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

In spite of greater infection control measures and increased media spotlight on the high numbers of fatalities linked to these infections, hospital-acquired infection rates around the country continue to rise. According to the New York Times, a government study has revealed that there has been an increase in the number of post-operative blood stream infections and catheter-associated urinary tract infections

The Agency for Healthcare Research and Quality says there was an 8% increase in postoperative blood stream infection rates, and a 4% increase in urinary tract infections last year. The numbers of bloodstream infections caused by placement of catheters in central lines, did not change from the previous year. There is however some good news for patients, New Jersey medical malpractice lawyers and health groups. There was an increase of 12% in the numbers of postoperative pneumonia infections contracted in hospitals. 

It's not all bad news, the agency says. Overall, there has been an improvement in patient care and safety, but these improvements are progressing at a rate that is far too slow.

Obviously, the increase in hospital-acquired infection rates is a cause of concern. This is in spite of increased media attention in recent years, focused sharply on hospital-acquired infections, especially bloodstream infections. It is a fact that several hospitals around the country have successfully implemented measures aimed at infection control. These measures have helped these facilities reduce their infection rates substantially. These steps include the use of checklists before and after operative procedures, more attention paid to hand hygiene procedures, more attention paid to equipment sterility and antibiotic therapy before and after a surgical procedure.

Getting hospitals to abandon their outdated methods that increase the risk of infection, and adopt simple, but effective steps to prevent infections has not been that easy. Things could soon change, however. The new health reform package passed by the Obama administration provides for penalties for hospitals with high rates of infections, beginning from 2015.

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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.

In the March issue of Academy Medicine, researchers claim that reusing certain products can save the healthcare industry billions of dollars every year, and dramatically reduce the amount of waste that the industry produces. Single use devices must be discarded after they are used. But researchers say that sterilizing some instruments like compression stockings can cut costs, and reduce the amount of waste that the hospital generates. According to the researchers, they have studied the effects of such reuse of products, and have found no adverse patient safety-related incidents.

However, concerns are beginning to mount about the danger to patients who could be at a higher risk of infections because of the hospital’s desire to save a few dollars or cut down trash. According to Michael Bennett who is the president of the Coalition for Patients Rights, it is unconscionable for a hospital to subject a patient to the risks of infections, just to save on costs.

As a New Jersey medical malpractice lawyer, I'm definitely very concerned about this potentially dangerous trend. American hospitals already struggle with a high infection rate, and we need more firm steps taken to keep these rates in check and minimize the threat of infections. While there is a need for reducing our carbon footprint and minimizing consumption in the healthcare industry, this could be done in other areas. Patient safety must not be compromised just to green hospitals.

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The New York Times has published an excellent report on the increasing frequency of radiation errors in many of New York’s hospitals, and the trail of debilitation, serious injuries or death that are often left behind. These increasing numbers of errors have come with the introduction of sophisticated complex machines that promise targeted cures using radiation therapy.

 The New York Times profiles a few cases where individuals have been injured by excessive dosages of radiation, and later died from their injuries. In one of the cases profiled, the radiation was delivered to the wrong parts of the body, because of technical malfunctioning of the equipment, and the failure of the staff to catch the error in time.

Much of the problem, the NYT says, comes from the fact that these new machines come with few technical safeguards to prevent errors in radiation. As a New Jersey medical malpractice lawyer, I find it hard to understand how a complex linear accelerator, that can deliver intense targeted radiation to specific affected parts of the body, can be allowed to function when there is a malfunction that causes radiation to be delivered to other parts of the body too. Yet, that is exactly what happened with the linear accelerator in one of the cases profiled in the New York Times report.  Warning messages in that case were not noticed by staff and technicians.

Hospitals and doctors have grown too reliant on these technologies that are still new. There has also been a failure in training staff to operate these machines properly.

For patients who have been injured by radiation errors, tracing their injuries to these errors can be hard. Often injuries don’t show up for months and years after the error has taken place. Even worse, the kinds of injuries that result from radiation errors are almost untreatable - there is little that can be done to repair the damage.

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Approximately 9 percent of American surgeons have made recent major medical errors, and a majority of them blame these on mental stress and burnout. Those findings come via a Mayo Clinic study, that included researchers from John Hopkins and the American College of Surgeons. Out of the 7905 surgeons who took part in the survey, close to 9 percent or 700 surgeons said that they had made medical errors in the three months before the study. 

