Hospital-Acquired Infections Remain A Stubborn Problem, Study Finds

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Posted on 15th April 2010 by gjohnson in Uncategorized

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There hasn’t been much progress made stamping out hospital-acquired infections, which contribute to roughly 100,000 fatalities a year, according to the 2009 National Healthcare Quality Report and National Healthcare Disparities Report. http://www.nytimes.com/2010/04/14/us/14infect.html?ref=todayspaper

The annual report was issued Tuesday by the U.S. Department of Health and Human Services’ Agency for Healthcare Research and Quality (AHRQ).

The bottom line is that improvements in patient safety continue to lag, with health-care associated infections (HAIs) are not anywhere near elimination, according to the report. http://www.ahrq.gov/news/press/pr2010/qrdr09pr.htm

A new section in the 2009 quality report said that of the five types of HAIs in adult patients who are tracked in the reports:

  • Rates of postoperative sepsis, or bloodstream infections, increased by 8 percent.
  • Postoperative catheter-associated urinary tract infections increased by 3.6 percent.
  • Rates of selected infections due to medical care increased by 1.6 percent.
  • There was no change in the number of bloodstream infections associated with central venous catheter placements, which are tubes placed in a large vein in the patient’s neck, chest, or groin to give medication or fluids or to collect blood samples.
  • However, rates of postoperative pneumonia improved by 12 percent.

In addition, although rates are improving incrementally, blacks, Hispanics, Asians, and American Indians are less likely than whites to receive preventive antibiotics before surgery in a timely manner.

“Despite promising improvements in a few areas of health care, we are not achieving the more substantial strides that are needed to address persistent gaps in quality and access,” AHRQ director Dr. Carolyn Clancy said in a prepared statement. “Targeted AHRQ-funded research in Michigan has shown that infection rates of HAIs can be radically reduced. We are now working to make sure that happens in all hospitals.”

Over 100 participating hospital intensive care units in Michigan have been able to keep the rates of central line-associated bloodstream infections to near zero, three years after adopting standardized procedures.

The project, conducted by the Michigan Health and Hospital Association Keystone Center, involved the use of a comprehensive unit-based safety program to reduce these potentially lethal infections. Last year, AHRQ announced new funding that has expanded the project to all 50 states, Puerto Rico, and the District of Columbia.

A copy of the full report can be found here. http://www.ahrq.gov/qual/qrdr09.htm

AHRQ’s annual quality and disparities reports, which are mandated by Congress, were first published in 2003. The reports show trends by measuring health care quality for the nation using a group of credible core measures. The data are based on more than 200 health care measures categorized in four areas of quality: effectiveness, patient safety, timeliness, and patient-centeredness.

  

Los Angeles Hospital On Trial For Lawsuit Over Consent For Infant’s Operation

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Posted on 13th April 2010 by gjohnson in Uncategorized

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A Tujunga man is suing Children’s Hospital in Los Angeles, alleging that his 6-month-old son was brain-damaged after undergoing double hernia surgery that the father never consented to. http://www.latimes.com/news/local/la-me-hospital-consent13-2010apr13,0,6085749.story

 The suit, which seeks $19 million, was brought by Eduardo Rivas, 43, against the hospital and two physicians. The case is being tried now in Los Angeles County Superior Court, where Rivas testified last week that he never signed a consent form the surgery performed on his infant son, according to The Los Angeles Times.

 Rivas’s son Nathan was born four months premature. The infant had been transferred to Children’s Hospital from Glendale Memorial Hospital, and Rivas got a call from a doctor and a Spanish-speaking social worker that Nathan had to have surgery.

 Through an interpreter Rivas, a roofing inspector, told the jury that the social worker had assured him the surgery was minor and that the only risk was a minor infection.

 Rivas, whose wife died shortly after Nathan’s birth, testified that he did not give his consent. But the next day, Nov. 16, 2007, the surgery was performed on Nathan.

