P0LITICAL CANDIDATES ARGUE OVER STAFFING OF NURSING HOMES

In our experience almost 80% of all cases against nursing homes for inadequate and negligent care arise from the facility not having enough trained and competent staff on duty. Far too many nursing homes have one or two CNAs taking care of 20 or more residents – an impossible task!

In Kentucky this problem has gotten the attention of politicians running for Governor. Democrat Steve Beshear said yesterday that Kentucky needs to consider requiring minimum staffing levels at nursing homes, but Governor Ernie Fletcher believes the nursing homes should be allowed to determine how many nurses they hire. I can tell you what the nursing home industry does when it is allowed to decide how many staff to hire – they cut corners to increase profits at the expense of good care. It’s called “putting profits over people.”

Unfortunately, my home state of Virginia doesn’t require minimum staffing levels despite repeated attempts by advocacy groups to get such a law passed. Call me a skeptic but I conclude that the nursing home industry is taking some of those profits (increased by lower labor costs) and contributing to the politicians who refuse to pass minimum staffing laws.

MARYLAND CUTS OFF FUNDS FOR NURSING HOME

The Maryland Office of Health Care Quality has asked the U.S. government to cut off federal payments to a Bethesda nursing home, under fire for six months over deficiencies in care. The nursing home, Bethesda Health and Rehabilitation, has been faulted in several inspections. Two elderly women, one a tracheotomy patient, have died and a resident, with a history of delusions and hallucinations, was allowed to leave the nursing home for a hair appointment. She never reached the hair salon and instead spent the day riding on the Metro and on a bus. A police officer eventually found her and took her home.

Sava Senior Care of Atlanta, which owns the nursing home, is a privately held company that operates 185 nursing homes in 18 states, including nine others in Maryland

PHARMACY ERRORS

I often listen to a radio show on National Public Radio - called the people's pharmacy. The show features many members of the medical community, discussing relevant health issues.
Yesterday, the show had a feature on pharmacy errors. The hosts reported that more pharmacy errors occur in the beginning of the month because that is when elderly receive their social security checks and buy their medications - thereby increasing volume of prescriptions to be filled. They also reported the story of a woman who was prescribed prenatal vitamins, and the pharmacy made an error, giving her chemotherapy medication - that likely caused a miscarriage.

This is serious stuff friends - we have cases of pharmacy negligence. Don't trust them! Open the bottle in the store; ask questions; don't sign the sheet until you have; make sure it is the same dose you normally receive; is it a generic? Have you had success with the generic? If not - ask then to get the doctor's office on the line. It may take an extra 5 minutes in line, but its worth it if you catch an error... And as medical professionals, pharmacists need to make sure they distributing the correct medications.

HOSPTIALS DO NOT WANT TO DISCLOSE THEIR MISTAKES!

What happens when the surgeon operates on the left knee when the patient was supposed to have surgery on the right knee? What happens when Mrs. Betty Jones receives medications intended for Mrs. Beth Jones and suffers a cardiac arrest as a result? To my mind, those acts of “mistakes” which lawyers call acts of negligence should be disclosed to the patient and their family.

In Washington State these acts of negligence, although not consistently reported to the patient and/or family, historically have been reported to the state Department of Health. But now the Washington State Hospital Association says it doesn't want the public to know which hospitals made the mistakes. It contends that a bill passed last year forbids release of such records, and the association has gotten the state to halt disclosure.

Read the article on reporting hospital mistakes.

Do the hospitals in your area report these problems? How about the hospitals in our area? Carilion Roanoke Memorial Hospital, Memorial Hospital of Martinsville and Henry County, Danville Regional Medical Center, Stonewall Jackson Hospital, Carilion New River Valley Hospital, Montgomery Regional Hospital, Wellmont Bristol Regional Hospital, Carilion Giles Memorial Hospital, Alleghany Regional Hospital, Carilion Franklin Memorial Hospital…and the list goes on!

IMPORTANCE OF NUTRITION

We see it everyday - nursing home resident's poor nutrition causes significant decline, or wound cannot heal because resident does not have calories needed. It appears that some facilities are trying to be creative in their approach to resident nutrition.

