Phone: (602) 307-0070

Fax: (602) 307-0080

Lawsuits over this medical device company’s filters converge in Phoenix

The federal multi-district litigation panel has appointed a federal judge in Phoenix to oversee the C.R. Bard Inc. (NYSE: BCR) IVC filter litigation nationwide, which includes upwards of 400 cases in which patients blame the New Jersey-based company of marketing a defective product.

The company’s IVC filter was designed to catch blood clots in patients who could not tolerate blood thinners, but lawyers nationwide are filing lawsuits alleging personal injuries.

C.R. Bard Inc. Building

New Jersey-based C.R. Bard Inc. Operates this facility in Tempe

Company officials declined comment on pending litigation, but according to the publicly traded company’s Form 10-Q filed with the U.S. Securities and Exchange Commission for the quarter ended March 31, Bard faces about 345 lawsuits that were part of the IVC Filter MDL. Another 30 lawsuits are pending in various state courts across the country, and a Canadian class-action lawsuit was filed against Bard in Quebec in March.

James Morris, an attorney with Morris Law Firm in Los Angeles, said he has somewhere between 30 and 40 of the MDL lawsuits on file with the U.S. District Court for the District of Arizona. He said that’s small compared to other law firms that are representing upwards of 100 cases.

The problem with the IVC filter is that pieces can break off and travel and potentially pierce other parts of the body or get embedded in the tissue and be difficult to remove, Morris said.

But at least two Phoenix interventional cardiologists say the fault lies with the physicians and patients, and not so much the manufacturer.

The temporary IVC filters are supposed to be taken out within six months, but many times if the interventional radiologist or an emergency room physician put the filter in a patient, these doctor’s don’t have a follow-up relationship with teh patient and patients may forget the device needs to be removed after a certain period, said Dr. Richard Heuser, chief cardiologist at St. Luke’s Hospital and Medical Center in Phoenix.

He said he doesn’t blame those doctors.

“They’re good at putting them in and taking them out, but they have no relationship with the family,” Heuser said. “From the consumer standpoint, if you have one placed, you need to make sure to follow up with your primary care physician and ask when it should be taken out.”

Dr. Nathan Laufer, director of the Heart and Vascular Center of Arizona here in Phoenix, said he’s never seen any of the IVC filters break off and get lodged into another part of a patient’s body.

“Lawsuits will be lawsuits and lawyers are looking for a place to sue,” he said.

He said he uses the IVC filters in patients when needed.

“You need to have strong indications for putting them in,” Laufer said. “There are very diverse practice guidelines, depending on which society you talk to. There is no standardization with the medical community.”

 

-Article from the Phoenix Business Journal

 


PHOENIX Magazine Top Doctors for 2016

Congratulations to our PHOENIX Magazine Top Doctors for 2016 – Drs. Nathan Laufer, MD, Adam Brodsky, MD, and Ashish Sadhu, MD!


Changing Healthcare Marketplace

From The President’s Page in Round Up Magazine:

Hello, my name is Adam Brodsky and I’m the president of the Society for 2016. As is Society tradition, I’ll be sharing with you some thoughts each month in Round-Up about various issues that we face practicing medicine today.

Before I begin with this month’s topic, I would like you to think for a moment about just how many non-physician voices there are trying to impact the practice of medicine. The list is practically endless: industry groups, hospitals, legislators, insurance companies, pharmaceutical companies, etc.

Now i freely admit that during my day practicing cardiology I almost never give any of these other voices a second thought. I do what I assume most of you do – blank out all the nonsense, simply focus on the patient in front of me and do what is best for that person. However, we all must recognize that eventually our ability to practice medicine the way we want to – the way that is actually best for our patients and best for society – will be adversely impacted by these other voices if there is no strong physician voice. I thank each and every one of you for taking the time to even read these pages. Simply by doing that you have demonstrated your commitment to a strong physician voice. I would also ask you to consider becoming more involved in organized medicine yourself and to ask your colleagues to become involved as well.

