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Articles Posted in Hospital Negligence

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As medical technologies are getting increasingly sophisticated so do the risks for hospital negligence and medical malpractice. The ECRI Institute recently released its 2016_Top_10_Hospital_C-Suite_Watch_List and going through this list almost feels like reading a sci-fi novel. Link to 30 page detailed report on blog.  Here is an overlook of the top 10 new medical technologies that hospitals should put on their watch list:

  1. Mobile Stroke Units are high tech ambulances specially outfitted with equipment allowing patients to be diagnosed and if necessary treated directly at their home by a specifically trained staff.  The units are also equipped with telemedecine technology that allows the mobile staff to communicate directly with remote clinical personnel. Strokes are a leading cause of death and traumatic brain injury. Timing is crucial and a reduction of time between the diagnosis and the treatment can save lives and reduce severe injuries.
  2. Medical Device Cybersecurity is a major risk to patients that hospitals have been so far unable to fully control. Medical devices such as a pace-maker or infusion pump are connected through a wire or wifi  to the Electronic Health Record of a patient. These devices can often be too easily hacked. Thieves can then use the personal data for identity theft or to invade the home of the patient when he or she is in the hospital.  In other cases it may even be a murder weapon. Dick Cheney’s doctor had the wifi disabled on his pace-maker due to fear he may be hacked to be assassinated.
  3. Wireless Wearable Sensors allow doctors to monitor inpatients and outpatients health in continuous time. It may allow for patients early release and therefore cost reduction.  Wireless wearable sensors come in two types: movement/activity sensors and physiologic sensors. The most recent movement sensors are so sophisticated that they can detect normal movements from tonic-clonic movements in someone suffering from a neurological condition such as Alzheimers or Epilepsy. Physiological sensors analyse small amounts of body fluid to detect a change in patient status.
  4. Miniature Leadless Pacemakers are revolutionary devices that do not require surgery. These new types of pacemakers are still in development and so far are only authorized for use for 15% of the patients necessitating such a device. Hospitals should proprely consider product warnings and make sure the patient is eligible for this type of device. Device repositioning and fixation as well as long term safety should be monitored closely.
  5. Blue-violet LED Light Fixtures may be the solution to fight dangerous healthcare-acquired infections and super-bugs such as staphylococcus aureusClostridium difficile and Enterococcus.  Recent studies have shown that, in specific settings,  this new technology can reduce contamination levesl better than other existing technologies. This technology is particularly interesting for burn unit rooms.
  6. High-cost cardiovascular drugs such as  PCSK9 inhibitors and angiotensin receptor neprilysin inhibitors may help reduce patients re-admission rates. Patients with high cholesterol are most of the time treated with statin doses. PCSK9 inhibitors are a different option for patients who do not respond well to statins. The angiotensin receptor neprilysin inhibitors are a new heart failure drug. Its the first heart failure drug to be approved over the lat 20 years. These drugs are still very new and patients should be monitored very closely for adverse effects.
  7. Rapid changes in robotic surgery offer more options than before. The da Vinci Robotic Surgical System that was introduced on the market more than 15 years ago starts to seem obsolete compared to the new models that are about to enter the market in 2016.
  8. Spectral CT scanner which has been on the market for 10 year now are being improved with new technology and tools and a great deal of marketing is being promoting them. These scanners are supposedly providing improved soft-tissue contrast and tissue characterization. However so far clinical studies have been weak at demonstrating the benefits of such technology.
  9. Injected Bioabsorbable Hydrogel (SpaceOAR) protects the healthy rectum tissues from patients undergoing radiation therapy for prostate cancer. 20% of prostate patients who are undergoing radiation therapy suffer rectum injuries causing pain, diarrhea, urgency and bleeding. This gel limits the risk of rectal injuries during radiation procedures.
  10. Warm Donor Organ Perfusion Systems to prevent organs from being damaged during transportation. Organ transportation is extremely challenging. 2/3 of the lungs and hearts that are donated have to be discarded because they were damaged during transportation . This new technology is suppposed to impoved the viability of donated organs.  While conventional storage is very basic and use ice and coolers, the new systems are providing warm perfusion of donated organs. The technology is available for lungs and hearts and should soon be available for other organs such as liver.
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In Davis v. South Nassau Communities Hospital, Edward Davis sued this  New York hospital for medical malpractice after he was injured in a car accident caused by an impaired hospital’s patient. The patient was Lorraine Walsh. Walsh presented herself to the South Nassau Communities Hospital Emergency Room with stomach pain. The ER doctor gave her a very powerful pain medication and told her she could go home.  Because the patient was allergic to morphine, she was given Diluadid, an opioid, which is stronger than morphine and Ativan, a fast acting benzodiazepine with a 6 hour half life intravenously.  The medication that was given by the ER doctor can impair the ability to operate a motor vehicle. However the doctor didn’t warn the patient nor ask if she was indeed driving home alone.

