A recent worldwide study has shown that more women are dying in childbirth in Canada, the US and Denmark. The study was funded by Bill Gates' Foundation to better understand the current rates of women dying from complications of pregnancy in several countries.
I couldn't help but reflect on these results reported on the Medscape Nurses website. As a veteran perinatal nurse who has experienced firsthand the circumstances of women dying while giving birth, and knowing that many "close calls" are only survivals because of the experience and skill of the health care team, I have to think that changes to health care delivery is costing women their lives.
Senior nurses always play a major role in any life threatening situation. The hospital budget may welcome two new nurses for the price of one senior nurse but is this budgetary decision costing patients their health and maybe even their lives? A chart review and interviews can quickly uncover just who was caring for that patient and if poor decisions were made by rookie staff. The right questions during discovery can reveal circumstances and events which secure the chain of events and the consequences for that woman and her baby.
A maternal death is always tragic. Maternal disability from complications of childbirth is also tragic. Only intimate knowledge of the entire health care team and their approach will uncover the merit of pursuing legal action. An increase in incidents means more clients seeking legal advice from a complete team approach. Are you ready?
Showing posts with label lawsuits. Show all posts
Showing posts with label lawsuits. Show all posts
Friday, April 16, 2010
Thursday, October 1, 2009
Should we believe what we read in professional journals?
When I pick up a professional journal, I am already convinced that what I read is based on impartial research and evidence. But should I be?
My assumption that articles are being provided by professionals with the public interest as a priority is the wrong assumption. I was unaware until just recently that pharmaceutical companies and medical device companies can be very generous in order to receive positive press about their latest drug or gadget. While, as a health care professional, I would like to believe that other health care professionals can provide unbiased research despite the gifts, I am not that trusting of human nature.
To be fair, journals are taking steps to prevent this practice of padding their publications with articles favouring the “latest and greatest.” Until it becomes routine, and every journal checks the background of their authors, I would suggest a double-check on that research your case may depend on.
My assumption that articles are being provided by professionals with the public interest as a priority is the wrong assumption. I was unaware until just recently that pharmaceutical companies and medical device companies can be very generous in order to receive positive press about their latest drug or gadget. While, as a health care professional, I would like to believe that other health care professionals can provide unbiased research despite the gifts, I am not that trusting of human nature.
To be fair, journals are taking steps to prevent this practice of padding their publications with articles favouring the “latest and greatest.” Until it becomes routine, and every journal checks the background of their authors, I would suggest a double-check on that research your case may depend on.
Sunday, August 23, 2009
Avandia Increases Risk to Type 2 Diabetics
In a recent study by Toronto’s Clinical Evaluative Sciences, the drug Avandia (rosiglitazone) demonstrated an increased risk of heart failure and death when compared to the other drug for the treatment of Type 2 diabetes, Actos (pioglitazone).
As published in the British Medical Journal, the study examined the records of 40 000 patients treated with these drugs; 23% were less likely to be hospitalized for heart failure and 14% less likely to die when given Actos (pioglitazone) instead of Avandia (rosiglitazone). This has major implications for the millions of patients treated for Type 2 diabetes in the last several years. Based on the study, for every 120 people taking Avandia, one more was hospitalized and for every 269 people, one would die.
The makers of Avandia, GlaxoSmithKiline, have initiated their own study in response. The results will not be known for several years probably after the two drugs become available as generic formulas.
Dr. Juurlink, principal investigator, has dismissed criticisms from GlaxoSmithKline that the study may have only dealt with patients who were sicker. He points out that you would expect to see more heart attacks if the patients taking Avandia were sicker yet the study revealed that there was no difference in heart attack rates between the two groups.
As Dr. Steven Nissen, chair of cardiovascular medicine at the Cleveland Clinic, has said, “I guess the final word would be: Who would want to take the chance? Why would you? So from my perspective while you can argue that it may not end the story, in the meantime, what should physicians do? And I think the answer is they should use the safer of the two drugs.”
As published in the British Medical Journal, the study examined the records of 40 000 patients treated with these drugs; 23% were less likely to be hospitalized for heart failure and 14% less likely to die when given Actos (pioglitazone) instead of Avandia (rosiglitazone). This has major implications for the millions of patients treated for Type 2 diabetes in the last several years. Based on the study, for every 120 people taking Avandia, one more was hospitalized and for every 269 people, one would die.
The makers of Avandia, GlaxoSmithKiline, have initiated their own study in response. The results will not be known for several years probably after the two drugs become available as generic formulas.
Dr. Juurlink, principal investigator, has dismissed criticisms from GlaxoSmithKline that the study may have only dealt with patients who were sicker. He points out that you would expect to see more heart attacks if the patients taking Avandia were sicker yet the study revealed that there was no difference in heart attack rates between the two groups.
