Medical-Legal News

The number of Hospital Medicine  experts or Hospitalists continues to grow --40,000 are expected within the next few years.  In addition to the growing number of hospitalists is the range of duties they perform. These physicians are increasingly being asked to fill voids in a variety of hospital functions, including patient care and supervisory roles.

"They're being asked to do bedside patient care, but they're being asked to do more. They're asked to be systems engineers, they're asked to be safety experts, they're asked to be the information manager, if you will, the IT guys," said Dr. Larry Wellikson, CEO of the Society of Hospital Medicine.

Earlier this year, consumer advocacy group, Public Citizen, called for the Department of Health & Human Services to investigate state medical boards for failing to punish doctors with serious medical practice violations.  Since then, not much has changed, as California's medical board failed to discipline 710 dangerous doctors even though they were disciplined by hospitals, surgical centers, and other healthcare organizations where they worked, according to a report released by Public Citizen.

What's more, 35 percent of those doctors were repeat offenders.  In the U.S., more than 200 doctors were deemed an "immediate threat to health or safety" of patients and had their clinical privileges suspended, limited, or revoked; California docs accounted for nearly half of those.  Despite hospitals taking action, medical boards let these doctors escape punishment.

According to California's medical board, a lack of adequate staffing and funding may have hindered its ability to follow up on the 710 physicians it failed to discipline, an issue that other medical boards might be struggling with amid state budget cuts.  "We believe more data needs to be obtained, but like many state agencies, we have a 20 percent vacancy rate, and we're trying to focus on our core functions," said Jennifer Simoes, a Medical Board spokeswoman, after reviewing the findings, reports the Los Angeles Times.

Imaging testing is often considered a driving force of escalating healthcare costs, as the tests are often expensive and overused.

Yet newly released Medicare data find that hospitals used double chest CT scans at almost the same rate in 2009 as they did in 2008, reports Kaiser Health News.

The number of Medicare patients getting two chest CT scans consecutively was 5.2 percent in 2009, a marginal drop from the 5.4 percent of patients the year before. The data suggest that many patients may be receiving two scans when all they need is one.

According to the Colorado Department of Public Health and Environment, the clinic used "unfair and deceptive business practices" to pressure patients into receiving unnecessary and pricey X-rays and CT scans.

The clinic is accused of conducting these CT scans on about 150 patients per week without orders or supervision from a licensed doctor, exposing them to potentially harmful radiation doses.

A report released by the Institute of Medicine, one of the nation's top scientific groups, claims that the system for regulating many medical devices ought to be abandoned and replaced as it fails to appropriately examine device safety and effectiveness before sale.

The report's recommendation to scrap the current system was unexpected, and it unleashed reactions ranging from outright rejection by industry officials, an embrace by patient groups and seeming disbelief from federal regulators, who had commissioned the review.

The report follows several recalls of medical devices in recent years, like one relating to metal-on-metal hip replacements. In its report, the panel found that existing rules used to approve many devices were never intended to play the critical role of screening out dangerous or ineffective products.

Two bills addressing medical and dental malpractice were passed by the Florida legislature and await signature by Florida's Governor Scott.  Among the new provisions in the laws is 1) a requirement that physicians and dentists licensed in a state other than FL must obtain an expert witness certificate before providing expert testimony, and 2) that experts witnesses (from FL or another state) may be disciplined by the Boards of Medicine, Osteopathic Medicine, and Dentistry if they provide deceptive or fraudulent testimony. The bill provides immunity from lawsuits for volunteer school sports team physicians when they gratuitously render care at a school athletic event.

The second bill is aimed at Florida's Medicaid program. A provision in the bill caps non-economic liability damages (i.e., pain and suffering awards) for Medicaid recipients at $200,000 for individuals and $300,000 per incident.

See the published survey results ranking 17 hospitals as best in class of a total of approximately 5,000 surveyed.  As one might expect, most of these 17 are major research centers and university hospitals.

Falls are a common cause of injury, particularly in older, hospitalized patients.  According to a new literature review appearing in the Journal of the American Academy of Orthopaedic Surgeons, many of the risks that frequently cause falls are not adequately addressed by the fall prevention initiatives used in healthcare facilities.

Falls are the leading cause of fatal and nonfatal injuries to older people in the United States.  Each year, more than 11 million people older than 65 fall.  That is one in three senior citizens.  This new literature review indicates that while many hospital falls are considered "preventable", the authors found that many risk factors for such falls are not under the caregivers' control and are therefore not necessarliy preventable.  

Although a so called "never event", yet by some estimates, wrong site, wrong side and wrong patient procedures occur more than 40 times every week in the United States.  The Joint Commission Center for Transforming Healthcare has partnered with two Rhode Island Hospitals to study and address these never events.

The Joint Commission recently announced a process improvement methodology to assess risk points and contributing factors of wrong-site, wrong-side, and wrong patient surgery as part of a previously launched collaboration to eliminate such events.

IT is an American impulse to covet the new and improved — whether it’s a faster computer, a smarter cellphone or a more fuel-efficient car. And in medicine, too, new drugs, devices and procedures have advanced patient care.

But the promise of innovation can also prove a trap, a situation now playing out with dire consequences for possibly tens of thousands of people who received artificial hips intended to let them remain active.

The implants, known as metal-on-metal hips, were regarded by device makers and surgeons as a major advance over previous designs that used both metal and plastic. Now federal regulators and medical researchers are scrambling to determine how many implant recipients have been injured by the devices, which can shed dangerous metallic debris through wear.

Caring for patients in a medical intensive care unit in a hospital and flying a 747 are complicated tasks that require tracking thousands of important details, some of which could get overlooked. That's why the pilot has a checklist and a copilot to make sure nothing slips by.

A new Northwestern Medicine study shows the attending physician in the intensive care unit could use a copilot, too. The mortality rate plummeted 50 percent when the attending physician in the intensive care unit had a checklist - a fairly new concept in medicine -- and a trusted person prompting him to address issues on the checklist if they were being overlooked. Simply using a checklist alone did not produce an improvement in mortality.