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.

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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A report in Bloomberg effectively illustrates the point that medical malpractice lawyers have supported all along - that controlling malpractice premiums could be done more successfully by cracking down on errant doctors, making it harder for them to practice their brand of medicine.

The report gives the example of a Los Angeles surgeon who has lost two medical malpractice claims, and has had his privileges at the Western Medical Center of Santa Ana suspended, but continues to perform surgeries at another facility. The Medical Board of California has not found it necessary to suspend his license even though it is aware of the two malpractice cases amounting to $528,552 that he lost, as well as the little issue at Western Medical Center.

According to the report, the National Practitioner Data Bank which acts as a bad-doctor-database has only received reports of errant doctors from half of the country's hospitals. When a hospital suspends a doctor's privileges for a minimum of 31 days, it is required to report this to the data bank. However, hospitals seem to be getting around that rule by only imposing a 30-day suspension on a doctor or by labeling such suspensions "a leave of absence." This simply makes a mockery of the rule. Instead, doctors like the Los Angeles neurosurgeon in the Bloomberg story, continue to be able to practice in other hospitals as if nothing had ever happened.

It's this kind of "malpractice" that must be stopped if we are to see any lowering of the malpractice premiums that doctors like to complain about. When such doctors are allowed to practice and patients suffer injuries, they have no choice, but to consult with a medical malpractice attorney.

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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.

Attorneys for Dara insisted that there was no evidence linking him with the Hepatitis infection.  They also argued that the five patients who contracted Hepatitis B were treated at the same hospital, and could have contracted the infection there. However, the hospital was ruled out as the source of the contamination. Back in 2002, Dara paid $56,000 in fines for health code violations.

Hepatitis B is a viral infection that can lead to chronic liver disease, cirrhosis of the liver and liver cancer. It's up to 100 times more infectious than the HIV virus.  Infected blood is one of the most common modes of transmission.

Medical Malpractice Lawyers

You shouldn't have to worry about contracting a deadly disease when you walk into your doctor's office for treatment. Unfortunately, the threat of being held accountable for errors and negligence by medical malpractice lawyers is often the only thing that coaxes health care professionals to carry out their responsibilities with care.

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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.

As covered in a recent article in the Star Ledger:  "The state would cull the information from billing records and publish it in its annual New Jersey Hospital Performance Report and make it available on the state website, Health and Senior Services Commissioner Heather Howard said."

"The bill also prevents hospitals that made the mistakes -- as well as physicians who have acknowledged playing a significant role in the error -- from seeking any payment for medical care associated with the error. "  I often receive inquiries from people who believe that they were victim's of medical malpractice and they cannot believe that they are still responsible for the physician's bills.   This part of the legislation may bring about fundamental fairness in these situations.   

The bill (S2471), approved unanimously by the Senate Health Senior Citizens and Human Services Committee in Trenton yesterday, provides broader disclosure under a compromise that hospital groups, the AARP, unions and state officials supported in principle.

It would require the health department to reveal the hospitals responsible for committing what the federal government deems the 14 most egregious mistakes. Those include operating on the wrong body part, leaving a sponge or other device inside a patient's body and allowing or creating a blood infection following surgery.

Since the Patient Safety Act was passed, critics have argued that the Act does not work to protect patients because it does not allow for the release of information about the specific hospitals where major surgical and medical errors were made. Knowing how many medical errors and what kind of errors have occurred in the state hospitals doesn't help patients make a decision while selecting a hospital for treatment. With this new legislation now giving patients access to the names of the hospitals where major mistakes have occurred, they are in a better position to make a decision based on comprehensive and accurate information. A law is not really a law if it doesn’t go as far it should to protect the rights of the people it's meant to protect. The reluctance of hospitals to have their identity revealed cannot be enough reason to keep this vital information from the public. As a Monmouth County medical malpractice lawyer who sees the results of preventable hospital errors on patients, I believe that this new legislation is just what the doctor ordered.

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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.  

