Wow! Friday's post went off the charts. In retrospect, our readers quickly went off topic regarding SpineArt's product portfolio and decided to battle over sterile versus unsterile implants. With the addition of Fat Bastard, El, and their followers, there were some inane and unrealistic comments made about potential infections arising from using implants that do not come pre-packaged sterile. Eventually, implants such as pedicle screws, end caps, rods, cross-connectors, offsets, cervical plates, and cervical screws will came in sterile packaging. This will definitely provide companies with the rationale to increase the cost of delivering their products to the hospitals, while providing an impetus to further lower your commissions. Whether this makes one bit of difference in a customer or hospital opting to use your product will be irrelevant. Until state laws are passed similar to the old spore testing laws, it will be business as usual. Who has the best implant complimented by the sexiest instruments in an organized and efficiently laid out tray will always be the winner.
So let's clarify some things for the general public. First off, contrary to many of the comments posted on Friday and Saturday, no one is dying from spine surgery because implants do not come pre- packaged sterile. It is ridiculous to argue that point. The standard protocol at nearly every hospital in the country is that instruments and implants must arrive no later than 48 hours prior to any surgery. If you can't deliver them within 48 hours, you're not getting the business. Are there occasional exceptions? Yes. But rarely does this get by the OR Gestapo. Not only are implants washed thoroughly upon arrival in Central Services, they are sterilized by a highly trained staff at extremely high temperatures. If Fat Bastard went into a Sauna at 270 degrees he probably would have to change his moniker to Fried Bastard. Nosocomial infections which are fungal or bacteria related rarely have occurred because of spinal fusion. Can anyone cite an actual case that was a by product of pedicle screws? These types of infections usually occur when the staff does not take precautionary measures such as washing their hand to minimize passing bacteria from one patient to another. The patient is usually at risk because of a low immune system.
But as one of our contributors cited, if hospitals mandate that spinal implants come pre-packaged sterile, should we then mandate that instruments come pre-packaged sterile? Where does it stop? Could that be another money maker? C'mon people, get serious. How many more hoops do you want the industry and its reps to jump through? Now you have to have an annual TB test, most people have been inoculated for Hep B, everyone has to take that ridiculous OR protocol screening on RapeTrax, you have to have knowledge on what to do if there is an electrical fire, and there is a minimum as to how many people can actually be in the OR at most hospitals. So before we get off on a tangent TSB needs to keep things in perspective. If our readers wanted a new version of Beavis and Butthead, well, we got a taste of it the last few days.
Fat Bastard: "Hey El, you know I'd like to kiss my derriere"
El: "FatBastard why would you want to kiss your derriere?"
Fat Bastard: "Cause I wanna see what my bunghole looks like."
El: "Be careful Fat Bastard because you might get polio in your holio"
And then we wonder why people make fun of our industry?
No vendors in my area deliver sets 48 hours in advance. They deliver 15 trays at Midnight for a 7:15 case. Let's be honest , we are running sets last minute for cases everyday because our company never has enough inventory.
ReplyDeleteHospitals used to sterilize everything and switch because of cost and safety. I think that coupled with UDI's sterile implants are the future. Depuy, SpineArt or any other company offering sterile implants reduce the workload on the hospital which is what they want. Once a hospital realizes they can sterilize to trays on instruments instead of 8 trays of implants and instruments they will drive the market to sterile pre-packed just like every other product in the hospital.
As far as being more expensive I believe the opposite is true. By packaging implants sterile the company can eliminate hundreds of trays reducing overhead and shipping. It may actually save our industry and get companies back in the black.
I was in an AP spine fusion back in the day, long before XLIF and we had to spin the patient on the Jackson table....sure do miss that fun! Anyway I digress, the alert scrub tech piped up just as we were closing the anterior portion that he noticed the indicator in the packaged bone graft material we had just implanted showed the implant was NOT, in fact sterile! We irrigated and pulse lavaged for 20 minutes, then closed, then crossed our fingers. Everything went fine and no infections!!
