Tampa Bay Personal Injury Lawyer - Medical Malpractice

Inadequate Staffing Takes its Toll in Health Care Industry

Don Greiwe — Mon, 20 Jul 2009 11:02:49 GMT

Recently, the American Nurses Association (ANA) released the results of an ongoing survey of nurses across the U.S., and the findings are grim. The survey received more than 15,000 responses from nursing professionals, and an alarming number of respondents reported insufficient staffing and a decline of care. Specifically, 50% of nurses say they would “not feel confident” having a loved one receive treatment in the facility they work in, and a shocking 72% believe that the staffing in their unit is insufficient. The staffing insufficiency has taken the largest toll on nurses - most are rarely afforded a full meal break and many have been forced to take on additional duties. Over half are considering leaving their current position, and nearly a quarter are considering leaving nursing all together.

For too long, nurses have been overworked and underappreciated. And in today’s health care climate, nurses have just as much impact on patient care as doctors. The ANA has launched a grassroots campaign entitled “Safe Staffing Saves Lives” to help better the work environment for nurses. A fitting name, the campaign focuses on the importance of adequate staffing in the health care industry. To date, 12 states – CA, CA, CT, IL, ME, NV, NJ, OH, OR, RI, TX, VT, WA – and the District of Columbia have adopted regulations addressing nursing staffing. But for many hospitals in Florida, there simply aren’t enough nurses to meet demand. One such example is Tampa General Hospital – which alone has 53 nursing positions open at the time of writing this. And the Florida Center for Nursing forecasts that the shortage is going to continue to grow.

There are a lot of things that need to be done to improve the state of patient care in America. The first step to any successful medical unit is adequate staffing. While some hospitals take the necessary steps to recruit an adequate staff, many others try to get by with the bare minimum. This bare-bones business model has taken its toll on nurses, and surely has taken its toll on patient care. A shortage of nurses can likely be linked in part due to the poor work environment nurses are subjected to daily. The nursing profession has one of the highest turnovers of any industry. And with 25% of those surveyed considering leaving nursing all together, it becomes a downward spiral that will only get worse unless something radical is done to better handle staffing shortages.

Originally posted at InjuryBoard by Don Greiwe

Doctor, Pharmacist Errors Lead to Acetaminophen Overdoses

Joe Saunders — Mon, 13 Jul 2009 14:50:26 GMT

When doctors prescribe pain medicines such as Percocet and instruct their patients to take one or two pills every four hours, they may be liable for acetaminophen overdoses. While prescribing such pain medicines, doctors often focus their attention on the amount of narcotic prescribed and fail to recognize that the amount of acetaminophen in those doses far exceeds the four gram safe limit of acetaminophen. Such errors may result in liver injury, liver failure and death.

Doctors are not the only health professionals liable for such errors. The pharmacists who fill such prescriptions may also be legally liable for the acetaminophen overdosage. Drugs containing acetaminophen are ubiquitous and healthcare professionals must take into account the overall acetaminophen a patient may be taking at a given time. Acetaminophen is found in commonly prescribed painkillers, Tylenol, cough medicine as well as many other over the counter medicines. Consumers should also be aware of the amounts of acetaminophen they're ingesting. The consequences of ignoring acetaminophen use can be fatal.

Originally posted at InjuryBoard by Joe Saunders

What the heck is going on in VA Hospitals?

C. Todd Alley — Mon, 06 Jul 2009 23:31:13 GMT

Two shocking news reports highlight the growing concern about VA hospital negligence and the quality of care provided to our soldiers stateside.

In the first article, reports from the New York Times and the Philadelphia Inquirer last month indicated that during a six-year period at the Veterans Affairs Medical Center in Philadelphia, approximately 92 of 116 Veterans were given incorrect radiation doses in a common surgical procedure to treat prostate cancer called brachytherapy. During this procedure, radioactive seeds are implanted surgically to kill cancer cells in the prostate. The procedure is considered relatively simple, yet investigators found that most veterans got significantly less than the prescribed dose while others received excessive radiation to nearby tissue and organs. Dale Warman of the Philadelphia VA Medical Center stated that all of the patients affected were notified and received follow up care rectifying the mistakes. Four of those patients have since died, although Mr. Warman indicated to reporters that none of the deaths were related to the botched procedures.

