A recent study published in Pediatrics reviewed 960 randomly selected charts from 12 children's hospitals. The study found 107 unique adverse drug events, which, broken down, included 11.1 adverse drug events per 100 patients, 15.7 per 1000 patient-days, and 1.23 per 1000 medication doses.

According to the study, “Twenty-two percent of all adverse drug events were deemed preventable, 17.8% could have been identified earlier, and 16.8% could have been mitigated more effectively. The most common medication classes causing adverse drug events were opioids/ analgesics (51%) and antibiotics, and the most common stages of the medication management process associated with preventable adverse drug events were monitoring and prescribing/ordering.” The highest rate of adverse drug events per patient occurred in the hematology/oncology units.

Opioid analgesics include morphine, codeine, fentanyl and other pain medications. The risk is pain medication overdose. There are several reasons for this including:

1. The increased difficulty of calculating dosages of pain medication for children
2. Failure to adequately monitor the patient
3. The dangerous nature of these medications
   

These are extremely dangerous drugs and a small error in administration of these drugs can result in serious injury or death. There are also situations where the pain medication has adulterations or other defects that cause injury. For example, in the last few months, FDA has announced a number of recalls and health alerts involving fentanyl.

If your child experienced serious injury or death after being administered a pain medication or any medication in a hospital, you should contact a medical malpractice lawyer immediately. To contact attorney Fred Pritzker, managing attorney for our medical malpractice cases, for information on medication overdose lawsuits, please call 1-888-377-8900 (toll-free) or submit our free case consultation form.

Article: "Development, Testing, and Findings of a Pediatric-Focused Trigger Tool to Identify Medication-Related Harm in US Children's Hospitals,"Glenn S. Takata, MDa,b, Wilbert Mason, MD, MPHc, Carol Taketomo, PharmDe, Tina Logsdon, MSf and Paul J. Sharek, MD, MPHg, PEDIATRICS, Vol. 121 No. 4, April 2008, pp. e927-e935.

Labels: children's health, medication error, pain medication overdose

A recent study published in The New England Journal of Medicine assessed the extent to which care processes recommended for pediatric outpatients are delivered by analyzing the medical records of 1536 children. The results were not encouraging:

On average, according to data in the medical records, children in the study received 46.5% (95% confidence interval [CI], 44.5 to 48.4) of the indicated care. They received 67.6% (95% CI, 63.9 to 71.3) of the indicated care for acute medical problems, 53.4% (95% CI, 50.0 to 56.8) of the indicated care for chronic medical conditions, and 40.7% (95% CI, 38.1 to 43.4) of the indicated preventive care.

Quality varied according to the clinical area, with the rate of adherence to indicated care ranging from 92.0% (95% CI, 89.9 to 94.1) for upper respiratory tract infections to 34.5% (95% CI, 31.0 to 37.9) for preventive services for adolescents.
Deficits in the quality of care provided to children appear to be similar in magnitude to those previously reported for adults. Strategies to reduce these apparent deficits are needed. (Quote from below-referenced article, "The Quality of Ambulatory Care Delivered to Children in the United States")

Poor medical care for children is unacceptable. Now that we know children are at risk, we need to find why their care is not adequate and fix the problems. Continuing medical education, a requirement for maintaining a medical license, should have mandatory courses on juvenile health. Also, agreed-upon basic guidelines for care need to be established, and federal and state governments need to make sure this basic care is paid for by public or private insurance.
For a number of reasons it is in our country’s best interests to care for our children. For those who can’t think beyond their pocketbook, adequate medical care for our children now will prevent future medical expenses when they become adults.

If you suspect that your child received inadequate medical care and was seriously injured as a result, please contact a medical malpractice attorney at Pritzker | Ruohonen. Attorneys Fred Pritzker, Rich Ruohonen, and Elliot Olsen have been named “Super Lawyers” by Law & Politics magazine. For a free consultation, call 1-888-377-8900 (toll-free) or submit our free case consultation form.

Article: "The Quality of Ambulatory Care Delivered to Children in the United States,"
Rita Mangione-Smith, M.D., M.P.H., Alison H. DeCristofaro, M.P.H., Claude M. Setodji, Ph.D., Joan Keesey, B.A., David J. Klein, M.S., John L. Adams, Ph.D., Mark A. Schuster, M.D., Ph.D., and Elizabeth A. McGlynn, Ph.D., The New England Journal of Medicine, October 11, 2007, Volume 257: 1515-1523.

Labels: children's health, medical malpractice lawyer

Park Nicollet Methodist Hospital in St. Louis Park, Minnesota, reported that it removed a healthy kidney from a patient instead of the patient’s cancerous kidney.

The hospital did not notice that the mistake until a day after the surgery when a pathologist noticed the kidney taken from the patient was healthy.

Minnesota law requires hospitals to report adverse health events, including “wrong-site” surgeries (Minn. Stat. Section 144.7065, Subdivision 2 (1)). Last year, 24 wrong-site surgeries were reported to the Minnesota Department of Health in accordance with this law.

In the four-and-a-half years that state as been assembling data, "I don't know if we've ever had a wrong organ removal," said Diane Rydrych, assistant director of the state's division of health policy.

