Medical Malpractice News and Views


Welcome to our blog where we discuss current issues in medicine and law. We welcome your comments.

Virginia OB/GYN, Who Routinely Performed Unnecessary Surgeries, Gets Prison Time

May 23, 2022

There are predators in the medical profession.  The profession is unable or unwilling to root them out.  The doctor I writing about today was proven to have preyed on vulnerable women in Southern Virginia for at least ten years between 2009 and 2019.  He almost certainly preyed on them for much longer than that.  He never should have had the chance.  As early as 1982, he lost his privileges at a local hospital for “poor clinical judgment” and for performing unnecessary surgeries.  His license to practice medicine was temporarily revoked in the 1990’s but reinstated in 1998.  How in the world was this man allowed to continue to practice medicine when he was a known predator?  His story is sadly one which is repeated over and over.  Patients deserve better.

Dr. Javaid Perwaiz was convicted of performing medically unnecessary surgeries and 52 counts of health care fraud. 

Dr. Javaid Perwaiz was an obstetrician and gynecologist who performed surgery on his female patients in the Norfolk area of Southern Virginia.  Apparently, Dr. Perwais was not satisfied with only performing the surgeries his patients actually needed.  To produce additional income, Dr. Perwais told some of his patients that they had cancer when they didn’t or that they would develop cancer, if they did not allow him to operate on them.

He kept many of his patients in the dark about what surgeries he was performing on them.  Hospital personnel became concerned when some of his patients told them they were at the hospital for their “annual clean out.”  Some women who were having difficulty getting pregnant after having had surgery performed by Dr. Perwaiz discovered that he had performed sterilization procedures on them without their knowledge or consent.

In addition to victimizing his many patients, Dr. Perwaiz defrauded health insurance companies and the Federal government by seeking and receiving payment for unnecessary surgeries.  He was finally arrested, tried and convicted in 2020 on 52 counts of health care fraud and filing of false statements.  As a result of his conviction, he has been sentenced to 59 years in prison.  The government also seized millions of dollars of cash and luxury automobiles, which it alleged were obtained with the funds he fraudulently obtained.

Dr. Perwaiz joins the ranks of other surgeons and physicians who have lied to their patients about their condition in order to get them to agree to undergo surgery.  The threat of cancer is a common theme for these people.

You will note that so far the story makes no mention of justice for the poor women victimized by Dr. Perwaiz.  Many of them were mutilated by his surgeries.  Many underwent needless pain and suffering from unnecessary surgeries.  Many certainly spent sleepless nights crying about the cancer they did not have.  Lawyers are circling these women and asking for the opportunity to represent them but one thing is for certain:  Dr. Perwaiz will not have enough insurance or assets to make it up to these women for what he put them through.

One of the lessons to be learned from the case of Dr. Perwaiz and his many predatory colleagues is that no one is minding the store while these people are hurting their patients.  When these people are discovered, it is almost always only after many years of predatory behavior.  They are often only discovered when they slip up and someone makes an unexpected discovery.

Where are those people who complain so loudly about medical malpractice suits while all this predatory behavior is going on?  Why don’t they take a little time away from their own busy practices making money to take a look at what their neighbors are doing and make sure they are on the up and up?  Why don’t they clean up their profession?  There is no way the lay public can know if people like Dr. Perwaiz are taking advantage of them.  Only those trained in medicine can make that determination but they are unwilling to devote the time or resources it would take to protect the public.  It is easier for them just to blame the lawyers for being greedy and ask politicians to protect them from lawsuits, even meritorious lawsuits.

Physician, heal thyself.  Cleaning up the medical profession would go a long way toward reducing medical malpractice lawsuits and it would benefit the public as well.  Keep that in mind the next time you hear some doctor or medical group complain about the burden of medical malpractice lawsuits.

