Podcasts about brockmeier

Brockmeier, Tim www.deutschlandfunk.de, @mediasres

Brockmeier, Tim www.deutschlandfunk.de, Informationen am Abend

Alexander Brockmeier, Head of Marketing, teilt in dieser Folge seine ganz besondere Verbindung zum Song „All I Need“ von Air. Dieser Song, der Ende der 90er erschien, begleitet ihn seit vielen Jahren – sowohl musikalisch als auch visuell, denn das dazugehörige Musikvideo hat sich fest in seinem Gedächtnis verankert. Fast schon filmreif erzählt er von der Zeit, als Air seinen beruflichen Werdegang beeinflusste und was diese Musik für ihn heute noch bedeutet. Ein Muss für alle, die die magische Verbindung zwischen Musik und Erinnerungen lieben!Höre deinen Lieblings-Podcast und deine Lieblingsmusik doch einfach auf einem sonoro Musiksystem.Das sonoro MEISTERSTÜCK und viele andere Produkte aus der sonoro Klangschmiede findet ihr hier: sonoro.comHinterlasse gerne eine Bewertung und abonniere unseren Podcast bei deinem Streamingportal der Wahl und verpasse keine Folge. Und wenn du alle Neuigkeiten zum Podcast „Mein Lieblingssong“ mitbekommen möchtest, dann melde dich hier für unseren wöchentlichen Newsletter an: Kostenloser NewsletterHier findest du uns auf Facebook oder Instagram.Geschichten aus den 70ern: Mein Lieblingssong - Album 1 als Hörbuchversion.Gibt es überall, wo es gute Hörbücher gibt.Geschichten aus den 80ern: Mein Lieblingssong - Album 2 als Hörbuchversion.Gibt es überall, wo es gute Hörbücher gibt.Habt ihr Lust auf eine „Mein Lieblingssong“-Tasse oder T-Shirt? Dann schaut mal in unserem Shop vorbei: Hier klicken! Hosted on Acast. See acast.com/privacy for more information.

„Zu den auffälligsten Merkmalen unserer Kultur gehört die Tatsache, dass es so viel Bullshit gibt.“ Das ist jedenfalls die These von Harry G. Frankfurts Buch über „Bullshit“. In Medien, Werbung, PR und vor allem in der Politik rollt eine unaufhaltsame Welle von Bullshit auf uns zu, nicht zuletzt im US-Wahlkampf, der gerade in die Endphase tritt. Aber was genau ist Bullshit? Warum ist er gefährlich und warum gibt es so viel davon? Darum geht es in der heutigen Episode. Für meine allererste Duo-/Crossover-Folge habe ich mich mit Daniel Brockmeier zusammengetan, um mir einen Überblick über das Bullshit-Feld zu verschaffen. Quellen Harry G. Frankfurt, Bullshit, Frankfurt/M. 2015 Daniel Brockmeier, Privatsprache: Philosophie (Podcast) über Steve Bannon, "Flooding the floor with shit": Sophistische Widerlegungen 8 Digitales Wörterbuch der deutschen Sprache, „Bullshit“ Max Black, The Prevalence of Humbug and Other Essays, New York und London 1983 60 Minutes, Statement zu Trumps Verweigerung eines Interviews Boeing, Statement Harry G. Frankfurt: “Donald Trump Is BS, Says Expert in BS”, in: Time 05.05. 2016 Trump bei der Präsidentschaftsdebatte (Video) Springfield pet-eating hoax (Wikipedia) ZAPP Das Medienmagazin: „Weidel, Söder, Merz: Die Populismus-Falle enthüllt“ (Video) Sarah Wagenknechts Aussagen über den Ukraine-Krieg: Deutschlandfunk Wagenknecht im Duell mit Weidel (Video) Harry G. Frankfurt, Ergänzungen zum Thema "Bullshit" (Video) CNN: Florida student Emma Gonzalez to lawmakers and gun advocates: ‘We call BS', Transcript der Rede von X [ehem. Emma] Gonzalez (Link), O-Ton (Video) Digitales Wörterbuch der Deutschen Sprache: „Schwurbeln“ (Link) Fabian Maysenhölder, "Esoterik" (Secta-Podcast #29)

Brockmeier, Tim www.deutschlandfunk.de, Das war der Tag

Brockmeier, Tim www.deutschlandfunk.de, Informationen am Abend

Brockmeier, Tim www.deutschlandfunk.de, Informationen am Abend

Brockmeier, Tim www.deutschlandfunkkultur.de, Studio 9

Brockmeier, Tim www.deutschlandfunk.de, Das war der Tag

Brockmeier, Tim www.deutschlandfunk.de, Informationen am Abend

In this episode of Coin Flips & Controversies, we present the case of ⁠⁠⁠⁠⁠⁠Large Rotator Cuff Tear in 71M ⁠ and feature expert faculty from the upcoming Shoulder360: The Comprehensive Shoulder Course 2024: Drs. Mirzayan, Bishai, Mazzocca, & Brockmeier.⁠⁠⁠⁠ Important Links: ⁠⁠⁠⁠⁠⁠Vote on Case⁠⁠⁠⁠⁠⁠ ⁠Full Video⁠⁠⁠⁠⁠⁠⁠ Shoulder360: The Comprehensive Shoulder Course 2024 --- Send in a voice message: https://podcasters.spotify.com/pod/show/orthobullets/message

Brockmeier, Timwww.deutschlandfunk.de, Informationen am Abend

Psychedelica Lex Episode 2023 – 087 Matthew Brockmeier, Esq. Discusses Colorado's Natural Medicine Health Act 08 March 2023 Part 1 of 1 ____________________________________________________ Author and host, Gary Michael Smith, Esq., is a decades-experienced, AV rated, attorney, American Arbitration Association panelist, founding director of the Arizona Cannabis Bar Association, board member of the Arizona Cannabis Chamber of Commerce, and general counsel to the nation's oldest federally recognized, 501C3, multi-racial peyote church. Psychedelica Lex is the first book to offer a comprehensive survey of the laws and regulations governing psychedelic substances. ABOUT THE PSYCHEDELICA LEX PODCAST AND CHANNEL President Nixon's enactment of the Controlled Substances Act in 1970 banished most psychedelics to Schedule I, making psychedelics for most purpose illegal. However, as the Congressional Record reveals, psychedelics never got a fair trial and little scientific evidence, if any, was considered by lawmakers. Prohibition was more about politics than public health. Yet, historical record, anecdotal evidence, and scientific studies all suggest that prohibition was an unnecessary and harmful overreaction and that many benefits may be derived from psychedelics. Psychedelica Lex puts the question of psychedelics on trial. Hosted by a veteran litigation attorney, each episode will explore psychedelics from different perspectives. As we explore the evidence together, you - the audience - will serve as jurors. Together we will examine every facet. Applying the rigors of cross examination and the Socratic method, we will seek an objective truth. ____________________________________________________________ The growth, trafficking, sale, possession, or consumption of psychedelics may be a felony punishable by imprisonment, fines, forfeiture of property, or any combination thereof. Most states have regulatory and criminal laws that mimic federal law. This podcast is for general informational purposes only. Material in this podcast is not intended to be and should not be used as a substitute for personal consultation with appropriate professionals. I am not your lawyer, and this podcast is not legal advice. PARENTAL ADVISORY: This podcast discusses psychedelic drugs. This episode may contain content that viewers may find offensive. Potentially offensive topics may include: drugs, sex, violence, religion, politics, science, public policy, economics, freedom of thought, free will, the nature of consciousness, art, and law. Language may be coarse and could include George Carlin's seven dirty words: sh*t, p*ss, f*ck, c*nt, c*cks*ck*r, m*th*rf*ck*r, and t*ts or some combination thereof. Opinions expressed in the podcast belong to the party who expressed them and do not necessarily reflect the opinion of Psychedelica Lex or its host. SPECIAL CAUTION - This podcast might place you at risk of changing your mind. Viewer discretion is advised.

