MSD Office Holiday Office Hours

The Staff of MSD would like to take this time to wish you and your family a warm, safe and happy Thanksgiving, giving thanks for all that we have, especially for the blessing and joy of family. The Delaware State Fire Marshal's Office has provided a reminder on the importance of fire safety in the kitchen. Thanksgiving is the leading day of the year for home fires involving cooking equipment.

In celebration of the Thanksgiving holiday, MSD offices will be closed on Thursday, November 23 and Friday, November 24.

Informative Education Program, Resolutions Adopted

MSD President Robert J. Varipapa, MD welcomed MSD members to the 234th Annual Meeting on Saturday, November 18th. The event took place at the Christiana Hilton in Newark. MSD was honored to host American Medical Association President, Jesse M. Ehrenfeld, MD, MPH. Senator Tom Carper accepted the 2023 President's Award and 50-Year Medical Service graduates in attendance accepted their honors. A robust educational program on Food as Nutrition exceed expectations and included a cooking demonstration with Drs. Kushner and Burday as chefs. MSD's Annual Council Meeting took place, adopting resolutions, accepting the 2024 budget, approving changes to the MSD Bylaws, and voting in elected seats. Please read the Annual Meeting Summary for more details about the meeting. MSD thanks all of its sponsors who contributed to this event. (Pictured is Dr. Varipapa providing opening remarks.)

MSD Highlighted in Report and During AMA Interim Meeting in November

To date there has not been comprehensive assessment of the efforts taken by organized medicine to advance health equity. As part of its commitment to embedding racial justice and advancing health equity, the American Medical Association (AMA) is working with racial justice organizations and other partners to bring together and support professional societies engaged in health equity work. One such support is the development of a national repository of state and specialty society policies, programs and actions focused on health equity. To that end, the AMA has produced and recently released the 2023 Health Equity in Organized Medicine Survey Report.

MSD has made a commitment to eliminate harmful race-based clinical algorithms, ensure our leadership and membership are truly diverse, and advance equity within the structures and policies internal to the organization. The Medical Society of Delaware was showcased at the AMA Interim Meeting that took place November 10-14, 2023, on its work to help eliminate raced-based clinical algorithms that incorrectly use race by taking proactive steps to ensure the elimination of the race correction factor in estimated glomerular filtration rate (eGFR or kidney function) calculations throughout the state by contacting all known labs. Read MSD's initiative on page 29 of the Report.

Through the Inflation Reduction Act

The Health Resources and Services Administration (HRSA) is sharing with rural health care professionals in the states the availability of funding to support health care organizations, especially safety net providers, in taking advantage of the tax credits, grants, and other supports made available by the historic Inflation Reduction Act (IRA) for projects to improve facility sustainability and climate resilience. The legislation creates unprecedented opportunities for health sector organizations to make investments in energy efficiency, renewable energy, Infrastructure resilience, and more.

The Department of Health and Human Services (HHS) Office of Climate Change and Health Equity (OCCHE) will be launching a “catalytic program” early in 2024 to help organizations understand how to take advantage of these programs and funding. OCCHE’s program will include collaboration with federal partners such as the Environmental Protection Agency and Department of Energy and will feature a series of national webinars on the various programs and opportunities, as well as breakout sessions by health care professional type to help organizations assess their needs and navigate IRA opportunities.

More details on the initiative will be provided during a November 30^th information session which you can sign up for here. Note that this webinar will be recorded and HRSA will send the link through the FORHP Weekly announcements when it is available. 

Vaccine for RSV Disease

Last week the Centers for Disease Control and Prevention (CDC) announced the release of more than 77,000 additional doses of Beyfortus (nirsevimab-alip), a long-acting monoclonal antibody designed to protect infants against severe respiratory syncytial virus (RSV) disease. These additional doses will be distributed immediately to physicians and hospitals through the Vaccines for Children Program and commercial channels – improving the availability for parents seeking to protect their eligible children, particularly those at highest risk of severe illness. CDC and FDA will continue to be in close contact with manufacturers to help ensure the availability of additional doses through end of this year and for early 2024 to meet the demand.