Posted in Arizona Medical Board, Cancer, disclosure of medical mistakes, Doctors, Fraud, Health Care Costs, Health Insurers, Lawsuits, medical ethics, Medical Malpractice, medical malpractice cases, medical malpractice lawyers, medical mistakes, Medicare, never events, plaintiff, Secrecy, Surgical Errors, tort reform |

Capitalism Can Be Bad For Your Health

May 16, 2022

Capitalism has done wonders for the world in terms of raising the standard of living for so many people.  Of course, like everything else in this world, capitalism is not an unbridled blessing.  It has its dark side.  When it comes to health care, capitalism has caused a lot of problems.  Among them are the rise of health insurance giants, the growth of hospital chains, big pharma, and the increasing emphasis on medicine as a business whose goal is to make money to name just a few.  Today, I want to discuss how capitalism affects rural hospitals.  Rural hospitals face many problems trying to serve their communities.  Capitalism sometimes makes things worse.

Public health: Gore and glory | Nature

If you had to design a system that would almost force rural hospitals to fail, you would do well to copy our present system.  Start with the absence of health insurance for many people who live in rural areas.  They need health care but cannot afford to get it.  Hospitals that provide care to them are stuck with bills that they can never collect.

The populations that rural hospitals serve are shrinking in most areas.  People are moving to the cities.  Many small towns are dying and taking their hospitals with them.  Most of the hospitals that have closed in the United States in recent years have been in rural areas.

Medical professionals, who spent years in school and have lots of student debt, often don’t want to practice in small towns with limited cultural opportunities.  Even if they enjoy small town life, they may not be able to meet their financial obligations with the limited money they can make in a rural as opposed to an urban area.

Rural hospitals need big ticket surgeries covered by insurance to compensate for care provided to uninsured patients but many insured patients are choosing to have their big surgeries in the nearby city.  This leaves the rural hospital with less profitable services such as outpatient procedures and emergency department visits.   They face increasing competition for even this revenue source from physician-owned surgery centers and freestanding urgent care centers.

Perversely, another problem rural hospitals face is that they often own the valuable land their hospital is built on.  This valuable real estate attracts venture capital, which buys the hospital and sells the real estate to a separate entity.  The new entity then leases the land back to the hospital.  The hospital, which was already having trouble making ends meet, now has a bill for rent that it did not have before.

Capitalism is driving all of these changes.  After making it almost impossible for rural hospitals to succeed, capitalism insists that rural hospitals fully pay their way.  Capitalism insists the law of supply and demand should apply to these hospitals.  If they cannot pay their way, they must not be really necessary and should go out of business.  This is a slap in the face of the people who live in rural areas and need health care.  Sorry, capitalism, our fellow citizens who live in rural areas deserve health care and it should be the obligation of the state to make sure they get it.

 

Posted in Doctors, drug companies, General Health, Health Care Costs, Health Insurers, Hospitals, Medical Costs |

Doctor Conflicts of Interest Are Getting Worse.

May 09, 2022

“Under no circumstances may physicians place their own financial interests above the welfare of their patients.”  American Medical Association Code of Medical Ethics Opinion 11.2.2.

Doctors rightly occupy a privileged position in our society.  We entrust them with our bodies, our health and, indeed, our very lives.  We trust them to put our interests first.  We trust them not to take advantage of us.  We trust them to be honest with us.  Without this level of trust, the physician/patient relationship cannot work.  Sadly, it seems that more and more often doctors are putting their own interests ahead of ours.  We need to be aware of this and to take it into account in our dealings with our doctors.  To do otherwise is foolish and naive.

Physician Conflicts of Interest

There are many ways in which a doctor can have a conflict of interest and the possibilities are increasing all the time.  Conflicts vary in terms of their influence and effect on the conduct of the doctor.  However, even when the doctor does not believe that the conflict is having any effect on her decision making, studies show it usually is.

Here are some conflicts of interest you should be aware of and take into account in your dealings with your doctor.

