Hospitals and medical schools are involved in heavy discussions about this problem, which has been nicknamed "distracted doctoring." University of Rochester Medical Center anesthesiologist and director of critical care Peter J. Papadakos says that what he sees is "not funny" when walking around a hospital. He says he has seen employees at all levels "glued" to their phones and other devices.
]]> Hospitals and doctors' offices are usually the ones who give their doctors and staff these devices to help them do their jobs. Doctors say that the modern medical field puts pressure on them to have instant access to data and patient information. They say they need this technology and its many benefits.However, recent cases show doctors have not only been too focused on their screens instead of their patients, but sometimes are not even doing work on them. Some examples are:
A particularly disturbing example is a recent case in Colorado, in which a man was left partially paralyzed after an operation where the neurosurgeon made around ten personal calls on his cell phone during the operation.
Hospitals are starting to limit the use of these devices in critical settings. Some doctors have also made their operating rooms "quiet zones" and banned any activity not focused on patient care. In addition, many schools are reminding their students that their first priority should be their patient. However, students find this difficult because the schools are also giving them more devices to use at the same time.
Since distracted doctoring is still a new problem, little research is available. However, doctors and nurses who engage in these activities while performing their duties are at risk of committing medical malpractice.
]]>One motivation behind the study was the lack of targeted research as to whether C-sections and vacuum devices are actually a safer way to deliver babies. At every critical stage of labor, poor choices on the part of delivery doctors, midwives and nurses can have a devastating effect on a baby's health.
Forcep-assisted deliveries of babies now represent less than one percent of delivery room procedures, down from five percent in 1990. Yet based on data from more than 400,000 births to first-time mothers, the authors found that use of forceps reduced the risk of seizure by 45 percent when compared to vacuum pumps and C-sections.
When representing a family with a birth injury claim, medical malpractice lawyers must take into account a range of complex evidence, from extensive medical records to evolving practice standards. Academic studies can provide a strong indication that procedures once thought safe need to be reevaluated, and begin to push medical professionals toward practices that are better for patients.
]]>Payments for malpractice claims based on these three categories of error increased from $21.7 million in 1991 to $91 million in 2010.
The study suggested that the increases in medical malpractice claims based on failure to diagnose may be partly due to the fact that diagnostic testing capabilities are growing much faster than the medical system's notification processes can handle.
How Can Patients Help Protect Themselves?
Unfortunately, a late diagnosis can mean the difference between survival and death for too many patients.
As the study noted, many missed or delayed diagnoses are the result of poor communication between the laboratory, the physician and the patient. Patients can help improve this communication by being proactive in their discussions with healthcare providers. Make sure you thoroughly report all your symptoms. If you were supposed to hear back about a test result and you haven't, call the doctor's office to follow up.
If you think you might have a serious illness, don't wait to go to the doctor. Make an appointment to get evaluated as soon as possible.
Not every missed or delayed diagnosis is a result of medical malpractice, but many are. If you think you may be the victim of medical negligence, contact an experienced New Jersey medical malpractice attorney who can evaluate your claim and advise you of your options.
Source: The Clinical Advisor, "Better Diagnostic Test Reporting Needed to Avoid Malpractice Claims," Ann W. Latner, Nov. 14, 2011.
]]>Medical experts have begun questioning the benefits of continued and prolonged use of bone building medication because of the medical side-effects due to prolonged use, which could potentially lead to medical malpractice claims against doctors who have overprescribed the drugs. Controversy has also arisen because of a debate over the type and language of that warning label that appears on the medication.
Recently, two Federal Drug Administration (FDA) panels met to discuss these issues. The panels discussed the injuries that have been linked to the medication. Several panelists commented that use of bone-building medications has only been shown to be effective for three to five years, but a small number of patients take the drug for longer. Beyond that time, patients have a higher risk of jaw disease or thigh fractures, according to recent reports. The panels considered whether to change the label to highlight the increased risks of long-term use, but the panel did not settle on specific language that must appear on the labels for leading bone-density drugs like Boniva, Fosamax and Actonel.
]]>Fluconazole, which also goes by the brand name Diflucan, is often given to chemotherapy patients and those preparing to undergo bone marrow transplants to combat fungi that sometimes plague patients once their immune systems are compromised by other medicines.
]]> The drug is also sometimes used to combat meningitis as well as thrush and vaginal yeast infections, among other things.According to the FDA, birth defects are less likely to occur when the drug is given in a single small dose of 150 mg or less. This is the typical dose for minor infections, such as thrush or vaginal yeast infections, according to the National Institute for Health (NIH).
But when given over a longer period of time at higher doses of 400-800 mg per day, the drug can cause problems for a developing fetus. Larger doses are sometimes given for meningitis and certain systemic fungal infections, according to NIH.
The risks associated with prolonged use of the potentially dangerous drug during the first trimester of pregnancy include bone abnormalities, cleft palate, and congenital heart disease.
Women who are pregnant should make sure to tell their prescribers about the pregnancy before taking this drug. Anyone who took large doses of fluconazole during the first trimester of pregnancy and whose baby was born with bone, palate, or heart disorders should seek professional advice about whether the drug may have caused the child's birth defect.
