Pitocin Uterine Tachysystole

Hospital mistakes and errors

Award-Winning Michigan Medical Malpractice Lawyers & Birth Injury Attorneys Helping Families Affected by Medical Negligence | Serving Michigan, Ohio, Washington, D.C. & All 50 States

Certainly, nobody enjoys being sick and confined to a hospital, attached to tubes and monitoring devices.  On the other hand, we often breathe a sigh of relief when we – or our loved ones –  are admitted to a hospital.  We often relax, thinking that we can stop worrying and let the medical experts and caregivers make us better.

But this is a false sense of security.  Approximately one out of every six deaths in the United States is caused by preventable hospital errors.  Ten to twenty times that many people will survive the errors, but have severe injury.  This means that over 400,000 people are killed in hospitals each year by preventable errors, and millions of people are severely injured as a result of these mistakes.

This important study published in the Journal of Patient Safety wasn’t the only alarming data brought to light by research published in 2013.  Not only are hundreds of thousands of people killed annually by hospital mistakes, but errors made by physicians are rarely reported or brought to light by other physicians, according to information recently published in the New England Journal of Medicine (NEJM).  In fact, in a 2010 study involving Medicare patients, the investigators found that 86% of the medical errors that occurred went unreported.  Also frightening is the fact that when hospitals identify the preventable errors that are made at their institutions, they rarely implement new policies to keep the mistakes from recurring.  To make matters even worse, when physician mistakes actually are reported (i.e., the physician had clinical privileges revoked or restricted), most physicians almost never suffer any disciplinary action by their state medical board, according to Public Citizen, the consumer rights group founded by Ralph Nader.  This means that negligent physicians’ medical licenses remain intact and these doctors are free to work at any hospital or medical center in their state.

Of course, this fairly recent and shocking data is not brand new news.  Over a decade ago, a groundbreaking report issued by the National Academy of Sciences found that the death rate caused by preventable hospital error was 98,000 annually.  This was based on data from the 1980s.  Hospitals began seriously tracking errors around the year 2000.  In 2003, the Centers for Medicare and Medicaid Services began gathering data on hospital quality, and this information has been available online since 2005.

With hospitals tracking errors for over a decade and having knowledge that the number of preventable deaths is very high – and that most medical errors go unreported – why are hospitals becoming more dangerous and not safer?  Why aren’t medical institutions implementing policies, procedures and programs to help curtail the devastating epidemic of preventable hospital death and injury?  And why aren’t state medical boards taking disciplinary action with most negligent physicians?  Where are the patient advocates and lobbyists, and why isn’t there a national outcry for patient safety reform?

Over the last decade, there also have been several studies that illuminate the reasons that hospital mistakes go unreported.  A national survey recently showed that often, physicians are unwilling to report the mistakes of their colleagues to anyone in authority.  According to the NEJM, the reasons for this include the following: fear of becoming a “tattler,” which can have financial consequences due to decreased referrals; lack of time to investigate errors further, and giving colleagues the benefit of the doubt; not wanting to cause a colleague legal problems; not having skills associated with being confrontational; and receiving mixed messages from hospitals about how or whether to report mistakes.

MICHIGAN MEDICAL MALPRACTICE LAWYERS DISCUSS HOW TO STAY SAFE DURING A HOSPITAL STAY

Aside from supporting patient advocacy and lobbying groups, which are very small compared to hospital lobbying groups, there are many steps patients and their family members can do to try and prevent negligence during a hospital stay.  The Olivia and Howard Geller Foundation for Patient Safety wrote a very detailed article titled, “How to Survive a Stay in the Hospital: Lifesaving Advice for Patients and their Families.”

Listed below are some suggestions the Foundation gives for staying safe in the hospital:

  • Have knowledge of the Patient’s Bill of Rights.
  • Ensure the patient is given correct medication.
  • Record, review, and report maltreatment or neglect.
  • Employ the use of a “patient sitter” or “granny cam.”
  • Bring a voice recorder, phone and camera.
  • Ask questions and demand answers.
  • Write down the name of caregivers.
  • Review medical records for mistakes.
  • Trust your instincts.  If it feels wrong, it probably is.

It is critical for the patient to play an active role in her treatment.  If the patient is not fully cognizant (which often is the case during a hospital stay), it is a good idea to have someone sitting next to her as often as possible.  When choosing a hospital, make sure the facility will allow a patient sitter to be present at all times.  Patient sitters can help ensure that caregivers wash their hands, don’t pull on items that can pull out lines that are in or on the patient’s body, and read the chart of the patient.  Lack of hand-washing and failure to read a patient’s chart (especially after a shift change) are well documented causes of preventable harm to a patient.

