Articles Posted in Medical Malpractice

After repeated state budget cuts, South Carolina hospitals recently got good news from the federal government. The federal Partnership for Patients program will give South Carolina hospitals $1 million per year for at least the next two years to improve hospital quality.

Participating hospitals must reduce readmissions by 20 percent and hospital-acquired conditions by 40 percent. Readmissions are typically used to determine hospital quality. The higher the readmission rate, the more likely the patient was not ready for discharge or was ill-prepared for discharge. Death and injury rates are higher among readmitted patients.

Hospitals will also target hospital-acquired conditions like infections, adverse drug events, catheter-associated urinary tract infections, injuries from falls, and adverse obstetrical events among others.

The bad economic environment has prompted South Carolina’s legislature to seek cuts from public programs. Eighteen hospitals will receive an 8% cut in their state funding. The hospitals have been recognized by the federal government for their treatment of the uninsured.

The cuts come at a time when the federal government is trying to reduce medical errors by investing in prevention. Health and Human Services (HHS) has pledged $1 billion to fund an initiative called Partnership for Patients.The program aims to reduce preventable injuries in hospitals by 40% and hospital readmission by 20 percent.The Centers for Medicare and Medicaid will also pledge up to $500 million to develop best practices and patient safety protocols.

HHS Secretary Kathleen Sebelius stated, “Reaching those targets would save up to $35 billion over the next 10 years. That’s a return of up to $10 for each dollar we’re investing..

In the battle against hospital acquired infections, a new tool has emerged: anti-microbial copper. Researchers, in a study funded by the US Department of Defense, installed the material on different hospital surfaces at the Medical University of South Carolina (MUSC) and two other US hospitals. The copper led to a bacteria decrease of 97% in operating rooms and a 41% decrease in hospital acquired infections.

The new technology holds strong promise for hospitals which have long struggled with hospital acquired infections. The Centers for Disease Control and Prevention (CDC) reports that one in twenty hospital patients will contract an infection from the hospital with 98,987 deaths from hospital acquired infections in 2002. The infections cost the US approximately $28.4 to $33.8 billion.

At MUSC, researchers first tested and observed the intensive care unit to determine what surfaces were most frequently touched. Bed rails, call buttons, and chairs near patients had the highest number of bacteria growth with nearly 17,000 colonies per 100 square meters. The bacteria included MRSA, a medication-resistant infection known as the “superbug.” Frequent cleaning only temporarily decreased the bacteria population. Researchers then installed the anti-microbial copper on the most-touched surfaces including over-bed tray tables, nurse call buttons, IV poles, nurses’ call devices, monitor bezels, and bed rails.

The Palmetto state barely received a “D” from the March of Dimes for the high rate of babies born prematurely. South Carolina, which received an “F” in 2010, was only 0.1% away from receiving an “F” in 2011. Of all births in South Carolina in 2011, 14.5% were premature, making the state the fifth worse in the country.

The March of Dimes, in their report on South Carolina, writes that the state is “moving in the wrong direction” on two fronts: the rate of uninsured women and late-preterm births. The number of uninsured women moved from 22% in 2010 to 24% in 2011. The report calls for expanded coverage for women of childbearing age because “health care before and during pregnancy can help identify and manage conditions that contribute to premature birth..

The rate of late-preterm births, births at 34-36 weeks, has increased slightly in South Carolina. Full-term births are 39 weeks. In 2010, the rate was 9.7%; in 2011, it is 10%. The March of Dimes links late-preterm births with early labor induction and C-sections. The organization calls on hospitals and health care professionals to increase consistency in how early induction and C-sections are treated before 39 weeks. South Carolina has tried to improve its late-preterm rates with an agreement to end early voluntary C-sections; half of SC hospitals have signed the agreement.

A South Carolina health care group has received an $11.25 million grant from the Duke Endowment to improve patient care through data collection. The group, Health Sciences South Carolina, is a statewide biomedical research collaborative composed of several hospital systems and three universities.

