Health Care Safety Index May 2015

A study published in JAMA demonstrated that 57.7 percent of reported concussions in high school players and 57.6 percent of concussions in college players occurred during practice. The high incidence of concussions in practice is troubling because players and coaches have much more ability to control the kinds of impacts that result in these injuries during practice, as opposed to games.  

A study in JAMA Internal Medicine established that atypical antipsychotic medications like Seroquel, Risperdal and Zyprexa increase the risk of falls for elderly patients.

The FDA issued a warning indicating that some drugs used to treat Type 2 Diabetes including Invokana, Jardiance, Invokamet, Xigduo XR and Glyxambi, can sometimes lead to ketoacidosis.

An article appearing in the International Journal for Quality in Health Care demonstrated that prescribing errors with the potential to cause harm frequently go undetected and the incidence of medication errors reported do not accurately reflect the profile of medication errors which occur in hospitals.

The US Preventive Services Task Force  issued new draft recommendations regarding who should undergo mammogram screening and how often. Mammograms were recommended for women between 50 and 74 every 2 years.

A study published in the New England Journal of Medicine concluded that Clindamycin and Trimethoprim-Sulfamethoxazole were equally effective in treating uncomplicated soft-tissue infections.

A study published in the BMC Medicine concluded that following a healthy lifestyle meeting dietary and weight and exercise recommendations helps (a) prevent colorectal cancer and (b) people diagnosed with colorectal cancer live longer.

An article published in Science determined that measles causes children to become immunocompromised for up to 3-5 years.

A study published in JAMA demonstrated that a medication regimen that included Daclatasvir, Asunaprevir and Beclabuvir resulted in a sustained virologic response after 12 weeks of treatment in 91.3% of patients diagnosed with hepatitis C.

A study published in Obstetrics and Gynecology concluded that there was up to a 41% chance that maternal deaths during pregnancy could be avoided with better maternal safety programs.

An article appearing in the Annals of Cardiothoracic Surgery detailed the successful minimally invasive aortic valve surgery program at the Cleveland Clinic.

A study published in Pain Management Nursing demonstrated that the presence of dogs can reduce pain and distress in children who undergo venipuncture.

A study published in the International Journal of Impotency Research concluded that there was no increased risk of mortality associated with long term testosterone therapy. 

Health Care Safety Index April 2015

Here are patient safety issues that have appeared in the news and medical journals throughout the last 30 days or so:

Toni Clarke, for Reuters, reported that AstraZeneca's diabetes drug, Onglyza, may be associated with an increased risk of death due to heart failure.

A study published in Circulation demonstrated that sudden cardiac arrest during sports activity occur most frequently in middle age, but the outcomes following such events are usually better. This is because the events are usually witnessed by others and followed by cardiopulmonary resuscitation.

Research undertaken by the American Orthopaedic Society for Sports Medicine demonstrated that one in three children who undergo ACL surgery experience a re-injury to the same ligament.

An article published in Annals of Internal Medicine discussed the 2015 American Diabetes Associations’ Standards of Medical Care in Diabetes which recommended lowering the floor body mass index of Asian-Americans which should prompt investigation into diabetes from 25 to 23, tailoring plans for blood glucose control to individual patients by considering age, other co-morbid medical conditions, life expectancy and the patient’s motivation and preferences. Finally, statins are now recommended for all diabetes patients older than 40.

Patient Safety in the News February through March 2015

The editors at medGadget discussed a study appearing in the journal Inorganic Chemistry regarding research at Bielefeld University in Germany which demonstrated a new method of disrupting the spread of cancer using molecules that bind to DNA.

Sarah Knapton, with The Telegraph, discussed research published in JAMA about a new stem cell treatment which is reversing the symptoms of multiple sclerosis.

Robert Preidt, for Health Day, discussed a study performed by Cancer Research UK, which demonstrated that obesity raises the risk of cancer in women 40%. 

Jane Brody, for the NYT, reported on a study appearing in The Lancet which described a constellation of symptoms which appear to foretell a diagnosis of Parkinson's disease, including tremors, balance problems, constipation, low blood pressure, dizziness, erectile and urinary dysfunction, fatigue, depression and anxiety.

Patient Safety in the News January 2015

Rachael Zimlich, for Modern Medicine Network, reported that the U.S. Health Resources and Services Administration is predicting a 340,000 nurse surplus by 2025.

Amy Norton, for HealthDay, reported on a study appearing in Cell, Host & Microbe which concluded that a change in stomach bacteria in young children can precede a diagnosis of Type 1 diabetes by a year, aiding in diagnosing this condition.

Suzanne Russell, with My Central Jersey.com, reported that Dr. Anthony DelPiano, a physician practicing in Jersey City, plead guilty to accepting bribes in exchange for test referrals to Biodiagnostic Laboratory Services LLC of Parsippany.

Steven Reinberg, for HealthDay, discussed a report from the American Cancer Society which revealed lung cancer has replaced breast cancer as the leading cause of cancer-related mortality among women in developed countries.

Michael Fleeman and Dan Whitcomb, for Reuters, reported on the introduction of legislation by California lawmakers seeking to end the right of parents in the state to exempt their children from school vaccinations based on personal beliefs.

