Vast cache of Kaiser patient details was kept in private home

Federal and state officials are investigating whether healthcare giant Kaiser Permanente violated patient privacy in its work with an Indio couple who stored nearly 300,000 confidential hospital records for the company.

The California Department of Public Health has already determined that Kaiser "failed to safeguard all patients' medical records" at one Southern California hospital by giving files to Stephan and Liza Dean for about seven months without a contract. The couple's document storage firm kept those patient records at a warehouse in Indio that they shared with another man's party rental business and his Ford Mustang until 2010.

Until this week, the Deans also had emails from Kaiser and other files listing thousands of patients' names, Social Security numbers, dates of birth and treatment information stored on their home computers.

The state agency said it was awaiting more information from Kaiser on its "plan of correction" before considering any penalties.

Officials at the U.S. Department of Health and Human Services began looking into Kaiser's conduct last year after receiving a complaint from the Deans about the healthcare provider's handling of patient data, letters from the agency show. Kaiser said it hadn't been contacted by federal regulators, and a Health and Human Services spokesman declined to comment.

Kaiser said it remained confident that this patient information was never disclosed or accessed inappropriately. It said that some employees were disciplined because company policies were not followed and that it had informed regulators of the steps it had taken to ensure this type of incident didn't happen again.

"Kaiser Permanente is committed to protecting the medical and personal privacy of its patients," spokesman John Nelson said. "In retrospect, we certainly wish we'd never done business with Mr. Dean."

Even with tougher government oversight of medical privacy in recent years, this case underscores how confidential patient information remains vulnerable in the hands of big healthcare institutions and legions of outside contractors.

"Kaiser has shown extraordinary recklessness in this situation," said Beth Givens, director of the Privacy Rights Clearinghouse in San Diego. "Healthcare companies have to make sure their contractors adhere to ironclad security practices."

Federal and state laws impose strict standards on anyone dealing with patient information. The privacy rule of the federal Health Insurance Portability and Accountability Act, known as HIPAA, bans the unauthorized disclosure of individuals' medical records and requires healthcare providers and vendors, such as billing and storage companies, to protect the information.

Despite those rules, personal medical information of 21 million people nationwide has been improperly exposed since 2009, according to federal data. Last year, Blue Cross Blue Shield of Tennessee agreed to pay $1.5 million to resolve allegations it violated federal law after 57 computer hard drives with patient information were stolen from an outside facility.

In October, Kaiser sued the Deans in Riverside County Superior Court, accusing them of violating their contract by not returning all of its patient information two years ago when Kaiser picked up the paper records.

In court filings, Kaiser said the Deans put patient data at risk by leaving two computer hard drives in their garage with the door open. In response, Stephan Dean moved them to a spare room. On a recent day they sat next to a red recliner where Ziggy, the family's black-and-white cat, curled up for a nap. Dean said those hard drives contained spreadsheets on thousands of Kaiser patients, prepared at the company's request.

At one point, Dean told Kaiser he was planning to contact patients about the whereabouts of their medical information because he felt Kaiser hadn't taken proper precautions. The company sought a temporary restraining order against Dean, barring him from disclosing any confidential information. A Superior Court judge granted Kaiser's request until Thursday, when another hearing is scheduled.

Dean, 47, got his foot in the door at Kaiser from his previous work labeling paper folders for courthouses, hospitals and doctors.

But the demand for folders was slipping as hospitals and doctors used computers more. Kaiser was at the forefront of this as it invested billions of dollars in its HealthConnect system, which it bills as the largest private-sector electronic health record in the world. Kaiser, with more than 9 million customers, is the nation's largest nonprofit insurer and hospital system.

Dean said his small business, Sure File Filing Systems, got a big break when Kaiser acquired the Moreno Valley Community Hospital in 2008. The company needed to organize and clear out thousands of old patient files and it gave the job to the Deans, Kaiser records show.

In August 2008, the Deans started packing up thousands of files from Moreno Valley and moving them to the warehouse in Indio.

Hospital clerks routinely messaged Dean asking him to pull records on specific patients, emails sent by Kaiser to Sure File show. Dean said some Kaiser employees would put the patient's full name in the subject line of the email, and other messages listed the patient's Social Security number, date of birth, doctors' names and treatment dates. One message started, "Good Morning Sure File," and requested adoption records for a child.