  • Relationships with pharmaceutical companies.  These can come in many flavors.  Representatives of pharmaceutical companies go from doctor office to doctor office meeting with doctors and handing out drug samples.  They take doctors to lunch or dinner.  They may give the doctor gifts.  The companies themselves hire doctors to speak at meetings or to advise the company on this issue or that.  Some doctors partner with pharmaceutical companies to develop new products.  The one thing all of these relationships have in common is that they are likely to play a role when it comes time for the doctor to decide whether to order a specific drug or whether to recommend a particular drug regimen.  Certainly, the drug companies believe in this effect or they would not be spending the amount of money they do trying to influence doctors.
  • Relationships with financial firms.  Some doctors have partnered with financial firms to “assist” their patients in getting financing so they can afford the services the doctor provides.  This occurs most often in the cosmetic surgery field where the patient’s health insurance doesn’t apply and the patient has to pay for the procedure on his or her own.  The doctor’s staff will sometimes help patients with the application process.  The interest rates charged by these companies may be much higher than what the patient could get on the open market.  The doctor may get a fee for every patient who signs up for a loan.
  • Relationships with manufacturers.  We live in an age of prostheses.  Surgeons often use hardware, which they place in our bodies.  These range from stents to keep coronary arteries open to spinal hardware to the hardware used in knee and hip replacements.  Some surgeons buy the hardware they are going to place in their patients directly from the manufacturer.  They then sell it to the hospital at which they are going to operate.  This purchase and sale by the surgeon can add many thousands of dollars in income for the surgeon from a given procedure.  Researchers have consistently found that surgeons who have these companies and have a financial interest in the hardware they use, place far more hardware than their colleagues who don’t buy and sell hardware.  This is not a coincidence.
  • Relationships with treatment centers.  Doctors may have a financial interest in the treatment center to which they send their patients for certain therapies or for surgery.  If they have such a financial interest, they tend to send more patients for these therapies or surgeries than do their colleagues who do not have the same financial interests.  One documented example was reported by the Wall Street Journal when it studied urologists who invested in expensive radiation machines for treating prostate cancer patients.  Those urologists who bought the machines were much more likely to order use of the machines for their patients than urologists who did not own the machines.  Again, this is not a coincidence.  These doctors have made a large investment and want to get their money back and to make a profit to boot.
  • Financial interest in the procedure to be performed.  There are many medical conditions which can be managed either with medical therapy or with surgery.  When you go to see the surgeon for a surgical consult, keep in mind that the surgeon gets paid for performing surgery.  She has a financial interest in recommending a surgical approach to your problem.  Study after study has found that surgeons perform many procedures that are not medically necessary and that could be handled as well or better by medical treatment.  This conflict on the part of the surgeon does not mean that surgery is not the best option for you.  It only means that you should be a critical listener and get a second opinion, preferably from someone without a financial interest in your decision.
  • Relationships with hospitals.  Hospital chains have been buying physician practices and the trend is accelerating.  When your doctor works for a hospital chain, she or he may be encouraged to send you to one of the chain’s hospitals for treatment or to therapy centers owned by the chain.  The hospital chain expects to increase its business and its profits by purchasing these doctor practices or it would not be opening up its wallet to buy them.

As President Ronald Reagan famously said, “Trust but verify.”  Ask questions of the doctor about conflicts.  Use the federal government site that shows payments from drug companies and manufacturers to doctors.  https://www.cms.gov/openpayments.  Remember that doctors are business people who are selling you a service.  Just because a doctor said it does not make it true.

Posted in Doctors, drug companies, Fee for Service, Health Care Costs, Health Insurers, Hip Replacement, Hospitals, joint replacement, Medical Costs, Medical Devices, medical ethics, Medicare, Plastic Surgery, PODS, Prostate Cancer, Secrecy |

Choosing A Lawyer.

May 02, 2022

I recently spoke to a gentleman, who lives here in Arizona,  Let’s call him, Bob.  Bob had been involved in an accident in another state.  The accident was the fault of the other driver.  The tow truck driver, who removed Bob’s motor home from the scene, told him he knew a good lawyer and had the lawyer call Bob.  Bob agreed to use the lawyer to make a claim for his property damage and his personal injuries.  It has now been almost two years since the accident and the lawyer won’t answer Bob’s calls, won’t send him correspondence with the other driver’s insurance company and is generally completely unresponsive to Bob’s requests for information.  Bob wanted to know what his options were.  I told Bob the first thing to do was to fire this lawyer and to demand that the lawyer send Bob his file.  Then I helped Bob find a good lawyer in the other state to represent him going forward.

