UCLA Medical Center gets failing grade on patient safety

A national report card on patient safety gave a failing grade to Ronald Reagan UCLA Medical Center, one of the country's most prestigious hospitals and one of only 25 nationwide to receive such low marks.

In a report issued Wednesday, the Leapfrog Group, an employer-backed nonprofit group focused on healthcare quality, gave a letter grade of F to UCLA Medical Center for performing poorly on several measures tied to preventing medical errors, patient infections and deaths.

Leapfrog withheld a failing grade for UCLA in June when it released its first-ever hospital safety scores to give low-performing hospitals time to show improvement.

Officials at UCLA disputed the failing grade and they said one patient death in 2010 unfairly lowered its grade from a C to an F under Leapfrog's methodology.

"UCLA is not an F hospital in quality and safety," said Tom Rosenthal, chief medical officer at Ronald Reagan UCLA Medical Center. "It is not a fair scoring system and it does a disservice to the public."

This debate over UCLA's score comes amid a proliferation of healthcare ratings by outside organizations trying to provide more information to consumers and employers. These scores are also taking on greater importance as some insurers and employers use them as one factor in determining whether a hospital or doctor should be included in a provider network.

Given those stakes, the California Hospital Assn. has called on Leapfrog and other rating organizations to offer more details on how their scores are tabulated and to focus on reliable measures that can assess patient care. Some highly regarded hospitals across the country, such as UCLA, fare well in one ranking and then poorly in the next.

Leapfrog gave an F to one other area hospital, Western Medical Center Anaheim. The hospital said it disagreed with Leapfrog's rating methods and added that it "continuously adds new systems to enhance our patient care."

Cedars-Sinai Medical Center received an A in Leapfrog's June report, but its grade dropped to a C on this latest review, which included more recent data from last year. Thirty Kaiser Permanente hospitals received an A and one got a B from Leapfrog.

Experts urge consumers to use these score cards as one tool in evaluating a hospital and to discuss any specific concerns with their doctor and other medical providers.

Leapfrog estimates that 180,000 Americans die annually from hospital accidents, errors and infections, and it says hospitals need to do more to protect patients from harm. Its hospital safety score is derived from 26 measures of publicly reported data.

Rosenthal said UCLA scores well on healthcare quality and patient outcomes on numerous measures tracked by the federal government and other rating organizations, suggesting that Leapfrog's methods are potentially flawed.

He said a liver transplant patient died during surgery in 2010 from an air embolism, one of several preventable medical errors that Leapfrog and other groups regularly track. Rosenthal said the patient's death was a regrettable mistake, but that error hasn't occurred since then.

Leah Binder, Leapfrog's president and chief executive, said her group's scoring methods are statistically valid and devised by a panel of leading experts in patient safety. She said UCLA scored poorly in several areas of patient care, such as foreign objects left in a patient during surgery and pressure ulcers.

"It isn't just one incident that gave them a score so far below the national average," Binder said. "We see it all the time that a hospital might have a stellar reputation, but behind the scenes they aren't safe for many of their patients."

On pressure ulcers, Rosenthal said, UCLA looked worse than its actual performance because of over-reporting in the hospital billing data that was reviewed by Leapfrog.

Overall, Leapfrog gave an A or B to 1,468 hospitals, or 56% of the 2,618 reviewed nationwide. The group issued a C to 1,004 hospitals, or 38%. At the bottom, 146 hospitals, or 6%, were labeled D or F.

Leapfrog reviewed 246 hospitals in California. The ratings are available online at http://www.hospitalsafetyscore.org.

chad.terhune@latimes.com

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Egypt president meets judges, fails to 'contain crisis'

CAIRO — President Mohamed Morsi suggested Monday that he would scale back broad powers he assumed last week but failed to appease Egypt's judiciary, which would still lack oversight of some institutions including the Islamist-led assembly drafting a new constitution.

Morsi and senior judges met for nearly five hours to discuss differences resulting from the president's declaration that his office was free from judicial review. Morsi told judges that the decree was meant to be temporary, and mainly aimed at shielding the long-troubled constitutional assembly from any judicial attempt to disband it.

