Chicago Accident and Injury Lawyer Blog

A recent study in the Archives of Internal Medicine found that health-care associated infections, such as pneumonia and sepsis affect 1.7 million hospital patients each year. Nearly 50,000 of those patients die as a result. The researchers of the study, focusing on infections acquired by those patients undergoing elective surgeries, estimated that these infections result in longer hospital stays and cost more than 8 billion each year.

Hospital-acquired infections are typically infections that do not originate from a patient's original admitting diagnosis. Within hours after admission to a hospital, a patient is exposed to the bacteria living in the hospital. As with the prevention of the spread of the common cold and the flu, proper hand-washing and glove-wearing are the two most critical deterrents to spreading hospital-acquired infections. Regardless of whether you are a caregiver in a hospital or just a visitor, it is important to always properly wash your hands. The CDC provides the following guidelines for proper hand-washing:

• Wet your hands with clean running water and apply soap. Use warm water if it is available.
• Rub hands together to make a lather and scrub all surfaces.
• Continue rubbing hands for 15-20 seconds. Need a timer? Imagine singing "Happy Birthday" twice through to a friend.
• Rinse hands well under running water.
• Dry your hands using a paper towel or air dryer. If possible, use your paper towel to turn off the faucet.
• Always use soap and water if your hands are visibly dirty.

Continue reading "HOSPITAL ACQUIRED INFECTIONS STUDIED" »

There are few things more private than your medical records. Those in the medical field, including hospitals, doctors, dentists and even insurance companies have a duty to protect your confidential medical information. With the trend towards computerizing medical records for efficiency purposes, also comes the ability of thieves and hackers to get at such sensitive information. Currently, in the event of a breach, the keeper of medical records must notify the federal government, but only if that breach affects over 500 patients.

The recent federal stimulus bill passed by the Senate in early February 2010 intends to make billions of dollars available for the computerization of medical files. As with any initiative involving confidential information, the fear exists that such information will end up in the wrong hands or be used for the wrong purposes. Although computerized records can assist in a patient's ability to receive more comprehensive medical care, computerized records are more susceptible to theft. As a patient, you should inquire with your health care providers about how they are maintaining and storing your medical information. You should always be asked to sign a consent form that conforms with HIPAA Privacy Rules before any medical provider shares your information.

Unfortunately, medical treaters may fail to diagnose a patient’s injuries after an injury-producing event. A patient involved in a major trauma is very likely to have multiple serious injuries. For example, an individual involved in a car crash or a construction site fall may have internal injuries in addition to obvious injuries, such as, broken bones or lacerations. The doctors treating the patient may properly focus on the obvious injuries, but fail to investigate any additional injuries or unforeseen conditions. This failure to diagnose may occur because of a failure to consider differential diagnoses, failure to order proper tests, a language barrier between patient and healthcare provider or the failure to otherwise consider additional injuries when there is a major trauma.

One cause of failure to diagnose injuries in a trauma situation is failure to determine that the injury is present. Injuries are often not visible to the naked eye. In many medical facilities throughout the world, trauma victims are assessed through the use of surveys developed by the American College of Trauma Surgeons in the Advanced Trauma Life Support (ATLS) course. The primary survey identifies immediately life-threatening problems. Once those problems are treated, medical treaters use the secondary survey to conduct a detailed examination of the patient results in a complete catalog of their injuries.

According to some researchers, this system does not always work in practice. “It is not uncommon for the secondary survey to be curtailed or hindered by other priorities, with the result that complete catalogue of injuries is not identified at presentation.” Missed injury and the tertiary trauma survey, Volume 39, Issue 1, Pages 107-114 C. Thomson, I. Greaves. The tertiary trauma survey, in which formal repeated examination of the patient is undertaken has been suggested as a better alternative to identify injuries not readily identifiable at the initial presentation.

Another cause of failure to diagnose an injury is due to a language barrier. I recently wrote an article about the importance of effective communication between patients and health care providers. Certainly, language barriers can prevent a clear communication between a patient and medical treater. It is a hospital’s duty to provide a translator and under federal law, hospitals are required to do so if they receive federal funding.

Extra steps may be necessary to ensure that trauma patients are properly treated, but improved outcome and prevention of long-term disability or death is worth it.

The Illinois Supreme Court ruled Thursday, February 4th, that caps on awards in medical malpractice cases violate the Illinois Constitution. This is the third time that the Court has rejected legislatures' attempts to impose such caps.

The case, Lebron v. Gottlieb Hospital target= "_blank", involves a girl who suffered a brain injury during delivery at Gottlieb Hospital. The law that the Court deemed unconstitutional capped the maximum non-economic damages that could be awarded in a medical malpractice case against a single doctor at $500,000. The law also set a $1 million limit on damages against hospitals and staff.

The court was not persuaded by medical malpractice caps in place in other states. Justice Fitzgerald, writing for the court, stated: "That 'everybody is doing it' is hardly a litmus test for the constitutionality of the statute." Justices Freeman, Kilbride and Burke joined the decision.

