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  • Early prenatal care, considered best for moms and babies, is on the decline in the US, data shows

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    Early prenatal care improves the chances of having a healthy pregnancy and baby. But a new federal report shows it’s been on the decline.The share of U.S. births to women who began prenatal care in the first trimester dropped from 78.3% in 2021 to 75.5% in 2024, according to data released by the Centers for Disease Control and Prevention on Thursday.Meanwhile, starting care later in pregnancy or getting no care at all has been on the rise. Prenatal care beginning in the second trimester rose from 15.4% to 17.3%, and starting care in the third trimester or getting no care went from 6.3% to 7.3%.“We know that early engagement in prenatal care is linked to better overall health outcomes,” said Dr. Clayton Alfonso, an OB-GYN at Duke University in North Carolina. When patients delay medical care during pregnancy, “we’ve missed that window to optimize both fetal and maternal care.”While the trend identified in the report held for nearly all racial and ethnic groups, the decrease in early prenatal care was higher for moms in minority groups. For example, first-trimester care dropped from 69.7% in 2021 to 65.1% in 2024 for Black mothers. Getting late or no prenatal care raises the risk of maternal mortality, which is much higher among Black mothers.Michelle Osterman, lead author of the report, said the overall findings represent a shift. Between 2016 and 2021, the timing of when U.S. women started prenatal care had been improving.The earlier prenatal visits begin, doctors said, the earlier problems can be caught. Visits give doctors a chance to share health guidance, and can include blood pressure checks, screenings, blood tests, physical exams and ultrasound scans.The report doesn’t provide reasons why prenatal care is starting later. But the proliferation of maternity care deserts across the nation is a growing concern, said Dr. Grace Ferguson, an OB-GYN in Pittsburgh.Many hospitals have shut down labor and delivery units “and the prenatal care providers that work at those hospitals also have probably moved,” said Ferguson, who was not involved with the report.A 2024 March of Dimes report found that more than 35% of U.S. counties are maternity care deserts, meaning there’s no birthing facility or obstetric provider. Women living in these areas receive less prenatal care, the report showed.Ferguson, who provides abortions as part of her OB-GYN care, said post-Roe v. Wade abortion restrictions may play a part because some obstetricians are choosing not to practice in states with more restrictive laws.Alfonso, who was not involved in the CDC report, said he also suspects that access issues for patients are pushing prenatal care later, particularly in rural areas. Patients may have to travel farther to get to appointments and may struggle to find a practice that accepts their insurance, particularly if they have Medicaid.Doctors fear that things could get worse.“If this trend continues,” Alfonso said, “I worry about kind of what that would mean for morbidity and mortality for our moms.”

    Early prenatal care improves the chances of having a healthy pregnancy and baby. But a new federal report shows it’s been on the decline.

    The share of U.S. births to women who began prenatal care in the first trimester dropped from 78.3% in 2021 to 75.5% in 2024, according to data released by the Centers for Disease Control and Prevention on Thursday.

    Meanwhile, starting care later in pregnancy or getting no care at all has been on the rise. Prenatal care beginning in the second trimester rose from 15.4% to 17.3%, and starting care in the third trimester or getting no care went from 6.3% to 7.3%.

    “We know that early engagement in prenatal care is linked to better overall health outcomes,” said Dr. Clayton Alfonso, an OB-GYN at Duke University in North Carolina. When patients delay medical care during pregnancy, “we’ve missed that window to optimize both fetal and maternal care.”

    While the trend identified in the report held for nearly all racial and ethnic groups, the decrease in early prenatal care was higher for moms in minority groups. For example, first-trimester care dropped from 69.7% in 2021 to 65.1% in 2024 for Black mothers. Getting late or no prenatal care raises the risk of maternal mortality, which is much higher among Black mothers.

    Michelle Osterman, lead author of the report, said the overall findings represent a shift. Between 2016 and 2021, the timing of when U.S. women started prenatal care had been improving.

    The earlier prenatal visits begin, doctors said, the earlier problems can be caught. Visits give doctors a chance to share health guidance, and can include blood pressure checks, screenings, blood tests, physical exams and ultrasound scans.

    The report doesn’t provide reasons why prenatal care is starting later. But the proliferation of maternity care deserts across the nation is a growing concern, said Dr. Grace Ferguson, an OB-GYN in Pittsburgh.

    Many hospitals have shut down labor and delivery units “and the prenatal care providers that work at those hospitals also have probably moved,” said Ferguson, who was not involved with the report.

    A 2024 March of Dimes report found that more than 35% of U.S. counties are maternity care deserts, meaning there’s no birthing facility or obstetric provider. Women living in these areas receive less prenatal care, the report showed.

    Ferguson, who provides abortions as part of her OB-GYN care, said post-Roe v. Wade abortion restrictions may play a part because some obstetricians are choosing not to practice in states with more restrictive laws.

    Alfonso, who was not involved in the CDC report, said he also suspects that access issues for patients are pushing prenatal care later, particularly in rural areas. Patients may have to travel farther to get to appointments and may struggle to find a practice that accepts their insurance, particularly if they have Medicaid.

    Doctors fear that things could get worse.

    “If this trend continues,” Alfonso said, “I worry about kind of what that would mean for morbidity and mortality for our moms.”

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  • ‘You feel helpless’: A Mideast health system buckles after U.S. cuts

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    AL KAWD, Yemen  — In the cramped examination room of this tiny village clinic, Rania Moussa lay on her side and covered her eyes with a pillow, her slight, childlike-frame belying the fact she is 13 years old. It had been days since she had taken an injection of the powerful antibiotics she needs to manage her condition, a type of anemia.

    But the clinic, which used to give them for free, now had none to offer; and aid cuts since the U.S. froze assistance last year meant it was unlikely to get them anytime soon. Without the medication, Rania’s mother said, her daughter couldn’t do anything.

    “She can’t walk; she can barely move. I had to carry her here. We could get the shots before, but now none of the clinics have them, so I have to buy them from pharmacies,” said Jamilah Omar, Rania’s mother. “We can barely afford food, let alone medications.”

    Somehow, Omar scraped together money for the antibiotics, which the clinic staff administered.

    In the year since the evisceration of U.S. Agency for International Development at the hands of Elon Musk and his so-called Department of Government Efficiency, or DOGE, discussions on its shuttering can devolve into political point-scoring, with advocates and opponents of the Trump administration shouting over each other about the savings made or lack thereof.

    Remnants of signage for the U.S. Agency for International Development on the facade of the Ronald Reagan Building and International Trade Center in Washington, D.C., on Dec. 29, 2025.

    (Brendan Smialowski / AFP via Getty Images)

    But it’s here, in places like the dust-swept grouping of cinder-block houses and dilapidated buildings that make up Al Kawd, where the real-world impact of those cuts can be most clearly felt.

    “You feel helpless,” said Areeda Fadhli, the 53-year-old medical assistant managing the clinic, as she shifted the pillow away to look at Rania’s face.

    “Imagine your son, your daughter, fading in front of you,” she said. “How do you think that feels?”

    Fadhli pointed to some boxes of basic medical supplies squirreled away in a corner.

    “It’s the last shipment and it came more than nine months ago,” she said. “We’re trying to stretch them as much as possible.”

    The contractions in Yemen reflect a wider ravaging of foreign assistance worldwide. In 2025, the U.S. pledged $3.4 billion in global aid, a fraction of the $14.1 billion funded under President Biden. That includes funds from USAID and other U.S. entities.

    And that amount is getting only smaller: Late last year, the Trump administration announced in 2026 it would provide $2 billion to U.N. programs in 17 countries, while pointedly excluding Afghanistan and Yemen.

    Two people in green shirts hold a child's head.

    Rabii Nasr, a nurse, cleans a child’s wound at a hospital in Yemen’s Abyan province. Her injury did not require stitches, which was fortunate because the hospital had run out of stitches and surgical thread.

    (Nabih Bulos/Los Angeles Times)

    Other wealthy nations are following suit, with Germany more than halving its humanitarian budget for 2026 compared with last year. France is planning to reduce development assistance by nearly 40%, and the U.K. is shrinking aid expenditures from 0.5% to 0.3% of its gross national income by 2027.

    The Trump administration offered different justifications for cutting foreign assistance. President Trump alleged there were “billions and billions of dollars in waste, fraud and abuse” while DOGE officials boasted about the cost savings. Secretary of State Marco Rubio said USAID did not serve, and in some cases harmed, the “core national interests of the United States.”

    Administration officials brought no evidence of corruption and cited examples of waste that proved to be inaccurate, such as Trump’s assertion that $100 million was spent on condoms to the militant group Hamas in Gaza.

    In any case, observers say the funds earmarked for foreign development assistance in the Biden era amounted to less than 1% of the federal budget.

    Last year, the U.S. slashed funding for Yemen from USAID and other sources from $768 million — amounting to half of the country’s humanitarian response budget in 2024 — to $42.5 million. The result, the U.N. says, is that 453 health facilities have faced partial or imminent closure across the country, including hospitals, primary health centers and mobile clinics.

    The Lancet, the esteemed British medical journal, published a study in July that estimated the cuts to USAID could result in 14 million otherwise preventable deaths worldwide by 2030. The estimates were based in part on the lifesaving effects of USAID’s past work on food security, HIV treatment, medical care and other services.

    The cuts already deeply hit Yemen, a country that is no stranger to tragedy. A calamitous civil war — which began in 2014 when Iran-backed Houthi rebels seized the capital and spurred a furious assault from a Saudi-led coalition — made Yemen in years past the site of the world’s worst humanitarian catastrophes.

    Though Yemen has since been surpassed in devastation by other conflict spots, 19.5 million people — slightly less than half of the population — needed humanitarian assistance in 2025, with the majority of them food insecure, the U.N. says.

    This year, with political upheaval persisting throughout the country, the expectation is that number will increase to 21 million; it’s a situation made more difficult by the Trump administration’s 2025 designation of the Houthis as a foreign terrorist organization.

    A soldier walks by a low wall with the words "American Embassy" on it.

    A soldier walks by the U.S. Embassy in Sanaa, Yemen, on Wednesday.

    (Osamah Abdulrahman / Associated Press)

    The designation, humanitarians say, in effect outlaws aid deliveries to areas under Houthi control, where 70% of the population resides. At the same time, the Houthis have detained 73 U.N. staff members and confiscated vehicles and telecommunications equipment, leaving the U.N. unable to operate.

    “You have the perturbations of the conflict and increased humanitarian needs at the same time as a challenging funding environment constrained the delivery environment,” said Julien Harneis, the U.N.’s resident coordinator in Yemen. “So all the conditions are coming together for a very difficult year.”

    For aid organizations in Yemen that relied on U.S. largesse, the aim has shifted to preserving whatever remains of their operations.

    An aid worker who spoke on condition of anonymity for fear of jeopardizing remaining assistance flows said the organization he worked for had shut down one of its two offices, fired 250 out of 300 employees and suspended support to dozens of health centers. The organization’s portfolio had shrunk from roughly $32 million to $2 million.

    “Yes, we have other donors from Europe and Canada, but it doesn’t equal even 5% of what the Americans would give,” he said.