 Children’s Hospital maintains that Rivas gave verbal approval for the surgery. But the hospital was unable to later find any records that proved that Rivas had given his approval, according to The Times. The consent form for the surgery had the name of Nathan’s doctor and a nurse, but not that of Rivas.

 Following his operation Nathan, who had a breathing tube when he came to Children’s Memorial, became  dependent on a ventilator and feeding tube.

 Rivas charges that his son’s condition was the result of his son’s reaction to anesthesia. The hospital blames Nathan’s medical woes on the fact that he was born premature, and had neurological problems.

 If Rivas wins his lawsuit Medi-Cal, the state insurer, will have to be reimbursed for the $913,000 it has already paid for Nathan’s care.    

 

 

Jury Awards Florida Mom $10 Million in Cerebral Palsy Lawsuit

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Posted on 13th April 2010 by gjohnson in Uncategorized

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 A Florida mother was awarded $10 million in a case where she alleged an ambulance service’s negligence lead to her son getting cerebral palsy. That’s because the ambulance took her to the wrong hospital when she was in labor. http://www.aboutlawsuits.com/cerebral-palsy-lawsuit-birth-in-ambulance-9606/

 The medical malpractice lawsuit had been brought by Margarita Chess of Volusia County, naming as defendants EVAC Ambulance, Bert Fish Medical Center, Halifax Medical Center, Arnold Palmer Hospital in Orlando and two physicians.

 All of the parties except the ambulance service had settled with Chase for $1.4 million before the case when to trial, the Orlando Sentinel reported.

 Chess’s son was premature, born when she was just six months into her pregnancy. As she went into labor in 2003, she was first at Bert Fish Medical Center in New Smyrna Beach. She was then supposed to be transferred and transported by EVAC to Halifax Medical Center. But somehow, the ambulance was instead sent to Arnold Palmer Hospital, more than 50 miles away.

 Chess’s son, Addison Chase, was born on the way to Arnold Palmer.

 The malpractice suit alleged that the infant had trouble breathing after he was born. The paramedics performed CPR, but Addison’s brain was deprived of oxygen. As a result he sustained brain damage, and now has the long-term disabilities of cerebral palsy.      

Judge Approves $110 Million Settlement For E-Ferol Infant Deaths

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Posted on 12th April 2010 by gjohnson in Uncategorized

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A federal judge last Friday approved a $110 million class-action settlement against the manufacturer and distributor of E-Ferol, an intravenous vitamin E supplement blamed for the deaths of roughly 40 premature babies in the mid-1980s.  http://www.google.com/hostednews/ap/article/ALeqM5ilowHbtEzzgYkDtSfASw-w1Vo6mgD9F0J4Q02

The settlement for the 369 plaintiffs, who had filed suit in Wichita Falls in Texas, was approved by U.S. District Court Judge Sidney Fitzwater.

E-Ferol, recalled in April 1984 after being on the market just over four months, was marketed as drug to prevent or reduce the chances of blindness in premature infants. E-Ferol didn’t have FDA approval for that use.

E-Ferol’s maker, Carter-Glogau Laboratories of Glendale, Ariz., and its distributor, O’Neal, Jones & Feldman Pharmaceuticals of Maryland Heights, Mo., are no longer in business.

Carter-Glogau and its former president, Ronald Carter, were indicted in 1987 along with the ex-president of O’Neal, Larry Hiland, according to the Associated Press. They were found guilty of conspiracy, marketing an unapproved drug and misbranding a drug.

The two officials were sentenced to six months in jail, and the company was fined $130,000, AP reported.

The class-action suit, which includes the parents of 42 infants as plaintiffs, was filed in 2003.  There have been more than 100 previous settlements involving E-Ferol.

While federal health officials linked E-Ferol to 40 deaths, the attorney in the class action suit, Art Brender, put that number at 80, according to AP.

 E-Ferol caused liver and kidney failure in the babies.

