Monday, October 22, 2012

Nazi Psychiatrists Tortured Patients to Death - Austria

Austria probes gruesome fate of Nazi-era disabled
GEORGE JAHN,
Associated Press
Updated 6:30 a.m.,
Friday, October 19, 2012


"The Nazi-era psychiatric patients were demeaned, starved, brutalized, and left to die. More than half, say those involved, suffered from broken ribs and other bone fractures from blows likely dealt by hospital personnel."

HALL, Austria (AP) — Forensic crews scraping away dirt from the remains of the Nazi-era psychiatric patients were puzzled: The skeletal fingers were entwined in rosary beads. Why, the experts wondered, would the Nazis — who considered these people less than human — respect them enough to let them take their religious symbols to their graves?

It turns out they didn't.

A year after the first of 221 sets of remains were exhumed at a former Austrian hospital cemetery, investigators now believe the beads were likely nothing more than a cynical smokescreen, placed to mislead relatives attending the burials into thinking that the last stage of their loved ones' lives was as dignified as their funerals.

But skeletons don't lie. Forensic work shows that more than half of the victims had broken ribs and other bone fractures from blows likely dealt by hospital personnel. Many died from illnesses such as pneumonia, apparently caused by a combination of physical injuries, a lack of food and being immobilized for weeks at a time.

Neither do medical records, which show that medical personnel cursed their patients as "imbeciles," ''idiots" and "useless eaters."

Indeed, there is now little doubt that for many of the dead — mentally and physically disabled people considered by the Nazis to be human garbage — their final months were hell on Earth.

Nazi extermination of the mentally and physically deficient has been documented since the end of World War II. But information gathered from the hospital cemetery in Hall, an ancient Tyrolean town of narrow, cobble-stoned alleys, cozy inns and graceful church spires east of Innsbruck, has filled out the picture in chilling new ways.

Historians, anthropologists, physicians and archaeologists say the Hall project represents the first time that investigators can match hospital records with remains, allowing them to identify, for example, cases in which patients had broken ribs, noses and collarbones that were not listed in their medical histories, suggesting that the patients had been beaten by those responsible for their care.

Faced with the horrors of the findings, those involved in the probe struggle to maintain the detached attitude of an investigator.

"At first, I sat here and worked through these documents in a relatively dry manner from the point of view of a scientist," psychiatrist Christian Haring said. "But as you read on at some point, you suddenly find yourself in a world where the goose-bumps appear."

Anthropologist George McGlynn said more than half of the sets of remains have broken bones, many of them unexplained in the patients' medical records.

"Why is a stubbed toe talked about in three different (documents), but six rib fractures that cause terrible pain isn't even mentioned?" he asked.

While such injuries did not kill directly, they may often have led to death. Many of the patients are listed as dying of pneumonia, and McGlynn said the "scary conclusion" is that rib injuries combined with sedation and forced immobility — patients are suspected to have been strapped to their beds for weeks at a time — may have generated fatal incidences of the disease.

"Nobody is being executed here, like you see in concentration camps," he said. "It was done in a more sinister, insidious way — people are loaded up with drugs until they get a lung infection."

Forensic examination of the bones shows infection that started at the skin level then "goes right into the muscle and all the way to the bone," McGlynn said.

Others apparently starved — if not to death, then to the point where they were susceptible to diseases that then killed them.

"We can assume that the patients suffered massively from hunger," said Haring, the psychiatrist, speaking of "enormous" losses in weight.

The Nazis called people deemed too sick, weak or disabled to fit Hitler's image of a master race "unworthy lives," in the terrible culmination of the cult of eugenics that gained international popularity in the early 1900s as a way to improve the "racial quality" of future generations.

"Patients, who on the basis of human judgment are considered incurable, can be granted mercy death after a discerning diagnosis," Hitler wrote in a 1939 decree that opened the flood gates to the mass killings.

More than 70,000 such people were killed, gassed to death or otherwise murdered between 1939 and 1941, when public protests stopped most wholesale massacres. From then until the end of the war in 1945, the killings continued at the hands of doctors and nurses. In all, at least 200,000 physically or mentally disabled people were killed by medication, starvation, neglect or in the gas chambers during the war.