Presidential spokesman Yasser Ali said after the meeting that Morsi's decree was not designed to "infringe" on the judiciary, suggesting not all of the president's actions would be immune from court review. The Supreme Judicial Council on Saturday condemned Morsi's expanded powers as an "unprecedented attack" on the courts. And Monday's talks did not seem to soften the sentiment of some council members.

"Our meeting with the president has failed to contain the crisis," Abdelrahman Bahloul, a member of the judicial council, told the newspaper Al Masry al Youm. "The statement issued by the presidency is frail and does not represent the members of the council."

The Judges Club, a separate legal organization, also was not satisfied that Morsi had scaled back enough of his authority. It called on its members to continue a partial strike in Alexandria and other cities. Ziad Akl, a political analyst, said Morsi's negotiations with the judges were a move to show the public he's not a dictator, "but, in reality, his declaration has not changed."

The talks in the presidential palace did not stop anti-Morsi demonstrations in Tahrir Square on Monday. But in a sign tensions may be easing, the Muslim Brotherhood, which Morsi helped lead until his inauguration in June, announced it was canceling a scheduled demonstration Tuesday to avoid bloodshed and possible clashes with Morsi opponents.

The consequences of the nation's restiveness played out as Morsi and the judges met Monday, with mourners turning out to bury two boys from opposite political sides who were killed in recent clashes: a 16-year-old antigovernment protester reportedly shot with a rubber bullet near Tahrir Square and a 15-year-old struck by a stone when a crowd attacked an office of the Brotherhood's Freedom and Justice Party in the Nile Delta.

"The presidency mourns two of the nation's finest young men," Morsi said in a statement.

But the images of two funerals made it clear that Morsi and the Brotherhood, although still Egypt's dominant political forces, miscalculated the depth of public anger that has bristled since last year's overthrow of longtime autocrat Hosni Mubarak and subsequent government setbacks, including judicial action disbanding the Islamist-led parliament.

Last month, Morsi, who for months has held wide executive and legislative powers, attempted to fire Prosecutor-General Abdel Meguid Mahmoud, only to retreat after a backlash from judges. His most recent decree to hold his office above judicial oversight struck many as another ill-conceived bid to consolidate his authority and advance an Islamist agenda.

Morsi contended that his intent was to prevent Mubarak-era judges from disrupting the country's political transition. Many Egyptians, including opposition figures, are suspicious of the courts, Mahmoud in particular. But Morsi's unilateral decree echoed the strongman tactics of his predecessor.

One of the president's biggest challenges is to protect the assembly drafting the constitution, which will open the way for new parliamentary elections. In June, the Supreme Constitutional Court, made up mostly of Mubarak-appointed judges, dissolved parliament. The court has since been deciding the fate of the Islamist-led assembly, which Morsi feared would also be disbanded.

Activists, liberals, women and non-Muslims have boycotted the assembly, saying that it is too focused on sharia, or Islamic law, which could limit civil rights. Protesters in Tahrir Square said they will continue their demonstrations until Morsi retracts more of his power.

Jaber Nassar, a legal expert quoted on state TV, said Morsi's meeting with the judges showed that he remains adamant on keeping broad authority. He called Morsi's announcement Monday "simply a political statement meant to curb protests against" his decree.

jeffrey.fleishman@latimes.com

Abdellatif is a special correspondent.

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Privacy groups ask Facebook to withdraw proposed policy changes

SAN FRANCISCO (Reuters) – Two privacy advocacy groups urged Facebook Inc on Monday to withdraw proposed changes to its terms of service that would allow the company to share user data with recently acquired photo-application Instagram, eliminate a user voting system and loosen email restrictions within the social network.

The changes, which Facebook unveiled on Wednesday, raise privacy risks for users and violate the company’s previous commitments to its roughly 1 billion members, according to the Electronic Privacy Information Center and the Center for Digital Democracy.

“Facebook’s proposed changes implicate the user privacy and terms of a recent settlement with the Federal Trade Commission,” the groups said in a letter to Facebook Chief Executive Mark Zuckerberg that was published on their websites on Monday.

