Article Misrepresented Deaton's Problems

The Sun March 2 included a story on the front page of the Maryland section headlined, "Poor Care Precedes 15 Deaths." The story concerned a report about Deaton Specialty Hospital and Home issued by the Maryland Department of Health and Mental Hygiene.

The report was critical in a number of areas, as is the purpose of this type of report. We understand we have problems in some areas, as noted in the report, and are working very hard to correct them.

We want to point out that the state has gone on record as saying that the problems noted in the report were not the cause of the patients' deaths.

We also want to emphasize that the report was very specific in stating that there was no evidence of criminal negligence or wrongdoing.

It further noted that all of the patients studied in the report were elderly and seriously ill. This is not unusual. Because of Deaton's expertise in treating seriously ill and elderly patients, the hospital often receives the sickest patients from its referral sources.

We do take offense that the headline and some of the bulleted items in the story that deal with patient care broadly assume and insinuate that the care at Deaton Hospital is poor and that, as a result, patients died.

This is not true. It is also an incorrect assumption that supposed lapses in care allowed patients to worsen and for them to suffer. This is also not true.

* Example: The article states that a 76-year-old woman was given a drug to which she was allergic. The woman later suffered respiratory distress and died. The implication was that she died as a result of an allergic reaction.

The fact is: The patient had been at Deaton for a number of months. She had previously been transferred to another hospital for three days for treatment of pneumonia.

Upon her readmission to Deaton, the family told the physician she had an "allergic" reaction to a certain sedative. The admitting physician at Deaton found that the reaction described was an expected effect from the sedative and was not an allergic reaction.

The woman was very ill and did finally succumb to respiratory failure. She did not die from an allergic reaction.

* Example: The story states that a 74-year-old stroke patient received no diagnosis or treatment for 17 straight days for rectal bleeding. The story says that he was then rushed to an acute care facility, where he died, and that doctors there found a rectal tumor.

The implication is that Deaton did not provide treatment, misdiagnosed a rectal tumor and the patient died.

The fact is: The rectal bleeding was known and closely monitored. The patient was also known to have diabetes, high blood pressure, vascular disease, a recent massive stroke and was unable to breathe on his own.

The testing required to evaluate the bleeding could have been quite risky considering the patient's problems. Cautious monitoring of the problem was not making the patient any more ill than he already was.

The patient was eventually transferred to an acute care hospital because of a sudden change in his vital signs. We now know that he had blood poisoning from his kidneys, which is not unusual in such an ill patient. At the acute care hospital, evaluation showed a bleeding hemorrhoid, not a rectal tumor as was reported.

* Example: The article describes a 72-year-old patient whose bed sore was allowed to worsen for two months. A week before he died, one sore grew so deep that the bone in his heel became visible. The implication is that the patient was ignored, suffered needlessly and died.

The fact is: Deaton takes care of very sick patients who often have a number of serious medical body system problems.

The hospital has a special wound management program to work with patients who are admitted with serious decubitus ulcers and sores that are often quite large and quite deep.

The wound certainly was not allowed to worsen. In fact, there was active treatment to try to repair the wound.

However, as some of the body systems began to shut down and death neared, the patient's skin system also began to fail and would not respond to treatment. The patient was not ignored.

* Example: The article told of an 88-year-old man found dead with cool skin. The story reported that the patient was supposed to be checked every hour, but the last documented check was eight hours earlier. The implication is that the man was not checked for eight hours, so long that he was cold and had possibly died as a result.

The fact is: The man was found dead with cool skin. Cool skin in an 88-year-old patient with serious multiple system problems is not unusual even if the patient is alive.

The implication is the man had not been checked for so long that he was dead and cold.

This was not the case. Deaton uses a procedure that puts a check sheet on patient doors. The sheets from the doors are then reviewed and a single summary entry is made in the patient's chart.

In this case the patient was checked at least every hour, usually more often. The problem arose because when state officials reviewed this case, they noted that the check-off sheets were not part of the permanent record.

We argued that as long as the sheets are reviewed and summarized in the permanent record, their inclusion is unnecessary. We will now change our procedure. The point is, the patient was monitored appropriately and received excellent care.

Finally, it should be noted that when being surveyed by the Joint Commission for Accreditation last year, Deaton requested to be reviewed under the much more strict guidelines used for an acute care hospital rather than as a nursing home.

The hospital did receive its accreditation following that review. Three areas were conditional, required extra work and needed to be re-examined by the commission. In February and March of this year, the commission came back to review the hospital on two of these issues. The hospital passed with flying colors.

The final issue is scheduled to be reviewed in late March. The hospital looks forward to a successful review in that area also.

For over 20 years, Deaton Specialty Hospital has filled an important and underserved niche between acute hospitals and nursing homes.

Most of our patients have serious problems with multiple body systems involved. Many are elderly.

While we do have some problems, and are working hard to correct them, our overall provision of care is excellent. We will continue to provide that high level of quality for which we are known.

Noel E. Kroncke

Baltimore

The writer is president of Deaton Specialty Hospital and Home.