Dean said Kaiser showed little concern for patient privacy in handling those requests. Only one out of more than 600 emails from Kaiser was password-protected with encryption, he said. Many medical providers use such technology so information isn't visible to others.

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California parks officials deliberately hid money, report says

Fear of embarrassment and budget cuts led California parks officials to intentionally conceal millions of dollars in a department account, according to an investigation conducted by the state attorney general's office.

The report, released Friday, is the most detailed official narrative yet regarding the root of the accounting scandal at the parks department.

The scandal broke last summer when it was revealed that the parks department had a hidden surplus of nearly $54 million even though it was threatening to close dozens of facilities.

About $20 million was found in an account where entrance fees and other revenues are deposited. Accounting discrepancies appeared to begin innocently more than a decade ago, leading to fluctuating reports on how much money was in the fund, investigators said.

But in 2002, when the problems were identified, parks officials made a "conscious and deliberate" decision not to reveal the money to officials at the Department of Finance, which plans the state budget.

Multiple high-ranking officials were involved, including the former chief deputy director, Michael Harris, who later lost his job over the scandal. However, the report said it remained unclear whether ousted director Ruth Coleman knew about the accounting problems. Coleman declined to be interviewed for the investigation.

Parks officials didn't report the money because they were concerned that their already reduced budget would be cut even further if the state's number-crunchers knew they had more money in a department account, the report said. Interviews conducted by investigators also showed that officials feared embarrassment if the accounting problems were revealed.

"Throughout this period of intentional non-disclosure, some parks employees consistently requested, without success, that their superiors address the issue," the report said. It wasn't until a new deputy director was installed at the parks department in January 2012 was the issue reported.

Richard Stapler, a spokesman for the California Natural Resources Agency, said officials are still determining whether the investigation will result in criminal charges.

John Laird, the resources secretary, said new policies and staff are in place to prevent similar problems in the future.

"It is now clear that this is a problem that could have been fixed by a simple correction years ago, instead of being unaddressed for so long that it turned into a significant blow to public trust in government," Laird, who oversees the parks department, said in a statement.

The rest of the $54 million was found in an account for off-road vehicle parks. Investigators said accounting discrepancies there appeared to be unintentional, and the result of various bookkeeping problems involving loans and tax changes.

For example, a 2010 modification to the gas tax mistakenly pumped millions of excess dollars into the off-road account, the report said. That problem has been fixed and the money has been reallocated, according to the Department of Finance.

The investigation from the attorney general's office is the third review of the parks department in recent weeks. One more report, from the state auditor, is expected to be released.

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Clearwire investor seeks to block sale to Sprint

(Reuters) – A large Clearwire Corp shareholder on Friday stepped up its campaign against the planned sale of the wireless service provider to its majority owner, Sprint Nextel Corp, saying it plans to ask the U.S. telecoms regulator to block the deal.

Crest Financial’s general counsel also said on a call with reporters that it will ask the U.S. Federal Communications Commission to block Sprint’s plan to sell 70 percent of itself to Softbank Corp of Japan for $ 20 billion.

Going to the FCC is a new line of attack on the Sprint deal by Crest, which has also filed a class action lawsuit on behalf of Clearwire investors. Dave Schumacher, Crest’s general counsel, said the fund said other minority investors told Crest they did not support the Sprint deal, but he did not provide details.

The investment fund, which owns around 8 percent of Clearwire, has said Sprint’s offer of $ 2.97 share for the roughly 50 percent of Clearwire it does not currently own, “grossly undervalues Clearwire.” Sprint’s offer is worth about $ 2.2 billion, but Schumacher said Crest had not done its own valuation and was basing its criticism of the price on estimates by analysts.

In going to the FCC, Crest will argue that the Clearwire deal artificially undervalues the company’s spectrum holdings, Schumacher said. That in turn potentially devalues future revenue for the U.S. government when it auctions off spectrum licenses.

“The merger is therefore a bad deal all around for Clearwire shareholders and also for the public at large,” said Schumacher.

Sprint spokesman Scott Sloat said the deal with Clearwire was the right one for Sprint, Clearwire and American consumers. He said the class action lawsuit was baseless.

A spokesman for Clearwire, Mike DiGioia, declined to comment on Crest’s intention to go to the FCC. He said a special committee of the board conducted a rigorous evaluation of the company’s options before agreeing to the Sprint deal.

