Medical Malpractice News and Views


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

Medication Errors Are Easy To Make.

August 15, 2022

A few months ago I wrote about the Tennessee nurse who was criminally prosecuted for administering the wrong medication to a patient.  The medication resulted in the patient’s death and the nurse was convicted of negligent homicide.  One of the defenses offered by the nurse was that the mistake she made was in part the result of the hospital’s use of a computerized medication dispensing machine.  There had already been a number of problems with the device.  The nurse claimed that the hospital had not corrected the problems and that the dispensing machine contributed to the death.

Covid: Pfizer says antiviral pill 89% effective in high-risk cases - BBC  News

The computerized dispensing machines pretty much all work the same way.  The nurse types in the first couple of letters of the name of the medication she is searching for and the machine offers her a list of medications that begin with those letters.  The nurse clicks on the medication she wants and the cabinet delivers it to her.

In the Tennessee case, the nurse was to have administered Versed to the patient.  Versed is a mild sedative that was intended to calm the patient before the imaging procedure she was about to undergo.  The nurse typed in VE and the list generated by the dispensing machine included Vercuronium as well as Versed.  In her haste, the nurse clicked on Vercuronium, a powerful paralytic drug, and administered that to the patient instead of Versed.  The Vercuronium paralyzed the patient and stopped her breathing, but only after the nurse had gone on to care for another patient.  By the time someone came to take the patient to her imaging procedure, it was too late to save her.

Safety advocates say the machines should require more than two or three letters be entered before the computer generates a list of drugs from which the nurse can choose.  One machine in common use only requires one letter be entered before it generates a list of choices. Had the machine in Tennessee required at least four letters, it would not have offered Vercuronium as one of the choices for the nurse and this tragedy would have been avoided.

One of the largest manufacturers of computerized dispensing devices has created a software fix, which requires the nurse to type in five letters before a list will be generated.  It did this a couple of years ago but left it up to the hospital customer whether to apply the software fix to existing machines or not.  Many hospitals did not.  The manufacturer has announced that the fix will be installed in all its new machines beginning later this year but there is still no way to force hospitals that already have the machines to require five letters.

While there is no question that typing in five letters is less likely to result in the wrong medication being selected, there are some reasons why five letters can be a problem.  There are a lot of medications out there with complex names that can be difficult to spell correctly.  Add to the equation that sometimes the medication is needed immediately because of a life-threatening emergency and you can see the problem.  Under the pressure and chaos of the emergency, the nurse may fumble the data entry through a spelling or typing error and getting the medication out of the machine may be delayed in a situation when any delay can cause death or catastrophic injury.

Anecdotal reports by nurses state that, after an adjustment period during which there is a lot of frustration, they get used to entering five letters before they can get a medication out of the machine.  There is no question that requiring five letters before a list is generated will save lives and prevent many medication errors.  Since the death in Tennessee, at least five reports have been made of similar errors caused by the dispensing machine requiring only one or two letters to be entered before offering nurses a choice of medications.

As I have observed on many occasions in the past, our advanced health care system is complex.  It requires many skilled providers, who must clearly and accurately communicate with one another.  Machines, including the medication dispensing ones, must be programmed correctly.  There is so much opportunity for error that the wonder is not that errors occur but that there are not more of them.

 

 

Posted in Hospital Negligence, Hospitals, Medical Devices, medical errors, Medical Malpractice, medical mistakes, Medication Errors |

Women With Heart Disease Just Can’t Catch A Break.

August 08, 2022

Women get the short end of the stick in a lot of areas of life.  Health care is one of them.  Heart disease, the leading cause of death in men and women in the United States today, does not present the same way in men and women.    The differences between heart disease and its treatment in men and women are quite pronounced and a real problem for women.

Conquering Cardiovascular Disease | NHLBI, NIH

For many years the conventional wisdom was that women did not get heart disease like men did.  It was believed that they were somehow “protected” against heart disease by the female hormones they produce.  If that was ever true, it is no longer true today.  The rate of heart attacks among mid-life women (ages 35 to 54) has been increasing over the past twenty years while, over the same period, it has been decreasing in men.  The onset of menopause is believed to be a major driver of the increase in risk factors for cardiovascular disease among women.

