Indiana Injury Lawyers Blog

The month of April is Distracted Driving Awareness Month, according to the National Safety Council. The problem of distracted driving is no longer a new issue. Each day, an average of more than nine people are killed and more than 1,060 injured in crashes caused by distracted driving, according to the CDC. You may think teenage drivers are the culprit, but you might be surprised by the recent findings of a recent survey conducted by AT&T.

Almost half of all adults admit to texting or emailing while driving, compared to 43% of teenagers. More than 98% of adults admit they knew it's wrong. Six in 10 say they weren't doing it three years ago. These are staggering numbers. "Texting while driving I not just a teen problem," says John Ulczcki of the National Safety Council. "Teens text. But you're looking at around 10 million teen drivers, but about 180 million other adult drivers." That's a lot of people are the roadways driving distracted.

A text message (sent or received) takes a driver's eyes off the road for an average of 4.6 seconds--about as long as it takes to drive the length of a football field at 55 mph, according to researchers at Virginia Tech Transportation Institute.

AT&T urges individuals to join the effort and help build awareness by making a personal commitment and joining their Texting & Driving...it can wait campaign.

Sources:
http://www.nsc.org/safety_road/Distracted_Driving/Pages/DDAM.aspx
http://www.distraction.gov/
http://www.att.com/gen/press-room?pid=2964
http://www.usatoday.com/story/news/nation/2013/03/28/adults-worse-than-teens-about-texting-behind-wheel/2026331/

Clinical Specialties of Martinez, GA., has received reports of eye infections among patients who used the drug to treat macular degeneration, a common vision disorder in seniors.

The Georgia-based compounding pharmacy is recalling 40 lots of the Roche drug Avastin that was distributed to doctors' offices in Georgia, Louisiana, South Carolina and Indiana since December 18, 2012.

Age-related macular degeneration is the most common cause of blindness among older Americans, affecting about 2 million people in the U.S. over age 50. The condition causes new blood vessels to grow in the eye and leak blood and fluid, damaging the retina and distorting vision.

The FDA has stepped up inspections of compounding pharmacies after a fungal meningitis outbreak last year was tied to the New England Compounding Center in Framingham, Massachusetts. The tainted steroid has killed 50 people and sickened more than 720 across the nation. Since the discovery last September, NECC has shut down.

This week, Margaret A. Hamburg, M.D., Commissioner of the Food and Drug Administration wrote in the FDA blog, "I firmly believe that new legislation is necessary to help FDA effectively oversee firms engaged in widespread distribution of sterile compounded drug products in advance of or without receiving a prescription." Dr. Hamburg continued on to say, "Protection Americans from unsafe and contaminated drugs is not just an important responsibility for FDA--it is part of our core mission."

People who have received these recalled drugs should consult with a physician as soon as possible. If you've been injured by the product you should contact a product liability or personal injury attorney to discuss your legal rights. You could be compensated for your injuries.

Kids in Danger (KID) recently released their annual report on children's product recalls from the previous year. Overall, there were 97 children's product recalls. The last time there were fewer than 100 children's product recalls was 2004. In 2012, the number of children's product recalls dropped by 20% but the number of incidents (up 49%), injuries (up 42%) and deaths (up 200%) associated with those products drastically rose over the year.

Findings of the report include:

• 31% of the recalls were for nursery products bought to be used with the most vulnerable consumers--infants and toddlers.

• One Product, the Flexible Flyer Swing Set, had 1,232 reported incidents before consumers were alerted to the dangers through the recall.

• Eight children and one adult died prior to the recall of these products.

• One of the most deadly products, the Nap Nanny and Chill Infant Recliner by Baby Matters, were not recalled by the manufacturer, but by retailers who stepped up to offer refunds to consumers.

• Sleep environment products continue to pose a significant hazard, with 7 deaths associated with these products.

KID recommends that parents check the products used with their children at SaferProducts.gov for recalls and injury reports and sign up for safety updates at KidsInDanger.org. If you or a loved one has been injured due to a defective product, you may be eligible to receive compensation under Indiana law. We advise you to speak with a knowledgeable personal injury attorney in evaluating your possible claim.

In recent years there has been increasing attention on concussions and brain injuries among athletes at all levels. Currently, more than 4,000 former players are suing the National Football League in federal court, alleging the league ignored and denied the link between football and brain damage. More recently, Junior Seau's family was informed last week that Seau's brain had tested positive for Chronic Traumatic Encephalopathy. Seau was a linebacker in the NFL for 20 years and committed suicide in May of 2011, just two years after his retirement.

