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Malpractice and medical liability

1,592 articles · Since 2004

Articles, page 18

Physician voices

After an adverse event: What should doctors disclose to patients?

4

What should doctors disclose to patients in the aftermath of adverse events? Does it matter if the adverse event was related to an error? Does it matter if it was preventable or not, anticipated or unexpected? Recently, I was at…

What should doctors disclose to patients in the aftermath of adverse events?  Does it matter if the adverse event was related to an error?  Does it matter if it was preventable or not, anticipated or unexpected?

Recently, I was at the Carolina Refresher Course facilitating a session on adverse events in anesthesiology.   We touched on a variety of issues, but spent the most time discussing the importance of disclosure conversations, as …

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After an adverse event: What should doctors disclose to patients?

Health policy

Many hospitals approach safety improvement the wrong way

7

The time has come to drive a stake through the heart of an oft-repeated assertion. How often have you heard something like the following when those of us in healthcare who want to stimulate quality and safety improvements draw analogies…

The time has come to drive a stake through the heart of an oft-repeated assertion.

How often have you heard something like the following when those of us in healthcare who want to stimulate quality and safety improvements draw analogies to the airline industry?

“Well, in an airplane, the pilot has an extra incentive to be safe, because he will go down with the ship. In contrast, when a doctor hurts a …

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Many hospitals approach safety improvement the wrong way

Physician voices

After a medical mistake, an apology is both simple and difficult

33

Elton John had it right: "It's sad, so sad. Why can't we talk it over. Oh, it seems to me that sorry seems to be the hardest word." Mistakes are all to common in medicine, but can we say the…

Elton John had it right: “It’s sad, so sad.  Why can’t we talk it over. Oh, it seems to me that sorry seems to be the hardest word.”

Mistakes are all to common in medicine, but can we say the “hardest word” when we’re involved?

Example 1: There’s a diagnosis of recurrent lymphoma in the ICU. The oncologist gives a phone order for cytoxan, prednisone, and vincristine. The recorder, working a double shift, …

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After a medical mistake, an apology is both simple and difficult

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Physician voices

Medical malpractice claims drag on too long

9

I am very fortunate to have never been sued. That is not necessarily because of my amazing ability as a physician. I always practiced in Veterans Affairs medical centers, where my status as a federal employee meant I would not…

I am very fortunate to have never been sued. That is not necessarily because of my amazing ability as a physician. I always practiced in Veterans Affairs medical centers, where my status as a federal employee meant I would not get sued by my patients. I also had an incredibly appreciative patient population.

But I know that most of my physician peers have been sued, successfully or unsuccessfully, at least once …

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Medical malpractice claims drag on too long

Physician voices

Cockpit culture and using the two challenge rule in the OR

2

With the crash of the Asiana 777, we're hearing a lot about cockpit culture and how communication across a hierarchy sometimes fails, even when the very lives of the folks communicating (or failing to do so) are on the line.…

With the crash of the Asiana 777, we’re hearing a lot about cockpit culture and how communication across a hierarchy sometimes fails, even when the very lives of the folks communicating (or failing to do so) are on the line.  This isn’t a new concept, and isn’t unique to aviation.  Many parallels have been drawn between aviation communication and healthcare team communications, …

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Cockpit culture and using the two challenge rule in the OR

Physician voices

Are physicians still responsible for mistakes in health care?

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Who is responsible for mistakes in health care? Who should take credit for success or blame for failure? Most families, patients and obviously the courts, hold the doctor responsible. It seems to me this is reasonable; it is the obligation…

Who is responsible for mistakes in health care?  Who should take credit for success or blame for failure?   Most families, patients and obviously the courts, hold the doctor responsible.  It seems to me this is reasonable; it is the obligation physicians assume and which society returns with empowerment and respect.  However, is this changing because of the Internet and big data?

In 2013, most patients have spent hours on the Internet …

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Are physicians still responsible for mistakes in health care?

Physician voices

Allowing patients to define a medical adverse event

80

Patients do need the power to complain about bad doctors and, trust me, there are some bad doctors out there. That being said, the other way for patients to get some retribution is to stop seeing that doctor. Word of…

Patients do need the power to complain about bad doctors and, trust me, there are some bad doctors out there.  That being said, the other way for patients to get some retribution is to stop seeing that doctor.   Word of mouth will spread, like any other business, and that doctor’s business goes under.