As she was driving back home, Lorraine Walsh, impaired by the medication, crossed a double yellow line into oncoming traffic and struck a vehicle driven by Edward Davis. Edward Davis suffered personal injury caused by the car accident. Davis then filed a medical malpractice lawsuit against the hospital and the physician. The suit was dismissed by the by the trial court and by the Appellate Division. Davis then appealed to the New York Court of Appeals.

The Court of Appeals had to rule on an interesting question: can a third party injured by an impaired patient sue a medical provider under the theory that the medical provider’s malpractice was the cause of of the third party injury even though the third party didn’t have a direct relationship with the medical provider. In a 4-2 decision, the New York Court of Appeals ruled that Davis’claim was permissible.  The Court held that defendants had a duty to plaintiffs to warn Walsh that the drugs administered to her impaired her ability to safely operate an automobile.“Our decision herein imposes no additional obligation on a physician who administers prescribed medication. Rather, we merely extend the scope of persons to whom the physician may be responsible for failing to fulfill that responsibility.” Judge Stein and Judge Abdus-Salaam dissented in a lengthy opinion

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Lenox HillHospital negligence and abuse is not only related to patient care, it can also be related to how well the hospital protects the identity of its patients. Yesterday, a former employee of the Lenox Hill Hospital in New York and his wife appeared in front of the Manhattan Supreme Court because they allegedly stole the personal information of more than 80 patients and use their credit cards to charge a total of $300,000 fraudulent charges at Saks Fifth Ave in Manhattan. They tried to charge over $1 million according to prosecutors. Kyle Steed and his wife pleaded not guilty to a 193-count indictment that included, grand larceny, attempted grand larceny, identity theft and possession of stolen property charges in a scheme that targeted elderly people. Read more in the NY Daily News

 

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The family of a hospital worker is angry and wants to know how such gross hospital negligence may have been committed by the Montefiore Medical Center in the Bronx, NYC. Anthony Luso, a worker at the Montefiore Medical Center suffered a finger injury while he was working at the hospital and went to the Emergency Room to be treated on Friday. He checked in and then went to the bathroom. He never got out. He was found dead in the locked bathroom on Monday after his family questioned the hospital and insisted on looking at video surveillance.  Read more on CBS New York

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imageFalls in hospitals can cause serious personal injury and sometimes death. Every year hundreds of thousands of people are falling in hospitals, rehabilitation centers, nursing facilities or other healthcare facilities. 30 to 50% of them will sustain injury. Elderly people are not the only ones at risk. Medical conditions, medication, surgery, medical procedures or diagnostic testings for example can result in weakening and confusion for any patient independently of his or her age and increase the risk of a fall.

According to a recent alert from the Joint Commission, falls in hospitals are a prevalent patient safety problem. Even though it can be difficult and complex to prevent, hospital can take action to prevent them. Here are recommendations suggested by the Joint Commission:

  • Raise awareness about the risk of falls by communicating it to clinical and non clinical staff at every level as well as to patients and their family
  • Establish an interdisciplinary fall prevention team. Reducing falls is the responsibility of everyone including nurses, physicians, environmental services, information technology, patient advocacy, pharmacy, occupational therapy, etc.
  • Use a validated tool to identify the risk of fall in each patient and make it part of his or her electronic medical records
  • Develop a personalized prevention plan for patients at risk
  • Educate patients
  • Conduct post-fall management

For more info on this subject, download the alert  from the Joint Commission

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imageHospital medical malpractice is the third leading cause of death in this country, behind heart disease and cancer.

In a recent article in the New York Times, a retired transplant surgeon explains how an unresponsive medical staff left him no other choice but to break into  into the crash cart, a box on wheels containing equipment hospitals use to resuscitate patients and pull out two liters of saline solution which he ran into his daughter’s IV Line to prevent her from dying.

