Azithromycin, an antibiotic commonly used to treat bronchitis, pneumonia, ear infections, and sexually transmitted diseases, may actually increase the risk of death in patients, according to a study published in the New England Journal of Medicine last month.
The antibiotic is no newcomer to the world of pharmaceutical drugs, having been introduced on the worldwide market back in the 1980s. The study is the first to actually documents serious risks of cardiovascular fatalities.
]]>According to the study, patients who take Azithromycin are 2.5 times more likely to die from heat complications in the first five days of treatment, when compared to other antibiotics or taking no antibiotics at all. The comparison was reportedly based on examination of patient records in Tennessee between 1992 and 2006.
Researchers compared about 348,000 presciptions of azithromycin to millions of records from individuals who weren't treated with any antibiotics or who received amoxicillin. There were apparently 47 more deaths per million among those taking azithromycin when compared to those on amoxicillin. Among patients already considered at high risk for heart problems, there were an additional 245 cardiovascular deaths per million among those taking azithromycin.
As researchers pointed out, the risks of death are rather low, but still worth consideration by physicians. When there are other safe and effective alternatives, doctors should perhaps turn to other options.
One of the interesting aspects of the findings is that many drugs, even ones that are generally considered safe, have side effects. When a doctor prescribes any medication, the total condition of the patient should be taken into consideration. Failure to do so may have serious consequences.
Source: AFP, "Common antibiotic boosts death risk: study," May 16, 2012
]]>In many of these cases, the errors are avoidable, and there are things patients can do to help prevent them.
]]>One common mistake is treatment of the wrong patient. This often occurs when hospital staff fails to confirm a patient's identity and confuses patients with similar names. Patients can help prevent this by ensuring hospital staff checks all their information and verifies it is correct.
Leaving surgical tools or items inside a patient can occur when surgical staff miscounts or fails to count equipment used inside a patient during an operation. When a tool is left inside a patient's body, the patient may develop unexpected pain, a fever or swelling post surgery. Keeping in mind the possibility that a tool may have been left inside of them, patients can ask their doctor.
Sometimes physicians operate on the wrong body part. This can come about when a patient's chart is incorrect, a surgeon misreads it, or the lighting in the room obscures marks indicating the correct side of the body. Patients can help prevent this by checking prior to surgery that the surgeons will be operating on the body part or side where the operation is supposed to take place.
Patients may become infected when doctors and nurses don't wash their hands, causing an infection to spread. A simple way to prevent this is to make sure hospital staff washes their hands before touching you. If you don't see them wash their hands, ask that they do so.
One medical mistake that is particularly uncomfortable to think about is waking up during surgery because of an under-dose of anesthesia. Most of the time, patients aren't in any pain, but can feel the operation going on, which can be distressing. One way to prevent this is to ask if a local anesthetic may be appropriate for the surgery rather than a general anesthetic.These, of course, are only some of the mistakes that can and do occur. It is good to keep in mind that while physicians are highly trained professionals, they are still capable of errors in judgment. Sometimes those mistakes have high costs, and patients have little choice but to seek recovery.
Source: CNN, "10 shocking medical mistakes," John Bonifield & Elizabeth Cohen, June 10, 2012
]]>The state of Louisiana filed suit against Glaxo last February, claiming that the pharmaceutical misrepresented the safety and effectiveness of the dangerous drug Avandia, and that physicians in Louisiana consequently submitted over 304,000 "false claims" for Medicaid recipients. Caldwell is apparently seeking over $10 billion in civil penalties, actual damages, attorney's fees and other expenses.
]]> Glaxo's claim against Caldwell is that the private attorneys he retained to prosecute the lawsuit are able to be compensated for their services only if the state recovers on its claims against the pharmaceutical.Pharmaceutical countersuits against states seeking to recover misspent funds have apparently become an increasingly common occurrence over the past couple years.
Dangerous drug litigation can be quite complex. While this case is an action of the state against the pharmaceutical for fraudulent marketing, most consumers are probably more interested in their ability to recover against a pharmaceutical for personal injuries resulting from the use of a medication or medical device. In such actions, it can be a daunting task going up against a giant firm that has great financial resources to litigate. But those who are harmed by the mistakes of drug manufacturers deserve to be compensated for their injuries.
Source: The Advocate, "Drug maker sues AG in Avandia drug case," Joe Gyan Jr., June 2, 2012
]]>Misplaced records resulting from doctor mistakes, according to the study, are still a problem even at hospitals that use electronic records. One way the mistake occurs, according to the study, is that doctors sometimes put an order in the record as a result of having multiple records on their screen at one time.