After 1941, McGlynn said, "a lot of the smaller institutions were given carte blanche to take care of things themselves. No longer were people being transported to (killing) centers. They were being put to sleep right there."

Hundreds of psychiatric patients from Hall were among those shipped to killing centers before 1941, but what happened there after that was unknown until two years ago, when an archivist searching through old hospital files discovered the graveyard during a hospital expansion.

The records show that as the war progressed, and able-bodied men and women became scarce behind the front lines, the Nazis made a cynical adjustment in their measurement of patients' value.

"'Worthy of life' and 'unworthy of life' were the terms used back then," Haring said. "The difference was ability to work or not."

Excerpts of medical histories provided to The Associated Press described one of the patients as suffering from "imbecility," but most were objective, bereft of demeaning descriptions. McGlynn, however, said he had examined records that show emotional abuse in addition to the physical violence the remains attest to.

"People are being threatened: 'If you don't do this we are going to stuff this tube down your nose and pump you full of stuff,'" he said. "These people were at the mercy of their captors."

Other evidence backs up his findings.

Documents show that the cemetery was created in 1942, a year after the formal end of the mass-killing campaign meant that Hall patients could no longer be shipped to gas chambers. It was shut down and abandoned in 1945, when the war ended. During that time, deaths in the psychiatric ward rose from an average of 4 percent a month in early 1942 to as high as 20 percent in some months before the end of the war.

Haring, an affable, soft-spoken man, is visibly shaken as he speaks of the horrors perpetrated by the previous generation of psychiatrists. But he hesitates to assign individual guilt to anyone caught up in the inhuman machinery of the Third Reich.

"It is easy for us now to point the finger and say 'what have they done?'" he said. "But ... I am not sure that I would have acted differently. We were simply paralyzed."

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Monday, October 8, 2012

Psych Diagnoses Fraud Leads to Pharmaceutical Prosecutions

NowPublic.com
Kevin Hall
October 8, 2012

Nearly all major psychiatric drug manufacturers have been convicted of illegal marketing and/or fraudulent claims. Several of these cases are linked below. Any that haven't been prosecuted, probably should be.

The reason behind this is simple. There are no medical tests to confirm or deny any mental disorder or diagnoses. A few decades back, psychiatrists "voted" that mental "illness" was caused by a "chemical imbalance of the brain." This is drug marketing, not science. Nobody votes in diabetes or cancer as medical disease and there are sound medical and lab tests for these and other medical diseases.

Psychiatric diagnoses is merely opinion of behavior. Psychiatrists simply vote on what is or is not a mental disorder and place these diagnoses into the American Psychiatric Association's "Diagnostic and Statistical Manual." Their controversial DSM5 is set to be released in 2013 and will likely lead to more pharmaceutical fraudulent marketing prosecutions and settlements.

The reason is simple. If there is no identifiable disease, there can never be a drug that will cure. In fact, there are no cures for any mental disorders. The drugs are generally uppers (ADHD drugs) or downers (anti-anxiety drugs and antipsychotics) that merely mask symptoms in some cases while having extremely dangerous side effects. The upper-type antidepressants have been proven to be very little, if any, more effective than a placebo (sugar pill) yet greatly increase sexual dysfunction while also increasing the likelihood of violence and suicide. Honest marketing would refer to them as anti-sex drugs.

The flow (explained and graphed here) is that psychiatrists create a disease by voting, then pharmaceuticals make the drug. Psychiatrists, usually at major universities, create fraudulent studies that the FDA approves on the word of the drug companies that funded the studies. Once they get approval for a certain condition (such as depression) and population (such as men over age 18, etc.), they get some paid-off psychiatrist to create and get published a study saying that the drug is helpful for other populations and diagnoses. This allows for what is termed off-label prescribing.

It's all fraud and all prosecutable.