Legal Ethics and Professional Responsibility

Sadly, there are lots of bad lawyers out there.  Some are new and just plain inexperienced.  Some have a lot of experience but little talent.  Some are lazy.  Some are both incompetent and dishonest.  Some are just plain dishonest.  While on the whole I believe the legal profession does a better job than the medical profession at policing itself and weeding out bad members, that is a pretty low bar and a lot of bad lawyers have either slipped through the cracks or just have not been caught yet.

I have written often about the importance of doing some basic research before allowing a doctor to perform a medical procedure on you or to make medical decisions about your care.  It is almost as important to do that same kind of checking before hiring a lawyer to represent you.  The biggest difference between making a mistake in choosing a doctor and a lawyer is that whatever mistakes a lawyer makes can usually be put right with money.  Doctors, on the other hand, can kill or maim you and no amount of money will make that right.

There are not as many ways to identify a problem lawyer as there are to identify a problem doctor.  Problem lawyers don’t get sued the way problem doctors do, so the presence or absence a lawsuits against them is not much of a key.  Bad lawyers usually just shuffle along and don’t cause quite enough harm to justify a suit.  They just give poor service to their clients and maybe drive them crazy.  Sometimes, the clients don’t even realize how bad their attorney is or how much money was left on the table when their case was settled.

One of the best ways of avoiding a problem lawyer is to look for a lawyer in places problem lawyers are not usually found.  You won’t usually find bad lawyers in Best Lawyers in America or in Superlawyers or in the American College of Trial Lawyers or in the American Board of Trial Advocates or among the lawyers certified as specialists by the State Bar of Arizona.  Choosing a lawyer who appears in one or more of these lists will not guarantee a good result or a great lawyer but, like choosing a board certified doctor, you will have given yourself the best chance of a good outcome.

As a general rule, I would recommend ignoring any lawyer who calls you or who is recommended by a tow truck driver or even a doctor.  You never know why these people are making the recommendations.  Often there is money or some other reward offered for successful referrals.  Even if they honestly believe in the lawyer they are recommending, there is no way to tell whether they have a legitimate basis for that belief.  Instead, you should affirmatively choose your lawyer and a good place to start are the lists I mentioned.

A word about advertising lawyers.  They are of uneven quality.  Just because they advertise does not mean that they are good lawyers or bad lawyers.  It just means that they are willing to spend a lot of money to get on the side of a bus or on a billboard.  Most of the time, advertising lawyers are not going to be found in the lists I mentioned.  Often, if cases they take need to be tried, they refer them out to an experienced trial lawyer.  One thing I can tell you about advertising lawyers is that you will usually not get much in the way of personal attention from an actual lawyer in those firms.  They typically use a lot of legal assistants to process their cases.  Some of those assistants will be very good and some won’t.  You just never know.

You are entitled to the services of a good, experienced, responsive attorney and you should insist on getting exactly that. Don’t settle for less.  If you are not getting what you are entitled to, don’t be shy.  Fire the unresponsive attorney, get your file from him or her and move on to an attorney who will give you good service and quality representation.

Posted in arizona certified medical malpractice lawyers, arizona certified personal injury lawyers, Arizona Medical Board, Doctors, Finding a Medical Malpractice Lawyer, Lawsuits, plaintiff, trial |

Medical Malpractice or Criminal Conduct?

April 25, 2022

Last week I wrote about an ICU doctor in Ohio, who was accused of deliberately overdosing 11 of his critically ill patients with a powerful painkiller and thereby shortening their lives.  After nearly a week of deliberations, the jury acquitted him on all charges.

