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The Nose

Spin Doctors

Posted 9/12/2001

As ill will and lawsuits keep accumulating around the Johns Hopkins Medical Institutions like poisonous lead in its bloodstream, the Nose almost feels a pang of pity for the bumbling medical giant. The federal Office of Human Research Protections is now investigating the Lead-Based Paint Abatement Repair and Maintenance Study done by Hopkins' Kennedy Krieger Institute in the mid- '90s. Lawyers are advertising on 92Q, trolling for more study participants.

In the course of the study (Mobtown Beat, Aug. 8), researchers exposed young children to lead-laced dwellings that had been partially repaired. On Aug. 16, in a blistering opinion, the Maryland Court of Special Appeals ruled that those children were improperly used as experimental subjects, and that two lawsuits against Kennedy Krieger could go forward.

The plaintiffs say that Kennedy Krieger failed to take quick and scrupulous care to protect residents of the houses from lead poisoning. But if it's any comfort to the lead-plagued youngsters and their families, the Nose can't help noticing that Hopkins has been nearly as slow and inept about protecting Hopkins.

From the beginning, Hopkins seemed to approach the lawsuits like a heavyweight champ facing an unranked opponent. You can't sue us, Hopkins argued. We're the good guys. We weren't even studying these children; we were studying the houses.

This line was a winner in Circuit Court, but the Court of Special Appeals slapped it down, then kicked it. Kennedy Krieger certainly was responsible for the children, the top court said. The researchers' apparent indifference, the court added, was reminiscent of the Tuskegee syphilis study--this nation's benchmark case of medical wrongdoing.

So Sept. 4, with the Nation's Best Hospital reeling, its reputation coming apart, Hopkins president Dr. William Brody--who'd somehow kept his name out of the coverage of the Kennedy Krieger case in The Sun and The Washington Post--decided to do something. He issued an internal memo.

And quite a memo it is. Brody's aim is to reassure the troops, and to protect them against "misinformation" they may have seen in the press. "At the bottom of this message," Brody writes, "is a fact sheet which I hope you will read, digest, and use in responding to questions about the study posed to you by your friends and colleagues."

Sadly, the president himself comes off as being more than a little misinformed. "In the study," he writes in the body of the message, "families with children who lived in the old lead-ridden housing in East Baltimore . . . had the opportunity to move into renovated properties." This fudges two key points: First, the researchers had not checked the children's previous homes, to see if they all were truly escaping "lead-ridden" housing, and second, the renovations were, by design, only partial ones.

The fact sheet's spin continues. "The [study] was a trial designed to monitor blood levels in children living in lead-abated houses," Brody's first bullet point says. This directly contradicts Kennedy Krieger's own court filings, which described the study as one of buildings, not people. "The purpose . . . was to study various lead-based paint intervention strategies in Baltimore City rental properties," Kennedy Krieger had argued in a June appellate brief; the occupants of those properties weren't mentioned till two paragraphs later.

Perhaps this shows some evolution in Hopkins' thinking. We doubt it, though. The tone of the memo, a mix of lab-coated dudgeon and noblesse oblige, reminds us all too well of how Hopkins got into this mess. The talking points cling to the same fatalism that led the researchers into the ethical swamp, arguing that these children's lives were going to be damaged by lead paint anyway. The houses, Brody writes in his memo, were in "Baltimore's highest-risk neighborhoods where all housing was old, heavily leaded, poorly maintained, had extremely high lead poisoning rates and population almost exclusively African-American."

At times, Brody seems to be arguing before a Court of Very Special Appeals, hoping to overturn the state's top court through sheer force of bluster. "The court also went on to decide issues that were not properly before it," he writes. In particular, he's troubled by the part of the ruling that says parents can't give consent for their children to be enrolled in studies, such as the lead-paint one, that have no therapeutic value. That, Brody writes, will cause "havoc"--"almost all pediatric 'nontherapeutic' research, as well as 'nontherapeutic' research involving adults who are unable to give informed consent because they are under a legal disability, will be banished from all institutions in Maryland."

Kennedy Krieger is planning to appeal the parental-consent part of the decision, Brody explains. He adds, "[W]e are determined to carry our message to the public and press." Consider it done, Dr. B! We can't wait to hear what you come up with next.

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