Med Mal News

Extraordinary Measures? Hospital Wants Right to Deny Them

In the case of Betancourt v. Trinitas Regional Medical Hospital, A-3849-08, a New Jersey appellate court is being asked to decide for the first time whether hospitals should be permitted a say in whether extraordinary measures are employed to keep comatose patients alive. In the suit, the hospital claims that “compelling a hospital and its independent physicians to provide medical services that are contrary to recognized standards of care to a moribund permanently vegetative person which will do nothing more than prolong an inhumane, painful death” is inconsistent with state law. The case arose after 72-year-old Ruben Betancourt suffered brain damage after accidentally removing his own ventilating tube following an operation. After he had spent a year in a persistent vegetative state, Betancourt's daughter became concerned that his doctors were unilaterally making medical decisions for him, such as by discontinuing his dialysis and issuing a “Do Not Resuscitate” order. She therefore went to court and was appointed guardian. The hospital appealed. In May 2009, before oral argument at the Appellate Division, Betancourt died. Now the plaintiff wants the case dropped as moot, while the hospital wants it to go forward, arguing that the appellate court should hear the case because it “presents issues of grave public importance.” The New Jersey Hospital Association and the Medical Society of New Jersey have filed amicus briefs on behalf of the hospital. Countering these are briefs supporting the plaintiff, filed by organizations such as Not Dead Yet, The American Association of People With Disabilities and the Rabbinical Council of America.

Unread Heart Tests Prompt Formal Change in Policies At NY Hospital

On May 20, New York City's Health and Hospitals Corporation (HHC) learned that physicians at the city's Harlem Hospital Center never read approximately 4,000 echocardiograms taken there. (HHC and the Columbia University medical school employ and supervise the doctors at Harlem Hospital Center.) The doctors at Harlem Hospital Center had relied on technicians to read the test results and alert them when follow-up tests or other actions seemed needed. In an HHC release, the organization's president, Alan D. Aviles, said, “While the process the doctors followed may have alerted cardiologists to those echocardiograms that were most likely to be abnormal, the failure to read echocardiograms in a timely manner is inexcusable and may have placed patients at risk.” Upon learning of the breach of medical protocol, HHC and Columbia put together a team of cardiologists to work through the backlog of unread echocardiograms. They also changed their internal policies to specify that all echocardiograms be reviewed and reported to the appropriate physician within two working days. In addition, the hospital's medical director will now be responsible for performing a monthly review of unread echocardiograms and for making a quarterly report on the subject to the Quality Assurance Committee of HHC's Board of Directors.

Extraordinary Measures? Hospital Wants Right to Deny Them

In the case of Betancourt v. Trinitas Regional Medical Hospital, A-3849-08, a New Jersey appellate court is being asked to decide for the first time whether hospitals should be permitted a say in whether extraordinary measures are employed to keep comatose patients alive. In the suit, the hospital claims that “compelling a hospital and its independent physicians to provide medical services that are contrary to recognized standards of care to a moribund permanently vegetative person which will do nothing more than prolong an inhumane, painful death” is inconsistent with state law. The case arose after 72-year-old Ruben Betancourt suffered brain damage after accidentally removing his own ventilating tube following an operation. After he had spent a year in a persistent vegetative state, Betancourt's daughter became concerned that his doctors were unilaterally making medical decisions for him, such as by discontinuing his dialysis and issuing a “Do Not Resuscitate” order. She therefore went to court and was appointed guardian. The hospital appealed. In May 2009, before oral argument at the Appellate Division, Betancourt died. Now the plaintiff wants the case dropped as moot, while the hospital wants it to go forward, arguing that the appellate court should hear the case because it “presents issues of grave public importance.” The New Jersey Hospital Association and the Medical Society of New Jersey have filed amicus briefs on behalf of the hospital. Countering these are briefs supporting the plaintiff, filed by organizations such as Not Dead Yet, The American Association of People With Disabilities and the Rabbinical Council of America.

Unread Heart Tests Prompt Formal Change in Policies At NY Hospital

On May 20, New York City's Health and Hospitals Corporation (HHC) learned that physicians at the city's Harlem Hospital Center never read approximately 4,000 echocardiograms taken there. (HHC and the Columbia University medical school employ and supervise the doctors at Harlem Hospital Center.) The doctors at Harlem Hospital Center had relied on technicians to read the test results and alert them when follow-up tests or other actions seemed needed. In an HHC release, the organization's president, Alan D. Aviles, said, “While the process the doctors followed may have alerted cardiologists to those echocardiograms that were most likely to be abnormal, the failure to read echocardiograms in a timely manner is inexcusable and may have placed patients at risk.” Upon learning of the breach of medical protocol, HHC and Columbia put together a team of cardiologists to work through the backlog of unread echocardiograms. They also changed their internal policies to specify that all echocardiograms be reviewed and reported to the appropriate physician within two working days. In addition, the hospital's medical director will now be responsible for performing a monthly review of unread echocardiograms and for making a quarterly report on the subject to the Quality Assurance Committee of HHC's Board of Directors.