Today I want to write about another criminal case involving a medical professional, but one which involved quite different legal issues.  In this case, a nurse in Tennessee was convicted of negligent homicide for giving a patient the wrong medication, which allegedly caused her death.  Unlike the case against the ICU doctor, there was no allegation that the nurse intended to cause any harm to the patient.  The only claim is that she was negligent.  She is awaiting sentencing but her case has sent huge shock waves throughout the medical profession.

Medical error—the third leading cause of death in the US | The BMJ

The illustration above is from 2013 but the leading causes of death in the United States have not changed much since then.  Preventable medical errors are the third leading cause of death, accounting for about 250,000 deaths each year.  These figures are courtesy of the federal government’s Centers for Disease Control.  Only a tiny fraction of these deaths caused by medical malpractice ever become the subject of a claim for compensation.  As evidenced by the furor over the arrest and conviction of this nurse, no one ever gets prosecuted for accidentally causing a patient’s death – until now.

The nurse in question was tasked with administering a sedative, Versed, to an elderly patient, who had suffered a brain injury and who was being prepared for a scan.  The Versed was to calm the patient so she would relax during the scan and not move around.  At the Vanderbilt University Medical Center, Versed was kept along with other highly-controlled drugs in a computerized medication dispenser.  The nurse went to the dispenser but, instead of Versed, she withdrew vecuronium, a powerful paralytic agent.  In order to withdraw the vecuronium, she had to override a number of safeties in the computerized dispenser.  Witnesses testified in the trial was that there were problems with the dispenser which required the nurses using it to routinely override its safety protocols.   The nurse administered the vecuronium to the patient and left the patient to await the scan.  When the transporter came to get the patient for the scan, she was brain dead.

The nurse was charged with two offenses.  The first was negligent homicide for administering the wrong medication.  The second was for gross neglect of a vulnerable adult for failing to monitor the effect of the medication on the patient.  The nurse admitted that she was distracted at the time of her mistake.

At least in part, our health care system relies on medical professionals to report mistakes, whether the mistake injures a patient or not.  Only by encouraging frank and honest reporting, can the system prevent future mistakes and learn from those that have already been made.  Despite its good intentions, the system already suffers from a culture of secrecy about medical errors.  Doctors and nurses who are afraid of being sued or of being the subject of medical or hospital discipline are already reluctant to report their own mistakes or those of other professionals.  Criminal prosecution of medical professionals is only going to make matters worse.

In addition to contributing to an even greater culture of secrecy and silence, criminal prosecutions are already causing some medical professionals to leave the profession altogether.  In their view, they do not get paid enough to run the risk of being charged with a crime, if someone is hurt on their watch or dies.  Even if they are able to successfully defend themselves in court, the legal fees alone may bankrupt them.

In my legal practice, I have seen far, far worse conduct than that for which this nurse was prosecuted.  I have seen impaired doctors injure their patients.  I have seen gross indifference to the well-being of the patient.  I have seen doctors and nurses blaming each other for careless mistakes.  What I have never seen, however, is someone prosecuted for the deaths or terrible injuries suffered by my clients, especially when, as here, the hospital had a major role in the injury.  It is already difficult to get a doctor to consent to a settlement in a medical malpractice case.  Fear of criminal prosecution will make settlement of meritorious cases even more difficult than it is today.  If anything could make an already bad system worse, adding the threat of criminal prosecution is probably it.

POST SCRIPT:  On May 13, 2022, the nurse was sentenced to three years probation.  If she satisfactorily completes her probation, her conviction will be expunged from her record.

Posted in Arizona Medical Board, disclosure of medical mistakes, Doctors, Hospital Negligence, Hospitals, Lawsuits, medical errors, medical ethics, Medical Malpractice, medical malpractice cases, medical mistakes, Medical Negligence, Medication Errors, Nurses, Prescription Errors, Secrecy |

Murder, Malpractice or Compassionate Care?

