- Jing Sun – Faculty Directory – Johns Hopkins Bloomberg School of Public Health
- Lupus-Specific Skin Disease and Skin Problems
- Lupus-Specific Skin Disease
- Chronic Cutaneous Lupus Erythematosus (CCLE) / Discoid Lupus Erythematosus (DLE)
- Subacute Cutaneous Lupus Erythematosus (SCLE)
- Acute Cutaneous Lupus Erythematosus (ACLE)
- Malar Rash
- Livedo reticularis
- Oral and Nasal Ulcers
- Raynaud’s Phenomenon
- Hives (Urticaria)
- Cutaneous Vasculitis
- Johns Hopkins Hospital hounds poor patients over 0.03 percent of revenue
- Johns Hopkins Hospital sues patients, many low income, for medical debt
- Former Patients of Dr. Nikita Levy of Johns Hopkins East Baltimore Medical Center Advised to Seek Legal Representation
- Johns Hopkins hospital sued poor and African American patients, study shows
- Protest at Johns Hopkins Hospital targets lawsuits against low-income patients
- More articles on healthcare finance:
- Sun Safety
- What does tanning do to the skin?
- What is ultraviolet radiation?
- What are sunscreens?
Jing Sun – Faculty Directory – Johns Hopkins Bloomberg School of Public Health
Home > Faculty > Jing Sun – Faculty Directory – Johns Hopkins Bloomberg School of Public Health
- Epidemiology (Primary)
- Division: Infectious Disease Epidemiology
2213 McElderry Street M139 Baltimore, Maryland 21205
Pure Research Profile
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PhD, Drexel University, 2015 MPH, University of Wisconsin – LaCrosse, 2011 MD, Guangdong Medical University, 2008
2018-2019 CFAR (Center for AIDS Research) Scholar Faculty Development Award, Johns Hopkins University
2018 Cooper Scholar, 20th International Workshop on Co-Morbidities and Adverse Drug Reactions in HIV.
2018 New Investigator Scholarship, Conference on Retroviruses and Opportunistic Infections (CROI 2018).
2017 Mentoring Workshop for Junior Investigator Scholarship, HIV & Aging: From Mitochondria to the Metropolis.
2017 Young Investigator Travel Scholarship, 8th International Workshop on HIV & Aging 2017.
2016 Co-recipient of Provost’s Postdoctoral Diversity Programming Award, Johns Hopkins University
2012 Student Research Award, American Public Health Association, Public Health Education and Health Promotion Section.
2017 Conference Travel Scholarship, Johns Hopkins University Department of Epidemiology.
- Mitochondrial function
- Viral hepatitis
- Liver cancer
- Illicit drug use
- Adverse childhood experience
Selected Recent Publications
- Sun, J., Brown, T., Tong, W., Samuels, D., Tien, P., Aissani, B., Aouizerat, B., Villacres, M., Kuniholm, MH., Gustafson, D., Michel, K., Cohen, M., Schneider, M., Adimora, AA., Ali, MK., Bolivar, H., Hulgan, T., African Mitochondrial DNA Haplogroup L2 is Associated with Slower Decline of ?-Cell Function and Lower Incidence of Diabetes Mellitus in non-Hispanic Black Women with HIV. Clinical Infectious Disease, 2020.
- Sun, J., Longchamps, R., Piggott, D.A., Castellani, C.A., Sumpter, J.A., Brown, T.T., Mehta, S.H., Arking, D.E., Kirk, G.D., The Association between HIV Infection and Mitochondrial DNA Copy Number in Peripheral Blood: A Population-based, Prospective Cohort Study. The Journal of Infectious Diseases, 2018.
- Sun, J., Brown, T., Samuels, D., Hulgan, T., D’Souza, G., Jamieson, B., Erlandson, K., Martinson, J., Palella Jr., F., Margolick, J., Kirk, G., Schrack, J., The Role of Mitochondrial DNA Variation in Age-related Gait Speed Decline among Older HIV-infected White Males. Clinical Infectious Disease, 2018.
- Sun J, Patel F, Rose-Jacobs R, Frank DA, Black MM, Chilton M. Mothers' Adverse Childhood Experiences and Their Young Children's Development. American Journal of Preventive Medicine. 2017.
- Sun J, Robinson L, Lee NL, Welles S, Evans AA. No contribution of lifestyle and environmental exposures to gender discrepancy of liver disease severity in chronic hepatitis b infection: Observations from the Haimen City cohort. PLoS One. 2017
See all publications by Jing Sun
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Lupus-Specific Skin Disease and Skin Problems
Most people with lupus experience some sort of skin involvement during the course of their disease. In fact, skin conditions comprise 4 of the 11 criteria used by the American College of Rheumatology for classifying lupus. There are three major types of skin disease specific to lupus and various other non-specific skin manifestautions associated with the disease.
Lupus-Specific Skin Disease
Three forms of specific skin disease occur in people with lupus, and it is possible to have lesions of multiple types.
In addition, a person can also have one of the three forms outlined below without actually having full-blown systemic lupus erythematosus (SLE), but the presence of one of these disease forms may increase a person’s risk of developing SLE later in life.
