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Articles Tagged with medical malpractice

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220px-Surgeons_at_Work251,000 people died from medical error in the US in 2013. This was the third highest cause of death that year  in the US after cancer (585,000) and heart disease (611,000) according to estimates calculated by Martin A Makary, professor and Michael Daniel, research fellow at the Department of Surgery of Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.

In a recent article published in the British Medical Journal, Martin Makary and Michael Daniel explain the difficulty of obtaining the exact numbers of people dying from medical malpractice in the US and how they “analyzed the scientific literature on medical error to identify its contribution to US deaths in relation to causes listed by the CDC“.

Every year the Center for Disease Control and Prevention (CDC)  compiles data from death certificates to prepare statistics related to causes of death in the U.S. On death certificates the cause of the death is coded according to an International Classification of Disease (ICD). The CDC is using the ICD codes to prepare its yearly statistics but these codes do not capture human or system errors.  Deaths certificates from patients dying in hospitals will list a medical condition but not a medical error.

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prescription drugThe fear of providing lawyers with new weapons for medical malpractice lawsuits and the idea that the FDA wants to tell doctors how to practice medicine are among the many reasons why most physicians are still opposed to mandatory training for prescription of painkillers .  In 2012 a recommendation by an expert panel to implement such training was rejected by the Food and Drug Administration (FDA). The American Medical Association was also against the recommendation.

However since 2012 the opiate addiction problem in the US grew so big that the government is looking at all possible solutions to fight this crisis. The role of the doctor is again taking center stage as, Today and tomorrow, the FDA is convening a new panel of experts to discuss the possibility of mandatory training for physicians prescribing opiates (see briefing document for the meeting).

The Obama administration and even some drug manufacturers have now stated that they wareere in favor of such mandatory training but other organizations such as the American Medical Association Task Force to Reduce Prescription Opioid Abuse are still against it.

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surgeryToo many patients requiring complex surgery are suffering the devastating consequences of medical malpractice committed by inexperienced surgeons who negligently performed the surgery.  Some medical experts believe that there should be some type of legal way to prevent patients from undergoing high risk surgeries with inexperienced surgeons in hospitals that handle a low volume of patients. In a recent article in the Washington Post, Sandra G. Boodman writes about a long-running battle known as the volume-outcome debate among medical experts. This debate was recently re-activated by the decision of John Hopkins, Dartmouth-Hitchcock and University of Michigan to require surgeons practicing specific types of high risk surgery to meet an annual threshold to be able to perform the procedure.   In her article Boodman takes the example of a pancreatic cancer patient who suffered a botched Whipple surgery after an inexperience surgeon convinced him she could do it. The patient had to undergo another surgery where a surgeon specializing in Whipple surgery successfully treated him. Boodman also refers to several studies demonstrating that in cases of complex procedures patients undergoing surgery at hospitals with a high volume of these types of surgeries had a much lesser risk to die than those in hospitals performing a low volume of the same procedures. The author also discusses the difficulty for patients to find information about how many times the surgeon performed the risky procedure and what is his or her success rate is.

Read the complete article here

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Desmoid-type_fibromatosis.gross_pathology Although very rare, failure to diagnose and treat desmoids tumors, also called aggressive fibromatosis, a tumor that develops in the fibrous tissue that forms tendons and ligaments, can be medical malpractice. Desmoids tumors are very rare and difficult to diagnose and doctors are still debating what is the most appropriate categorization and treatment. In a recent article in the Washington Post, Sandra G. Boodman writes about a 24 year woman who suffered several episodes of excruciating stomach pain before being diagnosed and treated for a desmoid tumor.

Johanna Dickson was 23 years old when the first symptoms of the disease occured. She had just come back from South Africa when she suffered a first episode of acute abdominal pain. She thought she caught some type of stomach bug in her last trip. The family doctor sent her to the hospital for various tests but nothing was found and the pain disappeared.

Another crisis happened six months later but it went away quickly so she didn’t even bother to see a doctor.

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spinal cord injuryThe medical practice of trying to avoid scar formation at the site of a spinal cord injury may indeed not be correct. Every year approximately 12,500 American will suffer a spinal cord injury and an estimated 276,000 people in the US are suffering from long term effects related to this injury. For decades the prevailing medical dogma was that that scars were preventing neuronal regrowth across the injured area but a newly released study says it is actually the opposite that happens. Scar forming cells called astrocytes may actually help nerve regrowth.  A study recently published in Nature and authored by  Mark A. Anderson, Joshua E. Burda, Yilong Ren, Yan Ao, Timothy M. O’Shea, Riki Kawaguchi, Giovanni Coppola, Baljit S. Khakh, Timothy J. Deming & Michael V. Sofroniew found that   “scars may be a bridge and not a barrier towards developing better treatments for paralyzing spinal cord injuries.”