Patients must remember that they are in charge.  They have a right to read their charts and medical records whenever they want, and people given permission by the patient also may read the records.  If a patient wants a patient sitter, she has the right to have one.  Some hospitals may make this difficult, especially during non-visiting hours, which is why it is important to discuss this with the hospital prior to admission.  In addition, patients should feel free to ask as many questions as they want.  It is prudent to ask the treating physician or staff member performing a procedure how many times she has performed the particular procedure, test, or surgery.

MICHIGAN MEDICAL MALPRACTICE LAWYERS DISCUSS HOW TO PREVENT A MEDICAL MISTAKE FROM OCCURRING DURING LABOR & DELIVERY

In the event of a hospital stay for labor and delivery, a very important question to ask is how competent the staff is at interpreting fetal heart rate tracings.  It is crucial to make sure that staff is present to review the tracings, and that the staff members – especially the physician – have experience and skill in interpreting the tracings.  Indeed, a 2013 study from Johns Hopkins found that 80,000 deaths AND 80,000 severe injuries each year are caused by wrong, missed or delayed diagnoses.  Even if a physician misses a diagnosis that can affect the well-being of an unborn baby, the baby’s distress will be noted on the fetal heart rate monitor, in most cases.  The key is to have a staff member skilled enough to detect even the early, subtle changes that indicate that distress in the baby is imminent.  Research shows that a lack of skill in fetal heart tracing interpretation and a breakdown in communication among the labor and delivery team are significant causes of preventable injury to the baby during labor and delivery.

Close monitoring of a baby’s heart rate is always important during labor and delivery.  This is because the fetal heart rate is often the only indication of how well the baby is doing.  If a baby starts to become oxygen deprived while in the womb, the fetal heart rate monitor will indicate this.

There are many conditions that can occur during labor and delivery that can cause a baby to be oxygen deprived and in distress.  Thus, it also is crucial to make sure the labor and delivery facility and physician have the capacity to perform an emergency C-section if indicated.  Of course, it is the duty of the physician to get informed consent from the mother for any procedure performed.  This means that the physician must explain the risks, benefits and alternatives of all procedures and potential delivery methods.  But when a baby is in distress, a C-section is often the best (and sometimes only) way to quickly deliver a baby to prevent brain damage when she is being deprived of oxygen in the womb.  Certain conditions, such as cephalopelvic disproportion (CPD) and total placenta previa, require a C-section delivery.

Important questions to ask the obstetrician include the following:

  • Will my baby have continuous electronic fetal heart rate monitoring?
  • Are you skilled in fetal heart rate tracing interpretation, and how many years of experience do you have?
  • Is there at least one other person involved in my labor and delivery that is skilled at fetal heart rate tracing interpretation?
  • If my baby gets in trouble, do you have the ability to deliver my baby very quickly by emergency C-section?
  • How many years of experience do you have in performing emergency C-sections?
  • Is there an additional physician immediately available in the event that multiple dangerous conditions occur simultaneously, such as my baby and I having difficulty at the same time?
  • Is there proper resuscitation equipment immediately available in case my baby needs to be resuscitated at birth?

In addition to proper fetal monitoring, the mother must also be properly monitored.  A mother’s blood pressure, heart rate, and physical signs (such as abdominal and back pain and lack of fetal movement) can give important information regarding impending or current fetal distress.

Conditions that can cause or lead to oxygen deprivation and distress in an unborn baby include the following:

  • Placental abruption.  In this condition, the placenta tears away from the uterus, either partially or fully.  If the tear is at the umbilical cord, the baby could be totally cut off from her oxygen supply.
  • Placenta previa.  This is when the baby covers the birth canal opening (the cervical os) either totally or partially.  If this condition is present at delivery, the baby must be delivered by C-section.
  • Umbilical cord compression.  When this occurs, the baby’s cord exits in front of her, which can cause the cord to be impinged upon (squeezed) by the baby’s body and the mother.
  • Nuchal cord.  This is when the baby’s umbilical cord is wrapped around her neck.
  • CPD and macrosomia (large baby).  CPD occurs when the baby is too large for the size of the mother’s birth canal / pelvis.
  • Premature rupture of the membranes (PROM).  PROM is when the mother’s water breaks before she is in labor.  This can cause premature birth and chorioamnionitis.
  • Breech or face presentation.  These conditions occur when the baby is not in the normal, head-first position.  In breech presentation, the buttocks are in a position to exit the birth canal first, and in face presentation the baby’s  face presents first.
  • Chorioamnionitis.  This is an infection of the placenta and fetal membranes, and if not properly managed during delivery, the infection can travel to the baby’s brain and cause permanent brain damage.
  • Uterine rupture.  This occurs when the uterus (womb) becomes torn, which can cause the unborn baby to enter the mother’s abdomen.
  • Misuse of a vacuum extractor and forceps during delivery.  These are risky delivery instruments that attach to the baby’s head.  They increase the risk of head trauma and brain bleeds.  Sometimes these instruments actually slow down the delivery process, such as when they are being used by an unskilled physician.  Furthermore, the instruments frequently are used when the physician should have quickly performed an emergency C-section.
  • Anesthesia mistakes and medication errors.  Improper use of medications can cause oxygen deprivation and heart rate problems in the baby.
  • Use of Pitocin and Cytotec.  These drugs can cause contractions to be too strong and frequent, which can severely deprive a babyThe Michigan medical malpractice lawyers at ABC Law Centers talk about Pitocin and birth injuries. of oxygen.
  • Oligohydramnios.  This is when the amniotic fluid is low, which can cause umbilical cord problems and other serious complications.
  • Preeclampsia.  This is when the mother has high blood pressure, which can cause a decrease in the supply of oxygen-rich blood going to the baby.
  • Vaginal birth after c-section (vbac).  This greatly increases the risk of uterine rupture.
  • Twin and multiple baby births.

