Sunday, February 10, 2013

The doctor who killed me

On August 11, 2011, I was given what amounts to a death sentence. I was told I had been diagnosed with pulmonary fibrosis induced by amiodarone toxicity. 

Oh, I'm still alive, although barely. The normal prognosis for pulmonary fibrosis is three to five years. I'm in early year three. It is rare for someone with pulmonary fibrosis to survive for more than five years. The months since I was diagnosed have been a living hell. Breathing becomes more difficult with each passing day. 

Pulmonary fibrosis is progressive and fatal. It kills more people annually than breast cancer. There is as yet no treatment for it.

Pulmonary fibrosis is a scarring of the tissue in the lungs. As pulmonary tissue hardens, it becomes increasingly difficult for the alveoli of the lungs to re-oxygenate blood supply. The victim eventually dies of oxygen deprivation.

The only remedy for a fibrotic lung is a lung transplant. For that, transplant centers use a one hundred-point scoring system to determine who gets transplants. People over sixty-five―that includes me, at seventy-five―seldom score high enough to get a transplant. 
How did I get pulmonary fibrosis?

In July 2010, an electrophysiologist, Dr. Stephen Prater,  in a Piedmont Heart Center group practice in Atlanta, prescribed 200 mg. daily of amiodarone for me. The purpose was to control non-life-threatening premature ventricular contractions of my heart. 

The electrophysiologist did not warn me as he should have that amiodarone can be a deadly poison. He did not follow U.S. Food and Drug Administration guidelines in prescribing the medication―the FDA says it’s to be used only in life-threatening situations, and then only as a treatment of last resort. And patients should be forewarned of the side effects of the drug.

Already by November 2010, family members were noticing the shortness of breath that had overtaken me so gradually that I didn’t recognize it.

By December 2010, when I had an annual physical with a cardiologist then at the same practice as the electrophysiologist, I complained of shortness of breath and cyanosis around my fingernails, both symptoms of amiodarone poisoning. In amiodarone poisoning, cyanosis―a blue coloration indicating oxygen deprivation in the blood―occurring around the fingernails is one of the symptoms of pulmonary disease. 

The cardiologist who saw me that day, Dr. Stuart Katz, who has since retired, didn’t connect the obvious symptoms of amiodarone poisoning with the symptoms I was displaying, although he knew I was taking amiodarone and specifically asked if the cyanosis could be due to that. 
The cardiologist took two chest x-rays as part of my physical, and the radiologist who read them noted the beginnings of interstitial lung disease―but no warning came to me of what the radiologist saw.

By January 2011, I was becoming increasingly aware of my declining lung capacity and of difficulty breathing. My wife Kathie and I began to talk to nurses who lived in our neighborhood, asking if they had any ideas of what could be causing my breathing difficulties. We still hadn't figured out that I was suffering from amiodarone poisoning. But the nurses did. Three of them―including Dr. Prater's own assistant―ganged up on the electrophysiologist in early February 2011 and told him they thought I had amiodarone poisoning. He  told his assistant to call me to tell me to stop taking the amiodarone―without any explanation of why.

When I had a follow-up appointment in the spring of 2011 with the cardiologist, and told him that the electrophysiologist had discontinued the amiodarone in February, the cardiologist went back to the radiologist’s description of my December chest x-rays and finally saw the warning about the developing interstitial lung disease―another term for idiopathic pulmonary fibrosis.

I was soon thereafter given an echocardiogram that ruled out congestive heart disease as the cause of my symptoms. The technician who administered that test told me my heart was as good as an astronaut’s. Chronic obstructive pulmonary disease (COPD) was also ruled out.

On August 11, 2011, the pulmonologist I was seeing told me that he and Dr. Prater had discussed my case and agreed that what I had was pulmonary fibrosis brought on by amiodarone toxicity.
I began seeing another Atlanta electrophysiologist after I had been diagnosed with pulmonary fibrosis. He said he would never have prescribed amiodarone in my case - and if he had, I would have received both extensive verbal warningas from him, and many pages of printed information about the dangeras lof the drug as well.

So there you are. Based on the longevity of males in my family, I should be expecting another ten  years of healthy, enjoyable life. But that is not likely now. 

I certainly won’t be the first person to die of amiodarone poisoning. There are many cases on record.

Most of us don’t know when death will come. As a result, we fail to do many things that need to be done to protect those we love and leave behind. I’ve been giving a lot of thought to the things that need to be done―to the physical things like writing a will (that’s done), and to the spiritual things like preparing the spirit for the crossing over (not completely done yet, but I’m working on it).