Usually, a skin biopsy is used to diagnose forms of cutaneous lupus, and various medications are available for treatment, including steroid ointments, corticosteroids (e.g., prednisone), and antimalarials (e.g., Plaquenil).
Chronic Cutaneous Lupus Erythematosus (CCLE) / Discoid Lupus Erythematosus (DLE)
Chronic cutaneous (discoid) lupus erythematosus is usually diagnosed when someone exhibits signs of lupus in the skin. People with SLE can also have discoid lesions, and about 5% of all people with DLE will develop SLE later in life.
A skin biopsy is used to diagnose this condition, and the lesions have a characteristic pattern known to clinicians: they are thick and scaly, plug the hair follicles, appear usually on surfaces of the skin exposed to sun (but can occur in non-exposed areas), tend to scar, and usually do not itch.
If you are diagnosed with discoid lupus, you should try to avoid sun exposure when possible and wear sunscreen with Helioplex and an SPF of 70 or higher. In addition, you doctor may prescribe medications to help prevent and curb inflammation, including steroid ointments, pills, or injections , antimalarial medications such as Plaquenil, and/or immunosuppressive medications.
Subacute Cutaneous Lupus Erythematosus (SCLE)
About 10% of lupus patients have SCLE. The lesions characteristic of this condition usually do not scar, do not appear thick and scaly, and usually do not itch. About half of all people with SCLE will also fulfill the criteria for systemic lupus.
Treatment can be tricky because SCLE lesions often resist treatments with steroid creams and antimalarials.
People with SCLE should be sure to put on sunscreen and protective clothing when going outdoors in order to avoid sun exposure, which may trigger the development of more lesions.
Acute Cutaneous Lupus Erythematosus (ACLE)
Most people with ACLE have active SLE with skin inflammation, and ACLE lesions are found in about half of all people with SLE at some point during the course of the disease.
The lesions characteristic of ACLE usually occur in areas exposed to the sun and can be triggered by sun exposure.
Therefore, it is very important that people with ACLE wear sunscreen and protective clothing when going outdoors.
About half of all lupus patients experience a characteristic rash called the malar or “butterfly” rash that may occur spontaneously or after exposure to the sun. This rash is so-named because it resembles a butterfly, spanning the width of the face and covering both cheeks and the bridge of the nose.
The malar rash appears red, elevated, and sometimes scaly and can be distinguished from other rashes because it spares the nasal folds (the spaces just under each side of your nose). The butterfly rash may appear on its own, but some people observe that the appearance of the malar rash indicates an oncoming disease flare.
Whatever the case, it is important to pay attention to your body’s signals and notify your physician of anything unusual.
50% of all people with lupus experience sensitivity to sunlight and other sources of UV radiation, including artificial lighting. For many people, sun exposure causes exaggerated sunburn- reactions and skin rashes, yet sunlight can precipitate lupus flares involving other parts of the body. For this reason, sun protection is very important for people with lupus.
Since both UV-A and UV-B rays are known to cause activation of lupus, patients should wear sunscreen containing Helioplex and an SPF of 70 or higher. Sunscreen should be applied everywhere, including areas of your skin covered by clothing, since most clothing items contain an SPF of only about 5.
Be sure to reapply as directed on the bottle, since sweat and prolonged exposure can cause coverage to dissipate.
People with lupus may experience a lacy pattern under the skin called livedo reticularis. This pattern may range anywhere from a violet web just under the surface of the skin to something that looks a reddish stain.
Livedo can also be seen in babies and young women, is more prominent on the extremities, and is often accentuated by cold exposure.
The presence of livedo is usually not a cause for alarm, but it can be associated with antiphospholipid antibodies.
About 70% of people with lupus will experience hair loss (alopecia) at some point during the course of the disease. Hair loss in lupus is usually characterized by dry, brittle hair that breaks, and hair loss is more common around the top of the forehead. Physical and mental stress can also cause hair loss, as can certain medications, including corticosteroids such as prednisone.
In many cases the hair will grow back, but hair loss due to scarring from discoid skin lesions may be permanent. There is no cure-all for hair loss, but treatments such as topical steroids and Rogaine may be prescribed. Sometimes dealing with the cosmetic side effects of lupus can be difficult, but some people find using hairpieces and wigs to be an effective means of disguising hair loss.
Oral and Nasal Ulcers
About 25% of people with lupus experience lesions that affect the mouth, nose, and sometimes even the eyes. These lesions may feel small ulcers or “canker sores.
” Such sores are not dangerous but can be uncomfortable if not treated.
If you experience these types of lesions, your doctor may give you special mouthwash or Kenalog in Orabase (triamcinolone dental paste) to help expedite the healing process.
Approximately one-third of all people with lupus experience a condition called Raynaud’s phenomenon in which the blood vessels supplying the fingers and toes constrict. The digits of people with Raynaud’s are especially susceptible to cold temperatures.
Often people with the condition will experience a blanching (loss of color) in the digits, followed by blue, then red discoloration in temperatures that would only be mildly uncomfortable to other people (such as a highly air-conditioned room).
It is very important that people with Raynaud’s wear gloves and socks when in air-conditioned spaces or outside in cool weather. Hand warmers used for winter sports (e.g., Hot Hands) can also be purchased and kept in your pockets to keep your hands warm.
