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To Err is Human: Building a Safer Health System: Medical Negligence Occurs but Why?

Sach Oliver — Fri, 27 Feb 2009 10:46:35 GMT

To Err is Human: Building a Safer Health System: Medical Negligence Occurs but Why?

The Institute of Medicine found a decade ago that as many as 98,000 people die every year from preventable medical errors, costing the nation an estimated $29 billion. The literature where this data is found is titled, To Err Is Human: Building a Safer Health System. The authors note medical errors kill more people than motor vehicle accidents, breast cancer, guns, AIDS, and many other harms. Matter of fact, they say medical errors are the nations 6^th leading cause of death.

The literature’s goal is to educate and set out plans to reduce medical errors and improve patient safety through the design of safer health systems. To Err is Human asserts that the problem is not bad people in health care – it is that good people are working in bad systems that need to be safer.

I agree with this literature in that most of the time it is not bad people causing harm, it is usually bad systems. Patient safety in America’s health care system should be a priority and “bad systems” should be held accountable for their actions that cause harm. Medical Negligence lawsuits are sometimes the only avenue harmed patients have to hold the “bad systems” accountable.

Originally posted at InjuryBoard by Sach Oliver

Cervical Corpectomy and Strut Graft Operations - Spinal Cord Injuries

Sach Oliver — Mon, 24 Mar 2008 07:25:44 GMT

A cervical corpectomy and strut graft operation is a surgery on the cervical spine that requires extreme skill and expertise on behalf of the surgeon. A corpectomy is surgery that relieves pressure on the spinal cord due to spinal stenosis. Spinal Stenosis is bone spurs pressing on the spinal cord. When pressure is placed on the spinal cord an array of problems can occur: walking, bowels, bladder, fine motor skills, hand problems, and other pains. The word strut graft is also known as a bone graft. When a corpectomy is performed, the front part of the spinal cord is removed by the surgeon and a bone graft is used to fill the space. Of course, if you or your family member has had this surgery you already know the above information. For a little more detail about this operation read further.

According to an article written by several surgeons from the Department of Neurosurgery at Stanford University Medical Center, long strut grafts or multiple strut grafts are vulnerable to dislodgment, displacement, fracture, and nonunion. These complications usually require a revision surgery which means something went wrong in the first surgery. In order to avoid complications the surgeon must be meticulous in the preparation of the vertebral endplate along with making the bone graft the exact size. Why is it crucial to make sure the bone graft that is placed into the cervical spine is the exact size? It is crucial because if the bone graft is too small it will move and dislodge. When a bone graft is displaced it often will protrude the spinal cord causing serious spinal cord damage that can lead to serious injury including loss of movement of legs, arms, other bodily problems. (see Management of Strut Graft Failure In Anterior Cervical Spine Surgery, Thongtragan, M.D., Balabhadra, M.D., Kim, M.D. Stanford University Medical Center, Neursurgery Focus, 2003)

Many medical articles and journals authored by some of the best cervical spine surgeons in the country explain how longer strut grafts and multi-level corpectomy procedures increase the chances of failure. Therefore, surgeons who are too aggressive and perform these multi-level procedures are increasing the risk of serious spinal cord injury for the patient.

For more information on this topic or to discuss how an attorney can assist you with a spinal cord injury, please do not hesitate to contact us.

Originally posted at InjuryBoard by Sach Oliver

Regulating the Health Care Market

Sach Oliver — Fri, 11 Sep 2009 08:55:00 GMT

Tort reform is a touchy subject. Many people argue that tort lawyers who take on medical malpractice claims are just trying to ruin doctors and get rich quick, all while driving up healthcare costs for others. However, looking at actual research, rather than repeating tired dogmas reveals the truth behind this subject.

The actual cost of medical malpractice claims equates to less that 2% of overall healthcare costs.[1] This percentage of spending is arguably low when one considers the benefits provided by this private sector regulation of doctors. In fact, the number of doctors who have ever been responsible for malpractice payments is very low. To be precise, 82% of doctors have never had a malpractice payment.[2] This proves that malpractice claims are much less common than many people think. Further, since 1991, 6% of doctors have been responsible for 58% of malpractice payments.[3]

With these numbers in mind, it is evident that many doctors will go through their entire career and will never be responsible for a malpractice payment. Does this prove that the healthcare market should be subject to less liability? I think that this would lead one to the opposite conclusion. Doctors know that they are subject to liability, and this gives them an incentive to perform adequately. Consumers of healthcare deserve to know which doctors are performing adequately, and those who are injured by inadequate performance deserve to be compensated.

