According to The New York Times, long-term care hospitals continue to provide poor care to elderly Americans. Long-term care hospitals, also called long term acute care hospitals, provide care typically after a person is being discharged from intensive care and is too sick to return to their nursing home. Close to 400 long-term care hospitals exist in the United States, a number that has dipped in the last decade after skyrocketing in the 90s from just 38.
The proliferation of long-term care hospitals during the period is now largely regarded as unnecessary and many elder care advocates say they harmed individuals while enriching their owners. Because patients at these hospitals are so sick, the hospital receives hefty sums performing multiple procedures and diagnostics on their patients. In 2017 alone, Medicare – which pays for two-thirds of all long-term care stays – paid out an eye-wateringly high 4.5 billion to these several hundred hospitals.
An investigation by The New York Times into Dr. William Hussel, currently accused of killing at least 25 of his patients, reveals glaring missteps by hospital administrators and nurses. According to the criminal complaint against the disgraced doctor, Dr. Hussel routinely administered opioid doses between five and 20 times the recommended amount at the intensive care unit he worked at in Ohio. Given the scope of his alleged crimes, the families who trusted the doctor only to find out that he killed their loved one are outraged and demanding answers. Mount Carmel, the hospital where the doctor is accused of killing his patients, has already paid out more than $13 million in legal settlements.
The investigation by The New York Times shows a hospital with an ineffective administration, insufficient safeguards to prevent prescribing excessive doses, and a hospital staff either too charmed or too intimidated to second-guess the doctors. According to the article, the “red flags” surrounding Dr. Hussel were apparent and ignored from the start of his tenure at the hospital. As a medical student, he pleaded guilty to creating a pipe bomb, which he originally planned on putting underneath the vehicle of another student who told the police he was stealing car stereos. The hospital said they had no knowledge of the criminal incident – even though it was reported to the medical board and available in the public record.
Last month, an Ohio doctor was charged with killing at least 25 of his patients administering lethal levels of the powerful opioid fentanyl. After four years of intentionally drugging his patients, murderous doctor’s killing spree finally ended late last year when a pharmacist finally alert hospital authorities. After an internal inquiry, the hospital deemed the deaths of 35 Dr. William Husel’s patient’s “suspicious.” Now, patients told that their loved ones died of natural causes are furious at the doctor and the hospital for allowing the doctor’s murder spree to continue for so long.
According to The New York Times, Dr. Husel began prescribing lethal amounts of fentanyl to patients at least four years ago. Typically, the doctor would prescribe these deadly doses to patients unlikely to survive anyway. As an acute care doctor who worked the overnight shift, prosecutors say he frequently worked with “new nurses” who may have lacked the experience or bravery to challenge the doctor’s prescribing habits. According to interviews with hospital authorities, the pharmacists also proved complicit in the overdoses by overriding hospital protocols which specifically warned about the likelihood of death caused by a massive fentanyl dose. Amazingly, prosecutors say they will not charge any other hospital staffers in the deaths although some have lost their jobs and nursing licenses.
More than eighty patients filed suit against a California women’s hospital for allegedly filming them while undressed and receiving medical care. These women claim that the secretly recorded footage includes them in stirrups receiving intimate medical procedures, sterilizations, and dilation and curettages after miscarriages, according to The Washington Post. The secret recordings took place over an 11-month period and could include up to 1,800 patients.
In response to the allegations, Sharp Grossmont Hospital concedes that computer monitors with “motion-activated cameras” were in three different operating rooms at the hospital during the time period. The hospital said the cameras were angled towards the “medication carts” and part of an investigation into missing narcotics at the hospital. While these “motion-activated” cameras were activated when sensing motion, they continued to record for long periods of time. This resulted in many patients have sensitive and personal medical procedures recorded without their permission. According to the lawsuit, these recordings showed patients “conscious and unconscious, partially robed on operating room tables, undergoing medical procedures and communicating with their doctors and medical personnel.”
The FDA has quietly expanded a so-called “exemption database” allowing medical device manufacturers to shield the injuries and fatalities attributed to their devices from public scrutiny. According to a recent article in Kaiser Health News, the number of malfunctioning devices submitted as an “alternative summary report” not available to the public numbered between 431,000 and 481,000 in the last three years. According to the FDA, the alternative database originated two decades ago to prevent medical device makers from reporting the same injuries multiple times. However, since its inception the exemption database has grown exponentially and, no longer providing clarity and efficiency, now assists in concealing harmful devices from public scrutiny. The FDA declined to provide Kaiser Health News with a list of exempt devices, although the federal agency did say the number of devices was “over 100.”
This development is unfortunate for doctors and patients who rely on public information about medical devices to make their health care decisions. Surgical staplers provide a good example of how the FDA’s alternative database harms patients. Surgical staplers are “designed to cut and seal tissues or vessels quickly,” according to the health news organization. These staplers also commonly malfunction, between 1994 and 2001 malfunctioning staplers reportedly caused 112 deaths in the country. In 2001, the medical manufacturers of these surgical staplers received an “exemption” from the FDA, which meant the majority of the injuries and fatalities caused by these devices would no longer show up in the public database. In 2011, the total number of injuries and fatalities attributed to surgical staplers was only 18. In 2017, the FDA removed the device from the exemption list and the number of reports skyrocketed to 79.
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.
Citing increased patient care, nurses at New York’s three biggest hospital systems are demanding a sharp increase in nursing staff. The group of nurses – 10,000 strong, according to The New York Times – say they are unable to fulfill their responsibilities and provide optimal care to each patient because there are not enough nurses on staff at Mount Sinai, New York-Presbyterian and Montefiore. The union representing the nurses in their negotiations with the hospitals, the New York State Nurses Association, say they are prepared to strike if their demands are not satisfied.
Speaking to The New York Times, Shanna Murphy, a neonatal nurse, said: “I’m often put in a situation where I’m having to choose between patients and not able to fully support my families.” This leads to what Murphy described as “drive-by nursing” where she does not have time to “actually sit with our patients and spend time with our patients and families.” Other nurses agree and cite a 2002 study directly linking patient care to the number of nurses on staff. Published by the Journal of American Medical Association, the research paper found that for every additional nurse the risk of patient fatality reduced by 7 percent.
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.
Once named one of ‘America’s Most Beautiful Physicians’, a New York doctor is now being hauled into court by former patients who say they lost his medical records and over-prescribed powerful pain medications, among several other allegations. Reported by NBC New York, cardiovascular surgeon David Gruener has recently come under scrutiny by government regulators and patients who describe less-than-competent experiences with the media-darling doctor. Despite allegations of overprescribing opioid medications, the doctor’s record is currently unblemished. The lawsuits against the doctor will likely change his spotless record soon, though.
The allegations against the doctor began surfacing when one of his former patients blamed him for an opioid addiction that became a $7,000-per-day habit. According to the patient, Dr. Gruener prescribed hundreds of Demerol shots and other opioids during 2011 and 2012. The surgeon prescribed all of this medication despite “clear signs of addiction” in, what the patient is alleging, a “clearly fraudulent scheme” to keep him addicted and the income flowing freely to his doctor. In the course of litigating his lawsuit against the doctor, the patient sought his own personal medical records. Unfortunately, the doctor could not produce these medical records, along with those of any other patients before 2012.