Clearwire’s chief executive, Erik Prusch, has said the company does not have attractive alternatives as it seeks funding to continue to upgrade its own network and could risk bankruptcy if the Sprint deal does not succeed.

Crest has sued Clearwire in the Court of Chancery in Delaware, where the company is incorporated, to permanently block the deal.

The Delaware court will hear arguments next week on Crest’s request to expedite the case and Schumacher said Crest hopes to move to a trial in April.

The deal needs approval by a majority of Clearwire’s minority shareholders and Sprint has said it has the support of three large Clearwire investors – Comcast Corp, Intel Corp and Bright House Networks LLC – which hold 13 percent of Clearwire stock. Schumacher said the fund would try to prevent the three from voting because of their affiliation with Sprint.

As Clearwire’s fight with its shareholders heats up, Sprint has its own shareholders to contend with.

A Kansas court on Friday declined Sprint’s request for an early dismissal of a lawsuit by a union pension fund that holds Sprint stock.

The lawsuit alleged that Sprint’s chief executive, Daniel Hesse, rushed merger talks with Softbank and did not get a fair price.

The ruling by Thomas Sutherland, the judge for the District Court of Johnson County, Kansas, will allow the pension fund to begin to demand documents and witnesses as it tries to prove its case.

Sloat, the Sprint spokesman, said the ruling only addressed the technical adequacy of the pension fund’s pleading and did not address the merits of the case. He said Sprint continued to believe the case was without merit.

(Reporting By Tom Hals in Wilmington, Delaware and Sinead Carew in New York; Editing by Bernard Orr and David Gregorio)

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Pacino says he didn't want to meet Spector

PASADENA, Calif. (AP) — Al Pacino says he decided not to meet famed record producer Phil Spector before portraying him in an HBO movie — only to find he already had.

A friend showed Pacino a 20-year-old photo in which the actor was standing next to Spector. Pacino said Friday he has no memory of the moment.

The movie, "Phil Spector," debuts in March. It focuses on the client-attorney relationship between Spector and Linda Kenney Baden, who represented him in his first trial on charges that he murdered actress Lana Clarkson. That ended in a mistrial, but Spector was convicted in a second trial and is now in prison.

Pacino says he didn't want to meet Spector in prison because he'd be a different man than the one Pacino is portraying, who hadn't yet been convicted.

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Skin Deep: Questions Surround Iris Implant Procedure – Skin Deep

ANITA ADAMS was born with one green eye and one brown eye. While differently colored irises, a condition otherwise known as heterochromia, may look exotic on David Bowie and Kate Bosworth, Ms. Adams did not like them on herself.

“I wanted my irises to match,” said Ms. Adams, 41, who works as a caretaker for at-risk adolescents in Grand Junction, Colo.

In mid-2008, she began looking online to see if there was any solution other than colored contact lenses (which comprised about 20 percent of the $7.8 billion global contact lens market in 2011, according to a January 2012 report published by BCC Market Research). She found a company, New Color Iris, marketing a device invented by a Panamanian ophthalmologist, Dr. Alberto Delray Kahn, that could apparently implant an artificial or prosthetic iris over her natural one.

The device was not approved by the Food and Drug Administration, nor were there any clinical studies or peer-reviewed publications about it. But Ms. Adams found Facebook posts and YouTube testimonials from patients whose eyes had gone from drab brown to an icy blue and were thrilled with the results. On his Web site, Kahnmedical.com, Dr. Kahn wrote that he supported “programs for the prevention of blindness in the Kuma and Embera Indians of Panama,” who have high rates of ocular albinism, which makes them sensitive to light. 

Ms. Adams was impressed. At the company’s request, she went for routine tests to her ophthalmologist, who told her he had never heard of the procedure and advised against it. She didn’t listen. “I went, ‘Oh, whatever,’ ” she said. “I don’t think anything was going to convince me not to do it. At that point my mind was made up.”

Ms. Adams is not alone in her quest for symmetry, whatever the risk.

Dr. Gregory J. Pamel, a corneal and refractive surgeon in Manhattan and a clinical assistant professor of ophthalmology at New York University, said that for the last two years he has received about three inquiries a month from patients who have learned from his Web site that he implants artificial irises for medical reasons. “They’d want to enroll in the clinical trial, and I would say, ‘There’s nothing available in the U.S.,’ ” he said. “There are no approved devices in the U.S. to change the eye color cosmetically. There are no clinical trials to date that are looking into this. There’s nothing on the horizon.”