]]> The study, to remedy the problem, altered its computer system so that each order for a test or treatment required an "order verification screen," which included a photo of the patient the doctor intended. In 2010, prior to the change, the hospital had 12 incidents in which a child received care intended for another patient as a result of mistaken orders.In 2011, after the change was implemented, there were three incidents. In each of the latter cases, the child had no photo on record. That year, there were also 10 incidents where a treatment or test was ordered for the incorrect patient, but another staff member caught the mistake in time. That number was down from 33 in 2010.
Sources did not indicate the risk levels involved in the mistakes either before or after the new process was implemented. Patient identification errors, however, are a "significant risk" that all consumers of health care should be aware of. The potential for a serious medical mistake is implicit in these cases, which should cause all of us concern.
Source: Reuters, "Can patient photos help cut medical errors?," Amy Norton, June 4, 2012
]]>One particular life-threatening birth condition known as hypoxic-ischemic encephalopathy (HIE) may-according to recent studies-be alleviated by a body-cooling therapy for years afterward.
]]> HIE is a condition in which there is injury to the brain, which can come about in a number of ways, such as problems during the course of delivery or anesthetic errors during the course of surgery. With HIE, decreased oxygen to the brain causes decreased blood flow and consequent brain injury. The effects of the condition can be serious, including death or sustained brain injury.Those who receive body-cooling treatment are, however, more likely to survive to ages 6 and 7 than those who don't receive the treatment.
The body-cooling therapy became available to doctors back in 2005, and is providing hope to parents facing the situation. Most hopeful is that body-cooling therapy does not appear to increase the risk of cognitive impairment later on in life.
As we noted, there are multiple possible causes of oxygen deprivation, including rupture of the uterus and compression of the umbilical cord. Sometimes these causes come about because of medical error.
Despite the fact that body-cooling therapy is providing hope for infants with HIE and their parents, the condition itself can bring many challenges and costs into parents' lives. Those facing this condition because of what they believe may be medical error should not hesitate to consult an attorney to have their case investigated.
Source: Fox News, "Body cooling treatment helps oxygen-starved newborns," Rachael Rettner, May 31, 2012.
]]>The 31-year-old man had apparently complained of chest pains, and his doctor made no mention of limitations in physical activity such as sex, despite the fact that he had a history of high blood pressure and was at high risk for atherosclerosis. The doctor had also been accused of failing to take proper medical history when the man had an appointment with him one week before his death.
]]> Jurors ended up finding that the man's doctor was liable for his death, but that the man himself was partly to blame. Specifically, the jury found the man was 40 percent responsible for his own death, since he knew his own medical history. Because of this, they jury's initial award of $5 million was reduced by 40 percent to $3 million.The details of the sexual activity in this case are less than savory, but that does not change the fact that the man's doctor failed to act according to the accepted standard of care. When a patient goes to see a doctor, they should not have to guess whether their doctor will provide them with basic health care. When they do not, medical malpractice allows patients and their families to deal with the consequences.
Source: Reuters, "Man Dies During Threesome, Family Wins $3M for Medical Malpractice," Andrew Chow, June 1, 2012.
]]>There are certain limits to the study. It was certainly a smaller study, and it isn't clear how representative the results of similarly situation surgical residents and doctors in general. Additionally, the risks of medical errors are only predictions based on fatigue level-researchers didn't actually track how many medical errors were caused by fatigued surgical residents.
]]> It isn't clear how much is being done to address the problem, but probably not enough. According to the doctor in charge of the study, new rules limiting work hours for surgeons in training-passed while the study was ongoing-may not be enough to improve the problem. It has been estimated that it would cost nearly $1.7 billion dollars to implement the new rules, mostly due to hiring new staff. Some have suggested taking preventive interventions for fatigued residents.This should cause all patients to be somewhat concerned. Patients entrust themselves to doctors and doctors in training trusting that they will get the job done right. When a medical mistake is made, it can cause significant damage, pain and suffering for patients. Whether caused by fatigue, distraction, miscommunication, or whatever, patients need to have some kind of recourse when their doctors err.
Source: Fox News, "Tired surgical residents may up error risk study suggests," May 22, 2012.
]]>The study, conducted in 2010 and 2011, looked at orthopedic surgical residents at two Boston-area hospitals. On average, the residents averaged five and a half hours of sleep per night. This, reportedly, made them tired enough during the day that one-quarter of their work time was spent in a state of impairment similar to being legally drunk. From a risk management perspective, this is obviously a problem.
]]> A total of 27 orthopedic residents were examined. Researchers looked at sleep and exercise habits, as well as use of sedatives, alcohol and other stimulants. The residents also keep daily sleep and work logs, and were monitored for their activity level with sophisticated technology.The data apparently showed that the residents participating in the study were functioning at only about 70 percent of their mental capacity during 27 percent of their waking hours.
