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“Enough Is Enough”: Widower Sues Hospital for Withholding Ivermectin, Claims Wrongful Death

"Enough Is Enough": Widower Sues Hospital for Withholding Ivermectin, Claims Wrongful Death

The family of a woman who died after a hospital…



"Enough Is Enough": Widower Sues Hospital for Withholding Ivermectin, Claims Wrongful Death

The family of a woman who died after a hospital refused to treat her with ivermectin for Covid-19 has filed a wrongful death lawsuit.

Scott Mantel, whose wife Deborah Bucko died at Mount Sinai Hospital on May 16, 2021 from complications related to Covid-19, filed the lawsuit in September. He contends that the hospital refused to administer ivermectin, which was prescribed by her doctor. Mantell claims that the refusal contributed to her death.

According to the lawsuit, Mantel "researched possible alternative treatments, and he read several news stories about patients with severe COVID-19 illness who had been treated successfully with ivermectin."

Despite her condition initially improving after she received the drug under a court order, the hospital's subsequent decision to stop the treatment led to a rapid decline in her health, according to the complaint.

"While she was being treated with the ivermectin and immediately afterwards, Ms. Bucko’s respiratory and cardiovascular functions showed significant improvement and she required significantly less oxygen, vasopressors, and ventilator support, which was clearly demonstrated in her medical records," reads the suit. "As a result of the ivermectin, Ms. Bucko was on her way to recovery."

Mantel’s lawsuit seeks not only compensation for himself and his two children but also punitive damages against the hospital. The claim is that Mount Sinai's withholding of ivermectin after it had been prescribed constituted a breach of standard medical care, the Epoch Times reports.

Mantel's lawyer, Steven Warshawsky, says that the hospital's refusal to comply with the court-ordered treatment, particularly given the patient’s initial improvement, was against the patient's best interests and the integrity of the doctor-patient relationship.

"Early on during the pandemic there were a lot of early legal actions seeking court orders requiring hospitals and doctors to treat patients with ivermectin, but here you have a situation where orders were issued and the hospital did not fully comply with them despite [the] patient showing progress of ivermectin," he said.

The controversy around the use of ivermectin as a treatment for COVID-19 has been a contentious issue within the medical community. Despite this, a lawyer for the FDA confirmed to the U.S. Court of Appeals for the 5th Circuit in August 2023 that doctors are legally permitted to prescribe ivermectin for the treatment of COVID-19.

"FDA explicitly recognizes that doctors do have the authority to prescribe ivermectin to treat COVID," said Ashley Cheung Honold, a Department of Justice lawyer representing the Food and Drug Administration (FDA), in a statement to the US Court of Appeals for the 5th Circuit.

Dr. Mary Talley Bowden, who supports the use of ivermectin, has criticized pharmacists who refuse to fill such prescriptions, arguing that this oversteps their authority and impacts patient care.

"This needs to come to an end. In telling my patients what medicines they can and cannot have access to, we effectively have a large group of pharmacists practicing medicine without a license," Bowden said on Friday. "They have no accountability for this yet they are allowed to dictate patient care."

"I see it every single day. Enough is enough," she continued.

The outcome of Mantel’s lawsuit could have implications for future cases where there is a conflict between hospital policies and the treatments doctors wish to prescribe. Warshawsky hopes that a favorable ruling will set a precedent affirming the right of physicians to administer treatments they deem necessary, without undue interference from hospital administration. The hospital is expected to respond to the motion later this month.

"I am hoping to not only get a good result for Deborah and her family but certainly to lay a precedent which is that physicians cannot withhold life-saving treatments from their patients, not only in the case of ivermectin, but also with other medications that might not be standard protocol for hospitals," said Warshowsky.

Tyler Durden Wed, 11/08/2023 - 23:20

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Berkshire Hathaway’s Q3 2023 Results — Manufacturing, Service, and Retailing

A review of Berkshire’s large collection of non-insurance operating businesses, with a focus on results in Q3 2023 as well as a longer term view.



“Over the years, I have made many mistakes. Consequently, our extensive collection of businesses currently consists of a few enterprises that have truly extraordinary economics, many that enjoy very good economic characteristics, and a large group that are marginal. Along the way, other businesses in which I have invested have died, their products unwanted by the public. Capitalism has two sides: The system creates an ever-growing pile of losers while concurrently delivering a gusher of improved goods and services. Schumpeter called this phenomenon ‘creative destruction.’”

