Bad nurses, bad doctors and bad seeds, Part 2: Favorite health stories of 2009

I started listing my favorite stories of the past year, in no particular order, on Dec. 21. Here is the rest of the list.

"At VA Hospital, A Rogue Cancer Unit," Walt Bogdanich, The New York Times

Bogdanich, a three-time Pulitzer winner, exposed serious failings at the Veterans Affairs hospital in Philadelphia, where the cancer unit made mistakes in 92 of 116 cancer treatments over six years and then tried to hide its mess.

The team continued implants for a year even though the equipment that measured whether patients received the proper radiation dose was broken. The radiation safety committee at the Veterans Affairs hospital knew of this problem but took no action, records show.

One patient was the Rev. Ricardo Flippin, a 21-year veteran of the Air Force. "I couldn't walk and I couldn't stand," he said, citing rectal pain so severe that he had to remain in bed for six months, losing his church job and his income.

Bogdanich posted six pages of medical records for one of the patients, showing how radioactive seeds that should have been aimed at cancer cells in his prostate instead damaged his lower bowels. And the Times worked with Thomas Jefferson University to create an animated graphic what went wrong.

The story also points the way to future stories, too. Antidote wrote in June about the Nuclear Regulatory Commission's ADAMS database and how to use it to find stories as good as the one Bogdanich found.

"Live Your Best Life Ever!" Weston Kosova and Pat Wingert, Newsweek

Kosova and Wingert knit together the health advice being spread by Oprah Winfrey's show, magazine and Web site to show how she is selling dangerous fringe treatments as cure-alls for the body and spirit. One of Oprah's guests, Suzanne Somers, is given some overdue scrutiny for the way she has used the Oprah machine to push bioidentical hormones.

Outside Oprah's world, there isn't a raging debate about replacing hormones. Somers "is simply repackaging the old, discredited idea that menopause is some kind of hormone-deficiency disease, and that restoring them will bring back youth," says Dr. Nanette Santoro, director of reproductive endocrinology at Albert Einstein College of Medicine and head of the Reproductive Medicine Clinic at Montefiore Medical Center. They just don't need as much once they get past their childbearing years. Unless a woman has significant discomfort from hot flashes-and most women don't-there is little reason to prescribe them. Most women never use them. Hormone therapy can increase a woman's risk of heart attacks, strokes, blood clots and cancer.

Antidote wrote in June about how to use this article as a "how to" for truth checking an organization, a company or a pundit.

"Ill Workers Denied Benefits Face Fight Alone," Evan George, the Los Angeles Daily Journal

George did the responsible thing when he first caught wind that employees were being denied benefits despite years of participating in disability insurance programs. He called the insurance regulators and asked how often this happened. They told him that the denials were a rarity. But he still thought something seemed fishy. The resulting investigation was an incredible top-to-bottom deconstruction of all the ways that people who find themselves disabled can be shoved out into the cold to deal with their injuries without a dime from insurers.

Curtis Walker said after suffering chest pains, shortness of breath and a sudden stroke he was left with weakness and pain which made it hard for him to return to his $100,000-a-year job as a tech specialist with Kaiser Permanente.

MetLife denied his claim outright, saying his symptoms were not stroke-related. Walker said he didn't know where to go next. His Kaiser doctors told him not to work. But his work-provided insurance said he was fine. He lost his job and with it his family's medical coverage.

Curtis wrote a letter to the California Department of Insurance asking for help.

In April 2005, he received a form letter saying his complaint against MetLife would be investigated. He says he never heard from the agency again. That's because the agency doesn't investigate complaints against the dozens of carriers who offer work-related, group disability plans in California, officials told the Daily Journal.

Disability insurance records, not surprisingly, are hard to find. The regulator wasn't helping George define the scope of the problem. They wouldn't even acknowledge the problem. So George scoured legal cases to try to come up with some hard numbers.

"When Caregivers Harm," Tracy Weber and Charles Ornstein, ProPublica/The Los Angeles Times

Sometimes investigative reporters spend so much time just digging for the data, talking victims into telling their story and trying to get the relevant agencies or companies to respond that they ignore the actual perpetrators. For ProPublica's year-long investigation into how nurses are regulated, Ornstein and Wood tracked down nurses and persuaded them to explain their behavior.

At least five employers reported Los Angeles nurse Carolyn Fay Thomas to the board for allegedly making medication errors and falsifying charts to hide her drug thefts.

And John Michael Jones racked up complaints from at least three hospitals for stealing and using drugs during work. Yet the board waited five years to revoke his license, even after he allegedly dozed off while performing CPR on a dying patient in 2002.

"I was high some of the times that I was working. Yes, I was," Jones, who denies falling asleep during CPR, said in an interview.

They have been following this line of inquiry all year, recently with a devastating investigation into temp nursing agencies. Within days of the first part story being published, Gov. Arnold Schwarzenegger replaced most of the California Board of Registered Nursing.

"Hospitals Drop the Ball on Physician Oversight," Alan Levine and Dr. Sidney Wolfe, Public Citizen

Swift action by a regulator or a governor or Congress makes for good headlines the week after an investigation, but how many reporters return to the topic years later to find out if the swift action really changed anything? In May, the advocacy group Public Citizen issued a report that reminded health writers of all the promises that have been made over the decades about the accountability and transparency of the physician discipline process.

Federal law requires hospitals to report a physician to the National Practitioner Data Bank (NPDB) whenever a hospital revokes or restricts the physician's privileges for more than 30 days for an issue involving medical competency or conduct. The NPDB opened for reporting and querying September 1, 1990. Although the NPDB has been open for nearly two decades, 49 percent of U.S. hospitals (2,845 of 5,823) have never submitted a clinical privilege sanction report on a physician; at the end of CY 2007, the NPDB contained only 11,221 adverse hospital clinical privilege reports, which is significantly below government and private sector estimates.

The NPDB was supposed to protect hospitals, and patients, from bad doctors. But it has fallen far short of its promise. Reporters across the country could take this report and use it to examine their own hospitals and how they are doing in weeding out dangerous physicians.