03/31/2009 01:55 PM
ER Patient Neglected in Chicago
Medicare threatens to revoke University of Chicago Medical Center's certification after patient's death.
The AP (3/28, Robinson) reported, "Medicare officials are threatening to take away the University of Chicago Medical Center's certification after the death of a man who sat in the emergency room for hours without being logged in, a center spokesman said." The patient's "wheelchair was parked within sight of the triage desk for 'a few hours' but...he was neither triaged nor logged in." He was later "pronounced dead" after his "daughter finally brought him to attention of the triage nurse." In a letter to the center, the federal government warned that "the center's Medicare certification could be lifted," but the spokesman stated that "such a warning was standard whenever such an incident took place."
"The Joint Commission, the major accreditor of US hospitals...said it was investigating the incident," the Chicago Tribune (3/28, Japsen) noted. The hospital claimed that an investigation by the Illinois Department of Health on Feb. 18 "found proper policies and procedures were in place but that staff members may not have followed the protocol." But, the letter indicated that "the hospital failed to 'maintain a central emergency services log' and 'provide a medical screening exam.'"
01/23/2009 01:45 PM
Facilitated Communication - Discredited by the American Psychological Association
Resolution on Facilitated Communication
by the
American Psychological Association
Adopted in Council, August 14, 1994, Los Angeles, CA
Facilitated communication (FC) has been widely adopted throughout North America in special/vocational education services for individuals with developmental disabilities who are nonverbal. A basic premise of facilitated communication is that people with autism and moderate and profound mental retardation have "undisclosed literacy" consistent with normal intellectual functioning. Peer reviewed, scientifically based studies have found that the typed language output (represented through computers, letter boards, etc.) attributed to the clients was directed or systematically determined by the paraprofessional/professional therapists who provided facilitated assistance (Bligh & Kupperman, 1993; Cabay, in press; Crews et al., in press; Eberlin, McConnachie, Ibel, & Volpe, 1993; Hudson, Melita, & Arnold, 1993; Klewe, 1993; Moore, Donovan, & Hudson, 1993; Moore, Donovan, Hudson, Dykstra, & Lawrence, 1993; Regal, Rooney, & Wandas, in press; Shane & Kearns, in press; Siegel, in press; Simon, Toll, & Whitehair, in press; Szempruch & Jacobson, 1993; Vasquez, in press; Wheeler, Jacobson, Paglieri, & Schwartz, 1993). Furthermore, it has not been scientifically demonstrated that the therapists are aware of their controlling influence.
Consequently, specific activities contribute immediate threats to the individual civil and human rights of the person with autism or severe mental retardation. These include use of facilitated communication as a basis for a) actions related to nonverbal accusations of abuse and mistreatment (by family members or other caregivers); b) actions related to nonverbal communications of personal preferences, self-reports about health, test and classroom performance, an family relations; c) client response in psychological assessment using standardized assessment procedures; and d) client-therapist communication in counseling or psychotherapy, taking therapeutic actions, or making differential treatment decisions. Instances are widely noted where use of facilitated communication in otherwise unsubstantiated allegations of abuse has led to psychological distress, alienation, or financial hardship of family members and caregivers. The experimental and unproved status of the technique does not preclude continued research on the utility of facilitated communication and related scientific issues. Judicious clinical practice involving use of facilitated communication should be preceded by the use of fully informed consent procedures, including communication of both potential risks and likelihood of benefit.
Facilitated communication is a process by which a facilitator supports the hand or arm of a communicatively impaired individual while using a keyboard or typing device. It has been claimed that this process enables persons with autism or mental retardation to communicate. Studies have repeatedly demonstrated that facilitated communication is not a scientifically valid technique for individuals with autism or mental retardation. In particular, information obtained via facilitated communication should not be used to confirm or deny allegations of abuse or to make diagnostic or treatment decisions.
THEREFORE, BE IT RESOLVED that APA adopts the position that facilitated communication is a controversial and unproved communicative procedure with no scientifically demonstrated support for its efficacy.
References:
(1) Bligh, S. & Kupperman, P. (1993). Evaluation procedure for determining the source of the communication in facilitated communication accepted in a court case. Journal of Autism and Developmental Disorders, 23, 553-557.
