Articles Posted in Hospital Negligence

We have written a number of times about how physicians and medical staff have a duty to use reasonable care while tending to patients they are assigned to. Indeed, the main impetus behind medical malpractice cases is the failure to use such care (i.e. acting as a physician with similar experience would in a given situation), but often malpractice cases may start even before this.

According to a recent Consumer Reports study, the lack of respect a patient may receive from hospital staff may lead to medical errors. For instance, certain pains and complaints of discomfort may be dismissed as a patient simply whining; or a doctor may not carefully listen to a patient’s concerns when he or she speaks up.

Among their many findings, researchers learned that patients who believed that they rarely received respect were more than twice as likely to experience a “preventable medical error” compared to those who received respect. Further, a quarter of the patients surveyed indicated that they were not always treated as adults with regard to their own care and a third of those surveyed said that medical personnel did not listen to their wishes without interrupting.

Following increased scrutiny since the death of comedian Joan Rivers in September, Yorkville Endoscopy—the facility where Rivers was receiving care prior to her death—will reportedly be losing recognition as an accredited and certified facility for insurance purposes.

Both the Centers for Medicare Services and the American Association for the Accreditation of Ambulatory Surgery Facilities apparently removed their blessing because of substandard care provided by the facility.

As readers may remember, the facility was cited for substandard care following an investigation of the events that led to Rivers’ death, including failure to take notice of deteriorating vital signs. The firm that manages Yorkville Endoscopy and other surgical centers, has been cited for substandard care at its other facilities as well, though the firm’s attorney says the violations in question are not out of the norm for the industry and, in any case, have since been corrected.

Some hospital error cases are based on patient readmissions that occur because of mistakes on diagnosing patients for discharge, and the lack of education that patients receive. Indeed, there are a number of things that hospitals can do in these areas to increase patient safety.  This post will highlight some important considerations that patients should be aware of. 

Your doctor or nurse should educate you about blood thinners – If you recently have had surgery, chances are that you may be discharged from the hospital with a prescription for a blood thinner. It is critical that your physician give you detailed instructions about your prescription, and you should ask all the questions you feel are necessary in order to feel comfortable with what you will be taking.

Read your discharge plan – Most hospitals have protocols where the patient is read their discharge plan, or it is explained to them by the physician or a designated agent. Essentially, the discharge plan should include what prescriptions will be given and how often the medications should be taken, when follow up appointments will take place, as well as who primary contact shall be should the patient have questions.

In a prior post, we highlighted the unfortunate story of a doctor taking a selfie with Joan Rivers while she was sedated prior to undergoing a procedure that led to her death. Indeed, such conduct is just as baffling as it is troubling. However, there are unfortunately more stories like it.

A recent HuffingtonPost.com report described the ordeal a 32 year-old man endured after waking up from a colonoscopy with women’s panties on. What has been described as a prank has led to the man experiencing severe emotional distress and even the loss of his job. The man was an employee at at the surgery center where the procedure was performed, and it was later learned that the prank was perpetrated by some of the man’s former colleagues. 

It is reasonable to believe that the man was heckled mercilessly because of the prank.

A number of our posts have focused on strategies to increase patient safety. They have ranged from surgical teams following checklists to establishing standards for when such procedures would be appropriate. However, a new system highlighted by fiercehealthcare.com could be an innovative strategy that could save patients’ lives

Patient early warning detection systems could help medical staff respond quicker to events before they become life-threatening. As described in the fiercehealthcare.com piece, patients would wear a monitor on their wrists that continuously provides updates on his or her vital signs (including blood pressure, pulse rate and pulse oximetry). The vitals are ranked on a scale of 0 to 5 and measurements are sent to an electronic health record. Patients who rank from 0 to 2.9 are in a clear (or “green” zone). If they rise above 3.0, the patient is in a dangerous zone and appropriate medical attention is administered.

A hospital in Michigan had implemented the system and studied the results from their test run. The bands reportedly reduced patient mortality rates by 35 percent. Moreover, the number of code blue emergencies were reduced by 50 percent.

Record keeping is an important aspect of a medical malpractice case. Essentially, if a hospital has bad record keeping practices, chances are that it may be easier to prove that reasonable steps were not taken to ensure the patient’s safety, or that established procedures were not followed that led to the patient being harmed.

Indeed, some hospitals have exceptional record keeping practices. However, a new reporting protocol may mask some hospitals’ shortcomings. According to a recent Claims Journal report, some diagnoses to be reported under ICD-9 reporting codes may not translate to ICD-10. 

For instance, an issue reported under ICD-9 may have several interpretations under ICD-10. Basically, accurate reporting under ICD-10 may make a hospital look safer than it really is. At the same time, other hospitals may seem less safe because of the different (and new) categories generated under the system.

If you are frustrated that you have not found a law firm to take your medical malpractice case, do not lose hope. Take solace in knowing that many clients talk to multiple law firms before they find a firm that is willing to take their cases.

The reasons for rejecting a case are varied. Some firms may not take cases that are valued below a certain amount of money. They know that it will take a substantial investment in order to get the case to trial, and if they don’t believe that they will achieve a successful verdict, or that the potential award amount won’t cover their costs, they won’t take the case. 

Others may not be interested in cases where the alleged malpractice will be difficult to prove (i.e. there may be other factors involved that caused the procedure to go bad or the desired result was unachieved.) When there is unclear evidence of malpractice, this may turn some law firms off. Others may not take the case because they may believe it is too complicated a matter to bring to trial (i.e., the case may not resonate with a jury).

Healthcare giant Johnson & Johnson announced recently that it would stop selling and distributing its power morcellators, after the Food and Drug Administration (FDA) found that its use in hysterectomies and myomectomies could lead to cancer in women. A report in the Journal of the American Medical Association found that 27 of every 10,000 women who underwent a hysterectomy using a morcellator machine could develop cancerous tumors that could spread to other parts of the body.

Moreover, scientists could not determine if a uterine fibroid could be cancerous prior to being removed with such a machine.  Because of this, they discouraged the use of power morcellators and advised doctors to fully discuss the risks and benefits of using other treatment options.

As such, Johnson & Johnson has pulled the machines from the marketplace.

New York is one of a few states that has yet to pass a law that will enable doctors to apologize to patients when procedures go wrong without fear of reprisal in the form of a medical malpractice suit. In the past, many doctors would not say anything or register any form of regret out of fear that it would be construed as an admission of guilt.

Even with this new landscape, the question of whether doctors should disclose each other’s mistakes remains a touchy subject. After all, doctors have enjoyed a long-established culture where they do not comment on each other’s mistakes. 

This is likely because peer review is not a part of the culture engendered among physicians, especially high level surgeons. Instead, criticism may be taken as a personal and a professional affront. Also, newer doctors are more likely to be reluctant to criticize a senior colleague out of respect (or fear). Moreover, busy doctors may not notice mistakes or believe that they do not have the time (or the responsibility) to air their concerns about their colleagues’ mistakes.