Jury Awards Woman $30 Million After Throat Catches Fire

February 3, 2015

A 55-year-old woman who can no longer speak or breathe on her own after her endotracheal tube caught fire during surgery to remove polyps from her vocal cords has been awarded $30 million in her malpractice lawsuit, a jury in Seattle ruled last week after a 6-week trial.

The patient, Becky Anderson, who was hospitalized for 3 months after the fire, suedear, nose & throat specialist Donald R. Paugh, MD, FACS, anesthesiologist Linda K. Schatz, MD, and their employers, Wenatchee (Wash.) Valley Medical Center and Wenatchee Anesthesia Associates, as well as Central Washington Hospital, also in Wenatchee, and Medtronic, the manufacturer of the endotracheal tube, saying that the company’s design of the tube was faulty and should have included a “double cuff” that, Ms. Anderson alleged, would have prevented the oxygen in the tube from igniting when exposed to the laser beam.

Ms. Anderson settled for $12 million with the hospital, and a jury awarder her another $17.1 million, comprised of $9.45 million from Dr. Schatz and her employer and $7.65 million from Dr. Paugh and his employer. The jury found that Medtronic wasn’t responsible for the fire and didn’t make the company pay anything.

In the lawsuit, Ms. Anderson blamed her doctors for giving her pure oxygen rather than room air or a lower oxygen concentration.

Jim Burger

Why Texting Could Be Ruining Your Spine

November 23, 2014

By KENNETH K. HANSRAJ, MD, CHIEF OF SPINE SURGERY, NEW YORK SPINE SURGERY & REHABILITATION MEDICINE, NEW YORK, NEW YORK and published by MPR November 18, 2014

Tilting the head forward to use smart devices for reading and texting may be putting as much as 60lbs of excess stress on the cervical spine and leading to early wear, tear, and degeneration. In the journal Surgical Technology International, Dr. Kenneth K. Hansraj outlines his model for assessing the weight seen by the spine when the head flexes forward at varying degrees. In a neutral standing position, the force to the cervical spine is 10–12lbs; this increases to 27lbs with a 15 degree head tilt. 40lbs at 30 degrees, 49lbs at 45 degrees, and 60lbs at 60 degrees. Poor posture often occurs when the head is tilted in a forward position with the shoulders in a rounded position; over time, this can contribute to incrementally increased stresses on the cervical spine and a possible need for surgery. Since it is unlikely that people will stop using these devices, Dr. Hansraj recommends greater awareness of proper posture with a neutral spine position while using hand-held technology.

Vitamin B may not reduce the risk of memory loss

November 13, 2014

Published 12 November 2014

Vitamin B may not reduce the risk of memory loss according to a new study (Wednesday 12 November) in the online issue of Neurology, the medical journal of the American Academy of Neurology.

For the current study, 2,919 people with an average age of 74 took either a tablet folic acid and of vitamin B12, or a placebo, every day for two years. Tests of memory and thinking skills were performed at the beginning and end of the study. All of the participants had high blood levels of homocysteine – an amino acid – high levels of which are linked to the risk of developing dementia.

Dr Doug Brown, Director of Research at Alzheimer’s Society said:

‘There is conflicting evidence for whether vitamin B improves memory and thinking so it’s good to see further clinical trials are being conducted in this area. We know levels of homocysteine, a protein linked to an increased risk of dementia, tend to increase with age. This might be because we are less able to absorb B vitamins from our diet as we get older. However, it is not a quick fix to take supplements.

‘This trial adds to a growing weight of evidence that vitamin B levels do not improve memory and thinking. More trials are needed to determine if there is a benefit of these vitamins for people already with dementia, or for people without high levels of homocysteine, as no one in this trail had dementia or was known to develop it. The best way to reduce the risk of dementia is to take plenty of exercise, eat healthily, properly regulate other health conditions, stop smoking and don’t drink over recommended limits.’

Research reference: Dhonukshe-Rutten, Rosalie A.M. et al, Results of two year vitamin B treatment on, cognitive performance. Neurology, the medical journal of the American Academy of Neurology Wednesday 12 November 2014.

Atlanta Attorney Deborah Gonzalez Talks Online Privacy, Security And Safety

November 4, 2014

Jennifer Law hacked. Online Child Molestation. Identity Theft. Cyper Bullying. Social Media. Passwords. Apps. Digital After Life. Digital Identity. Privacy.

