Videos show impact of medical errors

In powerful new videos, three courageous individuals share how systemic health care quality problems forever changed their lives and the lives of their parents, children, and families. The subjects in the videos are members of the Consumer Health Quality Council of Health Care for All and make a powerful call for reform. You can view them by clicking here.

Health Care For All seeks to create a consumer-centered health care system that provides comprehensive, affordable, accessible, culturally competent, high quality care and consumer education for everyone, especially the most vulnerable. The organization works to achieve this as leaders in public policy, advocacy, education and service to consumers in Massachusetts.

The video stories show how systemic problems in the quality of health care can have a permanent impact on lives. Health Care for All posted these stories to share their experiences and to enact change in the health system for the benefit of future consumers.

In the first video, Linda lost her mother to preventable medical errors. In the second, Ginny’s life was changed forever by a preventable hospital-acquired infection. And in the third, Lisa survived a terrible misdiagnosis and as an empowered health care consumer later saved her daughter from the same misdiagnosis.

If you are moved to do something, please visit http://www.hcfama.org/quality to join the movement for a safer, higher quality health care system.

Florida still facing high malpractice rates despite alleged reforms

Doctors in Florida still pay the highest malpractice insurance rates in the country despite efforts to keep malpractice claims out of court. In fact, malpractice claims have gone down, but the insurance rates remain high. Payouts on claims and legal expenses dropped in Florida about 43 percent between 2003 and 2005, the most recent data available. In 2003, Florida companies paid over $989-million and by 2005 that figure was $557-million, according to National Association of Insurance Commissioners records.

In 2003, under pressure from doctors and insurers, Florida made it more difficult to sue. Thousands of doctors marched at the State’s capital, demanding relief and some protested by delaying surgeries. The Legislature met in three contentious special sessions before agreeing on a $500,000 cap on medical malpractice claims. Malpractice insurance rates were supposed to drop by 8% under the statute, but that never happened.

Now some doctors are requiring patients to sign waivers that forfeit their right to file a lawsuit before getting treatment. Before patients ever see a doctor with Tampa Bay Women’s Care, they must sign a two-page waiver and any disputes about care must go to an arbitration panel.   The center has even posted videos on-line explaining the waiver program.  Patients may even be required to sign a statement indicating that they have reviewed the video at their next office visit with a Tampa Bay Women’s Care provider.

For more on this story, you can view the article in the St. Petersburg Times by clicking here.

R.I. Lawmaker Targets Hospital Errors

Between 44,000 and 98,000 patients die each year in U.S. hospitals because of mistakes, infections and other adverse situations. That’s more deaths than those caused by breast cancer, AIDS or car accidents.

Most of those deaths are avoidable, acoording to Rhode Island Sen. Charles J. Levesque (D-Dist. 11, Portsmouth, Bristol), who has introduced legislation aimed at reducing their occurrences in hospitals in his state.

Senator Levesque’s “Patient Safety and Medical Error Reduction Act” (2007-S 0650) would require all hospitals in Rhode Island to participate in a program to increase patient safety by reducing medical errors.

Most of the hospitals in Rhode Island are among the 3,000 hospitals nationwide already participating voluntarily in a campaign run by the Institute for Healthcare Improvement to reduce medical errors, infections and other mishaps.

Their voluntary participation is excellent, said Senator Levesque, but he would like to see them all taking part.

“Everybody involved in the health care system wants patients to be safe and to receive proper care when they’re in the hospital. I’m sure we can all agree that all hospitals in Rhode Island should be doing everything they can to reduce mistakes, hospital-acquired infections and medication errors so every patient can leave the hospital healthier than when he or she arrived,” said Levesque.

The act specifically lists two national organizations – the National Quality Forum and the Institute for Healthcare Improvement – that have developed programs to help reduce medical errors, but hospitals would be allowed to use other programs as long as they are approved by the Department of Health. Each hospital would be required to report their progress in improving patient safety.

The act would also link hospitals’ performance in terms of patient safety to funding by allowing the Department of Human Services to use it to determine their reimbursement rates.

Common ways hospitals can increase patient safety include standardizing safety, communication and sterilization procedures. Computerizing patient information to the greatest extent possible is also a way to reduce the possibility of human error.