Illinois Family Awarded $29.1 Million In Malpractice Case That Left Their Baby a Quadriplegic

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Posted on 11th April 2010 by gjohnson in Uncategorized

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  A family has secured $29.1 million in a medical malpractice case where they claimed their son became a quadriplegic due to negligence during his birth at Northwestern Memorial Hospital. http://www.suntimes.com/news/24-7/2142707,CST-NWS-verdict06.article

  The payout for the Arroyo family is a combination of an award they received last Friday from Judge Amy St. Eve of the Northern District of Illinois and a prior settlement. The judge awarded the family $22.6 million, in addition to the $6.5 million settlement the family reached with the hospital in 2009.

  The Arroyo’s son, Christian, is a spastic quadriplegic who has cerebral palsy and can’t walk, talk or eat through his mouth.

  Maria Arroyo came to Northwestern Hospital on May 16, 2003 with labor pains. Because of the baby’s premature condition and the fact that the mother’s water had broken, Maria was supposed to receive antibiotics to ward against Group Beta Strep Infection for the baby.

  But the obstetrician, a federal employee, didn’t administer the antibiotics to Maria, and during the baby’s first few hours he was showing symptoms of infection. But the government pediatricians still didn’t step in and order the antibiotics for Christian.

  The infection spread from Christian’s blood stream to his brain, causing permanent damage and cerebral palsy.        

  “Had the federal government’s doctors followed the standard of care and provided the antibiotics to Maria or Christian at the appropriate timed, Christian would have been a normal baby boy,”  David Pritchard, one of the family’s lawyers, said in a prepared statement.  

 

 

 

 

 

 

 

 

Xenon Used To Ward Off Brain Damage In English Newborn

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Posted on 9th April 2010 by gjohnson in Uncategorized

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Turning to an experimental treatment, doctors in Great Britain used xenon, an inert gas, to prevent brain injury in a baby born in serious condition. http://www.google.com/hostednews/ap/article/ALeqM5h6WHkV6rTnrO0B_jaHb6w7a1u99gD9EVKKUG1

In fact, newborn Riley Joyce was the first baby in the world to get the xenon gas treatment, which was developed by Marianne Thoreson, a University of Bristol professor of neonatal neuroscience, and Dr. John Dingley, a consultant anaesthetist at Swansea University’s School of Medicine. http://news.bbc.co.uk/2/hi/uk_news/england/bristol/somerset/8611130.stm

When Riley was delivered by an emergency Caesarean section at the Royal United Hospital in Bath, England, he didn’t have a pulse and wasn’t breathing. With his odds of sustaining permanent brain damage considered 50-50, his parents agreed to have him sent to St. Michael’s Hospital in Bristol for the experimental treatment.

 Within a week, Riley was eating and alert.

 The xenon was used to help cool Riley’s brain so he wouldn’t suffer permanent brain damage. Xenon can double the effect of cooling the brain, according to research.

 In the United Kingdom, more than 1,000 babies born at full term die or sustain brain trauma because of a lack of oxygen or blood supply at birth.

  Xenon will be tried on at least 12 babies before researchers start a bigger trial.

 

Pfizer Speaks Out On $20 Million In Payments To Physicians

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Posted on 4th April 2010 by gjohnson in Uncategorized

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The world’s largest drug manufacturer, Pfizer, tried really hard to make friends in the medical community last year. Wednesday the company said it had paid $20 million to 4,500 physicians and other medical professionals to consult and speak on its behalf the last half of 2009. http://www.nytimes.com/2010/04/01/business/01payments.html In Pfizer’s first public accounting of this kinds, the company also said that it had shelled out $15.3 million to 250 medical centers and research groups for clinical trials during that same time span. According to The New York Times, Pfizer is the first drug maker to disclose payouts for clinical trials. A number of pharmaceutical companies – namely Eli Lilly, Merck and GlaxoSmithKline — have fessed up to making payments to physicians. Pfizer made its disclosures as part of an “integrity agreement” it signed to settle a probe into the illegal promotion of pharmaceuticals for off-label uses. Some critics told The Times that they were skeptical that drug companies such as Pfizer would be totally forthcoming with the unaudited numbers they were disclosing.