ReplyDeleteSorry El and Fat Bastard....maybe there really is a God!?!?
When I was a kid I recall the family doctor sterilizing his syringes in an auto clave. He knew that his needle were clean. I am not comfortable with pre packaged equipment. I don't trust the industry.
DeleteGlaxoSmithKline had been selling contaminated drugs for over 10 years. They covered it up. J&J has had many recalls for contamination.
There was a Chinese syringe scandal.
The Pronvonost Protocol should be the law. Jail should be the punishment.
The company should have been sued for letting that leave their distribution center. Also, a lot of allografts are not technically sterile so they don't say sterile anywhere on the packaging. They will only say sterile if the product is treated with gamma or electron beam. Many tissue banks won't use radiation because they feel is kills off proteins needed for bone growth. I have seen that fire drill before and it was exactly that.
ReplyDeleteYup, vast majority of bone is not sterile. Look at MTF.
DeleteSo are these "sterile implants" being stored in a controlled environment at the hospital or tossed in the reps trunk? Hmmmm...
ReplyDeleteRep thinking: “Wrong size doc?” “You open it, you buy it – CHA CHING!”
Depuy doesn't charge if an implant is opened and not used.
DeleteHospital has been talking to my docs about gain-sharing. They'll measure twice before opening that sterile pack. Anyone have hospitals in gain-sharing relationships with the docs?
ReplyDeleteWhere is this hospital? Gain sharing is an excellent counter to POD proliferation.
DeleteThe only hospital requiring 48 hour advanced delivery is the VA, which is ironic because that is the most filthy building I have ever been in.
ReplyDeleteIn reality VA hospitals and military are far cleaner than civilian hospitals. Unlike civilian hospitals military hospitals are subject to inspections.
DeleteHere are the facts: http://medicalholocaust.blogspot.com/2012/05/hospital-infection-rates-military-vs.html
Now you know the truth.
I don't give a damn about inspections, I know a clean building when I see it, and the VA in my town is not clean. And that is not the only issue with VA's. Its a shame that the VA system is the best we can do for our vets. I would pay higher taxes to get them all private insurance and dismantle the VA's. And that is making a statement because otherwise I abhor higher taxes.
DeleteHow can someone who blogs all day really know any facts? Because you read something on another blog? I'm going to work now, why don't you go walk thru your local VA and report back to me, you could use the exercise.
I read your link you freaking moron. That study compares a single general army hospital, not the VA system. The other link on that page looking at hospital acquired infections was a biased take on the subject, disputing the data put out by the CDC. Your version of the truth is scary. Go outside and get some fresh air today. Later!
Delete2 Morons said, "AnonymousJune 12, 2012 4:33 AM
DeleteI don't give a damn about inspections, I know a clean building when I see it, and the VA in my town is not clean. And that is not the only issue with VA's. Its a shame that the VA system is the best we can do for our vets. I would pay higher taxes to get them all private insurance and dismantle the VA's. And that is making a statement because otherwise I abhor higher taxes.
How can someone who blogs all day really know any facts? Because you read something on another blog? I'm going to work now, why don't you go walk thru your local VA and report back to me, you could use the exercise.
AnonymousJune 12, 2012 4:42 AM
I read your link you freaking moron. That study compares a single general army hospital, not the VA system. The other link on that page looking at hospital acquired infections was a biased take on the subject, disputing the data put out by the CDC. Your version of the truth is scary. Go outside and get some fresh air today. Later!"
____________________________________________________________________________________________________________________
I do care about inspections. We inspect cars, restaurants, air travel, mines, ect.. but we do not inspect hospitals and only 27 states require that the report infections and you you are an asshole.
Check out the overhead costs for private insurance vs Medicare then report back with a link liar.
Here is want a google search revealed about infection rates in VA Hospitals. https://www.google.com/search?q=infection+rates+va+hospitals&ie=utf-8&oe=utf-8&aq=t&rls=org.mozilla:en-US:official&client=firefox-a
They are declining while civilian infections rates are climbing. How do you like them apples LIAR?
