevard
Salisbury, MD 21801
Phone/Fax: 410/543-9019

AN OUNCE of PREVENTION
by
Nan DeVincent-Hayes, Ph.D

Ways to Avoid Becoming a Medical Mistake Victim, and How to Take Control of Your own Treatment

by

Nan DeVincent-Hayes, Ph.D

and

Harry Bande, Pharm.D

BOOK PROPOSAL

4. TITLE:
An Ounce of Prevention: Ways to Avoid Becoming a Medical Mistake
Victim, and How to Take Control of Your own Treatment

5. OBJECTIVE:
To alert readers to mistakes being made by doctors, nurses, pharmacists, and other staff workers in hospitals, offices, and clinics--mistakes that could be avoided, but yet often lead to serious injuries or even death. By becoming aware of these potential errors, readers can then be on guard, practice preventive measures, and spare themselves and others harm and/or death.

6. FOCUS:
This book's intent is to guide readers through the medical maze where instantly they're placed in a position of losing their rights, and losing control of their lives. Thus, they become victims of doctors, nurses, technicians, pharmacists, and rules and regulations. Because the medical industry takes charge of a patient's life, it often also takes advantage of the person as well, thus relegating the individual to the dependent child status.
This book shows readers how they can exert themselves when dealing with doctors and other medical personnel, as well as what steps they can take to prevent a medical mistake happening to them.

7. Overview:
In 1995, Idaho's state pharmacy board took disciplinary action against 15 pharmacists for medication errors.

LADIES HOME JOURNAL reported that 24% of its polled readers experienced errors in their medications; 19% were victims of surgical mistakes.

A Florida hospital amputated the wrong leg of an elderly gentleman; someone hadn't checked his chart.

A mix-up between potassium chloride and a dextrose solution has killed 16 people since 1987, but the problem's never been fully corrected. When erroneously administered, potassium chloride causes death within seconds.

In January, 1995, Tetronicks pacemaker manufacturer finally admitted to making an inferior quality wire that killed a number of people by penetrating the heart's artery, and instantly bleeding them to death. They've since recalled the pacemaker but there's no simple and safe method for removing the wire in those patients.

The above are a few examples of the types of mistakes happening in the medical industry. And as this field continues to grow and expand, and come under the auspices of "big business" executives instead of trained health care experts, even greater errors will happen--many of which will kill innocent consumers.
Equally disparaging are the rights patients are losing, as HMOs and other monster corporations take over patient care as a money-making proposition, and not as a way to improve health care. No longer can most consumers choose their own doctors, fight the establishment if their bills are wrong, or even defend themselves against doctors' diagnoses when incorrect or rashly assigned without warrant. Women and the elderly are often the victims of this, having gone to physicians for persistent ailments, only to have been told that their problems lay in their "heads" and not in their bodies, and, hence, were classified as "unstable," or "anxious," or, worse, a "hypochondriac." This type of unfounded diagnosis goes on the patient's record and is passed from one doctor to another, one hospital to another, and the patient has no recourse in correcting the mistake, and yet ends up unfairly labeled for life.

Medications are one of the areas where a majority of major mistakes are made. And mail-order-pharmacies (MOPs) are the prime offenders of this, since a big chunk of the population uses them. Consider that over 30-plus million patients buy from just one MOP, alone. These express pharmacies deny patients any type of drug counseling, and thus have no idea if the pills they send to consumers are the correct ones. A number of patients have been seriously injured or killed by this type of medication dispensing.
And because doctors don't always understand the mechanics and purpose of the many drugs they prescribe, they not only fail in their attempt to heal their patients but they also make them worse by over-medicating, mixing incompatible prescriptions, and not counseling them. An example is the patient who told his doctor that he was violently allergic to Tetracycline, but the doctor didn't hear this since he was busy writing, and what he was writing was a prescription for that very drug. As a result, the patient--trusting his doctor--took the medication, ended up in respiratory failure, lost six months of work, and grew sicker than he was before he saw the doctor.
Thus, this book's purpose is to advise readers on how to protect themselves from mistakes, and how to exercise their rights. It also shows them how to become watch-dogs of the medical industry, where medical personnel are known to have abused patients, stolen from their prescription drawer, over-charged for tests, and even taken it upon themselves to determine who lives and dies. This book, then, offers step-by-step directions and recommendations, along with charts and graphs to help them.
It is these unnecessary errors in judgment and mistakes made by experts in the medical field that this book will examine and attempt to offer recommendations and solutions for. It will offer tips on what consumers can do to insure their good health, and list questions they should ask their pharmacists and doctors. It will also let them know when red flags should go up, and who to go to when a problem arises. Perhaps if by reading this book, patients become more aware of their treatment, they'll also become more prepared to take their health into their own hands.

