Many North County residents get nervous before they visit a surgeon for even a routine surgery. Given the high rate of deadly medical errors in the country, there is a shockingly high likelihood that something might go wrong—even if a surgeon has performed the exact procedure hundreds of times. In some situations, a medical error can result in the death of a patient and may lead to a wrongful death lawsuit.

In some cases, the medical mistake might not be the surgeon’s fault and instead might concern an anesthesia error, for example. However, many surgical errors are in fact attributed to surgeons, and a lot of these mistakes are avoidable. According to a recent article in The New York Times, one of the ways that surgeons work to avoiding making errors is by using a surgery “checklist.” Is a checklist really enough to prevent medical negligence?

What is a Surgical Checklist?

What is a surgical checklist, and how might it reduce the rate of medical errors and preventable deaths? The checklist is essentially what is sounds like – a list of items to check off to ensure that surgical mistakes are not being made. Surgical checklists might include the following items:

• Confirmation of patient’s identity by name tag on his or her wrist;
• Verification of the surgical site prior to the surgery;
• Listing of patient’s allergies and any medications being used during the surgery to prevent allergic reactions;
• Identification of any blood or other fluids in the operating room in the event that they are needed;
• Identification of surgeon, nurses, and other surgery team members by name prior to beginning the surgery; and
• List of every item in the operating room, including “needles, sponges, gauze, and scalpels,” and a check box to indicate each time an item is removed from the surgical tray, used during the surgery, and returned to the steel tray (to ensure that no items are left inside the patient).

How Checklists May Reduce Error Rates During Surgery

By having a checklist in the operating room and literally checking off each item that corresponds to a preventable medical error, surgeons may be able to prevent deadly surgical mistakes. But do the checklists really work? According to the article, a 19-item checklist that has been tested in operating rooms across the country led to this result: “The mortality rate fell to 0.8% from 1.5%, and surgical complications declined to 7% from 11%.” In other words, the use of a checklist does prevent mistakes in the operating room.

But does it work in all different types of hospitals and surgical settings? According to the article, “surgical checklists [have proven] effective in diverse settings,” meaning that they reduce deaths and serious medical mistake injuries in rural hospitals and urban hospitals, as well as in outpatient surgery centers and large-scale hospital facilities.

Contact a Rancho Bernardo Wrongful Death Attorney

If you lost a loved one because of a preventable medical error, it is extremely important to speak with an experienced Rancho Bernardo wrongful death attorney about your case. Contact the Walton Law Firm today to learn more about how our personal injury team can help with your claim.

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(image courtesy of Luis Melendez)

Tool Developed to Prevent Pediatric Medical Mistakes

A pilot study developed a tool aimed at preventing medical errors in pediatric patients. The study recently determined that, when it comes to pediatric inpatients, “nearly half of the harms in patient charts were preventable.” The study looked at 600 different pediatric medical charts. Of those, 240 charts—or 45 percent of those in the study—had recognizable harms that researchers determined to be “potentially or definitely preventable,” according to one of the researchers. The study has been published in Pediatrics.

The authors of the study, including David C. Stockwell, the medical director of the Pediatric Intensive Care Unit at Children’s National Medical Center in Washington, developed the Pediatric All-Cause Harm Measurement Tool (PACHMT) in order to determine the causes of pediatric medical errors and whether they’re preventable. Specifically, the tool detects “triggers,” which the researchers define as “a medical record based ‘hint’ that ‘triggers’ the search of the medical record to determine whether an adverse event might have occurred.” In other words, the PACHMT allows researchers to search pediatric inpatients’ medical records to determine whether a medical mistake might have taken place.

The PACHMT is more predictive of some types of injuries than others. To be sure, the positive predictive value depends largely upon the trigger. For instance, preventable infections that occurred in the hospital had the highest predictive value at nearly 86 percent. Oppositely, the positive predictive value of elevated pain was only about 7 percent.