Noel L. Griese
Atlanta, Ga.

Another case of physician abuse

Following is an email I recently received from a follower. 



I will withhold my name for obvious reasons. I am a 56 y/o retired Coast Guard aviator (rescue swimmer, Dropmaster, Loadmaster and flight mechanic) living in Washington state and part time in remote Southeast Alaska. I write today because I tripped over your blog (thankfully) last eve when I returned from 3 days in a hospital in Puget Sound, where I was cardioverted twice in 12 hours for AFIB.  

A bit of history: We think my AFIB started 5 yrs ago when I was pulling a noxious weed called Scotch Broom from our property. The juices in the plants had turned my hands green, as I was not wearing gloves. Scotch broom has a very very powerful alkaloid that interferes with electrical signals to the heart muscle. I have yet to meet a doctor that knew this and have yet to meet one that cared when I told them. A few days later I came down with spatial disorientation, nausea, rapid and uneven heartbeat. It was eventually noticed by an anesthesiologist that recognized it as AFIB before she put me under for shoulder surgery.

Unfortunately, I picked the wrong cardiologist here on the Olympic Peninsula, and he put me on Coumadin and forgot about me for 5-6 months while my heart was remodeling and growing fibrosis. I finally wised up and started reading up on the effects of long term AFIB with tachy (34-220 bpm), switched doctors, found a electrophys that did a TEE on me and immediately cardioverted me to normal S/R. Unfortunately, damage was already done from remodeling, and recurrence is common if AFIB is not treated like the emergency that it is. There are still a lot of ill-informed practitioners out there that repeat the old saw that AFIB is not life threatening.

Since then, I have had perfect sinus rhythm except for what seems to be an annual “dumb stunt” like getting dehydrated, unknowingly taking ephedrine (cold capsule), etc. that puts me back into tachy AFIB. Don’t drink, smoke, or drug, so am pretty careful about setting it off. 

2 weeks ago I went into AFIB after accidentally hitting a galvanized bolt head with my cutting torch, causing me to get a snootful of toxic smoke. 15 minutes later I was in AFIB. I tried to get the E/P to also test me for toxic metals, because a cardioversion would be pointless if I was still toxic, as I would surely revert to AFIB. Sure enough, three days later I was back in AFIB. 

Went to a different hospital, different heart doc, and he too was uninterested in finding the causative for the AFIB, he just wanted to sell ablation and drugs. Before cardioverting me, he had them dose me up with AMIODARONE and start a drip. After two ‘HITS”, he successfully cardioverted me. They sent me home the next day (yesterday) with a scrip for AMIODARONE 200x2 per day. Absolutely NO warnings or instructions regarding this drug. Interestingly, they spent over an hour warning me about the warfarin side effects and dangers but refused to discuss AMI when asked. I knew at the time AMI was bad, but had not been near a puter so I could research it. 

What I cannot seem to find is info on how soon damage is done with this poison, and at what dose. No one at the hospital knew or cared, or they were told to clam up. Who knows. You will never hear doctors or nurses badmouth any drug. They actually claimed that Predaxa and Xeralto were being given a bad rap!

So the question begs, who do you trust? As soon as you quiz a doctor about the stuff they claim it is safe or they advise you to seek help elsewhere. I have tried to find someone with the knowledge or guts to admit this is a slippery slope and advise me of a safer drug to keep me in S/R without trying to sell ablation, which has a success rate of MAYBE 40%. The ablation doc I saw claimed 80% which in itself should be enough to scare off anyone that does their homework. 

These doctors stick together like mafioso and I will soon run out of doctors that will accept my insurance that will talk to me. They will all want to know why you left the doc before them....

In closing, I am eternally sorry for the injustice done to you. I would see him in prison if it were possible. These guys think they are God and cover each other’s backsides, and the FDA is a whore to the big drug companies. If anyone does not believe it, they can easily find proof that the big pharm lobbyists were walking through the halls of Congress handing out cash payments to the politicians we all vote for. As an aside, AMI was not approved by the FDA initially, so docs were buying it from Europe and Canada and using it. Then the manufacture of AMI told the FDA they would cut off the flow of AMI to the USA if the FDA did not approve it. 

AMIODARONE is still one of the only drugs to get the blessing of the FDA without clinical trials. I doubt AMI is even approved for long term use for prevention of recurrence of AFIB, but I cannot find it yet.