Physician Practice Information (PPI) Survey

Thousands of U.S. physicians are getting a short patient-care hours survey from either their practice directly or from Mathematica. The input from physician practices and individual physicians randomly selected to participate in this study, launched in July, is critical for its success. Participation will ensure that practice expenses and patient-care hours are accurately reflected. Read more.

Estimates for U.S. Through November 11th

The Centers for Disease Control and Prevention (CDC) posted its first preliminary in-season flu burden estimates for the U.S. CDC estimates that from Oct. 1, 2023, through Nov. 11, 2023, there were between 780,000 -1.6 million flu illnesses, 360,000-770,000 flu-related medical visits, 8,000 to 17,000 flu-related hospitalizations, and 490-1,500 flu-related deaths. Estimates are based on Influenza Hospitalization Surveillance Network data.  

Flu Vaccines to Change in the Future

Flu vaccines will undergo a change in the future. Regulatory agencies have recommended that B/Yamagata lineage vaccine viruses be removed from flu vaccines in the future because these viruses have not been detected and, as a result, no human infections with it have been identified since March 2020. That means flu vaccines would go back to being trivalent, protecting against three different flu viruses. 

Wrong Size Cuffs Results in Inaccurate Measurements

The medical community has in recent years upped the attention it gives to the crucial preparatory and positioning steps in accurate blood pressure measurement. Nevertheless, millions of patients may still be getting mismeasured because their care teams continue to overlook one all-important detail: using an appropriately sized BP cuff. Using the wrong size of BP cuff results in strikingly inaccurate measurements, according to a study published in JAMA Internal Medicine. The authors found that use of a regular BP cuff resulted in a 3.6 mm Hg lower systolic BP reading among individuals who needed a small cuff. It also resulted in a 4.8 mm Hg and a 19.5 mm Hg higher systolic BP among those who needed a large or an extra-large cuff, respectively. Read more.

MSD Relaunches it's Mentorship Program - Join the Fun!

The Committee on Membership’s ad hoc work group has relaunched MSD’s mentorship program. All are welcome. You will be paired with a physician who you will meet and connect with based on your desired timelines and desired level of engagement. This program is built for you! Opportunities for individual and group meet-and-greets, check-ins, and virtual and/or in person events are being planned for everyone. You will make a difference! Current members of this workgroup include: Raghda Bchech, MD; Jay Dave, DO; Nicole Kushner, DO & Cydney Teal, MD. For questions contact Michelle.Seymour@medscodel.org

Sign up to participate today! Click the survey link below or scan the QR code with your phone: https://www.surveymonkey.com/r/MSDMentorProgram

"Kind to Kids" - Children, Teens in Foster Care Affected by Trauma

The Medical Society of Delaware (MSD) has selected Kind to Kids as our winter season charity fundraising beneficiary. Our goal is to raise $1,200 to help children and teens in foster care who are victims of child abuse and neglect. Your donation will provide direct support for a child in foster care. Kind to Kids is a foundation that helps meet the needs of children and teens in foster care who are deeply affected by the trauma in their lives. 100% of every dollar donated online will go directly to help a foster child during these difficult times. Please donate now and help us make a difference in the lives of these deserving kids. You can donate online at https://www.classy.org/fundraiser/5051939. Thank you for your support! 

Responding After a Physician Suicide

After the death of a physician from suicide, the organization’s response should be the same as if the death occurred from a car accident or cancer. This approach minimizes stigma and reduces the risk of suicide contagion. If family members approve of a memorial service or remembrance event, coordinate with them to ensure the event matches the religious beliefs and values of the physician who died. Offer support and mental health resources over several communications with team members.

LEARN MORE:

Toolkits:

• After a Physician Suicide
• Peer Support Program for Physicians

Checklist:

• After a Physician Suicide (PDF)

Podcast:

• Tackling Physician Burnout One Story at a Time

Webinar:

• Stress First Aid for Health Care Professionals

AMA STEPS Forward^® offers a collection of engaging and interactive educational content designed to help put the joy back into medicine.

