Alabama Personal Injury Blog - Medical Malpractice

Tips to Prevent Medical Errors

Jan Boswell — Wed, 11 Nov 2009 09:22:02 GMT

This blog is written in response to the blog, 98,000 Reasons to Care about Patient Safety, by Jane Ayre at InjuryBoard.com. This is the number of Americans who die from medical errors each year. As a nurse, I know that patient safety is a concept that is foremost in the minds of healthcare providers, administration, and regulatory agencies. How can you, the consumer, help prevent medical errors ? In this blog, I will outline tips to help the consumer prevent other medical errors.

1. Be an active part of your healthcare team. Ask questions not just in the hospital but anywhere you receive healthcare. If you don’t understand something, ask for clarification.
2. If you have a choice, choose a hospital at which many patients have had the procedure and surgery you need and have had good results.
3. When choosing a specialist, ask your own physician for a personal recommendation. I have been known to ask my primary doctor: “If this were your wife, who would you send her to for this condition?”
4. Ask all healthcare workers who have direct contact with you whether they have washed their hands. Adequate hand washing is a primary way to prevent infection.
5. Before you leave the doctor’s office or hospital, make sure you understand the treatment plan. This includes understanding about your medications, follow-up care, and when to contact the doctor.
6. Before you leave the hospital, make sure you understand when you can resume regular activities. Make sure your doctor understands your regular activity level. You should know when you can shower, take a tub bath, lift 5 lbs, return to work, etc.
7. If you are having surgery, make sure that you, your doctor, and your surgeon all agree on what exactly will be done. For example, if you are having surgery on your right arm, make sure all involved knows it is the right arm. Make sure the site is marked before surgery.
8. Make sure someone is in charge of your care. This could be your personal physician. You need a point person to direct your care.
9. Make sure that all health care professionals involve in your care has your important health information. I love patients who come in with a written history. It is important that healthcare professional know your allergies, past surgeries, past and current medical conditions, etc.
10. Have a family member or friend designated as your advocate. Ask that person today. Make sure they know your medical history and your preferences in regards to medical care.
11. Before a test or treatment, ask why it is needed and how it can help you. Be informed before you consent.
12. If you have a test, follow-up and get the results.
13. Learn about your condition and treatments. If you use the Internet, use reliable sources. Treatment recommendations based on the latest scientific evidence are available from the National Guidelines Clearinghouse at http://www.guideline.gov. One of my favorites is www.mayoclinic.com.
You can visit my previous blogs on detail ways to prevent medication errors. I have outlined below the top 6 tips:
1. Make sure all healthcare professionals involved in your care know everything you are taking. This includes over-the counter medications, vitamins, herbs, and dietary supplements. Review these with your doctors once a year.
2. Make sure all healthcare professionals involved in your care know about any allergies and adverse reactions you have had to any medications.
3. When you get a new prescription from your doctor, make sure you can read it.
4. Understand your medications. What is it for? How is it to be taken and for how long? What are the side effects? Can I take it with other medications? What should I avoid while taking this medication?
5. Ask the pharmacist if you have any questions about the directions on your medication labels.
6. Ask for written information about the side effects.

Be involved in your care. Ask questions until you understand. Never consent to a test, surgery, or procedure until you are informed. Do not feel like a nuisance, you are standing up for your right to safe medicine that is appropriate for you and your condition. Your diligence could save your life. Share this with your family and friends.

Adapted from Agency for Healthcare Research and Quality

Originally posted at InjuryBoard by Jan Boswell

Caps on Damages Make No Sense

Billy Cunningham — Sat, 07 Nov 2009 11:14:08 GMT

The Republican proposal on health care reform has provisions to limit compensation for non-economic injuries to persons injured or killed as the result of medical malpractice including residents of nursing home who are neglected or abused. Most of my practice over the past 23 years of my 35 year career has been representing nursing home residents. I began thinking of how I would tell clients and/or their families that nursing home neglect and abuse was included in the medical negligence bill proposed. How do I explain that injuries to the elderly, vulnerable members of our society are limited? Here are people who cannot protect themselves, who rely on nursing homes for their safety and well being, and to provide a quality of life that Congress knows what the limit of those injuries are? I thought of all the cases that I have handled involving injuries in nursing homes. The following are actual examples of victims of nursing home neglect and abuse that under the standard proposed by the Republicans would be limited in any award against the nursing home that caused the injuries or death the award.

