Morning Rounds: Raw Deals and Medical Mysteries

Good Morning.

Three medical mysteries that have experts scrambling today sound more like financial headlines than health: They're all about dough, raw deals, and jobs.

First up, raw dough: Microbiologists from the FDA are in Danville, Va. this morning, scouring a Nestle factory for clues. The plant is thought to be the source of the contaminated raw cookie dough (recalled last Friday) that has sickened at least 65 people in 29 states. The big question: How did E.coli 0157 — an especially nasty intestinal bug usually limited to cattle — get into the pre-packaged dough?

According to the Washington Post, federal investigators are checking "a broad range of possible factors," including all ingredients, worker health, plant equipment and location. The Post says:

Federal officials are also considering whether the dough might have been intentionally contaminated.

Meanwhile, outraged veterans and radiation oncologists around the country are wondering why it took six years for regulators to discover that at least one surgeon at the Philadelphia VA Medical Center was routinely botching surgeries to treat prostrate cancer, and then covering up his mistakes.

 

The treatment involved the improper placement of radioactive seed implants. According to the Philadelphia Inquirer,

Of 92 mismanaged cases, 57 men got significantly less radiation than prescribed, and 35 received excessive doses, including 25 who received too much radiation to the rectum.

The New York Times says that federal officials are also investigating cases of flawed implants at V.A. hospitals in Jackson, Miss., and Cincinnati.

And now about jobs, or rather Steve Jobs, the Apple CEO who has a slow-growing form of pancreatic cancer (an islet cell neuroendocrine tumor) that may or may not have spread to his liver. The Wall Street Journal got a tip Friday that Jobs is now recovering from a liver transplant he got at an unnamed hospital in Tennessee (Memphis reporters and bloggers think the surgery was there, though that's not been confirmed).

Jobs' personal plight shines a celebrity light on a problem that frustrates many transplant candidates: Why do waitlists for donated livers vary so widely from region to region (a median wait of more than 300 days nationally, compared to 48 days in Tennessee)?