Articles Posted in Surgical Complications

After the rapid pace of consolidation in the healthcare industry over the past decade, many patient advocates are beginning to study the effects of these mergers and acquisitions on the quality of patient care. While many of the business executives in charge of these restructurings tout improved patient health as a benefit, it appears the opposite may be true – at least in the short-term – for many patients. The study, which was reported by STAT, found that new patient populations, unfamiliar infrastructure, and new settings for physicians caused the bulk of problems related to possible declines in patient health after a hospital merger.

Since 2014, there have been more than 100 hospital or healthcare mergers each year. Last year alone, there were 115 mergers and this trend is likely to continue. For that reason, it is important to learn about its effects on patient care. After thoroughly reviewing several randomly chosen mergers and acquisitions, STAT found a disturbing pattern of patient neglect. In two examples, a surgeon and an anesthesiologist ended up in the wrong part of the hospital after being summoned for a time-sensitive procedure. In another example, an ER doctor was given only thirty minutes of training before being put to work in an Emergency Room. According to STAT, “[The Doctor] had not been brief on how to obtain backup help in the case of an unexpected emergency.” Therefore, when multiple ambulances arrived with several critical patients, the hospital was overwhelmed and ineffective in treating the majority of patients. In all of these circumstances, the hospital had reorganized itself and not properly trained the medical staff at the hospital.

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Patient neglect causes serious issues in hospitals throughout the country, including pressure ulcers, falls and medication errors. However, a new company is attempting to gather data about patients using artificial intelligence which will, hopefully, led to fewer patients neglected in hospital rooms. The new sensor from start-up Inspiren is currently on trial at a hospital in Queens.

The sensor, which is roughly the size of a thermostat and possesses a glowing ring, will attempt to accurately report when a patient is “checked on” by a nurse or hospital staff member. While common procedure across the country, “hourly” check-ins by nurses are not uniformly followed when the hospital or staff are busy. The sensor, which is named “iN” will sit on a wall and monitor when a staff member enters and leaves a room. If the “iN” glows green, then the patient has been checked on recently. Unsurprisingly, yellow and red serve as warning signs that a patient may need assistance. Unsurprisingly, iN will come with an app notifying nurses whenever a patient has not been checked on in an hour.

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A Georgia doctor who wanted to be known as the “dancing doctor” will no longer be a doctor in the State of Georgia. In a fantastic story by the New York Times, the dermatologist, whose name is Dr. Windell Davis-Boutte, would stop in the middle of her surgeries and perform a dance routine to popular hip-hop and rap songs. Then, the doctor would post them to her social media account, which was deleted after more than 100 patients came forward and several lawsuits were filed against the now-disgraced doctor.

Davis-Boutte advertised herself on her website as having “MASTERFUL SURGICAL EXPERTISE, having sought additional extensive training by some of the most famous surgeons in the world.” The patients who were harmed during her surgeries provide a different story. One patient, who was included in a video of the former dermatologist dancing to the song “Cut It” received a botched liposuction, breast augmentation, and Brazilian butt lift operation all on the same day. In the video, one of the 20 provided to the New York Times, the former doctor prods the midsection of the patient and then finger rolls her skin to the beat of the song. According to the newspaper, once the hook begins she starts “slicing the air with her scalpel… then making incisions, her scalpel moving rhythmically to the song.” The day after the surgery, the patient had a “collapsed lung and suffered from anemia because of her acute blood loss.”

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A new report by Christiana Care Health System showed that medication errors occurred in 47 percent of ICU Transfers. The study which followed 985 patients at almost 60 different ICUs across the East Coast who were transferred from the ICU to a non-ICU area in the same hospital or medical unit.  According to the study, an average of 1.88 errors occurred per patient transferred out of the ICU, a startlingly high number.

The report, authored by Andrea Tully and detailed in MDMag.com, found that the most common errors related to anti-infectives, hematologic agents, and intravenous fluids, electrolytes or diuretics. The patients with the highest risk of a medication error were patients taking the most medications and patients in need of renal replacement therapy. While 75 percent of these medication errors were deemed “Category C” which meant no actual harm or minimal harm caused to the patient, a full 25 percent caused harm to the patient. According to patient care advocates, these numbers are unacceptable.

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In an attempt to advance the medical field, a world-renowned heart surgeon stands accused of violating ethical rules and harming patients, according to a groundbreaking report by ProPublica. The heart doctor, O.H. “Bud” Frazier, is credited with saving thousands of lives in his obsessive, career-long drive to create an artificial heart. However, to reach his admittedly noble goal he skirted ethical guidelines, defrauded Medicare, and harmed patients in an attempt to advance his research. Perhaps most disturbingly, his clinic, Texas Heart in Houston, along with several other doctors on the staff, apparently knew of Dr. Frazier’s ethical lapses and proceeded to either do nothing or actively hide the illegal and immoral behavior, according to the newspaper’s expose.