These measures are very important, since Raynaud’s phenomenon can cause ulceration and even tissue death of the fingers and toes if precautions are not taken. People have even lost the ends of their fingers and toes due to the poor circulation involved in Raynaud’s phenomenon.
Cigarettes and caffeine can exacerbate the effects of Raynaud’s, so be sure to avoid these substances. If needed, your doctor may also recommend a calcium channel blocker medication such as nifedipine or amlodipine to help dilate your blood vessels.
About 10% of all people with lupus will experience hives (urticaria). These lesions usually itch, and even though people often experience hives due to allergic reactions, hives lasting more than 24 hours are ly due to lupus.
If you experience this condition, be sure to speak with your doctor, since s/he will want to be sure that the lesions are not caused by some other underlying condition, such as vasculitis or a reaction to medication.
Your doctor will probably distinguish these lesions from those caused by vasculitis by touching them to see if they blanch (turn white).
Approximately 15% of people with lupus will experience purpura (small red or purple discolorations caused by leaking of blood vessels just underneath the skin) during the course of the disease. Small purpura spots are called petechiae, and larger spots are called eccymoses. Purpura may indicate insufficient blood platelet levels, effects of medications, and other conditions.
Some people with lupus may develop a condition known as cutaneous vasculitis, in which the blood vessels near the skin experience inflammation that ultimately restricts blood flow. This condition can cause hive- lesions on the skin that may itch and do not turn white when depressed.
Other skin abnormalities may also be present, including actual gangrene of the digits. If left untreated, vasculitic lesions may cause ulceration and necrosis (cell death), and dead tissue must be surgically removed. Rarely, fingers or toes with aggressive ulceration and gangrene may require amputation.
Therefore, it is very important that you notify your doctor of any skin abnormalities.
Johns Hopkins Hospital hounds poor patients over 0.03 percent of revenue
Johns Hopkins Hospital sicced collections attorneys on thousands of patients over the past decade, often taking extraordinary measures to extract payment from patients who probably owed no money at all under the state laws governing the non-profit medical provider.
According to a new report from union researchers with National Nurses United (NNU), the hospital’s outside counsel sued 2,438 separate former patients between January 2009 and December 2018, typically over sums so modest that they pose no threat to the balance-sheet health of either JHH or the broader Johns Hopkins Medicine network of facilities and providers.
The median amount JHH deemed worth taking to court was $1,438. A hospital that has taken in $16.5 billion in operating revenue over the past decade has used the courts to go after a total of just $4.4 million in unpaid bills.
That works out to about a third of a penny for every dollar the hospital generated from in the 10 years of lawsuit activity detailed in the NNU report. But while inconsequential to the JHH bottom line, the money at issue is potentially ruinous for the people the hospital sues.
Forty-three Hopkins patients have ended up filing for bankruptcy after being sued by the hospital.
One such desperate victim of the Hopkins collections practices documented the way in which she was forced to teeter on the edge of a knife, financially speaking, when the hospital sought $10,745 from her.
She relied on food stamps to feed herself and two minors on a take-home income of $2,201.33 at the time the hospital sued.
Many of the approximately 2,000 patients sued by JHH who have not yet turned to bankruptcy for relief are ly not far from that life-changing cliff. More than 300 defendants live in zip codes where the median household income is below $45,000. More than 1,000 of them live in zip codes where the child poverty rate is 19 percent or higher.
These topline indicators are imprecise, but strongly indicate that those targeted by the hospital’s legal attack dogs probably should have been offered free or heavily subsidized care when they turned to the largest high-quality hospital in Baltimore, the report suggests.
As a not-for-profit medical provider, Johns Hopkins has received hundreds of millions of public dollars in tax exemptions. Maryland law is crystal clear about what all that subsidization from taxpayers is supposed to ensure for the neediest people in the state.
Anyone surviving on an income less than 200 percent of the federal poverty line may not be charged for health care that’s deemed necessary.
Families getting by on between two and five times the federal poverty income must be billed on a sliding scale that reduces their prices by between 20 and 80 cents on the dollar.
Some of those sued by Hopkins in the past decade almost certainly qualified for such financial assistance from the taxpayer-supported medical center. JHH did not respond to ThinkProgress’s repeated attempts to clarify how it delineates between patients it should sue and those it should work with according to financial assistance laws that govern its operations.
One unnamed Baltimore resident the hospital sued reported earning $13.95 an hour from a job at another non-profit employer in the area. That wage should have translated to at least a 60 percent writeoff on his bills from a 2014 visit to the hospital, the NNU researchers note, but he “was billed $2,100.86 and received no adjustment on the amount.”
JHH’s lawyers spent the next two years chasing the man’s meager earnings in court, repeatedly asking a judge to order his wages garnished to repay a debt he ly should not have owed under state law.
Another unnamed defendant in a Hopkins debt suit was working for McDonald’s when he ended up in the JHH emergency room. Despite his slack earning power, he was issued an unadjusted $1,990 bill for the visit and eventually subjected to a garnishment order to collect $2,081.98 – the original, dubious billing amount plus about a hundred bucks in interest and court fees.