Due to Presence of Undeclared Glyburide and Metformin

SugarMDs is recalling Lot: 22165-003 Advance Glucose Support Capsules in 60, 120 and 180 count bottles because FDA analysis has found the product to be tainted with glyburide and metformin. Glyburide and Metformin are active ingredients found in several FDA-approved prescription drugs used to treat type 2 diabetes. Products containing glyburide and metformin cannot be marketed as dietary supplements. Advanced Glucose Support Capsules are an unapproved new drug for which safety and efficacy have not been established and, therefore, subject to recall.

Infusomat Space Volumetric Infusion Pump System Recall

B. Braun Medical, Inc is recalling Infusomat Space Volumetric Infusion Pump System due to faulty occlusion alarms. On certain models, an occlusion alarm may sound when no occlusion exists, causing the pump to stop the delivery of medications, such as high-risk medications like vasopressors. The FDA has identified this as a Class I recall, the most serious type of recall. Use of these devices may cause serious injuries or death.

Due to Acetaminophen Instability

KinderFarms, LLC is voluntarily recalling all lots of KinderMed Infants’ Pain & Fever (oral suspension) and KinderMed Kids’ Pain & Fever (oral suspension) to the retail and consumer level. These products are being voluntarily recalled due to acetaminophen instability. The two products were manufactured and packaged for KinderFarms by a major, U.S.-based OTC pharmaceutical manufacturer with over 30 years of experience. Ongoing testing of sample batches indicated some product lots were no longer in specification and may pose a health risk. Out of an abundance of caution, KinderFarms has made the decision to voluntarily recall all KinderMed Pain & Fever products. As a result of the potential health risk with acetaminophen being outside of specification, the product may cause acute adverse health effects, including abdominal pain, nausea, vomiting or jaundice at higher doses.

Due to Malfunctions with Unintended Movement of Device

Asensus Surgical is recalling the Senhance Surgical System due to malfunctions that cause unintended movement of the robotically-assisted surgical device. This issue presented itself as an uncontrolled arm motion of the Laparoscope Instrument Actuator (LIA) where the LIA rotated continuously in one direction after the Surgeon removed the engagement of teleoperation on the Senhance System. The Senhance System is designed with emergency stop capabilities to stop this issue if observed. There has been no patient impact or harm that has occurred due to this issue, however, the potential for critical tissue trauma is possible.

Due to Serious Risks

The U.S. Food and Drug Administration (FDA) is warning consumers to not purchase or use any Neptune’s Fix products, or any other product with tianeptine -- a potentially dangerous substance that is not FDA-approved for any medical use but is illegally sold with claims to improve brain function and treat anxiety, depression, pain, opioid use disorder and other conditions. FDA has received severe adverse event reports after use of Neptune‘s Fix products, including seizures and loss of consciousness leading to hospitalization. Consumers who experience a bad reaction to any tianeptine product should seek immediate medical help. Neptune Fix’s labels state the product contains tianeptine, but may contain other harmful ingredients not listed on the label. These products, like other tianeptine products, can be purchased online and at gas stations, vape or smoke shops, or other locations. FDA is testing these products and will provide more information as it becomes available. FDA also continues to warn consumers about risks of using tianeptine. Learn More

Health professionals are encouraged to report adverse events or side effects related to the use of these products to the FDA's MedWatch Safety Information and Adverse Event Reporting Program.

FDA Issues Safety Communication

On Tuesday this week, the U.S. Food and Drug Administration (FDA) issued a safety communication to provide additional information about the voluntary recall of SoClean2 and SoClean3 equipment used to clean, sanitize or disinfect CPAP devices and accessories. This SoClean device recall includes new instructions for device use, including the importance of using a hose and mask adapter provided by the company. This voluntary recall is intended to help reduce potential health risks of exposure to ozone gas after the use of SoClean2 or SoClean3 equipment.

Due to Presence of Undeclared Sildenafil

Noah’s Wholesale is recalling one lot of the rock# 03032021, Exp: 12/2027,1200 mg/capsule because FDA analysis has found the product to be tainted with Sildenafil. Sildenafil is an ingredient known as a Phosphodiesterase Inhibitor (PDE-5) found in FDA-approved products for the treatment of male erectile dysfunction. The presence of sildenafil in this product renders the rock an unapproved drug for which the safety and efficacy has not been established and, therefore, subject to recall. Consumption of products with undeclared sildenafil may interact with nitrates found in some prescription drugs (such as nitroglycerin) and may cause a significant drop in blood pressure that may be life threatening. People with diabetes, high blood pressure, high cholesterol, or heart disease often take nitrates. Among the adult male population, who are most likely to use this product, adult males who use nitrates for cardiac conditions are most at risk. Noah’s Wholesale has not received any reports of adverse events related to this recall to date.

