Cleveland Personal Injury Lawyer - Medical Malpractice

Medicare, Others Won't Pay for Medical Errors

Nick DiCello — Fri, 03 Oct 2008 14:59:51 GMT

The Centers for Medicare and Medicaid Services (CMS) will no longer pay for care resulting from certain medical errors widely seen as preventable, including certain "never events." For example, Medicare will not pay a hospital or physician for a surgical procedure performed on the wrong patient or on the wrong body part. Nor will Medicare pay for procedures requred to remove foreign bodies, like sponges, left inside patients during surgeries. Additional events, including certain infections, injuries from falls, and serious bed sores have also made the list of conditions for which Medicare will no longer pay. Furthermore, hospitals are not permitted to charge the patients who have been harmed by these errors.

Finally... instead of rewarding hospitals for the quantity of procedures performed, our health care system, even if only a little bit, is beginning to recognize the need to reward quality of care and prevention. This is a most welcome initiative by Medicare. Some state Medicaid programs have instituted similar initiatives, and private insurers are likely to consider following suit.

While some of the occurrences/conditions on the list certainly should never happen, sending a a baby home with the wrong parents for example, accidents do happen. We all make mistakes, and when we do, we must take responsibility. Now in the health care industry, at least from Medicare's perspective, the providers who make certain preventable mistakes are held accountable like the rest of us. None of us would pay our auto mechanic to replace the windshield he accidentally cracked while adjusting our brakes. And while this is probably a poor analogy, the underlying principal and policy is the same as that espoused by Medicare's recent policy change.

Hopefully measures like the one now in place at Medicare will proliferate and help to make our health care system safer and more efficient for everyone.

Originally posted at InjuryBoard by Nick DiCello

Nurse to Patient Ratios and Quality Health Care in Ohio

Nick DiCello — Wed, 30 Jul 2008 10:43:51 GMT

In 2004, California passed a law setting minimum nurse to patient ratios for hospitals. The law was passed in response to studies and data suggesting that the more patients a nurse has to care for, the more likely one of his or her patients will receive substandard care and attention, and suffer injury, complications, or even die. California's law establishes minimum nurse to patient ratios, in part based upon the level of care required in any given hospital unit. For example, nurses working in critical care units will be assigned to less patients than a nurse working in a unit with patients who have less serious and/or complicated medical conditions and/or who require less monitoring or care. While the ratios fluctuate depending on the type of unit staffed, the maximum nurse to patient ratio allowed in California is one nurse for every four patients. This is a significant improvement over nurse to patient ratios in several Ohio hospitals.

The debate over nurse to patient ratios is a controversial one. Most hospitals claim lower nurse to patient ratios are unnecessary and that laws that define minimum ratios will drive up the already high cost of health care for everyone. Proponents of mandated nurse to patient ratios disagree and suggest that better nursing care will reduce cost by reducing injuries and complications. Furthermore, and more importatnlty, proponents of mandated nurse to patient ratios argue that patient safety necessitates legislation establishing nurse to patient ratios in the hospital setting.

Nurses in Ohio are proposing legislation, in part in response to what they claim to be inadequate legislation already in place. The proposal is nearly ready and is called the Ohio Patient Safety Protection Act of 2008. Proponents of the legislation are hoping Ohio legislators will introduce the Act later this year.

The Cleveland Plain Dealer's Diane Suchetka recently published an article addressing nurse to patient ratios in Ohio and describing efforts to pass the Ohio Patient Protection Safety Act of 2008. See her story. Diane chronicles some of the several e-mails and stories she received about the "horrors" expereinced in Ohio hospitals due to inadequate nursing staff and attention. What is interesting about Diane's article is that she heard from several nurses, many of whom strongly agree that nurse to patient ratios, sometimes as high as one nurse to every 10 or 12 patients, are dangerously high in too many hospitals in Ohio. Some nurses have even left the profession because they are fed up with an inadequate system.