    Some organizations have tried tailoring proposals to fit Washington’s regional priorities, including countering Iran and Al Qaeda, or by excluding terms that under the Trump administration have in effect become verboten.

    “Anything focusing on gender, feminism, or LGBT protection: A statement with any of those concepts wouldn’t get sign-off,” he said.

    To get a sense of what a difference a year makes, last January, before the aid cuts, Fadhli was about to extend the operations of the Al Kawd clinic from 12-hour shifts to 24.

    Three doctors — an OB-GYN specialist and two general practitioners — already made the daily 52-mile journey from Aden, the main city in Yemen’s south, to Al Kawd to treat about 300 patients every day. Medical assistants, chosen from local village women, received $100 a month and training sessions to work in the clinic and help serve the community’s needs.

    The clinic had enough basic medications for three months, and there was funding to procure specialized medicine for patients with complicated illnesses.

    “People come here because they have no money, but before we could offer them solutions to their problems,” said Dr. Umayma Jamil, the 37-year-old OB-GYN specialist who is the last remaining physician in the clinic. She comes only once a week, paid for by whatever funds the clinic can cobble together.

    Now, Jamil said, she will give a diagnosis, prescribe medicine and then see the patient return with the same complaint.

    “I ask them, ’Did you get medicine?’ And they say they can’t because there’s no money,” Jamil said.

    “It’s natural to be frustrated, but I don’t know what to do. It’s not in my hands.”

    The effects of such a drastic scaling down of aid aren’t restricted to smaller facilities; they extend even to major medical institutions such as Al-Razi, the main hospital in Abyan province, serving more than 30,000 people every year.

    Children are dying, and more children will die later this year

    — Julien Harneis, U.N. resident coordinator in Yemen

    Dr. Muhsen Abdullah, the surgeon who heads the emergency room, spoke with a weary tone of a ward without surgical thread or stitches, and anesthesiologists forced to ask patients to purchase their own anesthetic.

    “Surgical perishables, antibiotics, even iodine and rubbing alcohol — all this the patient has to buy from the outside before they come in for surgery. It’s ridiculous,” he said, adding that some patients postponed procedures because they couldn’t afford postoperative treatment.

    Around him were additional signs of disrepair: an X-ray examination board without a functioning backlight, and a dust-covered ultraviolet sterilization machine that hadn’t worked in months.

    With humanitarian groups operating under extremely tight budgets, there’s little they can do when epidemics hit — assuming they can detect them in the first place, because much of that information relied on health centers reporting outbreaks.

    “Now we have no reports. Zero,” the aid worker said. For example, he said, cholera cases in Yemen would appear to be fewer than last year, although suspected numbers are far larger.

    “How can they tell you anyway? There are no kits to test.”

    In Al Kawd, Fadhli and Jamil have already detected a few cases of cholera in the village. It’s a terrifying prospect, they said, because the disease transmitted by infected water killed a few dozen people — most of them children — last year. But with no money for quarantine or medications, there isn’t much they can do, so they expect the outbreak to get worse.

    That’s in line with predictions from Harneis, the U.N. resident coordinator, who said aid groups in Yemen were anticipating an increase in epidemics “which we won’t be able to control, and an increase in mortality and morbidity, particularly affecting young children.”

    “Children are dying, and more children will die later this year,” he said. And once such outbreaks hit, there’s no guarantee they’ll stay within the confines of Yemen, he added. “Epidemics don’t stop at the border.”

    This month, the U.S. completed its withdrawal from the World Health Organization, a decision, the group said, that made “both the United States and the world less safe.”

    Many in the aid community acknowledge USAID wasn’t perfect and understand complaints that it could be used to promote ideas the Trump administration denounces as “woke.”

    But they nevertheless lament the rollback of their work. One person likened it to America’s abrupt withdrawal from Afghanistan and leaving the field open for the Taliban to destroy all of USAID’s projects.

    “OK, you could say USAID was unsustainable, but there’s an argument to be made you shouldn’t close the tap completely,” said the aid worker, adding his employer has been operating in Yemen since 1994.

    “With this move, you’ve destroyed the work of decades.”

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    Nabih Bulos

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  • Panel tosses ex-UCLA doctor’s sex abuse conviction; lawyers weren’t told of juror’s ‘limited English’

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    An appeals court on Monday overturned a conviction for an ex-UCLA gynecologist serving 11 years in prison on charges of sexually abusing patients after determining that the trial judge failed to inform his lawyers that some of the jurors raised questions about the English proficiency of one of the panel members.

    A three-justice panel of the California 2nd District Court of Appeal ordered that the once-renowned cancer expert, James Heaps, 69, be sent back for a retrial on the charges involving the two patients he was convicted of abusing.

    In October 2022, after a complex two-month jury trial, Heaps was convicted of three counts of sexual battery by fraud and two counts of sexual penetration involving the two patients. Jurors acquitted him of abusing two other patients and deadlocked on charges involving four more patients. In April 2023, a judge sentenced him to 11 years in prison.

    The University of California system paid nearly $700 million to settle lawsuits brought by hundreds of Heaps’ accusers.

    John Manly, who represented more than 200 former patients in a lawsuit that resulted in the settlement with UCLA, said the reversal of Heaps’ conviction is “an indictment of California’s criminal justice system which allows criminals to threaten public safety and prey upon the most vulnerable.’’

    “These brave survivors suffered through a four-year ordeal of prosecution and trial resulting in an 11-year prison sentence for this monster,” he said. “Now they are being told that they must start over. … Our criminal justice system needs reforms that put victims first.’’

    During the jury deliberations, Los Angeles County Superior Court Judge Michael Carter, who presided over the trial, sent a judicial assistant, Luis Corrales, into the jury room to speak to the jury about a note sent by the foreperson describing the jurors’ “collective concern” that Juror No. 15 “did not speak English sufficiently to deliberate and had already made up his mind,” the appeals panel wrote.

    Juror No. 15 had been an alternate on the jury, but on Oct. 18 he replaced Juror No. 8. Only an hour later, the jury sent the note, signed by the foreperson. The note stated, “We have observed that the language barrier with Juror [No.] 15 is preventing us from properly deliberating. Juror [No.] 15 was not able to understand calls to vote guilty or not guilty, and expressed to us that his limited English interfered with his understanding of the testimony.”

    The judicial assistant spoke to the jury in English and, at the request of Juror No. 15, in Spanish. “At no time did the trial judge inquire of the jury or inform trial counsel of the note’s existence,” the appeals panel said, adding that the conversations with the judicial assistant were not transcribed.

    Heaps’ defense lawyer was not informed of the note or of the communications, and the trial proceeded to a verdict.

    Leonard Levine, Heaps’ trial lawyer, in a declaration to the appeals panel, said that had he been informed of the note, he would have sought to determine whether Juror No. 15 was “qualified to serve” and investigated the juror’s limited English and the jury’s view that Juror No. 15’s mind “is already made up.”

    The Court of Appeal found “the trial court’s handling of the note deprived defendant of his constitutional right to counsel at a critical stage of his trial.”

    “The failure to notify counsel about the jury’s note and the judicial assistant’s ex parte communications with the jury during deliberations amounted to a violation of the defendant’s Sixth Amendment right to counsel,” the panel found. The three-judge panel noted that it did not assess the juror’s English ability; rather, that was the shared opinion of the juror’s fellow jurors.

    The appellate court found that the prosecution failed to meet its burden to demonstrate, beyond a reasonable doubt, that the constitutional error was harmless. As a result, the panel reversed the conviction and remanded it for a new trial.

    “We recognize the burden on the trial court and, regrettably, on the witnesses, in requiring retrial of a case involving multiple victims and delving into the conduct of intimate medical examinations. The importance of the constitutional right to counsel at critical junctures in a criminal trial gives us no other choice,” acting Presiding Justice Helen I. Bendix wrote on behalf of the panel, with Associate Justices Gregory J. Weingart and Michelle C. Kim concurring.

    The ruling overturns Heaps’ convictions for sexual battery by fraud, a crime jurors found involved separate acts of violence or threats of violence, two counts of sexual penetration of an unconscious person by fraudulent representation and two counts of sexual battery by fraud. He is currently at California’s Correctional Training Facility in Soledad.

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    Richard Winton

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  • ‘We are heartbroken’: Florida couple sues IVF clinic after DNA test reveals baby isn’t theirs

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    A Florida couple has filed an emergency lawsuit against a fertility clinic, alleging their newborn child is not genetically related to either of them after an in vitro fertilization (IVF) procedure.The couple, identified in court documents as John and Jane Doe to protect their privacy, is suing IVF Life, Inc. D/B/A Fertility Center of Orlando and Dr. Milton McNichol, M.D.According to the complaint filed in Palm Beach County Circuit Court, the couple used their own egg and sperm to create three viable embryos at the clinic.In March 2025, one of the embryos was implanted in Jane Doe, resulting in a successful full-term pregnancy. The couple’s healthy female child, Baby Doe, was born on Dec. 11, 2025.The parents became suspicious when Baby Doe displayed physical characteristics of a child who was not racially Caucasian, despite both John and Jane Doe being Caucasian.Genetic testing subsequently confirmed that Baby Doe has “no genetic relationship to either of the Plaintiffs,” indicating the implanted embryo was not one of the couple’s.While the Does expressed a deep emotional bond with the child they carried and delivered, the lawsuit states their belief that Baby Doe “should legally and morally be united with her genetic parents.”The couple also fears that another person may be pregnant with or raising one or more of their own embryos or children.The couple claims they notified the defendants on Jan. 5, 2026, requesting cooperation to unite Baby Doe with her genetic parents and to determine the disposition of their remaining embryos. They have received no “substantive response.”The Plaintiffs are seeking emergency injunctive relief, asking the court to compel the defendants to take several actions, including:Immediately notifying all patients who had embryos in storage before Jane Doe’s implantation about the allegations in the complaint and providing them with a copy.Paying for free genetic testing for all patients and their children whose births resulted from embryo implantation through the defendants’ services over the past five years.Disclosing any parentage discrepancies discovered through this testing.Official statement from Fertility Center of OrlandoWe are actively cooperating with an investigation to support one of our patients in determining the source of an error that resulted in the birth of a child who is not genetically related to them. Multiple entities are involved in this process, and all parties are working diligently to help identify when and where the error may have occurred. Our priority remains transparency and the well-being of the patient and child involved. We will continue to assist in any way that we can regardless of the outcome of the investigation.Official Statement from the couple”Our baby was born just over a month ago via emergency C-section. Her birth was the result of the miracle of in vitro fertilization—a journey that took years of careful medical procedures, tremendous expense, and deep emotional and physical sacrifice. The result is a beautiful, healthy baby girl whom we love more than words can express.I have a million things I want to say and so many emotions I wish I could share, but for now, this is what we are able to tell you: due to a medical error- the wrong embryo implanted by the doctor – our baby is not genetically related to either of us. While we are beyond grateful to have her in our lives and love her immeasurably, we also recognize that we have a moral obligation to find her genetic parents. Our joy over her birth is further complicated by the devastating reality that her genetic parents—whom we do not yet know—or possibly another family entirely, may have received our genetic embryo. We are heartbroken, devastated, and confused. This situation has completely dictated and complicated our lives since the moment of her birth. Aside from necessary outings where we have been forced to pretend everything is okay, we have been living like prisoners in our own home. We hope that by sharing this it will allow us to begin living more freely and to finally celebrate the one beautiful thing that has come from all of this: our daughter. Our baby girl is completely innocent and so undeserving of any of this. We’re also sharing this to prevent harmful rumors or misinformation, as we’ve already seen inaccurate information circulating in a few stories and articles.Please bear with us as we navigate this deeply confusing and painful time, living with the heartbreak of not knowing what happened to our genetic embryos or whether we may have a biological child (or children) somewhere out there in the hands of strangers. The added fear that our daughter could be taken from us at any time is almost unbearable. There are so many details and potential outcomes to this story, but for now, we will leave it here until further progress has been made by our legal counsel. Until then, please keep our family in your hearts and prayers, and if you have any information on the family who might be at the other side of this, please contact us.”

