© The Medical-Legal News 2007
• According to the Chicago Tribune JCAHO does not check meaningful safety factors in hospitals and underestimates the number of patient deaths.
• Waste and errors cost the nation’s health system $100 billion per year.
— Commonwealth Fund
• Qui-tam suit: Pediatrix Medical Group will reimburse the government $25 million for upcoded claims on services for babies. The infants were not as ill as the billing claimed.
— Modern Healthcare
• Public Citizen, citizen.org, found in a study thatFlorida had 1,555 doctors practicing who had been disciplined by the state board. PC studied the national practitioner bank and found that 5 percent of all doctors caused more than half of malpractice judgments and settlements. Related story, Page 10.
• Around 14 percent of Americans receive medical help for illnesses or injuries either too late or not at all.
— CP Health Beat
• Bayer’s Trasylol, a heart surgery drug, has been implicated in a heightened risk of heart attack, strokes and kidney damage.
• A Wisconsin nurse killed a patient as a result of a drug error. She was criminally charged with a felony, which alarmed many in the health care industry. Criminal charges were later dropped. See related story, Page 5.
• HIPAA-wise: Patient confidentiality can be broken when nondisclosure would result in harm to the patient.
• Firefighters, even though they wear much protective gear, are exposed to a lot of cancer causing toxins. As such, they have higher-then-average rates of several cancers.
— Journal of Occupational Environmental Medicine
• The baldness drug Propecia (Finasteride) causes men to have lowered PSA readings by as much as 40 to 50 percent.
— The Lancet
• Attack on attacks: A few hospitals now have MDCT scanners. These scanners can detect a heart attack in about 15 seconds.
• Home trampolines sent 89,000 people to the hospital in 2004. Some deaths resulted.
— American Academy of Pediatrics
• A new hair-dryer like device called the LouseBuster, has been found effective in lice treatment. The device is welcome because lice are developing resistance to many insecticides. Info: leesiegel@ucomm. utah.edu.
• About 10 percent of the population at large is alcoholic. Among lawyers the rate is about 18-20 percent. The rate rises to 25 percent after 20 years of practice.
— American Bar Association
• A doctor was found guilty for being vicariously liable for the act of a nurse he did not employ during a routine removal of a breathing tube. The Alabama Supreme Court overturned the verdict stating that no master/servant relationship existed.
— Medical Malpractice Law and Strategy
• EMTALA fact: If a patient is admitted to a hospital from the ED, EMTALA rules do not apply as this is not a transfer or discharge.
• In a study, it was found that employers, workers’ comp and private insurers pick up 30 percent of hospital costs associated with Medicare and Medicaid. In short, those who can pay are overcharged.
— Millman Inc. via Medical Malpractice Law and Strategy
• Pharmaceutical company Merck pulled the plug on its lobbying campaign that was encouraging states to make its cervical cancer vaccine Gardasil mandatory.
• The physician-patient relationship does not have to be a formal contract but can simply be implied, according to recent cases.
— Medical Malpractice Law and Strategy
• The new spiral CT scan to detect lung cancer has its downside: Many people have false positives and undergo expensive and unnecessary testing.
— UC Berkeley
• Many hazardous drugs are found in the systems of healthcare workers. The drugs are known to be types that can damage DNA or cause cancers. The drugs’ presence is believed to result from the handling, cutting, crushing and administering of the medicines.
— American Journal of Nursing
• Brain dysfunction is a side effect of heart surgery occurring in about 40 percent of cases.
— St. Louis School of Medicine
• Eating soy products, grains, fruits and vegetables has been shown to lower the risk of developing lung cancer.
— University of Texas
• Yet another study has shown that elderly people with a positive attitude will live longer.
— Yale School of Public Health
• Many health experts are starting to recommend a daily power nap lasting 15 to 20 minutes, but not more than 30 minutes.
— CBS News
• The vast majority of med mal cases involve a severe injury and of these, 63 percent occur from an error that is demonstrable.