We receive a publication entitled "Nursing Homes, Long Term Care Management" written for nursing home industry. In their September publication, they feature the results of a study conducted by the Parker Jewish Institute, where many residents were given buffet meal time options, rather than typical plated service.

Now my first thought was - Americans love Buffets - great idea! But for additional reasons, it does seem to be a good idea. The study (although small in scope) showed "that by improving the dining experience by allowing choice, independence and increased ambiance, both psychological and medical outcomes could improve." WOW - that's a great, creative and simple way to provide increased quality of life, and care.

I wish we would see other facilities follow!

PS - for more info, see Parker Institute's website

TAKING A CRUISE THIS WINTER? BETTER WATCH OUT FOR THE SHIP DOCTOR!

The weather is starting to turn cold (finally) and folks have started thinking about taking a little cruise during the winter months to enjoy the warmth and clear waters of the Caribbean. Those sound like great plans – but you better not get sick on your trip!

First, many of these doctors are not board-certified in important medical specialties like internal medicine or emergency medicine. Second, the ship doctors are not employees of the ship’s owners so Royal Caribbean Cruises, Carnival Cruise Lines, Cunard Line, etc., are not responsible for the medical negligence of those doctors. Even worse, since many of these cruises travel in international waters the law of the good old USA may not apply and you may be required to sue the doctor in his or her native country – which may be Italy, Sweden, or Poland.

Here are 3 steps to take to decrease the risk of medical problems during your next cruise:

1. Buy travel health insurance providing for evacuations and emergency coverage.

2. Take copies of your important medical records with you on your cruise.Meet the cruise ship doctor upon arrival and discuss your significant medical conditions and medications.

3. Meet the cruise ship doctor upon arrival and discuss your significant medical conditions and medications.

MRSA…THE ELDERLY…AND NURSING HOMES!

The local and national news has been full of stories about wide-spread MRSA (Methicillin-resistant Staphylococcus aureus). MRSA is a variation of a common bacterium which has evolved the ability to survive treatment with antibiotics, including penicillin and methicillin. The organism is especially troublesome in nursing homes where residents may be found who have open wounds (decubitus ulcers or pressure sores and skin tears) and weakened immune systems and who are therefore at great risk for infection.

The spread of MRSA, particularly the more dangerous variety of “invasive MRSA” can be reduced by the practice of good hygiene by health care providers. The frequent use of alcohol wipes and good hand-washing can go a long way to prevent the spread of this life-threatening infection. However, if you have a loved one in a nursing home and you see any evidence of infection (increased temperature, swelling or redness around breaks in the skin, etc.) you should request immediate attention by a doctor….not a nurse…not even the Director of Nursing!

Get your resident to his or her doctor immediately…or you may regret your inaction for a long time to come!

DOCTOR BARRED IN MASSACHUSETTS MOVES TO ILLINOIS VETERANS ADMINISTRATION HOSPITAL

Dr. Jose Veizaga-Mendez, a surgeon, had a troubling history even before he was hired at a Marion, Illinois Veterans Administration (VA) hospital. The doctor was hired by the Illinois VA hospital even though he was barred from practicing in Massachusetts the previous year after accusations of "grossly" substandard care.

And just what happened as soon as Dr. Mendez started practicing at his “new” hospital? Mendez resigned from the Marion, Illinois hospital in August, shortly before the hospital suspended inpatient surgeries because of a spike in surgical complications and post-surgical deaths. It has been reported by news sources that nine people died at the Marion hospital during an unspecified six-month period when the typical mortality rate would have been two.

Doesn’t sound like good medicine to me! Hospitals are required to check the backgrounds of all physicians who receive staff privileges. Was any body checking this doctor’s application? United States Senators Dick Durbin and Barack Obama say their own investigation raises serious questions about Veterans Affairs Department claims that officials couldn't have known about a surgeon's troubling history before he was hired at the Marion VA hospital.

NURSING HOME ADVOCATES DEMONSTRATE AGAINST CARYLE

Caregivers and advocates for seniors arrived in D.C. held a demonstration on Monday outside the headquarters of private equity giant The Carlyle Group, which is taking over nursing home chain Manor Care Inc. for $6.3 billion. Nursing home workers, family members of patients and seniors advocates spoke about the need for safe staffing levels and improved care. On Tuesday, they plan to visit Capitol Hill and lobby Congress to hold hearings on private equity ownership of nursing homes.