According to ProPublica, Dr. Frazier, who quit performing surgeries last year when he turned 75, is accused of the following:

  • Inappropriately diagnosing patients with advanced stage heart failure, in an attempt to install experimental heart pumps in the patients. According to hospital records viewed by the newspaper, an internal investigation made the Board of Directors at St. Luke’s Hospital, the hospital in charge of Texas Heart, aware of the problem who wrote at the time that if “…the affiliation should be dissolved, the impact to St. Luke’s market position is unclear. It’s likely that such news would generate national attention and negatively impact our standing in the US News and World Report rankings.” The executives chose to do nothing at the time.

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New York hospitals rank among the lowest in the nation for patient safety, according to a non-profit group. The Empire State ranked 48th out of the 50 states, a one-spot improvement from last year. Overall, almost 6 percent of hospitals received an “F” for patient safety – a notable increase from the nationwide average of under 1 percent. A total of 137 hospitals in New York were graded, according to NBC New York.

The rankings, which are released every year, are released by Leapfrog Group and rank 2,500 hospitals across the country. The grades – ranging from an “A” to an “F” – are based on the rate of hospital errors (including medication errors), accidents, infections, and the number of preventable pressure ulcers, among several other factors. Leapfrog Group ranks hospitals individually and then aggregates the data and ranks each state collectively.

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A recent study highlighted the improving areas of medical care in the United States. Released by the Agency for Healthcare Research and Quality, the study tracked seven main criteria related to healthcare between 2000 and 2014 – person-centered care, patient safety, healthy living, effective treatment, care coordination, and affordable care.

Here is the breakdown on how America’s healthcare system changed according to each of the metrics:

  1. Person-Centered Care. The study defined “person-centered care” as whether or not a patient achieves their healthcare outcomes, not merely whether a disease has been effectively treated or managed. Overall, the trend for this metric has markedly improved since 2000. A full 83 percent of patients who had visited a doctor in the last 12 months reported improvement in person-centered care. Perhaps as important, none of the patients indicated their care “worsened” on this metric during the fourteen-year period.
  1. Patient Safety. Keeping a patient safe while in a hospital or doctor’s office also saw an improvement during the study. Overall 66 percent of patients reported an improvement in this metric, which reflects broader trends of data available in this area. Between 2008 to 2014, the number of infections related to a central venous catheter dropped from 1.9 per 1,000 patients to 0.67 per 1,0000. Similar improvements in patients receiving hip joint replacement surgeries. In 2009 a full 16.4 percent of Americans undergoing this notoriously tricky procedure reported “adverse effects”, a number that dropped to 9.8 percent by 2014.

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One of the highest-paid surgeons in the United States was hit with two lawsuits alleging that the doctor was not performing his own surgeries.  According to the lawsuit, Dr. David Samadi, the head urologist at Lenox Hill Hospital in Manhattan, routinely allowed medical residents, who are still in training, and other doctors to perform the surgeries. According to the lawsuit, Dr. Samadi may have left up to 1,000 of his patients in the hands of another, less-skilled doctor or resident.

According to Dr. Samadi, the surgeon was merely “double-booking” his surgeries, a controversial practice where the surgeon is not present for an entire surgery. Instead, he or she “delegates” portions or sections of the surgery to another medical professional. According to an analysis of hospital records, Dr. Samadi has performed 2,182 urologic surgeries since began working at Lenox Hill Hospital in 2013. A full 70 percent of these surgeries overlapped with another surgery. The New York Post reports that on a single day in 2014, the doctor “performed” eleven surgeries, and all but one overlapped. Continue reading

Medical errors are gaining more attention as a whopping one-fifth of Americans admit to having personally experienced one. At the same time, Johns Hopkins University has released a new study that reports medical errors may be the third highest cause of death in America. With America’s healthcare industry continuing to reshape itself, healthcare advocates worry that unintentional harm caused to patients may not be receiving enough attention.

med-errorIn a survey of over 2,500 Americans by the Institute for Healthcare Improvement/National Patient Safety Foundation, most Americans reported generally positive experiences with the healthcare system. However, a full 21 percent reported that they had personally experienced a medical error. According to the survey, the most common errors were related to a person’s diagnosis and were most common in an outpatient care. Continue reading

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