By sharing information with Instagram, the letter said, Facebook could combine user profiles, ending its practice of keeping user information on the two services separate.

Facebook declined to comment on the letter.

In April, Facebook settled privacy charges with the U.S. Federal Trade Commission that it had deceived consumers and forced them to share more personal information than they intended. Under the settlement, Facebook is required to get user consent for certain changes to its privacy settings and is subject to 20 years of independent audits.

Facebook, Google and other online companies have faced increasing scrutiny and enforcement from privacy regulators as consumers entrust ever-increasing amounts of information about their personal lives to Web services.

Facebook unveiled a variety of proposed changes to its terms of service and data use polices on Wednesday, including a move to scrap a 4-year old process that can allow the social network’s roughly 1 billion users to vote on changes to its policies.

If proposed changes generate more than 7,000 public comments during a seven-day period, Facebook’s current terms of service automatically trigger a vote by users to approve the changes. But the vote is only binding if at least 30 percent of users take part, and two prior votes never reached that threshold.

The latest proposed changes had garnered more than 17,000 comments by late Monday.

Facebook also said last week that it wanted to eliminate a setting for users to control who can contact them on the social network’s email system. The company said it planned to replace the “Who can send you Facebook messages” setting with new filters for managing incoming messages.

That change is likely to increase the amount of unwanted “spam” messages that users receive, the privacy groups warned on Monday.

Facebook’s potential information sharing with Instagram, a photo-sharing service for smartphone users that it bought in October, flows from proposed changes that would allow the company to share information between its own service and other businesses or affiliates it owns.

The change could open the door for Facebook to build unified profiles of its users that include people’s personal data from its social network and from Instagram, similar to recent moves by Google Inc.

In January, Google said it would combine users’ personal information from its various Web services – such as search, email and the Google+ social network – to provide a more customized experience. The unified data policy raised concerns among some privacy advocates and regulators, who said it was an invasion of people’s privacy.

“As our company grows, we acquire businesses that become a legal part of our organization,” Facebook spokesman Andrew Noyes said in an emailed statement on Monday.

“Those companies sometimes operate as affiliates. We wanted to clarify that we will share information with our affiliates and vice versa, both to help improve our services and theirs, and to take advantage of storage efficiencies,” Noyes said.

(Reporting By Alexei Oreskovic; Editing by Richard Pullin)

Social Media News Headlines – Yahoo! News

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Berry's ex says he was threatened before fight

LOS ANGELES (AP) — Halle Berry's ex-boyfriend claims the actress's fiance threatened to kill him during a Thanksgiving confrontation that left him with a broken rib, bruised face and under arrest.

Gabriel Aubry's claims are included in court filings that led a judge Monday to grant a restraining order against actor Olivier Martinez, who is engaged to the Oscar-winning actress.

Aubry, 37, was arrested on suspicion of misdemeanor battery after his confrontation with Martinez on Thursday, but he states in the civil court filings that he was not the aggressor and that he was threatened and attacked without provocation. Martinez told police that Aubry had attacked first, the filings state.

A representative for Martinez could not be immediately reached for comment.

Aubry's filing claims Martinez threatened him the day before the fight at an event at his daughter's school that he and the actors attended. Aubry, a model, has a 4-year-old daughter with Berry and the former couple have been engaged in a lengthy custody battle.

The proceedings have been confidential, but Aubry states a major aspect of the case was Berry's wish to move to Paris and take her daughter with her. The request was denied Nov. 9, Berry's court filings state, and Aubry shares joint custody of the young girl.

Aubry claims Martinez told him, "You cost us $3 million," while he was punched and kicked him in the driveway of Berry's home. Aubry had gone to the home to allow his daughter to spend Thanksgiving with her mother, the filings state. Aubry claims Martinez threatened to kill him if Aubry didn't move to Paris.

Berry was not in the driveway during the confrontation and neither was their daughter, the documents state.

Photos of Aubry's face with cuts and a black eye were included in his court filing.

A judge set a hearing for Dec. 17 to consider whether a three-year restraining order should be granted. Aubry has a Dec. 13 court date for the possible battery case, which has not yet been filed by prosecutors.

