Wrong-Site Surgery - It Just Should Never Happen

Posted on behalf of Daniel Clayton, selected as the ‘Nashville Best Lawyers Medical Malpractice Law – Plaintiffs Lawyer of the Year’ for 2012, in Medical Malpractice

A wrong-site surgery is a type of surgical error in which a surgeon either accidentally operates on a healthy body part or negligently operates on the wrong patient. These errors seem far-fetched and rare, but there is a report out of Chicago that wrong-site surgeries happen approximately 40 times per week across the country.
These types of surgical errors have been addressed previously. The Joint Commission Center for Transforming Healthcare examines hospitals and health care facilities in order to determine if they are following protocols. If the Commission is satisfied that these universal surgery protocols are being followed, it will accredit the hospital. Thus far, the Commission has accredited over 19,000 facilities across the country.
So what are these procedures and why is the rate of wrong-site surgery still so high? One procedure is to mark the correct body part with a marker prior to surgery. While this should decrease the number of surgical errors, the Chicago Sun-Times reports that some hospitals use markers with washable ink. When the patient is being prepared for surgery, the ink washes away and the risk of a wrong-site surgery is increased.
The Commission has also recommended that everyone take a brief timeout before the surgery starts double check what procedure will be done and make sure that it will be done on the correct patient. The Commission says, however, that not all surgeons and surgery support staff fully participate in the time out process, increasing the risk to patients.
Overall, the Commission found 29 specific places in which hospitals and surgeons are allowing errors in the process. The Commission believes these areas are a cause of the high rate of wrong-site surgeries.
Source: Chicago Sun-Times, “Surgical errors happen as much as 40 times a week around country despite guidelines,” Monifa Thomas, 4 July 2011
Tags: Medical Malpractice, Surgical error, Wrong-Site Surgeries

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Truck Drivers Using Cell Phones - Ban It

Posted on behalf of Daniel L. Clayton, selected as the ‘Nashville Best Lawyers Medical Malpractice Law – Plaintiffs Lawyer of the Year’ for 2012, in Trucking Accidents

After a tragic truck accident, the National Transportation Safety Board asked the federal government to make a law that would ban all truckers from using cellphones. That request became a reality when the federal government enacted a handheld cellphone ban for all commercial vehicle drivers.
Under this new ban, those truck drivers who are caught talking on their cellphone while driving can be fined up to $2,750. Additionally, trucking companies can also get in trouble for allowing their drivers to talk on the phone while driving. According to sources, if it’s learned that a company is allowing the use of handheld cellphones, the company can end up being fined up to $11,000.
This cellphone ban also includes all commercial vehicle drivers, like truck drivers, taxi drivers, limousine drivers and bus drivers. However, while handheld phones are banned, drivers can still use hands free phones.
And while the ban does come with some pushback from truck drivers who claim their phones are their only way to connect with family and maintain contact with the rest of the world, some companies are totally on board with the idea. One taxi company owner said that even before the ban, he never allowed his drivers to talk on their phones while driving.
“You take your eyes off the road for a second and anything can happen,” the owner said.
The hope is that with this ban, drivers will not be driving distracted by their cellphones. In turn, this could result in less truck accidents in not only Tennessee, but around the rest of the country too.
Source: KAAL, “Federal Law Bans Handheld Cell Phones,” Gordon Severson, Jan. 4, 2012

Tags: Cellphone Use, Distracted Drivers, Trucking Accidents

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Avoiding Surgical Errors

Posted on behalf of Daniel Clayton, selected as the ‘Nashville Best Lawyers Medical Malpractice Law – Plaintiffs Lawyer of the Year’ for 2012, in medical malpractice

