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Table of Contents
• Democracy1
• Public Citizen files first lawsuit challenging 'national emergency'1
• Energy & Environment6
• Major media commit errors of omission on climate change6
• Corporate Presidency11
• 'Self-funded' Trump propped up by super PAC megadonors11
• Corporate lawbreakers continue to flourish under Trump13
• Litigation10
• OSHA must enforce its electronic recordkeeping rule10
• Globalization & Trade7
• Giveaways to Big Pharma must be removed from revised NAFTA, says Public Citizen7
• Government & Financial Reform16
• Consumer protection enforcement sinks under 'tough-on-crime' Trump16
• Health & Safety1
• Medicare-for-All truths drown out industry lies1
• Public Citizen sheds light on sexual misconduct among nurses1
• Drug price battle heats up in Congress5
• FDA issues warning on deadly gout medication11
• Public Citizen Recommends15
• 'Can American Capitalism Survive?'15
• Other2
• Get to Know Public Citizen2
• President's View3
• Public Citizen in Your State12
• In the Spotlight14
• Public Citizen Crossword15
page 5
Public Citizen
Sheds Light
on Sexual
n January, Nathan Sutherland,
a nurse at Hacienda HealthCare
in Phoenix, Ariz., was arrested
based on DNA evidence for the
sexual assault of an incapacitated
adult female patient at the long-
term care facility. Sutherland had
worked at Hacienda since 2012
and cared for the woman in 2018
when he allegedly assaulted her.
The assault led to apregnancy; the
woman gave birth to a boy in late
December to the surprise of her
caregivers, whowere not aware of
her pregnancy. As of press time,
police were still trying to find out
whether Sutherland assaulted
, page 6
Medicare-for-All Truths
Drown Out Industry Lies
aryland resident Andy
Brodock stood outside the
U.S. Capitol in late February and
described to reporters how he
battled his insurance company in
his wife’s dying days to have her
cancer treatments covered.
Jennifer Epps-Addison, a
California resident and co-exec-
utive director of the Center for
Popular Democracy, similarly
described how she and her hus-
band struggle with their insurer
to get the care he needs for his
multiple sclerosis.
The stories are all too com-
mon — with Americans poor and
middle-class, urban and rural,
black and white — wrestling with
an inefficient and wasteful sys-
tem that makes it difficult, if not
impossible, for them to get health
, page 8
VOL. 39, NO. 2
Public Citizen Files First Lawsuit
Challenging ‘National Emergency’
hen President Donald
Trump stepped into the
White House Rose Garden to
announce that he was declaring a
national emergency to fund a bor-
der wall, Public Citizenwas ready.
Anticipating that Trumpwould
declare an emergency to sidestep
Congress, Public Citizen already
had spoken to people who live
along the Texas-Mexico border
and on whose land the govern-
ment wants to build a wall.
So on Feb. 15, just hours after
Trump’s declaration, Public
Citizen filed suit in theU.S. District
Court for the District of Columbia
on behalf of three landowners in
South Texas whowere told by the
government that it would seek to
build a border wall on their prop-
erties if money was available
in 2019, as well as the Frontera
Audubon Society, whose mem-
bers’ ability to observe wildlife
will be severely curtailed by the
wall and its harmful effects on
wildlife near the border.
Public Citizen's lawsuit was
the first in the country to chal-
lenge the declaration, and it gen-
erated media coverage in major
outlets, including The New York
Times, Bloomberg, Reuters, ABC,
CBS, CNN andMSNBC. Four more
lawsuits subsequently were filed
by other groups and by 16 state
attorneys general.
Public Citizen is urging the
court tohold that Trumpexceeded
his constitutional authority and
, page 4
Graphic courtesy of Isabelle Cardinal.

Public Citizen Probes Sexual Misconduct AmongNurses
, from page 1
other patients at the health center.
Sutherland’s alleged crime
underscores the potential sever-
ity of sexual abuse of patients by
nurses — made possible in part
because of the significant power
imbalance between nurses and
their patients. Nurses also spend
long hours with patients, often
providing care that involves close
proximity to patients.
Yet nurse sexual misconduct
has not received the attention
it deserves from the health care
community, professional orga-
nizations and regulators, who
are reluctant to recognize it as a
national public health problem.
Public Citizen undertook to shine
a light on this problem, releas-
ing a groundbreaking study in
December showing that state
nursing boards and health care
organizations are failing to protect
patients from nurses who engage
in sexual misconduct.
“The findings of the study and
the Arizona case unequivocally
show that it is time for state regu-
latory boards (including boards of
nursing) and the health care com-
munity to take a zero tolerance
stance against all forms of abuse
of patients by nurses or any other
health care professionals,” said
Azza AbuDagga, health services
researcher for Public Citizen’s
Health Research Group and lead
author of the study.
Only 882 U.S. registered and
licensed practical or vocational
nurses have been reported to
the National Practitioner Data
Bank (NPDB) over nearly 14 years
(from2003 through 2016) because
of sexual misconduct, according
to the study — the first to analyze
this national flagging system for
sexual misconduct by nurses.
