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← Older postsIndiana Preventable Medical Errors Decline
The Institute of Medicine (IOM) conducted a study in which it estimated that at least 44,000 to 98,000 preventable medical errors that result in death occur in United States hospitals annually. Even the lower figure of 44,000 deaths causes preventable medical errors to rank in the top ten leading causes of death in the United States. Following the release of this report, a large-scale effort to reduce these errors has been undertaken by hospitals nationwide, Indiana hospitals included. It appears to be working because Indiana hospitals saw a decrease in errors from 2008 to 2009.
In the Indianapolis Star article “Indiana’s preventable medical errors fall,” author Daniel Lee notes the overall drop in reported medical errors in the state from 105 errors annually in both 2007 and 2008 to 94 errors in 2009. In part, the decline can be attributed to the Department of Health’s Indiana Pressure Ulcer Initiative, a program aimed at reducing pressure ulcers (also called bed sores). Bed sores decreased by 33% in 2009 to 22 from 33 in 2008. Indiana University Health (formerly Clarian Health) reported the highest number of errors at 18, however, it is also the busiest hospital system in the state. The most common errors were retention of a foreign object (29 instances) and surgery on the incorrect body part (17 instances).
Connect the tubes – Not a game you want your nurse to play…
As technology advances we’ve come to embrace devices that make our lives easier. Smart phones that surf the internet, play games, send emails, send text messages, tweet, take pictures and, occasionally, make a phone call. A single universal remote that controls your television, DVD player, cable box, sound system, and maybe even your blinds is another example. However, this interchangeability might not be ideal in all settings, such as your hospital room.
Hospital patients can have a multitude of tubing entering their bodies in order to provide fluids, nutrition, oxygen, blood, and medicine. It might shock many to learn that much of that tubing is interchangeable. The interchangeability spans across gaseous, intravenous, feeding tubes, and more. If liquid food or air is mistakenly put into the bloodstream it can be extremely damaging and even deadly. Many healthcare professionals are demanding that the FDA force standards groups to redesign the tubing connectors. For example, a feeding tube’s connector wouldn’t be compatible with an intravenous line’s connection so the two wouldn’t work together. A survey in 2006 found that 16 percent of hospitals had experienced a case in which there had been a feeding tube mix-up; a clear need for regulation. However, slow approval processes by the FDA and resistance from manufacturers have delayed any regulation from occurring.
Your Medications and What They Mean to Your Health
Millions of people are prescribed medications, and many are prescribed multiple. Despite the stringent oversight of the U.S. Food and Drug Administration (FDA), many negative side effects or bad interactions with other medications can still occur, even when taking medications as instructed. These adverse drug events/reactions are defined as “any undesirable experience associated with the use of a medical product in a patient,” according to the FDA.
The main sources of these adverse events include:
- An individual’s body simply reacts badly to a drug in an unexpected way
- Incorrect dosing or incorrect administration of a drug
- Combination of medications resulting in an adverse event
Dr. Cindy Haines draws attention to these unfortunate events in her article, “What Patients Can Do to Prevent Medication Errors.” A study conducted by Health Services Research found that half a percent of all ambulatory healthcare visits in adults are related to adverse drug events. These undesirable effects account for 4.5 million doctor visits each year. The American Medical News found that nearly 1.9 million hospital stays had a drug-related adverse outcome in 2008.
Of these events, high risk factors can increase the likelihood of an adverse event occurring. People who take six to eight medications were found to be four times more likely to visit their doctor due to an adverse reaction to medication. Typically, the elderly take more medication so as a result they have a higher risk as well compared to young adults. None of these results include information based on children.
It is estimated that more than 100,000 patients die from adverse drug events in the U.S. each year. Dr. Haines suggests the best way to avoid such an event is to reduce the number of medications you take and to make lifestyle changes in order to prevent the need for medication. Things such as exercise, eating more plant-based foods, maintaining a healthy weight, and not smoking are great ways to prevent disease. Also, be aware what medications you are taking (prescribed or over-the-counter) and talk with your doctor and pharmacist about any potential drug interactions or known side effects.