You are in our prayers and you can be sure I will pass the word and that your life and work to inform people will not be in vain.

God bless,

sign me:

Another AFIB patient stuck in the middle....

USCG ret

Saturday, February 9, 2013

A case of physician negligence?

Following is an email I received recently. My comments are in blue. Identity of the person who wrote to me is confidential.

Noel Griese
Dear Mr. Griese:

I am fifty eight years old. I've had bouts of Atrial Fibrillation and had been taking Flecainide for years. In July of 2012 I had a cryoablation procedure with the intent of curing my Afib problem. I had more Afibs after the procedure, at which time I was prescribed amiodarone. Amio is prescribed widely for afib.  Its my understandong that amiodarone is the "holy grail" for heart arrhythmia problems. When I had my first Afib my cardiologist treated me as if I were the president. Now I'm a pariah. I've read that some cardiologits wil no longer see a patient that wants to stop amiodarone.

Due to amiodarone I now experience an unusual medicine/metal smell which I can only describe as torture. Check with your doctor, but I suspect the smell is due to the iodine in the amio. I had similar problems with my breath when I was on amio I have to bury my face in a pillow at night to alleviate the smell. Just watching television is agonizing. My cardiologist said "in the decades I've been prescribing Amiodarone, I've never heard of this problem".  He told me to stop taking aspirn. That didn't work. It took my pharmacist to read the amiodarone insert and discover it can cause an unusual taste or smell. My cardiologist told me to stop taking it. I didnt know Amiodarone stays in your system for months. It stays for up to two years - although the aftereffects can last for the rest of your life.

I've had hearing problems, and my sight is not as good as it was. My ex wife pawned that off on getting older. I believe its due to amiodarone. I've not heard of amio affecting hearing, but it can definitely affect eyesight.

I'm very sorry to read of your problems due to amioderone. Thank you.  This smell is driving me crazy. I don't know if this will affect my lungs or not, or don't know how long the smell will last. I'm also afraid of the possibility my Afibs will return. Are you aware of a non toxic Afib drug that works? Sorry, I don't - but your doctor may. Please write or call me anytime.  Thank you And thank you for sharing.

Thursday, October 4, 2012

Victim of a medical mistake? Write a letter like this one!

Following is a letter I wrote and sent to Dr. Carolyn M. Clancy at the Agency for Healthcare Research and Quality.

TUCKER, GA 30084
PHONE: 770‑496-7607    FAX: 770-493‑7232

                                                                                                                        October 2, 2012

Dr. Carolyn M. Clancy
Agency for Healthcare Research and Quality
Office of Communications and Knowledge Transfer
540 Gaither Road, Suite 2000
Rockville, MD 20850

Dear Dr. Clancy:

 I read the New York Times story about your draft questionnaire requesting information about medical malpractice. If your questionnaire flyer is ready, please send one to me.

An electrophysiologist here in Atlanta gave me a death sentence when he prescribed amiodarone for me in four different violations of FDA guidelines. I didn’t have a life-threatening condition. The electrophysiologist and my pulmonologist are in agreement that amiodarone toxicity led to pulmonary fibrosis and the destruction of my lungs within five months. While pulmonary fibrosis is not a well known disease, it kills more people annually than breast cancer, according to one of the medical foundations created to help victims.

I’m a journalist by background – two degrees in English, one in journalism, Phi Beta Kappa, Phi Kappa Phi, from the University of Wisconsin. I’ve been a professor at the Universities of Wisconsin and Georgia. I’ve had 17 books published, five dealing with medical subjects. No. 18 is just about ready for release. It’s about medical malpractice and the pros and cons of using CT scans for early diagnosis of lung cancer. It also presents the case for and against the I-ELCAP research project of Dr. Claudia Henschke, who was forced out of Weill Cornell and is now affiliated with Mount Sinai Medical Center in New York.

If you would like to see more information about my case, visit the blog I set up to start publicizing book 19, which, if I’m given enough time before I die, will be about medical malpractice and amiodarone. The blog is at I’ll be adding to the base site soon as I begin writing copy for the next book.


