Injury Law Report

Medication Errors Cause Serious Personal Injury - Part 2

ggarrow@garrowandevans.com (ggarrow) — Mon, 25 Jan 2010 14:36:50 -0500

Patients have been injured by taking the wrong medication simply because, in some instances, the doctor or other health professional's handwriting could not be read. The Institute for Safe Medication Practices reports that some abbreviations are more likely to be misinterpreted, misunderstood or simply written incorrectly than others. For this reason, it recommends that some medication abbreviations never be used by health professionals. Here's a chart that provides a list of abbreviations that should not be used by doctors. Click here.

Can Bad Handwriting Lead to Serious Personal Injury and Death?

ggarrow@garrowandevans.com (ggarrow) — Wed, 13 Jan 2010 00:00:15 -0500

Doctors and pharmacists often rely on the use of standard abbreviations in prescribing medication for their patients. But check out these most common abbreviation errors that can cause injury and death to unsuspecting patients:

Dangerous Abbreviations (National Coordinating Council for Medication Error Reporting Prevention)

Abbreviation	Intended meaning	Common Error
U	Units	Mistaken as a zero or a four (4) resulting in overdose. Also mistaken for "cc" (cubic centimeters) when poorly written.
µg	Micrograms	Mistaken for "mg" (milligrams) resulting in an overdose.
Q.D.	Latin abbreviation for every day	The period after the "Q" has sometimes been mistaken for an " I, " and the drug has been given "QID" (four times daily) rather than daily.
Q.O.D.	Latin abbreviation for every other day	Misinterpreted as "QD" (daily) or "QID" (four times daily). If the "O" is poorly written, it looks like a period or "I."
SC or SQ	Subcutaneous	Mistaken as "SL" (sublingual) when poorly written.
T I W	Three times a week	Misinterpreted as "three times a day" or "twice a week."
D/C	Discharge; also discontinue	Patient's medications have been prematurely discontinued when D/C, (intended to mean "discharge") was misinterpreted as "discontinue," because it was followed by a list of drugs.
HS	Half strength	Misinterpreted as the Latin abbreviation "HS" (hour of sleep).
cc	Cubic centimeters	Mistaken as "U" (units) when poorly written.
AU, AS, AD	Latin abbreviation for both ears; left ear; right ear	Misinterpreted as the Latin abbreviation "OU" (both eyes); "OS" (left eye); "OD" (right eye)
IU	International Unit	Mistaken as IV (intravenous) or 10(ten)
MS, MSO4, MgSO4	Confused for one another	Can mean morphine sulfate or magnesium sulfate

Medication Errors Cause Serious Personal Injury

ggarrow@garrowandevans.com (ggarrow) — Tue, 12 Jan 2010 18:16:56 -0500

Despite the health care industry's increasing reliance on technology, medication errors still causes significant injury --- and sometimes death --- to unsuspecting patients.

Some common types of medication errors include:

Incomplete patient information such as not knowing about a patients' allergies, other medicines they are taking, previous diagnoses, and lab results;

Unavailable drug information such as lack of up-to-date warnings;

Miscommunication of drug order, including poor handwriting, confusion between drugs with similar names, misuse of zeroes and decimal points, confusion of metric and other dosing units, and inappropriate abbreviations;

Lack of appropriate labeling as a drug is prepared and repackaged into smaller units; and

Environmental factors, such as lighting, heat, noise; and interruptions that can distract health professionals from their medical tasks.

The FDA began monitoring this serious problem nearly 20 years ago. Its website provides additional information on this topic.

Check our next post on how inappropriate abbreviations in orders written by doctors and pharmacists can cause death and serious injury.

DOJ Report: High Rate of Sexual Abuse and Rape of Jailed Juveniles

ggarrow@garrowandevans.com (ggarrow) — Fri, 08 Jan 2010 16:56:55 -0500

Is the Obama administration moving too slowly on reforms that would reduce sexual abuse and rape in U.S. prisons? A recent study from its own Department of Justice reports a "very high rate of staff sexual misconduct" against juvenile inmates. It cites two facilities in Virginia and one in Maryland, among others.

