Articles Posted in Medical Error

aanningA conscience-stricken surgeon in South Dakota has publicly confirmed one of the great frustrations for patients pursuing medical malpractice claims after they have been harmed: He says doctors are too willing to lie in court to protect themselves and colleagues, as he did two decades ago in a case involving a partner in his practice.

Dr. Lars Aanning says he no longer could live with his lie. Because he is 77, retired, and cannot be subject to colleagues’ retribution, he decided to ‘fess up, and to help attorneys who represent injured patients. Aanning says he does not know whether his false testimony was decisive in his partner’s lawsuit. But he confesses that he knew his colleague’s patient had suffered because of the treatment this stroke victim received. He also had had doubts before about his partner’s work.

He tells a reporter for Pro Publica, the Pulitzer Prize-winning online investigative site, that he knew at the moment he uttered his untruths that his lying flew in the face of everything he thought he stood for. But he says, “I did it as a matter of course. And I did it because there was a cultural attitude I was immersed in: You viewed all attorneys as a threat and anything that you did was OK to thwart their efforts to sue your colleagues. I just accepted that as normal. It wasn’t like, ‘I’m going to lie. It was, ‘I’m going to support my colleague.’ ”

ICUThe spots in hospitals where patients in the direst shape receive specialized treatment are themselves in need of urgent care, experts say, explaining that antiquated intensive care units (ICUs)

contribute to needless harm. But how exactly to yank them and the therapies they provide into the 21st century?

Usha Lee McFarling, a Pulitzer Prize winner, examines ICU reforms for the online health news site Stat, finding that these crucial and “heroic” hospital facilities fundamentally have changed little in a half century, although they now are jammed with new technology and devices. They serve almost 6 million Americans in grave condition, but in them, she says, “studies show serious and sometimes fatal medical errors are routine. And a recent review published in the journal Critical Care found no major advances in ICU care since the field’s inception in the 1960s.”

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.

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