/s/ Noel L. Griese

Noel L. Griese

Wednesday, May 9, 2012

I tell a dentist friend I'm the victim of yet another medical mistake

I have pulmonary fibrosis which doctors agree was caused by misprescription of a dangerous drug called amiodarone. In my case, the drug, which is supposed to be used only as a drug of last resort, was prescribed for a minor non-life-threatening condition. It caused pulmonary fibrosis, which is progressive and fatal. There is no treatment for PF. Following is an email I sent on May 9 to a dentists friend detailing yet another serious medical mistake.
                                                                  May 9, 2012
Barry -
I'm being infused for 28 days by an infectious disease doctor because of a strep viridans infection that was first diagnosed in late March but the lab work never reported to my personal doctor until early May. While I'm being infused is the ideal time for a dentist to work on me. That's the reason for looking for the old x-rays for comparison.
Kathie was the one pushing me to get copies of Dr. Ford's year-old x-rays that you have. I have no objections to a dentist/periodontist taking new x-rays for some that are almost a year old.
On March 21, I went to the Emergency Room at St. Joseph's Hospital in Atlanta (run now by Emory University Hospitals) on the orders of my pulmonologist. He wanted blood and urine work after I complained of chills and fever - my temperature was running from 95 to 103F.
The emergency room said that night after running the tests that there was nothing to worry about - just modestly elevated white blood counts indicating I was fighting an infection. They passed that report on to the pulmonologist next day. But then the Emergency Room at St. Joe's cultured the blood, and 3-4 days later diagnosed the strep viridans. Unfortunately, the St. Joe's Emergency Room didn't pass that on to the pulmonologist until I saw him routinely on May 1, more than a month after I'd been to the Emergency Room. I (or daughter Dawn who was with me) asked the pulmonologist on May 1 about what happened to the blood culture the Emergency Room doctor had said would be run. The pulmonologist then asked for a copy of the culture report from the Emergency Room, and on May 5 (a Saturday) the pulmonologist called to let me know about the strep diagnosis.
The problem with strep is that I have mitral valve leakage and the strep can attack heart valves. That can be fatal. The pulmonologist called me on May 5 and said he wanted me to go into the hospital immediately for treatment. I saw the infectious disease doctor on May 7. He said it would be enough for me to get an antibiotic daily for 28 days on an outpatient basis. The daily infusion treatment started on May 7, and I now have a picc line inserted in a main artery to permit the daily treatments.
This failure of the Emergency Room to report a serious diagnosis to my pulmonologist or, at the very least, to an infectious disease doctor, is just one more example of the out-of-control medical establishment in the U.S. Medical mistakes are the third leading cause of death in the U.S., after only heart disease and cancer. I'm dying of one such mistake, the misprescription of amiodarone which induced pulmonary fibrosis within five months.
Medical mistakes account for 200,000 fatalities per year in the U.S., with no progress made in reducing that number in the last 10 years. Hundreds of thousands more suffer needlessly each year because of medical mistakes. We're spending 17-18 percent of GNP in the U.S. on medical care - twice as much as any of the other developed nations. Our medical expenditures are approaching $3 trillion per year - and we're still making hundreds of thousands of medical mistakes annually. This is a dismal record!
Noel Griese
Anvil Brokers/Anvil Publishers, Inc.

Thursday, April 19, 2012

How the FDA let down America with a watered-down warning about amiodarone

This is a draft news release. Comments are welcome until it is finalized and distributed.

A highly toxic heart drug continues to be prescribed to millions of patients nationwide without the detailed consumer warnings promised by the U.S. Food and Drug Administration in 2003.

In late 2004,
the FDA required the makers of Cordarone and Pacerone, the then current brand names for amiodarone, to update their labels to include a black box with three important warnings:

1. This is a drug of last resort;
2. The drug results in 10-17 percent toxicity; and,
3. The drug results in 10 percent fatality.

Despite the fact that amiodarone kills one of 10 people who take it, the black box warnings stayed in effect for only a brief time before being watered down with less truthful labels dominated by legalese.

According to a story in the Nov. 24, 2004, Miami Herald, each dose or prescription of the drug amiodarone was supposed to include the new advisory that warned of its many risks and symptoms of fatal side effects and explained how the medication is supposed to be used. But the advisory, first discussed in October 2003, remained in draft form into late 2004, bouncing back and forth between the FDA and Wyeth,  the drug maker assigned by the FDA to write it.

The delay came in the midst of the FDA being questioned about its slowness in protecting Americans from potentially deadly drugs.

''How many people are dying right now as we speak as a result of their procrastination?'' asked Karen Muccino of Los Alamitos, Calif., whose father, John, died Feb. 20, 2004, of lung damage caused by amiodarone. Despite his training as an obstetrician, Muccino said her father never realized his dry cough was a symptom of a potentially fatal side effect of the drug.