Many of the Hopkins suits target even smaller amounts of money than these questionable examples. The hospital sued a man named Eric Simmons over the $524 remainder of its billings not covered by his insurance following an ankle injury.
An unnamed 55-year-old woman got sued for $280.13 that hadn’t been covered by her insurance, eventually informing a judge that she had just $92.18 in the bank – which led Hopkins’ lawyers to ask the court’s help extracting all $92.
18 through a bank levy.
The hospital’s media team repeatedly declined to answer detailed questions from ThinkProgress about the report’s findings, including specific queries about how JHH goes about determining which working-class patients are rich enough to sue and which should be given free or reduced-price care. The communications staff provided only a brief and vague statement portraying the debt litigation as just another part of taking care of the infamously hard-hit community it serves.
“Our mission is to improve the health of our community, and everything we do is to advance that goal,” Johns Hopkins Medicine’s senior public relations director Kim Hoppe wrote in an email.
“Our first priority is providing care. Those who have the ability to pay for their health services should do so.
For those who cannot pay, we consider it our mission to make sure they receive the care they need.”
The legally dubious and ethically grim practices detailed by the nursing union are not entirely new for Hopkins. A Baltimore Sun investigation published in 2008 documented similar abusive collections practices by the charitable hospital over the first decade of the millennium.
Though a hospital spokesperson initially responded to the Sun reporters by claiming the hospital only goes after “deadbeats,” JHH appeared to back down from the practices after the stories had put a spotlight on them. It filed less than 500 total debt suits from 2009 to 2013, after the Sun found 14,000 such cases in the prior half-decade.
That dramatic downturn in collections suits proved short-lived, however, as filings began to spike anew in 2014.
JHH’s lawyers have sued more than 300 people each year since, bringing the total to almost 2,000 lawsuits over the past five years – a far cry from the rate exposed by the Sun’s journalism but still a widespread assailing of financially vulnerable people who rarely received the financial assistance the hospital is required to extend.
Hopkins is far from alone in imposing such alarming billing and collection practices on an underprivileged community that turns frequently to a major urban medical provider operated under the kinds of charitable mandates that Maryland law contains.
San Francisco’s only level-one trauma center, recently renamed in honor of founder Mark Zuckerberg’s $75 million donation to the facility, habitually threatened emergency room patients with collections efforts until a Vox investigation shamed administrators into changing policy.
A cluster of emergency rooms housed within not-for-profit hospitals in the St. Louis area have been outsourced to a for-profit provider that sidesteps the type of financial assistance requirements Hopkins appears to be flouting, resulting in a spate of aggressive collections suits that caught local news attention in 2016.
And the same general flavor of practices was exposed at a western Missouri hospital back in 2014.
The debts many medical providers pursue in brazen and sharp-elbowed fashion are not only ethically dubious and legally suspect in the context of tax-exemptions, charitable-care funding allotments, and not-for-profit law. The prestidigitations of the debt collection industry often reveal that these debts are essentially bogus within the context of raw market forces.
Some health care providers don’t even bother hiring lawyers to go after unpaid billings. They simply sell their “bad paper” to third-party collectors, at pennies on the dollar.
The bird-in-the-hand logic these debt-buyers use to strike deals with doctors and hospitals has created an opportunity for consumer advocates and economic inequality activists: If the people doing the billing will take less than what the bill says to walk away, then the debts aren’t actually worth what hospitals say they are. Occupy Wall Street activists wiped out medical debts ostensibly worth $15 million in 2013, at a cost of just $400,000.
Despite the success that both journalists and radical activists have had in exposing the abusive practices and accounting fictions that help enforce the gaping class inequities of the world’s largest economy – and despite the legal constraints that are supposed to come with tax-exempt status – it remains possible for major institutions Hopkins to operate the same old way. And as the official JHH response to the damning findings of the NNU report illustrate, such institutions remain willing to bet that they can sweep aside criticism through public-relations banalities and radio silence.
Johns Hopkins Hospital sues patients, many low income, for medical debt
Johns Hopkins Hospital has filed more than 2,400 lawsuits in Maryland courts since 2009 against patients with unpaid bills, including a large number of residents from distressed neighborhoods surrounding the East Baltimore medical campus.
The number of cases has been increasing, from 20 in 2009 to a peak of 535 in 2016, according to a report released by the Coalition for a Humane Hopkins, which includes groups such as National Nurses United and the American Federation of Labor and Congress of Industrial Organizations (AFL-CIO).
The report stemmed from the coalition’s efforts to monitor charity care provided by the hospital, said Cecilia Behgam, a research analyst for the AFL-CIO. She said the group was surprised to see so many lawsuits from one of the nation’s most prestigious medical institutions and has asked Hopkins to halt the practice.
“We want them to stop suing low-income patients,” Behgam said. “We want them [to] better educate patients about financial assistance.”
The report comes at a time of increasing national attention on the high cost of health care and prescriptions, with various remedies proposed at the federal and state levels. Other hospitals nationwide, including those in Maryland, have been found to have aggressively pursued patients for unpaid bills.
The report cited a 2008 investigation by the Baltimore Sun that found 46 hospitals in the state filed more than 132,000 lawsuits for unpaid bills from 2003 to 2008 and won at least $100 million in judgments. In some cases, hospitals added annual interest at twice the rate permitted for other types of debts or placed liens against patients’ homes.