— Warren Buffett, 2022 letter to shareholders

When you see a person every day, or even once every few months, chances are that you will not notice the subtle impacts of the passage of time. But if you have not seen a friend or relative for five or ten years, you’re likely to be surprised. The accumulation of small changes over a long period of time can make a person almost unrecognizable.

This effect is also apparent when looking at a company like Berkshire Hathaway. It is not that individual business units within Berkshire change that much over time. Warren Buffett tends to stick to businesses that are fairly mature and stable and he hardly ever sells a business. The effect is produced by acquisitions that accumulate over time and make the overall conglomerate almost unrecognizable. For example, take a look at the following summary of Berkshire’s non-insurance operations in 1999:

This is the data I had in early 2000 as I built my initial position in the company. With the exception of Buffalo News, which was sold in 2020, Berkshire still operates the businesses in each of the segments listed in the 1999 annual report. However, all of these segments have been subsumed into larger groupings due to acquisitions made over nearly a quarter century. As much as I would like to have access to the financial data for See’s Candies today, it is just a small part of Berkshire’s current retailing segment. The same is true for the other segments of 1999.

Fast forward to the 2022 annual report. Here is the breakdown given for Berkshire’s manufacturing, service, and retailing group:

Within the two groups, results are further broken down into slightly more granular categories, but we are still faced with a very high-level view of Berkshire’s non-insurance operations. On the positive side, the size of Berkshire’s operations makes it unnecessary to expose granular information on individual businesses that could be helpful to competitors. On the negative side, shareholders see a cloudier view. However, with some work, we can still monitor trends in the information that Berkshire does provide to see how these businesses are doing, at least in aggregate.

At a very high level, we can look at quarterly net earnings for the group since 2018. This is useful since we can spot the slowdown during the steep pandemic-era decline in 2020 as well as the sharp recovery between mid-2020 and mid-2021. Since then, quarterly earnings growth has been relatively muted.

Source: Company Filings

This article presents a summary of Berkshire’s manufacturing, service, and retailing group based on how I follow these business units on a quarterly basis. After going through the data and presentation provided in Berkshire’s filings, I will provide a longer term view of the group.

Third Quarter and Year-to-Date Results

Let’s start with an overview from Berkshire’s Q3 report showing revenue and earnings for the group for the third quarter and first nine months of the year:

Copyright, Disclosures, and Privacy Information

Nothing in this article constitutes investment advice and all content is subject to the copyright and disclaimer policy of The Rational Walk LLC.  The Rational Walk is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to

Individuals associated with The Rational Walk own shares of Berkshire Hathaway.

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China’s Foreign Direct Investment Turns Negative For The First Time On Record

China’s Foreign Direct Investment Turns Negative For The First Time On Record

We got an early look that something is very broken in China’s…



China's Foreign Direct Investment Turns Negative For The First Time On Record

We got an early look that something is very broken in China's capital flows back mid-September, when we first reported that contrary to the official PBOC forex data, a more in depth analysis of China's fund flows reveals the biggest FX outflow since 2016 amid what we called was a "sudden surge in capital flight", one which also kicked in just before bitcoin's powerful thrust higher from $26K to $35K.

In retrospect, the reading wasn't a fluke, and three months after we reported that "China's Inward Foreign Direct Investment Falls To The Lowest Level On Record" the latest balance of payments data revealed that China recorded its first-ever quarterly decline in foreign direct investment (FDI), underscoring the capital outflow pressure we first flagged two months ago (and which was much more acute than the modest FX outflow signaled by the PBOC), and Beijing's challenge in wooing overseas companies and capital in the wake of a "de-risking" move by Western governments.

As shown in the chart below, direct investment liabilities in the country’s balance of payments - a broad measure of FDI that includes foreign companies' retained earnings in China - have been slowing over the last two years after hitting a near-peak value of more than $101 billion in the first quarter of 2022; since then the gauge weakened nearly every quarter and was a deficit of $11.8 billion during the July-September period, marking the first contraction since records started in 1998, which could be linked to the impact of "de-risking" by Western countries from China, as well as China's interest rate disadvantage (the chart below shows a striking correlation between inbound FDI and China's tumbling bond yields).

