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.
Showing posts with label legal nurse consultant. Show all posts
Showing posts with label legal nurse consultant. Show all posts
Friday, June 19, 2009
Monday, June 15, 2009
Defective Implanted Defibrillator Leads
A common procedure for people with irregular or unusual heart rhythms often receive defibrillators implanted into their chest to provide a necessary shock to maintain a healthy heart rhythm whenever necessary. It was a big, and unwelcome, surprise when the manufacturer, Medtronic, announced last year that their Sprint Fidelis leads were malfunctioning at rates that were higher than other leads. These defective leads were pulled from the implant market but cannot be changed or removed without a real risk of harm to the patient. Numbers vary depending on the source, but in the range of 87.9% to 94.3% of the leads are still in place in patients.
In May of 2009, the Heart Rhythm Society, an American cardiac physicians’ group representing MDs who implant and extract defibrillators and their associated leads, issued policy statements calling for hospitals to better police the experience and training of the surgeons who extract defibrillator leads. This is especially important given the risk to the patient to remove or change these defective leads. HRS also issued a statement calling for companies that produce the leads to do be more accountable in the tracking the performance of their devices once they’re on the market.
A legal nurse consultant can provide information for a case where there may be a suspicion of a malfunctioning cardiac defibrillator, its leads or an injury that occurred while the leads were being removed. One of the questions that must be answered is the experience of the doctor who connected or extracted the leads. While the new guidelines have yet to be determined in Canada, the training and experience of the physician may be relevant to the injury. Legal nurse consultants for the defence may be able to raise the level of experience as an avenue of defence of the doctor. Legal nurse consultants for the plaintiff will question the lack of experience of the physician as evidence of negligence.
The incidence of medical device failure is a serious one. And is definitely the type of case requiring the expertise of a legal nurse consultant.
In May of 2009, the Heart Rhythm Society, an American cardiac physicians’ group representing MDs who implant and extract defibrillators and their associated leads, issued policy statements calling for hospitals to better police the experience and training of the surgeons who extract defibrillator leads. This is especially important given the risk to the patient to remove or change these defective leads. HRS also issued a statement calling for companies that produce the leads to do be more accountable in the tracking the performance of their devices once they’re on the market.
A legal nurse consultant can provide information for a case where there may be a suspicion of a malfunctioning cardiac defibrillator, its leads or an injury that occurred while the leads were being removed. One of the questions that must be answered is the experience of the doctor who connected or extracted the leads. While the new guidelines have yet to be determined in Canada, the training and experience of the physician may be relevant to the injury. Legal nurse consultants for the defence may be able to raise the level of experience as an avenue of defence of the doctor. Legal nurse consultants for the plaintiff will question the lack of experience of the physician as evidence of negligence.
The incidence of medical device failure is a serious one. And is definitely the type of case requiring the expertise of a legal nurse consultant.
Saturday, May 30, 2009
What happens when entire health care portfolios are gone?
Recent administrative changes to Alberta Health Services are bringing changes to the organization. Within the Calgary area, for example, Women’s Health Services no longer exist. And the word is that this may be slated to happen province-wide.
The immediate effects are seen in the absence of top level management positions to advocate for health care services geared toward women’s health care. At a time of record numbers of maternity cases, maternity units in dire need of renovation and updating and increasing demand for gynecology services, there is no leadership with a specific interest in this specialty. There has also been a hiring freeze placed on nursing staff and support staff in these areas despite clear indications that there are understaffing issues and pending retirements.
What does this mean for medical liability attorneys? It means there are going to be cases emerging as a direct result of insufficient resources to provide the standard of care expected in Canadian hospitals. The staff will not available to maintain the current standard of nurse-patient ratios. Less qualified and experienced staff will be hired as a cost-cutting bridging measure which puts patients at risk. The equipment necessary to monitor patients for their safety and best outcome will either not be available or will be outdated and not meet current standards. The physical environment of the hospital patient will deteriorate—even to the point of being dangerous from an infectious disease standpoint with such things as cracks in the floors under delivery beds and beds unable to be cleaned to acceptable standards because they are need of replacement after years of use and breakdowns.
Nurses are aware of the shortfalls of working within a hospital environment during times of economic downturns while patient populations and acuity rise. Having that experience and perspective will assist you in evaluating and building your next case involving women’s health gone wrong.