Since the 1920s, CTE has been known to affect boxers. It was not discovered in football players until 2005, when researchers at Boston University confirmed 50 cases of CTE in former football players, including 33 who played in the National Football League.

CTE is common in athletes because of the repetitive brain trauma, including concussions as well as asymptomatic subconcussive hits to the head. CTE is a progressive degenerative disease of the brain. The frequent head trauma triggers progressive degeneration of the brain tissue and the build-up of an abnormal protein called tau.

Individuals with CTE may show symptoms of dementia, memory loss, aggression, confusion, and depression. These symptoms may appear within months of the trauma or many decades later.

Source: http://espn.go.com/espn/otl/story/_/id/8830344/study-junior-seau-brain-shows-chronic-brain-damage-found-other-nfl-football-players

Source: http://www.bu.edu/cste/about/what-is-cte/

We recently read an article about a lucky individual who decided to make homemade fireworks. We say lucky because he and his wife escaped without injury, but the same can't be said about their home.

According to the article, fire crews responded to an explosion inside a home in rural Huntington County, Indiana. The owner confirmed he was making fireworks in the home. The owner and his wife were both home at the time of the explosion but were not hurt. A small fire started but was put out by the owner.

Although the owner and his wife escaped injury, the home suffered major damage. The owner confirmed damage in every room, including the walls, floors, and roof. The explosion was so destructive the foundation of the home was cracked and the entire house is reportedly a total loss.

There's only a little bit of good news with this story; there are no injuries. However, this could have been a catastrophic disaster. Reading this article reminded us of the article we wrote last year for the Fourth of July.

Sources: http://www.wishtv.com/dpp/news/unusual-explosion-knocks-home-off-foundation1357748125067

If you have children, chances are you've been to a party with bounce houses to occupy the kids (and some adults). Bounce houses are considered safer trampolines since they have walls and are more forgiving. Most bounce houses also have a net door to eliminate the possibility of falling out.

Bounce houses are generally constructed of strong PVC and nylon then inflated with an electric blowing machine. In the U.S., cheaper varieties made of polyester are banned. In the states of Pennsylvania and New Jersey, it's mandatory that bounce houses pass both engineering and safety standards before they are rented out.

According to a new study published in the journal Pediatrics, bounce house injuries are on the rise. More than 11,300 children were treated for bounce house related injuries in 2010. The authors from the Center for Injury Research and Policy at Nationwide Children's Hospital in Columbus, OH say that "equals a child every 46 minutes nationally."

A majority of the injuries were fractures, sprains and strains, followed by injuries to the head, neck, and face. The most common cause of injury was falling, followed by colliding with other jumpers. These injuries are similar to trampoline injuries.
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In addition to the most common causes of injuries, there's an increase in number of injuries occurring because the bounce houses aren't properly anchored to the ground. In June 2011, strong winds lifted three bounce houses off the ground at a youth soccer tournament in New York, injuring 13 children.

Here are safety tips for bounce houses that should help ensure that you have a good experience:

• Ensure the operator places a tarp down to protect the bottom of the house and that the bounce house is weighed down with weights or sandbags.
• After the house has been inflated, check to see that there are no holes, rips, or punctures of any kind.
• If applicable, make sure lawn sprinklers are turned off.
• Place the bounce house in an area that has grass so that there is no chance of the bounce house being ripped or punctured by stones or gravel.
• Always have adult supervision when children are playing in the bounce house.
• Recommended age for children is four years or older.
• Group kids according to their size so the risk of injury is minimized. Also, abide by the maximum capacity regulations for the specific house.
• If there are strong winds, do not use the bounce house.
• Keep pets away from the bounce house so they don't puncture the unit with their teeth or claws.

The cause of a deadly explosion on the South Side of Indianapolis on Saturday, November 10th is still under investigation. Public Safety Director, Troy Riggs said Monday morning that the suspected cause of the explosion is natural gas. Citizens Energy Group has been conducting test and checking gas lines for possible leaks.

The explosion occurred in the Richmond Hill subdivision sometime after 11pm on November 10th. The subdivision consists of 126 homes and Marc Lotter, spokesman for Indianapolis Mayor Greg Ballard, told the Los Angeles Times that "most" of the homes incurred some kind of damage. Police have blocked off the entrances and only those who live in the subdivision are allowed in. While the investigation continues, most residents have been allowed back into their homes to gather belongings.