(2) Cabay, M. (in press). A controlled evaluation of facilitated communication with four autistic children. Journal of Autism and Developmental Disorders.
(3) Crewe, W. D., Sanders, E. C., Hensley, L. G., Johnson, Y. M., Bonaventura, S., & Rhodes, R. D. (in press). An evaluation of facilitated communication in a group of nonverbal individuals with mental retardation. Journal of Autism and Developmental Disorders.
(4) Eberlin, M., McConnachie, G., Ibel, S. & Volpe, L. (1993). Facilitated communication: A failure to replicate the phenomenon. Journal of Autism and Developmental Disorders, 23, 507-530.
(5) Hudson, A., Melita, B., & Arnold, N. (1993). Brief report: A case study assessing the validity of facilitated communication. Journal of Autism and Developmental Disorders, 23, 165-173.
(6) Klewe, L. (1993). An empirical evaluation of spelling boards as a means of communication for the multihandicapped. Journal of Autism and Developmental Disorders, 23, 559-566.
(7) Moore, S. Donovan, B., & Hudson, A. (1993). Facilitator-suggested conversational evaluation of facilitated communication. Journal of Autism and Developmental Disorders, 23, 541-551.
(8) Moore, S. Donovan, B., Hudson, A., Dykstra, J., & Lawrence, J. (1993). Evaluation of facilitated communication: Eight case studies. Journal of Autism and Developmental Disorders, 23, 531-539.
(9) Regal, R. A., Rooney, J. R., & Wandas, T. (in press). Facilitated communication: An experimental evaluation. Journal of Autism and Developmental Disorders.
(10) Shane, H. C., & Kearns, K. (in press). An examination of the role of the facilitator in "facilitated communication". American Journal of Speech-Language Pathology.
(11) Siegel, B. (in press). Assessing allegations of sexual molestation made through facilitated communication. Journal of Autism and Developmental Disorders.
(12) Simon, E. W., Toll, D. M., & Whitehair, P. M. (in press). A naturalistic approach to the validation of facilitated communication. Journal of Autism and Developmental Disorders.
(13) Szempruch, J., & Jacobson, J. W. (1993). Evaluating the facilitated communications of people with developmental disabilities. Research in Developmental Disabilities, 14, 253-264.
(14) Vasquez, C. (in press). A multi-task controlled evaluation of facilitated communication. Journal of Autism and Developmental Disorders.
(15) Wheeler, D. L., Jacobson, J. W., Paglieri, R. A., & Schwartz, A. A. (1993). An experimental assessment of facilitated communication. Mental Retardation, 31, 49-60.
01/24/2009 01:02 PM
Dr. Sanjay Gupta is not the right choice for Surgeon General
As a Chicago medical malpractice lawyer I have represented the family of an autistic child for severe damage to the child caused by the use of facilitated communication (FC). As soon as I saw that Dr. Sanjay Gupta was being considered for Surgeon General I was both surprised and dismayed. Dr. Gupta has actively supported facilitated communication (FC) as a valid means of helping autistic people communicate. FC has been thoroughly discredited by the scientific community, a fact which Dr. Gupta chooses to ignore. It appears that Dr. Gupta has been chosen for his good looks and his ability to entertain the public with medical anecdotes and not his scientific credentials. This President has promised to put science back in its rightful place. By supporting FC Dr. Gupta has demonstrated that he is no scientist.
I have written a letter to the Obama administration and everyone else I can think of in opposition to this appointment. Please feel free to copy it and/or expound on it and send it to the members of the Senate Health Committee. The letter and committee members are listed below:
I am a Chicago lawyer and a long time supporter of the President. I am writing to express my strong opposition to Dr. Sanjay Gupta as U.S. Surgeon General.Dr. Gupta has actively promoted facilitated communication (FC) as a valid way to help autistic people communicate. FC has been universally discredited scientifically, a fact Dr. Gupta has chosen to ignore. Consider this small sample of the vast sources rejecting the science of FC:
1. Facilitated Communication the Ultimate Fad treatment; Jacobson, Foxx, Mulick (2005)
2. Prisoners of Science, Frontline 1993
3. American Psychological Association position paper on FC.
4. Facilitated Communication and the Power of Belief: How Time Magazine Got it WrongNot only is FC a useless therapy for the autistic it is harmful to the children and families victimized by its use. Instead of being treated with recognized techniques to teach communication, autistic children lose valuable time in their formative years having their hands manipulated like puppets. This has no value for the child, but is financially very rewarding to the people selling FC.