The hospitals pursued the suits even though they collected millions of dollars from other patients, in the form of higher rates for hospital services, to cover costs for low-income patients who lacked insurance or enough insurance to cover out-of-pocket expenses.
Hopkins dramatically curtailed its debt collection practices for several years after the Sun investigation, only to start again more recently, the coalition report found.
Johns Hopkins spokeswoman Kim Hoppe said in a statement: “It is always our priority to provide the best possible care to every patient who comes to us. We have an extraordinary community benefits program and charity care policy, and it is our practice to inform our patients about our programs for free and discounted services.
“For patients who choose not to pursue those options or who have a demonstrated ability to pay, we will make every effort to reach out to them and to accommodate their schedule and needs. In those rare occasions when a patient who has the ability to pay chooses not to, we follow our state required policies to pursue reimbursement from these patients.”
D.C. lawmakers opt to close city’s public hospital within four years
Lakesha Spence, a 34-year-old who was sued and who lives just blocks from Hopkins Hospital, said her life has been upended since she learned last month that her bank account and paychecks were placed on a legal hold by a law firm representing the hospital over about $5,000 in unpaid medical bills.
The mother of a 3-year-old boy said she has had no access to paychecks from her $15-an-hour security guard job since April 9. That’s when she checked her account, believing she had about $152 in it, and found the balance at zero.
“It just left me stuck. I was stuck, and my depression kicked in and it messed me up really bad,” said Spence, who also cares for her mother. “All my paychecks went in there, and they took all of it out, every penny. I couldn’t feed my son or buy medicine for my mom or my son’s Pull-Ups. It made my depression go into overdrive.”
Spence, who has insurance through work, said she was treated twice at Hopkins, once for a depressive episode in January 2015 when she was brought involuntarily to Bayview after her mother called 911, then at the main hospital in April 2016 when she gave birth to her son. But she said she never was told about the charity care for which she said she would qualify. She also said she received no bills or phone calls.
She learned only in the fall that she was being sued and was due in court. She said she missed the court date because she could not afford to take time off from work.
Spence has since been granted a court motion, with the help of Maryland Legal Aid, that she is hoping will stop the withdrawals and return her pay so she can arrange a payment plan.
She said she is trying to get a breakdown of charges from Hopkins.
“To find out I owed Johns Hopkins Hospital was a shock to me,” she said, adding that the situation has left her “begging and pleading for any handout.”
“I owe everyone now. . . . It is a hard thing to go through,” she said.
The latest report did not examine the court filings of other hospitals in the state to see whether they had resumed such debt collection tactics, which include wage garnishments and bank account collections.
The Maryland Hospital Association said hospitals work with patients who can’t afford their bills and follow policies set by state regulators.
“All of Maryland’s hospitals are committed to serve every person who enters their doors, regardless of ability to pay,” said Erin Cunningham, a spokeswoman for the Maryland Hospital Association.
“For those who do not qualify to receive full or partial charity care, hospitals typically work out manageable payment plans, interest-free.
If patients still do not pay what they owe, hospitals do seek to recover unpaid medical bills.”
The association noted that Maryland hospitals have had fewer unpaid bills since passage of the Affordable Care Act of 2010 because more people have private plans or Medicaid, the federal-state health plan for low-income residents. “Uncompensated care” has dropped from over 7 percent of hospital revenue to about 4 percent, though Cunningham acknowledged that consumers have higher out-of-pocket costs.
House passes legislation to strengthen the ACA, boost generic drugs
The authors of the coalition report say these out-of-pocket costs — deductibles, coinsurance and co-pays — sometimes are the problem. Many of the lawsuits are for small amounts, which are still difficult for low-income patients to cover.
The report found that the median amount sought by Hopkins was $1,438, but the total amount added up to $4.4 million over eight years.
In 400 cases, the hospital won garnishments of patients’ wages or bank accounts, the report found. The totals were less than one-tenth of 1 percent of Hopkins Hospital’s operating revenue each year. In fiscal 2018, the revenue was $2.4 billion.
The Rev. Ty Hullinger, a coalition member, is pastor of three Catholic parishes in Northeast Baltimore. Hopkins filed 143 lawsuits in the Zip code where two of his churches are located, St. Anthony of Padua and Most Precious Blood.
“It seems that they are targeting certain residents and certain communities to go after these debts,” he said. “We look to our institutions to fulfill their obligations and mission and values. The hospital has a charge to provide charitable care . . . and it’s shocking and disheartening to learn the hospital has been reneging on this practice in recent years.”
