The maternity world was turned upside down in the past few years with the realization that a common painkiller administered to mothers following childbirth was having disasterous results for newborns. Now it has been established by Canadian researchers that toddlers with the same genetic variation as those newborns have died from the same drug given directly to them following surgery.
According to research done at the University of Western Ontario in London and the Hospital for Sick Children in Toronto, the very common drug is acetaminophen and codeine (one familiar brand name of this combination is Tylenol 3). Unfortunately, there are very young children with a genetic variation who convert the codeine into morphine very rapidly. The morphine then slows breathing and a high enough dose will stop breathing resulting in death.
These findings are significant for cases where an otherwise “healthy” young child has undergone an uneventful procedure yet had complications such as respiratory arrest or death. If the child received codeine, that could be the root of the problem.
Showing posts with label personal injury. Show all posts
Showing posts with label personal injury. Show all posts
Saturday, September 5, 2009
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.
Friday, July 3, 2009
Ultrasound Gel—Moms and babies at risk
Two infectious pathogens have been found growing in bottles of ultrasound gel in Canadian health care facilities. The connection was discovered by tracing skin infections on moms and babies who had recently had ultrasounds.
Ultrasound gel is often kept in squeeze bottles left with the machines that require it. Ultrasound machines and fetal monitors are the most common places you would find the gel. It does not contain any anti-bacterial properties.
The theory is that the nozzle of the bottles are coming in contact with the patient’s skin thereby contaminating the tip and allowing the pathogens to then find a great place to grow within the bottle. Gel that is heated only speeds the process of bacterial growth. Then this gel is used on the next patient. Suggestions for preventing the spread are to ensure bottles do not have direct contact with the skin and cleaning the nozzles of the bottles with an anti-bacterial wipe after each use.
A concern which crosses the mind of a nurse is one of infections that were missed. How many new moms developed wound infections following delivery because of the ultrasound gel used on their abdomens throughout the labour or prior to their caesarean section? How many babies developed skin infections that were never traced back to the gel?
Technique is so important to the outcome of a patient's care. And more attention needs to be paid to the systems in place to prevent infection and how they are actually followed on the front line of health care.
Ultrasound gel is often kept in squeeze bottles left with the machines that require it. Ultrasound machines and fetal monitors are the most common places you would find the gel. It does not contain any anti-bacterial properties.
The theory is that the nozzle of the bottles are coming in contact with the patient’s skin thereby contaminating the tip and allowing the pathogens to then find a great place to grow within the bottle. Gel that is heated only speeds the process of bacterial growth. Then this gel is used on the next patient. Suggestions for preventing the spread are to ensure bottles do not have direct contact with the skin and cleaning the nozzles of the bottles with an anti-bacterial wipe after each use.
A concern which crosses the mind of a nurse is one of infections that were missed. How many new moms developed wound infections following delivery because of the ultrasound gel used on their abdomens throughout the labour or prior to their caesarean section? How many babies developed skin infections that were never traced back to the gel?
Technique is so important to the outcome of a patient's care. And more attention needs to be paid to the systems in place to prevent infection and how they are actually followed on the front line of health care.
Wednesday, July 1, 2009
Can H1N1 be contained in hospitals?
The last few months have seen the outbreak of the H1N1 virus. It has been appearing all over the world and varies from mild to severe, sometimes resulting in death.
People present to the hospital for various reasons. Some are staff. Some are visitors. Some are injured. Some are booked surgeries and diagnostic tests. Some are very ill. When word of an outbreak occurs, everyone assumes that doctors, nurses and other hospital staff will take every precaution to protect themselves and others so that the infection cannot be spread within the hospital itself.
But is this true?
Sadly, it is not. The worst culprits are often doctors. Doctors who make dangerous assumptions. They discount the need for isolation precaution procedures already in place. They ignore nurses who tell them of the risk and precautions necessary before, during and after patient contact. They don't wash or sanitize their hands before and after seeing a patient. They contaminate the charts and the desk area where others work.
Often it is only after they receive as positive lab result (sometimes days later) that they acknowledge what they have done... and only to themselves.
Patients who develop complications after a hospital visit-- no matter what they were doing there-- need to have a thorough examination of the timeline. There is a very good chance it is a case of "white coat" contamination. Questions that need answers include: were isolation procedures implemented, reinforced and carried out at all times? Was any caregiver diagnosed with the same illness or treated with anti-flu drugs due to an unprotected exposure? Detective work by someone who knows how a hospital works behind the scenes can provide the answers.
People present to the hospital for various reasons. Some are staff. Some are visitors. Some are injured. Some are booked surgeries and diagnostic tests. Some are very ill. When word of an outbreak occurs, everyone assumes that doctors, nurses and other hospital staff will take every precaution to protect themselves and others so that the infection cannot be spread within the hospital itself.
