Hey everyone -
It’s WhiteCoat from EP Monthly. I had some extra articles after reading through my news feeds and thought you all might be interested in what’s going on in the healthcare world lately. When you’re done reading all of ERP’s great posts, check out the rest of this week’s Healthcare Update over at my place.
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How to decrease hospital mistakes. Self-help is good help. Some excellent steps that patients can take to help reduce hospital errors. For example, ask that hospital employees check your ID bracelet before doing anything to you. Ask what you’re being given or what test is being performed and why. Don’t be afraid to speak up.
The underlying case involved a pregnant patient who had a CT scan of her abdomen performed by mistake after her name was confused with another patient in the emergency department. She’s suing the hospital. Intrauterine radiation exposure may cause mental retardation, a low IQ, or growth problems. The child isn’t growing as well as expected. Do we assume that decreased growth is due to radiation? If so, what is a reasonable amount to compensate the child?
Getting compensated for your injuries is about to get a lot harder if you’re a Medicare recipient. Let’s say that you’re involved in a major car crash or you suffer a catastrophic injury at work. You need to be in the intensive care unit for several months and need rehabilitation for several more months. Your insurance company works out a settlement with whomever injured you. Right now, it is apparently up to the parties to determine whether the federal government may have a lien on settlement funds for the costs of care that it provided to you. Effective January 1, 2010, insurance companies will be required to report all proposed payouts to the feds under the threat of fines totaling $1000 per day. This attorney’s blog post gives an example of a plaintiff winning a verdict of $50,000 but being 50 percent at fault. If the amount of money that Medicare paid out on your behalf was more than your verdict, you could potentially get nothing – even if some of the verdict was allocated to compensate you for “pain and suffering.” Not sure how the reporting requirement will change current practice, but as it is set up, it I wonder whether Medicare beneficiaries will receive reimbursement for all of the Medicare taxes that they paid the government – just so neither party gets a windfall.
Is your doctor really as good as those state web sites say he is? Confidentiality clauses in malpractice settlements may decrease the number of reports being made.
Emergency physician faces time in the GreyBar Motel for swerving his car at two cyclists riding in Los Angeles. One cyclist slammed into the doctor’s car and busted up his face, the other cyclist hit the ground and had a shoulder separation. Ironically, the doctor reportedly stated that the cyclists had cursed at him and flipped him off, so he slammed on his brakes after pulling in front of them “to teach them a lesson.” The doc will now have 10 years to go over his lesson plan.
In other news, the LA Federal Penitentiary warden was quoted as saying “Good. Now we won’t have to wait in those @$*%!!@ lines with all of our inmates in the #@$%@# emergency room for the next ten years.”
Amusing rundown of all the police/emergency scanner calls during an evening in the Santa Barbara area. Go Roger the Scanner Guy! Add a few more domestics, a good foot pursuit, and a couple of more nursing home calls and that would be about what we hear on our scanner on an average night.
I used to hike up the fire road off Mandeville canyon where Thompson exhibited his heinous behavior. The rich folks in that neighborhood did not like anyone else enjoying the place. They got the city of LA to restrict parking to residents only – thereby limiting access to people wanting to enjoy the trails.
Hope he goes away for a while.
I went to the ER last week with my fiance, who broke his ankle. I know I should have pestered them more; I might have made them realize they lost his chart and we wouldn’t have been there for five hours in Express Care (they admitted they lost his chart, it wasn’t like it was just busy). And I know he should have told the splinting guy to make the splint looser, even though the guy kept saying it HAD to be tight; he lost circulation to his toes and had deep welts where the splint cut in. I’ve had good luck with that ER before (they’re very good with psych problems, which is rare, and they move patients along quickly most of the time), but between the records department causing us hell and that not-so-fun experience, I know I have to be on my toes around them.
“Do we assume that decreased growth is due to radiation?” I’d say you have to, at least unless you can prove there are other potential causes (like the mother smokes or drinks, or the child has a genetic issue, or the placenta or cord is damaged).
“If so, what is a reasonable amount to compensate the child?”
I think it depends entirely on how much he is injured. If he does need any specialists or anything, the hospital should cover that care. If he grows up and seems well within the range of normal, then it’s an unfortunate accident and the hospital needs to be more careful, but no harm, no compensation. I’m sure a jury would decide the mother deserves millions, though…
But that’s a pretty dumb mistake on the part of techs; she had no way of knowing CT scans were dangerous for a fetus (we all know x-rays are and I’d have less sympathy if she let them x-ray her, but I know I had no idea CT scans were a risk), and they’re supposed to check, every time. Besides, it looks like the last name was even different– they couldn’t call her name as “Kerry Higuera” instead of just “Kerry?” That’s a BAD mistake, a stupid and negligent one. If the boy is truly damaged, the hospital is responsible because they were negligent.
As an x-ray tech I have to say I feel for that tech. I have accidentally x-rayed the wrong patient before (thankfully not a pregnant one & only a Chest x-ray). The ER had changed my patient to another bed and when I said the patient’s name (incorrect though it was)…she answered. It was still my fault because I didn’t check her armband. Of course that was many years ago and now we have to ask their full name and birthday before we do anything (plus check the armband).
I really wish one of our ER docs could read this post. He will not order HCG’s on patients even if the exam is in the pelvic area and it has been 4 weeks since their LMP. He says there have been no studies to prove that radiation harms a fetus!!! We have argued with him to no end. We have all patients sign a pregnancy form now and explain the risks but it really aggravates me that he has this mentality. Do you really want to take that chance???
OK, I’ll admit some (certainly not all) of your posts are quite funny. But there is no way you should be passing yourself off as an MD. No way. Unless, of course, you ARE representative of the quality of education MD’s have in Canada, in which case, I’m sure glad to be an (educated) American!