But because of the perception that women don’t get heart disease like men, they don’t receive the same kind of preventive treatment that men receive that has caused the rate of heart attacks among men to decline.  Women are less likely to be put on a treadmill than a man with the same complaints.  They are also less likely than a man to receive a coronary angiogram, which is the gold standard when looking for the narrowed coronary arteries that cause heart attacks.  They are more likely to have their heart-related complaints attributed to some other cause.

What do you think of when someone says, “heart attack?”  If you are like most people, you think of chest pain.  While chest pain is the most common symptom of a heart attack, it is far from being the only symptom.  Even when a patient has chest pain due to a heart attack, it is not often like the movies where the person doubles over while holding his chest.  The chest pain caused by a heart attack can be no more than discomfort.  Chest pain can be completely absent.  Other symptoms of a heart attack may be arm pain, radiating or not, jaw pain, back pain, shortness of breath, fatigue, malaise, or indigestion.  Studies have shown that women having a heart attack are less likely than men to present with classic complaints of chest pain.

The fact that women don’t often have classic complaints of chest pain when having a heart attack has profound implications for their treatment and survival.  In the first place, women themselves don’t call for an ambulance as soon as men having heart attacks do.  They tend to wait longer before calling and often call a friend for advice before calling 911.  The reason for this delay is that women having a heart attack do not usually have classic chest pain and are therefore more likely to attribute the symptoms they are having to something other than a heart attack.  Denial plays a role for both women and men.  No one likes to think they are having a heart attack.

Women are not alone in attributing their symptoms to something other than heart disease.  Because they are not complaining of classic, crushing chest pain, the doctors examining women in the emergency department also tend to dismiss heart attack as the correct diagnosis.  Studies have found that women were not seen by a doctor in the ER as quickly as men with the same complaints.  They were less likely to be admitted to the hospital than a man with similar complaints and they were also less likely to receive diagnostic tests for heart attacks, such as an EKG.

Education appears to be the solution to these problems.  Women need to be educated about heart disease, their risk factors for it and how heart attacks present in women so they can recognize one, should it occur.  Doctors need to be educated about the increasing likelihood that a woman may experience a heart attack, the different symptoms of a heart attack in women and the importance of including women in studies of heart disease.

All patients should be polite but firm in insisting on a full evaluation any time they think they may be having a cardiac event.  I have seen too many cases of people in the middle of a heart attack sent home with reassurances that their problem is not cardiac in nature.  Many of those people died within hours of returning home.   Don’t let this be you.

Posted in Doctors, health, heart attack, Heart Attacks, Hospitals, Lawsuits, medical errors, Medical Malpractice, medical mistakes, Misdiagnosis, Obesity |

Doctors Behaving Badly.

August 01, 2022

Doctors are not immune to the mores of the society around them.  It seems that everywhere we look today, we see a coarsening of society.  Past generations may have cursed, but they didn’t do it all the time or loudly in public.  Certain subjects, which were not discussed in polite society, are all over television and the print media today.  Cases of road rage and public boorishness abound.  Doctors are following suit.

Doctor caught cursing at patient;... - Good Morning America

Poor behavior on the part of doctors comes in many forms.  According to surveys of doctors themselves, rude, bullying behavior in the office or hospital is the most frequently observed bad conduct.  Some doctors believe themselves a cut above the rest of us and certainly a cut above their patients.  They treat nurses and office staff, and sometimes even other doctors, with contempt.  They yell and call names.  They expect to be pampered and to have everything go smoothly and according to their wishes.  When the usual problems of daily life occur, they react badly.  If the bad behavior occurs in the office of the doctor who owns the practice, there is little anyone can do, except find another job or another doctor.  If it occurs in the hospital, other members of the staff or of the administration can call the misbehaving doctor onto the carpet.

Among the other forms of bad doctor behavior “on the job” are mocking patients behind their backs, being physically aggressive with staff, use of racist language and insults, being intoxicated, making inappropriate sexual advances to patients and staff, and lying about credentials.  All of these examples come from surveys of doctors asking about their colleagues and what they have observed.

Away from the job, doctors misbehave as well, although they have a little more latitude when they are on their own time and away from the office or hospital.  Even though it may occur “off the job” doctor misbehavior is a problem because it undermines the respect people have for doctors and weakens the physician/patient relationship.