We have all heard of the term "defensive driving." It is the concept of being proactive on the roadways to avoid getting into an accident with a negligent driver. For example, if you see a driver paying more attention to the cell phone conversation he is having than the road or a driver is following too closely behind you, you may change lanes or pull over to avoid getting rear-ended. This concept is also applicable to a certain extent to your doctor's visit. CNN has an article containing 5 tips for getting better care from your doctor. The article suggests thinking ahead of time what questions you want to ask and writing the questions down. Also, the article suggests asking when you will start to feel better. By being proactive at the doctor's office, you are putting your health first, which is the most important thing. While many doctors' offices across the U.S. are providing outstanding patient care, some are failing their patients. Be an active part of getting quality health care for yourself!

As a medical malpractice attorney, I appreciated an article recently posted on CNN.com encouraging patients to be proactive when receiving medical treatment in an effort to prevent medical errors. The article highlighted an unfortunate story involving a young pregnant woman who received a CAT scan of her abdomen when she was mistaken for another person with the same first name.

In an effort to reduce medical errors due to performing procedures and tests on the wrong person or body part, it is suggested that you do the following:

1. Identify yourself, your date of birth and the procedure you are getting to every doctor, nurse or technician who treats you.

2. Ask everyone who treats you to "Please check my identification bracelet."

3. Say: "Could you please look at my chart and tell me what procedure it states that I am having."

4. Tell your nurse that you want to mark up your surgical site with the surgeon present because if you mark it outside of the surgeon's presence and the surgeon does not know about the marking, then it may be pointless. Marking the site is an extra precaution to take to ensure that surgery is performed on the correct body part.

5. Speak up and if necessary, be impolite. Patients often nod their head or agree to what the nurses or doctors tell them in an effort to be polite. If something does not seem right, say something.

With the Chicago Marathon closely approaching, many runners are training for the big event. It is scheduled for Sunday, October 11, 2009 and we wish the participants success!

Tragically, two years ago, a 35-year-old Michigan police officer died during an unusually hot and humid Chicago marathon. An autopsy revealed that the officer's heart condition caused his death. Since the effects of marathon running on the heart has become a popular topic among researchers, The New York Times explored the issue in a recent health segment.

The Times article discusses a controversial study published last year in the European Heart Journal. In that study, scientists scanned the hearts of 108 experienced, male distance runners in their fifties, sixties and seventies; all had completed a minimum of five marathons in the prior three years. After studying the scans, the researchers found that more than a third of the men showed evidence of significant calcification or plaque build-up in their heart arteries.

Since the release of that study, researchers worldwide have attempted to clarify the issue. In one recent study, Canadian researchers examined 129 non-elite runners in Winnipeg, testing their blood just before and after running a half or full marathon. When runners reached their finish line, blood tests revealed that most of the half marathoners and even more of the marathoners displayed elevated cardiac troponin, a substance in the blood that usually suggests cardiac injury, and other blood markers of heart damage. When the runners were tested again after an hour, even more showed blood indicators of cardiac damage.

Although running is an excellent way to stay physically healthy, if you have ever experienced any heart problems, you should consult a doctor before attempting long distance or marathon running. If while training for or actually running a marathon you have any heart-related symptoms, such as shortness of breath or chest pains, stop running and see a doctor immediately. We know that heart attacks can and do happen during marathons, and those with a history of heart disease are particularly at risk.

As a medical malpractice attorney in Chicago, I have witnessed the tragic consequences of medical errors. Mayo Clinic researchers have released a new study outlining how different causes of medical errors contribute to mistakes. The researchers distinguish distress and fatigue and recommend that distress (caused by financial woes, family concerns and other elements) should be treated as a separate issue from fatigue during the training of medical residents.

Dr. Colin P. West, a internist at the Mayo Clinic in Rochester, Minnesota said that fatigue, lower quality of life, burnout, symptoms of depression and other signs of distress, independently led to increased rates of self-reported major medical errors among internal medicine residents.

The report is in the Sept. 23/30, 2009 issue of the Journal of the American Medical Association.

Continue reading "STUDY SHOWS MEDICAL MALPRACTICE CAUSED BY DISTRESS AND FATIGUE" »

As a personal injury lawyer in Chicago, I have represented many clients who were diagnosed with Post-traumatic Stress Disorder (PTSD). These individuals who experienced traumatic events, such as a being in a car accident, received compensation for their injuries related to their PTSD. Although PTSD is not always visible like a broken arm or leg, the injury and pain is very real.

For more information on Post-traumatic Stress Disorder, please review the following online resources and consult a psychologist or a psychiatrist:

PTSD Facts on Google Health
National Institute of Mental Health - PTSD
Mayo Clinic defines PTSD

Continue reading "PTSD: A SERIOUS CONDITION DESERVES SERIOUS COMPENSATION" »

Consumer Reports has ranked hospitals across the nation based on patient satisfaction surveys conducted in 2007 and 2008. Twelve Chicago hospitals received ranking below the national average, including: Thorek Memorial Hospital, Mt. Sinai Hospital Medical Center, Sacred Heart Hospital, Provident Hospital Of Chicago, Advocate Trinity Hospital, Norwegian-American Hospital, Holy Cross Hospital, St Bernard Hospital, South Shore Hospital, Roseland Community Hospital, Loretto Hospital and Jackson Park Hospital. Most of these hospitals serve poor areas with limited resources.

The ratings provide a useful resource for anyone who wants information about their local hospital. The Chicago hospitals' low scores are in multiple areas, including staff attentiveness, communication about new medications, room and bathroom cleanliness, quietness, communication with nurses, pain management, and discharge planning. The two areas of greatest concern -- communication about new medications and discharge planning -- are key areas of concern because they directly impact a patient's recovery. Lack of communication about new medications results in drug interaction problems. Ill-planned discharge instructions lead to risk of complications and re-hospitalization.

