Welcome to the latest edition of Investigative Roundup, highlighting some of the best investigative reporting on healthcare each week.
Nurse Unhooked COVID Patient's Oxygen
A nurse disconnected oxygen from an Indiana nursing home resident after days of aggressive oxygen therapy for COVID-19, according to a report by the .
Acting without a doctor's order and without informing the family, the nurse later wrote on social media: "I just want y'all to know the hardest thing I've ever done in 28 years start a patient on O2 for 4 days 12 LPM. with a non-rebreather mask...I asked him on day 4 if he's tired he said yes I said do you want me to take all this off for you and let you go and fly with the angels and he said yes ... I took it all off of him I went in the hallway and I cried and I let him go and he passed away ... after I left."
At the time, Indiana was facing down its worst surge of COVID-19 cases. The incident occurred at Wedgewood Healthcare Center, one of the hardest-hit nursing homes in southern Indiana, with a total staffing rating in the bottom 15% nationally, according to the paper.
The nurse told inspectors that she had been having a "terrible" week when she removed the patient's oxygen. She had been caring for over 40 COVID patients and forgot to contact the doctor, she said.
After a state health inspection, the nursing home was cited for several violations, including abuse and neglect. Indiana's attorney general is now investigating and the nurse could face criminal charges.
Hospitals Use Sneaky Code to Hide Prices
Hundreds of hospitals have embedded code in their websites that hides their federally mandated price transparency lists from search engines,
As part of a new federal transparency rule, hospitals are required to show prices that they negotiate with insurers, and display these prices prominently on their website. Computer experts say the code is sometimes used during webpage development, and usually removed later. While prices may still be accessible with the code in place, it can take clicking through multiple webpages to get to them, the paper reported.
"It's one thing not to optimize your site for searchability, it's another thing to tag it so it can't be searched. It's a clear indication of intentionality," Chirag Shah, of the University of Washington, told the Journal.
Reporters examined over 3,100 sites, including those belonging to the biggest healthcare systems and largest hospitals in the U.S. They found 164 pages that used the blocking code for data covering 307 hospitals. "The code was removed from pages with data for 182 hospitals after the Journal contacted their owners," the newspaper added.
Some hospitals said they didn't know why it was there in the first place. Others said it was a "legacy code," or that it was an error.
HIV Surge in West Virginia 'Tip of Iceberg'
Cases of HIV tied to intravenous drug use are soaring in West Virginia, a health emergency intimately connected with the state's opioid crisis, according to .
From 2014 to 2019, the percentage of HIV cases stemming from injection drug use jumped from 12.5% to 64.2%, the AP found.
Demetre Daskalakis, MD, chief of HIV prevention at the CDC, said that the outbreak of HIV cases in West Virginia's Kanawha County is "the most concerning in the United States." Because many cases may be undiagnosed, the current case count could be the "tip of the iceberg."
Cases are centered mostly around the cities of Charleston (the state capital) and Huntington, and began surging after a 2018 needle exchange program was cancelled. Opponents of such "harm reduction" programs complain that they don't stop drug abuse, although research shows that they do prevent secondary health problems and may bring some users into addiction treatment. (In Indiana, an HIV outbreak tied to injection drug use in 2015 was brought under control only after then-Gov. Mike Pence reluctantly agreed to allow needle exchanges.) Meanwhile, COVID-19 has undermined efforts to test for hepatitis, HIV, and sexually transmitted infections.
In Charleston, the nonprofit Solutions Oriented Addiction Response has stepped in by providing clean needles and information about HIV testing. As COVID cases fall, health officials in West Virginia say they plan to ramp up outreach for both HIV and coronavirus prevention in hard-to-reach populations such as the homeless. But a tough bill recently passed in the West Virginia Senate could shut down needle exchange programs.