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Articles Posted in Hospital Negligence

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Hospital PatientMost medical devices used by hospitals are legacy devices that are still operating on Windows 7 that Microsoft no longer supports.  Manufactured at a time when cybersecurity was not a preoccupation, these devices can now easily be hacked and potentially be dangerous to patients. As a result, on top of safeguarding traditional IT assets, hospitals now have to figure out a way to secure tens of thousands of legacy devices from hundreds of manufacturers connected to their network.  It is a real headache for most hospitals and healthcare organizations as many of them do not even keep an inventory of their medical devices. According to a recent study only 36% of healthcare organizations know where their medical devices are.

While some devices that can cause fatal injuries, such as insuline pumps or pacemakers, are being actively monitored and recalled by the FDA, it is estimated that all other medical devices have an average of more than 6 vulnerabilities per device and that 40% of devices used by hospitals are at the end-of-life stage and do not have security patches or upgrades available.

Not surprisingly, FDA regulations in this field are lagging with the agency only saying both hospitals and manufacturers are responsible for protecting devices from cyber attacks. Hospitals are pointing fingers at manufacturers for not providing the necessary support and want the FDA to mandate lifetime support of medical devices by manufacturers.  So far, the further the FDA went was to publish post-market guidance for medtechs on what they should do to secure their products. This is not enough as hospitals find themselves dealing with thousands of devices that they are supposed not only to track but also patch to prevent cyberattacks. With the ongoing Covid19 crisis, hospitals are unable to handle this task and as a result they become increasingly vulnerable to cyberattacks that could injure or kill patients.

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hospital readmission can be negligenceExcessive patient readmissions is usually a sign of hospital negligence. Not only can it worsen the patient’s condition and extend recovery time but it also increases the patient’s bill.

In order to curb readmission rates and make sure hospitals pay more attention to patients after their departure, the Hospital Readmission Program (HRRP) was created in 2010 as part of the Affordable Care Act. It took effect in October 2012 and since then, bad players with high readmission rates are being penalized by Medicare and get their payment for each of their Medicare patients reduced by up to 3%.

A total of 3,046 hospitals in the country are included in this program while hospitals treating children, veterans and psychiatric  patients are excluded.

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FDA-logoAfter a recent study pointed fingers at the mismanagement of medical device recall by the FDA (see previous blog),  further investigations are confirming an outdated and broken system that leaves patients at risk of serious injury and death as unaware doctors continue to use defective devices on their patients.

A recent example of this outdated process is the recall of a sleep apnea ventilator device manufactured by Philips. It is not clear so far as to when exactly, Philips executives found out that the foam used to dampen the noise of the machine was breaking down and could potentially be inhaled or ingested by patients, exposing them to carcinogenic or toxic effects. However, the company announced publicly, on April 26th, while reporting Q1 earnings that it was creating a provision of 250 million Euros to cover costs related to possible risks to users in some sleep and respiratory care machines. While the company had probably already identified that the defective devices were the ones manufactured between April 2007 and April 2021, it waited almost two other months to initiate a recall and warn consumers of potential carcinogenic and toxic effects.  After the issuance of the recall, the FDA issued a safety communication on June 30. It took until July 22nd for the FDA to classify the recall as class I event and publish a public notification.

Does this mean that all patients have been contacted and had their ventilator changed? Not at all. In the actual process, the customers of the manufacturer, such as the hospitals, the providers, the retailers or the distributors are in charged of contacting the patients and they usually don’t do it.  Instead, doctors wait for the patients to come in with symptoms.

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metal in mask MRIThe FDA recently received a complaint from a patient whose face was burned after wearing a facemask with metal during a MRI. The patient was undergoing a 3 TESLA MRI scan of the neck. The burns were consistent with the shape of the mask.

It is clearly negligent to allow a patient to enter an MRI without checking for metal in a face mask. Anyone who is being scheduled for a MRI procedure must be checked for metal placed in or on their body including in their face mask.

Typically, patients undergoing an MRI are submitted to a metal checklist during which they are asked if they are wearing electronic devices, had metal in their eyes, have implants, had previous surgery on their head or ears or are wearing items such as jewelry, hearing aids, medication patches and obviously these days, a mask that doesn’t contain metal.

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nursing home abuseVictims of nursing home abuse , hospital neglect or medical malpractice in New York State not related to Covid-19 can legally hold healthcare professionals responsible for their negligence again.

Yesterday, NY Governor Andrew Cuomo signed a law that rolls back the legal immunity that nursing homes and hospitals were granted during the coronavirus crisis

Since yesterday these institutions can again be held liable in criminal prosecutions and lawsuits.

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covid-19-236% of patients who are hospitalized for Covid-19 have heart injury and have a higher risk of death according to a recent study by Anu Lala, MD, Assistant Professor of Medicine (Cardiology) at the Icahn School of Medicine at Mount Sinai and published in the Journal of the American College of Cardiology.