John Muccino was taking amiodarone for atrial fibrillation, a common condition in which the heart beats out of rhythm. The FDA never approved the drug to treat that condition.

She said she was livid that the FDA did not immediately issue the patient warnings in the autumn of 2003. ''He would have been taken off the drug three months earlier and his life would have been saved,'' she said.

''What's happening with this drug goes to the heart of questions about how long it takes the FDA to act when known risks or dangers exist,'' Sen. Charles Grassley (R-Iowa) said at the time.

In October 2003, Dr. Janet Woodcock, who at the time ran the FDA's drug division, said the agency would take the rare action of requiring the advisory on all amiodarone prescriptions. Because of the dangers posed by the drug, Woodcock said the information would be written and distributed quickly, certainly by early 2004. ''Obviously this drug is a very risky drug,'' she said then.

The FDA initially approved amiodarone only for more severe disorders, and then only as a treatment of last resort. The approval was given without the drug undergoing clinical trials.

Patients taking amiodarone have for years right up to the present died from lung, thyroid and liver damage, gone blind or suffered from other side effects. The most common side effect is fatal lung damage. Yet, it is routinely prescribed for common heart rhythm problems despite the availability of safer alternatives.

According to 2004 data, doctors wrote more than two million prescriptions in a single year for atrial fibrillation and other heart conditions that amiodarone wasn't approved to treat. A Knight Ridder investigation in 2003 found that those prescriptions represented 82 percent of all the amiodarone dispensed from retail pharmacies during the 12-month period ending July 31, 2003.

In 2004, a class-action lawsuit was filed in New Jersey that accused drug makers of promoting branded versions of amiodarone for common heart ailments in an effort to boost their profits regardless of consequences for victims. The lawsuit contended that more than 1,000 people died, 100 had vision problems and thousands of others suffered severe medical complications from the branded versions of amiodarone.

U.S. drug companies initially marketed the drug under the trade names Cordarone and Pacerone. The drug rights for the Pacerone brand of amiodarone were initially held by Upsher-Smith Laboratories, and for the Cordarone brand by Wyeth-Ayerst Laboratories.

When a law firm tried to sue Wyeth in a class action, Wyeth and Upsher abandoned their brands, and the drugs went generic. The lawsuit was withdrawn. The generic drug amiodarone is now manufactured mainly in India and imported to the U.S.

By making the drug generic, the drug companies that were marketing amiodarone as Cordarone and Pacerone avoided class action litigation. The U.S. Supreme Court has ruled that the only causes of action a patient may take against a generic drug manufacturer is for a failure to warn if the generic drug does not copy the FDA-approved label exactly.

The FDA, meanwhile, had in 2003 asked Wyeth, the drug maker, to write a warning advisory for amiodarone prescriptions. Wyeth was given the job of writing the informational guide because it was the first company to sell the drug.

Wyeth spokesman Chris Garland said in 2004 that the FDA could approve the Wyeth advisory as early as December 2004.

In 2004, no one at the FDA would respond to written questions about the appropriateness of allowing a drug maker to be in charge of writing warnings that could reduce the drug’s sales, or whether the delays were excessive.

Dr. Valentin Fuster, the chairman of the American College of Cardiology's treatment guidelines committee for atrial fibrillation, said in 2004 that amiodarone shouldn't be the first drug a doctor tries when treating fibrillation. ''You don't use amiodarone as a drug for this except after everything else fails,'' he said.

Knight Ridder found that patients routinely got little information about its risks or alternative therapies. Over the years, the FDA has cited various manufacturers for downplaying the drug's risks and for promoting it as a first-line therapy.

In 2011, a Texas lawyer, Justin Williams, filed an action in which his firm first went to the FDA website looking for labeling information.  The FDA requirements for complete labeling by manufacturers were not available at the FDA site. What his firm eventually found was that manufacturers of generic amiodarone had updated their labels in 1998, 2000, and 2002, with no other updates until 2010.

Williams concluded from labels he had obtained from various victims of amiodarone poisoning and their family members that the targets in the lawsuit had failed to update their labels with appropriate warnings, so at they could be sued.

Williams filed suit and says he immediately became involved in one legal battle after another. The offshore companies making and marketing amiodarone hired one of the most aggressive, expensive and “win at all costs no matter what justice is” law firms in America.

The manufacturers produced labels from the years after the FDA required modifications after the initial black box warning. They produced labels Williams did not have from prior years that had the required warnings.

