We actually do all sorts of things in an unapproved manner in pediatrics. Even in the rest of medicine, doctors prescribe medications and recommend “off label” treatments regularly. Modern American medicine is a moving target. We’re always trying to optimize what we do.
-
Show this thread
-
In my son’s case, the ICD and the defibrillator pads around his heart are not approved for this purpose. That’s because there aren’t enough patients like my son to do the kind of huge study that the FDA require for government “approval.” However, we know they work great.
8 replies 61 retweets 419 likesShow this thread -
In addition to not being approved by the FDA, the use of ICDs in children like my son is not specifically described in the official cardiology guidelines. If every uncommon but well proven therapy was added to medical guidelines they’d end up being 1000 pages long.
8 replies 46 retweets 338 likesShow this thread -
Roll the clock back to the Obama years. Like I said, for some reason leftist “thinkers” got it in their head that ICDs were being implanted in far too many patients too great a cost. As a result, they decided to aggressively go after hospitals and MDs who used them off label.
7 replies 92 retweets 393 likesShow this thread -
To do this, for the very first time in history, the Obama Justice Department decided literally prosecute anyone not following the guidelines for ICDs. Remember, guidelines are just that - guidelines. They’re never intended to be rigid and doctors deviate from them regularly.
12 replies 133 retweets 525 likesShow this thread -
This prosecution went on for years and eventually wrapped up 100s of hospitals and 1000s of cardiologists. This is important: the basis of the prosecution was that all these institutions and doctors were installing off label ICDs in Medicare patients to commit actual fraud.
7 replies 81 retweets 407 likesShow this thread -
The situation got so bad that in 2013 the cardiology societies updated the ICD guidelines to say that off label use should be allowed based purely upon physician judgement if the patient is unusual because the life saving potential of the devices is so great.
15 replies 67 retweets 448 likesShow this thread -
Despite that, the Obama Justice Dept pushed forward and finally in 2015 settled the case for a fine of $250 million dollars again at 457 (!!) hospitals. Here’s the Heart Rhythm Society’s statement on this travesty: https://www.hrsonline.org/index.php/News/Press-Releases/20154/11/US-DoJ-Settlements-Related-to-Billing-of-Implantable-Cardiac-Defibrillators-ICDs …
12 replies 104 retweets 377 likesShow this thread -
Now, please note this was purely for Medicare patients. Private insurance companies continued to willingly pay for off label, off guideline ICD placements as long as there was appropriate medical justification. But the key point is
@TheDemocrats decided to prosecute for fraud!11 replies 72 retweets 423 likesShow this thread -
(As a side note, we just got notified that my son’s surgery is going extremely well and he might be out much sooner than we thought. If that’s the case, this thread will come to screeching halt).
42 replies 43 retweets 886 likesShow this thread
hell, yeah, Joe! Awesome!
Loading seems to be taking a while.
Twitter may be over capacity or experiencing a momentary hiccup. Try again or visit Twitter Status for more information.