More Than Half of Pediatricians Make Diagnostic Errors, Study Says

by Honey Berk Jun 22nd 2010 4:00PM

Maybe it’s time to rethink that age-old “doctor-is-god” stereotype.

Fifty-four percent of pediatricians say they make diagnostic errors at least once or twice per month, according to a new survey of more than 700 pediatricians and pediatric trainees.

The data for trainees was even more striking, with 77 percent admitting they make errors at least once or twice per month. And nearly half of the pediatricians surveyed say their errors harm patients at least once or twice per year.

However, according to Business Week, researchers did not ask the extent of the harm and said they didn’t have enough information to gauge the seriousness of it. But the authors say previous research points to the existence of diagnostic errors in 32 percent of pediatric malpractice claims.

“These are perceptions and much more research has to be done to really delineate how often this happens,” senior study author Dr. Geeta Singhal, of Baylor College of Medicine, tells Business Week.

Diagnostic errors typically include those that are delayed, wrong or missed, Business Week reports. Those detailed in the study involve a range of activities, from prescribing, dispensing and administering medications to surgery- and anesthesia-related activities that occur in the operating room.

The most frequent diagnostic error reported was viral illnesses being misidentified as bacterial illnesses, according to the study — so stop feeling guilty for thinking your child’s last bout with strep throat was just a cold. Other diagnostic errors frequently reported were the misdiagnosis of medication side effects, psychiatric disorders and appendicitis.

Pediatricians surveyed most often cited a failure to gather information through medical history, exam or chart review as the cause of errors. Other causes of misdiagnoses included failure of parents to seek care for their child in a timely manner, failure to follow up on abnormal lab tests and parents ignoring follow-up recommendations, Business Week reports.

Physicians say closer follow up of patients and improved teamwork between practitioners would decrease the likelihood of errors, as would improving access to information through electronic health records and diagnostic decision-support tools, according to the authors.

Singhal tells BusinessWeek that parents who are unsure of a diagnosis should be encouraged to ask for more information or seek a second opinion, since physicians are not always right.

“It’s important to me as a pediatrician and as a mom to empower our patients and our families to ask good questions of their physicians,” Singhal tells the magazine. “If they are not comfortable with the diagnosis, it’s OK to ask the doctor to elaborate more or help them understand better.”

Source:

http://www.parentdish.com/2010/06/22/more-than-half-of-pediatricians-make-diagnostic-errors-study-sa/

SHAKEN BABY SYNDROME OR MEDICAL NEGLIGENCE?

By Maureen Hickman

Managing Legal Clerk, Carters Law Firm, Sydney, Australia
e-mail: acii@…
Address: PO Box W261, Warringah Mall, Brookvale. NSW 2100, Australia
Telephone: 61 2 9907 1687
Facsimile: 61 2 9907 1657

Is it Shaken Baby Syndrome or the negligence of medical personnel for failing to carry out extensive medical investigation, following injury or death of a child diagnosed with sub-dural and retinal haemorrhages? That is the crucial question.

The worrisome aspect of the diagnosis of SBS by coroners, forensic pathologists and other medical specialists is that they focus their entire attention on this one medical hypothesis and ignore many other idiopathic causes (including
vaccination) of death/injury. Following any medical observation of co-existing sub-dural and retinal haemorrhages in a baby the conclusion is that these haemorrhages are distinctly characteristic of SBS. In other words, where the facts fit the theory, accept them without any further medical investigation into the cause.

Unfortunately, the medical professionals acting on behalf of the accused are brought into the matter some time after the cremation or burial of a child or sometimes the child is in other care, if injured. Because they have no access after death/injury, it is impossible to request further specific analysis of certain organs, blood testing, radiology screening etc., or to demonstrate that other explanations may exist for the death/injury.

The Brain Journal of Neurology,1 in an introduction, says ‘The neuropathology of inflicted head injury, whether adult assault or non-accidental injury (NAI) in children, has not been fully studied.’ Until such studies are carried out and
published, the current medical opinion on the link between subdural and retinal haemorrhages and SBS cannot be substantiated. If no medical literature is available defining the affects of alleged ‘shaking,’ why are medical practitioners and police personnel so determined to ignore other reasons for death/injury?

In a recent SBS case in Western Australia,2 where a father was accused of the murder of his son, Cameron Court, Scott J found the father ‘not guilty’. In the judgment dated 3rd June, 2003, Scott J said:

‘I was not satisfied beyond reasonable doubt that the accused caused the death of the deceased in the manner alleged by the Crown.