— Medical Malpractice Law and Strategy
• In a survey, 64 percent of nurses had suffered verbal or physical abuse recently. Patients were the No. 1 source of the abuse.
— Journal of Advanced Nursing
• Nursing home inspectors frequently failed to report serious problems in the homes.
• In a New York study of 600 nursing homes, 98 percent were short-staffed.
— New York Office of the Attorney General
• Nursing assistants administer 90 percent of nursing home care. These assistant positions have about an 80 percent turnover rate.
• Doctors are being urged to ask patients about their sex lives more frequently. Sexual dysfunction is a good indicator of more serious problems.
• It is below the standard of care when a doctor does not read the nursing notes during patient discharge.
— The Missouri Court of Appeals
• Medical facilities are required by law to accommodate deaf or hearing-impaired patients.
— Americans With Disabilities Act
• A patient with a health care surrogate does not give that surrogate permission to bind over the patient to arbitration, i.e. waive the patient’s right to a jury trial. •
— U.S. District Court of Southern Mississippi ,California Appeals Court
• The FDA says that about 1 percent of the U.S.drug supply is counterfeit. See www.safemedicines.org for updates.
• Women having ovarian cancer surgery are twice as likely to die when using general surgeons than with gynecologists or oncologists.
— Harvard Medical School
• In a study, nonstick fry pans and microwave popcorn gave off high levels of toxic perfluorinated chemicals. Cookware manufacturers plan to phase out these dangerous coatings by 2015. PFOAs are carcinogenic and mimic estrogen.
— Environmental Science & Technology
• Blue Cross of Tennessee has begun to require bariatric surgery candidates to take intelligence tests. This policy has many critics. The insurance company claims that tests are needed to ensure that patients are fit for the demands of the surgery.
— Modern Health Care
• The popular substitute to trans fat is interesterified fat, but in a recent study even the new substitute was associated with increased diabetes risk.
— Science News
• The five rights of drug administration are to verify the right patient, the right route, the right dose, the right time and the right medication.
• Most people don’t wash their hands the required 20 seconds it takes to kill germs.
— Cleaning 101.com
• The Illinois Supreme Court recently ruled that only nurses can testify as experts to the standards of care for nurses.
• From 1999 to 2003 about 100 brains from corpses were sent from a Maine medical examiner’s office to the Stanley Institute without survivors’ permission.
— Lexington Herald Leader
• A second large study shows no relationship between childhood MMR vaccines and autism.
• Since 2005, about 18,000 cases of medical identity theft have occurred, or about 2 percent of all identity theft cases. The number is actually believed to be much higher.
• Since 1983, about 1.5 million people have had adverse reactions to herbal supplements and vitamins.
— U.S. Poison Control Centers
• In a study of medical malpractice cases involving patient harm, poor documentation, scheduling problems and miscommunication were key factors.
— The Annals of Internal Medicine
• In a study of automated medicine dispensing cabinets, about one-half of all cabinets let nurses obtain all medications without pharmacist approval when they did an override.
— McKesson Medication Management Company
• In a hospital study of “smart” infusion pumps, 43,000 doses were delivered over a four month period. There were 122 dose alerts, seven of which were potential errors that were averted.
— George Washington University Hospital
• The FDA has approved the use of iridescent or shimmering coatings or drug tablets. Drug makers hope creating wild new colors will reduce medication errors and counterfeiting.
— EMD Chemicals
• Twelve states do not require children under eight to be in booster seats.
• The three lawyers who allegedly mishandled $200 million of fen-phen settlement money said they destroyed their notes showing how much they paid themselves and their clients.
• Men have a 77 percent higher risk, per mile driven, of dying in a traffic accident than do women.
• The AMA recently adopted a position that nurses and other non-doctors who have PhDs will “create confusion, jeopardize patient safety and erode trust.” Some nursing groups have cried foul claiming that the AMA resolution is an effort to protect doctors’ power and money.
