Doc’s Private Island for Sale; Opioid Settlement Deciders; Dialysis Silent Killer

Welcome to the latest edition of Investigative Roundup, highlighting some of the best investigative reporting on healthcare each week.

Gastroenterologist in Paradise

In the 1970s, the chief of gastroenterology at what is now the Robert Wood Johnson University Hospital Somerset in New Jersey bought an island off the Florida Keys for $25,000. It’s now on the market for $16.5 million, according to the Philadelphia Inquirer.

When Klaus Meckeler, MD, first saw the island, it was a pile of coral rock jutting out of the water with a moat dug around it. This was the work of the previous owner, who had planned to house monkeys for research there, but never did.

Meckeler hired contractors to level the island, lay a foundation, and build a house, which was completed in 1979. His family often took vacations there.

The next family to own it — they purchased it in 1995 for $750,000 — replaced the original solar array, added wind power, central air conditioning, and a desalination plant that can make 1,000 gallons of fresh water a day.

After substantial renovations to the 1.4-acre island, including new solar and wind power systems and a pool, it’s back on the market.

Meckeler, who died in 2008, was born and studied medicine in Germany. He was one of the first physicians to examine bile and pancreatic ducts with specialized endoscopes, according to the article. But ultimately, his son told the paper that his father “was a romantic.”

Opioid Settlement Deciders

As states receive $50 billion in settlement money from companies that made or sold epidemic-fueling opioids, they are assembling councils that will help decide how to spend those dollars. But the process of choosing council members has been contentious, according to KFF Health News.

Council members can range from healthcare providers to harm reduction specialists, from city government officials to law enforcement — and, somewhat less frequently, people with direct lived experience of addiction. Various stakeholders have different ideas about restitution for victims of the opioid epidemic and how the money should be spent.

For example, people who staff syringe exchanges might want more funding for their services, while police officers might want more squad cars and equipment, KFF Health News reported. There are also concerns that loading these councils with members of certain professional groups (such as treatment programs, hospital executives, or police) might lead to an allocation of funds that favors their interests.

For some councils that have already been assembled, members do not represent the racial makeup or geography of the state’s hardest-hit groups. There’s an all-white council in Louisiana, and one in New Jersey has little representation from the rural areas that had the highest overdose death rates.

Some councils have the final say on the allocation of the restitution funds, while others are advisory.

Deadly Dialysis Complication

About 500,000 Americans living with kidney failure need dialysis to clean their blood, usually multiple times a week. But every week about one will die from a preventable complication called venous needle dislodgement, according to KFF Health News. When the needle pumping clean blood back into their body falls out of an arm, patients can be drained of blood and die in minutes.

Nieltje Gedney was doing home dialysis in bed when her needle dropped out, and she applied pressure before losing too much blood, but, she told KFF Health News, “It was a bloodbath.”

A solution is available to dialysis companies and makers of dialysis machines: a patch that detects blood loss and an alarm with an automatic shut-off — but they aren’t covered by Medicare.

As more patients turn to home dialysis, experts and patient advocates worry that needle dislodgement will happen more frequently as patients sleep, or are left to apply pressure and shut off the machine themselves after losing too much blood.

There are no good data on how often these venous dislodgements happen, but a 2012 survey reported 76% of 1,100 dialysis nurses had witnessed one in the previous 5 years. One dialysis machine maker told KFF Health News they believe the dislodgements happen more often in clinical settings because staffers monitor many patients who are “frequently sleeping under blankets.”

A bill introduced by two U.S. representatives called the “Home Dialysis Risk Prevention Act” would extend Medicare coverage to alarms and related supplies for home dialysis patients.