Articles Posted in Medical Error

Ron Schwarz, 79, says he has hardly been able to eat since being admitted to the hospital. (Heidi de Marco/KHN)

Ron Schwarz, 79, says he has hardly been able to eat since being admitted to the hospital. (Heidi de Marco/KHN)

Although America grows grayer by the day, the care that elderly patients get at all too many hospitals after they’re admitted leaves them worse off when they are discharged, the Kaiser Health News service finds in a devastating report.

Kudos to writer Anna Gorman who puts together published studies and tough reporting to detail that, “About one-third of patients over 70 years old and more than half of patients over 85 leave the hospital more disabled than when they arrived. As a result, many seniors are unable to care for themselves after discharge and need assistance with daily activities such as bathing, dressing or even walking.”

barcode-b4d283303a1a8ec1667da9a9cf3325b8They may seem like a cryptic pile of digits on devices that most of us might never see but will have in us, sometimes in life-saving fashion. But “unique identification numbers,” emblazoned on everything from hip implants to pacemakers, may offer a ne safety check on a burgeoning aspect of health care. They also have gotten a major boost from the federal Medicare agency.

The Wall Street Journal has reported that the agency, after years of resistance, has agreed with the federal Food and Drug Administration and patient safety advocates that the makers of medical devices should put the identifying numbers on their products, and that this information also should be recorded in patient records, particularly the new electronic versions. To be sure, this is one  step in a long regulatory process.

But experts say it could be a big advance, allowing them to better detect flawed equipment, bad processes or practices, and other situations involving medical devices and harming patients’ health and safety. Some regulators and advocates for the device makers had fought this step for some time now. They contend that it adds to costs, and it hasn’t yet demonstrated a return for the investment.

bmi2Medical errors claim the lives of roughly 685 Americans per day─ more people than die of respiratory disease, accidents, stroke and Alzheimer’s. That estimate comes from a team of researchers led by a professor of surgery at Johns Hopkins. It means  medical errors rank as the third leading cause of death in the U.S., behind only heart disease and cancer.

In a new study published in the British Medical Journal, they define medical error broadly as:

[A]n unintended act (either of omission or commission) or one that does not achieve its intended outcome, the failure of a planned action to be completed as intended (an error of execution), the use of a wrong plan to achieve an aim (an error of planning), or a deviation from the process of care that may or may not cause harm to the patient.  Patient harm from medical error can occur at the individual or system level. …We focus on preventable lethal events to highlight the scale of potential for improvement. The role of error can be complex. While many errors are non-consequential, an error can end the life of someone with a long life expectancy or accelerate an imminent death.

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.

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