Articles Posted in Medical Malpractice

Any surgery has risks, even those we think of as routine. We often don’t think twice about scheduling some procedures for our children because they are so common they seem to be harmless; and, of course, the vast majority of us would never knowingly subject our children to harm. But even “routine” surgeries can have complications, as these recent news reports show.

South Carolina Surgery Mistakes
A 13-year-old girl in California was declared brain dead three days after undergoing a routine tonsil removal surgery in December 2013. The child’s physician recommended the surgery because she suffered from sleep apnea. During the patient’s recovery, she experienced excessive bleeding and trouble breathing, went into cardiac arrest and was declared brain dead. Whether or not she will remain on life support is a continuing issue before the courts.

Tonsillectomy is the most common surgical procedure in children. More than half a million tonsillectomies are performed in the United States each year. According to The Journal of Family Practice, mortality rates for the operation range from 1 in 10,000 to 1 in 35,000. The most common complication is postoperative bleeding, which usually occurs within the first 24 hours after surgery. About 1 in 200 patients is returned to the OR so that bleeding can be controlled. Other complications can include pain, nausea and vomiting. Many tonsillectomies are performed on an outpatient basis, but the Journal recommends that patients with sleep apnea, coagulation disorders, or other underlying diseases, and anyone younger than 4 years of age or living a long distance from the hospital should be admitted for overnight observation.

Blood infections in newborn babies in South Carolina were reduced by up to 58 percent in hospitals where intensive care workers used safety checklists, a new study shows.

The checklists covered the steps to be taken when blood catheters were inserted in an infant’s vein or artery. If the procedure is not done properly, the infant risks getting a bloodstream infection that can result in serious accidental injury or death.

Simply by using the checklists – and communicating more effectively with each other – workers in neonatal ICUs were able to prevent an estimated 131 newborn infections and 41 deaths.

According to a new report from the National Institutes of Health, whether someone treated for heart failure ends up being readmitted to a hospital is more closely tied to income level and community than to how sick they are or how well a hospital treats patients.

The research, which was presented to the American Heart Association, shows that the percentage of patients who are readmitted because of heart failure varies by region. Some regions had rates as low as 10 percent, and others were as high as 32 percent.

After studying records from over 3,000 hospitals and 1 million patients, researchers found that the availability of doctors or hospital beds, a patient’s income level and their ethnicity were more strongly connected to higher rates of readmission than any other factors–including how sick a patient was or how well the hospital cared for patients.

It seems the saying “location, location, location” may be important to remember in more contexts than real estate, according to the findings of a few recent health studies. One of the most significant studies focused on survival rates for heart attacks across the U.S.

The study, led by researchers at Yale University, looked at more than 500 hospitals across the country and compared hospital policies and practices with patient survival rates. Researchers found that survival rates doubled at hospitals which shared five common practices.

These practices centered largely on staffing and staff communication, with things like better teamwork among doctors and nurses or monthly meetings between paramedics and doctors positively impacting patients’ likelihood of surviving heart attacks. Unfortunately, according to their findings, fewer than 10 percent of the hospitals used even four of the five life-saving practices.

A recent study that looked at more than 19,000 operations found that the costs of medical care in the U.S. aren’t at all uniform–for example, you could be charged anywhere from $1,500 to $180,000 for the same type of surgery.

The study, carried out by researchers in California, compared the costs of treating appendicitis–which involves removing a person’s appendix through a surgical procedure called an “appendectomy.” The researchers looked at the cases of people between the ages of 18 and 59 who were hospitalized for three days or less and whose cases were classified as “uncomplicated..

The average bill for treatment was about $34,000, but researchers also came across a bill that totaled $182,955. Some of the differences in billing, the study found, happen because of the kind of hospital (public or for-profit, etc.) and how ill the patient is. For example, public hospitals tended to have lower costs on their bills than for-profit hospitals, the study found.

A recent study conducted in Spain showed that almost eight percent of fatally ill patients didn’t receive necessary treatment because they were misdiagnosed. Unfortunately, these mistakes were discovered only after the patients had died, during an examination of the deceased, commonly known as an autopsy. The Spanish study looked at how often autopsy findings matched doctor diagnoses in seriously ill patients who died in intensive care units, and it found a difference in 18.5 percent of the cases — or nearly one in five.

The Spanish study should alarm American patients and doctors, since fatal misdiagnosis is not a problem unique to Spain.

