Articles Posted in Medical Error

leapfrog-300x300A familiar health care advocacy group will expand its grading of 2,000 or so hospitals across the country to also provide new safety and quality information on 5,600 stand-alone surgical centers that perform millions of procedures annually.

It may seem like a small step, and the devil will be in the details of the new data that will be voluntarily reported, analyzed, and then made public by the Leapfrog Group, a national health care nonprofit that describes itself as being “driven by employers and other purchasers of health care.”

Surgical centers have burgeoned because they can be nimbler than the hospitals and academic medical centers they now outnumber. The centers can be set up without hospitals’ high overhead costs, including for staff and equipment that may be unnecessary for a specialty practice. The facilities also can be set up closer to patients, theoretically offering them greater access and convenience, including with easy navigation and parking.

andrews-300x208Celebrities can play an out-sized role in medicine and health care: Just consider the public attention paid to Angela Jolie or Ben Stiller and their discussions about cancer screening and the disease’s risks, or Michael Phelps, Mariah Carey, and Carrie Fisher raising awareness about mental health issues, or, yes, Gwyneth Paltrow promoting a rash of wellness goop.

But even with their wealth, accomplishment, looks, and social standing, public figures also can be savaged just like ordinary folks by medical errors that harm and even kill them and their loved ones, according to the Center for Justice and Democracy.

Michael_Jackson_in_1988-169x300The group has put out a study with 22 cases, documented by lawsuits and medical board sanctions, to show that, “Celebrity is no safeguard when it comes to medical malpractice,” Emily Gottlieb, the report’s author and the center’s deputy director for law and policy, said in a statement. “As this report illustrates, patients with fame and fortune are just as likely to be horrifically injured or killed by dangerous health providers as the general public.”

abcshow-300x188Big hospitals can’t exploit patients and violate their privacy by throwing open their facilities to Hollywood for television shows that plump institutions’ reputations. And academic medical centers need to think twice before letting their leaders strike cozy deals to enrich a choice few insiders by hawking important diagnostic information collected with best intentions by medical staff from patients for decades.

The roster of hospitals dealing with black-eyes from recent negative news stories about their activities includes well-regarded institutions in Boston and New York —  Boston Medical Center, Brigham and Women’s Hospital, Massachusetts General Hospital, and Memorial Sloan-Kettering Cancer Center.

Federal regulators busted the Boston hospitals with fines settled for just under $1 million for “inviting film crews on premises to film an ABC television network documentary series, without first obtaining authorization from patients,” reported the U.S. Health and Human Services’ department’s Office of Civil Rights.

brca-cancer-risk-261x300Even as a pair of prominent researchers saw their reputations crumble over controversies connected to their work, a University of Washington team showed anew the importance of rigorous, transparent, independent, and widely shared medical science  to patients, in this case those with cancer.

Let’s start with the seemingly positive take that’s accompanying publication in the journal Nature of research regarding an open database with prospectively valuable information on BRCA1 variants, what some have dubbed the “cancer risk” gene.

Everybody carries both BRCA-1 and BRCA-2 genes, named because BR stands for breast and CA for cancer. All of us have two copies of each gene, one passed down from our mother, the other from our father. The genes make proteins that help repair errors in our DNA that pop up from time to time when our cells divide and duplicate their genetic code.  Mutations in either BRCA gene can disable the repair process and make both women and men carriers of the defect susceptible to certain kinds of cancer.

cduntsch-300x300It carries the plot line of a compelling crime story: A knife-wielding assailant works his way into exclusive institutions across a metropolis. There, time after time, he rips into  victims, inflicting great pain and suffering. He acts under the noses of people who should know better. He gets stopped only when someone in law enforcement steps beyond norms to bring him to justice. There’s even a systemic flaw that makes the drug abusing criminal’s acts more awful.

It’s painful and tragic, however, that the saga of Christopher Duntsch, aka “Dr. Death,” is all too gory, true, and potentially avoidable. It has become even more public via modern technology, an increasingly popular and free podcast by Laura Beil on the Wondery site.

