Albany, New York Personal Injury Blog

Patients Given Easy Access to Medical Records


When you visit a medical provider you most likely watch them type or write notes as you explain your condition. If you are like most people, you have probably wondered just what is being said about you in your medical record. Most of us may never know. Even though a patient is absolutely entitled to get a copy of his or her medical records under New York Public Health Law Sections 17 and 18, access can prove challenging.

A recent study published in the Annals of Internal Medicine has shown that patients may benefit when their medical records are openly shared and easily accessible. Such an approach encourages patients to be more engaged in their health and wellbeing.

Jan Walker, from Beth Israel Deaconess Medical Center and the study’s lead author explained, “Knowledge is power….A patient goes to the doctor only once in a while but in between visits, you’re making all kinds of decisions that affect your health every single day.”

By creating more of a collaborative environment, patients may take more ownership of their health and therefore make better decisions. Patients may better understand treatment plans, avoid medication errors and remember to follow-up about various conditions. Additionally, patients may notice if their physician misunderstood them, or if there are inaccuracies in their medial record.

Physicians were concerned that patients would be confused or worried after seeing their records, and therefore require more of their time. Patients, however, largely appreciated the opportunity. Ninety percent expected they would be in greater control of their healthcare by having access to their records.

Since early research seems to indicate that patients having access to their medical records is beneficial, hopefully this type of open collaboration between doctors and their patients will continue and expand.

Source: The New York Times, Project Puts Records in the Patients’ Hands, Roni Caryn Rabin, 9 January 2012

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The Troubling Trend of “Distracted Doctoring”


By now almost everyone has heard of the dangers of distracted driving along with the troubling statistics about the number of injuries and deaths the behavior causes. But have you heard about “distracted doctoring”? The New York Times recently reported on this troubling trend going on in many hospitals and clinics.

As medical records have become electronic, and hospitals have heavily invested in technologies to reduce medical errors, more health care providers have access to devices that can be useful, but also cause distraction leading to medical malpractice. Doctors can be distracted by computers, smartphones, iPads and any number of technological gadgets they now frequently have within reach.

For example, during one surgery a neurosurgeon made at least 10 personal calls using a wireless headset. The patient he was operating on was left partially paralyzed, likely the result of the physician being distracted. A peer-reviewed survey published in the journal Perfusion found that half of technicians who monitor bypass machines admitted to texting during surgeries. Other doctors report seeing colleagues check email, look up airfares and shop on Amazon or eBay in surgical intensive care units.

Dr. Peter J. Papadakos, from the University of Rochester Medical Center, published an article in the journal Anesthesiology News on the subject of “electronic distraction”. He stated that “My gut feeling is lives are in danger,” he added that “We’re not educating people about the problem, and it’s getting worse.”

At least one hospital has taken action and enacted a policy making operating rooms “quiet zones” and banning all activities not directed at patient care. Hopefully more hospitals will follow suit in the interests of preventing distracted doctoring and promoting patient safety.

Source: The New York Times, As Doctors Use More Devices, Potential for Distraction Grows, Matt Richtel, 14 December 2011

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New York Seeks to Expand Medical Malpractice Courts


Medical malpractice cases can be some of the most complicated cases to litigate. Not only do cases often require significant investigation and expert testimony, but lawyers are frequently tasked with explaining complex scientific arguments to judges and juries with little to no medical background.

To help remedy this problem, one Bronx judge began focusing on medical malpractice cases, using his specialized knowledge to help parties settle claims before trial. That judge – Justice Douglas McKeon -now handles about 12 to 15 cases per month, bringing litigants in for frank discussions about the facts of their case and its probable value.

Fifteen years after Justice McKeon began his work, the federal government has provided a $3 million grant for a pilot program to expand so-called “medical malpractice courts” into Manhattan, Brooklyn, Queens and Erie County.

The pilot is designed to target high population areas that have both a large number of medical malpractice cases and high hospital malpractice costs.

What Does This Mean for Malpractice Plaintiffs?

Both sides potentially benefit from being able to settle cases earlier. Hospitals keep costs down, and are able to pass that savings on to patients. The same goes for plaintiffs, who may be spared the expense and burden of going through trial.