The story printed below on Abbott Labs (Depakote) came out last week. It's the Virginia Attorney General's press release www.oag.state.va.us/Media%20and%20News%20Releases/News_Releases/Cuccinelli/100212_Abbott_Labs.html .
Here are some other links to recent settlements with:

GlaxoSmithKline (Paxil) http://www.justice.gov/opa/pr/2012/July/12-civ-842.html ;

Johnson & Johnson, (Risperdal, Invega) www.nytimes.com/2012/04/12/business/drug-giant-is-fined-1-2-billion-in-arkansas.html?_r=0, www.bloomberg.com/news/2012-08-30/j-j-will-pay-181-million-to-settle-risperdal-ad-claims.html, http://www.bloomberg.com/news/2012-08-31/j-j-loses-appeal-of-257-7-million-risperdal-verdict.html  ;

Pfizer, (Zoloft,Geodon, etc.) www.msnbc.msn.com/id/32657347/ns/business-us_business/t/pfizer-pay-record-billion-penalty/#.UHLjXVF_P1U ;

Astrazeneca, (Seroquel) www.azcentral.com/business/articles/2010/04/27/20100427astra-zeneca-settlement.html ;

Bristol-Myers Squibb (Abilify) www.justice.gov/opa/pr/2007/September/07_civ_782.html ;

Eli Lilly (Zyprexa) www.justice.gov/opa/pr/2009/January/09-civ-038.html .

Maybe it is time that some of the psychiatrists creating the fraudulent diagnoses and studies start getting criminally prosecuted for fraud?


Commonwealth of Virginia
Office of the Attorney General



For media inquiries only, contact:  Brian J. Gottstein
Email: bgottstein@oag.state.va.us (best contact method)
Phone: 804-786-5874

Sentencing in Abbott Labs Depakote case: Judge approves $1.5 billion settlement to resolve complaints of off-label promotion of drug

~ Virginia-led investigation was largest state Medicaid fraud investigation in U.S. history ~
ABINGDON, VA (October 2, 2012) - As part of the largest Medicaid fraud case ever led by a state, Attorney General Ken Cuccinelli announced the sentencing of global health care company Abbott Laboratories Inc. in the United States District Court in Abingdon, Va., today. The court approved the $1.5 billion settlement reached on May 7, 2012, among Abbott, Virginia, the United States government, and 48 other states and the District of Columbia, in which Abbott pled guilty to a criminal charge and admitted civil liability for the company's unlawful promotion of the prescription drug Depakote for uses not approved as safe and effective by the Food and Drug Administration (FDA). 

The attorney general's Medicaid Fraud Control Unit (MFCU) was the lead investigative agency in the case, partnering with the prosecutors and civil attorneys from the U.S. Attorney's Office for the Western District of Virginia. This was the largest Medicaid fraud recovery in U.S. history resulting from a state-led investigation, with the Virginia MFCU spending more than four years on the investigation, traveling to 26 states to conduct interviews and sifting through more than one million records looking for evidence.

When it pled guilty in May, Abbott agreed to pay $1.5 billion to resolve its criminal and civil liability pertaining to government health care programs that were defrauded based on reimbursements paid for Depakote due to Abbott's illegal marketing practices. The settlement that was approved today includes a criminal fine and forfeiture totaling $700 million and civil settlements with the federal government and the states totaling $800 million. The civil settlement includes $270 million for the federal government's share of the Medicaid program; $239 million for the states' share of the Medicaid program; and $291 million for Medicare and other federal programs. Abbott will also pay a $500 million fine to the federal government, $198.5 million in criminal asset forfeiture penalties, and $1.5 million to Virginia MFCU to cover investigative costs. Virginia's share of the Medicaid civil settlement is $4.2 million. 

Abbott must also agree to the terms of a Corporate Integrity Agreement with the Office of the Inspector General for the Department of Health and Human Services.

"I've made fighting Medicaid fraud a priority in Virginia by increasing the size of our fraud team by adding 30 new people over the last two years," said Cuccinelli. "I'm committed to ensuring that money intended for medical services for the poor isn't stolen from them and the taxpayers through fraud. Medicaid dollars are limited, and fraud deprives people in true need of necessary medical care."

He continued, "This settlement will allow 49 states, the District of Columbia, and the federal government to recover money fraudulently taken from Medicaid, Medicare, and other health care programs." Louisiana is pursuing separate litigation.