Healthcare is changing before our very eyes and there is one thing that is certain; if we don’t take charge of our own destiny others will do it for us. And I can almost guarantee that if and when that happens, we, our patients, and most of society as a whole, won’t like the results.

The theme of this month’s issue is, “The Changing Healthcare Marketplace”. Despite the fact that medicine as a profession represents a series of individual interactions between individual patients and physicians, and despite the fact that attempting to heal another human being is one of the oldest and noblest professions, we all know that the modern practice of medicine is as much a business enterprise as it is a noble art form. While we physicians go about our daily routines treating patients, the landscape in which the business of medicine is practiced is rapidly changing. Many forces are at work in this regard, Nationally, the Affordable Care Act has played a large role. Large insurance companies have merged, wielding even larger market power. We are seeing the rapid proliferation of restrictive networks where insurance companies attempt to save money by limiting patient choice. I have had several patients myself whom I have seen for several years suddenly be told they can no longer see me because their plan changed to a narrow network. On our last visit together, both the patient and I are left to wonder: according to what logic is this supposed to be better for the patient and better for society?

In Maricopa County we have seen the consolidation of health systems into only a few major networks, each trying to force community physicians to declare their allegiance to a single network. Again, we and our patients are left to wonder: how is it in our interests to engage in these marketplace power games? Any large enterprise must adhere to certain business principles in order to remain viable and competitive, and healthcare companies are certainly no exception. However, I am often left owndering whether deep inside the executive suites of these large medical corporations the tail is actually wagging the dog. When company-wide medical practice decisions are more clearly linked to marketing strategy than patient care, when individual physician judgement is brushed aside in favor of universally applied order sets, and when entire cadres of personnel are hired and devoted to massaging data points on electronic dashboards; one is left to wonder if we have drifted too far afield from our original purpose.


Helping Students Explore Heritage

Article from JewishNews

laufersFor Judy and Nathan Laufer, supporting Jewish causes is part of their DNA. As the children of Holocaust survivors who were assisted by their Jewish communities, they know firsthand how a helping hand can make a difference.

The Laufers met and married in Montreal and then moved to Phoenix in the mid-1980s, where Nathan had already set up a medical practice. Judy, who was born in Budapest and grew up in Montreal, worked as a kindergarten teacher and eventually became President of the Boards of Solomon Schechter School and King David School, where their son, Andrew, was in the first class. She became actively involved in the Jewish Federation of Greater Phoenix and served as the chairperson for B’nai Tzedek Youth Philanthropy Program and for FIDF Phoenix. Recently, she joined the Arizona board of the American Israel Public Affairs Committee (AIPAC).

Together, the Laufers have co-chaired many Jewish events, including the 2015 Phoenix AIPAC dinner and the United States Holocaust Memorial Museum tribute dinner. In addition to supporting Jewish Arizonans on Campus (JAC) since its inception in 2008, they also support Jewish National Fund, Friends of the IDF, ASU Chabad and several Valley synagogues.

Nathan, a cardiologist, currently serves as President of the Arizona Medical Association and is the past President of the MAricopa County Medical Society as well as the Phoenix Board of the American Heart Association.

While judy remains busy volunteering in the Jewish community, she also runs Little Egg Publishing Co., a company she founded to publish children’s books. She is the author of “Where Did Papa Go?” and “Last Night I Had a Laughmare”.

On Feb. 29, JAC will honor the Laufers for their support. In light of this honor, Jewish News asked them four questions:

what is your connection to JAC?

We have supported the JAC event for many years and we believe in the work that they do. We appreciate all the time and effort that JAC puts in to connect Jewish youth to Judaism and to each other. The Laufer Family Scholarship is being established to provide the opportunity for Jewish students to explore their heritage. Making the journey to see their Eastern European roots should create a richer understanding of their Jewish history. We hope this experience will solidify their Jewish identity and help them understand the need for the Jewish State of Israel.

What does the Phoenix Jewish community mean to you?

We have supported the Phoenix Jewish community since we arrived 30 years ago. We feel incredibly lucky and fortunate to be able to support others. We are both children of Holocaust survivors and their Jewish community helped our families when they left Europe. It is an honor and a privilege for us to be able to give back.