The Month of July and Your Health
Many people take the opportunity to clear off their to-do lists during the summer months. An elective medical procedure might not want to be one of your check offs. A study by the Journal of Internal Medicine found that there is a 10% increase in fatalities in teaching hospitals during the month of July. In large part, this can be attributed to new doctors beginning their residencies during this time. Many of these deaths are attributed to errors in prescribing medications.
A 2008 study conducted on Medicare recipients, mandated by Congress, found that 1 in 7 hospital patients had an unintended harm that caused them to stay in the hospital longer, resulted in permanent injury, needed life-sustaining treatment, or caused death. While these numbers are staggering and should cause alarm, you are not necessarily helpless when it comes to preventing these errors. Being a proactive patient can help prevent some of these errors from occurring.
Being a proactive patient:
1. If you can, pick a hospital with a low-level rate of infection. Your doctor can help you look over your options.
2. Make sure your doctor is board certified in his or her specialty and that he or she has performed the procedure a number of times.
3. While convenient for recovery time, Friday afternoon procedures are not at the most optimal time for reducing errors. Doctors and staff have found to be more fatigued.
4. Hospitals that have switched to electronic medical records report less prescription and dosage errors as well as drug interactions.
5. Be aware of your predisposition for blood clots as measures can easily be taken to prevent them.
6. Enlist the help of friends and loved ones. They might be able to ask questions you haven’t considered or be able to help you make decisions when faced with difficult choices. Additionally, medications might sedate or impair your thinking, so it is a good idea to have someone who is helping to look out for you.
7. If having a surgical procedure done on certain body part, for example a knee, mark the knee that is supposed to be operated on and mark the other knee so that they know it is not the correct one.
8. Be aware of shift changes between nurses and make sure that all medication dosages and other pertinent information are passed along to the new shift.
9. Make sure that everyone has washed their hands or used hand sanitizer before interacting with you in order to reduce the risk of spreading bacteria that could cause infection.
10. Be nice! Being a good patient can help make the staff more attentive and willing to help.
Dying Indiana Doctor Complains About Unfairness of Malpractice Act
Indianapolis television station, WRTV channel 6, is reporting the case of an Indiana doctor, a victim of medical malpractice, who is publically complaining about the unfairness of the Indiana Medical Malpractice Act. http://www.theindychannel.com/health/27948488/detail.html. Dr. Hubbard has terminal cancer which was apparently misdaiagnosed at an earlier stage when it was treatable. Dr. Hubbard went through the medical review panel proccess required by the Act and received a unanimouis opinion that the defendant doctor committed malpractice. Yet, despite that decision, the defendant’s malpractice insurance company has refused to settle his claim. Futrthermore, Dr. Hubbard is upset because he has 4 million in lost future income and 1.8 million in medical expenses, yet despite these losses, the Act caps his recovery at 1.2 million.
Dr. Hubbard is finding out personally what other victims of malpractice have known for decades, that the Indiana Medical Malpractice Act is unfair the most to those who have suffered the most. Since the Act caps all damages, there is no remedy for those whose injuries exceed the 1.2 million cap. Consequently, for those who are paraiplegic, brain injured , quadriplegic, or families who have lost the lifetime income from the wrongful death of a loved one, the Indiana Medical Malpractice Act is patently unjust. My partner, Caroline Gilchrist, just settled a case involving a profoundly brain injured child as a result of malpractice during his mother’s labor and delivery. His mother must feed him, bathe him, dress him and otherwise provide around the clock care. He can not talk or walk and may never do so. The cost of a lifetime of care for this child will vastly exceed any recovery, even though a settlement in the case will most likely include the entire 1.2 million cap under the Act.