The system for coordinating organ donations and transplants in the United States is broken, according to experts who have testified over the course of many years to Congress. In this episode, hear their testimony about what is wrong with the current system and then we'll examine the bill that aims to fix the problems. Please Support Congressional Dish – Quick Links Contribute monthly or a lump sum via Support Congressional Dish via (donations per episode) Send Zelle payments to: Donation@congressionaldish.com Send Venmo payments to: @Jennifer-Briney Send Cash App payments to: $CongressionalDish or Donation@congressionaldish.com Use your bank's online bill pay function to mail contributions to: Please make checks payable to Congressional Dish Thank you for supporting truly independent media! Background Sources August 3, 2022. Senate Finance Committee. Lenny Bernstein and Todd C. Frankel. August 3, 2022. The Washington Post. February 10, 2020. Senate Finance Committee. The Bill Audio Sources July 20, 2023 Senate Committee on Finance, Subcommittee on Health Care Witnesses: LaQuayia Goldring, Patient Molly J. McCarthy, Vice Chair & Region 6 Patient Affairs Committee Representative, Organ Procurement and Transplantation Network (OPTN) Matthew Wadsworth, President and CEO, Life Connection of Ohio Raymond J. Lynch, MD, MS, FACS, Professor of Surgery and Director of Transplantation Quality and Outcomes, Penn State Health Milton S. Hershey Medical Center Donna R. Cryer, JD, Founder and CEO, Global Liver Institute Clips 30:40 Sen. Ron Wyden (D-OR): HRSA, the Health Resources Agency, is on track to begin the contract process this fall and we're just going to be working here to complement their effort. 36:30 Sen. Chuck Grassley (R-IA): In 2005, I started the investigation of the deadly failures of UNOS, the monopoly tasked with managing the US organ donation system. Since then, more than 200,000 patients have needlessly died on the organ waiting list. There's a reason that I call UNOS the fox guarding the hen house. For nearly two decades, UNOS has concealed serious problems [at] the nation's organ procurement organizations, known as OPOs, instead of working to uncover and correct the corruption. This human tragedy is even more horrific because many of these deaths were preventable. They were the result of [a] corrupt, unaccountable monopoly that operates more like a cartel than a public servant. 44:45 LaQuayia Goldring: As a toddler, at the age of three, I was diagnosed with a rare kidney cancer that took the function of my left kidney. And when I was 17, I went back into complete renal failure and I received a first kidney transplant at that time. Unfortunately, in 2015, I went back into kidney failure. And at that time, I wasn't ready for another transplant, but I didn't have a choice but to go back on dialysis. I've been waiting nine agonizing years for a transplant, dependent upon a dialysis machine five days a week, just to be able to live. I was told that I would receive a kidney transplant within three to five years. But yet I am still waiting. I am undergoing monthly surgeries just to be able to get my dialysis access to work so that I can continue to live until I get a transplant. The UNOS waitlist is not like one to 100, where everybody thinks you get a number. I'm never notified on where I stand on the list or when I will get the call. I have to depend on an algorithm to make the decision of what my fate will be. 47:55 LaQuayia Goldring: Just a few weeks ago, a donor family reached out to me to be a directed kidney donor, meaning they chose me specifically for a kidney transplant. But unfortunately, due to the errors in the UNOS technology, I was listed as inactive and this was a clerical error. And all that they told me was this was a clerical error, and they could not figure out why I was inactive. But when it came down to it, I'm actually active on the transplant list. 51:45 Molly McCarthy: The Federal monopoly contractor managing the organ donation system, UNOS, is an unmitigated failure. And its leadership spends more time attacking critics than it does taking steps to fix the system. I've seen this firsthand in my five years as a patient volunteer with the OPTN and three years ago, I stepped into the role of Vice Chair of the Patient Affairs Committee, or PAC. 53:45 Molly McCarthy: Further, I have been called by a board member telling me to stop focusing on system outage and downtime of the UNOS tech system. He told me that having downtime wasn't a big deal at all, "the donors are dead anyway." That comment speaks volumes to me about the lack of empathy and respect UNOS has for donor families. 55:00 Molly McCarthy: Congress needs to break up the UNOS monopoly by passing 1668, ensuring that HHS uses its authority to replace UNOS as its contractor. 1:00:15 Matt Wadsworth: Break up the OPTN contract and allow for competition. 1:00:40 Matt Wadsworth: I commend this committee for introducing legislation to finally break up this monopoly and I stand ready to work with you in any way possible to ensure that this bill passes. It's the only way this industry will be able to save more patients' lives. 1:02:10 Dr. Raymond Lynch: I want to differentiate between organ donation, which is the altruistic decision of the donor patient and their family, and organ procurement, which is the clinical care provided by OPO staff. This is what turns the gift of donation into the usable organs for transplant. Organ procurement is a clinical specialty. It's the last medical care that many patients will ever receive. It's reimbursed by the federal government and it's administered by OPOs that are each the only provider in the territory to which they hold federal contracts. Right now patient care delivered by OPOs is some of the least visible in American healthcare. I can't tell you how many patients were evaluated by OPO workers in the US in 2022. I can't tell you how many patients were examined, or how many families were given information about donation, or how many times an OPO worker even showed up to a hospital to do this clinical duty. This lack of information about what OPO providers actually do for patients is a root cause of the variability in rates of organ procurement around the country. My research has shown that what we call OPO performance is a measurable restriction on the supply of organs that results in the unnecessary deaths of patients with organ failure. For example, if the lowest performing OPOs from around the country had just reached the national median over a recent seven year period, there would have been 4957 more organ donors, yielding an estimated 11,707 additional organs for transplant. Because many OPOs operate in a low quality data environment and without appropriate oversight, almost 5,000 patients did not get adequate organ procurement care, and nearly 12,000 other patients did not receive life saving transplants. 1:03:55 Dr. Raymond Lynch: OPO clinical work is currently not visible, it's not benchmarkable, and it's not able to be adequately evaluated, analyzed, or compared. However, much of the hidden data about how OPOs provide care to patients is known to one entity and that entity is UNOS. 1:05:20 Dr. Raymond Lynch: We need a new network of highly skilled specialist organizations, each attending to areas of expertise in the management of the OPTN contract. 1:21:15 Sen. Marsha Blackburn (R-TN): When we look at OPTN, and look at the Securing Organ Procurement Act, the bill would strip the nonprofit requirement for the manager of the Organ Procurement and Transplantation Network, which would open the door for profiting from organ procurement and donation. And to me, this is something that I think many people really fear, especially people that are on a waitlist. And so what I would like for you to do is to address that and address those concerns. And why or why not you think the Act has it right. Dr. Raymond Lynch: Thank you, Senator. I think it's unfortunate that people would be afraid of that and it needs to be changed. Many of the patients that you referenced are waitlisted at for-profit hospitals. For-profit is a part of American healthcare. And I can tell you that our not-for-profit entity doesn't work. And there are for-profit hospitals and for-profit transplant centers that do work. So patients don't need to be afraid of that. They do need to be afraid of the status quo. 1:28:30 Sen. Ben Cardin (D-MD): Ms. Cryer, do you have any views as to why it's much lower percentage chances for a racial minority to be able to have a transplant? Donna Cryer: Yes. And it really does come down to UNOS not doing its job of overseeing the organ procurement organizations. We know from many studies that black and brown communities donate organs in the same percentage they are the population. So it is not a problem of willingness to donate. It is a problem, as Miss Goldring was starting to discuss, about UNOS not ensuring that OPOs go out into the communities, develop relationships far before that horrible decision is needed to [be] made to donate the organs of a family member. 1:56:45 Sen. Elizabeth Warren (D-MA): And among the many reforms the legislation would support HRSA's proposal to break up the OPTN monopoly contract into multiple smaller contracts, which would allow some competition and allow the best vendors in the business to manage different parts of the transplant network operation. That means hiring IT experts to do the IT. It means hiring logistics experts to do logistics, and so on. 1:57:15 Sen. Elizabeth Warren (D-MA): UNOS does not want to lose control, so they're pushing to have the government limit eligibility only to nonprofit vendors that have worked in the past on organ donation, meaning, for instance, that the IT company that is hired to run OPTNs computers systems would have had to have worked on an organ transplant network in the past and be a nonprofit. So Ms. McCarthy, the requirement UNOS wants would seem to make it so that only one organization could apply for the new contract: UNOS. 1:58:35 Sen. Elizabeth Warren (D-MA): Right now, Congress has an opportunity to root out corruption in this system, but if we don't act before the current contract expires we won't have another shot for years. August 3, 2022 Senate Committee on Finance Witnesses: Brian Shepard, CEO, United Network for Organ Sharing (UNOS) Diane Brockmeier, RN, President and CEO, Mid-America Transplant Barry Friedman, RN, Executive Director, AdventHealth Transplant Institute Calvin Henry, Region 3 Patient Affairs Committee Representative, Organ Procurement and Transplantation Network (OPTN) Jayme Locke, M.D., MPH, Director, Division of Transplantation, Heersink School of Medicine, University of Alabama at Birmingham Clips 36:15 Sen. Ron Wyden (D-OR): A 1984 law created the first computerized system to match sick patients with the organs they need. It was named the Organ Procurement and Transplantation Network. Someone needed to manage that system for the whole country, so the government sought to contract an organization to run it. UNOS was the only bidder for that first contract in 1986. The contract has come up for bid seven other times, UNOS has won all seven. Today, the network UNOS overseas is made up of nearly 400 members, including 252 transplant centers, and 57 regional organizations known as Organ Procurement Organizations, or OPOs. Each OPO is a defined geographic service network. Families sitting in a hospital room thinking about donating a loved one's organs does not have a choice of OPOs. 37:40 Sen. Ron Wyden (D-OR): Between 2010 and 2020, more than 1,100 complaints were filed by patients and families, staff, transplant centers, and others. The nature of these complaints runs the gamut. For example, in a number of cases, OPOs had failed to complete critical mandatory tests for matters like blood types, diseases, and infection. Our investigation found one patient died after being transplanted with lungs that a South Carolina OPO marked with the wrong blood type. Similar blood type errors happened elsewhere and patients developed serious illness. Some had to have organs removed after transplant. Another patient was told he would likely die within three years after an OPO in Ohio supplied him with a heart from a donor who had died of a malignant brain tumor. UNOS did not pursue any disciplinary action. In a case from Florida, another patient contracted cancer from transplanted organs and the OPO sat on the evidence for months. In total, our investigation found that between 2008 and 2015, and 249 transplant recipients developed a disease from transplanted organs. More than a quarter of them died. 38:55 Sen. Ron Wyden (D-OR): Delivering organs has been another source of life threatening errors. We found 53 such complaints between 2010 and 2020, as well as evidence that this was just the tip of the iceberg. In some cases, couriers missed a flight. In others, the organs were abandoned at airports. Some organs were never picked up. Many of these failures resulted in organs being discarded. 39:20 Sen. Ron Wyden (D-OR): It's reasonable to assume that many more errors are going unreported. Why? Because filing official complaints with UNOS appears to accomplish zero productive oversight or reform. Organ transplant professionals repeatedly told the Finance Committee that the complaint process was, and I quote here, "a black hole." Complaints went in, UNOS went quiet. In interviews with the Committee UNOS leaders have dragged their feet, dodged tough questions, and shifted responsibility onto others. investigations and disciplinary measures rarely amount to much more than a slap on the wrist. Only one time -- just once -- has UNOS recommended that an OPO lose their certification. 55:05 Diane Brockmeier: We must update the archaic technology system at UNOS. As OPOs, we are required to work with UNOS technology DonorNet every day. DonorNet is outdated, difficult to us,e and often slow to function when every minute counts. Manual entry subjects it to error and OPO and Transplant Center staff are not empowered with the right information when time is critical. I did serve in leadership roles on the OPO Committee from 2017 to 2022. Committee members and industry leaders voiced repeated requests to improve DonorNet. The consistent response was UNOS IT did not have the bandwidth to address this work. The limitations of the UNOS technology are delaying and denying transplants to patients that are dying on the waitlist. Poor technology impacts the disturbingly high kidney discard rate in the United States, where one in four kidneys never make it to a patient for transplantation. Critical time is lost due to the inefficiency of DonorNet, wasting time on offers that will not be accepted. Of course an available organ should be offered to the patient in this sequence. However, far too much of the matching, particularly on older donors and organs that are difficult to place, are left to the individual OPOs and transplant centers to find each other despite, rather than facilitated by, UNOS technology. Mid-America Transplant intentionally identifies surgeons who accept kidneys that have been repeatedly turned down many times. These are life saving options for those patients. In May of 2022, one of these patients was number 18,193 on the list. Relying on DonorNet alone, that kidney would never had been placed and the chance to save a life would have been wasted. 55:20 Diane Brockmeier: UNOS lacks urgency and accountability around identifying and remediating this preventable loss of organs, and they are not required to publicly report adverse events when patients are harmed, organs are lost, or the quality of patient care is deemed unsafe. UNOS does not require clinical training, licensure, or certification standards for OPO staff delivering critical patient care. In this environment, who's looking out for the patient? Who's being held accountable for poor patient care? No OPO has ever actually been decertified, regardless of its performance or its safety record. 57:55 Diane Brockmeier: When an OPO goes out of sequence to place an organ that would otherwise be thrown away, UNOS requires an explanation; however, when organs are recovered and discarded, you must remain silent. 58:05 Diane Brockmeier: We must remove conflicts to ensure effective governance. From 2018 to 2020, I served as a board member for the OPTN. Serving on the board of the OPTN automatically assigns membership to the UNOS board. My board experience revealed that at times UNOS actions are not aligned with its fundamental vision of a life saving transplant for everyone in need. How can you fairly represent the country's interest and a contractor's interest at the same time? 58:35 Diane Brockmeier: Board members are often kept in the dark about critical matters and are marginalized, particularly if they express views that differ from UNOS leadership. Preparatory small group calls are conducted prior to board meetings to explore voting intentions, and if the board member was not aligned with the opinion of UNOS leadership, follow up calls are initiated. Fellow board members report feeling pressured to vote in accordance with UNOS leadership. 59:10 Diane Brockmeier: To protect patients, I urge Congress and the administration to separate the OPTN functions into different contracts so that patients can be served by best-in-class vendors, to immediately separate the boards of the OPTN and OPTN contractors, and to ensure that patients are safeguarded through open data from both the OPTN and OPOs. 1:00:45 Barry Friedman: Approximately 23% of kidneys procured from deceased donors are not used and discarded, resulting in preventable deaths 1:00:55 Barry Friedman: Organ transportation is a process left to federally designated Organ Procurement Organizations, OPOs. Currently, they develop their own relationships with couriers, rely on airlines, charter flights, ground transportation, and federal agencies to facilitate transportation. In many cases, organs must connect from one flight to another, leaving airline personnel responsible for transfers. While anyone can track their Amazon or FedEx package, there is currently no consistent way of tracking these life saving organs. 1:01:45 Barry Friedman: Currently there is no requirement for OPOs to use tracking systems. 1:02:20 Barry Friedman: I also believe there's a conflict of interest related to the management of IT functions by UNOS, as the IT tools they offer transplant centers come with additional costs, despite these being essential for the safety and management of organs. 1:02:35 Barry Friedman: UNOS is not effectively screening organ donors so that they can be quickly directed to transplant programs. UNOS asks centers to voluntarily opt out of certain organs via a filtering process. As a result, OPOs waste valuable time making organ offers to centers that will never accept them. Time wasted equates to prolonged cold ischemic time and organs not placed, resulting in lost organ transplant opportunities. 1:03:10 Barry Friedman: Due to the limited expertise that UNOS has in the placement of organs, it would be best if they were no longer responsible for the development of organ placement practices. The UNOS policy making [process] lacks transparency. Currently OPTN board members concurrently serve as the board members of UNOS, which creates a conflict of interest that contributes to this lack of transparency. UNOS committees are formed in a vacuum. There is no call for nominations and no data shared with the transplant community to explain the rationale behind decisions that create policy change. 1:11:35 Dr. Jayme Locke: The most powerful thing to know about this is that every organ represents a life. We can never forget that. Imagine having a medication you need to live being thrown away simply because someone took too long to get it to you. Your life quite literally in a trash can. Organs are no different. They too have shelf lives and they are measured in hours. Discarded organs and transportation errors may sound abstract, but let me make this negligence real for you. In 2014, I received a kidney that arrived frozen, it was an ice cube you could put in your drink. The intended recipient was sensitized, meaning difficult to match. The only thing we could do was tell the waiting patient that due to the lack of transportation safeguard, the kidney had to be thrown in the trash, the final generous act of a donor in Maryland. In 2017, I received a kidney that arrived in a box that appeared to have tire marks on it. The box was squished and the container inside had been ruptured. We were lucky and were able to salvage the kidney for transplant. But why should luck even play a role? 1:12:45 Dr. Jayme Locke: In one week, I received four kidneys from four different OPOs, each with basic errors that led to the need to throw away those life saving organs. One due to a botched kidney biopsy into the kidneys collecting system, another because of a lower pole artery that had been cut during procurement that could have been fixed if someone involved had assessed the kidney for damage and flushed it before packing, but that didn't happen. Two others arrived to me blue, meaning they hadn't been flushed either. 