The argument is often heard that those who are compensated force others into higher healthcare costs because doctors are then forced to pay higher premiums, and pass this cost on to the consumer. However, there is little correlation between malpractice premiums and malpractice payouts.[4] Rather, doctors’ premium increases can be attributed to declining interest rates and investments.[5] These are some important considerations for us during these times. Assumptions should not guide us. We should look at the facts of this subject ourselves, and encourage others to do the same.

Our firm believes the overwhelming majority of doctors are wonderful people and fantastic physicians. It is the minority of doctors who are negligent and should be held accountable for their actions.

[1] “Malpractice a Tiny Percentage of Health Care Costs,” available at http://www.justice.org/cps/rde/xchg/justice/hs.xsl/8686.htm, (accessed September 7, 2009).

[2] “By the Numbers- Few Doctors Responsible for Malpractice Payments,” available at http://www.justice.org/cps/rde/xchg/justice/hs.xsl/8692.htm, (accessed September 7, 2009).

[3] Id.

[4] “No Correlation Between Malpractice Payouts and Insurance Premiums,” available at http://www.justice.org/cps/rde/xchg/justice/hs.xsl/8689.htm, (accessed September 7, 2009).

[5] Id.

Originally posted at InjuryBoard by Sach Oliver

Failed Back Surgery Syndrome: Unfortunate Reality or a Malpractice Cover-up?

Ryan Scott — Fri, 03 Oct 2008 14:41:10 GMT

Trauma, aging, improper body mechanics and normal wear and tear can all injure your spine. And damage to any part of your back — especially pressure on your nerves — can cause pain and other symptoms.

Most back problems respond to nonsurgical treatments, such as anti-inflammatory medication, ice, heat, gentle massage and physical therapy. When conservative treatments don't help, back surgery may offer relief. But it doesn't help every type of back pain, and sometimes, it can be detrimental. Around 2000 cases of failedback surgery syndrome are produced each year in the United Kingdom alone. It is unclear how many of those cases are actually malpractice in disguise.

Patients with failed back surgery syndrome live with the constantanxiety of relapse and steady deterioration of a range of neurologicalsymptoms, yet current medical management focuses narrowly onrelieving pain. This is another strand in the web in which patientsare caught: good pain relief brings the illusion of improvedphysical ability. However, for many patients, after a briefhoneymoon period pain, spasm and weakness appear at a loweractivity level, and the web tightens to immobilize the ensnarednerve roots (and patients) even more.

Many of these patients are viewed as “fakers”, “whiners”, or just “greedy”. This is simply not the case. The real problem for victims of injury comes with distinguishing between failed back syndrome and medical malpractice. It has become all too common in cases of malpractice that surgical mistakes are lumped into the “catch-all” category of failed back surgery syndrome, and the patient is convinced that this was an accepted risk of treatment.

Be sure that your failed back syndrome is not actually a failed surgery. If the pain and symptoms increased, and you were told, “This was a possibility” or given the failed back surgery syndrome excuse, seek a 2nd and 3rd opinion. It just might be the case that your syndrome is acutally a symptom of a failed surgery.

Originally posted at InjuryBoard by Ryan Scott

Telemedicine: Bringing Experts to Rural Hospitals

Ryan Scott — Wed, 01 Apr 2009 16:57:59 GMT

Shop, email, read the news, and NOW... get medical attention! That's right, many hospitals are employing the internet to maximize the resources of specialist through telemedicine. According to the American Telemedicine Association, using monitoring devices and miniature cameras connected to the internet, many of the sickest patients are getting specialized attention from doctors hundreds and thousands of miles away.

According to the association, many hospitals, especially in rural areas, have turned to technology to improve the quality of healthcare to their patients. Just recently, a hospital in Northwest Arkansas installed the telemedicine technology in its Intensive Care Unit. The hospital links up with its parent company and sister facility in a large urban city to maximize the use of its intensivits. Intensivists are doctors specially trained to treat the most critically ill patients. With the use of this technology, intensivists in St. Louis can monitor the real-time vitals of a patient in rural Arkansas and use the cameras to zoom in close enough to count the patient's eyelashes.