8. Author's Credentials:

Dr. Nan DeVincent-Hayes has a background and degrees in biology and chemistry, and is a published writer in a number of different areas in over 100 magazines and newspapers, with cover stories. She has written about the inequities of organ transplants for Parade magazine (60+ million circ. and readership, Sunday newspapers), about AIDS for Redbook; effects of drinking and driving for Woman's Day (approx. 30+ million circ.); on the aging of America for Prime Times, as well as many other medical/scientific concerns for such publications as Current Health, Science Discovery, and others, including newspapers. She's also published in People magazine, US, Grit, Brides, Mature Years, Writers Digest, and so on. She has books out with New York City publishers, and currently is under negotiation with another book publisher. Her Ph.D is in writing, having graduated Summa cum laude from the University of Maryland College Park; she's also earned an M.S.Ed and an M.S. bioresearch.
Dr. Harry Bande is an experienced pharmacist who has not only owned his own business, but has also worked for a mail-order pharmacy until he could no longer endure the dangers in that industry. His supervisors at the drug mill refused to listen to his concerns for patient safety, and because he spoke out against the practice, he was fired. Bande has a Pharm. D. (doctor of pharmacy) from Duquesne University, a M.Ed in Health and Health Education, a certificate in drug and alcohol abuse, and a B.S. in pharmacy from Duquesne University. He has over forty years of pharmacy experience, and he researches and writes about the industry.

9. Sample Contents:
Enclosed are samples of the text to appear in the book. The sample chapter will serve to give an idea of the nature of the material, the author's writing style, and the focus of the book:

- Prologue
- Table of Contents
- Introduction
- Chapter One: Finding the Right Physician

NOTE:
Please keep in mind that the following sample chapter is tentative, and, though offering in-depth information, it remains incomplete since the book is now currently being written, and new or expanded information is constantly coming to the attention of the authors. Additions and deletions will be made before the final manuscript is submitted.

Prologue
Consider this:

Confusion between dilute and concentrate lidocaine killed 43 patients nationwide, and has gone unreported since the late 1970s.

Ten years ago it cost $23.00 to immunize a child; today, it's $200.00. Why the increase when the vaccines have already been researched, created, produced and marketed? In Belgium, the polio vaccine costs $.77; in England, $1.80; and in the U.S., it's $10.00. The drug Coumadin is another example; it's increased 255%+ from 1987 to 1995, and yet consumers have already paid for its costs over and over.

A new mail-order pharmacy, MedExpress, has been created to provide vitamins, nutrients, and drugs specifically for AIDS patients. This MOP doesn't fall under any governmental regulations, thus allowing mishaps to occur.

In January, 1995, Tetronicks pacemaker manufacturer finally admitted to making an inferior quality wire that killed a number of people by penetrating the heart's artery, and instantly bleeding them to death. They've since recalled the pacemaker but there's no simple and safe method from removing the wire.

Doctors and pharmacists prescribe and recommend certain drugs because drug manufacturers induce them to do so through direct cash payments, multi-million dollar grants, and other incentives.

A mix-up between potassium chloride and a dextrose solution has killed 16 people since 1987, but the problem's never been fully corrected. When erroneously administered, potassium chloride causes death within seconds.

Seeing how popular generic drugs have become (they now make up over half the 2.4 billion prescriptions written yearly), pharmaceutical manufacturers are increasing the prices, while many manufacturers are buying out other drug makers.

Copley Pharmaceutical made a big deal about notifying pharmacists to pull the bacteria-laden asthma medication, Albuterol, but patients weren't made aware of this. In its mailgram to pharmacists, Copley states: "Seriously ill persons such as those with compromised immune systems . . . may be at risk of a potentially serious infection." In May, 1997, this same huge drug firm was fined $10.65 million for defrauding the FDA for a period of over six years when they illegally cut corners on the manufacturing of four generic drugs.

In 1995, Idaho's state pharmacy board took disciplinary action against 15 pharmacists for medication errors.

A Florida hospital amputated the wrong leg of an elderly gentleman; someone hadn't checked his chart.

A Maryland lady went in for elective surgery, only to find out years later that during that surgery, her kidney was removed to give to a wealthy sheik's son who needed a transplant.

The list is endless. The above citations are only a few of thousands of cases of medical horrors surfacing--horrors that we, as consumers, are victims of. This books presents many of the medical mistakes that have happened and are ongoing by doctors, pharmacists, and hospital personnel--mistakes that easily could have been avoided. This is a book that will blow your socks off and make you wonder why we stand for it and what we can do about it.

To protect yourself from becoming a victim of medical screw-ups, to prevent your being taken advantage of by "big business," which medicine is, you need only read this book and heed its advice. It's as simple as that. No other book exists that tells you how to handle yourself in the face of nameless, domineering, and overbearing medical workers who tell you what to do without your input, and order you around simply because someone behind the scenes is dictating to them as well, and that "someone" is often a business executive and not a medical expert. When you get right down to it, the health industry is just that--a trade, a business, whose bottom line is M-O-N-E-Y. And you're the banker of that money, but a banker without any rights.
You can change that by reading this book. It might save your life, and that of your loved ones.