April 18, 2022

A 46 year old critical care specialist is on trial in Ohio.  He is accused of deliberately overdosing critically ill patients with fatal amounts of the potent painkiller, Fentanyl.  He was originally charged with 25 deaths but the court threw out 11 of those deaths.  The trial has been going on for almost two months.

How to Handle Your Fear of Needles | Allure

In each of the 14 cases left, the patient was brought to the hospital in critical condition and was not expected to live.  The prosecution alleges that the doctor deliberately overdosed the patients in order to cause their deaths.  The doctor’s attorney claims the doctor was acting out of compassion and trying to relieve the terrible pain of his patients so they might pass away peacefully.  According to the prosecutor, even shortening a life by one day is enough to justify conviction.

The case raises thorny questions about ethical responsibilities of doctors dealing with end of life issues.  There is no protocol for determining the amount of Fentanyl to administer to a patient in extreme pain.  It is the responsibility of the treating physician to decide how much to order.  When making the decision, the doctor must walk a fine line.  She does not want to order too much but at the same time needs to order enough to reduce the patient’s pain to a comfortable level.  What is more important in the case of a terminally ill patient?  To be pain free for the last few days of life or to extend that life as long as possible, even if it means those last days are full of pain?  From whose point of view should these questions be answered?  From the point of view of the patient who just wants to be pain free or from the point of view of the patient’s family which may want the loved one to live as long as possible, regardless of how painful that may be for the family member?

Of course, the answers to these questions are complicated by the fact that the family members either are suing the hospital for the deaths of their loved ones or already have sued and collected.

End of life issues are never easy.  They are not easy for the patient leaving this life or for the family members being left behind, who often are concerned more with their own needs than with those of their dying loved one.  Don’t force your family to make these decisions without guidance.  Make a living will to let them know how you want to end your life or at least how you do not want to end it.

P.S.  After nearly a week of deliberations, the jury acquitted the defendant on all charges.

Posted in Doctors, Hospitals, Informed Consent, medical errors, medical ethics, Medical Malpractice, medical mistakes, Medical Negligence, Medication Errors, Secrecy |

Lots of Developments in Treatment of Breast Cancer

April 11, 2022

There is never a good time to develop breast cancer but for women who have had the misfortune of being diagnosed with breast cancer, the treatment options have never been better than they are today.  The statistics remain daunting, however,  In 2021, over 280,000 women were diagnosed with breast cancer.  Almost 45,000 women died of breast cancer last year, many of whom had been fighting the disease for years.

Aromatase inhibitors cut breast cancer recurrence in younger patients - Cancer  Research UK - Cancer news

Early detection and treatment are key to the improvement of outcomes.  When breast cancer is still localized at the time of its diagnosis, the survival rate is almost 99%.  Localized breast cancer means that it is still in the breast only.  Treatment usually involves removal of the tumor and then adjuvant therapy.

If the cancer has spread outside the breast but no further than the local lymph nodes, the survival rates are around 86%.  The treatment is more extensive for this stage, which is usually referred to as Stage III breast cancer.  The surgeon will excise the tumor and sometimes even the whole breast as well as nearby lymph nodes in an attempt to assure that all of the cancer has been removed.  Chemotherapy is common in the treatment of Stage III breast cancer.

The poorest prognosis is associated with breast cancers that have spread beyond the breast and into structures such as the brain, the bones or the vital organs.  Survival rates at this stage, Stage IV, are only around 28%,

An additional factor in survival is the type of breast cancer and whether it is estrogen or progesterone receptor positive or not.  If the cancer is negative for these receptors, the cancer is much more aggressive and more difficult to treat.  It spreads its cells earlier in the process and has poorer survival rates, even when detected early.

In my law practice, I see breast cancer patients from time to time.  Fortunately for my clients, as breast cancer treatment has become more successful, fewer and fewer women are being harmed by delays in diagnosis.  It is not that there are no more diagnostic misses.  In spite of the best intentions of physicians, those remain fairly constant.  The good news is that, even when there has been a miss and a delay in treatment, the woman still gets a good outcome.  If a patient gets a good outcome, even if there has been a delay, it is very difficult to get a jury to find in her favor so I have a hard time accepting those cases.

