Articles Posted in Medical Error

Computerized_physician_order_entryThe United States has spent billions of dollars to try to slash medical errors, the third highest cause of death in the nation. But computerized systems that allow physicians to enter their drug orders−a key tool in the fight against one of the most common cause of medical errors−aren’t yet stopping as many problem prescriptions as they need to, says a nonprofit organization that rates hospitals’ safety.

The Leapfrog Group, with the help of outside information technology experts, surveyed 1,800 hospitals nationwide, asking them about their systems, and testing them with dummy orders for fictional patients to see if they caught errors.

The good news: 96 percent of the hospitals said they now have digitized prescription ordering systems in place, and working to some degree.

CR-TOC-Cover-05-2016California leads the nation in its number of practicing physicians─and some of those doctors are so awful they’re dangerous, Consumer Reports has found in its deep dive into state licensing boards and MD discipline. The magazine, in a cover story headlined “What you don’t know about your doctor could hurt you,” compiles some ghastly illustrations of bad doctors, including:

  • A pediatrician with a fetish who fondled the feet of patients’ moms during exams;
  • An ob-gyn who surgically removed the wrong ovary from a patient;

For-profit clinics that market to patients with eating disorders or alcohol or drug abuse problems have grown in popularity in recent years. They can be pricey, but their operators insist the residential facilities offer expertise, attentive, needed, and specialized care that hospitals and medical centers cannot. But as the centers have proliferated, health care experts are expressing growing concern about their costs, safety, effectiveness, and marketing.

And now local prosecutors have stepped in, asserting in what may be a landmark case, that a California addiction treatment center is guilty of a patient’s negligent homicide.

The case in Riverside County involves an ailing 53-year-old, longtime smoker and alcohol abuser who sought detox care at one of the 1,500 addiction treatment centers just in the Golden State.

What does it take to make hospitals safer so patients aren’t harmed? Big stuff and small, some of it surprising─and all of it mattering a lot. For instance:

  • Getting caregivers to wash their hands. It’s the top cause of debilitating and sometimes deadly hospital-acquired infections. Some institutions empower nurses to police and remind dirty doctors; some install video cameras to catch scofflaws; others run frequent and largely successful ─for awhile─ publicity campaigns.
  • Paying extra attention to hygiene with procedures, often considered routine, that break the skin, even a little bit. This has paid off in big reductions in some hospitals in infections linked to catheters put in veins and arteries, especially the central line (for IVs).

Let the patient beware is an adage that may need to be extended to yet another realm of healthcare: dentistry. Kudos to a reporting team in Texas for their recently published investigation, disclosing that dentists all too frequently are involved in procedures in which their patients die and that ineffectual regulators fail to halt dodgy practices and feckless practitioners, some of whom hopscotch across the country with impunity.

The seven-part Dallas Morning News series finds that at least 1,000 dental patients have died in the last five years due to questionable oral healthcare. The report says the numbers may be greater but that regulatory laissez-faire prevents the public from understanding the severity of the issue.

Patients who go to dental practices for issues as minor as tooth decay and as significant as oral surgery all have ended up dead, often after undergoing poorly supervised anesthesia, the paper says.

cjdTo hear many in the health care professions and tort reform advocates tell it, malpractice litigation represents one of the great scourges of modern medicine, racking up costly and time-consuming verdicts, clogging the civil justice system, and leading caregivers to wasteful defensive practices, including over-testing and over-medicating.

Bah, humbug, to such myths, The Center for Justice & Democracy at New York Law School has replied in its fifth annual Medical Malpractice by the Numbers briefing book.

The latest work, which is available online for free (click on the previous link and follow to the end of the document for a download hyperlink) provides concise, relevant references in 128 pages of carefully footnoted citations to factual research on medical malpractice, including these salient findings:

The Centers for Disease Control and Prevention offers but one voice among many that has declared that the United States is in the midst of a prescription drug abuse epidemic. As the CDC notes: “Since 1999, the amount of prescription painkillers prescribed and sold in the U.S. has nearly quadrupled, yet there has not been an overall change in the amount of pain that Americans report. Overprescribing leads to more abuse and more overdose deaths.” Indeed, the agency says 44 Americans die daily due to prescription painkiller overdoses.

Those grim statistics provide a stark context for a startling Los Angeles case: Prosecutors have won a second-degree murder conviction against a female physician from the suburb of Rowland Heights for her role in the overdose deaths of three of her patients. The Los Angeles Times said this was one of a handful of instances in which a physician has been prosecuted on homicide charges for prescribing painkillers that led to a patient’s death.

The paper quoted experts who raised concerns as to whether the case would send a chill through the medical community, with doctors growing more sparing of powerful painkillers for patients who need them; others said that the physician involved had been reckless in her prescribing, had seen a patient overdose in her office but continued to write scripts for him, and had received multiple calls from authorities warning her that her patients had died with drugs she had prescribed in their systems.

The “say what?” study last month describing the disturbing frequency of errors in medical diagnoses has prompted much navel-gazing in many quarters.

One story, in KaiserHealthNews.org (KHN), quoted Leslie Michelson, who heads Private Health Management, a company that charges substantial fees for helping patients figure out what’s wrong with them, as saying he wasn’t surprised.

Too often his company has found that its clients don’t have the condition originally diagnosed; sometimes, the diagnosis is correct, but the treatment is not.

If any work places should be distraction-free, a short list would include the command post for launching nuclear arms, the control tower of a busy airport and the operating room. We have no information about the first two, but a recent study shows that the people working in the surgical suite might be monitoring their smartphones instead of monitoring you.

As KaiserHealthNews.org (KHN) and the Washington Post reported, “Cellphone use is not generally restricted in the operating room, but some experts say the time for rules has come. In interviews, many described co-workers’ texting friends and relatives from the surgical suite. Some spoke of colleagues who hide a phone in a drawer and check it when they think no one is watching.”

Sometimes a member of the surgical team might be reviewing pertinent medical data on the device, but too often, they’re being used for decidedly nonmedical purposes. As Dwight Burney, an orthopedic surgeon, told KHN/Post, “Sometimes it’s just stuff like shopping online or checking Facebook. The problem is that it does lead to distraction.”

Patients who suspect malpractice after they’ve had an unforeseen injury from a surgical procedure quickly learn that the operating room works on a basic “honor system” for reporting errors. If something goes wrong, the surgeon is required to describe the event in his or her dictated report of the operation. Of course, that lets the surgeon control what gets put on paper.

Now there is a budding movement to have cameras in operating rooms record what happens and save the recordings for possible use later — both to educate professionals and as potential legal evidence.

The Washington Post has an article describing a bill introduced in the Wisconsin legislature to require such recordings. The man behind the move is the brother of a patient who died from too much propofol, the same anesthetic drug that killed Michael Jackson.

Patrick Malone & Associates, P.C. listed in Best Lawyers Rated by Super Lawyers Patrick A. Malone
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