But is this true?
Sadly, it is not. The worst culprits are often doctors. Doctors who make dangerous assumptions. They discount the need for isolation precaution procedures already in place. They ignore nurses who tell them of the risk and precautions necessary before, during and after patient contact. They don't wash or sanitize their hands before and after seeing a patient. They contaminate the charts and the desk area where others work.
Often it is only after they receive as positive lab result (sometimes days later) that they acknowledge what they have done... and only to themselves.
Patients who develop complications after a hospital visit-- no matter what they were doing there-- need to have a thorough examination of the timeline. There is a very good chance it is a case of "white coat" contamination. Questions that need answers include: were isolation procedures implemented, reinforced and carried out at all times? Was any caregiver diagnosed with the same illness or treated with anti-flu drugs due to an unprotected exposure? Detective work by someone who knows how a hospital works behind the scenes can provide the answers.
Thursday, June 18, 2009
Changes to Care for Moms with Breech Pregnancies
The standard of care in Canadian hospitals since 2000 has been to deliver all breech babies by caesarean section. This method of delivery was based on solid research which showed the risks for potential harmful outcomes to the baby were too high for vaginal delivery. The Society for Obstetricians and Gynegologists of Canada has recently announced that this standard care will be reversed.
It is a basic premise of mechanics. The largest part of a fetus is the head-- and breech babies have their heads delivered last. There is always a risk that the head will prove too large for the mother's pelvis which results in fetal death and dismemberment as well as major injury to the mother during attempts to save the baby.
The other harsh reality is that delivery with best outcomes for mom and baby requires genuine finesse and loads of experience-- neither of which is easily found in our latest generation of obstetricians. They haven't seen or done enough breech deliveries to be good at it.
As a labour and delivery nurse in her third decade of experience, I have seen the time where breech pregnancies were delivered without a c-section. I have also seen babies severely compromised in the process when the obstetrician is not skilled enough to do it.
Two issues present themselves in the world of medical liability:
1. Will mothers be completely informed and truly understand the risks their babies face? If a delivery goes very wrong during this period of attempting to reduce the c-section rate by any means possible, can the defence argue against years of evidence that planned c-section delivery is best for the baby's safety?
2. Thousands of women were not given the choice in the type of delivery. Does this mean they have grounds to question that lack of options should obstetricians return to vaginal delivery of term breech pregnancies?
Breech deliveries are high risk, even in the operating room babies can have a traumatic delivery, cases presenting themselves over the next few years will require specialized expertise to determine if every possible factor was considered before the method of delivery was determined.
It is a basic premise of mechanics. The largest part of a fetus is the head-- and breech babies have their heads delivered last. There is always a risk that the head will prove too large for the mother's pelvis which results in fetal death and dismemberment as well as major injury to the mother during attempts to save the baby.
The other harsh reality is that delivery with best outcomes for mom and baby requires genuine finesse and loads of experience-- neither of which is easily found in our latest generation of obstetricians. They haven't seen or done enough breech deliveries to be good at it.
As a labour and delivery nurse in her third decade of experience, I have seen the time where breech pregnancies were delivered without a c-section. I have also seen babies severely compromised in the process when the obstetrician is not skilled enough to do it.
Two issues present themselves in the world of medical liability:
1. Will mothers be completely informed and truly understand the risks their babies face? If a delivery goes very wrong during this period of attempting to reduce the c-section rate by any means possible, can the defence argue against years of evidence that planned c-section delivery is best for the baby's safety?
2. Thousands of women were not given the choice in the type of delivery. Does this mean they have grounds to question that lack of options should obstetricians return to vaginal delivery of term breech pregnancies?
Breech deliveries are high risk, even in the operating room babies can have a traumatic delivery, cases presenting themselves over the next few years will require specialized expertise to determine if every possible factor was considered before the method of delivery was determined.
Tuesday, May 26, 2009
What role could a nurse have in a law firm?
Canadian nurses have discovered a new area of specialty-- legal nurse consulting. It can be the best of both worlds for an experienced RN. She can use her established knowledge and skills in a whole new way. She can explore employment options outside of shiftwork. She can remain an important member of a professional team that can make a difference.
Here is how a nurse works within the team:
*Strategizes with the legal professional for successful resolutions between parties involved in health care-related litigation or other medical-legal or health care-legal matters;
*Educate attorneys and/or others involved in the legal process regarding the healthcare facts and issues of a case or claim;
*Research and integrate healthcare and nursing literature as it relates to the healthcare facts and issues of a case or a claim:
*Review, summarize, and analyze medical records and other pertinent healthcare and legal documents and comparing and correlating them to the allegations;
*Assess issues of damages and causation relative to liability within the legal process;
*Identify, locate, evaluate, and confer with expert witnesses;
*Interview witnesses and parties pertinent to the healthcare issues in collaboration with legal professionals;
*Draft legal documents in medically related cases under the supervision of an attorney;
*Develop collaborative case strategies with those practicing within the legal system;
*Provide support during discovery, depositions, trial, and other legal proceedings;
*Support the process of adjudication of legal claims.
