Medical Malpractice

Published on: June 28, 2013

Bronx Medical Malpractice Prevention – Reducing Hospital Negligence – Better Patient follow up decreases Hospital Re-admission rate from 26.3% to 17.6%

The Bronx collaborative, a group of hospital and medical insurers demonstrated in a study that patients who were participating in a special program to manage transition between hospital and home were less likely to be re-admitted to hospitals than patients who received the current standard care.

Medical problems that lead to hospital re-admissions can often be prevented by personal contacts with patients before and after their discharge. Intensive pre-discharge education, post discharge follow up appointment with the physician and phone calls to review medication and discuss concerns are significantly lowering the re-admission rate and improving patient satisfaction.

Published on: June 26, 2013

Medical Malpractice – Amoxicillin-clavulanate (Augmentin) is the most common cause of Drug Induced Liver Injury (DILI)

By GGCRBHS&M

Drug-induced liver injury (also called DILI or drug-induced hepatotoxicity) is a significant cause of personal injury and wrongful death in many patient populations. According to a study published in in the June issue of Gastroenterology induced liver injury is caused in 75% of cases by a single prescription, in 16% of cases by a dietary supplement and in 9% of cases by multiple agents.

The population based study performed in Iceland, demonstrated that the incidence of DILI was the highest reported to date. Lead author Einar Björnsson, Department of Internal Medicine, Section of Gastroenterology and Hepatology, National University Hospital, Reykjavik, Iceland Faculty of Medicine, University of Iceland, presents the study in the video below.

Published on: June 25, 2013

Medical Malpractice – Hospital Negligence: the cost of replacing 6 frequently-touched near patient surfaces in a 20-bed ICU with antimicrobial copper can be recouped in 2 months, based on less infection and shorter stays

By GGCRBHS&M

Installation of antimicrobial copper surface is a very effective way to fight infections and prevent personal injury due to hospital negligence. A unique study presented by the York Health Economics Consortium (YHEC) at the International Conference on Prevention and Infection Control (ICPIC) in Geneva, investigated the economic benefits of deploying antimicrobial copper touch surfaces in intensive care units (ICUs) to fight the rampant international epidemic of healthcare-associated infections (HCAIs) . The model is transparent and the results show rapid return on the investment.

Published on: June 24, 2013

Despite their many beneﬁts, Emergency Department Information Systems (EDIS) may also lead to medical errors and cause patient safety and quality concerns

By GGCRBHS&M

Dosing errors, delay to treat or failure to diagnose a medical condition because of poor interaction between humans and computers or loss of data can result in serious personal injury and wrongful death.

Poor choice or inadequate implementation of Emergency Department Information Systems (EDISs) can threaten health care quality and patient safety. Findings and recommendations from two work groups from the American College of Emergency Physicians were released in a report last Friday in Annals of Emergency Medicine.

The report indicates that The Health Information Technology for Economic and Clinical Health Act of 2009 and the Centers for Medicare & Medicaid Services “meaningful use” incentive programs as well as additional requirements for detailed reporting of quality metrics have been major catalysts for the development and implementations of EDISs. However systems functionality varies greatly and it is crucial for emergency providers to actively participate in decisions about EDISs selection, implementation and monitoring.

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Published on: June 24, 2013

Medical Malpractice – Failure to diagnose colon cancer – the use of a quarterly report card improves precancerous polyp detection rate from 44.7% to 53.9%

By GGCRBHS&M

During colonoscopy, endoscopists can find potentially precancerous growths (polyps) and remove them, however some polyps especially on the right side of the colon are more difficult to detect. Failure to detect these polyps reduces the efficacy of colonoscopy for colon cancer screening.

By using a quarterly report card, endoscopists at the Roudebush Veterans Affairs Medical Center in Indianapolis were able to increase the overall adjusted adenoma (precancerous polyp) detection rate from 44.7 percent to 53.9 percent, and to improve the cecal intubation rate from 95.6 percent to 98.1 percent. The complete study can be found in the June issue of GIE: Gastrointestinal Endoscopy, the monthly peer-reviewed scientific journal of the American Society for Gastrointestinal Endoscopy (ASGE)

Published on: June 22, 2013

Reminder: Stephen Mackauf to co-chair Obstetric Malpractice Forum

By GGCRBHS&M

Our partner Stephen Mackauf and John E. Hall Jr. from Hall Booth Smith, P.C. will co chair the 12th Annual Advanced Forum of the American Conference Institute on Obstetric Malpractice Claims on June 26th-27 2013 in Philadelphia. For more iinformation see our prior post here.