I also took into account the principle of law that I could only draw an inference against the accused if it was the only rational inference that was available on the evidence. That rule was of importance in determining whether the Crown had proved beyond reasonable doubt the necessary intent for the offence of murder. It was also important because this was a circumstantial evidence case relying upon conclusions said to be available from medical findings.

I was unable to conclude beyond reasonable doubt that the death of the deceased was caused by the deceased being shaken by the accused in the manner alleged by the prosecution. The evidence, which I have reviewed extensively in these reasons, gave rise to considerable doubt as to whether shaking was the cause of the death of the deceased. It was not necessary to consider the intent of the accused further.

For these reasons I acquitted the accused of both murder and manslaughter.’

Application for Leave to Appeal was made on 23rd June, 2003 but this Application has not yet been heard before the court and therefore it is not known at this time whether an appeal will take place. The particulars of the appeal by the
prosecutors are as follows:

‘(a) The expert medical opinion was that the child had died from a brain injury
due to trauma;
(b) The Respondent’s explanation did not account for the constellation of
injuries found on the deceased;
(c) The constellation of injuries found on the deceased was consistent only with
the Baby-Shaking Syndrome. The baby died as a result of being subjected to
acceleration/deceleration forces combined with rotational effect.’

In another SBS Australian case3 heard in 1998, a father was found ‘not guilty’ of manslaughter of his daughter, Rikki-Lee Walters. In the judgment dated 24th March, 1998, Black A.J. said:

‘In my view, this is a case of circumstantial evidence and, accordingly, in order to convict the accused I have to be satisfied not only that the circumstances are consistent with the accused having committed the crime but also that the facts are such as to be inconsistent with any other rational conclusion. Before drawing an inference on the accused’s guilt from circumstantial evidence, it is essential for me to be sure that there are no other circumstances which would weaken or destroy the inference.

” Applying the above principles to the present case it means that in order to convict the accused I would have to be satisfied first of all that the subdural haemorrhage found in Rikki-Lee was caused by the accused violently shaking
Rikki-Lee in a way that a reasonable person in his position would have realised that by doing so Rikki-Lee was being exposed to an appreciable or significant risk of serious injury and that no other reasonably possible explanation for her death exists. That would involve amongst other things my finding beyond a reasonable doubt that the possibilities put forward by Dr. Kalokerinos and/or Dr. Donohoe were not reasonable.

Dr. Kalokerinos

‘I did not form the view that either of those doctors was putting forward a fanciful untenable proposition. Perhaps putting the burden the correct way I am not satisfied that their evidence should be rejected as unreliable nor amI
satisfied that their propositions are unreasonable.’

Following the death/injury of a child and the subsequent police accusation of SBS by a parent/carer, any severe adverse effect of vaccination is one medical investigation that is not carried out by the prosecution medical team. If you meticulously peruse past medical/hospital documentation of these children as well as a health chronology prepared by parents since the birth of the child, a high percentage have had serious adverse reactions to vaccines administered prior to their death/injury. These vaccine adverse events, even though the mechanism is sometimes uncertain, cannot be categorically denied as untenable by the elected judges and juries who hand down decisions affecting the life and freedom of others.

In the Walters case, vaccination was put forward as a possible case of death. Dr. Kalokerinos in his evidence said ‘a possible cause of Rikki-Lee’s death [was] of ‘Scurvy haemorrhages precipitated by Pertussis Vaccine’.

The fact that Rikki Lee had a bad reaction to vaccination was noted on the Report of Death to the Coroner, dated 23 April, 1998: ‘The deceased received two-monthly injections on Wednesday 19.4.98 at her three-monthly period because she had been sick. The deceased then suffered a bad reaction to the injections, however the mother did not return her to the Doctor – Signed by Police Constable.’

It is noted that the medical practitioner said in a statement to police that at the time of vaccination: ‘I cannot recall this consultation, however it is my usual practice to OBSERVE the child and ask general questions as to the child’s health. If the child had been obviously unwell with fever, the vaccination would not have been ordered. Further, the child did not appear to have any physical injuries or (to be) suffering from neglect and if the child had been I am aware of the guidelines in relation to me contacting the Department of Community Services. The child received vaccinations from nursing staff as this is usually the normal practice at the centre.’

We know that the child was ill because both parents have alluded to this fact when giving police statements. Did the medical practitioner give adequate information to the parents on the risks and benefits of vaccination so an informed decision could be made? The father alleged that the medical practitioner in a consultation lasting 3 — 4 minutes: did not take any notes of the consultation; did not examine the child for contraindications to the administration of a vaccine; did not question the parents on the health of the child and did not explain the risks and benefits of vaccination.

