Articles Posted in Medical Errors

New York City amended its opioid lawsuit against Purdue Pharmaceuticals to include the company’s owners, the Sackler family, as well as several retailers and pharmacy chains, including CVS, Rite-Aid, Walgreens, and Walmart. The lawsuit alleges that Purdue Pharmaceuticals, maker of OxyContin, deceptively marketed their addictive drugs under the direction of their owners, the Sackler family, and the retailers who dispensed the drugs enabled the opioid epidemic currently ravaging communities across the country. In addition to increasing the number of defendants allegedly responsible for contributing to the opioid epidemic, the lawsuit also consolidated dozens of lawsuits filed by other local governments.

The consolidation of lawsuits and inclusion of the popular drugstores was widely expected, the group of defendants is being sued by local governments across the country and by the federal government. The inclusion of the Sackler family, on the other hand, was a recent development in the opioid cases. According to The New York Times, a lawsuit against Purdue Pharmaceuticals in Massachusetts unearthed emails showing members of the Sackler family were “far more involved” than previously believed. According to the lawsuits against the company, Purdue Pharmaceuticals deceptively marketed Oxycontin, a powerful and addictive opioid, as appropriate for long-term pain management and claiming, without evidence, that “less than one percent of [Oxycontin users] become addicted.” The aggressive promotion of Oxycontin led to $1 billion in annual sales within a few years and is now widely understood to have ignited the country’s opioid epidemic.

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A recent study by The Doctors Company found that misdiagnosis is the top allegation in medical malpractice lawsuits filed across the country that involve children. The researchers conducting the study said “misdiagnosis” included missed, failed or the wrong diagnosis and were largely the result of inadequate medical examinations, according to Fierce Healthcare. The study conducted by a non-profit doctors group involved reviewing over 1,200 medical malpractice lawsuits filed across the country through 2008 and 2017.

The report also illuminated several prominent trends in medical malpractice lawsuits. For example, poor communication was cited as a factor causing the child’s injury in 15 and 22 percent of the lawsuits. Systemic failures were also a common factor. Systemic failures typically meant not notifying patients of important test results, according to the online news agency.

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The New York Medical Board is slow to punish doctors who lose their license to practice in other states. According to The New York Post, the state licensing board for doctors took between “a few weeks to several months” to stop 14 doctors who had lost their ability to practice medicine in New Jersey over the last six months. Perhaps even more worrisome, the local newspaper found that two of those doctors were still practicing medicine despite being deemed unfit to practice just across the river. New Jersey did not perform much better at ensuring potentially dangerous doctors stayed away from the state’s patients – five doctors with their New York licenses suspended in the last six months were still practicing in the state.

Perhaps overstating the obvious, Patient-safety advocate Betsy McCaughey told The Post that licensing board’s slow movement on incompetent doctors “could lead to unnecessary additional harm to patients.” The founder of the Committee to Reduce Infection Deaths then harped on the unnecessary risk to patients by stating “all you have to do is send an email.” McCaughey correctly notes that the New Jersey Board of Medical Examiners receives a daily alert for doctors whose license has been suspended or permanently revoked. With this information delivered each day, it is not unreasonable to expect a prompt investigation.

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The federal government opened a probe into a hospital run by the Department of Veteran Affairs. According to the New York Daily News, the federal probe is a response to a veteran’s allegations of neglect, medical malpractice, and elder abuse. The local newspaper describes the experience of Gary Zambito, who served in the armed forces during the Vietnam War. During his military service, Zambito suffered an injury which led to health complications for the next fifty years. While he trusted the VA to look after his care, Zambito describes a nightmare of incompetence and fraud. Zambito says the care provided by the VA was so insufficient that it “nearly killed” him. After suing the government for $4 million, the federal government opened a probe into the nursing home and hospitals for criminal malfeasance.

According to the veteran, he sought help from his local VA hospital on Long Island back in 2015 when he started experiencing “dizzy spells” that would commonly end in blackouts. Zambito says he told doctors that being knocked unconscious in the Vietnam War led to heart problems – specifically, an irregular and rapid heart rate. Despite this knowledge, doctors did not seem interested in drawing the connection between Zambito’s fainting spells and his heart condition. After being told that there was nothing the doctors could do to help him, Zambito spent the next three years simply enduring the dizzy spells and fainting. According to his attorney, the veteran fell and injured himself 18 times over the next 14 months. Finally, he went to a private doctor who prescribed the drug Flecainide Acetate, which eliminated the fainting problem immediately.

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In a major victory for New York nurses, several major hospitals agreed to establish minimum staffing levels for nurses at hospitals. The unions representing the nurses in negotiations had threatened to a 10,000-strong strike at the hospitals if the hospitals did not satisfy their demands. Marc Kramer, the lead negotiator for the hospitals, told The New York Times, “This significant investment in our nursing teams will ultimately benefit patients in the long term, while preserving hospital’s flexibility to deliver the individual, tailored health care that our institutions are known for around the world.” The hospitals agreeing to minimum staffing levels for nurses include Mount Sinai, New York-Presbyterian, and Montefiore hospital systems.

Nurses have fought for established minimum nursing ratios for years. Frustrated by the Albany’s reluctance to take action, the nurses finally threatened to walk off the job this year. While the exact ratios have not been decided yet, California’s mandatory minimum ratios differ depending on the circumstances – more nurses are required in the ICU than an urgent care clinic. For example, California requires one nurse for every eight healthy babies in a nursery ward. The New York Times says that New York-Presbyterian nurses describe a workload that is at least double what would be legal in California.