“,”author”:”Meredith Cohn andÂ Lorraine Mirabella”,”date_published”:”2019-05-20T00:00:00.000Z”,”lead_image_url”:”https://www.washingtonpost.com/wp-apps/imrs.php?src=https://arc-anglerfish-washpost-prod-washpost.s3.amazonaws.com/public/X6OPV6D3FMI6TDW66SV7KIPPC4.jpg&w=1440″,”dek”:null,”next_page_url”:null,”url”:”https://www.washingtonpost.com/local/johns-hopkins-hospital-sues-patients-many-low-income-for-medical-debt/2019/05/20/d850cafa-7b19-11e9-a5b3-34f3edf1351e_story.html”,”domain”:”www.washingtonpost.com”,”excerpt”:”The hospital has filed more than 2,400 lawsuits in Maryland courts since 2009 against patients with unpaid bills.”,”word_count”:1178,”direction”:”ltr”,”total_pages”:1,”rendered_pages”:1}
Former Patients of Dr. Nikita Levy of Johns Hopkins East Baltimore Medical Center Advised to Seek Legal Representation
February 20, 2013, by Thomas C. Cardaro
952313_gavel.jpg The experienced trial attorneys at Cardaro & Peek, LLC are currently investigating potential claims on behalf of any former patients of Dr. Nikita Levy, a former gynecologist at Johns Hopkins Hospital’s East Baltimore Medical Center.
Baltimore police have uncovered an “extraordinary” amount of evidence that Dr. Levy secretly videotaped and photographed his former patients. Dr. Levy had worked for Johns Hopkins for over 20 years and had seen numerous patients during that time. According to the Baltimore Sun, nearly 100 women have already reached out for fear that they may have been one of Dr. Levy’s victims.
Former patients who were victimized by Dr. Levy may be entitled to financial compensation.
Johns Hopkins Hospital may face substantial liability for Dr. Levy’s actions. Hospitals in other states have paid multi-million dollar settlements in cases where physicians faced similar allegations. For example, according to the Baltimore Sun, a number of patients received a $50 million settlement last year in a case in which a physician took obscene photographs of children.
Whether or not Johns Hopkins can be held liable for Dr. Levy’s invasion of privacy will depend on a thorough investigation into the circumstances surrounding the incident.
Jeff Peek, a partner at Cardaro & Peek, LLC in Baltimore, told the Maryland Daily Record that “I would be looking for people in the circle of trust who knew or should have known that there was wrongdoing.” According to Mr. Peek, a key question will be “Were there opportunities institutionally to shut this guy down that were overlooked?”
Dr. Levy was let go by Johns Hopkins on February 8, 2013 after a colleague reported the allegations to hospital officials. The hospital had determined that Dr.
Levy had been illegally photographing his patients and storing those images electronically. The Johns Hopkins Medicine Board of Trustees is also starting its own independent investigation into the matter. On February 18, 2013, Dr.
Levy was found dead in his home. Initial reports indicate that the cause of death was an apparent suicide.
If you or a loved one were one of Dr. Nikita Levy’s numerous former patients, protect your rights by contacting the experienced trial attorneys at Cardaro & Peek, LLC. The trial attorneys at Cardaro & Peek, LLC have decades of experience litigating claims against hospitals and healthcare providers.
Consultation is free and there are no fees or expenses unless there is a recovery. Cardaro & Peek, LLC will invest its own resources and time investigating your claim, and there is no obligation for repayment of expenses unless there is a recovery.
Contact us for a free consultation today at (410) 752-6166.
Beth Moskowicz, Lawsuit ly Against Hopkins Following Accused Doctor’s Suicide, The Maryland Daily Record, Feb. 19, 2013.
Scott Dance & Justin Fenton, Hopkins Patients Stream Forward Over Records, The Baltimore Sun, Feb. 20, 2013.
Press Release, Johns Hopkins Hospital, Statement from Johns Hopkins Medicine on the recent news surrounding Nikita Levy, M.D. (Feb. 18, 2013).
Johns Hopkins hospital sued poor and African American patients, study shows
Johns Hopkins hospital in Baltimore, Maryland, filed more than 2,000 lawsuits often against poor and African American patients, and including many of their own neighbors, for unpaid medical bills, a new study has revealed.
The hospital, one of the state’s largest, filed 2,400 lawsuits between 2009 and 2018 that totaled $4.8m in alleged debt from patients, according to a report from the American unions AFL-CIO and National Nurses United and community advocacy group Coalition for a Humane Hopkins. The median unpaid debt that led to a lawsuit was $1,438.
The report took a closer look at suits against patients who live in Baltimore, which made up 46% of the total lawsuits the hospital filed.
The zip codes with the most patients, according to the report, are made up of predominantly African American and low-income patients.
Nine of 10 zip codes with the highest number of patients sued by JHH have poverty rates that are higher than the state average.
JHH has a history of filing thousands of lawsuits for unpaid medical bills.
A 2008 investigative series from the Baltimore Sun revealed that JHH and Johns Hopkins Bayview medical center, another hospital within the Johns Hopkins network, collectively filed 14,000 lawsuits against patients from 2003 to 2008. While the number of lawsuits has since dropped, the report notes that they have started to rise again over the last five years.
Johns Hopkins Medicine did not respond to the Guardian’s request for comment.
Not-for-profit hospitals suing their patients has been a long-criticized practice – particularly because these hospitals get tax breaks on federal, state and local levels – but has continued for years in the United States
Lawsuits are filed by hospitals in many places, not just Baltimore. An investigation from ProPublica and NPR found that a single hospital in St Joseph, Missouri, filed 11,000 lawsuits over a four-year period.
Another hospital in Evansville, Indiana, filed 20,000.
Though public investigations have led these hospitals to change their financial assistance policies and forgive the debts of some of their patients, no one tracks how often hospitals sue their patients outside of these investigations.
