Kenneth J. Bush, P.A.
Medical Malpractice Lawyer
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Miami Medical Malpractice Law Blog

Lack of malpractice insurance a matter for state medical board

Florida patients may be surprised to learn that, according to a New Jersey court, doctors in the Garden State are not required to inform their patients they lack medical malpractice insurance. A man had sued a surgeon due to improperly placed screws in his foot. On Sept. 29, the New Jersey Supreme Court ruled that the lack of insurance was a matter for discipline by the state medical board and not for a lawsuit. The court also ruled that medical facilities were required to do due diligence to check a physician's insurance or lack of credit and could be sued if they did not.

The man had already been awarded $750,000 by a lower court on the basis of medical negligence, but he had sought an additional sum on appeal. The Supreme Court agreed with the lower court's ruling that the facility where the surgical procedure took place could not be sued for allowing an uninsured doctor to work there. However, according to state law, doctors who do not have either malpractice insurance or a line of credit in the amount of $500,000 to cover any potential liability may receive civil penalties and disciplinary action from the state medical board.

Book outlines non-technical skills needed for safe surgeries

A new book aims to make surgery safer for patients in Florida and around the world by helping surgeons improve on the non-technical skills essential for a successful operation. The book, which is called "Enhancing Surgical Performance: A Primer in Non-Technical Skills," is based on 12 years of research by the University of Aberdeen in Scotland.

Approximately 12 percent of all hospital patients experience some sort of "adverse event" while receiving care. Half of those incidents are related to surgery. A surgical adverse event is any mistake made by surgical staff during a procedure, including wrong-site surgery, leaving instruments in a patient's body, avoidable infections or drug errors. According to researchers, many of these incidents occur as a result of non-technical issues, such as lack of communication or cognitive errors.

Beating cancer with early awareness

There may be Florida residents interested in learning more about how the survival rate of a cancer patient can double when they gain understanding about their condition early on. According to a 2013 Boston study, physicians believe that misdiagnosis only occurs up to 10 percent of the time. However, a 2014 study revealed that around 28 percent of the information patients receive from medical staff and physicians is incorrect.

The Boston study also discovered that errors were occurring in over 70 percent of the lung cancer scans and in 75 percent of the mammograms screening for breast cancer. More recently, a British study involving 10,000 respondents determined that when patients receive detailed and accurate information on the cancer type, treatment options and life going forward, their survival rate is twice as high. However, when the patients were informed about the possible side effects, the likelihood of a positive outcome declined by 35 percent.

Addressing medical misdiagnoses in the U.S.

Florida patients may want to know about how the alarming rate of misdiagnoses in the United States is being addressed. According to experts in patient safety, approximately 5 to 15 percent of physicians' diagnoses are incorrect. Many of these mistakes may be attributable to physicians' insecurities, compelling them to endorse coworkers' poor decisions, overlook potential symptoms or assume that the most prevalent answer is correct.

However, the rate of mistakes made by physicians in the U.S. is not necessarily quantifiable. Often times, the error is more complex than simply forgetting an instrument inside a patient while performing an operation. It can be harder to monitor misdiagnoses because many of these mistakes are attributable to the respective staff member's deduction and decision-making at the time of the incident, unlike a medication error that can be easily tracked.

Medical errors, veterans and the VA

Florida residents may be interested in learning about the quality of care provided at health care facilities associated with the Veterans Administration. Approximately 5.8 million veterans received care from clinics and hospitals in the Department of Veteran Affairs system during 2014. Along with a 14 percent increase in the number of veterans seeking VA hospital care, the dangers of adverse events in the VA system are also on the rise.

The Veterans Health Administration's National Center for Patient Safety is in charge of monitoring the investigations into these type of incidents. According to a report released by the Government Accountability Office on Aug. 28, the rate of investigations into medical errors declined by 18 percent between fiscal years 2010 and 2014. During that same time frame, the rate of medical errors increased by 7 percent.

Study shows lack of sleep doesn't impact surgeon performance

Florida readers may be surprised by a new study that indicates sleep deprivation during the previous night does not negatively impact the performance of physicians doing elective surgery the following morning. The study, which was conducted by researchers at the University of Toronto, was published in the New England Journal of Medicine on Aug. 26.

In response to proposals calling for doctors to warn patients they are sleep-deprived before performing a procedure, researchers looked at 39,000 cases performed by 1,448 experienced surgeons in Ontario. The data, which was gathered over a five-year period, showed that patients had a 22.2 percent chance of suffering a surgery-related complication when the surgeon worked the midnight shift the night before and a 22.4 percent chance when the doctor did not. Thirty days after the procedure, the risk of a patient dying was 1.1 percent whether or not the doctor worked the midnight shift before surgery. The authors of the study believe their results show doctors need not inform patients they are fatigued before performing surgery.

Understanding MELAS and methods of diagnosis

Researchers at The First Affiliated Hospital of Dalian Medical University in China have published a study in which they reviewed the resources available to health care professionals for diagnosing MELAS. Florida residents might know that this stands for mitochondrial myopathy, encephalopathy, lactic acidosis and stroke-like events.

Mitochondrial health conditions are rare and result from a mutation of mitochondrially expressed genes in an individual's DNA. MELAS is a neurodegenerative illness that worsens with time. It affects several systems in the body, particularly the muscles and nervous system. The disease is often misdiagnosed because it manifests and progresses differently. Despite this, some of the early symptoms include exercise intolerance, lack of appetite, muscle pain and weakness, recurrent headaches, seizures and vomiting. Additionally, stroke-like events could occur in severely affected individuals before they turn 40.

The dangers of childbirth in the U.S.

Florida parents may be interested in learning more about some of the dangers associated with commonplace practices used in U.S. childbirths. Electronic fetal monitoring, the procedure used to determine whether a pregnant woman will encounter complications that could require a vacuum extraction or emergency C-section, has been described as unnecessary and dangerous for patients. Extensive research has consistently found that routine EFM procedures have no measurable effect on reducing the rate of injury or death for the baby or mother.

In 1980, 45 percent of U.S. pregnant woman received EFMs, and by 2013, the total had risen to 85 percent. EFM is now the most widely used obstetric procedure in the United States. With the advent of modern science, the consensus now believe that the more technology employed, the safer the treatment, despite evidence to the contrary. Even if the tool has proven not to be effective, physicians are more hesitant to refrain from using whatever is at their disposal.

A look at medical malpractice claims and hospital prevention

Florida residents may be interested in some information about the steps that hospitals can take to help prevent harm to their patients. Failure to make a concerted effort toward curbing hospital errors can result in patient injury or death.

Statistics show that there are around a million medical injuries that occur each year around the country during medical procedures, many of which could be the basis of a medical malpractice claim. Of those who were fatally injured, approximately 7,000 people died due to a medication-related mistake and approximately 12,000 were killed during a surgery that was not medically necessary.

The potential benefits of recording surgeries

Although video equipment and recordings seem to be ubiquitous, Florida patients may wonder why these technologies are not used more in the operating room. Audiovisual recordings in medical environments may seem lacking, but legislation has been proposed in at least two states that would mandate recording in this setting. In both states, women suffered severe or fatal consequences because of anesthesia mistakes, and the laws proposed are aimed at providing more accountability and oversight related to surgeries.

Surgery mistakes can include wrong-site procedures, leaving implements in a patient and operating on the wrong patient. While these situations may be easier to identify because of the outcomes, some patients suffer adverse results without understanding why. It may be difficult to pinpoint issues such as poor infection prevention, lack of attention, or incorrect hand washing protocol as factors in a negative outcome. With an audiovisual record, families may find answers to questions about medical errors.