A 2004 article by Dr. Kaveh G. Shojania, who works in the Department of Medicine at UC-San Francisco, discusses the dangers of misdiagnoses in seriously ill patients, and points to several factors that can lead doctors to the wrong conclusions. Dr. Shojania also points out how the reduced incidence of autopsy in the United States makes it difficult to track the rate of misdiagnosis. An example of this could be a 2003 report published in the Journal of the American Medical Association, which found that nine percent of acutely ill U.S. patients received a misdiagnosis that seriously impacted their treatment. The authors reached this figure by surveying autopsies recorded between 1966 and 2002.

A recent report about robotic drug dispensers, a kind of technology used more and more often in hospitals, found that the dispensers may be more likely to contain harmful bacteria, and be able to spread those bacteria to medications and patients.

According to the report, hospital staff in North Carolina found harmful Bacillus cereus germs during a routine test of drugs dispensed by a pharmacy robot system. The germ is not only potentially harmful to humans, it is resistant to many common disinfectants, including alcohol. Bacillus cereus is commonly associated with certain kinds of food poisoning, according to the U.S. Food and Drug Administration.

While the most common effects of Bacillus cereus infection are digestive problems or vomiting, the germ has been known to cause lung infections, gangrene, brain swelling and even death.

Controversy has accompanied recent overhauls and changes to the medical system in the United States. The switch to electronic health records (or EHRs) and other digital systems seem to be at the heart of much of the controversy.

Recent articles about the safety and security of EHRs have questioned how ready hospitals and doctors are for the switch from traditional, paper-based record keeping. Another recent study, focusing on emergency room records, showed that the more designers improved the ability of EHR software to recognize unapproved abbreviations used by doctors (for things like medications or symptoms), the more doctors used them. That increased the risk of the notes being misread by another doctor or pharmacist.

However, patient safety and security wasn’t the main concern behind a recent letter from the American Medical Association (AMA) to the Department of Health and Human Services (DHHS), urging government regulators to ease impending deadlines–and, more specifically, the financial penalties tied to them. The AMA letter, addressed to DHHS Acting Administrator Marilyn B. Tavenner, says that doctors are facing a “storm” of overlapping regulations and deadlines from government mandates.

News of dangerous bacterial infections, large Medicare fraud and other breakdowns in patient safety and care in our healthcare system haunted this year’s Patient Safety Awareness Week. Now, recent findings show, the privacy and safety of your information might be another hidden healthcare danger. Though doctors and healthcare advocates agree that digital medical records, which can capture information like a patient’s address, drug allergies and previous medical history, can help doctors and hospitals to increase the quality of care a patient receives, many also agree that the new system is far from perfect.

Weaknesses in the security and safeguarding of digital medical records are especially disturbing when combined with a push from the federal government to have hospitals and healthcare providers comply with the transition to digital record keeping. Congress provided $27 billion in the 2009 stimulus package specifically to encourage doctors and hospitals to use digital health record systems. Doctors and other providers who do not transition to digital records will face steep cuts to the amount of Medicare fees they can receive, starting in 2015. A few S.C.-based companies and universities are developing systems and technology to help the State stay current in the advance of the digital healthcare wave.

Many experts and patient advocates agree that consumers need more access to, and better understanding of, their digital medical records. Patients also need to be able to monitor their records more closely, to keep false, unclear or inappropriate information from being shared. Unfortunately, recent studies of current systems show many serious gaps in quality and ease of use. Even if a patient can see a complete medical record, which is often not the case, the records are very technical and full of jargon.

South Carolina, ranked sixth in the nation in infant mortality, has announced a new effort to reduce infant mortality by ensuring the health of mothers on Medicaid. Physicians, hospitals and state agencies will help mothers seek treatment for substance abuse, depression and domestic violence.

The program, entitled Screening, Brief Intervention and Referral to Treatment (SBIRT), provides reimbursement and a questionnaire for use with each pregnant Medicaid patient. Domestic violence victims and survivors were targeted because they have a higher murder rate and rate of drug and alcohol abuse. South Carolina is ranked 7th in the nation for domestic violence.

South Carolina suffers from historically high infant mortality rates in part due to high poverty levels. According to America’s Health Rankings, SC is 45th in children in poverty at 25.7%. Only 66.5% of mothers receive early prenatal care. Lack of adequate early prenatal care can contribute to premature births and increase death rates.