Social media is a frequent site of “off the job” misbehavior for doctors as it is for many other citizens.  Much of this bad behavior takes place on Facebook, where the doctor may be and often is identified as a doctor.  Facebook misconduct includes racist language, insults, sending sexual images and images showing drug use.

Some doctors post videos of themselves interacting with unconscious patients.  Famously, the surgeon performing a procedure on comedienne Joan Rivers took a selfie of himself with the unconscious Ms. Rivers without her permission.  This might not have sparked the attention it did had she not died as a result of the procedure.

Some pictures or videos of patients do not blur their faces, which allows them to be identified and which destroys the privacy of their medical care.  If done without the advance consent of the patient, this is a serious breach of ethics and of the HIPAA rules.

Other instances of doctors behaving badly relate to criminal acts.  They may be criminal acts against patients, such as sexual assault or inappropriate touching.  These are especially problematic when the patient is unconscious and cannot appreciate and report the violation.

Criminal acts by physicians most often involve fraud against either health insurance companies or a government program, which pays for treatment.  The federal government regularly reports on doctors it has caught who submit bills for medical treatment that never happened or which was not medically necessary.  Sometimes these frauds reach into the millions of dollars and involve a network of doctors and other providers.

There is a phrase used in connection with keeping travel safe that applies here:  “If you see something, say something.”  Bad behavior that is ignored is not going to stop.

Posted in Doctors, Fee for Service, Fraud, Hospitals, medical ethics, Medicare, Nurses, Secrecy |

What You Want To Know Before They Operate.

July 25, 2022

You have been referred to a surgeon and she has advised you that you need surgery.  What now?  There are certain steps you should always take when this happens.

Surgery | JAMA Network

What happens if I don’t get the surgery?

This is always an option.  Just don’t get the surgery.  Ask the surgeon what is likely to happen if you choose not to get the surgery.  Remember in all discussions with the surgeon who wants to do the operation that this is how the surgeon makes money.  There is an old saying, “When the only tool you have is a hammer, every problem looks like a nail.”  The surgeon doesn’t get paid, if you don’t get the operation.  The surgeon may be 100% right that you need this surgery and that it is important that you get it.  Just keep in mind that just because a doctor says it does not make it true.

What are the risks and benefits of the surgery?

This is a conversation you should always have whenever considering a surgical procedure or any type of medical care, for that matter.  It is how you give “informed consent” to the surgical procedure or the treatment.  If you don’t know what the risks and benefits of the proposed surgery are, how can you give informed consent?  Hint:  You can’t.

There is no free lunch.  Every medical procedure or treatment has risks.  What are they and how do they stack up to the benefits you are hoping to get?  Unless you have no other option, the benefits of the surgery should outweigh the risks.

How likely is the surgery to solve the problem?

It is one thing to know the risks of the surgery.  It is another to know how likely the surgery is to solve your problem.  Sometimes the surgery may be the only way to save your life.  Under those circumstances, you may have to accept even a low chance of success.  It is all you have.  On the other hand, if the condition the surgery is intended to fix is not critical and the risks are high, you may be better off passing on the proposed surgery?

Are there alternatives to the surgery?

In my reading, I have often come across articles which compare surgical outcomes with non-surgical ones for a given medical condition.  Sometimes the non-surgical treatment is just as effective as surgery and often has far less risk attached to it.  You should always ask if there is a non-surgical alternative and, if there is, how effective it is.

How often do you perform this surgery and what is your complication rate?

Regardless of how badly you need the surgery, you should be concerned about the experience of the surgeon who will be performing it.  The statistics are clear.  Surgeons who do your operation often get better results than surgeons who only do it occasionally.  The more often your surgeon does your procedure, the better.

If the surgeon who wants to operate on you does not want to talk about complications or her experience, you should find another surgeon.

Where do you plan to perform the surgery?

Some surgeries are complex enough that they should only be performed in hospitals where emergency services are available, if things go wrong or if your recovery will require an overnight stay.

