Articles Posted in Medical Malpractice

The risk of physician-related ED medication errors among seriously ill and injured children in rural EDs can be significantly reduced with telemedicine consultations according to a study published in the current issue of Pediatrics, the Official Journal of the American Academy of Pediatrics.

The study looked at 234 seriously ill and injured children presenting to 8 rural EDs with access to pediatric critical care physicians from an academic children’s hospital. 73 received telemedicine consultations, 85 received telephone consultations, and 76 received no specialist consultations. Medications for patients who received telemedicine consultations had significantly fewer physician-related errors (3.4%) than medications for patients who received telephone consultations (10.8%) or no consultations (12.5%).

A doctor can commit medical malpractice if he is not properly trained to use the Electronic Medical Record (EMR) system. In a recent case study Web Morbidity and Mortality looks at the case of an epileptic patient who experienced temporary toxicity because of a medication error linked to improper use of EMR.

After being treated in a hospital for seizures, a patient was discharged with an outpatient plan that was to begin phenytoin 500 mg once daily. The resident doctor who prepared the prescription was not familiar with the Electronic Medical Record and failed to notice that the EMR default frequency for phenytoin was “TID” which means 3 times a day. Because the dose was much bigger than normally prescribed an alert was triggered by the EMR but this alert was overridden by the resident doctor who also seemed to suffer from alert fatigue.

Read the complete case and commentary on WebM&M.

Central Line-Associated Bloodstream Infections (CLABSI) are often the result of medical malpractice. An estimated 250,000 CLABSIs occur every year in the US with 800,000 of them happening in the emergency room. More than 30,000 people die from CLABSI in the US every year. The CDC estimates that the yearly cost related to CLABSI is $1 billion.

To prevent these infections, the Joint Commission Today released a very useful toolkit to supplement a previously published monograph entitled “Preventing Central Line-Associated Bloodstream Infections – A Global Challenge, A Global Perspective” . This document provides best practices and guidelines for healthcare professionals who insert and care for intravascular catheters and who are responsible for the surveillance, prevention, and control of infections in all healthcare settings.

Medication errors in nursing homes are one of the most common types of medical malpractice. Lack of Physician involvement, lack of adequate staff and training are often the reason why significant medication errors are all too common in nursing homes.
Here is an link to an article and a video about medical errors in Michigan nursing homes but there is little doubt that this problem exists at a national level as well.

Even though a lot of tactics are available now for doctors to avoid medical errors the fear of them happening and constant worry about patients can push doctors to the edge. Physicians burnout is a widespread problem.

In a very interesting blog Dr Diane Shanon explains that she was worn down by over worrying about medical errors such as incorrect orders, intravenous catheter left in too long and leading to infection, care providers forgetting to wash his or her hands and spreading dangerous infections from one patient to the other or misread EKGs or X-rays. She suffered such a terrible burn-out that she decided to walk away from her career as a physician.

In 2014 medical malpractice will represent $0.60 per every $100 of hospital revenue or an average of $135 per hospital admission according to “Hospital and Physician Professional Liability Benchmark report” recently released by Aon and the American Society of Healthcare Risk Management.

According to the report the number of medical malpractice claims and their costs are expected to remain stable in 2014.

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