Arizona Medical Malpractice Blog

CDC Teams up with Surgeons Group to Prevent Surgical Site Infections

Mon, 07 May 2012 18:06:00 GMT

The Centers for Disease Control and Prevention recently announced that surgical site infections across the country are down. However, the agency wants to maintain the momentum of progress in reducing the number of these infections. The agency has teamed up in a strategic collaboration with the American College of Surgeons in order to reduce these infection rates further.

The partnership between the Centers for Disease Control and Prevention and the American College of Surgeons is based on the sharing of expertise and resources. The initiative will track, report and prevent surgical site infections. The initiative will share resources by the Centers for Disease Control and Prevention's National Center for Emerging and Zoonotic Infectious Diseases and the American College of Surgeons’ National Surgical Quality Improvement Program. These organizations will form a working group to focus on both infectious as well as noninfectious complications found after surgery.

Arizona medical malpractice lawyers believe that this initiative will bring together the best minds in the healthcare industry. For instance, the initiative is expected to pool together not just financial resources and research, but also bring together a host of clinicians, surveillance experts, as well as leaders in infection prevention and control.

According to the Centers for Disease Control and Prevention, across the country, there was a decline in surgical site infections in 2010. However, substantial decreases were found only in coronary artery bypass grafting. This, in turn, affected the overall surgical site infection rates across the country. What this indicates is that there is a continued need to make further progress towards preventing these very preventable infections.

Infection Risks from Robotic Drug Dispensers

Tue, 10 Apr 2012 21:07:00 GMT

More and more hospitals around the country are now using the help of so-called robotic drug dispensers, to lower the burden on healthcare personnel. However, Arizona medical malpractice lawyers believe that there is a high risk of contamination of drugs and consequent infections with the use of these dispensers.

Staff numbers at the Wake Forest Baptist Medical Center in North Carolina recently conducted a routine screening of the robotic drug dispenser in their facility. They were shocked to find cultures of the Bacillus cereus bacteria in the samples dispensed by the robot.

This particular type of bacteria is extremely harmful, and causes thousands of hospital-acquired infections every year. What makes the bacteria so dangerous is that it is resistant to many types of antibiotics used to treat infections in hospitals.

The dispenser in this case was being used to prepare intravenous drugs. If a bacillus cereus-contaminated intravenous drug is administered to patients, the patient may be at high risk of developing a bloodstream infection.

Bloodstream infections are potentially life-threatening. The organisms can quickly find their way into the bloodstream, speeding up the infection process. Fortunately, in this particular North Carolina hospital, the staff members did not discover any infections resulting from the contaminated drug dispenser.

However, when the researchers completed their investigations, they were able to link the contamination with the dispenser’s washing station and tubing. According to the researchers, there are no specific maintenance and cleaning procedures that are outlined for the washing station, and therefore, there is a potential for confusion over the exact cleaning practices to be followed. Improper cleaning could easily lead to contamination of the drug dispenser.

This is the first time the researchers have found bacterial contamination of any robotic dispenser anywhere in the country. However, it is likely that the contamination problem exists in dispensers elsewhere in the country too.

CDC Reports Increase in C. Difficile Infections

Mon, 12 Mar 2012 19:40:00 GMT

Even as the numbers of other hospital-acquired infections like MRSA and central line-associated infections have been declining in number, the number of infections caused by the deadly Clostridium difficile bacteria has actually been increasing. The Centers for Disease Control and Prevention is reporting historic highs in the incidence of these deadly infections.

Annually, approximately 14,000 Americans and 300,000 people fall sick from C. difficile infections. An overwhelming majority of these infections occur in healthcare settings. According to the Centers for Disease Control and Prevention, more than 90% of these infections are linked to medical care. Out of these, 75% are traced to hospitals, nursing homes, doctors’ offices, clinics, outpatient settings and other healthcare environments.

What the Centers for Disease Control and Prevention and Arizona medical malpractice attorneys are really concerned about is the increase in the number of infections that have been traced to outpatient facilities, doctor’s offices and other facilities that were not linked to these infections before.