Just as not all surgeons are equal, not all hospitals or surgical centers are equal.  The surgeon may be choosing this hospital because it is close to her office.  That is not much of a benefit to you.  Look up this hospital on the  web site where the government compares hospitals across a number of areas.  I have seen a lot of well-done operations screwed up by nurses or other health care providers at the hospital.  You don’t want that to happen to you.

Do I even need this surgery – Part 2?

Now that you have asked the surgeon who wants to operate whether you need this surgery and whether there are other alternatives, it is time to ask someone else who doesn’t have a financial interest in doing the surgery.  Find another surgeon and get a second opinion.  Don’t use someone recommended by the first surgeon or you end up with their golf buddy who may not give you an objective answer

Other questions.

There are probably lots of other questions you should be asking, depending on your particular situation.  Surgery is a big deal.  You don’t want to have someone cutting on you, if you don’t need to or if the risks outweigh the prospective benefits.  Think carefully about your situation and add some questions of your own to this list.

Good luck.

Posted in Doctors, Hospital Negligence, Hospitals, Infection, Informed Consent, medical errors, medical ethics, Medical Malpractice, Medicare, Nurses |

The Retained Foreign Object.

July 18, 2022

Something is going on and I am not sure what it is or why.  The incidence of objects being left behind in the body of the patient is increasing.  What is being left behind, you ask?  Mostly it is the usual things:  sponges, towels, laparotomy pads, surgical instruments, and fragments of broken objects.  Recently, I have had three patients come to me with guide wires left behind.  I have no idea how anyone can leave a nearly three foot long guide wire behind.  Needless to say, none of these objects should be left in patients after medical procedures.

An example of retained surgical clamp (ntRSFB). Clinical presentation... | Download Scientific Diagram

The problem of foreign objects left behind following the performance of a medical procedure is one which has been around since the first surgeries were performed.  A lot of thought and effort has gone into developing safeguards to prevent it from happening.  In spite of all of the effort and thought, however, the problem still occurs with depressing regularity.  In fact, the problem seems to be increasing in its frequency.  More and more objects are being left behind.

Among the likely explanations for an increase in cases of surgical items being left behind, the Covid pandemic is at or near the top of the list.  Like so many aspects of our lives, the Covid pandemic upset the lives and routines of the surgical teams at hospitals.  Elective surgeries were postponed.  Highly skilled and experienced surgical teams were not allowed to perform surgeries and their teamwork and precision suffered.  Study after study has shown that teams which perform the same procedure over and over have the lowest complication rates.  They are like a well-oiled, precision machine.  The other side of the coin is that teams that only occasionally perform a procedure are more likely to have mistakes and poor outcomes.  Even good teams that have had their practices interrupted are going to accumulate some rust during the down time.

Not only has the Covid pandemic interrupted the routines of surgical teams, it has caused some highly competent medical professionals to leave the field or to shift to another area.  I have written in other posts about the ripple effects of traveling nurses being highly paid.  Some operating room nurses have chosen to leave the operating theater in return for a larger paycheck.  Some skilled nurses and technicians have just had it with the medical profession and the risk of infection and have moved to other fields or have retired.  When elective surgeries did resume, new teams had to be created and trained.  Even experienced teams had to work hard to get back to their pre-pandemic form.

The root problem is, of course, the fallible nature of the human beings who work in the health care system.  They are people and people make mistakes.  One of the procedures which has been developed to prevent objects from being left behind is the requirement that every object introduced into the operative field be counted before being used and again at the conclusion of the procedure.  If the counts do not match, the operative team must locate the missing object.  In almost every foreign object case I have ever seen, the counts were recorded as being correct.  Clearly, if an object was left behind, there was some error in the process of counting it.  Either it was not properly recorded before being used or was improperly counted as being present at the end of the procedure when it was in fact still in the patient’s body.

Retained foreign objects can cause catastrophic problems, including death and paralysis.  They routinely cause pain to the patient.  If not detected immediately after the operation, and many are detected at that time, they can cause infection and chronic health problems.  At a minimum, they are going to require another procedure to remove them from the body.

If you have had a medical procedure and an object has been left behind, if it is not discovered shortly after the procedure, it is usually only going to be discovered because you have unexplained pain that just won’t go away or because you develop chronic problems for which there is no good explanation.  The moral of the story is for you to be polite but persistent when you have prolonged pain or problems following a surgical procedure.   In most cases, it won’t be because of a retained object, but you want the doctors to get to the bottom of your problem, whatever it may be.