    LONGWOOD, Fla. —

    A Florida couple has filed an emergency lawsuit against a fertility clinic, alleging their newborn child is not genetically related to either of them after an in vitro fertilization (IVF) procedure.

    The couple, identified in court documents as John and Jane Doe to protect their privacy, is suing IVF Life, Inc. D/B/A Fertility Center of Orlando and Dr. Milton McNichol, M.D.

    According to the complaint filed in Palm Beach County Circuit Court, the couple used their own egg and sperm to create three viable embryos at the clinic.

    In March 2025, one of the embryos was implanted in Jane Doe, resulting in a successful full-term pregnancy. The couple’s healthy female child, Baby Doe, was born on Dec. 11, 2025.

    The parents became suspicious when Baby Doe displayed physical characteristics of a child who was not racially Caucasian, despite both John and Jane Doe being Caucasian.

    Genetic testing subsequently confirmed that Baby Doe has “no genetic relationship to either of the Plaintiffs,” indicating the implanted embryo was not one of the couple’s.

    While the Does expressed a deep emotional bond with the child they carried and delivered, the lawsuit states their belief that Baby Doe “should legally and morally be united with her genetic parents.”

    The couple also fears that another person may be pregnant with or raising one or more of their own embryos or children.

    The couple claims they notified the defendants on Jan. 5, 2026, requesting cooperation to unite Baby Doe with her genetic parents and to determine the disposition of their remaining embryos. They have received no “substantive response.”

    The Plaintiffs are seeking emergency injunctive relief, asking the court to compel the defendants to take several actions, including:

    • Immediately notifying all patients who had embryos in storage before Jane Doe’s implantation about the allegations in the complaint and providing them with a copy.
    • Paying for free genetic testing for all patients and their children whose births resulted from embryo implantation through the defendants’ services over the past five years.
    • Disclosing any parentage discrepancies discovered through this testing.

    Official statement from Fertility Center of Orlando

    We are actively cooperating with an investigation to support one of our patients in determining the source of an error that resulted in the birth of a child who is not genetically related to them. Multiple entities are involved in this process, and all parties are working diligently to help identify when and where the error may have occurred. Our priority remains transparency and the well-being of the patient and child involved. We will continue to assist in any way that we can regardless of the outcome of the investigation.

    Official Statement from the couple

    “Our baby was born just over a month ago via emergency C-section. Her birth was the result of the miracle of in vitro fertilization—a journey that took years of careful medical procedures, tremendous expense, and deep emotional and physical sacrifice. The result is a beautiful, healthy baby girl whom we love more than words can express.

    I have a million things I want to say and so many emotions I wish I could share, but for now, this is what we are able to tell you: due to a medical error- the wrong embryo implanted by the doctor – our baby is not genetically related to either of us.

    While we are beyond grateful to have her in our lives and love her immeasurably, we also recognize that we have a moral obligation to find her genetic parents. Our joy over her birth is further complicated by the devastating reality that her genetic parents—whom we do not yet know—or possibly another family entirely, may have received our genetic embryo.

    We are heartbroken, devastated, and confused.

    This situation has completely dictated and complicated our lives since the moment of her birth.

    Aside from necessary outings where we have been forced to pretend everything is okay, we have been living like prisoners in our own home. We hope that by sharing this it will allow us to begin living more freely and to finally celebrate the one beautiful thing that has come from all of this: our daughter.

    Our baby girl is completely innocent and so undeserving of any of this. We’re also sharing this to prevent harmful rumors or misinformation, as we’ve already seen inaccurate information circulating in a few stories and articles.

    Please bear with us as we navigate this deeply confusing and painful time, living with the heartbreak of not knowing what happened to our genetic embryos or whether we may have a biological child (or children) somewhere out there in the hands of strangers. The added fear that our daughter could be taken from us at any time is almost unbearable.

    There are so many details and potential outcomes to this story, but for now, we will leave it here until further progress has been made by our legal counsel. Until then, please keep our family in your hearts and prayers, and if you have any information on the family who might be at the other side of this, please contact us.”

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  • Justice Department drops demand for records naming transgender kids treated at Children’s Hospital L.A.

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    The U.S. Department of Justice has agreed to stop demanding medical records that identify young patients who received gender-affirming care from Children’s Hospital Los Angeles, ending a legal standoff with families who sued to block a subpoena that some feared would be used to criminally prosecute the parents of transgender kids.

    The agreement, filed in federal court Thursday, allows the hospital to withhold certain records and redact personal information from others who underwent gender-affirming treatments, which Trump administration officials have compared to child mutilation despite support for such care by the nation’s major medical associations.

    Several parents of CHLA patients expressed profound relief Friday, while also acknowledging that other threats to their families remain.

    Jesse Thorn, the father of two transgender children who had been patients at Children’s Hospital, said hospital officials have ignored his requests for information as to whether they had already shared his kids’ data with the Trump administration, which had been scary. Hearing they had not, and now won’t, provided “two-fold” relief, he said.

    “The escalations have been so relentless in the threats to our family, and one of the things that compounded that was the uncertainty about what the federal government knew about our kids’ medical care and what they were going to do about that,” he said.

    Less clear is whether the agreement provides any new protections for doctors and other hospital personnel who provided care at the clinic and have also been targeted by the Trump administration.

    The agreement follows similar victories for families seeking to block such disclosures by gender-affirming care clinics elsewhere in the country, including a ruling Thursday for the families of transgender kids who received treatment at Children’s National Hospital in Washington, D.C.

    “What’s unique here is this was a class action,” said Alejandra Caraballo, a civil rights attorney and legal instructor at Harvard, who was not involved in the Los Angeles case. “I can’t undersell what a major win that is to protect the records of all these patients.”

    Some litigation remains ongoing, with families fearful appeals to higher courts could end with different results. There is also Republican-backed legislation moving through Congress to restrict gender-affirming care for youths.

    Another father of a transgender patient at Children’s Hospital, who requested anonymity because he fears for his child’s safety, said he was grateful for the agreement, but doesn’t see it as the end of the road. He fears the Trump administration could renew its subpoena if it wins on appeal in cases elsewhere.

    “There’s some comfort, but it doesn’t close the book on it,” he said.

    In a statement to The Times, the Justice Department said it “has not withdrawn its subpoena. Rather, it withdrew three requests for patient records based on the subpoenaed entity’s representation that it did not have custody of any such records.”

    “This settlement avoids needless litigation based on that fact and further instructs Children’s Hospital Los Angeles to redact patient information in documents responsive to other subpoena requests,” the DOJ statement said. “As Attorney General Bondi has made clear, we will continue to use every legal and law enforcement tool available to protect innocent children from being mutilated under the guise of ‘care.’”

    Children’s Hospital did not respond to a request for comment.

    “This is a massive victory for every family that refused to be intimidated into backing down,” Khadijah Silver, director of Gender Justice & Health Equity at Lawyers for Good Government, which helped bring the lawsuit, said in a statement Friday. “The government’s attempt to rifle through children’s medical records was unconstitutional from the start. Today’s settlement affirms what we’ve said all along: these families have done nothing wrong, and their children’s privacy deserves protection.”

    Until last summer, the Center for Transyouth Health and Development at Children’s Hospital Los Angeles was among the largest and oldest pediatric gender clinics in the United States — and one of few providing puberty blockers, hormones and surgical procedures for trans youth on public insurance.

    It was also among the first programs to shutter under coordinated, multi-agency pressure exerted from the White House. Ending treatment for transgender children has been a central policy goal for the Trump administration since the president resumed office last year.

    “These threats are no longer theoretical,” Children’s Hospital executives wrote to staff in an internal email announcing the closure of the clinic in June. “[They are] threatening our ability to serve the hundreds of thousands of patients who depend on CHLA for lifesaving care.”

    In July, Atty. Gen. Pam Bondi announced the Justice Department was subpoenaing patient records from gender-affirming care providers, specifically stating that medical professionals were a target of a probe into “organizations that mutilated children in the service of a warped ideology.”

    California law explicitly protects gender-affirming care, and the state and others led by Democrats have fought back in court, but most providers nationwide have shuttered under the White House push, stirring fear of a de facto ban.

    Parents feared the subpoenas could lead to child abuse charges, which the government could then use to strip them of custody of their children. Doctors feared they could be arrested and imprisoned for providing medical care that is broadly backed by the medical establishment and is legal in the states where they performed it.

    The Justice Department’s subpoena to Children’s Hospital Los Angeles had initially requested a vast array of personally identifying documents, specially calling for records “sufficient to identify each patient [by name, date of birth, social security number, address, and parent/guardian information] who was prescribed puberty blockers or hormone therapy.”

    It also called for records “relating to the clinical indications, diagnoses, or assessments that formed the basis for prescribing puberty blockers or hormone therapy,” and for records “relating to informed consent, patient intake, and parent or guardian authorization for minor patients” to receive gender-affirming care.

    According to the new agreement, the Justice Department withdrew its requests for those specific records — which had yet to be produced by the hospital — on Dec. 8, and told Children’s Hospital to redact the personally identifying information of patients in other records it was still demanding.

    Thursday’s agreement formalizes that position, and requires the Justice Department to return or destroy any records that provide personally identifying information moving forward.

    “The Government will not use this patient identifying information to support any investigation or prosecution,” the agreement states.

    According to the attorneys for the families who sued, the settlement protects the records of their clients but also all of the clinic’s other gender-affirming care patients. “To date, they assured us, no identifiable patient information has been received, and now it cannot be,” said Amy Powell, with Lawyers for Good Government.

    Cori Racela, executive director for Western Center on Law & Poverty, called it a “crucial affirmation that healthcare decisions belong in exam rooms, not government subpoenas.”

    “Youth, families, and medical providers have constitutional rights to privacy and dignity,” she said in a statement. “No one’s private health records should be turned into political ammunition — especially children.”

    The agreement was also welcomed by families of transgender kids beyond Southern California.