As Dr. Steven Nissen, chair of cardiovascular medicine at the Cleveland Clinic, has said, “I guess the final word would be: Who would want to take the chance? Why would you? So from my perspective while you can argue that it may not end the story, in the meantime, what should physicians do? And I think the answer is they should use the safer of the two drugs.”
Monday, August 17, 2009
Changes in Health Care
Health care as an industry is changing in Canada and the US. Budget concerns seem paramount and are apparently the stimulus for these changes. It must be remembered though that fiscal responsibility should not compromise patient care. Already in my nursing practice, I see incidents that lead to unsafe situations for patients and staff. Professional responsibility forms are being filled out at an alarming rate as staff try to stop the tide of unsafe health care sweeping Canada.
This past weekend, the CEO of Alberta Health Services was quoted as saying that just because a unit had a registered nurse running it in the 1990s does not mean it needs to be run by one now. He states that things must change not stay the same. Dr. Duckett could not be more wrong! I shudder to think of the professional liability of health care workers who make mistakes because they are not trained to see the entire medical picture. And let’s not forget the human price of those mistakes—the patient, the family and the staff all pay a high emotional and psychological price for a negative impact on a poorly managed case.
A registered nurse has always been in charge of a hospital unit. Not because of her special status in the hierarchy but because of her experience, skills and education. To have the head of Alberta Health Services not comprehend (or appreciate) the importance of this role is shocking. It also means that negligence and malpractice is about to become a common theme in Alberta trial law.
I wonder if Dr. Duckett has budgeted for increased insurance , settlements and claims?
This past weekend, the CEO of Alberta Health Services was quoted as saying that just because a unit had a registered nurse running it in the 1990s does not mean it needs to be run by one now. He states that things must change not stay the same. Dr. Duckett could not be more wrong! I shudder to think of the professional liability of health care workers who make mistakes because they are not trained to see the entire medical picture. And let’s not forget the human price of those mistakes—the patient, the family and the staff all pay a high emotional and psychological price for a negative impact on a poorly managed case.
A registered nurse has always been in charge of a hospital unit. Not because of her special status in the hierarchy but because of her experience, skills and education. To have the head of Alberta Health Services not comprehend (or appreciate) the importance of this role is shocking. It also means that negligence and malpractice is about to become a common theme in Alberta trial law.
I wonder if Dr. Duckett has budgeted for increased insurance , settlements and claims?
Wednesday, August 12, 2009
Can there be a budget during a pandemic?
It is well established that we are about to face a flu season that will take a heavy toll on health care workers as well as the general public. Meetings are held to provide information and plans on how to cope, but there are also phrases like “we still have stay within budget” from administration. This sets a dangerous environment where the cost of caring for the ill and dying takes precedent over the actual care needed. Can there be a budget during a pandemic? Bureaucrats and politicians think so. Front line health care providers do not. Managers are pressured to keep their budgets under control under all circumstances.
As a nurse, I have to question just how safe patient care will be during this crisis. Increased staff shortages will be a certainty with health care workers ill themselves or caring for family members. Paying overtime for replacement staff is already discouraged so how do units replace badly needed staff to care for the ill in the hospitals? There will be a lack of equipment as unit budgets are stretched to pay for supplies. There are already reports of defective protective equipment from poor quality sources and from being stored under the wrong conditions.
The fallout from the H1N1 pandemic will resound for years. No doubt it will also find its way into lawyers’ offices and court rooms. Perhaps there the question of how much a pandemic will cost will be answered.
As a nurse, I have to question just how safe patient care will be during this crisis. Increased staff shortages will be a certainty with health care workers ill themselves or caring for family members. Paying overtime for replacement staff is already discouraged so how do units replace badly needed staff to care for the ill in the hospitals? There will be a lack of equipment as unit budgets are stretched to pay for supplies. There are already reports of defective protective equipment from poor quality sources and from being stored under the wrong conditions.
The fallout from the H1N1 pandemic will resound for years. No doubt it will also find its way into lawyers’ offices and court rooms. Perhaps there the question of how much a pandemic will cost will be answered.
Wednesday, July 22, 2009
Personal Injury Lawyers Need to Consider This
A personal injury claim can be a complicated process. A client can present with injuries that seem to have been minor but turned much worse. Under the current conditions of an overloaded, budget-cutting health care system like the one we currently have in Canada, as an attorney, you need to consider the timeline of medical care provided to your client.
It is not unusual for me as a practising RN to hear of patients being delayed care that would have made receovery that much easier and faster. Only ten days ago, I heard from a friend who went to see a physician for a suspected broken ankle. The wait to see a doctor was five hours with no pain relief or comfort measures. He was given a requisition for an x-ray. A full week later, he receives a call to return for a cast... he really does have a broken ankle. The long term consequences of having a fracture in joint that will now not heal properly are immense. Surgeries, physiotherapy, degenerating joint health all that could have been prevented by an immediate diagnosis and treatment with a cast.
