Yourlawyer.com (Medical Malpractice News) http://www.yourlawyer.com/practice_area/medical_malpractice Tue, 21 May 2013 03:20:19 -0400 pixel-app en Mount Sinai Medical Center Surgeon Removes Patient's Wrong Kidney http://www.yourlawyer.com/articles/read/19303 Mon, 13 May 2013 00:00:00 -0400 http://www.yourlawyer.com/articles/read/19303 A surgeon at Mount Sinai Medical Center removed the wrong kidney from a patient and has since been relieved of his clinical and administrative duties, officials at the hospital – one of New York City’s most celebrated – said late last week.

The patient, a 76-year-old male, was on dialysis, with both of his kidneys failing and diseased, until the wrong one was removed during surgery, hospital spokeswoman Dorie Klissas told the Associated Press (AP), adding that doctors subsequently removed the second failed kidney and that the patient is doing well.

Klissas told AP: "This event should never have occurred at Mount Sinai. We apologized to the patient, and we will do all we can to ensure that something like this never happens again."

Klissas would not give the date and time that the incident occurred, nor would she provide the surgeon’s name, citing it was hospital policy not to comment about issues regarding personnel, AP reported.

Wrong-side surgeries happen at hospitals across the U.S., the AP reported, noting that many of these facilities try to make their operating rooms "mistake proof."

In July 2008, a surgeon at a Minneapolis hospital who removed a cancer patient’s wrong kidney blamed beeper calls and other patients when he made a mistake on the patient's chart, a state investigation there found, according to the AP report.

Wrong-side surgery happens frequently enough to pose a “significant risk” for many surgeons during his or her career, according to a National Center for Biotechnology Information (NCBI) study, as reported on by NatureWorldNews.com.

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Post-Hospital Syndrome sending many Patients back to Hospitals http://www.yourlawyer.com/articles/read/19145 Thu, 24 Jan 2013 00:00:00 -0500 http://www.yourlawyer.com/articles/read/19145 People who’ve recently endured a hospitalization are likely to end up back there days and weeks later with an entirely new problem, caused by their previous stay in the hospital.

According to a USA Today report on a new study appearing in the recent edition of the Journal of the American Medical Association, “post-hospital syndrome” is the cause for many readmissions to hospitals in the U.S. Researchers found that 1-in-5 elderly Medicare patients who were hospitalized returned there within a month. Most of these returning patients are affected by conditions caused by their previous stay in a hospital.

One example provided by researchers and the news source would be a patient who was hospitalized with pneumonia only to return there within a month after they suffered a fractured bone or other serious injury caused by a fall. This likely happened because they were weakened physically during their previous hospital stay, causing them to fall unexpectedly after they were discharged for their original malady.

An author of several studies that were used for this research summed it up for USA Today saying, “They come into the hospital with one thing but they leave with another.”

The study looked at more than 3 million hospitalizations of Medicare patients over an unspecified period of time. Ninety percent of people hospitalized with a heart attack originally were back in the hospital a month later, or less, with a different problem. That rate is 78 percent for patients hospitalized with pneumonia, and 65 percent for heart failure patients.

While there are many risks to staying in a hospital, such as the increased likelihood of acquiring a serious infection or other illness or a condition caused by inadequate or improper care, “post-hospital syndrome” is not caused by those increasingly common factors.

When a person is hospitalized, even though their overall health is of primary concern, the conditions they must endure on their road to recovery is likely making them more susceptible to problems after they are released from their stay. Poor and interrupted sleep, the amount and potency of medications, and prolonged periods of bed rest are just some conditions inside a hospital that can be disorienting and lead to trouble when a person returns home from their stay. This is even true for otherwise “healthy” individuals who are forced to endure a hospital stay. When they get home, they may be confused or delirious, or even just overall weakened by their extended period of bed rest. This can pose serious problems when they get home and attempt to return to their normal activities.

Adding to the risk of “post-hospital syndrome” is the likelihood that a patient in the hospital is not of the soundest mind - at that time - to be receiving instructions on specialized care they may need or things they must do, such as cleaning wounds, that if they’re not done properly, could land them back in the hospital with another series of problems.

The study suggests that hospitals and their staffs consider this part of a patient’s health when they’re administering drug treatments and providing other care. For instance, instead of waking a patient in the middle of the night to deliver medications, it may be best to wait until they’ve had a proper night of rest.

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Clinic that implants Lap-Band devices gets FDA warning http://www.yourlawyer.com/articles/read/19097 Wed, 02 Jan 2013 00:00:00 -0500 http://www.yourlawyer.com/articles/read/19097 People who might visit oBand Centers near Marina Del Rey, Calif., are not getting enough information on the potentially dangerous risks associated with a Lap-Band surgery offered through these facilities.

According to an MMM-Online.com report, the Food and Drug Administration has sent a Warning Letter to oBand Centers there regarding information on their Web site that lacks clear distinctions and descriptions of the side effects associated with its service and specifically, the Lap-Band device and the surgery to implant it. 

The FDA has been cracking down on surgery centers that offer Lap-Band, a device that is inserted around a person's stomach that's designed to severely restrict a person's appetite and promotes rapid and extensive weight loss. Lap-Band is typically only approved in rare circumstances, usually for morbidly or severely obese people. Since this restriction has not been drawing in the expected clientele volume, clinics that offer the Lap-Band procedure have resorted to a flooding of the market with advertisements for these clinics and procedure. 

In many cases, these promotionals have fallen short of FDA regulations for advertising medical devices, surgeries, or any other medical procedures that dictate how much of a product's side effects must be discussed in an ad and whether that information is readily available to would-be patients of a center. 

oBand Centers, according to several other sources, is actually a referral service for weight loss clinics that offer the Lap-Band procedure, much like the Web site 1-800-Flowers is for participating florists.

In fact, it was an aggressive billboard campaign, 1-800-GET-THIN, that first called attention to questionable marketing practices exercised by the makers of Lap-Band and the clinics that offered the outpatient surgeries. The pitch told prospective patients that they would "get thin" and that it's a routine procedure but that's farthest from reality as the Lap-Band procedure can have serious complications and create disastrous results for the wrong recipients. 

The Lap-Band can migrate from its original location, voiding the purpose of the surgery and putting a recipient in severe pain and at grave risk of serious injuries and maybe death.

The letter from the FDA to oBand Centers orders the company to alter its marketing campaigns, specifically information on its Web site, to call more attention to the side effects and risks of these surgeries. According to the report, "the company's website fails to reveal material facts about Lap-Band risks. The letter also says that a web video that is intended to convey indications for use, contraindications, warnings and adverse events is not accessible to viewers, due to the brief appearance of the information and tiny, blurry print that renders the content illegible."

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Staph infection reported among cardiac patients at LA's Cedars-Sinai http://www.yourlawyer.com/articles/read/19070 Tue, 11 Dec 2012 00:00:00 -0500 http://www.yourlawyer.com/articles/read/19070 Five heart patients at Los Angeles' Cedars-Sinai Medical Center contracted staph infections last summer after one surgeon implanted them with a new heart valve.

According to an NBC News report, the hospital is not releasing the name of the surgeon who has been linked to the outbreak. The patients all had heart valve surgeries performed by that same surgeon during the same week in June 2011. The surgeon allegedly had an inflammation on his hand that likely caused the spread of the infection. Hospital administration say that although the surgeon wore gloves, they likely developed "microscopic tears" that allowed the infection to pass to patients during the surgeries.

The patients were all confirmed to be infected with staphylococcus epidermidis bacteria. There is no indication from the NBC report on the clinical outcomes for the infected patients. The surgeon is still employed at Cedars-Sinai Medical Center but is not currently performing surgeries.

News of the outbreak was reported on Sunday this week. The hospital released a statement, according to the report: “We have apologized to the patients involved, worked diligently to answer any questions they have, and provided appropriate follow-up, support and monitoring,” a hospital spokesman said.

These infections and outbreaks are becoming more common as some medical care facilities are forced to make budgetary cutbacks that often affect the sanitary conditions that are supposed to be maintained in a hospital. It also creates staffing crunches that force unqualified doctors to perform surgeries when they either aren't qualified or are physically unable to do so. 

It is likely the victims of the staph infection outbreak will seek legal action for damages they incurred from the medical costs and future injuries they may suffer due to the carelessness during their surgeries. Thousands of surgery patients are injured during their procedures, often due to medical error or unsafe conditions and equipment. 

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Columbia University's Kreitchman PET Center Halts Research, Patients Exposed to Impure Imaging Drugs http://www.yourlawyer.com/articles/read/17906 Sat, 17 Jul 2010 00:00:00 -0400 http://www.yourlawyer.com/articles/read/17906 Columbia University’s Kreitchman PET Center is coming under fire for the way brain research was conducted there. Apparently, the center has violated Food & Drug Administration (FDA) regulations over the past four years, causing patients involved in brain studies to be exposed to impure imaging drugs.

According to a New York Times article published yesterday, Columbia University has since quietly suspended research at the Kreitchman PET Center and reassigned top managers there as a result of an FDA investigation.

Kreitchman PET Center, located in Manhattan, New York City, is considered the nation’s leader in the use of positron emission tomography, or PET, for psychiatric research, according to The Times. Pharmaceutical companies provide millions of dollars to the center every year to study drug actions and the biology of brain disorders.

To perform a PET scan, patients must first be injected with a drug called a radiotracer. According to The Times, such drugs are considered very safe, but degrade quickly. As such, many labs make these drugs themselves, following strict FDA protocols which regulate the allowable radiation levels and the purity of the drugs. Drugs that contain impurities can have effects in the body that are unpredictable.

According to The New York Times, an FDA investigation found that researchers at the Kreitchman PET Center routinely injected mental patients with drugs that contained potentially dangerous impurities, repeatedly violating agency regulations over a four-year period. The FDA first wrote to Columbia in December 2008, citing lax internal quality control and sloppy procedures for formulating drug injections. It warned that: “Failure to promptly correct these violations may result in legal action without further notice.”

Then in January 2010, FDA investigators returned and found that many of the Kreitchman PET Center’s lab practices had not changed. The agency cited a long list of specific violations, including one instance in which the staff hid impurities from auditors by falsifying documents, The Times said. One former lab worker told The Times that the FDA “raided the place like it was a crime scene, seizing hard drives.”

According to The Times, during its last investigation, , which took place from Jan. 5 to Jan. 21, the FDA cited six categories of violations. Since 2007, “at least 10 batches” of drugs had been “released and injected into human subjects” with impurities that exceeded the level the lab had agreed to set, investigators said. At least four injections “had impurity masses that more than doubled the maximum limit implemented.” Agency investigators also found a forged document, a hard copy record that had been altered to hide a drug impurity that showed up clearly in the computer records, The Times wrote

The FDA did not make its investigation public.

Many of the patients involved in this type of research suffer from schizophrenia and other brain disorders that make them especially vulnerable to poorly prepared imaging drugs, as these medications may act on the brain receptors involved in their illness, The Times said.

Perhaps one of the most disturbing aspects of The Times report is that, according to former employees interviewed for article, this conduct was commonplace and condoned. They told The Times the center was under “such pressure to produce studies that it papered over and hid impurities in drugs to stretch its resources and went ahead with business as usual despite FDA warnings.”

A resignation letter from one former employee obtained by The Times stated: “These are not the actions of a rogue, but instead are systematic forgeries condoned and approved by the lab director.”

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Teva, Baxter Hit with Record Punitive Damages in Nevada Hepatitis C Outbreak http://www.yourlawyer.com/articles/read/17746 Mon, 10 May 2010 00:00:00 -0400 http://www.yourlawyer.com/articles/read/17746  

Teva Pharmaceutical Industries and Baxter Healthcare Services have been hit with a $500 million punitive damage judgment in a lawsuit stemming from a hepatitis C outbreak linked to two Las Vegas, Nevada endoscopy clinics. The judgment was the largest jury award in the state’s history.

The hepatitis C outbreak at the center of the lawsuit was traced to the Endoscopy Center of Southern Nevada and its sister clinic, Desert Shadow Endoscopy Center. The Southern Nevada Health District traced nine cases of hepatitis C directly to unsafe injection practices at the outpatient surgical centers, and said 100 others were possibly linked to them. At least 50,000 people were tested for blood-borne diseases because of the clinics’ practices.

According to a Reuters report, plaintiff Henry Chanin claimed he contracted hepatitis C after vials of propofol were reused for his colonoscopy procedure at one of the clinics. Teva made the propofol, and Baxter distributed it, Reuters said. The lawsuit was the first of hundreds of civil lawsuits stemming from a hepatitis C outbreak two years ago.

According to The Las Vegas Review-Journal, Chanin’s lawsuit had alleged the propofol packaging did not include appropriate warnings against reusing vials between patients. The complaint also argued that the 50-milliliter vials of propofol should not have been sold to endoscopy centers because they tempted nurses to reuse the vials instead of throwing away leftover drug.

On Friday, a Clark County District Court jury ordered Teva to pay $356 million and Baxter $144 million. Earlier, the same jury awarded Chanin $5.1 million in compensatory damages.

The doctors and nurses who performed Chanin’s colonoscopy were also named in his lawsuit, but settled those claims earlier, the Review-Journal said.

Both Teva and Baxter say they plan to appeal the verdict.

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Radiation Overdoses Occuring Too Often http://www.yourlawyer.com/articles/read/17522 Mon, 25 Jan 2010 00:00:00 -0500 http://www.yourlawyer.com/articles/read/17522 The New York Times has published a disturbing article on radiation overdoses and their deadly consequences.

Sadly, the Times investigation revealed that radiation overdoses are more common than some might think.  The investigation uncovered 621 mistakes involving radiation treatment errors from 2001 to 2008 at hospitals in New York State. In 133 of the cases, the devices used to shape or modulate radiation beams were left out, wrongly positioned or otherwise misused. In 284 cases, the investigation found radiation missed all or part of its intended target or treated the wrong body part entirely.

According to the Times, radiation errors were most often attributed to “software flaws, faulty programming, poor safety procedures or inadequate staffing or training.”

Unfortunately, the Times found that patients in New York are unable to vet the radiotherapy center where they get treatment because the state does not disclose where or how often medical mistakes occur. What’s more, fines or license revocations are rarely used to enforce safety rules. According to the Times, New York State issued just three fines against radiotherapy centers over the past eight years, the largest of which was $8,000.

The Times article also highlights two patients who suffered greatly because of radiation overdoses. In one case, a 43-year-old man died in 2007, following radiation treatments at St. Vincent’s Hospital in Manhattan for tongue cancer. The hospital failed to detect a computer error that directed a linear accelerator to blast his brain stem and neck with errant beams of radiation – on three consecutive days. Prior to his death, the radiation overdoses left the man in severe pain, deaf, struggling to see, nauseated and unable to swallow. He sustained burns, and the radiation caused his teeth to fall out and ulcers his mouth and throat.

I another case, a 32-year-old mother of two with breast cancer received three times the recommended dosage of radiation during all 27 scheduled treatments at the State University of New York Downstate Medical Center in Brooklyn because a therapist incorrectly programmed the linear accelerator. She was left with a gaping wound so painful that she considered suicide, the Times said. Her cancer returned while she was being treated for the wound, and ultimately proved fatal.

 

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FDA Cites Red Cross for Problems with Blood Supplies http://www.yourlawyer.com/articles/read/17276 Fri, 13 Nov 2009 00:00:00 -0500 http://www.yourlawyer.com/articles/read/17276
The agency investigation, which took place last year, revealed a substantial amount of violations. According to Dow Jones, over 200 significant violations were discovered at 12 Red Cross facilities nationwide. The data is part of a report posted to the FDA’s Web site.

According to the agency, it is responsible for regulatory oversight of the U.S. blood supply. FDA promulgates and enforces standards for blood collection and for the manufacturing of blood products, including both transfusible components of whole blood, pharmaceuticals derived from blood cells or plasma, and related medical devices. FDA also inspects blood establishments and monitors reports of errors, accidents and adverse clinical events. CBER (Center for Biologics Evaluation and Research) works closely with other parts of the Public Health Service (PHS) to establish blood standards, and to identify and respond to potential threats to blood safety or supply.