While male nurses account for
approximately 10 percent of U.S.
nurses, they accounted for 63 per-
cent of the nurses reported to the
NPDB due to sexual misconduct.
Sexual misconduct by nurses
is reported to the NPDB only if it
results in an adverse disciplinary
action by state nursing boards
(or, less commonly, certain enti-
ties such as hospitals) or malprac-
tice payments. The low number
of nurses reported to the NPDB
because of this misconduct —
despite the fact that millions of
nurses worked in the profession
over the study period — suggests
that many nurses who commit
sexual misconduct go unpun-
ished, AbuDagga said.
“Our findings, alongwithother
published evidence, suggest that
many nurses in the U.S. who
exploit their patients are not being
held to account,” said AbuDagga.
“State nursing boards have full
access to the NPDB data. They
Major Media Commit Errors of Omission on Climate Change
even in 10 Americans say
they are interested in climate
change and that themedia should
cover it more, according to a
national survey conducted by the
Yale Program on Climate Change
And Public Citizen believes
journalists and media outlets
should give climate change the
media coverage it deserves —
that is, a lot more coverage. The
organization launched its “Cover
Climate” campaign in 2017 to
push for more and better media
coverage of the climate crisis and
A recent 2018 year-end report
by Public Citizen reveals, for the
second year in a row, that media
outlets do a poor job of linking cli-
mate change to extreme weather
events like heat waves, droughts
and hurricanes.
The report surveyedtranscripts
from six national television news
networks (ABC, CBS, CNN, Fox,
MSNBC and NBC) and articles
from the top 50 U.S. newspapers
by circulation, as well as top
onlinenews sources. The analysis,
“Carbon Omission: How the U.S.
Media Failed to Connect Extreme
Weather to Climate Change in
2018,” found that a lowproportion
of news piecesmentioned climate
change in relevant contexts,
such as extreme drought and
floods. Even when discussing
extraordinary heat, the media
mentioned climate change just
34 percent of the time.
The year also sawmultiple hur-
ricanes whose destruction was
exacerbated by climate change,
like Florence and Michael, and
media connections to climate
were even scarcer in that context.
Major online news sources
published more than 10,000
pieces on the two storms, but
only 10 percent of those pieces
mentioned climate change. For
television news, a mere 8 percent
of segments made the connec-
tion, while printmedia fared even
worseat 5percent.However, these
numbers are an improvement
over the previous year (6 percent
for television and online media
and 3 percent for newspapers).
“It’s tough to solve a crisis that
people aren’t talking about,” said
David Arkush, managing direc-
tor of Public Citizen’s Climate
Program. “News outlets need to
report accurately and more fre-
quently on the urgency and sever-
ity of the crisis, as well as the fact
that we have excellent, extremely
popular solutions for most of the
One bright spot is that the
media did better in 2018 on most
topics than in 2017 —often signifi-
cantly better. A number of publi-
cations stood out as producing
much high-quality work. Perhaps
most notable was the launch of
the Invading Sea project, a collab-
orative effort by theMiami Herald,
The Palm Beach Post, the South
Florida Sun Sentinel and WLRN
PublicMedia to spur action on the
threat of sea-level rise in Florida.
One of the most important
aspects of climate change is solu-
tions, the report notes — in partic-
ular that we already have feasible,
affordable and popular solutions
formost of the problem. But news
media mentioned mitigation or
solutions just 13 percent of the
time when discussing climate
change. For newspapers, the fig-
ure was 8 percent and for televi-
sion news just 5 percent. Online
news significantly boosted the
average, with a rate of 16 percent.
“News outlets are giving the
crisis of climate change far less
attention than it merits — and far
less than the public wants,” said
Arkush. “The media have a major
role to play in jump-starting the
kind of national conversation we
need to rise to this challenge, and
there is plenty of reason to believe
better climate coverage would
engage audiences.”
, page 7 
Public Citizen recently led a
groupofmore than 70 civil society
organizations on a letter oppos-
ing the Big Pharma handouts in
NAFTA 2.0. The diverse group
included Consumer Reports,
Doctors Without Borders,
NETWORK Lobby for Catholic
Social Justice, Social Security
Works, Oxfam and the AFL-CIO.
Meanwhile, the corpora-
tions that stand to benefit from
the revised NAFTA proposal are
mobilizing. According to a recent
Axios report, two well-connected
GOP operatives have just founded
“Trade Works for America,” a
lobby group aiming to win con-
gressional support for Trump’s
NAFTA rewrite.
According to one of the found-
ers, the group’s funding comes
from “the pharmaceutical indus-
try, oil and gas, the automotive
and agricultural sectors, and
traditional GOP donors.” This
NAFTA 2.0 text is not the transfor-
mational replacement of the cor-
porate-rigged trade-pact model
that Public Citizen and its allies
have demanded. But, as Wallach
noted, if we fight to get the Big
Pharma giveaways out, swift and
certain enforcement of improved
labor and environmental stan-
dards in, and achieve some other
key improvements, then the final
package Congress likely will vote
on in the first half of 2019 could
stop some of NAFTA’s continuing,
serious damage to people across
North America.
need to discipline nurses with
malpractice payments for sexual
misconduct to protect the pub-
lic. Without such licensing action
these nurses would simply be able
to abuse more patients.”
