Charlottesville Personal Injury Lawyer - Medical Malpractice

Database of Medical Malpractice Unavailable to the Public

Paul Thomson — Tue, 01 Dec 2009 21:13:24 GMT

Tulsa World reported that there is a national database of medical malpractice data that the public is unable to fully access. The database is maintained by the U.S. Department of Health and includes about 460,000 records of malpractice lawsuits. However, the public can only view the lawsuit's allegations and the patient's health, while the remaining information is only open to hospitals, managed care organizations, and state licensing agencies.

The American Medical Association believes the information should remain private because it is unreliable. Supposedly, data is often submitted late and some of the information is untrue or misleading. The AMA argues that it is a flawed program. However, many individuals believe that this is just a way to protect doctors. The information should be available to the public because people have a right to know if their physician has been involved in a medical malpractice claim. Medical professionals need to be held accountable and potential patients should not be kept in the dark. If the patient is able to obtain this information he or she can then question their doctor about it and make an informed decision as to whether they wish to remain under the doctor’s care.

Originally posted at InjuryBoard by Paul Thomson

Corruption in Psychiatric Healthcare

Paul Thomson — Mon, 16 Nov 2009 01:00:00 GMT

The Chicago Tribune reported startling ties between psychiatrist Dr. Michael Reinstein and pharmaceutical company AstraZeneca. The doctor, worth about a half million dollars to the drug maker, did research on the antipsychotic drug, Seroquel. Dr. Reinstein claimed his research found the best-selling drug had the pleasant side effect of decreased appetite, resulting in patient weight loss, despite the fact that Seroquel and similar drugs have been linked to weight gain and diabetes.

Communication between the two parties is even shadier than the unusual research conclusions. Dr. Reinstein, who also did promotional tours for AstraZeneca, is said to have made demands for his expenses to be covered and to have made threats to prescribe his patients to a competitor if his wishes were not fulfilled. AstraZeneca officials who were skeptical of Reinstein's research findings were hushed by others in power due to the doctor's importance as a customer. Both Reinstein and the company have denied making such statements, however, records of spending reveal that AstraZeneca paid the doctor $490,000 over ten years. While it is not uncommon for companies to pay researchers, this amount is excessive and also should be disclosed to the public.

AstraZeneca and Reinstein broke ties in 2008 for unknown reasons, but regardless, patients' lives were changed. Several individuals are quoted in the article who have gained excessive weight and been diagnosed with diabetes since taking Seroquel prescribed by Dr. Reinstein. It is unacceptable for doctors and drug companies to disregard their patients' well-being in order to make a profit. Corporate and individual greed does not have a place in our healthcare system!

Originally posted at InjuryBoard by Paul Thomson

Hospitals Rarely Disclose Adverse Events to Patients

Paul Thomson — Fri, 13 Nov 2009 09:30:00 GMT

Medpage Today reported that hospitals rarely give their patients explanations when they experience adverse effects of treatment. A survey revealed that over sixty percent of the time, patients do not receive explanations for adverse events. However, when patients were told about adverse events, they were twice as likely to rate the quality of care highly. About 31% of the events were preventable; and some 40% of the effects were related to medications started during the hospital stay. The physician review also determined that three quarter of the effects were severe.

Disclosure was associated positively with favorable patient impressions of the hospital care they received.

This is because an increased level of communication can lead to greater trust from the patient, an more positive perception of care, and possibly even a lower risk of malpractice. Dr Wachter in an editorial stated that the study "adds to the accumulating evidence that disclosure is not only ethically correct but, if done well, can lead to higher levels of patients’ trust, increased perceptions of quality and perhaps even lower malpractice risk." Hopefully, studies like these will provide physicians the confidence to start fulfilling their ethical duties and advising patients of adverse events and effects.

Originally posted at InjuryBoard by Paul Thomson

Post-LASIK Problems Underplayed and Unreported

Paul Thomson — Thu, 22 Oct 2009 12:24:29 GMT

Aggressive marketing has made the well known vision correction surgery known as LASIK surgery (laser-assisted in situ keratomileusis) a $2 billion industry, with it coming under fire for overstating the benefits of the surgery and downplaying its risks. As many as 75,000 patients a year are estimated to have lasting post operative problems including poorer vision and even blindness! Even more alarming is that the FDA has recorded only a tiny fraction of these problems. From 1998 to 2008, the agency admitted that it had received only 140 reports of post operative problems!!! Clearly, these problems are not getting recorded effectively.