The message of all this is clear.  Do your part to detect breast cancer early.  Self-examination is the first step.  Regular check ups and routine mammograms are essential.  Keep those statistics improving.

Posted in Breast Cancer, Doctors, General Health, health, Lawsuits, Mammogram, medical errors, Medical Malpractice, Medical Malpractice Case Value, medical malpractice lawsuits, medical mistakes, Medical Negligence, science news |

When Immune Systems Go Haywire

April 05, 2022

I recently lost one of my sisters to sepsis.  She got an infection that lingered until her immune system couldn’t deal with it any longer and it sent her body into septic shock, which killed her.  Over a quarter of a million people in the United States die of sepsis each year.  Six times that many develop sepsis each year but manage to survive.  However, those who survive sometimes are left permanently damaged from their bout with sepsis.  Sepsis is becoming more and more common as our population ages.  It is now the 10th leading cause of death in the United States.

Resources - End Sepsis

Our bodies generally do a good job of dealing with injuries and illnesses.  Over millions of years, evolution has tried out many solutions to these problems.  It has generally kept the ones that are successful and discarded those which are not.  Sometimes, however, we can have too much of a good thing and that is pretty much the case with sepsis.

Sepsis occurs when the body overreacts to an infection.  The infection is most often bacterial but viral, fungal and protozoan infections can cause sepsis as well.  Infants, children and older adults are particularly susceptible to sepsis.

Our bodies usually handle infections effectively.  Our immune system detects them and sends white blood cells and other killers to attack the invaders.  The immune forces successfully kill off the infection and subside.  Sometimes, however, and for reasons that are not well-understood, the immune system perceives the threat to be so great that it needs to bring out its largest guns.  Continuing the battle imagery, this is like setting off multiple nuclear weapons.  It cannot be done without causing a lot of collateral damage.

The substances sent out by the immune system tell the body to produce inflammatory cells, which in turn cause the blood vessels to dilate and leak.  This in turn interferes with the blood’s job of oxygenating the organs and tissues.  One of the ways in which it interferes is by causing blood pressure to drop.  This is sepsis.  Sometimes the drop is so severe that the organs do not get enough oxygen to operate properly and begin to shut down.  This leads to what is called multi-organ failure.  When the organs fail, they don’t provide the necessary support to the circulatory system which causes further damage to circulation.  Now the body is in septic shock and the potential for death is high.

As should be apparent by now, sepsis is a medical emergency with the potential for death.  It needs to be addressed as soon as possible.  It has been estimated that every hour of delay in treating sepsis decreases a patient’s chances of surviving by 8%.  Prompt treatment, of course, requires that we be able to recognize sepsis when it appears.  Unfortunately, sepsis shares its symptoms with many other illnesses.  Even well-trained doctors sometimes have difficulty recognizing sepsis because it is often accompanied by other medical conditions which have similar symptoms.

Err on the side of caution and prudence.  Seek prompt treatment, even if you are unsure whether the symptoms you are seeing are the result of sepsis or something less life-threatening.  The sooner sepsis is recognized and treatment is begun, the better the chances of survival without permanent damage.  The poster above from an organization dedicated to treating sepsis is helpful in identifying some of the symptoms of sepsis that should lead a patient or the patient’s family to seek prompt medical attention.  Be aware of these symptoms of sepsis and act promptly.

Posted in antibiotic resistant bacteria, blood infections, Doctors, health, Hospitals, Infection, Misdiagnosis, science news, Sepsis |

Newest MRI Technology Will Save Lives

March 28, 2022

“Time is brain.”  When a patient has a stroke, the sooner treatment can be begun, the better the outcome.  For strokes which occur outside the hospital, and that is most of them, valuable time is sometimes lost before the patient or someone around the patient recognizes something is terribly wrong and calls 911.  More time is lost transporting the patient to the hospital.

