Malpractice and medical liability

1,592 articles · Since 2004

Articles, page 25

Doctors need to become whistleblowers after medical error

August 17, 2010Aug 17, 20107

Perhaps the most important principle in practicing medicine, drummed into medical students and junior doctors time and time again, is to do no harm. Our medical interventions and treatments can be given either too early, too late, or inappropriately, with…

Unfortunately, when doctors have harmed patients, the guidelines of what to do thereafter are not as clear, raising the question, “What should doctors do in these …

Medical education

Commercial CME funding and the rise of medical errors

Thomas Sullivan

August 5, 2010Aug 5, 201013

While the percentage of commercial support for continuing medical education (CME) has continued to drastically drop over the past few years (29% decrease from 2007 to 2009), recent data, which show an epidemic of medication errors in hospitals, make this…

At a time when 30 million more patients will flood our hospitals, do we really need to …

Conditions and diseases

Unread echocardiogram fallout at Harlem Hospital Center

Larry Husten, PhD

August 3, 2010Aug 3, 20103

Recently, the New York Times reported that Harlem Hospital Center had finally completed its investigation into thousands of echocardiograms that after receiving an initial reading by a technician had never been read by a physician. It turns out that out…

Recently, the New York Times reported that Harlem Hospital Center had finally completed its investigation into thousands of echocardiograms that after receiving an initial reading by a technician had never been read by a physician.

It turns out that out of 7,000 tests that went unread, only 14 patients “might have been misdiagnosed because their tests had not been handled properly,” according to the hospital spokeswoman quoted in the story. …

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Conditions and diseases

The difficulty of regulating x-ray radiation in the ER

WhiteCoat, MD

August 2, 2010Aug 2, 201013

A recent article in the New England Journal of Medicine touched off another salvo about how non-clinicians have no problems judging the abilities of clinicians in the world of medicine. The article begins by presenting the case of a woman…

A recent article in the New England Journal of Medicine touched off another salvo about how non-clinicians have no problems judging the abilities of clinicians in the world of medicine.

The article begins by presenting the case of a woman who awoke with facial paralysis and then went to the emergency department. On arrival, she received CT scans and MRI scans of her brain. When those were normal, she was diagnosed …

Conditions and diseases

Defensive medicine forces residents to use test oriented care

a medical resident, MD

July 26, 2010Jul 26, 20107

A recent article in US News and World Report, Most U.S. Physicians Practicing Defensive Medicine, claims that physicians are ordering more tests and escalating the work-up of sick patients, all in the name of defensive medicine. Is it true? Absolutely.…

A recent article in US News and World Report, Most U.S. Physicians Practicing Defensive Medicine, claims that physicians are ordering more tests and escalating the work-up of sick patients, all in the name of defensive medicine.

Is it true? Absolutely.

It is especially true in the emergency department, where we have one shot to get things right, or else. Ironically, by practicing defensive medicine we are not practicing …

Physician voices

Data and transparency is needed to reduce medical mistakes

Kevin

July 21, 2010Jul 21, 20102

An excerpt from On the Mend: Revolutionizing Healthcare to Save Lives and Transform the Industry. by John Toussaint, MD, and Roger Gerard, PhD Admitting Error In a lean environment, doctors and nurses must allow mistakes to be visible in order…

An excerpt from On the Mend: Revolutionizing Healthcare to Save Lives and Transform the Industry.

by John Toussaint, MD, and Roger Gerard, PhD

Admitting Error

In a lean environment, doctors and nurses must allow mistakes to be visible in order to perform root-cause analysis and fix the process. But showing mistakes hits most medical providers in a vulnerable place—right in the collective fear of lawsuits and a highly conditioned need to be …

Conditions and diseases

Unnecessary testing needs more than tort reform to cure

Michael Kirsch, MD

July 17, 2010Jul 17, 201029

Recently, while covering for one of my partners on a weekend, I was consulted by a physician to do a procedure. The doctor wanted his patient to undergo an EGD, which is a scope test that examines the esophagus, stomach…

Recently, while covering for one of my partners on a weekend, I was consulted by a physician to do a procedure.

