A surgeon's failure to recognize a surgical patient's dangerously low hemocrit and hemoglobin levels prior to surgery and their subsequent further drop during surgery led to his death, according to a malpractice lawsuit filed in Ohio.
According to the decedent's sons who filed the lawsuit, "The father had a left heart catheterization in June and as a consequence of the results, decided to have elective surgery for a coronary artery bypass grafting. The lawsuit stated that as a direct result of the cardiac catheterization procedure, the man sustained an injury to his right femoral artery. This caused a retroperioneal hemorrhage that the doctor did not diagnose and repair.
In fact, nothing was done about the issue even as the surgery was underway. This was in spite of the fact the patient’s hemocrit and hemoglobin levels were dropping; levels that were low even prior to surgery. These low levels were red flags that the doctor did nothing about. As a result of this failure to diagnose the right femoral artery injury, the plaintiff lost a large volume of blood."
Making matters worse, the patient was actually given a blood thinner causing even more significant blood loss. According to the plaintiff's lawyer, the doctor was negligent in not recognizing the blood loss as life threatening and attempting to find its source and stop it before loss of life.
As the US healthcare system moves toward a paperless, electronic medical records system, some have advocated for a universal patient identifier (UPI) system in which every medical patient is identified by the assigned number.
Proponents for such a system include Dr. Michael F. Collins, a board certified phsyician in internal medicine and chancellor of the University of Massachusetts Medical School, who writes in favor of such a plan in the Wall St. Journal.
Dr. Collins argues, "An ID system 'could be the safest and most efficient way to manage health-care data."
Yet, others worry about the privacy rights of patients. Dr. Deborah C. Peel writes in the same article, "Yes, assigning everyone a universal patient identifier, or UPI, would improve doctors' ability to share information and make it easier for hospitals to differentiate one John Smith from another. But a universal health ID system would empower government and corporations to exploit the single biggest flaw in health-care technology today: Patients can't control who sees, uses and sells their sensitive health data." Dr. Peel is a psychiatrist and a health privacy expert in Texas.
While patient privacy is an important concern, patient safety is the highest concern and if, as Dr. Collins argues, a UPI would make healthcare safer for all involved, that is an avenue that should be explored.
An Indiana jury awarded $1.5 million to an Indiana woman who was injured after a surgeon opted not to perform surgery on her. The ensuing delay coupled with a failure to carefully monitor the patient after the decision not to operate led to the jury award.
According to the News and Tribune, "Michelle Wells Fischer, 30, has short gut syndrome — caused by the removal of most of her small intestine in 2003. Jurors found her surgeon, Dr. William H. Garner III, liable for her injuries.
Fischer, then a 21-year-old Greater Clark County Schools special education teacher, checked in at Floyd Memorial Hospital and Health Services at noon June 5, 2003, complaining of abdominal pain.
She saw Garner for a surgical consultation. Her attorney, Pete Palmer, said Garner initially thought surgery was necessary and scheduled the procedure for the next day. When he met with her again the next morning, he decided to cancel the surgery based on new information.
“After changing his mind to operate, he then went out of town for the weekend and did not procure any surgical coverage,” Palmer said.
Unfortunately, Fisher's condition did worsen and emergency surgery was performed.
Fischer had ischemic bowel disease, or dead bowel. Palmer argued Fischer’s entire bowel would not have died if they had performed the surgery as scheduled.
“We argued the standard of care in the medical community says you either need to operate in a timely fashion, or if you don’t believe operating is the best option at a particular time, you need to continue to follow that patient,” Palmer said. “It’s not enough to just say no operation.”
The case revolved around two issues related to the standard of care a healthcare provider owes a patient. First, a proper decision about surgical intervention must be made based upon the entirety of the medical situation as supported by medical science. Second, follow-up care must be provided so that a decision NOT to provide care (an operation in this instance) does not lead to further complications and harm to the patient.
The jury decided that in this instance these two principles had been violated.
While the industry's steady progression toward electronic health records is generally a positive step in the right direction, it is not a cure all that will entirely eliminate medical errors. While EHRs do indeed eliminate errors arising from illegible handwriting, human transcription errors, and the misfiling of records. However, EHRs come with their own set of issues, according to an article published by the
Digital Journal, "Unfortunately, EHRs have not worked exactly as planned. As these systems are still rather new, there have been challenges in developing software that fits the need of the end-users. Entering information can be a very time-consuming process, with doctors and physicians needing to learn proper codes for ailments and treatment plans. Additionally, there may be more of a potential for user error than with general medical records. Mistakes may be made when information is entered, for example, information from one patient could but copied and pasted into another patient's file, and this may go unreported due to unfamiliarity with the systems. Further medical professionals may then rely on this incorrect information, which could have a serious impact on patients. EHRs also have the potential for overloading doctors and physicians. The systems can be set up to send alerts when major events are soon to occur, such as a prescription expiring, which could cause problems. Instead of checking in on lab reports or determining a patient's progress, prescriptions could be automatically refilled or harmful treatment plans continued. Finally, EHRs are accessed using computer networks, which may result in unique challenges to medical facilities. Computer systems often suffer outages, leaving medical professionals unable to access a client's information, which could prove costly in situations where time is of the essence. Patients may also have privacy concerns if their medical records are easily accessible to a large number of people at a health care facility. Access to EHRs will need to comply with all HIPAA rules.