The FDA issued reminders on the need to record adverse results to clinics offering the surgery after they discovered that many did not have systems to do so. Poor results include dry eye, poorer vision, halos, glare, and sometimes blindness. Not only is there insufficient data to confirm the estimated 75,000 patients experiencing these results, but the existence of such complications is often downplayed by marketing schemes.

This has led three federal agencies, the Food and Drug Administration, Defense Department, and National Eye Institute, to develop a plan outlined in this article. The plan starts with the FDA creating a website for patients to report results, followed by the Defense Dept. measuring how many active-duty military patients had poor results, and ending with a larger study of patients to determine how many had postoperative problems. The plan will end in 2012 and officials hope this more accurate data will help improve the surgery in the future.

Originally posted at InjuryBoard by Paul Thomson

Doctors Urged Not To Induce Labor Unless Medically Necessary

Greg Webb — Thu, 06 Aug 2009 14:21:17 GMT

Under revised guidelines released recently by the nation’s association of obstetricians and gynecologists, physicians are being advised not to induce labor for non-medical reasons prior to thirty-nine weeks into a pregnancy. These guidelines, which are the first to be released since 1999, arrive after concern about the increase in the numbers of these procedures in the last twenty years; in 1990 the rate of induced labor was 90 per 1,000 births, however, this number increased to 225 per 1,000 births in 2006. The guidelines also describe when and how to induce labor in clear-cut medical situations, such as an irregular fetal heartbeat.

The guidelines are non-binding, but could be interpreted to hold the doctor liable if something goes wrong. Over the years, physicians who induce labor early for their patients’ convenience, as opposed to health concerns, have become commonplace. Patients often request early induction because they are tired of their pregnancy, want to make sure their doctor will be on duty to deliver their baby, or want to time their delivery to most efficiently manage their time off of work. While the guidelines take no position on these “soft” reasons for inducing labor, they do stress for the first time that mature fetal lung testing before thirty-nine weeks gestation by themselves are not enough to justify inducing. The guidelines also call for a physician who is capable of performing Caesarean sections (C-sections) to be on hand if inducing does not produce a successful vaginal delivery.

While many hope the consequences of these guidelines will lead to a reduction in the rate, a Houston ob-gyn called the new guidelines “lax” and was skeptical of whether they would have a significant effect. Many physicians feel a stronger statement needs to be issued to get hospitals on board. Although induction is relatively safe, it is being tied to the increased risk of C-sections; studies also found induced labor leads to higher medical costs due to longer stays in hospitals.

There is no specific number for the rate of inductions performed for non-medical reasons; studies have put it from 15 percent to 55 percent of the total number.

Originally posted at InjuryBoard by Greg Webb

Tattoos, Nicotine Patches And Other Medical Devices May Pose Problem During M.R.I.s

Greg Webb — Tue, 31 Mar 2009 17:44:35 GMT

Federal health officials warn that patients who wear nicotine or other drug patches during M.R.I. scans may get burned due to the machine’s huge magnet that can heat tiny metal elements found in the patches. Not all patches contain these aluminum elements. The Food and Drug Administration (FDA) has received at least five reports of patients wearing patches who experienced a skin burn similar to a sunburn during an M.R.I. screening; federal officials are usually only alerted to a fraction of the injuries associated with a particular drug or device so the number may be much more.

About sixty different types of drug patches are sold in the United States, and about twenty contain the small metal fragments. Some of the patches do not warn patients about these metal fragments, and since few people review the box after donning the patch, the FDA will soon require that all manufacturers put warnings, such as "Remove Before M.R.I." on the patch itself. Patients should consult their physician regarding whether or not to replace or reuse the patches after removing them for scans.

This patch alert is the latest in an assortment of safety warnings involving increasingly powerful M.R.I. devices, due to the unpredictable effects of strong magnets used in the devices that are continuing to be discovered. Radiologists are now warning patients that they can experience discomfort or injury if they have tattoos, implanted medical devices or shrapnel. Tattoos also contain metallic elements in some cases, which can lead to warming in the skin that can grow uncomfortable. Some M.R.I. screening rooms place metal detectors in front of the rooms to prevent the problem of patients forgetting to remove metal objects before entering.