There are, however, iris implants for patients with serious conditions like aniridia, a rare hereditary absence or partial absence of the iris, that are available under a special “compassionate use” F.D.A. provision. The provision allows patients with serious or life-threatening medical conditions to be treated with devices that have not been approved by the F.D.A., but “we can only use it for people with trauma,” Dr. Pamel said. “I would be very hesitant and skeptical about any technology that purports to change the iris color for cosmetic reasons.” 

Dr. Kenneth Steinsapir, an oculofacial surgeon and ophthalmologist in Los Angeles, also received calls from patients wanting their eye color changed, so he began investigating New Color Iris. He found no positive reports, but he did find a number of studies reporting serious complications. In July 2010, he blogged about it on his Web site, lidlift.com. “The colored disk that is put in the eye has been shown to cause harm,” he wrote.  “If you are not albino and missing iris pigment or have part of the iris missing either from a birth defect or from trauma, then there is no compelling medical reason for this surgery.” 

But Ms. Adams was determined to fix her perceived imperfection. In September 2008, she wired nearly $2,000 to New Color Iris, and a month later flew with her mother (paying their airfare) to Panama. She was told the surgery would present no complications other than a slight risk of glaucoma. She signed a consent form, paid an additional $5,000 and underwent the 15-minute procedure.

For two days, Ms. Adams’s vision was blurry, which she was told was normal. By the third day, she could see well enough to tour around the city. “I was happy with the experience at the time,” she said.

She appeared on “Inside Edition” to talk about how delighted she was, for which she said New Color Iris paid her $500, promising an additional $500 for every future media appearance she did. She also allowed the company to use her likeness on its Web site and on YouTube.

Ms. Adams was pleased with her matching irises for about two years. But in fall 2010, she said, her vision grew “spotty,” and she was “scared to death I was going blind.” She repeatedly tried to contact Dr. Kahn as well as the company in New York, but said she received no response. She started a Facebook page (now dismantled) highlighting her negative experience, noticing that other people had shared similar stories.

And when she returned to the New Color Iris Web site, she was redirected to another site, Brightocular.com, which was marketing another implant to cosmetically change eye color and offering more glowing testimonials.

Ms. Adams said she contacted it using a fake name and was told that the procedure was being offered in Istanbul and soon “in all of Europe” and that the company was not affiliated with New Color Iris. Convinced this was untrue, she contacted Dr. Steinsapir in February 2011, and he began blogging about a possible relationship between the two companies. On Aug. 16, 2011, Dr. Steinsapir received a certified letter from Kevin J. Abruzzese, a lawyer in Mineola, N.Y., representing Stellar Devices, which owns the trademark for Brightocular, that denied that any association existed between the two companies. The letter also asserted that Stellar Devices was working with Minnesota Eye Consultants, in Minneapolis, to obtain “F.D.A. compassionate approval for a patient with aniridia,” and ordered  the doctor to remove “any and all defamatory content” about Brightocular.

Still skeptical, Dr. Steinsapir found a registered trademark for Brightocular, originally filed March 18, 2010 and granted registration on April 19, 2011.

But the company to which the trademark was registered was not Stellar Devices, but New Color Iris. What’s more, New Color Iris and Stellar Devices shared the same Midtown Manhattan address. Dr. Steinsapir later published his findings. He said he also arranged surgery for people who had iris color surgery and needed urgent help.

Alain Delaquérière contributed research.

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S&P 500 index closes at a five-year high

NEW YORK — Standard & Poor's 500 closed at its highest in five years Friday after a report showed that hiring held up in December, giving stocks an early lift.

The S&P 500 finished up 7.10 points at 1,466.47, its highest close since December 2007.

The index began its descent from a record close of 1,565.15 in October 2007, as the early signs of the financial crisis began to emerge. The index bottomed out in March 2009 at 676.53 before staging a recovery that has seen it more than double in value and move to within 99 points of its all-time peak.

The Dow Jones industrial average finished 43.85 points higher at 13,435.21. It gained 3.8% for the week, its biggest weekly advance since June. The Nasdaq closed up 1.09 point at 3,101.66.