What should cause our readers concern is that the surgeons' level of fatigue made them 22 percent more likely to cause a medical error than if they were rested and alert.
In out next post, we'll continue looking at this topic, and what the findings may mean in connection to medical malpractice suits.
Source: Fox News, "Tired surgical residents may up error risk study suggests," May 22, 2012
]]>Reed points to managed-care and insurance companies as have a large part in shifting the medical ethic away from doing what is best for the patient to doing what works to drive up profits.
]]> Reed apparently suggests in her book that reform of the system requires that malpractice damages be controlled and that overhead costs of medical care be reduced. Interestingly, she advocates a single-system of medical care, saying that such a system would save on medical costs by cutting out the insurance bureaucracy.While we will not comment on the notion of a single-payer health care system, it is certainly the case that some medical malpractice suits are frivolous. Meritless suits are a problem in a variety of personal injury cases. That being said, medical errors can have enormously harmful effects on their victims. Any new suggestions for a medical system need to have some way to keep doctors accountable to patients for their errors and faulty judgments.
To cut out such protections or minimize them greatly is to do an injustice to those who suffer at the hands of careless doctors, some of whose mistakes should not allow them to continue practicing their profession.
Source: Nashville Ledger, "Physician: Drive for profit hurts health care," Stephen W. Hines, May 18, 2012.
]]>The initial surgery was for a penile implant. Such surgery is commonly performed for the treatment of erectile dysfunction, after all other forms of treatment have failed. With the surgery, there is the risk of infection, even years after the surgery is performed. In this man's case, he had an additional risk because of diabetes and high blood pressure.
]]> In the Florida man's case, he developed an infection two weeks after the operation, which eventually turned into gangrene and required amputation.He hopes to win the malpractice case on the grounds that his doctors had reason to know that he was not a good candidate for the surgery in the first place, and on the grounds that the doctor didn't exercise proper care after the surgery.
According to the doctor, the infection was probably the result of the man's failure to follow medical instructions to avoid sex after surgery for a period of time. The man's attorney, however, argued that the infection could have had a number of other causes.
It isn't clear how strong of a case the man has here, given the facts available. To win a medical malpractice case, a victim has to prove that a doctor violated the accepted standard of care. While it isn't clear whether the doctor in this case has done that it is clear that whatever went wrong will be the cause of great suffering and humiliation for this man.
Source: ABC News, "Diabetic Sues Doctor After His Infected Penis Is Amputated," Susan Donaldson James, May 17, 2012.
]]>Last Friday, a Philadelphia woman was awarded $78.5 million in a medical malpractice case against medical center she had accused of creating the circumstances which ultimately resulted in her son's cerebral palsy. In particular, she blamed faulty diagnostic procedures.
]]> According to the woman's attorneys, the woman had demonstrated signs of complications when she arrived at the hospital which caused her son to be deprived of oxygen, resulting in cerebral palsy. The problem, they argued, could have been avoided by delivering the child right away, but the doctor in charge mistakenly determined that the baby had died.It wasn't until 81 minutes after that determination that a fetal heartbeat was detected and an emergency cesarean section was performed. Outdated medical equipment and failure to provide trained staff were determined to be part of the problem.
The jury in the case determined that it was the medical center, and not the doctor, that was responsible for the birth injury.
Cerebral palsy is one of a number of conditions that can result when an improperly executed birth. Others include, spastic quadriplega, hypoxia, developmental delays, microcephaly and mental retardation.
Source: Philadelphia Inquirer, "Phila. Jury awards $78.5M in medical malpractice case," Chris Mondics, May 6, 2012.
]]>As a recent case shows, however, there is still some question as to whether federal law permits claims against generic drug companies for design defects.
]]> The case at issue involves a New Hampshire woman who had suffered a severe skin reaction after taking the generic anti-inflammatory drug sulindac for shoulder pain. As a result of taking the drug, she suffered burns on two-thirds of her body and permanent near-blindness.According to the 1st U.S. Circuit Court of Appeals, who upheld the woman's $21 million jury award, the drug was unreasonably dangerous due to its risk of causing Stevens Johnson syndrome, a life-threatening skin reaction.
Referring to the 2011 case that insulated generics from liability for label warnings not provided by brand name pharmaceuticals, the court said that the Supreme Court would have to issue a separate ruling in order to extend that decision to design defects and that generics are liable for them until then.
Attorneys for the generic drug company in the case were upset by the decision, pointing to FDA approval of the drug, but the plaintiff's attorney noted that the drug's risks outweigh its benefits, and generic drug makers should be responsible for injuries occurring in the sale of the product.