These infections lead to a variety of symptoms that include inflammation and severe diarrhea. Healthy persons may not be at a high risk of contracting the infections. However, persons who have recently been on a course of antibiotics may have a much higher risk of contracting these infections. People who are on antibiotics are approximately 7 to 10 times more likely to contract C. difficile infections. Those who have finished a course of antibiotics are up to 3 times more likely to contract the infection. This is because antibiotics tend to strip the system of essential bacteria, and this leaves the door open for Clostridium Difficile bacteria.

The CDC recommends judicious use of antibiotics, immediate testing of persons who are on antibiotics and have diarrhea, bleaching of contaminated surfaces, and wearing gloves and gowns while treating infected patients, to prevent C difficile infections.

Filthy Medical Implements Increase Risk of Infections

Sat, 25 Feb 2012 19:57:00 GMT

Deadly infections caused by unsterilized, filthy medical devices and surgical tools cause a high number of postsurgical infections every year. The Food and Drug Administration have been aware of the problem for at least a few years now, but has failed to take any action.

The agency's failure to take action is perplexing to Arizona medical malpractice attorneys, because there have been several highly publicized outbreaks involving patients who were infected by contaminated medical equipment. For instance, veterans who went to Department of Veterans Affairs centers in Tennessee, Georgia and Florida, for endoscopies and colonoscopies, were administered the procedures with filthy devices. As a result, these patients developed illnesses ranging from HIV to Hepatitis B and C. Some of the veterans have filed lawsuits against the Department Of Veterans Affairs.

The previous year, there had been a hepatitis A outbreak at a Las Vegas endoscopic Center. There too, the implements had not been sterilized properly, and as a result, at least 6 people were infected. Investigations into that incident revealed that endoscopes had not been properly cleaned after use. Staff had also been reusing instruments that are typically meant for single use only.

Soon after the Las Vegas outbreak, the Centers for Medicare and Medicaid Services conducted inspections of about 1,500 outpatient surgery centers across the country. Out of these, 28% were cited for deficiencies related to sterilization of equipment.

According to the Food and Drug Administration, the number of surgical infections is so high because there has been a recent proliferation of highly complex surgical instruments, combined with inadequate testing of devices by manufacturers. Additionally, staff in charge of sterilizing devices between procedures, may be overstressed due to lack of sufficient staffing resources, and may be under pressure to get the devices sterilized quickly before the next procedure.

Delivery Time Does Not Impact Health of Babies with Birth Defects

Sat, 18 Feb 2012 22:34:00 GMT

For years, conventional medical wisdom has held that when a baby has an identifiable abnormality, delivery should preferably be scheduled for a weekday. As a new study indicates to Arizona medical malpractice lawyers, there may be no grounds for that belief. According to the study, infants with birth defects who were delivered on weekends fared just as well as infants with birth defects born during weekdays.

Researchers from the University of Rochester Medical Center in New York investigated 2 groups of newborn infants. Both groups stayed at the same hospital during the same period of time, and both groups had the same rate of admission to the neonatal intensive care unit. Additionally, both groups also required antibiotic therapy and respiratory assistance the same number of times.

A total of 200 incidents were involved in the study. In all these cases, doctors identified nonlethal birth defects during pregnancy.

However, the researchers found no difference in the health of the babies, when these were delivered on weekends compared to weekdays. The researchers say that the timing of the delivery is not really important when it comes to the health of a baby.

In fact, it would be much better for the mother if the delivery was actually allowed to take place naturally, without any induction. There are complications involved in inducing labor. For instance, there is the risk of heavy bleeding, and a higher risk of a Cesarean section when labor is induced. Also, when labor is induced, women are more likely to have an extended hospitalization stay.

Overall, the researchers recommend that when a baby is known to have a birth defect, the delivery be allowed to commence naturally whenever the woman is ready.

Nurses Work Hour Caps Help Reduce Risk of Medical Errors

Tue, 31 Jan 2012 22:32:00 GMT

A new study finds that state-mandated caps on working hours encourage nurses to avoid working overtime, thereby reducing the risk of fatigue, and minimizing the risk of errors. According to the study which was conducted as part of the RN Work Project funded by the Robert Wood Johnson Foundation, the caps on working hours for nurses, have reduced overtime hours for newly registered nurses, and has confirmed that long working hours can indeed increase the risk of fatigue and risk of medical errors.

