Sunday, March 05, 2006

Nurse Practitioner Student Notes Serious malpractice issues with military hospitals

I read this article today and was so disheartened by what I read. It's a sad and scary thing to realize that these doctors have almost no repercussions when they injure patients. According to the Feres Document, active duty personnel and their survivors cannot recover damages from the military when their injuries are incident to service. Judges have said that it applies to medical malpractice and medical negligence claims on behalf of service members. What this means is.. if you are in the military and something happens to you or your family member in a military hospital... you're screwed... It seems that most of these errors are happening due to no one reading the medical records of the patients or not heeding what has been written. The other reasons seem to be gross error on surgeon's parts.
I also find it very interesting to see that medical doctors were the only ones listed as defendants.... Not nurse practitioners. I would be very interested in seeing the ratios of nurse practitioner malpractice suits.

A Times-Union review of recent state and federal records found that the 60-bed Jacksonville Naval Hospital is sued for medical negligence at nearly five times the rate of civilian hospitals in Northeast Florida. And because only dependents and retirees can sue -- federal law forbids claims for active service members -- the hospital's true malpractice rate might be even higher.

The government has settled 15 medical negligence claims against the hospital since 2001. Eleven involved deaths. Two other cases are pending, and both involve patients who died. A sampling:
# Air Force veteran Wanda Lloyd, 40, died in 2003 after emergency room doctors misdiagnosed her chest pains and failed to call a cardiologist.

# Seven-month-old Michael Hugaboom died in 2004 after doctors mistook his meningitis for chickenpox.

# Christian Rivera died just after his birth in 2000 when doctors missed the warning signs of fetal distress. His mother hemorrhaged after delivery, went into a coma and died 10 months later.

Patterns in the court cases point toward a system-wide breakdown at Jacksonville Naval Hospital, the Navy's fourth-largest. Patients are killed or maimed when records disappear and doctors fail to communicate. Family practitioners perform procedures that should be done by obstetricians -- or shouldn't be done at all. And the Navy lets doctors go unpunished even when they make serious mistakes.

Unlike civilian doctors, military doctors aren't required to be licensed in the same state where they practice. And under federal law, they cannot be sued individually.

"They have no personal liability whatsoever. Never have. Never will," Roberts said. "It plays a role, I think, in the risks that they take and the calculations that they make."

The Times-Union reviewed the licenses of 18 current and former Navy and contracted civilian doctors named in negligence claims pending or settled since 2001. Four doctors were the subject of more than one claim. Yet the newspaper did not find negative marks related to any of the cases.

Only one doctor was cited for any reason, and that was for failing to report an address change.

Bono said negative incidents at Jacksonville Naval Hospital trigger a "strict and rigorous" quality review process: Questionable doctors are reviewed by their peers, who make recommendations on restrictions or other discipline. Larkins-Pettigrew herself headed one such review panel in 2001, even after the Navy was sued in a botched childbirth case that Larkins-Pettigrew said landed her on a national database of troubled doctors.

More serious mishaps are reviewed by the Navy's Bureau of Medicine and Surgery in Washington and an independent review team. The Navy surgeon general has sole authority to report the physician to the database or to state licensing boards, Bono said. The process can take years, and the database is hidden from public view. Citing privacy laws, the Navy surgeon general's office won't say how many of its doctors from Jacksonville have been reported to the database.

However, Vice Adm. Donald Arthur, the current surgeon general, told the Times-Union an estimated 10 to 15 doctors nationwide are reported to the database each year.

Computerized records will also improve continuity of care by letting military hospitals share information more efficiently, Bono said. The hospital rolled out its new electronic system in November.

But it won't work without careful doctors and records technicians. In a 2004 deposition, Navy gynecologist Cynthia Wilkes admitted she didn't read the medical records before performing a hysterectomy in 2002 that led to Jocelyn Foster's death.

Wilkes said that if she had read the records, the knowledge of Foster's abdominal problems would have prevented her from doing the operation and Foster would be alive. Instead, Foster died after Wilkes sliced through her bowel and injured her bladder. The Navy settled her family's lawsuit for $1 million.

Part of Wilkes' explanation was that she didn't have all the records. Though they were ordered, Wilkes testified, the Navy's outpatient record department never delivered them.

Wilkes admitted responsibility for the death. But the surgeon general told the Times-Union that Navy medical officials didn't refer her to the practitioner database because they didn't believe she was to blame.

To read the rest of the story, click the title....

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