If the medical practitioner did not recall the consultation, how could he remember whether there were any physical injuries or whether the child was suffering from neglect? Remember, the doctor took no notes according to the parents. The doctor made the statement: ‘If the child had been obviously unwell with fever, the vaccination would not have been ordered’. We know, however, that the doctor admitted only OBSERVING the child so how could he make a diagnosis of whether the child had any contraindications for the administration of the six vaccines?

In the medical diagnosis of subdural and retinal haemorrhages in any case of death/injury of a child, police and investigators adopt the view that the individual caring for the child at the time of the occurrence is the person guilty of SBS. This causes distress and despair for the accused and their family, if they are not guilty of any offence.

Law firms acting on behalf of accused individuals require medical professionals who are not obedient or compliant to prevailing standards of the medical rhetoric and investigation of SBS and who will look into all other possible causes, including vaccination, of death/injury. It is therefore very important for the worldwide networking of law firms and helpful medical professionals in SBS cases.

Brain, A Journal of Neurology, Vol. 124, No. 7, 1290-1298, July, 2001.
The Queen —v- Craig Douglas Court — No. 28 of 2002, in the Supreme Court of
Western Australia, at Perth, Heard 19-23, 26, 28 & 29 May, 2003.
Regina —v- Scott Warren Walters — No. 70031 of 1996, in the Supreme Court
ofof New South Wales Criminal Division, judgment 24th March, 2998.

Source:

http://www.indiadivine.org/audarya/ayurveda-health-wellbeing/968038-shaken-baby-syndrome-medical-negligence.html

Standards Of Care To Pregnant Women Reveals Scandals And Misdiagnoses

Mired in scandals, disgraced doctors and misdiagnoses

By Breda Heffernan

Tuesday June 08 2010

OUR Lady of Lourdes Hospital in Drogheda has been mired in a series of high-profile scandals and controversies in recent years, many of which have centred on the standard of care given to pregnant women.

MICHAEL NEARY

Disgraced obstetrician Dr Michael Neary was struck off the medical register in 2003 after an investigation found he had needlessly removed the wombs and ovaries of dozens of expectant mothers.

A state inquiry concluded that his actions over the course of 20 years were motivated more by a “phobia” of losing patients than by malice or incompetence.

However, the scandal led to the introduction of a “whistleblower” clause to give legal protection to health workers who raised concerns about the conduct of colleagues.

GARDA TANIA MCCABE

Sergeant Tania Corcoran-McCabe was six months pregnant with twins when she presented at the hospital in March, 2007 with stomach pains. Doctors failed to diagnose that she was suffering ruptured membranes and she was sent home.

She was rushed back to the hospital within 24 hours by which stage she was suffering from sepsis and an emergency caesarean section was performed. Sgt Corcoran-McCabe died on the operating table while one of her twin boys, Zach, also lost his life.

An inquest returned a verdict of death by medical misadventure in relation to the young mother.

SYMPHYSIOTOMY PROCEDURES

Our Lady of Lourdes came in for sharp criticism earlier this year after it was revealed that staff had continued to perform painful symphysiotomy procedures on pregnant women up until the early 1980s, despite other hospitals ending the practice nearly 20 years earlier.

The procedure, which involved widening the pelvis during childbirth, left many women with long-term health problems including incontinence, back pain and depression.

Mother Kathleen Naughton, who is still living with the consequences of the symphysiotomy she underwent there 35 years ago, said doctors at the time considered themselves to be “gods”.

X-RAYS

Thousands of X-rays had to be reviewed after Scottish locum radiologist Dr James Murphy mistakenly gave the all-clear to nine lung cancer patients, eight of whom subsequently died. He worked at Our Lady of Lourdes in Drogheda and Our Lady’s Hospital in Navan between August 2006 and August 2007.

An investigation found that the misdiagnoses resulted in delayed treatment which took months off the lives of some patients. One had to wait over a year before being diagnosed.

To add insult to injury, during the X-ray review, a mailing error led to the families of 179 dead people being mistakenly told their loved-ones’ cases were going to be re-checked.

MICHAEL SHINE

Surgeon Michael Shine, who retired from the hospital in 1995, was struck off the medical register in 2008 after the Medical Council found he had abused his professional position by making sexual advances towards three male patients.

He was acquitted of sexual assault during a court case seven years ago following complaints by patients treated at the hospital from the 1960s to the 1990s.

