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Articles Posted in Medical Malpractice

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Endoscope.png30 % of duodenoscopes, 24% of gastroscopes and 3% of colonoscopes have unacceptable level of “bio dirt” from previous clients bodies leading to a potential risk of infection according to a new study by researchers at 3M infection Prevention Division and presented at the 40th Annual Conference of the Association for Professionals in Infection Control and Epidemiology (APIC).

After being used flexible endoscopes are manually cleaned by a hospital technician who will visually inspect them and then soak them in high level disinfectant. However the study indicates that visual inspection is not enough as contamination is often invisible to the naked eye. The study suggests hospitals should improve their cleaning protocol by having specific guidelines by type of instrument and by identifying if there are any critical steps missing in the manual cleaning process.

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Diagnostic errors are not a new problem, in 1991 the Harvard medical Practice Study, investigated Medical Malpractice in New York Hospitals and found out that diagnostic errors were accounting for 14% of physicians errors and that 75% of them were due to doctors negligence.

In 1999 a study from the Institute of Medicine “To Err is Human”, looks at diagnostic errors and classifies them in four different categories: error or delay in diagnosis, failure to employ indicated tests, use of outmoded tests or therapy and failure to act on results of monitoring or testing.

Despite these studies, diagnostic errors have been largely ignored until recent research calculated the impact of such errors. Results from a 2009 report funded by the federal Agency for Healthcare Research and Quality showed that 28% of diagnostic mistakes were life-threatening or had resulted in death or permanent disability.

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230px-Cerebral_angiography%2C_arteria_vertebralis_sinister_injection.JPG Angiography alone doesn’t detect Ischemia and may lead to misdiagnosis when a patient is being checked for chest pain. A routine Functional Flow Reserve Measurement (FFR) after the angiography would lead to a change of diagnosis for 1 out of 4 patients according to a new study presented at EuroPCR 2013 by Nick Curzen, Professor of Interventional Cardiology, University Hospital Southampton NHS Foundation Trust and Faculty of Medicine, University of Southampton, Southampton, UK.

Most cadiologists base their decision on the angiography only. The angiography is an X-ray of the blood vessel (see picture) that the cardiologist uses to assess if some blood vessels are blocked or damaged. The study argues that angiography only doesn’t detect ischemia, a restriction in blood supply to tissues, causing a shortage of oxygen and glucose needed to keep tissue alive. This may lead cardiologists to fail to diagnose a medical condition and to develop an inappropriate treatment plan for the patient.

Researchers, studied 200 patients suffering from Chest Pain. Each patient underwent an angiography. Based on the angiography only a cardiologist made a diagnosis and developed a treatment plan for each patient as well as recommendations for medical treatment such as percutaneous coronary intervention (PCI), coronary artery bypass grafting (CABG) or request for more information. The cardiologist left the room and then each patient had a Fractional Flow Reserve (FFR) measurement. Results with FFR were shown again to the cardiologist. Based on this additional information the cardiolgist changed the treatment for 25% of the patients.

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The average profit margin for a hospital to treat an infected patient is $ 55,000 while the margin to treat a similar patient without infection is just $ 6,500 according to a recent study from The Johns Hopkins University School of Medicine published in the American Journal of Medical Quality.

Hospitals lose on average $14,000 per patient when the bill is paid by Medicare or Medicaid but when the bill is paid by private insurance the hospital makes on average a margin of $216,000 per patient before expenses.

The study demonstrates that it is in the financial interest of private insurers to help hospitals find ways to reduce the number of CLABSI infections.

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Severely injured women are 21% less likely to receive appropriate care in a trauma center than men. Results are similar for women injured after a fall or a car accident, across all income levels and also when comparing rural versus urban patients according to a study , led by Andrea Hill, MSc, PhD, a post-doctoral fellow at the Sunnybrook Health Science Centre and the University of Toronto in Canada, and presented yesterday at the American Thoracic Society International Conference .

The researchers studied more than 98,800 patients admitted to trauma centers for severe injuries. Results show that 49.6% of women and 63.2% of men received care after being severely injured.

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Methicillin-resistant Staphylococcus aureus (MRSA) infection is caused by a specific staph bacteria that is resistant to antibiotics and therefore very difficult to treat. If not diagnosed on time MRSA can be life threatening. MRSA is a major concern for hospitals where the superbug can attack older patients or those suffering from weakened immune system. Patients necessitating medical tubing such as intravenous line or catheters are also at risk as well as patients staying in nursing homes. MRSA is also an issue in child care centers, military camps and jails.

There is an urgent need to find therapeutic ways to fight this superbug. In research appearing in the Journal PLOS ONE , Shelley Haydel, a researcher at Arizona State University’s Biodesign Institute demonstrate that particular metal ions attached to the clay may have the potential to kill MRSA as well as a range of other dangerous pathogens including E-coli. Medical property of clay has been recognized since antiquity when it was used for its wound healing property.

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There is a higher rate of failure to diagnose breast cancer among women who are screened using computed radiography compared to women who are screened using digital direct radiography according to a new study lead by Anna M. Chiarelli, Ph.D., senior scientist in Prevention and Cancer Control at Cancer Care Ontario in Toronto, and published online in the journal Radiology.

The study results show that cancer detection with digital mammography that involves direct radiography technology was similar to that with screen film mammography in women aged 50–74 years; however, for computed radiography the risk of cancer detection is significantly lower-by 21%-among all screening techniques.

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Percutaneous nephrolithotomy, or PCNL, is a minimally invasive urological surgery during which a surgeon removes medium to large kidney stones through a small incision in the back using a hollow scope. The use of PCNL is increasing especially among women and complications are on the rise particularly blood infections. Patients are at risk of developing complications if they are older, sicker and treated in more recent years. Age is significantly associated with increased odds of mortality according to a research from from Khurshid R. Ghani, M.D., of Henry Ford Hospital’s Vattikuti Urology Institute, which was published in the Journal of Urology.

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Nurse staffing directly impacts the safety of children in pediatric hospitals. According to a study, led by Dr. Tubbs-Cooley at Cincinnati Children’s Hospital Medical Center, children treated in hospitals with staffing ratios of 1 : 4 or less were significantly less likely to be readmitted within 15–30 days.

Each one patient increase in a hospital’s average staffing ratio increased a medical child’s odds of readmission within 15–30 days by 11% and a surgical child’s likelihood of readmission within 15–30 days by 48% according to the study published in BMJ Quality and Safety in Health Care

This research is coming few days after the Registered Nurse Safe Staffing bill was introduced in Congress.

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Regular mammograms allow early diagnosis of breast cancer and can save lives. For it’s annual May breast cancer awareness campaign, HCC invites New York City’s public Hospital Staff to “dedicate” their Mammogram to someone they love to promote mammograms awareness.

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