Medical Malpractice

Adverse events in hospital care is killing an estimated 15,000 Medicare patients every month, or one in seven hospitalized Medicare patients, according to a government survey released Tuesday, November 16 and reported by USA Today.

The Department of Health and Human Services (HHS) conducted a survey of adverse events in hospitals studied a representative sample of 780 Medicare patients discharged from hospitals in October 2008. The patients suffered a range of ailments, from infections to death. Of the 780 cases, 12 patients died. Five of those deaths were related to the use of blood-thinning medication. Two other deaths that were medication-related resulted in a patient suffering hypoglycemic coma and over-sedation that led another patient to respiratory failure. The focus of the survey was to have a better understanding of adverse events in hospitals since about 47 million Americans are enrolled in Medicare, a government health insurance program for people age 65 and older.

Peter Pronovost of Johns Hopkins University, is a leading advocate for reducing hospital errors, and was quoted in the article as saying, “We spend two pennies trying to deliver safe health care for every dollar we spent trying to develop new genes and new drugs. We have to invest in the science of health care delivery.” Not much progress has been made in health care delivery since a 1999 study by the Institute of Medicine on medical errors found that about 98,000 patients die a year from medical mistakes, including medication errors, infections, and under-diagnosis.

If you or a loved one has suffered needlessly from the effects of a medical or medication error by your physician, the Florida medical malpractice attorneys at Farah & Farah are available to talk with you about your legal rights.

In the early 1980s, Dr. Thomas Graboys, a doctor at Harvard Medical School, was highly sought out for second options by patients across the United States who had been told they needed to undergo bypass surgery because they had a high risk of suffering a heart attack. Graboys often cited a study done by the National Heart, Lung and Blood Institute, which followed patients for five years who were experiencing blood vessels to the heart narrowing. The study found that in most cases, medical therapy was just as effective as surgical therapy.

Graboys also conducted a study of his own, reviewing the medical records of 100 high-risk heart disease patients who were candidates for bypass surgery, but he believed surgery was unnecessary. He found that 76 decided to forgo the surgery; and 18 months later, 75 were alive. Of the 24 patients who decided to have surgery, after 18 months, two had died. While statistically these results are essentially the same, it does show that bypass surgery isn’t right for everyone.

A 1985 article in Health Letter, a publication of Public Citizen, found that between 1971 and 1978, bypass operations performed on men 65 and older rose by an alarming 955 percent. The bypass rate for younger people also rose sharply. In 1985, with bypass surgeries costing about $20,000, Graboys estimated that for every 100 patients who decided, based on a second opinion, to forgo or delay a coronary artery bypass, approximately $1.4 million could be saved in medical expenses.

Many patients aren’t aware that bypass surgery isn’t a cure-all for coronary artery disease. In the surgery, a graft is inserted to be used as a detour around a blocked artery. The graft can narrow over time and require patients to undergo a second operation years later.

The article in Health Letter notes that complication and mortality rates from bypass surgery are low, but not zero. There is a small risk associated with the procedure, such as the risk of heart attack, the risk of dying from the surgery, as well as the risk of post-operative problems occurring, such as infection or stroke. The article also notes that elderly people are at a far greater risk as well. Thus, the conclusion is reached that it is in fact a good idea to “think twice” before undergoing bypass surgery, as fewer deaths could occur and millions if not billions of dollars could be saved if more patients sought second opinions before undergoing surgery.

If your doctor has recommended bypass surgery or another extensive procedure for you, it is a good idea to consult another physician for a second opinion. Ask a local medical school or medical societies which doctors they recommend to treat your injury or illness. Doing so could save you money in the future, even if you have to pay the cost of a second opinion out of pocket if your insurance won’t cover it. If you discover the procedure isn’t necessary, you will not only be spared expenses associated with the operation but the additional risks of unnecessary surgery.

During the past year, there have been embarrassing stories coming out of universities, some of them Ivy League, about medical doctors who are paid consultants for major pharmaceutical companies.

An article on Boston.com stated that Sen. Charles Grassley of Iowa has uncovered many conflicts between academia and business, and Harvard and Emory physicians have reportedly broken the university rules for reporting the amount of money they have collected from Big Pharma. In some cases, the medical doctor is not just a spokesman for the company at gatherings of other doctors, but promotes the drug to patients, raising all kinds of ethical questions about conflict-of-interest.

Now Harvard University wants to tackle the bad public relations. Harvard Medical School has announced that its 11,000 faculty cannot take personal gifts, travel, and meals at ritzy spas and hotels in exchange for giving promotional talks on behalf of drug and medical device makers.

The university is taking a leadership position so that its image is not tarnished and Harvard is not used to market products. The new policy also requires university personnel to report any payment of at least $5,000. And Harvard says that a firewall will be erected concerning continuing education, often sponsored by industry.