Dow Jones reported that violations include blood components distributed with incorrect references to donor gender, and blood distributed in cases in which a donor was not properly cleared to give blood. "FDA regards the violations discussed in this letter to be significant," the agency said in its October 30 letter to the Red Cross, quoted Dow Jones. The FDA said it may levy fines of up to $5,000 for every unit of blood or blood component that was distributed and may have put the public's health at risk.

To date, Dow Jones indicated that documents do not state if there were any injuries reported or experienced as a result of the blood distributed by the American Red cross. Also, Red Cross spokeswoman Stephanie Millian said it has not received any reports of adverse events related to the blood products mentioned in the FDA report, said Dow Jones.

The FDA noted that from 2003 through 2008 the Red Cross had to recall 7,363 "unsuitable" blood components, said Dow Jones. Also, in a statement, the Red Cross said that over the last 18 months it has made system-wide change to address problems, and that most cited problems took place prior to 2008.

The Red Cross also argued, said Dow Jones, that the blood problems cited are just a fraction of the blood units it collects and processes annually, some six million unites. "The blood supply is safer today than ever before, and people should not hesitate to give or receive blood," the Red Cross said, quoted Dow Jones.

The Red Cross has been under intense scrutiny for more than a decade, and has been cited for similar violations by the FDA, most recently in 2005. A federal court in the 1990s ordered the Red Cross to correct systemic problems in tracking and distributing blood, according to Dow Jones. Meanwhile, the FDA's report said its investigation found the Red Cross has "repeatedly promised to implement and monitor corrective actions, but the corrective actions have not prevented recurrence of the problem."

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Rhode Island Hospital Fined Over Wrong-Site Surgery http://www.yourlawyer.com/articles/read/17222 Tue, 03 Nov 2009 00:00:00 -0500 http://www.yourlawyer.com/articles/read/17222 Last week, we wrote about the fifth reported botched surgery at the same hospital since 2007. Rhode Island Hospital—the largest hospital in that state—allegedly operated on the wrong body part, described as a wrong-site surgery, five times.

Now, says the Associated Press (AP), the hospital has been fined $150,000 and mandated to take what the AP described as “the extraordinary step” of putting in video cameras in its operating rooms, citing Rhode Island health officials. The unprecedented move involves a nonsurgical team clinician observing hospital surgeries for one year, monitoring if surgeons are marking operation sites, and taking time outs to determine if the correct body part has been located for surgery, said the AP.

Rhode Island Hospital has 45 days to install the recording equipment in its operating rooms and every doctor will be taped during surgery at least twice a year, reported the AP. It will be at the hospital’s discretion to advice surgeons if they are being monitored.

Health officials and the State Department of Health were looking into how a surgeon at the hospital mistakenly operated on the wrong area of a patient’s hand. That alleged mistake represented the fifth such wrong-site surgery in two years at the hospital, a teaching hospital for Brown University’s Alpert Medical School. According to state health director, David Gifford, the $150,000 fine represents the second such fine in as many years, said the AP. The prior fine, for $50,000, was imposed following three wrong site neurosurgeries in 2007, added the AP, noting that, according to Gifford, these are the only two fines ever issued by his department.

While this was the third wrong-site surgery in one year, Rhode Island News reported that that surgery was the fourth wrong-site surgery in just six years, all taking place in the neurosurgery area.

The recent surgery, based on a letter previously cited by the AP, revealed that Hospital President Timothy Babineau said the error occurred late last week on a patient scheduled to undergo surgery on two fingers meant for a joint on one of the fingers, but operated on another finger. Babineau said, reported the AP, the surgery was then performed on the correct finger. The patient has since been released.

According to the AP’s recent report providing additional details on the scandal, the surgery was meant for two fingers; however the surgeon performed two operations on the same finger. The site of the planned surgery was to have been indicated, with the team ensuring—prior to making an incision—that they were operating on the correct patient, the correct procedure, and the correct body part, said the AP. The protocols are long established in the medical field and also include marking of the body part scheduled for the operation.

According to Gifford, the surgical team marked the wrist, not each of the two fingers; the surgeon did not mark the site, and the team did not take a “time-out” prior to the second surgery, said the AP. Apparently, when the error was discovered, the team confirmed with the family of the patient if they should conduct the correct surgery on the correct site, said the AP, but—astonishingly—even after the mistakes already made, the team still did not conduct the recommended timeout, a mistake Gifford described as “amazing.”

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Botched CT Scans at Cedars-Sinai Prompt Lawsuit http://www.yourlawyer.com/articles/read/17152 Wed, 21 Oct 2009 00:00:00 -0400 http://www.yourlawyer.com/articles/read/17152 radiation overdose from a  CT brain scan at Cedars-Sinai Medical Center has filed a class action lawsuit against the hospital.  The lawsuit, which was filed in Los Angeles Superior Court, also names GE Healthcare as a defendant.

Last week, we reported that officials at Cedars-Sinai confirmed that 206 patients mistakenly received eight times the regular dose of radiation during CT brain scans, which are used to diagnose strokes.  The machine at Cedars-Sinai had been set at the higher level since February 2008,, but the mistake had not been detected for 18 months. According to the Medical Center, the overdoses were discovered in August, when a patient reported hair loss.

It is not yet known what led to the overdoses at Cedars-Sinai. They may have been the result a device malfunction, or appropriate procedures may not have been followed. In an alert posted on its Web site, the  Food & Drug Administration (FDA) said it was concerned that the radiation overdosing may reflect more widespread problems with CT quality assurance programs, and that the problem could go undetected and unreported, putting patients at increased risk for long-term radiation effects. The agency advised every facility performing CT imaging to review its CT protocols and be aware of the dose indices normally displayed on the control panel.

The Cedars-Sinai radiation overdose class action lawsuit includes all individuals who received a CT brain perfusion scan at Cedars Sinai Medical Center from February 2008 through August 2009. It also includes anyone who received such a scan that utilized CT image machines manufactured by GE Healthcare, Inc. and GE Healthcare Technologies at any medical facility during the two year period preceding the suit.

The lawsuit was filed on behalf of Trevor Rees, one of the 206 patients subjected to a radiation overdose at Cedars-Sinai.  Rees received his CT scan in December 2008, and experienced hair loss in the weeks following the procedure, as well as red and flaky skin on his face and scalp.  However, the lawsuit claims he only heard of the botched CT scans at Cedars-Sinai through media reports.  Rees did receive a phone call from  hospital officials last month, but says  he was only asked if he had experienced any side effects following his scan.  Rees claims he was not told the real reason for the call.

The lawsuit claims Cedars-Sinai staff and the scanner's manufacturer, General Electric Healthcare, were negligent in performing the scans.  The suit also alleges medical malpractice, product liability and breach of warranty. It seeks general and economic damages.

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LASIK Surgery Study to Look at Potential Quality of Life Issues http://www.yourlawyer.com/articles/read/17147 Tue, 20 Oct 2009 00:00:00 -0400 http://www.yourlawyer.com/articles/read/17147 LASIK surgery is the subject of a study just launched by the Food & Drug Administration (FDA).  According to an agency press release, the study is to be a collaborative effort between the National Eye Institute and the U.S. Department of Defense.

LASIK—laser-assisted in situ keratomileusis—surgery involves using a laser to cut a small flap in the eye’s cornea to allow for reshaping of the corneal tissue with another laser to correct nearsightedness, farsightedness and, sometimes, astigmatism.  LASIK was approved a decade ago and an estimated six million Americans have undergone LASIK surgery with hundreds of thousands of Americans undergoing LASIK yearly.  The surgery permanently reshapes the cornea, there are no guarantees of 20/20 vision, and the long-term safety of LASIK remains unknown.

LASIK is not for everyone, especially those with misshapen or excessively thin cornea, early cataract formation, big pupils, dry eyes, or underlying conditions such as lupus or rheumatoid arthritis.  LASIK risks include lost vision, painful dry eye, glare, and night-vision problems.  Serious complications affect about one percent of the cases and FDA estimates place customer dissatisfaction at five percent.  Unfortunately, aggressive marketing campaigns often lead patients to  believe clear sight is guaranteed, even though one in four patients seeking LASIK is deemed a poor candidate.

According to the FDA, the goal of the LASIK Quality of Life Collaboration Project is to determine the percentage of patients with significant quality of life problems after LASIK surgery and identify predictors of these problems.  The federally funded study will consist of three phases:

  • Phase 1, which began in July 2009, is to design and implement a Web based questionnaire to assess patient-reported outcomes and evaluate quality of life issues post-LASIK, some of which may relate to the safety of the lasers used in the LASIK procedure.
  • Phase 2 will evaluate the quality of life and satisfaction following LASIK as reported by patients in a select, active duty population treated at the Navy Refractive Surgery Center.
  • Phase 3 will be a national, multi-center clinical trial and will study the impact of the procedure on quality of life following LASIK in the general population. Patient enrollment in Phases 2 and 3 have yet to begin but plans are underway. Phase 3 is expected to end in 2012.

According to the FDA, the  results of the project will help identify factors that can affect quality of life following LASIK and potentially reduce the risk of adverse effects that can impact the surgical outcome. If any of these factors are related to the safety or effectiveness of the lasers used in LASIK surgery, the FDA will evaluate whether any action is necessary. The project is part of the FDA’s ongoing effort to better monitor and improve the safety and effectiveness of the lasers used in LASIK surgery.

The announcement of the LASIK study came at the same time the FDA issued warning letters to 17 LASIK ambulatory surgical centers after inspections revealed inadequate adverse event reporting systems at all the centers. The inspections did not identify problems with the use of the LASIK devices at these facilities.

Under legislation passed in 1990, user facilities, which include nursing homes, outpatient clinics and ambulatory surgical centers, must report device-related deaths to the FDA and to the device manufacturer. They also must report device-related serious injuries to the manufacturer or to the FDA if the manufacturer is not known. Requirements include having a written protocol for adverse event reporting.

The FDA inspected ambulatory surgical facilities that perform LASIK over the past several months and additional inspections are pending. The FDA regulates ophthalmic lasers used in LASIK, including monitoring their continued safety and effectiveness by analyzing reports on their post-market use.

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VA Head Testifies About Botched Treatments http://www.yourlawyer.com/articles/read/17133 Thu, 15 Oct 2009 00:00:00 -0400 http://www.yourlawyer.com/articles/read/17133 medical scandals at the Department of Veterans Affairs. In one case VA centers in three cities have been accused of reusing colonoscopy and endoscopy equipment without properly sanitizing the equipment. At last count, some 50 veterans have tested positive for blood borne pathogens.

The VA also recently sent erroneous letters to veterans with potential neurological diagnoses, but who do not have ALS—Lou Gehrig’s disease—telling them they were diagnosed with the debilitating, deadly disease. At last count, some 600 veterans received the distressing letters. And, last June, the brachytherapy program at the VA Medical Center in Philadelphia was shut down, after it was learned that scores of veterans had received incorrect radiation doses over a six-year period.

The Washington Times is now reporting that the VA Department’s agency chief Eric Shinseki acknowledged at a Congressional panel yesterday that the Department did make serious safety errors at some of its centers and also was lax in conducting necessary educational and monetary services to thousands of veterans. "While this process is at times painful, it is the right thing to do for veterans and the nation and will ultimately result in greater trust and better quality," said Shinseki when discussing the issues specifically at the Philadelphia center, said the Washington Times.

In addition to the scandals involving shoddy brachytherapy procedures, endoscopies, and colonoscopies, and inaccurate ALS notifications, there have been other problems.

Shinseki also talked about delays in education funding for veterans who had been deployed to Iraq and Afghanistan. "Across the nation, veterans who applied for benefits under the GI Bill have been told their payments are being delayed because of an overwhelming number of problems at both the department and the schools," said Representative Bob Filner (California-Democrat), the committee chairman, quoted the Washington Times.

According to Representative Steve Buyer (Indiana-Republican) who is the ranking committee member, the educational benefit delays, as well as delays in processing disability claims is still increasing, reported the Washington Times. "The challenges you have stepped into are almost a runaway train, so how do you stop that train?” said Buyer, quoted the Washington Times.

The VA has scheduled a so-called “emergency exercise” so that the agency can "enter the spring semester with no backlog," said Shineski, speaking of the education funds. And, although the VA resolved 92,000 claims in July alone, another 91,000 claims were received, said Shinseki, wrote the Washington Times.

Concerning veterans who are suffering with post-traumatic stress disorder (PTSD), Shinseki said they will receive care, but did not explain a new rule that concerns this care. The Washington Times explained that the new rule, which is being considered by the VA, would include a change to what is required to confirm that a veteran does indeed suffer from PTSD. "If a stressor is related to the veteran's fear of hostile military or terrorist activity and a VA psychiatrist or psychologist confirms that the claimed stressor is adequate to support a diagnosis of PTSD," veterans would be eligible for medical treatment. New York Democrat, Representative John Hall who is also the chairman of the Veterans subcommittee on disability assistance and memorial affairs, spoke with veterans’ organizations about the rules limitations such as needing a VA doctor to make a diagnosis and what qualifies as a contributing factor or trigger, noted the Washington Times.

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Cedars-Sinai At Center of CT Scan Radiation Overdosing Probe http://www.yourlawyer.com/articles/read/17109 Mon, 12 Oct 2009 00:00:00 -0400 http://www.yourlawyer.com/articles/read/17109 botched CT brain scans that were performed at Cedars-Sinai Medical Center in Los Angeles, California.  On Friday, the Food and Drug Administration (FDA) issued an alert to hospitals nationwide, warning them to review their safety procedures for CT scans.  However, the alert did not name Cedars-Sinai specifically.

According to the Associated Press, officials at Cedars-Sinai said on Friday that 206 patients got eight times the regular dose of radiation during CT brain scans, which are used to diagnose strokes.   According to the FDA alert, patients involved in these incidents had received radiation doses of 3-4 Gy to the head, rather than the expected dose of  0.5 Gy (maximum).   

The machine at Cedars-Sinai had been set at the higher level since February 2008, the Associated Press said, but the mistake had not been detected for 18 months.  According to the Medical Center, the overdoses were discovered in August, when a patient reported hair loss.  Other patients had also suffered hair loss and skin reddening.   Cedars-Sinai has notified all patients who received the overexposure and provided resources for additional information.

In its alert, the FDA said it was concerned that the radiation overdosing "may reflect more widespread problems with CT quality assurance programs and may not be isolated to this particular facility or this imaging procedure (CT brain perfusion). If patient doses are higher than the expected level, but not high enough to produce obvious signs of radiation injury, the problem may go undetected and unreported, putting patients at increased risk for long-term radiation effects."

The FDA is encouraging every facility performing CT imaging to review its CT protocols and be aware of the dose indices normally displayed on the control panel.  An FDA spokesperson told the LA Times that it does not yet know what led to the overdoses at Cedars-Sinai.   They may have been the result a device malfunction, or appropriate procedures may not have been followed.  

According to the LA Times, a statement issued by Cedars-Sinai said that since the overdosing was discovered, it had "instituted additional double-checks in its operations of the scanner and additional equipment protocols to ensure that this does not happen again."    

In addition to the FDA,  the overdoses at Cedars-Sinai are being investigated by the California Department of Public Health.  Depending on the outcome of the state investigation, the hospital could face restrictions on doing CT scans under its state license, LA Times said.

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Study Finds Doctors Make Mistakes When Overwhelmed http://www.yourlawyer.com/articles/read/17021 Wed, 23 Sep 2009 00:00:00 -0400 http://www.yourlawyer.com/articles/read/17021 medical errors, they know that their exhaustion is a contributing factor to those errors. Reuters, citing a study just reported in the Journal of the American Medical Association, said that “general distress and mental fatigue” are also factors that contribute to physician errors.

"While fatigue is important, said study lead, Dr. Colin West of the Mayo Clinic in Rochester, Minnesota, “there is this whole domain of distress beyond fatigue that also demands attention," quoted Reuters. The findings are hoped to better enable ways to reduce stress on residents, which is hoped to reduce errors, said Reuters. "I think this is going to have an impact on health care reform," West said. "We need (to put) resources into training and medicine to control work hours and maintain physician well-being," he added, said Reuters.

According to a 1999 U.S. Institute of Medicine report, said Reuters, it was estimated that between 48,000 to 98,000 Americans die annually from an array of medical errors, such as overdoses and infections, deemed preventable.