According to a 1999 Institute of Medicine report, To Err is Human, costs of preventable “adverse events” in hospitals are estimated to be between $17 billion and $29 billion every year.

“Mistakes in hospitals hurt everyone. They tarnish the health care industry, they cost everyone money in the form of higher health care and insurance costs, and worst of all, they cost lives. I commend the hospitals in Rhode Island that are already taking the initiative to reduce errors and infections, and I hope this legislation formalizes this process and ensures every hospital’s full compliance,” said Senator Levesque.

The Great Medical Malpractice Hoax

Public Citizen has just issued a must-read report entitled The Great Medical Malpractice Hoax. This report examines the issue of medical liability in two parts. The first part reviews NPDB data and shows that the claims of the business and medical lobbies are exaggerated and unsupported by the facts. The second part examines data related to physician error and discipline. This section notes some disturbing trends and reveals that the real medical crisis is the high incidence of preventable medical error, as well as the lack of accountability for a small set of doctors who commit a substantial number of avoidable errors that seriously injure patients.

The report goes on to say: “Fundamentally, an agenda that blames injured patients and seeks to close access to the courts – contravening a Constitutional right – is about protecting business profits over patient health. It is far past time for real health care reform, and for a health care system that puts patient safety first.”

This report analyzes data in the National Practitioner Data Bank Public Use File, dated 31 December 2005, and issued the following key findings:

• Medical Malpractice Payments Are Actually Declining. The number and the total value of malpractice payments to patients have been flat since 1991. Both show a significant decline since 2001, when the last so-called “crisis” began.
  • The number of malpractice payments declined 15.4 percent between 1991 and 2005.
  • Adjusted for inflation, the average annual payment for verdicts declined 8 percent between 1991 and 2005.
  • Payments for million-dollar verdicts were less than 3 percent of all payments in 2005.
• Payments Correspond to Severity of Injury. The medical liability system is not irrational – patients do not win big jury awards for frivolous claims. Instead, evidence shows the current system works reasonably well. Patients with minor injuries receive little compensation, while the bulk of malpractice awards occur in cases involving severely debilitating injuries or death.
  • Over 64 percent of payments in 2005 involved death, or major or significant injuries.
  • Payments for “insignificant injury” were less than one-third of 1 percent of payments in 2005.
• Patient Safety Is the Real Crisis. The latest NPDB data underscore the fact that the real medical malpractice crisis continues to be inadequate patient safety, rather than the legal system. Instead of being distracted by business lobby myths about the court system, heath care providers should improve patient safety and better protect the health of patients.
• Improving Patient Safety Will Save Lives. One-third of malpractice cases resulting in a malpractice payment in 2005 (4,504) involved the death of a patient.[8] Yet, as a 1999 landmark study by the Institute of Medicine showed, an estimated 44,000 to 98,000 patient deaths occur each year as a result of preventable medical errors in hospitals.[9] Stemming preventable errors alone would, conservatively, prevent ten times as many deaths as are now accounted for by malpractice cases.

You can read the full report by clicking here.

Medication errors among the most common medical mistakes

Medication errors are among the most common medical mistakes, injuring or killing at least 1.5 million people a year and incurring at least $3.5 billion a year in extra hospital costs alone, according to a report issued in July by the Institute of Medicine of the National Academy of Sciences. This was the institute’s second report on the subject, and the committee that compiled it stated that insufficient progress had been made since its first report, “To Err Is Human,” was issued in 1999.   The New York Times published a story on the report which can be viewed by clicking here.

Death rates for heart surgeons to be published

Massachusetts will begin to publicize the patient death rates for heart surgeons. A website will feature the mortality rates for 55 surgeons that perform cardiac bypass operations. Based on the state’s most recent statistics, nearly 4,000 patients have undergone bypass surgery in 14 MA hospitals.

Beginning Dec. 18, it will be possible to go to a website and look up the mortality rates for 55 surgeons who perform cardiac bypass operations. The decision will make Massachusetts the fourth state to release such data on heart surgeons.

The heart bypass results will be posted on the Mass-Dac web site, the Harvard Medical School center that collects and analyzes heart patient data for the state.

The Division of Health Care Quality in the Department of Public Health’s website also will post an abbreviated form of the mortality data.