I recently settled a matter with a hospital in Chicago for malpractice solely because FC was used. The responsible hospital paid $1 million to settle before we even filed suit and demanded a confidentiality agreement. The parents of the child in my case were actually convinced by a doctor that their child was a genius trapped in an autistic body. After nine years of FC the family finally realized that they were the victims of the pseudoscientific hoax that is FC.
In his inaugural speech the President said '¦we will restore science to its rightful place¦' Dr. Gupta is a fine television personality, but no supporter of Facilitated Communication is fit for the countryTMs top scientific post.
Christopher T. Hurley
Democrats by Rank
Edward Kennedy (MA)
Christopher Dodd (CT)
Tom Harkin (IA)
Barbara A. Mikulski (MD)
Jeff Bingaman (NM)
Patty Murray (WA)
Jack Reed (RI)
Bernard Sanders (I) (VT)
Sherrod Brown (OH)
Robert P. Casey, Jr. (PA)
Kay Hagan (NC)
Jeff Merkley (OR)
Republicans by Rank
Michael B. Enzi (WY)
Judd Gregg (NH)
Lamar Alexander (TN)
Richard Burr (NC)
Johnny Isakson (GA)
John McCain (AZ)
Orrin G. Hatch (UT)
Lisa Murkowski (AK)
Tom Coburn, M.D. (OK)
Pat Roberts (KS)
12/29/2008 12:43 PM
Electronic health records may help reduce malpractice suits
The November 24 issue of Archives of Internal Medicine discusses a new study that suggests that the use of electronic health records (EHRs) may help reduce paid malpractice settlements for physicians. An abstract of the article can be found here.
The study examined 1140 practicing Massachusetts physicians in 2005, and after controlling for potential confounding variables, the authors found a trend favoring EHR use--although the result was not statistically significant. In addition, since a small number of physicians in both groups were queried, the authors have only placed "cautious" emphasis on the results.
Comments about this post can be directed to Chicago Medical Malpractice Attorney Chris Hurley at (312) 553-4900.
12/17/2008 08:51 PM
Hospital infection lawsuits on the rise
Hospital infections are on the rise and so are lawsuits that claim medical malpractice caused the infections. The Wisconsin Law Journal recently reported that "A new type of med-mal lawsuit is on the increase -- claims based on hospital infections." According to the Law Journal, "Plaintiffs' attorneys say that hospitals can no longer argue that these infections are inevitable."
Betsy McCaughy, founder and chair of the Committee to Reduce Infection Deaths, said, "This is the next asbestos. Now that the evidence is overwhelming that nearly all infections are preventable, hospitals that don't follow the proven protocols are inviting lawsuits."
Sadly, most of these infections can be prevented through stricter sanitary and bacterial testing procedures.
If you or a loved one was diagnosed with a serious infection during or after a hospital stay, contact the Chicago medical malpractice attorneys at Hurley McKenna & Mertz at (312) 553-4900 to discuss your case.
11/23/2008 04:01 PM
Growing Sense of Outrage Over Executive Pay
Finally, it appears that Wall Street executives are getting what they deserve. The Washington Post reports that bonuses this year are likely to be sharply lower than in years past. Johnson Associates, a compensation consulting firm, predicts annual incentive pay for senior executives will fall at least 60 percent this year at investment banks, and by 55 percent or more at commercial banks.
ItTMs about time. We have been writing about the excessive corporate executive compensation for years and it appears that the rest of the financial industry is finally seeing the light. Compensation is being scrutinized as never before, especially on Wall Street, where the year-end bonus season is coinciding with a government bailout of finance companies.
At a time when the average taxpayer already is feeling stretched and public money is being used to support an industry that paid out $33 billion of bonuses last year-- upper level management has an even greater duty than before to shareholders to not offer excessive pay packages and instead focus on corporate governance.