1:13:15 Dr. Jayme Locke: Opacity at UNOS means that we have no idea how often basic mistakes happen across the country, nor can we have any confidence that anything is being done to redress such errors so they don't keep happening. 1:13:40 Dr. Jayme Locke: Women who have been pregnant, especially multiple times, are harder to match, contributing to both gender and racial disparities in access to transplant. This is a very real example of how a constrained pool of organs and high discards disproportionately hurt women and women of color, who are more likely to have multiple pregnancies. 1:14:25 Dr. Jayme Locke: Number one, immediately separate the OPTN board from any of the boards of any contractors. Number two, bring in real experts to ensure our patients are served by the best of the best in each field, separating out key functions of the OPTN, including policy, technology, and logistics. And number three, ensure that patients are safer by holding all contractors accountable through public adverse event reporting and immediate redressing of problems. 1:22:00 Sen. Chuck Grassley (R-IA): The system doesn't seem to be fair to racial minorities or people living in rural communities. So what are your efforts underway to understand the root causes and help make the system fairer to patients on the waiting list to explain the factors that result in the disparity for minorities in rural populations in the process? And how can the federal government address a problem if we have to be involved in addressing it? Dr. Jayme Locke: One of the most important things that we don't currently do is we don't actually account for disease burden in terms of examining our waiting lists. So we have no way of knowing if we're actually serving the correct people, if the correct people are actually making it to the waiting list. Disease burden is super important because it not only identifies the individuals who are in need of transplantation, but it also speaks to supply. So areas with high rates of end stage kidney disease burden, like the southeastern United States are going to have much lower supply. And those waiting lists predominantly consist of African American or Black individuals. So if you want to make a truly equitable organ system, you have to essentially get more organs to those areas where there are higher disease burdens. I think the other thing is that we have to have more focus on how we approach donor families and make sure that we have cultural competence as a part of our OPOs, and how they approach families to ensure that we're not marginalizing minority families with regard to the organ donation process. 1:30:00 Brian Shepard: The OPTN IT system that UNOS operates has 99.99% uptime. It is a highly reliable system. We are audited annually by HRSA.... Sen. Ben Cardin (D-MD): My information shows it's had 17 days down since I think 1999. That's not correct? Brian Shepard: In 23 years, yes, sir. Sen. Ben Cardin (D-MD): Okay, well, every day there's a loss of life, isn't it? Brian Shepard: That's the total amount of time over the couse of -- Sen. Ben Cardin (D-MD): I hope our national event system isn't down 17 days a year. Brian Shepard: The system has never been down for a day. And to my knowledge, and I have not been at UNOS since 1999, there's been maybe one event that was longer than an hour, and that was three hours. But the total amount of time since 1999 -- Sen. Ben Cardin (D-MD): So you're satisfied with your technology? You think you have the right technology? You're satisfied with your tracking systems now? You think everything is okay? Brian Shepard: We constantly improve our technology. We're subjected to 3 million attempts a day to hack into the patient database and we successfully repelled them all. So we are never satisfied with our technology, but we do maintain 99.99% uptime. We disagree with the USDS analysis of our systems. 1:37:25 Brian Shepard: If you're asking whether UNOS can prevent an OPO from operating or for being an OPO -- Sen. Rob Portman (R-OH: Well not prevent them, but require them to do something .You don't have the ability to require them...? Brian Shepard: The peer review process has significant persuasive authority, but all the payment authority and all the certification and decertification authority live at CMS. 1:39:00 Sen. Rob Portman (R-OH: Do you think there should be tracking of organs in transit? Brian Shepard: I think that's a very beneficial thing. UNOS provides an optional service that a quarter of OPOs use. Many OPOs also use other commercially available trackers to do that. There is not a single requirement to use a particular system. 1:41:55 Sen. Elizabeth Warren (D-MA): Mr. Shepherd, you are the CEO of UNOS. We have documented these problems and you've received more than 1000 complaints in the last decade alone. So tell me, in the 36 years that UNOS has had the contract to run our national organ system, how many times has UNOS declared its OPO Members, any OPO members, not in good standing. Brian Shepard: Two times, Senator. 1:43:20 Sen. Elizabeth Warren (D-MA): How many times has UNOS put an OPO on probation? Brian Shepard: I don't know that number off the top of my head, but it's not a large number. Sen. Elizabeth Warren (D-MA): It's not large, in fact it's three. 1:45:20 Brian Shepard: Approximately 10% of the budget of this contract is taxpayer funded. The rest of that is paid by hospitals when they list patients. 1:49:30 Sen. Todd Young (R-IN): Once an OPO is designated not in good standing, Senator Warren referred to this as toothless. It does seem toothless to me. I'll give you an opportunity, Mr. Shepherd, to disabuse me of that notion and indicate for me what penalties or sanctions are actually placed on an OPO when they are designated not in good standing. Brian Shepard: The statute does not give UNOS any authority to offer sanctions like that. The certification, decertification, payment authorities belong entirely to CMS. UNOS's statute doesn't give us the ability -- Sen. Todd Young (R-IN): So it is toothless in that sense. Brian Shepard: It is designed to be, by regulation and contract, a quality improvement process, in contrast to the oversight process operated by a federal agency. 1:51:15 Sen. Todd Young (R-IN): To what extent is UNOS currently tracking the status of all the organs in transit at any given time? Brian Shepard: UNOS does not coordinate transportation or track organs in transit. We do provide a service that OPOs can use to use GPS trackers. Some of the OPOs use ours and some use other commercially available products. Sen. Todd Young (R-IN): So why is it, and how does UNOS plan to optimize organ delivery if you don't have 100% visibility into where they are at any given time? Brian Shepard: I think that the GPS products that we offer and that other people offer are valuable, they do help in the delivery of kidneys. Only kidneys travel unaccompanied, so this is a kidney issue. But I do think that GPS trackers are valuable and I think that's why you've seen more and more OPOs use them. 1:52:50 Sen. Ron Wyden (D-OR): Mr. Shepherd has said twice, with respect to this whole question of the power to decertify an OPO, that CMS has the power to do it. UNOS also has the power to refer an OPO for decertification under the OPTN final rule. That has been done exactly once. So I just wanted it understood with respect to making sure the committee has got what's really going on with respect to decertifying OPOs. 2:00:15 Dr. Jayme Locke: Obviously people have described that we have about a 25% kidney discard, so one in four. So if you look at numbers last year, these are rough numbers, but that'd be about 8000 kidneys. And really, I think, in some ways, these are kind of a victim of an entrenched and cumbersome allocation algorithms that are very ordinal, you have to go sort of in order, when data clearly have shown that introduction of multiple simultaneous expiring offers would result in more efficient placement of kidneys and this would decrease our cold ischemia time. 2:00:50 Dr. Jayme Locke: So if you take UNOS's organ center, they have a very rigid system, for example, for finding flights and lack either an ability or interest in thinking outside the box. So, for example, if there are no direct flights from California to Birmingham, Alabama, instead of looking for a flight from San Francisco to Atlanta, understanding that a courier could then pick it up in Atlanta and drive it the two hours, they'll instead put on a flight from SFO to Atlanta and allow it to go to cargo hold overnight, where it literally is rotting, if you will, and we're putting extra time on it. Sen. Ron Wyden (D-OR): Just to make sure everybody gets this. You're saying you've seen instances of something being put in cargo hold when it is very likely to rot? Dr. Jayme Locke: That is correct. So if the kidney arrives after 10pm at the Atlanta airport, it goes to cargo hold. We discovered that and made calls to the airlines ourselves and after several calls to the airlines, of course they were mortified, not understanding that that was what was happening and actually had their manager meet our courier and we were able to get the kidney out of cargo hold, but this went on before we figured out what was happening because essentially they fly it in, it sits in cargo hold, it comes out the next morning to catch the next flight. Instead of thinking outside the box: if we just get it to Atlanta, it's drivable to Birmingham. And those hours make a difference. Sen. Ron Wyden (D-OR): That sounds way too logical for what UNOS has been up to. 2:03:05 Sen. Ron Wyden (D-OR): Miss Brockmeier, UNOS has developed this organ tracking system. Do you all use it? I'm curious what you think of it. Diane Brockmeier: Thank you for the question, Senator. We did use and participate in the beta pilot through UNOS and made the decision to not move forward using their product, and have sought a commercial alternative. Sen. Ron Wyden (D-OR): And why was that? Diane Brockmeier: Part of the issues were some service related issues, the lack of the interconnectivity that we wanted to be able to facilitate a more expedited visual tracking of where the organ was. Sen. Ron Wyden (D-OR): Was the tracking technology low quality? Diane Brockmeier: Yes, sir. 2:11:25 Sen. Ron Wyden (D-OR): All right, let's talk for a moment about the boards that are supposed to be overseeing these, because it looks to me like there's a serious conflict of interest here and I'll send this to Ms. Brockmeier, and perhaps you'd like to get to it as well, Mr. Friedman. The Organ Procurement and Transplantation Network, which is the formal title of the organ network that operates under federal contract administered by HHS, and UNOS, which is the contractor that operates the network and controls information about the network, have the same boards of directors, despite efforts by the government to separate them. That means the people who look out for the best interests of UNOS, the multimillion dollar nonprofit, are the same people who look out for the interests of the entire organ transplant network. Sure sounds like a conflict to me. 2:12:55 Diane Brockmeier: I think there should be an independent board. I think the division of the responsibilities of the board and by the inherent way that they're structured, do pose conflicts. It would be like if you had an organization that was a supporting organization, you'd want to hold it accountable for its performance. And the current structure really limits that opportunity. 2:19:50 Dr. Jayme Locke: And if you think about IT, something as simple as having a system where we can more easily put in unacceptable antigens, this was a debate for many years. So for context, we list unacceptable antigens in the system that allows us to better match kidneys so that when someone comes up on the match run, we have a high probability that there'll be a good tissue match. Well, that took forever and we couldn't really get our unacceptable antigens in, so routinely people get offered kidneys that aren't going to be a match, and you have to get through all of those before you can get to the person that they really should go to. Those are simple examples. But if we could really have transparency and accountability around those kinds of things, we could save more lives. 2:23:10 Sen. Ron Wyden (D-OR): Mr. Shepherd told Senator Warren that only 10% of UNOS funds come from taxpayer money and the rest comes from fees paid by transplant centers who add patients to the list. But the fact is, Medicare is the largest payer of the fees, for example, for kidneys. So we're talking about inefficiency, inefficiency that puts patients at risk. And certainly, taxpayer dollars are used to cover some of these practices. May 4, 2021 House Committee on Oversight and Reform, Subcommittee on Economic and Consumer Policy Witnesses: Tonya Ingram, Patient Waiting for a Transplant Dr. Dara Kass, Living Donor and Mother of Transplant Recipient LaQuayia Goldring, Patient Waiting for a Transplant Steve Miller, CEO, Association for Organ Procurement Organizations Joe Ferreira, President, Association for Organ Procurement Organizations Matt Wadsworth, President and CEO, Life Connection of Ohio Dr. Seth Karp, Director, Vanderbilt Transplant Center Donna Cryer, President and CEO, Global Liver Institute Clips 5:15 Tonya Ingram: The Organ Procurement Organization that serves Los Angeles, where I live, is failing according to the federal government. In fact, it's one of the worst in the country. One analysis showed it only recovered 31% of potential organ donors. Audits in previous years found that LA's OPO has misspent taxpayer dollars on retreats to five star hotels and Rose Bowl tickets. The CEO makes more than $900,000. Even still, the LA OPO has not lost its government contract and it has five more years to go. 30:00 Rep. Raja Krishnamoorthi (D-IL): Unusual among Medicare programs, their costs are 100% reimbursed, even costs unrelated to care. So, extravagant executive compensation and luxury perks may be passed off onto the taxpayer. 46:55 Dr. Seth Karp: We have 10 hours to get a liver from the donor to the recipient, and about one hour to sew it in. For heart, we have about six hours. Time matters. 47:55 Dr. Seth Karp: Last year, I had the opportunity to co-write a viewpoint in one of the journals of the American Medical Association with TJ Patel, former Chief Data Scientist of the United States. In that article, we provided evidence that the metrics used to judge the performance of organ procurement organizations are basically useless. Until the recent OPO Final Rule, performance was self-reported, and OPO employees admitted to having gamed the system. When threatened with decertification, one of the OPOs themselves successfully argued that because the performance data were self reported and unaudited, they failed to meet a reasonable standard and the OPO should not be held accountable. In other words for decades, the metrics supposed to measure performance didn't measure performance, and the results have been disastrous, as you have heard. 49:45 Dr. Seth Karp: Whenever I, and quite frankly most everyone else in the field, gives a talk on transplantation, we usually make two points. The first is that organ transplantation is a miracle of modern medicine. The second is the tragedy that there are not enough organs for everyone who needs one. I no longer use the second point, because I don't believe it. Based on my work, I believe that there are enough organs for patients who require hearts, lungs, and probably livers, and we can make a huge improvement in the number of kidneys available. In addition to improving OPO performance, new technologies already exist to dramatically increase the organ supply. We need a structure to drive rapid improvement in our system. 54:00 Joe Ferreira: One common misconception is that OPOs are solely responsible for the entire donation and transplantation system, when, in fact, OPOs are the intermediary entity and their success is highly dependent on collaborations with hospitals and transplant programs. At the start of the donation process, hospitals are responsible for notifying any OPO in a timely manner when a patient is on a ventilator and meets medical criteria to be an organ donor. Additionally, transplant centers must make the decision whether to accept or decline the organs offered by OPOs. 57:55 Matt Wadsworth: As geographic monopolies, OPOs are not subject to any competitive pressure to provide high service. As the only major program in all of health care 100% reimbursed for all costs, we do not face financial pressures to allocate resources intelligently. 1:02:10 Rep. Raja Krishnamoorthi (D-IL): Mr. Ferreira, I'd like to turn to you. You run the OPO called the Nevada Donor Network. I have your OPO's 2019 financial statement filed with the CMS. It appears that your OPO spent roughly $6 million in 2019 on administrative and general expenses. Interestingly, in 2019, I see your OPO spent approximately $146,000 on travel meetings and seminars alone. And your itemization of Administrative and General has an interesting line item for $576,000 for "ANG". It took me a minute but that means you have an "Administrative and General" subcategory in your "Administrative and General" category. Very vague. Now Mr. Ferreira, I was informed by Mr. Wadsworth, a former executive of yours at the Nevada Donor Network, that your OPO has season tickets to the NHL's Las Vegas Golden Knights, isn't that correct? Joe Ferreira: That is correct, Mr. Chairman. Rep. Raja Krishnamoorthi (D-IL): And you also have season tickets to the Las Vegas Raiders too, right? Joe Ferreira: That is correct. Rep. Raja Krishnamoorthi (D-IL): And according to Mr. Wadsworth and others, your OPO took a board retreat to Napa Valley in 2018. Joe Ferreira: That is correct. Rep. Raja Krishnamoorthi (D-IL): And Sonoma in 2019, right? Joe Ferreira: That is correct. Rep. Raja Krishnamoorthi (D-IL): Mr. Ferreira, what you're spending on the Raiders, the Golden Knights, Napa Valley and Sonoma have one thing in common: they have nothing to do with recovering organs. 1:10:30 Dr. Seth Karp: In 2019, there were six heart transplants that were performed using donors after circulatory determination of death. And I don't want to get into the technical aspects of that. But in 2019, that number was six. In 2020, that number was 126. This is a new technology. This is a way that we can increase the number of heart transplants done in United States dramatically. And if we think that there were 500 patients in the United States waiting for a heart in 2020, 500 patients that either died or were delisted because they were too sick, and you think in one year, using a technology, we got another 100 transplants, if we could get another 500 transplants out of that technology, we could almost eliminate deaths on the on the heart transplant waiting list. That technology exists. It exists today. But we don't have a mechanism for getting it out to everybody that could use it and it's going to run itself through the system, it's going to take too much time. 1:24:05 Rep. Andrew Clyde (R-GA): You know, I'm a little disappointed that we're discussing race as a factor in organ transplant. We're all one race in my opinion; color makes no difference to me. We're the human race. And to me, the interjection of race into this discussion is very concerning. Discrimination based on race was outlawed almost 60 years ago through the Civil Rights Act of 1964. Now, I'm not a medical doctor, and I have very little knowledge of medicine. But last year, there was an article that came out in LifeSource and it says, "Does my race and ethnicity matter in organ donation?" And so my question here is for Dr. Karp. In your experience, would you agree that a donor's organs are more likely to be a clinical match for a recipient of the same ethnicity? Could you comment on that? Is that actually a factor, or not? I mean, we're all human beings, we all, you know, have similar bodies. Dr. Seth Karp: Yes. So there definitely are certain HLA types that are more common. That is race-based. So the answer to that question is yes. Rep. Andrew Clyde (R-GA): Okay. All right. And so if you have more of one particular race, more donations of one particular race, then naturally you would have more actual matches of that particular race. Is that correct? Dr. Seth Karp: That would tend to be the case. Rep. Andrew Clyde (R-GA): Okay. All right. All right. Okay, that's just a question that I wanted to clear up here. 1:34:20 Donna Cryer: We'd like to see investments in languages that are spoken by the community. Educational resources should be, as required by law, for those with limited English proficiency. They should be in the languages spoken by the community. They should be hiring diverse staff to have those most crucial conversations with families. The data shows, and certainly experience and common sense shows as well, that having people of color approaching families of color results in more donations. Executive Producer Recommended Sources Music by Editing Production Assistance

