New Jersey Accident and Injury Law Blog : New Jersey Injury Lawyer & Attorney : The Grossman Law Firm : Serving Monmouth County, Bergen County

Medical malpractice attorneys in New Jersey and around the country will be concerned at an increasing trend among hospitals to recycle single-use medical products. The trend is part of efforts to reduce the amount of waste that hospitals produce, and make the healthcare industry more eco-friendly. However, it also raises concerns about how such efforts to green hospitals can impact patient safety, and increase the risk of infections.

 

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It's one of a patient's worst medical malpractice nightmares - a New Jersey doctor, whose clinic was allegedly the source of a hepatitis B epidemic which has already had five of his patients testing positive for the disease. Now, state regulators have indefinitely suspended the medical license of Doctor Parvez Dara.

Health inspectors have described the conditions at Dr. Dara's Toms River office, including blood stains on the floor of the room where the doctor conducted chemotherapy treatments. Inspectors found medication vials left open, and blood inside a bin used to store blood veils. They also found saline and gauze that had not been sterilized. Earlier, health officials had advised approximately 3,000 of Dara's patents to be tested for hepatitis B, after five cancer patients who were undergoing treatment under him, contracted the diseases. Two of his patients were confirmed to have hepatitis B in February, and three others tested positive later.  None of the five patients had any other risk factors for hepatitis B.

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As a Bergen and Monmouth County medical malpractice lawyer, I am aware of  per se negligence or what is referred to in the legal community as res ipsa loquitur type of negligence by doctors or other staff in hospitals. So, it comes as a relief to know that many of these types of obvious errors are not only preventable, but also easily preventable.

According to this news report that relies on a study on the effects of using checklists to go though pre and post surgery routines, post surgery death rates in hospitals can be dramatically reduced if surgeons and other staff in the surgical theater actually use a simple checklist as a guideline of sorts. The checklist, that's been designed by the World Health Organization includes 19 points, including such sweet and simple gems like

• Mark the area or body part to be operated with a pen.
• Make sure that you have the right patient on the table. Ask his name.
• After the surgery, make sure that you haven’t left needles, sponges or other calling cards behind in the patient's body.

Hardly rocket scientist stuff, but according to the study that was conducted across a total of eight international cities, the effects of using a checklist like this reduces post surgery hospital deaths by close to 50 per cent. Post surgery complications dropped by nearly one third.

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New Jersey hospitals may soon be required to reveal not only the serious mistakes at their facility that have contributed to patient injuries or death, but also the identity of the facility. Until now, the state was not required to reveal the facilities responsible for making mistakes including such preventable ones as operating on the wrong part, leaving behind medical instruments or devices in the patients' body or allowing situations to develop that could lead to infections.

When the Patient Safety Act was passed 4 years ago, it required New Jersey's hospitals to report medical and surgical errors that occurred at the facility to the Department of Health and Senior Services. It was believed that Information about medical mistakes would foster a culture of accountability and openness.  Since the Act was passed, more numbers of errors are beginning to be reported, helping the DHSS to add to its database of errors that are likely to happen in a New Jersey hospital, and the best ways to help prevent these in future. At the time the Act was passed, legislators believed that hospitals would be more open about mistakes and disclosing information about these, if their names were not revealed. The bill was passed against the protests of patient safety groups who believed that such secrecy protected hospitals unfairly.

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Madison, New Jersey based Quest Diagnostics, the largest medical diagnostic facility in the country has admitted that it sent out a large number of erroneous Vitamin D test results to doctors and patients in 2008. The company launched an investigation into the matter in June when doctors from around the country began questioning the validity of some of the test results that they had received.   The announcement comes after a probe confirmed that errors had indeed been made with an unspecified number of Vitamin D blood tests that the company had conducted last year.

The company hasn't confirmed how many patients may have been affected by the inaccurate test results nor has it admitted the number of laboratories that were involved in these messed up results. According to industry watchers however, the number is possibly in the thousands. The company has faced problems with Vitamin D analysis testing of the blood before, and had changed its test design from an earlier FDA approved one to a new design. However, the new test design has problems of its own, especially when used to test large volumes.

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USA Today has an interesting report on how pharmacy boards across many states have a majority of their board members made up of employees of major chain pharmacies, ensuring that any oversight of pharmacies or reduction of filling errors is limited at best.

The concept of having pharmacy chain employees on state pharmacy boards supposedly ensures that these boards have the expertise of seasoned professionals to draw from. While that may be true, it also ensures that the boards are staffed with a number of members who act to protect the interests of the pharmacies they work for. It reduces the concept of an "independent" state board regulating and overseeing the functioning of thousands of pharmacies in a state, to a farce.

