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How Corporate Health Care Leaders Maintain Their Impunity: The Case of Purdue Pharma's Funding of the Washington Legal Foundation to Attempt to Weaken the Responsible Corporate Officer Doctrine

The ongoing epidemic of narcotic (opioid) abuse, and the resulting rise in the deaths due to overdoses, has focused attention on pharmaceutical companies' aggressive promotion of these drugs which minimized their substantial risk. A recent article in the Intercept showed how the leadership of one such company tried to insulate itself from responsibility for such actions even while such promotions were continuing. Background: Impunity of Top Leaders of Big Health Care Organizations For years, we have railed against the impunity of top leaders of health care organizations.  We have noted that despite numerous legal settlements made by health care organizations of alllegations like fraud , bribery , and kickbacks , almost never do top leaders who presided over these actions face any negative consequences.  Lack of deterrence caused by such impunity appears to be a major cause of  the epidemic of continuing unethical behavior, crime and corruption on the part of large health car

Health Care and Your Gallbladder

The gallbladder is a 4-inch, pear-shaped organ. It’s positioned under your liver in the upper right section of your abdomen. The gallbladder stores bile, a combination of fluids, fat, and cholesterol. Bile helps break down fat from food in your intestine. The gallbladder delivers bile into the small intestine. This allows fat-soluble vitamins and nutrients to be more easily absorbed into the bloodstream. If you have problems with your gallbladder, you can feel very sick and not know exactly what’s going on until you get medical attention.

According to Every Day Health.com, the gallbladder releases bile, via the cystic duct, into the small intestine to help break down the foods you eat — particularly fatty foods. Typically the gallbladder doesn't cause too many problems or much concern, but if something slows or blocks the flow of bile from the gallbladder, a number of problems can result. Most gallbladder symptoms start with pain in the upper abdominal area, either in the upper right or middle. Below are common symptoms of gallbladder conditions:

·         Severe abdominal pain
·         Pain that may extend beneath the right shoulder blade or to the back
·         Pain that worsens after eating a meal, particularly fatty or greasy foods
·         Pain that feels dull, sharp, or like cramps
·         Pain that increases when you breathe in deeply
·         Chest pain (angina)
·         Heartburn, indigestion, and excessive gas
·         A feeling of fullness in the abdomen
·         Vomiting, nausea, fever
·         Shaking with chills
·         Tenderness in the abdomen, particularly the right upper quadrant
·         Jaundice (yellowing of the skin and eyes)
·         Stools of an unusual color (often lighter, like clay)

Some gallbladder problems, like simple gallstones that are not blocking the cystic duct, often cause no symptoms at all. They're most often discovered during an x-ray or CT scan that's performed to diagnose a different condition, or even during an abdominal surgery. More detailed info is located at this website: http://www.everydayhealth.com/gallbladder/symptoms/.

Gallstones form when substances in bile harden. Rarely, you can also get cancer in your gallbladder, according to the National Institutes for Health (NIH). Many gallbladder problems get better with removal of the gallbladder. Fortunately, you can live without a gallbladder. Bile has other ways of reaching your small intestine. More details are found at this site: https://www.nlm.nih.gov/medlineplus/gallbladderdiseases.html.

According to HealthLine.com, any disease that affects your gallbladder is considered a gallbladder disease. Symptoms of a gallbladder problem may come and go. However, you’re more likely to develop a gallbladder problem if you’ve previously had one. While gallbladder problems are rarely deadly, they should still be treated. You can prevent gallbladder problems from worsening if you take action and see a doctor. More info is found at this website: http://www.healthline.com/health/gallbladder-problems-symptoms#3.

Some problems associated with the gallbladder are gallstones, gallbladder attack and gallbladder disease. Gallbladder pain is usually caused by biliary colic, gallstones, cholecystitis, pancreatitis and cholangitis, according to LiveScience.com. Gallstones in particular are troublesome, and they are solidified particles of substances in the bile. They are made of a combination of bile salts, cholesterol and bilirubin. 

Gallstones can be as small as a grain of sand or as large as a golf ball. Gallstones can block the gallbladder ducts so that bile cannot reach the small intestine as effectively, which may prevent the gallbladder from doing its job and can lead to other gallbladder diseases. And, while most gallstones pass on their own, some require a minor procedure or even surgery.

According to the Mayo Clinic, factors that contribute to the risk of gallstones include obesity, high-fat or high-cholesterol diets, diabetes and taking medicines with estrogen. Women, people over 60, Native Americans and Mexican-Americans are also at a higher level of risk. Symptoms of a gallbladder attack may be similar to those of a heart attack and other conditions, so it is important to consult a doctor for a correct diagnosis. More info about the gallbladder is located at this site: http://www.livescience.com/42965-gallbladder.html.

Gallbladder problems are more common than you may think. Gallstones affect more than 25 million Americans with 1 million new cases diagnosed annually, according to the American Gastroenterological Association. And there are other things that go wrong with the gallbladder besides just gallstones, according to GallbladderAttack.com. People can go for years with digestive symptoms and never realize that they may be related to a gallbladder problem.

That's because they are so interwoven with other digestive symptoms such as indigestion, gas, bloating, constipation, diarrhea and nausea. Much more detailed material is located at this website, including some naturopathic options for treatment: http://www.gallbladderattack.com/gallbladdersymptoms.shtml.

Because gallstones are related to diet, particularly fat intake, the incidence of gallstones varies widely among nations and regions. For example, Hispanics and Northern Europeans have a higher risk for gallstones than do people of Asian and African descent. People of Asian descent who develop gallstones are most likely to have the brown pigment type, according to the University of Maryland Medical Center (UMMC).

Also, having a family member or close relative with gallstones may increase the risk. Up to one-third of cases of painful gallstones may be related to genetic factors. Studies indicate that the disease is complex and may result from the interaction between genetics and environment. Some studies suggest immune and inflammatory mediators may play key roles.

The UMMC reports as well that people with diabetes are at higher risk for gallstones and have a higher-than-average risk for acalculous gallbladder disease (without stones). Gallbladder disease may progress more rapidly in patients with diabetes, who tend to have worse infections. As well, being obese or overweight is a significant risk factor for gallstones. In such cases, the liver over-produces cholesterol, which is delivered into the bile and causes it to become supersaturated.

Men are also at increased risk for developing gallstones when their weight fluctuates. The risk increases proportionately with dramatic weight changes as well as with frequent weight cycling. For a significant in-depth study of gallbladder health issues, visit this website: http://umm.edu/health/medical/reports/articles/gallstones-and-gallbladder-disease.

If you have gallbladder disease, your gastroenterologist may recommend removing your gallbladder, according to the Florida Medical Clinic. You may need a referral from your family doctor if you don’t already have a specialist in this area of treatment. The surgical removal of the gallbladder is called a cholecystectomy. Gastroenterology is the study of the normal function and diseases of the esophagus, stomach, small intestine, colon and rectum, pancreas, gallbladder, bile ducts and liver. More details are found at this site: https://www.floridamedicalclinic.com/recognizing-the-symptoms-of-a-gallbladder-attack/.

If you feel you may be experiencing symptoms of a gallbladder attack, get to your doctor or a medical facility as soon as possible to rule out other possible health issues. Get an action plan to deal with your pain and for any treatment that is recommended. The short and long term effects of getting a proper diagnosis and follow through is critical to reduce pain and suffering.

Until next time. 

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