Unfortunately most patients and their families don’t have the medical knowledge and the means to make things different if the staff is negligent or a medical error is being committed. Here are the reactions of some of the readers to this article.

 

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baby in hospitalTo precribe Proglycem (diazoxide) to a baby with risk factors for pulmonary hypertension can be medical malpractice leading to severe personal injury.  FDA MedWatch, the FDA Safety Information and Adverse Event Reporting Program recently released a drug safety communication to warn that 11 cases of pulmonary hypertension in infants and newborns treated with diazoxide, the active ingredient in Proglycem, have been indentified since the drug was launched in 1973. The drug is usually used in hospital setting after the birth of the baby.

Doctors should not prescribe this drug to babies suffering from meconium aspiration syndrome, respiratory distress syndrome, transient tachypnea of the newborn, pneumonia, sepsis, congenital diaphragmatic hernia, and congenital heart disease.

Babies with no risk factor for pulmonary hypertension should be closely monitored as well. Parents and caregivers should look for signs of difficulty breathing such as flaring nostrils, grunting, unusual movement of their child’s chest, rapid breathing, difficulty feeding, or a bluish color of the lips. They should stop the medication and contact their doctor immediately if they see any of these signs.

Read more in the FDA Safety Alert

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Montefiore_Medical_Center_logoMore than 12,500 patients of a New York Hospital had their financial records compromised after an assistant clerk sold them for $3 a piece to a ringleader who made purchases at various high end retailers in Manhattan. Between January and June 2013 32 year old Monique Walker who worked in the financial department of the Montefiore Medical Center in the Bronx sold information such as names of patients, social security numbers, credit card numbers and birth dates to 28 year old Fernando Salazar who was sending his “buyers” Patricia Charles, 43, Lawrence Davenport-Brown, 23 and Charde Lawrence, 28, of Staten Island, Ashly Garrett, 25, of Queens, Sasha Rivera, 31, of Brooklyn, and Crystal White, 32 to shop at various high end venues in Manhattan. They all face charges including grand larceny, possession of a forged instrument, identity theft, unlawful possession of personal identification information and related counts. Read more in the NY Daily News 

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ambulancesHospital negligence can sometimes also happen outside of the hospital when a healthcare facility doesn’t proprely mitigate the risk of vehicular theft in front of its entrance. In a recent blog post, the Joint Commission is warning about reports of patients and other individuals who have been stealing ambulances, delivery vans, police cruisers snow plows and private cars that were left unoccupied and running in front of hospital entrances. According to the Joint Commission the risk is especially high for hospitals and healthcare facilities with a very active emergency department. Thieves are often patients who either are at the hospital under the supervision of a law enforcement agency, have substance abuse problems or mental health issues. Individuals with no links to the hospital or the patients have also been reported stealing unattended vehicles at hospital entrances. These types of incidents are extremely dangerous not only for the medical staff which can be injured when trying to stop the suspect or can be unwittingly kidnapped during the vehicle theft but also for pedestrians and road users who could be struck by a suspect attempting to flee.

The Joint Commission recommends that hospitals work with ambulance services, authorities as well as vendors and suppliers to make sure their vehicles are secured when left unattended in front of hospitals.  Valet parking staff should receive specific training and security personnel should monitor locations where vehicles stop near entrances and exits. Signage reminding drivers to remove their keys from the ignition when their vehicles are unattended can also help mitigating the risk of vehicular theft.

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Pigment_stone_extractionAfter two patients died and many other suffered personal injury from a recent “superbug”outbreak involving duodenoscopes, the safety of these medical devices (see previous blog) and the method used by hospitals to reprocess them are being questioned. In a recent Hazard Report, the ECRI Institute is recommending culturing Duodenoscopes as a key step to reducing carbapenem-resistant Enterobacteriaceae (CRE).  The Institute believes that duodenoscope procedures are vital when treating and diagnosing conditions of the gall bladder and pancreas with Endoscopic Retrograde Cholangiopancreatography (ERCP) procedures and the risk of infection can be mitigated if hospitals upgrade their reprocessing methods by also scope culturing.The Institute recommemds that hospitals not only check with the duodenoscope manufacturer as to whether they are using the appropriate reprocessing method but also add a baseline culture of all duodenoscpoes.  Read the complete ECRI High Priority Hazard Report 
Picture Duodenoscopy image of two pigment stones extracted from common bile duct courtesy of Wikipedia