Going down the tubes…

I have today for you a perfect example of the wretched state our health and safety have come to when we grow to DEPEND on governmental regulation to defend us from all risks and hazards. Thanks to @EllenRichter on Twitter for sharing this article from the New York Times. I’m sure Ellen does not agree with my take on it. Oh well.

U.S. Inaction Lets Look-Alike Tubes Kill Patients

Right off the bat, I have to blow my whistle on the bald-faced editorializing right there in the headline! Oh my gosh, it’s our nasty government’s fault that hundreds of helpless patients have been killed or harmed through its unconscionable failure to further regulate the medical device manufacturers. No. No. No. The federal government should have no role in this matter. The FDA (or as the Times refers to it, the F.D.A. — they must have gotten a R.E.A.L.L.Y. good deal on periods and need to find ways to use them up!), born in the Progressive orgy of a century ago, produces more bureaucratic red tape than measurable benefit and has for decades. Yet, over the years, companies who fall under its jurisdiction have come to rely on it to tell them what to do and what not to do. The FDA has become an overprotective nanny for an entire industry, a significant portion of our economy and one that touches millions of lives. But guess what? The industry is all grown up now. It should not need a nanny anymore!

What’s worse, the companies bawl, they remain paralyzed from acting to fix the problem because US regulators, state regulators, foreign regulators, and international standards regulators can’t agree on which regulations to issue. They say they can’t win, so to a large degree they do nothing, and people continue to get enteral feedings infused into their veins unnecessarily.

Of course the tubes should be manufactured and made available in a way such that a tube feeding or a blood pressure cuff can never be connected to an IV or a tracheostomy. In a true free market, the companies that make the safer products will get the business, and the ones who lag will lose. This is even though the latter’s wares will likely be cheaper. Why? No responsible hospital risk manager will approve a purchase of inexpensive devices that have a demonstrable risk of causing harm and multi-million dollar lawsuits. And hospitals with irresponsible risk managers, or with risk managers who aren’t part of the device approval process, deserve every lawsuit that results from their behavior.

But the deeper the state injects itself into the market, the less free it becomes. Thus, free market rules no longer apply. Entire industries become dependent on the state pencil-pushers to tell them how they may and may not do business. And, unfortunately, it is difficult to get the genie back into the bottle.

I grieve for those harmed by this issue, I empathize with their loved ones, I have seen how easily it can happen, and every quarter I make a special point of telling my students how vigilant they need to be in reducing the risk. Just remember, everyone: a hospital will never be risk-free. The question is, who is in the best position to mitigate the risk. I say, NOT THE NANNY!


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