Additionally, Dr. Hubbard is finding out for the first time that just because a medical review panel composed of the defendant’s peers finds the defendant committed malpractice it does not mean there will be a settlement. In fact, it is unlikely there will be a settlement, even in cases of obvious malpractice. This is also due to the affect of Indiana’s cap on damages. The malpractice insurance carriers in Indiana have figured out that if a vicitim of malpractice is asking for the maximum of $250,000 the doctor is responsible for, they are better off proceeding to trial regardless of the medical review panel’s decision. This is because they know juries in Indiana are very conservative and consequently, they will win a certain percentage of those cases. Consequently, if they are going to pay $250,oo if they settle and $250,00 if they lose at trial , they might as well try the case. If they win even 2 out of every 10 they have saved the company money. It is not about what is right or just, or even whether the defendant actually committed malpractice, only about how the insurance comapny can increase its profits. Until there is some penallty for proceeding to trial and losing, they will continue to “game the system.” And vicitms, like Dr. Hubbard, will be victimized twice, once by an act of malpractice and a second time by the Indiana Medical Malpractice Act.
More Mistakes are Made By Physicians Later in the Day
Although the US Preventive Task Force recommends that anyone between the ages of 50 and 75 be screened for colon cancer, The American Journal of Gastroenterology reported in its March issue a recent study which found that the more colonsocopys a physician performs during the day the less likely they are to discover potentially cancerous polyps. In fact, the most colonsosopy’s performed by the physicians in the study was tweleve and that, on average, by the twelfth procedure the physician would miss almost half of the number of polyps discovered during the first hour. http://news.yahoo.com/s/nm/20110428/hl_nm/us_colonoscopy . This study is another example of how physicians are not immune to the same factors which lead to errors in other jobs in society. Therefore, it is important for the medical community to begin to implement known safety protocols to prevent the tens of thousands of errors whcih result in injury and death every year in the United States due to medical negligence. Until that day arrives every patient and their family members must be diligent in doing all they can to first insure they are receiving the appropriate care. However, if you have been the vicitim of medical malpractice, don’t let it happen to someone else, call either Caroline or myself and let us hold the healtcare provider accountable. Procedures and policies change only when there is also a system of accountability. We look forward to doing all we can to help you and your family.
Who is covered by the Indiana Medical Malpractice Act?
The Indiana Medical Malpractice Act has to be followed in a negligence case when the healthcare provider is a “qualified healthcare provider” – which essentially means that the healthcare provider has followed certain steps, which include obtaining malpractice insurance coverage and paying a surcharge funds the monies managed by the Indiana Patient’s Compensation Fund.
Physicians, nurses, hospitals, midwives, paramedics, dentists, optometrists, podiatrists, chiropractors, physical therapists, occupational therapists, psychologists, and EMT’s are examples of the type of healthcare providers that are included in the definition of a “health care provider” under the Act. Pharmacists and pharmacies generally are not. Some nursing homes are qualified health care providers, but not all.
If you do not know whether your case falls under the
How To Select A Personal Injury Attorney, Part 2
My last post provided a general overview of how to select a personal injury attorney, but I now want to discus some specific qualifications you should look for in making your decision. First, and most important, is whether that attorney has trial experience and would be willing to take your case to a jury trial, if necessary. Be sure and meet with your attorney, not just a paralegal, and ask that attorney about his/her trial experience. An attorney’s willingness to try a case is important because insurance companies keep close track of a personal injury attorney’s record. When an insurance company determines that the attorney will settle for the last offer, whatever it may be, instead of proceeding to trial, it will never offer a reasonable some for your claim. Instead, the insurance company will simple make a minimal offer and wait until the attorney agrees to settle to avoid a trial. This does not mean every personal injury claim should be tried and, in fact, most personal injury claims are settled for a reasonable sum without a trial. But you have little chance of receiving what you deserve if there is not a credible threat of trial.
Second, look for an attorney who can provide you with individualized service. After all, you are hiring your attorney to serve your needs at a very difficult time in your life. Therefore, you should be able to speak with your attorney when you have questions and you should expect that attorney to be willing to tell you exactly what progress is being made on your case and what a reasonable expectation for the future may be. In some cases you maybe working with your attorney off and on for several years, so you should feel comfortable with your lawyer.