The study is part of a ten-year longitudinal study that kicked off in 2006. The purpose of the study was to learn more about career patterns of registered nurses, including their turnover rates in hospitals. The data came from nurses in 34 states, and the results of the study have been published in the Nursing Outlook.

The study focused on 16 states which have rules that restrict the number of overtime hours that nurses can work as of 2010. Arizona does not yet have rules that restrict the number of overtime hours for nurses. In those states that have such restrictions in place, the researchers found that 59% of the nurses were less likely to work mandatory overtime than nurses in states that do not have such regulations in place.

In addition, nurses who were working in states which had regulations on the number of hours that nurses can work, worked an average of 15 minutes less a week than those nurses in states that do not have such regulations in place. Earlier, Arizona medical malpractice lawyers had feared that limiting the number of work hours for registered nurses could increase voluntary overtime, but that does not seem to have happened.

Study Finds Most Medical Errors Involving Medicare Patients Go Unreported

Sun, 08 Jan 2012 21:14:00 GMT

Under the Medicare program, hospitals are required to track medical errors, and report adverse patient events. However, a new study finds that only one out of every 7 errors that occur in a hospital are recognized and reported.

According to the study by the Inspector General of the Department of Health and Human Services, most medical errors are probably going unreported. The study found that while almost all hospitals have some type of system in place for employees to track medical errors, and inform hospital managers of serious errors, hospital staff members too often fail to report serious errors that harm Medicare patients.

In fact, according to the report, many of these errors resulted in adverse events that were so serious that the person ultimately died. These adverse events that were not reported included medication errors, bed sores, excessive bleeding from improper use of blood thinners and excessive overdose of painkillers, leading to delirium. According to the inspector general's report, more than 130,000 Medicare patients were exposed to one or more adverse events in a hospital in a single month.

None of this is very surprising to Arizona medical malpractice lawyers. Since the Institute of Medicine issued its path-breaking patient safety report To Err is Human in 1999, hospitals have found it hard to encourage employees to come forward to report errors. Initially, the problem seemed to be an unwillingness to admit mistakes because of the fear of repercussions. That seems to no longer be the case. Now, the failure to report errors seems to stem from the inability to recognize what constitutes errors serious enough to cause patient harm. In other words, staff members don't seem to be able to recognize the kind of errors that can seriously lead to patient harm and the need to report these errors.

Human Error Primary Factor in Ventilator Alarm-Related Patient Deaths

Wed, 28 Dec 2011 20:59:00 GMT

An increasing number of patient deaths associated with ventilator alarm-related errors confirms to Arizona medical malpractice lawyers that alarm fatigue is a much-neglected aspect of patient safety in the United States. According to the Boston Globe, more than 100 people have died over the past 6 years alone as a result of ventilator alarm-related errors.

What is even more concerning is that few of these alarm-related errors are due to defective ventilators or ventilator malfunctioning. Human error seems to be a primary factor in these errors and deaths.

An investigation by the Boston Globe and the ECRI Institute found that a total of 119 people died in ventilator alarm-related incidents between 2005 and 2011. Defective or malfunctioning ventilators were associated with only 2 of those fatalities. The rest were all the result of human error on the part of caregivers or healthcare staff. In these cases, caregivers or nurses either ignored the ventilator alarms, or did not hear them. In other cases, the alarms were set incorrectly.

Alarm fatigue and its role in propagating medical errors is something that Arizona medical malpractice attorneys have been probing deeper into. The vast number of ventilator and cardiac monitor alarms in hospitals and home healthcare settings leads to nurses and caregivers becoming so overwhelmed by the alarms that they may ignore these when they do go off. Many times, alarms are false, and as a result, caregivers become used to false alarms, and may not respond as quickly or at all, when there is an alert.