Inadequate nursing staffing patterns place all of us at risk. Furthermore, it places unreasonable burdens on our nursing professionals. Nurses are an integral part of our hospital and health care systems. Indeed, nurses are the caregiver's direct contact with the patient. Hospitals should be staffed with an adequate number of nurses and nurses should not be overloaded with patients. Adequate staffing cannot be viewed as a business decision. Instead it must be viewed, as succinctly stated by the proponents of the proposed new legislation, as a patient safety issue.

Originally posted at InjuryBoard by Nick DiCello

Apologies from Doctors for Medical Errors Reduce Lawsuits

Nick DiCello — Wed, 21 May 2008 21:26:01 GMT

People who believe they have been injured by another's negligence or reckless conduct often want an apology from the responsible party. Too often, however, as a lawyer, I have to advise clients that the civil justice system does not compel apologies or acknowledgement of wrongdoing, and that if they are looking for an apology, they won't get one by way of a lawsuit. Rather, justice is only available in monetary or equitable compensation. Given the adversary nature of the civil justice system, apologies and admissions are hardly ever voluntarily offered, or judicially compeled, to the injured. Indeed, even at trial, the "Perry Mason moments," when the witness spills it all on the stand, never actually happen.

The phrase "we all make mistakes" is entrenched in our culture and taught to all of us from a young age. Indeed, we all do make mistakes. Why then, in the context of injured persons seeking redress for mistakes, are we so reluctant to admit what we all know - that all of us make mistakes? There are several reasons those accused of injuring someone refuse to apologize, even where the evidence may be overwhelming or when the accused believes he or she made a mistake or is responsible, if at least in part. Primary among them is that an apology can be interpreted as an admission of negligence or wrongdoing, and perhaps an invitation for litigation or a powerful piece of evidence later on if the matter goes to court. Accordingly, corporations and insurance carriers generally advise against apologizing or taking responsibility.

Recently, however, there has been a movement among some hospitals and doctors to implement a policy of promptly disclosing medical errors and offering sincere apologies and fair compensation. Of course, doctors have an ethical obligation to disclose medical errors, but, what a refreshing approach in a culture of "deny and defend." This approach is radical in the eyes of many, however, if you were to ask a young child what he or she is taught to do when he or she makes a mistake, that child would most likely tell you what he or she learned from his or her parents - tell the truth, take responsiblity and try to make it right (think of the young Beaver Cleaver retrieving the baseball from his neighbor's living room).

As evidence that this approach, implemented by some highly respected medical institutions such as Johns Hopkins, Stanford and the University of Illinois Medical Center, is consistent with our generally held values, promptly admitting medical errors, apologizing to the patient and offering fair compensation seems to be resulting in less lawsuits filed against these institutions and their doctors. For example, since implementing the policy at the University of Michigan Health System, existing claims and lawsuits dropped to 83 in August, 2007, down from 262 in August, 2001 according to the Medical Center's Chief Risk Officer. See http://search.cleveland.com/sp?aff=100&keywords=doctors+apologize+for+errors.

Not only have the number of claims and suits gone down at hospitals implementing this approach of prompt and full disclosure, but because settlements are being negotiated early, the cost for everyone involved is significantly reduced by avoiding litigation.

Unfortunately, as is the case with every profession and every field, errors and mistakes occur. In the medical field, errors and mistakes often result in injuries. This is why doctors and hospitals have insurance and are required to have insurance - because mistakes do happen. Recent studies have demonstrated that one of every 100 hospital patients suffers negligent treatment and that as many as 98,000 people die every year due to medical errors and negligent treatment. Studies also show, however, that as few as 30 percent of medical errors are disclosed to patients. Finally, only a very small fraction of those injured by negligent medical care - some studies suggest as low as 2% - actually pursue legal claims. See http://search.cleveland.com/sp?aff=100&keywords=doctors+apologize+for+errors.