___

Anthony McCartney can be reached at http://twitter.com/mccartneyAP .

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Books: Woe Is Syphilis, and Other Afflictions of Famous Writers

The old Irishman was a swollen, wheezing mess, blood pressure wildly out of control, kidneys failing, heart fibrillating. “What we have here,” said his new Spanish doctor, “is an antique cardiorenal sclerotic of advanced years.”

In fact, what the doctor had there was William Butler Yeats: the poet had a long list of chronic medical problems and experienced one of his regular cardiac crises while wintering in Spain. He still had three poetically productive years ahead of him before he died of heart failure in 1939, at age 73.

What makes antique case histories like Yeats’s so compelling to research, so interesting to read? Admittedly, they have educational value — medicine moves forward by looking back — but their major attraction is undoubtedly the operatic vigor of their emotional punch. As we contemplate the poor health of historic notables, we can sigh gustily at the immense suffering our ancestors considered routine, wince at the lunatic treatments they so innocently underwent, and marvel over and over again that the body, the brain and the mind can take such divergent paths.

These pleasures are present in abundance in the newest addition to the genre of medical biography, “Shakespeare’s Tremor and Orwell’s Cough.” Dr. John J. Ross, a Harvard physician, writes that he stumbled into the field by accident while trying to enliven a lecture on syphilis with a few literary references. The discovery that Shakespeare was apparently obsessed with syphilis (and suspiciously familiar with its symptoms) hooked Dr. Ross.

The resulting collection of 10 medico-literary biographical sketches ranges from the tubercular Brontës, whose every moist cough is familiar to their fans, to figures like Nathaniel Hawthorne, whose medical stories are considerably less familiar.

Dr. Ross’s discussion of Shakespeare is unique in the collection for its paucity of relevant data: so few details are known of the playwright’s life, let alone his health, that all commentary is necessarily supposition. Dr. Ross is not the first to note that references to syphilis are “more abundant, intrusive and clinically exact” in Shakespeare’s works than those of his contemporaries. This observation, along with the apparent deterioration of Shakespeare’s handwriting in his last years, leads to the hypothesis that Shakespeare had syphilis repeatedly as a young man, and wound up suffering more from treatment than disease.

The Elizabethans dosed syphilis with a combination of hot baths (treating the disease by raising body temperature endured into the 20th century), cathartics and lavish quantities of mercury. The drooling that accompanies mercury poisoning was considered a sign of excellent therapeutic progress, Dr. Ross writes: “Savvy physicians adjusted the mercury dose to produce three pints of saliva a day for two weeks.”

And so, when Shakespeare signed his will a month before he died with a shaky hand, was his tremor not possibly a sign of residual nerve damage from the mercury doses of his sybaritic youth? No amount of scholarship is likely to confirm this theory, but details of the argument are gripping and instructive nonetheless.

The story of the blind poet John Milton runs for a while along similar lines. Much is known about the long deterioration of Milton’s vision and other particulars of his delicate health, but Dr. Ross observes that many of his problems seem to have cleared up once he actually became blind. Was he vigorously medicating himself with lead-based nostrums in hopes of forestalling what Dr. Ross argues was probably progressive retinal detachment, then recovering from lead poisoning once his vision was irretrievably gone? Another intriguing if unanswerable question.

Just as the competing injuries of disease and treatment battered the luminaries of English and American literature, so did pervasive mental illness.

Jonathan Swift was a classic obsessive-compulsive long before he succumbed to frontotemporal dementia (Pick’s disease). Poor Hawthorne, so forceful on the page, was in person a tortured shrinking violet, the embodiment of social phobia and depression. Emily Brontë’s behavior was strongly suggestive of Asperger syndrome; Herman Melville was clearly bipolar; Ezra Pound was just nuts.

Yet they all wrote on, despite continual psychic and physical torments. Perhaps the thickest medical chart of all belongs to Jack London, who survived several dramatic episodes of scurvy while prospecting in the Klondike (he was treated with raw potatoes, a can of tomatoes and a single lemon), then accumulated a long list of other medical problems before killing himself (inadvertently, Dr. Ross argues) with an overdose of morphine from his personal and very capacious medicine chest.