The doctor wanted his patient to undergo an EGD, which is a scope test that examines the esophagus, stomach and first portion of the small intestine called the duodenum. We gastroenterologists do this test routinely to search for an explanation for a patient’s symptoms, or to determine if these organs …

Physician voices

Fire in the OR and how hospitals should report medical mistakes

Maggie Mahar

July 14, 2010Jul 14, 20107

Did you know that if there is a fire in the OR during surgery hospitals in some states don’t have to report the event to anyone? When I read a recent story in the Cleveland Plain Dealer headlined, “Reporting Surgical…

Did you know that if there is a fire in the OR during surgery hospitals in some states don’t have to report the event to anyone?

When I read a recent story in the Cleveland Plain Dealer headlined, “Reporting Surgical Fires Could Improve Patient Safety in Ohio, Experts Say,” I was stunned.

The piece begins:

When fire breaks out and burns a patient during surgery in Pennsylvania, the hospital is required by law

…

Physician voices

Cancer in a transplant kidney, is it the doctor’s fault?

Amy Tuteur, MD

July 13, 2010Jul 13, 20102

May you never be an interesting case. That's a cautionary proverb familiar to medical professionals. While it's bad to get sick, it's much worse to get sick with something uncommon or unusual. The more fascinating a case is for doctors,…

May you never be an interesting case.

That’s a cautionary proverb familiar to medical professionals. While it’s bad to get sick, it’s much worse to get sick with something uncommon or unusual. The more fascinating a case is for doctors, the more difficult it is for patients. Difficult to diagnose, difficult to treat, and often difficult to survive.

Kenneth Liew was doubly unfortunate. He was an interesting medical case and an interesting …

Conditions and diseases

Mark Midei and the failure of peer review

Robert Wachter, MD

July 8, 2010Jul 8, 201012

A couple of months ago, a Baltimore reporter called to get my take on a scandal at St. Joseph’s Hospital in Towson, an upscale suburb. A rainmaker cardiologist there, Dr. Mark Midei, had been accused of placing more than 500…

A couple of months ago, a Baltimore reporter called to get my take on a scandal at St. Joseph’s Hospital in Towson, an upscale suburb.

A rainmaker cardiologist there, Dr. Mark Midei, had been accused of placing more than 500 stents in patients who didn’t need them, justifying the procedures by purposely misreading cath films. In several of the cases, Midei allegedly read a 90 percent coronary stenosis when the actual …

Physician voices

Florida EMTs may go bankrupt because of a malpractice lawsuit

WhiteCoat, MD

July 2, 2010Jul 2, 201046

An ambulance service was recently held liable for failing to “do what was necessary” before accepting emergency transport of pregnant patient. A child was born at 25 weeks gestation -- 15 weeks premature -- and was not breathing. Babies born…

An ambulance service was recently held liable for failing to “do what was necessary” before accepting emergency transport of pregnant patient.

A child was born at 25 weeks gestation — 15 weeks premature — and was not breathing. Babies born at this age have a viability of 50-70%. In other words, up to half of children born at this age of gestation die. The family called 911. The paramedics arrived, performed …

Medical education

Medication errors spike when new residents start in July

MedPage Today

June 30, 2010Jun 30, 20107

by Kristina Fiore Deaths from medication mistakes appear to spike in July, when medical residencies begin, researchers say. Over nearly a 30-year period, fatal medication errors appear to jump 10% solely in that summer month in U.S. counties with teaching…

by Kristina Fiore

Deaths from medication mistakes appear to spike in July, when medical residencies begin, researchers say.

Over nearly a 30-year period, fatal medication errors appear to jump 10% solely in that summer month in U.S. counties with teaching hospitals, David P. Phillips, PhD, of the University of California San Diego and Gwendolyn E.C. Barker, BA, of the University of California Los Angeles, reported online in the Journal of General Internal …

Physician voices

How transparency reduces malpractice and defensive medicine

Brad Wright, PhD

June 22, 2010Jun 22, 201011

Physician errors have been the subject of discussions about both health care costs and health care quality. We are told that if we reform the malpractice system -- capping damages -- that physicians will practice medicine less defensively and costs…

Physician errors have been the subject of discussions about both health care costs and health care quality.

We are told that if we reform the malpractice system — capping damages — that physicians will practice medicine less defensively and costs will go down as a result. We are also told that the quality of care delivered by our health care providers is less than optimal — there are estimates that nearly …

Physician voices

Heart catheterization worries that every cardiologist face

John Mandrola, MD

June 18, 2010Jun 18, 20105

Malpractice and heart catheterization have been in the news recently. A spicy concoction for sure. An epidemiological study published in an online subsidiary of Circulation addresses the role of three major medical issues facing cardiologists today: malpractice, heart catheterization, and…

Malpractice and heart catheterization have been in the news recently.

