Med Mal News

Malpractice Proves Profitable

A study published in the Journal of the American Medical Association (JAMA) asserts that hospitals are being incentivized to provide substandard care by the manner in which insurers pay them. Specifically, hospitals not only are not penalized for bad medical outcomes, they reap additional profits from the extra services injured patients require to remedy the effects of bad medical care. The study, conducted by Texas Health Resources, the Boston Consulting Group and Harvard University's schools of medicine and public health, looked at the records of nearly 35,000 patients who underwent treatment at one of 12 hospitals run by Texas Health Resources. Of these, more than 1,800 experienced avoidable medical complications, which, on average, more than doubled their hospital bills, increasing hospital profits.

Although the study's authors took pains to state that hospitals surely do not encourage medical mistakes as a means of increasing revenues, they also observed that the financial incentive to improve patient safety and welfare is absent under the current system of medical bill payment. They suggest that the payment system be changed to reward hospitals that provide quality care, perhaps with bonuses, and penalize those that don't meet standards by not paying for such care.

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State Cracks Down on Dental Office

An Oklahoma dentist has voluntarily surrendered his licenses to practice at the urging of the State's board of dentistry after investigators observed a rash of hepatitis cases in patients who had undergone procedures in his dental office. In March, the State board issued a complaint against Wayne Scott Harrington, D.M.D., who has held a dental license in Oklahoma since 1977, asserting that it found evidence of several safety lapses at Harrington”s office, including failure to properly sterilize equipment and permitting dental assistants to administer anesthesia when they were not licensed to do so. The complaint can be found at http://tinyurl.com/dyb2xdn.

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Consent Forms for Premature Infant Study Inadequate

The federal government's Office of Human Research Protections recently sent a letter to the University of Alabama at Birmingham ' the lead site of a 2004-2009 research study of the effects of oxygen levels on premature newborns ' admonishing the researchers for putting infants at increased risk of developing blindness or dying while failing to inform their parents of those risks. The study involved 1,300 babies born between 24 and 27 weeks of gestation and treated at one of 23 academic institutions. The level of oxygen administered to newborns is, according to the generally accepted standard of care, between 85% and 95%, but there has been debate over which level within this range is optimal. However, there was previous well-regarded evidence showing that the higher levels of oxygen are likely to cause more eye diseases, including blindness, in babies; and that infants treated with lower oxygen levels are more likely to die. In fact, 130 of the infants given the lower levels of oxygen died, and 91 babies assigned to the high-level oxygen group developed eye disease.

The agency's letter, which ultimately asks its recipients to explain how they will avoid breaches of protocols for obtaining informed consent in future studies, noted that “[t]he template for the consent form used in this study did not mention any risks relating to the randomization between the higher and lower levels of oxygen, instead suggesting that this was a low risk study, noting that all of the treatments in the study were 'standard of care,' and that there was 'no predictable increase in risk for your baby.'” The letter can be accessed at http://tinyurl.com/cgekadq.

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Malpractice Proves Profitable

A study published in the Journal of the American Medical Association (JAMA) asserts that hospitals are being incentivized to provide substandard care by the manner in which insurers pay them. Specifically, hospitals not only are not penalized for bad medical outcomes, they reap additional profits from the extra services injured patients require to remedy the effects of bad medical care. The study, conducted by Texas Health Resources, the Boston Consulting Group and Harvard University's schools of medicine and public health, looked at the records of nearly 35,000 patients who underwent treatment at one of 12 hospitals run by Texas Health Resources. Of these, more than 1,800 experienced avoidable medical complications, which, on average, more than doubled their hospital bills, increasing hospital profits.

Although the study's authors took pains to state that hospitals surely do not encourage medical mistakes as a means of increasing revenues, they also observed that the financial incentive to improve patient safety and welfare is absent under the current system of medical bill payment. They suggest that the payment system be changed to reward hospitals that provide quality care, perhaps with bonuses, and penalize those that don't meet standards by not paying for such care.

'

State Cracks Down on Dental Office

An Oklahoma dentist has voluntarily surrendered his licenses to practice at the urging of the State's board of dentistry after investigators observed a rash of hepatitis cases in patients who had undergone procedures in his dental office. In March, the State board issued a complaint against Wayne Scott Harrington, D.M.D., who has held a dental license in Oklahoma since 1977, asserting that it found evidence of several safety lapses at Harrington”s office, including failure to properly sterilize equipment and permitting dental assistants to administer anesthesia when they were not licensed to do so. The complaint can be found at http://tinyurl.com/dyb2xdn.

'

Consent Forms for Premature Infant Study Inadequate

The federal government's Office of Human Research Protections recently sent a letter to the University of Alabama at Birmingham ' the lead site of a 2004-2009 research study of the effects of oxygen levels on premature newborns ' admonishing the researchers for putting infants at increased risk of developing blindness or dying while failing to inform their parents of those risks. The study involved 1,300 babies born between 24 and 27 weeks of gestation and treated at one of 23 academic institutions. The level of oxygen administered to newborns is, according to the generally accepted standard of care, between 85% and 95%, but there has been debate over which level within this range is optimal. However, there was previous well-regarded evidence showing that the higher levels of oxygen are likely to cause more eye diseases, including blindness, in babies; and that infants treated with lower oxygen levels are more likely to die. In fact, 130 of the infants given the lower levels of oxygen died, and 91 babies assigned to the high-level oxygen group developed eye disease.

The agency's letter, which ultimately asks its recipients to explain how they will avoid breaches of protocols for obtaining informed consent in future studies, noted that “[t]he template for the consent form used in this study did not mention any risks relating to the randomization between the higher and lower levels of oxygen, instead suggesting that this was a low risk study, noting that all of the treatments in the study were 'standard of care,' and that there was 'no predictable increase in risk for your baby.'” The letter can be accessed at http://tinyurl.com/cgekadq.

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