Source: AALNC
Here is how a nurse works within the team:
*Strategizes with the legal professional for successful resolutions between parties involved in health care-related litigation or other medical-legal or health care-legal matters;
*Educate attorneys and/or others involved in the legal process regarding the healthcare facts and issues of a case or claim;
*Research and integrate healthcare and nursing literature as it relates to the healthcare facts and issues of a case or a claim:
*Review, summarize, and analyze medical records and other pertinent healthcare and legal documents and comparing and correlating them to the allegations;
*Assess issues of damages and causation relative to liability within the legal process;
*Identify, locate, evaluate, and confer with expert witnesses;
*Interview witnesses and parties pertinent to the healthcare issues in collaboration with legal professionals;
*Draft legal documents in medically related cases under the supervision of an attorney;
*Develop collaborative case strategies with those practicing within the legal system;
*Provide support during discovery, depositions, trial, and other legal proceedings;
*Support the process of adjudication of legal claims.
Source: AALNC
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.
Thursday, May 7, 2009
Another Diet Pill Recall Alert
According to a May 1, 2009 news release by attorneys at Morgan & Morgan, the Food & Drug Administration (FDA) issued a warning to consumers to immediately stop using Hydroxycut products. Hydroxycut products, dietary supplements manufactured by Iovate Health Sciences, Inc., have been linked to serious liver injuries and at least one death. The products were sold in Canada as well.
This recent example in the product liability field is within the expertise of the legal nurse consultant as part of the legal team. Legal nurse consultants are not hired to know the law but rather to understand the injury, what caused it, its extent and how it could have been prevented. Once the free legal consultation has been completed, the legal nurse consultant can piece together vital pieces of information to assist the attorneys in evaluating the merit of each case.
Nurses have specialized knowledge and resources to assess the risks and benefits of a product, whether it was regulated and for what particular use, identify common off label uses of a product, explore the history of the product and the side effects that have been reported as well as personal patient histories which might have affected the outcome with this product. Then they can assist in the preparation of cases for legal teams faced with a large scale recall within the healthcare-related industry.
This recent example in the product liability field is within the expertise of the legal nurse consultant as part of the legal team. Legal nurse consultants are not hired to know the law but rather to understand the injury, what caused it, its extent and how it could have been prevented. Once the free legal consultation has been completed, the legal nurse consultant can piece together vital pieces of information to assist the attorneys in evaluating the merit of each case.
Nurses have specialized knowledge and resources to assess the risks and benefits of a product, whether it was regulated and for what particular use, identify common off label uses of a product, explore the history of the product and the side effects that have been reported as well as personal patient histories which might have affected the outcome with this product. Then they can assist in the preparation of cases for legal teams faced with a large scale recall within the healthcare-related industry.
Wednesday, May 6, 2009
What is a legal nurse consultant?
The legal nurse consultant is a licensed registered nurse who performs a critical
analysis of healthcare facts and issues and their outcomes for the legal profession,
healthcare profession, and others, as appropriate. With a strong educational and
experiential background, the legal nurse consultant is qualified to assess adherence to standards of healthcare practice as it applies to the nursing and healthcare professions.
There is a diversity of practice settings and services performed by legal nurse
consultants nationwide.
The legal nurse consultant practices the art and science of this nursing
specialty in a variety of settings, including law firms, government offices, insurance
companies, hospital risk management departments, and as self-employed practitioners.
The legal nurse consultant is a liaison between the legal and healthcare communities and
provides consultation and education to legal, healthcare, and appropriate other
professionals in areas such as personal injury, product liability, medical malpractice,
workers’ compensation, toxic torts, risk management, medical professional licensure
investigation, and criminal law.
analysis of healthcare facts and issues and their outcomes for the legal profession,
healthcare profession, and others, as appropriate. With a strong educational and
experiential background, the legal nurse consultant is qualified to assess adherence to standards of healthcare practice as it applies to the nursing and healthcare professions.
There is a diversity of practice settings and services performed by legal nurse
consultants nationwide.
The legal nurse consultant practices the art and science of this nursing
specialty in a variety of settings, including law firms, government offices, insurance
companies, hospital risk management departments, and as self-employed practitioners.
The legal nurse consultant is a liaison between the legal and healthcare communities and
provides consultation and education to legal, healthcare, and appropriate other
professionals in areas such as personal injury, product liability, medical malpractice,
workers’ compensation, toxic torts, risk management, medical professional licensure
investigation, and criminal law.
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