A spicy concoction for sure. An epidemiological study published in an online subsidiary of Circulation addresses the role of three major medical issues facing cardiologists today: malpractice, heart catheterization, and medical costs.

It is hard to get more controversial.

Heart catheterization, the invasive assessment of the coronary artery lumen, has always been a hot-potato topic. The “percent-normal” was the buzz word when I …

Conditions and diseases

Peer review may require random over-reads

Larry Husten, PhD

June 9, 2010Jun 9, 201014

“Let’s kill all the lawyers.” It’s every doctor’s favorite Shakespeare quote. And if you’re giving a talk to doctors there’s no better way to get the audience on your side than by starting with a lawyer joke. But perhaps we…

But perhaps we shouldn’t be too hasty about killing all those lawyers. As recent commentary about the Mark Midei case makes clear, modern medicine doesn’t know how to police itself. And until medicine does …

Physician voices

Interruptions in the emergency department can lead to errors

MedPage Today

June 8, 2010Jun 8, 20102

by Nancy Walsh Busy clinicians in the emergency department reduce the time they spend on clinical tasks when interrupted, working faster and possibly cutting corners, a prospective observational study found. Overall, clinicians were interrupted 6.6 times per hour, and 11%…

by Nancy Walsh

Busy clinicians in the emergency department reduce the time they spend on clinical tasks when interrupted, working faster and possibly cutting corners, a prospective observational study found.

Overall, clinicians were interrupted 6.6 times per hour, and 11% of all tasks were interrupted, according to Johanna I. Westbrook, PhD, of the University of Sydney, in Australia, and colleagues.

The mean “time on task” for uninterrupted tasks was 1 minute and 26 …

Physician voices

Why patients file medical malpractice lawsuits

John Schumann, MD

June 7, 2010Jun 7, 201044

Time to turn our attention to an unpleasant topic: Lawsuits. Who files them? Why? And what actually happens? There have been oceans of ink spilled about medical malpractice. An oversimplification of the various positions on malpractice and malpractice reform goes…

Time to turn our attention to an unpleasant topic: Lawsuits.

Who files them?

Why? And what actually happens?

There have been oceans of ink spilled about medical malpractice. An oversimplification of the various positions on malpractice and malpractice reform goes something like this:

(+) Malpractice suits are good. They keep healthcare professionals and hospitals on their toes; if the threat of a big payout improves safety and quality, then lawsuits provide an important regulatory

…

Health policy

Tort reform for doctors in exchange for less salary

Jeffrey Parks, MD

June 7, 2010Jun 7, 201030

Matt Steinglass at The Economist has interesting take on tort reform, specifically that limiting physician liability for adverse patient outcomes must come with an equable cost to doctors. In Europe, the costs accrued due to medical errors are covered by…

Matt Steinglass at The Economist has interesting take on tort reform, specifically that limiting physician liability for adverse patient outcomes must come with an equable cost to doctors.

In Europe, the costs accrued due to medical errors are covered by the wide-ranging social safety net; the lottery system of massive medical malmalpractice judgments is virtually absent.

It’s part of the social contract: doctors accept limited salaries in exchange for limited liability;

…

Physician voices

Defensive medicine starts early in residency training

WhiteCoat, MD

May 19, 2010May 19, 20107

Part of a resident’s job is to learn the ropes in preparing for independent practice. While you’re a resident, you get the benefit of having someone looking over your shoulder to critique you as you determine how you are going…

I frequently tell residents that different attending physicians practice medicine in different ways. Some practice defensive medicine more than others, some prescribe antibiotics more than others and some …

Physician voices

Patient wants an apology, not money, after medical malpractice

Tricia Pil, MD

May 16, 2010May 16, 201049

This is the true story of a hospitalization as told from three points of view: first, the recollections of the patient (who happens to be a physician); second, events as recorded in the medical charts by doctors and nurses; and…

FRIDAY

Patient:
It is fall 2005, and I am nine months pregnant. A healthy 33-year-old pediatrician, I am a longtime patient of Doctor A and …

Malpractice and medical liability

Articles, page 25

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