Who Will Test the Test-Makers?

"Schools far from 'satisfactory,' " screams your Feb. 17 headline. "Officials say tests are in shakedown stage," whispers the subtitle.

Those two should be reversed, for it is extremely important that before they accept scores at face value, John and Jane Q. Parent know that the measurement instrument itself is faulty.

Any teacher will tell you that it is virtually impossible to design a test question which will be interpreted in the same way by every child, but some of the "challenges" on the state tests have been unbelievable.

Our do-it-now governor insisted that we test statewide before piloting the tests, and the results were predictable.

It's hard to imagine that the test-creators had ever spent an hour in a classroom.

Now legendary are the directions for an hour-long test activity that began, "Look out your window and based upon what you see . . ." A small oversight here is that there are no windows in many air-conditioned schools.

Teachers were not to open instructions until they were ready to deliver them orally to students, and so there was no time to plan adjustments.

And ask your local school about the scoring. Try to find out why it makes sense that even though some schools include special education students and others do not, all students are tested and all scores averaged into results that are compared side-by-side.

While you're there, ask the teachers of those special ed students what the testing days do to the fragile confidence that has taken years to build -- when we know ahead of time that the children won't be able even to understand the test directions. Talk about a set-up! And for what purpose?

That's what the students are asking, too. It didn't take long for fifth graders to learn that there were no individual scores -- the school is graded as a whole -- and to decide that if their efforts weren't going to help middle school placement there was no need to knock themselves out trying. Many just stopped working.

How long do you suppose it took the middle school and high school students to reach the same conclusion?

And wouldn't it be interesting to know why, when there are state tests, and private schools and parochial schools are state-accredited, only the public schools are held accountable for attaining the state's standards?

When the tests were introduced, a very perceptive principal pointed out that their purpose was for our schools to show progress by the year 2000. If there were successes at the beginning, it would be difficult to show dramatic improvement.

It is no secret that the curriculum is test-driven, and this assessment required a totally different approach to teaching than had been in place previously -- even to the point that topics usually covered in the sixth grade were included on the fifth grade tests.

So we were all set up -- and it continues every time the media trumpets the "obvious failure" of the schools.

Test scores are a ready-made topic for attention-grabbing headlines. You know that the reverberations will last for weeks, and -- like talk show hosts -- controversy is what keeps people coming back.

It doesn't seem too much to ask you to give your readers credit for some independent judgment, and furnish the whole picture -- including questions about the tests and the test-makers.

Barbara Kines

Lutherville

Cheap Shots against Farrakhan

This response is to the attention of Gregory P. Kane, the editorial board of the Baltimore Sun and the community at large.

On March 11, on the Opinion * Commentary page of The Sun, Mr. Kane wrote a column entitled, "Questions for Farrakhan."

Not only was this column sloppily researched and poorly written, was a disrespectful representation of the theology, history and good works of the Nation of Islam.

It suggests that Mr. Kane has some personal ax to grind with Minister Louis Farrakhan. Whatever the reason, his diatribe is rife with falsehoods and innuendo. . . .

Minister Farrakhan has never said or implied that he is the sole arbiter of black "racial loyalty." It is, however, natural that the masses of our people, Muslim and non-Muslim alike, look for principle, courage and, yes, loyalty to our interests in others who aspire to leadership.

Mr. Kane was very wrong and irreverent in taking cheap shots at our faith by invoking the image of the Most Hon. Elijah Muhammad on a "spaceship." Minister Farrakhan has never taught us any such thing.

How dare Mr. Kane insult and mock the tenets of our religious faith. He would not question Christians on their belief that the Jesus of 2,000 years ago is still alive; why make mockery of our belief concerning Mr. Muhammad?

The writer goes on to say that Minister Farrakhan "snitched" on Minister Malcolm X in 1962. To whom? About what?

Shadowy language and baseless accusations of this kind make up the bulk of this harangue. Mr. Kane asks if Minister Farrakhan "delivered Malcolm to his enemies in Chicago." What enemies? Mayor Daley? Sam Giancana? George Halas? He never says, but when innuendo is the currency in which one trades, one never does specify, does one?

Minister Farrakhan has never been involved in any conspiracy, plot or scheme concerning Minister Malcolm's death.

Like many of Messenger Muhammad's sincere and dedicated followers, Minister Farrakhan was deeply hurt and disappointed at Malcolm's treachery against his teacher. That hurt guided his pen in December 1964, as he wrote that Malcolm was "worthy of death."

Only a fool or a fiend would persist in the incorrect idea that the Muslims would kill Malcolm at our own hand.

We believe in the same powerful God who brought apostates and heretics to his own bar of justice in his own good time throughout history.

The Nation of Islam is a blessing to America. We work with communities which have known wholesale neglect and abuse, and bring forth new life by God's power. The leadership of Minister Farrakhan is valid, right and proper.

To attack such a good man and such good work in such an outrageous way is at least poor judgment and at most a mean-spirited, purposeful departure from right and propriety.