The Illinois Hospital Association argues that the ratings are misleading since they only focus on patient experiences, not clinical quality care. Nonetheless, the Association says all of the Chicago hospitals on the list have attempted to make patient improvements.

Click here if you would like to see more information on the ranking provided by Consumer Reports for a fee.

The Joint Commission, a health care regulatory group that promotes quality and safety in health care in the United States, has enlisted parents in a national campaign to prevent medical errors in children. The Committee has furnished brochures -- available online, in English and Spanish -- as part of the group's Speak Up campaign.

The campaign's brochures provide parents with questions and answers that can help them navigate many common, yet complex health care situations. Among the topics are:
• Preparing for your child's visit to the doctor's office
• What you should ask the doctor
• How you can help prevent your child from getting an infection
• Taking medicine safely
• Having a blood test, X-ray, MRI or CT scan
• Going to the hospital
• Having a safe operation

The program urges parents and guardians of children to inquiry into the necessity of all tests and treatments for a child's illness or injury. If a parent does not understand what a doctor is saying, tell him or her. By asking questions a parent is helping the doctor understand what information is needed.

The program also recommends that parents remind caregivers to wash or clean their hands before touching children. Hand washing helps prevent infections. Additionally, parents should always pay attention to the care that their child receives, confirming that the child is getting the right treatments and medicines by the right health care professionals. They also encourage parents to ask about the side effects of medicine and the risks of medical tests.

The average total awaiting time in a U.S. Emergency Room in 2008 was 4 hours and 3 minutes. Sadly, it is a 27 minute increase in nationwide average wait time from 2002. What is causing the added wait time and what can be done to prevent such long waits?

First, according to the American College of Emergency Physicians, a January 2009 press release indicated that physicians believe that the recession is the one chief reason for the increase in emergency room visits. Many of these people that were once seen by a primary care physician are now going to the emergency room due to the loss of their health insurance. Unfortunately, this delay in care can end up proving to be a much more serious condition for patients in an already already overburdened emergency room system.

What do you do when you are confronted with a potentially four hour wait? Here are some tips for working with emergency room personnel:

1. Request that the triage nurse do a quick re-assessment of the patient, especially if you believe the patient is getting sicker while awaiting treatment in the emergency room. As the saying goes, the squeaky wheel does get the grease, however, make sure that you are not using inappropriate or threatening language. Be respectful.

2. If dealing with the triage nurse, request to speak with the charge nurse or a charge physician if there is a problem.

3. If you cannot speak with a charge nurse or a charge physician, request to speak with the administrator on call.

4. The last resort may be to dial '0' from the emergency room department waiting room phone and request to page the patient advocate or hospital administrator.

Belligerence or request for VIP treatment usually will backfire. Everyone in the emergency room is there because of a sickness or problem. However, make sure that you are adequately observing any changes in the patient’s condition.

Continue reading "AVERAGE E.R. WAITING TIME INCREASED " »

On May 22, 2009, Chicago personal injury attorney, Jeffrey J. Kroll, was a panelist on a program entitled “Key Word Searches: Have We Lost Our Way?” The program was presented by the American Bar Association, Section of Litigation. This is the Third Annual National Institute on e-discovery. The program addressed practical solutions for dealing with Electronically Stored Information.

Jeff addressed recent judicial opinions questioning the practice of searching for ESI based on a unilaterally-creative list of key words. Recent opinions show a change in the way searches are and should be conducted.

The Law Offices of Jeffrey J. Kroll has been involved with a number of complex cases involving e-discovery. Many product liability and medical malpractice cases are ripe with e-discovery issues.

The Philadelphia Daily News reports that a jury awarded a 53 year old widow $2.185 million in damages for medical malpractice committed against her late husband in April 2006. Zachary James, the deceased, was taken to a North Philadelphia hospital after experiencing chest, back and leg pains. The ER physician ordered several lab tests, yet many were not performed for over two hours. To complicate matters, the ER physician left to attend a corporate meeting, leaving a doctor serving his first day on the job as the only attending ER physician. After James' X-rays and tests were developed, the ER physician should have reviewed them, but neither attending doctor did.

James died later that night from a dissecting aortic aneurysm. The X-rays and other tests that would have revealed this condition weren't interpreted until the following morning.

The defense argued during the 10-day jury trial that there wasn't enough time to save Mr. James. Plaintiff attorneys for the James family countered that Mr. James was never given the opportunity to survive.

Mr. James' widow, Rosalyn, was quoted as saying, "I know it would never bring him back, but now he's at peace because I fought for him."

My deepest condolences to the James family. I am pleased that the jury listened to all the evidence and found in favor of a man who was never given the chance to live.

Continue reading "UNREAD X-RAY LEADS TO $2.185M MALPRACTICE VERDICT" »

As a medical malpractice attorney in Chicago, I have previously discussed the University of Chicago's Urban Health Initiative. Data (from an 8 month period analyzing 396 patients) provided from the U. of C. to the Chicago Tribune showed that one in three of the patients being redirected from the U. of C. emergency room to Mercy Hospital and Medical Center are poor and uninsured.

Nearly 7 percent of the patients have no health insurance coverage. 25 percent of patients transported by ambulance 5 miles north to Mercy were covered by the Medicaid health insurance program for the poor, which is known for paying hospitals low rates, particularly in Illinois.