The study points to how seriously depression, mental stress, burnout, emotional exhaustion and other factors impact a surgeon’s ability to perform his duties safely and responsibly. However, the researchers found no connection between these errors and the number of hours a surgeon worked, his compensation, or his work environment. This means that these errors are not being caused by work pressure and other external factors. Minimizing the impact of these factors would therefore, not decrease the rate of errors.  

Medical malpractice lawyers and patient safety advocates will be even more concerned about the fact that these errors continue to haunt surgeons for months after they have occurred. This only increases the kind of strain and emotional exhaustion these surgeons experience, and enhances the risk of making more medical errors.

700 surgeons performing major medical errors in a period of three months is no small matter. As a New Jersey medical malpractice lawyer, I am concerned about how little we are focusing on treating surgeon burnout to prevent medical errors, and the scant space this issue has in the ongoing healthcare reform debate.  

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The Wall Street Journal has compiled a great list of how to prevent hospital infections. The list is the result of recommendations from healthcare providers, administrators as well as infection controlling agencies. The Wall Street journal list is divided into two. The first part covers newly developed technologies and procedures that can help hospitals control and lower their infection rates. The second part consists of basic steps that hospitals are currently taking to prevent infections, but can do a better job of enforcing.

The new technologies include.

• A fluorescent solution developed by an epidemiologist which can be sprayed in a room after it has been cleaned to detect missed spots.
• A shower-like cubical equipped with a fogger which can be used for sterilization.
• Computer software that allows hospital authorities to monitor any sudden infection outbreaks in any part of the hospital. Data like this can help authorities control the infection source, preventing an epidemic.
• Antibacterial hand soaps have been much maligned for their role in the evolution of drug-resistant bacteria. However, using a mild antibacterial soap for washing helps lower infection rates.
• In New Jersey, hospitals are required to report preventable errors. These laws help keep hospitals in check, motivating them to control infection rates.

The basic steps that hospitals are taking to prevent infection rates include:

• Using alcohol-based sanitizers and placing these in areas where doctors and nurses can easily find them.
• Creating checklists for use in intensive care units and surgical rooms. Checklists are an extremely simple way of monitoring simple procedures
• Hospitals have also developed portable medical kits that contain equipment necessary for simple procedures. For instance, a nurse who has to change a dressing, can have all equipment that she needs from the gauze to antibacterial solution, in the kit, minimizing the need for her to rush back to pick up something she forgot.
• Ventilator-associated pneumonia is an extremely common infection in hospital intensive care units. These conditions can be prevented by regularly cleaning the patient’s mouth, teeth and gums, and elevating the head of the bed at 30 to 35 degrees.
• Newer quick diagnostic tests can be used to check for infections quickly, with results available in a matter of hours.

Scott Grossman is a New Jersey medical malpractice lawyer representing victims of medical malpractice in Monmouth, Bergen, Passaic and Ocean Counties, and across the state of New jersey.

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The Obama administration has announced a $25 million grants to states to help them evaluate methods to discourage “frivolous" medical malpractice lawsuits. The program will offer states grants that they can use to identify ways to improve patient safety, as well as alternatives to medic malpractice lawsuits, like admission of errors and apologies by hospitals and doctors.

Early indications are that the President, who might have been attempting to woo Republican support for his health care reforms by this move, hasn’t really succeeded in doing so. Republicans have been quick to pooh-pooh the program, saying that it’s too weak an effort to get rid of frivolous lawsuits. The program has also been criticized by public interest groups who believe that the program will do nothing to win Republican support while bartering away the rights of injured patients, which would be dangerous.

As a New Jersey medical malpractice lawyer who constantly comes across patients who have suffered a range of injures from the carelessness of health care professionals, I firmly believe that we don’t try to win lawmaker support by signing away the rights of injured victims to receive justice. The medical malpractice debate won't go away any time soon, and the funding that has been announced will not really help move the debate forward to its logical and rightful conclusion - medical malpractice lawsuits have little impact on health care costs.

We are not going to have affordable healthcare for all in this country by limiting justice for those unfortunate few who are injured by medical negligence.

Fact: Lower malpractice insurance costs would actually have a minimal impact on healthcare spending. Insurance costs, even at the rates that they are at now, are actually not that big an expense for doctors who continue to be the most highly paid professionals in the country.

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