A Greenwood Schools teacher and her husband are believed to have died in the blast. Seven others were injured, five homes destroyed and 80 were damaged. Thirty-one of those homes may need to be demolished.

Deputy Code Enforcement Director Adam Collins estimated the damage at $3.6 million.

Source:
http://www.wthr.com/story/20067901/source-of-indianapolis-explosion-still-unknown

http://abcnews.go.com/US/wireStory/indiana-blast-investigation-focuses-natural-gas-17696038#.UKKjH4dlFKI

A deadly fungal meningitis outbreak that was linked to spinal steroid injections contaminated at a Massachusetts compounding facility has some lawmakers calling for increased federal oversight over pharmacies and other compounding facilities. Deborah Autor, Deputy Regulatory Commissioner at the nation's Food and Drug Administration (FDA), said it is often difficult to determine exactly where the agency's authority lies with regard to the regulation of specialty pharmacies. In response to the fungal meningitis outbreak, some members of Congress have stated they intend to introduce legislation that would provide the FDA with greater authority over compounding pharmacies.

Compounding facilities are specialized pharmacies that create custom drugs based on the needs of individual patients. Such facilities alter the dosage, physical form, ingredients, and other drug properties on an as needed basis. Compounding facilities also provide pharmaceuticals that are not normally available commercially to doctors and medical facilities. The industry reportedly includes approximately 7,500 pharmacies that generate as much as $3 billion in revenue per year. Still, drugs created at a compounding facility are not subject to FDA review before they reach patients.

All pharmacies are regulated by a state board. When the FDA was created in 1938, the agency was only provided with authority over drug manufacturers. Not long after, pharmaceuticals created by drug manufacturers became the primary producers of prescription medications. In the 1990s, however, the number of compounding pharmacies throughout the nation purportedly began to increase. Over time, many compounding facilities stopped creating drugs for individual patients and began to create large quantities of pharmaceutical products for commercial sale. Regulators for the FDA reportedly began to examine the pharmacies more closely in order to determine whether the facilities were simply engaging in unregulated drug manufacturing. Still, several attempts made by lawmakers to extend the FDA's regulatory authority were unsuccessful.

The recent fungal meningitis outbreak is not the first time compounding pharmacies have been accused of injuring patients with contaminated drugs. In 2005, two individuals were allegedly blinded by a drug created at a compounding facility. Three people were reportedly killed in both 2005 and 2006 by compounded drugs. In early 2012, 33 patients in seven states came down with eye infections after using drugs that were purportedly created at a compounding pharmacy.

Investigators from the Centers for Disease Control and Prevention (CDC) have linked the fungal meningitis outbreak to the New England Compounding Center (NECC) located in Framingham, Massachusetts. Since the outbreak began, at least 200 people in 14 states developed the rare disease and 15 people have died as a result of infection. Many compounding pharmacy experts believe NECC no longer operates as a compounding facility and has crossed the line into the unauthorized manufacture of drugs. In 2006, the FDA issued a warning letter to the company for selling a drug for general distribution instead of based on individual patient prescriptions. Still, the agency failed to re-inspect NECC's facility.

According to FDA officials, the agency faces a number of challenges in regulating compounding facilities. The International Academy of Compounding Pharmacists has reportedly spent at least $1 million over the last ten years to defeat Congressional measures aimed at federal regulation of compounding facilities. Additionally, portions of a 1997 law that tasked the FDA with compounding facility oversight in limited instances were ruled unconstitutional by the United States Supreme Court. A 2003 attempt to create an FDA advisory committee focused on compounding pharmacy oversight was also allegedly thwarted.

Still, according to former Chief Counsel for the FDA, Sheldon Bradshaw, the FDA has sufficient authority to regulate facilities like NECC. Bradshaw stated he was shocked by the claims of some FDA officials that the agency lacks authority to act against the compounding facility. It will be interesting to see whether the FDA is tasked with additional regulatory powers with regard to pharmacies and other compounding facilities in the future.

Continue reading "FDA Regulatory Authority Over Compounding Pharmacies is Unclear In Indiana, Throughout Nation" »

A recent fungal meningitis outbreak has infected at least 170 people in 11 states. The death toll from the outbreak that has reportedly been linked to spinal steroid injections compounded at the New England Compounding Center (NECC) in Framingham, Massachusetts currently stands at 14. According to the nation's Centers for Disease Control and Prevention (CDC), as many as 14,000 patients in 23 states may have received a contaminated steroid injection. NECC has reportedly stopped all of its manufacturing processes and recalled all of the company's products, including three batches of allegedly tainted steroid injections sent to 75 medical facilities.