Ohio-based Manor Care runs about a dozen nursing homes in the Washington area and hundreds more nationwide. Manor Care also owns and operates nursing homes in Richmond, Fairfax, and Virginia Beach, Virginia.

My take – Carlyle will squeeze the profit and life out of each and every nursing home purchased ….leaving the residents as victims!

READ THE CONTRACT

Please... read a nursing home or assisted living facility contract before you, or any member of your family signs it.. WHY is this so important? The contract may state you give away your right to a jury. It might state you can only recover $10,000 in damages should the facility provide poor care to your loved one... It may say you pay for their attorneys fees if they sue you for non payment. You need to know what you are agreeing to, and in many circumstances, you need to NOT agree. Yup, either cross that section out, refuse to sign or in many cases, you may have a few days to revoke portions of the agreement.

Hope for the best, but prepare for the worst - and this includes contracts with long term care facilities.

NURSING HOMES RECEIVE FUNDS TO HOUSE MENTALLY ILL

Mentally ill patients are eligible for nursing home care paid for by Medicaid if they need 24-hour supervision or hands-on assistance. Nursing homes in Ohio are using a Medicare loophole to accept hundreds of mentally ill patients discharged from hospital psychiatric wards, spending millions of taxpayer dollars to house patients who often do not qualify for nursing home care, a state investigation found.

The three Cleveland-area nursing homes at the center of the inquiry, all run by Saber Healthcare Group, received $59 million in Medicaid funds from 2005 through August 2007, according to the state. The state's Department of Mental Health estimates that about 1,300 psychiatric patients a year are admitted to Ohio nursing homes under a Medicaid rule that allows 30-day convalescent stays. The system provides a windfall for nursing homes, at the public's expense, said William O'Boyle, a licensed clinical counselor who evaluated nursing home patients for the Department of Mental Health.

This situation creates two major problems. First, the nursing homes are defrauding the federal government by keeping elderly psychiatric patients in their facility long past the time permitted by Medicaid. Second, most nursing homes do not have appropriately trained staff to deal with psychiatric patients…putting both the psychiatric patient and the rest of the residents at risk!

NATIONAL ALLIANCE TO IMPROVE ASSISTED LIVING CARE

For years, assisted living facilities in America “flew below the radar screen” of most state and federal regulators. Additionally, there were no resident advocacy groups established to look out for those people living in assisted living facilities. That is about to change!

Fifteen elder care, elder law, and senior advocacy groups announced today the formation of the Assisted Living Consumer Alliance (ALCA). The ALCA will be a national non-profit organization advocating for stronger consumer protections for assisted living residents.

Assisted living is the fastest growing type of senior housing. Currently, over one million Americans live in assisted living facilities. Assisted living increasingly is taking the place of nursing home care for many older Americans who no longer are able to live safely on their own due to increased frailty or dementia.

This is great news!

PHARMACY NEGLIGENCE

We have two open cases right now against pharmacies.
Arizona Daily Sun Assistant City Editor LARRY HENDRICKS reports this week (read it in full here) - that an Arizona jury awarded $6 million last week to the family of a Coconino High School wrestling coach who died of a toxic drug interaction in December 2002.

Decedent's estate filed suit against both the prescribing doctor, and the pharmacy claiming "Walgreen's staff would have been given a computer warning on the drugs' toxic interaction and would have been duty-bound to warn Warren and/or his physician of the danger."

In conclusion, "the jury concluded that Warren was 1 percent responsible for his death, that Parfitt was 2 percent responsible, and Walgreen's was 97 percent responsible, according to court documents."

Please know folks - that while pharmacists have a duty to warn of known interactions, and to counsel you on the medications, in today's fast pace world - there is rarely ANY counseling. Take the time to ask the pharmacists - "what is this drug? What is it for? Have I taken it before?" If you have an allergy, ask "Is this drug like _____, I am allergic?" Yes, they should check this for you, but in case they don't, like in Arizona, better to be safe than sorry.