During the same eight-month period tracked, 31.3 percent of the patients admitted to U. of C. from its emergency room were covered either by Medicaid or were uninsured.

U. of C. is the state's largest private provider for patients covered by Medicaid and also serves a large number of people with no health coverage.

I understand the need to educate people who do not have true medical emergencies that they should be treated at appropriate facilities, but I remain concerned that individuals who need immediate treatment may get turned away under the U. of C.'s program.

Public health officials from the Chicago Department of Public Health are testing hundreds of patients and staff members at Evanston Hospital, Northwestern Memorial Hospital and Children's Memorial Hospital after a first-year pediatric resident was found to have tuberculosis (TB). The Public Health Department is contacting anyone who may have had "significant contact" with the resident from November to April 1.

The Department of Public Health calls the situation a "cause for concern" rather than one of alarm.

The resident was working in the infant special care unit at Evanston Hospital, which is part of the Northshore University Health System, from February 11 to March 12. The department is contacting the 80 patients she treated that month and another 30 to 40 health workers. The resident also worked at Northwestern Memorial's Prentice Women's Hospital from November 3 to 21. The department is contacting 17 patients it believes may have been affected. She also worked at Children's Memorial Hospital between November 1 and April 3. In all, 150 patients and 300 staff members may be at risk for exposure, but the possiblity that any patients would have been infected is "highly unlikely" according to a spokewoman from Children's Memorial.

If you have been around someone who has TB disease, you should go to your doctor or your local health department for tests.

The Department of Veteran Affairs has launched an investigation into whether there is a connection between improperly seterilized endoscopy equipment and a veteran's postivie HIV test. In addition to the positive HIV test, sixteen other veterans have tested positive for hepatitis B and hepatitis C at two VA facilities.

The VA has publicly acknowledged that more than 10,000 veterans were possibly exposed to HIV and hepatitis at three VA facilities while undergoing colonoscopies and other procedures with equipment that had not been properly cleaned. The VA is offering free testing for hepatitis B, C and HIV to those veterans. The facilities in question are located in Murfreesboro, Tennessee, Atlanta, Georgia and Miami, Florida. The VA is reviewing procedures at other facilities and claims to have encountred no additioanl problems. The VA has also brought in additional staff to help with testing and counseling in the affected facilities. The VA has also said it will pay for treatment for the infected vets even if they didn't hepatitis or HIV from the dirty equipment.

Lawmakers are also calling for an investigation into the potential problems of contamination; whether any patient has contracted an infection from unsterilized equipment; and how the government can prevent such problems from happening again.

On February 3, a 78-year old wheelchair-bound man sat for hours within sight of the triage desk at the University of Chicago Medical Center, but no one bothered to log him in or triage him. It wasn't until the man's daughter got the attention of a triage nurse that it was discovered the man was not breathing. Soon thereafter, he was pronounced dead.

The medical center issued a statement after conducting an internal investigation and stated that it had proper polices and procedures in place, but staff members may not have followed the protocol. The statement also mentioend that "appropriate discliplinary actions are being taken." As they should be.

In response to this tragic and dispicable episode, Medicare officials are threatening to take away the hospital's certification. University of Chicago Medical Center has publicly acknowledged the warning and has responded that it is already drafting a plan to assure that there will not be another incident like this in the future. The hospital also noted that the threat is "standard procedure" any time an incident like this occurs. It is unfortunate that these incidents happen with such regularity that a "standard procedure" threatening decertification even exists. It is absolutely reprehnisble that this man died in the manner in which he did. To be ignored in his moment of need is irresponsible and disgraceful. My heart goes out to this man and his family.

Continue reading "CHICAGO AREA HOSPITAL IN DANGER OF LOSING MEDICARE CERTIFICATION" »

The Medical Device Safety Act, HR 1346/S 540, restores the law that was in effect prior to February of 2008 when the U.S. Supreme Court decided that the FDA's approval of a medical device warrants immunity for medical device manufacturers. The Supreme Court's decision means that medical device manufacturers are not fully held accountable for producing dangerous and defective products.

I have previously blogged about my concerns over immunity for big business. Immunity removes the right to fully compensate tort victims and it removes the checks and balances system that the civil justice system creates.

The United States Supreme Court held 6-3 today that FDA regulations do not trump state law to the contrary and that state-law tort claims are not preempted by the FDA’s approval of labeling after being informed of the relevant risk.

As previously blogged about, Diana Levine lost her arm due to complications after being given the anti-nausea medication Phenergan, manufactured by pharmaceutical giant, Wyeth, incorrectly. Levine sued Wyeth in a Vermont state court and was awarded over $6 million in a jury trial. This verdict was upheld by both the state appellate and supreme courts. Wyeth then appealed to the U.S. Supreme Court, contending that the drug’s labeling and warnings were FDA-approved and that FDA regulations trump state laws to the contrary.

The Supreme Court ruled against Wyeth today, holding that the FDA's oversight of drug labeling doesn't prevent the filing of state-level consumer liability lawsuits against drug companies. So what does this mean? This is a victory for American consumers. The Supreme Court has allowed consumers to retain their remedy under the law when drug companies fail to provide adequate warnings for the safe use of their drugs. And as Levine's lawyer noted, this decision "reaffirms the important role state law plays in promoting consumer safety and providing compensation for injuries." To read the full court opinion, please click here.