Institutions implementing this approach of promptly disclosing medical errors, issuing apologies and offering compensation should be applauded. However, when analyzed from another perspective, it is disappointing that this approach is considered revolutionary. After all, all this approach boils down to is taking responsibility and doing the right thing. We should not just applaud those who do take responsibility for their mistakes, we should demand it from everyone, including our doctors.

Originally posted at InjuryBoard by Nick DiCello

Gadolinium Based Contrast Agents Pose Risk for Kidney Patients

Courtney Mills — Mon, 10 Dec 2007 16:19:30 GMT

Earlier this year the FDA released an alert about gadolinium-based contrast agents, announcing its decision to ask all manufacturers of these agents to place black-box warnings on these contrast agents. Gadolinium-based contrast agents are used by diagnosticians to heighten the image quality of a magnetic resonance image (MRI).

The announced black box warning in May of 2007 came as a result of growing concerns over the injuries that the contrast agents have caused in patients who are in moderate to end stage kidney disease. Gadolinium-based contrast agents are linked in these particular patients to a disease termed nephrogenic systemic fibrosis.

There are five approved gadolinium-based contrast agents by the FDA: Magnevist, MultiHance, Omniscan, OptiMARK, and ProHance. There have been over two hundred cases worldwide reported of NSF/NFD. Patients who are considering use of contrast agents should consider screening for kidney problems before being treated with these contrast agents.

For more information on this subject, please refer to the section on Drugs, Medical Devices, and Implants.

Originally posted at InjuryBoard by Courtney Mills

New Brain Center to Open for Children in Cleveland

Jack Landskroner — Thu, 19 Jul 2007 17:31:46 GMT

Brain tumors are the leading cause of cancer death in children. More than 2,200 cases of pediatric brain tumors are diagnosed each year. This week Rainbow Babies and Children's Hospital of Cleveland announced it will will use one of its most significant gifts ever "to establish a pediatric brain tumor center, aiming to make the hospital a national research leader."

The center, launched Tuesday, is a partnership between Rainbow and University Hospitals' Ireland Cancer Center. It will create a virtual operating room that will simulate brain surgery, allowing young doctors to learn the latest techniques without having to open a child's head.

The timely and effective treatment of brain tumor is critical to the survival of brain tumor patients. With this new center in Cleveland, both the research behind the study of the behavior of tumors as well as the treatment provided to patients should flourish in what is already recognized as one of the strongest medical communities in the nation.

For more information on this subject matter, please refer to the section on Medical Malpractice.

Originally posted at InjuryBoard by Jack Landskroner

Patient Abuse Leads to Probation for University Hospitals of Cleveland

Jack Landskroner — Sat, 26 May 2007 09:35:38 GMT

The pyschiatric unit of University Hospitals of Cleveland was placed on probation by the Ohio Department of Mental Health after a grand jury indicted Herman Brown, a UH employee since April of this year, on multiple counts of rape, kidnapping, gross sexual imposition and sexual battery. "The hospital on May 18 acknowledged the rape of one patient after Brown's arrest. But the Ohio Department of Mental Health said Friday that four patients were sexually assaulted."

The state agency has put UH on probation, citing its failure to provide patient safety, staff supervision or appropriate background checks of workers.
Brown had worked at the hospital since April even though prior felony convictions should have prevented him from working there. The hospital said a temporary agency that provided Brown failed to conduct a proper background check.

State law requires that individuals employed in a capacity such as Mr. Brown, must clear a criminal background check before they are offered a position. In particular, this is a necessity when an employee will be exposed to and trusted with the care of vulnerable patients in an unstable mental or emotional state. Most mental health professionals would agree that this is a necessary safeguard which should always be followed. In this situation, Mr. Brown had a felony record and under no circumstances should he have been offered the position or the opportunity he was given by University Hospitals which provided him the unsupervised access to the victims. It is the very reason the laws requiring employment screening and background checks were put into place.