How did you meet each other?

We both came from Montreal, Canada. Montreal has a very cohesive Jewish community and we knew each other through groups of frinds. We re-met through mutual friends several years later when neither of us was attached. we knew almost immediately that this was “beshert!“.

How and where would you spend free time?

In our favorite place, Coronado, California. It would be reading, walking, biking or visiting with friends at the clubhouse. We also love to travel to new places, made even more special when our son, Andrew, joins us.


Details:

Who: Jewish Arizonans on Campus

What: Comedy Night featuring comedian Dan Naturman and honoring Dr. Nathan and Judy Laufer

When: 6:30PM reception; 7:30 performance, Monday, Feb 29

Where: Hilton Scottsdale Resort & Villas, 6333 N. Scottsdale Rd.

Cost: $54; $25 students

Register: 480-390-6173; events@myjac.org or myjac.org


Dr. Adam Brodsky 2016 Maricopa Medical Society President

From the MCMS Roundup Magazine:

With the end of the year we also get ready to welcome in a new group of leaders in our Society, and it is only fitting that Round Up take the time to sit down with in-coming President Adam Brodsky, MD and ask him to tell us a bit about where he has been, and where he feels the society is going.

Dr. Brodsky and his family

Dr. Brodsky specializes in cardiac and peripheral intervention and treatment, and holds a master’s degree in Management in addition to his medical degree. He currently practices at the Heart & Vascular Center of Arizona, is affiliated with Banner University Medical Center – Phoenix, and has contributed many articles, abstracts and book chapters to the theory and practice of cardiovascular medicine. He also flies to outreach centers in Show Low and Globe, Arizona.

He joined MCMS and has served on the board since 2013. Maintaining involvement in organized medicine has long held importance with Brodsky, dating back to his time in medical school when he served in several leadership positions, including class vice president. This early start has impressed upon Brodsky the importance of role models and mentors along his career path. Not only to provide counsel and perspective in medical practice, but to help highlight the importance of individual physician involvement.

When it comes to striving for medical excellence and the rights and needs of today’s physicians, Brodsky believes he cannot afford to stand by without playing a bigger role.

“When I look around and see so many doctors who are just too busy to get involved, and at the same time I realize that there are important issues that we face as physicians and that simply sticking our heads in the sand and hoping we can just get by isn’t really a feasible strategy, I feel that I really have little choice.” he said. “If I don’t step up, who will?”

It is this experience, enthusiasm and perspective that Brodsky brings to the table as our new Society President, and we look forward to seeing what his hard work, and yours, can accomplish in 2016.

Background

Originally from Minneapolis, Minnesota, Brodsky had an interest in medicine early on. With his dad working as a Neurologist, it seemed bound to happen. He followed his interest to medical school at Northwestern University, Feinberg School of Medicine in Chicago, Illinois. It was here he met his wife Valerie. The two of them went on to complete their residencies together, Dr. Brodsky in Internal Medicine, at Beth Israel Deaconess Medical Center in Boston, Massachusetts. He also completed a Cardiology Residency and fellowship in Interventional Cardiology at Northwestern University, Feinberg School of Medicine, Chicago, Illinois and earned a Master’s in Management in Evanston, Illinois.

Initially, Brodsky had a troublesome time choosing his specialty; torn between surgery and internal medicine.

“I enjoyed the procedural aspects of surgery but didn’t want to give up the cerebral and longitudinal aspects of general internal medicine” he said.

Deciding to pursue internal medicine only opened up another set of options to choose from as he considered several fascinating specialties. Brodsky was particularly drawn to high-acuity specialties, with intensive care and pulmonary critical care as alluring options. However, after a Critical Care Unit rotation involving several cardiology cases, Brodsky decided this was the specialty that would best suit his desire for intensive care and a long-standing involvement with his patients.

“I was able to see high acuity patients in a variety of settings including acute coronary syndromes, acute valvular dysfunctions, and electrophysiologic emergencies.” he said. “I would additionally be able to maintain a longitudinal relationship with those patients once they left the hospital.”

