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Neuromuscular Blocking Agents Wrong-Drug Errors at PA Medical Facilities

Paul Napoli — Mon, 07 Dec 2009 11:20:59 GMT

December 6, 2009

The Pennsylvania Patient Safety Authority released a report in its December 2009 Patient Advisory regarding wrong-drug errors of neuromuscular blocking agents at Pennsylvania medical facilities.

Patients are administered neuromuscular blocking agents (NMBAs) in emergency departments, intensive care units, interventional radiology areas and medical and surgical units to paralyze skeletal muscles during surgery conducted under general anesthesia and for patients requiring intubation for airway management. The drug renders patients unable to move or breathe and can be especially dangerous if administered to a patient not properly ventilated. They do not affect the patient’s level of consciousness, anxiety or ability to feel pain.

NMBAs are considered high alert medications because their misuse has the potential to cause catastrophic injuries or death. They should only be administered in a facility with proper equipment for intubation and oxygen administration and personnel trained to perform respiratory support and airway maintenance.

The Authority received 154 reports of medication errors involving NMBAs from Pennsylvania healthcare facilities between June 2004 and June 8, 2009. 77.9% of these reported events actually reached the patient and 9.1% resulted in harm to the patient, which rate of occurrence is nearly 13 times greater when compared to the rate of 0.7% for all medication errors reported to the Authority in that time period.

One instance of a NMBA wrong drug error included in the Authorities report:
A patient was admitted for a planned surgery. While in holding area of the OR prior to surgery, anesthesia staff started an IV [intravenous] infusion and administered what they thought was midazolam [Versed®] 1.6 mg IV. The patient immediately began flailing and reaching up to her face, and she became apneic. Ambu bag ventilation was initiated, and pulse ox was placed and was 90%. The patient was taken to the OR to be ventilated and monitored until patient awoke (approximately five minutes). The patient described being awake and paralyzed with vivid recollection.

Wrong drug errors involving NMBAs or any other medication may have contributing factors such as unsafe storage, similar product labeling or packaging, look-alike drug names or unlabeled syringes. The Authority outlined several risk reduction strategies to prevent wrong drug errors involving NMBAs including separate storage, warning labels, limiting access by dispensing NMBAs only from the pharmacy and computer reminders for the pharmacy to verify ventilatory assistance before dispensing the drug.

Some of the most common forms of hospital negligence include wrong-site surgeries, medication errors, surgical errors, development of hospital-acquired infections, improper use of anesthesia, improper treatment of a diagnosed medical condition, failure to monitor or stabilize a patient, or improper use of a medical device. Hospital negligence can result in serious injuries and even deaths. If you have been injured as the result of negligence while you were a patient in a hospital, or if a loved one died due to hospital negligence, you may be able to file a claim and collect compensation for pain and suffering, lost wages, medical expenses and other losses. Call Napoli Bern Ripka, LLP at 888-529-4669 today to discuss your legal options.

Originally posted at InjuryBoard by Paul Napoli

AAJ Goes Underground to Debunk Rumors About Tort Reform

David Mittleman — Fri, 04 Dec 2009 10:00:00 GMT

The American Association for Justice is getting an important message across by advertising in Union Station throughout December. Blanketing the metro station’s walls, the message reads “98,000 patients may die annually from medical errors…That’s like 737s crashing every day for a whole year…Tort law won’t fix health care…Tell Congress to put patients first.” The message is meant to counter Republican attacks against healthcare reform legislation: Republicans and health insurance companies have rallied for putting limits on medical liability lawsuit awards, claiming that tort reform is the answer to the escalating costs of private health care insurance.

Union Station is one of most highly-trafficked areas for commuters travelling to our nation’s capital. The American Association for Justice specifically wants to remind Senate staffers that many people die of medical errors, and will be left with no recourse if Republicans have their way with tort reform.

As the American Association for Justice so aptly states, “health care reform is about making sure that every American has access to quality, low-cost healthcare, not about limiting the rights of innocent patients harmed by medical negligence.” Despite the opposition’s arguments, tort reform would do very little in reducing current health care costs. In fact:

· Medical malpractice is a tiny percentage of health care costs – less than one and a half percent of overall spending – according to the Government Accountability Office (GAO) and Congressional Budget Office (CBO). Restricting patients’ legal rights would have little to no effect on premiums or health care costs.

· Medical malpractice suits are less than one percent of the entire civil caseload, and have been declining for nearly a decade.