It is important, however, that the decision to settle remains voluntary. Although a judge may encourage a very candid discussion of a case’s merits, failings and monetary value, plaintiffs should feel no pressure to settle. Either side should feel free to take the case to trial if they believe the other party is not being reasonable in settlement negotiations.

One thing still remains true – even with a streamlined process, malpractice claims still involve complex issues that are best handled by experienced professionals. If you’ve been the victim of medical negligence, contact a New York medical malpractice attorney with a proven track record of success.

Source: Wall Street Journal, “More NY courts to focus on medical malpractice,” 11 November 2011

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Hospital’s “Quiet Zone” Found to Decrease Medication Errors


Medication errors injure approximately 1.3 million Americans each year and cause, on average, at least one death every day. All told, these errors cost over $3.5 billion each year.

The Federal Drug Administration lists several common causes of the errors, including poor communication, poor procedures or techniques, confusing packaging and ambiguities in product names or abbreviations. Unfortunately, many medication errors can be traced to the same route cause – medical professionals who make mistakes because they are stressed-out, exhausted or distracted.

“Quiet Zone” an Intentional Response to Dangerous Errors

A new initiative at Egleston children’s hospital in Atlanta is attempting to reverse this trend. The hospital has set up a dedicated quiet zone that nurses can use to place medication orders without being interrupted. Hospital leaders created the zone two years ago after noticing that distracted staff members were making potentially dangerous errors when ordering medicine.

Since the zone has been implemented, medication errors at the hospital have been reduced by two-thirds.

Egleston’s example is being held up by Medicare and Medicaid chief Dr. Donald Berwick as an example for the rest of the nation to follow – not only because it will reduce costs and promote efficiency, but because it will save lives. Dr. Berwick has witnessed dangerous medication mistakes at even the most renowned hospitals. In fact, as a young resident he mistakenly gave the wrong transfusion to a baby, nearly killing the child.

Fatigue Increases Risk of Error

Dr. Berwick attributed his error to the sleep-deprived schedule most young residents continue to face. There is mounting evidence to show that fatigue plays a huge role in medication errors. In studies, fatigue and sleep deprivation have been linked to decreased vigilance, poor memory, delayed reaction time, slower information processing and poor decision making. In relation to those performance measures, staying awake for 24 hours has been found to be the equivalent of having a blood alcohol level of .10 percent.

Hopefully, the increased awareness of issues of fatigue and distraction combined with innovative responses, such as Egleston’s quiet zone, will help increase patient safety throughout the country.

Source: Los Angeles Times, Pressing for better quality across healthcare, Noam N. Levy, 4 October 2011

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Doctor Shopping Study Shows Access to Doctors is Not Equal


Access to doctors is usually thought to be an issue for Americans that live without health insurance. However, for the many Americans that receive public insurance, such as through Medicaid and the Children’s Health Insurance Program (CHIP), access to a physician is also a concern.

Due to differences in how much doctors are paid by private insurance companies and public insurance programs, there is concern that doctors give scheduling priority to patients who have private insurance. According to the New York Times, many doctors refuse to take Medicaid recipients as patients due to the low payments for services and repeated threats to cut Medicaid fees.

To check if doctors truly gave scheduling preference to patients with private insurance, the Obama Administration proposed randomly auditing doctors from around the country. Often called “doctor shopping,” the audit would consist of calling doctors’ offices with callers posing as new patients looking to schedule an appointment. Using a script, two calls would be made -one stating the caller had private insurance and one stating the caller had public insurance – both would give the offices symptoms of conditions that require “urgent” evaluation.

After the calls are made, the information gathered, such as how many days from the call the appointment is scheduled for, would be able to indicate if patients with private insurance receive priority. Time reports that following an outcry from the medical community the Obama Administration’s auditing plan was scrapped; however, other studies using the same or similar methods have been conducted.

A recent New England Journal of Medicine (NEJM) study confirms what the Obama Administration may have feared, that doctors really due give scheduling preference to patients with private insurance. Specifically, the study found that children on public insurance who required urgent care or evaluation had a longer average wait for an appointment than children with private insurance. Longer waits may lead to delayed diagnosis with potentially severe consequences.

With more Americans set to receive Medicaid in 2014, when the new health care law takes effect, making sure that Americans receiving public insurance have access to doctors is important. Doctor shopping/audit studies, as argued by Time, are a method that the government and other health care advocates can use to ensure that everyone has access to quality care in an equal manner.