If you have had a foreign object left behind in your body following a procedure, go see an experienced medical malpractice attorney.  There is no excuse for objects to be left behind and you are entitled to compensation for the error.

Posted in blood infections, disclosure of medical mistakes, Doctors, Hospitals, Medical Devices, medical errors, Medical Malpractice, medical malpractice lawyers, medical mistakes, Medical Negligence, never events, Nurses, retained sponge, retained surgical instruments, Sepsis, Surgical Errors |

Your Tax Dollars At Work – The Arizona Medical Board

July 11, 2022

At least the Arizona Medical Board lets the public know what it has been doing.  It publishes a running list of all of the disciplinary action it has taken over the past year.  It makes for very interesting reading.  Here is a link.

State Medical Boards Continue To Fail The Public.

As the Board states, it has “legal authority to revoke, suspend, restrict, fine, reprimand or censure, require monitoring or additional education, or impose other remedial measures on the license of” physicians or physician assistants (P.A.) if the physician or physician assistant “has committed unprofessional conduct or is mentally or physically unable to safely engage in the practice of medicine.”

I have been practicing law for over 45 years.  Over 40 of those years have been spent in the area of medical malpractice, first as a lawyer defending doctors and hospitals and the last 30 representing victims of medical malpractice.  I know from that long experience how common malpractice is and how often patients are hurt by avoidable medical mistakes made by doctors.  I know how often injured patients complain to the Arizona Medical Board.  That is what makes it so frustrating to review the discipline handed down by the Arizona Medical Board.

During the last twelve months, the Arizona Medical Board has revoked the licenses of only three doctors.  It has accepted the surrender of the licenses of another twelve doctors for disciplinary reasons.  These disciplinary actions amount to a total of 15 cases.  Last year there were nearly 10,000 doctors practicing in the state of Arizona.  Out of the nearly 10,000 doctors .0015% either had their licenses taken away or surrendered them in the last twelve months.  This is an almost criminally low number given the amount of malpractice in this state.

If you are a below average physician, the actions of the Arizona Medical Board should reassure you.  Of the 15 licenses that were revoked or surrendered, only one was as the result of alleged negligent treatment.  One and one only.  If you malpractice on patients, the odds are greatly in your favor that the Arizona Medical Board is not going to take away your license.  You may suffer some inconvenience and get a nasty letter from the Board but you will be free to keep on being a substandard doctor and injuring patients.

The surest way to lose your license is to develop a problem with alcohol or drugs.  Eight of the revoked or suspended licenses involved alcohol or drug use by the physician.  The Board is very aggressive in its treatment of impaired doctors and that is a good thing for the public.

Three doctors lost their licenses because they overprescribed opioids to their patients.  The Feds and the pharmacies are watching prescription patterns and trying to catch the doctors who run pill mills.

Two doctors lost their licenses after they were convicted of health care fraud.

One doctor was accused of improperly touching two of his female patients and surrendered his license.

Finally, one doctor surrendered his license in the face of charges that he engaged in improper charting and treatment of patients in a telemedicine setting.  It is not clear whether and to what extent the telemedicine played a role in the decision to discipline this doctor.  This may represent a hostility on the part of the Board to the development of telemedicine as no one else in the state surrendered their licenses for allegations of poor charting or not properly examining their patients before ordering treatment.

If you ignore the low discipline rate of the Arizona Medical Board, you have no right to complain if you find yourself the victim of one of the doctors whom the Board allowed to keep on practicing despite complaints of malpractice.  It is up to you if you do something or not.

Posted in Arizona Medical Board, Doctors, Fraud, medical errors, Medical Malpractice, medical mistakes, Medical Negligence, Surgical Errors |

Bacterial Infection: A Relentless Killer.

July 04, 2022

They are all around us.  The bacteria that cause infections are all around us.  They live on our skin, in our guts, on the food we eat, on the surfaces we touch, and in our mouths.  They float on the currents of air that surround us.  They are in the exhaled breath of the people who pass us on the street or who stand next to us in the elevator.  They are literally everywhere.  Of course, we evolved with bacteria and have developed barriers to keep them at bay.  If they manage to penetrate our barriers, however, they may get by our immune systems and multiply unchecked.  If that occurs, death is the usual outcome.

