Surgical Complications

March 23, 2019

Hospitals Wrongly Blame Mother for Birth Complications

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.”

March 19, 2019

Hospitals Search for Best Way to Ensure Aging Surgeons are Safe to Operate

by Gallivan & Gallivan

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.

March 13, 2019

Patient Care Declines After Hospital Mergers

by Gallivan & Gallivan

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.

February 8, 2019

The Rate of Women Dying During Birth Continues to Increase in America

by Gallivan & Gallivan

America is one of only two countries in the world where the rate of deaths during pregnancy increased between 1990 and 2018. In an exhaustive expose in National Geographic, the news magazine details the causes of the country’s high rate of death for pregnant women, the widening racial disparity, and the progress meant to help alleviate the unnecessary and tragic problem. Given the increased attention to the issue in recent years, public health advocates are hopeful the trend will begin reversing itself in the next few years.

Overall, 700 women die each year giving birth in the United States – a rate of approximately 14 deaths per 100,000 births. However, this data does not show the wide racial disparities in the maternal death rate. For black Americans, the likelihood of dying during birth is more than three times higher than the average at 47 maternal deaths per 100,000 births. Native Americans also have a higher maternal death rate at almost 39 per 100,000. Comparatively, Hispanic and Asian American women have a lower-than-average rate of maternal deaths at 12.2 and 11.6, respectively. Researchers and public health advocates say the high maternal death rates are directly linked to a woman’s ability to access adequate prenatal healthcare – with almost 9 percent of black Americans receiving no prenatal care before giving birth. The research found a full 60 percent of the maternal deaths last year were fully preventable. Continue reading

February 5, 2019

New HBO Documentary “Bleed Out” Shines Light on Medical Errors

by Gallivan & Gallivan

The new documentary “Bleed Out” provides an infuriating first-hand account of a routine surgery that went horribly wrong and changed a woman’s life. The documentary, which was released on HBO this month, dives into the third most common killer of Americans – preventable medical errors. According to a study released by Johns Hopkins University, medical errors kill 250,000 Americans each year.

The harrowing documentary follows Judie Burrows, who went in for a routine hip replacement surgery almost a decade ago and is now unable to speak, broke, and suicidal. According to her son, Steve Burrows, comedian and documentarian, his mother fell down in November 2009 and broke her hip. After spending eight days in a Wisconsin hospital without any plan of care, the hospital finally performed X-rays and rushed the woman into heart surgery. Unfortunately, the doctors in charge of caring for Judie did not consider her daily blood-thinner medication and the patient ended up losing half of her blood during the surgery.

December 26, 2018

After Committing Medical Malpractice in Another State, Doctors Can Still Practice in New York

by Gallivan & Gallivan

Doctors accused of medical malpractice or other unprofessional conduct in another state may still be able to practice in New York State. In a report analyzing 250 doctors accused of professional misconduct, USA Today found that doctors accused of running pill mills, were found liable for medical malpractice, and engaging in inappropriate relationships with their patients, are still practicing medicine – just in a different state. In most states, including New York, a doctor who voluntarily surrenders his license in a different state is not automatically disqualified from practicing medicine.

Unlike most states, however, New York even allows some doctors with felony convictions to practice medicine. Under New York’s licensing scheme for doctors, a medical board is allowed to approve or deny a doctor’s license to practice medicine in the state based on their own criteria. In circumstances where a doctor voluntarily relinquishes his or her license in another state, there is rarely a “paper trail” describing any misconduct. According to LoHud.com, some states do not track allegations of misconduct against doctors and other states do not make the information available to licensing boards in other states. This haphazard system undoubtedly endangers these doctor’s patients.