In December we wrote about this problem and noted that the Institute of Medicine was recommending that new doctors’ workloads be eased a bit, saying that young doctors—and their patients—may benefit from sleep breaks. Now, said Reuters, doctors, unions, and others have been looking to cut residents hours, traditionally at 100-to-120 hours each week and still at no less than 80 weekly hours in training hospitals, according to West and his team. The team looked at 163 medical schools and 356 residents worldwide.

The study revealed that 39 percent of the residents admitted to making “at least one major medical error” during the time under which the study was conducted and also were likelier to admit to being “sleepy, fatigued, or stressed,” said Reuters. "What we have shown in these data is that fatigue is important ... but it's only part of the issue, and previous studies have not paid much attention to the distress factors," West said, quoted Reuters. "Over the course of their training and the course of their career, everyone has made a major error. Everyone tries to be perfect, but no one is," West added.

In December, ECanadaNow noted that residents are exhausted when treating patients, which could result in “serious medical errors.” The vast majority of residents—a whopping 75 percent—reported being “burnt out” before ever reaching the 80-hour weekly limit, said ECanadaNow, which noted that even 30-hour shifts might be excessive.

According to a December Associated Press (AP) piece, regulations passed in recent years limited the amount of hours residents were allowed to work to 80 per week.  Regardless, an Institute of Medicine report entitled, “Resident Duty Hours: Enhancing Sleep, Supervision and Safety” that was cited in December, indicated that residents are still too tired and their hospitals should provide opportunities for trainees to get some rest.

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Death Puts Surgical Fires In The Spotlight http://www.yourlawyer.com/articles/read/17000 Fri, 18 Sep 2009 00:00:00 -0400 http://www.yourlawyer.com/articles/read/17000 surgical flash fire caused the death of a woman last week at Marion, Illinois’ Heartland Regional Medical Center. The Associated Press (AP) reported that the woman was seriously burned in a fire that occurred during surgery, dying six days later at the Vanderbilt University Medical Center in Tennessee.

The reason for the surgery has not been released; however, the state medical examiner in Tennessee said the woman, whose death was ruled accidental, died from thermal burn complications, said the AP. According to a Heartland statement, "There was an accidental flash fire in one of the hospital's operating rooms," quoted the AP, which noted that a patient was injured just before the fire was put out; the hospital did not explain how the fire started.

KFVS, citing the ECRI Institute—a group that tracks surgical fires—approximately 550-650 surgical are reported annually, with 20-30 deemed serious, and one or two deemed deadly. ECRI accident and forensic investigator, Mark Bruley, who has studied surgical fires for some 30 years, said that most—about 75 percent—occur when high oxygen levels are found under “surgical sheets or drapes,” which can cause the material to ignite, reported KFVS. Another common flash fire occurs when surgical staff use alcohol-based cleaners and do not permit the alcohol to fully dry before setting up electronic scalpels, said KFVS, which can cause vapor ignition.

According to Bruley, the fires are “100 percent preventable.”

"Let me put it this way, there's not a whole lot the patient can do to prevent a surgical fire if anything…. An informed health care community with the surgeons and anesthesiologists and OR nurses being informed on how to prevent the fires is the real critical issue," said Bruley, quoted KFVS.  

The AP noted that concern about surgical fires has increased in recent years with the advent of electrosurgical tools—such as scalpels and cauterizers—and the use of less flame retardant, disposable synthetic fabrics, which have replaced cloth hospital drapes. The ECRI, said the AP, recommends anesthesiologists stop using 100 percent oxygen, giving the patient only what he/she requires and diluting the oxygen content with room air when electrosurgical tools are in use.

"What we've been advocating for years is that the open delivery of oxygen under the drapes essentially has to stop," said Bruley, quoted the AP, with noted that there are needed exceptions, for instance in operations involving cardiac pacemakers or a neck artery. Bruley also noted, said KFVS, that many of these accidents, such as the recent death involving 65-year-old Janice McCall of Energy, Illinois, result in legal action.

The medical community is not unaware of the issue with surgical fires. According to MD Publishing, a trade publication, it recently wrote that “The OR is a complex setting, with high-tech demands and team members with varying competencies working on cases that are often emergent or urgent. These factors make the OR prone to errors, which are more likely to occur during periods of procedural confusion and deviation from protocol.” The article listed an array of adverse events possible in the operating room under such circumstances, stating that surgical fires are among the high-risk outcomes.

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Injuries From Laser Hair Removal, Other Procedures Sparking Lawsuits Against Medical Spas http://www.yourlawyer.com/articles/read/16957 Tue, 08 Sep 2009 00:00:00 -0400 http://www.yourlawyer.com/articles/read/16957 medical spas are increasingly filing lawsuits over injuries sustained as a result of procedures aimed at removing facial hair, wrinkles and acnes scars, according to a report in The New York Law Journal.  According to one personal injury attorney interviewed by the Journal, medical spas are lightly regulated, and are being used by consumers more frequently - a formula that could lead to an explosion of litigation involving such facilities in the coming years.

According to The New York Law Journal, medical spas are facilities where small plastic surgery procedures are performed.  They should not be confused with day spas, where clients can receive facials, massages and other treatments.  According to the Law Journal article, most states require that the plastic surgery procedures being performed at medical spas be supervised by a doctor.  Sadly, that doesn't always happen, and injuries can result.

According to The New York Law Journal, laser hair removal procedures are triggering many medical spa lawsuits.  In one case detailed by the Law Journal article, an Arizona woman was "severely burned and scarred" during such a procedure.  In another Arizona lawsuit, a man claims he sustained scarring, "extreme pain" and burning from laser hair removal on his back and shoulders.

Plaintiffs in these cases can often win big judgments and settlements, the Law Journal said.  For instance, earlier this year a North Carolina woman won a $500,000 judgment against a medical spa over a serious blood infection she allegedly developed from a procedure to reduce fat in her stomach.  

An attorney who represents medical spas in product liability lawsuits told The New York Law Journal that such facilities are being "targeted" by the plaintiffs bar.  The attorney said such facilities could protect themselves by making sure that risks of procedures are fully disclosed, and that they obtain and document patients' informed consent.

In the meantime, some states are moving to tighten regulations for medical spas, the Law Journal said.

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Bronx Jury Awards $60 Million in Medical Malpractice Case http://www.yourlawyer.com/articles/read/16745 Wed, 15 Jul 2009 00:00:00 -0400 http://www.yourlawyer.com/articles/read/16745 A Bronx jury has awarded $60 million in damages to a woman in a medical malpractice case against a Queens County plastic surgeon  for a botched thigh lift procedure.   The plaintiff in the case, Allison Hugh of the Bronx, was represented by Parker Waichman LLP, one of the nation's premier plaintiffs' litigation firms.

Hugh's lawsuit alleged that the thigh lift procedure performed by Ferdinand A. Ofodile, M.D. caused significant and permanent injury and deformity to the labia of her vagina which cannot be surgically corrected.   The complaint alleged Dr. Ofodile failed to inform and provide Ms. Hugh with informed consent and failed to inform her of the risks involved in this type of procedure, including the risk of vaginal opening and deformity. Dr. Ofodile also failed to use proper surgical techniques by leaving too much tension in the skin of her groin area, according to the lawsuit.

The jury found that Dr. Ofodile failed to appropriately advise Ms. Hugh about the risks of this type of procedure. It also found that he deviated from good and accepted medical practices in his surgical technique.

Ms. Hugh was awarded $10 million for past  pain and suffering, and $50 million for future pain and suffering.

Ms. Hugh was represented by the law firm of Parker Waichman LLP.  The firm has has consistently obtained large verdicts and multi-million dollar settlements on behalf of his clients.

Parker Waichman LLP is a leading national law firm concentrating primarily with negligence and personal injury matters, mass tort, pharmaceutical, medical device, products liability, construction and consumer litigation. The firm has offices in New York, New Jersey and Florida, and represents plaintiffs nationwide.

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VA Cancer Probe Continues http://www.yourlawyer.com/articles/read/16691 Tue, 30 Jun 2009 00:00:00 -0400 http://www.yourlawyer.com/articles/read/16691 Dr. Gary D. Kao, the doctor linked to scores of potentially shoddy medical procedures conducted at the Veterans Administration (VA) Medical Center in Philadelphia admitted to making mistakes when administering radiation seed implantation—brachytherapy—to prostate cancer patients. It seems 92 veterans allegedly received incorrect radiation doses.

But, Kao, who admitted to “missing his target” when performing brachytherapy, claimed this type of error is not unusual and something for which he refused to be singled out, reported the Associated Press (AP). “Contrary to the allegations that I was a ’rogue’ physician, ... I always acted in the best interest of the patients in delivering this important treatment,” said Kao, quoted the AP. Kao, a radiation oncologist, was quoted when testifying at a Senate field hearing at the hospital, said the AP, noting that Kao worked at the VA center from 2002 to 2008.

KYW1060 reported that Kao testified that it is understood that radioactive seeds can move outside of the prostate to tissue and other organs, "The chance of seeds in the bladder, or outside the prostate, is a recognized risk of the procedure," said Kao. Senator Arlen Specter asked Kao at this point, "It's a recognized risk, but did you notify patients?" quoted KYW1060, to which Kao responded, "No sir.” Kao claimed such errors did not constitute a lower level of care that required reporting to the Nuclear Regulatory Commission (NRC) and other agencies, said the AP. “Brachytherapy was and still is an evolving field,” claimed Kao, quoted the AP.

The prostate is the size of a walnut and is located near the bladder and rectum, said the AP. Brachytherapy involves implantation of radioactive seeds to kill cancer cells, explained the AP previously, noting that most veterans allegedly received ‘”significantly less” dosing than what was prescribed, while others “received excessive radiation to nearby tissue and organs.” Brachytherapy is an option only used in patients diagnosed with “small, early-stage, non-aggressive prostate cancers,” said Philly.com.

According to an earlier AP report, the team performing the brachytherapy “botched” dosing on most cases, but continued to conduct treatment despite that “monitoring equipment was broken,” citing The New York Times. The AP reported that the NRC found incorrect dosing occurred because, generally, seeds landed outside of the prostate in tissue or nearby organs. Kao performed most procedures, said Philly.com, noting that Kao stopped seeing patients a year ago.

In one case, a patient testified to losing his job because he was forced on five months bed rest after Kao allegedly implanted radiation seeds into his rectum, not his prostate, said the AP. Although the VA said the problem likely came from hemorrhoids or constipation, an Ohio State University physician diagnosed the problem as radiation burn, surgically correcting the problem, the AP reported.

In another case, a patient underwent a seed removal from his bladder, alleged that three seeds were expelled in blood clots, and suffered radiation irritation to his rectum and bladder. The patient claims he never received the VA letter allegedly sent to all its brachytherapy patients. The cancer remains and the patient’s options are significantly limited and include surgery to remove the prostate, bladder, and colon, forcing use of urine and feces collection bags, said Philly.com.

The VA center’s brachytherapy program has been suspended, said the AP, noting that a review of 12 other VA hospitals in which brachytherapy is conducted revealed some problems, as well; none allegedly as severe or frequent as at the center in Philadelphia. According to the AP, Kao took a leave from the University of Pennsylvania last week.

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4th VA Patient Has HIV http://www.yourlawyer.com/articles/read/16489 Mon, 27 Apr 2009 00:00:00 -0400 http://www.yourlawyer.com/articles/read/16489 shoddy colonoscopies and endoscopies at Veterans Affairs (VA) hospitals has risen from three to four this week. Now, the Associated Press (AP) is reporting that the Department of Veterans Affairs confirmed a fourth person has tested positive for HIV, the virus that causes AIDS.

This brings the number of positive AIDS tests to two from the VA hospital in Miami and one each from Murfreesboro, Tennessee and Augusta, Georgia VA hospitals, said the AP. The VA said it is looking into issues with cleaning medical equipment used for colonoscopies and also for equipment used for ear, nose, and throat examinations at three of its hospitals located in the Southeast, said the AP. And, while the VA says it is unable to confirm if the cases are connected to treatment at its sites, the AP noted that the VA warned nearly 11,000 veterans who received care at those hospitals to undergo blood testing.  Many believe dirty equipment is to blame.

HIV and hepatitis B and C are spread by contact with infected body fluids, especially blood.  HIV—the human immunodeficiency virus—is the virus that causes AIDS (acquired immunodeficiency syndrome); AIDS is the final stage of HIV infection. Hepatitis B and C are liver diseases that can lead to cirrhosis or cancer of the liver. Vaccines exist only for hepatitis B.  HIV/AIDS and hepatitis B and C can all be fatal.

The shoddy tests were conducted as far back as five years ago and put patients at risk because they were treated with equipment that was not appropriately sterilized, thus exposing them to the bodily fluids of other patients, noted the AP. The VA acknowledged in its warnings letters to the over 10,000 veterans who received the invasive procedures that they were potentially exposed to other patients’ bodily fluids and should be tested for diseases such as hepatitis and HIV, said the AP in an earlier report. Also, the VA admitted in late March that water tubes and reservoirs it used in colonoscopies and endoscopies were rinsed—not disinfected—between procedures, which could expose subsequent patients to contamination.

According to an earlier VA statement, reported the AP, the number of so-called "potentially affected" patients totals 10,797, including, it said, 6,387 who underwent colonoscopies at Murfreesboro, 3,341 who underwent colonoscopies at Miami, and another 1,069 who were treated at Augusta’s ear, nose, and throat clinic.

In an earlier Washington Times article, the VA admitted that the three hospitals did not appropriately sterilize colonoscopy equipment on a variety of occasions since 2003.  Also, WSMV said in an earlier report that, late last year the VA found a wrong tubing valve might have been used during procedures as far back as April 2003, which could have resulted in body fluid transmission between patients.

In addition to the four patients who now test positive for HIV, there have been six positive results for hepatitis B and 20 for hepatitis C at the three VA clinics, said the AP. At least one patient consulted with malpractice attorneys and more are expected.

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South Dakota Urology Clinic Exposed Patients to Diseases http://www.yourlawyer.com/articles/read/16456 Tue, 21 Apr 2009 00:00:00 -0400 http://www.yourlawyer.com/articles/read/16456 malpractice at the Siouxland Urology Center in Dakota Dunes, South Dakota has likely exposed many thousands of patients to dangerous, deadly blood borne diseases.  CNN reports that Siouxland Urology might have exposed nearly 6,000 patients to HIV and hepatitis.  As with a variety of other similar contaminations, Siouxland Urology reused single use medical products, potentially passing on serious diseases to other patients.

Siouxland Urology has been ordered to contact about 5,700 of its former patients who were treated at the Center since 2002, said CNN, after a routine inspection there revealed that Siouxland Urology was reusing a variety of medical supplies, including sterile saline bags, tubing, and other cystoscopy supplies.  Cystoscopies, explained CNN, are a diagnostic procedure that targets the lower urinary tract.  "We witnessed the practice while we were in the facility," said Barb Buhler of the South Dakota Health Department, quoted CNN.  Buhler was referring to a January 21 inspection.  Siouxland Urology is under a provisional license, said state officials.

South Dakota Department of Health inspectors—who are registered nurses (RNs)—noticed that a saline bag, on a pole in an examining room where a cystoscopy was going to shortly take place, was dated two days prior, according to Bob Stahl, from the South Dakota Department of Health, reported CNN.  The RN inspectors questioned the staff who said that “they routinely reused saline bags and tubing,” had been doing so since the clinic’s opening in 2002, and did not understand why reusing one-time use medical supplies presented a problem, said Stahl, who noted that the bags and tubing clearly state “for single use only,” said CNN.

"They used the bags and tubing on multiple patients," Stahl said, quoted CNN, adding that, "It was their standard operating procedure….  They told the inspectors that this was a common practice all over the country.  We disagreed and told them this was not a common practice." Reusing such supplies can enable patient bodily fluids to backflow into the saline bags and tubing.

"Siouxland Urology Center informed certain of its patients by U.S. mail that a prior cystoscopy procedure could have potentially exposed them to an infectious disease," its Website said, according to CNN.  The clinic’s clients are generally from South Dakota, Iowa, and Nebraska; the clinic is providing free blood tests to its potentially infected patients, said CNN.