The immediate effects are seen in the absence of top level management positions to advocate for health care services geared toward women’s health care. At a time of record numbers of maternity cases, maternity units in dire need of renovation and updating and increasing demand for gynecology services, there is no leadership with a specific interest in this specialty. There has also been a hiring freeze placed on nursing staff and support staff in these areas despite clear indications that there are understaffing issues and pending retirements.
What does this mean for medical liability attorneys? It means there are going to be cases emerging as a direct result of insufficient resources to provide the standard of care expected in Canadian hospitals. The staff will not available to maintain the current standard of nurse-patient ratios. Less qualified and experienced staff will be hired as a cost-cutting bridging measure which puts patients at risk. The equipment necessary to monitor patients for their safety and best outcome will either not be available or will be outdated and not meet current standards. The physical environment of the hospital patient will deteriorate—even to the point of being dangerous from an infectious disease standpoint with such things as cracks in the floors under delivery beds and beds unable to be cleaned to acceptable standards because they are need of replacement after years of use and breakdowns.
Nurses are aware of the shortfalls of working within a hospital environment during times of economic downturns while patient populations and acuity rise. Having that experience and perspective will assist you in evaluating and building your next case involving women’s health gone wrong.
Thursday, May 14, 2009
Critical Flaw Costs Lawyer Thousands
A critical flaw was discovered by a defending attorney after the plaintiff’s attorney had spent thousands of dollars bringing the case to discovery.
a. 25 yr old woman in third pregnancy with one living child; first pregnancy had a compromised outcome
b. Premature rupture of membranes at 34 weeks of pregnancy; stabilized and transferred to antepartum unit to wait for pregnancy to reach 36 weeks, a common practice at this time
c. Sudden onset of bleeding and pain at 35 ½ weeks; fetal monitoring shows fetal distress; to OR and baby delivered within 8 minutes of primary nurse entering patient’s room
d. Mother had significant blood loss but fully recovered; baby needed extensive resuscitation but died two days later
e. Claim was made against the primary physician, admitting physician, and primary care nurse. Basis of the claim was that the patient’s call for help was not answered for twenty minutes by primary care nurse. This was substantiated by the patient’s husband watching the clock on the wall of the room.
Two vital errors were made by the plaintiff’s attorney that could have been identified by a legal nurse consultant:
1. He did not ask the primary care nurse what her patient load was at the time of the incident. There had been layoffs on the unit at this time. The incident also occurred during a time of night when nurses commonly take a one hour break and patient loads can be heavy. On this night, the primary care nurse was caring for six triage patients, an early labour patient and two antepartum patients which she had told the nurse in charge was too heavy for patient safety. However, the primary care nurse was never obliged to give him this information during discovery.
2. He did not confirm the actual presence of a clock on the wall of the patient’s room for her husband to time the response time. This unfamiliarity with hospital layout and the custom of clocks on the walls of rooms in other parts of the maternity unit cost the plaintiff their claim against the primary care nurse and wasted the attorney’s resources in preparing the case as well as three hours in discovery with the primary care nurse.
a. 25 yr old woman in third pregnancy with one living child; first pregnancy had a compromised outcome
b. Premature rupture of membranes at 34 weeks of pregnancy; stabilized and transferred to antepartum unit to wait for pregnancy to reach 36 weeks, a common practice at this time
c. Sudden onset of bleeding and pain at 35 ½ weeks; fetal monitoring shows fetal distress; to OR and baby delivered within 8 minutes of primary nurse entering patient’s room
d. Mother had significant blood loss but fully recovered; baby needed extensive resuscitation but died two days later
e. Claim was made against the primary physician, admitting physician, and primary care nurse. Basis of the claim was that the patient’s call for help was not answered for twenty minutes by primary care nurse. This was substantiated by the patient’s husband watching the clock on the wall of the room.
Two vital errors were made by the plaintiff’s attorney that could have been identified by a legal nurse consultant:
1. He did not ask the primary care nurse what her patient load was at the time of the incident. There had been layoffs on the unit at this time. The incident also occurred during a time of night when nurses commonly take a one hour break and patient loads can be heavy. On this night, the primary care nurse was caring for six triage patients, an early labour patient and two antepartum patients which she had told the nurse in charge was too heavy for patient safety. However, the primary care nurse was never obliged to give him this information during discovery.
2. He did not confirm the actual presence of a clock on the wall of the patient’s room for her husband to time the response time. This unfamiliarity with hospital layout and the custom of clocks on the walls of rooms in other parts of the maternity unit cost the plaintiff their claim against the primary care nurse and wasted the attorney’s resources in preparing the case as well as three hours in discovery with the primary care nurse.