· The GAO and CBO have found no evidence of so-called “defensive medicine,” instead determining that doctors run additional tests to generate more income or help diagnose patients.

Originally posted at InjuryBoard by David Mittleman

Pharmacy Board Administers Slap on the Wrist in Death Case

Jeffrey Meldon — Sun, 17 Aug 2008 20:42:30 GMT

This week the Board of Pharmacy of the Florida Department of Health fined pharmacist Edna Irizarry $1000 and required her to attend an 8 hour continuing education course for her role in causing the death of 3 year old Sebastian Ferrero. Horst Ferrero, his father, said "The board choose to apply the minimum penalty $1000 in Sebastian's case, although the damage inflicted to my son was the maximum possible--his death."

Sebastian's father and mother, Luisa Ferrero, choose not to file suit against any of the medical personnel involved in their son's death and instead have focused their efforts on establishing reliable patient safety protocols to assure that what happened to their son will never happen to another child. The Ferrero's received a $850,000 settlement from Shands at the University of Florida and have donated all of the money to help establish a full-service, free-standing children's hospital in Gainesville.

The young child was taken to Shands hospital last October 8 for some routine tests. Based on his weight he should have been prescribed a 5.75 gram dose of arginine. Instead Irizarry, the pharmacist in charge, signed off on a dose 10 times that. Even after the child's mother questioned the nurse on duty about the dosage, the procedure continued unabated. After the child developed a severe headache Mr. Flerrerro asked the doctor on duty to check out his son but he only looked at his chart and asked the nurse how much medication the boy had received but never examined Sebastian or the bottles of R-Gene that contained the lethal dosage.

The Pharmacy Board decided to levy the light punishment based on Ms. Irizarry's lack of prior discipline for medical negligence. The Ferroro's believe that when the mistake cost their son his life, it sends the wrong message to administer minor punishment. Harsher punishment would help spread the word among the medical community, and pharmacists, in particular, that you always need to double check your prescriptions.

This is certainly not the first and it won't be the last time the medical community fails to recognize that harsh punishment will reinforce the need to protect the public from unnecessary careless and sometimes fatal acts of negligence.

Originally posted at InjuryBoard by Jeffrey Meldon

Postscript: Wrongful Death Results from Routine Liposuction Surgery

Mark Bello — Tue, 13 Oct 2009 18:48:08 GMT

This is a postscript of an October 5, 2009 blog penned by attorney and InjuryBoard member David Mittleman. I am sad to report that the family of Rohie Kah, 37-year-old mother of three who was left brain dead and on life support after a routine liposuction procedure at the Weston MedSpa in Weston, Florida, has made the tough decision to discontinue artificial life support measures. Kah's attorney, Michael Freedland, had this to say about the circumstances of the surgery:

“...at some point during the [routine] procedure...scheduled to last two hours, something went terribly wrong. "A 37-year-old, healthy mother of three shouldn't go into a medical spa for a routine procedure and come out brain dead."

Ms. Kah was scheduled for a liposuction procedure known as Carboxy Therapy, a medical procedure that improves the appearance of cellulite and stretch marks by injections of carbon dioxide. Lidocaine, a commonly used local anesthetic, was used during the procedure. Attorneys say it is possible she was given too much lidocaine; often seizures are a side effect of too much lidocaine. Medical examiners have yet to say if lidocaine contributed to her condition, but plastic surgeon Dr. Jennifer Levine of New York City said the anesthetic can prove deadly if administered incorrectly.

"Lidocaine can have a direct toxic effect, depending on the dose that's injected."

This case is in the beginning stages of an investigation, but it has been revealed that the medical facility was not licensed. However, Dr. Omar J. Brito, a licensed doctor, performed the liposuction procedure. So, what went wrong and why was the procedure performed if the facility is not licensed? Unfortunately, the answers will do little to ease the pain inflicted on the family – her husband and three young children, ages 4, 5 and 7 who are facing life without her.

Medical Malpractice is a serious issue and a leading cause of wrongful death. If you or a loved one has been the victim of medical malpractice or have experienced the death of a loved one due to the negligence of a health care professional, contact a medical malpractice attorney. You may be able to file a wrongful death lawsuit for loss of income and benefits, loss of companionship, medical bills, long-term care, and funeral expenses. If you do not have an attorney, be sure to seek a referral from a professional to a professional. Companies like Lawsuit Financial can help families locate attorneys in their needed specialty. Professional lawsuit funding can also help families deal with the financial realities that accompany the death of a loved one if caused by another's negligence. Most compassionate lawsuit funding companies will provide a complimentary assessment of a litigation situation and explain funding options. We extend our profound sympathies to the family of Rohie Kah.