Is your client a pharmaceutical firm facing claims about side-effects and adverse reactions involving long-term injuries? Evaluate how quickly the client was seen by a doctor, how soon were they given treatment for the symptoms? Did they spend days in a hallway in a crowded emergency room?
Unfortunately, this is not an unknown story in hospitals and doctors' offices. Perhaps you have more than an injury claim... perhaps you also have a negligence claim against a hospital.
It is not unusual for me as a practising RN to hear of patients being delayed care that would have made receovery that much easier and faster. Only ten days ago, I heard from a friend who went to see a physician for a suspected broken ankle. The wait to see a doctor was five hours with no pain relief or comfort measures. He was given a requisition for an x-ray. A full week later, he receives a call to return for a cast... he really does have a broken ankle. The long term consequences of having a fracture in joint that will now not heal properly are immense. Surgeries, physiotherapy, degenerating joint health all that could have been prevented by an immediate diagnosis and treatment with a cast.
Is your client a pharmaceutical firm facing claims about side-effects and adverse reactions involving long-term injuries? Evaluate how quickly the client was seen by a doctor, how soon were they given treatment for the symptoms? Did they spend days in a hallway in a crowded emergency room?
Unfortunately, this is not an unknown story in hospitals and doctors' offices. Perhaps you have more than an injury claim... perhaps you also have a negligence claim against a hospital.
Sunday, June 28, 2009
Physical Condition of Hospitals
When was the last time you spent time in a hospital ward looking closely at the physical condition of the building?
Did you notice the chipping paint? The peeling wallpaper? The cracks in the floors? The stained ceiling tiles? The upholstery that was worn thin and so stained it can't be cleaned anymore? The blinds that are missing slats and won't open or close? The curtains that are worn and stained? The bed linens that are stained? The clutter of equipment in the hallways and rooms?
I notice these things every time I step into the hospital ward I work on. I do my best to make sure stained linen is changed before my patient ever goes near the bed. That stained curtains are taken down and replaced. But it is impossible to hide the deterioration of everything else.
The patients who are admitted to hospital are acutely ill or requiring some immediate intervention. Mothers are arriving to deliver their babies. The physical environment should be one of impeccable cleaniless and condition. Yet Canadian hospitals are often falling far short of this standard under the guise of fiscal restraint. Even if the money would be spent to restore the units, there isn't any place to physically put patients while the work is done.
Can a hospital defend its infection rate and care when it can't provide patients with an environment that promotes health and healing?
Did you notice the chipping paint? The peeling wallpaper? The cracks in the floors? The stained ceiling tiles? The upholstery that was worn thin and so stained it can't be cleaned anymore? The blinds that are missing slats and won't open or close? The curtains that are worn and stained? The bed linens that are stained? The clutter of equipment in the hallways and rooms?
I notice these things every time I step into the hospital ward I work on. I do my best to make sure stained linen is changed before my patient ever goes near the bed. That stained curtains are taken down and replaced. But it is impossible to hide the deterioration of everything else.
The patients who are admitted to hospital are acutely ill or requiring some immediate intervention. Mothers are arriving to deliver their babies. The physical environment should be one of impeccable cleaniless and condition. Yet Canadian hospitals are often falling far short of this standard under the guise of fiscal restraint. Even if the money would be spent to restore the units, there isn't any place to physically put patients while the work is done.
Can a hospital defend its infection rate and care when it can't provide patients with an environment that promotes health and healing?
Friday, June 19, 2009
Canadians give clear message on health care
As early as July 2008, Leger Marketing did a study which showed 70% of Canadians believe prescription medications are prescribed more often than necessary. The same study showed one third of Canadians do not believe the Canadian health care system meets their needs.
The lack of confidence in health care to meet their needs is a powerful commentary on the current state of healthcare in Canada. Recent changes to some provincial health care systems will result in even less ability for Canadians to access the care they need, when they need it.
Patients who enter a system when they are already doubting their care may be more likely to seek compensation for negligent care. Adding to this atompshere is the lack of trust simmering between front line staff and management. Internal strife directly impacts patient care-- and the patients know it.
A legal nurse consultant assists attorneys faced with these claims primarily through careful analysis of the choronology and the care records to determine if the facts translate into merit. This "weeding out" process helps reduce costs while also establishing a base for claims which move forward.
The lack of confidence in health care to meet their needs is a powerful commentary on the current state of healthcare in Canada. Recent changes to some provincial health care systems will result in even less ability for Canadians to access the care they need, when they need it.
Patients who enter a system when they are already doubting their care may be more likely to seek compensation for negligent care. Adding to this atompshere is the lack of trust simmering between front line staff and management. Internal strife directly impacts patient care-- and the patients know it.
A legal nurse consultant assists attorneys faced with these claims primarily through careful analysis of the choronology and the care records to determine if the facts translate into merit. This "weeding out" process helps reduce costs while also establishing a base for claims which move forward.
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