Types of Preventable Pediatric Injuries

When the authors of the study reported on preventable pediatric injuries, what were the most common harms they identified? The following represent some of the most common preventable injuries experienced by young patients:

• Intravenous catheter infiltrations or burns;
• Respiratory distress;
• Constipation;
• Pain; and
• Surgical complications.

The harms occurred in patients with hospital stays between 24 hours and 6 months, with a median stay of 4 days. The study data looked almost equally at male and female patients, whose median age was 4 years old.

Currently, the PACHMT isn’t perfect, as its developers have noted. And the study also had limitations, with a “relatively small sample size and the lack of two physician reviewers.” However, their study emphasizes how trigger tools, such as the PACHMT, can “lead to a better understanding of the epidemiology of harm in hospitalized children, as well as allow tracking of change with patient-safety-focused interventions.”

While some medical errors don’t result in serious harms, many medical mistakes lead to severe and even fatal injuries. If you or someone you love recently sustained injuries because of a medical error, you should contact a dedicated San Diego medical malpractice attorney. You may be eligible for financial compensation.

Photo Credit: paul goyette via Compfight cc See Related Blog Posts: Patients at Risk of Injury in Smaller Military Hospitals Medical Error Prevention and Medical Malpractice Legislation

Small and Underused Military Hospitals

According to a recent article in the New York Times, military hospitals that care for about 1.35 million active-duty service members and their families show “signals of failing in a system” of care. What is wrong with these hospitals? Investigators for the New York Times identified two major issues.

The first issue was size. The hospitals are so small, and so few patients use them, that “it compromises the ability of doctors and nurses to capably diagnose and treat serious illnesses.”

The second issue was underuse. About two-thirds of military hospitals served only 30 patients or fewer per day in 2013, and many served 10 or fewer patients each day. To put this number in perspective, the highest number of inpatients is still “less than a third as many as the typical civilian hospital. That means about half the beds in these military hospitals remain vacant on a daily basis.

According to Dr. Lucian L. Leape, a patient safety expert at the Harvard School of Public Health, these hospitals “should be outlawed.” The Pentagon is planning to scale back on the military hospital system, thus encouraging patients who would otherwise enter the doors for surgery or treatment for a serious illness to visit a civilian hospital instead. What will happen to the hospitals? Many will be converted into outpatient clinics or birthing centers.

Medical Errors and High Rates of Patient Injury

The New York Times report emphasizes the serious problems these hospitals experience in relation to maternity patients and birth injuries or birth defects. The following birth injuries occur with much more frequently at military hospitals:

• Trauma to the infant during birth: 95 percent higher risk at a military hospital than a civilian hospital;
• Postpartum hemorrhage: 43 percent higher risk, on average, at a military hospital;
• Shoulder dystocia and resulting harm in the infant: 40 percent high risk on average;
• Maternal trauma with instruments: 22 percent higher risk at a military hospital than at a civilian hospital.

Birth-related injuries are not the only ones that patients are at risk for at military hospitals. The article also demonstrates higher rates of injury during even routine surgeries, such one to correct a hiatal hernia. Although more than 25,000 Americans undergo this surgery each year, one patient at military hospitals lost her stomach as a result of a medical error. Another example involves the six-year-old son of a Navy officer who suffered fatal injuries after receiving improper treatment at a California military hospital.

Some commentators suggest these high rates of injury are caused by a lack of training for young doctors at these facilities. Other suggest that limited financial resources are to blame.

If you or a loved one suffered personal injuries because of a medical professional’s negligence, it is important to talk with an experienced San Diego medical malpractice lawyer. Given the recent focus on raising the damages cap, you may be eligible to receive substantial compensation for your injuries.

Photo Credit: taliesin via morgueFile See Related Blog Posts: Medical Error Prevention and Medical Malpractice Legislation San Diego Medical Malpractice and NFL Drug Abuse Claims

A ballot initiative over pending medical malpractice legislation in California, called “one of the nation’s most expensive ballot campaigns” by the Washington Post, received additional support via a television advertisement from Senator Barbara Boxer. A recent article in the Los Angeles Times explains that Boxer “emerged as a forceful spokeswoman for an initiative to raise some medical malpractice awards in the state.”