Source: Time, Why Secret Doctor Shopping Studies Are Necessary, Dr. Zachary F. Meisel and Dr. Jesse M. Pines, 15 August 2011

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Reduction in Medical Errors at Veterans’ Hospitals


A patient can have a difficult time coping with the knowledge that his or her doctor made a mistake, and rightly so. Doctors are supposed to help their patients, not potentially harm them as the result of negligence, medical errors or medical malpractice.

Unfortunately, medical errors are not at all uncommon in America’s health care system. Surgical errors, considered highly preventable, still occur roughly once in every 75,000 surgeries. Considering how many surgeries take place in the United States each day, many patients are being harmed.

On the bright side, some health care systems have been successfully tackling the problem of medical errors. According to a recent study, the Veterans Health Administration (VHA), the nation’s largest integrated health care organization, has made a number of improvements which have contributed to a decrease in medical errors.

Between 2006 and 2009 medical errors at the VHA declined from 3.2 each month to 2.4. Close calls increased from 2 per month to 3.2. An increase in close calls, accompanied by a decrease in actual errors, may be a positive indication of increased awareness and reporting by medical professionals.

Overall, during the four year time frame, there were 101 actual errors and 136 close calls. The most frequent medical errors were wrong-patient and wrong-side procedures.

In order to decrease medical errors the VHA focused on checklists and creating a team focused approach to health care, stressing cooperation, communication and speaking up about possible mistakes.

Although the success of the VHA in decreasing medical errors is a step in the right direction, even one mistake is too many when patients’ lives are at stake. Hopefully ongoing awareness and prevention efforts will continue to improve health care at the VHA and around the country.

Source: Medical errors down at U.S. veterans’ hospitals

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Technology: Causing Medical Errors Instead of Preventing Them


Despite being born 16 weeks early, baby Genesis was quickly adapting to life outside the womb. His parents were thrilled with his progress until his recovery took a tragic turn. His mother was told to come to the hospital immediately, where she saw CPR being administered to her son. After 40 minutes, Genesis was pronounced dead.

What caused the sudden change in Genesis’ health? – A huge overdose of sodium chloride. How did it happen? The wrong data was entered into a computer program by a pharmacy technician processing an electronic IV order. The automatic alerts built into the IV compounding machine were not activated.

Although not the first time new medical technologies have contributed to potential medical malpractice, the case of baby Genesis highlights some of the problems as technology is being more heavily integrated into hospitals.

New Technologies Introduce New Opportunities for Medical Errors

Unfortunately medical errors related to computers and electronic data are not uncommon. Although these technologies aim to prevent adverse events by taking human errors out of the equation, technology also has the potential to cause medical errors in other ways. These include: software bugs, computer crashes, user error due to inadequate training, and problems as information is transferred from one electronic system to another.

In just the voluntary reports submitted to the U.S. Food and Drug Administration, there were 370 reports of problems with health information technologies since the beginning of 2008. These errors were responsible for multiple patient injuries and deaths. For example, a patient died after a network problem delayed the transmission of a critical diagnostic image. Other problems included vital signs disappearing from monitors, and patients’ allergy information not being carried over during a computer update.

Dr. Ashish Jha, an associate professor from Harvard University’s School of Public Health, highlighted the concern, “Technologies can be enormously helpful, but what is emerging is that when implemented poorly, they can be harmful.”

The importance of this issue is only likely to grow. The federal government is providing $23 billion in incentives to encourage medical providers to purchase new technologies to implement electronic medical records or automate drug orders.

Source: Baby’s death spotlights safety risks linked to computerized systems

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July: A Dangerous Month to Visit the Hospital


July is a wonderful month in many respects, summer is in full swing, and people are enjoying nice weather and time outside. For hospital patients, however, studies show July can be a dangerous time.

Why is this summer month an unfortunate time to visit the hospital? There is a so-called “July Effect”. Every year in July, experienced residents leave the hospitals they have been working at, and new doctors fresh out of medical school arrive to take their places.

Incoming residents not only have less clinical knowledge, but also are inexperienced with hospital systems. For example, being unfamiliar with the hospital’s pharmacy system, new doctors ordering prescriptions may make mistakes in drug dosages. Or, incoming residents may order more unneeded tests resulting in longer hospital stays.

