Articles Tagged with medical malpractice

Medical technology advancements globally increase quality and length of life however they don’t come without risks and hazards. New health technologies if not proprely used can also hurt patients and lead to medical malpractice. Every year the ECRI Institute publishes a list of the top 10 Health Technology Hazards. The 2018 report just came out.  Here are the 10 most important safety issues in Health Technology for 2018:

1. Cyber security attacks

   The health care sector is the second most attacked sector by ransomewares after the financial sector. Health information not only contain patient health information but also crucial financial information such as social security numbers. Unfortunately many healthcare organizations are extremely vulnerable.  Their computers operating systems are often outdated and they are not prepared to face criminals holding patient’s information hostage and expecting payout in exchange. Last month a sophisticated group of hackers operating under the name “Dark Overlord”stole pictures from a high profile London plastic surgeon that included pictures of in-progress genitalia and breast enhancement of patients. Patients include celebrities and members of the royal family. The hackers also attacked numerous medical centers in the US last year.

In a recent study,  a majority of doctors said they overtreat patients because they fear medical malpractice lawsuits. Not only is this fear exaggerated but also doctors seem to use it as a good excuse to perform unnecessary procedures that are very profitable to them.  For example angioplasty procedures to implant heart stents in patients are among the most overused interventions. Many procedures not only put patients at risk unnecessarily but inflate the nation’s medical bill.

In the study “Overtreatment in the United States” published in PLOS One yesterday, Heather Lyu from the Department of Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, United States of America, Tim Xu, Daniel Brotman, Brandan Mayer-Blackwell, Michol Cooper, Michael Daniel and Elizabeth C. Wick from the Department of Surgery and the Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America,  Vikas Saini and Shannon Brownlee from The Lown Institute, Boston, Massachusetts, United States of America and Martin A. Makary from the Department of Surgery and the Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America surveyed 2,106 physicians about over treatment. The survey found that according to physicians themselves,  20% of  all medical care provided to patients are unnecessary.  Physicians indicated that they felt 25% of tests, 22% of prescription medications and 11% of procedures were not needed. 85% of doctors  said they were over treating for fear of medical malpractice and 59% because they were pressured by their patients. However 70.8% of them recognize that when they over treat patients, physicians tend to perform unnecessary procedures that are the most profitable to them. Over treatment can cause additional and unnecessary harm to patients  and obviously unnecessary financial burden to patients and to insurance companies. Spine surgery, operations done to narrow blood vessels in the leg or stent procedures are all profitable procedures that are the most often found unnecessary for the patient.

Picture: courtesy of Wikipedia

In 2003 Florida lawmakers decided to limit non economic damages for negligence of practitioners to $500,000 or $1 million “if the negligence resulted in a permanent vegetative state or death”.  At the time lawmakers said the cap would stop the medical malpractice insurance crisis and prevent doctors from leaving Florida. However there is no evidence of crisis Today and the Supreme Court of Florida recently ruled that this cap was unconstitutional.

The ruling arose from the case of  a victim of medical malpractice who saw the initial amount awarded by a jury substantially reduced by a judge based on this cap. Susan Kalitan had her esophagus perforated during an outpatient surgery for carpal tunnel syndrome. She spent 3 months in the intensive care unit including six weeks in a medically induced coma. She sued the North Broward Hospital District  and other people involved in her care at the public district. She was initially awarded $4.7 million  by the jury for pain and suffering. This amount was reduced to $1 million by Broward Circuit Judge Jack Tuter based on the cap described above.  After the cap was found unconstitutional by the Fourth District Court of Appeals, the hospital appealed the decision. In a 30-page opinion the Supreme Court confirmed that the cap was unconstitutional.

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Failure to provide adequate cyber security in a healthcare facility can be medical malpractice. Last year, healthcare became the most frequently hacked industry in the US. According to a recent ECRI analysis, 90% of healthcare providers suffered security breaches in the past. With attackers spending an average of 200 days in a network it is estimated that 1 in 3 Americans will have his or her health records compromised by hackers in 2016. Every patient breached record costs an average of $363. Cyber attacks cost the healthcare industry yearly an average $6 billion. Last year hackers stole $88.4 million by hacking health records.

Quest Diagnostic, a medical laboratory based in New Jersey but handling tests for many New York City Healthcare facilities just announced that it was hacked. 34’000 patients had their data exposed according to the New York Times.

Health records are the main targets of cyber attacks but medial devices are also being hijacked putting patients at risk of dangerous health incidents. To make sure patients are safe and to avoid negligence lawsuits the healthcare industry has to fight back. Equipment needs to be proprely managed and security patches need to be timely implemented. Network security needs to be reviewed on a regular basis. Vulnerable medical devices must be identified. When reusing an electronic medical device on a new patient, the medical staff must make sure that all previous data are erased.  Requests for Proposals to manufacturers or consultants must be exchanged in a cyber safe manner. New devices or patches that are added to the network must be tested before being released.

Wrong patient error is medical malpractice that can have deadly consequences. As healthcare is becoming more and more sophisticated, patients are visiting multiple care providers and their personal data are being shared through multiple IT systems. The growing complexity of the health care system has led to an increase in patient errors according to a recent report released by the ECRI Institute.

The report entitled “Deep Dive” is based on the analysis of more than 7,500 events of patient identification errors.  The researchers found that most identification errors are corrected before they affect the patients. However some do reach the patients. Some patient identification errors may have limited consequences. For example, a nursing home resident was mistaken for another resident and taken for an unnecessary exam to an affiliated hospital. Other identification errors can have dangerous consequences. An infant was infected with hepatitis B after receiving breast milk pumped from the wrong mother. Some wrong patient errors can be fatal. A patient who suffered cardiac arrest was not resuscitated because the medical staff followed a “do-not-resuscitate” order from another patient.

Wrong patient errors can happen at all stages of a medical process, from registration to electronic data entry, surgical intervention, medication administration, diagnostic or blood transfusion. They can occur in various settings such as nursing homes, doctor offices, hospitals or pharmacies. They are not only committed by doctors but also by nurses, transporters, medical secretaries or anyone else from the medical staff interacting with the patient. Often as the patient is mistaken for another one, the error doesn’t affect only one person but two.