Mr. A. who had a grapefruit sized vaginal malignant tumor that the nursing home never knew about- death case.

Mr. B. , an Alzheimer patient in a ‘special unit’ who despite no other physical diseases developed multiple state 4 pressure sores, contractures and severe weight loss – death case.

Mr. C., a smoker, who was strapped in a wheelchair and unwatched burned to death when a lighter caught his clothing on fire.

Mrs. D who was overdosed with psychotropic medications to keep her quiet and while trying to escape the torture fell in a bush and lost an eye. After this incident she was moved to a nursing home that properly cared for and weaned her off the psychotropic medications. She was discharged and the last I heard was playing the slot machines in Biloxi. Personal injury case.

Mr. E. who was beaten to death by another nursing home resident who had previously beaten other resident. No precaution was taken to protect any of these residents.

Mr. F. who was demented and known to have a desire to leave the facility and fell from an open window. death case

Mr. G. who went in a nursing home for a 21 days rehabilitation after hip surgery and developed a pressure sore so big on his leg that the leg had to be amputated- personal injury case.

When you look at the data which shows that medical malpractice is a very miniscule part of the cost of health care, you have to ask yourself whether proposed limits are fnecessary for health care reform or fair to the victims.

Originally posted at InjuryBoard by Billy Cunningham

AHA Advocates substituting good ole boys for juries

Pete Burns — Wed, 21 Oct 2009 09:14:53 GMT

The American Hospital Association is advancing a bizarre version of malpractice “reform”. It advocates substituting a local panel of experts appointed by state authorities for juries. So the state medical association would appoint doctors in each community to sit in judgment of doctors in their communities. That would be an effective way to curb malpractice suits! Suppose we gave the same opportunity to contractors, business executives, and drug companies? Industry insiders could be counted upon to reduce the cost of litigation to their comrades by shifting the burden of malfeasance to the victim. Heaven help us if we replace our venerable jury system with the good ole boy network.

Originally posted at InjuryBoard by Pete Burns

CBO Report

Pete Burns — Mon, 12 Oct 2009 09:32:58 GMT

The Congressional Budget Office has determined that limiting the rights of malpractice victims would only result in three tenths of one percent savings in medical cost. http://www.latimes.com/news/nationworld/nation/la-na-malpractice10-2009oct10,0,4877440.story

Is that small saving worth sacrificing a fundamental American value? The overwhelming majority of malpractice verdicts are based upon “never events” - medical errors which the Joint Commission on Hospital Accreditation say are inexcusable. http://www.citizen.org/pressroom/release.cfm?ID=2920. These errors include operating on the wrong limb, leaving a sponge or medical instrument in the patient following surgery, leaving an incapacitated patient unattended, prescribing or administering the wrong medication. These are not matters of defensive medicine but rather simple negligence.

Our system of justice strives to make the one who caused the injury responsible for the consequences. Forcing the victim of a “never event” to shoulder a major portion of the loss would slightly reduce the cost of medical care but it would violate our dedication to personal responsibility.

Originally posted at InjuryBoard by Pete Burns

Tort Reform - As Seen In The Movies

Pete Mackey — Wed, 23 Sep 2009 08:36:09 GMT

Remember the opening scene in the movie "10"? The elderly woman sitting in a chair against the wall lets one loose, whereupon the sleeping dog next to her bolts out of the room. As Dudley Moore watches in wonderment, the butler explains, "whenever Mrs. Kissel breaks wind, we beat the dog."