Since 1993, companies have been allowed by Congress to take a tax deduction for executive compensation over $1 million--but required that the pay be tied to performance. This is what created the culture where giant stock option grants make up the bulk of executive pay at many of the biggest public companies. Bonuses should be strictly connected to stock performance and we think that slowly, the agencies that monitor banking institutions and Wall Street will eventually get to that point. Public opinion will demand it.
Comments about this post can be directed to Chicago Medical Malpractice Attorney Chris Hurley at (312) 553-4900.
11/24/2008 08:39 AM
Patient sues Chicago Hospital, doctor for contracting HIV and hepatitis from infected kidney donor
A Chicago transplant patient filed a medical negligence suit this week against the University of Chicago Medical Center and one of its surgeons, alleging that she contracted HIV and hepatitis C after receiving a kidney from an infected donor.
The Chicago Tribune reports that the hospital knew that the donor, who was homosexual, was in a high-risk group but withheld the information from the patient. According to the lawsuit, had the patient known of the true nature of the donor's lifestyle and the risks associated with receiving his kidney, she would not have consented to the surgery.
Four transplant recipients contracted HIV from the donor, whose infection went undetected in what hospital officials say is the first documented case of the virus being transmitted by organ donation in the U.S. in more than 20 years. Tests conducted on the donor returned negative results probably because the HIV and hepatitis were contracted near the time of death and hadn't had the opportunity to progress. The suit charges medical malpractice for failing to notify the woman of the donor's high-risk behavior and for failing to test her for HIV three months after the transplant" which is recommended by the Center for Disease Control and Prevention when organs are donated by high-risk donors.
Comments about this post can be directed to Chicago Medical Malpractice Attorney Chris Hurley at (312) 553-4900.
11/17/2008 09:07 AM
Minority Trauma Victims More Likely To Die Than Whites
Chicago Sun Times writer Monifa Thomas reports that Blacks and Hispanics who receive treatment for head injuries and other trauma are more likely to die than whites with similar injuries. New research also showed that regardless of race, uninsured trauma victims died more often than those who were insured.
The study, published in the Archives of Surgery, offers the latest evidence of how race and insurance status affect patient outcomes -- whether the condition in question is cancer, heart disease, car accident injury or gunshot wounds. Data collected from more than 376,000 patients at 700 hospitals showed that trauma victims who were white and had health insurance fared better than Blacks, Hispanics and the uninsured, even when the severity of the injury was the same.
According to researchers, lack of insurance was the biggest predictor of poor outcomes" and since minorities were more likely than whites to be uninsured they were more likely not to survive traumatic injury. But the data also showed that Hispanics with insurance were still 51 percent more likely to die after being treated for a trauma wound than whites who had insurance. African Americans with insurance were 20 percent more likely to die compared to insured whites.
There are some variables that could cause this disparity such as uninsured patients having preexisting conditions that hurt their survival chances or the fact that minorities are more likely to be treated at under-resourced facilities. But in theory, trauma centers, are supposed to treat all their patients the same, regardless of whether they are insured and regardless of their race--any practice other that would be a violation of federal law. If anything, this study brings to light how universal health care coverage could help alleviate the disparity between the care 'haves' and the 47-million uninsured 'have-not' receive.
Comments about this post can be directed to Chicago Medical Malpractice Attorney Chris Hurley of the law firm of Hurley McKenna & Mertz, P.C. at (312) 553-4900.
11/17/2008 09:06 AM
Failure to perform timely PSA tests leads parties to settle wrongful death case for $875,000
A recent wrongful death case involving claims that a doctor failed to diagnose prostate cancer settled for $875,000. The decedentTMs estate claimed a hospital and treating physician failed to perform annual prostate-specific antigen (PSA) testing in the two years before the diagnosis.
The facts alleged that the plaintiff underwent regular annual physicals. But, when he was 52, he underwent a digital rectal exam and was then diagnosed as having metastatic prostate cancer. He underwent treatment but died six months after his diagnosis. He was survived by his wife and two adult children. The parties settled before suit was filed.
The Chicago Medical Malpractice Attorneys at Hurley McKenna & Mertz believe that no one should receive substandard medical care. If you or a loved one has been injured or has died as a result of medical negligence, please contact us at (312) 553-4900 for a consultation.
