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Los Angeles Medical Malpractice Legal Blog

Medication errors, diagnostic mistakes most common EHR errors

Anyone in California seeking medical care has a right to assume their electronic health records (EHRs) will be accurate. Unfortunately, this isn't always the case. According to a study referenced in a healthcare industry publication, 30 percents of all patient harm events resulting in malpractice claims involving EHRs were related to medication errors. Diagnostic mistakes were also common.

For the study, researchers looked at medical malpractice claims over a two-year period and reviewed more than 200 claims involving EHR technology. Thirty-one percent of the claims were related to medication errors, another 30 percent were related to complications with treatment, and 28 percent were associated with diagnostic errors. The majority of the EHR errors that resulted in patient harm involved ambulatory care patients. Overall, ambulatory care EHR errors outnumbered inpatient care EHR-related issues for all medical services, except for nursing.

Delayed diagnosis tops allegation list in medical claims

People who work in emergency rooms and hospitals in California may be interested in a new report that gives insight into lawsuits filed against medical providers. The report found that more than 50% of allegations in civil claims filed against hospitals were due to a failure to make a prompt diagnosis. The report came from Coverys, a Boston-based provider of insurance.

Coverys looked at more than 1,300 closed emergency department-related medical malpractice cases. The cases analyzed were filed between 2014 and 2018. A delay of diagnosis was found to be the root cause in the majority of the examined cases. Not having a complete family history of the patient, failing to do a physical exam on the patient and ordering incorrect diagnostic tests were often the causes of the delayed or incorrect diagnosis. This lack of information is often due to the urgent nature of the emergency department.

New Harvard research model may help reduce prescription errors

Sound-alike/look-alike (SALA) medications cause an estimated 250,000 hospitalizations in California and across the United States each year. This number may soon be reduced thanks to a new model developed by Harvard Pilgrim researchers.

Medications that sound and look alike other medications can be inadvertently mixed up when they are being filled at the pharmacy. According to the American Society of Health-System Pharmacists (ASHP), thousands of people are injured each year due to these medications. In one SALA case in 2016, there were 55 reported cases of medication errors between the prescriptions Brilinta, a blood thinner, and Brintellix, an antidepressant. At least two serious adverse effects occurred due to these medications.

New study: surgeons' unprofessional behavior can harm patients

A study published in JAMA Surgery shows that those who undergo surgery are more liable to develop post-operative complications if the surgeons display unprofessional behavior. Seven million surgical procedures are performed every year in California and across the U.S., and unprofessional behavior is estimated to impact the lives of at least 500,000 patients annually.

From two medical centers that were part of the National Surgical Quality Improvement Program, researchers were able to study 202 reports of surgeons' unprofessional behavior. Examples of such behavior included disrespectful communication, poor care and the failure to follow through with professional responsibilities. Researchers also examined 13,653 patients, 1,583 of whom developed a complication within 30 days of their operation.

Erb's palsy: what it is and how it is treated in California

One to two out of every 1,000 newborns around the country develop a condition called Erb's palsy. This refers to palsy, or weakness, caused by damage to the upper nerves of the brachial plexus, a collection of nerves essential for movement and sensation in the arms, hands, and fingers.

The brachial plexus is located near the neck. Erb's palsy can often arise when doctors stretch a baby's neck to the side during a difficult delivery. Because the upper nerves are damaged, the infant will likely be able to move the fingers but not the shoulder. This is one symptom of Erb's palsy, along with weakness and loss of feeling in the arm.

California's malpractice statute of limitations

Proper health is essential to all aspects of life. For this reason, society looks to medical professionals to provide an exceptional level of service.

Unfortunately, not all medical professionals rise to the occasion, and such action may lead to harm. In those cases, parties may be able to bring medical malpractice cases against the physicians. However, there are a few important facts to understand, particularly regarding the statute of limitations.

Proving causation: an obstacle to many malpractice claims

Medical malpractice refers to the failure of a doctor, nurse or other medical professional to act according to a reasonable standard of care. If this leads to a patient being injured, then the patient may have good grounds for a claim. California residents should know that this second step, the step of proving causation, is not always easy.

There are many cases where a correlation may be pointed out but not causation. For example, someone undergoes surgery, the surgeon makes a mistake, and the person develops a complication. If that complication is known to arise even when all goes well with the procedure, then patients cannot assume a link between negligence and the injury.

Patients diagnosed with Alzheimer's might have something else

Many older adults in California suffering from memory loss receive an Alzheimer's disease diagnosis. According to new research about the causes of dementia, many of them might have a different form of dementia. Many types of neurodegenerative diseases fall under the label of dementia, and the symptoms of limbic-predominant age-related TDP-43 encephalopathy typically resemble Alzheimer's. Also referred to as LATE, the brain disease results from misshapen deposits of the protein TDP-43 whereas Alzheimer's arises from buildups of beta-amyloid protein on brain tissue.

Due to the differences, clinical trials for Alzheimer's treatments likely produced poor results because some of the participants actually had LATE instead of Alzheimer's. With the release of a new study about LATE, the lead author said that clinicians needed a better understanding of LATE to avoid misdiagnosing patients with Alzheimer's.

Reducing errors with medication reconciliation training

If the medications listed in a California patient's medical records are inaccurate, certain prescriptions could do more harm than good. This is why physician assistant student researchers from the University of Kentucky Markey Cancer Center have implemented a patient medication interview. The team is recommending standardized medication reconciliation training after a pre-implementation review identified several instances where medical record technicians were not prepared to properly conduct medication reconciliation procedures.

In addition to not receiving sufficient medication reconciliation training, some medical technicians were not familiar with electronic medical records for patients. The research team discovered instances of patients not being able to recall what medications they were taking as well. Some patients also failed to bring either their actual medication(s) to visits or an updated medication list.

How nurse anesthetists can identify and manage patient risks

Certified registered nurse anesthetists (CRNAs) provide an important service for patients in California undergoing procedures requiring the proper delivery of anesthesia. Yet these specialists also perform their services with a high degree of independence. This increases the odds of being subjected to a malpractice lawsuit if the patient outcome isn't as expected.

According to the Nurses Service Organization (NSO), medication mistakes, oversights with intervention or treatment and failing to monitor a patient's condition are among the more common anesthesia errors related to allegations made against nurse anesthetists. Based on a review of two case studies, the NSO has come up with suggestions for identifying and managing risks involving nurse anesthetists. The first suggestion is for CRNAs to keep their training, experience and skills up to date. It's also advised that nurse anesthetists always verify that informed consent is properly obtained.

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