Proposition 46, Damage Caps, and Medical Malpractice Legislation

The ballot measure, known as Proposition 46, “would increase the limit on certain medical malpractice damages from $250,000 to approximately $1.1 million.” Since 1975, non-economic damages have been capped at $250,000. Unlike economic damages, which typically compensate a victim for hospital bills, medical visits and treatments, and so forth, non-economic damages compensate victims for injuries such as loss of enjoyment of life, disfigurement, and pain and suffering. Also unlike economic damages, non-economic damages cannot be measured in a fixed dollar amount, and can therefore vary widely from case to case.

According to Senator Boxer, putting a higher cap on medical malpractice damages would help to “prevent medical errors in the first place because there is more at stake.” In order to prevent medical errors, Proposition 46 would require additional safety practices. Specifically, it would “require hospitals to randomly test physicians for drugs,” and it also would “[r]equire doctors to check a statewide database of prescriptions before prescribing certain drugs in an effort to curb abuse of those medications.”

Advertising in a Costly Campaign

In the recent advertisement narrated by Boxer, viewers are shown images of children who died because of “preventable medical errors.” The advertisement does not specifically refer to raising the medical malpractice damages cap, but instead emphasizes that changes to the current medical malpractice law would “hold the medical industry accountable for mistakes.”

Currently, trial attorneys who support Proposition 46, along with consumer and healthcare advocates, have raised approximately $5 million for the campaign. Opponents of the ballot initiative, who released a television ad in late August, include doctors and malpractice insurers, have raised more than $54 million. While the opponents are better funded, a spokesperson for a consumer advocacy group emphasized that those in favor of the initiative “will be competitive on television.”

Medical malpractice awards are a very hot topic in California. News of the ballot initiative to raise the cap for certain compensatory damages even made national news, and California residents eagerly await the November vote. If you or a loved one has been injured because of medical malpractice, contact an experienced San Diego medical malpractice attorney to discuss your case.

Photo Credit: NGerda via Wikimedia Commons See Related Blog Posts: San Diego Medical Malpractice and NFL Drug Abuse Claims Medical Malpractice Initiative Will Appear on November Ballot

Narcotics Prescriptions and Medical Negligence in Football?

Back in May, approximately 500 former NFL players filed a lawsuit in the U.S. District Court in northern California alleging that physicians affiliated with the pro sports league “illegally dispensed powerful narcotics and other drugs to keep players on the field without regard for their long-term health.” The initial complaint was amended shortly after its original filing date to add another 250 players to the lawsuit. Now, 750 plaintiffs are involved in the case against the NFL.

Only a handful of the players are identified by name, however, including Marcellus Wiley, who played for Buffalo, Dallas, Jacksonville, and San Diego during his time in the league. Some of the other named players include Richard Dent and Jim McMahon. McMahon, as many remember, was also involved in the concussion class-action case that was settled for $756 million last year. The players involved in the current claim are seeking class-action certification.

What are the details of the new lawsuit? First, it spans a number of decades, covering the years between 1968 and 2008. During that forty-year period, the former players argue that “team physicians and trainers across the NFL routinely—and often illegally—provided powerful narcotics and other controlled substances on game days to mask the pain.”

Some of the prescribed painkillers include Percodan, Percocet, and Vicodin. But more than just painkillers are involved. The former players also contend that powerful anti-inflammatories like Toradol, and sleep aids like Ambien, were “handed out like candy at Halloween” and “often combined in cocktails,” according to the article in the Insurance Journal. Indeed, the lead attorney in the lawsuit indicated that some of the teams that have been implicated even “filled out prescriptions in players’ names without their knowledge or consent.”

Long-Term Health Damage from San Diego Physician’s Decisions

The alleged effects of narcotic use in the NFL have included long-term health damage, according to the players involved in the lawsuit. They’ve reported a “range of debilitating effects,” which include chronic muscle pain, bone ailments, permanent nerve damage, and organ damage as a result of addiction to some of the drugs named.