The Washington Post reports that the Justice Department "reported…12 percent of incarcerated juveniles, or more than 3,200 young people, had been raped or sexually abused in the past year by fellow inmates or prison staff.” USA Today reports, "In the worst facilities surveyed - in Indiana, Maryland, North Carolina and Texas - more than 30% of youths reported they had been sexually victimized.” Of the 195 juvenile facilities in the study 13 had an overall victimization rate that could be identified as “high rate”.

The overall victimization rate mostly is a measure that includes all reports of unwilling sexual activity between youth and all reports of staff sexual misconduct, regardless of the level of coercion and type of sexual activity.

The 13 “worse” facilities include the following:

In Loco Parentis (commitment made in place of the parent)

Pendleton Juv. Corr. Fac. (IN)

Corsicana Res. Trtmt. Ctr. (TX)

Victory Field Corr. Acad. (TX)

Indianapolis Juv. Corr. Fac. (IN)

Shawono Ctr. (MI)

Parental/guardian consent (parental consent to commitment)

Samarkand Yth. Dev. Ctr. (NC)

Culpeper Juv. Corr. Ctr., Long Term (VA)

Woodland Hills Yth. Dev. Ctr. (TN)

Backbone Mtn. Yth. Ctr., Swanton (MD)

L.E. Rader Ctr. (OK)

Bon Air Juv. Corr. Ctr. (VA)

Cresson Secure Treatment Unit (PA)

New Jersey Training School (NJ)

Child Loses Finger in Stroller - Injury Forces Recall

ggarrow@garrowandevans.com (ggarrow) — Sun, 15 Nov 2009 00:00:10 -0500

British stroller maker Maclaren failed to inform government regulators for 5 years about the danger of its strollers. The company has known for some time that the stroller hinges could cause serious injuries to the fingers of children.

In 2004, 23-month-old Connecticut toddler Carlos DeWinter lost his right pinky in a Maclaren Triumph stroller, according to court papers obtained by The New York Post. As his mother, Jane DeWinter, was shopping for a Maclaren Triumph stroller at a shop near Greenwich, NY, the dangers of this product became exceedingly clear. She began to do what any parent would do in testing the stroller. She examined the one-handed folding and unfolding mechanism and tried to lock the stroller into the open position. At that point, Carlos put his finger on the hinge, and his pinky finger was quickly amputated.

Despite two surgeries, the pinky finger could not be reattached.

The pricey stroller can be retrofitted by going to the Maclaren recall website and filling out a form for hinge covers. You also can call directly, but the company has been experiencing a high volume of calls.

Infants Injured by Maclaren Strollers - Fingers Amputated

ggarrow@garrowandevans.com (ggarrow) — Fri, 13 Nov 2009 18:21:07 -0500

According to recent press reports, the British stroller maker Maclaren knew for at least 5 years that its strollers could cut the tips off --- or completely amputate --- a child's fingers, but did nothing to alert the federal watchdog Consumer Products Safety Commission until very recently.

Conceding that the fingers of 12 children have been severed by the stroller's hinges when they were opened or closed, Maclaren agreed to a "voluntary recall" of all of its stroller models dating back to 1999. According to the CPSC, companies are required by federal law to report immediately on learning of a problem with a product that makes it a substantial or potential hazard. Because of Maclaren's years delay in doing so, it faces fines upwards of $1 million if it wants to continue marketing its popular strollers in the U. S. How could a stroller turn into a deadly device that cut off the fingers of children? More on a case that highlights this problem in our next installment of the Injury Law Report.