I didn't say hospitals don't get inspected, I said I don't give a damn about an inspection if I can see with my own eyes what a shit hole our VA is. And I also pointed out that your "source" was not a comparison to a VA, but an Army Hospital, one army hospital. It was not a comparison of VA's to civilian hospitals as you claimed, liar.
DeleteAgain, your ignorance of the numbers you read becomes obvious when you try to claim that private insurers have more overhead than Medicare. What is overhead in an insurance company? The simplified answer is the percentage of costs used to manage the company that are not used to pay benefits. So there are 2 ways to lower the overhead percentage, lower the overhead cost OR RAISE THE AMOUNT YOU PAY IN BENEFITS. Since MC mostly covers those over 65 and covers them until death, and since 50% of all medical costs are incurred in the last 6 months of life, MC payments are huge compared to private insurance so their overhead percentage is lower. It might also be a factor that the IRS does their collection, the OIG investigates their fraud, they do not have to market or compete and there is no pre admission certification process so those factors play a huge role in overhead percentages. They should probably spend some overhead on fraud prevention because the MC system is rife with it, and every penny paid to a fraudulent claim makes their overhead percent go down even more. Private insurers have to pay taxes. Medicare doesn't even count many of its own employees as overhead. Medicare also has the ability to simply borrow (increase the deficit) if they run out of money unlike a private company that has to borrow and actually pay it back with interest. That interest counts as overhead while the deficit borrowing by MC lowers the overhead percentage.
The fact is that the percentages don't tell the truth unless you have some knowledge. On a per patient basis, Medicare spends MORE in admin costs which is the real comparison, but the huge amount of beneficiary payout makes the percentage lower than private insurance overhead percentage. Thats damn shitty considering the facts in the above paragraph.
http://www.forbes.com/sites/aroy/2011/06/30/the-myth-of-medicares-low-administrative-costs/
I don't really think you are a liar, you are just too stupid to understand what you're saying.
There is know why for the surgeon to know if something is sterile unless he sterilizes it himself. You can stick your head in your butt about surgical infection rates or you can be honest. There is an epidemic of surgical infection and if you don't know it you should know it. Now you do know it. http://www.kevinmd.com/blog/2011/03/high-rate-surgical-site-infections-ssis-nations-hospitals.html
ReplyDeleteMSM your head is wood
You are not doing what you should
Wouldn't do it if he could
Stop doing more harm than good.
You are part of an industry that maims and kills more Americans than all of our wars combined. You are part of the medical industry. What you do is exploit human suffering for obscene profits. Then like the weasels you industry vultures are you snipe at all the other vultures.
There will come a time sooner than later when the ruling class gets its comeuppance. You are probably a low level wise ass bean counter. What you ought to do if if you care about people you'd hook up with a qui tam lawyer and nail the slime ball who employs you. Me, if I had your inside info I'd torch their McMansions and shoot them as they ran out. Since the gvt won't enforce the law it's up to the people to do so.
Soon you will know someone who was killed of maimed by the medical industry. If you have a heart and it's family that gets MRSA or dies from a blunder you will want your pound of flesh.
If you read my other blogs you will find out that I am not fat but I am a bastard -- kinda like the Inglorious Basterds and my best buddy is kinda like the Bear Jew.
I checked out the link on this post too you freaking moron. There are 10 comments by surgeons on this post, all of them state the writer is a dumb ass like you. He claims proper hand washing would help in colorectal surgical site infections! Morons unite!!!
DeleteFat Bastard, you need to get some better data and you won't find it on blogs, including this one.
Should we cower when you pontificate FB?
DeleteThe NIH, CDC, Johns Hopkins, JAMA US Surgeon General and the WHO are my sources. Your source is your ass. Simply Google Death by Medicine
DeleteYou industry hacks are out numbered. There will be retribution and justice. Count on it. Treason is still a crime.
