Articles Posted in Emergency Room Errors

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A Tuesday, July 15, 2014 a story in the Science section of the New York Times covered the circumstances in which doctors are faced with a dilemma in practice. They are reluctant to say to a patient or his or her family that they were sorry for a poor outcome in medical care. It has long been discussed whether doctors should approach patients and family members of patients to express regret or say the word “sorry” because of a bad outcome.

Many risk managers would stand in the way of doctors saying they were sorry for fear that those words might translate into an admission of wrongdoing, guilt and/or negligence.

The New York Times story, written by a physician, Abigail Zuger M.D., relates the medical issue to that of a plumber who worked in her home; a chain of events led to gushing water. Although the plumber wasn’t directly at fault for the problem, he happened to be at the wrong place at the wrong time when he turned a bolt, screw or valve that was old and ready to break at anytime. The issue there was whether the plumber could have said “I’m sorry” without taking responsibility. The writer of this story wrote that saying, “I’m sorry” is not an expression of anything other than empathy and not an admission of fault.

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Charles Blevins, 63, underwent outpatient arthroscopic knee surgery. Four days after the surgery, Blevins went to a hospital emergency room complaining of fever and a hot and swollen knee. He was diagnosed as having pseudomonas infection and required hospitalization for one month; during that time he received IV antibiotics.

The infection, however, destroyed Blevins’s right knee joint, which necessitated a total knee replacement and required revision about a year later.

Blevins filed a lawsuit against the surgical center alleging the use of unsterile surgical instruments. According to Blevins’s lawsuit, at least 3 other patients contracted the same type of infection during the 10-day period surrounding his surgery. The lawsuit did not claim lost income.

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In May 2001, Michael Hamilton was a worker at the Behr Process Corp. plant in Chicago Heights, Ill., when he began experiencing severe pain.  He was taken by ambulance to St. James Hospital in Chicago Heights, Ill. 

At the hospital, Hamilton was met by Dr. Jose Almeida.  Within a few hours, Hamilton was discharged saying that his pain had ended.  He was instructed to see his primary care physician the next day.  However, the next day Hamilton was found dead in his mother’s apartment.  An autopsy revealed that Hamilton died of pericardia tamponade, which is blood surrounding the heart as a result of an aortic dissection.

The mother of Hamilton, Evelyn Hart, filed a lawsuit in Cook County claiming that the hospital, St. James and Dr. Almeida, as well as the doctor’s employer, Excel Emergency Care LLC, were negligent. 

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An Alabama medical negligence case that found its way to the state supreme court, arose out of a jury’s verdict in the amount of $3.2 million. The verdict came in favor of the family of Lauree Ellison involving medical malpractice and hospital negligence at Baptist Medical Center East (BMCE).  The trial court denied the defendant’s post judgment motions seeking a new trial, or in the alternative, a reduction in the judgment.  The motion to reduce the verdict amount was based on the statutory cap contained in the Alabama code.

On Sept. 3, 2005, Lauree Ellison was treated in the emergency room as a patient of Baptist Medical Center East in Montgomery, Ala.  She was 73 years old and suffered from a number of chronic pre-existing medical conditions.  Ellison was there for an evaluation after she had fallen at her home. 

While she was in the emergency room, she mentioned that she had a sore throat.  An emergency room physician ordered a strep test, which was negative. The exam lab results showed that Ellison did not have an infection, and the x-rays that were done were unremarkable for injuries from her fall. She was then discharged and returned home.

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In September 2007, 55-year-old Barbara Ann Drebek-Doyle underwent a CT scan of the sinuses due to her recurrent sinusitis condition. The test was performed at Advocate Condell Gurnee Outpatient Radiology Center. The scan was interpreted by the defendant Dr. David E. Foosaner, a radiologist.  In a lawsuit that was filed by Ms. Drebek-Doyle, she contended that Dr. Foosaner chose not to detect and report a brain mass or tumor that was seen on the CT scan. As a result, the tumor remained undiscovered and untreated for 3.5 years. 

In March 2011, an MRI of the brain showed the brain mass at the top center of Ms. Drebek-Doyle’s head. Surgery was done to remove the benign mass, a meningioma that was in the membrane lining of the brain. Meningioma occur most frequently with women; they cause various types of symptoms.  Some symptoms include chronic headache, nausea, vomiting and balance issues. If the tumor is not removed fairly quickly, there is a risk that it may increase in size and cause much more serious effects, including death.