Fungal meningitis is a rare infection that can cause the membranes which surround the brain and spinal cord to swell. Although other forms of meningitis are contagious, fungal meningitis cannot be transmitted from one person to another. In order to become infected, a person must have the fungus injected into their central nervous system. Symptoms of infection may include fever, muscle weakness, light sensitivity, headaches, back pain, and a stiff neck. The incubation period for fungal meningitis is normally one to four weeks. Still, the CDC has stated patients may have begun receiving contaminated injections as early as May 21, 2012.

The exact cause of the fungal meningitis outbreak is currently under investigation by the CDC, United States Food and Drug Administration (FDA), and the Massachusetts Department of Public Health. Investigators have reportedly linked the current outbreak to a preservative-free steroid, methylprednisolone acetate, commonly used to relieve back pain. At least 50 vials of the drug have allegedly tested positive for the fungus.

NECC and other compounding facilities are used to alter a drug manufacturer's product in an effort to meet the needs of each specific patient. The facilities often change the dosage or physical form of a drug. They also commonly provide drugs that are not commercially available. Compounding facilities are reportedly popular with small clinics and private medical practices because they offer a more affordable alternative to purchasing large quantities of drugs from the manufacturer. Although the FDA oversees pharmaceutical drug manufacturers in the U.S., it apparently does not have equivalent regulation authority over drug compounders.

In the State of Indiana, at least six health care facilities dispensed steroid injections from the three batches of drugs that are suspected of being contaminated with fungal meningitis. State health officials have asked clinics and other health care providers who used the products to warn patients who may have received the allegedly contaminated injections of the potential risks. Additionally, at least one patient who was injected with a contaminated shot at an Indiana health care facility has died.

Continue reading "Fungal Meningitis Outbreak Linked to Spinal Steroid Shots Administered in Indiana, Nationwide" »

The Ford Motor Company is recalling half a million Ford Escape SUVs. The recall is due to problems with the accelerator pedal sticking. Ford issued a recall after an accident claimed the life of an Arizona teenager who was unable to stop her Ford Escape SUV.

The Escape recall affects models manufactured from 2001-2004 with the 3-liter, V-6 engine with cruise control. In total, 484,600 vehicles have been recalled due to this problem. The accelerators speed control cables could become stuck on an engine cover when the pedal is almost fully depressed.

In total, the U.S. National Highway Traffic Safety Administration received 99 complaints about the problem, including 13 crashes, 9 injuries, and one death.

Recently, Ford has had several recalls involving the Escape SUV. A week ago, Ford recalled 11,500 of the new 2013 models with 1.6-liter engines because the fuel lines can crack and leak gasoline, causing fires. A few days before that recall, Ford recalled 10,000 2013 Escapes to fix carpet padding that could interfere with braking.

More than 2.1 million Ford Escapes have been sold, making it one of Ford's most popular vehicles since it went on sale in 2000.

If you own a Ford Escape SUV, click here to see if your vehicle has been affected by the recent recalls.

A recent report published in the Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report found that injuries and deaths related to motorcycle crashes were significantly reduced by the use of motorcycle helmets. According to the report, motorcyclists accounted for 14 percent of all traffic fatalities across the nation in 2010 despite that motorcycles traveled less than one percent of all vehicle miles driven. The report authors also stated the most effective way to raise the rate of helmet use is to adopt a universal motorcycle helmet law that requires all drivers and passengers to wear a helmet whenever traveling on a motorcycle.

The report authors examined data from the National Highway Traffic Safety Administration regarding fatal traffic crashes throughout the nation between 2008 and 2010. Next, they compared motorcycle crash data with economic information regarding the estimated cost savings related to wearing a motorcycle helmet. According to the report, motorcycle helmet use saved about $3 billion across the nation in 2010. The authors stated, however, that an additional $1.4 billion would have been saved if everyone riding on a motorcycle in 2010 was wearing a helmet.

According to the report, helmet use in states with a universal helmet law saved an average of $725 in medical and productivity costs per registered motorcycle. In states without such a law, helmet use reportedly saved an average of $198 per registered motorcycle. The authors stated the cost savings from helmet use ranged from about $1,627 per registered motorcycle in North Carolina to $48 in New Mexico. According to the report, 23 of the 25 states that fell below the median helmet use cost savings of $286 were either partial helmet law states such as Indiana, or states without a helmet law.