Dr. Ross has not written a perfect book. The fictionalized scenes he creates between some of his subjects and their medical providers should all have been excised by a kindly editorial hand, which might also have addressed more than a few grammatical errors. Frequent leaps from descriptive to didactic mode as Dr. Ross updates the reader on various medical conditions can be jarring, like PowerPoint slides suddenly deployed in a poetry reading. True literary scholars might dismiss the book as lit crit lite, a hodgepodge of known facts culled from the usual secondary sources.

But all these caveats fade into the background when Dr. Ross hits his narrative stride, as he does in chapter after chapter. Then the stories of the wounded storytellers unfold smoothly on the page, as mesmerizing as any they themselves might have told, those squinting, wheezing, arthritic, infected, demented, defective yet superlative examples of the human condition.

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Cyber Monday shoppers look for online deals, many while at work

Retail reporter Shan Li and consumer columnist David Lazarus talk with Trae Bodge, senior editor at Retailmenot.com Insider about Cyber Monday.

Consumers hopped online for some more Internet shopping on Cyber Monday after last week's post-Thanksgiving Black Friday frenzy came to a close.

Many started early this year: Online spending on Black Friday topped $1 billion for the first time as some shoppers turned to their computers instead of braving the crowds in person.

Cyber Monday is "the Super Bowl of online shopping," said Jonathan Johnson, president of bargain site Overstock.com.

As of late afternoon, the site's traffic was up compared with last year's Cyber Monday, he said, but it was too early to predict how the entire day's sales would shake out. In the last few years, he said, Cyber Monday shoppers with high-speed Web access have started browsing Overstock at home after a day at the office.

"It used to be during the work hours that people shopped the most," Johnson said. "Now, it's a big hump in the middle of the day during work hours, then slows down during the commute home, and the biggest hump is at night."

This Cyber Monday, up to 129 million consumers were expected to hit Web merchants to take advantage of discounts, promotions and free shipping, according to the National Retail Federation.

Some of them, just returning to work after Thanksgiving, indulged right at their desks.

"People at work already take care of personal business like online banking. During the holidays they shop and buy gifts," said Andrew Lipsman, vice president of industry analysis at research firm ComScore Inc. "People can also shop without family members looking over their shoulder and kids snooping around to see what they're getting."

Nancy Lu, 28, of Los Angeles' Koreatown planned to surreptitiously browse the websites of favorite stores such as Macy's and J. Crew in the hopes of scoring some bargains for herself and her family. The personal assistant said she was hoping to get holiday shopping done early this year.

"I'm usually the person at the malls two days before Christmas trying to find something for everyone," she said. "If I find really good deals on Monday then I can relax later on."

For the last two years, Cyber Monday has been the year's biggest online spending day, Lipsman said. That's up from 12th place in 2006. Last year, Cyber Monday sales totaled $1.3 billion, and ComScore predicted they could reach $1.5 billion this year.

More consumers are using laptops, smartphones and tablet computers to do their shopping this holiday season.

On Black Friday, 57.3 million Americans visited an online retail site, up 18% from a year earlier, ComScore said. The National Retail Federation said that for the first time ever, more than half of shoppers over the long Thanksgiving weekend said they checked out stores online.

Cyber Monday, its name coined in 2005, quickly gained traction as shoppers took advantage of work computers with faster Internet connections, Lipsman said. Now, he said, at-work transactions account for about half the dollars spent at online retailers that day.

Nearly half of workers plan to do some of their shopping online while at the office this holiday season, according to a survey from CareerBuilder. More women than men said they had shopped at work in the past: 43% compared with 36%.

The retailer with the most-visited site on Black Friday was e-commerce giant Amazon.com Inc., followed by Wal-Mart Stores Inc., Best Buy Co., Target Corp. and Apple Inc., ComScore said. Amazon is the nation's largest online-only retailer.

Nearly all merchants with a Web presence are participating in the flurry of promotions and discounts surrounding Cyber Monday, said Trae Bodge, a shopping expert at deals site RetailMeNot.

She said some people admit to devoting three or more hours to shopping while at work.