A former Army mechanic from Ohio was recently awarded $275,000 in a medical malpractice case after a VA surgical team left two 11 x 14 inch towels in his body after removing a cancerous kidney.
The surgical oversight required 47-year-old Robert Sanner to undergo multiple follow-up exams, including a CT scan that revealed the error, then two additional surgeries ─ first to remove the towels and later to repair an incisional hernia caused by the second surgery, according to an account on Outpatientsurgery.net. Sanner missed a year of work due to the surgical errors.
I have seen the devastating effects of Surgical errors- operating on the wrong leg, leaving in sponges due to an incorrect sponge count, leaving a surgical instrument in, operating on the wrong back level and, perhaps the saddest, one dear lady who went in to have her cancerous kidney removed, but the surgeon removed her good kidney. Despite a vigorous and determined fight against the cancer, she died about a year and a half later. If he had removed the cancerous kidney – it would have been a total and complete cure.
“Never-Events” More Common Than Expected
The National Quality Forum lists Sanner’s situation as a “never-event” ─ a preventable medical mistake that should never happen. Others include operating on the wrong body part, as well as medical mistakes that lead to death or serious personal injury. But how common are these incidents?
Towels, sponges, needles and other surgical instruments are left inside one of every 1,000 to 1,500 people who undergo abdominal surgery, according to Findarticles.com. The problem is the traditional counting procedure, which is subject to human error.
Counting Objects is Useful but Flawed
While it is widely used, counting relies on total accuracy in a chaotic environment characterized by distraction, interruption and strict time constraints. To test its reliability, researchers at a major academic health care center in New York recently reviewed surgical incident reports from 2000 through 2004. The findings were:
•· Among 153,263 surgical procedures, there were 1,062 counting discrepancies ─ a rate of 0.69 percent
•· One in 7,000 surgeries involved a retained item ─ or one in 70 counting discrepancy cases
•· Final count discrepancies prevented 54 percent of retained items
•· Count discrepancies increased with the length of the surgery, the number of nursing teams and when surgery was performed on an emergency basis, or on a weekend or holiday
Counting plays an essential role in preventing retained objects from being left in surgical patients, but the practice has serious limitations. Additional safety measures, such as mandatory x-rays during long or emergency procedures and equipment screening systems that detect surgical objects are necessary to improve patient safety.
Source: “Lessons Learned From Retained Object Lawsuit,” Outpatient Surgery, 12/16/11

Tags: medical malpractice, surgical errors

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Driver Fatigue Responsbile for many Bus and Truck Accidents

On behalf of Daniel Clayton posted in Trucking Accidents

Several disturbing commercial bus accidents over the past several months have put the spotlight on federal regulations and industry practices in both the motor coach and commercial trucking industries. According to the National Transportation Safety Board (NTSB), studies show that between 13 and 31 percent of commercial bus and trucking accidents are caused by driver fatigue — and the industries’ economic models probably contribute directly to the problem.
Bus and trucking companies work to strict schedules, and those schedules often require overnight driving. According to sleep scientists, even experienced drivers with no other medical issues will always find it a challenge to stay awake on overnight runs — especially when driving between 4:00 and 6:00 a.m. when the body’s natural rhythms are urging us to sleep.
Added to that is a high rate of obesity and sleep apnea among commercial bus and truck drivers. Those medical issues can make it even harder for drivers to remain awake and alert in challenging conditions, according to transportation and public safety consultant Darrel Drobnich, who is an expert on driver fatigue.
“No matter how much sleep you have had, no matter how young you are, that time of day is extremely dangerous to drive a motor vehicle,” he explains.
Sleep scientists, labor leaders and safety advocates say that the motor coach and trucking industry policies result in far too many drivers on the road with too little rest
Federal regulations mandate a certain amount of rest for commercial drivers, although the rules vary between commercial truck drivers, bus drivers and others. For example, commercial truckers with Class A licenses are permitted to drive no longer than 11 hours before they must take a 10-hour break. The 11-hour driving period can be extended slightly if the driver takes off-duty breaks within the shift rather than driving straight through, but they can only be on duty for a total of 14 hours before they must go off duty.
Bus drivers are only allowed to drive for 10 hours before they must go off duty for 8 hours, but taking breaks can extend the total amount of time they are on duty. Even if their on-duty time isn’t extended, bus drivers can drive for 10 hours, take 8 hours off, and then drive for another 10 hours — meaning they can legally work two full 10-hour shifts in only 28 hours.
“The consequence is an entire industry populated by people not getting enough sleep,” said Larry Hanley, president of the Amalgamated Transit Union, which represents commercial bus drivers.
Of course, challenging schedules and tight profit margins do encourage some companies and drivers to ignore the rules. After bus or trucking accidents, it is often discovered that drivers were on the road for far longer than was legal — sometimes using false log books to deflect scrutiny.
The NTSB is urging the government to replace paper log books with electronic devices that keep track of how many hours drivers are actually on the road. Other proposals include mandating more frequent rest stops during shifts or even requiring a second driver in every truck.
Source: Associated Press, “Fatal Va. bus crash shines light on driver fatigue,” Joan Lowy, June 11, 2011

Tags: Bus Accidents, Causes of Trucking Accidents, Driver Fatigue, NTSB, Trucking Accidents

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Accident Fatalities Going Up in Tennessee