Read more in Medical News Today

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depressedA doctor who doesn’t screen a child treated for Cushing syndrome for depression related mental illness may commit medical malpractice.

Cushing syndrome is a rare disease that occurs when the body produces too much of the hormone cortisol. It can lead to obesity, infections, bone fractures and kidney stones. Therefore it shouldn’t be left untreated.  The disease can be caused by taking too much glucocorticosteroid medicine or by a pituitary gland tumor that releases Adrenocorticotropic hormone (ACTH) among other causes. When a child suffers from this syndrome the usual treatment is to remove the tumor that produces the excess cortisol.

A study recently released by the National Institute of Health however shows that children that have been treated for this syndrome have a high risk of developing anxiety and suicidal thoughts months after they have been successfully treated. The study looked at 149 patients and found that 6% of them thought about suicide and experienced depression, irritability, anxiety and anger with outbursts of rage after the treatment. These symptoms appeared from 7 to 48 months after the treatment.

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renal mass

renal mass in a 3 year olds child

Failure to timely diagnose Denys-Drash syndrome can be medical malpractice that can lead to renal failure and ultimately death. Denys-Drash syndrom is a very rare congenital disorder that affects young children. There are only 150 known cases in the world therefore very little information is available for doctors to diagnose and treat this disorder.

What is known so far is that  90% of the children with this disorder develop a rare pediatric kidney cancer known as Wilms tumor. Undescended testes and severe proximal hypospadias are also associated with this disorder. The Journal of the American Academy of Physician Assistants (JAAPA) recently released an article describing the case of a 3 year old patient affected by this syndrome. The authors Shawn C. Smith,  Barry Chang and Laura Beth Fleming are all from the Cardon Children Medical Center in Mesa, AZ where the patient was admitted.  The article describe how the authors of the article diagnosed the disorder and which treatments were used to treat the patient. The complete article can be found here 

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Distribution of the maxillary and mandibular nerves, and the submaxillary ganglion. Source: Wikipedia

Facial nerves, Source: Wikipedia

Failure to diagnose a rare disease called trigeminal neuralgia (TN) can be medical malpractice. The disorder can cause pain so extreme to a patient that it has been nicknamed “the suicide disease”.

In a recent article in the Washington Post, Sandra G. Boodman describes the story of a 59 year old man who almost died after a cohort of doctors he visited were unable to make a proper diagnosis.

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Medical malpractice is on the rise in hospices. Once a place handled by nuns and caring volunteers, hospice care has become a multi-million dollar business handled by not so caring CEO’s who are often putting profits ahead of patient needs.

Recently the FBI busted Brad Harris the 30 year old owner and CEO of a Texas Hospice for instructing nurses to overdose patients.  The Daily Beast  writes that during the course of the investigation Harris texted one of the nurses “You need to make this patient go bye-bye”. Harris who has no medical education also texted another nurse to increase by four times the patient’s medication. In another conversation Harris said “if only this F*** would die”.

Because hospices are paid by the government through Medicaid and Medicare  they receive a cap amount of $27,820.75  per patient. Therefore a patient who stays alive too long is not profitable for a hospice. The incentive is to have more patients with shorter stays. The FBI said Harris spoke about “finding patients who would die within 24hrs”.

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NursingMedical malpractice is often preventable. According to statistics from the Journal of the American Medical Association, 80% of adverse events in the health care system are the result of human errors. Medical malpractice is not only committed by doctors but also by nurses and other health care professionals. In a recent article in Minority Nurse, Nicole Thomas, a legal nurse consultant shares some very interesting statistics about medical malpractice. She also gives the following tips to nurses to avoid being sued for medical malpractice:

  1. Nurses should make sure they always proprely document their work. When a nurse writes a clear and precise description of what happens to a patient when he is under her care it  not only helps her and the staff make sure the patient is proprely being taken care but it also protects the nurse in case of a potential lawsuit. A nurse who defends herself  by saying “I did it but I forgot to document it”  will have trouble convincing the jury in a medical malpractice trial.
  2. Not only nurses should document everything but they should make sure their notes are easy to read. Even though a nurse may have been doing the right thing, unreadable notes open the door for a patient to question the nurse’s actions in considering filing a medical malpractice lawsuit.
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