Here is the most recent version of the practice guidelines for obstetric anesthesia as prepared by a task force of the American Society of Anesthesiologists.
Articles Posted in Medical Negligence
Has Hill v. NHC Been Settled? UPDATE
I heard a rumor that the appeal in Hill v. NHC Healthcare/Nashville,LLC, M2005-01818-COA-R30-CV, (Tenn. Ct. App. April 30, 2008) (Rule 11 granted Aug. 25, 2008) has been dismissed.
This important opinion held that the defendant nursing home’s arbitration clause was unconscionable as a matter of law. The hope was that this case would give some guidance on the circumstances under which arbitration clauses could be upheld in nursing home contacts.
Does anyone know what happened to this case?
Fire in the Operating Room
The February 18, 2009 edition of The Wall Street Journal has an interesting article about fires in the operating room, which happen approximately 650 times per year in the United States.
A sample: "Because each member of the [surgical] team may be focusing on his own role in a procedure, ‘the No. 1 cause of fires is lousy communication’ says Patricia Seifert, editor-in-chief of AORN Journal, the monthly publication of the Association of Perioperative Registered Nurses."
Here is a website dedicated to raise awareness about this problem: www.surgicalfire.org.
Diagnosis of Appendicitis
State Volunteer Mutual Insurance Company’s Winter 2008-09 quarterly newsletter, Risk Points, has an interesting article discussing the diagnosis of appendicitis. This illness occurs in 250,000 people in the United States every year, and the mortality rate increases 500% if the appendix ruptures.
A sample from the article: "Thus clinicians should focus on the time of onset rather than the time the patient first presents for evaluation when deciding whether a ‘wait and see’ approach is warranted. A good habit is a scheduled return appointment or referral within a reasonable time frame for a second evaluation in patients with unconfirmed abdominal pain etiologies When a diagnosis is unclear, it is crucial that your rationale, patient instructions and followup plan are well documented in the chart."
The article begins on Page 2.
Lawyer Medical Malpractice Reports Due March 2
The Tennessee Medical Malpractice Reporting Act found at Tenn. Code Ann. §§ 56-54-101, et seq. went into effect on January 1, 2009 and replaced statutes regarding similar previous reporting requirements. Bold the old and new statute require that lawyers report all medical malpractice settlements and judgments obtained in calender year 2008.
The Act requires the report to be filed with the Department of Commerce and Insurance offices on or before March 1 of each year. Since March 1 falls on a weekend, the report will be due March 2nd.
The new medical malpractice forms and instructions for the 2008 calendar year can be found at the Department of Commerce and Insurance’s web site. That site is http://www.state.tn.us/commerce/insurance/medExpRpt.html.
Making Surgery Safer
There is a great article in today’s New York Times titled "Simple Checklist Makes Surgery Safer."
An excerpt: "a year after surgical teams at eight hospitals adopted a 19-item checklist, the average patient death rate fell more than 40 percent and the rate of complications fell by about a third, the researchers reported.’
The Times article is based on an article in the January 14, 2009 edition of the New England Journal of Medicine, which reports on a research project conducted by the World Health Organization.
Tennessee Nursing Homes Rank At the Bottom
According to the Tennessean. Tennessee nursing homes rank No. 48 (beating only Louisiana and Georgia), according to new survey information out from the Centers for Medicare and Medicaid Services. Less than 7% of the nursing homes in Tennessee were rated above average.
The paper reports that
"[o]f the 40 nursing homes listed in Davidson, Rutherford, Sumner, Williamson and Wilson counties, 11 fell well below average. Three of those — Briley Nursing and Rehabilitation Center in Whites Creek, Greenhills Health and Rehabilitation Center in Nashville and Cumberland Manor Nursing Center in Nashville — not only received the poorest marks for overall quality, but also received the lowest possible score in every category."
Medical Malpractice Reporting Statute
Many plaintiff’s lawyers from across the state received assessments from the Department of Commerce and Insurance for failure to report data concerning medical malpractice settlements and judgments received during the prior year. Many of the penalities approach $20,000 and, as one lawyer told me, the penality he has been assessed is greater than the fee he received in the case.
Some people have asserted that the reason plaintiff’s lawyers have to report this data is my fault. That is not accurate. Here are the facts.
Since 1986 I have pushed for mandatory reporting of medical malpractice verdicts and settlements data. Unfortunately, the state of Tennessee only recently began keeping data on verdicts in med mal cases, and most settlements are cloaked with a confidentiality agreement. Therefore, we had no good data to fight the constant whining by the medical community that there was a med mal litigation crisis.
“Hospital Compare” Website
The U.S. Department of Heath and Human Services has a website that delivers information on how well hospitals care for patients with certain medical conditions or surgical procedures, and the results of a survey of patients about the quality of care the patients received during a recent hospital stay.
The site is here.
Information on Doctors
The Federation of State Medical Boards has a website that allows you to order professional information on physicians and physician assistants. The reports include infomoration about disciplinary sanctions, education, medical specialty, licensure history and locations. The cost of each report is $9.95.
Go the this site to place an order.
Limited information on Tennessee doctors (and other licensed health care providers) can be obtained for free at this site.