Another news report on medical errors explains that the deadliest are those in which the provider fails to perceive that a hospitalized patient is developing problems and fails to intervene before things go from bad to deadly.

The jargon used is “failure to rescue” but I don’t think that label is accurate or helpful. Failure to rescue implies that a medical provider is actively sitting and refusing to do anything, knowing that a patient is in peril. The described problem is that the provider fails to perceive that problems are imminent and fails to intervene to stop the slide.

The study apparently logs 1.12 million safety problems out of some 40 million hospitalizations studied. The study found more than 238,000 preventable deaths over a three year period.

My gut tells me that in this era of rationed care and health care for profit, bottom line considerations lead to understaffed patient care. Rushed or overwhelmed medical providers have less time for patient care. Less time means less opportunity to observe the patient and notice changes or developing problems.

As a trial lawyer, you analyze these issues in terms of what a reasonably attentive medical provider should do and what a reasonable facility should provide by way of staffing. That includes having sufficient staff that allows the provider time to get a history, examine the patient, review the charts and note the problems.  Anything else promotes care that leaves patient survival to chance.

David Sugerman

I suppose it should come as no surprise, but a new study reveals much higher than expected medication error rates for hospitalized children. Prior to the study, the accepted medication error rate for hospitalized children was two out of 100. The study reveals that the rate is more than five times higher at 11 out of 100.

That translates to 7.3 percent of hospitalized kids. Projected out, we’re talking about 540,000 kids per year.

The issue has been under study for some time, but the findings are getting more publicity because of the Quaid twins incident. Medication errors are one of those never-should-happen malpractice events. These results really raise a red flag for those of us concerned with child safety. Let’s hope that our medical providers take these findings to heart, and that they develop new approaches to eliminate these preventable errors.

David Sugerman

Very articulate 60-Minutes interview of actor Dennis Quaid regarding his first-hand experience with preventable medical errors. The video is a bit long, but it is a compelling piece.

Quaid’s twin infant children both received the wrong dose of Heparin, a blood thinner, while hospitalized at Cedar Sinai Hospital in Los Angeles. There were actually two separate overdose incidents for each baby. In each instance, hospital staff gave the drug in doses a thousand times stronger that what is appropriate for an infant.

The description is graphic. Every parent’s worst nightmare. Mr. Quaid explains what those of us who handle these cases have known for a long time. Preventable medical errors commonly kill patients.

The problem is worse because patients are at the mercy of providers. When you’re driving your car, you can drive defensively. But when your child is hospitalized, all you can do is hope and pray that everyone is being attentive.

David F. Sugerman

So this is an interesting piece on medical errors in Oregon. According to a summary on Oregon Live, 83 reported medical mistakes killed at least 24 people in Oregon hospitals in 2007. By all accounts, the numbers underreported. The numbers have increased since the 2006 report (65 cases reported).

The mistakes range from medication errors to wrong-site surgeries to objects left in patients during surgery. Of the reported errors, 30 resulted in serious injury, though “serious” is not defined.

Perhaps the biggest concern is the increase in numbers. While the numbers look low, the number of reported mistakes increased by 25 percent. Perhaps this means only that more are being reported. Still, you have to hope that we’re getting better at identifying and eliminating causes of preventable error.

The good news is that reporting systems can help increase patient safety, as long as they are properly used. Let’s hope that the reporting process starts to take the trend of cases downward.

David F. Sugerman

The Center for Justice and Democracy compiles fact sheets on a number of civil litigation topics, including case filings, litigation expenses, lawyer fees and the like.

Here’s a nice annotated summary from the Civil for Justice and Democracy of the myths connected with the civil justice system:

http://centerjd.org/MB_2007civil.htm

Two of my favorites:

1) The “frivolous lawsuit malpractice crisis” is shown to be a myth.

From an article in the New England Journal of Medicine:

“A recent Harvard School of Public Health study that closely examined 1452 closed claims concluded that ‘[p]ortraits of a malpractice system that is stricken with frivolous litigation are overblown.’[fn4] The study found that most injuries resulting in claims were caused by medical error, and that those that weren’t were, nevertheless, not “frivolous” claims. [fn5]”

Source: David M. Studdert, Michelle Mello, et al., “Claims, Errors, and Compensation Payments in Medical Malpractice Litigation,” New England Journal of Medicine, May 11, 2006.

2) And then there’s the tidal wave of litigation that is overrunning our courts because too many injured people file lawsuits:

“The number of tort trials concluded in U.S. District Courts declined by 80 percent from 1985 to 2003.”

Source: Bureau of Justice Statistics, U.S. Department of Justice, “Civil Justice Statistics,” found at http://www.ojp.usdoj.gov/bjs/civil.htm

There are all sorts of other topics covered in the CJD reports. If the general importance of the civil justice system matters to you, you might want to peruse their website, www.centerjd.org

David F. Sugerman

In the world of medical practice, there are different kinds of mistakes. Some are classified as those that never should happen. Like operating on the wrong leg or the wrong patient. Or transfusing with mismatching blood. Simple system controls should make these never-happen events the stuff of fiction.

So what happens when surgery gets done on the wrong leg or the wrong person. In the perfect world, it should be very simple. Those who made the mistake should apologize, cover the patient’s harms and losses, and improve their systems to make sure these things don’t recur. That’ s not too hard.

But that often doesn’t happen. In many cases, the hospital or physician goes so far as to bill for the mistaken procedure. Let me see if I’ve got this straight: A patient goes in for surgery on a right hernia, and the surgical team mistakenly opens the left side, checks it, finds it’s fine, and then opens and repairs the right. Tell me you’re not really going to bill for the mistake?!

Oddly enough, it happens way too often. Here’s a url of a recent summary of the issue: http://www.msnbc.msn.com/id/23341360/

Interestingly, the story talks about patients who describe themselves as non-litigous being outraged to the point of filing a claim when billed for these procedures. I know that the talk show commentators report otherwise and that politicians love to push the notion that everyone sues. Not so. From the trenches a simple truth emerges. Very few people want to revisit the mistakes that left them horribly injured, and even fewer want to go to court. But read their stories, especially if you think that the civil justice system is broken or that the courthouse doors should be locked tight against those with injury claims.

David F. Sugerman