Articles Posted in Medical Errors

A new study published in the Journal of General Internal Medicine finds that the springtime transition to Daylight Savings Time may result in an increase in medical errors made by healthcare orders. The study was published in August 2020 by a group of authors including Branu Prakash Kolla of the Department of Psychiatry and Psychology at the Mayo Clinic; Brandon J. Coombes of the Division of Bioinformatics at the Mayo Clinic; Timothy I. Morgenthaler of the Center for Sleep Medicine at the Mayo Clinic; and Meghna P. Mansukhani of the Center for Sleep Medicine at the Mayo Clinic.

According to the Journal of General Internal Medicine, the observational study’s objective was to examine “the change in reported patient safety-related incidents (SRIs), in the week following the transition into and out of DST over a period of 8 years.” It specifically observed incidents at “A US-based large healthcare organization” with locations in various states around the country. It measured “Voluntarily reported SRIs that occurred 7 days prior to and following the spring and fall time changes for years 2010–2017,” and separately identified incidents that were likely to have resulted from human error. Changes in SRI numbers “from the week before and after the time change (either spring or fall) were modeled using a negative binomial mixed model with a random effect to correct for non-independent observations in consecutive weeks.” Continue reading

White Plains Center for Nursing Care received 51 citations for violations of public health laws between 2015 and 2019, according to New York State Department of Health records accessed on November 4, 2019. The White Plains nursing home’s citations, which include 19 more than the statewide average, resulted from five inspections by the state inspectors. The violations described in these citations include the following:

1. The nursing home failed to ensure that residents’ drug regimens were free from unnecessary drugs. Section 483.45 of the Federal Code requires that nursing homes keep “each resident’s drug regimen… free from unnecessary drugs,” defining as unnecessary any drug that is used in an excessive dose, for an excessive duration, without proper monitoring or indications, and/or in the presence of adverse consequences. A March 2019 citation found that White Plains Center for Nursing Care did not ensure that one of five residents reviewed was properly monitored for pain and the effectiveness of pain medication he was receiving. An inspector specifically found that the resident “was receiving Opioid medication on 5 out of 7 days during the assessment period,” but that there was no evidence the resident’s pain level was evaluated before medication was provided. A review of records by the Department of Health found further that the records did not prompt medical staff to document residents’ pain levels.

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An estimated 161,000 Americans die each year because of preventable medical errors, according to a new study by Johns Hopkins University. The study, which was published by Leapfrog Group, a nonprofit which ranks hospital safety, shows that fatalities by preventable medical errors are trending downward. Three years ago, the number of preventable deaths stood at 206,000.

“We are cautiously optimistic we are going to see real change and that is good news from this report,” Leah Binder, President and CEO of the Leapfrog Group, told Modern Healthcare. “But 161,000 is still a lot of people it’s a terrible problem. We have a long way to go.” Binder continued to explain that the number of preventable deaths is likely an underestimate since the study only looked at 16 safety categories and the “subset of each safety issue” in each category. According to Leapfrog Group, 15 of the 16 measures used to judge patient safety are the same used by the Centers for Medicaid and Medicare Services (CMS) to judge nursing home quality.

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Between 2015 and 2019, The Knolls, a nursing home in Valhalla, New York, received 35 citations for violations of New York and federal health laws. That figure is three more than the statewide average of 32 citations, and resulted from a total of four inspections by the New York State Department of Health. According to the Long Term Care Community Coalition, The Knolls is considered a “Special Focus Facility Candidate,” meaning that it has been identified by the Centers for Medicare & Medicaid Services as having a record of poor care that may merit inclusion in CMS’s limited list of facilities that receive enhanced oversight. The violations described in the Department of Health citations, which were accessed on November 4, 2019, include the following:

1. The nursing home did not properly store and label drugs and biologicals. Section 483.45 of the Federal Code states that nursing homes must label drugs and biologicals “accordance with currently accepted professional principles, and include the appropriate accessory and cautionary instructions, and the expiration date.” According to a July 2018 citation, The Knolls kept in storage an emergency box containing “2 vials of medication and 3 normal saline intravenous (IV) flush syringes [that] had past due expiration dates.” A nurse manager told a Department of Health inspector that emergency boxes “are supposed to be checked every night,” and that if materials are expired, a nurse is supposed to send a request to the facility’s pharmacy for replacement. Per a pharmacy consultant interviewed by the Department of Health, the medications in question “should have been removed.”

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A new study suggests that doctors are more likely to skip screenings and otherwise make mistakes with patients later in the day. According to a JAMA Network Open study, doctors ordered fewer breast and colon cancer screenings for patients with an afternoon appointment – despite the fact that all patients were due for a screening. According to the study, the doctor was most likely to order a medical screening for his patient with an 8 AM appointment. By 4 PM, the likelihood that the doctor would order screens for their patient had dropped by 10 to 15 percent.

Other studies have confirmed that poorer outcomes for patients are more likely in the afternoon. A 2014 study, cited by The New York Times, found that doctors were more likely to dole out unnecessary antibiotic prescriptions in the afternoon. In fact, the likelihood of an unnecessary antibiotic is 26 times higher for a 4 PM appointment compared to an 8 AM appointment.  Other studies located by the New York Times found that patients were less likely to receive the flu vaccine and more likely to receive prescription opioids for back pain. Even the amount of hand washing by doctors fell during the afternoon hours.