On Feb. 17, 2017, Joe and Sarah Dudley were getting ready for a late Valentine's Day celebration when Joe started complaining about feeling sick. He had a bad headache. “So I told him to go lay down, and we'd just celebrate another time,” Sarah said. Shortly after, Joe started running a high fever – 103.6 degrees. He could barely walk, so Sarah brought him to an urgent care clinic in Des Moines, Iowa. The physician's assistant on duty diagnosed Joe with the flu – despite a negative test – and sent him home. He was too weak to walk out of the clinic. “They brought a guy back with a wheelchair, put a gurney bill down and physically put him in the wheelchair – physically sent him home,” Sarah said. Joe got sicker, and two days later, ended up in the emergency room. At the hospital, doctors told Sarah that Joe didn't have the flu. It was much worse. He had bacterial meningitis, which by then was on track to cause permanent brain damage. Sarah watched it unfold over the next few weeks. Joe had three strokes – two while hospitalized in the intensive care unit. “When he was actually able to come out of it, he had to relearn to walk, relearn to talk. [He had] permanent nerve damage on his right side, lost his hearing,” she said. Sarah said the illness drastically changed Joe. The man she married was calm and avoided conflict. The one who left the hospital became prone to anger and bouts of paranoia. “You never know what mood he's going to be in, or what's going to set him off, and there's no cure for it,” she said. Shortly after, the Dudleys decided to pursue a medical malpractice case against the clinic. The case took up the next six years of the Dudleys' lives. The case went to trial in late 2022 after the Dudleys could not reach a settlement with the clinic's insurance company. A jury last November awarded the Dudleys $27 million in non-economic damages for Joe's initial misdiagnosis and the lifetime of support he will likely need for his brain injury. The clinic has appealed the case, so the Dudleys have yet to receive any money. When – or if – they do, Sarah said much of the award will go toward Joe's medical care in the future. “With his brain injury, he's going to go downhill pretty quickly – dementia, it's going to come eventually,” she said. If the Dudleys were to pursue their case now, under a new Iowa law, their outcome would look much different. Iowa joined most Midwestern states, including Missouri, Kansas and Wisconsin, when it passed a law in February putting a hard cap on non-economic damages that can be awarded by a jury for medical malpractice. Iowa's new law caps non-economic damage jury awards at $1 million when an independent clinic is involved, like in Joe Dudley's case. For hospitals, the limit is $2 million. Starting in 2028, that cap will increase by 2.1% each year. The law also created a task force to make recommendations to reduce medical errors. https://www.iowapublicradio.org/state-government-news/2023-02-16/iowa-governor-signs-cap-on-medical-malpractice-damages-for-pain-and-suffering https://www.legis.iowa.gov/legislation/BillBook?ga=90&ba=HF%20161 The health care industry has long pushed for these caps on damages awarded for things that can't be assigned a monetary value — like pain and suffering. They claim the caps help clinics stay open by avoiding sudden high-dollar financial blows while helping to attract much-needed health care providers. But some question whether these caps help – or hurt – Midwesterners seeking justice for medical errors. ‘It sucks to be sued' The Dudleys case was one of two high-dollar medical malpractice jury awards that grabbed headlines in Iowa last year. The other was a nearly $98 million award to an eastern Iowa couple whose infant sustained extensive brain damage from a botched delivery. About half that award was non-economic damages. It's believed to be the highest payout in state history. https://www.desmoinesregister.com/story/news/health/2022/03/22/mercy-hospital-iowa-city-medical-malpractice-lawsuit-kromphardt-jill-goodman-97-million-verdict/7129763001/ These cases are one of the reasons the health care industry has sought hard caps on non-economic damages. Andy Conlin, a lobbyist for the Iowa Independent Physician Group, shared his opposition to the bill at a subcommittee hearing on the bill in January. “You never know when you're going to end up…seeing one of these, these judgments come down the pike and really negatively impact your facility, maybe even put your facility out of business,” Conlin said. However, these high-dollar jury awards are exceptionally rare in the U.S. For the past six years, Iowa has averaged 160 medical malpractice case filings a year. They make up a fraction of a percent of the average 666,000 civil cases filed in the state, according to the Iowa Judicial Branch. https://www.legis.iowa.gov/docs/publications/FN/1368141.pdf The vast majority of medical malpractice cases don't go to trial because they either get dismissed by a judge or reach a settlement before. From 2018 to 2022, just 48 cases in Iowa ended up before a jury, and of those cases, juries ruled in favor of the plaintiff – people like the Dudleys – seven times. [Source: Iowa Judicial Branch spreadsheet] These big awards aren't the health care industry's only concern. They say caps also lower the rate of increasing medical malpractice insurance premiums and help to entice badly-needed doctors to Iowa's rural areas. Mikayla Brockmeier, a third year medical student at Des Moines University, helped lobby for the caps. Brockmeier said before Iowa passed its law, she and other med students were seriously considering leaving Iowa to practice in neighboring states like South Dakota, which has a non-economic damage cap of $500,000. “If you do not feel like you have the support of the state, then honestly, it makes it really incredibly hard to practice,” she said. But opponents say caps do little, if anything, to help the growing financial and staffing challenges the health care industry is facing. “I think the story here is pretty simple. It sucks to be sued. It's really not fun,” said Charles Silver, a law professor at the University of Texas at Austin who has studied the effects of Texas' non-economic damage cap extensively. https://law.utexas.edu/faculty/charles-m-silver/ Texas passed a constitutional amendment in 2003 that capped non-economic damages at $250,000 for an individual. https://www.texmed.org/TexasMedicineDetail.aspx?id=58464 The Texas Medical Association claims the move has since brought more licensed physicians into its rural areas. https://app.texmed.org/tma.archive.search/5238.html Silver said his research contradicts this claim. https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3309785 “If you have a growing population, you need to control for that,” he said. “And when you control for that, in Texas, what you find is that the physician population actually grew slightly more slowly after tort reform than before.” Federal projections of obstetricians and gynecologists, or OB-GYNs, in the Midwest also paint a conflicting picture of this concern. OB-GYNs have one of the highest rates of medical malpractice claims. https://iid.iowa.gov/documents/med-mal-report-2021 According to federal figures, by 2030, Iowa, Kansas and North Dakota — states with non-economic caps — are projected to have the greatest shortage of OB-GYNs in the Midwest, while Illinois, a state with no caps, is among states projected to have more than enough OB-GYNs. https://bhw.hrsa.gov/sites/default/files/bureau-health-workforce/data-research/projections-supply-demand-2018-2030.pdf It's also unclear how much influence caps have on premium rates for medical malpractice insurance. According to the Medical Liability Monitor, Iowa had the fifth-lowest average premium rate in the country in 2022. [Source: Spreadsheet from Iowa Justice Association] Minnesota, which has no caps, had the lowest average rate in the country. While Illinois, another with no caps, had the second-highest rate. A 2003 Government Accountability Office report studied the reason for a sharp increase in medical malpractice premiums in the early 2000s, which sparked tort reform policies in places like Texas. https://www.govinfo.gov/content/pkg/GAOREPORTS-GAO-03-702/html/GAOREPORTS-GAO-03-702.htm It found several factors played into the increasing premiums, including the fact that insurer losses on malpractice claims had increased overall in the past decade, but other significant factors had nothing to do with the liability system. They included the fact that insurance companies had recently taken a financial hit on their investments and also that the number of companies competing in the medical malpractice marketplace had dropped since the 1990s. There's no clear consensus from research on how non-economic damage caps affect things like premium rates and physician recruitment, said Robert Leflar, a retired law professor at the University of Arkansas, who's an expert in tort reform. https://www.sciencedirect.com/science/article/pii/S0012369213604791 But he said there's one group that clearly benefits from the caps: “the insurance companies who have smaller payouts and who have less risk of huge payouts.” The Iowa Insurance Institute did not respond to requests for an interview. Leflar said it's also clear who is hurt by caps. “The seriously disabled people,” he said. “The people who suffer through a lifetime of paralysis or pain and the family members of disabled people who have to give up a lot of their lives to take care of them.” Damage caps can make it harder for such people to sue because medical malpractice lawyers will be less likely to take on their pricey cases with less payout, Leflar said. ‘There's not much left' Roxanne Conlin, the Dudleys' attorney, said it's likely she wouldn't have been able to take their case now, as the total payout

