Wednesday, December 04, 2013

Preventable Hospital Error the Third Leading Cause of Death

The Journal of Patient Safety has a new study out showing that approximately 440,000 deaths per year can be attributed to preventable hospital error...NYT has the full analysis:
Until very recently, health care experts believed that preventable hospital error caused some 98,000 deaths a year in the United States — a figure based on 1984 data. But a new report from the Journal of Patient Safety using updated data holds such error responsible for many more deaths — probably around some 440,000 per year. That’s one-sixth of all deaths nationally, making preventable hospital error the third leading cause of death in the United States. And 10 to 20 times that many people suffer nonlethal but serious harm as a result of hospital mistakes.
“Do you as an American have the right to know if the hospital down the street left an object in a patient?” said Binder. “That information has now been taken out of the hands of the consumer by lobbyists. We should always tilt towards transparency.”

Thursday, November 14, 2013

A Sad State of Affairs in the Texas "Safety Net"

Being poor or uninsured in Texas means you get left behind to die...not that it should surprise anyone...a well-written article by a Texas doctor who is in the trenches daily trying to heal people with no support from our great state.

But UTMB is no longer the state-subsidized charity hospital it used to be. The changes began before Hurricane Ike in 2008. But after the storm, UTMB administrators drastically cut charity care and moved clinics to the mainland, where there are more paying patients. The old motto “Here for the Health of Texas” was replaced by “Working together to work wonders.” Among those wonders are a new surgical tower and a plan to capitalize on Galveston’s semi-tropical charm by attracting wealthy healthcare tourists from abroad. Medical care for the poor is not, apparently, among the wonders. Whereas UTMB accepted 77 percent of charity referrals in 2005, it was only taking 9 percent in 2011.
UTMB ascribes these changes to financial strain from Hurricane Ike, the county’s inability to negotiate a suitable indigent-care contract and loss of state funding. The state blames budget shortfalls. The Affordable Care Act, better known as Obamacare, could have been a huge relief. However, Gov. Rick Perry rejected billions of dollars in federal funding to expand Medicaid, funding that should have brought access to more than a million Texans, including many St. Vincent’s patients.
Perry’s refusal is catastrophic health policy. For patients, it means that seeking medical care will still require risking bankruptcy, and may lead nowhere. For doctors, the message was not only that our patients’ lives don’t matter, but also that medicine—our old profession, so full of people who genuinely want to help others—will continue to be part of the economic machine that entrenches poverty. When the poor seek our help, they often wind up with crippling debt.

Friday, August 30, 2013

"The Worst Surgeon I've Ever Seen"

Thank God this surgeon has finally lost his comfort to the patients he maimed or killed though:
Physicians who complained about Duntsch to the Texas Medical Board and to the hospitals he worked at described his practice in superlative terms. They used phrases like “the worst surgeon I’ve ever seen.” One doctor I spoke with, brought in to repair one of Duntsch’s spinal fusion cases, remarked that it seemed Duntsch had learned everything perfectly just so he could do the opposite. Another doctor compared Duntsch to Hannibal Lecter three times in eight minutes.
Enforcement by the Texas Medical Board can only make things better--bad doctors only hurt and kill patients...and make things more difficult for good doctors...the Texas Observer has a well-written piece about the lack of enforcement.  Hopefully things will change for the better before more innocent patients are maimed or killed:
Public Citizen concluded that the board moves slowly because it’s understaffed and underfunded. But when I talked to Medical Board spokesperson Megan Goode about this, she said Public Citizen had it wrong—that the board isn’t underfunded at all. Things were rough during the state budget crisis in 2011, but now hiring is back up to normal.
The problem, she said, isn’t staff. In an official statement, she wrote, “The way the law is currently written, with a high bar of evidence for the board to meet, the process can take time so that the board can build a solid case. It would clearly be a policy decision for the Legislature to consider whether the process or the standards for evidence required for a temporary suspension need to change.”
Leigh Hopper, formerly the Medical Board spokesperson, put it more bluntly. “You could have a Medical Board that’s the size of the [Texas Department of Public Safety],” she said, “but the state doesn’t want that. It’s more or less satisfied with the way that things work.”

Thursday, August 29, 2013

President Lincoln was a Great Trial Lawyer

Nice to see the courage from UH law student Benjamin Kemmy to highlight the hypocrisy of tort "reformers" in Texas...and the greatness of our 16th President--a great trial lawyer.

My favorite example is the 1857 case, Macready v. City of Alton. Mary Macready, a New York actress, was walking down the street in Alton, Ill., and fell through some sidewalk construction and badly injured her ankle, leg and back. Lincoln demanded $20,000 but was only able to recover $300 at a jury trial.
Imagine that! Not more than four years before he began prosecuting the war to save the Union, the Great Emancipator was prosecuting a simple P.I. case!
But if you know a little bit about Lincoln, and you’re a not a member of Texans for Lawsuit Reform, that shouldn’t come as too big of a surprise. Lincoln, a true lover of the American justice system, had great respect for its foundational practice—the trial by jury.
Juries, as Lincoln well knew, are one of the indispensible features of self-government, where we as representatives of our community decide what practices endanger our safety and wellbeing.
Or as Lincoln put it, in his famous Rock Island Bridge case, “What is reasonable skill and care? This is a thing of which the jury is to judge.” And it’s precisely the thing that Texans for Lawsuit Reform don’t want us as jury to judge.

Thursday, June 27, 2013

Our Constitutional Rights Slipping Away...

The latest from the Dallas Morning News confirms what most attorneys already know--in Texas, civil jury trials are disappearing.  Walk into the Harris County Civil Courthouse and wander around the empty floors--it feels like an abandoned building.  The Seventh Amendment is being eroded by many things: the high costs of litigation, tort "reform," arbitration and people who distrust ordinary Texans to serve on a jury.  A sad state of affairs.  

“The Texas appellate courts have all but told trial judges that they need to grant more motions for summary judgment and let fewer cases go to trial,” said Steve McConnico, an Austin lawyer.
“We write motions for summary judgment today for our corporate clients that we would have laughed at only a few years ago,” said McConnico, whose clients include large energy and pharmaceutical companies. “The Texas Supreme Court has made proving causation and damages in all kinds of cases much more difficult.
“It is sad that this valuable and effective constitutional right is going away and people are not more outraged,” he said.

Friday, May 17, 2013

Learning is Good for Every Industry

A New York Times Op-Ed summarizes a study showing that hospitals learn from litigation and make changes to help protect all of us:
Over 95 percent of the hospitals in my study integrate information from lawsuits into patient safety efforts. And risk managers and patient-safety personnel overwhelmingly report that lawsuit data have proved useful in efforts to identify and address error.
A good goal for every industry, whether it is in the medical field, legal field, petroleum industry--learn from your mistakes so you don't do it again.  Common sense, right?  Unfortunately, sometimes, it takes a lawsuit to bring about learning...