A Case that Shook Medicine

The father of an 18-year-old woman who died within 24 hours of an ER admission in October 1984 set in motion a series of reforms that would improve modern medical education. Work hour limitations were enforced by the Accreditation Council on Graduate Medical Education after the father learned his daughter was treated by medical residents working extremely long hours with little supervision. By pursuing his case against the hospital, he also “helped set the stage for the medical-errors movement that began in the 1990s.”

Lawyer and journalist Sidney Zion set in motion a number of events to avenge the death of his dauhgter Libby Zion. It took 10 years for his daughter’s case to go to trial, but he was persistent. By championing the cause of patients and families who believed they had been harmed by the medical profession, Zion helped set the stage for the medical-errors movement that began in the 1990s. To aggrieved patients and their families, Zion became a sort of folk hero.

The Washington Post ran a story on the case and Sidney Zion’s efforts on November 28, 2006. Click here to read the complete story.

This story highlights the need for a vibrant system of justice in this country. For years, trial lawyers have used litigation and the threat of litigation to help American citizens. Holding those who cause harm accountable is the bedrock of our system.

Death in Illinois ER ruled homicide

A coroner’s jury has declared the death of a heart attack victim who spent almost two hours in an Illinois hospital waiting room to be a homicide. The patient had waited almost two hours for a doctor to see her after complaining of classic heart attack symptoms - nausea, shortness of breath and chest pains.

She was seen by a triage nurse about 15 minutes after she arrived, and the nurse classified her condition as “semi-emergent.” The patient’s daughter twice asked nurses after that when her mother would see a doctor.

When her name was finally called, a nurse found the patient slumped unconscious in a waiting room chair without a pulse. She was pronounced dead shortly afterward. She died of a heart attack, but the jury at a coroner’s inquest ruled that her death also was “a result of gross deviations from the standard of care that a reasonable person would have exercised in this situation.”

Restraining doctors isn’t the answer

It is not only with automobile claims that insurance companies throw obstacles in the path of claimants. As highlighted in an op-ed piece in today’s Boston Globe, physicians too have to contend with obstacles in their pursuit of quality healthcae for patients. As the author points out in the article, over the past few years, insurers have heightened pressure on physicians to do what is in their best interest, as opposed to the patient’s.

The author is a primary care physician in private practice in Framingham, Massachusetts. He gave an example of one pressure filled decision:

A watershed moment came for me last year when I diagnosed liver cancer in a 23-year-old man. No one wearing a clinical hat would disagree that this young man’s future hinged on what a PET scan would show — whether the cancer was confined to the liver or had spread — but you wouldn’t know that from the battle I waged with his insurer. It took more than three hours, culminating in an impassioned plea to a senior insurance company executive, to obtain the precious approval number for the scan. A major casualty was a canceled morning of patients.

He left us with the stark reminder that the ownership of healthcare belongs to patients, and decisionmaking belongs to physicians and their patients. If only the insurers felt this way……

Medical malpractice needs reform indeed

We are inundated with reports of how medical malpractice laws throughout the country need to be reformed to make it tougher to sue doctors. Claims of runaway juries and frivolous lawsuits often are used as a backdrop for tort reform movements. A recent article in the Milford Daily News highlighted many of the fallacies of these arguments. It focuses on the case of a young girl profoundly injured by alleged medical negligence who is unable to sue because of a statute of limitations. Indeed, the article made several great arguments for reforming the law to make it easier to sue.

The paper also included a companion article which included statistics on actual results in legal cases against physicians. The article begins as follows:

Every time a jury awards a multimillion dollar payment to a patient harmed by a doctor, critics decry the supposed proliferation of frivolous lawsuits from patients looking to cash in by suing physicians.

Yet a Daily News analysis finds that patients rarely prevail in malpractice suits against doctors.

Only five plaintiffs who have sued doctors for negligence at Middlesex Superior Court since 1998 have been awarded payments by judges or juries (see box). Eighty-eight plaintiffs had their claims dismissed after a trial during the same time period, a Daily News review of court records found.

When you hear cries about the need to put an end to the so-called “litigation lottery” and runaway juries, you should re-read these articles to see who truly gets the short end of the stick.