That's good news for retailers, many of which will continue to roll out deals online this week.

shan.li@latimes.com

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Survey finds lots of unused vacation time

As an information technology supervisor at Pitzer College in Claremont, Dennis Crowley had so much work to do last year that he finished 2011 without using nearly five days of paid vacation.

"And to be frank, I was too busy to even realize I was losing time," he said.

Crowley's situation is not unusual. A survey by Harris Interactive Inc. found that by the end of 2012, Americans will leave an average of 9.2 days of vacation unused, up from the average of 6.2 days in 2011.

Nearly 90% of those questioned said they would take more leisure trips on their vacation if they had the time and money to do so, according to the survey of more than 2,000 U.S. adults that was commissioned by travel website Hotwire.

Hotwire has a selfish reason for pointing out the survey results: The travel website says vacationers can save lots of money by traveling between Thanksgiving and Christmas. During the holiday gap, hotel rates drop 33% in Boston, 28% in San Francisco and 26% in Seattle, compared with the peak summer travel season, according to the website.

Crowley has learned his lesson. He said he is keeping closer tabs on his vacation time this year. But instead of using his accrued vacation time to travel, he said is spending more time with his children.

Airline food getting more healthful

On the nation's airlines, the days of free lunch are long over. That also goes for breakfast, dinner and snacks. Once complimentary, most airline food now comes with a price tag.

But there is some good news about what you get to eat on commercial airlines: It is getting more healthful.

That's the assessment of Charles Platkin, a professor of nutrition at the City University of New York's Hunter College who has tested and ranked airline foods off and on since 2000. With few exceptions, Platkin said most airlines now offer at least one healthful meal alternative on their menu.

"It's actually moving in a good direction," he said. "It's been an ebb and flow, but the overall trend is positive."

Platkin gave the top ranking this year to Virgin America, noting that the airline based in California offers low-calorie options such as roasted pear and arugula salad, a "protein plate" with hummus and whole wheat pita bread, plus oatmeal for breakfast. He gave the airline 41/4 stars out of a maximum of five stars.

At the bottom of the list was Allegiant Air, with a rating of only one and a half stars. Platkin said the Las Vegas airline "made it clear that their foods were not healthy. It shows."

The airline's snacks include M&Ms, Oreo Brownies and Pringles chips.

Air Canada and Alaska Airlines came in second and third, respectively, in Platkin's ranking. The other big airlines — including United, American, Delta and US Airways — ranked in the middle of the list.

Platkin does not eat the food on every airline. "I don't have that kind of time," he said. "I have classes to teach."

Instead, he collects and reviews lists of food items, including the ingredients and calorie numbers, from the airlines.

TSA defends stopping traveler over watch

A traveler was stopped by federal security officers at the Oakland International Airport this month because of an unusual wristwatch he was wearing.

When word got out about the incident, critics of the Transportation Security Administration blasted the agency, saying it was another example of the TSA overreacting.

In hopes of stifling the uproar, the TSA released a photo of the watch last week. This is no ordinary timepiece. It includes a toggle switch, wires and what look like tiny fuses attached to the wristband.

A TSA explosives detection team determined that the watch was not an explosive device. Still, the Alameda County sheriff's deputies, who were called by the TSA to investigate, arrested the watch owner, Geoffrey McGann, a teacher and artist from Rancho Palos Verdes. He was jailed on suspicion of possession of components to make a destructive device, according to news reports.

The Alameda County district attorney's office declined last week to file charges against McGann.

McGann's attorney accused the TSA of being "hyper-vigilant."

The TSA responded in its blog last week, saying, "Terrorists take everyday items and attempt to manipulate them to make improvised explosive devices. Our officers are trained to look for anomalies such as this one."

hugo.martin@latimes.com

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Nokia imaging chief to quit

HELSINKI (Reuters) – Nokia‘s long-time imaging chief Damian Dinning has decided to leave the loss-making cellphone maker at the end of this month, the company said in a statement.

The strong imaging capabilities of the new Lumia smartphone models are a key sales argument for the former market leader, which has been burning through cash while losing share in both high-end smartphones and cheaper handsets.