Originally posted at InjuryBoard by Mark Bello

Neglect on Nursing Board Dealt with Swiftly

Shanley Monroe — Sat, 25 Jul 2009 04:13:08 GMT

One of the hot button issues facing the nation is health care reform. Most public officials agree that health care reform is necessary. The question is not whether reform is needed, but rather how to reform the system. Patients who need emergency or long-term treatment in hospitals face more than the challenge of recovery; many also face the challenge of an over-inflated medical bill. This is just one of the many reasons you may prefer to keep your hospital visit as short as possible. You trust that your caregivers are doing their best to restore you to health and help you go home sooner rather than later. After all, they’re charging you $10 for an aspirin; one would hope that kind of price tag buys you quality care and puts you on track for a speedy recovery. Unfortunately, recent reports have revealed that the Nursing Board for the state of California may have been overlooking complaints about unfit or neglectful nurses.

The Nursing Board’s failure to address problems with the state’s health professionals caused Governor Schwarzenegger to fire three of the six board members, among them the president and vice president. The official reason for the firing was the “unacceptable time it takes to discipline nurses accused of egregious misconduct”, according to The Los Angeles Times and ProPublica. Investigations have revealed that nurses throughout the state have been allowed to continue working despite misconduct that harmed patients, criminal convictions, and incompetence. The California Board of Nursing allowed nurses accused of misconduct to continue practicing with clean records. Many who had been fired or prohibited from working in other states kept practicing without facing any disciplinary action from the board. On average, The Los Angeles Times’ investigation found that the board takes three years and five months to look into a given complaint. This is more than 6x the amount of time it takes for other state boards to address complaints in Arizona, Texas, or Ohio. This means that, since the board is also responsible for processing complaints to a nurse’s record and revoking licenses, mistreatment of patients in California hospitals has been essentially ignored by the Board of Nursing for years.

In one particular case, Laguna Beach resident Spencer Sullivan became a quadriplegic after a successful neck operation in 2001. State records allege that following the operation, a nurse gave Sullivan twice the amount of medication he was supposed to receive, causing him to suffer brain damage. The Sullivan family filed a complaint with the California Board of Nursing in the months following the operation. After suing the hospital, the incident was again reported to the board in 2005, this time by the family’s insurer. Not until April of 2008 did the board file a complaint against the nurse.

If you or a loved one has been a victim of neglect or misconduct by a health professional, you should consult an attorney as soon as possible for help filing a complaint and possibly recovering damages for injuries you have suffered. If you are sick or injured, the last thing you should have to worry about is neglect or abuse from your caregiver. An attorney with knowledge of official complaints and medical misconduct can help you through the process of protecting yourself, your family, and your rights.

Originally posted at InjuryBoard by Shanley Monroe

Malpractice Trial of James Woods' Brother (Michael): The Power of Apology in Litigation

Mark Bello — Mon, 07 Dec 2009 12:18:12 GMT

I am certain that I am not telling you something you don’t already know; an apology goes a long way to beginning to repair a damaged relationship or righting a wrong. Knowing that someone is truly sorry for the hurt he/she has caused is an important step in moving forward. An apology also serves to acknowledge a mistake, intentional or unintentional, and, further, serves as notice, even if unstated, that a person will try his/her hardest not to repeat the offending conduct.

However, the apology must be sincere; a “phony” apology will have an effect that is opposite of what the apologist may truly intend. If one says “I’m sorry”, one must mean it.

As you may or may not know, the family of Michael Woods, brother of actor James Woods, has settled a high profile, hotly contested medical malpractice lawsuit against Kent Hospital in Rhode Island. Yes, there was an undisclosed financial settlement, but that is not the point. There were two additional aspects of the resolution of the case; without them, the trial would, likely, have continued to a contentious verdict and endless appeals. The two additional features of the settlement, you ask? The first was a sincere apology from hospital president Sandra L. Coletta who had dinner with the actor the evening before the settlement and offered the apology for the hospital’s role in his brother’s death. The second important feature of the settlement was a promise from the hospital to invest $1.25 Million over the next five years into the creation of the “Michael J. Woods Institute” at Kent Hospital. A separate board (which will include a Woods family member) will run the institute which will assist in developing new procedures and training for hospital staff members. Coletta said:

“We know we’re not perfect at Kent Hospital… Mistakes were made. We can do better.”

