Articles Posted in Medical Negligence

To be precise, I am not talking about iPhones.  I am talking about the apps for iPhones.  There are hundreds and hundreds of iPhone apps for health care providers that permit one to help formulate a differential diagnosis, check for drug-drug interactions, or identify medications.

So, does the standard of care require a doctor to buy and use these apps relevant to his or her field?

Not today.  But as time goes on look for the standard of care to include either the knowledge of relevant data that can be gathered from such sources or ready means to access it via iPhone, Blackberry, etc.  Medical students are already being trained for the use of these devices, and it is only natural that the standard of care will ultimately incorporate the use of  these tools.

David B. Troxel, MD of the Doctors Company has written a great article about VTE inThe Doctor’s Advocate..  The article reviews the risk factors for VTE, the prevention of VTE, and the diagnosis of DVT and includes a reference to the American College of Chest Physicians’ guidelines.

Read here – and learn.

SVMIC, the medical malpractice insurer owned by doctors for doctors, has published information about a seminar it offered to its insureds addressing the issue of surgical checklists.

This is how SVMIC describes the seminar it called "“Applied Aviation Safety Practices for Surgeons and Anesthesiologists:”

The basic premise of these seminars was that human errors, often supported by poorly designed systems, are the primary cause of preventable patient deaths and injuries. These human errors share similarities with, and will respond to, many of the same error reduction methods used in high reliability industries such as aviation and nuclear power. One of the hallmarks of high reliability industries is the conscientious and consistent use of checklists.

The Doctors Company, a medical malpractice insurer, has published this article about keeping medical records. 

An excerpt:

The following entries should appear in the office or hospital records of each patient:

One medical malpractice insurer, The Doctors Company, has an interesting article on medical malpractice claims concerning pap smears.

Here is a excerpt from the article that discusses the scope of the problem:

To put the potential magnitude of this problem in perspective, a College of American Pathologists (CAP) study of the five-year “look-back” at previous negative Pap smears following the diagnosis of HSIL/carcinoma found that 10 percent of prior smears were false negatives for SIL/carcinoma. If atypical squamous cells of undetermined significance (ASC-US) were included, 20 percent of prior smears were false negatives. In 1996, the American Cancer Society predicted 15,700 new cases of cervical cancer and 4,700 deaths. Published studies indicated that 60–75 percent of women dying from cervical cancer either never had a Pap smear or had not had one in the five years prior to diagnosis. Therefore, if one assumed that 40 percent of the predicted new cases of cervical carcinoma had a single Pap smear in the prior five years with a 20 percent false-negative rate, there was a potential for 1,256 new claims for failure to diagnose cervical carcinoma on a Pap smear in 1996 alone!  [Footnotes omitted.]

Public Citizen ranks Tennessee 40th in its 2008  ranking of serious doctor disciplinary actions taken by state medical licensing boards.

The Tennessee board took a total of 40 serious disciplinary actions against the 18,137 doctors in Tennessee, or a total of 2.44 actions per 1000 physicians.  The total leading states were Alaska (6.54 per 1000) and Kentucky (5.87 per 1000).  The two states with the lowest rankings were Minnesota (0.95 per 1000) and South Carolina (1.23 per 1000).

In 2006 Tennessee ranked 29th on the list and in 2007 it ranked 28th. 

Many of us know that  doctors prescribe drugs for uses other than those approved by the FDA. 

This article discusses off-label drug prescribing and suggests that physicians who prescribe a drug for an off-label use follow the following steps to obtain informed consent:

• a statement that the off-label use is an “experimental use” so all the possible side effects and complications are not known;
• a list of the common and/or known risks and complications with use of the medication;
• a statement that the details of the treatment have been fully explained in lay terms or in terms that are easily understood by the patient;
• a statement that no guarantees about the results of the medication are given; and
• a statement that the patient is not required to take the medication.

Read the entire article here.

The Idaho Supreme Court has permitted an expert to opine that two defendants in a medical negligence case engaged in not just negligent but reckless conduct.

In Jones v. Crawford, 2009 Opinion 53 (Idaho S. Ct. April 8, 2009), a defendant appealed from an adverse jury verdict in a wrongful death case.  Plaintiffs charged that the decedent’s death from an air embolus after spine surgery was a result of the negligent and reckless conduct of the defendants.  The trial judge permitted the plaintiff’s experts to opine that the conduct of two of the defendants was reckless.

In affirming the trial judge’s decision to admit the expert testimony on the issue of recklessness, the Idaho Supreme Court said

Here are the 28 medical events that the National Quality Forum says should never occur:

Surgical Events

Surgery performed on the wrong body part
Surgery performed on the wrong patient
Wrong surgical procedure on a patient
Retention of a foreign object in a patient after surgery or other procedure
Intraoperative or immediately post-operative death in a normal healthy patient

These are not the words of some crazy plaintiff’s lawyer.  These are the words of a doctor.  Dr. Amy Tuteur at Harvard.

An excerpt:  "If I had been angry about what happened to the patient, I was even angrier after learning of the deception. The hospital had deliberately lied to protect its staff members. They lied to cover up medical negligence, with the assumption that the doctors in question would continue to practice at the same hospital, free to make similar mistakes."

Read it all for yourself.  Don’t forget the comments.  All of the comments.  Keep reading.