09/29/2008 07:39 PM
Hospital and Illinois Drug Company sued for Heparin overdoes
The families of two newborns who died after they were inadvertently given massive doses of Heparin have sued an Indianapolis hospital and the Illinois-based company, Baxter Healthcare Corp., that makes the blood thinner.
The Chicago Tribune reports that parents of two of the three newborns who died in September 2006 filed suit after injections of heparin that were 1,000 times greater than the recommended dose for infants were administered. Also suing are the parents of two infants who were overdosed but survived. The error occurred in part because of a mix up over labeling, which Baxter changed in October 2007.
Baxter recalled all its heparin vials in February after receiving contaminated ingredients from a supplier, Baxter officials said.
Comments about this post can be directed to Chicago Medical Malpractice Attorney Chris Hurley at (312) 553-4900.
09/09/2008 03:51 PM
Does Linking Chicago DoctorsTM Pay to Performance Mean Better Healthcare?
Does linking Chicago doctorsTM pay to performance mean better healthcare? ThatTMs essentially the question posed by Dr. Sandeep Juahar this week in the New York Times. Apparently, employers and insurers, including Medicare, have started about 100 initiatives across the country that reward health care providers by paying for performance-- called P4P for short--with the general intent to reward doctors for providing better care.
For example, doctors are now being encouraged to voluntarily report to Medicare on 16 quality indicators, including prescribing aspirin and beta blocker drugs to patients who have suffered heart attacks and strict cholesterol, for prescribing ACE inhibitor drugs to patients with congestive heart failure and administering antibiotics to pneumonia patients in a timely manner. The doctors and hospitals who perform well receive cash bonuses.
On the surface, it seems like a good idea to reward doctors and hospitals for quality, not just quantity. But there may be unintended consequence to P4P. For example, Medicare requires that antibiotics be administered to a pneumonia patient within six hours of arriving at the hospital. The problem is that doctors often cannot diagnose pneumonia that quickly. It takes blood tests and chest X-rays to detect pneumonia, but the Medicare standard pressures doctors to treat an illness that they donTMt have the solid test results to confirm. So as a result of the guidelines, ER patients are taking more antibiotics despite the risk of dangers of antibiotic-resistant bacteria and antibiotic-associated infections, like colitis.
Juahar claims that with P4P giving out bonuses, many doctors have expressed concern that they feel pressured to prescribe 'mandated' drugs, even to elderly patients who may not benefit, and to cherry-pick patients who can comply with pay-for-performance measures. Juahar claims that whenever you try to legislate professional behavior, there are bound to be unintended consequences. And at this point, it is not clear that pay for performance will actually result in better care, because it may end up only benefiting physicians who already meet the guidelines.
The Chicago Medical Malpractice attorneys at Hurley McKenna & Mertz, P.C. think that Doctors and hospitals should never have to take a financial hit for trying provide innovative healthcare that the guidelines have not had the opportunity to address. If they can collect bonuses by maintaining the status quo, what is the incentive to improve?
If you have comments about this post, please contact Chris Hurley at (312) 553-4900.
08/28/2008 05:20 PM
18 California Hospitals cited for substandard care
Shaya Tayefe Mohajer of the Associated Press recently reported that 18 hospitals in California were fined for state health code violations where patients received sub-par care that in some cases, led to death. Violations included an improperly inserted catheter, a ventilator that wasn't turned on and surgical sponges left inside patients after operations. The report also found some patients experienced awareness during their procedures due to improper anesthesia.
The fines were the latest of dozens of penalties the state issued in recent years to more than 40 hospitals. The report detailed a death at a hospital in which a worker failed to turn on the ventilator for a patient who was being transferred. At another hospital, a patient died after falling from a wheelchair with no seat belt on, and another of the fined hospitals lost a patient from a medication overdose. In what appears to be an epidemic of poor healthcare, at another hospital, a registered nurse improperly inserted a catheter into a patient's neck vein, which caused an air bubble and lead to the patientTMs death. The California Department of Health investigation found the nurse had not completed a required anatomy class or the hospital's training on protocol for catheters.