Dr. Brodsky Teaching His StudentsHe explained. “In fact, since the advent of the hospitalist medicine and the declining number of internists or family physicians who see their patients in the inpatient setting, I have found that paradoxically, that I and perhaps a few other specialists are often the only ones who maintain continuity with our patients both in and out of the hospital.”

Heading to the Valley of the Sun

After graduating, Brodsky made his way to the opportunities, and enjoyable outdoor lifestyle, of Arizona.

“The ability to teach at a cardiology residency and fellowship while remaining in private practice and still live in a major city is unique.” he explained. “As the associate fellowship director for the general cardiology fellowship at Banner University Medical Center – Phoenix, and key faculty for the interventional cardiology fellowship, I enjoy my responsibilities in training the next generation of young cardiologists.”

This love of encouraging medical education and involvement is something he shares with his colleagues at The Heart and Vascular Center of Arizona (HVCAZ).

“HVCAZ is a pioneering small group of like-minded cardiologists who are involved in academic medicine, the business aspects of running an independent private practice, as well as local organized medicine.” he said.

Brodsky was introduced to the practice group in part through one of his own mentors, Dr. Nathan Laufer, whom he describes as a pioneering interventional cardiologist. Laufer is a current MCMS member and past president. He is currently serving as president of ArMA.

In addition to the unique opportunities of working and practicing in Phoenix, Brodsky and his wife enjoy the many opportunities for outdoor recreation nearby.

“We enjoy weekend camping trips year-round with our four young children, moving between desert campgrounds in the winter and higher elevation campgrounds along the Mongolian Rim in the summer months.” he said. “We also enjoy skiing locally at both Arizona Snowbowl and Sunrise Ski Resort.”

Today’s Physician

Dr. Brodsky and family

Physicians today, as well as medicine in general, are facing a wealth of challenges. Brodsky shared with us his feelings on these challenges, as well as the areas he feels deserve the most focus as he takes the reins in 2016.

“Medicine is in danger of becoming commoditized.” Brodsky explained. “Both from without: by the corporate practice of medicine, and from within: from the proliferation of the guidelines.”

Because our culture is so steeped in marketing, particularly with the advent of social media and other internet resources, healthcare networks and other medical providers must strive for their patients’ attention on all channels. And, too often, brand recognition strategies require breaking consumers’ bonds with previous personal physicians in favor of a newly identified brand with a higher visibility.

Additionally, specific services and medications are widely advertised, resulting in patients insisting on specific brands instead of relying on the referral of their physicians – effectively forcing their hand. Since so many physicians are already battling the epidemic of patients self-diagnosing via the internet, circumstances like these only compound an existing struggle.

The doctor-patient relationship is already put under a lot of strain. Physicians struggle against reimbursement and recording guidelines, limiting their time with their patients and increasing time spent in tracking software. Brodsky shared his concerns that stringent regulations are putting that relationship under another kind of strain: undermining physicians’ confidence to prescribe the best care for their patients.

“We do a good job of teaching medical guidelines to our students and residents but sometimes our residents are unable to apply them to real-life situations.” he said. “I have found many situations in which a resident will be recommending a certain treatment plan with which they themselves seem to be vaguely uncomfortable, but nevertheless they press on with the recommendation, blindly following some medical guideline they learned, when in fact that guideline is simply not relevant to their patient.”

While it is possible that residents simply have difficulties choosing which guidelines to follow, too often there is simply not a guideline that fits their exact patient.

“It’s this ability to think independently that I fear we may be losing with our reliance on guidelines for everything.” Brodsky said.

Independent physician thinking is one of the biggest things Brodsky wants to focus on as MCMS President in the next year, maintaining the independent practice of medicine. In his view, this includes employed doctors, as well as those privately practicing. Both should feel they have the ability to exercise control over their patient care practices.

While self-employed and employed physicians have different needs, the ultimate goals for both are the same within the Society. Different programming and approaches to suit individual physician experiences can help us all reach our mission – to preserve the practice of medicine as it should be – regardless of the changing medical marketplace.