Duntsch, now serving a life sentence in prison, moved from one hospital to another in Dallas, where the cancer-researcher and neurosurgeon morphed himself into a spinal surgeon. He was awful. Colleagues reported him to hospitals and medical licensing officials. They stepped in front of him in operating suites and took instruments out of his hands during surgeries. Duntsch, D magazine says, abused drugs, partied, and talked about having wild sex often before long, complex operations. There have been reports that he may intentionally have tried to maim patients. His surgeries were tied to deaths.

kprobes-300x167An innovation in medical treatment — which was supposed to offer more affordable, accessible, and even convenient care — instead may be getting swamped with safety problems that long have plagued hospitals and academic medical centers.

USA Today and Kaiser Health News Service deserve credit for digging into patients’ nightmares with specialized surgical centers, not only those performing “routine” procedures but also those handling increasingly longer, more complex, and difficult operations. The many surgeries, once the province only of big and well-staffed hospitals, put patients at risk, the newspaper reported, saying:

[Our] investigation found that surgery centers operate under such an uneven mix of rules across U.S. states that fatalities or serious injuries can result in no warning to government officials, much less to potential patients. The gaps in oversight enable centers hit with federal regulators’ toughest sanctions to keep operating, according to interviews, a review of hundreds of pages of court filings and government records obtained under open records laws. No rule stops a doctor exiled by a hospital for misconduct from opening a surgery center down the street.

krumholzIn many parts of the developing world, families play a big part in patients’ hospital care. They not only sit for long hours with loved ones, supporting and encouraging their recovery. They also may help with direct services, bathing and cleaning patients, tending to their beds and quarters, and even assisting with their medications and treatments.

Such attentiveness from loved ones— once common in this country, too —  may be deemed by many now as quaint and unnecessary, what with the rise of big, shiny, expensive American hospitals.

But think again: As Paula Span reported in her New York Times column on “The New Old Age,” care-giving institutions across the country have become such stressful, disruptive places that seniors, especially, not only heal poorly in them but also may be launched into a downward cycle of repeat admissions.

colonoscopy-300x214More than 15 million Americans each year undergo an invasive medical test, roughly once a decade and starting at age 50. If some medical experts had their way, more patients would get this cancer checkup, beginning at an even younger age. But as Emily Bazar, a senior editor and consumer columnist (Ask Emily) for the independent, nonprofit Kaiser Health News service, points out, physicians may want to heal themselves and their hygiene practices before pushing even more patients to get colonoscopies and endoscopies (procedures to examine the upper gastrointestinal tract).

That’s because a growing body of research shows that the switch by doctors, hospitals, and specialty centers to reusable scopes to peer into various parts of the body have resulted in rising infection rates among colonoscopy and endoscopy patients, among others.

Inspections show that the reused scopes don’t get cleaned properly and all the time. The more complex the medical device, the greater the risk, as clinicians and patients learned when complex and dirty duodenoscopes were tied to the deaths of 35 patients since 2013 and the sickening of dozens of others, leading to congressional investigations, lawsuits, and product recalls.

Robots are the shiny new toys of surgery in American hospitals. They promise ultra-precise, tiny cuts that give patients faster healing and better outcomes. Wherever you live, your local TV news outlets have likely run uncritical, gee-whiz stories about hospitals and surgeons bringing in these robots, featuring glowing patient testimonials.

So what’s not to like? You need to watch a new documentary airing Friday night on Netflix to get the other side of the story, and there’s plenty. And also about other medical devices that promise much but deliver more pain than benefit.

CMS-300x105As many as 2 million already ailing Americans will acquire an infection while hospitalized, with 90,000 of them dying as a result. Hospital acquired infections (HAIs) will add to the cost of an individual patient’s care anywhere from $1,000 to $50,000, while they will impose a direct hit of anywhere from $28 billion to $45 billion for institutions’ bottom lines. If HAIs seem like a problem for U.S. health care, they certainly are —  why is Uncle Sam suddenly proposing to retreat on regulations to crack down on them?

USA Today reported that patient safety advocates are sounding alarms about new rules, set to take effect in November, from the Centers for Medicare and Medicaid Services (CMS). The agency, which wields great sway over hospitals because so many patients’ medical costs are covered by Medicaid and Medicare, plans to slash the information it provides to the public on HAIs involving: “super bugs” like MRSA (methicillin-resistant Staphylococcus aureus), post-operative sepsis and surgical site infections, as well as accidents and injuries ranging from bedsores to respiratory failure after surgery.

CMS also would stop informing the public about “never events,” medical mistakes committed in hospitals and considered so ghastly that they “never” are supposed to occur.

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