Some doctors will find they make a lot less money at the end of the year. But others welcome not being perceived as salesmen for huge drug and device companies.

Doctors will still be allowed to conduct industry-sponsored research and even sit on the board of a drug or device maker. The bottom line is the patient should come first, not the latest drug or device. To promote a drug that later turns out to be dangerous while taking payments from the drug company, could be perceived as medical malpractice.

It has been understood for a long time that a tired doctor-in-training is not a good doctor.

A 2004 study found that medical residents in their first year who were forced to work around-the-clock every third night, were responsible for more than half of preventable medical errors, according to an article in the Wall Street Journal.

After that study, resident hours were limited to 80 per week, down from 120 hours in one week, according to the Accreditation Council for Graduate Medical Education (ACGME), which certifies residency programs.

Now there is another plan from ACGME, published in the New England Journal of Medicine, that the public has 45 days to comment on before the new guidelines go into effect, if approved by the board, in July 2011.

The plan suggests that first-year residents limit their shifts to 16 hours. Second-year residents would be allowed to work continuously up to 24 hours. They can stay an additional four hours to hand patients off to another doctor. The only limit now is a 30 hour shift. Young doctors will also be required to have more direct supervision by experienced doctors in hopes of catching medical errors.

While this sounds like a win-win for the patient, medical institutions estimate fewer work hours from staff will increase costs to each institution of up to $15,000.

That is a bargain when you consider the cost of a Jacksonville medical malpractice lawsuit.

Studies show 98,000 patients die every year as the result of medical errors. What exactly is the cost of a life? If you have been injured by a doctor or suspect a medical error has occurred, you have a time limit within to bring an action. An experienced Florida medical malpractice attorney will always conduct a comprehensive review of your situation.

No matter what their specialty, doctors responding to a published survey say that liability worries lead them to order unnecessary tests and procedures to protect themselves against malpractice lawsuits, a Wall Street Journal article reported.

Published in the Archives of Internal Medicine, among the 1,231 doctors who responded, 91% reported “believing that physicians order more tests and procedures than needed to protect themselves from malpractice suits.”

It didn’t matter whether they were generalists (91%), medical specialists (89%), surgeons (93%), or other specialists (94%). In fact, the only difference in response was seen between men (93%) who agreed with the statement, and women (87%) who agreed.

The majority of respondents believe that in order for doctors to reduce unnecessary tests, there would need to be some type of protection against “unwarranted” medical malpractice lawsuits. The defendant, or medical doctor or hospital, generally consider any type of malpractice lawsuit “unwarranted,” even if it involves medical error.

This is exactly what they have in Michigan, where pharmaceutical companies cannot be sued for defective drugs. Nationwide, medical device makers enjoy a shield from liability from injuries by defective devices thanks to the Riegel decision by the U.S. Supreme Court.

With an estimated 100,000 medical errors occurring every year from failing to diagnose, medication errors, doctor or nurse mistakes, the medical profession might be more concerned with reducing injury to patients than shielding itself from liability, which costs about $30 billion annually.

The nationwide effort to reduce the cost of medicine may be stymied by physicians’ fears of malpractice lawsuits unless they receive some type of shield from liability. Until that happens they will continue to order expensive tests that may not be necessary, which is a concern for Florida medical malpractice attorneys. Some might even consider that insurance fraud.

We’ve come to think of them as a routine way to deliver babies, but C-sections or cesarean sections are a major surgery where a doctor cuts through a woman’s abdomen and uterus to deliver a baby. The woman must remain in the hospital for awhile as she tries to get out of bed to walk, which at first, is extremely painful. Estimates say that up to one-third of New York C-sections are unnecessary.

The rate of cesarean sections is increasing annually – from over 10% in 1975 to the highest rate ever in 2007 – 31.8%. Besides the danger of major surgery to women, a government study from 1999 to 2002 finds an increase in neonatal mortality of 69% following C-section births compared to vaginal delivery. That translated to 17,000 infant deaths in the U.S.

The Health Research Group at Public Citizen is alarmed at the trend and is encouraging women not to put themselves through unnecessary surgery and risk potential birth injury, unless there is an emergency.

In an article in Public Citizen News, the authors say that doctors should encourage VBACS’s or a vaginal birth after C-section. Traditionally it was thought that, once a C-section, always a C-section, out of fear of a ruptured uterus, but the American College of Obstetrics and Gynecology revised those guidelines six years ago. In fact, some hospitals believe a VBAC is safer than enduring more C-sections.

Dr. Sidney Wolfe of Public Citizen encourages the use of midwives for low-risk woman. Midwives can deliver in a hospital or at home and are less likely to turn to surgical intervention.

