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Small reforms that can significantly improve patient safety in the hospital — part 1

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On behalf of of Kahn Gordon Timko & Rodriques P.C. posted in Medical Malpractice on Thursday, October 4th, 2012

The injuries and deaths that occur accidentally in hospitals seldom make headlines. Contrast that with the media coverage of an airplane crash. Even a near miss receives significant air time and numerous printed pages. Not only do the majority of medial mistakes go unreported, but hospital personnel seem not to learn from them. The same preventable mistakes occur over and over again. Moreover, patients are seldom able to learn which hospitals have better or worse safety records than others in the same categories.

The problem of compromised safety in hospitals is significant. Surgeons in the U.S. operate on the wrong body parts as often as 40 times each week. About a quarter of all hospitalized patients will be injured in some way by a medical error. To put it another way, if medical errors were a disease, it would be the sixth leading cause of death in the United States – just ahead of Alzheimer’s and behind accidents.

However, hospitals are seldom accountable for errors. Very few publish statistics on outcomes, making it almost impossible for patients to choose a hospital systematically when they need one. As a result, patients select hospitals based on factors such as available parking, closeness and neighbour or relative report.

This does not have to be the case. The next blog post will describe five reforms that hospitals can make to keep patients safer – creating online dashboards, publishing safety culture scores, videotaping common procedures such as colonoscopies, making sure that patients have access to physician notes and are empowered to correct them, and removal of patient gag orders that prevent people from speaking out about poor care.

Source: Wall Street Journal, “How to stop hospitals from killing us,” Sep. 21, 2012.

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Some New York hospitals ban recording child birth

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On behalf of of Kahn Gordon Timko & Rodriques P.C. posted in Medical Malpractice on Friday, February 4th, 2011

Parents have been recording their children’s lives since the inception of technology. However, with the growing abilities of technology and the rise of successful medical malpractice lawsuits, hospitals are rethinking their policies. Up to this point, many health care professionals allowed recording the birth process because video cameras could be used without being in the way.

Many hospitals in New York are now changing the rules regarding recording devices allowed in the delivery room. In many places, cell phones and video cameras must be turned off, and pictures and videos are only allowed once the baby has been safely delivered. The hospital says their intent is not to limit the rights of new parents; rather, they are interested in protecting the rights of their staff, especially in lieu of recent medical malpractice lawsuits.

Video of a child’s birth introduces a wild card if it is presented to juries. What may have previously been a “he said, she said” argument between the parents and the hospital may now be recorded. Jury can witness first-hand how nurses and doctors responded to parents’ concerns or emergencies. Some hospitals attribute their ban on recording devices on the doctors’ need to focus. When there are flashing cameras or extra bodies moving around the room, it gets harder to concentrate.

Other hospitals have taken a more proactive approach, and they simulate the situation by recording their practice operations. One such doctor encouraged patients to record everything, stating that his goal is to be as transparent as possible. “If something goes wrong, we try to explain immediately what happened. A video is not inconsistent with the goal of trying to be transparent.” Everyone hopes their doctors will be so forthcoming, especially if mistakes lead to a birth injury lawsuit.

Source: The New York Times, “Cameras, and Rules Against Them, Stir Passions in Delivery Rooms,” Katharine Q. Seelye, 2 February 2011

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Medical Tube Errors Yet Another Example of Preventable Mix-ups

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On behalf of of Kahn Gordon Timko & Rodriques P.C. posted in Medical Malpractice on Friday, September 3rd, 2010

Say you go in to the hospital for treatment that requires you to use a feeding tube. However, the nurse administering it accidentally hooks up your liquid-food bag to a tube feeding into a vein. As Gardiner Harris reports in The New York Times, feeding such food into the bloodstream is like “pouring concrete down a drain.”

This happens, but no one knows for sure how often. The woman in Harris’ story passed away following the nurse’s mistake.

It is estimated that hundreds of deaths and serious injuries occur due to tube errors at hospitals. There is no specific number on hand because, for the most part, these errors are not reported. It could very well be much more common.

While no hard numbers are readily available, a 2006 study did report that 16 percent of hospitals admitted to feeding tube mix-ups. Even more concerning is the fact that this is not even close to a new problem.

For the past 14 years, advocates for safer hospitals have pushed to have tubes serving different needs (e.g. tubes delivering food to the stomach and tubes delivering medicine to the bloodstream) be incompatible with one another, to wit, impossible to confuse.

However, medical device manufacturers have resisted any sort of change to an already profitable endeavor and the Food and Drug Administration has dragged its feet through the approval process.

Meanwhile, hospital patients continue to suffer injury or worse as a result of hospital negligence.