Right now, state boards allow patients to complain about anything and they have to investigate that complaint. …

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Allowing patients to define a medical adverse event

Physician voices

An ovary removed instead of an inflamed appendix: What happened?

19

On June 10, 2013 a 32-year-old pregnant woman was reported to have died after having an ovary removed instead of her inflamed appendix. As the infected appendix festered, she became septic and succumbed to multiple organ failure. This tragedy occurred…

On June 10, 2013 a 32-year-old pregnant woman was reported to have died after having an ovary removed instead of her inflamed appendix. As the infected appendix festered, she became septic and succumbed to multiple organ failure. This tragedy occurred in the UK in late 2011, but has just come to light.

How could this have happened?

Let me count the ways.

The surgery was performed by two trainee surgeons. Their …

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An ovary removed instead of an inflamed appendix: What happened?

Physician voices

In practicing medicine, offense wins championships

10

It’s not surprising that physicians fear lawsuits, as more than 61 percent of doctors older than 55 have been sued at least once, according to the American Medical Association. But is this fear completely justified? I believe that the media…

It’s not surprising that physicians fear lawsuits, as more than 61 percent of doctors older than 55 have been sued at least once, according to the American Medical Association.

But is this fear completely justified? I believe that the media tends to sensationalize malpractice with stories about high judgments and horrific cases.

The facts are this:

…

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In practicing medicine, offense wins championships

Physician voices

How defensive medicine is akin to the war on terrorism

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From my interview with Andrew Thompson the other day, the issue of a medical malpractice crisis was raised. Mr. Thompson averred that such a concept is pure myth, a spook story older docs tell young interns around the campfire at…

From my interview with Andrew Thompson the other day, the issue of a medical malpractice crisis was raised.  Mr. Thompson averred that such a concept is pure myth, a spook story older docs tell young interns around the campfire at night.  And he may be right.

In a paper from the Journal of Healthcare Quality, researchers at Johns Hopkins demonstrated, using data from the National Practitioner Data …

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How defensive medicine is akin to the war on terrorism

Health policy

To improve patient safety, lawyers need to embrace transparency too

14

How do we reduce medical errors? It’s a question at the forefront of the minds medical and policy leaders today. Entire books have been devoted to the subject, and there is no shortage of suggestions to improve patient safety. Internist…

How do we reduce medical errors?

It’s a question at the forefront of the minds medical and policy leaders today.  Entire books have been devoted to the subject, and there is no shortage of suggestions to improve patient safety.

Internist Danielle Ofri recently wrote a New York Times op-ed on the issue, where she reflected on a “near miss” she had during …

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To improve patient safety, lawyers need to embrace transparency too

Physician voices

A surgeon interviews a medical malpractice attorney: Read and decide

16

My interview series continues, this time with local litigation attorney Andrew Thompson, Esq. The topic this time is medical malpractice. I asked him a bunch of questions. He answered. See what you think. 1. In your opinion, is there a…

My interview series continues, this time with local litigation attorney Andrew Thompson, Esq. The topic this time is medical malpractice. I asked him a bunch of questions. He answered. See what you think.

1. In your opinion, is there a medical malpractice crisis in this country?

No. This is not even a close issue. The concept of a “crisis” or dramatic increase in the number of medical malpractice cases is a fabrication …

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A surgeon interviews a medical malpractice attorney: Read and decide

Physician voices

Medical mistakes occurred at all levels of my care

76

Medical and surgical errors are very common in the hospital setting. They increase malpractice lawsuits, the cost of medical care, patients’ hospital stays, and morbidity and mortality. As an infectious diseases specialist for over forty years, I was not aware…

Medical and surgical errors are very common in the hospital setting. They increase  malpractice lawsuits, the cost of medical care, patients’ hospital stays, and morbidity and mortality. As an infectious diseases specialist for over forty years, I was not aware how common these errors are until I became a patient myself after being diagnosed with hypopharyngeal carcinoma. My initial cancer was successfully removed, but a local recurrence occurred twenty months …

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Medical mistakes occurred at all levels of my care

Patient voices

Misdiagnosis is more common than you think

4

An important study in the Journal of the American Medical Association finds that misdiagnosis is more common than you might think. According to the study, almost 40% of patients who unexpectedly returned after an initial primary care visit had been…

An important study in the Journal of the American Medical Association finds that misdiagnosis is more common than you might think.  According to the study, almost 40% of patients who unexpectedly returned after an initial primary care visit had been misdiagnosed.  Almost 80% of the misdiagnoses were tied to problems in doctor-patient communication, and more than half of those problems had to do with things that were missed in the …

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Misdiagnosis is more common than you think

Physician voices

Can physicians really stop the actions of reckless caregivers?