In any case, substantial damage has been done to the credibility of The Sun in Baltimore's black community . . .

Minister Jamil Muhammad

Baltimore

The writer is the Baltimore representative of the Nation of Islam.

Appalled at Welfare

The article "Welfare reform replaces food stamps with cash" (March 8) was very enlightening. As a Maryland resident it's nice to know that a portion of my monthly salary goes to welfare recipients to spend any way they desire.

Drugs, alcohol, cigarettes and lottery tickets have been suggested as ways my money is spent. As a productive member of society, I am appalled at the way our elected officials run this program.

Kurt S. Willem

Hydes

Fighting Crime

In his Feb. 27 column, Michael Olesker expressed concern that it may soon be impossible to find an impartial jury as everyone in the Baltimore area is being affected too closely by some semblance of the crimes which they are asked to judge.

I would tell him not to lose too much sleep over it. When everyone in this community is finally touched by crime, maybe then we'll start to be more serious in taking care of the problem.

Our society has become barbarous due to the docile nature of our court system. When we have a jury that after hearing facts can emotionally stand up and say, "Send that criminal to jail and throw away the key," maybe then the criminals will finally get the point.

After all, America has embraced the concept of innocence until proven guilty -- but isn't it a little ironic that we can then bring the "innocent" to trial. It's an important philosophical dilemma.

If we really want to have any impact on crime in our city, we've got to start taking a harder stand on offensive crimes and devote less resources to "personal" criminals, such as the non-dealing drug users.

While I don't expect the tenets of the criminal justice system to change much, all eyes are on the mayor and the new police chief to mirror the public sentiment and start making our streets and homes safe.

Lonnie Fisher

Baltimore

Crab Grass

Looking at the front page of The Sun March 11, I was struck by the absurdity of our priorities in this city.

In the right-hand columns was an article about the residents of Park Heights meeting with the new police commissioner and telling him the horrors of living in their neighborhood.

In the left-hand columns was an article about the city's plan to spend millions of dollars to redo the grass in the Inner Harbor in the shape of a crab. Get real.

Margaret Steiner

Baltimore

First Lawyer

I applaud Tim Baker's March 14 column on the financial cost of running for attorney general. Clearly, the skill for raising money does not reflect the capability to be Maryland's first lawyer.

However, Mr. Baker's suggestion to put the candidate on a political ticket is most unfortunate and is a sad commentary on voters who too often mindlessly vote for an incumbent.

The only way a challenger can break this bad habit is to get attention with slick TV spots that merchandize the candidate's qualifications.

When this tactic determines an election, everybody loses.

However, I think Tim Baker misses the point. He laments that a nice guy like Joe Curran should be subjected to the rigors of raising money, implying that Mr. Curran should be able to stay in elective office as long as he wishes and escape challenge by well-heeled candidates.

Mr. Curran might very well be the best guy for the job. However, good lawyering is achieved by the infusion of new ideas, perspectives and priorities. The one thing that the attorney general's office does not need is institutional memory.

The lawyer who represents the people of Maryland should be creative, courageous and articulate. We shouldn't need expensive campaigns that depend on high-tech sound bites for voters to decide which candidate will best serve them.

Rachel S. Levy

Baltimore

KAL Cartoon about Cows Called Distorted

The March 9 cartoon by KAL depicting cows which are distorted presumably as the result of receiving bovine somatotropin (bST) shows a blatant disregard for the truth.

It also does a great disservice to our agricultural and scientific communities and ultimately to the American consumer.

After years of extensive testing and undue delays, the Food and Drug Administration recently approved the use of synthetic bST.

Bovine somatotropin is a natural hormone which is normally found in milk at trace levels.

When bST is given to lactating dairy cows, milk production can be increased 10 to 30 percent, allowing dairy farmers to produce milk more efficiently. The milk from cows receiving bST is indistinguishable from the milk from cows not receiving bST.

Bovine somatotropin is a new and safe tool for increasing milk production. However, a vocal minority had adamantly opposed the approval of this product. KAL's cartoon supports their unfounded opposition.

The cartoon indicates that other western nations won't approve its use. That European politicians have yielded to animal rightist and other environmental extremist groups is no reason for the United States to do the same.

Furthermore, since when was it this country's goal to lower our food production and raise our food prices to European levels?

KAL's cartoon claims that there is a question of a link between bST and cancer.

The mainstream scientific community regards this claim against bST as ludicrous. Claims of carcinogenesis are, of course, a popular ploy with groups attempting to block new technology by raising fears about that technology.

KAL's final point against bST is the existence of a milk surplus. The ability of American agriculture to produce an abundant supply of food cannot be used as an argument to abandon new technologies which further this productivity.

If this were the case, advances in agriculture would have ended decades ago.

The use of bST may result in the normal consequences of a technological advance in a competitive market -- increased supply and decreased prices.

This potential decrease in prices is why many dairymen wish this advance had not become available at this time.

However, banning safe technology for political or economic reasons is a dangerous message to send to the industries which invest millions in the research and development of new products.

Thomas W. Powel

Union Bridge