Medical debt is considered a “low priority debt” by the National Consumer Law Center, below other types of debt unpaid credit card bills or a mortgage because it typically carries low or no interest.
A 2016 study found that one in six Americans have medical debt on their credit reports, worth a collective $81bn.
Measures to prevent hospitals from issuing large, surprise health bills have been introduced to Congress, though gridlock around the Affordable Care Act has largely prevented anything from getting passed. Meanwhile, medical costs continue to rise, with the average American family of four spending about $28,000 for healthcare a year even with insurance.
“,”author”:”Lauren Aratani in New York”,”date_published”:”2019-05-15T18:45:44.000Z”,”lead_image_url”:”https://i.guim.co.uk/img/media/50d265eca23fd4485cdddbb4859a575b26f2a9/0_205_3500_2100/master/3500.jpg?width=1200&height=630&quality=85&auto=format&fit=crop&overlay-align=bottom%2Cleft&overlay-width=100p&overlay-base64=L2ltZy9zdGF0aWMvb3ZlcmxheXMvdGctYWdlLTIwMTkucG5n&enable=upscale&s=bf3840e63027a26e74aed2efd6449a43″,”dek”:null,”next_page_url”:null,”url”:”https://www.theguardian.com/us-news/2019/may/15/johns-hopkins-hospital-sued-poor-african-american-patients-study”,”domain”:”www.theguardian.com”,”excerpt”:”Baltimore hospital filed 2,400 lawsuits often against poor and black patients for unpaid medical bills between 2009 and 2018″,”word_count”:457,”direction”:”ltr”,”total_pages”:1,”rendered_pages”:1}
Protest at Johns Hopkins Hospital targets lawsuits against low-income patients
Kelly Gooch – Monday, July 22nd, 2019 Print | Email
Union leaders and supporters held a weekend rally urging Baltimore-based Johns Hopkins Hospital to stop suing low-income patients over medical debt, according to The Baltimore Sun.
Participants also urged support for nurses' unionization efforts at the July 20 rally.
Overall, hospital officials estimated that at least 150 people protested.
Among the participants were union leaders with the National Nurses United, which a group of Johns Hopkins Hospital nurses is trying to join, according to the Sun.
The nurses began unionizing efforts last year due to what they deemed “inadequate conditions and other standards” at Johns Hopkins Hospital, “compared to other nationally recognized university hospitals.”
Corey Lanham, a regional collective bargaining director for National Nurses United, told the Sun that hospital management has tried to stop unionization efforts by preventing talks between nurses about union issues and stopping them from visiting other hospital units on their days off to talk to colleagues about organizing.
According to the newspaper, about 3,200 nurses would be eligible to join National Nurses United.
Johns Hopkins Medicine administrators said Johns Hopkins “fully supports the rights of our nurses to organize,” the Sun reports, citing an email sent July 20 to Johns Hopkins Medicine employees.
The administrators also said National Nurses United “has sought to undermine the hospital's standing in our community by publicizing misleading and unfair accusations about our hospital’s medical debt collection practices.”
A coalition of Baltimore citizens, backed by the National Nurses United and the AFL-CIO union, published a joint report with the unions in May that found Johns Hopkins Hospital won wage garnishments or seized funds from patient bank accounts in hundreds of cases and that the cases disproportionately affected low-income patients.
Kim Hoppe, a Johns Hopkins Medicine spokesperson, told the Sun July 20 that patients receive “more than a dozen contacts via mail or phone call along with multiple opportunities to file for medical or financial hardship.”
She told the newspaper the hospital offers financial counseling and assistance, and that lawsuits against patients are only filed “after all contact points have been exhausted and a patient has declined to respond or engage.” She noted to Becker's that Maryland requires hospitals to pursue payment on unpaid medical bills from people who can afford to pay.
Read the full Sun report here.
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Linkedin Pinterest Skin Skin and Hair Care Preventing Skin Cancer Melanoma
Everybody needs some sun exposure to produce vitamin D (which helps calcium absorption for stronger and healthier bones).
But unprotected exposure to the sun's ultraviolet (UV) rays can cause damage to the skin, eyes, and immune system. It can also cause cancer. There are other contributing factors such as heredity and environment. But sunburn and excessive UV light exposure do damage the skin.
This damage can lead to skin cancer or premature skin aging (photoaging).
What does tanning do to the skin?
Tanning is the skin's response to UV light. When UV rays reach the skin, the skin makes more melanin. Melanin is the color (pigment) that causes tanning. Tanning does not prevent skin cancer.
What is ultraviolet radiation?
Energy from the sun reaches the earth as visible, infrared, and ultraviolet (UV) rays.
Ultraviolet A (UVA) is made up of wavelengths 320 to 400 nm (nanometers) in length.
Ultraviolet B (UVB) wavelengths are 280 to 320 nm.
Ultraviolet C (UVC) wavelengths are 100 to 280 nm.
Only UVA and UVB ultraviolet rays reach the earth's surface. The earth's atmosphere absorbs UVC wavelengths.
UVB rays cause a much greater risk of skin cancer than UVA.
But UVA rays cause aging, wrinkling, and loss of elasticity.