Nokia’s Chief Executive Stephen Elop has replaced most of the top management since he joined in late 2010 and Dinnig is the latest of several executives to leave.

Dinning did not want to move to Finland as part of the phonemakers’ effort to concentrate operations and will join Jaguar Land Rover to head innovations in the field of connected cars, he said on Nokia’s imaging fan site PureViewclub.com.

(Reporting By Tarmo Virki, editing by William Hardy)

Tech News Headlines – Yahoo! News

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Rolling Stones mark 50th year with London show

LONDON (AP) — The Rolling Stones made a triumphant return to the London stage on Sunday night in the first of five concerts to mark the 50th anniversary of their debut as an American-oriented blues band.

They showed no signs of wear and tear — except on their aging, heavily lined faces — as frontman Mick Jagger swaggered and strutted through a stellar two-and-a-half hour show. He looked remarkably trim and fit and was in top vocal form.

The Stones passed the half-century mark in style at the sometimes emotional gig that saw former bassist Bill Wyman and guitar master Mick Taylor join their old mates in front of a packed crowd at London's 02 Arena.

It was the first of five mega-shows to mark the passage of 50 years since the band first appeared in a small London pub determined to pay homage to the masters of American blues.

Jagger, in skin-tight black pants, a black shirt and a sparkly tie, took time out from singing to thank the crowd for its loyalty.

"It's amazing that we're still doing this, and it's amazing that you're still buying our records and coming to our shows," he said. "Thank you, thank you, thank you."

Lead guitarist Keith Richards, whose survival has surprised many who thought he would succumb to drugs and drink, was blunter: "We made it," he said. "I'm happy to see you. I'm happy to see anybody."

But the band's fiery music was no joke, fuelled by an incandescent guest appearance by Taylor, who played lead guitar on a stunning extended version of the ominous "Midnight Rambler," and Mary J. Blige, who shook the house in a duet with Jagger on "Gimme Shelter."

The 50th anniversary show, which will be followed by one more in London, then three in the greater New York area, lacked some of the band's customary bravado — the "world's greatest rock 'n' roll band" intro was shelved — and there were some rare nostalgic touches.

Even the famously taciturn Wyman briefly cracked a smile when trading quips with Richards and Ronnie Wood.

The concert started with a brief video tribute from luminaries like Elton John, Iggy Pop and Johnny Depp, who praised the Stones for their audacity and staying power. The Stones' show contained an extended video homage to the American trailblazers who shaped their music: Muddy Waters, John Lee Hooker, Otis Redding, Bob Dylan, Johnny Cash and others. The montage included rare footage of the young Elvis Presley.

The Stones began their professional career imitating the Americans whose music they cherished, but they quickly developed their own style, spawning hundreds — make that thousands — of imitators who have tried in vain to match their swagger and style.

The concert began with some early Stones' numbers that are rarely heard in concert, including the band's cover of the Lennon-McCartney rocker "I Wanna Be Your Man" and the Stones original "It's All Over Now."

They didn't shy away from their darker numbers, including "Paint It Black" and "Sympathy for the Devil" — Jagger started that one wearing a black, purple-lined faux fur cape that conjured up his late '60s satanic image.

He even cracked a joke about one of the band's low points, telling the audience it was in for a treat: "We're going to play the entire "Satanic Majesty's Request" album now," he said, referring to one of the band's least-loved efforts, a psychedelic travesty that has been largely, mercifully, forgotten.

He didn't make good on his threat.

He also made fun of the sky-high ticket prices, which had exposed the band to some criticism in the London press.

"How are you doing up in the cheap seats," he said, motioning to fans in the upper rows of the cavernous 02 Arena. "Except they're not cheap seats, that's the problem."

But Jagger seemed more mellow than usual, chatting a bit about the good old days and asking if there was anyone in the crowd who had seen them in 1962, when they first took to the stage.

He said 2012 had been a terrific year for Britain and that the Stones nearly missed the boat, playing no role in the celebration of the Queen's Diamond Jubilee, the London Olympics, or the new James Bond film.

"We just got in under the wire," he said. "We feel pretty good."

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Agency Investigates Deaths and Injuries Associated With Bed Rails

Thomas Patterson for The New York Times

Gloria Black’s mother died in her bed at a care facility.