Source Article

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The Push for Accountability Regarding Hospital-Acquired Infections

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On behalf of of Kahn Gordon Timko & Rodriques P.C. posted in Medical Malpractice on Friday, August 27th, 2010

Every year, 80,000 hospital patients develop catheter-related bloodstream infections (CRBSIs). Of those affected, nearly 40 percent – or 30,000 – die as a result. Catheters are often used to monitor the flow of blood in a patient or distribute much-needed medication and nutrients.

CRBSIs account for close to a third of all hospital-acquired infection deaths in the United States, according to The Washington Post. They also cost millions of dollars in healthcare spending.

Some of the most common causes for these infections are catheters that are improperly prepared by hospital staff or those that are left inside patients too long. The Post also reports five, seemingly common sense, steps that hospital staff could take to “all but eliminate” these infections.

  1. Wash your hands
  2. Clean the patient’s skin with an effective antiseptic
  3. Put sterile drapes over the patient
  4. Wear sterile protective gear – mask, hat, gown and gloves
  5. Use a sterile dressing on the catheter site

Amazingly, many of these steps seem to be ignored.

That’s why 21 states have adopted regulations for hospital-acquired infection reporting in the past five years, bringing the total to 27. As the statistics roll in, it becomes clearer and clearer that these infections are not just killing patients, but costing the United States millions of dollars.

In 2005, only six states required such reporting from hospitals and nursing homes. That means that reporting and prevention measures, to a large degree, were handled by the hospitals or homes themselves.

Obviously, the system wasn’t working.

Researchers at Johns Hopkins University School of Medicine estimate that setting up an infection-control program costs about $3,000 per prevented infection. The cost if an infection develops usually falls in the neighborhood of $33,000.

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To Cut Healthcare Costs, Cut Hospital Negligence and Medical Error

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On behalf of of Kahn Gordon Timko & Rodriques P.C. posted in Medical Malpractice on Wednesday, August 11th, 2010

In 2008, close to $80 billion was spent on medical injuries and costs related to them. Of this, $19.5 billion was spent on preventable medical errors. These numbers are from a study commissioned by the U.S. Society of Actuaries (SOA), a group of highly-intelligent individuals used to looking at the big picture and diagnosing problems and opportunities.

Both the picture and the problem are big in this case, as healthcare costs in the United States skyrocket. More often than not, medical malpractice reward caps are brought up as a solution to healthcare affordability. Malpractice lawyers are painted as greedy and injured patients are usually just looked over completely.

Still, in 2008, the economy absorbed nearly $20 billion in additional costs due to hospital negligence, medical malpractice and practitioner error.

55 percent of these medical injuries involved at least one of five things.

  • Bedsores and pressure ulcers, usually the result of a failure to properly monitor a bedridden patient
  • Infections acquired after an operation has been performed
  • Mechanical complications arising from medical devices, implants and grafts
  • Postlaminectomy syndrome, often occurring after spinal surgery to relieve a pinched nerve
  • Hemorrhaging during surgery or another medical procedure

There certainly is no one solution to America’s healthcare crisis, but any solution must start from the willingness to consider all options. Instead of penalizing the victims of medical malpractice, the field needs to take a hard look at its own shortcomings and consider ways to address them.

Related Resource

  • Society of Actuaries Study Finds Medical Errors Annually Cost at Least $19.5 Billion Nationwide (Press Release)

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40 Percent of Doctors Would Rather Not Report Negligence or Error

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On behalf of of Kahn Gordon Timko & Rodriques P.C. posted in Medical Malpractice on Wednesday, July 28th, 2010

A mere 64 percent of U.S. physicians feel that it is completely necessary to report instances of negligence and ineptitude among their colleagues. This was the main takeaway from a recent survey conducted among nearly 2000 physicians, in seven specialty areas, across the country.

Researchers were quick to point out that, as with most surveys, the results may speak to more than the simple numbers. Negligence is certainly a hazy area in some instances and, when it comes down to one doctor and another, could be taken as a simple difference in opinion.

Even so, the fact that almost 40 percent of physicians felt that it was not their job to “report all instances of significantly impaired or incompetent colleagues to their professional society, hospital, clinic, and/or other relevant authority” should be shocking and embarrassing for the medical community.

How many cases of medical malpractice might be avoid if physicians took a more active role in ensuring the safety of their hospital or clinic?

In the study, 17 percent of physicians said that they had firsthand experience or otherwise direct knowledge of incompetent or impaired colleagues. More than 30 percent of these physicians had not reported their peers, most claiming that they believed someone else would take care of it.

Others claimed that they did not believe anything would happen with the report anyway and feared retaliation from other members of the hospital staff.

Especially at a time when physicians are bonding together over the support of medical malpractice caps, it seems like they might do more to ensure that these malpractice cases are not occurring to begin with.

Kudos to those physicians with a vested interest in their environment and the safety of the place where they work, but if this study is at all accurate, there is still a long way to go.

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