NY NURSING HOME CONVICTED WITH HIDDEN CAMERA

We have previously written about the use of hidden cameras, often called “Granny Cams” to document whether appropriate care is being provided to our loved ones who live in nursing homes. It now appears police are using this strategy to prove criminal conduct.

The owners of a Cortland Nursing Home have been found guilty of neglecting a comatose patient following an undercover investigation. Videotapes showed that on numerous occasions the staff neglected to reposition a patient, treat his bedsores or provide other care. Highgate LTC Management of Niskayuna, the company that owns the facility, could either be fined or banned from receiving Medicaid funding when sentenced this week.

At a jury trial last week, the company that operates the Northwoods Rehabilitation and Extended Care Facility was found guilty of six counts of violating public health law and three counts of second degree falsifying business records.

NURSING HOME OPERATORS TO FALL UNDER GREATER FEDERAL SCRUTINY

Nursing home operators and their use of government dollars will come under closer scrutiny, according to details in the new Office of Inspector General's (OIG) 2008 work plan. The OIG will review nursing facility cost reports and evaluate the government's oversight of Medicare expenditures contained in the reports.

My bet is the federal review will find some rats in the basement! Read the OIG report here.

CALL A LAWYER ASAP

I was reading a case summary today, on how parents could recover for assault that occurred to their child. They recovered for their own emotional damages and the emotional damages experienced by their child. In Virginia, emotional distress claims must be brought WITHIN 1 YEAR. That means, from the date of the ACCIDENT you only have one year. The moral of the story is, if something happened - please call RIGHT AWAY. We have had to turn cases down because folks have called too late, or worse, we have received great cases but the statute of limitations limits the claims we can make. Every state is different, so please don't assume Virginia is like NC or TENN or anywhere else.

$26 MILLION TO FAMILY

Check out the full article in the Boston Harold - written by Jessica Fargen, here.

" A Brockton family whose brain-damaged boy will never walk or talk because of a botched delivery at a Boston teaching hospital says they have the answers they’ve long sought after a $26.5 million jury verdict in their favor.
“It’s a relief. We finally found out what happened to Jose,” said Jose Bejarano Sr., whose 10-year-old son, Jose Jr., has cerebral palsy and requires around-the-clock care. “We asked questions before and we never had an answer.”
A Suffolk County jury issued the verdict Thursday. The damages against two Brigham and Women’s doctors are believed to be the largest medical malpractice award this year and one of the biggest in state history, Bejarano’s attorney said.
“It was an award for him,” said Bejarano, 42, a self-employed trucker. “It’s for him just to make his life better, as much as we can.”
Bejarano and his wife, Maria, said the money allows them to continue to care for Jose at home. Jose uses a wheelchair, eats through a feeding tube and cannot care for himself. He communicates with his eyes, Bejarano said.
..."The doctors’ attorney, Edward Hinchey, maintains Jose’s injuries are not the doctors’ fault.
“We cannot point to the exact cause or timing of injury other than to say it didn’t happen when (Mrs. Bejarano) was being monitored. From that we can say it happened before she came to Brigham,” he said.
He said he was “stunned and disappointed” by the verdict and will likely appeal.


WOW - that jury must have felt very strongly about this case!

LIMITING AWARDS FOR PAIN AND SUFFERING CAN HURT!

Darrie Eason is an excellent example of what's wrong with proposals to cap damages for pain and suffering in medical malpractice cases. The high cost of malpractice insurance is a problem. But adding insult to patients' injuries by arbitrarily limiting jury awards is not the answer.

Eason was told she had cancer and decided to undergo a double mastectomy but was subsequently told by her doctors that the devastating diagnosis was a mistake. Her tissue sample had been mislabeled. She never had cancer! Tragically, by then her breasts had been removed. If it's proved that her travail was caused by somebody's negligence, she can collect economic damages - lost wages and the cost of hospitalization, surgery, physical therapy and the like. But that just covers her expenses. So, what else is there? Whatever a judge or jury considers just compensation for her pain and suffering. Under current law, without caps, she could be awarded millions of dollars. Impose the cap sought by President George W. Bush and she could get no more than $250,000.

Read the Newsday Report here.

VIRGINIA'S MENTAL HEALTH SYSTEM

We specialize in Medical Malpractice and Nursing Home abuse - so why would I write about Mental Health in Virginia? I write about it because it is system in great need of reform, and one that affects so many aspects of healthcare.