Methicillin-resistant Staphylococcus aureus (MRSA) is on the rise among children. MRSA used to be primarily contracted in a hospital setting; however, now its prevalence is on the rise in community-based settings. Nationwide Trends in Pediatric Staphylococcus aureus Head and Neck Infections, a study published in the Archives of Otolaryngology-Head and Neck Surgery, shows that from January 2001 to December 2006 there was a 16.3 percent increase in the percentage of resistance for all pediatric head and neck S. aureus infections.

Good hygiene helps reduce the spread of infection. Suggestions include:

• Wash hands thoroughly with soap and water or use an alcohol-based hand sanitizer.

• Cuts and scrapes should be cleaned and covered with a bandage until they heal.

• Avoid contact with other people's wounds.

• Avoid sharing personal items such as towels or, for older teens and adults, razors

Research shows that the number of cases is increasing at alarming rates. Part of the problem is an increased resistance to the antibiotics used to treat MRSA. Doctors are also recognizing and testing for MRSA more often.

The infection usually starts with red bumps resembling pimples. The site can become swollen.

A Department of Justice special court will hand down rulings today in cases asking whether certain vaccines cause autism in children.

Parents in three test cases which were heard in 2007 alleged that exposure to thimerosal, a mercury-containing preservative which is found in some some vaccines, combined with the MMR (measels, mumps, rubella) vaccine caused autism in their children. The government defended by aruging that the parents' claims were not supported by "good science." Presently, the Center for Disease Control (CDC), the World Health Organization (WHO) and the Institute of Medicine have found no credible link between vaccinations and autism.

Today's ruling will affect only families that claim MMR vaccines and thimerosal-containing vaccines can combine to cause autism. Families who have claimed that thimerosal-containing vaccines alone or that MMR vaccines alone can cause autism will be unaffected by today's decision.

Since 2001, thousands of parents with autistic children have filed petitions seeking compensation with Vaccine Injury Compensation Program at the Department of Health and Human Services. By mid-2008, more than 5,300 cases were filed in the program, 5,000 of which await adjudication.

The University of Chicago (U of C) is in the midst of a major restructuring that includes a plan for changing how it admits emergency room patients. Along with 450 layoffs, the emergency room may decline to accept every illness and injury under its new Urban Health Initiative plan The decision involves a new version of patient triage, essentially weeding out the individuals who could be treated elsewhere.

Costs are the driving force behind the change. According to the medical center, 40% of the 80,000 patients who go to its emergency room every year do not need to be there. The medical center says that these patients could be treated at community hospitals (whose costs are 30 to 40 percent lower than the U of C). These visits cost the hospital tens of millions of dollars a year. Additionally, the hospital has seen a rising number of uninsured patients and those covered by Medicaid.

I see the value in a plan for individuals to seek treatment at a facility that is appropriate for the level of their injury. Obviously, not every cut calls for emergency room treatment. However, the concern is that patients may not get the care that they need. It is concerning to think that people will be turned away. "This is tricky," said Jim Unland, president of The Health Capital Group, a consulting firm based in Chicago. "If patients really need to be in an ER and the U of C is turning them away, I have a problem with that."

Continue reading "UNIVERSITY OF CHICAGO BUDGET CUTS: IS TURNING AWAY PATIENTS FROM THE ER DOING NO HARM?" »

Government advisers are recommending a ban on Darvon, a pinkiller that has been on the market for fifty years. A Food and Drug Administration (FDA) advisory panel voted 14-12 last Friday to recommend withdrawing Darvon after a hearing on its risks and beneifts.

Darvon, which is mainly marketed as Darvocet, is one of the top 25 most commonly prescribed medications in the United States. The drug was first approved in 1957 when there were few alternatives for pain except aspirin and powerful narcotics.

At least one consumer group, Public Citizen, has petitioned the FDA to ban Darvon because the drug offers weak pain relief and poses an overdose risk, with the potential to be used in suicides.

According to a new study published in the New England Journal of Medicine, when surgical teams performed a simple checklist prior to surgery, patient morality rates were cut nearly in half and complications fell by more than a third.

The study involved 7,688 patients in 8 hospitals around the globe and reported that death rates declined from 1.5% before the checklist was institued to 0.8% afterwards. Serious complications fell from 11% to 7%.

The checklist was comprised of nineteen tasks to be performed throughout the surgery - seven before anesthetizing the patient, seven just before the first incision, and five before the patient leaves the operating room. Basic safety tasks, such as whether enough blood was available in case of bleeding, made up another six items on the checklist.

Doctors disagree on what the results of this study mean. Some are skeptical and characterize the behavioral change as "trivial," while others think that the net effect makes for more effective teamwork which can help save lives. Whether the changes can be sustained over time, however, is another question. A phenomenon known as the "Hawthrone effect" may be largely responsible for the checklist's success. The Hawthorne effect was named for a series of experiements designed to determine how to increase productivity in a factory in Chicago. All of the tactics implemented improved worker output during the experiment, but researchers realized that the effect they were really meausring was a boost in motivation among workers who knew they were being watched. With this most recent surgery checklist, however, researchers checked whether teams behaved differently when the researchers were present and when they were not and luckily found no difference.