In 2010, the Food and Drug Administration reported that there had been reports of 800 alarm-related adverse outcomes last year alone. Most of these were classified as ‘preventable,’ and were associated with human error. In September this year, the agency issued an alert that too many alarms were being neglected or ignored, and also warned that caregivers and nurses were becoming much too dependent on alarms. In fact, the ECRI Institute has now ranked alarm hazards as one of the top 10 health technology hazards.

Forceps Delivery Could Be Safer for Newborns than Vacuum Deliveries, C-Sections

Wed, 07 Dec 2011 23:39:00 GMT

For years now, the conventional belief has been that a forceps delivery is more dangerous for newborn, than delivery through a vacuum pump or a C-section. A new study seeks to dispel that belief. According to the study, delivery through forceps is probably less dangerous for a newborn than vacuum deliveries or C-sections.

The research was led by obstetricians from Johns Hopkins School of Medicine in Baltimore. The researchers analyzed data involving more than 400,000 births to first-time mothers. They found that the babies that were delivered via forceps delivery were about 45% less likely to suffer birth trauma like seizures or bleeding in or around the brain, compared to those who were delivered by a vacuum delivery or a C-section.

Out of the more than 15,000 births in the study that were via forceps delivery, just .12% had a seizure at birth. For babies that were delivered by C-section or via vacuum deliveries, the rate was around .3%. Risks of other complications like subdural hemorrhage and intraventricular hemorrhage were even lower in forceps deliveries. However, cesarean sections were found to be linked to a lower risk of subdural hemorrhage, or bleeding around the brain.

The study does not offer Arizona medical malpractice lawyers any conclusive evidence about which type of delivery is safer. However, it does seem to challenge the traditional belief that forceps deliveries are much more dangerous than C-sections and vacuum deliveries. C-sections have become widely popular in the United States, and in 2007, approximately 1/3rd of all American births were through C-sections. According to the obstetricians, there does not seem to be enough evidence that these deliveries are safer than forceps deliveries.

There could be a simple reason why the risks of seizures are lower with forceps deliveries. Seizures occur because of a lack of oxygen supply to the brain, and it's easier to get a baby out of the mother using forceps, than it is by C-sections or vacuum pumps.

Report Recommends Better Tracking of Hospital Medical Errors

Mon, 21 Nov 2011 17:09:00 GMT

The high numbers of medical errors in hospitals that are part of the Medicare and Medicaid programs have been under scrutiny by Arizona medical malpractice lawyers since last month when a survey found that more than 15,000 patients on Medicare die in hospitals from medical errors every month. A new report finds that regional Medicare and Medicaid agencies are not doing a good enough job of reporting medical errors to accreditation agencies, and as a result, these errors are not being tracked and corrected.

According to an Office of the Inspector General report, the Centers for Medicare and Medicaid Services’ regional agencies are not notifying accreditation agencies like the Joint Commission, when inspectors find adverse events in hospitals. The Centers for Medicare and Medicaid Services report analyzed 88 complaints against accredited hospitals filed with the Joint Commission. The report focused on the most serious “immediate jeopardy complaints.” The report says that the Centers for Medicare and Medicaid Services notified the Joint Commission in only 28 out of those 88 sample complaints.

This means that in far too many cases, inspectors find serious medical errors in hospitals, but fail to report these to national accreditation agencies. Hospitals are not notified about these errors, and may continue making the same mistakes over and over again. The hospitals are not given a chance to learn from their errors, and continue to participate in Medicare and Medicaid programs. Hospitals may not be in a position to correct errors. Patients in these hospitals may be at a risk of adverse events because of the failure of error-tracking procedures.

The Joint Commission has praised the Centers for Medicare and Medicaid Services report, and has said that it receives very little timely and reliable information from the regional Medicare and Medicaid agencies. Only some of the regional agencies send in information regularly.

High Risk of Patient-to-Patient Acinetobacter Baumannii Infections from Contaminated Surfaces

Mon, 21 Nov 2011 04:09:00 GMT

Many hospital rooms occupied by patients who suffer from Acinetobacter baumannii infections may continue to retain sources of contamination of the deadly drug-resistant organisms. This places hospital personnel and other patients at a risk of infection long after the patient has vacated the room.