Stocks have surged this week after lawmakers passed a bill to avoid a combination of government spending cuts and tax increases that have come to be known as the "fiscal cliff." The law passed late Tuesday night averted that outcome, which could have pushed the economy back into recession.

The Labor Department said U.S. employers added 155,000 jobs in December, showing that hiring held up during the tense fiscal negotiations in Washington. It also said hiring was stronger in November than first thought. The unemployment rate held steady at 7.8%.

The jobs report failed to give stocks more of a boost because the number of jobs was exactly in line with analysts' forecasts, said JJ Kinahan, chief derivatives trader for TD Ameritrade.

"The jobs report couldn't have been more in line," Kinahan said. "The market had more to lose than to gain from it."

Among stocks making big moves, Eli Lilly and Co. jumped $1.84, or 3.7%, to $51.56 after saying that its earnings will grow more than Wall Street expects, even though the drugmaker will lose U.S. patent protection for two more product types this year.

Walgreen Co., the nation's largest drugstore chain, fell 61 cents, or 1.6 percent, to $37.18 after the company said that a measure of revenue fell more than analysts had expected in December, even as prescription counts continued to recover.

Stocks may also be benefiting as investors adjust their portfolios to favor stocks over bonds, said TD Ameritrade's Kinahan. A multi-year rally in bonds has pushed up prices for the securities and reduced the yield that they offer, in many cases to levels below company dividends.

Goldman Sachs reaffirmed its view that stocks "can be an attractive source of income," and warned that there is a risk that bonds may fall. In a note to clients, the investment bank said that an index of AAA rated corporate bonds offers a yield of just 1.6 percent, less than the S&P 500's dividend yield of 2.2%.

The 10-year Treasury note fell, pushing its yield higher. The yield on the 10-year note fell 2 basis points to 1.91%. The note's yield has now climbed 52 basis points since falling to its lowest in at least 20 years in July.

Other notable stock moves;

-- Accuray Inc. plunged $1.37, or 20%, to $5.41 after the radiation oncology equipment company reported weak sales and said it would cut 13% of its staff.

-- Lululemon, a yoga apparel maker, dropped $3.14, or 4.2 percent, to $71.95 after Credit Suisse predicted slowing momentum and downgraded its stock.

-- Finish Line Inc., an athletic footwear and clothing company, fell $1.58, or 8.3%, to $17.18 after it reported a small loss after sneaker trends changed and customers didn't take to its new web site launched in November. Analysts had forecast a profit.

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Bieber urges crackdown on paparazzi after photographer's death

Justin Bieber and his collection of exotic cars have been tantalizing targets for celebrity photographers ever since the young singer got his driver's license.

A video captured the paparazzi chasing Bieber through Westside traffic in November. When Bieber's white Ferrari stops at an intersection, the video shows the singer turning to one of the photographers and asking: "How do your parents feel about what you do?"

A few months earlier, he was at the wheel of his Fisker sports car when a California Highway Patrol officer pulled him over for driving at high speeds while trying to outrun a paparazzo.

This pursuit for the perfect shot took a fatal turn Tuesday when a photographer was hit by an SUV on Sepulveda Boulevard after taking photos of Bieber's Ferrari. And the singer now finds himself at the center of the familiar debate about free speech and the aggressive tactics of the paparazzi.

Since Princess Diana's fatal accident in Paris in 1997 while being pursued by photographers, California politicians have tried crafting laws that curb paparazzi behavior. But some of those laws are rarely used, and attorneys have challenged the constitutionality of others.

On Wednesday, Bieber went on the offensive, calling on lawmakers to crack down.

"Hopefully this tragedy will finally inspire meaningful legislation and whatever other necessary steps to protect the lives and safety of celebrities, police officers, innocent public bystanders and the photographers themselves," he said in a statement.

It remained unclear if any legislators would take up his call. But Bieber did get some support from another paparazzi target, singer Miley Cyrus.

She wrote on Twitter that she hoped the accident "brings on some changes in '13 Paparazzi are dangerous!"

Last year, a Los Angeles County Superior Court judge threw out charges related to a first-of-its-kind anti-paparazzi law in a case involving Bieber being chased on the 101 Freeway by photographer Paul Raef. Passed in 2010, the law created punishments for paparazzi who drove dangerously to obtain images.

But the judge said the law violated 1st Amendment protections by overreaching and potentially affecting such people as wedding photographers or photographers speeding to a location where a celebrity was present.