As a result of the study findings, the U.K's national Health Service sent out an alert to all of its hospitals, calling on them to implement the surgical checklist. Five U.S. states (New York, Washington, North Carolina, South Carolina and Indiana) have endorsed it and plan to require hospitals to use it. We will hopefully see Illinois follow suit in the near future.

A new study suggests that doctors don't always report incompetent or impaired colleagues, even though almost all think they should. The study, published in the Annals of Internal Medicine, is believed to be the first of its kind. Researchers evaluated the extent to which doctors support and adhere to professional standards. More than 3,500 doctors were surveyed for the study.

Of the 1,662 doctors who responded, 96% said physicians should always report colleagues who are impaired, incompetent, or make a medical mistake. However, of those who had direct knowledge of peer incompetence within the past three years, only 55% made a report.

Cardiologists, pediatricians, family practitioners, surgeons, internists, and anesthesiologists were among the specialists surveyed. Those least likely to report a fellow doctor for incompetence were cardiologists and practitioners. According to the CEO of the American College of Cardiology, Jack Lewin, cardiologists may be more apt to deal with problems within their practice since they tend to practice in groups. He also said many doctors may avoid reporting colleagues for fear of being sued.

Within the legal world, this environment may contribute to the significant difficulty finding physicians who are willing to testify against their peers in a court of law. If they won't report them to the appropriate medical oversight agencies, testifying against them in a public forum is even more unlikely.

There is no question that there needs to be some kind of whistleblower protection for doctors so that they no longer fear reporting colleagues. There needs to be accountability for doctors who make medical mistakes. If they won't report each other, who will report them?

Continue reading "DOCTORS DON'T ALWAYS REPORT THEIR INCOMPETENT PEERS" »

Two recent studies show that many patients are scheduling when their babies will be born, through elective induction of labor or early planned cesarean section, increasing the risk of medical complications to mother and baby. Induction is the artificial start of labor through the use of medications. A recent study looking at 17,000 induced Scottish births revealed that more than 25% were elective, showing no apparent medical reason. However, such unnatural initiation of labor has risks and should be reserved where there is a true need to deliver early or on a date certain. Risks of induction of labor include an increased need for cesarean delivery, increased risk of infection, prolonged labor and hospitalization, and increased chance of the newborn requiring additional medical treatment. There are medical reasons where inducing labor is recommened for the safety of mom and/or baby. However, without a medical indication, any benefit of delivering on a certain date is outweighed by the risks inherent with unnaturally starting labor. Induction of labor should be reserved for situations of necessity, not convenience.

Another rush to delivery relates to planned, repeat cesarean sections. A recent study found they were being performed too early. The U.S. study found that 36% of planned cesarean births were performed before 39 weeks gestation. Such early, planned deliveries are most likely being driven by convenience. However, like induction, research reveals risks associated with rushing to delivery without a medical need. Specifically, babies born before 39 weeks "are at increased risk for birth-related health problems." The American College of Obstetrics and Gynecology (ACOG) recommends that planned cesarean sections should not be performed before 39 weeks absent a medical need, unless there is evidence that the baby's lungs are sufficienty mature. As the author of the editoral accompanying the study noted, "many doctors and their patients are running a yellow light if not a red light" when electing to deliver before 39 weeks. Rather, the "window of safety" is now considered smaller, with the optimal time for planned C-section to be within a week of the due date.

Just last week the ECRI Institute published its annual top ten major health technology hazards that should be on every hospital's list of safety concerns. The list is based on the Insitute's experience in investigating and consulting on device-related incidents, as well as on information found in the Institute's medical device problem reporting databases and in other problem reporting databases.

The top ten hazards include the following:
1. ALARM HAZARDS: Clinical alarms can be instrumental in preventing patient injury or death, but if the alarm conditions aren't effectively communicated, patients are at risk. The ECRI Institute placed alarm hazards as the number one hazard because alarm issues are among the problems most frequently reported to the Institute. The variety of affected equipment is considerable - reports involve patient monitoring equipment, ventilators, dialysis units and other devices.

2. NEEDLE STICKS & OTHER SHARPS INJURIES: Consequences from getting stuck can range from serious cuts to exposure to HIV or Hepatis B or C.

3. AIR EMBOLISM FROM CONTRAST MEDIA INJECTORS: The x-ray imaging of blood vessels requires that contrast media be injected into the patient's blood vessels. To improve the control and precision of injection, power contrast media injectors have increasingly replaced handheld syringes in recent years. Unfortuantely, injecting contrast media into the blood vessels creates the risk of injecting air, which may potentially result in a fatal embolism.

4. RETAINED DEVICES & UNRETRIEVED FRAGMENTS: The FDA and ECRI Institute receive reorts of foreign bodies left inside patients following treatment. Retained devices refers to an entire device being left behind in a patient's body (such as a sponge or clamp). Unretrieved device fragments refers to situations in which a protion of device breaks away from the whole and remins inside the patient. Retention of these objects can sometimes lead to serious infection or damage to the surrounding tissue.

5. SURGICAL FIRES: Most surgical fires can be avoided as long as surgical staff are trained to recognize and control the three elements that combine to cause fires: ignition source, oxygen, and fuel.

6. ANESTHESIA HAZARDS DUE TO INADEQUATE PRE-USE INSPECTION: Inspection of anesthesia equipment is often inconsistent and incomplete. Hospital staff sometimes conduct pre-use checks using obsolete procedures or procedures designed for models other than the one being used. Staff may also skip a protion of the inspection, which leaves the safety of the anesthesia system in question and increases the risk of patient injury or death.