Preventing Injury --- No Sponge Should be Left Behind

ggarrow@garrowandevans.com (ggarrow) — Sat, 18 Jul 2009 20:00:22 -0500

It’s the entire hospital’s responsibility…and particularly the operating room team handling surgeries routinely…to ensure that foreign objects are not left inside of patients after surgery. Yes, it does occur. It’s rare, but leaving a sponge inside a patient after an operation is one of those errors that simply should not happen.

A hospital should regularly review its surgical count policy to ensure that everyone on the OR team accepts responsibility for preventing retained foreign objects. One nurse recommends involvement of the entire OR team. The surgeon as "captain of the ship" doctrine is fading from view. The nurse conducting the count, as well as others in the OR, are just as accountable as the surgeon.

If you are a medical professional, take a look at what this nurse and her medical team have done to improve patient safety and avoid medical negligence.

At minimum, a simple checklist must be used. “With 234 million operations performed worldwide every year, universal use [of a] checklist could save hundreds of thousands of lives,” says Atul Gawande, surgical team leader and an HMS associate professor of surgery at Brigham and Women’s Hospital in Boston. Solving the left behind sponge problem, as you can see, involves not only better sponge counting, but a system that reduces complications during surgery for all patients.

Pennsylvania Employee Law Blawg by Brian J. Pulito, Esq.

ggarrow@garrowandevans.com (ggarrow) — Thu, 09 Jul 2009 17:07:43 -0500

Sponges Left Inside After Surgery Can Cause Serious Injuries

ggarrow@garrowandevans.com (ggarrow) — Fri, 13 Feb 2009 16:53:27 -0500

Doctors leaving sponges inside patients after surgery? Does this really happen? Yes, and unfortunately, is not as unusual as you think. Some studies suggest that about 1,500 people in U. S. medical facilities have objects accidentally left inside them after surgery. Others suggest it could be higher --- as many as 3000 to 5000 cases yearly. The most common object left behind? Sponges. Amounting to about 2/3 of the surgical objects left inside of patients, these sponges can lead to pain, infection, bowel obstructions, problems in healing, longer hospital stays, additional surgeries and, in rare cases, death.

More than a few patients have complained about nagging pain after surgery that will not go away. Back pain, for example, when the surgical problem does not routinely cause back pain. Or multiple infections that have no clear explanation. These patients go back and forth to the doctor, and sometimes get labeled as complainers. Many live with pain for years. Only when an x-ray or MRi is taken do they find a left behind sponge or scapel or other surgical object. Sometimes emergency surgery is necessary to remove the foreign object, particularly if it has been there so long that the body has absorbed it (grown into or stuck to organs).

Is there anything begin done by the medical community to avoid this problem?

Avoid Salmonella Injury With a Few Precautions

ggarrow@garrowandevans.com (ggarrow) — Tue, 10 Jun 2008 00:00:10 -0500

Given the present Salmonella outbreak, the CDC recommends a few simple precautions to be taken while preparing foods.

* Refrigerate within 2 hours or discard cut, peeled, or cooked tomatoes.

* Avoid purchasing bruised or damaged tomatoes and discard any that appear spoiled.

* Thoroughly wash all tomatoes under running water.

* Keep tomatoes that will be consumed raw separate from raw meats, raw seafood, and raw produce items.

* Wash cutting boards, dishes, utensils, and counter tops with hot water and soap when switching between types of food products.

The above advice should be considered even after this present Salmonella outbreak is over.

Salmonella Injury or Death is Rare, but Early Treatment Strongly Urged

ggarrow@garrowandevans.com (ggarrow) — Mon, 09 Jun 2008 00:00:10 -0500

Can Salmonella kill people who contract it? Yes, but severe illness is rare and death even more unusual.

Here’s what the CDC says about what you can expect from Salmonella illness: Most persons infected with Salmonella develop diarrhea, fever, and abdominal cramps 12–72 hours after infection. Infection is usually diagnosed by culture of a stool sample. The illness usually lasts 4 – 7 days. Although most people recover without treatment, severe infections may occur. Infants, elderly persons, and those with impaired immune systems are more likely than others to develop severe illness. When severe infection occurs, Salmonella may spread from the intestines to the bloodstream and then to other body sites, and can cause death. In these severe cases, antibiotic treatment may be necessary.

