Healthcare Risk Management 2005-10-01

Risk managers have spent the past several years promoting the idea of full disclosure and saying "I'm sorry" after an adverse event, but until now you've had to assure skeptics that apologies would reduce the number of lawsuits, not increase them.

Insurer sees good results from disclosure, apologies

One prominent insurer is seeing substantial improvements in how malpractice claims are handled by promoting a full-disclosure policy for physicians.

Fake JCAHO surveyors and false alarms still a problem

Hospitals are still at risk from people posing as surveyors from JCAHO and other accrediting organizations, but authorities say there are no new leads on who the frauds are or why they are trying to gain access. There is a heightened awareness of the impostors, however, as evidenced by recent false alarms.

Duke opens web site on recent mix-up in surgery

The Duke University Health System in Durham, NC, has responded to patients' efforts to gain more information about how two hospitals mistakenly washed surgical instruments in used hydraulic fluid instead of detergent and failed to notice the mix-up for weeks. Approximately 3,800 patients were exposed to the contaminated instruments during surgery.

PA hospital says results of CPOE reduce drug errors

A Pennsylvania hospital reports that it is seeing tremendous results from a computerized order entry system (CPOE), with an 85.7% decrease in improper doses and a 76.8% decrease in medication omissions.

Clinic Intranet encourages doctors to report concerns

When officials with the Everett (WA) Clinic wanted to change the organization's culture to emphasize patient safety, they realized that a key strategy was getting physicians and employees to report their concerns freely and without fear of backlash. Simple encouragement wasn't enough, so they turned to a more sophisticated solution that not only encourages more candid reporting but also consolidates what used to be a hodgepodge of data-collection methods.

Reader Question: Best to comply with the spirit of the 250-yard rule

Question: We're uncertain about whether the 250-yard rule still applies with EMTALA. When the final rule came out in 2003, we heard conflicting opinions about whether we were still responsible for providing emergency care within 250 yards of the hospital. Is there a definitive answer yet?

Legal Review & Commentary: Adverse drug interaction involving Coumadin results in $2.5 million Alabama verdict

News: A patient on Coumadin therapy was admitted after suffering from a fall. The attending physician prescribed Toradol and Phenergan, and the next day the patient was discharged home. The following day she fell into a coma and was readmitted. She died several days later. Her estate claimed that all the treating providers were negligent in their care and treatment of the decedent. The jury concurred and awarded her estate $2.5 million.

Legal Review & Commentary: Heparin use contributes to death: $1 million arbitratio

News: A middle-aged woman presented at the emergency department with flu symptoms. She was also disoriented. After initial tests were performed principally a spinal tap, in which blood was found she was admitted and was eventually transferred to the intensive care unit. It was suspected that she had suffered from a heart attack, so heparin was initiated. Approximately five days later, she was noted to have bilateral paralysis and was subsequently transferred to another facility, where she was also diagnosed as having lung cancer. She sued the hospital and attending physicians for failure to properly monitor her care and treatment, specifically claiming that the continuance of heparin was contraindicated.

Patient Safety Alert supplement

Saying 'I'm sorry' is starting to pay off with reduced lawsuits and legal costs