How often are lawyers, deponents, and other participants surreptitiously recording depositions, including conversations during breaks that are meant to be private or privileged? Jim Garrity reports on this troubling conduct and surmises that it happens a lot more than many realize. As always, Garrity offers practice tips at the end of the episode, and our research on the topic appears in the show notes below. Thanks for listening!SHOW NOTESDefendant's Second Motion for Terminating Sanctions (filed Sept. 29, 2020), Plaintiffs' Opposition to Defendant's Second Motion for Terminating Sanctions (Redacted) (filed Jan. 28, 2021), and Findings of Fact, Conclusions of Law, and Order Denying Defendant's Second Motion for Terminating Sanctions and Granting Alternative Relief, Winters v. Dennis, Case No. A-15-723886-C, Dept. XI (Dist. Ct. Nevada July 26, 2021)Andrew C. v. Karcher, et al., 2006 WL 2664267, Case No. B184495 (Ct. App. Cal. Sept. 18, 2006) (sanctions imposed in form of $6,000 fine and order barring use of deposition transcript, where lawyer alleged arranged for second camera and a microphone to capture testimony and conversations of opposing counsel and his client)Picard v. Guilford House, LLC, No. X03CV106016061S, 2014 WL 1876595 (Conn. Super. Ct. Apr. 3, 2014) (order staying case, imposing fines, and expressing an intention to refer plaintiff's counsel to the bar following allegations that lawyer left her iPhone on, in record mode, during all breaks during the deposition, allegedly picking up privileged conversations between a key defense witness and defense lawyers; rejecting arguments of privilege in the recording or an absence of privacy expectations by those who were recorded.)Knopf v. Esposito, 2018 WL 1226023, Case No. 17-cv-5833 (DLC) (S. D. N. Y. Mar. 5, 2018) (sanctions imposed after attorney video recorded deposition despite denying five times on the record that he was not recording)Brockmeier v. Solano Cnty. Sheriff's Dep't, No. CIV S-05-2090 MCEEFB, 2010 WL 148179 (E.D. Cal. Jan. 12, 2010) (noting, without ruling on it, that defendant's efforts to depose the pro se plaintiff were disrupted when “…counsel for defendants became aware Plaintiff was apparently surreptitiously recording the deposition and conversations in the room during breaks by way of an audio recording device in her purse…”)Fluckiger v. Hawkins, No. 1:11-CV-00120-DAK, 2012 WL 6569485 (D. Utah Dec. 17, 2012) (where plaintiff admitted to secretly recording his depositions on a personal audio or video recorder, counsel was ordered to review the tapes and certify whether they had been altered in any way)Hylton v. Anytime Towing, No. 11CV1039 JLS WMC, 2012 WL 3562398 (S.D. Cal. Aug. 17, 2012) (ordering pro se plaintiff to attend a second deposition and “to destroy the unauthorized computer recording he made of the first deposition,” finding that the plaintiff “secretly recorded the deposition proceedings on his laptop computer, including off-the-record sidebars between defense counsel”)