Between 2008 and 2010, 14,283 people were killed in motorcycle crashes throughout the United States. 42 percent of those killed were not wearing a protective helmet at the time of the accident. In the 20 states with a universal helmet law, only about 12 percent of those killed in a motorcycle crash were not wearing a helmet. In states with a partial helmet law that requires only a specific subset of the population to wear a protective helmet while riding on a motorcycle, approximately 64 percent of those killed in a motorcycle crash in 2010 were not wearing a helmet. In those states without a helmet law, about 79 percent of people who died in a traffic accident while riding a motorcycle in 2010 were not wearing a helmet.

Motorcycle crashes in Indiana are often caused by another driver's negligence or inattention. Due to the limited protection provided by a motorcycle, the injuries sustained in an Indiana motorcycle accident are often catastrophic or fatal.

What do you think? Should the State of Indiana pass a universal motorcycle helmet law?

Continue reading "CDC Report Suggests Helmet Laws Save Lives and Money in Indiana, Nationwide" »

We recently read an interesting article by Steven Jefferson at WTHR.com about an Indiana State Police Department initiative to crack down on traffic violators.

Steven writes about the initiative and the approach used by the Indiana State Police Department to find aggressive drivers who are breaking the law. Steven says...

"The aggressive driver campaign involves motorcycle officers, air patrols in a helicopter and other police cars you might not recognize."

Steven goes on to say...

"Trooper Justin Hobbs' pickup has a fake Indiana Department of Transportation sticker so the speeding drivers paid us no attention on Wednesday's ride-along."

Summer months are popular times for family vacations and long weekend trips. With an increase in traffic and motorcycles on the roadways, it's never a bad time to crack down on aggressive drivers and those committing safety violations.

Construction zones are more common during the warmer months. Most construction zones have a 45 MPH speed limit with speeders' fines being doubled.

The Indiana State Police is hoping to slow down the number of traffic deaths with this recent initiative, specifically in rural areas. They're not just looking for speeders, but those following too close, changing lanes without properly signaling and driving too fast for weather conditions.

We applaud the ISP's efforts and hope this new initiative helps catch aggressive drivers whose reckless driving may endanger others.

Warm weather has arrived and summer vacation season is well underway. Basking in the warm glow of the sun can make us feel great, and in the short term, make us look good. In the long term, over-exposure to ultraviolet rays damages the fibers in the skin. Effects of sun exposure put us at higher risk of cellular damage, age spots, early wrinkling and skin cancer.

The summer season is a great reminder to use sunscreen whenever outdoors, but protection from UV radiation is important all year round.

We recently read an article about a 69-year-old man who spent the last 28 years as a truck driver. Since the man spent countless daylight hours behind the wheel and over exposure to damaging UV rays, the left side of his face looks decades older than the right side. The name for his condition is unilateral dermatoheliosis (one-sided photo aging). Even with the window closed, UVA rays can penetrate window glass if it's not tinted enough to protect passengers inside the vehicle.

The previous example is just a reminder that UV rays can reflect off of surfaces like water and glass. Harmful UV rays can also reach you on cloudy and hazy days.

The Centers for Disease Control and Prevention recommends easy options for protection from UV radiation:

• Seek shade, especially between 10:00am--3:00pm.

• Wear clothing to protect exposed skin. If you can see light through a fabric, UV rays can get through, too. Be aware that covering up doesn't block out all UV rays.

• Wear a hat with a wide brim to shade the face, head, ears and neck.

• Wear sunglasses that wrap around and block as close to 100% of both UVA and UVB rays.

• Use sunscreen with sun protective factor (SPF) 15 or higher. The American Academy of Dermatology recommends products with a SPF of at least 30.

• Avoid indoor tanning.

The sun's UV rays can damage your skin in as little as 15 minutes. Apply sunscreen before going outside, even on slightly cloudy days, and reapply if you stay outside for more than two hours.

If you'd like more information on skin cancer, risk factors and prevention, please visit the Centers for Disease Control and Prevention's website.

If you live in Indiana you should know texting while driving was made illegal as of July 2010. We even wrote an e-newsletter all about the topic and the specific language in the law. You should also know that if you caused an accident while texting, you could be liable for damages. However, what about the person who's texting you? Can they also be held liable?

This week, a New Jersey judge ruled a teenager who texted her boyfriend could not be held responsible for an accident he caused while reading the text message that she sent.