Tuesday, May 12, 2009
Nursing shortage is important to lawyers
A report issued by the Canadian Nurses Association shows that the shortage of registered nurses is expected to grow to 60 000 by 2022. The current absentee rate for RNs is twice as high as any other profession with an average of 14 days per year. Workload, short-staffed units, lack of basic equipment and large numbers of less qualified and less experienced staff are taking a huge toll on the skilled work force in Canadian hospitals.
"It gets to a point where you have nurses so tired that when one of their colleagues calls in sick, they just say: 'Give me a warm body' - regardless if he or she has the education." Personal care workers are heavily relied on in some regions. "We need (them), don't get me wrong," Linda Silas, President of the Canadian Federation of Nurses Unions said. "But for patient safety and quality care, you need the nurses around and we shouldn't jeopardize this because of the shortage."
There is also a noticeable shortage of doctors, pharmacists, and physiotherapists.
Why should this matter to a lawyer? Because when your client comes to you with their story of what happened to them in the healthcare system, you need to be aware of the dynamics of the environment in which the event(s) took place. What were the staffing levels at that moment? What were the qualifications and experience of the direct care givers as well as their supervisors? Was the care being given by a worker outside of their scope of practice? Was fatigue or illness a factor in the level of care being provided at that moment?
Legal nurse consultants are registered nurses who have hands-on experience with the healthcare environment. They know first hand how the level of care is affected by the dynamics of the unit and the people in it. Let their expertise and insight bring to light nuances of the case that could so easily be missed.
"It gets to a point where you have nurses so tired that when one of their colleagues calls in sick, they just say: 'Give me a warm body' - regardless if he or she has the education." Personal care workers are heavily relied on in some regions. "We need (them), don't get me wrong," Linda Silas, President of the Canadian Federation of Nurses Unions said. "But for patient safety and quality care, you need the nurses around and we shouldn't jeopardize this because of the shortage."
There is also a noticeable shortage of doctors, pharmacists, and physiotherapists.
Why should this matter to a lawyer? Because when your client comes to you with their story of what happened to them in the healthcare system, you need to be aware of the dynamics of the environment in which the event(s) took place. What were the staffing levels at that moment? What were the qualifications and experience of the direct care givers as well as their supervisors? Was the care being given by a worker outside of their scope of practice? Was fatigue or illness a factor in the level of care being provided at that moment?
Legal nurse consultants are registered nurses who have hands-on experience with the healthcare environment. They know first hand how the level of care is affected by the dynamics of the unit and the people in it. Let their expertise and insight bring to light nuances of the case that could so easily be missed.
Sunday, May 10, 2009
Top 5 Reasons to Have Legal Nurses of Canada on Your Team
Because of the legal nurse consultant’s expertise in healthcare-related issues, he or she can bring the following benefits to the litigation team:
1. Cost-effectiveness: The LNC critically analyzes the healthcare facts of a case and
helps the attorney select and manage cases. Many cases can be either rejected or
settled quickly by using the resources and knowledge of an LNC.
2. Resourcefulness: The LNC has access to a national network of healthcare and
professional resources and contacts. The LNC is well versed in the use of medical
libraries, medical equipment, and other resources.
3. Knowledge: The LNC has a thorough understanding of healthcare issues and trends
related to the entire litigation process. The LNC “speaks the language” of
physicians, healthcare providers, and patients.
4. Experience: The LNC has a background of clinical experience, which includes the
ability to interpret medical records, documents, and health science literature.
5. Advantage: The LNC is a relatively new area of expertise which means adding one to your legal team is an advantage during the legal process.
1. Cost-effectiveness: The LNC critically analyzes the healthcare facts of a case and
helps the attorney select and manage cases. Many cases can be either rejected or
settled quickly by using the resources and knowledge of an LNC.
2. Resourcefulness: The LNC has access to a national network of healthcare and
professional resources and contacts. The LNC is well versed in the use of medical
libraries, medical equipment, and other resources.
3. Knowledge: The LNC has a thorough understanding of healthcare issues and trends
related to the entire litigation process. The LNC “speaks the language” of
physicians, healthcare providers, and patients.
4. Experience: The LNC has a background of clinical experience, which includes the
ability to interpret medical records, documents, and health science literature.
5. Advantage: The LNC is a relatively new area of expertise which means adding one to your legal team is an advantage during the legal process.
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