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With more doctors putting in long hours, the profession now carries one of the highest risks of burnout. According to the AMA, physicians suffer from “burnout” roughly twice the rate for the general population. The blame, according to doctors, lies in the corporatization of healthcare which has rapidly accelerated over the last decade. Doctors say that corporate healthcare chains squeeze as many patients as possible onto each doctor attempting to maximize their revenue. This leaves doctors without adequate time to diagnose a patient, record their medical information, and deal with their health insurance companies. In a New York Times article, the author states that doctors work nights and weekends to adequately care for all their patients at “a high personal cost.”

Regulations also eat up an unnecessary amount of time, according to doctors. The E.M.R. or Electronic Medical Record appears especially burdensome. Data shows that primary care physicians are now spending two hours typing into the E.M.R. for each hour spent with their patients. The time spent on the E.M.R. does not even include the compliance workshops and continued medical education required of all doctors.

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A disgraced doctor pleaded guilty to three charges of manslaughter last week in Queens, according to The New York Daily News, Indicted on felony charges last year, Dr. Lawrence Choy ran a ‘pill mill’ out of his Queens office from 2012 to 2016. The former doctor routinely prescribed the so-called ‘Holy Trinity’ of drugs to his patients – an opioid, a benzodiazepine, and a muscle relaxer. All three medications are both extremely addictive and extremely dangerous because of their ability to suppress breathing and cause an overdose. Tragically, Dr. Choy’s reckless prescribing habits caused three of his patients to fatally overdose.

After the deaths of his patients, Dr. Choy closed his medical practice and fled to Wyoming. The long-distance move did not matter to federal authorities who charged Dr. Choy with 231 crimes last year in a complaint detailing the doctor’s recklessness and indifference to his patient’s suffering. According to prosecutors, Choy’s pill mill in Queens was popular across the entire northeast – patients from New Jersey and Pennsylvania routinely made the trip just to visit Choy. According to federal prosecutors, Choy began doling out oxycodone prescriptions beginning in 2012 when Choy received a tax bill for more than $1 million. Once word got out that Choy would exchange prescriptions for cash, addicts would travel to the Queens doctor to get their fix and drug dealers would travel to get their supply. A single oxycodone pill prescribed by Choy could be sold for $30 on the street, less than the cost of a month’s prescription without insurance.

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An ophthalmologist is facing a lawsuit and revocation of his medical license after operating on the wrong eye. The Chicago woman, Sutton Dryfhout, says she came in for a routine cyst removal surgery and experienced a living nightmare. According to Dryfhout, Dr. Benjamin Ticho realized his mistake after the surgery when Dryfhout was already in post-operative care. Amazingly, the doctor chose to attempt surgery on the correct eye – with Dryfhout no longer under anesthesia. The lawsuit filed by Dryfhout says Dr. Ticho came into the recovery room and told a nurse that he “forgot something” and then asked them to hold down the patient while he attempted to operate on her left eye. The nurse allegedly complied.

Speaking to New York Daily News, Dryfhout said she screamed and yelled for Dr. Ticho to stop and that she could “[feel] surgical instruments including a needle and scissors going into her eye and could feel burning from a cautery pen being used on her eye.” Dryfhout also alleges the ophthalmologist did not follow proper hygiene protocols by using unsterile equipment and performing the entire operation without gloves. After the impromptu surgery on the correct eye ended because of Dryfhout’s screams for help, Dr. Ticho allegedly went to the patient’s medical records and consent forms and changed all references to performing surgery on her “left eye” to her “right eye.”

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Two New Yorkers sued their doctor and fertilization clinic after the alleged medical malpractice caused a tragic mix-up involving three sets of angry parents across the country. According to CBS New York, Annie and Ashot Manukyan went to CHA Fertility Center in Los Angeles for in-vitro fertilization treatments. After the treatment, the New York couple did not become pregnant. Unfortunately, that is because their genetic material was used to impregnate another couple in Los Angeles. The Los Angeles couple actually became pregnant with twins who they believed was their child. Unfortunately, the couple was carrying the child of the Manukyans and another Los Angeles couple. The parents found out at birth of the mix-up when one of their children was a different race than the parents.

The Manukyan’s were immediately notified and because the birth parents wanted to keep the child, they had to sue in New York courts to have their genetic child brought to them. In a recording released by the attorneys for the Manukyan’s, the genetic mother broke down crying when she discussed her heartbreak over not carrying and delivering her own child. The New York judges ruled in favor of the birth parents and the child is now living in New York.

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An outbreak of a rare blood infection in a New York hospital traced back to an opioid-stealing nurse, reports Gizmodo. According to the technology and science website, six cancer patients developed a serious and rare blood infection from June to July 2018 at Roswell Park Comprehensive Cancer Center in Buffalo, New York. According to the website, none of the victims died as a result of being infected by Sphingomonas paucimobilis.

The bacterial infection is typically found in soil and water, thus rarely harming people. When six people all came down with the infection – which sickens individuals to the point of constant vomiting – hospital authorities say they suspected a medical contamination. After an investigation at the hospital, authorities realized the common thread between the patients involved a nurse who administered their hydromorphone intravenously.  Hydromorphone is a powerful opioid. In response to questions by hospital investigators, the nurse admitted that she removed a certain amount of medication for the patients and then diluted the syringe with water so the dosage appeared unchanged.

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