In a similar case in which medical equipment was rinsed—not sterilized—shoddy colonoscopies and endoscopies at Veterans Administration facilities have exposed over 10,000 military veterans to HIV and hepatitis B and C following exposure to tainted equipment, with three patients testing positive for HIV, six for hepatitis B, and 19 for hepatitis C. At least one patient consulted with malpractice attorneys and more are expected.  The shoddy tests were conducted as far back as five years ago.

HIV and hepatitis B and C are spread by contact with infected body fluids. HIV—the human immunodeficiency virus—is the virus that causes AIDS (acquired immunodeficiency syndrome); AIDS is the final stage of HIV infection. Hepatitis B and C are liver diseases that can lead to cirrhosis or cancer of the liver. Vaccines exist only for hepatitis B. HIV/AIDS and hepatitis B and C can all be fatal.

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Several HIV Cases Linked to One VA Clinic http://www.yourlawyer.com/articles/read/16453 Mon, 20 Apr 2009 00:00:00 -0400 http://www.yourlawyer.com/articles/read/16453 Shoddy colonoscopies and endoscopies have exposed thousands of military veterans to dangerous, life-threatening pathogens.  Earlier this month, the Associated Press (AP) reported that one patient tested positive for HIV following exposure to tainted equipment at a Veterans Administration (VA) medical facility.  Now, the AP is reporting that a total of three patients have tested positive for HIV, one each from VA facilities in Murfreesboro, Tennessee; Augusta, Georgia; and Miami, Florida.

The shoddy tests were conducted as far back as five years ago and have prompted testing of over 10,000 veterans, said the AP. To date, said the AP over 5,400 patients have been notified of their follow-up test results.

HIV and hepatitis B and C are spread by contact with infected body fluids, especially blood.  HIV—the human immunodeficiency virus—is the virus that causes AIDS (acquired immunodeficiency syndrome); AIDS is the final stage of HIV infection. Hepatitis B and C are liver diseases that can lead to cirrhosis or cancer of the liver. Vaccines exist only for hepatitis B.  HIV/AIDS and hepatitis B and C can all be fatal.

Testing is required because patients were treated with equipment that was not appropriately sterilized, thus exposing them to the bodily fluids of other patients, noted the AP.  The VA acknowledged in its warnings letters to the over 10,000 veterans who received the invasive procedures that they were potentially exposed to other patients’ bodily fluids and should be tested for diseases such as hepatitis and HIV, said the AP in an earlier report. Also, the VA admitted in late March that water tubes and reservoirs it used in colonoscopies and endoscopies were rinsed—not disinfected—between procedures, which could expose subsequent patients to contamination.

According to a prior AP piece, the VA stated that hepatitis B and C were diagnosed in 16 patients, but argued that it would be impossible to determine if contamination occurred at VA facilities.  Since, the VA has confirmed, said the AP, that there have been six positive results for hepatitis B and 19 for hepatitis C at the three VA clinics.  At least one patient consulted with malpractice attorneys and more are expected.

The VA admits that it remains unclear if veterans who underwent procedures with the same type of equipment at the 150 other VA hospitals might also be facing similar contamination issues, said the AP.  Apparently, a nationwide safety training campaign took place and ended March 14 and an equipment mistake was corrected by the time campaign ended said the AP, citing a VA spokeswoman.

According to a VA statement, reported the AP, the number of so-called "potentially affected" patients totals 10,797, including, it said, 6,387 who underwent colonoscopies at Murfreesboro, 3,341 who underwent colonoscopies at Miami, and another 1,069 who were treated at Augusta’s ear, nose, and throat clinic.

In an earlier Washington Times article, the VA admitted that the three hospitals did not appropriately sterilize colonoscopy equipment on a variety of occasions since 2003.  Also, WSMV said in an earlier report that, late last year the VA found a wrong tubing valve might have been used during procedures as far back as April 2003, which could have resulted in body fluid transmission between patients.

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Veteran Diagnosed with HIV Following Botched Procedure at VA Hospital http://www.yourlawyer.com/articles/read/16375 Tue, 07 Apr 2009 00:00:00 -0400 http://www.yourlawyer.com/articles/read/16375 shoddy colonoscopies and endoscopies they underwent as long as five years ago.  Now, the Associated Press (AP) reports one patient has tested positive for HIV following exposure to tainted equipment at a Veterans Administration (VA) medical facility.

HIV and hepatitis B and C are spread by contact with infected body fluids, especially blood.  HIV—the human immunodeficiency virus—is the virus that causes AIDS (acquired immunodeficiency syndrome); AIDS is the final stage of HIV infection.  Hepatitis B and C are liver diseases that can lead to cirrhosis or cancer of the liver.  Vaccines exist only for hepatitis B.  HIV/AIDS, hepatitis B, and hepatitis B can all lead to death.

According to the AP, the VA previously stated that hepatitis B and C were diagnosed in 16 patients, but argued that it would be impossible to determine if contamination occurred at VA facilities. At least one patient consulted with malpractice attorneys and more are expected. The man, who is in his 50s, tested positive for hepatitis C; he and his lawyers believe a colonoscopy at the Murfreesboro VA two years prior to be the culprit, said WSMV last month. Now, the long-married father must endure protected sex with his wife for the rest of their lives, it noted.

The VA acknowledged in warnings letters to over 10,000 veterans who had received the invasive procedures in the past five years, that they were potentially exposed to other patients’ bodily fluids and should be tested for diseases such as hepatitis and HIV, said the AP in an earlier report.  Also, the VA admitted in late March that water tubes and reservoirs it used in colonoscopies and endoscopies were rinsed—not disinfected—between procedures, which could expose subsequent patients to contamination.

The Washington Times reported that following its confirmation that the first round of tests found one veteran tested positive for HIV, the VA said,  "These results do not indicate that there is any relationship between these patients' conditions and the endoscopy procedures they underwent…  However, VA is conducting an epidemiologic investigation to look into the possibility of such a relationship."  The VA also admitted that three of its hospitals did not appropriately sterilize colonoscopy equipment on a variety of occasions since 2003:  Murfreesboro, Tennessee (April 2003 to December 2008), Augusta, Georgia (January 2008 to November 2008), and Miami, Florida (May 2004 through March 2009), said the Washington Times, which also noted that 3,174 test results have been received to date.

WSMV said in an earlier report that late last year the VA found a wrong tubing valve might have been used during procedures as far back as April 2003, which could have resulted in body fluid transmission between patients.

This January, the VA finished a report on the problem in Murfreesboro, including the cause for equipment switches, incorrect equipment use, and improper sterilization processes, said WSMV; however, the VA insisted that, in the majority of cases “unclear product instructions” from Olympus—the equipment provider—are to blame for the potential spread of deadly infections.

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NJ Oncologist Linked to Hepatitis Outbreak Has License Suspended http://www.yourlawyer.com/articles/read/16368 Mon, 06 Apr 2009 00:00:00 -0400 http://www.yourlawyer.com/articles/read/16368 hepatitis B and C and HIV, the virus that causes AIDS, has had his license to practice medicine suspended, effective immediately, and on an emergency basis, the Associated Press (AP) is reporting.

According to a prior AP article, New Jersey health officials confirmed that about 3,000 people treated by Dr. Parvez Dara must undergo testing for the blood borne diseases after five of his patients reportedly tested positive for hepatitis B.  Hepatitis B is a liver infection that can be transmitted through blood and blood products.

The state was looking to temporarily suspend Dara’s medical license said Asbury Park Press (APP) last week and Dara was scheduled to face the state Board of Medical Examiners Friday; regulators were also looking at a number of other health code violations.

While Dara’s attorney claims that the five patients also were seen at the same hospital and could have been contaminated there, health officials argued that the hospital was ruled out as an infection source. “The investigation looked at all sites where the patients received care…. The only common site was the physicians’ office,” said state Health Department spokeswoman Marilyn Riley, quoted the AP, last week.

But, Friday, investigators reported finding blood in a variety of areas in the doctor’s office including the floor of the chemotherapy room and in a bin that held blood vials, said the AP, which noted that the investigators also found open medicine vials, “unsterile saline and gauze” as well as cross-contamination of ”pens, refrigerators, and countertop; use of contaminated gloves; and misuse of antiseptics,” among other violations.

According to Deputy Attorney General Siobhen Krier, who was speaking to investigators, “This was not a one-time episode.  This is a case of egregious, bad medical judgment displayed over a long period of time,” quoted the AP.  Krier also said that Dara’s history of health code violations not only posed “a clear and imminent danger to the public,” but also was occurring as far back as 2002, said the AP, with Dara paying close to $56,000 in fines for infection control health code violations.

The committee said that Dara showed “a significant and gross deficiency in judgment,” that could not be corrected by merely changing his practices, said the AP.  “Dr. Dara’s own testimony has not persuaded the committee that he has an appreciation for the gravity of multiple breaches of basic infection control practices,” the committee said in the license suspension order, quoted the AP.

APP reported last week that a 32-page court order requested late last month by Attorney General Anne Milgram sought “the suspension or revocation of the license of Respondent to practice medicine and surgery. It being alleged in the Complaint that Respondent is presently incapable of safely discharging the functions of a licensee and it being further alleged that the continued practice of medicine and surgery by Respondent pending final disposition of the Verified Complaint represents a clear and imminent danger to the public health safety and welfare.”

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New Jersey Hepatitis B Outbreak Likely Linked to One Oncologist http://www.yourlawyer.com/articles/read/16358 Fri, 03 Apr 2009 00:00:00 -0400 http://www.yourlawyer.com/articles/read/16358
According to the Associated Press (AP), New Jersey health officials have confirmed that about 3,000 people treated by Dr. Parvez Dara must be tested for the diseases after five of his patients reportedly tested positive for hepatitis B.  Hepatitis B is a liver infection that can be transmitted through blood and blood products.

The first two cases were confirmed in February and the remaining three were confirmed more recently.   Dara has offices in Toms River and Manchester, New Jersey, the AP reported.  Following the confirmation, health officials sent a letter—dated March 28—to all of Dara’s patients going back to 2002 and warning them of the risks of the blood borne diseases and urging them to receive testing, said the AP.

The source and cause of the transmission remain unclear, said the AP; however, Fox News reported that New Jersey health officials believe shoddy injection practices might be to blame.  Dara, who treats cancer patients and patients with blood disorders, said the AP, administers chemotherapy, which is injected, at his offices, said Fox News.

The state is looking to temporarily suspend Dara’s medical license said Asbury Park Press (APP) and Dara is scheduled to face the state Board of Medical Examiners today, said Fox News; the regulators will also look at the possibility of other health code violations.  For now, Dara is not performing procedures and is only handling patient consultations, the AP reported.

While Dara’s attorney claims that the five patients also were seen at the same hospital and claims they could have been contaminated there, health officials argued that the hospital was ruled out as an infection source. "The investigation looked at all sites where the patients received care....  The only common site was the physicians' office," said state Health Department spokeswoman Marilyn Riley, quoted the AP.

APP reported that a 32-page court order requested late last month by Attorney General Anne Milgram sought "the suspension or revocation of the license of Respondent to practice medicine and surgery.  It being alleged in the Complaint that Respondent is presently incapable of safely discharging the functions of a licensee and it being further alleged that the continued practice of medicine and surgery by Respondent pending final disposition of the Verified Complaint represents a clear and imminent danger to the public health safety and welfare.”

The APP indicated that officials for the state Department of Health and Senior Services and the Ocean County Health Department conducted the investigation.  Letters were sent to 2,800 former and current patients of Dara.

Patients in possession of the health department’s letter, an insurance card, and identification can obtain blood testing at one of Community Medical Center’s outpatient labs (contact Ocean County Health Department at 1-732-341-9700 ext 7502 for locations); appointment are not required, said APP.  Patients are also free to have blood testing conducted at their own health car provider.

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Vets Endangered by Improperly Sterilized Equipment http://www.yourlawyer.com/articles/read/16313 Fri, 27 Mar 2009 00:00:00 -0400 http://www.yourlawyer.com/articles/read/16313
WSMV reports that no less than 10 patients have tested positive for hepatitis B or C or HIV.  At least one man has consulted with malpractice attorneys and more are expected.  The man, who is in his 50s, tested positive for hepatitis C; he and his lawyers believe a colonoscopy at the Murfreesboro Veterans Administration two years prior to be the culprit, said WSMV.  Now, the long-married father must endure protected sex with his wife for the rest of their lives, it noted.

The VA won’t say exactly what happened, but did acknowledge in warnings to veterans who had received the invasive procedures in the past five years that they were potentially exposed to other patients’ bodily fluids and should be tested for diseases such as hepatitis and HIV, said the AP.

The VA admitted this week that the water tubes and reservoirs it used in colonoscopies and endoscopies were rinsed—not disinfected—between procedures.  This practice could expose subsequent patients to contamination, said the Miami Herald.  In south Florida alone, over 3,000 veterans underwent medical procedures since 2004 in which the improper processes were followed, said the Miami Herald; Boston.com reported that up to 9,000 patients may have been contaminated.  WSMV reported that, late last year, the VA found a wrong tubing valve might have been used during procedures as far back as April 2003, which could have resulted in body fluid transmission between patients.

This January, the VA finished a report on the problem in Murfreesboro, including the cause for equipment switches, incorrect equipment use, and improper sterilization processes, said WSMV; however, the VA insisted that, in the majority of cases—seven out of 10 factors cited—the problem was with the equipment manufacturer, Olympus.  According to WSMV, the VA said that "unclear product instructions" from Olympus are to blame for the potential spread of deadly infections.

Now, the government has become involved. "We owe these folks the highest obligation because they have protected our country; we should protect them," said U.S. Representative Jim Cooper (Democrat-Nashville).  "So Congress needs to do whatever it takes to make sure all of our veterans are safe," He told  WSMV.

Boston.com reported that Senator John F. Kerry  (D-Mass) asked the VA’s inspector general to initiate an inspection of sanitation procedures at VA hospitals, saying in a statement that, “The Veterans Administration has inherited a tragic situation, and a full review is needed so we can find out how this happened, correct the situation, and make sure it never happens again….  The Obama Administration has already …  taken responsibility.”

The Miami Herald reported that VA hotlines and clinics in Florida received thousands of calls and hundreds of visits from worried veterans looking to schedule testing following the VA’s announcement earlier this week.

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Health Workers Expose 60,000 to Hepatitis http://www.yourlawyer.com/articles/read/16012 Fri, 06 Feb 2009 00:00:00 -0500 http://www.yourlawyer.com/articles/read/16012 hepatitis because of lapses in injection safety practices, reports the Associated Press (AP).  The contaminations involved 33 outbreaks and were mostly caused by violations of simple safety standards, said the AP.

It seems that syringe reuse is the major culprit.  Apparently, a number of health care workers believed that discarding used needles was sufficient to prevent the transmission of deadly blood borne diseases, and continued administering injections with the same syringe barrel, thus enabling the potential for infection transmission.  Contamination can occur in the medicine vial and in the barrel when shots are administered in this manner, noted the AP.

The Centers for Disease Control and Prevention (CDC) called the shoddy injection practice trend “a wider and growing problem.” One such example of such a health care practioner cited by Newsday wasHarvey Finkelstein,the Dix Hills, NY doctor who in 2007 was blamed for exposing thousands and infecting at least one because of his negligent practices.

Authors of the study concluded that all the infectious outbreaks were caused by "failure of health care personnel to adhere to fundamental principles of infection control," quoted Newsday.  The piece was published in a recent issue of the Annals of Internal Medicine

Mentioned in the piece was Finkelstein, who, in addition to exposing and infecting patients, was observed by health officials reusing syringes in multidose vials.  Also cited was the Nevada endoscopy clinic that put 40,000 patients at risk for hepatitis contamination, reported Newsday.  In that case, said the Wall Street Journal, six patients contracted hepatitis C.

The researchers also note that the CDC’s findings represent just a small piece of a larger problem and point out that part of the problem has to do with “a lack of oversight,” according to chief study author Nicola Thompson, said Newsday. "Outpatient settings often do not have the same type of focus on prevention and infection control.  There's been a lack of oversight," Newsday quoted Thompson as saying.