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A Tennessee woman is suing her doctor at Vanderbilt University Medical Center for allegedly operating on the wrong kidney. The woman, Carla Miller, went to the Nashville hospital in November 2017 running a fever and complaining of pain in her side. The medical professionals at the hospital decided Miller would need a stent put in her right kidney. A stent is a small mesh tube and was intended to connect Miller’s right kidney to her bladder. Unfortunately, the doctors botched the surgery and put the stent on her left kidney, which was functioning normally at the time.

Now, Miller is suing the hospital for medical malpractice. She says that the failed surgery caused permanent damage and she will now be on dialysis for the rest of her life. Further, Miller will need to undergo two more surgeries – one surgery to remove the misplaced stent and one surgery to place the stent in the correct location. According to the lawsuit filed by Miller, she is seeking $25 million in damages from the hospital. Describing the ordeal to CBS New York, Miller said, “This type of error is shocking and inexcusable in modern medicine, and it is mind-boggling that it could occur at an institution like Vanderbilt.”

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The Joint Commission released its report on the top sentinel events of 2018 and, unsurprisingly, patient falls and “unintended retention of a foreign body” took the top spot for another year. According to the Joint Commission, a sentinel event is “an unexpected event in a healthcare setting that results in death or serious injury to a patient.” While the overall number of sentinel events has declined in the last decade, some hospitals have seen a sharp increase.

Overall, these are the top ten sentinel events recorded in 2018 followed by the number of events self-reported to The Joint Commission:

  1. Falls (111)

America has one of the highest maternity mortality rates in the developed world and, sadly, that rate is only increasing each year. According to hospitals, these ever-increasing number of childbirth complications are primarily caused by demographic and financial considerations out of their control – poor access to healthcare compounded by pre-existing health problems which commonly afflict low-income mothers. A recent analysis by USA Today, however, shows a different cause and puts the primary blame on the hospitals, not the mothers.

According to the newspaper, many of the hospitals with a high rate of childbirth complications are “training hospitals” for medical students. The newspaper delves into several stories of women receiving poor care while delivering their child at the hands of these physicians-in-training. In one instance, Felicia West slipped in the bathroom and fell on her six-month pregnant belly. After being admitted to Touro hospital in New Orleans she suffered a seizure and went into respiratory arrested. The doctors performed a C-section on West’s child and, while the baby was fine, the mother’s health continued to deteriorate. The doctors misdiagnosed her with a rare blood disorder and in the following days, her blood pressure continued to increase. According to the American College of Obstetricians, a blood pressure reading over 160 is the “most important factor” of a coming stroke in pregnant women and new moms. Strokes that are not “treated expeditiously can result in maternal death.”

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With Americans living even longer, hospitals have begun evaluating the best methods to ensure elderly surgeons are safe and competent in the operating room. Unlike other industries, such as aviation where commercial pilots are required to retire at 65, doctors and surgeons are not obligated to put down the scalpel and leave the operating room upon reaching a certain age. Given the precision and high stakes of performing an operation, health care experts worry whether this is a good idea – especially when studies show that doctors are not accurate judges of their own abilities.

Research has unambiguously shown that cognitive and physical abilities decline with age and surgeons must possess exceptional skills in both these areas to remain effective. The consequences of a delayed reaction or a minor slip of the forceps can be the difference between a patient living or dying. Studies on the mortality rate of patients with elderly surgeons have been mixed, however, with some studies showing a higher rate of patient deaths for surgeons over the age of 60 and other studies showing a lower rate. Speaking to The New York Times, Dr. E. Patchen Dellinger, an expert on aging physicians, said that the older surgeons bring to the operating room may outweigh his or her decline in abilities. In his opinion, there “are sharp, wonderful doctors, and those who need to stop” which he estimated to be approximately 5 to 10 percent of doctors over the age of 75.

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After a decade of rapid consolidation in the healthcare industry, researchers are now analyzing the effect of hospital mergers and the results show lower-quality care and higher prices for patients. According to an analysis by The New York Times, hospitals see an increase in both patient mortality rates and “patients with major health setbacks” after merging with another hospital. With one less competitor in the geographic area competing for patients, the higher price for medical care after a merger should not be surprising. However, hospitals and healthcare systems have often rallied public support for their mergers by touting improved patient care as one of the tangible benefits. Given the increased breadth of healthcare offered by larger hospitals and a supposedly synergistic benefit from having a single healthcare provider, hospitals reasoned that larger and more capable hospital systems would lead to better outcomes for their patients.

While touting better care for patients may be an effective tool for helping hospitals receive approval for their merger, the evidence on the subject points in a different direction. Several Medicare studies show hospital competition “results in lower rates of mortality from heart attacks and pneumonia.” A national study on cardiologists measured whether market concentration, or the number of cardiologists competing against each other for patients, effected patient care. The results showed that patients in areas with a “highly concentrated market,” where the majority of cardiologists worked for the same hospital or employer, are more likely to “have heart attacks, visit the emergency department, be readmitted to the hospital or die.” The author notes these increases “are large” – a cardiology practice that increased its market share from 40 percent to 60 percent would see heart attack rates increase by 5 to 7 percent.

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