The civil justice system is slow, subject to legal spin, and not exactly easy to navigate.
Fortunately there are medical watchdog organizations that are not simply figureheads or puppets for large healthcare organizations. They call a spade a spade.
I had filed, at the request of my mother when she was still lucid and living, a complaint in Dec. 2010 with the Medicare Quality Improvement Organization (QIO) where my mother was treated and injured.
The QIO investigated and the records were reviewed by an independent expert physician of the appropriate specialty. There report is as follows (redacted of names, places and dates; emphases mine):
(It's regrettable that my mother left this earth before seeing this report.)Dear Mr. Silverstein,
[QIO organization] is the Quality Improvement Organization authorized by the Medicare program to review medical services provided to Medicare patients in [state]. Our responsibilities include a review of medical records to determine whether services meet professionally recognized standards of health care, are medically necessary, and are delivered in the most appropriate setting. We also review written complaints about the quality of Medicare services received by Medicare patients. Where we identify quality concerns, we provide education and feedback to providers and their medical staffs to improve the quality of services they provide in their facilities.
In response to your initial written concern, a QIO physician has reviewed the medical records concerning the services your mother received on 05/##/10 at [YY Hospital].
You are concerned about the following:
Concern:
Your mother was admitted at [YY Hospital] on May ##, 2010. You are concerned regarding the failure of the staff to properly conduct medication reconciliation which resulted in denial of a critical heart rhythm maintaining medicine, Sotalol, to your mother who had been taking it for approximately 8 years.
Response:
A QIO physician reviewer has reviewed the complete medical record for this admission and previous admissions. It was noted that the medication Sotalol was on the 4/##/10 discharge summary and the [later] 4/##/10 ER visit, current medications listed Sotalol 120mg every 12 hours.
It appears that on the 05/##/10 ER visit the current medication list does not include Sotalol and it does not appear that the patient received Sotalol on admission on 5/##/10. Also, the cardiology consult note on 5/##/10 states Sotalol was on hold but that is not clear from the ER note or admission H&P. It appears that Sotalol was not given from 05/##/10 - 05/##/10. Appropriate medication reconciliation of this medication appears not to have been performed. Therefore, a quality of care concern has been identified and confirmed.
Concern:
You are concerned that this failure resulted in lack of continuity of care and many medical complications your mother suffered which include, permanent CNS and cardiac injury as well as increased risk for CVA.
Response:
The QIO physician determined that there is a lack of continuity of care based on the review of the medical records submitted. It appears that the failure to administer Sotalol resulted in the recurrent atrial fibrillation on 5/##/10 and other subsequent medical complications. Therefore, a quality of care concern has been identified and confirmed.
As required by Federal regulations, prior to reaching our decision we gave [YY Hospital] an opportunity to discuss the services your mother received.
After a thorough review of your medical records and any additional information provided by the facility, we determined that the services your mother received did not meet applicable professionally recognized standards of health care. [That phraseology might be considered a technical description of malpractice - ed.]
In addition to determining whether or not care met professionally recognized standards of health care, we have reviewed the medical records pertaining to the services provided to your mother to see if there were any opportunities for improvement.
We share your concern about the quality of service your mother received and have initiated appropriate action as warranted by our review findings. [I was told the hospital was required to develop and/or follow a remediation plan to prevent further errors of this kind, and report back to the QIO for several quarters on their progress - ed.]
Before reaching our decision, we gave all involved practitioners and providers an opportunity to review our response concerning the services your mother received.
Please note that the information concerning individual practitioners contained in this letter is confidential and cannot be given out to anyone else, unless that practitioner's identity is not disclosed or he/she) has given consent.
If you have other concerns regarding this matter, please contact us.
Sincerely,
[Doctor Name]
QIO Medical Director
So, there are in fact organizations that will not tolerate substandard medical care.
These organizations need to receive increased influence and authority.
Of course, I mentioned early in this post that seeking justice is not a linear process.
It seems part of the problem is that many hospitals have problems with basic honesty, accountability, and medical expertise.
Exhibit one in that regard is the statements from the hospital's representatives even after Medicare found them to have not met applicable professionally recognized standards of health care:
"Defendant is unable to determine what plaintiff's claims are."
On issues of health IT's role in the errors, the response was Blame the Vendor:
"Claims are more appropriately brought against the software manufacturer." [Which could likely have a "hold harmless" agreement with the hospital - ed.]
This is reminiscent of the hemming and hawing in the aforementioned cases, and leads me to conclude many hospitals are, through legal games and technicalities, burying their mistakes with little accountability.
I submit that if after Medicare finds hospitals to have not met applicable professionally recognized standards of health care resulting in patient injury, yet the hospitals profess they "cannot determine plaintiff's claims", then those hospitals needs to find themselves new medical and Board-level leadership.
-- SS
scotsilv@aol.com (InformaticsMD) 06 Oct, 2011
--
Source: http://hcrenewal.blogspot.com/2011/10/there-are-still-some-medical-watchdog.html
~
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The civil justice system is slow, subject to legal spin, and not exactly easy to navigate.