The Woods lawsuit was filed two years ago, alleging that Kent staffers missed or ignored signs and symptoms of Michael Woods’ impending heart attack. Staffers allegedly left Woods unattended, in a hallway, on a hospital gurney, until the heart attack occurred and killed him. The highly publicized and contentious lawsuit included harsh public words of criticism for the hospital from James Woods. At a news conference announcing the settlement, James Woods praised Coletta and called her “very gracious”. This is quite a change in rhetoric; it is amazing what a sincere apology can accomplish. James Woods said that Coletta had apologized to his family and, further, admonished the press:

“Let’s not rub anyone’s nose in anything,” he said. “They did do it (the apology) and people don’t do it…I don’t want to put her in the position of saying it twice.”

He indicated that the apology was the framework for the settlement. The process started with a phone call from the hospital president; during the call, Woods said, he heard something he had been waiting to hear for over two years: Someone from Kent Hospital was saying “I’m sorry” for his family’s tragic loss.

Ironically, the definitive book on the subject of the effect of an apology to patient or a patient’s family who believes to have been wronged by a hospital or physician was written by someone named (I kid you not) Michael Woods; the book is called “Healing Words: The Power of Apology in Medicine”, by Michael Woods, MD. In the book, "the other Michael Woods" opines that the words "I'm sorry" do not seem to be in the average doctor’s playbook when conversing with patients or their families. Dr. Woods offers his colleagues his "four R's of apology", to help assuage patients and reduce the incidents of malpractice lawsuits. The “four R’s” are:

· Recognition - Knowledge that an apology is in order. Read the feelings of the patient and family.

· Regret - Respond with appropriate empathy. Express regret for what the patient or his family is going through. Acknowledge their feelings. Expressing regret is not an admission of guilt or fault.

· Responsibility - Own up to what's happened and be accountable, even if it was unforeseeable. Disclose and explain details that led to the outcome.

· Remedy - Do what it takes to make it right. Explain corrective measures to the patient and his family. Make them realize that you will not to abandon them.

Here is more from Dr. Woods:

"No matter what role you play (in the health care field)…at one time or another you've been a consumer of medical services. Try to remember the last time a doctor apologized to you, even for a relatively minor infraction like keeping you waiting. Can you recall a single instance? If you're a clinician, consider these questions: When was the last time you told a patient I'm sorry? When did you last hear another physician apologize to a patient?”

As an attorney with 33 years experience in handling personal injury and medical malpractice lawsuits as a litigator and, over the last 10 years, as a litigation funding specialist, I have never had the experience of hearing an apology from a medical professional to any client of mine. Lawsuit Financial has provided lawsuit funding for legal professionals all over the United States; not a single one of these professionals has ever reported that the impetus for settlement was a sincere apology. I invite legal professionals who are reading this post to comment on whether they have been involved in litigation where an apology was given and assisted in resolving the case.

Most medical professionals, I presume, are afraid that an apology will serve as an admission of liability. However, much litigation is conducted in anger; I submit, as does Dr. Woods, that fostering a less contentious legal environment, one of increased cooperation, should result in an improved, less adversarial, atmosphere for case resolution. Dr. Woods proposes an appeal to our basic humanity, an appeal to our capacity to forgive. A patient’s relationship with his/her doctor, positive or negative, will have a substantial impact on whether that patient will institute litigation for a medical mistake. And, an already positive relationship will only be enhanced by a sincere apology for a medical mistake. “Bedside manner” is an important tool for any physician. As Dr. Woods says:

“…when a doctor's interpersonal and communication skills are as good as his or her technical abilities, the results are good for everyone: better patient outcomes, more patient referrals, lower employee turnover, and better risk management."

Lawsuit Financial, the pro-justice lawsuit funding company, congratulates the Woods family and Kent hospital on sensibly resolving a contentious medical malpractice lawsuit. We sincerely hope that this resolution model becomes more prevalent in medical-legal litigation resolution.

Originally posted at InjuryBoard by Mark Bello

Virginia Board of Medicine Reprimands Doctor after Lawsuit-A Case That DID Make a Difference

Ben Glass — Sat, 07 Nov 2009 06:45:47 GMT

The Virginia Board of Medicine has issued a formal reprimand to a doctor who has now promised to refer to a specialist any patient who has complaints of rectal bleeding.