Patient Safety in the News December 2014

Recent changes in drug labels: The following drugs had modifications to the contraindications, warnings or precautions section of their labels: Adcetris (brentuximab vedotin) for Injection; Arava (leflunomide) Tablets; AVELOX (moxifloxacin hydrochloride) Tablets and IV; Bosulif (bosutinib) Tablets; Cardizem (diltiazem hydrochloride) Tablets; Cubicin (daptomycin for injection) Intravenous; Cymbalta (duloxetine) Delayed-release Capsules; Foscavir (foscarnet sodium) Injection; Lopid (gemfibrozil) Tablets; Mycobutin (rifabutin) Capsules; Mytelase (ambenonium chloride) Tablets; Sensipar (cinacalcet hydrochloride) Tablets; Sovaldi (sofosbuvir) Tablet; Sylatron (peginterferon alfa-2b); Taxotere (docetaxel) Injection Concentrate; Unasyn (ampicillin sodium/sulbactam sodium) Injection; Votrient (pazopanib hydrocholoride) Tablets and Zelboraf (vemurafenib) Tablet. Click here for more information from the FDA.

Robert Pear, for the New York Times, reported on a study which revealed that half of the physicians listed as serving Medicaid patients were unavailable either because they were not actually taking Medicaid patients or because the information about their medical practice was outdated.

Robert Preidt, for Health Day, discussed a study in the Annals of Epidemiology that indicated that despite lower smoking rates, cigarettes are still responsible for 3 out of 10 cancer deaths in the United States.   

Marie Ellis, with Medical News Today, reported on an article in JAMA Pediatrics which found that children diagnosed with autism spectrum disorder were twice as likely to be born with mothers with preeclampsia during pregnancy.

Patient Safety in the News through November 9, 2014

NEJM published a study revealing that by merely adopting an I-PASS patient hand-off system (“I” illness severity,  “P” patient summary,  “A” action list,  “S” situation awareness and contingency plans and “S” synthesis) residents decreased miscommunications and medical errors by 23%.  

Pediatrics published a study analyzing outpatient medication errors amount young children. 27% of medication errors were related to parents inadvertently giving children medication twice.

Joseph Goedert reported that the Cleveland Clinic will be expanding its use of the IBM Watson Supercomputer to help oncologists deliver personalized treatment to cancer patients. The computer be used to identify patterns in genome sequences and also to review databases of medical journals.

Hannah Nichols discussed a study published in Arthritis Care & Research, which demonstrated that low birth weight and preterm birth are associated with an increased risk of hip osteoarthritis requiring surgery.

Academic Radiology published a study that demonstrated that when residents were interrupted while interpreting radiographic studies, they committed more errors.

Mary Elizabeth Dallas discussed an article published in the Journal of Athletic Training which demonstrated that (a) 50% of highs school athletes are not likely to report a concussion and (b) 25% of college players are likely to play with a concussion. Additionally, 25% of high school athletes surveyed reported receiving no education about concussions at all.

Latest Questions and Answers - July and August 2014

Here are the latest answers to the questions that were posted online. Please note that I do not edit the questions.

Question.

How do I go about finding an attorney that will represent my father’s medical issue? He resides in Florida, but transplant was in Tennessee. Since he had his kidney transplant he’s been having complications and hasn’t been treated the right way. We have been trying to resolve this matter the right way and it seems almost impossible. We need immediate assistance for our father.

Answer.

I have no idea whether you have a viable malpractice case because you didn’t provide enough information about the complications your father has been experiencing. Nevertheless, if you want to hire an attorney to investigate a case you’re going to have to hire someone in Tennessee. Attorneys take these cases on a contingency basis which means you only have to pay if you succeed. Additionally, initial consultations are usually free. You can use the “Find a Lawyer” service through this website to research medical malpractice attorneys. Then, visit each attorney’s website and look for a firm that has a record of successful verdicts. If you are unable to find a lawyer who meets these qualifications within your state, sometimes you may contact an out of state lawyer who can refer you to a qualified attorney in your state while providing support related to the issues of medicine.

Below are some articles you may find helpful. They are written for a New Jersey audience (where I practice) but the ideas discussed in these articles usually apply in most other jurisdictions as well.

Question.

I had upper abdomen pains. Could not move, was nauseaed, became very hot, started sweatting alot, pain went to into back. Went to ER, spoke to a nurse they gave me some malox with a pain killer in it. I also took a chest xray and a ekg and then was released. I was told that I had gas. I never saw a doctor. 2 months later went to a different ER for same thing and was told that I had to have surgery very soon. I had a golf ball size gall stone. Do I have some kind of case against the 1st ER and doctors.

Answer.

The usual presentation of a patient who was suffering from gallstones include symptoms of pain in the upper abdomen and upper back, nausea, vomiting, bloating, indigestion, heartburn, and gas. So, gallstones should have been in the differential diagnosis of the physicians. I think the real question in the case is whether it is financially viable because presumably you would’ve needed surgery if the diagnosis was earler. Consequently, assuming there was no permanent harm the damages in the case amount to two months of pain and suffering. I wouldn’t take on a case like that, but financial viability is a judgment call. The articles below explain this in more detail.

Below are some articles you may find helpful. They are written for a New Jersey audience (where I practice) but the ideas discussed in these articles usually apply in most other jurisdictions as well.