]]>On August 1st, the reputable journal published findings from the CUMC team in which more than 21,000 Medicare beneficiaries' records were analyzed. Reviewing data from 1995 to 2005, study subjects consisted of patients who were aged 65 and older, diagnosed with either breast, lung or colon cancer, and had at least one erythropoiesis-stimulating agent (ESA) and chemotherapy benefits claim.
]]> ESA, used to treat anemia in patients receiving chemotherapy, may have been the focus of the study; however the CUMC team discovered that the therapy causes a number of safety and cost concerns.Of the patient records analyzed, 24 percent (5,099) received ESAs for one week or less, which constituted misuse of the drug therapy. Another 7.6 percent (1,601) were prescribed the therapy in excess of 14 weeks, which was longer than the recommended treatment period noted on product labeling. Another 13.6 percent (2,876) of the patients received the treatment in the absence of chemotherapy, which was also inconsistent with product labeling. The CUMC study findings highlighted a number of issues, including inappropriate use of ESA, physician propensities to prescribe off-label, patient safety, and resource waste.
Recently the United States Food and Drug Administration (FDA) announced new dosing guidelines for ESAs when prescribed to patients with chronic kidney disease. The change was prompted by findings that ESAs increased the risks of adverse cardiovascular incidents such as stroke, blood clots and heart attack in these patients, potentially leading to medical malpractice claims.
ESA use increased 340 percent in the United States from 2001 to 2006. Considering that the National Institutes of Health reported that cancer cost the American public an estimated $263.8 billion in medical costs and lost productivity in 2010, ESA therapy costing the Medicare system an estimated $1 billion dollars each year is significant.
Cancer impacts millions of lives and patients rely on their doctors to know the risks certain drug therapies have on their life and health. The CUMC study proves that doctors need to be better educated on treatment interventions or their patients will suffer the consequences.
]]>Breast cancer screening guidelines have been a source of debate for some time. In 2009, the United States Preventive Services Task Force weighed in on the issue. The Task Force, reviewing and analyzing new data, suggested a different protocol. Instead of screening starting at age 40, the Task Force recommended biennial mammography screenings for women aged 50 to 74. However, a change in the screening process could lead to many doctors failing to diagnose and detect the cancer.
Groups such as the American Cancer Society and the American College of Radiology strongly disagreed with the Task Force's recommendation and announced that they would continue recommending annual screenings starting at age 40, which is consistent with the new ACOG guidelines.
Mammograms, according to some breast care experts, are imprecise and can lead to inaccurate results. These results have led to patient anxiety and unnecessary treatments and procedures. Still, mammograms are seen as a vital tool in reducing breast cancer mortality in the United States.
The Centers for Disease Control and Prevention (CDC) predict that 450 men and 39,520 women will die from breast cancer in 2011. The CDC also estimates that another 2,140 men and 230,480 women will be diagnosed with the condition this year. Early detection has been the key to saving lives. While the medical community debates proper treatment courses for patient, the real test is that doctors need to tailor patient care based on the individual's needs.
]]>The main proponents, Dr. Anil Potti and Joseph R. Nevins, published their study in 2006, claiming that it had been a great success. The physicians started three clinical trials where some of their methods were put in place. The entire cancer community was increasingly excited about the potential the study offered.
However, when other physicians and organizations reviewed the study, several potential problems began to emerge. After a four-year period of scrutiny and review, the entire study was discredited due to unreliable data. Duke shut down the trials, and redacted the published research. Some of the study's participants died while receiving treatment proscribed by the Duke team, leading to several medical malpractice lawsuits against the university.
While initially offering great promise, gene research continues to try to find a way to accurately diagnose and treat different types of cancer. Those who have the disease are encouraged to speak to their physicians to learn about the best potential treatment options available. Do not be afraid to seek a second or third opinion, as often different doctors will have different ideas that may be helpful for you.
]]>While the shifts may be physically demanding, it allowed student doctors to get an opportunity to see several different types of injuries and illnesses. Having had the chance to both participate and observe in the treatment plans for a wide range of conditions allowed student doctors to be ready when they faced these issues on their own.
]]> Unfortunately, the long hours led to mistakes - in correctly diagnosing injuries as well as proscribing proper treatment plans. This caused officials with the Committee of Interns and Residents, the union for student doctors, to create new rules that limit the hours a student doctor may work. This union works with student doctors in major public hospitals, including facilities in New Jersey. In the past, students frequently worked 100-hour work weeks, sometimes having shifts that ran at least 30 consecutive hours.The union previously had managed to impose limits that restricted a student doctor to a maximum shift length of 16 hours. Proponents of the change hope that these restrictions will reduce the number of mistakes that occur, which often lead to medical malpractice cases. Student doctors will no longer be forced to work past the point of exhaustion, and will have the time to learn more about medical conditions that may be affecting their patients.
However, the patients may be the ones who suffer the most due to these changes. When a student doctor's 16-hour shift is up, he or she leaves the hospital. This means that a new doctor will have to take over, which could lead to gaps in patient care. Additionally, when the doctor is practicing professionally, he or she will not have been exposed to as many issues as student doctors have in the past. As more doctors finish their residencies, the true impact of these changes on patient safety will become clearer.