Look for an attorney that has experience in your type of personal injury claim. There are many different legal claims that fall under the umbrella of “personal injury” law. These include workers compensation, which involves any on the job injury by an employee, construction site injuries; involving injured workers that may have claims in addition to workers compensation, automobile accidents, slip and falls, medical malpractice claims, defective products or medical devices, pharmaceutical claims, etc. Very few “personal injury” attorneys handle every type of claim, and even the ones who advertise for certain types of claims, such as claims against drug manufacturers for injuries caused by side effects, will refer your claim to another attorney who is actually litigating the claim.. It is particularly important for you to find a lawyer who has experience if your claim involves more complex litigation. For example, medical malpractice claims in Indiana are very difficult claims that should only be handled by experienced attorneys. This is because Indiana has some peculiar laws related to malpractice claims that can create traps for the inexperienced that may prevent a recovery in an otherwise valid claim.
Another consideration when looking for a personal injury attorney, is whether that attorney is willing to advance the litigation expenses of your case, to be reimbursed out of any settlement, or whether they expect you to pay those expenses as the case proceeds. Litigation expenses include items such as, medical record copies, court filing fees, physician opinion letters, expert fees, depositions, etc. These expenses can be a few hundred dollars or tens of thousands of dollars, depending on the nature of the case and whether it is tried or settled. Caroline and I are here to help you, not add to your burdens, and if you come to us because you have unpaid medical bills and then you are asked to pay hundreds, if not thousands of dollars, for litigation expenses, we have done nothing but add to your burden. Your personal injury attorney should have enough confidence in your case and enough capitalization to be willing to advance any expense that may be incurred while representing you.
Caroline and I are here to serve you by using our expertise and knowledge of the law to help guide you through our complex legal system. If you want to know if we can help you or your family call us at 317-272-0008 or email me at rbaker@bakerandgilchrist.com
How to Select a Personal Injury Lawyer, Part 1
With all of the competing claims by lawyers through websites, direct mail solicitations, and television and radio advertising how is a person with no prior contact with the legal profession suppose to pick an attorney when they have questions because they or a family member has been injured? First, it is important for you to try and recognize what type of claim you may have because the type of claim may dictate the type of lawyer you want to speak with. For example, if you believe you may have a medical malpractice claim then you certainly want a lawyer who has experience litigating medical malpractice cases, including actual, successful, trial experience. That is particularly important in medical malpractice claims because they are some of the most difficult injury cases to handle as an attorney and there are very few attorneys in Indiana who have litigation experience representing victims of malpractice.
On the other hand, if you have been injured in an automobile collision then there are many attorneys who can provide you with some basic advise, and if necessary, be of assistance by representing your interests before an insurance company. Until just this year, attorneys in Indiana were permitted by the Indiana Supreme Court to send ” direct mail” advertisements to anyone involved in an automobile collision. These attorneys would purchase police accident reports and solicit business from those injured in the collision. It was not uncommon for parties to a collision to receive dozens of solicitations through the mail including videos and slick brochures. I have had clients bring in a large stack of direct mail advertisements from attorneys. However, after the first of this year that has changed. Now attorneys in Indiana are prohibited from direct mail advertising during the first 30 days following an automobile collision. If you have been solicited by an attorney within 30 days of an automobile collision you should contact the Indaina Supreme Court Disciplinary Commission.
If you you have a claim arising from an automobile (including semi tractor/trailer collisions) you must first consider whether you even need an attorney. How do I know if I need an attorney? Caroline and I always tell people who call us that if we can not add value to your claim we will tell you that you don’t need an attorney. By “adding value” I mean will you recover more in your pocket with representation than without? If the answer is no then you don’t need an attorney. If the only damage is property damage to an automobile then it is unlikely an attorney will be able to help because the value of the automobile is fairly fixed. You are entitled to the fair market value of the automobile if it totaled and loss of use. If it can be repaired then it is the cost of repairs, plus loss of use, plus the diminished value of your automobile because it has a collision history versus the same automobile that has a clean repair record.