Die 99. Folge des Podcasts Fipsi, der als erster seiner Art den Dialog zwischen Philosophie und Psychologie anstrebt. Das menschliche Leben ist historisch verfasst und diese Identität findet in Erzählungen ihren Ausdruck. Dieser Zusammenhang ist in den letzten Jahrzehnten von Jens Brockmeier erforscht worden, mit dem Hannes Wendler und Alexander Wendt in dieser Folge ins Gespräch kommen.Auf YouTube finden Sie alle Episoden von Fipsi unter https://www.youtube.com/playlist?list=PLpIT6jK3mKTiQcXbinapKRbf39mLEpKWmAuf Spotify finden Sie Fipsi unter https://open.spotify.com/show/0il832RRDoPZPaNlC7vams?si=5KbdEcF1TImSHexKYGccfw&dl_branch=1Die Website der Arbeitsgemeinschaft: https://www.phi-psy.deMelden Sie sich mit Rückmeldungen und Anmerkungen gerne unter fipsi@phi-psy.deDiskutieren Sie mit uns auf Telegram: https://t.me/FipsiPPP oder https://t.me/PhiundPsyFür das Intro bedanken wir uns bei Estella und Peter: https://www.instagram.com/elpetera

Brockmeier, Timwww.deutschlandfunkkultur.de, Studio 9Direkter Link zur Audiodatei