On the Personal Side:

  • 1. Describe yourself in one word: Aware. I try to maintain an awareness of what’s going on around me, whether it be my students/residents, my patients, my business partners and/or my competitors.
  • 2. What is your favorite food, and favorite restaurant in the Valley? Chicago deep dish pizza. I heard they’re opening a Lou Malnati’s here in Phoenix; finally, a real Chicago Pizza.
  • 3. What career would you be doing if you weren’t a physician? Pilot or astronaut.
  • 4. What’s a hidden talent that you have that most wouldn’t know about you? Pilot. I own one third of a PA-46 310 Piper Malibu. I have 960 hours to date. I learned to fly when I was a cardiology fellow in Chicago. I would take a one hour lesson one night after work during the week and another one hour lesson during the day on the weekend (if I wasn’t on call). It took me about nine months to earn my private pilot’s license. Once I moved to Phoenix, I earned my instrument rating. I now fly to various medical conferences during the year. I fly to two different medical outreach clinics as well, once a month, one in Show Low, AZ and one in Globe, AZ.
  • 5. Best movie you’ve seen in the last ten years? The Martian. Human ingenuity always amazes and inspires me
  • 6. Favorite Arizona Sports Team (College or Pro)? No time.
  • 7. Favorite activity outside of medicine? Camping with family/friends. Flying.
  • 8. Tell us about your family! Wife, Valerie, two sets of twins – girls, Lauren and Eden ages 8; twin boys, Shai and Sol ages 6.

Happy Nurse Practitioner’s Week!

Heart and Vascular Center of Arizona has a fantastic team of Nurse Practitioners!

This is a great opportunity for us to recognize and celebrate our NP’s this special week! Happy National Nurse Practitioner Week to more than 205,000 NPs who care for millions of Americans each year. Thank you for the positive difference you make by providing exceptional health care and education to patients nationwide.


World Stroke Day is October 29

World Stroke Day is observed worldwide on October 29 to underscore the serious nature and high rates of stroke, raise awareness of the prevention and treatment of the condition, and ensure better care and support for survivors.

We know there are 5 million patients in the U.S. today with AF and we anticipate that the number will more than double to ~12 million by 2050. Despite warfarin and NOAC availability and adoption, the latest data still shows that 50% of patients won’t or don’t take warfarin long-term, and 30% won’t or don’t take a NOAC long-term, leaving patients at risk of stroke. This highlights the need for more alternatives for stroke prevention.

We need to continue educating patients with AF and their caregivers on stroke risk and the breakthrough alternative we can now offer them with WATCHMAN.

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Dr. Laufer Featured on the Opinion Page of the Arizona Republic

Dr. Laufer, President of the Arizona Medical Association, was featured on the Opinion Page of the Arizona Republic today regarding the possibility of the University of Arizona’s College of Medicine, Phoenix being in jeopardy of losing its independent accreditation.

You can read the story on the Arizona Republic website here.

 

Dr. Laufer also wrote a letter to Arizona Governor  Doug Ducey, which can be Downloaded here or viewed below:

Download the PDF file .

 


New Arizona Law Allows Lab Tests Without Doctor’s Order

From 91.5 KJZZ

Doctors order lab work to check a patient’s health and look for a variety of diseases. Now, Arizonans don’t have to wait for a physician to write them a test order because of a new law that went into effect July 3. It allows anyone to get any test any time, making it one of the most expansive laws in the country.

Starting this week, patients will be able to walk into a testing center and order their own lab test.

A patient will choose a test and then get a finger prick. The small amount of blood from that finger prick can be used for up to 70 different kinds of tests. California-based Theranos offers more than 200 different kinds of tests from glucose levels to HIV screenings. Consumers can see the results on their phone in a few days.

Vicki Wieler is looking forward to checking her own health on her time frame.

Nowadays a person has to be 100% in charge of their own healthcare. If I wanted to check on my cholesterol, I could just go in and get a quick cholesterol test.

Wieler would have to pay out of pocket because the law doesn’t require insurance companies to cover the lab tests. But a cholesterol test with Theranos costs as little as $3.

Wieler said this way of testing is much cheaper because it cuts down on doctor’s visits.