Once the patient arrives at the hospital, there is one more critical step which must be performed before treatment can be begun.  The patient must be imaged to determine if the stroke is one caused by blood clots, an ischemic stroke, or one caused by bleeding into the brain, a hemorrhagic stroke.  Blood thinners, which can be a vital form of treatment for an ischemic stroke, cannot be given to a patient with a hemorrhagic stroke for obvious reasons.  If the hospital does not have an MRI machine or if the MRI machine is in use, even more valuable time can be lost.  Enter the Swoop MRI machine.

A portable MRI machine

As you can see from the picture, the Swoop is small and portable.  It can be wheeled down hospital hallways and into the patient’s room.  It does not need its own room.  It does not need a dedicated team to operate it.  A single operator can manage it using a tablet.  Because it has smaller magnets, it does not require a dedicated power source either.  It can even be plugged into the wall in the patient’s room.  It can be ready to begin scanning two minutes after arriving in the patient’s room.  It costs as little as 1/10th as much as a larger machine so many smaller hospitals can afford one.  It has been approved for use by the FDA and is already at work in some hospitals.

The Swoop MRI is another example of the march of technology in medicine and elsewhere.  It is sometimes hard to believe that the Apple iPhone only came into existence a little less than 15 years ago.  It seems like it has been with us forever.  The Swoop won’t be the last new invention to take advantage of the advances in chip making and miniaturization.

Posted in Uncategorized |

Nursing Is A Dangerous Profession

March 21, 2022

Hats off to nurses.  They do most of the hands on work of providing medical care to the community.  They are not well-paid for their efforts.  The average salary for a registered nurse across the United States is about $77,000, not a lot of money in this day and age.  Nursing assistants make around $31,0o0 per year and Licensed Practical Nurses around $49,000.

Nurses (TV Series 2020– ) - IMDb                                                       (Not all nurses look like these actors from the TV series Nurses.)

Let’s talk for a moment about what nurses must do to earn their salaries.  I am going to limit my discussion to nurses who practice in hospitals.  They are the ones who are probably the most front-line of the nurses.

Someone has to work the 11 p.m. to 7 a.m. shift while the rest of us are sleeping.  Someone has to work the Labor Day and Memorial Day shifts as well as the shifts on Christmas Eve and Christmas Day.  It doesn’t take a genius to recognize that working these shifts is hard on the nurses and their families.

Nurses work hard under the best of circumstances.  During the Covid pandemic, many have gone above and beyond what most of us would consider to be the call off duty.  Not only have they been regularly exposed to a deadly virus, many of them have worked extremely long hours in understaffed hospitals overwhelmed by repeated surges of patients.  Unsurprisingly, illness, death, exhaustion, burnout and depression have been common among these nurses.  Many have found the work to be so hard that they have left the profession altogether.

As if these risks were not enough, nurses face the risk of physical assault while on the job.  According top data published by the CDC, nurses faced a 13% risk of being violently assaulted in a given year.  In other words, 13 nurses out of every 100 will be physically assaulted in a given year.  On top of that, nurses face an even greater threat of non-violent assaults each year.  38 out of 100 nurses are subject each year to verbal assaults, sexual harassment and threats of violence, according to the same CDC data.  Anecdotal reports from nurses themselves demonstrate even higher rates than reported by the CDC.  In response to survey questions, 21% of nurses reported a physical assault in the preceding year and 50% reported a verbal assault.  These statistics make nursing one of the most dangerous jobs around.  Days lost to serious workplace violence are much higher in healthcare jobs than other industries.

In spite of these high numbers, many observers believe that workplace violence directed at nurses is underreported.  Violent altercations are so common that many nurses just consider them part of the job.

Although current figures are not yet available, all available evidence points to a rise in assaults on nurses as patients and their families insist on unproven treatments or refuse to abide by masking policies or claim they or their loved ones are being wrongly diagnosed with Covid as part of a government plot.  These are indeed troubled times for the nurses upon whom we depend so much.

 

 

 

 

Posted in Hospitals, Nurses, Uncategorized |