You haven't linked any of your bullshit claims to those sources. All of your sources are blogs, which are inherently biased, and some of them made baseless disagreements with the CDC without backing any of their disagreements up with a fact or a source. You are a rebel without a clue. You don't even know the definition of treason or you wouldn't have used it on a blog full of spine vendors.
DeleteFrom this point forward, you posts will be considered entertainment. People who work and make a living being entertained by misinformed, misguided, underperforming, overly confident Gen Yers posting on subjects they know nothing about in between games of Mortal Combat.
I took your suggestion and googled "Death By Medicine" and the 5th result was a simple explanation of the faulty logic used by the authors and people like you who look at numbers you don't understand and then think you are an authority. Check it out http://www.sciencebasedmedicine.org/index.php/death-by-medicine/
Fat Bastard how long have you been living under a rock, all of a sudden you find this blog and now we can't get rid of your non-sense. You have the IQ of the little boy sitting on the porch in the movie Deliverance, oh I forgot that's Scott Walker.
ReplyDeleteDo you ever worry that you industry hacks might kill or maim the wrong person and that their family might hunt you down and kill you? That day is coming. The 99% and the Oath Takers are learning the alarming truth.
DeleteYour definition of "truth" is probably the most alarming thing about you and your agitated band of internet fact followers. You are pathetic sitting around on a computer all day searching for conspiracy theories and talking smack while you do NOTHING. You have neither the mental or physical ability to muster any action, constructive or destructive. You are nothing but a punk with a mouse in your hand. Too scared to go out into the real world and have any effect on it. The dash on your tombstone will stand for NOTHING.
Delete@ Bastard Hunter
ReplyDeleteActually I use a laptop and I am a sumo wrestler. I could kill you easily and enjoyably and legally if you would like to meet me.
The CDC, Surgeon General, AMA, NIH, WHO, back up everything on Medical Holocaust. I don't deal in theory, I deal in facts. You have to attack the messenger you filthy RethugliCON because you can't discredit the message. Facts are facts you right wing scumbag and the day is coming when you thugs will be dragged into the streets and killed. That's what happens to tyrants. 75% of my readers would like to see you medical industry thugs face a firing squad. I would serve on that firing squad and I would use a BB gun on you punks.
The truth I post about you thugs is exposing the medical industry and inspiring patriots and victims to vanquish you greedy terrorists. There are more of us than there are of you. Prison terms for you thugs certainly will beat the alternative. I hear Club Fed is not that bad.
I cross post to militia and oath taker sites. I am also gun enthusiast and I present my articles, philosophy and ideas to other gun enthusiasts and everything I say is protected speech so if some guy whose wife is killed by the medical industry seeks some some do it yourself justice the truth I present may have been the source of his inspiration.
The 2nd amendment puts teeth in the 1st amendment.
I am not a punk with a mouse in my hand. You on the other hand are a mouse with a dick in your hands.
Congrats... you just got PWNED by Mr Fat Bastard, champion for patients and victims of the Medical Holocaust.
As I said, your ignorant rants are entertaining to those of us in the real world. Your threats are the most entertaining part since you are on an anonymous blog and no one can find you or vice versa. Thanks for the chuckles.
ReplyDeleteThe surgeon general backs up medical holocaust, that's too much! Hahahaha
I don't threaten. These are predictions. The ruling class will be exterminated.
ReplyDeleteThe information on Medical Holocaust is all sourced. Stop by and prove any of it wrong liar. I don't censor.
Google Death by Medicine
You medical industry slime are in deep shit. Anger and outrage is building. Oppression breeds violence.
Stop by Medical Holocaust loser.
I'm pretty sure you threatened to kill me. I'm still quaking.
DeleteI checked out Medical Holocaust and it is indeed a loser. A blog with a bunch of other peoples research reposted by some jackass named Fat Bastard. Thanks for sharing your reliable sources.
You are a tool.
Good luck with that. The "Opressed" will never fight because they are too stupid and lazy to do anything. You reference the 99% but 99.9% of the 99% want nothing to do with the movement. If you want to do some good run for office and make a difference.
ReplyDelete