According to a survey conducted by an infectious disease specialist at the University Of Maryland School of Medicine, nearly 50% of hospital rooms used by patients who had a an Acinetobacter baumannii infection, were found to be contaminated even after the patient left the room. Signs of contamination were found on surfaces like drawer handles, touch pads and bed rails.

Researchers analyzed rooms occupied by fifty ICU patients who were infected with the Acinetobacter baumannii, a drug-resistant germ that typically causes infections in critical care units. These organisms often cause deadly infections in veterans returning from combat. Researchers tested at least ten surfaces in each room, and found that at least one was contaminated with the bacteria. 40% of the rooms showed signs of such contamination.

The most commonly contaminated surfaces were supply cart handles, with a 20% contamination rate. These were followed by flooring, infusion pumps, touch pads and bed rails. Approximately 85% of the germs that were found on the surfaces were the ones that caused the infection.

What this indicates to Arizona medical malpractice lawyers is the importance of proper sterilization and sanitization procedures for rooms occupied by patients with deadly infections. Arizona medical malpractice lawyers are also aware of other surveys that have shown that rooms of patients who suffer from MRSA and Clostridium difficile infections also have such contaminated surfaces that increase infection risks. However, the Acinetobacter baumannii bacteria is a special challenge, because these germs survive even on inanimate surfaces for days, and even months.

Researchers Successfully Use Protein to Limit Cerebral Palsy-like Brain Injury in Mice

Sat, 19 Nov 2011 20:14:00 GMT

Researchers at Washington University have discovered a protein that can help limit the extent of brain injury that occurs when a baby is deprived of oxygen during delivery. Such deprivation of oxygen can cause a condition called cerebral palsy. The researchers found that the protective protein called Nmnat1 can help reduce critical brain damage and limit the extent of cerebral palsy.

Arizona medical malpractice lawyers find a number of causes for oxygen deprivation in a baby during the delivery process. There may be complications from a spike in maternal blood pressure, and this typically happens because doctors fail to monitor maternal health. Doctors may fail to perform an emergency cesarean section, leading to the baby being forced through the birth canal. In such cases, there is a disruption in the supply of oxygen to the baby, causing brain damage with possibly long-term consequences. One of these long-term consequences is cerebral palsy, a condition that affects an individual’s mobility, movement and mental development.

The researchers found that Nmnat1 helps protect brain cells from damage, probably by blocking the effects of the neurotransmitter glutamate, which kills off healthy brain cells. The researchers examined the effects of Nmnat1 on mice that that had suffered oxygen and blood flow deprivation. They found that mice that had genetically-engineered higher levels of Nmnat1 had much lower brain damage to critical areas of the brain that are responsible for causing cerebral palsy, than the mice that did not.

Follow-up studies further found that the mice with the higher levels of Nmnat1 suffered minimal or no brain damage at all. Researchers are now concluding that introducing Nmnat1 doses could help prevent the loss of brain cells in a baby suffering from oxygen deprivation, and thereby block or limit cerebral palsy.

Use of Pediatric-Specific Procedures Can Reduce Infection Rates

Sat, 19 Nov 2011 18:45:00 GMT

A new study indicates that hospital ICUs can reduce the risk of infections in pediatric patients by following procedures that are tailored specifically for pediatric patients, including a focus on central line maintenance.

Pediatricians from Johns Hopkins University in Baltimore studied pediatric infections as part of an ongoing effort by the National Association of Children's Hospitals and Related Institutions. They found that the rate of pediatric ICU infections fell to 2.3 infections per 1000 central line days from 5.2 infections, after they used pediatric-specific procedures.

The doctors recommend a bundle of instructions that Arizona medical malpractice lawyers believe would be easy for any ICU to follow. These include scrubs of chlorhexidine and proper hand washing procedures to reduce infections.