The hospitals were fined $25,000 for each violation. If you have questions relating to medical malpractice please contact the Illinois Medical Malpractice Attorneys at Hurley McKenna & Mertz, P.C.
08/28/2008 05:19 PM
Supreme Court to hear arguments on Unconstitutionality of Illinois' Medical Malpractice caps
A lawsuit testing the constitutionality of Illinois' medical malpractice damage caps is expected to come before the IllinoisTM Supreme Court this fall. The 2005 state law limits medical malpractice awards for non-economic damages such as pain and suffering to $500,000 for doctors and $1 million for hospitals. The law does not limit compensation for economic damages such as the cost of medical care and lost wages.
The case that could overturn the law was filed by Frances LeBron, whose daughter Abigaile was seriously injured during her October 2005 birth. The complaint alleges that the girl suffers mental impairment and cerebral palsy and will need extensive medical care for the rest of her life. In November, Cook County Circuit Judge Diane Larsen sided with plaintiffs and declared the law unconstitutional and invalid in its entirety. She said the statutory limits on awards interfered with juries' responsibility to award appropriate compensation for injuries.
At least twice before the Supreme Court has declared laws that limit personal injury awards to be unconstitutional, partly on grounds they violate the separation of judicial and legislative powers. Arguments before the high court have not been scheduled but could come as early as next month. A consistent ruling by the Supreme Court will mean that this law limiting the damages of the most severely injured victims will be rejected like those before it. If you have comments about this post, please contact Chicago Medical Malpractice Attorney Chris Hurley at (312) 553-4900.
08/20/2008 10:05 AM
Medical Credit Scores unethical and illegal
Those focused on fighting hospital negligence have long been concerned that hospitals may begin to routinely consider a patientTMs credit rating or ability to pay for health care when making treatment decisions. Last week in fact, in a Chicago Tribune column, Cory Franklin advocates for more federal oversight of hospitals and other health care professionals relating to credit reporting and billing. In his column, Franklin claims that the 'inevitable partnership' of credit and medical histories are already being collected by at least one company in an attempt to predict how reliably patients will pay for their medical bills.
A scenario where medical tests are not conducted on a sick patient because of the patientTMs low credit score is an unsettling possibility. Discriminating against patients who have poor credit or medical histories is not only unethical--it is illegal-- and opens up doctors and hospitals to medical malpractice claims. The Emergency Medical Treatment and Active Labor Act (EMTALA) specifically prohibits this practice. If you have questions about medical malpractice, please contact Chris Hurley at (312) 553-4900.
08/19/2008 06:24 AM
FDA warns that CT scans can interfere with pacemakers or defibrillator function
The Food and Drug Administration (FDA) issued a warning last month to doctors who treat patients with electronic devices such as pacemakers, cardiac defibrillators and insulin pumps. Judith Graham of the Chicago Tribune reports that the FDA public health alert cautioned doctors that these types of medical devices can malfunction when patients get computerized tomography (CT) scans. The health alert can be found here.
There have been six confirmed reports of devices that malfunctioned after a CT scan and nine other reports of suspected problems. No deaths have occurred as a result of this complication.
In its alert, the FDA warned that devices that could be affected by CT scans include pacemakers, implantable defibrillators, neurostimulators, drug infusion and insulin pumps, cochlear implants and retinal implants. Millions of Americans are equipped with these devices-- which use electrical current to help various organs overcome functional deficiencies. Among other measures, the alert recommends that CT operators use the least amount of X-ray exposure possible and stand prepared to treat adverse reactions.
From legal perspective, medical malpractice occurs when a doctor, hospital, or other health care provider fails, or breaches, their duty to care for a patient. In the case where a CT scan is scheduled for a patient equipped with a defibrillator or pacemaker, the FDA alert warns doctors to take certain precautions to ensure the medical device does not malfunction-- since it is forseeable that complication and injury can occur if the condition is ignored. If you think a healthcare professional made a mistake treating your condition, the first thing you should do is seek legal advice. The lawfirm of Hurley McKenna & Mertz, P.C. has successfully fought for patients who have received negligent healthcare at the hands of doctors and hospitals. If you have questions or comments about this blog post call Chris Hurley at 312-553-4900.