    “This has been hanging over those families specifically in L.A., of course, but for all families,” said Arne Johnson, a Bay Area father of a transgender child who helps run a group of similar families called Rainbow Families Action. “Every time one of these subpoenas goes out, it’s terrifying.”

    Johnson said each victory pushing back against the government’s demands for family medical records feels “like somebody is pointing a gun at your kid and a hero comes along and knocks it out of their hand — it’s literally that visceral of a feeling.”

    Johnson said he hopes recent court wins will push hospitals to resist canceling care for transgender children.

    “Parents are the ones that are fighting back and they’re the ones that are winning, and the hospitals should take their lead,” he said. “Hospitals should be fighting in the same way the parents are, so that their doctors and other providers can be protected.”

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    Kevin Rector, Sonja Sharp

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  • Thousands of nurses go on strike at several major New York City hospitals

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    Thousands of nurses in three hospital systems in New York City went on strike Monday after negotiations through the weekend failed to yield breakthroughs in their contract disputes.Nurses were to start walking off the job at 6 a.m. at The Mount Sinai Hospital and two of its satellite campuses. The other affected hospitals are NewYork-Presbyterian and Montefiore Medical Center in the Bronx.About 15,000 nurses are involved in the strike, according to New York State Nurses Association.The strike, which comes during a severe flu season, could potentially force the hospitals to transfer patients, cancel procedures or divert ambulances. It could also put a strain on city hospitals not involved in the contract dispute, as patients avoid the medical centers hit by the strike.The hospitals involved have been hiring temporary nurses to try and fill the labor gap during the walkout, and said in a statement during negotiations that they would “do whatever is necessary to minimize disruptions.” Montefiore posted a message assuring patients that appointments would be kept.The work stoppage is occurring at multiple hospitals simultaneously, but each medical center is negotiating with the union independently. Several other hospitals across the city and in its suburbs reached deals in recent days to avert a possible strike.The nurses’ demands vary by hospital, but the major issues include staffing levels and workplace safety. The union says hospitals have given nurses unmanageable workloads.Nurses also want better security measures in the workplace, citing incidents like an incident last week, when a man with a sharp object barricaded himself in a Brooklyn hospital room and was then killed by police.The union also wants limitations on hospitals’ use of artificial intelligence.The nonprofit hospitals involved in the negotiations say they’ve been working to improve staffing levels, but say the union’s demands overall are too costly.Nurses voted to authorize the strike last month.Both New York Gov. Kathy Hochul and Mayor Zohran Mamdani had expressed concern about the possibility of the strike. As the strike deadline neared, Mamdani urged both sides to keep negotiating and reach a deal that “both honors our nurses and keeps our hospitals open.”“Our nurses kept this city alive through its hardest moments. Their value is not negotiable,” Mamdani said.The last major nursing strike in the city was only three years ago, in 2023. That work stoppage, at Mount Sinai and Montefiore, was short, lasting three days. It resulted in a deal raising pay 19% over three years at those hospitals.It also led to promised staffing improvements, though the union and hospitals now disagree about how much progress has been made, or whether the hospitals are retreating from staffing guarantees.

    NEW YORK —

    Thousands of nurses in three hospital systems in New York City went on strike Monday after negotiations through the weekend failed to yield breakthroughs in their contract disputes.

    Nurses were to start walking off the job at 6 a.m. at The Mount Sinai Hospital and two of its satellite campuses. The other affected hospitals are NewYork-Presbyterian and Montefiore Medical Center in the Bronx.

    About 15,000 nurses are involved in the strike, according to New York State Nurses Association.

    The strike, which comes during a severe flu season, could potentially force the hospitals to transfer patients, cancel procedures or divert ambulances. It could also put a strain on city hospitals not involved in the contract dispute, as patients avoid the medical centers hit by the strike.

    The hospitals involved have been hiring temporary nurses to try and fill the labor gap during the walkout, and said in a statement during negotiations that they would “do whatever is necessary to minimize disruptions.” Montefiore posted a message assuring patients that appointments would be kept.

    The work stoppage is occurring at multiple hospitals simultaneously, but each medical center is negotiating with the union independently. Several other hospitals across the city and in its suburbs reached deals in recent days to avert a possible strike.

    The nurses’ demands vary by hospital, but the major issues include staffing levels and workplace safety. The union says hospitals have given nurses unmanageable workloads.

    Nurses also want better security measures in the workplace, citing incidents like an incident last week, when a man with a sharp object barricaded himself in a Brooklyn hospital room and was then killed by police.

    The union also wants limitations on hospitals’ use of artificial intelligence.

    The nonprofit hospitals involved in the negotiations say they’ve been working to improve staffing levels, but say the union’s demands overall are too costly.

    Nurses voted to authorize the strike last month.

    Both New York Gov. Kathy Hochul and Mayor Zohran Mamdani had expressed concern about the possibility of the strike. As the strike deadline neared, Mamdani urged both sides to keep negotiating and reach a deal that “both honors our nurses and keeps our hospitals open.”

    “Our nurses kept this city alive through its hardest moments. Their value is not negotiable,” Mamdani said.

    The last major nursing strike in the city was only three years ago, in 2023. That work stoppage, at Mount Sinai and Montefiore, was short, lasting three days. It resulted in a deal raising pay 19% over three years at those hospitals.

    It also led to promised staffing improvements, though the union and hospitals now disagree about how much progress has been made, or whether the hospitals are retreating from staffing guarantees.

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  • Semaglutide fails to slow progression of Alzheimer’s in highly anticipated trials, Novo Nordisk says

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    An oral version of semaglutide, the active ingredient in blockbuster drugs Ozempic and Wegovy, failed to slow the progression of Alzheimer’s disease in closely watched trials, Novo Nordisk said Monday.In two Phase 3 trials of more than 3,800 adults receiving standard care for Alzheimer’s, the company evaluated whether an older pill form of semaglutide worked better than a placebo. The drug was shown to be safe and led to improvements in Alzheimer’s-related biomarkers, the company said, but the treatment did not delay disease progression.Novo had long treated Alzheimer’s as a long-shot bet for the popular GLP-1 drugs. Use of these drugs for diabetes and weight loss has exploded in recent years, and they have shown benefits for a wide range of additional health conditions, such as protecting the heart and kidneys, reducing sleep apnea and potentially helping with addiction.Smaller trials and animal studies had suggested GLP-1s might help slow cognitive decline or reduce neuro-inflammation but larger trials like Novo’s were needed to confirm whether patients saw actual benefits.”Based on the significant unmet need in Alzheimer’s disease as well as a number of indicative data points, we felt we had a responsibility to explore semaglutide’s potential, despite a low likelihood of success,” said Martin Holst Lange, chief scientific officer and executive vice president of Research and Development at Novo Nordisk said in a statement on Monday that thanked trial participants.A one-year extension of the trials will be discontinued, Novo said. Results from the trials have not yet been peer-reviewed or published but will be presented at upcoming scientific conferences.Novo has been facing increased competition in the weight loss market and recently announced lowered prices for some cash-paying patients using Ozempic and Wegovy. Novo shares fell Monday after the Alzheimer’s trial announcement.

    CNN —

    An oral version of semaglutide, the active ingredient in blockbuster drugs Ozempic and Wegovy, failed to slow the progression of Alzheimer’s disease in closely watched trials, Novo Nordisk said Monday.

    In two Phase 3 trials of more than 3,800 adults receiving standard care for Alzheimer’s, the company evaluated whether an older pill form of semaglutide worked better than a placebo. The drug was shown to be safe and led to improvements in Alzheimer’s-related biomarkers, the company said, but the treatment did not delay disease progression.

    Novo had long treated Alzheimer’s as a long-shot bet for the popular GLP-1 drugs. Use of these drugs for diabetes and weight loss has exploded in recent years, and they have shown benefits for a wide range of additional health conditions, such as protecting the heart and kidneys, reducing sleep apnea and potentially helping with addiction.

    Smaller trials and animal studies had suggested GLP-1s might help slow cognitive decline or reduce neuro-inflammation but larger trials like Novo’s were needed to confirm whether patients saw actual benefits.

    “Based on the significant unmet need in Alzheimer’s disease as well as a number of indicative data points, we felt we had a responsibility to explore semaglutide’s potential, despite a low likelihood of success,” said Martin Holst Lange, chief scientific officer and executive vice president of Research and Development at Novo Nordisk said in a statement on Monday that thanked trial participants.

    A one-year extension of the trials will be discontinued, Novo said. Results from the trials have not yet been peer-reviewed or published but will be presented at upcoming scientific conferences.

    Novo has been facing increased competition in the weight loss market and recently announced lowered prices for some cash-paying patients using Ozempic and Wegovy. Novo shares fell Monday after the Alzheimer’s trial announcement.

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  • UC nurses cancel planned strike after reaching tentative deal with university

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    A planned labor strike by University of California nurses has been called off after the university system and the nurses’ union reached a tentative deal on pay and benefits, both groups announced Sunday.

    The four-year deal, between UC and the California Nurses Assn., covers some 25,000 registered nurses working across 19 UC facilities. The two groups had been bargaining over a new contract since June.

    The deal follows another one announced on Nov. 8 between UC and the University Professional and Technical Employees union, which represents 21,000 healthcare, research and technical professionals across the UC system. Those groups had been negotiating a new contract for 17 months.

    The nurses’ union had planned to strike Monday and Tuesday in solidarity with a third union, AFSCME 3299, which represents patient care technical workers, custodians, food service employees, security guards, secretaries and other workers at UC hospitals and campuses.

    Kristan Delmarty, a registered nurse at UCLA Santa Monica and member of the nurses association’s board of directors and bargaining team, said the union “organized for and won important patient protections” in the deal — which she said nurses will vote to approve this week.

    “Going into this round of bargaining, it was our priority to ensure UC nurses were given the resources to care for our patients and ourselves after years of short-staffing and under-resourcing,” she said. “We achieved our goal and now we stand together with our AFSCME colleagues, whose essential work demands the same resources guaranteed by a fair contract.”

    The nurses association said thousands of its members still planned to join AFSCME picket lines “while not on work time.”

    UC officials also lauded the deal. Missy Matella, associate vice president for systemwide employee and labor relations, said it “reflects the tireless work and collaboration of UC’s bargaining team, medical center leaders, and systemwide leadership working hand in hand with our dedicated nurses.”

    “We’re grateful to the nurses and the CNA bargaining team for their partnership and shared commitment to what matters most: our patients and the UC community,” Matella said. “This strong, forward-looking deal honors the vital role nurses play in delivering exceptional care and advancing UC’s public service mission.”

    AFSCME 3299 was still planning to strike. On Sunday morning, it posted a video to social media of members readying strike signs.

    “When we show up together, we win together. This is for our families, our patients, and for the future we deserve!” the group wrote on X. “Members and allies, bring your energy, see you on the line!”