AWARD-WINNING MICHIGAN MEDICAL MALPRACTICE LAWYERS HELPING CHILDREN AFFECTED BY BIRTH INJURIES

When labor and delivery are not properly managed, a baby can get brain bleeds or become severely oxygen deprived for other reasons.  When a baby goes without sufficient oxygen for too long, permanent brain injury can occur.  Babies can end up with cerebral palsy, hypoxic ischemic enecephalopathy (HIE), periventricular leukomalacia (PVL), intellectual and developmental disabilities, seizure disorders, and hydrocephalus.  Babies can also become brain damaged if an infection in the mother is not properly managed and it travels to the baby’s brain after birth.  Permanent brain damage in a baby can also occur if a baby’s blood sugar or bilirubin levels are not properly monitored and treated when abnormal.

It is crucial for the physician to monitor the mother and baby very closely during pregnancy and around the time of delivery, and prevent or treat conditions that can cause brain damage. Failure to properly monitor and treat the mother and baby is negligence. Failure to follow standards of care and guidelines, and to act skillfully and expediently also constitutes negligence. If this negligence leads to a permanent injury in the baby, it is medical malpractice.

If you are seeking the help of a Michigan medical malpractice lawyer for your baby, it is very important to choose a lawyer and firm that focus solely on birth injury cases.  Reiter & Walsh ABC Law Centers is a national birth injury law firm that has been helping children for almost 3 decades.

Michigan medical malpractice lawyers helping babies and children affected by birth injuries.Attorney Jesse Reiter, president of the firm, has been focusing solely on birth injury cases for over 28 years, and most of his cases involve hypoxic ischemic encephalopathy (HIE) and cerebral palsy.  The partners of the firm, Mr. Reiter and Rebecca Walsh, were recently recognized as two of the best medical malpractice lawyers in America by U.S. News and World Report 2015, which also recognized ABC Law Centers as one of the best medical malpractice law firms in the nation.  U.S. News and World Report has given Mr. Reiter the honor of being one of the “Best Lawyers in America” every year since 2008. Ms. Walsh has been handling high profile medical malpractice cases for adults and children her entire career and has attained numerous verdicts and settlements in excess of $1 million.

The medical malpractice lawyers at ABC Law Centers have won numerous awards for their advocacy of children and are members of the Birth Trauma Litigation Group (BTLG) and the Michigan Association for Justice.  In fact, Mr. Reiter is one of only 2 attorneys in Michigan to have been elected Chair of the BTLG.

If your child was diagnosed with a birth injury such as hypoxic ischemic encephalopathy (HIE), cerebral palsy, a seizure disorder, intellectual disabilities or developmental delays, the award-winning Michigan medical malpractice lawyers at ABC Law Centers can help.  We have helped children throughout the country obtain compensation for lifelong treatment, therapy and a secure future, and we give personal attention to each child and family we represent.  Our nationally recognized medical malpractice firm has numerous multi-million dollar verdicts and settlements that attest to our success and no fees are ever paid to our firm until we win your case.  Email or call Reiter & Walsh ABC Law Centers at 888-419-2229 for a free case evaluation.  Our award-winning Michigan medical malpractice lawyers are available 24 / 7 to speak with you.

SOURCES:

  • James, John T. “A new, evidence-based estimate of patient harms associated with hospital care.” J Patient Saf 9.3 (2013): 122-128.
  • Gallagher, Thomas H., et al. “Talking with Patients about Other Clinicians’ Errors.” New England Journal of Medicine 369.18 (2013): 1752-1757.
  • Levinson, Daniel R., and Inspector General. “Adverse events in hospitals: national incidence among Medicare beneficiaries.” Department of Health & Human Services (2010).
  • Levine, Alan S., Robert Eugene Oshel, and Sidney M. Wolfe. State medical boards fail to discipline doctors with hospital actions against them. Washington DC: Public Citizen, 2011.
  • Woolf, Steven H., et al. “A string of mistakes: the importance of cascade analysis in describing, counting, and preventing medical errors.” The Annals of Family Medicine 2.4 (2004): 317-326.

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