According to the WSJ and based on CDC data, one of the leading causes of infection in outpatient settings, such as doctors offices and long-term care facilities, is shoddy injection practices.  The Journal reported that it is not necessarily healthcare workers understanding that needles cannot be reused, but rather, their knowledge that syringes must be disposed after use, which means that those in the health care industry are not always following the CDC’s guidelines for injection administration.  As a matter-of-fact, the CDC and others are kicking off a "One Needle, One Syringe, Only One Time" campaign next week, to bring education around the issue.

Blood borne diseases can be transmitted when an infected person is given a shot and either the needle or syringe is reused.  Microscopic backflow can enter the syringe from the contaminated person and then also enter a multi-use medicine vial, which puts future patients at risk from the needle, the syringe, and the multi-use vials explained the Journal.  Hepatitis C is the most common chronic blood borne viral infection in the U.S. said the CDC, with about 3.2 million Americans suffering from lifelong, chronic infection; about 1.4 million Americans are infected with chronic hepatitis B.  Both forms can lead to liver disease and death.

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Surgical Checklist Can Reduce Deaths by Half http://www.yourlawyer.com/articles/read/15869 Thu, 15 Jan 2009 00:00:00 -0500 http://www.yourlawyer.com/articles/read/15869 surgical errors.  Pointing out that airline pilots use similar tools, which have been proven to make flying safer, the National Post reports that using such lists prior to, during, and after surgery can drastically reduce the risk of serious complications and fatalities by at least on-third.

The international study was published yesterday by a variety of hospitals said National Post and appears in the New England Journal of Medicine, said The Canadian Press.  According to The Canadian Press, the number of preventable deaths numbers at around 1.5 million annually with an astounding 10 million people internationally being spared surgical complications if use of a simple 19-step checklist is employed.  Patient safety experts in Canada are working with hospitals there to implement the checklist, which was devised in cooperation with the World Health Organization last summer.

TopNews said 7,500 noncardiac patients in eight hospitals in Toronto, Seattle, London, New Delhi, Amman, Auckland, Manila, and Ifakara were studied; Harvard’s Dr. Alex B. Haynes led the study.  Half the patients underwent surgery with and the other half without the checklist, said TopNews.  The aim of the study was to see whether or not covering the items on the checklist at points during the procedures would result in saved lives and decreased complications.  The researchers that when the list was followed, surgery-related fatalities dropped by an astounding 40 percent while post-surgical complications fell by 36 percent, said The Canadian Press.

The study specifically reviewed about 500 procedures conducted with and 500 conducted without the checklist and found that the 1.5 percent death rate before the checklist was introduced dropped to 0.8 percent when the checklist was used, said The Canadian Press.  Also, with the checklist, complication rates dropped to seven—from 11—percent, surgical site infections dropped from 6.2 to 3.4 percent, and unplanned operating room returns dropped from 2.4 to 1.8 percent.

"It does take a couple of minutes.  And that couple of minutes will be paid back in dividends," Phil Hassan, CEO of the Canadian Patient Safety Initiative, told The Canadian Press, adding, "It's cost-saving to the hospital but it's also beneficial to the patient, which is really a win-win, right?"  Dr. Bryce Taylor, University Health Network's surgeon-in-chief, told The Canadian Press that, "As soon as we were through the study I was convinced enough about this that the next month we introduced it at Princess Margaret Hospital ... and then the month after that we introduced it at Toronto Western Hospital … So, since about last April, almost a year now, we have been using it for all 23,000 operations here at UHN every year that we do. It is standard practice now."

The checklist is a three-part document that involves steps along the course of surgery:  Prior to administering anesthesia, prior to making the incision, and prior to exiting the patient from the operating room, said The Canadian Press.  Some steps, noted the paper, were very simple such as having the surgical team introduce themselves to each other and ensure they all agree on what surgery will be performed; confirming if the patient has allergies, if blood has been ordered in the event a transfusion is needed, and if antibiotics are needed and have been administered; ensuring surgical tools have been traced; and correctly labeling surgical specimens.

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Quest Diagnostic Testing Errors Reported http://www.yourlawyer.com/articles/read/15821 Fri, 09 Jan 2009 00:00:00 -0500 http://www.yourlawyer.com/articles/read/15821 inaccurate test results affect possibly thousands of patients over the past two years said Reuters, which noted that Quest Diagnostics is the country’s largest diagnostic testing provider and has locations nationwide.

Newsday quoted Gary Samuels, a Quest spokesman as saying that problems in "a few of our laboratories" led to the testing errors that occurred on tests conducted from 2007 through the middle of 2008.  It seems, said Samuels, that the majority of the mistakes involved exaggerating vitamin D levels in patients, according to Newsday, which explained that an error of this kind could result in patients not taking necessary vitamin D supplements.  The elderly; the obese; exclusively breastfed babies; those who have limited sun exposure; people with fat malabsorption syndromes, such as cystic fibrosis; or those suffering from inflammatory bowel disease are at greatest risk for vitamin D deficiency.

Vitamin D maintains normal calcium and phosphorus blood levels; aids in the absorption of calcium, which helps develop and maintain strong bones; and protects against osteoporosis, high blood pressure, cancer, and some autoimmune diseases, explains the Mayo Clinic.  Vitamin D deficiency could lead to rickets in children, which can cause skeletal deformities; in adults, vitamin D deficiency can cause osteomalacia, which results in muscular weakness and weak bones, says the Mayo Clinic.

According to Quest’s medical director for endocrinology, Dr. Wael Salameh, the mistakes originated with the test's “reagents and calibrators,” which involve a chemical used in the testing; "issues with some sites not following proper operating procedure," were also to blame, Salameh said, reported WebMD.  Quest notified physicians by letter late last year and offered free retesting, according to Samuels, said Newsday.  Samuels reported that Quest has fixed the cause of the errors and that about 10 percent of the tests are likely questionable, said Reuters.  Salameh would not provide information on the number of vitamin D tests conducted citing competitive reasons for its refusal to release the data, Reuters noted.

Although Quest Diagnostics refused to provide figures on the number of vitamin D tests it conducts, Newsday said that vitamin D testing has been on the rise in recent years following studies which have linked lower vitamin D levels with heart attacks, bone weakness, and other conditions.  USA Today reported that lower vitamin D levels might also be linked to certain cancers, diabetes, and immune system disorders. Richard Reitz, a Quest medical director told USA Today last year that vitamin D testing rose by approximately 80 percent in the one-year period from May 2007 to May 2008.

It seems that last June, doctors began calling the lab and questioning test results, said USA Today; it was at that time that Quest opened its investigation of the problem.  Newsday also reported that the editor of Dark Report, Robert Michel, the paper that broke the story, said, "The question most lab professionals would ask is why would it take 18 months to recognize the problems and begin to offer retests."  Michel pointed out that the Quest lab test recall is the largest such recall of its kind that he is aware of since he entered the field nearly 20 years ago.

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Early C-Sections Risky http://www.yourlawyer.com/articles/read/15815 Thu, 08 Jan 2009 00:00:00 -0500 http://www.yourlawyer.com/articles/read/15815 birth injuries when delivered by early cesarean section.  According to a new study, over one-third of all American babies—those born via planned and repeat C-section prior to 39 weeks gestation—are at increased risk for birth-related problems, reports WebMD.

C-section births accounted for one in every five births ten years ago; that number has increased, said WebMD.  It seems that women who have undergone at least one C-section are likelier to proceed with a C-section and not a vaginal birth for subsequent pregnancies, WebMD explained, adding that, according to national figures 40 percent of the annual 1.3 million C-section births performed are repeat, with most being planned procedures.

The American College of Obstetrics and Gynecology (ACOG) suggests that unless medically necessary, such planned, elective procedures prior to the 39-week gestational mark should not be considered unless testing confirms the baby's lungs are mature enough for delivery, said WebMD.  US News and World Reports HealthDayNews added that delivering a baby just two weeks earlier doubles the risks that the baby will experience breathing problems requiring mechanical ventilator intervention; infection, such as the blood infection newborn sepsis; and low blood sugar.  At 38 weeks, the complication rate is 1.5 times increased.  WebMD reported that, according to the study, babies born between their 37th and 38th weeks experienced up to four times the risks.

HealthDayNews quoted Dr. Alan T.N. Tita, study lead and assistant professor of obstetrics and gynecology and an epidemiologist at the University of Alabama at Birmingham as saying that, "About 36 percent of women were delivered prior to 39 weeks, electively by Caesarean.  These early deliveries were associated with adverse outcomes.  There was a two-fold increase in morbidity in those delivered at 37 weeks compared to women delivered at 39 weeks." The study appears in the January 8 issue of the New England Journal of Medicine.

The new study looked at 13,258 women who underwent elective, repeat C-section deliveries at one of 19 U.S. academic medical centers affiliated with the Eunice Kennedy Shriver National Institute of Child Health and Human Development's Maternal-Fetal Medicine Units Network, said HealthDayNews.  Dr. Peter Bernstein, a maternal-fetal medicine specialist at Montefiore Medical Center and Albert Einstein College of Medicine in New York City, said that while the increase in complications was not surprising, "The bigger surprise to me was that nearly 36 percent of elective procedures were done before the 39th week”, reported HealthDayNews.  "The institutions that participate in this network are big academic centers," Bernstein said. "In the academic world, these are among the top institutions, and that more than one-third apparently aren't following ACOG guidelines is a surprise," he added.

WebMD said that the study found that planned, repeat, early C-section procedures were being performed on women who were insured, older, and married.  Also, women who want to have their babies delivered by their own doctor are also more likely to schedule the birth, working around the doctors’ schedules rather than leave the performing physician up to chance and the baby’s timing.

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Medication Errors Often Seen in Chemotherapy Treatment http://www.yourlawyer.com/articles/read/15778 Fri, 02 Jan 2009 00:00:00 -0500 http://www.yourlawyer.com/articles/read/15778 Medication errors are more common that previously believed in chemotherapy treatment.  It seems about seven percent of adults and 19 percent of children receiving outpatient chemotherapy treatment—in clinics or at home—have been subjected to incorrect dosing or other medication mistakes, according to a new study by the University of Massachusetts Medical School, reports Science Daily.  The team looked at the records of nearly 11,000 drugs taken by cancer patients at three adult and one pediatric oncology clinics said White Coat Notes, which added that an earlier study that only looked at medications given at a cancer center revealed a three percent error rate.

Study lead Kathleen E. Walsh, MD, assistant professor of pediatrics at the University of Massachusetts Medical School and a Robert Wood Johnson Physician Faculty Scholar, said, "As cancer care continues to shift from the hospital to the outpatient setting, the complexity of care is increasing, as is the potential for medication errors, particularly in the outpatient and home settings," quoted Science Daily.  Science Daily also noted that data analysis on about 1,300 adult patient visits and 117 pediatric visits from September 1, 2005 and May 31, 2006 revealed medication errors were more common than previously reported.

Of 90 medication errors—such as incorrect dosing due to confusion, conflicting orders, and overhydration—involving adults, 55 could have potentially harmed the patient, while 11 caused harm, said Science Daily.  Over half of the errors to adults involved clinical administration; 28 percent, the ordering of drugs; and seven percent, use of medication in patients homes, said Science Daily, adding that 40 percent of 22 errors in children harmed four and could have potentially harmed the rest.  Some errors in pediatric dosing occurred over wrong medication amounts or frequency, reported WebMD.  Errors in adult dosing occurred, WebMD added, over confusion over conflicting orders, overhydration prior to treatment, and abdominal pain because treatment for constipation did not occur prior to treatment, for example.

"As cancer care shifts from the hospital to the outpatient setting, adults and children with cancer receive more complicated, potentially toxic medication regiments in the clinic and home," the team wrote, said WebMD.  The study was published in the Journal of Clinical Onclology, said WebMD, which pointed out that the journal described the errors as “high” in both adult and pediatric cancer patients.

The team concluded, reports the Washington Post, that treatment orders should be written on the day of treatment and pediatric care include improved communication and training as well as heightened parental support.  "Requiring that medication orders be written on the day of administration, following review of lab results, may be a simple strategy for preventing errors among adults, while most of the errors involving children may have been avoided by better communication and support for parents of children who use chemotherapy medications at home," said Dr. Walsh, quoted Science Daily.  

White Coat Notes said that most errors involved dosing errors usually resulting from duplicate orders—one written at diagnosis and one at treatment.  Only five such errors were caught before treatment said White Coat Notes.  WebMD pointed out that the researchers indicated that prevention of such outpatient medical errors fails because of a variety of issues such as “a lack of recognition of errors, communication problems, and fragmentation of care."


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Senator Pushes Accountability for Nonprofit Hospitals http://www.yourlawyer.com/articles/read/15698 Thu, 18 Dec 2008 00:00:00 -0500 http://www.yourlawyer.com/articles/read/15698
Over the past several months, The Wall Street Journal has published a series of articles on non-profit hospitals' quests to increase revenues.  The reports detail not only the aggressive practices they employ to squeeze payments out of those unable to afford it, but their quests to increase profits through special programs, such as transplant programs.

According to Fiercehealthcare.com, Grassley had earlier brought up the topic of nonprofits at a Senate Finance Committee hearing this past summer. At the hearing, a 53-year-old leukemia patient testified about her experience with the M.D. Anderson Cancer Center, which demanded a total of $105,000 in cash up front before it would provide chemotherapy.

According to The Wall Street Journal, Grassley's proposed legislation would, among other things, require nonprofit hospitals to spend a minimum amount on free care for the poor and limit executive compensation.  Nonprofit hospitals would face penalties - including losing their tax exempt status - if they failed to comply.

According the Journal, legislation isn't Grassley's first choice for forcing nonprofits to fall in line.  He would like the Treasury Department to reinstate charity-care requirements that were undone by the IRS in 1969.  But the Journal said the senator is ready to introduce a bill in the first quarter of 2009 if that doesn't happen.

The Wall Street Journal reported that in the past, Grassley's staff has said nonprofit hospitals should spend at least 5% of their patient revenue on charity care. However, there is no indication of what threshold would be required under any new law.

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Doctors Give US Emergency Care A Failing Grade http://www.yourlawyer.com/articles/read/15660 Thu, 11 Dec 2008 00:00:00 -0500 http://www.yourlawyer.com/articles/read/15660 failing grade for its emergency care service according to the American College of Emergency Physicians, the Associated Press (AP) is reporting.  Overall, the system received a D-, said the AP.

According to the AP, no state received an A ranking.  The AP cited a glut of patients as adding to the problem, combined with a lack of resources.  Also, said the AP, many patients without health insurance will turn to emergency rooms to receive care, which is increasing emergency care demand at a time when some hospitals are closing emergency rooms due to rising costs and shrinking staffs.  “The emergency care system in the United States remains in serious condition, with numerous states facing critical problems … the nation has too few emergency departments to meet the needs of a growing and aging population,” the AP quoted from the report.

The AP described America’s emergency room system as a “ticking time bomb,” citing a dearth of physicians and nurses and adding that the report said the ER system was, “fraught with significant challenges and under more stress than ever before.”

A report on WKOWTV.com also noted that the report stated that, “our country's emergency care system is below average and is being made worse by the U.S. financial crisis.”  The report stated that over 300,000 Americans go to ERs for care daily and that 90 percent of the states earned poor rankings receiving mediocre ratings or earning near-failing marks, said WKOWTV.

According to WKOWTV, the report graded the states individually and the nation overall in categories that included emergency care and patient safety and found that there are very significant lapses in a wide array of ranking areas.  Half of the states and Washington, D.C. earned seven and less out of 10 key indicators.  Only five states receiving a score of 10.  The five report card categories  were: Access to Emergency Care (30 percent), Quality and Patient Safety Environment (20 percent), Medical Liability Environment (20 percent), Public Health and Injury Prevention (15 percent), and Disaster Preparedness (15 percent).  

“That is a national disgrace,” the organization’s president, Nicholas Jouriles, an emergency physician in Moreland Hills, Ohio, told the AP. “The nation’s emergency physicians have diagnosed the condition and prescribed the treatment. It’s time to get serious and take the medicine,” he warned.

Meanwhile, on the same day as this bleak report was issued, the Trust for America’s Health and the Robert Wood Johnson Foundation issued a separate study stating that the U.S was “underprepared for a major disaster, such as a biological attack or a pandemic,” said the AP.