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    Kevin Rector

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  • Still grappling with pandemic changes, hospitals face uncertain future with funding cuts

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    Five years ago, the COVID-19 pandemic brought fear, anxiety and uncertainty to hospitals across the nation. Grappling with sudden financial, medical and cultural shifts, regional health care leaders found themselves stuck at the precipice of how to save lives while…

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    CHRISTY AVERY christy.avery@newsandtribune.com

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  • Still grappling with pandemic changes, hospitals face uncertain future with funding cuts

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    Five years ago, the COVID-19 pandemic brought fear, anxiety and uncertainty to hospitals across the nation. Grappling with sudden financial, medical and cultural shifts, regional health care leaders found themselves stuck at the precipice of how to save lives while…

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    CHRISTY AVERY christy.avery@newsandtribune.com

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  • Still grappling with pandemic changes, hospitals face uncertain future with funding cuts

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    Five years ago, the COVID-19 pandemic brought fear, anxiety and uncertainty to hospitals across the nation. Grappling with sudden financial, medical and cultural shifts, regional health care leaders found themselves stuck at the precipice of how to save lives while…

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    CHRISTY AVERY christy.avery@newsandtribune.com

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  • ‘It’s hard to see so many kids die.’ How volunteering in Gaza transformed American doctors and nurses

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    When Texas neurologist Hamid Kadiwala told his parents he was heading to Gaza to volunteer at a hospital there, they begged him to reconsider.

    “Why would you take that risk?” they asked. What about his Fort Worth medical practice? His wife? His four children?

    But Kadiwala, 42, had been deeply shaken by images from Gaza of mass death and destruction and felt a responsibility to act. Israel’s siege on the small, densely populated Gaza Strip was “a history-shaking event,” Kadiwala said. “I want my kids to be able to say that their father was one of those who tried to help.”

    Kadiwala is one of dozens of American doctors and nurses who have worked in the Gaza Strip since 2023, when Israel began bombing the enclave in retaliation for the deadly Hamas attacks of Oct. 7.

    Neurologist Hamid Kadiwala poses for a portrait at Tarrant Neurology Consultants in Fort Worth.

    (Desiree Rios / For The Times)

    The volunteers — men and women of all ages, agnostics as well as Muslims, Christians and Jews — have labored under the constant threat of violence, amid raging disease and with little access to food and medicine they need to save lives.

    Many are hopeful that the new ceasefire between Israel and Hamas that took effect Friday will halt the violence. But even with new aid rolling in, the humanitarian crisis in Gaza remains daunting.

    With foreign journalists largely barred from Gaza and more than 200 Palestinian media workers slain by Israeli bombs and bullets, on-the-ground testimony from doctors and nurses has been critical to helping the world understand the horrors unfolding.

    But bearing witness comes at a steep personal cost.

    As Kadiwala drove into the enclave in a United Nations convoy late last year, he saw an endless expanse of gray rubble. Emaciated young men swarmed his vehicle. The sky buzzed with drones. Bombs sounded like rolling thunder.

    Kadiwala compared the landscape with dystopian films such as “Mad Max.” “It’s so hard to understand because our brains have never seen something like that,” he said.

    He knew that worse was yet to come.

    “You have to get numb,” he told himself as he prepared to enter Nasser Hospital in Khan Yunis, where he would be living and working for more than a month. “These patients are here for help, not to see me cry.”

    Child patients are forced to share beds or lie on makeshift mattresses in the hospital corridors due to limited resources.

    Child patients are forced to share beds or lie on makeshift mattresses placed in the corridors due to limited resources and space at Nasser Hospital as the pediatric ward of the hospital is overwhelmed with the waves of displaced families arriving from the north in Khan Yunis, Gaza, on Sept. 22.

    (Abdallah F.s. Alattar / Anadolu via Getty Images)

    Death in Gaza

    The explosions began each morning shortly before the call to prayer.

    “Within 20 minutes, there would be 150 people sprawled wall-to-wall with serious injuries,” said Mark Perlmutter, an orthopedic surgeon from North Carolina who has been to Gaza twice, and who was working at Nasser in March in the violent days after a ceasefire broke.

    Perlmutter, 70, had volunteered on more than 40 humanitarian missions: in Haiti after its devastating earthquake, in New Orleans after Hurricane Katrina and in New York after the 9/11 attacks on the World Trade Center.

    Nothing prepared him for Gaza.

    Hospitals stank of sewage and death. Doctors operated without antibiotics or soap. Never before had he seen so many children among the casualties. The hospital filled with shell-shocked kids who had been wrenched from collapsed buildings and others with bullet wounds in their chests and heads.

    “I would step over babies that were dying,” he said. “I would see their blood expanding on the floor, knowing that I had no chance of saving them.”

    Palestinians try to put out a fire at the emergency department of the Nasser Hospital.

    Palestinians try to put out a fire at the emergency department of the Nasser Hospital after it was hit by an Israeli airstrike in Khan Yunis on March 23.

    (AFP via Getty Images)

    In one haunting experience, an injured boy lying on the ground reached for Perlmutter’s leg, too weak to talk. Perlmutter knew it was too late for the boy, but that other patients still had a shot at survival.

    “I had to pull my pant leg away to get to one I could save,” he said.

    Perlmutter is Jewish and until visiting Gaza was a supporter of Israel. Around his neck he wears as a pendant a mezuzah, which contains a small scroll with verses from the Torah. It was a gift from his late father, a doctor who survived the Holocaust.

    But working in Gaza changed him.

    After treating so many kids with gunshot wounds, he became convinced that Israelis were deliberately targeting children, which the Israeli military denies.

    As he toiled, he and another doctor, California surgeon Feroze Sidhwa, began taking photos of the carnage. Together they would go on to publish essays in U.S. media outlets detailing what they had seen and to send letters to American leaders begging for an arms embargo. Sidhwa would conduct a poll of dozens of American doctors, nurses and medics who said they, too, had treated preteen children who had been shot in the head.

    Activism was a new calling for Perlmutter. He knew it might cost him relationships with loved ones who supported Israel and possibly even patients at his medical practice back in North Carolina. He knew it was straining his relationship with his wife. But he plowed ahead.

    “It’s hard to see so many kids die in front of you and not make that your life.”

    Hospitals under siege

    Andee Vaughan, a 43-year-old trauma nurse, has spent much of her life in ambulances, emergency rooms and on backcountry search-and-rescue trips in her home state of Washington. She spent months providing medical care on the front lines of the war in Ukraine.

    She prides herself on maintaining her cool, even under trying circumstances. But while volunteering at Al-Quds Hospital in Gaza City, she often felt tears welling up.

    It wasn’t the mayhem of mass casualty events that shook her, nor the sound of shallow breaths as a patient who had been shot in the skull slipped toward death.

    It was the seemingly countless victims who under normal circumstances could have been saved.

    Like the boy she watched suffocate because the hospital didn’t have enough ventilators. Or patients who perished from treatable infections for lack of antibiotics and proper dressings for wounds.

    Medical workers treat a patient at Al-Quds Hospital in Gaza City.

    Andee Vaughan, bottom right, worked day and night for three months at Al-Quds Hospital in Gaza City.

    (Courtesy of Andee Vaughan)

    “I am haunted by the patients on my watch who probably shouldn’t have died,” Vaughan said.

    Virtually every person she encountered suffered from diarrhea, skin infections, lung problems and chronic hunger, she said. That included exhausted Palestinian doctors and nurses, many of whom had lost family members, been displaced from their homes and were living in crowded tent cities where hundreds of people shared a single toilet. Many Palestinian medical staffers have been working without pay.

    “You have a whole system in survival mode,” said Vaughan, who contracted giardia shortly after arriving in Gaza and who ate just once a day because there was so little food.

    Vaughan spent three months in Gaza and volunteered to stay longer. Then her hospital came under attack.

    As Israeli forces advanced on Gaza City to confront what they described as the last major Hamas stronghold in the strip, Al-Quds was sprayed by gunfire and rocked by bombs. Most of its windows were blown out. A tank missile hit an oxygen room, destroying everything inside.

    Vaughan filmed videos that showed Israeli quadcopters — drones equipped with guns — hitting targets around the hospital.

    “They are systematically destroying all of Gaza,” she said. “They’re shooting everything, even the donkeys.”

    A trauma nurse, center, cuts the shirt off a young patient at Al-Quds Hospital in Gaza City.

    Andee Vaughan, center, cuts the shirt off a young patient at Al-Quds Hospital in Gaza City.

    (Courtesy of Andee Vaughan)

    Just a third of Gaza’s 176 hospitals and clinics are functional, and nearly 1,700 healthcare workers have been killed since the war began, according to the World Health Organization.

    It is not lost on Vaughan that most of the weapons used in those attacks come from the United States, which has provided Israel $21.7 billion in military assistance since the Oct. 7, 2023, Hamas-led attack, according to a study by the Costs of War project at Brown University.

    U.S. involvement in the war is what prompted Vaughan to volunteer in Gaza in the first place. “I was there in some ways to make amends for the damage that we have done,” she said.

    Vaughan was evacuated from Gaza last month, bidding goodbye to colleagues and patients who were so malnourished their bones jutted from their skin like tent poles.

    She was ferried to Jordan, where on her first morning since leaving Gaza she went down to breakfast, saw a buffet overflowing with food, and began to sob.

    Coming home

    A doctor talks to a nurse.

    Dr. Bilal Piracha talks to a nurse about a patient’s condition at White Rock Medical Center in Dallas on Oct. 6. Piracha has been to the Gaza Strip three times this year, performing humanitarian work at a local hospital.

    (Emil T. Lippe / For The Times)

    After three tours in Gaza, Dallas emergency room doctor Bilal Piracha now works with a kaffiyeh draped over his scrubs.

    The black-and-white scarf, a symbol of Palestinian liberation, often sparks comments from patients, some of them disapproving. Piracha, 45, welcomes the opportunity to talk about his experience.

    “This is what I have seen with my own eyes,” he tells them. “The destruction of hospitals, the destruction of nearly every building, the killing of men, women and children.”

    Dr. Bilal Piracha stands inside an emergency operating room.

    Dr. Bilal Piracha stands inside an emergency operating room at White Rock Medical Center in Dallas on Oct. 6.

    (Emil T. Lippe / For The Times)

    Like many other U.S. doctors and nurses who have spent time in Gaza, Piracha is racked with survivor’s guilt, unable to forget the patients he couldn’t help, the mass graves he saw filled with bodies, the hunger in the eyes of the local colleagues he left behind.

    “Life has lost its meaning,” he said. “Things that once felt important no longer do.”

    He now spends most of his free time speaking out against the siege, traveling throughout the U.S. to meet with members of Congress and making frequent appearances on TV and podcasts. He has marched in antiwar protests and dropped massive banners from Texas highways that say: Let Gaza live.

    He is in frequent touch with doctors in Gaza, who are hopeful that the new ceasefire will put a stop to the violence, but say massive amounts of medical supplies and other humanitarian aid are needed immediately.

    Piracha doesn’t know what to tell them.

    “We can give them words of hope and prayers, but that is it,” he said.

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    Kate Linthicum

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  • Lawrence General, Holy Family hospitals rebrand with unified name

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    METHUEN — Across the Merrimack Valley, signs for three longtime health care institutions are coming down.

    On Tuesday, mayors, state legislators, Lt. Gov. Kim Driscoll and other officials gathered outside Holy Family Hospital in Methuen to hear the new name for the medical facility and those for Holy Family Hospital in Haverhill and Lawrence General Hospital.