Check out today's Washington Post, Shortage of Beds And Psychiatrists Plagues Much of Va.
Reimbursement Cited as Problem, Too
Chris L. Jenkins writes that "Virginia lacks experienced psychiatrists to evaluate the mentally ill, there aren't enough beds for those seeking emergency treatment in many areas and hospitals are losing money on mentally ill patients, according to a state government report."
He goes on to cite the 230-page report released this week by the General Assembly's, prepared by the Joint Legislative Audit Review Commission, "states that 47 of Virginia's 135 localities do not have public psychiatrists and that 87 do not have public child psychiatrists. In addition, half of the state's psychiatrists are in seven Virginia localities, according to the report, and one in five are in Fairfax County, Fairfax City and Falls Church. "

So what happens to those in need of treatment that don't get it? Many end up in long term care facilities- yes, nursing homes, in rooms next door to your loved ones needing rehab or skilled care. It is not that I am afraid of mental illness, I have personal and professional experience with Virginia's system.... but I am confident a different level of care is required for someone suffering from dilusions relating to dementia, than someone who suffers from dilusions and schizofrenia.

The study also found "that on a single day in 2005, 60 percent of the 6,350 mentally ill people were in state hospitals or were in jails." It also affects our emergency care system - as Emergency rooms are usually the first stop for someone "in danger to themselves or others."

Bottom line - STATE needs to do something about it, and soon.

ANOTHER CANCER STUDY -

An article in yesterday's Washington Post:


Long-Hidden Dangers?
Early Exposure to DDT May Raise Risk of Breast Cancer
By Rick WeissWashington Post Staff Writer Tuesday, October 9, 2007; Page HE01
A new study has found a significant link between women's exposure to DDT as young girls and the development of breast cancer later in life.
The results are something of a surprise, researchers said, because several previous studies have found no link between cancer and the insecticide, which was widely used during the 1950s and '60s but was banned in the United States in 1972.

The new work differs from all other studies, however, by focusing on the age at which women were exposed. Echoing the situation with some other breast cancer risks, such as radiation, it finds that DDT increases the risk of breast cancer in adulthood only if the exposure occurred at a young age, before the breasts were fully developed.
All told, girls who had the highest levels of the chemical in their blood during that crucial developmental period were five times more likely to get breast cancer years later than were girls who had the lowest levels. That fivefold increase is a bigger boost in risk than is now attributed to hormone replacement therapy or having a close relative with breast cancer.
Although there is nothing that women today can do about their DDT exposures decades ago, the results could influence an ongoing controversy about the extent to which the chemical should still be used around the world.
That question has haunted the World Health Organization because, despite its environmental and potential human health risks, DDT remains one of the most potent weapons against the mosquitoes that transmit malaria, a global scourge that kills about a million people every year, most of them children.

As always, scary news.

Summary of Nursing Home negligence

Not a weekend goes by, when I am not asking in some social setting "What type of law do you practice?" Typically, I answer directly - "I sue nursing homes." The last time I said this, the other person, a nurse, asked "I hope you sue the corporations and remind them they don't hire enough nurses." She clearly has some insight into for-profit long term care.

Other times, people will ask why someone would sue a nursing home. Examples I give: Because the nursing home let a resident roll down the stairs in his wheelchair; because they gave someone the wrong medicine and she died; because they didn't give someone the right medicine and he died; because they didn't feed someone's grandmother and she died of malnutrition; because a lady was left unattend and left the facility, only to die in the cold; because a man was left unattended and fell and broke his neck; because someone was dropped and broke a hip; because the staff failed to treat a wound and the wound got so big, a lady's bones were exposed..... The list goes on.. Too many cases and examples to recount.

The moral is - if you are going to put a loved on in a place like this - you need to be the eyes and ears. Oh yeah, and the BIGGER MORAL is - the priority of the companies should be taking care of patients, and not making money. Again, I ask for too much - capitalism with the goal of the greater good, not just immediate financial gain.

CHICAGO AREA NURSING HOME ALLOWED SEXUAL ABUSE

This sad story comes to us from the Chicago Sun Times. A Lake County-owned nursing home failed to protect an 82-year-old woman resident, allowing repeated, unsupervised visits by a man who later admitted sexually molesting her, a lawsuit filed by her family contends.