Originally posted at InjuryBoard by Greg Webb

Checklists Lower Hospital ICU Infection Rates

Greg Webb — Mon, 23 Feb 2009 08:00:00 GMT

Hospital-acquired infections originating from tubes and catheters inserted into the body have long been accepted as the norm in intensive care units. These infections include ventilator-associated pneumonia, related to a tube lodged in the windpipe to assist in breathing, urinary tract infections, related to a catheter inserted into the bladder to drain the urine, and bloodstream infection, related to a catheter threaded in the veins reaching the upper chamber of the heart.

For years hospital staff have believed infections were the price patients had to pay for intensive care. At one hospital, for every 1,000 “device days” (for example, 100 ICU patients using a device for 10 days), seven patients would get pneumonia, six would get blood infections and four would get a urine infection. But, staff thought, there were antibiotics to combat the infections, and the insurance company would pay for the nearly $25,000 extra in hospital bills. Moreover, without the devices, many patients would have died.

The Institute for Healthcare Improvement, a nonprofit founded by Harvard pediatrician Donald Berwick, is trying to change those thoughts. The IHI is a nationwide effort to reduce medical errors, standardize treatments, cut waste and bring patient-centered medical care to the bedside. About 4,000 hospitals have participated in the programs.

One major component of the Institute’s plans are checklists for every patient, which have become known as “bundles:” a “ventilator bundle” for patients on a ventilator, “UTI bundle” for patients with urinary catheters, and a “central line bundle” for those with central lines. There is even a bundle for doctors, requiring them to wear a sterile gown, mask and gloves before placing a central line.

While these checklists may include what should be routine behavior from doctors and nurses, routine procedures are typically never followed 100 percent. Without these written guides set by the IHI, checklists are expected to be followed by memory, which is unrealistic.

At the hospital mentioned above, implementing the checklists caused a 50 percent decline in ICU infection rates and a 21 percent reduction in cost per ICU discharge. Where some staff had been skeptical about the initiative to reduce infection rates, simple checklists caused the hospital’s culture of patient safety and quality to change for the better.

Originally posted at InjuryBoard by Greg Webb

Insulin Pen System In Beaumont Army Medical Center May Have Caused Blood-borne Disease

Greg Webb — Sun, 15 Feb 2009 18:28:57 GMT

Beaumont Army Medical Center, in Fort Bliss, Texas, has contacted 2,114 diabetes patients who have been treated at the hospital since August 2007 because they may be in danger of developing such blood-borne diseases as HIV or hepatitis. At the center, diabetes patients are treated with insulin injection pen systems that are designed with a reservoir of insulin for multiple uses on a single patient. Though a sterile needle is used for each patient, it is possible that the pens were used by more than one patient through the end of January. The commander of the facility claims transmission of the blood-borne disease from one patient to the other using the same insulin injection pen was unlikely, but one study showed blood was found to have traveled by the needle of the injection pens back into the reservoir of insulin where contamination may have occurred.

The error in administering the insulin came to light after two nurses reported concerns about patients using the same injection pens. An investigation was launched and the staff was retrained on the appropriate use of the insulin pens. Army officials said the injection pen system is used at nine military hospitals and clinics. Army Surgeon General Lt. Gen. Eric Schoomaker has ordered a review of the use of insulin pens throughout the entire branch of service. Jones Army Community Hospital potentially exposed fifteen patients to blood-borne diseases also due to the improper administration of insulin. Schoomaker has assured the exposed patients that their risk of developing a blood-borne disease is low. Officials at Beaumont are researching how staff members implemented the wrong procedure regarding the pens and are determined to restore the public’s confidence in its services.

Originally posted at InjuryBoard by Greg Webb

Disruptive Doctors Causing Medical Errors and Workplace Problems

Greg Webb — Wed, 24 Dec 2008 08:00:00 GMT

Hospital staff members are blaming badly behaving doctors for low morale, stress, and high turnover, which contribute to medical mistakes, preventable complications, and even death, a recent study showed.