Before insertion, doctors and nurses must take special care to:

Wash hands before insertion
Wash the area with a mix of chlorhexidine for a minimum of 30 seconds,
Use a special insertion checklist that will allow staff to stop insertion in non-emergency situations, when proper hygiene procedures are not being followed
Use sterile barriers for both staff and patient
Avoid using iodine at the insertion site
For maintenance, doctors and nurses must
Conduct a daily assessment of whether the line is really needed
Use a chlorhexidine scrub to care for the catheter site
Change gauze dressings every two days and clear dressings every seven days, unless these are soiled or loosened
Replace tubing within twenty-four hours after starting an infusion
Change caps within 72 hours, or according to manufacturer recommendations
Use a prepackaged change kit

In adult ICUs, hospitals have experimented successfully with central line insertion safety procedures to reduce infection rates. However, the exact same procedures are not likely to benefit pediatric patients. For these patients, proper and daily maintenance of the ports can result in greater benefits in reducing infection rates.

October is World MRSA Awareness Month

Sun, 16 Oct 2011 20:38:00 GMT

Arizona medical malpractice lawyers and health groups will not be the only ones focusing on the risks from deadly methicillin-resistant staphylococcus aureus infections this month. October is being marked as World MRSA Awareness Month, and the aim is to increase awareness about the need for preventing MRSA infections and finding new treatment options. Events have been planned across the country.

World MRSA Awareness Month is sponsored by the MRSA Survivors Network, and the group is demanding that the World Health Organization and the Centers for Disease Control and Prevention develop an MRSA surveillance and reporting system for all countries.

MRSA infections are caused by the MRSA organism, which is resistant to many types of antibiotics, including those that are effective against other types of staph infections. The infection can be picked up in both community and healthcare settings, and is frequently seen in hospitals.

Approximately 20,000 people in American hospitals die every year from invasive MRSA infections. There are several reasons why Arizona hospital negligence lawyers come across many infections caused by MRSA in hospitals. MRSA tends to attack people with a weakened immune system, and most people in a hospital are recovering an illness or have undergone surgery. Therefore, the risks of infection are always high. Additionally, MRSA infections can easily spread through the use of contaminated tubes and lines used in a hospital.

This month, Arizona medical error attorneys and doctors recommend proper handwashing and hand hygiene practices in order to prevent MRSA infections. These infections can also be prevented by better environmental cleaning, making use of the most advanced cleaning technologies. Patients who have contracted MRSA should be kept in isolation, and new hospital admissions must be screened for MRSA

Close to Half of All Clinicians Find Diagnostic Errors in Practice

Sun, 16 Oct 2011 20:22:00 GMT

Arizona medical malpractice lawyers find scant attention is being paid to the prevention of medical injuries caused by misdiagnoses in hospitals, in spite of the fact that these errors are surprisingly frequent occurrences. According to a new study by QuantiaMD, nearly 50% of physicians surveyed found diagnostic errors in their practice at least once every month.

The report, titled Physician Perspectives on Preventing Diagnostic Errors, focused on 6,400 clinicians who were asked about their experiences with diagnostic errors. Nearly half of them, or 47%, said that they found these errors every month in their practice. However, more than 90% believed that these errors were at least partly preventable.

Most diagnostic errors seemed to be the result of physicians’ failure to consider other types of diagnostic possibilities and atypical patient presentations. Additionally, the risk of diagnostic errors also increases under external pressures. Doctors who order too many diagnostic tests may also run the risk of making errors.

In the survey, 64% of clinicians said that at least 10% of the mistakes they made had directly contributed to patient injury. Diagnoses of some types of conditions are at a higher risk for errors than other conditions. For instance, 54% of the clinicians reported errors in the diagnosis of pulmonary embolism, followed by bipolar disorder with 51% of the clinicians reporting errors in the diagnosis of this condition. These conditions were followed by appendicitis, breast cancer, myocardial infection, lung cancer, prostate cancer, colorectal cancer, heart failure, stroke, and other types of cancers.

Seventy-five percent of the doctors said that atypical patient representation was a factor in misdiagnoses, followed by a failure to consider other diagnoses, which accounted for 50% of errors. Other factors include inadequate patient history, insufficient follow-up on test results, and failure to account for a symptom, failure to order appropriate tests, inadequate physical examination, and failure to correctly interpret results.