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Gender Gap in Heart Attack Care http://www.yourlawyer.com/articles/read/15647 Tue, 09 Dec 2008 00:00:00 -0500 http://www.yourlawyer.com/articles/read/15647 under-treated, receiving recommended medications and procedures either less than men or later than men in similar, massive, cardiac emergencies.

"We're doing better but not good enough for women," Dr. Hani Jneid, lead author of the study from Baylor College of Medicine in Houston, told the AP.  Jneid said, noted the AP, that the research team could not say if treatment decisions were or were not appropriate for patients.  CTV.ca (Canada TV) said the study looked at over 78,000 heart attack victims and was conducted by a team from institutes nationwide.  The study revealed, said CTV that female death rates for ST elevation myocardial infarction—known as STEMI and known to cause more heart damage than other heart attacks—were 10.2, while men experienced a rate of 5.5.  News-Medical.net explained that women hospitalized with STEMI were about twice as likely to die in the first 24 hours of hospitalization over men.

Dr. Laura Wexler of the University of Cincinnati College of Medicine, another researcher involved in the study said that even though heart disease is the leading cause of death in women, it is still thought of as being a man’s disease.  "It's very important for the public—women and the people who love them—to get over the idea that it's not a disease of women," Wexler said to the AP.  "However, the finding of persistently higher death rates among women experiencing the more severe type of heart attack (STEMI) and the persistent gender gap in certain aspects of care underscore the existing opportunities to enhance post-heart attack care among women," Jneid said, according to News-Medical.net.

CTV also reported that the study revealed that much of the recommended treatments following heart attack that were not given or were given later to women included administration of Aspirin; women were 14 percent less likely to receive Aspirin compared to men.  Also, women were 10 percent less likely to receive beta blockers, 25 percent less likely to receive reperfusion therapy, and 22 percent less likely to receive speedy angioplasty, noted CTV, which explained that Aspirin is used to prevent blood clots and reduce the risk of a repeat heart attack, beta blockers restore regular heart rhythms, reperfusion therapy restores blood flow, and angioplasty opens blocked arteries.

News-Medical.net reported that the study results were reported in Circulation: Journal of the American Heart Association and that the research team looked at information derived from the American Heart Association’s “Get With The Guidelines” (GWTG) program.  The team reviewed patient outcomes from 420 hospitals between 2001 and 2006, News-Medical said.

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Report Warns of Clinics Offering Questionable Stem Cell Treatments http://www.yourlawyer.com/articles/read/15618 Thu, 04 Dec 2008 00:00:00 -0500 http://www.yourlawyer.com/articles/read/15618 unproven stem cell treatments, a new report says. The International Society for Stem Cell Research (ISSCR), which released the report, said governments and regulatory bodies need to take action to prevent such abuse.

According to Reuters.com, stem cells are the body's master cells.  They come in a wide range of forms, including the cells in bone marrow that are widely used to treat cancer and other conditions, to embryonic stem cells -- those that give rise to all the cell types in the body.  It is thought that  stem cell therapy holds out the promise  of new and better treatments  for  diseases like Parkinson's, as well as catastrophic injuries, Reuters said.

According to the  ISSCR report, Canadian researchers  analyzed 19 Web sites, all of which offered expensive stem cell therapies for everything from stroke to allergies. While theoretically, stem cell therapy does hold a great deal of promise, such treatment is the standard of care for only a few diseases and conditions.  These include hematopoietic stem cell transplants for leukemia and epithelial-stem-cell-based treatments for burns and corneal (eye) disorders.

The authors of the ISSCR report assessed whether the claims made by the websites were substantiated by research reported in the professional medical literature. The report provides clear evidence that the vast majority of the clinics examined over-promise results and gravely underestimate the potential risks of their offered treatments, the authors wrote.

The ISSCR has released Guidelines for the Clinical Translation of Stem Cells that examine the scientific, clinical, regulatory, ethical and societal issues that must be addressed to ensure that basic stem cell research is responsibly transitioned into appropriate clinical applications.  The guidelines establish standards that can be used to judge the claims made by stem cell clinics and whether the treatments they offer are being developed responsibly. The ISSCR guidelines also  provide information for patients and their doctors for evaluating a stem cell therapy.

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Over 50 Dead in Texas Hospital Scandal http://www.yourlawyer.com/articles/read/15610 Wed, 03 Dec 2008 00:00:00 -0500 http://www.yourlawyer.com/articles/read/15610 poor care, according to a federal investigation, said the Associated Press (AP).

The AP reported that some of the investigation’s findings included one resident swallowing a latex glove three times; another resident—a teenager—with what the AP characterized as mild retardation, might have been raped by one of the institution’s male employees.

Worse, noted the AP, the federal investigation reviewed no less than 500 allegations that included claims of “abuse, neglect, and other mistreatment that occurred from the very short period from July through September.  The allegations were indicated in a letter sent by the Department of Justice to Texas Governor Rick Perry, said the AP.  Another finding noted that “the frequent and ‘disconcerting’" use of physical restraints was a factor in many of the injuries, reported the AP, pointing to the January 2007 death of a teenage resident who “died while being held in restraints,” according to the letter.  The letter also cited an injury at another facility later the same year in which, "staff reportedly broke a resident's shin bone as they slammed him to the ground during a restraint," reported the AP.

The AP pointed out that the letter stated that over 800 employees from the 13 cited facilities were suspended or fired for mistreating patients since fiscal year 2004, a fact first brought to public attention by the AP this past April, indicating that the problem of reckless abuse and poor care has been ongoing for some time in the Texas state school institution system.

This is the third time in as many years that the Justice Department has investigated the Texas facilities, which are also known as state schools, said the AP, which noted that “similar findings” were also revealed in 2006 at the Lubbock State School; however, the letter cited by the AP discusses a dozen other state schools.  The AP also reported that no less than 114 such residents died in the 12-month period from last to this September.  The letter noted, said the AP, that while some of the deceased residents were considered “medically fragile,” over 50 of the deaths appeared have resulted from “avoidable conditions” that included “pneumonia, bowel obstructions, or sepsis.”

While a spokeswoman with the group that is responsible for the deadly institutions discussed improvement and investigations, advocate Jeff Garrison-Tate, is calling for state school closure and described the report to the AP as "devastating and horrifying."  Garrison-Tate expressed concern that the Legislature will likely provide the institutions funding for staffing as opposed to putting funding and other resources in community-based group homes, said the AP.  "These places are not fixable," Garrison-Tate told the AP, adding that, "It scares the heck out of me that the Legislature might dump more money into these toilets."  Meanwhile, Texas agency spokeswoman Laura Albrecht, said state officials are reviewing the investigation's findings, reported the AP, which also noted that Albrecht said, via email, that the state schools are “adding positions, improving staff training, reducing the use of restraints, and expanding community services for state school residents.”

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Tired Doctors: Group Calls For Better Residency Scheduling http://www.yourlawyer.com/articles/read/15612 Wed, 03 Dec 2008 00:00:00 -0500 http://www.yourlawyer.com/articles/read/15612 The Institute of Medicine is recommending that new doctors workloads be eased a bit, saying that young doctors - and their patients - may benefit from sleep breaks.

ECanadaNow.com noted that release of the report may enable more rest for resident.  Today, residents are exhausted when treating patients, which could result in “serious medical errors.”  The vast majority of residents—a whopping 75 percent—reported being “burnt out” before ever reaching the 80-hour weekly limit, said ECanadaNow, which noted that even 30-hour shifts might be excessive.

According to the Associated Press (AP) noted, regulations passed in recent years limited the amount of hours residents were allowed to work to 80 per week.  However, the recent Institute of Medicine’s report entitled, “Resident Duty Hours: Enhancing Sleep, Supervision and Safety” indicates that residents are still too tired and their hospitals should provide opportunities for trainees to get some rest.

USA Today noted that it was the Accreditation Council for Graduate Medical Education (ACGME), the organization that is responsible for residency programs that instituted the 80-hour-per-week limit back in 2003.  That limit, said USA Today, was to be averaged over a four-week period and should ensure that no more than 30 hours be worked at any given time.  In the past, residents typically worked over 100 hours or more weekly, said USA Today.

Yesterday, an Institute panel recommended that those individuals working the “maximum 30-hour shift should get an uninterrupted five-hour break for sleep after 16 hours,” the AP said.   “Our committee's charge was not to focus necessarily on longer scheduling or shorter scheduling, but smarter scheduling to try to really identify the areas where we could have an impact in preventing excessive fatigue, both acute and chronic, that might contribute to medical errors,"  panel member Dr. Daniel Munoz of Johns Hopkins University School of Medicine told the AP.

The Salt Lake Tribune spoke with surgery intern Brent James, who said he often worked 90-to-120-hour weeks, taking late night calls he was unable to remember the following day.  James has since been elected to the Institute and agrees with the call for reduced resident work hours, which are expected to improve training and reduce the chances of fatigue-related medical errors.  "We know that if people are too tired they will make mistakes,"  James told the Tribune.

The Tribune noted that the Institute report suggests that residents not work long hours without rest, moonlighting be restricted, and residents take more days off.  However, the Institute did not suggest a change to the 2003 80-hour-per-week maximum.  The Tribune pointed out that despite the cap on weekly hours, the 80-hour limit is often exceeded, indicating closer ACGME monitoring might be called for.

Although some feel additional reductions might hinder residents’ training, the AP quoted Rebecca Sadun of the American Medical Student Association who said the recommendations are "unambiguously a step in the right direction.  Sadun cited the current limits as being “insufficient” as they do not allow residents sufficient rest throughout the course of their shifts.

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Facing Abuse Lawsuits, All Kinds of Minds Founder Resigns http://www.yourlawyer.com/articles/read/15577 Wed, 26 Nov 2008 00:00:00 -0500 http://www.yourlawyer.com/articles/read/15577 allegations of child molestation.  According to the Durham News & Observer, Dr. Mel Levine announced Tuesday that he would leave All Kinds of Minds in June, when his contract expires.

Levine denies the abuse allegations, and his lawyer told the News & Observer that his resignation is not related to them.

Levine founded All Kinds of Minds in 1995 to focus on teacher training. The institute's approach is based entirely on Levine's books and teachings, the News & Observer said.  Levin's methods focus on creating individual plans for children, and he shuns labels like ADHD.

According to the News & Observer, Levin's innovative approach drew patients from across the country and turned him into a world-famous child development expert.  As  result, All Kinds of Minds has millions of dollars worth of contracts with schools across the nation.

According to the News & Observer, five patients Levine treated when he practiced in Boston are suing the doctor, saying that he improperly touched them during physical exams.  The lawyer representing those patients told The New York Times that more than 50 other former patients or their parents had contacted him with complaints Levine.

A Durham attorney also told the News & Observer that several North Carolina patients have reported similar allegations to the state Medical Board.  The Medical Board is barred by state law from confirming an investigation into those charges.

According to The New York Times, since the lawsuits were filed against Levine, All Kinds of Minds has lost nine of its 80 contracts.

In a statement, All Kinds of Minds board Chairman Roch Hillenbrand said the board regretted the circumstances surrounding Levine's resignation, but maintained the move was necessary. "The mission of [All Kinds of Minds] is so critical to tens of thousands of young learners, and to those who teach, guide and counsel them, that it had to be placed above any one person," Hillenbrand said.

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California Fertility Clinic Failed to Test Donors for Chlamydia, Gonorrhea http://www.yourlawyer.com/articles/read/15449 Wed, 05 Nov 2008 00:00:00 -0500 http://www.yourlawyer.com/articles/read/15449 fertility clinic in California has not been testing donors for sexually transmitted diseases and other viruses, prompting the Food & Drug Administration (FDA) to issue the facility  a warning letter.  According to the letter, the Center for Fertility and Gynecology in Tarzana, Calif., tested semen donors in laboratories using non-FDA approved screening tests.

The Center for Fertility and Gynecology claims to be the largest  fertility center in the San Fernando Valley.   It accepts semen from men and eggs from women, often anonymously, that can be used to get women pregnant.

The FDA warning letter followed an inspection of the facility conducted by the agency in June.  The FDA investigator found significant deviations from the regulations for human cells, tissues, and cellular and tissue-based product.   In several instance, the FDA said the California clinic didn't test donors for chlamydia, a disease that can cause infertility, and gonorrhea, which can be life threatening if it spreads to the blood or joints.

The FDA cited instances in 2005, 2007 and as early as February where the clinic failed to test for the two diseases. The semen was used to fertilize eggs in women, the FDA said.

The FDA warning letter also sites several instances where the clinic did not adequately test  for other virus.  For example, in 2007 and 2008, the center failed to  test donated semen for Human T-lymphotropic virus, types I and II and cytomegalovirus (CMV).  Semen from both donors were used to fertilize embryos, and transferred to various women.

The FDA letter also cites one instance in 2006 where the fertility clinic received a positive CMV test result for a semen donor. However, the clinic had  no documentation that the physician of record, donor, and surrogate were notified of the positive result. In addition, there is no documentation that the surrogate consented to proceed with the embryo transfer.

The FDA wants the clinic to respond within 15 business days to explain what steps it has taken to correct the violations and prevent future ones.

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After Child’' Death, Stony Brook Hospital Uses New System http://www.yourlawyer.com/articles/read/15407 Tue, 28 Oct 2008 00:00:00 -0400 http://www.yourlawyer.com/articles/read/15407 death of a six-year-old Mastic Beach boy last September, the Stony Brook University Medical Center is implementing a pediatric early warning system in its emergency department.  Children now being treated in the Stony Brook University Medical Center’s emergency department are now evaluated by this system.

Earlier this month, the state Department of Health cited Stony Brook University Medical Center for not correctly diagnosing William Gonzalez, the six-year-old boy.  William died from heart complications on September 11, 2007, after it was discovered, too late, that he had an enlarged heart.  The state cited Stony Brook University Medical Center for its failure to consider other causes for the boy's symptoms.  The prior month, William's parents took him to Brookhaven Memorial Hospital when he began vomiting, was tired, and was unable to keep food down.  He was diagnosed with reflux at Brookhaven Memorial and was referred to Stony Brook.  William was seen at Stony Brook three times and each time he was seen, was treated reflux.

In its correction plan, which the state accepted October 20, Stony Brook said it initiated a process known as the "Watchful Eye Algorithm" in its emergency department.  "This algorithm of Pediatric Early Warning Scores (PEWS), adapted from Cincinnati Children's Hospital, is a method of categorically assessing and addressing patient status ... to treat those patients at risk of significant clinical deterioration," the plan said.

The PEWS system measures breathing, heart rate, pulse and behavior, according to the Cincinnati Children's Hospital Website.  Also, nurses regularly check patients to update their score.  If a child's score increases, doctors are called.

William's father, Daniel Gonzalez, said he was pleased by the plan, "especially if my son's death at Stony Brook was not in vain and if this hopefully will not let another child or adult die."

In a prepared statement, hospital spokeswoman Lauren Sheprow said, "Clearly this case was a tragedy, and we express our deepest sympathies to the Gonzalez family.  We initiated a review of this case a year ago in September, and actions were already in place well before the plan of correction was drafted."

Stony Brook University Medical Center was also cited by the health department because an abdominal X-ray four days before his death revealed that William's heart was enlarged.  The diagnosis of an enlarged heart suggests there should have been a follow-up chest X-ray, which would have shown an enlarged heart.  But, the state said, that step was never taken.

In the plan of correction, Stony Brook hospital maintained that "an enlarged cardiac silhouette is a common distortion on abdominal ... films ... Thus this finding is not alarming" and would not require "immediate physician notification."

 Regardless, Stony Brook hospital admitted that it now requires the radiology department to inform doctors if such a finding arises.

An enlarged heart may be due to damage such as heart attack, congestive heart failure, and dilated cardiomyopathy, whereas gastroesophageal reflux disease—GERD or acid reflux—is a condition in which the stomach’s liquid content regurgitates—backs up or refluxes—into the esophagus.