Ryrdrych says most hospitals have safety measures in place to prevent wrong-site surgery, including marking body parts to be operated on in advance of surgery and requiring a "time out" in the operating room to give surgical staff a chance to double check documentation and voice any concerns.

"I would say that these events are always preventable or almost always preventable" said Rydrych. (KARE 11 interview)

Certainly, this tragic loss of a healthy kidney could have been prevented. To contact a surgery malpractice lawyer at our law firm, please call toll-free at 1-888-377-8900, email Fred Pritzker, or submit the firm’s free case consultation form.

Posted March 2008.

Labels: Methodist Hospital, surgery malpractice, wrong kidney

Methadone is a strong opioid-based pain medication. According to Pain Treatment Topics (www.pain-topics.org), methadone overdoses and deaths have increased. Some of these incidences are associated with medical malpractice. Possible problems may be:

• Prescribing the wrong dosage of methadone
  
• Prescribing methadone without taking into consideration other medications the patient is taking and how those medication will interact with the methadone
• Methadone overdose due to nurse error or the error of another medical professional
  

Death or serious injury due to methadone overdose should be discussed with an experienced medical malpractice attorney.

Posted March 2008.

Labels: malpractice attorney, methadone, overdose

Pritzker | Ruohonen attorneys Fred Pritzker and Elliot Olsen recently secured a $950,000 recovery on behalf of a young man who developed septic arthritis eight days following knee surgery. The suit alleged that the doctors responsible for his care failed to recognize, test and treat his knee infection. Experts retained on behalf of the young man offered evidence that the doctors failed to diagnose septic arthritis, failed to perform arthrocentesis, failed to open the knee capsule and drain out and remove infected fluid and tissue and failed to place the patient on IV antibiotics.

Our client later required massive skin grafting to cover the large leg wound that resulted from the infection. As a result of the damage to the articular cartilage in his knee, the young man will experience pain and increasing disability that will lead to extensive future treatment including knee replacement and perhaps above-the-knee amputation. Read more about the recovery for failure to diagnose septic arthritis.

Posted February 2008.

Labels: failure to diagnose septic arthritis, malpractice lawsuit, septic arthritis

The 8th annual MEDMARX® Data Report released today by the U.S. Pharmacopia (USP) states that medication mix-ups are on the rise due to a proliferation of drugs with similar names and/or packaging. In fact, from 2003 – 2006, more than 1,400 commonly used drugs were involved in errors linked to drug names (brand and generic) that look alike or sound alike.
According to findings in the MEDMARX report, 1.4% of the errors resulted in patient harm, including seven errors that may have caused or contributed to patient deaths. However, due to widespread underreporting of incidents, the study's authors believe that the number of adverse events resulting from look-alike/sound-alike errors is actually understated.

"Errors resulting from look-alike/sound-alike drugs are a problem that spans the entire health care system," said Darrell Abernethy, M.D., Ph.D., chief science officer, USP. "By recording and communicating not only the name of the drug, but also what it is being used for, prescribers, pharmacists and consumers can work together to dramatically reduce these types of medication errors."

According to the USP:

Consumers picking up prescriptions should check the indication for use appearing
on the drug's label or ask their pharmacist for this information. If the
indication given by the pharmacy is different from what the prescriber said the
medication is for, that is a red flag for the consumer to ask questions.
Consumers should also exercise their right to receive counseling from the
pharmacist every time they begin a new medication to ensure they know the name
of the drug and its pronunciation, what it is and how to take it.

Recently, several hospitals have administered heparin overdoses to infants due to a look-alike medication error. Read more about heparin overdoses.

To contact Pritzker Ruohonen regarding a medication error, please call toll-free at 1-888-377-8900 or submit the firm's free consultation form.

Labels: look-alike drugs, medication error, sound-alike drug names

It has long been thought proficient hand-washing in hospitals was the most important aspect to controlling the spread of infection. It is also common practice for doctors and nurses in a hurry to use alcohol-based hand gels rather than conventional soap and water. Dr. Mark Rupp at the University of Nebraska Medical Center put these practices to the test.

Rupp observed hygiene practices in two intensive care units over two years to compile his data. According to The New York Times:

More gel dispensers were put in the units, and usage rose from 37 percent to 68 percent in one unit and from 38 percent to 69 percent in the other. Compliance for hand washing of any kind in most hospitals is estimated to be about 40 percent, according to experts, although some hospitals do better.

Bacteria samples taken every two months showed that health workers’ hands were cleaner when using the hand gel. However, the rates of infections in the ICUs did not show any clear relationship with the rate of hand gel usage. One unit also showed an increase in infections.

Rupp stated that better hand washing does not play a large enough role to cut down on infection. He said, “Hand hygiene is still important, but it’s not a panacea.” Rupp suggest other ways to help cut down on infection, including a better cleaning of hospital units, proper insertion and maintenance of catheters, and having doctors only prescribe antibiotics when necessary. He also called for hospital workers to cease wearing rings and to trim fingernails shorter than CDC recommendations (quarter of an inch).

Labels: hand gel, handwashing, hospital infections