Health Care Reforms Stymies Caps on Medical Malpractice Damages

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Posted on 30th March 2010 by gjohnson in Uncategorized

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President Obama’s health care reform is a triumph for those, like us, who oppose the unfair setting of limits on malpractice awards. We don’t believe that state lawmakers should have the right to tell someone who has lost use of their limbs, or suffered permanent brain damage, that their case is only worth $350,000, or $500,000. Under the law, that should be a jury’s decision, not a legislator’s.

Now, there is more legal backing for our viewpoint, out of Washington. Advocates of setting of caps on malpractice awards against doctors had been lobbying in D.C. for some support for their position as part of the health care changes.

But the overhaul that the president signed into law last week doesn’t address the issue of malpractice-award limits, according to The Wall Street Journal. http://online.wsj.com/article/SB10001424052748703416204575145683793783008.html?mod=googlenews_wsj

Proponents of the caps claim that huge malpractice verdicts have sent the cost of malpractice insurance through the roof in this country.

These advocates also argue that fear of being sued for malpractice is contributing to health-care costs skyrocketing, as physicians take defensive measures such as ordering unnecessary tests and procedures to cover their backs in case they are sued later on http://www.nytimes.com/2010/03/27/health/27patient.html?ref=business

Obama’s health care reform marks the third defeat that proponents of medical malpractice limits have suffered in recent weeks. Both the Illinois Supreme Court and the Georgia Supreme Court just tossed out limits in those states, $500,000 and $350,000, respectively.

The Journal pointed out that some malpractice changes did make it into the new health-care legislation. For example, the new law sets aside $50 million for states that try to slash malpractice costs by creating alternatives for trying cases or improving patient safety.

But there is also a provision that lets attorneys for plaintiffs to bypass any alternatives, and instead file suit in state court.

In the Georgia malpractice cap that was overturned, the case involved was that of a woman awarded $1.15 million for pain and suffering she suffered from a botched facelift.

In Illinois, the case led to that state’s malpractice limit being tossed out stemmed from a girl being born with brain damage.

The Journal quoted Theodore Olson, the attorney for the doctor in that case. He said it was hard to understand the notion that the state Legislature couldn’t set limits on damages. Why so?

If a jury of her peers believes a woman deserves $1.15 million because her face was like an open wound after her facelift, who are Georgia lawmakers to say she should only get $350,000?

Georgia Overturns Malpractice Cap In A Case That Puts A Face On Why Limits Are Unjust

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Posted on 24th March 2010 by gjohnson in Uncategorized

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This one means something personal to me. Tommy Malone of Atlanta, Georgia is the best lawyer I know. He is a long time personal friend, a man who has mentored me, chuckled at some of my “out there” theories and co-counseled cases with me. His son, Adam Malone, may be the finest “young lawyer” in America. Adam has the combination of character, intelligence and sincerity that if he wanted to run for President, he would be a serious contender. He will someday have the position I now hold as Chair of the Traumatic Brain Injury Litigation Group.

I first saw the video of the catastrophic ruin a greedy doctor made of this woman’s face last summer at our national convention. My paralegal Jayne, who sat next to me while we watched, it has asked me about how the appeal has come out, a dozen times since.   Here the problem wasn’t that a jury wasn’t favorable to Adam’s client. The reason for the appeal was that the law, put in to assure that all doctors didn’t leave the State of Georgia (how ridiculous is that to even say) had limited her right to recover for this horrible disfigurement, drastically reducing the verdict.   The Georgia Supreme Court has said that was wrong and ruled the cap on damages unconstitutional.  In this case there may be the coming to justice that will forever put a stop to artificial restraints on what victims of malpractice and other wrongdoing can recover.

With this action, Georgia has become the latest state to throw out caps on awards in medical malpractice suits.  In this case,  Betty Nestlehutt, who is 75 now,    was horribly disfigured from a botched facelift. http://www.ajc.com/news/georgia-politics-elections/state-high-court-overturns-392119.html?printArticle=y

If you watch the video,  you will see the injustice on capping this wrongdoing. http://www.georgiawatch.org There is no way that Georgia’s $350,000 limit on noneconomic malpractice damages could be considered adequate payment for her ordeal.   It’s particularly heart-wrenching to watch Nestlehutt’s spouse try to carefully apply some kind of bandages to her wounds, as she flinches in pain.

