WhiteCoat

Healthcare Update Satellite — 02-06-2014

More medical news from around the web over at my other blog at DrWhiteCoat.com

Holy feces, Batman! How bad of a marriage do you have to be in for your wife to inject “fecal matter” into your IV line while you’re recovering from a heart procedure in the hospital? Whacked out wifey is a former nurse who will now enjoy an extended stay in Arizona’s Maricopa County jail. Thanks to PJ for the link!

Pennsylvania jury awards a $32 million judgment against two nurses who failed to notify an obstetrician about a change in the fetal heart rate for 13 minutes during the mother’s labor. Child later born with cerebral palsy. Hospital, doctor, and a third nurse were all found not liable for the injuries.

The “Affordable” “Care” Act is keeping costs down alright … by refusing care to sick children. A 2 year old with a neck mass being evaluated for cancer, a child with a chronic severe medical condition, an infant with a skull abnormality – all denied care in Washington.

Patients aged 55 and over in Washington State who sign up for Medicaid aren’t getting “free” care. After their death, the state comes after all the assets in their estates, seeking reimbursement for all the medical expenses it has provided.

Texas patient high on methamphetamines convicted of assault on emergency service personnel and faces up to 10 years in prison in sentencing hearing next month. Lola Thompson reportedly headbutted a family member trying to drop her off at the hospital, breaking his nose, then attacked an emergency department nurse, punching her in the face five times. Thompson required three times the normal dose of sedation to calm her down.

Nurse in Canadian emergency department tells anorexic patient with “mental problems” to “go get some supper and come back.” Patient reportedly felt like cutting herself and wanted to “speak to somebody,” but apparently had no other emergency medical issues. Abuse of the emergency department, uncaring staff, neither, or both?

As Ecuador plans to change its malpractice code to establish a 3-5 year prison term for health professionals who cause death by “unnecessary, dangerous and illegitimate actions,” 150 doctors have resigned. Ecuadorian President Rafael Correa says he has more than 700 doctors from other countries who would be willing to practice in Ecuador if the current physicians leave. Wonder if the foreign docs know about the new malpractice law …

Portland, Oregon emergency physician Dr. Jamie Schlueter is one of the team docs for the US athletes in Russia. Excited to go and “hopes no one needs me” – a comment that, for some reason, pisses off one of the readers.

Feds investigating president of American Academy of Pain Medicine after several of his patients die from medication overdoses. One patient notes that his wife went to the physician’s clinic, was initially seen by the physician and then her care was transitioned to a nurse practitioner with “no oversight.” In 14 months, the patient’s medication dose had increased more than sixfold.

Interesting side note is that deaths from drug overdoses in women increased fivefold between 1999 and 2010. In 2010, more than 15,000 women died from drug overdoses and nearly 1 million women visited the emergency department for drug abuse or misuse.

Even more interesting side note is that the fivefold increase in drug overdose deaths in women seemed to start shortly after the Joint Commission declared pain as a “fifth vital sign” and made pain management a “standard.
Has anyone ever considered that the Joint Commission edicts may be responsible for increasing patient deaths?

Should we be doing pelvic exams in the emergency department? In 94% of patients, the results of the exam had no effect on the clinical plan. Good discussion in the comments at ALiEM.

4 Responses to “Healthcare Update Satellite — 02-06-2014”

  1. Ken Jones MD says:

    The Equadorian Med/mal crisis is hard to imagine even in a strict socialist state. Urge all who know the leadership in the AMA,ACS,AOA, and all MD members in congress to support these Docs and to help strike this bill down before the hammer and sickle takes out anyone it chooses. lots more will die without surgery than as a post-op complication

  2. JA-RN says:

    The issue of Medicaid reimbursement is nothing new. My mother entered a nursing home in Maryland 8 years ago & went on Medicaid. After her death, the first expenditure from her estate was to reimburse the government for Medicaid expenses.

  3. Skeptical Scalpel says:

    “Has anyone ever considered that the Joint Commission edicts may be responsible for increasing patient deaths?”

    Yes, I have. Here’s what I said in October of 2013. http://www.physiciansweekly.com/pain-5th-vital-sign/

  4. markps2 says:

    Regarding the patient who reportedly felt like cutting herself.
    It is the “Catch 22″. If you are healthy enough to seek help, it means you don’t need it.

    From the book-movie Catch 22.
    Doc Daneeka says, “He has to be crazy to keep flying combat missions after all the close calls he’s had. Sure, I can ground Orr. But first he has to ask me to.”

    “That’s all he has to do to be grounded?”

    “That’s all. Let him ask me.”

    “And then you can ground him?” Yossarian asked.

    “No. Then I can’t ground him.”

    “You mean there’s a catch?”

    “Sure there’s a catch,” Doc Daneeka replied. “Catch-22. Anyone who wants to get out of combat duty isn’t really crazy.”

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