]]>Any major surgical error can be devastating, but a wrong-site surgery is one that is especially frustrating for patients. For example, doctors have been known for amputating the wrong limb, necessitating loss of both limbs since the correct procedure has yet to be performed. A 2006 study found that the incidence of wrong-site surgery in the U.S. could be as high as 2,700 cases per year-about seven patients each day.
]]> Although surgeons and their staff take precautions, often patients are seen by numerous doctors before the actual procedure, which can increase the chance of error. Regardless, patient safety advocates argue that these cases are preventable and should never happen.Advocates have recommended the use of a checklist, which the American Academy of Ophthalmology uses to minimize the risk of wrong-site surgeries. Unfortunately, mistakes keep occurring, such as when a nurse mistakenly wipes off a surgical-site mark. Also, surgeons can become disoriented when examining a patient and end up marking or indicating the wrong item for surgery.
Patients can ask the staff which procedures they follow to ensure that the correct body part or site is marked in the records. One recommendation from the Joint Commission's Universal Protocol is that the surgical team take a time-out and review with each other the procedure to be done.
To prevent the wrong procedure on the wrong individual, the patient can ask the staff if they know his or her complete name and birthday and ascertain that the information is noted correctly on the charts.
Reading and comprehending the informed consent form is vital for patients to ensure that errors are not made regarding the procedure to be performed, and that the correct and complete medical history is taken into account.
Finally, if the patient is not comfortable about something, he or she should make inquiries and talk to the surgeon before the procedure to allay any other fears.
]]>While many birth defects are not preventable, expectant mothers can reduce their risks for birth defects and injuries. Preventive measures include taking folic acid daily, abstaining from smoking, drinking or using illegal drugs, following prescription instructions and learning how to reduce risks for infections. In addition to these measures, mothers receiving early prenatal care can significantly reduce their babies' risk for birth defects and injuries.
]]> Prenatal care impacts fetal health, because according to health experts, most birth defects occur in the first three months of pregnancy. This is a crucial stage of fetal development, because organs and organ systems are forming.Proof that prenatal care is a key to prevention can be supported by national and international data. In March 2011, researchers in the Netherlands reported that after reviewing records from 1990 to 2005, incidences of cerebral palsy fell. The decline is attributed to sound care for at-risk mothers, proactive treatment of newborns, and improvements in prenatal care. This international study complements findings announced in the United States one month prior.
In the February 2011 online edition of the journal "Pediatrics," University of California researchers confirmed a correlation between cerebral palsy and low-birth weight babies. By analyzing over 6 million birth records, pediatric neurologist Dr. Yvonne Wu and her colleagues estimate incidence of cerebral palsy at 2 to 2.5 cases per every 1000 live births, as compared to the Netherlands study which reported 1.4 per 1000. In addition, the study found that women who do not receive prenatal care doubled their risk of delivering a child with this birth injury.
In order to reduce the risk of this incurable condition, medical professionals may need to be more proactive with monitoring expectant mothers, in order to reduce risks for brain injuries to neonates. Prospective parents have an obligation to seek competent prenatal and pediatric care for their children to ensure healthy development.
]]>The study showed the link between the opioids and the following birth defects:
While the study notes that the risk of birth defects only increased slightly with the use of the pain killers by expectant mothers, it is an increased risk none-the-less. Because the risk is known, your doctor should discuss the possible complications to your child before prescribing the pain killers to you.
If you were prescribed opioids while pregnant and you child suffered a birth defect, speak with an experienced medical malpractice attorney.
]]>One aspect of New Jersey medical malpractice claims that many people may not understand is that, under most circumstances, state law protects hospitals, medical staff, paramedics and other employees from civil liability for damages resulting from mistakes made when performing advanced life support services. The new law would expand this immunity to EMTs, nurses and other clinicians, and further defines the protected services to include basic life support.
Obviously, better training and oversight of emergency responders would be an asset for victims of motor vehicle accidents, construction accidents and other tragedies who suffer traumatic brain injuries, spinal cord damage, burns and other harm. Prompt, expert treatment is the first step toward recovery, and New Jersey needs to invest in the best support possible for its citizens. Putting patients first by holding EMS providers accountable to stricter licensing requirements and regulations is a positive step.
]]>The New York Times reports that the early discharges may be an indication as to the "intense pressure patients face when they become ill." The pressures faced are many, and could be familial, social or economic in nature, according to Anne Elixhauser, senior research scientist for the Agency for Healthcare Research and Quality, in the New York Times.
With the recession and the revelation that many Americans are without health insurance, the cost associated with a hospital stay is not insignificant. The average length of a hospital stay in 2008 was four days, at nearly $7,000 per day, according to the agency.
While the pressures that people face are not to be ignored, there should be concern that the early departures could have severely negative impacts on both the health of patients and legal recourse available to them should malpractice have occurred. If there is cause for a medical malpractice claim, the fact that a patient left early could either prevent the suit altogether or severely mitigate any damage award.
There may be pressure to leave the hospital early, but it is important to consider all of the possible consequences of doing so.
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