December 22, 2018

Patient Safety Ratings at New York Hospitals Drop

by Gallivan & Gallivan

Continuing the state’s decade-long decline, New York ranked a dismal 48^th in overall patient safety. The rankings, which are released twice each year by the non-profit organization Leapfrog Group, compile data from hospitals across the country and measure the rate of medical errors, infections and injuries, and patient satisfaction, to determine each hospital’s ranking. Since Leapfrog Group began ranking patient safety in 2012, New York has fallen from 40^th worst state in the country to 48^th. In the tri-state area, Connecticut also ranks low for patient safety while New Jersey ranks among the best states in the country.

According to Leapfrog, the worst hospitals in the state are located in New York City and upstate. In fact, five of the 20 hospitals across the country that received an “F” from Leapfrog are located in the five boroughs. In the Hudson Valley, the hospital results were mixed. Here are Leapfrog’s patient safety ratings for the local-area hospitals:

A

November 13, 2018

Jury Hands Life Sentence to “Butcher Surgeon” for Medical Malpractice

by Gallivan & Gallivan

A Texan surgeon is going to spend the rest of his life in prison because of his horrific incompetence on the operating table. The almost unbelievable case follows Doctor Christopher Duntsch who managed to maim 32 of his patients. Nicknamed by local newspapers as “Dr. Death,” the criminal conviction shows how a broken system allowed a deranged, drug-addled, and incompetent doctor to harm so many of his patients.

After studying medicine at the University of Tennessee Health Science Center, Duntsch moved to Dallas where he worked at Minimally Invasive Spine Institute, a $600,000-a-year job that only lasted a couple weeks. After leaving the institute, the deranged doctor moved to Baylor Regional Medical Center in Plano. Less than a year into his stint at the prestigious hospital, colleagues begin to describe surgeries gone horrifically wrong. Concerned about excessive blood loss, one surgeon told The Dallas Morning News that he grabbed Duntsch’s medical instruments to stop him from operating. Another doctor described one surgery as “pathetic on what should have been a fairly easy case.”

November 3, 2018

Maternal Mortality Rates Skyrocket Across Country

by Gallivan & Gallivan

Across the United States, women giving birth are now almost three times more likely to die than they were just three decades ago. In a new report published by the Centers for Disease Control and Prevention, the United States now leads the developed world in maternity mortality. Tragically, the majority of these deaths fall upon poor women and women of color. Perhaps even worse, the study shows that the majority of these deaths are completely preventable. With the increased attention on infant mortality rates in recent years, it appears medical professionals and researchers need to focus their efforts on improving the health of both the pregnant mother and the infant.

The wide-ranging report published by the government agency surveyed nine states to identify the characteristics and causes of maternal deaths, and consequently provide recommendations for reducing the nation’s shamefully high mortality rate. After collecting data from the states, the CDC reports that almost 60 percent of maternal deaths are preventable. The most common causes of death among all Americans were hemorrhaging, cardiovascular and coronary conditions, and infections.

October 11, 2018

With Rise of Superbugs, Hospitals and Doctors Vow an Aggressive Response

by Gallivan & Gallivan

In response to an increase in superbugs, medical centers are taking an aggressive stance by implementing strict hygiene standards and educating patients about antibiotic resistance. Superbugs are bacterial infections resistant to medical treatment, such as antibiotics. A global increase in the number of antibiotic prescriptions coupled with a lack of new antibiotics produced in the last few decades created strains of bacteria resistant to antibiotics. According to the Centers for Disease Control and Prevention, superbugs (and antibiotic resistance, more generally) present one of the world’s “most pressing public health problems.”

Filled with infectious diseases and compromised immune systems, hospitals are a breeding ground for superbugs and their patients are uniquely susceptible. Thankfully, hospitals are stepping up and setting new standards to prevent the spread of infection. In an article by the Wall Street Journal, several hospitals detail new procedures meant to improve hygiene and stop germs from spreading. In addition to routine hand washing, medical staff at these hospitals also clean stethoscopes, blood pressure cuffs, IV poles and pumps, bed railings, and computer keyboards. Stethoscopes, in a surprise to hospital staff interviewed by the WSJ, usually carry the same number of germs as a doctor’s hands after just a single physical examination.