The hospital claims this helps "bridge the specialty gap" that exists because smaller community hospitals cannot afford to staff such a focused specialty. The hospital says it’s like getting two doctors, one on site, the specialist on-line.

This could be great news for those of us who live in smaller communities. However, no technology will replace the need for an actual caretaker at the patient's side (even if only for the patient’s own emotional and mental well-being). Whether hospitals use this technology as a much needed supplement for stretched-to-the-max healthcare providers and not as a method to replace the human face of medicine remains to be seen.

Originally posted at InjuryBoard by Ryan Scott

Expert Doctors in Medical Negligence Cases

Sach Oliver — Mon, 01 Dec 2008 17:40:21 GMT

I have been on the phone with expert doctors all day and I am always so grateful when a doctor speaks language I can understand. Fortunately, the doctors I have been working with are willing to explain the complicated medical terminology and be patient with my questions.

Before ever calling a doctor, I will sit down with the medical records and pull up the internet. Then I will use a medical dictionary online or emedicine or medline to find each word that I do not understand. I always keep a working definitions page on each of the medical negligence cases so I can reference it throughout litigation if need be.

When working on these complicated medical negligence cases, it is crucial the expert doctor be capable of explaining all issues to me and most importantly to the jury. Because if they can’t explain something to me, it is highly unlikely it will go over real well with a jury or judge. Our firm is blessed and in turn our clients are blessed to work with highly competent, patient, and caring experts.

Originally posted at InjuryBoard by Sach Oliver

Bacterial Meningitis-Failure to Diagnose

Jeanie Oliver — Fri, 14 Dec 2007 09:30:31 GMT

Bacterial meningitis is easy to identify. Doctors just have to do the tests. Why, then, do people die every year from this disease? One of the major reasons is that emergency room personnel, especially, tend to take one look at vomiting and diagnose "nausea". They all too often leave it at that. The major symptoms for bacterial meningitis

include the following: nausea, high fever, stiff neck, confusion, sleepiness. It is so simple to tell immediately if these symptoms are potential killers with proper tests. The most important test for bacterial meningitis is a spinal tap. Because meningitis is an inflammation of the fluid surrounding the brain and spinal cord, this test will tell right away if the above symptoms are something common like the flu or a disease more damaging or deadly like bacterial meningitis. When left untreated, this disease causes irreversible damage to the brain, hearing loss, vision loss, learning disabilities, and the ultimate irreversible damage: Death. Medical professionals must take responsibility for the task of diagnosing the patient. We as patients don't know about tests that could rule out diseases like meningitis. We assume that doctors will give us tests to see if we are going to die or be damaged for life. Simply put, they don't always. Innocent people die or are irreversibly harmed every day because the doctors did not order tests.

Since young children and college students are at such a high risk for bacterial meningitis, health care professionals should automatically consider testing for meningitis when such symptoms as listed are presented by patients that fall in this high risk group. To fail to diagnose this harmful disease should be considered an act of malpractice by health care professionals. For more information on bacterial meningitis, you can contact the Centers for Diseases Control and Prevention at www.cdc.gov.

For more information on this subject, please refer to the section on Medical Malpractice and Negligent Care.

Originally posted at InjuryBoard by Jeanie Oliver

Pulse Oximetry

Sach Oliver — Thu, 04 Dec 2008 15:50:35 GMT

We handle medical negligence cases quite frequently where oxygen or the lack of oxygen is an issue. In these cases pulse oximetry comes up and naturally folks ask many questions, including myself. So, here is some information that explains the term pulse oximetry.

What is pulse oximetry?

Pulse Oximetry is a simple non-invasive method that monitors the percentage of hemoglobin which is saturated with oxygen. This data is necessary whenever a patient’s oxygenation is unstable, including intensive care, critical care, and emergency department areas of a hospital.

How is a patient’s hemoglobin measured?

A sensor is placed on a thin part of the patient’s anatomy, usually a fingertip, earlobe, or across the foot. A light containing both red and infrared wavelengths is passed from one side to the other. Changing absorbance of each of the two wavelengths is measured, allowing determination of the absorbances due to the pulsing arteria blood alone, excluding skin, bone, muscle, fat, and fingernail polish. Based upon the ratio of changing absorbance of the red and infrared light caused by the difference in color between oxygen-bound and oxygen unbound blood hemoglobin, a measure of oxygenation can be made.