The fact that UH was relying on an employment agency does not excuse the hospital from responsibility for the injuries suffered by these innocent victims. Both the agency and University Hospitals should step up and right this wrong. Both entities must provide full public disclosure as to the circumstances of just how this reckless error occurred in order to assure steps can be taken preventing such a grave error from occurring again. The agency and hospital must also address the harm done, in accord with state law, by compensating the victims appropriately for the harm they have suffered including the cost of treatment to date, the pain they have experienced and their mental anguish as well as for their future needs including the necessary treatment and care required to heal these open wounds from the incident and to learn to live with the ugly scars which they will carry with them indefinitely.

Originally posted at InjuryBoard by Jack Landskroner

Failure to Diagnose Skin Cancer

Paul Grieco — Thu, 24 May 2007 15:04:32 GMT

As summer approaches remember that with increased outside activity comes the risk of skin cancer as a result of too much sun. Failure to diagnose skin cancer can lead too serious health problems and ultimately result in death. Recently a jury in California, found a dermatologist negligent for failing to biopsy a cyst. The patient's cyst later metastasized into cancer resulting in numerous surgeries and 24 hour around the clock care. As a result of the horrendous affect on the patient's life, the jury awarded $5.7 million to the patient and his wife.

Originally posted at InjuryBoard by Paul Grieco

Class Action Settlement Reached in Lawsuit Over Human Tissue Samples

Jack Landskroner — Sat, 07 Apr 2007 10:41:37 GMT

Previously I have blogged about the cases we are handing on behalf of recipients of transplanted human tissue stolen from cadavers without authorization from the deceased or consent from their family members. In these cases, the billion dollar a year human tissue industry shortcutted required screening processes which would have revealed that many of the unwitting tissue donors were not viable donors. As a result the recipients are now at risk for multiple infectious diseases. This, however, is not the only circumstance where surviving families have been mislead as to their loved ones remains.

A former Los Alamos pathologist has agreed to pay $800,000 in a final settlement over tissue samples taken in secret from hundreds of bodies at Los Alamos Medical Center in a Cold War-era study into radiation. Stewart was involved in a program in which pathologists at the hospital provided Los Alamos National Laboratory with tissue samples from hearts, livers, brains and other organs. Families who signed autopsy release forms were not told of the study nor were they told the tissue would end up in the hands of government scientists, the lawsuit said. The medical center and the University of California, which ran the lab at the time, agreed to settle their part of the lawsuit in 2001. More than 400 families shared $9.5 million under that settlement.

The bottom line is that it is illegal for any person or institution to alter the state of a deceased loved one without the written consent of the deceased or authorization from the surviving heirs.

Originally posted at InjuryBoard by Jack Landskroner

Nursing Homes Need to be Monitored

Paul Grieco — Tue, 27 Mar 2007 16:42:56 GMT

Nursing homes just like hospitals and doctors offices need to be properly monitored in order to prevent injury and death due to negligence. All too often negligence in nursing homes goes undetected and is ignored due to the fact that those that are patients are typically the oldest and sickest and unfortuneately can be ignored. Many states are now starting to inhance their inspections of nursing homes looking to make sure they are in compliance with applicable laws. Such laws and enforcement of the laws is just the beginning of holding nursing homes accountable. If you believe a loved one is being improperly cared for and being put at risk in a nursing home make sure you report it and take action. Everyone must speak up for those that cannot protect themselves.

Originally posted at InjuryBoard by Paul Grieco

Rise in c. diff cases is concern

Justin Madden — Thu, 22 Mar 2007 09:45:07 GMT

When doctors prescribe antibiotics such as clindamycin, patients need to be alert and concerned about c. diff. When antibiotics overwhelm the bacteria in the colon, a patient can become severely sick and dehydrated, and the colon can suffer. C. diff, if not addressed, can prove fatal. There are occasions where c. diff is the result of medical malpractice.

When prescribed powerful anti-biotics, ask your doctor many questions about what to do if diahrea, and flu-like symptoms, present. Be certain family memebers or a neighbor is aware that you are on theis medication so that they

Originally posted at InjuryBoard by Justin Madden