UVA also increases the damaging effects of UVB, including skin cancer and cataracts.
In most cases, ultraviolet rays react with melanin. This is the first defense against the sun. That’s because melanin absorbs the dangerous UV rays that can do serious skin damage. A sunburn develops when the amount of UV damage exceeds the protection that the skin's melanin can provide.
A suntan represents the skin's response to injury from the sun. A small amount of sun exposure is healthy and pleasurable. But too much can be dangerous. Measures should be taken to prevent overexposure to sunlight.
These preventive measures can reduce the risks of cancers, premature aging of the skin, the development of cataracts, and other harmful effects.
Dr. Anna Chien, dermatologist and Co-Director of the Johns Hopkins Department of Dermatology’s Cutaneous Translational Research Program, and her team have discovered that visible light can cause skin inflammation and skin discoloration.
The best way to protect yourself against the damaging effects of the sun is to limit exposure and protect your skin.
The best way to prevent sunburn in children over 6 months old is to follow these tips from the American Academy of Dermatology:
Generously apply a broad-spectrum water-resistant sunscreen with an SPF (Sun Protection Factor) of at least 30 to all exposed skin. Broad spectrum means the sunscreen protects you from both UVA and UVB rays. Re-apply about every 2 hours and after swimming or sweating.
Wear protective clothing such as a long-sleeved shirt, pants, a wide-brimmed hat, and sunglasses, whenever possible. Look for clothing with a UV protection factor (UPF) or made of a tightly woven fabric.
Seek shade when appropriate. Remember that the sun's rays are strongest between 10 a.m. and 4 p.m. If your shadow is shorter than you are, seek shade.
Use extra caution near water, snow, and sand. They reflect the damaging rays of the sun. This can increase your chances of sunburn.
Get vitamin D through a healthy diet that may include vitamin supplements.
Do not use tanning beds. Ultraviolet light from the sun and tanning beds can cause skin cancer and wrinkling. If you want to look tan, try using a self-tanning product. But also use sunscreen with it.
Protect your lips with lip balm with at least SPF 15.
Examine your entire skin on a regular basis. If you notice anything changing, growing, or bleeding on your skin, see a healthcare provider right away. Skin cancer is very treatable when caught early.
Remember, sand and pavement reflect UV rays even while under an umbrella. Snow and water are also good reflectors of UV rays. Reflective surfaces can reflect most of the damaging sun rays.
Also take special care to buy protective eyewear for you and your children. Choose sunglasses with labels stating they provide UV protection.
Remember that many over-the-counter and prescription medicines increase the skin's sensitivity to UV rays. So it’s possible to develop a severe sunburn in just minutes when taking certain medicines. Read medicine labels carefully and use extra sunscreen as needed.
What are sunscreens?
Sunscreens protect the skin against sunburns and play an important role in blocking the penetration of ultraviolet (UV) radiation. But no sunscreen product blocks UV radiation 100%.
Terms used on sunscreen labels can be confusing. The protection provided by a sunscreen is indicated by the sun protection factor (SPF) listed on the product label. A product with an SPF higher than 15 is recommended for daily use.
Sunscreens contain ingredients that help absorb UV light. Sunblocks contain ingredients such as zinc oxide and titanium dioxide that physically scatter and reflect UVB light. Keep in mind that not all sunscreens protect against UVA rays.
Look for products that have broad-spectrum coverage that includes protection from UVA rays.
A sunscreen protects from sunburn and minimizes suntan by absorbing or reflecting UV rays. Using sunscreens correctly is important in protecting the skin. Consider the following recommendations:
Choose a sunscreen for children and test it on your child's wrist before using. If your child develops skin or eye irritation, choose another brand. Apply the sunscreen very carefully around the eyes.
Choose a broad-spectrum sunscreen that filters out both ultraviolet A (UVA) and ultraviolet B (UVB) rays.
Apply sunscreens to all exposed areas of skin, including easily overlooked areas. This includes the rims of the ears, the lips, the back of the neck, and tops of the feet.
Use sunscreens for all children over 6 months old. It doesn’t matter what skin or complexion type the child has. All skin types need protection from UV rays. Even dark-skinned children can have painful sunburns.
Apply sunscreens 30 minutes before going out into the sun to give it time to work. Use it liberally and reapply it every 2 hours after being in the water or after exercising or sweating. Sunscreens are not just for the beach. Use them when you are working in the yard or playing sports.
Use a waterproof or water-resistant sunscreen and reapply it after swimming or sweating heavily.
Using a sunscreen with SPF of 20 to 30 offers substantial protection from sunburn and prevents tanning.
High SPF sunscreens protect from burning for longer periods of time than sunscreens with a lower SPF. SPF 15 blocks 93% of the UVB and SPF 30 blocks 97%.
Talk with your older child or teen about using sunscreen and why it's important. Set a good example for them by using sunscreen yourself.
Teach your teen to avoid tanning beds and salons. Most tanning beds and salons use ultraviolet-A bulbs. Research has shown that UVA rays may contribute to premature skin aging and skin cancer.
One of the best things you can do to protect and improve your health is to stay informed. Your Health is a FREE e-newsletter that serves as your smart, simple connection to the world-class expertise of Johns Hopkins.