Have you been injured undergoing dialysis? No one should suffer a serious injury during dialysis, but in the US, such occurrences are unacceptably common.
It’s a sad fact that the US has the world’s highest death rate among dialysis patients. Each year, about 1 in 5 patients die, almost twice the mortality rate of countries with the best outcomes. Death and injury resulting from hemorrhaging that occurs when a
dialysis needle dislodges from a patient – a largely preventable occurrence – happens all too frequently at US dialysis clinics.
Lawyers at our firm who specialize in medical malpractice are working right now on behalf of people injured because of shoddy dialysis care. If you or a loved one were the victim of a dialysis injury, you may be entitled to compensation for medical bills, lost wages, pain and suffering, and other damages. Our dialysis injury lawyers are offering free legal evaluations to people hurt during dialysis. It is vital that you contact our dialysis injury lawyers today to protect your legal rights.
ProPublica Dialysis Investigation
Kidney dialysis became common in the US as a result of a 1972 law that mandated Medicare coverage for almost all patients who depended on the procedure. Close to 400,000 Americans receive chronic dialysis. More than 90 percent of US dialysis patients receive what’s called in-center hemodialysis, in that they receive treatments three times per week at outpatient facilities.
According to a recent ProPublica investigation, Medicare has long favored large companies because of their ability to hold down the cost of dialysis. As a result, almost two-thirds of US dialysis clinics are now owned by one of two companies, Fresenius Medical Care North America, a subsidiary of a German medical supply company, and DaVita Inc. in Denver. Each has at least 1,500 clinics and more than 120,000 patients. No other operator in the US has more than 300 clinics.
To conduct its investigation, ProPublica reviewed inspection records from more than 1,500 clinics in California, New York, North Carolina, Ohio, Pennsylvania, and Texas from 2002 to 2009 obtained via Freedom of Information Act requests from the Centers for Medicare and Medicaid Services (CMS). The investigators also interviewed patients, doctors and public officials. The investigation discovered poor conditions were relatively common at dialysis centers around the country.
In nearly half of the units, inspectors noted dirty or unsafe conditions, including dried blood in treatment chairs or on walls, floors, and ceilings. Hundreds of clinics were cited for lapses in infection control, and dozens more for prescription errors. In many cases, staff at dialysis centers were monitoring more than the recommended number of patients. Almost none have doctors on the premises and some do not even have a registered nurse. While clinics are supposed to be inspected every three years, records showed some had gone for more than five years without one.
The ProPublica piece also pointed out that the general public has had little access to dialysis safety data. While CMS has a Dialysis Facility Compare tool on its website, it does not contain detailed quality data, the report said. However, it should be noted that just days before ProPublica published its investigation, CMS released all of the data.
Injuries From Dialysis Needle Dislodgement
According to ProPublica, dialysis patients die or are hospitalized every year as a result of catastrophic hemorrhages during treatment. This can occur when the tube feeding blood back into a patient becomes dislodged. In dozens of cases in which patients suffered such harm, government inspection records show, regulators later cited clinics for failing to adhere to minimum standards of care, ProPublica said.
As the investigation points out, such injuries are largely preventable. Yet in a 2007 survey conducted by the Renal Physicians Association, about 5 percent of respondents said they had been the victim of a needle dislodgement mid-treatment within the previous three months. Another review, based on incidents in a Pittsburgh hospital system, suggested that each year hundreds of patients may fall victim to more serious bleeding episodes, ProPublica said. ProPublica’s own review found at least one fatality resulting from needle dislodgements in each state during the period covered by its review, plus dozens of additional cases in which patients required hospitalization, blood transfusions or other emergency interventions.
One nurse told ProPublica that needle dislodgement during dialysis is akin to “turning up the pressure on your garden hose.” In some cases, significant blood loss can occur in less than 10 minutes.
According to the report, government cause-of-death data confirms that treatment-related bleeds kill dialysis patients each year: From 2006 to 2008, facilities gave “hemorrhage from dialysis circuit” as the primary cause of death for 18 patients and as a secondary cause for six more. However, a cause of death is not always apparent, as almost 1 in 5 were attributed to “unknown” or “other” causes during the same time frame. Almost 700 deaths were attributed primarily to “hemorrhages from vascular access,” or, more rarely, “accidents related to treatment.” In a handful of cases, facilities checked off one of these, as well as “hemorrhage from dialysis circuit,” as causes for the same deaths, ProPublica found.
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