According to the study, of the
882 nurses who faced conse-
quences for sexual misconduct
that resulted
i n
reports, 866
were reported
by state nurs-
ing boards .
Nursing boards
administered harsh punishments
in most of these cases; 91 percent
of such reports involved serious
actions —including revocation,
suspension or voluntary surrender
of the nursing license. In contrast,
state nursing boards took serious
actions in only 75 percent of the
nurse reports for other types of
However, nearly half of the
nurses who engaged in sexual
misconduct with patients that
led to NPDB malpractice payment
reports — 16 out of 33 — were not
disciplined by state nursing boards
for their misconduct, the study
found. The findings for nurses are
consistentwith those froma
2016 study by Public Citizen
that showed that 70 percent
of U.S. physicians — 177 out
of 253 — who engaged in
sexual misconduct that led
to sanctions by hospitals or
other health care organizations or
malpractice payments were not
disciplinedby statemedical boards
for their unethical behavior.
The nurseswith sexual miscon-
duct-related reports identified in
the new study accounted for just
a small fraction (0.6 percent) of all
nurseswithNPDB reports thatmet
the study criteria. Similarly, Public
Citizen’s 2016 study showed that
physicians with reports related
to sexual misconduct accounted
for approximately 1 percent of the
total physicianswithNPDB reports
that met the study criteria.

OSHA Must Enforce Its Electronic Recordkeeping Rule
he federal government broke
the law by refusing to collect
worker health and safety data and
by hastily rescinding the require-
ment that it do so, two Public
Citizen lawsuits maintain. The
complaints — filed against theU.S.
Occupational Safety and Health
Administration (OSHA) — are
aimed at ensuring that the data
will be collected.
OSHA’s electronic record-
keeping rule, as issued in May
2016, requires certain businesses
with 250 or more employees and
employers in high-risk industries
with20ormoreemployees toelec-
tronically submit an annual sum-
mary of work-related injuries and
illnesses. Under that rule, such
establishments alsowere required
to submit more detailed work-
place injury and illness records
to OSHA. The rule also included
anti-retaliation measures prohib-
iting employers fromdiscouraging
workers from reporting an injury
or illness.
The data employers were
required to submit under the 2016
rule is crucial to protectingworker
health and safety and to facilitat-
ing independent research into
workplacehazards. But theTrump
administration has attempted to
thwart the electronic reporting
rule at every turn.
Shortly before the July 2018
deadline for collecting the data,
OSHA announced that it would
not require, or even accept, the
submission of the forms used to
transmit the detailed workplace
injury and illness records from
employers to OSHA. Instead of
following notice-and-comment
rulemaking procedures required
by the Administrative Procedure
Act for altering regulatory require-
ments, OSHA simply announced
the suspension on its website.
OSHA’s suspension of the rule
prompted Public Citizen’s first
lawsuit, filed in July 2018. The
lawsuit was filed on behalf of
Public Citizen’s Health Research
Group, the American Public
Health Association and the
Council of State and Territorial
Epidemiologists. Then, in January
2019, the Trump administration
finalized a new rule rolling back
the requirement that employers
submit the detailed information
required by the 2016 rule.
In doing so, OSHA failed to
provide a reasoned explanation
for reversing its position on the
risks and benefits of requiring
establishments to electronically
submit the forms. Public Citizen
filed the second lawsuit, challeng-
ing the rollback, on the day that
OSHA announced it.
“When it issued the electronic
reporting rule after an exhaus-
tive process, OSHA concluded
that requiring the submission of
workplace injury and illness data
would greatly enhance worker
health and safety,” said Michael
Kirkpatrick, the Public Citizen
attorney handling the case. “Now,
OSHA has rushed through a new
rule drawing exactly the opposite
conclusion but has failed to pro-
vide any good reason for reversing
Public Citizen argues that
OSHA’s rollback was not a prod-
uct of reasoned decision-making,
lacked supportive evidence, failed
to adequately respond to public
comments opposing it and will
undermine worker health and
safety. The suits asks the court
to ensure that OSHA require and
accept electronic recordkeep-
ing rule submissions of the more
detailed injury and illness data as
required by the 2016 rule.
A final ruling on the first law-
suit is expected this spring. Public
Citizen hopes that the court will
agree that OSHA acted improperly
by refusing to accept the required
worker health and safety data last
July and that it will order OSHA
to collect the data that the agency
previously turned away. A deci-
sion on the legality of the 2019
rule rolling back the reporting
requirement is unlikely to come
soon, as that litigation is in the
early stages.
“Injury and illness reporting
is critical to holding employers
accountable for hazardous work-
places,” said Shanna Devine,
Public Citizen’sworker health and
safety advocate. “OSHA’s rever-
sal of these basic transparency
requirements sends a clear mes-
sage to America’s workforce that
the Trump administration places
industry interests before worker
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today is april 4 2019 time 9am

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