And according to Wiley, who suffered partial renal failure earlier this year, the then-San Diego team doctor David Chao regularly supplied him with painkiller injections over an entire season. Chao allegedly gave Wiley the “multiple injections” to help him cope with what he had diagnosed as a “severe groin sprain.” However, an independent physician diagnosed Wiley with “a torn abdominal wall” that actually “required surgery.” The Medical Board of California has since placed Chao on probation, and his license was revoked. And back in 2012, a jury found Chao liable for another patient’s injuries.

The players will need to prove a “cause and effect” relationship between the painkillers and their current injuries. Additionally, they’ll need to show that their health problems are more pronounced than those of other people their age who haven’t been exposed to the same levels of painkiller medications.

Medical malpractice is a serious issue. Indeed, right now many patient advocates in California are working to raise the cap on the damages available to medical malpractice victims in our state. If you have sustained injuries because of medical negligence, you should seek legal counsel. Contact a San Diego medical malpractice attorney at the Walton Law Firm to learn more about how we can help with your case.

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Over the past year, consumer advocates across the state of California have been thinking about the current cap on medical malpractice damages and the possibility for raising that cap. According to an article in Reuters, just last week advocates in favor of raising the medical malpractice cap indicated that “they had gathered enough signatures to place an initiative on the November ballot.” The ballot initiative was a response to thus-far ineffective legislation attempts to raise the damages cap.

The ballot initiative is likely to be controversial, and until quite recently it wasn’t clear whether California residents would have to vote on raising the decades-old medical malpractice cap, or whether the state legislature would have taken care of this without a costly election fight. The cap should have been raised, and the Walton Law Firm strongly supports the effort to raise it.

For San Diego residents who have sustained injuries because of medical negligence, the outcome of the ballot initiative will be very important. In the meantime, if you have suffered a personal injury due to medical malpractice, it’s important to seek advice from an experienced San Diego medical malpractice lawyer. At the Walton Law Firm, we’re paying close attention to the ballot initiative, and we can talk with you about your case today.

Recap: California Medical Malpractice Damages Cap

As you might recall, California currently has a cap at $250,000 for damages connected to pain and suffering. In other words, a jury cannot award more than that amount for pain and suffering sustained because of medical malpractice. Many Californians don’t believe this cap is sufficient. In particular, Consumer Watchdog, a Santa Monica-based organization, has been at the center of the current ballot initiative, which is also backed by trial lawyers, according to the article in Reuters.

What would the ballot initiative achieve? The advocates at Consumer Watchdog are hoping to raise the damages cap to $1.1 million—a number that “would more than quadruple the amount of money a patient could be awarded for pain and suffering in a malpractice case.” In short, raising the damages cap is patient-friendly goal. The backers of the initiative have collected 840,000 signatures, which is far more than the 505,000 signatures required under California law to “get it on the ballot.”

Legislative Compromise Failures Leads to Ballot Initiative

In February, state senate Democratic leader Darrell Steinberg introduced a bill concerning the medical malpractice damages cap that would have “avoided a costly and ugly battle between doctors and lawyers over the ballot initiative,” Reuters reported. The compromise proposed by Steinberg would have raised the damages limit to $500,000 under California’s Medical Injury Compensation Reform Act (MICRA). According to Steinberg, the $500,000 compromise would still be “far below the rate of inflation since MICRA became law 39 years ago.”

While representatives for both lawyers and doctors seemed like they “were close to agreeing on the deal proposed by Steinberg,” it turned out that “talks fell apart,” forcing Consumer Watchdog’s hand with the ballot initiative. Without a legislative compromise, the medical malpractice cap is going to go to the voters. Consumer Watchdog is joined by Consumer Attorneys of California.

According to an article in the Washington Post, “the most expensive race of 2014 could be this California ballot measure.” Indeed, the article described the ballot initiative as one that “pits doctors against trial lawyers in a high-stakes political death match.”

It will be important to follow the ballot initiative closely, as it could have serious implications for medical malpractice lawsuits throughout our state. If you have sustained because of medical negligence, contact us today to learn more about filing a claim for financial compensation.

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