Articles Posted in Hospital Mistakes

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At the forefront of the current New York State budget debate is whether or not non-economic damages in New York medical malpractice lawsuits should be capped at $250,000.00. Non-economic damages are those damages awarded by a jury for pain and suffering and loss of enjoyment of life.

According to hospitals and doctors around the State, medical malpractice lawsuits are universally “frivolous.” In response, we ask New York doctors to comment on what just happened to 2 year old Malyia Jeffers. Specifically, we welcome their thoughts on whether this is a case of emergency room malpractice.

A short time ago, Malyia woke up with a fever. When the fever began to rise and Malyia began to show bruising on her cheeks, her parents rushed her to Sacramento’s Methodist Hospital emergency room. According to a CNN report entitled “Harmed In The Hospital? Should You Sue?”, Malyia sat in the emergency room for nearly five (5) hours before she was examined by a physician. By the time emergency room personnel diagnosed her with sepsis (i.e., a blood infection), it was too late. The infection was advanced and, to save her life, doctors had to amputate her left hand, most of her right hand, and both of her legs. Sepsis is typically treated with intravenous antibiotics. “And time matters,” said Michael A. Bottar, of Bottar Leone, PLLC. “It is well known that for every hour of delay in the administration of antibiotic therapy for sepsis, there is an associated 7% rise in mortality.”

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“Because of confidentiality agreements that insurance companies insist upon following a New York medical malpractice settlement, the public does not know about the number and severity of medical errors. They are common and can be deadly,” said Syracuse hospital negligence lawyer Michael A. Bottar, Esq., of Bottar Leone, PLLC.

The statistics are alarming. According to a study recently released by the Office of the Inspector General (OIG), 1 in 7 Medicare patients were harmed by the medical care they received while hospitalized. “14% ?!” Bottar remarked. “We often file claims on behalf of families who suffer a loss due to New York hospital negligence, but we had no idea mistakes were this prevalent.”

The OIG study reported that as many as 180,000 patients are harmed annually, with a price tag of $4,400,000,000.00. The study was based on doctors sampling and reviewing medical records of just under 1,000 Medicare patients in 2008. For advice about how to stay safe during a hospital stay, patients should review the Consumer Reports on Health’s Staying Safe in the Hospital.

The most common hospital errors include prescription medication dosing errors (receiving too much or too little medication), improperly combining medications, infections, bed sores, equipment malfunction, falls and poor wound care. Wrong site and wrong side surgical errors also occur. Statistics suggest that nearly 50% of hospital mistakes were/are preventable.
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Syracuse University Hospital mistakes were the focus of a 68 page report generated by the New York State Department of Health (“DOH”). The DOH is an agency charged with oversight of medical care in the State of New York, including events that may give rise to claims for medical malpractice, failure to diagnose, birth injury, infection and wrongful death. The full report is available here.

According to Syracuse hospital mistake lawyer Michael A. Bottar, Esq., the report cited University Hospital for several violations of state regulations — one of which was an incident where a student doctor known as a “medical resident”, overseen by an unqualified attending physician, performed a complex operation on a patient’s spine because the neurosurgeon was busy in another operating room.

Syracuse surgery mistake lawyer Anthony S. Bottar, Esq., noted that the DOH, in its Statement of Deficiencies and Plan of Correction, found shortcomings in doctor performance, patient safety, quality of care and infection control practices.

In another aspect of the report, University Hospital was cited for the apparent absence of a “time out” during a surgical procedure, which is a process where surgical staff stop and verify that they have the correct patient in the operating room and are about to operate on the correct body part. The “time out” process is intended to prevent surgical errors, such as wrong-site surgery – like in 2004 – when a Syracuse surgeon about to remove a blood clot made an incision on the wrong side of an infant’s head, as well as wrong-side surgery – like in 2006 – when a Syracuse surgeon operated on the wrong side of a patient having a tumor removed from an adrenal gland. During the latter procedure, the surgeon failed to review radiological films.

Poor medical controls and oversight may also cause or contribute to a medical misdiagnosis, which we blogged about here.
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Syracuse medical malpractice lawyer Anthony S. Bottar, managing partner of Bottar Leone, PLLC, one of Upstate New York’s oldest law firms with a practice limited to medical malpractice, wrongful death, birth injuries, work injuries, brain injuries, and product/premises liability, was elected president of the New York State Academy of Trial Lawyers, an organization dedicated to protecting, preserving and enhancing the civil justice system.

The New York State Academy of Trial Lawyers boasts a membership of more than 1400 judges, law clerks, law firms, lawyers, paralegals and law students, including: Syracuse medical malpractice lawyers handling cases concerning stroke misdiagnosis, failure to diagnose cancer and failure to prevent a heart attack; Syracuse work injury lawyers handling cases concerning construction site accidents, scaffolding accidents and injuries caused by a fall from a height; Syracuse birth injury lawyers handling cases concerning fetal hypoxia and ischemia, cerebral palsy and Erb’s palsy; Utica brain injury lawyers handling cases concerning concussions, post-concussion symdrome and TBI; Watertown medical malpractice lawyers handling cases concerning Samaritan Medical Center negligence and Fort Drum physician mistakes; and Watertown injury lawyers handling New York State Thruway accidents.

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A malpractice claims analysis was recently published by CNY HealthPro, in conjunction with the Nurses Service Organization. The analysis reviewed nurse practitioner lawsuit claims data in an effort to increase medico-legal awareness, decrease nurse practitioner malpractice and prevent patient injuries from nurse practitioner mistakes.