Similarly, if you have only suffered “minor” physical injuries then it is likely you will recover as much compensation without an attorney as with an attorney. This is because the amount you may recovery is limited. You can always recover your medical expenses and in many cases lost wages, but where an attorney can add value is recovery for the intangible damages such as, pain and suffering, scarring, disfigurement, permanent disability, etc. In the case of minor injuries, and by “minor” I mean a couple of thousand dollars in medical expenses or less, there are not a lot of intangible damages and there is not much an attorney can do that will add value over and above what you could recover directly from the insurance company once you consider the additional cost of attorney fees. However, this is not always the case. For example, if there is a young girl with facial scarring her medical bills will likely be minor but the amount of any intangible recover will be significant. Therefore, it is essential that you always consult with an attorney if you or a family member has been injured in a automobile collision, since it is not always obvious whether an attorney can truly be of assistance. Call Caroline or me and we will be happy to review the facts of your claim and tell you if you really need an attorney.
Suppose you know you have been badly injured and you will likely need an attorney, how do select an attorney in those cases? Of course the first thing to look for is whether the attorney you are considering has experience in personal injury litigation. This may seem obvious, but it is a common seense rule that I frequently see ignored. There are many attorneys that represent a variety of clients, including everything from bankruptcy to divorces. While they may be able to assist you in some personal injury claims, experience can never be overestimated. In Indiana attorneys can not hold themselves out as “specializing” in personal injury law, so it is important to look at what types of personal injury cases the attorney or firm has handled and whether they have the experience necessary for your case. I personally have never practiced any other types of law since graduating from law school 25 years ago and so I have seen just about everything. If your case is somehow unique and I don’t feel qualified to represent you I will tell you I can’t help and refer you to another attorney who I know has the experience and training that will insure you receive the advice you need.
Injured On a Commercial Construction Site?
One of the most dangerous jobs in the United States is that of a construction worker. A construction worker may be an ironworker, a hod carrier, a carpenter, a laborer, a electrician, or a variety of other skilled and unskilled positions. The occupational safety and health administration (OSHA) governs the rules and regulations for safety on all construction sites in the United States. Indiana also has its own division of occupational safety and health (IOSHA) which in addition to OSHA also oversees safety on construction sites in the State of Indiana. However, compliance with safety regulations on a construction site is often left to the subcontractor, whose main focus may be keeping to a construction schedule and saving money rather than the safety and health of its employees. As a result, corners are cut, safety regulations are violated, and construction workers suffer permanently disabling personal injuries or are killed.
For example, one of the most common construction site accident scenarios involves ironworkers who fall. Although OSHA has numerous regulations that require fall protection at commercial construction sites, fall protection is often overlooked or ignored. Ironworkers need to not only be required to tie off when they are ” walking the iron” but they must also have nets above 20 feet to protect them in case of falls, in addition to numerous other safety requirements.
There are too many potential scenarios for injury and too many rules and regulations to set forth in this blog, however, if you are a construction worker or construction worker’s family with questions about your legal rights and remedies, it is important for you to understand that Workers Compensation is not your only remedy. Many times when construction workers are injured on a construction site they are told by their employers, or even some attorneys, that Worker’s Compensation is their only remedy because they were injured in a workplace accident. This is rarely true at commercial construction sites. This is because there is always a contract between the landowner and the general contractor\construction manager. The contract will require the general contractor to be responsible for insuring that OSHA’s rules and regulations are followed on the job site. And even though there is a subsequent contract between a general contractor\construction manager and a subcontractor which requires the subcontractor to also follow safety rules and regulations, the law in Indiana states that the general contractor can not pass on that responsibility to the subcontractors. This means that if safety rules and regulations are not followed as required by OSHA and a construction worker suffers personal injuries or is killed, they or their family may sue directly the general contractor, and in some cases the landowner, in addition to receiving Worker’s Compensation.
The ability of a construction worker to receive compensation in addition to Worker’s Compensation is extremely important. Worker’s Compensation in Indiana only provides limited benefits in the case of permanent injury or death. It certainly would not provide enough compensation for a permanently disabled worker to provide for his family and pay the bills in most cases. The ability to pursue a “third party claim” against a landowner or general contractor means that substantially more money is likely to be available to the injured worker or his family that will protect the future. If you have been injured or lost a loved one in a construction site accident, please contact us at Baker and Gilchrist. We have over 23 years of experience as
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