In November 2006, when Clara Marshall began suffering from the effects of dementia, her family moved her into the Waterford at Fairway Village, an assisted living home in Vancouver, Wash. The facility offered round-the-clock care for Ms. Marshall, who had wandered away from home several times. Her husband Dan, 80 years old at the time, felt he could no longer care for her alone.

Thomas Patterson for The New York Times

Gloria Black, visiting her mother’s grave in Portland, Ore. She has documented hundreds of deaths associated with bed rails and said families should be informed of their possible risks.

But just five months into her stay, Ms. Marshall, 81, was found dead in her room apparently strangled after getting her neck caught in side rails used to prevent her from rolling out of bed.

After Ms. Marshall’s death, her daughter Gloria Black, who lives in Portland, Ore., began writing to the Consumer Product Safety Commission and the Food and Drug Administration. What she discovered was that both agencies had known for more than a decade about deaths from bed rails but had done little to crack down on the companies that make them. Ms. Black conducted her own research and exchanged letters with local and state officials. Finally, a letter she wrote in 2010 to the federal consumer safety commission helped prompt a review of bed rail deaths.

Ms. Black applauds the decision to study the issue. “But I wish it was done years ago,” she said. “Maybe my mother would still be alive.” Now the government is studying a problem it has known about for years.

Data compiled by the consumer agency from death certificates and hospital emergency room visits from 2003 through May 2012 shows that 150 mostly older adults died after they became trapped in bed rails. Over nearly the same time period, 36,000 mostly older adults — about 4,000 a year — were treated in emergency rooms with bed rail injuries. Officials at the F.D.A. and the commission said the data probably understated the problem since bed rails are not always listed as a cause of death by nursing homes and coroners, or as a cause of injury by emergency room doctors.

Experts who have studied the deaths say they are avoidable. While the F.D.A. issued safety warnings about the devices in 1995, it shied away from requiring manufacturers to put safety labels on them because of industry resistance and because the mood in Congress then was for less regulation. Instead only “voluntary guidelines” were adopted in 2006.

More warnings are needed, experts say, but there is a technical question over which regulator is responsible for some bed rails. Are they medical devices under the purview of the F.D.A., or are they consumer products regulated by the commission?

“This is an entirely preventable problem,” said Dr. Steven Miles, a professor at the Center for Bioethics at the University of Minnesota, who first alerted federal regulators to deaths involving bed rails in 1995. The government at the time declined to recall any bed rails and opted instead for a safety alert to nursing homes and home health care agencies.

Forcing the industry to improve designs and replace older models could have potentially cost bed rail makers and health care facilities hundreds of million of dollars, said Larry Kessler, a former F.D.A. official who headed its medical device office. “Quite frankly, none of the bed rails in use at that time would have passed the suggested design standards in the guidelines if we had made them mandatory,” he said. No analysis has been done to determine how much it would cost the manufacturers to reduce the hazards.

Bed rails are metal bars used on hospital beds and in home care to assist patients in pulling themselves up or helping them out of bed. They can also prevent people from rolling out of bed. But sometimes patients — particularly those suffering from Alzheimer’s — can get confused and trapped between a bed rail and a mattress, which can lead to serious injury or even death.

While the use of the devices by hospitals and nursing homes has declined as professional caregivers have grown aware of the dangers, experts say dozens of older adults continue to die each year as more rails are used in home care and many health care facilities continue to use older rail models.

Since those first warnings in 1995, about 550 bed rail-related deaths have occurred, a review by The New York Times of F.D.A. data, lawsuits, state nursing home inspection reports and interviews, found. Last year alone, the F.D.A. data shows, 27 people died.

As deaths continued after the F.D.A. warning, a working group put together in 1999 and made up of medical device makers, researchers, patient advocates and F.D.A. officials considered requiring bed rail makers to add warning labels.

But the F.D.A. decided against it after manufacturers resisted, citing legal issues. The agency said added cost to small manufacturers and difficulties of getting regulations through layers of government approval, were factors against tougher standards, according to a meeting log of the group in 2000 and interviews.

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