A Conversation with Recovering Hope President Sadie Brockmeier (04.18.22) --- Send in a voice message: https://anchor.fm/wcmp-news/message

Join us to learn how the 2021 CoMoGives campaign was promoted, what worked, what didn't and how we'll adjust to make it even better next year. John Baker, director of Community Foundation of Central Missouri (the foundation that powers CoMoGives), will talk through the ins and outs of planning and supporting our community's $1.8M with MayeCreate's Monica Pitts and Stacy Brockmeier. For a fully-formatted article version of this blog, head over to our website: https://mayecreate.com/blog/learn-how-our-community-raise-1-8m-in-one-month-with-john-baker-stacy-brockmeier

A Conversation With Recovering Hope President Sadie Brockmeier (12.20.21) --- Send in a voice message: https://anchor.fm/wcmp-news/message

Wie ist es eigentlich als Politiker hauptberuflich zu arbeiten? Viele von ihnen sind so präsent in den Medien, aber wie sie eigentlich arbeiten ist vielen nicht bewusst. Deshalb habe ich heute einen waschechten Poliker zu Gast. Und nicht nur irgendeinen, sondern den jüngsten Landtagsabgeordneten im Landtag NRW - Alexander Brockmeier. Was bedeutet es Berufspolitiker zu sein? Was hat sich für ihn dadurch alles verändert? Wie ist es für ihn, immer der jüngste zu sein? Das und mehr erfährst du in dieser Folge von Alexander.

This week we have the amazing Dr. Brockmeier on the show to dive into some personal questions about women's health. We cover just about everything from painful sex, to birth control, to menopause. We ask the uncomfy questions and of course share a few laughs. You guys do NOT want to miss out on this one- trust us.You can follow Dr. Brockmeier @sdmomdoc on Instagram 

This week we have the amazing Dr. Brockmeier on the show to dive into some personal questions about women’s health. We cover just about everything from painful sex, to birth control, to menopause. We ask the uncomfy questions and of course share a few laughs. You guys do NOT want to miss out on this one- trust us.

This week we have the amazing Dr. Brockmeier on the show to dive into some personal questions about women’s health. We cover just about everything from painful sex, to birth control, to menopause. We ask the uncomfy questions and of course share a few laughs. You guys do NOT want to miss out on this one- trust us. You can follow Dr. Brockmeier @sdmomdoc on Instagram

This week we have the amazing Dr. Brockmeier on the show to dive into some personal questions about women’s health. We cover just about everything from painful sex, to birth control, to menopause. We ask the uncomfy questions and of course share a few laughs. You guys do NOT want to miss out on this one- trust us.

Our guest is Kevin Brockmeier, an imaginative and acclaimed writer based in Little Rock, Arkansas. His many books include the novels "The Illumination" and "The Brief History of the Dead" as well as the story collections "Things That Fall from the Sky" and "The View from the Seventh Layer." He joins us to discuss his new book, a collection of very short stories called "The Ghost Variations." As per a critic writing for Booklist: "Brockmeier's 100 extremely short ghost stories present a range in tone from unsettling to terrifying, and pack a fearful punch with an economy of language, even for readers primed to feel uneasy.... The tales themselves are gems: modern, haunted treasures to be discovered." Please note that Brockmeier take part in a virtual author event this coming Friday (the 12th) at 7pm on the Zoom platform; the event is being presented by Magic City Books and more info is posted here .

Der jüngste Landtagsabgeordnete in Nordrhein-Westfalen, Alexander Brockmeier, über die Coronapolitik, Bildung in der Pandemie und junge Köpfe in der FDP

Sarah Brockmeier ist Wissenschaftliche Mitarbeiterin am Global Public Policy Institute (GPPi) in Berlin und arbeitet dort im Bereich „Frieden und Sicherheit“.

Bei Tests denkt man oftmals an A/B-Tests auf der Website mit unterschiedlichen Textvarianten, Bildern und sonstigen Elementen. Doch bei den Tests geht es deutlich weiter, deshalb wird auch von Experimenten gesprochen. Das heisst, es werden Ideen von möglichen Features mit bestehenden Daten validiert, ob ein solches Experiment überhaupt sinnvoll ist. Und wenn es sinnvoll ist, wird der Test umgesetzt.

In this episode, Belinda Pollard, Alison Young and Donita Bundy interview Bill Brockmeier, who reveals how his adventure in historical fiction has detoured into writing an opera libretto! Bill also speaks about the non-profit Hearts Need Art, which uses creativity to help hospital patients combat anxiety, depression and loneliness. Don't forget to like and subscribe to the podcast! And go to gracewriters.com to connect with our online community.

Preview award-winning author Kevin Brockmeier’s upcoming release, The Ghost Variations: One Hundred Stories. On this episode of Arts & Letters, Brockmeier shares three stories from his latest project, available in the spring of 2021 and published by Penguin Random House. This episode airs Friday, Oct. 23 at 7:00 pm and Sunday Oct. 25 at 9:00 pm. A certain Russian philosopher maintained that people are not born with their souls but must labor to create them. Anyone who fails to do so, he insisted, will dissolve upon dying into nonexistance. In addition to his latest book, The Ghost Variations: One Hundred Stories , Kevin Brockmeier is the author of the novels The Illumination , The Brief History of the Dead , and The Truth About Celia ; the story collections Things That Fall from the Sky and The View from the Seventh Layer ; the children’s novels City of Names and Grooves: A Kind of Mystery ; and a memoir of his seventh-grade year called A Few Seconds of Radiant Filmstrip . His work

Warum hat Deutschland kein Vorschulsystem? Verkörpert die FDP kein Lebensgefühl mehr? Wie wird man liberaler Influencer? Wie drängt man Rechtsextremismus zurück? Wann kommt das Wahlrecht ab 16? Fragen über Fragen in unserer zweiten Ausgabe des Podcast-Formats "50 Fragen an...". In dieser Ausgabe sprechen wir mit unserem jüngsten Landtagsabgeordneten im Landtag von NRW, Alexander Brockmeier und klären auch die wichtige Frage: "Trump oder Putin?".