How bacteria can save children's lives - BBC Future

Although in our antiseptic world we don’t often think of it, we continue to be engaged in a struggle with infection-causing bacteria that has been going on for millions of years.  It is a classic fight.  The bacteria evolve in some way that makes them more efficient.  Perhaps they develop a new way to enter our bodies.  Perhaps they develop a way to bypass our immune systems.  Whatever it may be, we in turn must evolve to meet and overcome the new threat.  As soon as we meet this threat, there will be a new one.  The struggle never ends.  The enemy is implacable.

Modern science is a new factor in the continuing battle and has come to play a huge role.  We are no longer solely on our own and depending on our bodies to develop new defenses.  Modern science has given us antibiotics.  Countless lives have been saved through their use.  Unfortunately, we have not been good stewards of the riches of antibiotics.  We have overused them to the point that they are no longer as effective as they once were.  Our implacable enemy has not given up.  The bacteria have been evolving ways around our antibiotics and passing those successful traits on to their descendants.  The battle against infectious bacteria continues, even if we don’t think about it in that way.

Modern science has been a mixed blessing in some respects.  Although it has given us potent weapons against infectious bacteria, it has left our immune systems confused.  Over millions of years our immune systems developed to meet the threats of a world in which dangerous bacteria were a constant threat.  Today, however, we no longer live with livestock either in the house or right outside.  The floor of the house is no longer packed earth.  The food we eat has been refrigerated, the water we drink chlorinated.  Our immune systems, which were once 24-hour-a-day workhorses, have been largely put out to pasture.  With few real threats to address, our immune systems are at risk of going haywire and attacking risks that do not exist.  Most commonly, the non-existent risk the immune system attacks is part of our own body.  This theory, that immune systems made inactive by the cleanliness of the modern world overreact, is called the hygiene hypothesis.

In the modern, developed world, there has been a great rise in autoimmune diseases.  These are the diseases in which the immune system attacks the host’s body with sometimes terrible results.  One of the most common autoimmune diseases on the rise in the developed world is Type 1 diabetes.  Those of you who read this blog regularly know that one of my grandsons was diagnosed with Type 1 diabetes when he was only three.  He is fortunate enough to have good health insurance and is about to celebrate his 12th birthday.  He has a blood glucose sensor and an insulin pump, which are both great helps in keeping him alive and healthy.  Other autoimmune diseases include systemic lupus erythematosus, rheumatoid arthritis, multiple sclerosis and inflammatory bowel disease, to name just a few.

Perhaps the best thing we can do to protect ourselves is recognize that this battle with infectious bacteria is still ongoing.  Not only is it not going to end soon, it will probably never end as long as human beings and bacteria continue to exist on this world.  We need to respect our enemy and be careful in our use of antibiotics and other antiseptics so they do not lose their effectiveness.  A good, thorough washing of our hands with soap and water is always a good place to start in avoiding bacterial caused infections.

 

Posted in antibiotic resistant bacteria, blood infections, General Health, health, healthy living, Infection, Medical Devices, science news, Sepsis, Type 1 Diabetes |

Have I Been The Victim of Medical Malpractice?

June 27, 2022

As I have written on many occasions, if you are the victim of medical malpractice, don’t count on anyone informing you of that fact.  Despite the obligation of doctors and hospitals to be honest with their patients, the curtain of silence and secrecy descends when there has been malpractice.  In fact, the worse the injury to the patient, the more likely it is that the doctors, nurses and hospital administrators will do all they can to keep the patient in the dark about what happened.

Secrecy - Wikipedia

Medical malpractice is frighteningly common.  In my experience, you cannot be in a modern hospital for three days without someone making some sort of mistake involving your care.  Thank goodness that on most of these occasions no serious harm occurs to the patient but these incidents add up and eventually someone is really hurt – maybe even killed.  If that happens, it is rare that anyone admits a mistake was made.  Patients have to figure it out on their own.