David and Linda Kuber lost parts of their legs during a 2009 crash in New Jersey, after 19-year-old Kyle Best sideswiped their car when driving while texting. However, Kyle wasn't typing or sending a text. He was reading a text message sent from his girlfriend, Shannon Colonna. Shannon knew Kyle was on his way home from work and driving. Kuber's attorney is saying, "She wasn't physically in the car, she was electronically present. She and he were assisting each other in a violation of the law."

There's no precedent for a lot of legal areas in the Digital Age.

The Kuber's attorney is using the word "assisting" when making his argument; similar to aiding and abetting. For example, the man who knowingly holds the door open during a bank robbery is just as likely to be convicted of bank robbery as the safe cracker.

Judge David Rand said, "Drivers are bombarded with all forms of distractions. I find that there was no aiding, abetting here in the legal sense. I find it is unreasonable to impose a duty upon the defendant in this case under these facts. Were I to extend this duty, in my judgment, any form of distraction could potentially serve as basis of a liability case."

David and Linda Kuber plan to appeal the decision once the lawsuit against the driver has been decided.

This may not be the end of the issue. The Court of Appeals could overturn the decision of the trial court. Other states' courts could also come to a different conclusion. What do you think about holding drivers who text while driving responsible for the injuries they cause to others? What about the sender of the text message?

Recently, CBS News came out with some pretty amazing statistics about the wide disparity in costs for a common surgical procedure across the country. For the appendectomy, a common and often performed operation, one would expect to pay virtually the same price regardless of what part of the country the surgery was done. Not so, according to the following report, which was included in the journal Archives of Internal Medicine on Monday, April 23, 2012. Surprisingly, the findings in this report were very similar to those results from a study conducted in 66 United States and Canada hospitals, which indicated a wide disparity in charges depending on geographic location.

In a California study funded by the Robert Wood Johnson Foundation, it was revealed that the average cost of the procedure was around $33,000 but the extremes ranged from under $2,000 to more than $180,000. As would be expected, the lowest price charged a patient for the surgery was in a rural northern California town and the highest bill was for a lady who had the procedure in technology rich Silicon Valley. The patients, both female, had essentially the same number of preoperative studies done, had the type of surgical procedure and were only in the hospital for one day. The only significant difference was that the lady who had the surgery done in Silicon Valley was said to have been a cancer patient, although there was no indication of any cancer related treatment provided to her during the one day hospital stay. In the overall study, the cost disparity seemed to be related to two things, the health of the particular patient and the place where they had the appendectomy done. Those who were older with other medical problems such as diabetes, heart conditions, high blood pressure or lung issues necessitated additional workup and longer stays in the hospital than others. The other disparity was simply venue.

Data for the overall study was gathered from California hospitals for 19,368 appendectomy patients in 2009. Comparisons were made only for patients between the ages of 18 and 59, whose procedure was a standard appendectomy requiring a hospitalization of less than four days. This billing data included the hospital room, operating room, the surgical procedure, surgical supplies, other tests and medications. Examiners looked at the gross billing to the patients, prior to any health insurance company write-offs or payments, and did not have access to what the hospital actually was paid. Since the data looked at did not reveal whether any patient was covered by health insurance, the total gross billing was the amount owed to the medical care facility if they were uninsured and even under the best of circumstances hospital patients may still owe some portion of the billed amount even if they have insurance. Charges were determined to be the highest at profit oriented hospital facilities and non-profit hospitals, with the lowest charges seen at county facilities.

The results were that some disparities could be rationalized but clearly there was no rationale for one third of the cost differences. According to the International Federation of Health Plans, the average price for an appendectomy should be around $28,000.

Dr. Renee Hsia with the University of California, San Francisco, said "there's no method to the madness" and "there's no system at all to determine what is a rational price for this condition or this procedure", suggesting that the system itself was broken. Her idea is that people are not able to hospital shop when the need arises, since medical care facilities don't advertise their services and the related costs. Another physician with Dartmouth College's Center for Health Policy Research, Dr. David Goodman, deemed the findings of the study to be "very concerning." Also weighing in one the findings was Caroline Steinberg, with the American Hospital Association, who said that two people having the same procedure done in the same hospital at the same time would receive the same bill, since the real variation is where the operation is done and the hospital's costs in providing the services. Interestingly, some other countries control wide fluctuations in the costs of medical care by governmental intervention, whereas the United States favors more competition between medical care facilities. Dr. Howard Brody from the University of Texas Medical Branch in Galveston, Texas, a long time opponent of spiraling medical costs, said that unfortunately "the laws of supply and demand do not work well on health care."