In a case handled by our office several years ago, a Virginia jury awarded $1 million to a patient whose complaints of rectal bleeding and abdominal discomfort went were diagnosed as hemmorhoids for years.

According to the Board of Medicine's order, Alan Joshua, MD has "read additional literature" about colo-rectal cancer and no longer performs flexible sigmoidoscopy or anoscopy on patients with rectal bleeding. Instead, he refers them to colo-rectal surgeons for evaluation.

At trial, specialists testified that had this patient been seen by a specialist earlier, he could have avoided massive rectal surgery that left him injured for life.

The Board of Medicine's Order Reprimanding Dr. Joshua and making Virgina safer is here.

Originally posted at InjuryBoard by Ben Glass

Lawsuit Abuse? Medical Malpractice Crisis? Shame on Doctors and the AMA!

Wayne Parsons — Mon, 06 Jul 2009 02:33:01 GMT

Headline news: Medical Malpractice Payments Fall to Record Low, Public Citizen Study Shows:

Medical malpractice payments were at or near record lows in 2008, but the decline almost certainly indicates that a lower percentage of injured patients received compensation, not that health safety has improved, Public Citizen reported in a study released today.

Medical malpractice is so common, and litigation over it so rare, that between three and seven Americans die from medical errors for every one who receives a payment for any malpractice claim, Public Citizens analysis of medical malpractice payment data and the best available patient safety estimates indicate.

For the third straight year, 2008 saw the lowest number of medical malpractice payments since the federal governments National Practitioner Data Bank began tracking such data in 1990. The 11,037 payments in 2008 were 30.7 percent lower than the average number of payments recorded by the NPDB in all previous years. Ratios of payments per capita and per physician have fallen even lower compared to historical norms. There were 13.5 payments per million physicians in 2006 (the most recent year for which the number of physicians is available), which is 29.2 percent lower than the average in previous years. The value of payments in 2008 (as distinct from the number of payments) was the lowest or second lowest on record, depending on the method used to adjust for inflation.

The sad history of doctors, the AMA and their insurance companies - along with the U.S. Chamber of Commerce - trying to fool the American public has been highlighted once more by the facts. I am waiting to see a doctor tell me that he is not on the side of the medical and insurance company scam. Lawsuit Abuse is a fiction. I am sick and tired of the Big Lie. I am trial attorney and I am proud of what I do.

The Public Deserves The Truth About Lawsuit Abuse and Medical Malpractice

Rather than spend millions to deceive you folks about lawsuit abuse why isn't the medical profession trying to find and weed out careless doctors? When did they ever do that?

Originally posted at InjuryBoard by Wayne Parsons

Physicians' Group Sues the Texas Medical Board

Brooks Schuelke — Fri, 28 Dec 2007 09:06:41 GMT

As part of Texas' 2003 tort reform, the Texas Medical Board was given more resources and more powers to police doctors. Where "regulation" through medical malpractice cases decreased, the TMB was supposed to take up the slack to help keep Texans safe.

And the TMB started going after doctors. So much so that physicians groups asked legislators to hold hearings on the new TMB enforcement. The first hearing, held in October, was an 11 hour affair where emotions ran high. But apparently, the physicians weren't satisfied. Earlier this week, a national physicians' group filed suit against the Texas Medical Board Among other things, the suit alleges the the TMB officials have numerous conflicts of interest, make arbitrary rulings on administrative matters, have breached physicians' privacy by leaking complaints to the press, and have retaliated against physicians critical of the TMB.

I don't know who is right in this fight. But I do know that the story has the potential to impact medical malpractice cases for quite some time.

Originally posted at InjuryBoard by Brooks Schuelke

The Poor Record of the New Jersey Board of Medical Examiners

Karen Gatlin — Mon, 15 Sep 2008 15:37:00 GMT

Dr. Joseph Gluck, a New Jersey pediatrician, was the former director of the New Jersey Board of Medical Examiners from 1998 to 2006. It was therefore surprising to hear him recently state that the board does not properly review complaints and has failed to protect the public against incompetent and, perhaps, dangerous physicians. New Jersey has one of the ten worst records in terms of imposing sanctions on physicians who are a danger to the health and safety of the public. Instead of revoking licenses, the board has often imposed a reprimand or suspension, allowing physicians to maintain or resume their practices after a short period of non practice. There needs to be more oversight of the Board to ensure that proper action is taken to protect New Jersey citizens from incompetent or impaired physicians.

Originally posted at InjuryBoard by Karen Gatlin