Nurses are required to submit reports when a mistake occurs.  One basis for requiring a report is to alert the hospital to the presence of the mistake so that corrections can be made to prevent similar occurrences in the future.  A second basis is to alert risk management.  Risk management may approach the patient or the patient’s family and try to resolve any claim or may just try to keep the patient from finding out about the mistake.

As a lawyer representing injured patients, I know about this requirement and routinely ask for a copy of the report.  Just as routinely, I am informed that the report is covered by the hospital’s peer review process, which is itself protected from disclosure by statute.  The statutory protection is ostensibly to encourage everyone to be frank about what happened so corrections can be made.  In practice, the hospital claims everything is peer review so as to reduce the likelihood the patient will be able to successfully prove her case.  Let’s face it.  Hospitals are in business to make money and paying patients fair value when they are injured by the hospital’s nurses or other employees is no way to pad the hospital’s bottom line.

Doctors have similar incentives to keep patients in the dark when they have made a mistake.  Doctor mistakes can result in doctors losing their privileges at the hospital.  In order to practice at a hospital, a doctor must apply for privileges and demonstrate that she or he is competent to do the procedures they want to do at the hospital.  If the doctor makes a mistake at the hospital, a committee may investigate and take away the doctor’s privileges.

Even if the mistake does not occur at the hospital, the doctor still has a strong motivation to keep it a secret.  Mistakes get reported to the Arizona Medical Board, which can investigate the doctor and the alleged mistake.  The Board’s actions can range anywhere from doing nothing (the most common action, thank you very much) to taking away the doctor’s license to practice medicine in the state of Arizona.  There are also a number of in between disciplines involving restrictions on the doctor’s practice or requiring additional education by the doctor to prevent the mistake from happening again.

If you or a family member find yourself with an unexpected injury, you need to start asking questions.  Don’t expect to get honest answers but at least begin asking questions.

Ask for copies of your medical records so you can see what the doctors and nurses claim happened.  You are entitled to a copy of your records.  Again, don’t expect much in the way of honest reporting.  The records may say what happened but they are highly unlikely to contain admissions that mistakes were made.  For example, the operative note may say that suddenly there was “brisk bleeding,” which the surgeon promptly addressed.  The surgeon does not explain that the brisk bleeding occurred when she or he nicked an artery by mistake.

If, after reviewing your records and asking questions, you still have questions about what happened, go see an experienced malpractice lawyer.  She or he may not be able to answer your questions but that is a good place to start after you have finished talking to the health care providers.

Posted in arizona certified medical malpractice lawyers, Arizona Medical Board, disclosure of medical mistakes, Doctors, electronic medical records, Hospital Negligence, Hospitals, Lawsuits, medical charts, Medical Malpractice, medical malpractice claims, medical malpractice lawsuits, medical malpractice lawyers, medical mistakes, Medical Negligence, Nurses, plaintiff, Secrecy, Surgical Errors |

Medical Ethics and Secrecy. You Cannot Have Both.

June 20, 2022

Over the many years I have been representing victims of medical malpractice, I have found that almost never will anyone inform the patient that he or she has been the victim of malpractice.  The sole exception is when a foreign object is left behind.  It is pretty difficult to pretend that the presence of a foreign object left behind in the body is just one of those things that happen from time to time through the fault of no one.  There aren’t very many foreign objects left behind so, in the vast majority of malpractice cases, the patient is on her or his own in figuring out what happened

So where do medical ethics fit into all of this?  Doctors have an ethical duty to be honest with their patients.  Only under certain limited circumstances can they withhold information from their patients.  Each of those limited circumstances requires that the withholding of the information be in the best interest of the patient.  It is unethical for a doctor to withhold information from the patient for the benefit of the doctor.  As you can see, there is no ethical justification for a doctor to fail to inform her patient that they have been injured by a medical mistake and yet it happens every day of the week in every large hospital in this country and probably twice on Sundays.

Doctors like to posture about how honest and ethical they are.  Sadly, for many of them, they are only honest and ethical when it suits their interests.  If honesty is going to require financial sacrifice, or embarrassment or the admission of a mistake, they are not going to be quite so honest and open.