In an even more startling report, last month a congressional panel questioned officials at the Department of Veterans Affairs after 10,000 veterans were exposed to HIV and other infectious diseases from contaminated colonoscopy equipment at three Southeast VA hospitals (Miami, FL, Murfreesboro, Tenn., and Augusta, Ga). Some former VA patients had colonoscopies performed as long ago as 2003. Patients are at risk because according to reports, the equipment used may have been improperly operated or cleaned. As of mid-June, the VA’s Inspector General reported that six veterans taking the follow-up blood checks tested positive for HIV, 34 tested positive for hepatitis C and 13 tested positive for hepatitis B. All but 724 affected patients have been notified of test results.

Questions have been raised whether the problem is isolated to only a few VA hospitals, or if it is more widespread. The patients at the VA are current and former soldiers who have protected and served our country. The men and women of the armed forces deserve the highest quality healthcare in America. But unfortunately, these appalling reports shed light on growing concern that they receiving substandard care.

Originally posted at InjuryBoard by C. Todd Alley

Health Care Industry Funds Trips for Military Doctors

Don Greiwe — Mon, 22 Jun 2009 09:36:41 GMT

Numerous health care industry corporations have been paying for the travel of top U.S. military doctors in order to influence their prescription drug medication and medical device decisions, says a disturbing new Pentagon Travel report.

In one case, medical device manufacturer Cardinal Health paid Dr. John Szabo, former chief of the pharmacy service at a U.S. Army Health Clinic in Hawaii, $5,000 to attend a “leadership conference” in 2002. Just a year prior, Dr. Szabo was given over $1,000 by GlaxoSmithKline to attend a diabetes conference. And this is just one example. The investigation found 8,700 trips by Department of Defense officials paid for by the health care industry, totaling more than $10 million, from 1998 to 2007. Top medical industry sponsors include Johnson & Johnson ($215,221), GlaxoSmithKline ($120,690), and Hologic Company ($102, 876).

Companies have been using these tactics for years. Shahram Ahari, a former sales representative for the drug company Eli Lilly & Company, bluntly explained the strategy behind the free trips: “If it costs them a thousand dollars for a dinner, that’s a [patient’s drug] payment for one month. If they fly you on the Concord to Paris for five grand, even if they get one patient out of it, it’s a lifetime of cash.”

Studies in the Journal of the American Medical Association and CHEST, a medical specialty journal, have found a link between perks bestowed on doctors and an increased likelihood that physicians would prescribe a company’s drugs. And it’s no surprise that the health care industry is taking aim at the doctors and decision makers within the Department of Defense. The DoD prescription drug budget has quadrupled since the turn of the century to $6 billion a year.

Further, a recent article published in the St. Petersburg Times on June 19, 2009, reported that Medtronic, the world’s largest medical device firm, admitting to paying $850,000 to a former Army surgeon who was later accused of forging signatures and falsifying data for a study touting the benefits of one of the company’s implants.

Washington politicians have reacted in seemingly bipartisan fashion to curb the program. Senators Chuck Grassley [R – Iowa] and Herb Kohl [D – Wisconson] proposed legislation this year that would require drug companies and medical device manufacturers to publicly disclose all gifts given to doctors valued at more than $100. The bill will also require disclosure of physician ownership in private companies.

The bill doesn’t go so far as to outlaw the program, and maybe it should. But for now, the bill is a positive step towards health care transparency.

Originally posted at InjuryBoard by Don Greiwe

Empowered at Home Act Returns to the Congressional Floor

C. Todd Alley — Tue, 16 Jun 2009 10:19:37 GMT

The Empowered Home Act is common sense. The bill looks to solve a serious health care concern by ensuring America’s senior citizens are given simple and potentially cost-saving alternatives to nursing home care.

More than one million senior citizens in America live in nursing homes, and it’s no surprise that many of them would prefer to remain at home. In fact, 89% of people 50+ want to remain in their homes as they age, according to AARP's Public Policy Institute. However, under the current Social Security Act, nursing home coverage under Medicaid is required, while home and community-based health services are optional. These optional services are often far cheaper than nursing home care – but since they’re optional, they are the first on the chopping block in a poor economy nonetheless.

The Empowered Home Act makes these home and community-based services required in state Medicaid programs. AARP President Jennie Chin Hansen put it best, “there's no excuse for a program as critical as Medicaid to force people into more expensive institutions when we could be saving money and improving the quality of life for so many Americans."

According to govtrack.us, the bill was introduced by a bypartisan group of senators in 2008. Then the bill was referred to the Committee on Finance, never to be heard from again.