Duane Stapher, 64, was sentenced to probation last month after he pleaded guilty to sexually abusing the woman, who has severe dementia and lives at Winchester House in Libertyville. Winchester House employees allegedly saw Stapher put his hands under the woman's clothing but didn't report it to supervisors or the woman's family.

Read the full story here.

CASE REPORT: PATIENT SUES LAB OVER FALSE CANCER DIAGNOSIS

Imagine this…you are 35 years old, a single mother, and your doctor informs you that you have lobular cancer! You are scared and worried! Are you going to die? You decide to undergo a double mastectomy to remove the cancer. The next thing you hear is that it was all a mistake – you never had cancer in the first place! Unbelievable maybe but it happened!

The Associated Press is reporting today that this actually happened to a woman in Melville, New York. According to a New York State Health Department report, this unfortunate young woman was the victim of a mix-up at the pathology laboratory which analyzed the original tissue studies. It appears a lab technician at CBL Path mislabeled tissue samples.

A lawsuit has been filed against the laboratory – can anyone blame this young woman!

Read the news article here…and believe it or not it happened a second time at the same lab as reported here.

FAMILY DENIED TREATMENT

We have heard rumors about this... Physicians refusing to treat families who have filed medical malpractice cases. We often thought it would be the attorneys denied care first, but sadly, we were wrong. READ HERE.

MALPRACTICE FINDING AGAINST WICHITA CLINIC PHYSICIAN
Clinic barred family after suit
BY RON SYLVESTER
The Wichita Eagle
When Karie Zimmer challenged one doctor at Kansas' largest medical clinic, the rest of the physicians refused to treat her and her family.
Zimmer, a Wichita police officer, suffered a life-threatening punctured artery during surgery at the Wichita Clinic.
A Sedgwick County District Court jury recently found the doctor, Jeannine Cobb, at fault and awarded Zimmer more than $140,000 in medical malpractice damages.
What the jury didn't hear during the eight-day trial earlier this month was that the Wichita Clinic continued to treat Zimmer and her family for nearly two years -- until she filed the lawsuit in August 2005.
Zimmer said a vascular surgeon called her to cancel an appointment at one of the Wichita Clinic's offices. Days later, she received a letter from the chief medical officer.
"Based on this we find it necessary to sever our relationship with you," Robert Kenagy wrote, referring to Zimmer's lawsuit.
"This means we will no longer provide services to you or any member of your immediate family at any Wichita Clinic location," read the letter dated Nov. 11, 2005.
Because the city's health insurance limited her to the Wichita Clinic, Zimmer said her family was without medical care for about six weeks.
Kenagy told The Eagle that Zimmer isn't the only patient to receive such a letter after filing a lawsuit against the clinic.

WOW - anyone think healthcare is a "right" - think again!

WHO TRIED TO INFLUENCE THE COURT OR JURORS?

This is unbelievable! I don’t know which side was “playing dirty” but if the guilty party is ever identified they should be sent to jail!

122 medical malpractice cases had been filed against a former West Virginia osteopathic physician, Dr. John A. King. Separate suits were filed against Putnam General Hospital (at the time owned by HCA, Inc) for hiring Dr. King. In August a civil jury found Putnam General Hospital negligent for hiring Dr. John A. King. That verdict exposes the hospital to the lawsuits alleging King harmed or even killed patients through unnecessary surgery and other malpractice during his six months there.

Now it gets dirty and the Internet video website Youtube comes into play! It appears someone posted video depositions of several plaintiffs along with other video clips purporting to show some plaintiffs engaging in activities they testified they could not engage in due to injuries suffered as a result of Dr. King’s negligence. The only problem is the video was shot at great distance and it is difficult to determine whether the individuals in the video are actual plaintiffs in the cases. The problem created by the release of these videos is that three weeks earlier, Putnam County Circuit Judge O.C. Spaulding had barred both sides from releasing any information from the cases. The judge did not want potential jurors to be swayed by the videos even before the trial started.

The video that helped trigger the judge's ruling had apparently been released by a media consultant hired by the defense! Read more about this story.