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    By Teddy Tauscher | ttauscher@eagletribune.com

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  • TikTok video showing Santa Barbara clinic staff mocking patients stirs anger

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    A group of healthcare workers in Santa Barbara were fired on Wednesday after a video apparently showing patients’ bodily fluids was posted on TikTok, according to their employer.

    The now-deleted post, made by a former employee at Sansum Clinic — a nonprofit outpatient care facility owned by Sutter Health — showed eight workers mocking what appeared to be the bodily fluid of patients on exam tables with the on-screen caption, “Are patients allowed to leave you guys gifts?” and “Make sure you leave your healthcare workers sweet gifts like these!” In one image, the medical staff are seen pointing and smiling at a spot with their thumbs up. The caption reads, “Guess the substance!”

    A spokesperson for Sacramento-based health system Sutter Health said that, although the original poster was not an employee at the time the video was posted, others who appeared in it had been terminated.

    “This unacceptable behavior is an outright violation of our policies, shows a lack of respect for our patients and will not be tolerated,” the company said in a statement shared with The Times.

    The video spread over the weekend on platforms including X, Instagram and Reddit, sparking an outpouring of anger among commenters along the way.

    “No place for shaming the patient in medicine,” one user on Reddit wrote.

    “My question is what is the culture of your clinic because why did this many employees feel comfortable participating in this?” another user inquired on Instagram.

    According to an online statement from Sansum Clinic, officials were notified of the post by concerned patients and immediately conducted a review of the video.

    “Within 24 hours of becoming aware of the posts, we placed the employees on administrative leave, and within another 24 hours, we terminated those involved,” the health system posted.

    The video was deleted soon after it was posted once commenters questioned the participants’ ethics. But it was reposted by multiple other accounts and disseminated further through “stitches” of individuals reacting to the post on TikTok and other platforms.

    A Sansum spokesperson said the clinic remained steadfastly committed to patient privacy and dignity.

    “We expect all team members to live our patients-first mission and uphold the highest standards of compassion, professionalism and respect,” he said. “We are using this inappropriate incident to reinforce our comprehensive policies with all our team members across the organization.”

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    Christopher Buchanan

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  • There may soon be a new approach to treat hard-to-control high blood pressure

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    Doctors may soon have a new way to treat high blood pressure, even among people for whom medicines haven’t worked well in the past.Baxdrostat, an experimental medicine made by AstraZeneca, showed promise in treating people with uncontrolled or resistant high blood pressure in a recent trial. If the medicine gets approved by regulatory authorities, it will be one of the first new approaches to treating high blood pressure in decades, researchers say.Scientists presented the trial results Saturday at the European Society of Cardiology Congress 2025 in Madrid and simultaneously published them in the New England Journal of Medicine.For the study, researchers enrolled 800 adults who still had high blood pressure after taking two or more medications for at least four weeks. To qualify for the study, patients’ systolic blood pressure had to be between 140 and 170.Blood pressure is measured in millimeters of mercury, which is abbreviated as mm Hg. The measurement has an upper number, or systolic reading, and a lower number, a diastolic reading. Systolic pressure measures the force of blood as it pumps out of the heart into the arteries; diastolic is the pressure created as the heart rests between beats.Normal blood pressure is less than 120/80 mm Hg, and elevated blood pressure is considered to be from 120 to 129/80 mm Hg. At 130/80 mmHg or higher, according to new U.S. guidelines, a person’s medical provider will want them to take a blood pressure medication if lifestyle changes — including eating healthier, reducing salt in the diet and exercising more — don’t work first.The researchers on the new trial placed the participants into three groups. One received 1 milligram of baxdrostat, another got 2 mg, and another got a placebo, which does nothing. Participants took their dose in addition to medicines they were already taking.At 12 weeks, about 4 in 10 patients taking baxdrostat reached healthy blood pressure levels, compared with less than 2 in 10 who got a placebo.Specifically, participants who got 1 or 2 mg of baxdrostat daily saw their systolic blood pressure – the upper number in the reading – fall around 9 to 10 mm Hg more than those taking a placebo. This reduction, studies show, is large enough to cut cardiovascular risk.When blood pressure is high, the force of the blood pushes against the walls of their blood vessels, making the heart less efficient: Both the vessels and the heart must work harder, and it’s more difficult to get blood to essential organs and cells. Without treatment, high blood pressure will eventually damage the arteries, raising the risk of conditions like a heart attack, stroke, coronary disease, vascular dementia and cognitive problems.Heart disease is the No. 1 killer in the world. Lowering blood pressure is the most modifiable way to avoid such a death.Nearly half of all adults in the U.S. have higher than normal blood pressure, and 1 in 10 people have what doctors call resistant hypertension: Despite being on three or more medications, they are not meeting the goal for blood pressure control.When a patient has high blood pressure, doctors may need to try a variety of medications to see what works best.Adding baxdrostat to the list of options could be a big help for patients, according to Dr. Stacey E. Rosen, volunteer president of the American Heart Association, who was not involved with the new research.“What’s interesting about this medication is that they can really be a wonderful partner, so to speak, with some of the more classically recommended anti-hypertensive medications,” said Rosen, who is also a senior vice president of women’s health and executive director of the Katz Institute for Women’s Health of Northwell Health in New York City.Medication options now on the market control blood pressure in a variety of ways. Some, such as vasodilators, relax and widen arteries and veins to allow blood to get through easier and increase flow. Diuretics primarily work by removing excess fluid and salt from the body by increasing urine production. Centrally acting alpha agonists help prevent the nervous system from responding to stress. ACE inhibitors keep the body from producing angiotensin II, a hormone that makes blood vessels constrict. ARBs, or angiotensin II receptor blockers, help reduce the production of aldosterone, a hormone that promotes salt and water retention. Calcium channel blockers can keep calcium away from the cells of the heart and arteries so they don’t have to work as hard.Each can have different side effects, including dizziness, rapid or slower heart rate, exhaustion, upset stomach and swelling in the legs.Baxdrostat’s side effects, the study showed, were mild overall. The most common problem was abnormalities in potassium and sodium levels, but this was rare.Baxdrostat takes a new approach to managing high blood pressure. It focuses on blocking aldosterone, a hormone created by the adrenal glands that helps kidneys regulate salt and maintain the body’s water balance. Some people produce too much aldosterone, leading their body to retain too much water and salt, pushing up blood pressure.“We’ve also known for a while now that most of us eat too much salt and in doing that, it raises blood pressure. But we’re also increasingly recognizing that aldosterone may have a direct impact on causing damage to the blood vessels, to the heart, to the kidneys,” said Dr. Jenifer Brown, one of the lead investigators and co-author of the published study.Brown said she often sees cardiology patients at Brigham and Women’s who may have had a heart event, so she needs to be aggressive in getting their blood pressure under control to prevent another. Some patients may have trouble tolerating other blood pressure medications. For others, the standard medicines just don’t work well. Baxdrostat could be a good complement, she said.“We really have had the same tools as clinicians for many years,” Brown said. “I would be excited to have an option like this.”In an editorial accompanying the publication, Dr. Tomasz Guzik, a cardiovascular scientist at the University of Edinburgh, and Dr. Maciej Tomaszewski, a cardiovascular expert at the University of Manchester, write that next steps should be to figure out which patients would best respond to this new medicine and provide longer-term data. If the medication works long-term, they wrote, it could become a “central piller of therapy for difficult-to-control hypertension.”AstraZeneca said it plans to submit its data to regulatory agencies before the end of 2025.

    Doctors may soon have a new way to treat high blood pressure, even among people for whom medicines haven’t worked well in the past.

    Baxdrostat, an experimental medicine made by AstraZeneca, showed promise in treating people with uncontrolled or resistant high blood pressure in a recent trial. If the medicine gets approved by regulatory authorities, it will be one of the first new approaches to treating high blood pressure in decades, researchers say.

    Scientists presented the trial results Saturday at the European Society of Cardiology Congress 2025 in Madrid and simultaneously published them in the New England Journal of Medicine.

    For the study, researchers enrolled 800 adults who still had high blood pressure after taking two or more medications for at least four weeks. To qualify for the study, patients’ systolic blood pressure had to be between 140 and 170.

    Blood pressure is measured in millimeters of mercury, which is abbreviated as mm Hg. The measurement has an upper number, or systolic reading, and a lower number, a diastolic reading. Systolic pressure measures the force of blood as it pumps out of the heart into the arteries; diastolic is the pressure created as the heart rests between beats.

    Normal blood pressure is less than 120/80 mm Hg, and elevated blood pressure is considered to be from 120 to 129/80 mm Hg. At 130/80 mmHg or higher, according to new U.S. guidelines, a person’s medical provider will want them to take a blood pressure medication if lifestyle changes — including eating healthier, reducing salt in the diet and exercising more — don’t work first.

    The researchers on the new trial placed the participants into three groups. One received 1 milligram of baxdrostat, another got 2 mg, and another got a placebo, which does nothing. Participants took their dose in addition to medicines they were already taking.

    At 12 weeks, about 4 in 10 patients taking baxdrostat reached healthy blood pressure levels, compared with less than 2 in 10 who got a placebo.

    Specifically, participants who got 1 or 2 mg of baxdrostat daily saw their systolic blood pressure – the upper number in the reading – fall around 9 to 10 mm Hg more than those taking a placebo. This reduction, studies show, is large enough to cut cardiovascular risk.

    When blood pressure is high, the force of the blood pushes against the walls of their blood vessels, making the heart less efficient: Both the vessels and the heart must work harder, and it’s more difficult to get blood to essential organs and cells. Without treatment, high blood pressure will eventually damage the arteries, raising the risk of conditions like a heart attack, stroke, coronary disease, vascular dementia and cognitive problems.

    Heart disease is the No. 1 killer in the world. Lowering blood pressure is the most modifiable way to avoid such a death.

    Nearly half of all adults in the U.S. have higher than normal blood pressure, and 1 in 10 people have what doctors call resistant hypertension: Despite being on three or more medications, they are not meeting the goal for blood pressure control.

    When a patient has high blood pressure, doctors may need to try a variety of medications to see what works best.

    Adding baxdrostat to the list of options could be a big help for patients, according to Dr. Stacey E. Rosen, volunteer president of the American Heart Association, who was not involved with the new research.

    “What’s interesting about this medication is that they can really be a wonderful partner, so to speak, with some of the more classically recommended anti-hypertensive medications,” said Rosen, who is also a senior vice president of women’s health and executive director of the Katz Institute for Women’s Health of Northwell Health in New York City.

    Medication options now on the market control blood pressure in a variety of ways. Some, such as vasodilators, relax and widen arteries and veins to allow blood to get through easier and increase flow. Diuretics primarily work by removing excess fluid and salt from the body by increasing urine production. Centrally acting alpha agonists help prevent the nervous system from responding to stress. ACE inhibitors keep the body from producing angiotensin II, a hormone that makes blood vessels constrict. ARBs, or angiotensin II receptor blockers, help reduce the production of aldosterone, a hormone that promotes salt and water retention. Calcium channel blockers can keep calcium away from the cells of the heart and arteries so they don’t have to work as hard.