- Breda Heffernan

Source:

http://www.independent.ie/national-news/mired-in-scandals-disgraced-doctors-and-misdiagnoses-2211019.html

Five Myths About Medical Negligence

by Jane Akre

Wednesday, November 04, 2009 4:18 PM EST

Friday Debate

As the House heads into a floor debate on health care reform, a key promise of the Obama administration, a new white paper summarizes the outstanding issues of the debate.

Five Myths About Medical Negligence is produced by the American Association for Justice (AAJ), a trial lawyers group based in Washington D.C., whose members represent those injured by medical malpractice, estimated to killed at least 98,000 a year.

The opposing side of the debate is generally headed by the U.S. Chamber of Commerce and associated industries such as asbestos, insurance, and pharmaceutical companies that believe limiting lawsuits is necessary to slow the rising costs of health care down and protect its members.

Among the Five Myths AAJ addresses are:

· Myth #1: There are too many “frivolous” malpractice lawsuits.

The actual number of so-called frivolous lawsuits filed a year is questionable.

IB News asked the Institute for Legal Reform for examples of frivolous lawsuits. We asked the office of Sen. Saxby Chambliss who has just offered a “loser pays” proposal to keep down “frivolous lawsuits” and we asked the Texans for Legal Reform. So far none have been provided.

The case usually named, the 1994 McDonalds coffee burning case of Stella Liebeck, is generally regarded as a case with merit, as outlined in the documentary ‘Hot Coffee.’

Stella Liebeck

In 1992, Liebeck, age 79, of Albuquerque, New Mexico suffered third-degree burns over six percent of her body, primarily in her inner thighs, genital, and groin area, from scalding hot McDonald’s coffee.  She asked McDonalds for $20,000 to cover her medical bills. When the company refused she litigated. At trial, McDonalds admitted it had received more than 700 burn claims by others and still chose not to warn the public about its coffee, kept at 180 to 190 degrees rather than the customary135 to 140 degrees.

The $2.7 million the jury awarded her amounted to two days of coffee profits for McDonalds, but a judge reduced the award to $480,000 calling McDonald’s conduct “reckless, callous and willful.”

Reed Morgan, who represented Ms. Liebeck against McDonalds told the Tulane Lawyer after the case that tort reform is not only “totally unnecessary” but also an assault on free enterprise.

“The general public doesn’t understand that the vast majority of attorneys who handle plaintiffs’ cases are entrepreneurs who don’t have the financial wherewithal to do what an insurance company can do with ease – to spend as much money as it takes to win. A plaintiff’s attorney is at severe risk in handling these cases. He’s got a very tight budget. He’s got to use common sense on what he can prove and what it is going to cost to prove it. He must ask himself, ‘Does this case have merit?”‘

While the number of ” frivolous” lawsuits has not been calculated, the number of injured patients can be documented.

*  According to the Institute of Medicine, in its “To Err is Human” report, November 1999, about 98,000 people are killed in hospitals each year from preventable medical errors, such as wrong diagnosis, medication mix-ups or overprescribing or delayed treatment.

*  Recently, the Hearst newspaper group in its “Dead By Mistake” investigation into medical malpractice nationwide found that number to be closer to 200,000 individuals when you include hospital acquired infection.

*  A 2004, Healthgrades report from the independent health care ratings company reported that among 37 million patient records from all 50 states, there were 195,000 hospital deaths from preventable medical errors between 2000 and 2002.

Medical errors add another $29 billion to the cost of health care.

When Harvard looked at the files of 1,400 medical negligence claims they found that 97 percent had merit and that 80 percent involved death and serious injury. According to the authors of the 1990 study, “Patients, doctors, and lawyers,” found that “Portraits of a malpractice system that is stricken with frivolous litigation are overblown.”

Are the injured all flocking to file a lawsuit?

Not really, Harvard School of Public health finds only one in eight people injured by medical negligence file a malpractice claim. And oftentimes that claim is to seek discovery, or records of what went wrong with their treatment.

And the National Center for State Courts finds the filings for medical malpractice dropped eight percent between 1997 and 2006 with awards dropping too, according to the National Association of Insurance Commissioners over 50 percent between 2003 and 2008.

The AAJ other “Myths” include:

2) Malpractice Claims Drive Up Health Care Costs

3) Doctors Are Fleeing

4) Malpractice Claims Drive Up Doctors’ Premiums

5) And Tort Reform Will Lower Insurance Rates #

Read more: http://www.injuryboard.com/national-news/five-myths-about-medical-negligence-.aspx?googleid=273972#ixzz0Xqzinl6p