Published on: June 7, 2013

Medical Malpractice – Disturbingly high rates of dirty endoscopes show Hospital Negligence in cleaning process

By GGCRBHS&M

30 % of duodenoscopes, 24% of gastroscopes and 3% of colonoscopes have unacceptable level of “bio dirt” from previous clients bodies leading to a potential risk of infection according to a new study by researchers at 3M infection Prevention Division and presented at the 40th Annual Conference of the Association for Professionals in Infection Control and Epidemiology (APIC).

After being used flexible endoscopes are manually cleaned by a hospital technician who will visually inspect them and then soak them in high level disinfectant. However the study indicates that visual inspection is not enough as contamination is often invisible to the naked eye. The study suggests hospitals should improve their cleaning protocol by having specific guidelines by type of instrument and by identifying if there are any critical steps missing in the manual cleaning process.

Published on: May 27, 2013

Diagnostic Error – medical malpractice that can be life-threatening or result in death or permanent disability.

By GGCRBHS&M

Diagnostic errors are not a new problem, in 1991 the Harvard medical Practice Study, investigated Medical Malpractice in New York Hospitals and found out that diagnostic errors were accounting for 14% of physicians errors and that 75% of them were due to doctors negligence.

In 1999 a study from the Institute of Medicine “To Err is Human”, looks at diagnostic errors and classifies them in four different categories: error or delay in diagnosis, failure to employ indicated tests, use of outmoded tests or therapy and failure to act on results of monitoring or testing.

Despite these studies, diagnostic errors have been largely ignored until recent research calculated the impact of such errors. Results from a 2009 report funded by the federal Agency for Healthcare Research and Quality showed that 28% of diagnostic mistakes were life-threatening or had resulted in death or permanent disability.

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Published on: May 26, 2013

Medical Malpractice – Failure to diagnose Ischemia – Routine Fractional Flow Reserve measured after angiography decreases misdiagnoses

By GGCRBHS&M

230px-Cerebral_angiography%2C_arteria_vertebralis_sinister_injection.JPG Angiography alone doesn’t detect Ischemia and may lead to misdiagnosis when a patient is being checked for chest pain. A routine Functional Flow Reserve Measurement (FFR) after the angiography would lead to a change of diagnosis for 1 out of 4 patients according to a new study presented at EuroPCR 2013 by Nick Curzen, Professor of Interventional Cardiology, University Hospital Southampton NHS Foundation Trust and Faculty of Medicine, University of Southampton, Southampton, UK.

Most cadiologists base their decision on the angiography only. The angiography is an X-ray of the blood vessel (see picture) that the cardiologist uses to assess if some blood vessels are blocked or damaged. The study argues that angiography only doesn’t detect ischemia, a restriction in blood supply to tissues, causing a shortage of oxygen and glucose needed to keep tissue alive. This may lead cardiologists to fail to diagnose a medical condition and to develop an inappropriate treatment plan for the patient.

Researchers, studied 200 patients suffering from Chest Pain. Each patient underwent an angiography. Based on the angiography only a cardiologist made a diagnosis and developed a treatment plan for each patient as well as recommendations for medical treatment such as percutaneous coronary intervention (PCI), coronary artery bypass grafting (CABG) or request for more information. The cardiologist left the room and then each patient had a Fractional Flow Reserve (FFR) measurement. Results with FFR were shown again to the cardiologist. Based on this additional information the cardiolgist changed the treatment for 25% of the patients.

Published on: May 22, 2013

Negligence – Central Line Associated Bloodstream Infections (CLABSI) significantly increase hospital profit margin

By GGCRBHS&M

The average profit margin for a hospital to treat an infected patient is $ 55,000 while the margin to treat a similar patient without infection is just $ 6,500 according to a recent study from The Johns Hopkins University School of Medicine published in the American Journal of Medical Quality.

Hospitals lose on average $14,000 per patient when the bill is paid by Medicare or Medicaid but when the bill is paid by private insurance the hospital makes on average a margin of $216,000 per patient before expenses.

The study demonstrates that it is in the financial interest of private insurers to help hospitals find ways to reduce the number of CLABSI infections.