And so it goes with tort reform. Malpractice carriers raising their rates? Beat the dog. Too many OB/GYNs aren't able to practice their love with women all across this country (note to W - the awesome quote does not make up for the lie)? Beat the dog. Need to throw a bone to the naysayers in order to get a healthcare bill passed? Beat the dog. What do they do when beating the dog doesn't lower malpractice premiums or lower healthcare costs? At that point, it doesn't matter, because it was never about the dog, anyway.

Originally posted at InjuryBoard by Pete Mackey

Study Does Not Support Changing Med-Mal Tort System

Billy Cunningham — Fri, 18 Sep 2009 13:34:43 GMT

In December, 2008, the Congressional Budget Office (“CBO”) prepared a study paper entitled Key Issues in Analyzing Major Health Insurance Proposals. One of the issues addressed were proposals which seek to change medical practices by focusing on the ways in which patients and medical providers settle disputes about treatment. That is a fancy way of saying proposals to modify the laws about medical malpractice.

The study found that in 2003 approximately 181,000 severe medical injuries occurred in U.S. hospitals that were attributable to negligence. Only 17% of those patients chose to file a malpractice claim. Interestingly, the study reported that patients who did not file a claim may have been unaware that the negligence had occurred, or they may have been discouraged from filing a lawsuit because of the time, effort and expense involved.

In 2008, CBO estimated that healthcare providers are likely to spend more than $30 billion to defend against and pay medical malpractice claims. However, that money represents about 1.5% of national health expenditures and less than 3% of total payments to doctors and hospitals. The report goes on to discuss caps on award damages in medical malpractice cases and determined that savings resulting from such caps would reduce total healthcare spending by less than 0.2%. The bottom line of the study by CBO was that it had not found consistent evidence that changes in the medical malpractice environment would have a measurable impact on healthcare spending. With such a small percentage of the overall health care costs involved, you wonder why there is such a clamor for change? Could it be that insurance companies see another way to make even more money while denying the injured their day in court?

In summary, this study produced during Bush’s administration does not support a change in our medical malpractice system. The changes proposed all involve a federal type system. A federal system is contrary to what most tort reformers advocate out of the other side of their mouths-state’s rights. For example, in the two states where I practice, Mississippi has very restrictive punitive damages laws and Alabama has very restrictive standards of proof in medical malpractice cases. Why can’t the states control their own destiny over such a minute matter in the healthcare debate?

Originally posted at InjuryBoard by Billy Cunningham

Replace "Deny & Defend" with "Honesty & Apology"

Pete Burns — Sun, 13 Sep 2009 12:41:06 GMT

Tying “Tort Reform” to health insurance reform could benefit both the doctors and the patients. The typical victim of a medical error wants fair compensation not a lawsuit. Most doctors who negligently injure a patient would rather that their insurance company quickly settle the matter than go through a lawsuit.

The University of Michigan Health System started a policy of “honesty and apology” in 2002. CBS reports that the policy change has reduced claims from 262 in 2001 to 83 in 2007. Fewer claims have allowed the system to drop its malpractice insurance cash reserves from 73 million to 13 million. http://www.cbsnews.com/stories/2009/09/12/eveningnews/main5306072.shtml

Wouldn't it be appropriate to reduce medical malpractice litigation by encouraging insurance companies to pay legitimate claims? After all, that is why doctors buy insurance.

Originally posted at InjuryBoard by Pete Burns

Health Care Crisis- Common Sense Approach or Political Football

Billy Cunningham — Fri, 11 Sep 2009 16:43:32 GMT

In last Wednesday night’s address, President Obama directed the Secretary of Health and Human Services to move forward on Bush administration initiative of demonstration projects in individual state to test whether doctors are truly practicing defensive medicine contributing to unnecessary costs, how to put patient safety first and to let doctors focus on practicing medicine. This statement was one of the few times the Republican side of Congress stood up to clap. But what is really happening? What will these projects discover?