A doula, or labor support professional, is also someone who will advocate for the patient and deter unnecessary C-sections, says Wolfe. And in the old adage, follow the money trail – doctors make more money when they perform a C-section, and they take less time.

According to Health News Florida, the American Academy of Pediatric Dentistry says that sedation for children in the dental chair is safe. But if curious consumers ask questions, the AAPD has also sent memos to its members telling them how to answer questions.

Those questions might arise after four deaths of children in the dental chair. Three deaths have occurred in Florida. In 2006, Dasia Washington, 10, from Pompano Beach made the headlines. Two dentists lost their careers. She had been given nitrous oxide, lidocaine, and epinephrine and was strapped to a board to keep her still. But Washington thrashed about. Her death was blamed by a lack of oxygen. She had asthma and head and facial deformities that caused her breathing problems. The dentists say they didn’t do anything wrong. More recently, Dylan Stewart of Cedar Key, 5 died in April and Cory Moore, 9, of Tampa died in February 2009 after sedation or anesthesia in the dental chair.

The memo provided by Health News Florida, says dentists are supposed to say: “The health, safety and welfare of children is a top priority…Our deepest condolences go out to the family … (and) Deaths due to sedation and/or anesthesia are extremely rare…”

Rare makes no difference when it’s your child. The professional Academy says that pediatric sedation is safe but can product complications if the drugs interact with other medications or if there are underlying medical conditions. There are no national statistics kept on pediatric dental chair deaths. Though thought to be very rare, nobody knows for sure. If you or a loved one has experienced an adverse event at the dentist (besides tooth pain) and sedation or anesthesia was used you will want to know if the practitioner was appropriately trained. Experienced Jacksonville medical malpractice attorneys conduct thorough investigations into serious injury and fatal medical professional errors to ensure that an injured victim’s rights are protected.

Helen Haskell founded the patient advocacy group, Mothers Against Medical Error, after her son died from a preventable hospital failure.

Lewis Haskell was 15 and entered the hospital in 2000 for routine surgery. His doctor, a first-year medical resident had been on duty for more than 30 hours when the teen died. She had failed to rescue or respond to signs of decline in the patient’s health. His mother knows that fatigue played a role. Medical residents must work 30 hour shift as often as three times a month and that leads to errors.

A Harvard study from 2006 finds that 20 percent of first-year-residents say they’ve made a fatigue-related mistake. In some cases it has led to patient’s death. What can be done?

Haskell’s group along with Public Citizen is advocating lowering the number of hours a doctor works in one shift. It makes sense? How many pilots worth 25 to 30 hours at a time? The group has a Web site www.WakeUpDoctor.org where the public can share stories and get more information. The main resistance comes from the organization that sets standards for the training of physicians, The Accreditation Council on Graduate Medical Education (ACGME). In the past, it has convinced the Occupational Safety and Health Administration or OSHA to leave the shift lengths alone. By this July, the ACGME will make a decision about limiting work hours for residents working at member hospitals.

Medical malpractice in Florida and throughout the United States can involve a host of mistakes – from over medicating to under-diagnosing and wrong-site surgeries. Occasionally medical devices are left in patients that can cause months, even years of mysterious complications, even death.

Now a medical device company has a new way to search for objects unintentionally left behind in patients during surgery. Made by RF Surgical Systems of Bellevue, Washington, the RF Surgical Detection System uses a wand to scan for any device remaining in a patient, no matter what its size or consistency. That could include something as small as a grain of rice or discarded gauze and sponges. The wand is used over the patient before they are closed up, relieving medical personnel of doing an actual count of devices, sponges, and gauze.

The best guess as to how often that happens is about one incident in 8,801 cases up to 18,760, according to researchers who published a report in the New England Journal of Medicine. The researchers based their conclusion on medical malpractice claims, which could mean that they are grossly underestimated since only about one in eight who are injured by medical malpractice ever file a claim. More than 100 hospitals are reportedly using the system, at a cost of about $15 per surgery. Patients may well want to add whether a hospital is using the wand before scheduling surgery.

Source:http://www.chicagotribune.com/health/sc-health-0217-sponges,0,3903380.story

Along with the national agencies that regulate auto product liability, smaller local partners also keep an eye on automobile safety standards. One such local agency is the Automotive Product Liability Resource Center (APLRC.com), located in sunny Santa Barbara, CA.

The goal of APLRC.com is to persuade the automobile manufacturers that it is more cost-efficient to manufacture safer automobiles than to pay the high costs of product liability litigation. To that end, the agency serves as a nationwide collaboration of attorneys, experts and victims to increase successful plaintiff verdicts in automobile safety lawsuits.

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