The L.A. city attorney's office is now appealing that decision.

Raef's attorney, Dmitry Gorin, said new anti-paparazzi laws are unnecessary.

"There are plenty of other laws on the books to deal with these issues. There is always a rush to create a new paparazzi law every time something happens," he said. "Any new law on the paparazzi is going to run smack into the 1st Amendment. Truth is, most conduct is covered by existing laws. A lot of this is done for publicity."

Coroner's officials have not identified the photographer because they have not reached the next of kin. However, his girlfriend, Frances Merto, and another photographer identified him as Chris Guerra.

The incident took place on Sepulveda Boulevard near Getty Center Drive shortly before 6 p.m. Tuesday. A friend of Bieber was driving the sports car when it was pulled over on the 405 Freeway by the California Highway Patrol. The photographer arrived near the scene on Sepulveda, left his car and crossed the street to take photos. Sources familiar with the investigation said the CHP told him to leave the area. As he was returning to his vehicle, he was hit by the SUV.

Law enforcement sources said Wednesday that it was unlikely charges would be filed against the driver of the SUV that hit the photographer.

Veteran paparazzo Frank Griffin took issue with the criticism being directed at the photographer as well as other paparazzi.

"What's the difference between our guy who got killed under those circumstances and the war photographer who steps on a land mine in Afghanistan and blows himself to pieces because he wanted the photograph on the other side of road?" said Griffin, who co-owns the photo agency Griffin-Bauer.

"The only difference is the subject matter. One is a celebrity and the other is a battle. Both young men have left behind mothers and fathers grieving and there's no greater sadness in this world than parents who have to bury their children."

Others, however, said the death focuses attention on the safety issues involving paparazzi

"The paparazzi are increasingly reckless and dangerous. The greater the demand, the greater the incentive to do whatever it takes to get the image," said Blair Berk, a Los Angeles attorney who has represented numerous celebrities. "The issue here isn't vanity and nuisance, it's safety."

richard.winton@latimes.com

andrew.blankstein@latimes.com

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6 takeaways from Google’s antitrust settlement with US regulators

Google Inc. has settled an U.S. antitrust probe that largely leaves its search practices alone. In a major win for Google, the Federal Trade Commission unanimously concluded that there is not enough evidence to support complaints from rivals that the company shows unfair bias in its search results toward its own products.

Below are six of the biggest takeaways from the decision announced Thursday:

— Google promised to license hundreds of important mobile device patents to rivals that make gadgets such as smartphones, tablets and gaming devices, on “fair, reasonable and non-discriminatory terms,” the FTC said. Google got the patents as part of its $ 12.4 billion purchase of Motorola Mobility last year. The patents cover wireless connectivity and other Internet technologies.

— Upon receiving a request to do so, the online search leader pledged to stop using snippets of content from other websites, such as the reviews site Yelp Inc., in its search results. It had already scaled back this practice before the FTC settlement after a complaint from Yelp that triggered the FTC probe. Under the agreement, specialty websites such as those on shopping and travel can request that Google stop including such snippets in the search results, while still providing links to those websites.

— Google pledged to adjust its online advertising system so marketing campaigns can be more easily managed on rival networks. Some FTC officials had worried that Google’s existing service terms with advertisers make that difficult.

— The FTC’s unanimous conclusion that Google does not practice unfair “search bias” to promote its own properties against competitors is a major victory for the online search leader. It means it won’t have to change its search formula, considered to be the company’s crown jewel.

— Not everyone was happy with the results. FairSearch, a group whose members include rival Microsoft Corp., said the FTC’s “inaction on the core question of search bias will only embolden Google to act more aggressively to misuse its monopoly power to harm other innovators.”

— Next up, European regulators are expected to wrap up a similar investigation of Google’s business practices in the coming weeks.

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Plot spoilers pose 'Downton Abbey' challenge

LOS ANGELES (AP) — There are many delicious reasons to watch the returning "Downton Abbey" and an exasperating one to skip it: The cover's been blown on major plot twists.

In what may be outsized revenge for the American Revolution — or payback for years of exporting lousy U.S. TV and fast food — the Brits are sharing "Downton Abbey" with us, but only after first airing each season.

