Mad Cow Connection

A laboratory experiment gives powerful new evidence that an infectious protein that causes mad cow disease also causes a new type of fatal human brain disease that has killed 51 people in Europe.

The study, appearing today in the Proceedings of the National Academy of Sciences, makes clear that people in Britain who developed a new type of Creutzfeldt-Jakob disease could have gotten it from eating meat from cattle infected with bovine spongiform encephalopathy, the so-called mad cow disease. The brain disease has not been found in America.

Experts said the study also suggests the infectious protein, called prion, that causes the diseases can move between species more easily than once believed.

An outbreak of BSE occurred in British cattle early this decade. Later, some people in Britain developed a new, more deadly type of Creutzfeldt-Jakob disease. In 1996, experts suggested mad cow disease might be linked to the brain-wasting human disease.

The European Union banned the importation of British beef for three years until last August. France still bars imports of the meat. Officials in Britain banned sale of bone-in domestic beef in 1997 and lifted the sanction last Thursday.

More than 175,000 British cattle died of BSE during the 1990s. At least 48 people in Britain have died of the new form of CJD, along with two in France and one in Ireland. Neither disease has been detected in the United States.

Although a link between mad cow disease and the new type of CJD had been suggested, there were experts who questioned the connection and contended a true scientific link was lacking. The new study from the University of California, San Francisco, virtually removes doubt.

In the study, researchers created a strain of mice that had genes for the normal form of bovine prion protein. The mice were inoculated with prions taken from diseased cows. After 250 days, all the test mice developed neurological disease.

Honesty and Malpractice

Hospitals can forestall costly malpractice litigation by owning up to their mistakes and offering fair compensation before the patient or his family even realizes the error, a study suggests.

The study, published today in the Annals of Internal Medicine looked at a policy in effect since 1987 at the Veterans Affairs Medical Center in Lexington, Ky. The policy calls for full disclosure to patients who are injured either accidentally or through negligence.

"This diminishes the anger and desire for revenge that often motivate patients' litigation," wrote Steve S. Kraman, the hospital's chief of staff. He said plaintiffs' attorneys become more willing to negotiate a settlement without trying to punish the institution with a big verdict.

The study, written by Kraman and the hospital's legal counsel, compared the 407-bed hospital's liability payments with those of 38 similar veterans hospitals from 1990 through 1996.

The center paid out $1.3 million during the period, an average of $190,113 a year, or $15,622 per claim. Liability payments at the other hospitals ranged from less than $1 million to $12 million at the Lexington facility. Only six had lower liability totals; 28 had higher totals.