Dr. Iain Sanderson, Health Sciences’ chief medical informatics officer, said, “Our goal is to enable an explosion of public health research..

The grant will allow the organization to centralize and analyze information from studies across their hospitals. Researchers hope to analyze the information for clues into the effectiveness of different physician interventions.

A recent survey of U.S. physicians found that the majority (52%) believed the current level of care their patients receive is sufficient. However, media outlets and policy makers have focused on the minority (28%) who believe they are personally over-treating patients.

The report, published in the Archives of Internal Medicine, tries to argue that the fear of malpractice suits is a driver for high health care costs.

The report cites that 42% of surveyed physicians believe that patients in their practice are receiving too much care. An analysis of the figures, however, shows that only 28% believe they personally are treating patients too aggressively. An overlapping 29% believe that others– in their personal opinion–are giving too much care. The 29% figure doesn’t show a trend of over-care, but rather focuses on perception, not fact.

Forty-five hospitals in South Carolina intend to sign an agreement to end elective C-sections before the 39th week of pregnancy. Pregnancies are normally 40 weeks long. Some experts believe that a good national average for caesareans is 4.5 percent. The United States had 31 percent, or one in three deliveries via C-section, in 2007.

The rate of elective C-sections as opposed to caesareans for medical reasons appears relatively low. A 2006 survey by the Childbirth Connection found that only one of 1,600 surveyed first-time mothers elected to have a caesarean for no medical reason. Childbirth Connection argues that the increasing rate of C-section deliveries is not due to a mother’s desire, but instead from a medical and hospital culture that favors quicker births.

In South Carolina, 8 percent, or 2,500 of Medicaid-paid pregnancies, use elective C-section, according to an Associated Press article.

A physician’s assistant (PA) was found negligent in the death of a 42-year-old woman from congestive heart failure less than two months after giving birth to twins at The McDowell Hospital in Marion, NC. The lawsuit was brought by the husband who claimed the defendants did not do all they could to save the life of his wife.

The man will be awarded $667,000 in the case where he was seeking $6.8 million. The suit was filed against seven doctors, one physician’s assistant, Asheville Radiology, The McDowell Hospital and McDowell Emergency Physicians. Most of the defendants settled out of court, however, two doctors, the PA and McDowell Emergency Physicians took the case to court.

The woman was diagnosed with pneumonia after giving birth, in February, 2008, and was prescribed a medication for treatment upon her discharge. Suffering from shortness of breath and nausea, the woman returned to the emergency room several times within the following weeks and was again treated for pneumonia. She was later admitted to the hospital where she was found to have congestive heart failure. She died several weeks later after suffering a stroke.

The Des Moines Register reports that the state of Iowa has settled a lawsuit filed against the University of Iowa Hospitals and Clinics after a young girl went to the hospital in 2007 for a stomach surgery, and had to have her leg amputated after she developed compartment syndrome.
The state will pay $875,000 to the now 16-year-old girl who had her right leg amputated and her left leg now suffers a permanent foot drop. The suit alleged that the girl’s legs were elevated for over 10 hours causing increased pressure to build in her leg muscle compartments leading to muscle and nerve damage.
The hospital is overseen by the Iowa Board of Regents and the State Appeals Board had to approve the settlement.

The Good Samaritan Medical Center in West Palm Beach, Florida paid $650,000 to settle a lawsuit against a man with a “retained foreign object and medication error.” The man also reached a confidential settlement against two radiologists.

The now 68-year-old man was admitted to the hospital in October 2009 to undergo surgery for diverticulitis. His recovery was slow, and after five months he was in more pain than prior to his surgery. He went back to the doctor and had several X-rays and CT scans before the surgeon and gastrointestinal doctor found a sponge in his stomach that had been left behind during surgery.

The man declined further treatment at Good Samaritan and went to another hospital to have the sponge removed and a portion of his intestines, due to perforation. The man also received an incorrect dosage of blood pressure medicine, however, he did not have any lasting issues over that error.