Source: Thomson Reuters News & Insight, "1st Circuit affirms $21 mln award in generic drug suit," Terry Baynes, May 4, 2012.
]]>The FDA has apparently not commented on how widely the gel had been distributed, but health care professionals were ordered to stop using the product immediately. The agency did say that patients exposed to the bacteria develop severe skin inflammations. For those undergoing invasive biopsy procedures, the bacteria could be carried into tissues, causing abscesses or blood poisoning.
]]> The FDA also found that the bacteria could make its way into the digestive tract, potentially causing pneumonia or other infections if exposed to the lungs and other tissues.Ultrasound gel is widely used to capture images of a child in utero, but it isn't clear whether the product in question had been used for this purpose. The FDA commented that the risks presented in abdominal ultrasounds by the gel were remote unless the patient has open cuts on her skin, though the risks in a transvaginal ultrasound are greater.
As with dangerous pharmaceutical drugs, patients receive treatment expecting that any pharmaceutical device or product they use is safe for the purpose intended. When patients are made ill or injured by such products, they often feel like they have nowhere to turn. Those who've suffered because of a pharmaceutical drug or other product may be entitled to compensation for injuries, medical expenses and other costs.
Source: CNN Health, "U.S. marshals seize ultrasound gel that allegedly sickened 16 patients," Todd Sperry, April 18, 2012.
]]>News sources are reporting that a Polish dentist, in an act of anger and revenge, removed all her ex-boyfriend's teeth during an appointment to treat a toothache, just days after their breakup. As a result of the incident, she is facing up to three years in jail, as well as an investigation for medical malpractice and abusing the trust of a patient.
]]> The case is instructive on a number of levels, including the dangers of seeking medical care from an ex. Another interesting aspect of the story is the issue of whether the doctor's actions constituted medical malpractice. Technically, medical malpractice is an act or omission characterized by professional negligence, which by definition falls below the standard of care generally accepted by the medical community.Medical malpractice laws vary by state, but generally require the establishment of four elements. The first is the standard of care according to which the doctor is to act or not act in the treatment of a patient. These are generally nationwide standards. The second element is that the doctor failed to act according to the standard of care. The basic issue in this element is whether a reasonable and prudent doctor would have made the same mistake in the same or a similar situation. The third element is that a real injury must have actually resulted, and the fourth is that the doctor's negligence was the legal cause of the injury.
It isn't clear whether the actions of the dentist in this story would fall within the definition of negligence. What happened here was certainly no error, but intentional, and this isn't the kind of case one would typically associate with medical malpractice. More often, medical malpractice claims result from doctors cutting corners, overlooking details, or taking unnecessary and unfair risks.
Whatever the case may be with respect to the medical malpractice investigation, the dentist's actions were tortious and constituted a serious violation of trust and professionalism, regardless of the personal problems that motivated them. It is a reminder, as well, of the ever-present possibility of lapses of judgment in medical professionals.
Source: 5 NBC Chicago, "Heartbroken Dentist Accused of Yanking Ex-Boyfriend's Teeth," Dominique Z. Scott, May 1, 2012.
]]>Five hospitals will reportedly be participating in the program, which targets what is often termed "defensive medicine" and seeks to expedite the resolution of disputes in cases of medical error. Defense medicine, as sources point out, is widely believed to be one of the largest factors behind rising health care costs. Doctors, so the theory goes, are so concerned about medical malpractice suits that they often order unnecessary tests just to cover themselves from potential liability.
]]> The program requires hospitals to promptly disclose and investigate unanticipated, negative outcomes of medical procedures. If the hospital is found to be at fault, it will issue an apology and make an offer of financial compensation. Patients who accept the offer would waive the right to future litigation. Hospitals are not required to apologize or make a financial offer if they determine no errors were made and the medical outcome was unavoidable because of an underlying disease or the inherent risks of surgery. The program seeks to correct policies which leave a bad taste in the mouth of patients who are injured by doctor's mistakes.The new Massachusetts program is reportedly based on a previous one designed by the University of Michigan Health Care System. That program has apparently been credited with resolving a majority of claims outside court, as well as with cutting legal and insurance-related malpractice expenses for hospitals.
Medical malpractice attorneys, as our readers might guess, would welcome any changes which favor greater openness on the part of medical professionals, who all too often have the tendency to want to cover up responsibility for their mistakes. This Massachusetts program may promote that, though it is questionable whether it reflects a desire on the part of hospitals and their insurers to avoid litigation.
Those who are injured by the negligence of a doctor often face unbearable medical bills and great frustration. Such suits can help relieve injured patients from the financial stress that can result from these medical errors.
Source: Insurance Journal, "Massachusetts Docs Eye New Approach to Medical Malpractice Claims," April 19, 2012
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