“It’s concerning to see net outflows where China’s doing its best at the moment to try and open — certainly the manufacturing sector — to new inflows,” said Robert Carnell, regional head of research for Asia-Pacific at ING Groep NV. “Maybe this is the beginning of a sign that people are just increasingly looking at alternatives to China for investment.”

"Some of the weakness in China's inward FDI may be due to multinational companies repatriating earnings," Goldman analyst Hui Shan wrote (full note available to pro subscribers) adding that "with interest rates in China 'lower for longer' while interest rates outside of China 'higher for longer', capital outflow pressures are likely to persist."

According to Julian Evans-Pritchard, head of China economics at Capital Economics, the unusually-large interest rate gap "has led firms to remit their retained earnings out of the country".

Although he sees little evidence that foreign companies are, on aggregate, reducing their presence in China, "we do think that, over the medium-term at least, increasing geopolitical tensions will hamper China's ability to attract FDI and instead favor emerging markets that are more friendly to the West."

Driven by the FDI outflows, China's basic balance - which encompasses current account and direct investment balances and are more stable than volatile portfolio investments - recorded a deficit of $3.2 billion, the second quarterly shortfall on record.

"Given these unfolding dynamics, which are poised to exert pressure on the RMB, we anticipate a sustained strategic response from China's authorities," Tommy Xie, head of Greater China Research at OCBC wrote, and while he is hardly alone in expecting a powerful response from Beijing to stop the bleeding before China is fully "Japanified" so far the ruling Communist Party has failed to materially stimulate its economy, the result of a staggering 300% in consolidated debt to GDP, which has largely tied Beijing's hand for the past 4 years.

Xie expects China's central bank to continue counter-cyclical interventions - including a strong bias in daily yuan fixings and managing yuan liquidity in the offshore market- to support the currency in the face of these headwinds.

Separately, onshore yuan trading against the dollar also hit record-low volume in October, highlighting authorities' stepped-up efforts to curb yuan selling. The latest data showed that onshore volume of yuan trading against the dollar slumped to a record low of 1.85 trillion yuan ($254.05 billion) in October, a 73% drop from the August level.

The PBOC has been urging major banks to limit trading and dissuade clients to exchange the yuan for the dollar, sources have told Reuters. This happened after our September report that FX outflows from China had hit $75 billion, the highest since the country's 2015 devaluation.

In an attempt to reverse the bleeding, the Chinese government has embarked on a big push in recent months to lure foreign investment back to the country. Bloomberg reported that on Wednesday, the Ministry of Commerce asked local governments to clear discriminatory policies facing foreign companies in a bid to stabilize investment confidence. It's doubtful the move will have any impact on capital flows which are not driven by "discriminatory" policies and have everything to do with China's dismal economy.

It cited the need to ensure subsidies for new energy vehicles are not limited to domestic brands as one example. In some industries, foreign firms wait longer and are subject to more rigorous reviewing process when applying for licenses.

In August, the internet regulator met with executives from dozens of international firms to ease concerns about new data rules. The government has also pledged to offer overseas companies better tax treatment and make it easier for them to obtain visas.

But Beijing’s pledges have rung hollow for some firms, with foreign business groups decrying “promise fatigue” amid skepticism about whether meaningful policy support is forthcoming. They also have incentive to repatriate earnings overseas because of the wide gap in interest rates between China and the US, which may be pushing them to seek higher returns elsewhere.

The FDI outflows are adding pressure on the onshore yuan, which has hit the weakest level since 2007 earlier this year. China’s benchmark 10-year government bond yield is trading at 191 basis points below that of comparable US Treasuries, versus an average premium of about 100 basis points over the past decade.

The lack of investment among global firms in China will have far reaching effects on the world’s second-largest economy, especially as it tries counter US curbs on access to advanced technology.

Aside from geopolitical risks, companies had also been pulling back on investment in China last year as the country rolled out pandemic restrictions. While those curbs have been removed, firms are still contending with other challenges from rising manufacturing costs in China and regulatory hurdles as Beijing scrutinizes activity at foreign corporations due to national security concerns.

“Some of the most damaging things have been the abrupt regulatory changes that have taken place,” said Carnell, pointing to this year’s anti-espionage campaign, which resulted in some firms having their offices raided by local authorities. “Once you damage the sort of perception of the business environment, it’s quite difficult to restore trust. I think it will take some time.”