Doctors are almost always held in high regard in society.  Many of them are paid very well for the services they provide.  They live in nice houses and drive fancy cars.  They also want society to give them privileges that are not given to other professions or to the rest of the general public.  For example, throughout the United States doctors routinely ask that they be given special treatment when it comes to lawsuits.  They want to limit the rights of the patients who get injured by medical negligence.  As a general rule, doctors win about 80-85% of malpractice cases that go to trial.  It is hard to convince a jury to find against a doctor.  When a patient does manage to convince a jury to award them damages because of medical malpractice, doctors want to have those damages limited, so that they can put more money in their pockets.  The fact that they spread money around at the state legislature and make large campaign contributions doesn’t hurt when it comes to asking for these special privileges.  There is also often an implied threat that doctors will go elsewhere to practice medicine, if they are not given special privileges.

Another reason doctors claim they are entitled to special privileges is because they are the real victims when a malpractice suit is brought.  Not only do they hide their malpractice from their patients when it occurs, they claim that there is really very little malpractice in the first place.  Their unethical behavior in withholding information from their patients about why they are damaged, is used as evidence of the absence of malpractice in general.  They claim malpractice rarely occurs and that suits against them are frivolous.

It is not just the malpracticing doctor who unethically hides information from his patient.  His fellow doctors go right along.  In today’s world of medicine, there are so many doctors involved in the care of a patient that it is an unusual case in which a number of doctors are not aware when something goes wrong and why.  Yet no one says a word.  These honest and ethical pillars of society keep their mouths closed and leave the patient to fend for herself.

I guess it is asking too much of these honest and ethical doctors that they actually be honest with their patients.  Just don’t walk around taking bows for being so ethical when you are only looking out for yourself.

 

 

 

 

Posted in disclosure of medical mistakes, Doctors, Fraud, Hospitals, Malpractice caps, Malpractice costs, medical errors, medical ethics, Medical Malpractice, medical malpractice damages caps, medical malpractice lawsuits, medical mistakes, Medical Negligence, never events, Nurses, plaintiff, Secrecy, tort reform, trial |

Want To Live Longer and Healthier? Think Positive.

June 13, 2022

My mother lived until just before what would have been her 96th birthday.  She had a great attitude about life.  She kept busy gardening and volunteering as long as she could.  When old friends passed on, she made new, younger friends.  She talked to her friends on a daily basis.  She read the paper every day and kept up on world and local affairs.  She remained mentally sharp and engaged right up to the end.  I certainly hope that some of that will pass down to me but science tells us that we have more control over our later years than we ever thought.

old man old age happy

The brain is a powerful organ.  The most recent research suggests that people with positive attitudes about aging tend to live substantially longer and healthier lives than those who have negative thoughts about aging.  This is true even after allowing for other variables.  It is not just the people who start out healthy whose positive attitudes extend their lives.  Even those with pre-existing health problems can obtain a great deal of benefit from positive attitudes.  And, it turns out, we can improve our attitudes, if we work at it.

Here is a link to an interview with an author who has written on the subject of the benefits of a positive attitude and how we can go about improving our attitudes.  The first step she recommends is becoming aware of the attitudes we already have about aging.  For example, what are the first things you think of when you think of an older person?  Are you thinking about sickness, dementia, disability or are you thinking about activity, social interactions, using leisure to make the community better?

The author next recommends listening to comments around you.  What do the people you come into contact with think about older people?  Do they harbor negative stereotypes or positive ones?  Don’t let the negativity around you drag you down.  Speak up and don’t let negative attitudes fester.  Advocate for all older Americans bring to their families and communities.

Many older Americans are positive contributors to their communities.  They volunteer at charities or at the library or for political campaigns.  Like my wife, many grandparents help their children by picking up grandchildren from school or babysitting when a child is too sick to go to school or is off from school while Mom or Dad still have to go to the office.  Some older people are successful enough to be able to donate, not just their time, but some of their excess funds to make their communities a better place to live.

Be active.  Sedentary lifestyles lead to early mental decline and physical disability.  People who are more physically active often have better mental attitudes.

Lastly, avoid social isolation.  The more an older person interacts with others, the better for everyone.  Be like my mother and make new, younger friends.  Be sure not to neglect your old friends.  Make a special point to call them or go see them, especially if they are alone.

May you live a long and happy life.

 

Posted in General Health, health, healthy living |