A survey of health care workers at 102 nonprofit hospitals from 2004 to 2007 found that 67 percent of respondents thought there was a link between disruptive behavior and medical mistakes, and 18 percent said they knew of a mistake that occurred because of a disruptive doctor. Dr. Alan Rosenstein, medical director for the West Coast region of VHA Inc., authored the study.

L. Silverthorn, a nurse in Washington, recounted a patient she knew was in danger; he had a shunt in his brain to drain fluid, but he was vomiting and had an extreme headache, two signs that the shunt was blocked and fluid was building up. She paged the on-call resident twice, receiving a response that she didn’t “know what to look for” because she’s “not a doctor.” After an ignored third page, she called the attending physician at home, who rushed the patient into surgery.

A survey by the Institute for Safe Medication Practices found that 40 percent of hospital staff members had been so intimidated by a doctor that they did not share their concerns about orders for medication that appeared to be incorrect. Consequently, 7 percent say they contributed to a medication error.

Abusive behavior by doctors has been decreasing in the past five to ten years, physicians and nurses report, though it is still a major problem. Some nurses say they have ducked scalpels thrown across the operating room, and more say they are insulted and yelled at, often in front of patients or other staff members. One-third of the nurses in Dr. Rosentein’s study knew of a nurse who had left a hospital because of a disruptive physician.

“Most people are trying to do the best job they can under a high-pressure situation,” said Dr. Joseph M. Heyman, chairman of the trustees of the American Medical Association. “About three to four percent of doctors are disruptive,” said Dr. William A. Norcross, director of a program at the University of California, San Diego, that offers anger management for physicians, “but that’s a big number, and they really gum up the works.”

The leading offenders of disruptive behavior are specialists in high-pressure fields such as neurosurgery, orthopedics, and cardiology. Dr. Peter B. Angood, chief patient safety officer at the Joint Commission, the nation’s leading independent hospital accreditation agency, witnessed an incident where a nurse called a surgeon to come verify his next patient and mark the operation spot. The surgeon yelled at the nurse to get the patient ready herself. The surgeon showed up late to the operating room, and wound up operating on the wrong part. The surgeon then “berated the entire team for their error . . . when the error was the surgeon’s because he failed to cooperate in the process,” Dr. Angood said. A hostile environment increases the risk of medical errors, said Dr. Angood. Dr. Norcross blames the training surgeons get. “That whole structure teaches a disruptive behavior.”

Things may be changing for the better. Two of the six core skills taught in medical schools and residency programs are good communication and leadership. Hospitals are also either “getting rid of [disruptive] doctors, or sending them to anger management,” noted D. Thomas R. Russell, executive director of the American College of Surgeons.

collaboration and communication between fields. Ms. Silverthorn says the changes are overdue, a view most other staff members agree with. “We go to school, we have a very important job, but there’s no respect.”

Originally posted at InjuryBoard by Greg Webb

Studies Show Emergency Rooms Overwhelmed By Uninsured

Greg Webb — Mon, 22 Dec 2008 08:00:00 GMT

A recent report, released by the American College of Emergency Physicians, states the nation’s system of emergency rooms is in serious trouble. More and more unemployed or uninsured Americans are turning to emergency rooms as a last resort becaue emergency rooms are legally obligated to see all patients who enter their doors, regardless of the patient's ability to pay. Doctors warn that the facilities, which are already overburdened, could have even more trouble handling cases of broken bones, heart attacks and other traumas that they deem their core mission. Even before the recession, emergency rooms around the country were reporting dangerously long waits for patients and the frequent need to redirect ambulances to other hospitals. Just two years ago, a government survey found there were about 120 million visits to emergency rooms annually, a third higher than a decade earlier. Even then doctors called emergency rooms overburdened, so a recession will just make conditions worse; hospitals will have to absorb the unpaid medical bills and some are already experiencing a much higher influx of patients without insurance.

escalating number of uninsured and the delays in getting primary care create a crisis. One of the physicians’ major concerns is the potentially long wait by patients requiring a hospital bed. After surveying its members last year, the doctor’s group learned of at least two hundred fatalities related to the practice of “boarding”, in which patients on stretchers line the corridors of the facility until they can be moved into a bed.

Originally posted at InjuryBoard by Greg Webb