Table of Contents
(Below is a sampling (tentative) of what each chapter might contain:)

PART I: WORKING WITH YOUR PHYSICIAN

Chapter 1: Finding the right Physician
Among other exciting offerings here, this chapter also will providelist of traits readers should look for in getting the right doctor.

Chapter 2: What to Do at the Initial Visit
This chapter offers advice on choosing and meeting with a doctor, and offers a list of a list of questions and other materials patients should present to their doctors, along with a list of their expectations and wishes are for their medical care.

Chapter 3: Following Doctor's Orders
Here, patients are taught how to be proactive rather than reactive about their health care.

Chapter 4: Handling Medical Tests
The various tests and procedures are discussed here along with a list of issues regarding the tests the patient should discuss with his or her doctor.

Chapter 5: Taking Control
This chapter then outlines the procedure for patients to express their dissatisfaction with their medical care and how they may transfer their records and other needed materials.

Chapter 6: Firing Your Physician
Along with the above chapter, this section shows patients how to it tactfully and professionally discharge their doctor witout animosity or repercussions of insurance problems.

PART II: STAYING ALIVE IN HOSPITALS

Chapter 7: Checking Out the Hospital
This section offers techniques on how patients may protect themselves from inferior care, and examine hospital practices and dangers that may confront them.

Chapter 8: Getting Through the Admissions Process
This chapter helps consumers get through this process and discusses what records and other materials should be taken with them when being admitted.

Chapter 9: Working with Nurses, Doctors, and Technicians
This chapter presents insights on nursing care, and how patients can become active participants in that care

Chapter 10: Patient Rights in the Hospital
A list of patient rights and discussion of them is presented here, along with how patients can fight back.

Chapter 11: Transferring/Discharge Procedure
When patients feel their hospital treatment is going nowhere or they disagree with the treatment plan or a change in that plan, they have the right to discharge themselves; this chapter shows the procedure and pros/cons for doing that.

Chapter 12: Post-Hospitalization
This chapter directs patients on how to get detailed instructions at their discharge, and what to expect days after hospitalization.

PART III: CONQUERING PHARMACY DANGERS

Chapter 13: Surmounting the Perils of (MOPs)
The dangers of express or mail-order pharmacies (MOPs) are discussed in length here, along with a list of questions patients should ask about their pharmacy care.

Chapter 14: Conquering the Perils of Retail and Independent Pharmacies
This chapter explains how the typical neighborhood or independent drug stores differ from MOPs and retail or chain stores, and gives guidelines as to which is safer and why.

Chapter 15: How to Protect Yourself from Over-the- Counter Mistakes
This chapter gives a list of off-the-shelf medications that can prove

PART V: APPENDICES

This section will offer charts--which may be pull-outs--for the readers' benefit. Below is a tentative list of the types of information to be enclosed in this book.

Pull-Out Sections on rights and medication

End Matter
- Glossary
- Charts
- A lists
- Miscellany

Introduction

It's a fact that consumers are needlessly dying from negligent medical care, and from unnecessary mistakes happening in hospitals, clinics, pharmacies, and even doctors' offices. Anymore, patients have to be as savvy as their medical care-givers in order to protect themselves from those who are supposed to cure them.
It's also a fact that as medical practices expand, often with a dozen or more physicians in one company (in order to get the managed care dollars), the once-all-important, one-on-one patient-doctor contact has gone the way of the dinosaurs. And with the increase in staff comes the increase in mistakes, as care-givers lose sight of the individualism of their patients and instead see only their ailments.
Likewise, drug stores and hospitals fall into the same trap of increasing patient load, supplementing the increase with periphery medical personnel instead of trained professionals, and herding consumers in and out as fast as possible in order to see more, do more, and get more. Thus, the age-old corner drug store has now become a mail-order pharmacy (MOPs) replete with assembly line practices and mentalities. They have emerged as one of the primary culprits of poor patient care since they're not regulated by any government agency in our country. And it's even true that these same MOPs are gulping up the smaller retail and community pharmacies in one swift, smooth motion with the primary intention of forming giant drug stores that are more impersonal than the large physician corporations. Some MOPs have even taken it upon themselves to join drug manufacturing monoliths--such as Merck Pharmaceuticals consolidating with MedCo mail-order-pharmacy. This leaves patients no recourse in getting individualized care. If anything, such mergers blur the line between legal and "conflict of interest."
Equally true is that these assembly-line pharmacies in other countries are allowed to mail out drugs to American consumers without requiring doctors' prescriptions, and that some of the chemicals they mail include not only narcotics, but also FDA-unapproved drugs. And just as true is that some doctors who are educated in less demanding non-American medical schools are permitted to practice in the States, taking care of innocent and trusting consumers who often end up mutilated or dead. So who's protecting the patient--meaning YOU--in all this? Read this book and follow its advice to stay alive.
Completion of this Introduction and sample chapters can be found in the full proposal.
--- End Partial Proposal -

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