— AMA; AJN
• In a study of 360 ventilated tube-fed patients, about one-half of the patients developed pneumonia.
— Critical Care Medicine
• By 2010, 40 percent of American nurses will be over 50.
— Robert Wood Johnson Foundation
• Physicians have been slow to adopt e-mail for doctor-patient communications, though studies have shown it can lessen workloads. One reason may be that doctors are less likely to be reimbursed for electronic consultations than for in-person ones.
— Center for Studying Health System Change
• Complications can develop several weeks after the stoppage of the blood clot drug Heparin.
• A 2006 report on the U.S. healthcare system showed marginal gains in quality in several sectors, with hospitals having a 7.8 percent quality improvement.
— Leapfrog Group, AHRQ
• Nurses are involved in about 18,000 malpractice cases per year with the average case paying out $100,000. Doctors are involved in more than 150,000 with each case costing $170,000.
• Sugar slows the uptake rate of alcohol into the blood, but sugar free sweeteners do not. People imbibing on mixed drinks made with artificial sweeteners are apt to be more intoxicated.
— Royal Adelaide Hospital , Australia
• X-ray scans in airports use about one-tenth the radiation of a normal medical X-ray.
— Albert Einstein Medical College
• The number of doctors in group practices has tripled since 1965. Group practices tend to be more profitable.
• Community hospital profits were at an all time high in 2005 at $28.9 billion.
• Arsenic in building lumber may become a major problem in New Orleans hurricane debris.
— University of Miami
• Numerous patient safety performance tools can be found at ismp.org and at physiciansafetytool.com.
— Modern Health Care
• The FDA recently investigated a “designer embryo service.” The service was fertilizing eggs and selling them based on predicted characteristics that they should possess once grown into children. Ethics issues were inferred.
• Twenty-five years ago about 5 percent of Americans scored themselves as procrastinators. Today the number is 26 percent.
• EMTALA: An ED patient’s treatment cannot be delayed to request bill payment or insurance information. The ED can ask about financial matters so long as the query does not delay treatment.
• A liquid protein-based bandage has been developed that can be painted on.
• Maine and Alabama have been recruiting hairdressers to alert them to signs of spousal abuse.
— The Los Angeles Times
• In a survey, 67 percent of hospital CEOs said that financial issues were their biggest worry. Quality came in fifth and patient safety sixth.
— American College of Healthcare Executives
• The North American Association for the Study of Obesity has guidelines on informed consent that doctors can use with bariatric surgery patients. Many lawsuits involving bariatric surgery focus on a lack of informed consent. Americans spend $30 billion a year on diets, yet two-thirds of Americans remain overweight.
— NAASO, CDC
• About one-half of hospital EDs are believed to be overcrowded. There has been an almost 20 percent increase in ED visits in the last 20 years.
— CDC, Lewin Group
• About 40 percent of patients in hospitals may experience alcohol withdrawal. Caregivers are advised to recognize it.
— Nursing Made Incredibly Easy
• An expert witness is not needed if a defendant medical caregiver freely admits that his service was below the standard of care.
— Missouri Court of Appeals
• A patient with an infection costs the healthcare system an extra $6,300. In a study, hospital-acquired infections occurred in about 4 percent of patients.
— Health Data Management, Hamot MedicalCenter
• The number of psychiatric patients who visit an ED is on the rise, though many staffers in EDs have little psychiatric training.
• The first penis transplant was done in Chinalast year. The surgery went well and the organ was not being rejected by the recipient’s body. However, the patient requested removal of the new organ because of psychological concerns.
— European Urology
• Almost one-third of nurses say they know of other nurses leaving their jobs as a result of verbal abuse by doctors.
• Disciplinary actions against nurses taken by a board of nursing are usually documented in a “public order” in most states. This order is public record and a permanent mark on the nurse’s record.
• Pecans, pistachios and walnuts have been found very helpful to blood vessel health. •
— Loma Linda University
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