The negligence at University Hospital is just a symptom of the malaise that affects so many of hospitals, including those we have in New Jersey. It has its roots in the fact that we have no single federal agency to oversee our hospitals. That, and the sad truth that many times hospitals are large employers in the community they are located in, and any attempts to close them down face stiff resistance from locals, makes it harder for hospitals like University to be shut down. Around the country, it’s the same story. Hospitals are rarely held accountable for the errors they make, with anything resembling serious action. A facility that continues to make disastrous mistakes like University Hospital can continue to stay in business because the system is dysfunctional enough to prevent even bad hospitals from going under. No prizes for guessing who suffers when our nation's health facilities continue to provide sub par care – patients who in many cases, simply have no other choice.

In New Jersey, we have seen the number of preventable hospital errors increase steadily over the past three years. Like University Hospital which has faced more than a few medical malpractice lawsuits in the past , we have our own facilities in New Jersey where patients are more likely to return in worse condition than they were in when they arrived. So, the next time people whine about medical malpractice lawyers and malpractice insurance contributing to the skyrocketing healthcare costs in this country, it might be appropriate to point them towards this report.

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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.

For those who are shocked that hospital error rates continue to rise despite the Act, state health officials are convinced that the increasing statistics are not nearly as grim as they seem. They say it points to the fact that hospitals are getting better at reporting their errors than they used to be.   In fact, the disturbing statistics on preventable hospital mistakes in New Jersey are not the result of a health system going to shambles, they say, but an indication that hospitals are now training staff to be better equipped to notice these errors and report them.

As far as I am concerned, 72 totally preventable deaths in a hospital setting are still 72 more than we should have. We must remember we're not talking about people dying of cancer or other illnesses, or succumbing to wounds from an accident here.  We're talking about mistakes made by surgeons, and errors in prescribing and dispensing medication to patients. We're talking about the presence of bed sores that only result when a bedridden patient hasn't been turned in several hours. These are all entirely preventable mistakes, and until we start seeing a reverse trend in statistics every time the Patient Safety report comes out, there's no reason for a pat on the back and a self satisfied smirk. As I pointed out in this post on the concealing of hospital error information in New Jersey, the need for New Jersey medical malpractice lawyers is increased when we  continue to have cases like the 456 reported preventable errors that were committed in our hospitals last year.  

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 The New York Times has an interesting report on a little-known phenomenon in our hospitals that could point in a small way to the reason New Jersey medical malpractice lawyers are as busy as they are. It's about the way obnoxious, brusque or just plain abusive physicians may be contributing to some frightening medical and surgical mistakes.

According to the report, all too often, nurses who play such an important part in the doctor-patient relationship are humiliated, berated and even abused by physicians, so much so that it creates problems in communication. The Times uses some real life incidents to signify how sometimes, fear of approaching a doctor who's known to have a short fuse, can actually deter the nurse from approaching him when a patient's condition is worsening, or when there is an important life-and-death decision to be made about a patient. This lack of communication resulting out of fear of the doctor has led in too many instances, to serious complications, the need for additional surgery to repair the damage, and in some cases, even death. 

Although the report stresses that most physicians are not abusive, almost every nurse can tell you of at least one instance when she was at the receiving end of a doctor's anger. It could be in the operating room - and it's not unheard of to have surgical tools flung at you - or it could be verbal humiliation that leaves the nurse thinking twice before she calls the doctor during an emergency.

These "Doctors Gone Wild" scenarios have terrible implications for patient safety. An abrasive temperament can lead to dangerous physician errors, and it causes delays in giving patients the emergency treatment they require when nurses are too afraid to make a call to the physician in question. There's no doubt that the medical profession is an extremely stressful one, but there's probably no other field that demands better control over your emotions. Some hospitals do ask their doctors to sign up for anger management classes after one scalpel thrown across the operating room too many, but it still continues to be a problem, and is no doubt, contributing to at least some instances of medical malpractice.

Stress comes with the territory when you decide to take up a career in medicine, and if you have a natural tendency to react badly to stress or take it out on others, you should probably reconsider the professional path you are about to choose. Once you're outfitted in a white coat, there are simply too many patients whose lives depend on you keeping a cool head at all times, for you to have the luxury of blowing steam in the work place.

Doctors who are stressed out, or simply have a tendency to react viciously are just one reason why medical mistakes can occur. These mistakes can have serious and even fatal consequences. If you have been injured by a mistake committed by a physician, you should know that you have ways to obtain compensation for your suffering and trauma. Get in touch with me at my New Jersey medical malpractice lawyers office for an evaluation of your case.

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