Why is it so important?

Pulse oximeters may be used in a variety of situations, but are of particular value for monitoring oxygenation and pulse rates throughout anesthesia.

In intensive care oximeters are used extensively during mechanical ventilation and frequently detect problems with oxygenation before they are noticed clinically.

Safety features and hazards related to how pulse oximetry should be handled in hospitals?

When patients are sedated for procedures such as endoscopy, oximetry has been shown to increase safety by alerting the staff to unexpected hypoxia.

However, on rare occasions, oximeters may develop faults and like all monitoring the reading should always be interpreted in association with the patient’s clinical condition.

Perhaps the major challenge facing pulse oximetry is whether this technology can be incorporated effectively into diagnostic and management algorithms that can improve the efficiency of clinical management in the intensive care unit.

Pulse oximetry is probably one of the most important advances inrespiratory monitoring. Over the last 15 years, numerous studies have focused on the technical aspects of pulse oximeters and found that these intrustments have a reasonable degree of accuracy.

I would like to thank John Shaw, our law clerk, for helping me research this important topic.

Originally posted at InjuryBoard by Sach Oliver

Juvenile Diabetes

Sach Oliver — Fri, 28 Nov 2008 08:52:00 GMT

Juvenile diabetes mellitus, commonly known as Type 1 diabetes, is a syndrome with disordered metabolism and inappropriately high blood glucose levels due to a deficiency of insulin secretion in the pancreas.

Juvenile diabetes is a cause by autoimmune destruction of the B cells of the pancreas which normally secrete insulin. An estimated 1.4 million people have Type 1 diabetes in the United States.

What causes Juvenile diabetes?

The exact cause of juvenile diabetes is still unclear. However, it is believed that juvenile diabetes results from an infectious or toxic insult to persons whose immune system is genetically predisposed to develop an aggressive autoimmune response either against altered pancreatic B antigens or against molecules of the B cell resembling a viral protein. Juvenile Diabetes is NOT caused by obesity or by eating excessive sugar.

What are some of the symptoms of juvenile diabetes?

There are many symptoms of juvenile diabetes. If your child has the above symptoms, he or she must be seen by a physician as soon as possible. The following symptoms may occur suddenly. They include:

Why should parents worry about juvenile diabetes?

Consequences of unmanaged Juvenile Diabetes may do permanent damage if not caught in a timely fashion. These consequences include:

Eyes: leading to diabetic retinopathy and possible blindness
Blood vessels: increasing risk of heart attack, stroke, and peripheral artery obstruction.
Nerve: leading to foot ulcers, impotence, and digestive problems
Kidneys: leading to kidney failure.

What are the treatments of juvenile diabetes?

Diet
Insulin
Self monitoring of blood glucose
Exercise

If you have questions or concerns about this topic, please do not hesitate to contact our firm. I would like to thank John Shaw, our law clerk, for helping me research this important topic.

Originally posted at InjuryBoard by Sach Oliver

Pay First” Hospital Care

Sach Oliver — Fri, 20 Mar 2009 12:13:56 GMT

PAY FIRST” HOSPITAL CARE

A hospital in Wynne plans to require some of its patients who are seeking non emergency care to pay upfront for their care. This seems to be a growing trend in small nonprofit facilities. They plan to start within the coming months.

A Wall Street Journal article last year said it is unknown how many hospitals are requiring upfront payment such as this. In 2006, the Journal reported, about 14% of nonprofit hospitals responding to a voluntary survey by the IRS said they require upfront payments or payment arrangements before admitting patients.

Because of bad debt, patients facing higher deductibles and co-insurance than in the past, these are the reasons for the change. Critics say that this is only going to get worse as the economy remains in a downslide.

As a consumer in this economy, I would have to agree with the critics because people are losing their homes and jobs. They are having problems meeting their utilities, car payments, and credit cards. It seems to consumers that medical bills are quite a distance behind the cost of having the necessities of life.

This post written by: Leona Crowe, Legal Assistant to Sach Oliver

Originally posted at InjuryBoard by Sach Oliver