Avoid Salmonella Injury With a Few Precautions

ggarrow@garrowandevans.com (ggarrow) — Sun, 08 Jun 2008 15:35:19 -0500

Salmonella Contamination of Tomatoes Causes Injuries Nationwide

ggarrow@garrowandevans.com (ggarrow) — Sun, 08 Jun 2008 14:41:46 -0500

Salmonella food poisoning from raw tomatoes has spread to 16 states, causing U.S. health officials to speculate that the outbreak might be nationwide.

Judging from the number of cases, the contamination appears to have first begun in Texas and New Mexico in mid-April. The latest statistics from those two states' health departments put the number of cases at 56 in Texas and 55 in New Mexico. An additional 50 people are suspected to have been poisoned with the Saint Paul strain of salmonella bacterium in Arizona, California, Colorado, Connecticut, Idaho, Illinois, Indiana, Kansas, Oklahoma, Oregon, Utah, Virginia, Washington and Wisconsin.

Are all tomatoes a problem? No, according to the CDC. The "problem" tomatoes at this time? Apparently Roma and Red Round.

What tomatoes appear to be safe for consumption? The FDA says cherry tomatoes, grape tomatoes, tomatoes sold with the vine attached, and homegrown tomatoes are not implicated in the outbreak.

How does an otherwise nutritional vegetable plant cause widespread illness? Basically, it's not a problem with the tomato itself but how it may be harvested or grown. The salmonella bacteria is common in animal feces. It is believed that the tomatoes somehow came in contact with animal feces during the growing or harvesting process. It is not common for tomatoes to cause this kind of illness without some external contamination source.

More about this outbreak in tomorrow's blog.

Trasylol Caused Injuries When Cheaper Alternatives Were Available

ggarrow@garrowandevans.com (ggarrow) — Wed, 05 Mar 2008 11:10:16 -0500

The risks associated with Trasylol --- kidney failure, serious heart problems and possibly death --- long ago could have been avoided if Bayer and the FDA would have heeded the warnings revealed in several studies. Why was Trasylol the drug of choice for controlling bleeding during surgery when cheaper alternatives were available? Recent studies state that the cost per dose of Trasylol is $1,300. The generic drug Amicar, which also limits bleeding in operations, is $11 per dose. The generic Cyklokapron, another option, is $44 per dose. According to the studies, neither of the generic drugs was linked to increased risk of kidney failure, heart attack or stroke. What is the reason for exposing the American public to increased risk at a high cost when cheaper and safer options are available?#

Were You Given Trasylol During Heart Surgery?

ggarrow@garrowandevans.com (ggarrow) — Tue, 04 Mar 2008 00:03:00 -0500

If you had open heart surgery prior to November 2007, you may have received Trasylol without even knowing it. Most likely you received a drug to control bleeding during the operation. Your doctors made the decision to use Trasylol or a similar drug, and it’s not the type of decision about which you would have been consulted. So how can you find out if you or a loved one received the drug? The first place to check would be the medical records. Obtaining a copy of the medical records of the surgery generally is not difficult, but sometimes the copying charges can be a bit expensive (for example, $1.00 per page).

In many states, you may be able to obtain your first set of medical records or a loved one records without charge. To hold down the costs, just ask for copies of the medical records of the operation and not any other medical records that the hospital may have for the person in question. You can obtain the other medical records later if you really need them.

Once the records are obtained, you will need a professional to review them. A lawyer may be able to look at them and tell if Trasylol was given. If you or a loved one have symptoms consistent with the problems associated with Trasylol such as unexpected kidney damage (or death of a loved one), then a lawyer should recommend that the medical records be reviewed by a medical expert. #