Now the bill has been reintroduced on both the Senate and House floor. Sponsoring the bill on the House floor is Rep. Frank Pallone [D-NJ] and Rep. Diana DeGette [D-CO]. In the Senate, Sen. John Kerry [D-MA], Sen. Susan Collins [R-ME] and Sen. Charles Grassley [R-IA] are sponsoring the bill.

Clearly, this bill has bipartisan support. And why shouldn’t it? It reduces the overall cost of Medicaid, while giving seniors more options for care and improving their quality of life.

You can track the bill’s progress here. If you see the common sense in this bill, make sure you let your local senator and congress persons know. Click here to easily contact your local U.S. Senators and U.S. Representatives.

Originally posted at InjuryBoard by C. Todd Alley

Nearly 50% of Hospitals Don't Report Significant Physician Misconduct

Don Greiwe — Wed, 10 Jun 2009 10:45:42 GMT

Last month, Public Citizen reported a decline in physician discipline among state medical boards. Now Public Citizen has released another disturbing report on the health care industry. The report shows almost 50% of U.S. hospitals have not reported a single disciplinary action to the National Practitioner Data Bank (NPDB). The NPDB was established by the Health Care Quality Improvement Act of 1986 to protect patients from questionable physicians. Reporting physician disciplinary actions to the NPDB for misconduct resulting in a 31+ day revocation or suspension of license is required by law.

In 1991, a year after the NPDB was opened for reporting, there was 830 reports recorded. In 2007, that number was 551 (and that is not even the recent low). While it would be great to assume that this lower reportage is due to less need for physician discipline, Public Citizen has other explanations.

The report noted that some hospitals avoid the legal requirement to report moderate to long term suspensions by a number of means. One such way is changing their bylaws, intentionally making more types of misconduct warrant a suspension less than 31 days. Also, hospitals can ask the physician to take a "leave of absence" in place of a suspension. This means that the hospital would not be required to report the suspension, and thereby avoiding any blemish to their record. Some hospital officials argue that the NPDB creates an adversarial environment between the doctor and the hospital.

“It is impossible to justify the fact that thousands of hospitals, which collectively have granted admitting privileges to hundreds of thousands of doctors, have not reported a single discipline case in 17 years," said Sidney Wolfe, MD., acting president and director of Public Citizen's Health Research Group, which issued the 38-page report.

The failure of hospitals to discipline or report therefore deprives state medical boards of critical information and creates the potential for patient harm. Now is the time to revise the reporting standards of NPDB – and to close loopholes so many hospitals have used to avoid reporting physician discipline.

Originally posted at InjuryBoard by Don Greiwe

Suspicious Bonus System Leads to Injury

Jim Clark — Mon, 01 Jun 2009 16:11:27 GMT

Fox 13 Tampa Bay recently investigated a suspicious alleged bonus system in place at Brooksville Regional Hospital. According to the allegations, 47 year-old Dave Roberts arrived at the ER after injuring his back and was in obvious pain, was unable to walk, and had lost control of his bladder. The ER doctor chose only to administer two shots (presumably for pain) and ordered an X-ray. Roberts was then sent home. Three days later (the next business day), Mr. Roberts went to a specialist who immediately recognized the severity of the spinal injury and emergency surgery was performed. Unfortunately, Mr. Roberts suffered severe, permanent injury, which according to the lawsuit, was a direct result of Brooksville Regional’s hurry to get Roberts out the door.

It has been uncovered that Brooksville Regional gave a financial incentive to ER physicians for moving patients quickly through the ER. Allegations suggest that ER doctors were offered a quarterly bonus if the average length of stay for a patient in the ER was less than two hours. The hospital is likely using these incentives to decrease the waiting times of patients in the ER (a desire fueled in part because ER wait time is a hot advertising trend) – which by itself is a good intention. Unfortunately some hospitals, such as Brooksville Regional, appear to have decided to rush ER visits instead of adequately staffing their emergency room department.

This bonus system clearly causes a conflict of interest between the doctor’s professional duty of care and the Hospital’s interest in profit and reputation. Bonuses are common in the industry, but a bonus which directly contradicts the ability for a healthcare professional to provide adequate care is unacceptable. And for patients like Dave Roberts, it can ruin lives.

Originally posted at InjuryBoard by Jim Clark

New Report Suggests Declining Physician Discipline

C. Todd Alley — Mon, 27 Apr 2009 10:28:33 GMT

Public Citizen, a well-known, well-respected non-profit public interest organization, just released its yearly study of state medical boards for 2008. In this study, Public Citizen tracked the records of all 50 state medical boards’ serious disciplinary actions. “Serious disciplinary action” means actions which include revocations, surrenders, suspensions and probations.