48

In 2010, a surgical scrub technician named Kristen Parker was sentenced to thirty years in federal prison after allegedly diverting fentanyl from operating rooms, injecting herself with the powerful intravenous narcotic, refilling the contaminated syringes with saline, and replacing them…

In 2010, a surgical scrub technician named Kristen Parker was sentenced to thirty years in federal prison after allegedly diverting fentanyl from operating rooms, injecting herself with the powerful intravenous narcotic, refilling the contaminated syringes with saline, and replacing them to be used on patients.  She was infected with hepatitis C, and her drug diversions infected over two dozen patients in the Denver area.

In 2012, David Kwiatkowski, also positive for …

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Can physicians really stop the actions of reckless caregivers?

Physician voices

How can doctors avoid killing or hurting people in their care?

15

Hospitals are very focused on avoiding harming patients lately. They have been moving in that direction for a long time, but with health care reform legislation, payments are on the line, which makes something that was a very good idea…

Hospitals are very focused on avoiding harming patients lately. They have been moving in that direction for a long time, but with health care reform legislation, payments are on the line, which makes something that was a very good idea into an imperative.

In the year 2000, the Institute of Medicine, a non-profit organization that monitors various aspects of medical care, reported that 44,000-98,000 people died each year due to medical …

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How can doctors avoid killing or hurting people in their care?

Physician voices

Resolving medical liability claims with disclosure, apology and offer

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An apology can be a powerful statement that influences how another responds to a perceived wrong. This can be especially true within the context of a doctor-patient relationship. Yet, most physicians have been conditioned to employ a “deny-and-defend” approach to…

An apology can be a powerful statement that influences how another responds to a perceived wrong. This can be especially true within the context of a doctor-patient relationship. Yet, most physicians have been conditioned to employ a “deny-and-defend” approach to adverse medical outcomes, avoiding apologies because they believe it could imply an admission of guilt or ultimately initiate a lawsuit.

Apology in medicine is neither new or a fringe concept (currently …

Read more…

Resolving medical liability claims with disclosure, apology and offer

Physician voices

Being sued for malpractice launches a mix of overwhelming emotions

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Just as Sherry Gorman describes in her compelling post, being sued for malpractice can launch a complicated mix of often overwhelming emotions so debilitating that personal and professional lives are never the same. Since so many physicians are sued at…

Just as Sherry Gorman describes in her compelling post, being sued for malpractice can launch a complicated mix of often overwhelming emotions so debilitating that personal and professional lives are never the same.

Since so many physicians are sued at some point during their career—some estimates say as many as 9 out of 10 —becoming educated about the malpractice process …

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Being sued for malpractice launches a mix of overwhelming emotions

Physician voices

Is the era of patient centered care decidedly anti-physician?

45

I’m lucky to practice in a national regional anesthesiology center, a hospital with five dedicated nerve block suites, each with the latest in ultrasound equipment, nurses trained in conscious sedation, regional anesthesiology colleagues and infrastructure to support regional practitioners. It…

I’m lucky to practice in a national regional anesthesiology center, a hospital with five dedicated nerve block suites, each with the latest in ultrasound equipment, nurses trained in conscious sedation, regional anesthesiology colleagues and infrastructure to support regional practitioners. It seems like there is so much we can do for patients, but really, there is only so much a physician can do. We need a little help from the patient …

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Is the era of patient centered care decidedly anti-physician?

Physician voices

How diminishing returns may render the surgical timeout ineffective

15

Wrong site surgery is never acceptable. A surgeon ought never to find himself in a situation where he has to inform the family that he just operated on the wrong body part. It is embarrassing, unprofessional, and an egregious violation…

Wrong site surgery is never acceptable.  A surgeon ought never to find himself in a situation where he has to inform the family that he just operated on the wrong body part.  It is embarrassing, unprofessional, and an egregious violation of the patient/physician covenant.

That being said, we have allowed this issue to be defined entirely in terms of “systems management”.  And hence the …

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How diminishing returns may render the surgical timeout ineffective

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