Most of the lawsuits I deal with have more than one named defendant. For example, the plaintiff (typically a deceased patient’s next of kin) might sue a hospital, a nursing home, and the attending physician at each facility. Sometimes they go a bit further and may even include the administrator, the director of nursing, and individual HCPs, such as the wound care nurse or the registered dietitian nutritionist. When a lawsuit ...

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I read it again this week, and I wonder why the editors of our medical journals continue to perpetuating this falsehood. An article in a prominent journal stated again that medical errors are the third leading cause of death in the United States. We all know this is not the case, and yet editors continue to let this be stated in their journals as if it were fact. Ever since the ...

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An excerpt from Malpractice: A Neurosurgeon Reveals How Our Health-Care System Puts Patients at Risk. It is not possible to live life in a way that every choice and decision awaits a definitive, double–blind study with a statistically significant ...

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A South Carolina jury awarded a woman $4,618,500 for a needlestick injury she sustained in the parking lot of a Target store. She had parked her car, and while walking to the store, her daughter picked up a hypodermic needle. As she swatted the needle out of the child’s hand, it punctured the woman’s palm. She went into the store and notified an employee. HIV post-exposure prophylaxis medications were prescribed which she ...

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As a physician, I knew exactly what was happening when I walked into the emergency room. My eyes were nearly swollen shut. My throat was closing. I was in the midst of a severe allergic reaction known as anaphylaxis. I urgently needed epinephrine, a potent medicine that could halt my life-threatening symptoms. When I told the nurse what was happening, she rushed me to the trauma room where doctors and nurses encircled ...

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“The unintended consequences of these seemingly well-intentioned laws are doctors who can’t apologize for harming their patients even if they want to …” A recent JAMA article about disclosing medical error described a hypothetical situation involving a dermatologist who, after completing skin biopsies on two patients, discovered that the instruments had not been sterilized. He wondered if he should tell the patients and what he should say. The authors of ...

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I have been a rehabilitation specialist and case manager working with patients who have neurological and neuropsychiatric impairments for thirty years. About three years ago, my life took an unanticipated detour when I was perforated during a baseline colonoscopy. All of my experience as a case manger and patient advocate could not prevent this error or the others that followed. Although my health, body, and life were forever altered by the ...

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A few years ago, I missed a diagnosis.  I know that’s not earth-shattering, but the stakes are high for a cardiologist.  Ms. A was an 82-year-old woman with chest pain. She underwent a transcatheter aortic valve replacement (TAVR) for severe aortic stenosis.  The pre-procedure coronary angiogram showed no coronary artery disease and the echocardiogram post TAVR was perfect. However, a few months after the procedure, she reported arm pain.  It was ...

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It was recently reported that medical errors are the third-eading cause of death in the United States after heart disease and cancer. The estimated number per year is over 400,000. This is not new information, and unfortunately, this will not be a simple problem to fix. A portion of these deaths result from health care providers lacking resources and being overextended, both contributing to making errors. Some will also result from ...

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For the last couple of days, the Twitter medical community has been discussing the latest in a long line of papers attempting to estimate the role of medical error as a cause of death. A recent entry appeared in the BMJ and was by a surgeon at Johns Hopkins, Dr. Martin Makary, who claims that 251,454 patients die from medical error every year. Makary's review extrapolated that figure from three papers ...

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Josef Stalin famously said: "One death is a tragedy; one million is a statistic." Perhaps 250,000 preventable deaths from medical errors, according to an analysis by Makary and Daniel in the BMJ, maketh a Stalin. The problem with Makary’s analysis, which also concluded that medical errors are the third leading cause of death, isn’t the method. Yes, the method is shaky. It projects medical errors ...

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I dialed the number to return the call of the nursing home. The nurse who answered the phone was relieved to hear my voice on the other line: “Dr. Mass, thank God you called back! She has been pacing since she woke up, and she refuses to take her meds. We’ve kept her away from Catherine, so they don’t get into another fistfight. But we can’t handle her here anymore. ...

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For a moment, let's forget about his unfiltered voice, bullying, flip-flops, ego, and violence-focused rhetoric. I know suspending this discussion might be interpreted as some as my supporting Donald Trump. I do not. I would rather, however, look at how Donald Trump in the White House might affect the day-to-day lives of physicians. And by this I am not referring to his support or opposition to universal health care, for I ...

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A 42-year-old patient arrived for her annual gynecologist appointment complaining of a self-detected breast lump. She had several questions about her condition and wanted to tell her doctor about a family history of breast cancer.  The doctor was in a hurry and advised her to ask the staff, but the staff was busy with other patients and told her to call them later. The patient did not call. The gynecologist ordered ...

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38 states currently have an apology act. This means that if doctors feel they owe a patient an apology, they may provide one without any ramifications, if future legal actions are taken by the patient/patient’s family. In 2006, I spent 218 days in the hospital after the healthy birth of my daughter. My chronic autoimmune disease, scleroderma, masked certain signs of preeclampsia, which went undiagnosed. This led to a massive infection ...

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In September 2010, a seasoned pediatric intensive care unit nurse administered an accidental overdose to a critically ill baby, giving ten times the amount of calcium that was prescribed. Five days later, this baby, with an already tenuous heart condition, died. The nurse recognized her mistake immediately, informed her superior, and also told the family and physicians. She was, however, escorted out of the hospital, put on administrative leave, and ...

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A Kentucky appeals court ruled that a surgeon was not responsible for a burn caused by an instrument that had been removed from an autoclave and placed on an anesthetized patient's abdomen. According to an article in Outpatient Surgery, the surgeon was not in the room when the injury occurred and only discovered it when he was about to begin the procedure. An insufflator valve had been sterilized and was ...

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For decades, many physicians have been pushing for comprehensive tort reform on the national level. Malpractice claims in the U.S. are twice those of other developed countries such as England, Canada, and Germany. Payouts in a U.S. claim can easily reach 3 million dollars or more; in Germany most claims are around $30,000 or less. A survey conducted by RAND in 2011 estimates that 99 percent of American physicians in high-risk ...

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Did you hear about that recent, groundbreaking study on defensive medicine?  Probably not.  The sites where I regularly read health policy news -- Vox, the Incidental Economist, and the Upshot, for instance -- all failed to mention it.  (Correct me if I'm wrong.) Published in the British Medical Journal, researchers found that doctors who charged more, presumably by ordering more tests, were sued less often: "In six ... specialties, a greater use of ...

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Diagnostic tests such as CT scans are not perfect. A test can make two errors. It can call a diseased person healthy: a false negative. This is like acquitting a person guilty of a crime. Or a test can falsely call a healthy person disease: a false positive. This is like convicting an innocent person of a crime that she did not commit. There is a trade-off between false ...

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