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Las Vegas Clinics Tied to More Hep C Cases http://www.yourlawyer.com/articles/read/15388 Fri, 24 Oct 2008 00:00:00 -0400 http://www.yourlawyer.com/articles/read/15388 hepatitis C at two Las Vegas outpatient medical clinics, according to a recent Associated Press (AP) report.  “In putting everything together, we’ve identified 114 cases, in total, linked to the two clinics,” he said.

Hepatitis C is a typically asymptomatic, incurable blood disorder transmitted through blood-to-blood contact; often leads to chronic, long-term infection resulting in approximately 70% of those infected developing liver disease; is a risk factor for liver cancer; and can lead to liver transplantation. Hepatitis C can cause swelling of the liver, stomach pain, fatigue, and jaundice and, even with no symptoms, can slowly damage the liver, the AP points out.

“We still have some analysis to do,” Labus noted of the total, which represents an increase from the 86 reported in July, “but we don’t expect the numbers to change much.”  The AP reports that district officials say nine cases are the result of the Endoscopy Center of Southern Nevada’s and the Desert Shadow Endoscopy Center’s shoddy infection control practices. The other 105 people diagnosed with hepatitis C since becoming patients at the clinics could have contracted the disease in other ways, Labus said.  Health officials say those diagnosed are undergoing treatment.

Both clinics, which were affiliated with Dr. Dipak Desai—a prominent Nevada gastroenterologist who headed several endoscopy clinics in the Las Vegas area—have since been closed. Desai surrendered his license to practice medicine during health district and police investigations.  Meanwhile, he and other former clinic owners face over 120 lawsuits alleging medical negligence, as well as a separate class-action suit initiated by patients who did not fall ill but are claiming emotional distress.

The virus likely spread when clinic staff reused syringes, using a single dose of anesthesia medication on multiple patients, the district said.  Contamination would occur with the backflow of blood when patients with a blood-borne disease were injected with medication; that syringe, in turn, would be reused to withdraw medication from a different vial, contaminating that vial and resulting in infection.  The Southern Nevada Health District said that the unsafe practices had been in place for several years.

The AP reports that Labus said about 50,000 former Endoscopy Center patients and 13,000 former Desert Shadow Center patients were notified to receive testing for hepatitis B, C, and HIV.  To date, there have been no links between the outbreak and any hepatitis B or HIV cases.  HIV is the virus that causes AIDS, and is transmitted through the exchange of bodily fluids, including blood-to-blood contact.  Meanwhile, 7,331 people provided the agency with medical information.  Labus is planning to distribute a final report to district administrators by January 2, the one-year anniversary of the when the massive outbreak was first discovered.

The widow of one of the clinic’s former patients filed a lawsuit alleging that her 60-year-old husband’s death and hepatitis C diagnosis were related to the clinic’s shoddy medical practices.  The man died in 2006.  The health district maintains that there have been no deaths linked to the outbreak, said the AP.

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Study: Low-Tech Solutions Might Minimize Medical Errors http://www.yourlawyer.com/articles/read/15364 Tue, 21 Oct 2008 00:00:00 -0400 http://www.yourlawyer.com/articles/read/15364 medical mistakes, researchers are looking at basic, low-tech solutions, such as implementing a color-coding system.  Anesthesiologists at Penn State Hershey, in simulated emergency room (ER) situations, tested such a system in which standardizing and color-coding medication labels were used.  The system could significantly decrease costly and potentially harmful medication errors.  The study will be presented this weekend at the annual meeting of the American Society of Anesthesiologists in Orlando, Florida.

Imitating ER situations, volunteer anesthesiologists, residents, and nurses drew medications with different colored labels.  When the label color on the syringe matched the label color on the medication bottle, fewer near-mistakes occurred compared to when there was no color match.  When peel-off labels were removed from the medication bottle and placed on the syringe to be used, errors were reduced and fewer commands were skipped.  "Many 'high-tech' solutions have been suggested, including use of bar codes, radiofrequency identification for medications, and computerized medication administration processes," researcher Dr. Elizabeth H. Sinz, of the department of anesthesiology at Penn State Hershey, said in a news release issued by the society.  "But, besides their high costs, all of these methods have flaws that may produce as many errors as they eliminate.  Furthermore, these solutions are often impractical for fast-paced situations in operating rooms or during emergencies," she said, adding, "Simple system
s, such as the color-coding methods used in our study, are more reliable and useable than complex systems," she said.

In July we reported on a study—led by Ross Koppel, Ph.D of the University of Pennsylvania (HUP) School of Medicine—that revealed how patient medication errors were linked to hospital technology flaws.  The research revealed how hospital nurses use bar-coded technology that matches patients with their medication, showing that both the technology design and its implementation—often relied upon as a "cure-all" for medication administration errors—is flawed and can increase the likelihood of some errors.  Even worse, it seems that “the urgencies of care” and creative attempts to cope with the problems have caused other medication errors.  The group found 31 "causes" of problems resulting in workarounds, including:  “Unreadable medication-barcodes (crinkled, smudged, torn, missing, covered by another label); malfunctioning scanners; unreadable or missing patient-ID-wristbands (chewed, soaked, missing); non-barcoded-medications; medications in distant refrigerators; lost wireless connectivity; problems with patients in contact isolation; and emergencies.”

There are some of the 1.5 million adverse drug reactions annually that are caused by medication mistakes that, in turn, cost the health care industry about $3.5 billion each year.  On average, hospital patients are subject to one medication administration error daily, according to the Institute of Medicine; in hospitals, medication administration accounts for 26% to 32% of adult patient medication errors.  Koppel emphasized, "It's not that staff are lazy or careless, it's that the system does not work as well as it should.  If the refrigerated medication is two floors and a long hallway away, you're not going to wheel your 87-year-old patient to the fridge.  You make a copy of her barcode.  And while you do that, you help another two patients who also need refrigerated medications."

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SLS Residential Defendants Sanctioned After Threatening Former Patients http://www.yourlawyer.com/articles/read/15277 Wed, 08 Oct 2008 00:00:00 -0400 http://www.yourlawyer.com/articles/read/15277
The class action lawsuit, filed by two former SLS Residential patients, alleges that they were subjected to physical and mental abuse.  The complaint, which was filed on behalf of all SLS patients, seeks  $75 million in compensatory damages, $150 million in punitive damages and an injunction that would bar SLS from further violating patients' rights.

The SLS class action lawsuit  alleges that staff illegally employed manual restraints and put patients in isolation rooms where they were physically and emotionally abused, subjected patients to nightly searches of their bodies and rooms, and denied patients the right to refuse treatment, leave the facility or phone family members.  The complaint also charges SLS with discrimination under the Americans With Disabilities Act, and claims patients were targeted for mistreatment because they were mentally disabled.

Southern District Judge Stephen Robinson assessed SLS $35,000 in sanctions after he determined that 80 former patients  had been told by SLS therapists that their private medical records would be made public if they became plaintiffs in the class action lawsuit. In some cases, the therapists falsely told their former patients that the judge had actually ordered the publication of medical records.

At a hearing held by Judge Robinson on July 8, a therapist who had worked at SLS for two years testified that its Chief Clinical Officer, Dr. Shawn Prichard, had called a meeting to discuss contacting the potential class action lawsuit plaintiffs and their families, and distributed a list of their names and phone numbers.

In addition to using threats to coerce  former patients into opting out of the class action lawsuit,  the callers contacted other institutions where some former SLS patients were being treated and tried to convince personnel at institutions to sign opt outs on their patients' behalf.

In levying sanctions against SLS, Judge Robinson called the defendant's conduct "egregious".   "Under the guise of caring for their former patients, the defendants sought to capitalize on the potential plaintiffs' vulnerability and discourage them from participating in the lawsuit." Judge Robinson said. "This conduct is astounding to the court."

In his decision, the judge held SLS management responsible for the conduct of the therapists.  "These calls were not the result of inadvertence, misplaced good intentions, or even the product of rogue employees who took it upon themselves to manipulate class members," Judge Robinson said. "Rather, it was a scheme designed and implemented by the very highest managers at SLS who are, not incidentally, named defendants in this lawsuit."

In addition to the $35,000 Judge Robinson voided all of the opt-outs signed by potential plaintiffs, and ordered corrective notices to be mailed. He also ordered all the defendants to cease contact with the potential plaintiffs.

The class action lawsuit is not the only legal battle that SLS Residential is facing right now.  Last week, SLS filed a lawsuit in the New York state Supreme Court seeking to reverse the revocation of its operating license by the state Office of Mental Health (OMH).  In 2006, OMH fined SLS Residential $110,000 for violations of the state Mental Hygiene Law and ordered that it stop admitting patients - and stop violating the rights of the patients it was treating.  The OMH said SLS Residential routinely restrained clients and kept them from making phone calls. It also found that staff would search patients, their rooms and packages sent to them.

In seeking to revoke its licenses, OMH alleged that SLS used illegal restraints on patients long after being told not to, that it administered sedatives to patients when they refused to take their medications and that it failed to report troubling incidents to the state, including patients behaving suicidally and complaining of abuse by staff.

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Medicare Will No Longer Pay for Hospital Errors http://www.yourlawyer.com/articles/read/15253 Thu, 02 Oct 2008 00:00:00 -0400 http://www.yourlawyer.com/articles/read/15253 medical errors that injure patients while they are in a hospital’s care.  Medicare provides coverage for the elderly and disabled.

Medicare put 10 “reasonably preventable” conditions on its initial list, saying it will not pay for mistakes that include when patients receive incompatible blood transfusions, develop infections after certain surgeries, or must undergo a second operation to retrieve a sponge left behind from a first surgery.  Also, serious bedsores, injuries from falls, and urinary tract infections caused by catheters are included in the policy’s first iteration of the list.  The new policy also prevents hospitals from billing patients directly for costs generated by such hospital medical errors.

Officials believe the new regulations could apply to several hundred thousand hospital stays of the 12.5 million people covered annually by Medicare.  Medicare is the largest insurer in the country and its decision to refuse payment for these preventable conditions has prompted others in the public and private sectors to adopt similar standards.  For instance, in the past year, four state Medicaid programs announced that they will not pay for as many as 28 “never events”; the programs include New York.  Some large insurers have followed suit including WellPoint, Aetna, Cigna, and Blue Cross Blue Shield plans in seven states and so have some state hospital associations.  “Never events” are so called because they represent situations that are not supposed to have ever happened.

The Congressionally-mandated Medicare measure is not expected to generate large savings—$21 million annually, versus $110 billion spent on inpatient care in 2007.  “This is a specific case of the larger pay-for-performance trend, the idea that you should pay more for quality than lack of quality, or in this case pay less for defects,” said Dr. Donald M. Berwick, president of the Institute for Healthcare Improvement. “This whole trend is like a juggernaut, and it is not going to stop.”

Regarding pay-for-performance, Medicare now grants bonuses to those doctors and hospitals that report quality measures and is looking at rewarding physicians who follow protocols for diabetes, coronary artery disease, and congestive heart failure treatment.  Also, the Medicare Payment Advisory Commission, an arm of Congress, recently recommended reducing payments to hospitals with high readmission rates.

“Historically, there’s been some acceptance that these things happen,” said Brock D. Nelson, the hospital’s president. “We’ve come to now accept that they’re avoidable. And that’s a sea change.”  Some improvements have been technological, such as an electronic prescribing system that has worked to reduce medication errors by half.  Nontechnological efforts include diligent hand-washing, nurses being trained to provide more patient information during shift changes, and high-risk medications—such as heparin—being marked with pink labels to help prevent mix-ups.  Heparin has made the news on a number of occasions recently for massive dosing errors occurring as a result of similar packaging for its different dosage vials.

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Most Hospitals Fail Required Colon Cancer Quality Checks http://www.yourlawyer.com/articles/read/15121 Thu, 11 Sep 2008 00:00:00 -0400 http://www.yourlawyer.com/articles/read/15121 medical negligence because they do not meet a key quality standard in the care and treatment of colon cancer patients.  That standard involves checking sufficient lymph nodes following surgery to  see  if the cancer has spread to other areas of the patient’s body.  Leading medical organizations report that doctors should examine no less than 12 lymph nodes to determine if the colon cancer has metastasized and to accurately diagnose the cancer stage, a key indicator of the cancer’s severity.  When a cancer metastasizes, it has moved to other areas in the body.

Colon cancer treatment involves surgery to remove that part of the colon that contains the cancer as well as some healthy tissue on either side of the cancer to help ensure no cancer remains in the organ.  Then, nearby lymph nodes are removed and tested for the presence of cancer.  Checking too few lymph nodes may offer the false impression that the cancer has not spread.

Information from the lymph node checks helps to guide and determine future cancer treatment, including whether or not a patient with metastatic cancer receives the appropriate chemotherapy that can help to improve patient survival.  A review of data from 1,296 U.S. hospitals indicated that only 38 percent of those hospitals checked at least 12 lymph nodes in at least three quarters of those patients who underwent surgery to remove colon cancer in 2004 and 2005.  This means that in the vast majority of cases, a complete check was not undertaken.

This data does indicate an increase over the 15 percent of hospitals that met this standard in 1996 and 1997.  Despite that there has been an increase, the figures are still far below what is recommended, according to the Journal of the National Cancer Institute.  "We were disappointed at how low the compliance rate is still," said Dr. Karl Bilimoria of Northwestern University's Feinberg School of Medicine in Chicago.  Bilimoria led the study.  It is not uncommon to fail to find cancer if only, say, six lymph nodes are checked and to only detect the cancer when more lymph nodes are examined, Bilimoria added.

The researchers continue to try to determine why so few hospitals are meeting the standard.  "Maybe some people don't know that they should be reaching a certain number.  And certainly there may be some people who don't believe that it's important," Bilimoria said.

Information on 82,120 patients treated in 2004 and 2005 was included in the study.  The hospitals that did not meet the standard are treating about two thirds of colon cancer U.S. patients.  The study was released one day following other research, which also raised questions about the quality of U.S. colon cancer care.

Meanwhile, a team led by Dr. Gregory Cooper of University Hospitals Case Medical Center in Cleveland also found that 60 percent of older patients successfully treated for colon cancer did not receive the standard and recommended screening to detect cancer recurrence.

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Prostate Cancer Patients Received Wrong Dose of Radiation at VA Medical Center http://www.yourlawyer.com/articles/read/15113 Wed, 10 Sep 2008 00:00:00 -0400 http://www.yourlawyer.com/articles/read/15113 medical mistake was made.

The errors date all the way back to February 2002, when the VA began a treatment program that involved implanting patients with  radioactive seeds to destroy cancer cells in their prostates.  The treatment is known as brachytherapy, and is used to treat patients with low-risk prostate cancer.  In all, 114 men received the prostate cancer treatment at the Philadelphia VA Medical Center. At least two men have died since their treatment, but their deaths were not due to prostate cancer, the Associated Press said.

According to the Nuclear Regulatory Commission, the VA informed it in May that one patient's CT scans revealed that he got a radiation dosage that was less than 80 percent of what was prescribed.  That discovery was followed by  a review of  medical records and testing on 112 living veterans implanted with the seeds since the program started. The VA discovered that 55 patients received radiation doses that were  too low.

When the VA first announced the radiation mishap early last month, at least one medical expert told the Philadelphia Inquirer that the mistake should have been caught sooner.  "The routine in the U.S. is to assess the implant at three to four weeks out," said Eric M. Horwitz, clinical director of the radiation oncology department at Fox Chase Cancer Center.  

The Philadelphia VA has suspended its prostate cancer treatment program as a result of the ongoing probe. The Nuclear Regulatory Commission announced Tuesday that a special inspection is now under way at the facility. Three inspectors from the Commission will review the medical center's policies and procedures, qualifications and training of those administering the treatment, and the center's response.  The Commission said it would release a report 45-days after the inspection is complete.

The 55 affected veterans have been notified and VA doctors are reviewing each case to determine what, if any, additional care the men may need, the Commission said.  

The Philadelphia VA Medical Center has come under scrutiny for other medical errors.  Last month, VA officials said they were also investigating an incident in which an Air Force veteran on the blood thinner warfarin had his blood drawn twice July 30 and was put in a research study without his knowledge or consent. According to the Philadelphia Inquirer, as many as six patients had their  blood drawn without their consent.