That wouldn't matter much in the drama's early 20th-century setting but we're not there, are we, PBS and U.K. network ITV? A little gimmick called the Internet makes it impossible to keep story developments from spreading like germ warfare.

As with sports fans who must avoid all media and big-mouthed friends to keep game scores a surprise, "Downton Abbey" addicts are forced to shun rude news reports and blogs about what happens to character A, B or C (no spoilers here, promise).

Heedlessly type in "Downton Abbey season three" online and you risk stumbling into the startling truth that ... well, never mind. If you know, you have our sympathy. If you don't, live in blessed ignorance and careful isolation from Sunday's debut until the Feb. 17 season finale.

"It is unfair that England gets to see 'Downton Abbey' before us because we beat them in a war" was the saucy comment posted on Twitter by producer Damon Lindelof of "Lost" fame.

It's certainly a development galling enough to draw insults. But as Downton's courtly master, Lord Grantham (Hugh Bonneville), once rebuked a blunt-spoken visitor: Steady on, sir, the ladies have suffered quite enough of a shock!

Rebecca Eaton, executive producer of PBS' "Masterpiece" showcase that's home to "Downton," contends it's premature to assess the impact here of the U.K. airing that wrapped Christmas Day. Will ratings be dented by dampened enthusiasm or piracy?

"It will be difficult to say until it airs in this country," Eaton said, with the size of the audience providing a key measurement.

The bar is high compared with last year, when "Downton Abbey" became the most-watched series ever for "Masterpiece" with more than 17 million viewers across seven episodes. With its swooning, buzz-worthy romances, the drama also fed social media and gave PBS a new veneer of cool.

But what's to be done if the season endgame is stuck in your brain? As a famous Brit said in more dire circumstances, never surrender! Go along for the ride that the beautifully produced soap opera-cum-fairy tale offers, admiring how the devilishly clever Julian Fellowes, its creator and writer, foreshadows the events to come.

As Downton's residents adjust to post-War War I England, "there are chills and spills involved in that for all the characters, some laughs and some tears," as Fellowes neatly summed it up.

Knowing the destination doesn't mean you can't appreciate the scenery, including these highlights:

— Newcomer Shirley MacLaine as an American visitor, talking smack with British in-law Violet (Maggie Smith), each wittily knocking the other's nation and values. MacLaine wears pasty, kabuki-like makeup as armor; Smith meets insults with world-weary eyes.

— Michelle Dockery keeping it real as Lady Mary, who's surrendered to love with Matthew (Dan Stevens) while barely softening her sharp edges and steely devotion to family tradition. Bonus: The willowy actress was born to wear sleek 1920s dresses.

— Fashion and its evolution, as Downton's upstairs ladies move from lovely but fussy wardrobes to sassier, clean-lined garb and (except for steadfast Mary) shorter hair, reflections of liberating changes that include the promise of universal suffrage for all British women.

— Stevens as golden-boy Matthew, emerging intact from World War I and still conflicted about his future role as lord of the manor. A side game: See if Stevens, smart as he is, looks distracted by the novels he read on the set as a judge for Britain's Man Booker Prize.

— Cultural, medical and other period tidbits, which are fascinating and a reminder that wise historians never would choose to live in a time before their own. In one instance, a character who may have cancer is told that test results will take up to two nerve-shattering months.

— Fellows' charming faith in the tender side of revolutionaries, at least ones that mate with landed gentry. Irish chauffeur-turned-activist Tom Branson (Allen Leech), who previously turned moist-eyed over the murder of the Russian royal family, loses it again in season three over fiery political warfare.

— A stately house, but fast-paced action. Fellowes said he took a cue from the American mash-up approach to storytelling perfected in shows like "ER" and "The West Wing," with stories big and small, sad and funny and "all sort of plotted up together." The look is period but the energy is "much more modern," as Fellowes put it.

But modernity can be troublesome, proof being the Internet imperiling the drama's surprises for U.S. viewers. Whatever the outcome, Eaton said "Masterpiece" will tread carefully in making changes.

ITV is the primary funder of "Downton Abbey" and has international premiere rights. While a September debut fits the U.K. TV marketplace, it would mean stiffer competition for "Downton" as U.S. networks launch their fall slates, Eaton said.

"We want to make sure we don't do something with 'Downton' that will hurt it in the long run," she said — which, for now, extends to the drama's fourth season set to air on "Masterpiece," its co-producer with Carnival Films.