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The New York Times carried this story that points to how, for so many patients in New York and across the country, medical malpractice laws may be the only thing standing between them and healthcare anarchy. The story focuses on the City's hospitals, in particular University Hospital in Syracuse, but the implications are just as relevant for any hospital in New Jersey.

The report uses the case of a 56-year-old woman, Sharon Yacketta who has had to undergo 19 surgeries in the past 4 years – one to correct her original problem of urinary incontinence, and the remaining 18 to correct the horrific errors that resulted from that first surgery.   Since that first botched operation when surgeons at University Hospital managed to rupture her right ureter, Yacketta has battled infections, and watched helplessly as her urinary incontinence ballooned into a vastly more complicated condition.  

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Pharmacies and physicians in Ohio are test driving an electronic prescription system that marks a move from old, handwritten paper prescription to paperless prescription procedures, promising among other things, the reduction of errors.

Physicians in some counties already have the e-prescription system installed, and have been using it with success. There has been a lot of positive feedback about the system that allow doctors to maintain records of patients, and then send their prescriptions to the pharmacy to be filled and ready by the time the patient gets there. The program is part of a nationwide promotion of the system by the federal government including a Medicare bonus incentive for doctors who prescribe through the system, that's expected to kick off in 2009.

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A new state report released last week says that preventable hospital errors in New Jersey have increased since last year, a trend that has been noticed every year since the error data tracking system kicked off in 2005.

In 2007, according to the third Patient Safety report by the state Department of Health and Senior Services, a total of 72 people died as a result of preventable hospital errors. The report takes into account all types of preventable mistakes in a hospital environment, from surgical and medical mistakes, to bed sores and falls that occur as a result of negligence. The 72 deaths were an increase by 30 from the previous year. There were a total of 456 hospital errors reported for 2007, which was also higher than in 2006. In fact, the rate of errors has grown every year since the Patient Safety Act regulations involving the reporting of hospital errors, came into force. The Patient Safety Act requires all preventable hospital errors committed by hospital staff, including nurses, doctors, surgeons, and others to be reported  to the Department of Health and Senior Services.

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New Hampshire's Pharmacy Board has a neat way of protecting their pharmacists from pharmacy error lawsuits – if an error doesn't result in any disciplinary action, they simply don’t record the incident.

As this report reveals, because of this protective system, citizens have no way of telling how many errors a particular pharmacy or pharmacist has scored on their tally. The State Board of Pharmacy only releases records to the public in case there is any disciplinary action taken against the pharmacist in question, for his error. The Board admits it takes this step to protect the pharmacies and pharmacists. The pharmacies may be safe and protected. But who, we wonder, is responsible for protecting citizens? When records are available for public review only in the event of a disciplinary action, then it becomes hard for people to know exactly how many pharmacies have been diligent in following regulations and maintaining safe dispensing practices, and how many have been casually sweeping pharmacy errors under the Board's carpet. 

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"American Bandstand" or your local dentist's office? FoxNews.com reported a lawsuit filed last month by a Syracuse, New York woman against her dentist who allegedly punctured her sinus cavity during a tooth extraction. The lawsuit claims the Dentist, Dr. George Trusty, was dancing to the 70's hit "Car Wash" while using a drill on the woman's molar.

Ms. Brandy Fanning, 31, of Syracuse, New York, said that as a result of the injuries she sustained by the dentist's actions, she had to undergo emergency surgery. According to court papers, Ms. Fanning is seeking $600,000 for her medical expenses, pain and suffering in the lawsuit she filed against Dr. Trusty in U.S. District Court in Syracuse last month.

 

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When I read this story, I was horrified by what happened to a newly pregnant St. Louis woman who went to Walgreens to fill a prescription for prenatal vitamins and was instead given a potent chemotherapy drug that killed her unborn child. The woman and her husband filed a lawsuit seeking some form of justice against the powerful pharmacy chain, alleging that Walgreens failed to properly supervise pharmacy personnel who dispensed the medicine, failed to verify the prescription with her physician, and failed to follow appropriate protocol.

The couple alleges in their complaint that she began to feel ill and began vomiting about a month into her pregnancy and assumed it was morning sickness, all the while taking what she thought were the prenatal vitamins.  About a month later, she miscarried her baby. It is alleged that her unborn child was killed due to the ingesting of the potent chemotherapy drug.  After her miscarriage, she continued to take the chemotherapy drugs (still thinking they were prenatal vitamins) because she believed that the vitamins would prepare her for a subsequent pregnancy. It wasn't until she telephoned Walgreens for a refill that the pharmacist realized the mistake.  Please read the full article.  I implore you to write in about your own personal stories pertaining to pharmacy mistakes and errors and your opinions about what has happened to this couple.