On behalf of Daniel Clayton posted in Wrongful Death

Recently, I posted on the fact that law enforcement in Tennessee was going to be cracking down on risky driving behaviors in the hopes of combating the traffic fatality toll that has been on the increase so far this year. At that time, Kendell Poole, director of the Governor’s Highway Safety Office in Nashville reported that there had already been 238 fatal motor vehicle accidents in the state. Now, just a few short weeks later, that total number has already climbed over 300.
In response to this drastic increase, aside from extra enforcement, Tennessee motorists may have also noticed electronic message boards along the interstates showing the current total number of people who have died in a motor vehicle accident so far this year. Last Friday the sign reported the number was 317. By Monday it was already at 331.
When looking at what is causing this increase — after so many years of decreases — Poole points to the fact that the weather turned warmer earlier this year, which means more people are out and about. Specifically, more people are also out on their motorcycles.
Statistically speaking, motorcyclists and drivers not wearing seat belts have accounted for 41 percent more deaths so far for this year than in 2011.
Poole also said that his office is really concentrated on getting the message of safe driving to men between the ages of 18 and 34. He said this demographic is more likely to not wear a seat belt and to drink and drive, which greatly increases the risk of getting into an accident.
Source: The Tennessean, “Death toll soars on Tennessee’s roads,” Brian Haas, May 9, 2012

Tags: Car Accidents, Motorcycle accidents, Trucking Accidents, Wrongful Death

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Stability Control for Trucks and Buses

Posted on behalf of Daniel Clayton, selected as the ‘Nashville Best Lawyers Medical Malpractice Law – Plaintiffs Lawyer of the Year’ for 2012, in Trucking Accidents

The National Highway Traffic Safety Administration recently proposed making it a regulation for all large trucks and buses to come with electronic stability control. The idea is that this safety system, which became a requirement this year for passenger cars, light trucks and SUVs, could result in the prevention of thousands of crashes and hundreds of personal injuries throughout the country.
The safety system works by automatically applying the brakes to individual wheels on a truck or bus, including a motor coach, as soon as a driver starts to lose control. This electronic stability control, which can sense when the driver is about to lose control, would then help to stop the vehicle from rolling over.
This stability safety system would also kick on to prevent a truck or bus from skidding on a slippery road, or from flipping over when a driver suddenly jerks a wheel to avoid an object in a roadway.
According to the NHTSA, the technology could end up preventing more than 2,300 crashes a year that involve larger buses and trucks. This in turn would result in preventing somewhere between 649 and 858 injuries and another 49 to 60 deaths.
So far, safety advocates are fans of this recent proposal, with the president of Advocates for Highway and Auto Safety really driving home how important this would be in terms of buses as millions of families use motor coaches as a way to travel.
Of course, while rollovers are not the only type of accidents involving trucks and buses, they are some of the deadliest. But what do you think about this proposal? Should it be mandated? What other steps can be taken to reduce the number of crashes involving large trucks and buses in Tennessee?
Source: Business Week, “Gov’t proposal aimed at bus, truck rollovers,” Joan Lowy, May 16, 2012

Tags: Bus Accidents, Rollover Accidents, Trucking Accidents

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The Role Fatigue Plays in Surgical Errors

Whenever anyone goes in for any type of surgical procedure, it’s natural to want to believe that the surgeon involved is well-rested and that fatigue would not be impairing their decisions. And while this may be the case with many surgeons, a recent study looking at first-year surgical residents found the opposite to be a true roughly a quarter of the time. In fact, 27 percent of the time, their fatigue was on par with the mental “impairment” of someone who is intoxicated. Naturally, this level of fatigue also increased their hypothetical chances of making medical mistakes.
The study examined orthopedic surgical residents at two separate hospitals. These residents were initially asked questions related to their sleep and exercise habits, as well as their use of any sedatives, alcohol or other stimulants. In addition, the residents all wore an “actigraphy” type of wristwatch that would record a person’s movement in order to determine their level of activity.
From here, researchers found that on average, residents get roughly five and a half hours of sleep and were only using about 70 percent of their mental effectiveness about a quarter of the time. By only using 70 percent of their mental effectiveness, researchers also found there to be a 22 percent greater risk of them making some sort of a medical mistake than those doctors who had gotten enough rest.
However, when looking at this study and the amount of risk, it is important to note that the risk is a prediction that was based on how tired the residents were. The actual number of medical mistakes was not assessed in this study.
This study was also started in 2010 and went into 2011. During this time, rules were put in place that bars a first-year resident from working longer than a 16 hour shift. And while one can argue that the rule was put in place as a way to try and combat fatigue in the field, researchers from this study point to the fact that there is a good chance that more still needs to be done to prevent fatigue.
Source: Reuters, “Tired surgical residents may up error risk: study,” Andrew M. Seaman, May 21, 2012
Tags: Medical Malpractice, Surgical Error

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