As for the current run, Eaton, who's no spoilsport, had only this to say: "I think it's the best season yet."

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Online:

http://www.pbs.org

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EDITOR'S NOTE — Lynn Elber is a national television columnist for The Associated Press. She can be reached at lelber(at)ap.org.

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Scant Proof Is Found to Back Up Claims by Energy Drinks

Energy drinks are the fastest-growing part of the beverage industry, with sales in the United States reaching more than $10 billion in 2012 — more than Americans spent on iced tea or sports beverages like Gatorade.

Their rising popularity represents a generational shift in what people drink, and reflects a successful campaign to convince consumers, particularly teenagers, that the drinks provide a mental and physical edge.

The drinks are now under scrutiny by the Food and Drug Administration after reports of deaths and serious injuries that may be linked to their high caffeine levels. But however that review ends, one thing is clear, interviews with researchers and a review of scientific studies show: the energy drink industry is based on a brew of ingredients that, apart from caffeine, have little, if any benefit for consumers.

“If you had a cup of coffee you are going to affect metabolism in the same way,” said Dr. Robert W. Pettitt, an associate professor at Minnesota State University in Mankato, who has studied the drinks.

Energy drink companies have promoted their products not as caffeine-fueled concoctions but as specially engineered blends that provide something more. For example, producers claim that “Red Bull gives you wings,” that Rockstar Energy is “scientifically formulated” and Monster Energy is a “killer energy brew.” Representative Edward J. Markey of Massachusetts, a Democrat, has asked the government to investigate the industry’s marketing claims.

Promoting a message beyond caffeine has enabled the beverage makers to charge premium prices. A 16-ounce energy drink that sells for $2.99 a can contains about the same amount of caffeine as a tablet of NoDoz that costs 30 cents. Even Starbucks coffee is cheap by comparison; a 12-ounce cup that costs $1.85 has even more caffeine.

As with earlier elixirs, a dearth of evidence underlies such claims. Only a few human studies of energy drinks or the ingredients in them have been performed and they point to a similar conclusion, researchers say — that the beverages are mainly about caffeine.

Caffeine is called the world’s most widely used drug. A stimulant, it increases alertness, awareness and, if taken at the right time, improves athletic performance, studies show. Energy drink users feel its kick faster because the beverages are typically swallowed quickly or are sold as concentrates.

“These are caffeine delivery systems,” said Dr. Roland Griffiths, a researcher at Johns Hopkins University who has studied energy drinks. “They don’t want to say this is equivalent to a NoDoz because that is not a very sexy sales message.”

A scientist at the University of Wisconsin became puzzled as he researched an ingredient used in energy drinks like Red Bull, 5-Hour Energy and Monster Energy. The researcher, Dr. Craig A. Goodman, could not find any trials in humans of the additive, a substance with the tongue-twisting name of glucuronolactone that is related to glucose, a sugar. But Dr. Goodman, who had studied other energy drink ingredients, eventually found two 40-year-old studies from Japan that had examined it.

In the experiments, scientists injected large doses of the substance into laboratory rats. Afterward, the rats swam better. “I have no idea what it does in energy drinks,” Dr. Goodman said.

Energy drink manufacturers say it is their proprietary formulas, rather than specific ingredients, that provide users with physical and mental benefits. But that has not prevented them from implying otherwise.

Consider the case of taurine, an additive used in most energy products.

On its Web site, the producer of Red Bull, for example, states that “more than 2,500 reports have been published about taurine and its physiological effects,” including acting as a “detoxifying agent.” In addition, that company, Red Bull of Austria, points to a 2009 safety study by a European regulatory group that gave it a clean bill of health.

But Red Bull’s Web site does not mention reports by that same group, the European Food Safety Authority, which concluded that claims about the benefits in energy drinks lacked scientific support. Based on those findings, the European Commission has refused to approve claims that taurine helps maintain mental function and heart health and reduces muscle fatigue.

Taurine, an amino acidlike substance that got its name because it was first found in the bile of bulls, does play a role in bodily functions, and recent research suggests it might help prevent heart attacks in women with high cholesterol. However, most people get more than adequate amounts from foods like meat, experts said. And researchers added that those with heart problems who may need supplements would find far better sources than energy drinks.

Hiroko Tabuchi contributed reporting from Tokyo and Poypiti Amatatham from Bangkok.

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