    Each can have different side effects, including dizziness, rapid or slower heart rate, exhaustion, upset stomach and swelling in the legs.

    Baxdrostat’s side effects, the study showed, were mild overall. The most common problem was abnormalities in potassium and sodium levels, but this was rare.

    Baxdrostat takes a new approach to managing high blood pressure. It focuses on blocking aldosterone, a hormone created by the adrenal glands that helps kidneys regulate salt and maintain the body’s water balance. Some people produce too much aldosterone, leading their body to retain too much water and salt, pushing up blood pressure.

    “We’ve also known for a while now that most of us eat too much salt and in doing that, it raises blood pressure. But we’re also increasingly recognizing that aldosterone may have a direct impact on causing damage to the blood vessels, to the heart, to the kidneys,” said Dr. Jenifer Brown, one of the lead investigators and co-author of the published study.

    Brown said she often sees cardiology patients at Brigham and Women’s who may have had a heart event, so she needs to be aggressive in getting their blood pressure under control to prevent another. Some patients may have trouble tolerating other blood pressure medications. For others, the standard medicines just don’t work well. Baxdrostat could be a good complement, she said.

    “We really have had the same tools as clinicians for many years,” Brown said. “I would be excited to have an option like this.”

    In an editorial accompanying the publication, Dr. Tomasz Guzik, a cardiovascular scientist at the University of Edinburgh, and Dr. Maciej Tomaszewski, a cardiovascular expert at the University of Manchester, write that next steps should be to figure out which patients would best respond to this new medicine and provide longer-term data. If the medication works long-term, they wrote, it could become a “central piller of therapy for difficult-to-control hypertension.”

    AstraZeneca said it plans to submit its data to regulatory agencies before the end of 2025.

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  • California resident tests positive for the plague. Officials blame Lake Tahoe flea

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    A South Lake Tahoe resident has tested positive for the plague — yes, the same pest-transmitted disease estimated to have killed 25 million Europeans in the Middle Ages.

    It is believed that the person contracted the rare and dangerous disease after being bitten by an infected flea while camping in the South Lake Tahoe area, according to El Dorado County health officials. The patient is under the care of a medical professional and recovering at home, health officials said.

    “Plague is naturally present in many parts of California, including higher-elevation areas of El Dorado County,” Kyle Fliflet, the county’s acting director of public health, said in a statement. “It’s important that individuals take precautions for themselves and their pets when outdoors, especially while walking, hiking and/or camping in areas where wild rodents are present.”

    Plague is a very serious disease but can be treated with easily available antibiotics, according to the U.S. Centers for Disease Control and Prevention. The sooner a patient is diagnosed and receives treatment, the greater their chances of making a full recovery, according to the CDC.

    The disease is caused by the bacterium Yersinia pestis and is most commonly spread to humans by bites from infected fleas, according to El Dorado County health officials. The disease can also be spread by infected-rodent bites or by exposure to infected dogs and cats.

    The disease is extremely uncommon and infects on average seven people in the U.S. per year, according to the CDC. Nevertheless, it must be taken seriously because of the high potential for death if left untreated.

    The last plague case reported in El Dorado County was in 2020 and was also believed to be transmitted in the South Lake Tahoe area, health officials said. Two California plague cases were reported in 2015, probably caused by bites from an infected flea or rodent in Yosemite National Park. All three patients received treatment and made a full recovery, health officials said.

    There were 45 ground squirrels or chipmunks recorded with evidence of exposure to the plague bacterium in the Lake Tahoe Basin from 2021 to the present, according to the California Department of Public Health, which routinely monitors rodent populations for plague activity across the state.

    El Dorado County health officials urged residents and visitors to take steps to avoid exposure to rodents or ticks when exploring the wilderness around Lake Tahoe. Measures include wearing long pants tucked into boots, using a bug repellent with DEET, never feeding or touching rodents, refraining from camping near animal burrows or dead rodents, and leaving dogs at home when possible.

    More than 80% of plague cases in the U.S. have been in the bubonic form, from which patients will develop swollen, painful lymph nodes called buboes, according to the CDC. This form of the disease typically results from an infected-flea bite, and symptoms such as buboes, fever, headache, chills and weakness develop within two to eight days, according to the CDC.

    In July, an Arizona resident died of the pneumonic form of the plague, which can develop when bacteria spread to the lungs of a patient with untreated bubonic plague. This is the most serious form of the plague and can have an incubation period of just one day. It’s also the only form of the plague that can spread from human to human.

    During the Middle Ages, infected rats were to blame for the Black Death in Europe in the 14th century. The last urban rat-infected plague outbreak in America took place in Los Angeles in 1924 and 1925, according to the CDC.

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    Clara Harter

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  • Kaiser mental health professionals in Southern California go on strike

    Kaiser mental health professionals in Southern California go on strike

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    Psychologists, therapists and other mental health professionals who work for Kaiser Permanente across Southern California went on strike Monday morning, protesting that the healthcare organization had failed to address enduring problems that hamper its mental health care.

    The National Union of Healthcare Workers said that nearly 2,400 mental health workers had launched their job action after Kaiser management had turned down proposals that the union said would stanch employee turnover and improve care. The NUHW contract for the workers expired Sept. 30.

    “Unless we strike, our coworkers are going to keep leaving,” San Diego psychologist Josh Garcia said in a union statement before the walkout, “and our patients are going to keep struggling in an underfunded, understaffed system that doesn’t meet their needs.”

    Ahead of the strike, Kaiser said it had made strong proposals to improve wages, benefits and preparation time for therapists. It faulted the union for “slow walking the negotiation process,” saying that any strike was “because NUHW leadership chose this path — rather than a path to an agreement.”

    The strike comes one year after Kaiser agreed to a $200-million settlement with California regulators who found that patients were subjected to excessive wait times for therapy appointments. Kaiser agreed to pay a $50-million penalty and spend $150 million over five years to improve its mental health care.

    Kaiser said that even before the state settlement, it had started ramping up mental health care spending. The organization said it had spent more than $1 billion to expand its mental health care in recent years and increased its Southern California mental health workforce by more than 30%.

    As the healthcare organization was seeing “throughout California, throughout the nation, this mental health crisis, we knew that we needed to act quickly,” said Rhonda Chabran, its vice president of behavioral health and wellness for Southern California and Hawaii.

    Union leaders said problems have persisted. In a recent letter to the state, NUHW alleged Kaiser was continuing to violate California law, which sets timelines for providing mental health care, and that “these failures are widespread.” NUHW said in its surveys of the Kaiser mental health workers in Southern California, 62% of respondents said their departments lacked enough staff to provide timely and appropriate care.

    The union said it was pushing for higher wages, better benefits and more guaranteed time to handle duties outside of patient appointments. NUHW members lamented that unlike in Northern California, where the union said that Kaiser therapists are now guaranteed seven hours a week to handle tasks such as preparing treatment plans, Southern California therapists with Kaiser may only get two hours a week to do so.

    “There’s a lot of things that we need to do in preparing for a visit: Developing appropriate treatment plans. Writing letters for our clients … They do not give us the time to do that,” said Lisa Delgadillo, a Kaiser psychiatric social worker in Fontana. “People think therapy is just talking to people, but it’s more than that.”

    Kassaundra Gutierrez-Thompson, a psychiatric counselor, said she sees a dozen or more patients a day in a Kaiser virtual therapy program meant for “mild to moderate” patients. The sessions each last a half hour, she said, but scheduling and other tasks cut into that time.

    Gutierrez-Thompson likened it to being a factory worker. “It’s really hard to stay a good therapist in this system,” she said. “We have to make choices like, ‘Do I make eye contact, or do I finish this note?’”

    NUHW has also proposed a series of raises totaling more than 30% over four years. Union leaders said the wage hikes were needed to bring their compensation in line with other health professionals at Kaiser.

    Kaiser said that its Southern California therapists already have generous benefits and compensation, with wages that are above market rates, and that it had offered raises at the bargaining table totaling more than 18%. It also said it had offered more time for duties outside of face-to-face appointments, but that the union proposal could pull therapists away from seeing patients for a significant chunk of their working week.

    The healthcare system said it had plans in place to minimize possible disruptions from the walkout, which has no defined length. Because Kaiser relies not only on employees but “an external network of contracted providers” for mental health care, it estimated that 60% of its patients receiving mental health and addiction services are currently getting care from providers who will not be participating in the NUHW strike.

    If their regular provider is on strike, Kaiser said, “patients will have the opportunity to be seen by another professional in our extensive network of highly qualified, licensed therapists.”

    Union leaders urged the state to keep tabs on how Kaiser was providing care during the strike, pointing out that the state Department of Managed Health Care found it had canceled appointments for tens of thousands of patients during a walkout by Northern California therapists two years ago.

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    Emily Alpert Reyes

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  • Private equity carves path in pet care

    Private equity carves path in pet care

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    WATERTOWN, Mass. — When most of the state’s powerful Democrats are decrying private equity investments in the health care system, U.S. Sen. Elizabeth Warren is making a pitch against investment firms wading into the care of animals as well.

    Private equity has bought about 30% of all veterinary practices in the United States, Warren said during an appearance at the Heal Veterinary Clinic on Monday. These firms have also vertically integrated in the industry, many also buying up the labs where medical testing is done, and the insurance firms that pay for — and more and more frequently deny coverage for — a pet owner, the senator said.

    “The consequence has been that the quality of care has gone down while prices have gone through the roof. We’ve seen about a 60% increase in prices overall,” Warren said.

    Steward Health Care used private equity investments in its eight community hospitals in Massachusetts. Those hospitals were reportedly mismanaged before the company went bankrupt earlier this year, leaving two hospitals closed in its wake.

    The senator from Cambridge met with owners of private practice vet offices, veterinary technicians working in the field, and one vet tech who said he left the industry in December after working under a corporate company because of the structural issues he saw.

    They described vet offices bought out by these companies as dedicating less time to patients and focused on upselling pet owners to opt into more expensive care, and vets feeling overburdened and leaving the industry due to working longer hours while understaffed — what they described as profit-enlarging measures that aren’t reflected in their paychecks.

    Focused on profit

    “There’s these average cost-per-transaction expectations for doctors, and they’ll say they want to offer the ‘gold standard of medicine,’ which is full diagnostics, full blood work, panels done in hospital — which is more expensive than sent out — full X-rays, sometimes urinalysis as well, when it’s not necessary for what they’re there for,” said Isabel Urban, a veterinary technician. “It’s pushing clients to do more than they really need to do.”

    Urban works at a corporate-owned veterinary office, but asked that her employer not be named.

    Karen Holmes, owner of Holmes Family Veterinary Clinic in Walpole, said one of her patients had to go to a private equity-owned urgent care for emergency care recently when her dog was throwing up, where she paid $1,700 for a full examination when they “proposed a laundry list of possibilities” but but ultimately just sent them home with stool softener.