7. MISLEADING DISPLAYS: The sole fucntion of displays, which are often built into a variety of medical devices to convey information, is to inform the user. However, some displays are ambiguous or counterintuitive. While they may function as designed, these displays present information in ways that invite misinterpretation.

8. CT RADIATION DOSE: CT is thought to be responsible for about 6,000 additional cancers a year, roughtly half of them fatal.

9. MR IMAGING BURNS: Heating during an MR scan can ocur, so it's importatnt that patients tell the MR technologist to signal if they feel undue heat during the scan.

10. FIBEROPTIC LIGHT-SOURCE BURNS: Fiberoptice light sources are designed to illuminate treatment sites through a number of devices. There are two burn hazards in particular that are commonly reported - burns from the light itself and burns from heated cable connections.

In an effort to prevent these accidents, the ECRI Institute includes a number of recommended tips for hospital staff. For you and your family, consider this top ten list the best reasons to do your best to stay out of the hospital!

Continue reading "TOP TEN HEALTH TECHNOLOGY HAZARDS" »

According to a new study which will be published in this week's Journal of the American Medical Association, at least 2 million older Americans are taking a combination of medications or supplements that can be a risky mix. The study found that one in ten older men are taking potentially harmful combination. The study notes that while the results aren't always or even necessarily disastrous, older people are more vulnerable to side effects and drug-to-drug interactions.

The study notes three commonly used and risky combinations:
* Lisinopril, a blood pressure medication, taken in conjunction with potassium. The combination of these two drugs can cause abnormal heart rhythms.
* Prescription cholesterol drugs ("statins") taken in conjunction with over-the-counter niacin, a type of vitamin B that also lowers cholesterol. This combination can increase the risk of muscle damage.
* Aspirin taking in conjunction with over-the-counter ginkgo supplements. The combination of these two over-the-counter remedies increases the chances for excess bleeding.

Experts advise that you should ask your doctor about any side effects of prescription drugs and inform your doctor before taking other medicines. Similarly, doctors should closely monitor what their patients are taking and advise their patients on potential interactions. Taking multiple medications, despite possible bad interactiosn, isn't necessarily a bad idea as long as patients are in close contact with their doctor.

Continue reading "ALERT YOUR DOCTOR TO ALL MEDICATIONS" »

Celebrity Dennis Quaid and his wife, Kimberly, have accepted a $750,000 settlement from Cedars-Sinai Medical Center in Los Angeles.

Quaid's twin babies, Zoe and Thomas, were being treated at Cedars-Sinai in November 2007 for staph infections when an employee accidentally administered dosages of heparin, a blood thinner, that were 1,000 times the recommended amounts for newborns. Thankfully, both children fully recovered. The California Department of Public Health later fined Cedars-Sinai $25,000 for multiple failures to adhere to established policies and procedures for safe medication use.

The Quaids remain involved with a lawsuit against Baxter Healthcare Corporation, the manufacturer of heparin, alleging negligently labled medication bottles. The settlement with Cedars-Sinai has no effect on this pending lawsuit.

Continue reading "DENNIS QUAID ACCEPTS A SETTLEMENT FROM L.A. HOSPITAL" »

Bedside manner is important to patients. You want your doctor to care about you and your medical needs and to understand how you feel, especially in the event that you have a potentially fatal disease. On prime-time medical television shows, such as, Grey's Anatomy and ER, the doctors are often deeply affected by the diagnoses they are making and they "put themselves in the shoes" of their patients. In reality, there is only a 10 percent chance that a patient with a deadly disease will get an empathetic response from a doctor.

In a study published in the Archives of Internal Medicine named, "Missed Opportunities for Interval Empathy in Lung Cancer Communication" by Dr. Diane S. Morse and colleagues at the University of Rochester Medical Center, the researchers analyzed twenty recorded and transcribed consultations between lung cancer patients and nine physicians. Of the 384 opportunities to provide empathy, physicians responded with empathy 10 percent of the time.

Surgical fires in the operating room affect between 550 and 650 patients a year. Twenty to thirty of these victims will suffer serious, disfiguring burns while one or two of these patients will die. This information comes from the Pennsylvania Patient Safety Reporting System, which is collecting this data for the first time ever.

These types of medical errors are almost always preventable. What needs to occur is better training and communication. The nation’s doctors, nurses and others in the operating room need to be trained in basic steps to keep fires from happening and hold surgical fire drills to make sure the appropriate steps are undertaken. Fewer than half of the hospitals in the United States conduct operating room drills to prevent and control fires.

The chief focus of this training should be between the surgeon and the anaesthesiologist. Common sense tells us that the three primary elements needed to ignite a fire in an operating room are heat, air and fuel. With seventy percent of the surgical fires occurring due to electrical surgical tools known as Bovies, a device that uses a high-frequency electric current to cut tissue or stop bleeding, the communication between the surgeon and anaesthesiologist is of the utmost importance.

Some have taken steps to prevent surgical fires, including discontinuing oxygen face masks, lowering oxygen levels and requiring staff to implement checklists for the prevention of steps before the procedures are actually undertaken. This is a favorable step in preventing an operating room mishap.