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Late last week, a friend of mine called the office to tell me about a co-worker who fell victim to the ever-increasing incidence of pharmacy error. The co-worker, let’s call her “Janet,” hadn’t been feeling well and visited her physician, who diagnosed a common infection and prescribed a course of antibiotics. Janet filled the prescription at her local chain pharmacy located in Western Monmouth County. Within a day or two after starting the medication, Janet was feeling increasingly sicker, and at one point, thought she was having a stroke, as one side of her body lost all sensation. Janet’s husband rushed her to the emergency room; at first, the ER doctors thought she was suffering from a rare allergic reaction to the antibiotic, but soon learned that the pharmacy filled the prescription with the incorrect dosage, double the dosage originally prescribed by the doctor! Continue Reading...

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I'm feeling particularly cranky today. In my continuing tirade against the auto insurance industry's apparent war against its insureds, I want to once again address the way in which, you, the consumer, with the good driving record, who has dutifully paid premiums on time, is getting the shaft by your insurer. God help us all if we need our auto insurance to pay our medical bills after a motor vehicle accident.

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Last week, the Florida based supermarket chain Publix Super Markets announced the launch of its free prescription drug program at its 684 Publix Pharmacies for seven well-known antibiotics.
Customers will only have to provide their prescription and they can get up to a two week supply, filled at no charge, regardless of prescription insurance provider. Bravo Publix!

 

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A recent post on The Blotter, an ABC News Blog, reported yet another incident of pharmacy negligence in the wake of the report on "20/20" last month. This time, a seven year old  Modesto, California boy was given an adult high blood pressure medication by a Walgreen's pharmacy, instead of the medication he needed for a mental health condition. The boy ended up in the hospital and the boy's mother was urged to report the incident. Not knowing where to turn, she called ABC News. The drug the boy was given, Toprol XL, is usually administered to adults with high blood pressure. The drug the boy was supposed to take was Tegretol-XR.  Both drugs sound very similar and are apparently often confused, to the point that in 2005, the FDA issued a warning about the potential for confusing these two medications. In the case of the seven year old, Walgreen's released a statement to ABC News, whereby it shifted some of the blame to the boy's doctor for hand writing the prescription which was ultimately misread by the pharmacy.

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Citizens of New Jersey, would it shock you to learn that in response to concerns about a dangerous increase in pharmacy-related prescription errors, your state legislature has introduced a bill, which if enacted into law, would preclude all forms of recourse should your pharmacist’s mistake cause you or your loved ones to suffer serious physical injuries. Well it’s hard to believe, but amazingly true: pharmacists would receive total immunity from civil liability for any errors committed resulting in serious harm as long as the error was reported to the New Jersey Board of Pharmacy. Even more astonishing is the likely effect the legislation will have on the large national and regional pharmacy chains- complete insulation from liability for the negligent acts of their pharmacist employees. Continue Reading...

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Tonight's 20/20 program (see "Tragic Mistakes") sheds light on what can only be called a silent epidemic of the occurrence of pharmacy errors across the nation. The segment featured the tragic story of a young mother who gave her four-month old daughter who was born prematurely what she thought was an anti-seizure medication. What she actually gave the infant was an adult dose of a diabetes medication, which left her daughter permanently disabled, unable to talk, walk or feed herself. Walgreen's, the national pharmacy chain, was responsible for the dispensing error, this act of negligence that caused irreparable harm.

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The Food and Drug Administration (FDA) announced last week that it intends to implement a tougher  approach when considering potential conflicts of interest for its advisory committee members and for recommending eligibility for meeting participation. Doctors who receive more than $50,000 from a company or a competitor whose product is being discussed would no longer be allowed to serve on the committees.

The new rules are important, as these doctors, powerful advisers who receive payments from drug companies, have enormous influence over ultimately what drugs are approved, and this has shown to be a potentially dangerous situation for the public, while making drug companies millions of dollars.

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Let's say you go to your internist this past winter complaining of a sinus infection. Your trusted doctor prescribes you a brand new antibiotic, not the usual one you've tolerated well and taken in the past. Why did he prescribe this new drug as opposed to the old standby? Is it because your doctor believes this new drug is the state of the art in fighting sinus infections... or is something else motivating him?

The pharmaceutical industry's influence on doctors' prescribing practices looms largely in the background in today's medical practice. It's more than lunches or free pens from the perky sales rep dispensing free samples with the office manager. Way more.

 

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