The priority should be safety of the patient. I trust no one can disagree about that. Critics on the right have and are continuing to cite the lack of tort reform as a major deficiency of the current proposals on the medical crisis debate. Big business and the U.S. Chamber of Commerce have spent millions of dollars in a public relations campaign aimed at demonizing trial lawyers, portraying them as unethical con-artists out to game the system. Never have I seen them cite the 2007, Congressional Budget Office study that estimates that costs associated with medical malpractice claims only amounted to 2% of overall health care spending. Nor have they cited a number of other studies that suggest that the high cost of medical insurance has virtually no correlation with the frequency or amount of malpractice payouts but is actually a result of insurance companies playing the market and—in some cases—intentionally misrepresenting the influence of malpractice payouts in order to keep premiums high.

Mike Ferrara in his blog of September 7 referred everyone to Texas with all its caps passed in 2001, but which has "three of the top ten most expensive cities in the country to receive health care: McAllen, Harlingen and Corpus Christi. In each of these cities, every Medicare patient is costing the country more than $10,000 a year (a couple thousand more than the national average)."

Shouldn’t Congress and the medical community be focusing on real solutions to our health care crisis? Let’s face it medical malpractice is real and profoundly affects the victims when physician, hospital, nursing home and other health care providers violate the standards of care each promise to provide. Why shouldn’t they be held responsible like you or I are when they run medical stop signs and injure somebody? According to studies conducted over the last decade, up to 98,000 people die every year as a result of an estimated 15 million instances of PREVENTABLE medical errors. These statistics place death by malpractice as the 6th leading cause of death in the United States.

Lest we forget, the 7th Amendment to the United States Constitution guarantees all Americans the right to a fair trial before a jury of their peers. This right is a foundational principle of our civil liberty. To take that away when the facts do not support the rhetoric about medical malpractice is to do exactly the opposite of what conservatives and liberals all should hold dear - each of us should be responsible and accountable before the law. The importance of a civil justice system that protects everyone and treats all litigants—rich and poor alike—as equals before the law should not be swept under the rug in guise of health reform.

Perhaps, I am worrying unnecessarily. If the projects the President is proposing are performed in a non-political atmosphere, the true facts will come to light. What I fear is that politics will control the day not common sense.

Originally posted at InjuryBoard by Billy Cunningham

Misdiagnosis

Pete Burns — Mon, 17 Aug 2009 14:36:18 GMT

Kentucky Senator Mitch McConnell is yet another anti consumer republican trying to shift the focus from insurance reform by pretending that problems in health care are the result of “junk lawsuits”. A well researched editorial published by a leading newspaper in McConnell’s home state points out that McConnell’s claims are contradicted by empirical evidence. Lexington (KY) Herald-Leader (8/16). So long as opponents of health insurance reform misdiagnose the cause of our problem they will not identify a cure.

Originally posted at InjuryBoard by Pete Burns

Finding Quality Medical Care ... And Avoiding Bad Care

Pete Mackey — Sat, 15 Aug 2009 18:22:47 GMT

When a lay person calls me about a legal problem, it is generally a friend or former client. We encourage them to call us because, although we confine our practice to civil jury trials, we want them to get quality representation if their problem is outside our area of expertise. In southwest Alabama, we know who's good and who to avoid. Medical care is no different - most doctors and hospitals are committed to quality care, but there are some to avoid.

Patrick Malone, a trial attorney in Washington, D.C. who specializes in representing the victims of medical malpractice, has written a new book on this subject - The Life You Save. I read several pages of the first chapter of the book on Amazon. It looks like a must read. Mr. Malone demystifies the process of choosing a doctor or hospital, tells you how to communicate with your doctor and lets you know the types of symptoms that demand immediate treatment. Check it out. The title of Chapter One says it all - "This Book May Save Your Life."

Originally posted at InjuryBoard by Pete Mackey