Anu Lala’s team studied the records of 3000 patients who checked in at the emergency room of five New York City hospitals during the first two weeks of April. Among these 3000 patients. 60% of them were male. The average age was 66 year old. 25% were self-identified as African American and 26% were self identified as Hispanic or Latino. A quarter of them had a history of heart disease and another quarter had cardiovascular risk factors.

High level of Troponin is an indicator of  myocardial injury or hearth damage

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Mount-Sinai-HospitalPatient safety, infection control staffing ratio as well as patient boarding and conditions are out of control at the Emergency Room of Mount Sinai Hospital in New York. Executives who 3 years ago hired medical experts to assess the ER department issues, are fully aware of the situation but are doing nothing to improve it. According to former employees at all levels, at Mount Sinai Hospital profit comes before patient safety.  Staffers and doctors who worked there, were so horrified by the conditions of the ER that most of them quit after a few months. Dr. Eric Barton was the head of the emergency department for the Mount Sinai hospital Network for less than a year. He told the New York Post that he had to leave because the organization was not caring for patients. Nurses who quit because of the horrendous wok conditions remember seeing patients going into cardiac arrest without anyone noticing. Patients requiring critical care are often not admitted in the critical care unit timely because it is overloaded. ER Nurses who according to medical safety standards are supposed to care for five to six patients a day are assigned 14 to 18 of them a day.

Globally Mount Sinai has a solid reputation because some excellent doctors work there. It ranks #3 in New York and #14 in the US Best Hospitals Honor Roll of the US News ranking. It also ranks nationally in 9 adult and 5 pediatric specialties. Additionally the hospital was rated a high performer in 4 adult specialties and 7 procedures and conditions. The problem with Mount Sinai is that to access this high ranked care, patients are being parked in very unsafe conditions for up to two days in the emergency room or in the nearby hallways. The conditions are so bad that a worker said the emergency room at Mount Sinai look like Times Square.  While the hospital ranked well in the US News ranking  it ranks very poorly  – 3,874 out of 4,221 hospitals – in term of patient satisfaction on the NY department of Health website.

Shortly after the Post denounced the horrendous conditions at the Emergency Room, Governor Cuomo announced that he had ordered the State Health Department to probe the allegations in the Post.

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New York State hospitals and especially New York City hospitals and nursing homes are the institutions the most affected in the country by Candida Auris, a dangerous fungal infection resistant to most medications. The disease already killed a patient at Mount Sinai hospital last year and 309 cases have been confirmed in New York and 109 in New Jersey out of a total of 587 for the entire country.

Hospitals that have been contaminated by Candida Auris germs report that it is very difficult to eradicate it in the facility. It takes special cleaning equipment. Sometime tiles have to be ripped of the walls to get rid of the bug.

Candida Auris a hospital superbug invades New York

If  a loved one is in a nursing home or at the hospital ask if they had any cases of Candida Auris

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Kigs County Hospital has the highest number of wrongful death claims468 people died of medical malpractice in NYC’s public hospitals in the past 5 years according to a recent article in the New York Post.  Among all 11 HHC hospitals, Kings County Hospital in Brooklyn had the worst record. 91 claims of wrongful death related to medical malpractice were filed against the Brooklyn hospital between the beginning of 2014 and the end of 2018. Bellevue, a much larger city hospital located in Manhattan came second with 54 wrongful death claims filed against it during the same period.

The Post analysed City Comptroller data obtained through a Freedom of Information request and found that the city paid $34 million to 56 families in 2014. Among the cases closed, the Post found out that  some patients died in horrific conditions from gross medical malpractice committed by these hospitals. Among the most shocking were:

  • The wrongful death of a woman who died from organ failure after doctors at Kings County Hospital in Brooklyn ignored her tuberculosis diagnosis and botched her treatment. Her family was awarded  $3.2 million, one of the largest amounts paid by HHC to the 56 families.
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FrostbiteAs New York hospitals are gearing up for an increased number of patients visiting the emergency room for cold related injuries it is important that physicians and nurses be up to date with proper management of cold injuries as medical malpractice such as failure to diagnose and timely treat systemic hypothermia can be fatal.

In a recent article published in Medscape, Blair Peters, MD (Resident Physician, Department of Plastic and Reconstructive Surgery, University of Manitoba Faculty of Medicine, Canada) and  Edward W Buchel, MD (Associate Professor of Surgery, Section of Plastic Surgery, University of Manitoba Faculty of Medicine; Head, Consulting Staff, Winnipeg Health Sciences Centre, Canada) provide an in depth analysis of the various types of cold injuries and the most appropriate manner to treat them.

Systemic hypothermia needs immediate treatment

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