Rare disease, fraud, or clerical error?

Many thanks to Jay Hancock for his interesting article about the Justice Department accusing Kernan Hospital of fraud in presenting a diagnosis of kwashiorkor in the billing for a number of patients ("Feds charge fraud in Kernan diagnoses," Nov. 8). I find it hard to believe that any medical personnel would be so stupid as to bill for patients with a wildly unlikely diagnosis of kwashiorkor. It seems more likely that a billing clerk entered an erroneous ICD (international classification of disease) code by mistake.

Mr. Hancock is correct in pointing this out as "evidence of a flawed medical system."

Incidentally, I had the pleasure of knowing Dr. Cicely D. Williams who first described kwashiorkor on the Gold Coast (now Ghana) in the early 1900s.

Dr. Timothy Baker, Baltimore

The writer is professor of international health at the Johns Hopkins Bloomberg School of Public Health.