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Houston Medical Malpractice Law Blog

Distractions may increase surgical errors

Researchers at the University of Kentucky Medical Center conducted a test involving 15 surgeons with experience ranging from one to 30 years. The surgeons were evaluated on their ability to understand and repeat back words under four variable conditions. These included quiet, background noise in the operating room with music, background noise in the operating room without music, and noise filtered through a surgical mask. The surgeons were tested while performing surgical tasks and while they were not. The experiment was conducted to determine how different variables affect the number of surgical errors that may occur.

The Journal of the American College of Surgeons published the results in its May issue, noting that speech comprehension decreased when background noise was present and the words were unpredictable. However, music appeared to be a barrier only when the surgeon was engaged in a task. There has long been disagreement among healthcare professionals over whether music can sooth operating room surgeons and staff or whether it is a distraction.

Misdiagnosis more common than surgical or medication errors

While the majority of people living in Texas who seek medical attention will receive proper treatment, between 10 and 20 percent of patients may end up with an incorrect diagnosis or one that is not made in a timely manner. Although there is more attention paid to medication and surgical errors, diagnostic errors are actually more common. Even more alarming, this type of medical malpractice occurs mostly in primary-care settings and is related to common medical issues like pneumonia or urinary tract infections.

Misdiagnosis is not a new problem. A study done by the Harvard Medical Practice Study in 1991 found that 14 percent of adverse events were due to diagnostic errors and that three-quarters of these mistakes were related to negligence. In spite of the severity of issues these mistakes cause and their frequency, little attention is paid to them. In the 1999 Institute of Medicine's report on medical errors, misdiagnosis was only mentioned two times.

Surgical error causes removal of wrong organ

Texas residents may be surprised to hear that a patient had the wrong kidney removed by a surgeon at Mt. Sinai Medical Center in New York. This came as quite a shock as the hospital enjoys an excellent reputation and is considered a superior teaching hospital. Apparently, this patient had a serious disease in both of his kidneys, which the hospital states was a possible cause for the surgical error. Surgeons have since done a second operation and removed the other kidney and the patient is on dialysis.

Johns Hopkins has done a study of surgical errors such as this and discovered that doctors do the wrong procedure on people approximately 20 times a week across the United States. The wrong procedure may mean that a person expecting a colonoscopy might instead have an appendectomy.

Pregnant women advised against valproate for baby

Expectant mothers in Texas may be interested to hear that the Food and Drug Administration has advised pregnant women not to take valproate sodium products. According to the FDA, studies show that IQ scores in children whose mothers took valproate while they were pregnant are lower than other children's scores.

Valproate medications have been approved to prevent migraines as well as treat epilepsy and manic bipolar disorder episodes. However, the director of the Division of Neurology Products in the FDA's Center for Drug Evaluation and research states that the treatment benefits of valproate are far outweighed by the birth injuries they can contribute to. He advises that pregnant women should never take valproate or products containing valproate.

Telemedicine is getting closer every day

The technology that has been changing lives for decades has now arrived in a virtual medical office. The time is fast approaching when patients will Skype their visits with their doctors and their laboratory results are a keystroke away. Presently, Texas patients are seeing the beginning of this electronic medical practice when their doctors have all their information on laptops and prescriptions are sent electronically to the pharmacy instead of on a slip of paper. This may also change the rules in medical malpractice.

A Center for Disease Control survey has shown that the percentage of physicians using electronic medical records is now 72 percent as opposed to just 48 percent in 2009. Further statistics show that this use of technology has been helping correct human error, which kills around 98,000 people every year. The federal government has been overseeing the digital change in medicine, and Medicare is beginning to authorize payment for it.

Bullying medical professionals may lead to errors

There are "bullies" in just about every profession in Texas and the rest of the country, but when the bullies in question are doctors and nurses, it can affect the safety of patients. In recent years, there has been growing concern that disruptive behavior from doctors and nurses is directly leading to surgical errors. An organization that accredits hospitals has published standards that state disruptive behavior includes things like physical threats, verbal outbursts and refusing to perform duties or answer questions.

This concern is backed up by research data: A recent study was completed by the The Joint Commission Journal on Quality and Patient Safety that surveyed more than 4,500 health care workers. More than three-quarters of of respondents reported disruptive behavior from doctors and nearly two-thirds reported disruptive behavior from nurses. Those surveyed stated that two-thirds of these behaviors were a factor in medical errors, and a third were a factor in patient deaths.

Study shows hospitals make money from surgical errors

Texas residents who regularly receive medical care may be shocked to hear about a study that recently appeared in the Journal of the American Medical Association showing that hospitals make more money when a patient does not receive proper care. Researchers found that when a patient ended up with complications stemming from hospital negligence, the hospital ended up taking in an average of $30,500 more than if a patient was cared for properly. While the researchers do not believe this is intentional, increased revenue creates little incentive for hospitals to improve patient care.

The study looked at over 34,000 patients who underwent surgery in 2010 and found that just under 2,000 ended up with preventable complications, including blood clots and infections. Those who suffered complications had their median hospital stay quadruple to 14 days, and in many cases, insurance providers paid the hospital for the extra care.

Robotic surgery may have human errors

Texas residents may have noticed that robotic surgery has spread across the U.S. in recent years. In fact, the use of robot machines has grown from approximately 112,000 surgeries in 2008 to over 360,000 in 2012. The robot surgery machines cost $1.45 million and hospitals, as a way of competing for business, have put it into their websites and advertising to attract patients. The machine, called the Da Vinci, has been rated as highly effective in certain kinds of surgeries, particularly where there is only a small space in which to operate.

In recent years, however, there have been a number of reports of injuries and deaths in operations using robot surgery machines. Some cases have resulted in jury findings of medical malpractice and large awards to injured persons or their survivors. In some cases in which persons were injured or died, expert testimony questioned the use of robots, asserting, in effect, that it was not appropriate to use such complicated machinery for a simple procedure.

Using malpractice cases to prevent future malpractice

In an effort to reduce the number of medical malpractice cases in Texas and throughout the United States, an attorney has proposed a system that would allow these cases to be used as teaching tools to prevent future medical errors. The attorney, who represents patients in medical malpractice cases, has stated that these cases represent a large amount of information that could be used to help doctors avoid similar behaviors.

The proposed program would remove the names of the patients, protecting their anonymity. This would be done by having lawyers from both sides create summaries of the trial and highlight important information. These summaries would then be made available in a database that doctors and hospitals would have remote access to via the Internet. This database could also allow other practitioners to leave notes regarding their experiences, vastly expanding the amount of information about malpractice cases and helping to make doctors more attentive.

Dentist may face criminal charges in unusual case

Texas residents and people throughout the country should be concerned about the type of public health issue exemplified by a recent extreme case involving an Oklahoma dentist who may be facing felony charges along with charges of creating a public health menace. The practitioner, who has been practicing for 36 years, had voluntarily given up his license, but the dentistry board has now asked the local prosecutor to investigate charges of practicing dentistry without a license among other felonies that could carry a penalty of four years in prison.

The incident that started the investigation occurred when one of the dentist's patients tested positive for HIV; although more complete testing found them free of HIV, they tested positive for Hepatitis C too. The dentist had two offices, in which investigators found "rusty instruments," sterilization equipment being misused and potentially contaminated drugs. This dentist had previously been sued for medical malpractice in a case that settled over 10 years ago. 

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