Philadelphia Medical Malpractice Lawyer Blog

A new study published in The Journal of the American Medical Association reveals that the likelihood of patient survival after cardiac arrest (when the heart stops) in a hospital is significantly impacted by the time of day the attack occurs. This study follows earlier studies that demonstrated that patients fare worse during weekend care than they do during care received during the workweek for the same health problems.

In the recently-published study, almost 87,000 patients who suffered from cardiac arrest were studied at 507 hospitals during 7 years. Typically, when a patient's heart stops, a team of medical professionals is called urgently to the patient's bedside to begin rendering care from a "crash cart" that contains equipment such as a defibrillator and various drugs. As a practical matter, patients who suffer from a cardiac arrest are usually very sick and even at the best of times the rate of survival is fairly low (among the studied patients, approximately 20% of those who suffered a cardiac arrest during the day shift survived to the point of hospital discharge), but something about the night shift seems to make the chances of survival even worse. In the study, only 15% of those patients who suffered a cardiac arrest during the 11 p.m. - 7 a.m. shift survived long enough to be discharged from the hospital.

This study would suggest that the level of patient care received a night is subpar - either because the night shift workers are too tired to react as efficiently as the day shift workers or because there is less staff during the night hours such that they can't check patients as often and react to problems as quickly or because the experience and skill level of night shift workers is lower than that of day shift workers. Whatever the explanation, it is reasonable to conclude that differences in care are not limited to cardiac arrest situations.

Posted by Leon Aussprung | Permalink | Email This Post

Posted In: Hospital Care

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Evidence showed that poor nursing care at Pennsylvania Hospital of the University of Pennsylvania Health System, including failure to contact a physician as ordered when the patient's blood pressure dropped below 100 and the absence of documented nursing care for a 16.5 hour period after surgery, resulted in the death of a 55 year old woman following a routine hernia operation. At trial, medical records presented to the jury showed that after surgery, a resident examined the patient and noted in her chart that nurses should call a physician if the patient's blood pressure dropped below 100. The same records showed that later the same day, at 5:15 p.m., a nurse recorded a blood pressure of 90/60, but did not call a doctor. This was the last nursing note written in the chart for the patient until 9:45 the next morning, reflecting a gap in documented care of 16 and 1/2 hours. The 9:45 a.m. chart noted that the patient was "extremely sedated, requiring painful stimuli for arousal and with a blood pressure of 90/58."

Following the 9:45 a.m. note, the patient's morphine pump was stopped and she was transferred to the intensive care unit, where she died two and a half days later. Attorneys for the woman's family argued that the nurses violated the standard of care by not calling for a doctor when the patient's blood pressure dropped below 100. Although attorneys for the hospital disputed that the nurses' care was negligent, a nursing supervisor employed by the hospital testified that a doctor should have been called when the patient's blood pressure dropped below 100.

In addition to the allegations that the nurses were negligent for failing to call for a doctor, the plaintiff's attorneys argued that the patient was over-medicated with morphine. Evidence presented at trial showed that people with compromised livers, which this patient had because of a chronic alcoholism condition, process morphine 50% slower than patients with a healthy liver. Attorneys for the hospital essentially argued that the patient was caused by her alcoholism and related medical problems such as liver disease and high blood pressure.

A jury voted 10-2 to award the patient's family $1.2 million dollars, which was $900,000 more than the highest offer the hospital had made to settle the case prior to trial. The hospital has stated it will appeal the verdict.

Posted by Leon Aussprung | Permalink | Email This Post

Posted In: Hospital Care

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In 2002, baby Ira Faustino died after having heart surgery performed by Dr. William I. Norwood at duPont Hospital for Children. In 2005 Ira's parents filed a medical malpractice suit after learning for the first time that Ira suffered brain damage as the result of allegedly negligent conduct by Dr. Norwood during the surgery. The Faustinos claim that it was not until Dr. Norwood was fired from duPont in 2005 amidst heavy media coverage that they learned that Dr. Norwood had allegedly been performing experimental surgeries on critically ill children in an attempt to develop a new surgical procedure for heart problems. Only after the media coverage revealed apparent problems with Dr. Norwood's techniques did the Faustinos learn that Dr. Norwood had used an unconventional cooling method on Ira to prepare him for surgery and then fraudulently concealed that fact from his parents after he died. It is alleged that Dr. Norwood used an untested cooling method that cooled the body more quickly than standard methods, but resulted in seizures and brain damage in some patients. Because Dr. Norwood allegedly did not tell the hospital or parents of patients that he was not cooling patients in a traditional manner, it was never suggested to the Faustinos that this aspect of the surgery could have been the cause of Ira's death. The Faustinos allege that if they had known at the time that Ira died that Dr. Norwood had used the unconventional cooling technique and that Ira suffered brain damage thereafter, they would have filed suit sooner and not allowed the 2 year statute of limitations to expire.

duPont and Dr. Norwood are asking the Court to punish the Faustinos' attorney for filing the lawsuit, arguing that she knew it was frivolous because the statute of limitations had clearly expired before it was filed. In support of their argument, duPont and Dr. Norwood allege that the Faustinos knew immediately after Ira's death that he died from fluid in the lungs, which is a common complication of the surgery he had. Further, duPont and Dr. Norwood argue that the Faustinos were told that Ira died from "complications of surgery," which they assert demonstrates there was no overt act of fraudulent concealment as required by Pennsylvania law to extend the statute of limitations. The Faustinos, on the other hand, argue that duPont and Dr. Norwood's failure to advise them that an unconventional cooling method was used on Ira during surgery was an overt act of fraudulent concealment.

This case demonstrates that complex issues, both legal and medical, that can arise in medical malpractice cases. The assistance of an experienced attorney who is willing to explore all available legal theories is crucial to success in this complicated area of the law.

Posted by Leon Aussprung | Permalink | Email This Post

Posted In: General Information

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