Due to Presence of Microbial Contamination

Bayer is recalling one lot of Vitrakvi (larotrectinib) Oral Solution 20 mg/mL in 100 mL glass bottles due to microbial contamination identified as Penicillium brevicompactum observed during routine ongoing stability testing. Given that Vitrakvi is indicated for the treatment of solid tumors that are NTRK gene fusion positive, it is expected that patients on Vitrakvi may be immunocompromised. Although there is little data in the literature on human pathology caused by Penicillium brevicompactum, there are cases of invasive disease caused by similar Penicillium species, particularly in patients with underlying immunosuppression. Therefore, there is a reasonable probability that ingestion of Penicillium brevicompactum in patients on Vitrakvi with underlying immunosuppression may result in invasive fungal infections of the blood or pneumonia that can be life-threatening. To date, Bayer has not received any adverse events related to this recall.

ChristianaCare

Jennifer A. Ranton, MD

MSD spotlights members throughout the state, highlighting medical students, residents, and practicing colleagues, whether they are new to membership or have been a member over the years.

This week's spotlight is on Jennifer A. Ranton, MD, Family Medicine physician with Saint Francis Family Practice & Tiny Steps. Read more about Dr. Ranton.

If you would like to be featured in a future Member Spotlight, please contact Michelle Seymour, Manager of Membership.

Uma Chatterjee, MD - OB/GYN, Saint Francis Women's Center

Yvette Gbemudu, MD - Family Medicine, Henrietta Johnson Medical Center

Susan M. Green, MD - Occupational Medicine, Internal Medicine, Retired

Nemish Mehta, MD - Pediatrics, Bear Internal Medicine and Pediatrics, PA

Shilpa P. Mehta, MD - IM/Peds, Bear Internal Medicine and Pediatrics, PA

Please join MSD in welcoming the newest members of the Medical Society of Delaware. As the third oldest medical society in the country, MSD has an amazing history. Thank you for taking part in our continued success!

Charles G. Case, MD - Family Medicine, Henrietta Johnson Medical Center

Dean E. Johnson, MD - EM, Bayhealth, EM Residency Program Director

MSD members are afforded a seven-day review period from the date of this publication to comment regarding applicants for membership. Please contact Michelle Seymour at (302) 224-4905 or Michelle.Seymour@medsocdel.org with any comments on the current pending members(s) listed above or if you know of someone interested in joining MSD. You could be eligible for a membership referral dues discount!

The Latin phrase Rerum Cognoscere translates to learn, examine, or become aware of facts or things. In this section, we highlight measurable items of interest in health care from MSD, Delaware, the US, and the world.

• Ellume tests available for those who are blind or have low vision (free at-home COVID-19 tests) https://acl.gov/accessibletests
• Find COVID-19 Vaccines: https://www.vaccines.gov/
• No Cost COVID-19 Testing Locator can help people find current community and pharmacy partners participating in the Increasing Community Access to Testing (ICATT) program.
• FDA At-Home OTC COVID-19 Diagnostic Tests provides a list of all FDA-authorized at-home over-the-counter (OTC) COVID-19 diagnostic tests
• Federal website for information on navigating COVID: COVID.gov
• CDC Isolation and Precautions for People with COVID-19
• COVID-19 Therapeutics Locator
• CDC COVID Data Tracker
• CDC will report regional-level test positivity data from the National Respiratory and Enteric Virus Surveillance System (NREVSS)
• COVID-19 by County Community Level Check (# hospital admissions and beds used and total number of new cases)
• (Delaware) General Questions: call 211 or email DPHCall@delaware.gov or Vaccine@delaware.gov for vaccine-specific questions.
• Latest information on Delaware's response (testing, treatment, vaccination): de.gov/coronavirus (Updated 2/2023)