On May 7, Abbott pled guilty to misbranding Depakote by promoting the drug to control agitation and aggression in elderly dementia patients and to treat schizophrenia when neither of these uses was FDA approved. In an agreed statement of facts filed in the criminal action, Abbott admitted that from 1998 through 2006, the company maintained a specialized sales force trained to market Depakote in nursing homes for the control of agitation and aggression in elderly dementia patients, despite the absence of credible scientific evidence that Depakote was safe and effective for that use. In addition, from 2001 through 2006, the company marketed Depakote in combination with atypical antipsychotic drugs to treat schizophrenia, even after its clinical trials failed to demonstrate that adding Depakote was any more effective than an atypical antipsychotic alone for that use.

The FDA is responsible for approving drugs as safe and effective for specified uses. Under the Food, Drug and Cosmetic Act (FDCA), a company in its application to the FDA must specify each intended use of a drug. A company's promotional activities must be limited to only the intended uses that are FDA approved. Promotion by the manufacturer for other uses - known as "off-label" uses - renders the product misbranded, and is illegal.

Virginia's role in the Abbott case
In September 2007, the Virginia attorney general's Medicaid Fraud Control Unit (MFCU) was contacted with allegations of off-label drug marketing by Abbott Pharmaceuticals.

Although neither the whistleblowers nor the defendant in this case were located in Virginia, the whistleblowers came to Virginia because the MFCU has a national reputation for successfully investigating major national cases, such as the Purdue Pharma Oxycontin case, the Octagon case, and others.

Following Virginia MFCU's initial investigation, the unit contacted the U.S. Attorney's Office for the Western District of Virginia because of their history of working together on such cases. They then began a joint investigation.

On October 31, 2007, the first qui tam ("whistleblower") suit was filed in the United States District Court in Abingdon, Va., against Abbott Laboratories for marketing the drug Depakote for off-label uses. Three other qui tam complaints from other relators were subsequently filed.

MFCU investigators operating out of the attorney general's offices in Roanoke and Abingdon were assigned to the investigation full-time and spent more than four years and 38,000 man-hours on the investigation, traveling to 26 states to conduct interviews and sifting through more than one million records looking for evidence.

The investigation uncovered that Abbott illegally marketed Depakote for non-approved uses, including as an alternative to antipsychotics to treat dementia patients in nursing homes, and for schizophrenia. The investigation also revealed that Abbott paid rebates to health care professionals and long-term care pharmacies for increasing their off-label use of Depakote. 

Attorney General Cuccinelli would like to thank Randall "Randy" Clouse, Director and Chief of Health Care Fraud and Elder Abuse section, and the following MFCU investigators and attorneys for their work in this case: Erica Bailey, Mary Blackburn, Steve Buck, Beverly Darby, Harold Erwin, Elizabeth Fitzgerald, William Clay Garrett, Doug Johnson, John Johnston, Kristy Knighton, Adele Neiburg, John Peirce, and Joey Rusek.

Virginia's MFCU: A history of stopping Medicaid fraud
The Virginia MFCU was established in 1982 within the attorney general's office to investigate and prosecute insurance fraud against the federally funded Medicaid program for indigent health services. MFCU employs a professional staff of criminal investigators, auditors, and several assistant attorneys general who are experienced in commercial and financial investigations. MFCU works regularly with federal and state law enforcement agencies, as well as private insurance companies operating within Virginia.

Over the past 30 years, prior to the Abbott case, Virginia's MFCU had recovered nearly $800 million by tracking down and prosecuting Medicaid fraud offenders. This fiscal year alone, MFCU has recovered more than $22 million. MFCU was also involved in the recovery of more than $634 million after a joint criminal investigation revealed that Purdue Pharma Company fraudulently misbranded the drug OxyContin by marketing the drug to physicians as a slower release -- and thus less addictive -- drug than other prescription opioids. 

From 2010 to today, Attorney General Cuccinelli increased the number of Medicaid fraud and elder abuse staff by more than 50 percent (from 56 to 86) to better combat fraud in Virginia's Medicaid program and to protect the elderly from individuals who abuse and neglect them in nursing homes and health care facilities. It is the only section of the office that he has grown significantly during his tenure, while he has maintained a smaller general fund budget allocation than when he came into office.

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