Continue reading "OPERATING ROOM FIRES ON THE RISE " »

On October 2, 2008, the Illinois Supreme Court ruled that a mother whose fifteen-year-old son died of a drug overdose can pursue a wrongful death lawsuit alleging wilful and wanton misconduct by paramedics from the City of Park Ridge. Jo Ann Abruzzo v. City of Park Ridge, Docket No. 104935. The trial and appellate courts had ruled that the City of Park Ridge was shielded from liability based on the State’s Tort Immunity Law for Municipalities. The Illinois Supreme Court determined that based on the facts this case, the lawsuit could proceed under a less restrictive law covering emergency medical services. The Illinois Supreme Court noted that the Emergency Medical Services Systems Act, 210 ILCS 50/3.150(a) applied to the death of the young boy and not the absolute immunity that the City of Park Ridge claimed under the Tort Immunity Act, 745 ILCS 10/1-101.

This ruling by the Illinois Supreme Court, although based on the particular facts of this case, will allow lawsuits to proceed against paramedics where there are situations, like here, when they fail to assess or examine a person appropriately. This lawsuit is favorable to consumers, however, it is on a very fact-sensitive basis. Most municipalities will claim that they are immune from lawsuits based on the Tort Immunity Act. Of course, each case needs to be evaluated based on its particular facts.

Continue reading "A WRONGFUL DEATH LAWSUIT AGAINST PARAMEDICS ALLOWED TO PROCEED" »

The average time that patients wait in a hospital emergency room has grown from 38 minutes to almost an hour over the course of the last decade. The increase in visits made to the U.S. emergency rooms is 32% over the last ten years. Unfortunately, the number of hospital emergency departments have dropped. Obviously, with the number of emergency room visits increasing and the number of emergency departments decreasing, this spells a recipe for disaster for patients.

This is troubling news for consumers. This clearly identifies that people in need of medical care are being delayed, including people suffering from heart disease, heart attacks or other life threatening situations that require immediate care. Fifty six minutes can, literally, be a life and death situation for someone in the emergency room. These types of delays will inevitably expose hospitals and their emergency rooms to litigation in the future.

Coincidentally, the findings also demonstrated that summer and winter were the busiest seasons in the emergency rooms and the early evening, around 7:00 p.m., tended to be the busiest time of the day.

Continue reading "WAIT TIME IN EMERGENCY ROOM ON RISE" »

This fall, the United States Supreme Court will hear oral arguments in the case of Wyeth v. Levine, No. 06-1294 . Diana Levine was using a drug company’s anti-nausea drug (Phenergan) which resulted in serious complications and, ultimately, the amputation of her arm. A Vermont jury awarded her $6.7 million dollars, concluded that the drug manufacturer had failed to warn of the risks associated with the drug. Wyeth is contending that the drug met FDA labeling requirements and should face no liability under state law. The drug company is arguing that the Federal Drug Administration’s authority to approve drug labeling pre-empt’s state laws governing products liability.

First and foremost, allowing the preemption argument would eliminate a significant incentive for the drug company to ensure that its drug labels reflect accurate and up to date information. It would all but eliminate any type of failure to warn product liability litigation against the drug companies.

As one reporter noted "The FDA does not have the ability at this time to oversee in a comprehensive fashion everything it regulates.” If the FDA’s position is adopted by the Supreme Court, it would eliminate any incentive for the drug company to ensure that its drug labels reflect accurate and up to date information. Who gets hurt? The answer is: the consumers. Without such lawsuits, regulators and the public may never hear of evidence that the drug manufacturers knowingly marketed products that were unsafe or untested . . . until it is too late and another senseless death or catastrophic injury occurs.

Continue reading "ARE PATIENT’S RIGHTS AGAINST DRUG COMPANIES IN JEOPARDY?" »

It seems like everywhere you go you hear people complain that there are too many lawsuits and that lawyers are running doctors out of practice. That is the perception that the insurance industry is trying to manifest. The fact is, however, that the Illinois tort system does NOT appear to be the cause of the undisputed rise in doctor’s liability insurance premiums. According to an Illinois State Bar Association-commissioned study by Neil Vidmar, a professor at Duke University Law School, the data show no upward trends in filings overall or in filings per 100 treating physicians from 1994 through 2004. In fact, medical malpractice filings from 2000 through 2004 were substantially lower than in 1994 and 1995. Significantly, while there was a modest increase in medical malpractice case filings between 1996 and 2004, when adjusted for the growth in physicians who treat patients, there is no evidence of a medical malpractice claims increase.

Continue reading "MEDICAL MALPRACTICE IN ILLINOIS" »

Medication errors are among the most common medical mistakes, harming at least 1.5 million people every year states a July 2006 report from the Institute of Medicine. Now, for the first time ever, the mortality rates of Illinois hospitals are available to the general public from the Centers for Medicare and Medicaid Services (CMS) .

This is good news for Chicagoland residents as they can now review hospital mortality rates for heart attacks, heart failures and pneumonia. This type of information allows patients to make educated decisions when seeking quality healthcare. As a consumer, I support the government’s efforts to provide us with more healthcare information. It was also refreshing to see that several area hospitals appeared on multiple “lowest” mortality rates. Unfortunately, three Illinois hospitals had mortality rates for pneumonia which were higher than the national average. Arguably, some of these needless deaths resulted from substandard medical care.

Continue reading "MORTALITY RATES FOR CHICAGOLAND HOSPITALS AVAILABLE TO THE PUBLIC" »