    Holmes said she does not blame the vets for being thorough, but that she could have given more focused medical attention that would not have racked up the same cost — and that as a private practice owner she sometimes absorbs the price of certain things for her patients.

    “She’s an older woman. I don’t know what her income is, but it’s not a lot, and she loves her dog,” Holmes said. “I see my clients struggling and suffering, and I’m loath to send them to places where I know the same blood work that I run, that I send to the same labs, is going to be two or three times what I charge them.”

    Vets’ high suicide rate

    Urban said that patients have accused her of killing their pets when she presents them with the high cost of their care.

    Zack Beckwith formerly worked at a private equity-financed vet hospital, but said he had to quit in December because his mental health was suffering due to the job. He said he was working in unsafe conditions with the animals, he was often putting in extra hours of unpaid labor outside of his shift to help when they were understaffed, and that employees were chided for taking time off for family emergencies.

    “They’re continuously looking for more profit, more hospitals,” Urban said. “They want to open 60 hospitals in a year, and they don’t care that these corporations can’t staff these hospitals. They’re like, well, it’s OK, if one person works overnight and they’re drowning, as long as they continue to do that and they can continue to be paid the minimum amount, it’s OK.”

    Beckerwith said the suicide rate for veterinary technicians is five times higher than the general population. When Warren asked what they could do to get him to rejoin the understaffed industry, he said he didn’t think he would ever go back.

    “Right now it seems so hard to get out of the hole that’s been dug in this field,” he said. “I just wish humanity would come back to the field. My management, over time, just got less and less human and cared less and less about our people.”

    ‘Only value in the mix’

    Warren asked the veterinarians what they thought of the argument that private equity comes into businesses that are not running as profitably as they could be, and disciplines them to become more profitable.

    Amanda Leef, co-owner of Heal Veterinary Clinic in Watertown, and Holmes said they get approached multiple times a week by firms interested in buying their companies.

    “Every business should be profitable, and sure, it allows us to buy a new X-ray machine, because we have capital to invest. But what’s really different is having profit be the only value in the decision mix,” said Jamie Leef, co-owner and general manager of Heal.

    He continued, “We have other values. They are about community. They’re about taking care of clients. Once you bring those things into the mix, the profit starts to subside a little bit as being the driver of decisions.”

    Consolidation of care

    Warren sent a letter last month with Sen. Richard Blumenthal of Connecticut to private equity firm JAB Holding Company with their concerns about their spending “billions on buying up veterinary practices” and “the rapid consolidation of veterinary care.”

    Private equity isn’t exclusively seeping into health care industries. It is infiltrating other markets, managing roughly 20% of all business in the U.S. as of 2021, according to Forbes.

    “For more than a decade, private markets have enjoyed a remarkable period of sustained growth, more than doubling from US$9.7 trillion in assets under management (AUM) in 2012, and are estimated to have reached $24.4 trillion AUM by the end of 2023,” says a report from EY.

    Private equity companies benefit from tax advantages carved out by Congress.

    “Your tax dollars are helping private equity come chew up the veterinary industry, and this is something we have got to make changes in this area, but particularly when health is involved,” Warren said Monday.

    Warren’s visit was aimed at garnering support for a bill she filed with Sen. Ed Markey, in light of the Steward Health Care hospital crisis, to better regulate private equity in health care.

    “It would take away the tax advantages that they have. It would force them to be more transparent. So if your veterinary practice gets bought out by private equity, you will know that, so that our regulators will know to take a closer look at what goes on, and then special provisions in the health care field when life and death is on the line. We need to have more oversight when private equity moves in, and we need more responsibility when these private equity executives alter the delivery of health care so that lives are put at risk, then they need to be held personally responsible for that,” Warren told reporters.

    The bill hasn’t had much traction with her colleagues — as her previous attempts to take on private equity in health care have also been met with resistance in Congress.

    “I have not enough to get it across the finish line, I’ve got a lot of people who are learning about private equity, but it won’t surprise you to learn private equity hires lobbyists and family veterinary practices don’t, so it’s not a level playing field in trying to get the message across,” she said.

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    By Sam Drysdale | State House News Service

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  • Opinion: Why are so many California hospitals closing their labor and delivery units?

    Opinion: Why are so many California hospitals closing their labor and delivery units?

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    Last week, Keck Medicine of USC announced the closure of USC Verdugo Hills Hospital obstetric services on Nov. 20. They cited a 40% decline in deliveries over the past decade within “our community” and the resulting financial effect on the hospital as reasons for the decision. While this justification appears reasonable at first glance, it conceals an unsettling trend with significant implications for maternal health.

    The closing of hospital labor and delivery units is a nationwide trend, resulting in “maternity care deserts.” The closures primarily affect patients with Medicaid insurance, which pays for more than 40% of deliveries in the United States, and through Medi-Cal, more than 50% of deliveries in California. Unequal access to obstetric care contributes to America’s shamefully high maternal mortality rate which, at 22 maternal deaths per 100,000 live births in 2022, was double or triple the rate of peer nations.

    Obstetric care is different from many other types of healthcare in its unpredictability. Babies do not arrive on anyone’s schedule, and the busyness of labor and delivery units can wax and wane accordingly. For doctors to care for laboring mothers and their babies safely, hospitals must be staffed for the possibility of a sudden abundance of patients requiring emergency care.

    The modern fee-for-service healthcare model, which pushes hospitals to maximize efficiency and reduce staffing, treats the resiliency necessary for delivering babies as a drag on their bottom line. In this model, hospitals must fund round-the-clock capacity but are only reimbursed when their facilities and staff are in action. So if not enough deliveries are happening, expenses outweigh reimbursement. This drives hospitals to get out of the baby delivery business altogether.

    California has experienced a higher rate of obstetric unit closures than other states, and it continues to accelerate. More than 46 labor and delivery departments closed in the state between 2012 and 2023, with 60% occurring within the last three years. These closures are not limited to sparsely populated rural areas: 17 were within Los Angeles County, resulting in a local rate of closures that far outpaces the declining birth rate. This year, five more California hospitals have stopped providing obstetric care, and USC Verdugo Hills Hospital will be the fifth in L.A. County to close labor and delivery within a two-year period.

    Healthcare and medical benefit administrators talk of scaling and consolidation, of concentrating obstetric care at fewer hospitals so that there will be enough deliveries to cover the expense of remaining open. This will only work if we assume that market forces will sort out the balance between supply and demand so enough labor and delivery departments remain open to meet demand. But such forces only work if prices are dynamic and responsive to changes in supply. Insurance providers, especially Medicaid and Medi-Cal, have not shown this type of flexibility.

    Medi-Cal, the Medicaid program in California, has reimbursement rates for obstetric care that are fifth lowest in the nation. In our state, even busy labor and delivery departments that care primarily for Medicaid patients do not break even. South L.A.’s Martin Luther King Jr. Community Hospital is struggling to stay open despite increasing its volume of obstetric patients as other Los Angeles labor and delivery units have closed. This shows that the amount paid by Medi-Cal is below the market cost of providing obstetric care. This deficit is at the core of the California closures.

    There are at least two paths forward.

    The first is to increase Medi-Cal’s reimbursement of each delivered patient. The second would require directly regulating and subsidizing the maintenance of labor and delivery units the way the state does for emergency rooms. Either approach will be costly, because providing safe, modern, evidence-based obstetric care is expensive.

    Reproductive freedom is much in the news this campaign season. It should include reasonable, safe and dependable access to labor and delivery services.

    Anna Reinert is an assistant professor of clinical obstetrics and gynecology at USC’s Keck School of Medicine.

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    Anna Reinert

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  • Trahan calls for fed probe of Steward finances

    Trahan calls for fed probe of Steward finances

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    BOSTON — U.S. Rep. Lori Trahan is urging federal authorities to investigate Stewart Health Care System’s plans to sell its Massachusetts hospitals after the bankrupt company announced plans to close two of the facilities.

    In a letter to the heads of U.S. Department of Justice, Federal Trade Commission and Department of Health and Human Services, Trahan said Steward’s decision to sell two hospitals — Carney Hospital in Dorchester and Nashoba Valley Medical Center in Ayer, will “have a long-lasting impact on accessible healthcare” in those communities.

    The Westford Democrat, whose district includes Ayer, called on the agencies to probe the closures and “closely monitor” the sale of Steward’s six other hospitals in Massachusetts, including Holy Family’s locations in Methuen and Haverhill.

    “It is crucial to ensure that healthcare services remain accessible and affordable for patients as these hospitals transition to new ownership,” Trahan wrote.

    The Department of Justice and other agencies recently launched an investigation into the impact of “greed” at Steward and other health care systems. As part of the investigation, the agencies plan to review the impact of private equity firms on patient health, worker safety and the quality of care for patients.

    The Texas-based company is also the target of an investigation by the U.S. Attorney’s office in Boston, which is probing allegations that include fraud and violations of the Foreign Corrupt Practices Act. The federal law prohibits U.S. companies or citizens from engaging in bribery and corruption overseas.

    Trahan’s request would expand the scope of that investigation to include “domestic crimes” as well as “the consumer harms patients have faced because of the company’s actions.”

    Trahan cited the role of the private equity firm Cerberus Capital Management in Steward’s finances in Massachusetts and other states. She said acquisitions and sale-leaseback deals enriched Cerberus and Steward’s executives, including CEO Ralph de la Torre.

    Last week, the U.S. Senate’s Committee on Health, Education, Labor, and Pensions voted to initiate the investigation and issue a rare congressional subpoena for Steward’s CEO Ralph de la Torre to testify on Capitol Hill before the panel at a September hearing.

    Steward plans to put its 31 U.S. hospitals up for sale to pay down $9 billion in outstanding liabilities owed to creditors as part of the company’s bankruptcy proceedings. The company filed for federal bankruptcy protections in May.

    Bids on Steward’s Massachusetts hospitals and other states were due last week= but the company hasn’t disclosed prospective buyers. The company’s attorneys have asked a federal bankruptcy judge on Monday to postpone a court hearing on the hospital sales until Aug. 13 as it finalizes lease terms and other details.

    Meanwhile, the Healey administration’s plans to provide about $30 million in repurposed state-Medicaid funding to keep the hospitals running as they transition to new ownership is facing opposition from a committee representing creditors during the company’s bankruptcy proceedings.

    In a court filing late Monday, the committee said it has “significant concerns” that the $30 million pledged by the state may provide near-term (and important) assistance in transitioning the hospital to new owners, “it will do so at the expense of the rest of debtors, their estates and their creditors.”

    Gov. Maura Healey has pledged that “not a dime” of the $30 million will go to Steward and will instead help ensure a smooth transition to new hospital ownership. But she noted that her administration has little or no authority to block the hospital closures.

    “It’s Steward’s decision to close these hospitals, there’s nothing that the state can do, that I can do, that I have the power to do, to keep that from happening,” Healey told reporters on Monday. “We are in this situation … because of the greed of one individual, Ralph de la Torre, and the management team at Steward.”

    Christian M. Wade covers the Massachusetts Statehouse for North of Boston Media Group’s newspapers and websites. Email him at cwade@cnhinews.com

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    By Christian M. Wade | Statehouse Reporter

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