The plaintiff maintained that if the radiologist defendant had reported the mass in 2007, it could have been removed at that time. Instead, the delay caused Ms. Drebek-Doyle to suffer various problems over the next 3 ½ years, including increased headaches, loss of balance, memory deficits, bowel incontinence and fatigue. 

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It is estimated that 250,000 people die each year in the United States as a result of medical malpractice according to the U.S. Department of Health and Human Services.  Approximately 80,000 Medicare patients suffer preventable adverse events that contribute to their deaths; as many as half of those deaths are due to emergency room errors. 

In 2003, the nonpartisan Congressional Budget Office stated that “181,000 severe injuries (attributable to medical negligence) occurred in U.S. hospitals [,]”.  These numbers show that medical malpractice deaths have worsened during the past ten years. Despite this increase, state governments and legislatures have tried to impede the amount of money recoverable to injured or killed persons and/or their families as the result of medical malpractice. 

For example, in Missouri, where I have been a member of the bar since 1976, nearly 1/3 of medical malpractice cases involve surgery in some way. The next largest percentage of medical errors reported there is 18.7% for misdiagnosis leading to severe injury or death followed by 13.2% involving falls or injuries during transport of patients. 

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Kody Myrick, 17, suddenly slumped over at his job and had difficulty speaking. He was brought to Bakersfield Memorial Hospital’s emergency department. A nurse there made note of a possible stroke. Then an emergency room physician diagnosed profound neurological deficits and ordered a brain CT scan. The scan results showed an abnormality.

Four hours after the onset of symptoms, Kody was seen by a hospitalist to arrange admission to the hospital. The doctor called in admission orders and included a diagnosis of possible stroke. However, Kody was not seen by a doctor for the remainder of that night.

Kody’s neurological condition worsened suddenly the next morning. He was later diagnosed as having an ischemic stroke, which resulted in significant damage to his brain stem. Kody now suffers incomplete tetraplegia and requires 24-hour care.

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On Feb. 13, 2008, Richard Potrawski was taken by ambulance to Little Company of Mary Hospital in Evergreen Park, Ill., after suffering a head injury during a slip and fall on ice.  Mr. Potrawski was brought to the emergency room at 12:30 pm.  He had a large contusion above his right eye and a medical history of congestive heart failure as well as atrial fibrillation for which he was taking Coumadin, a blood thinner.

Mr. Potrawski had the potential for a brain bleed, but the defendant ER physician, Dr. Melissa Uribes ordered a CT scan which was done at 2:30 pm.  A scan revealed a 1-cm left-sided subdural hematoma.

Little Company of Mary Hospital did not have a neurosurgeon on staff, so Dr. Uribes took steps to find a hospital with neurosurgical services that would admit Mr. Potrawski. 

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Continuity of care is paramount in patient healthcare. The goal is always to give the patient the best medical care while at the same time reduce medical errors. For the last 20 years hospitals and physicians have been using electronic health records (EHR).

Although the intent was noble, EHR has caused serious and even catastrophic injury and harm to patients because of poorly written software programs for healthcare providers. Sometimes the medical recording software does not allow for certain medical conditions, treatments and tests. In those cases, the medical providers simply use the drop down or other shortcut to comply with the entry requirements.

It used to be that narrative nursing notes would be important in providing details of patient care. But in most hospital settings, nurses simply use default screens on a computer to make their entries. Physicians often are not able to read the nurses’ remarks or notes. 

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Sometimes we have to wonder: Would we get the best care possible if we were to be transported to a hospital emergency room? Our local hospital has a good reputation, but it is managed by humans, correct? And humans are known to make mistakes.

The quality of care was debated in the case of a young woman who died in a Brooklyn hospital five years ago. She was an aspiring novelist named Sabrina Seelig.Only 22 at the time of her death, Seelig might have received inadequate care. At least, that is what her family believes.

Convinced she was the victim of errors and misjudgment in the emergency room at her local hospital, they filed a medical malpractice suit. The case went to trial this spring, and the trial lasted four weeks. A jury decided that neither the hospital nor an emergency room doctor or nurse had been negligent.

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