The unfortunate truth is most cardiologists and electrophysiologists who prescribe amiodarone don’t believe the watered-down warnings that come with amiodarone. They think the warnings are "just stuff the lawyers require." Many do not tell patients about the warnings and dangers because they have been bought off or brainwashed by drug companies to think the side effects will never happen to their patients.

Representative Henry  Waxman (D-Calif.) is currently trying to get a law passed to give the same rights to sue the makers of generics as victims have to sue the makers of brand name drugs.

Thursday, April 12, 2012

How the medical professionals responsible for 200,000 deaths per year are protected

It's no secret that medical mistakes are the third leading cause of deaths in the U.S., behind only heart disease and cancer. For the past decade, an estimated 200,000 Americans have died annually of medical mistakes. Hundreds of thousands more suffer needlessly because of such mistakes. There has been almost no progress made in improving on these dismal statistics.

A big part of the reason is the medical profession's penchant for protecting doctors, especially the bad ones who cause the most problems. The American Medical Association, its state affiliates and the lobbyists funded by this powerhouse have done everything in their power to protect the doctors and other medical professionals responsible for what amounts to 200,000 annual cases of manslaughter.

One of the supposed deterrents to medical malpractice are the"ethics hotlines" operated by most hospitals. Employees are supposed to call these in-house lines to report observed cases of suspected malpractice.

I recently had a procedure performed by a medical technician. To protect her identity, let's call her "Peggy."

Peggy now works at a hospital in the Atlanta area. Her prior employer was Crawford Long Hospital in Atlanta. It's a hospital that was started by a doctor named Crawford Long. Since the early 1990s, it's been the property of and operated by Emory University Hospitals. The hospital's name was recently changed from Crawford Long to Emory Midtown as part of a rebranding.

Peggy observed a case of what she considered malpractice. She saw a doctor bullying a not very knowledgeable older female patient into having an unnecessary surgery performed immediately. She called the Crawford Long ethics hotline to report the details. She was told it was a doctor-patient issue and to stay out of it. Discouraged, and fearful of losing her job, she clammed up.

That's one example of the way nurses, who often see ethical and malpractice violations by doctors, are intimidated by a now thoroughly corrupt system of healthcare. I say thoroughly corrupt because of the billing dishonesty and corruption that now goes on across the board as doctors, hospitals and charlatans who are in the business of fraud try to game or outright cheat the cumbersome  reimbursement system operated by private health care insurers and the federal Medicaid and Medicare systems.

I can speak firsthand about fatal medical mistakes. Dr. Stephen Prater, an Atlanta electrophysiologist, prescribed a drug called amiodarone for a non-life-threatening condition for me. He initially said my minor premature ventricular contractions required no treatment. When I came for a second appointment, however, during which there was no change in my condition, he decided to prescribe amiodarone "to improve my quality of life." He prescribed it without any warning of its extremely dangerous side effects, and without any baseline testing - both violations of Food & Drug Administration recommendations. Within five months my lungs were destroyed by pulmonary fibrosis, a progressive and fatal disease. The specifics are detailed in other posts on this Web site.

Nurses played a key role in persuading the electrophysiologist who put me on amiodarone that I was suffering from amiodarone poisoning. I'd suggested at a January 2011 appointment with Dr. Prater that I should be tested for amiodarone toxicity. He didn't think that necessary until three nurses ganged up on him in February. Only then did I get a phone call from his assistant saying the doctor thought I should stop the amiodarone. Turned out I had developed fatal pulmonary fibrosis from the amiodarone. Dr. Prater has never apologized for unnecessarily poisoning me. 

My freelance writer friend Randy Southerland of Atlanta observes, "There is a 'no blame' culture in medicine today. The idea is that if people are not punished for mistakes they are more likely to report them. Now some third party payers are moving toward refusing to pay for treatment for so called 'never events' - (such as) operating on the wrong body part, (or) adverse drug reactions. (There is a long list compiled since 2001.) The hospital doesn't get paid for fixing the problem and they are not allowed to bill the patient or anyone else for (such events). The result is that mistakes start to go down where there are financial consequences for making them. The same thing happens when success rates are public knowledge."

Randy's observations are valid, but I would argue that the 'no blame' culture for which AMA lobbyists have argued at great expense to the medical consumer has done little to nothing to improve a broken system. If a doctor kills someone through his or her fault, I say the way to improve the system is to litigate.