Fortunately there are medical watchdog organizations that are not simply figureheads or puppets for large healthcare organizations. They call a spade a spade.
I had filed, at the request of my mother when she was still lucid and living, a complaint in Dec. 2010 with the Medicare Quality Improvement Organization (QIO) where my mother was treated and injured.
The QIO investigated and the records were reviewed by an independent expert physician of the appropriate specialty. There report is as follows (redacted of names, places and dates; emphases mine):
(It's regrettable that my mother left this earth before seeing this report.)Dear Mr. Silverstein,
[QIO organization] is the Quality Improvement Organization authorized by the Medicare program to review medical services provided to Medicare patients in [state]. Our responsibilities include a review of medical records to determine whether services meet professionally recognized standards of health care, are medically necessary, and are delivered in the most appropriate setting. We also review written complaints about the quality of Medicare services received by Medicare patients. Where we identify quality concerns, we provide education and feedback to providers and their medical staffs to improve the quality of services they provide in their facilities.
In response to your initial written concern, a QIO physician has reviewed the medical records concerning the services your mother received on 05/##/10 at [YY Hospital].
You are concerned about the following:
Concern:
Your mother was admitted at [YY Hospital] on May ##, 2010. You are concerned regarding the failure of the staff to properly conduct medication reconciliation which resulted in denial of a critical heart rhythm maintaining medicine, Sotalol, to your mother who had been taking it for approximately 8 years.
Response:
A QIO physician reviewer has reviewed the complete medical record for this admission and previous admissions. It was noted that the medication Sotalol was on the 4/##/10 discharge summary and the [later] 4/##/10 ER visit, current medications listed Sotalol 120mg every 12 hours.
It appears that on the 05/##/10 ER visit the current medication list does not include Sotalol and it does not appear that the patient received Sotalol on admission on 5/##/10. Also, the cardiology consult note on 5/##/10 states Sotalol was on hold but that is not clear from the ER note or admission H&P. It appears that Sotalol was not given from 05/##/10 - 05/##/10. Appropriate medication reconciliation of this medication appears not to have been performed. Therefore, a quality of care concern has been identified and confirmed.
Concern:
You are concerned that this failure resulted in lack of continuity of care and many medical complications your mother suffered which include, permanent CNS and cardiac injury as well as increased risk for CVA.
Response:
The QIO physician determined that there is a lack of continuity of care based on the review of the medical records submitted. It appears that the failure to administer Sotalol resulted in the recurrent atrial fibrillation on 5/##/10 and other subsequent medical complications. Therefore, a quality of care concern has been identified and confirmed.
As required by Federal regulations, prior to reaching our decision we gave [YY Hospital] an opportunity to discuss the services your mother received.
After a thorough review of your medical records and any additional information provided by the facility, we determined that the services your mother received did not meet applicable professionally recognized standards of health care. [That phraseology might be considered a technical description of malpractice - ed.]
In addition to determining whether or not care met professionally recognized standards of health care, we have reviewed the medical records pertaining to the services provided to your mother to see if there were any opportunities for improvement.
We share your concern about the quality of service your mother received and have initiated appropriate action as warranted by our review findings. [I was told the hospital was required to develop and/or follow a remediation plan to prevent further errors of this kind, and report back to the QIO for several quarters on their progress - ed.]
Before reaching our decision, we gave all involved practitioners and providers an opportunity to review our response concerning the services your mother received.
Please note that the information concerning individual practitioners contained in this letter is confidential and cannot be given out to anyone else, unless that practitioner's identity is not disclosed or he/she) has given consent.
If you have other concerns regarding this matter, please contact us.
Sincerely,
[Doctor Name]
QIO Medical Director
So, there are in fact organizations that will not tolerate substandard medical care.
These organizations need to receive increased influence and authority.
Of course, I mentioned early in this post that seeking justice is not a linear process.
It seems part of the problem is that many hospitals have problems with basic honesty, accountability, and medical expertise.
Exhibit one in that regard is the statements from the hospital's representatives even after Medicare found them to have not met applicable professionally recognized standards of health care:
"Defendant is unable to determine what plaintiff's claims are."
On issues of health IT's role in the errors, the response was Blame the Vendor:
"Claims are more appropriately brought against the software manufacturer." [Which could likely have a "hold harmless" agreement with the hospital - ed.]
This is reminiscent of the hemming and hawing in the aforementioned cases, and leads me to conclude many hospitals are, through legal games and technicalities, burying their mistakes with little accountability.
I submit that if after Medicare finds hospitals to have not met applicable professionally recognized standards of health care resulting in patient injury, yet the hospitals profess they "cannot determine plaintiff's claims", then those hospitals needs to find themselves new medical and Board-level leadership.
-- SS
scotsilv@aol.com (InformaticsMD) 06 Oct, 2011
--
Source: http://hcrenewal.blogspot.com/2011/10/there-are-still-some-medical-watchdog.html
~
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