According to Syracuse New York nurse practitioner error lawyers Bottar Leone, PLLC, nurse practitioners are increasingly becoming the focus of malpractice cases because of the growing role they play in dispensing medical care. According to the HealthPro/NSO report, the highest number of claims against nurse practitioners arose out of care provided in the medical care office. Nurse practitioner specialties with the most claims against them included adult/geriatric NPs, family NPs, and pediatric/neonatal NPs. The most severe claims — meaning those with the most significant injury to the claimant — conerned care that was or should have been provided by a pediatric/neonatal nurse practitioner. The largest settled claims involved a pediatric/neonatal NP’s failure to diagnose.
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It is well-known that very sick patients, especially those in the intensive care units at Central New York hospitals, e.g., Crouse Hospital (Syracuse), St. Joseph’s Hospital Health Center (Syracuse), Community General Hospital (Syracuse), SUNY Upstate University Hospital (Syracuse), Faxton-St. Luke’s Healthcare (Utica), St. Elizabeth’s Medical Center (Utica), Oswego Hospital (Oswego), United Health Services Hospital (Binghamton), and Samaritan Medical Center (Watertown), require close monitoring. According to Dr. Phillip H. Factor, of Beth Israel Hospital in New York, “[r]elying on electronic monitors is not sufficient in the sickest of the sick; these patients require direct observation.”

A recent study suggests that very sick patients assigned to ICU rooms that could not be directly observed from a nursing station, were more likely to die while hospitalized. Data from the study is still being analyze to determine why deaths were more likely and what can be done to lessen the risk, such as increasing the nurse-to-patient ratios for remote ICU beds so that nurses spend more time at the bedside.
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In the March edition of Consumer Reports, two Central New York hospitals will share the spotlight for having no central line bloodstream infections. A central line is a large diameter tube or catheter, usually inserted into a vein in the neck, chest or groin. Once in place, a central line can be used to deliver intravenous drugs and nutrition to patients. Without proper placement and maintenance, central lines are prone to infections. Central line bloodstream infections can lead to sepsis and death. As many at 15% of all hospital infections concern a central line.

Consumer Reports surveyed more than 100 hospitals nationwide. Of the hospitals surveyed, there were no reports of central line infections at Community General Hospital in Syracuse, New York. Likewise, there were no reports of central line infections at Cayuga Medical Center in Ithaca, New York.

In order to avoid hospital infections, both Community General Hospital and Cayuga Medical Center have developed protocols to decrease the possibility of contamination by, e.g., instructing staff to wear gowns, gloves and masks, draping the patient, and limiting the number of times that the central line is handled. Further, both hospitals attempt to limit how long a central line is in place because the longer a line is in place, the greater the risk for infection.

In addition to hospitals without infections, the report also highlighted New York hospitals with higher-than-average infection rates. One Syracuse hospital with a higher-than-average surgery infection rate was Upstate University Hospital. Crouse Hospital was noted to have below average colon-surgery site infections.
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A few weeks ago, Syracuse’s Crouse Hospital launched a “Shhhhh” campaign. Around the hospital, visitors are staff are being reminded by posters to keep quiet. Recent studies show that a quiet environment helps to lower a patient’s heart rate and blood pressure, and may speed the healing process.

Crouse Hospital is not the first New York State hospital to adopt a quiet environment. In 2007, Montefiore Hospital in the Brox implemented a Silent Hospitals Help Healing, or SHHH, program. Crouse Hospital, like Montefiore, plans to reduce noise by silencing beeping monitors, eliminating squeaky cart wheels, reducing intercom pages, automating doors to prevent slamming, and encouraging late-night “whispering” between hospital staff, patients and visitors. Other ideas include installation of noise-reducing ceiling tile, curtains, turning beepers to vibrate, wearing soft-soled shoes, and headsets for patients to listen to television programming or music.

A secondary benefit of a quiet hospital is a calm working environment, which should operate to decrease hospital mistakes and medical malpractice caused by distractions due to stress, commotion and noise.
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As many as 200,000 people die every year due to mistakes made in U.S. hospitals. Central New York hospitals are no exception.

In 1992, a 64 year old woman presented to Crouse Hospital in Syracuse, New York, for cancer therapy. She was supposed to receive an injection of carboplantin, but due to a medication mistake made by a hospital pharmacist, the woman received cisplantin. Cisplantin is far more powerful than carboplantin. Because of the Crouse Hospital prescription medication error, the woman died.

Probably because the woman was the wife of New York State Court of Appeals Judge Richard D. Simoons, Crouse administrators accepted responsibility for undeniable Central New York hospital negligence, stating that it was an “unmistakable human error.” The hospital also stated that “it would not surprise us if we settled this without going to a lawsuit.” Whether a lawsuit was necessary to secure compensation for the woman’s pain and suffering is unknown.
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Crouse Hospital recently received the American Stroke Association’s 2010 award for Silver-Plus Performance Achievement. The award recognizes Crouse Hospital‘s commitment to stroke care, including timely recognition of stroke symptoms and prompt treatment by tPA, where appropriate. The hospital’s pledge to patients should lead to a lower number of misdiagnosed strokes and permanent disabilities.

Strokes kill more than 100,000 people every year, and are a leading cause of long-term disabilities. 75% of strokes occur in people over age 65. Strokes are more common in women and African Americans. Stroke symptoms include: numbness of face, arm or leg; sudden confusion; vision disturbances; difficulty speaking; absence of coordination; and a “thunderclap” headache.

Nearly 90% of strokes are ischemic, which is where a blood clot prevents blood from flowing. tPA can be used to treat ischemic strokes, provided it is administered quickly. Failure to administer tPA may be due to medical malpractice such as an emergency room error.
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