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Rare disease, fraud, or clerical error?

Many thanks to Jay Hancock for his interesting article about the Justice Department accusing Kernan Hospital of fraud in presenting a diagnosis of kwashiorkor in the billing for a number of patients ("Feds charge fraud in Kernan diagnoses," Nov. 8). I find it hard to believe that any medical personnel would be so stupid as to bill for patients with a wildly unlikely diagnosis of kwashiorkor. It seems more likely that a billing clerk entered an erroneous ICD (international classification of disease) code by mistake.

Mr. Hancock is correct in pointing this out as "evidence of a flawed medical system."

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Incidentally, I had the pleasure of knowing Dr. Cicely D. Williams who first described kwashiorkor on the Gold Coast (now Ghana) in the early 1900s.

Dr. Timothy Baker, Baltimore

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The writer is professor of international health at the Johns Hopkins Bloomberg School of Public Health.

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