WhiteCoat

Healthcare Update — 08-29-2011

Also see the Satellite Edition of this week’s update over at ER Stories‘ resurrected blog.

Patients gone wild goes international. High patient volumes and lack of adequate staffing cause patients to become “aggressive over lack of service” in Australia. “Five or six” nurses assaulted in one week. Note to patients: Assaulting nurses won’t get you faster care or better care. Trust me.

West Virginia plaintiffs awarded $91.5 million after jury decides that dementia-stricken parent died from lack of sufficient food and water over a span of 3 weeks. Plaintiffs successfully argued that the nursing home was not properly staffed, leading to the patient’s death. Defendant nursing home vows to appeal, alleging that the state’s $500,000 damage caps should apply.

Not really sure what kind of leap of logic required to make this connection, but a man in New Jersey sued his doctor for prescribing him Ambien for insomnia. The patient was *allegedly* inspecting a gun after taking Ambien, woke up to the telephone ringing, the barrel of the gun just happened to be in the patient’s mouth, and the patient just happened to pull the trigger of the gun when he woke up.
Two lower courts said that the case should be thrown out. The New Jersey Supreme Court reinstated the case, giving the plaintiff additional time to find an expert willing to state that his case has merit. So far a psychiatrist and an emergency physician have affirmed the case has merit. Hopefully the family medicine experts will have more common sense.
Personally, I think the injury was caused by the patient’s garden gnome. I just don’t trust those things.

Just in case the above lawsuit left you wondering, a lawyer “InjuryBoard” Blog just posted an article stating that “frivolous” malpractice claims are not that common.

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How much is pain and suffering worth after giving birth to a stillborn baby? If you live in New York, one lawyer argues that the bar is now set at $1 million. All you NY obstetricians don’t forget — Texas still has out a welcome mat and is a lot more physician-friendly.

Another hospital closing its doors — this one in East Cleveland. Huron Hospital had been providing medical care to patients for 130 years. Now the hospital’s owner, the Cleveland Clinic, states that the patient volumes are insufficient to keep it open.
Cleveland’s lawyers are suing to force the hospital to stay open … so then other lawyers can sue the hospital for providing inadequate care.

Their plan is working. Illinois offers new Medicaid HMO plan. Only problem is that the bureaucratic hurdles and low payments associated with the plan are keeping most medical providers from participating.
Now patients are driving long distances – if they can actually find a doctor that takes their new “insurance.” Then patients find that those providers who do take their new insurance don’t know how to manage many of the complex medical problems. One doctor who was seeing a new patient for the first time “had a look of panic on her face” when the patient was rolled into the waiting room in a wheelchair, then “spent less than five minutes” with the patient.
One family interviewed for the article vowed to “pay out of pocket” so that their family member with Downs Syndrome could continue seeing her same doctor.
That’s just what the government wants you to do.

Federal malpractice reform nearing a reality? H.R. 5 sets a $250,000 cap on non-economic damages. The “Gang of Six” is including malpractice reform in its deficit reduction recommendations.
According to the article, trial lawyers are arguing out of both sides of their alimentary tract in trying to keep caps from being instituted. On one hand, they are blasting H.R. 5 because it is “a federal government takeover of an issue that has always been decided by the states.” On the other hand, “AAJ-funded attorneys are currently challenging state damage caps in federal court, alleging that they violate federal law.”

Doctor countersues family that filed medical malpractice lawsuit against him after family member died from overdose of narcotic medications doctor prescribed. Law school professor interviewed for article concerned that more of such countersuits may have a “chilling effect,” discouraging patients from pursuing legitimate malpractice claims.

Want to know the things that Parkland Hospital did wrong in order to be cited by the feds for “dangerous practices”? CMS finally published a list of violations.

Does EMTALA apply to animals? Young deer walks through automatic doors into hospital emergency department. Staff traps deer in patient dining room then discharges deer without even performing a screening exam. The Centers for Forest Animal Services are going to come down hard on you unless you develop an action plan to prevent this from happening again.

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9 Responses to “Healthcare Update — 08-29-2011”

  1. roy in nipomo says:

    You have good grounds for not trusting those gnomes: http://www.fieldandstream.com/files/photo/23/gnome.jpg

  2. Don Miller says:

    In my small community we had a suicide 2 weeks ago of a 30 year old woman. Found dead in her bathtub after taking 29 ambien. She had been using Ambien for about a month.

    I don’t know all the details, but the family believes it was triggered by the Ambien use. I am skeptical, but it does appear to be impulse driven and not planned. (No note, Plans for next day, clothes laid out for next day)

    • DensityDuck says:

      Most suicides are spur-of-the-moment things; an instantaneous confluence of opportunity and deranged whim. They built a net under the Golden Gate Bridge because almost every surviving jumper says that the first thing they thought after letting go was “I wish I hadn’t”.

    • KT says:

      Zolpidem is a pretty interesting drug. It’s all but been taken off the market here in Australia. Working in retail pharmacy, I saw it go from being a common drug to filling probably less than one prescription a month for it – still available though as far as I’m aware. The behavioural side effects are not unkown, and any doctor and pharmacist covering their butt would make sure the patient is aware of them. Every drug has its risks.

  3. DefendUSA says:

    My husband used to take Ambien…it had some very negative side effects. He would get up in the night and eat a 16oz box of cereal and not remember, it made his snoring so much worse and sometimes he would initiate intimacy more than once as if he were drunk because he could not remember that it was done! Needless to say, he does not take it anymore. The one time I took it, I apparently sat straight up in bed and said, “I’m a killer on the slopes.” I do ski, but am nowhere near “a killer!” :)

  4. Soronel Haetir says:

    The worst experience I had with a sleep med was with something called sonata (which I am pretty sure isn’t available in the US anymore). I woke up hallucinating and was drawn to the LED on one of my computers thinking it was an oil furnace I was being fed into. I came to my senses some time later pushing against the computer case with my heart pounding and absolutely drenched in sweat. Having experienced that and having read about others’ experience with ambien and other such medications I am willing to credit almost any story someone puts forward about their reaction (such as that put out by the late Ted Kennedy). The scary part is that being drawn to the LED was probably the best thing that could have happened to me under the circumstances, if it weren’t for that I would likely have taken a nasty tumble down a set of stairs and done a face plant into a window-box air conditioning unit.

    That said, I don’t think a pharmaceutical company should be held liable so long as they were diligent about discovering the risk and communicating it once discovered.

  5. Kipper says:

    Am I reading that correctly that one of Parkland’s violations was failing to have *even a single RN* on premises 24 hours a day? What the hell?

  6. SeaSpray says:

    I have to say that I will never …ever again take any kind of sleep aid in the Lunesta category again.

    A few years ago, I wrote what was meant to be a funny post …a true story of what I thought was some incredibly DITZY behavior in my uro appt that day. On the surface it was.

    http://seaspray-itsawonderfullife.blogspot.com/2007/08/i-did-ditzy-thing-at-urologist-office.html

    Everything I did was absolutely true as described. It was funny. I even joked about it with the m/a in the back who was wondering where my urine was and then with my urodoc.

    Then after writing the post and joking about it …to my horror …I realized what bizarre behavior that was and I was never so scared in my life because I seriously thought something was wrong with my brain!

    As per my prescribing physician …it was the LUNESTA! And I never had another incident like that again. I never took it again!

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