Every time you go to the doctor you’re paying.

There are 41 testing centers in Walgreens around Arizona. Theranos holds several patents on its technology, which it claims can run multiple tests on smaller amounts of blood. But some scientists are skeptical about the quality of results because, until recently, details of the technology and process hadn’t been released to the public. Last Friday, the Food and Drug Administration authorized the finger stick device.

Theranos isn’t the only one offering these tests. Some more traditional laboratories, such as Sonora Quest Laboratories, are also now offering direct access testing.

Vice President of Business Development Christina Noble said “We don’t know where this is going to lead. This could become a larger part of our business moving forward.”

The company decided to make a portion of its tests available to the public. Even though the state law doesn’t require doctor’s involvement, Noble highly recommends it.

We believe strongly that the patients need to have that relationship with the provider to make sure they are choosing the right test at the right time for the right condition.

Twenty-seven other states and Washington D.C. allow residents to order tests directly. The practice is unregulated in many of those places and so it’s legal in the absence of a prohibition. Nine states allow a limited number of tests with a doctors order and 13 prohibit it.

Dr. Nathan Laufer said he wants patients to get blood work he orders in a timely and affordable manner.

If they can go and get this kind of a blood test done at their local pharmacy for a fraction of the cost and then send us the results, that could be quite beneficial to the patient.

Sonora Quest and some other labs charge significantly more for some tests than Theranos. Dr. Laufer is concerned that with expanded access and low-cost tests, some patients may over-zealously test themselves.

It’s a mixed blessing for our practice. I think we are going to be getting a lot of phone calls asking us to interpret tests we did not order.

The law includes a provision that excludes doctors from being required to review the results of tests patients get on their own.

Laufer said he hopes routine checks on sugar levels and cholesterol will allow patients to more proactively follow up on their health. But since Arizona is one of the first states to have this broad of a testing law, the real effects remain to be seen.


New President, Officers Announced for the Arizona Medical Association

arma

 

Phoenix, AZ – Nathan Laufer, MD became the 124th President of the Arizona Medical Association (ArMA) on May 29, 2015 at the association’s annual meeting in Phoenix. Dr. Laufer will serve a one-year term in that capacity.

Laufer-webDr. Laufer received his undergraduate and Medical Degree from McGill University in Montreal, Canada. He completed his Internal Medicine residency at the University of Toronto and a cardiology fellowship at the University of Michigan, whose faculty he then joined. Dr. Laufer is Board Certified in internal medicine, cardiology and interventional cardiology and has been in practice since 1984.

Dr. Laufer is an active member of organized medicine and the Arizona Community. He has served ArMA previously as president-elect. In the Arizona community, Dr. Laufer is a past president of the Maricopa County Medical Society and President and Founder of the Cardiovascular Society of Arizona. He is a board member (past president) of the Arizona Affiliate of the American Heart Association.

 

Dr. Laufer is the founder and medical director of the Heart & Vascular Center of Arizona in Phoenix, where he practices in Consultative Cardiology, Coronary and Peripheral Catheterization, Interventional Cardiology with expertise in Coronary, Peripheral and Carotid Intervention, and Pacemaker Implantation. He has been an integral part of cardiovascular research and development since 1984.

In his role as ArMA president, Dr. Laufer will be responsible for leadership of the ArMA Board of Directors and members, for organizational support and representation, and for communication with the membership of the organization through the quarterly AZMedicine magazine.

the following officers were also elected to serve one-year terms: president-elect – Gretchen Alexander, MD, Phoenix; vice-president – Michael Hamant, MD Tucson; and at-large members, Jacqueline Chadwick MD, Phoenix; Jennifer Hartmark0-Hill, MD, Phoenix;and Mriam Anand, MD, Phoenix; treasurer – Ronnie Dowling, MD, Show-Low; AMA Delegation Chair – Immediate Past President Jeffrey Mueller, MD Phoenix; and Outgoing Past President Thomas Rothe, MD, Tucson.

ArMA has been promoting and providing leadership in the field of medicine for more than a century. For more information, visit www.azmed.org