The report consists of the number of serious actions taken per 1000 practicing physicians in each state. It then determines nationwide and statewide trends. Since 2004, serious actions taken nationwide are down over 20% (3.72 to 2.92). Without any data to suggest that perhaps there is simply less number of physicians “deserving” of discipline, the data can only suggest that the variability is a result of changes in boards’ practices. This being the case, medical boards across the nation are “dropping the ball” when it comes to protecting patients from doctors who need to be disciplined.

Most worrisome about the report is finding that Florida ranks in the top 10 worst states when it comes to serious disciplinary actions taken. Florida had always been ranked fairly low, however 2008 was by far their “worse” year. Dr. Sidney Wolfe, acting president of Public Citizen, says the change may be attributed to budget constraints, limiting the board’s ability to investigate complaints or open up their own investigations. Such a poor ranking may also be indicative of poor leadership, lack of true independence from state medical societies, or an unreasonable legal standard for disciplining doctors.

Many feel that lessor penalties – such as fines or reprimands – do not do enough to get the attention of the medical community. If the state medical boards, including Florida’s, do not rigorously punish all those medical doctors deserving of such punishment, then it simply isn’t fulfilling their obligation to the state, to the community, and to the patient.

Originally posted at InjuryBoard by C. Todd Alley

National Standards Planned to Measure Physician Performance

Brenda Fulmer — Mon, 14 Apr 2008 18:13:00 GMT

According to an article published April 1, 2008, in the New York Times, a national set of standards is currently being developed to help regulate the way health insurance companies rank physician performance, and represents a significant compromise between major physician groups (including the American Medical Association and the American College of Surgeons) and the nation's health insurers (including Aetna and United Health Care). Dr. Nancy Nielsen, the President of the American Medical Association, believes that the agreement will put an end to the conflict between insurers and doctors that has prevented development of standard criteria that assists patients in choosing their doctors. Physician report cards would be based on cost and quality of care, and insurers say they will allow independent parties to review their rankings. Previous rating efforts have been controversial since physicians claimed that health plans placed too high an emphasis on cost, and not the quality of care provided. The standards are also being supported by employers and various labor and consumer groups, organizations which helped lead efforts to resolve the differences between doctors and health plans.

According to Debra Ness, the President of the National Partnership for Women and Families, "Consumers and patients are desperate for information to make better decisions and better choices."

Hopefully, these national standards will help to assist patients in making informed decisions about choosing medical providers for themselves and their loved ones.

Originally posted at InjuryBoard by Brenda Fulmer

One out of 15 Children Hospitalized for Drug Errors

Brenda Fulmer — Mon, 14 Apr 2008 17:57:00 GMT

In a study to be released next week in the April 2008 edition of the journal Pediatrics, researchers found that roughly one out of 15 hospitalized children - a staggering 540,000 kids each year - will suffer a medication mix-up, accidental overdose, or drug reaction. This number is far higher than earlier estimates of roughly 2 incidents per 100 hospitalized children, and reinforces the need for aggressive prevention strategies. More than half of the problems were related to powerful painkillers, including overdoses and allergic reactions. The study involved a review of charts selected at random for 960 children treated at 12 children's hospitals in the United States in 2002. The study methodology identified 15 "triggers" or events that might identify possible drug-related side effects in a patient's chart (including specific antidotes for drug overdoses such as the administration of naloxone or Vitamin K, suspicious side effects, and particular lab tests). If a trigger was found in the chart, a more comprehensive review of the patients' care was then completed.

Patient safety experts said the problem is likely more wide-spread than indicated in this particular study. In particular, this study did not include general community hospitals where many children are treated, but instead focused on children's hospitals where one would presume greater protections are already in place such as proper identification and use of medications to prevent accidental administration of adult doses of powerful medications to infants and children, as has occurred in a number of recently publicized cases involving Dennis Quaid's twins and other children at an Indianapolis hospital.

Dr. Charles Homer of the National Initiative for Children's Healthcare Quality, the group that helped develop the detection tool used in this study, indicated, "…these kinds of errors and experiencing harm as a result of your health care is much more common that people believe. It's very concerning." The study's author hopes that a big push to prevent medical errors in recent years has put a dent in the problem since the data was collected in 2002.

Originally posted at InjuryBoard by Brenda Fulmer