Conventional wisdom among physicians has been that if possible you should avoid hospital stays during July, but now studies are also backing up the dangerous impact of the “July Effect”.

A comprehensive study reported in the Annals of Internal Medicine showed that at teaching hospitals during the month of July, more medical errors and surgery complications occur, and efficiency in patient care declines. Most disturbingly, patient death rates in hospitals were found to increase between eight and 34 percent during July.

Some hospitals are taking steps prevent these problems during the changeover month. These measures include more comprehensive orientation sessions and having the most experienced doctors on-call and ready to assist and advise newer colleagues. Now that the real impact of the “July Effect” has been documented hopefully more institutions will follow suit.

Source: The July Effect: Why Summer is the Most Dangerous Time to Go to the Hospital

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Study Says Benefits of E-Prescribing Outweigh Implementation Challenges


A study recently published in the Journal of General Internal Medicine found that implementing new electronic prescribing systems can decrease the occurrence of medication errors, but it also can present adaptation challenges for physicians using the systems.

Researchers at New York’s Weill Cornell Medical College analyzed e-prescribing implementation at a clinic with 17 doctors between February 2008 and August 2009. The study focused on e-prescribing error rates with the clinic’s previous system, errors occurring 12 weeks after the new system was implemented and errors happening one year after the new system was in place.

The researchers found that e-prescribing errors greatly declined over the new system’s first year, reporting the following statistics:

  • 557 e-prescribing errors under the previous system
  • 338 e-prescribing errors 12 weeks after implementation
  • 191 e-prescribing errors one year after implementation

During the first year of implementation, the overall rate of e-prescription errors fell from 36 percent to 12 percent, and the rate of improper abbreviations for prescriptions dropped from 24 percent to 6 percent. But, the rate of e-prescription errors temporarily doubled within the first 12 weeks of implementation, rising from 9 percent to 18 percent before returning to original level one year after implementation.

In addition to analyzing the rate of e-prescribing errors, the researchers also surveyed 15 of the doctors about their experiences with the new e-prescribing system. The doctors’ reports revealed challenges with the new system. Forty percent of the surveyed doctors stated that they were not satisfied with the new system, and only about a third of them thought the new system was safer than the previous system. The doctors also reported that the system slowed prescription orders and refills.

However, the demonstrated benefit of the new e-prescribing system significantly outweighs the downsides the doctors experienced in this study. The new system resulted in almost two-thirds fewer e-prescribing errors, greatly reducing the risk of illness or death from dangerous medication errors.

If you or a loved one has suffered harm from a medication error, contact a medical malpractice attorney with experience in medication-error cases to discuss any legal claims you may have.

Source: Upgrading E-Prescribing Systems Can Reduce Rx Errors, Pose Challenges

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Proposed Cuts to Senior Services May Impact Aid for Victims of Nursing Home Abuse


A proposed $39 million in cuts to New York’s senior services would have serious consequences for the elderly. The cuts include the shutdown of multiple senior centers and the elimination of funding for elder abuse victim services.

It estimated that there are 120,000 cases of elder abuse in New York City alone, a majority of which go unreported. Oftentimes it is someone entrusted with a senior’s care who engages in negligence or abuse.

Nursing home abuse can take many forms. These include physical abuse, emotional abuse, sexual abuse and financial exploitation. Since seniors may be unable or embarrassed to come forward with allegations of abuse, it is important for loved ones to watch for signs that something may be wrong. Besides the obvious signs of bruises and wounds, other signs of abuse may include unresponsiveness, infantile behaviors, withdrawal and unusual financial transactions.

Nursing home neglect is also prevalent. Signs of neglect include bedsores, dehydration, malnutrition, falls and bed-related strangulation or suffocation.

The seriousness of the problem of nursing home abuse and neglect makes the possible elimination of funding for elder abuse victim services unfortunate. As some of society’s most vulnerable members, the elderly often need people to advocate on their behalf.

If you or a loved one has been the victim of nursing home abuse or neglect contact an experienced personal injury lawyer. A knowledgeable nursing home abuse attorney can stand up for victims’ rights and work to see they are compensated for their suffering.

Source: National Center on Elder Abuse

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