While foreign companies make up less than 3% of the total number of corporations in China, they contribute to 40% of its trade, more than 16% of tax revenue and almost 10% of urban employment, state media has reported. They’ve also been key to China’s technological development, with foreign investment in the country’s high-tech industry growing at double-digit rates on average since 2012, according to the official Xinhua News Agency.

“A decline in trade and investment links with advanced economies will be a particularly significant headwind for a catching up economy such as China, weighing on productivity growth and technological progress,” Kuijs said. And since youth unemployment - the single, most direct precursor to the one thing Beijing fears most of all, social unrest - is already at an all time high and will continue to rise (even if China will no longer report on what it is), the likelihood that Beijing will pursue some bazooka stimulus, both fiscal and monetary, only grows with every month that Beijing does not pursue such a critical, if temporary, measure to prevent catastrophe.

Tyler Durden Wed, 11/08/2023 - 18:00

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Bullion & Black Gold Breakdown As Loosening Financial Conditions Foil Fed’s Plan

Bullion & Black Gold Breakdown As Loosening Financial Conditions Foil Fed’s Plan

As earnings season winds down and macro catalysts are…



Bullion & Black Gold Breakdown As Loosening Financial Conditions Foil Fed's Plan

As earnings season winds down and macro catalysts are scarce (Fed Chair Powell said nothing at all today on monetary policy... but speaks again tomorrow), so Treasury yields drifted lower and stocks struggled (led by banks and energy).

The reflexive (loosening) reversal in financial conditions, since The Fed bragged about the market doing its (tightening) job for them has been significant to say the least - erasing, according to Goldman, around 50bps of the 100bps implied rate-hikes that the Q3 tightening created...

Interesting, 'hard' data has fallen along with the tighter financial conditions...

Source: Bloomberg

...but 'soft' survey data has ignore the tightening financial conditions...

Source: Bloomberg

Small Caps were clubbed like a baby seal again. The Dow ended red as The S&P and Nasdaq battled it out for a green close and their 8th and 9th up-day in a row respectively...

The Nasdaq rose 10 days in a row in Nov 2021, but the S&P hasn't risen for 9 days in a row (which it would do if green tomorrow) since 2004...

Eli Lilly's FDA approval for its Tirzepatide GLP-1 analog drug for obesity treatment sent Obesity-based stocks higher at the expense of restaurants and gyms etc...

Source: Bloomberg

Regional banks were battered once again (after yesterday's FHLB news)...

Treasuries were mixed today with the long-end outperforming once again (30Y -9bps, 2Y +2bps). On the week, the long-end is the big winner (-13bps) while the short-end is the only segment of the curve higher in yield (2Y +10bps, 5Y +1bps)...

Source: Bloomberg

Having dis-inverted, the yield curve (2s30s) tumbled back to one-month lows...

Source: Bloomberg

The dollar went nowhere today, hovering at those pre-payrolls-plunge highs...

Source: Bloomberg

For the second day in a row, Bitcoin jumped higher around 1130ET, but couldn't hold the gains...

Source: Bloomberg

Gold prices continued to drift lower, but remain well off their pre-Israel lows...

Crude prices crashed to near 4-month-lows with WTI tagging a $74 handle intraday...

Is crude following tightening financial conditions with a two-month lag?

Source: Bloomberg

Or was yesterday's record call option volume a sign of the bottom getting close?

Source: Bloomberg

Finally, liquidity in the crucially-important US Treasury market remains very poor - at its worst since 2010...

Source: Bloomberg

The last time liquidity was this bad - in March 2020 - The Fed unleashed its largest money-drop ever.

And in light of that liquidity crisis, is it any wonder that Warren Buffett is holding his drypowder.

Since the pandemic first struck, the conglomerate’s holdings of cash have declined, but its holdings of T-bills have soared past $126 billion to a record. Wondering why he is not snapping up those 'cheap' stocks you keep hearing about on TV?

Simple - according to his favorite indicator, stocks are only back to the same level of 'expensive' as they were at the peak of the dotcom bubble...

Source: Bloomberg

As Buffett once remarked, “Our stay-put behavior reflects our view that the stock market serves as a relocation center at which money is moved from the active to the patient.”

Tyler Durden Wed, 11/08/2023 - 16:00

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