In fact, a jury had found that she was entitled to $1.265 million in damages – a verdict that the George Supreme Court upheld, leading to the overturning of the state’s cap on malpractice awards.

Nestlehutt, who was in the real estate business with her husband in Marietta, Ga., decided to get a facelift in 2006. Her physician convinced her to get a long list of procedures, including the facelift. But after the surgery, Nestlehutt developed raw, open wounds on her face.

Nestlehutt’s face remained scarred, and the video says she is embarrassed to be seen now and doesn’t like to go out.

On Monday Georgia’s highest court ruled on Nestlehutt’s case, finding that the state’s $350,000 limit on noneconomic damages, such as a plaintiff’s pain and suffering, from malpractice was in violation of the Georgia constitution, which guarantees the right to a jury trial.

In the high court’s unanimous ruling, Georgia Chief Justice Carol Hunstein wrote that the state’s 2005 limit on damages “clearly nullifies the jury’s findings of fact regarding damages and thereby undermines the jury’s basic function…The very existence of the caps, in any amount, is violative of the right to a jury by trial.”

Last month the Illinois Supreme Court scrapped the state’s $500,000 cap on malpractice damages against doctors and $1 million cap for hospitals, saying that the limits were unconstitutional. Roughly two dozen state now have caps on malpractice damages.

Georgia was limiting malpractice damages to $350,000 against physicians and $1 million against health-care providers.

In Nestlehutt’s case, a jury awarded her $115,000 for past and future medical care; and $1.15 million to her and her husband for noneconomic damages, with $900,000 of that for the woman’s pain and suffering.

Plastic surgeon Dr. Harvey “Chip” Cole had appealed the jury verdict, based on the state’s malpractice cap.

The real credit in this case must go to Adam Malone.  Rather than declining this case because of the cap, he saw it as just the right case to prove in undeniable ways the injustice of the cap.  He advocated in a special way unique to who he is and changed the law of Georgia and perhaps the law of the land.

Adam, I am proud to know you.

Former Arena Football Player Sues Team Doctor for Malpractice Over Concussions

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Posted on 19th March 2010 by gjohnson in Uncategorized

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A case in Denver may be the first lawsuit where a professional football player is charging a team doctor with malpractice, for the way the physician treated his concussions, since the issue of head injuries came to national prominence three years ago, according to The New York Times. http://www.nytimes.com/2010/03/19/sports/football/19concussions.html?ref=sports

The legal action was filed Wednesday by a former Arena Football League player, Clay Rush, against Dr. Saurabh Mangalik, team doctor for the now-defunct Colorado Crush, as well as the physician’s employer, HealthONE Clinical Services. The doctor and HealthONE were independent contractors for the team.

In the lawsuit, which was filed in a Colorado state court in Denver, Rush alleges that in 2008 he suffered several hits to his head during several games. The litigation alleges that Mangalik botchedhis treatment of Rush, which had led to permanent brain injury for the player.

The suit charges that Mangalik just treated Rush for a headache, failing to evaluate and observe him before letting him go back to play.

In a phone interview with The Times, Mangalik denied any wrongdoing and said he didn’t know there had been any problems with Rush’s care until he was contacted by the newspaper.

The doctor also asserted that he had warned Rush and Crush trainers that the injured player should not resume practice or return to play until his brain injury symptoms, such as headaches and dizziness, disappeared.

The Colorado Crush team don’t exist anymore.

There have been lawsuits similar to the one filed by Rush. La Salle University last November paid $7.5 million to settle a suit brought by a player who sustained a bad concussion and claimed that the school’s medical staff didn’t give him adequate treatment.

Ten years ago, former National Football League running back Merril Hoge sued Dr. John Munsell, the former Chicago Bears team doctor. The case was later settled, with the terms remaining confidential, according to The Times.

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