Fans wurden durch Social Media in den 2010ern endgültig zu einer Macht, mit der es umzugehen galt. Was steckt dahinter? Musik von The Raconteurs. --- Send in a voice message: https://anchor.fm/alexmatzkeit/message

In einer unruhigen Welt wird Deutschland immer wieder aufgefordert, sich auch an militärischen Einsätzen zu beteiligen. Bundesregierung und Opposition reagieren darauf zurückhaltend, unabhängig von Parteizugehörigkeiten. Der Grund ist Deutschlands Rolle als Kriegstreiber im 20. Jahrhundert, als deutsche Soldaten in viele Länder einmarschierten. Rezension von Gaby Mayr. Dietz Verlag 2019 ISBN 978-3-8012-0548-5 240 Seiten 22 Euro

Wir sind zu Gast in der Denkfabrik des Global Public Policy Institute (GPPi) und treffen Friedens- und Konfliktforscherin Sarah Brockmeier. Sarah beschäftigt sich mit deutscher Außenpolitik, Völkermordvermeidung & Friedenssicherung. Letztes Jahr erschien ihr Buch "Krieg vor der Haustür: Die Gewalt in Europas Nachbarschaft und was wir dagegen tun können" (Dietz-Verlag), das sie mit Philipp Rotmann geschrieben hat. Mit Sarah geht's zunächst einmal um ihren Werdegang und wie sie zur Konfliktforschung gekommen ist. Kann man Frieden studieren? Wozu müssen wir uns Krisen in anderen Teilen der Welt beschäftigen? Was geht uns das an? Was ist überhaupt eine "Krise"? Warum wurde der Völkermord in Ruanda in den 1990ern nicht verhindert? Hätte er verhindert werden können? Woran erkennt man einen Völkermord? Und was hat "Responsibility to Protect" der Vereinten Nationen damit zu tun? Was für ein Think Tank ist das GPPi? Wer finanziert es? Gibt es eine politische Ausrichtung? Welche geopolitischen Interessen hat Deutschland? Wieso sind wir in der NATO am besten aufgehoben? Was kommt nach der NATO? Braucht es eine europäische Armee? Wie blickt Sarah auf die deutsche Waffenexportpolitik? Warum sind Rüstungsexporte wichtig für uns? Ist es richtig, Waffen an Saudi-Arabien zu verkaufen? Wieso soll Deutschland "internationale Verantwortung" übernehmen? Was ist mit diesem "Engagement" gemeint? Müssen am Ende mehr deutsche Soldaten in Kriege geschickt werden? Wir blicken auf entscheidene deutsche Kriegseinsätze zurück wie Jugoslawien und Afghanistan. Außerdem geht's um Heiko Maas, US-Atombomben und Drohnenangriffe via Ramstein. Das und vieles, vieles mehr in Folge 412 - wir haben sie am 2. Mai im Berliner Büro vom "Global Public Policy Institute" aufgezeichnet. Bitte unterstützt unsere Arbeit finanziell: Jung IBAN: DE36700222000072410386 BIC: FDDODEMMXXX Verwendungszweck: Jung & Naiv PayPal ► http://www.paypal.me/JungNaiv Sarah online: - Blog http://www.peacelab.blog/ - Twitter https://twitter.com/sarahbrockmeier

Address by Bill Brockmeier, The Lord’s Guidance, Hemet 2012

Address by Bill Brockmeier, Seven Kings of Judah, Hemet 2007

Address by Bill Brockmeier, The Word of God, Hamer Bay 2018

Address by Bill Brockmeier, Service In the Workplace, Kirkland 2018

Podcast: Lifting the Quality of Project Sponsorship, with Andrea Brockmeier In this podcast, Elise Stevens is joined by Andrea Brockmeier to discuss how Project Managers can lift the quality of project sponsorships they’re involved in. As the Project Management Director at Watermark Learning, Andrea Brockmeier works with Analysts, Relationship and Project Managers, and Scrum team […]

Podcast: Lifting the Quality of Project Sponsorship, with Andrea Brockmeier In this podcast, Elise Stevens is joined by Andrea Brockmeier to discuss how Project Managers can lift the quality of project sponsorships they’re involved in. As the Project Management Director at Watermark Learning, Andrea Brockmeier works with Analysts, Relationship and Project Managers, and Scrum team […]

Zusammen mit Gast Daniel Brockmeier vom Filmpodcast Spätfilm besprechen Alexander und René Sergio Leones Duck, You Sucker! In Deutschland kennt man Duck, You Sucker! unter dem Titel Todesmelodie, in Italien als Giù la testa und international auch als Fistful of Dynamite. Der Titel: Once Upon a Time… The Revolution hätte ihm wohl am besten zu Gesicht gestanden, aber dazu mehr im Podcast. Insgesamt ist der Film weit weniger hoch angesehen, als beispielsweise Leones Once Upon a Time in the West (Spiel mir das Lied vom Tod) oder The Good, the Bad and the Ugly (Zwei Glorreiche Halunken). Ob wir das ähnlich sehen, und wenn ja warum, erfahrt ihr im Podcast. Natürlich sprechen wir auch über die Hintergründe und die verschiedenen Schnittfassungen, bevor wir den Film dann zusammen mit Daniel Beat-für-Beat auseinander nehmen. Viel Spaß! Daniels Filmpodcast Spätfilm findet ihr übrigens auf http://www.spaetfilm.de Daniel auf Twitter: @privatsprache und @spaetfilm Episodenlinks: Trailer A Fistful of Dynamite: https://youtu.be/-vXs7PauVms

In der 8. Folge zum #Horrorctober dürfen wir Daniel Brockmeier vom Spätfilm begrüßen. Gemeinsam ekeln wir und durch Eraserhead, dem ersten Spielfilm von Verwirrmeister David Lynch. Neben unendlichen grauslichen Bildern gibt es noch die Bürden junger Eltern und eventuelle politische Statements zu besprechen.   Im Spätfilm hat Daniel im Zuge des #Horrorctobers bereits einen Podcast zu Eraserhead gemacht: Hier entlang   Kritik, Lob, Wünsche und Feedback an bildnachwirkung@gmail.com   Links: Homepage vom Spätfilm Twitter (Spätfilm): @Spaetfilm Twitter (Bildnachwirkung): @Bildnachwirkung Twitter (Daniel): @Privatsprache Twitter (Nenad): @nenaditacka Facebook: Spätfilm Facebook: Bildnachwirkung Daniel auf Letterboxd: Daniel Nenad auf Letterboxd: Nenad Todorović Juri auf Letterboxd: MrCutterknife

Diane and I talk about the intersection of loss and life, compassion, signing the driver's license, donation to proceed, opportunity to honor, crisis tunnel vision, can't even go there, global consent, allocation decisions, skin as a living dressing for wounds, matched up by x-ray, body doesn't recognize it as a pig's heart, process is far more regulated, Grey's Anatomy, hopping on a helicopter with "the cooler", iced and triple bagged, emotionally charged situations, and the mouse with the ear.

Dynasty Podcasts Chicagoverse 089 - Ryan Brockmeier (Midway: The Story of Chicago Hip-Hop) dynastypodcasts.com @dynastypodcasts Filmmaker Ryan Brockmeier visits Dynasty Podcasts to speak about preparing his documentary, Midway: The Story of Chicago Hip-Hop. Brockmeier discusses assembling a staggering amount of interviews, with a focus dating back to Chicago's hip hop culture in the late '70s up through now. Brockmeier also speaks about long-term ambitions for the project, which, at the time of recording, had clocked in 152 Chicago hip hop-focused interviews since August 2014. Broadcast on Facebook Live from Cards Against Humanity in Chicago as part of the #DYNASTYNEXT initiative. Hosted by Jaime Black Produced by Audrey Sutherland x Ingrid Lejins x Julia Johanek x Prov Krivoshey x Madison Keenan Logo design by Danyelle Sage | danyellesage.com Voice imaging by Alice Hayes

Erin Quill talks to Joe “Zonker” Brockmeier about the new annual technical conference LinuxCon. Zonker gives some details on his keynote, “A musical guide to the future of Linux,” and offers a glimpse of what attendees can expect from LinuxCon. http://www.fossdevcamp.org/events/linuxcon2009

Erin Quill chats with Joe “Zonker” Brockmeier and Martin Lasarche about the updates and new features in openSUSE 11.1.

Erin Quill interviews Joe ‘Zonker’ Brockmeier and Martin Lasarsch about the release of openSUSE 11.0. They discuss KDE 4, a quicker installer and package manager, and live CDs.

This edition of open audio is hosted by Joe ‘Zonker’ Brockmeier, openSUSE Community Manager. Zonker talks to some of the team that brought together the merged openSUSE Forums, Wolfgang Koller, Keith Kastorff, Kim Groneman, and Rupert Horstkötter.

Dave and Erin get a chance to sit down and meet Zonker, Novell’s new openSUSE community leader, during BrainShare 2008. Time: 11:34 MP3 Size: 4 MB