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Drug Name Mix-Ups Injure Thousands http://www.yourlawyer.com/articles/read/15058 Tue, 02 Sep 2008 00:00:00 -0400 http://www.yourlawyer.com/articles/read/15058 A new study has found that similar drug names are responsible for thousands of medication errors every year.  According to the study,  conducted by U.S. Pharmacopeia, at  least 1.5 million Americans are estimated to be harmed each year from a variety of medication errors, and name mix-ups are blamed for a quarter of them.

The Food & Drug Administration (FDA) rejects about 1/3 of all proposed new drug names every year because they sound or look too similar.  Unfortunately, this has not entirely eliminated the problem, mainly because there are so many drugs on the market. It is just too difficult to track them all. 

Many drug-mix ups involving medications with similar names occur because a pharmacist cannot read a doctor's handwriting on a prescription.  But even when doctors employ computerized prescriptions, errors can occur if a physician, for example, clicks on "Actos" when he or she meant to select "Actonel".  In other instances, a pharmacist may be at fault, if drugs are not alphabetized properly and she grabs the wrong one. 

On a few occasions, mix-ups involving similar sounding medications have been so frequent that the names of drugs have been changed.  For example,  according to the Associated Press, the Alzheimer's drug Reminyl now is named Razadyne, after mix-ups, including two reported deaths, with the old diabetes drug Amaryl. The cholesterol pill Omacor is now named Lovaza, after mix-ups with blood-clotting Amicar.

But changing medication names to avoid mix-ups is hardly efficient.  So now, several initiatives are underway to deal with the problem.  According to the Associated Press, last week Pharmacopia opened a Web-based tool to let consumers and doctors easily check if they're using or prescribing any of these error-prone drugs, and what they might confuse it with.

The Associated Press also reports the FDA is preparing a pilot program that would shift more responsibility to manufacturers to guard against name confusion. The FDA is trying to find ways that drug makers can better test for potential mix-ups before they seek approval for their products.

There are also things consumers can do to protect themselves from such medication errors.  For one thing, patients  should question the pharmacist if the tablets look different than last time.  It is also wise to ask a doctor to write a diagnosis on the prescription.  For instance, writing "for heart" next to "clonipine," could prevent a pharmacist from dispensing the gout medicine colchicine, or Klonopin which is for seizures.

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Study Reveals Fertility Treatments Induce Gene Mutations in Males http://www.yourlawyer.com/articles/read/15041 Thu, 28 Aug 2008 00:00:00 -0400 http://www.yourlawyer.com/articles/read/15041 Y-chromosome defects or "microdeletions" in male offspring.  Although this study was small, it "at least sounds an alarm about the genetic safety of assisted reproductive technology," the investigators conclude.

This means that the chromosomal defects, or deletions, could result in defective sperm production and possibly also hypospadias.  Hypospadia is a relatively common congenital malformation of the male sex organs in which the urinary outlet, or urethra, does not open through the glans of the penis, but rather, develops on the underside of the penis.  This defect makes it difficult for the patient to urinate normally and to control one’s stream of urine.  Generally, hypospadia occurs because of a hormonal imbalance or deficiency that takes place at a critical point in fetal development prior to birth.  Early corrective surgery is generally called for before the child reaches the age of three.

Prior research has linked assisted reproductive technologies such as IVF and ICSI with low birth weight, pre-term delivery, cerebral palsy, and major birth defects.  Because of this, some researchers believe that such therapies may prompt gene mutations.  In this new study, Dr. He-Feng Huang, from Zhejiang University, and colleagues worked to find answers to this issue by testing for genetic mutations in 19 male infants who were conceived through IVF, 18 who were conceived through ICSI, and 60 baby boys were were conceived naturally.  In addition, the fathers of the infant boys were also tested.  Because the researchers were hoping to isolate the impact of the fertility treatment, they only studied those infants whose parents had a normal genetic background.

Huang and his colleagues found Y-chromosome microdeletions in one infant conceived with IVF, representing 5.3 percent of the population tested.  Microdeletions were also found in three baby boys conceived with ICSI, which represented 16.7 percent of the population tested. By contrast, no Y-chromosome deletions were seen in the control group.  The report also indicated that one of the four infants with microdeletions had hypospadias.

The investigators noted that this study is not the first to link ICSI with hypospadias; however, the mechanism has been unclear in the earlier studies. The new findings suggest that the association may be mediated through Y-chromosome microdeletions.

ICSI has long been the main method used to overcome male infertility and its use is on the rise. With ICSI, a single sperm is injected directly into a single egg.  If successful fertilization occurs, the embryo is then placed into the female—in IVF treatment—to undergo development as usual.  Fertilization rates—which are not the same as pregnancy rates—are relatively high when ICSI is employed with approximately 75%-80% of all eggs manipulated through ICSI becoming fertilized.

Larger studies "should be conducted to confirm our preliminary results," the researchers conclude.

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Study Says Popular ICU Glucose Treatment Could be Dangerous http://www.yourlawyer.com/articles/read/15035 Wed, 27 Aug 2008 00:00:00 -0400 http://www.yourlawyer.com/articles/read/15035 A new analysis by the Dartmouth Medical School questions the benefits of a widely accepted sepsis treatment called tight glucose control.  This treatment is used for patients not only with sepsis, but also with other critical illnesses.  The Dartmouth researchers are concerned the treatment not only might not help such patients, it could cause harm.

Tight glucose control involves nurses testing patients' blood-sugar levels hourly, and, if required, adjusting intravenous insulin drips.  The treatment began being heavily promoted by medical groups such as the Surviving Sepsis Campaign back in 2004.  That promotion was prompted on one study, which took place in Belgium that indicated that critical-care patients often had high blood sugar that could lead to fatal complications.

Sepsis is a bloodstream infection that can result in death by causing multiple organ failure. The Surviving Sepsis Campaign is a larger group that includes the American Thoracic Society, the Society of Critical Care Medicine, and the American College of Emergency Physicians.  At its urging, and following the single 2001 Belgium study of 1,548 patients, hospitals adopted the glucose-control treatment.  That single study concluded that tight glucose control treatment reduced the death rate in the hospital's surgical intensive-care unit to 4.6% of total critical-care patients from 8.0%.

The Dartmouth researchers found that the glucose-control treatment failed to save more lives than standard sepsis therapy, such as antibiotics, fluids, and blood-pressure medicines.  The researchers also found that the treatment significantly increased the incidence of hypoglycemia—low blood sugar—which, in extreme cases, can lead to coma and seizures that can trigger devastating brain damage.  "In critically ill adult patients, tight glucose control is not associated with significantly reduced hospital mortality but is associated with an increased risk of hypoglycemia," Dartmouth researchers reported in Wednesday's Journal of the American Medical Association.  "Overall, it seems that the time has come to reconsider whether professional societies should continue to recommend tight glucose control as the standard of care in all critically ill adults," said Renda Soylemez Wiener, a critical-care doctor and lead author of the study.

The research revealed that glucose-control therapy had no significant effect on death rates; that hypoglycemia was multiplied five-fold among patients on the therapy; and that glucose-control treatment was linked to a modest reduction in sepsis infection.  The researchers also pointed out that, "Hypoglycemia is not benign in critically ill patients.  "It has been linked to serious neurologic events ranging from seizures to coma."

In January, the New England Journal of Medicine published a German study of 537 patients from multiple hospitals in which severe sepsis patients were randomly assigned to intensive insulin therapy such as tight glucose control, or to standard treatment. The trial was stopped early for safety reasons, including a four-fold increase in hypoglycemia and a doubling of serious adverse events. Those researchers concluded that intensive insulin therapy "placed critically ill patients with sepsis at increased risk for serious adverse events related to hypoglycemia.”

 

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After 22-Hour Wait, Man Dies Unattended in North Carolina Hospital http://www.yourlawyer.com/articles/read/14999 Thu, 21 Aug 2008 00:00:00 -0400 http://www.yourlawyer.com/articles/read/14999 medical malpractice.  This time, a 50-year-old mental patient, Steven Sabock, died after workers at Cherry Hospital in Goldsboro, North Carolina left him in a chair for 22 hours without feeding him or helping him use the bathroom.  Federal officials have threatened to cut off the facility’s funding and the state just deployed a team to help Cherry draft new procedures to ensure patients receive proper care.  This, just two month after national media attention was focused on the case of Esman Green, the woman who was videotaped as she writhed on the floor for a full hour, ignored and unattended—despite workers clearly in the area—until she fell to her at Brooklyn’s Kings County Hospital Center (KCHC) on June 19.

An investigator’s report released Monday found that Sabock died in April after he choked on medication and was left sitting in a chair for nearly a full day at Cherry Hospital.  Surveillance video showed hospital staff watching television and playing cards just a few feet away.  In Green’s case, surveillance video was also used to show staff’s indifference and neglect to their patient.

Federal officials have threatened to cut off funding because of Sabock’s death and also in response to a report that a physician punched a patient after the teen bit the doctor.  Department of Health and Human Services spokesman Tom Lawrence said the state team also may investigate what, if any, disciplinary action should be taken following Sabock’s death.  Lawrence added that this is an isolated incident, but officials are concerned.  “It’s not the kind of thing that we in our wildest dreams would expect to happen in our hospitals—in our wildest nightmares, I guess,” Lawrence said.

The investigation released Monday stated that Sabock died in April after Cherry Hospital nurses left him unattended in a chair and did not feed him or help him to the bathroom.  The report said that Sabock sat unattended in the room over the course of  four work shifts and that he ate nothing the day he died and had little food in the three days preceding his death.

According to Lawrence, the state has until August 23 to file a report with the Centers for Medicaid & Medicare Services detailing what changes officials are making and that if the Centers rejects the report, federal funds will be ceased, effective September 1.  Department of Health and Human Services Secretary Dempsey Benton said in a statement that nurses may be reassigned to provide more patient supervision and that officials are also ways to improve management of staff resources.

In the New York case, Green’s patient records were falsified and the New York Civil Liberties Union released a video confirming that Green slumped out of her chair and underwent convulsions as workers and fellow patients walked by her, doing nothing as she died.  As a result, six people were fired.  Also, KCHC has long been the subject of complaints and lawsuits by advocates for the mentally ill.  The Department of Justice began investigating allegations of patient mistreatment at KCHC earlier this year.

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California Fines Hospitals for Substandard Care http://www.yourlawyer.com/articles/read/14990 Wed, 20 Aug 2008 00:00:00 -0400 http://www.yourlawyer.com/articles/read/14990 patient care violations.  A fine of $25,000 was levied for each violation, with some hospitals cited for two violations.  Violations cited included such horrors as an improperly inserted catheter, a ventilator that was not turned on, and surgical tools that were left inside patients after operations.

The fines were made public earlier this week and resulted from investigations conducted by the California Department of Public Health.  The hospitals were fined $25,000 for each violation, which represented the latest of dozens of penalties the state of California has issued in recent years to more than 40 hospitals.  "The number of penalties will decrease and the quality of care will dramatically improve as hospitals take action to improve," said Kathleen Billingsley.  Billingsley is director of the health department's Center for Healthcare Quality. "The entire intent of these fines is to improve the overall quality of care in California."

In addition to the other violations, the report detailed a death at a La Mesa hospital in which a worker failed to turn on a ventilator for a patient who was being transferred.  A patient in Los Alamitos died after falling from a wheelchair because the seat belt was not engaged. A Santa Ana hospital lost a patient because of an error with a medication overdose.  It was also found that at Doctors Medical Center in San Pablo, a registered nurse improperly inserted a catheter into a patient's neck vein on September 1.  In that case, the patient died as a result of an air bubble that traveled from the catheter tube into the patient’s body.  In addition to the death, the report also revealed that the registered nurse had not completed a required anatomy class, nor had the nurse completed the hospital's training on protocol.

Anaheim General Hospital was cited for failing to ensure that medical devices were electrically safe and functioning within manufacturer's guidelines, for not preventing access to dangerous items, for failing to protect patients from extreme environmental temperatures, and for failing to maintain the pharmacy's refrigerated temperatures where medications are kept.  Scripps Green Hospital was cited for failing to ensure patient safety in the surgical department.  A patient fell off an operating table during surgery.  In other cases, patients had surgical instruments or sponges left inside their bodies during surgery.  When this occurs, a second surgery is required in order to retrieve and remove such items.  The report also found that some patients experienced surgical awareness during their procedures due to improper anesthesia administration.

The state of California has issued 61 such penalties to 42 hospitals, Billingsley said.  Most of the 18 hospitals are in Southern California, said Ken August, a spokesman for the California Department of Public Health.  All California hospitals are required to comply with state and federal laws to remain accredited.  This disciplining marked the fourth time the department has disciplined hospitals since a state law went into effect last year authorizing the agency to fine hospitals for placing patients in serious jeopardy.

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Medical Malpractice Claims Lawsuit Attorney | Health Care Provider, Medical Care Standards | Lawyers http://www.yourlawyer.com/practice_area/medical_malpractice Wed, 20 Aug 2008 00:00:00 -0400 http://www.yourlawyer.com/practice_area/medical_malpractice Medical Malpractice Lawyers, Medical Negligence Lawsuits

If you or a loved one has been victimized by medical malpractice or medical negligence, Parker Waichman LLP urges you to contact one of our medical malpractice attorneys by completing the form at right or call us at 1-800-LAW-INFO(1-800-529-4636) immediately. Our compassionate and committed medical malpractice lawyers are dedicated to helping the victims of medical malpractice get their lives back on track.

Medical malpractice injures thousands of people every year. Medical malpractice is the failure of a medical professional or facility to meet the standard of good medical practice in the areas in which the medical professional or medical facility specializes. A medical professional may be a doctor, a nurse, a medical technician, or other health care provider. A medical facility may be a hospital, nursing home, medical testing facility or clinic. If good medical standards are not met, harm may result to a patient and the medical professional or facility my be liable for any resulting damages and injuries that may cause lifelong medical bills, loss of income or death.

According to an article published in the Journal of the American Medical Association (JAMA), over 225,000 people die yearly due to medical malpractice, with nearly half of the deaths occurring in hospital emergency rooms. Medical malpractice has become the third leading cause of deaths in the United States. Additionally, a Harvard Medical School study found that over 5% of all hospital patients were injured as a result of medical malpractice.

How Large Is The Problem of Medical Malpractice?

In 1990, according to a Harvard Medical Practice study, approximately 80,000 people die due to medical malpractice making it a much greater problem than most people realize. This figure is based on the extensive study “Patients, Doctors and Lawyers: Medical Injury, Malpractice Litigation, and Patient Compensation in New York,”. While these medical malpractice statistics are alarming, it is even more disturbing that these statistics do not even include medical malpractice deaths that have occurred in clinics, private doctors offices, or other treatment facilities.

Are Medical Malpractice Lawsuits Common?

While medical malpractice numbers are staggering only a few claims are filed. The Harvard Medical Practice Study found that only one in eight patients that suffers due to medical malpractice ever files a lawsuit and concluded that medical malpractice is not accessible enough for medical malpractice victims, including birth injury and other cases of negligence. A New England Journal of Medicine article analyzed malpractice data from 1991 through 2005 and found that each year during the study, 7.4% of all physicians had a malpractice claim and only 1.6% had a claim that led to a payment. Having been successful at representing and obtaining compensation for medical malpractice victims, Parker Waichman LLP urges you to contact us by completing the form at the right or call us at 1-800-LAW-INFO (1-800-529-4636) if you feel that you or a loved have been injured by medical error or negligence.

Medical Malpractice Victims - Legal Help

If you are seeking a medical malpractice lawyer, Parker Waichman LLP has successfully represented medical malpractice victims that have been injured due to medical errors or negligence including dental malpractice, nursing home and hospital negligence. The attorneys at Parker Waichman LLP have represented clients in medical malpractice cases across the State of New York, including the boroughs of Manhattan, Brooklyn, Bronx, Queens, Staten Island and Westchester. Parker Waichman LLP has offices in Nassau and Suffolk County. Parker Waichman LLP also represents victims of medical negligence in New Jersey, Washington, D.C., Maryland and Florida.

The links below are a few of the medical malpractice claims Parker Waichman LLP has represented for our clients. Please visit the links for more information regarding the medical negligence claims and feel free to contact us if you feel that you or a loved one have been harmed by a physician or other medical professional due to medical malpractice or negligence.

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