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Godes JN Ison ER Penner IE Reagan ME 《Health care law newsletter / Weissburg and Aronson, Inc》1995,10(4):16-22
While the regulations are revolutionary in their use of "substantial compliance," the interpretation and application of HCFA's new remedial scheme are still uncertain, as states are given broad discretion in defining important terms and in applying and interpreting the criteria to select remedies. Further complicating the issue is the fact that some states, including California, intend to seek waivers from HCFA to substitute their own state enforcement systems for most, if not all, of the new federal system. Based upon these uncertainties, the enforcement of nursing facility standards will likely be in a state of flux for some time to come. 相似文献
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In malignant hyperthermia, myophosphorylase reaction shows characteristic changes that take place within minutes: (1) a generally strongly weakened reaction; (2) numerous negatively reacting fibres; (3) frequently, fibre sections that show spotty and/or striatal weak or negative reactions and fibre sections with strong striatal reactions with relatively narrow sarcomere spacings (a "sign of hypercontraction"). Obviously, the morphological findings that show characteristic "striated fibres" are typical of the malignant hyperthermia syndrome! It is important to note that the muscular fibres showing such changes are, as a rule, inconspicuous when using other stains and reactions. These pathological myophosphorylase reactions were observed in five deceased patients (one independently of anaesthesia after an extended walk) and in 19 pigs (18 times after halothane testing and once in an experimental animal with clinical evidence of the presence of malignant hyperthermia). These reactions were not noted in pigs with negative halothane reactivity or prior to halothane testing. They were also not seen in a large number of very different healthy and diseased control and reference cases from our biopsy and autopsy material. Myophosphorylase reaction enables convincing demonstration of malignant hyperthermia, past or present. Hence, it is possible to elucidate puzzling deaths or verify apparently clear death occurring during or subsequent to anaesthesia or simply following stress ("human stress syndrome"). Many of these deaths doubtlessly escape the attention of clinicians using the usual morphological examination methods. However, the reaction cannot be used to identify potential victims. 相似文献
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Lauerman N 《Defense law journal》1978,27(3):189-230
This is a discussion of the issue as to whether a woman who either becomes pregnant while on pills or suffers side effects as a result of taking birth control pills has a breach of warranty cause of action under the Uniform Commercial Code. It is concluded that the woman has no cause for action against her doctor. In fact, it is unlikely that the woman will be able to support a claim of breach of warranty against anyone in the chain of supply, either the pharmaceutical company or the distributor. Previously decided cases offer no precedent as to when a breach of warranty can be found as a result of side effects produced by pills. Warnings which presently accompany oral contraceptives are insufficient. However, a woman claiming damages must prove that the side effects she suffered were directly caused from use of oral contraceptives. There is the assumption of risk issue, whether the woman assumes the risk by reading the information booklet and deciding to take the pills anyway. Revised warnings should certainly be included with pills. 相似文献
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