Report: Health care regulator often fails

CHICAGO -- The nation's most influential health care regulator often gives its seal of approval to medical centers riddled with life-threatening problems, according to a published report.

The Chicago Tribune investigation also found that the Joint Commission on Accreditation of Healthcare Organizations underreports patient deaths from infections and hospital errors.

The Oakbrook Terrace, Ill.-based commission is empowered by Congress to ensure the quality and safety of hospitals. It touts its surveys as an assurance that hospitals are clean, adequately staffed and provide superior care.

But the Tribune report found the commission often fails in its role. Among the findings:

Less than 1 percent of hospitals failed to receive accreditation from the commission in the past 17 years, and some hospitals received accreditation scores in the midst of public health crises.

For example, Palm Beach Gardens Medical Center in Florida retained its high ranking even after federal public health investigators found that its patients were in "immediate jeopardy" because of infection-control deficiencies.

Hospital inspection dates are announced up to three months in advance, giving medical centers time to upgrade conditions. The commission also allows hospitals to choose the patient files that will be reviewed by inspectors.

The commission uses a voluntary reporting system that underestimates the number of avoidable patient deaths.

For example, the organization documented just 12 cases of preventable hospital-borne infections since 1995. The Tribune, using other sources, found about 75,000 such deaths in one year.

Commission officials acknowledged flaws in the survey process.

"We have missed things," said Dr. Dennis O'Leary, commission president. "These are fallible systems."

But O'Leary also defended the commission, saying its methods have helped it earn hospital officials' trust and cooperation.

Marin volunteers seek cause of high cancer rates

SAN RAFAEL, Calif. -- Women living in wealthy Marin County, just north of San Francisco, suffer one of the nation's highest breast cancer rates, a cluster that has confounded health officials.

On Saturday, about 2,000 volunteers went door-to-door through the county asking questions that could help point to an answer: How many residents have cancer, where do they live and do they have any idea why rates have climbed so high?

"My hope now is that everybody realizes that as a community we can change our statistics," said Judi Shils, founder of the Marin County Cancer Project.

According to the Berkeley-based Northern California Cancer Center, white women living in Marin County are 45 percent more likely to develop breast cancer than women elsewhere in the country. A study the center released in July found cancer rates in Marin increased 37 percent during the 1990s -- even as they remained flat in the rest of the San Francisco Bay area and California's other urban counties.

The researchers focused on white, non-Hispanic women because fewer than 10 cases of breast cancer are found each year in Hispanics, blacks or other populations in Marin County, which is 80 percent white.

On Saturday, volunteers asked women residents a series of questions, ranging from age to family cancer history and whether they could identify any environmental factors that might contribute to the cancer rate.

Hospital may have sought favors for prescribing drug

BOSTON -- A hospital apparently agreed to continue prescribing an expensive prostate cancer drug as long as its manufacturer agreed to pay for, among other things, a Christmas dinner and golf tournaments.

According to the federal grand jury testimony of a former TAP Pharmaceuticals sales representative, the chairman of the urology department at Lahey Clinic once asked for a $2,000 grant for a clinic holiday party to be held at a fancy Boston restaurant.

TAP reached an $885-million settlement with the government last year to resolve federal allegations that the company inflated the price of Lupron, a drug used to treat prostate cancer.

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