These are the types of topics that Deborah Gonzalez discussed at the Athens Regional Library on October 28, 2014 regarding online privacy, security and safety.

Gonzalez recently published two new books “Managing Online Risk: Apps, Mobile & Social Media Security and “Online Security for the Business Traveler.”

Gonzalez defined privacy as “A person’s right to control access to his or her personal information.” She said “If you put it out there on social media, consider it public.” Information collected is as much as you give them and she discussed security of smart phones, tablets, cloud computing and passwords.

Gonzalez discussed identity theft, what to do if you are a victim of identity theft and gave resources including the Federal Trade Commission (FTC) website with consumer information. She also went into how to protect your online identity and cyber bullying.

Interesting tidbits she shared:

  • 90% of cell phone apps send personal information back to the developer – you gave permission.
  • Techies cannot keep up with the hackers.
  • Some hotels have “evil twin” networks, meaning there is a twin internet connection. She said you should ask the hotel if they have a secure line with a password to be sure you are getting on the right connection.
  • The concept of the “Internet of Things” – there are more devices connected to the internet than there are people.
  • Posting false credentials is equal to false advertising.
  • She mentioned a book called “The Digital Afterlife” which deals with what happens or should happen with your digital identity after death.
  • Gonzalez shared printed materials on online security from the FTC which are available and free for the asking.

About Deborah Gonzalez:

Gonzalez, attorney at law, is an intellectual property lawyer from Atlanta and New York, who practices social media, art, music, entertainment and digital law. She is particularly interested currently in speaking with kids and teens as they build their online identity and can be at risk for online victimization, both from people they know and people they don’t, as well as speaking with adults.

For more information, go to http://www.dgonzalezesq.com, www:law2sm.com, http://www.managingonlinerisk.com, Twitter: @law2sm, Facebook: Law2sm.

A depressing sign of America’s obesity problem: fatter crash test dummies

October 29, 2014

October 28 at 5:21 PM/The Washington Post

Crash test dummies have long helped auto manufacturers keep cars as safe as possible, but the slim plastic mannequins are increasingly poor mirrors of the modern American man and woman.

So the world’s leading producer is making a fatter version.

See The Washington Post for the full article.

Patient early warning detection system reduces mortality rates by 35 percent

October 23, 2014

October 21, 2014 | By Katie Sullivan/Fierce Healthcare

Patient early warning detection system alerts staff to minor changes in a patient’s conditions and can help prevent more serious events down the line and reduce mortality rates.

St. Joseph Mercy Oakland hospital in Michigan implemented a detection system with the overall goal of reducing mortality rates, David Bobryk, clinical informatics project, said in a video interview with Suzanna Hoppszallern, senior editor of Hospitals & Health Networks.

Patients wear a monitor on their wrists that continually tracks their vital signs–blood pressure, respiratory rate, pulse rate, pulse oximetry and body temperature–and sends the information to an electronic health record. The stats then travel to monitors that calculate a wellness index measured from a 0 to 5 scale. If patients’ vitals rank from 0 to 2.9, they’re in the clear “green” zone, but if they jump to 3.0 or above, a dangerous “red” zone, nurses on the unit are alerted to check on the patients.

“This tool helps combine that into a single value and makes it really easy for the clinician–green 0 to 2.9 the patient is doing well–red, 3.0 to 5.0 you need some action on the patient,” Bobryk said during the interview.

While using the tool over the course of a four-year study, Bobryk said the hospital reduced mortality rates by 35 percent, while code blues were cut in half and the average length of stay were cut by 5.3 percent.

Clinicians and staff are sometimes skeptical of new technologies, but Bobryk said the hospital broke down those barriers and resistance by allowing nurses to take the tool home with them and monitor themselves at home. They also included staff and hospital leadership in the design meetings from the very beginning.

Ebola: CDC Tightens Protection Rules

October 22, 2014

Published: Oct 21, 2014/By Michael Smith, North American Correspondent, MedPage Today/Reviewed by Robert Jasmer, MD; Associate Clinical Professor of Medicine, University of California, San Francisco

Faced with dismay over the Ebola infection of two nurses, the CDC has tightened its guidance for personal protective equipment.

The major change in the new guidance is an insistence that no skin be exposed during the care of an Ebola patient.

But the CDC is also insisting that people likely to treat Ebola patients need to practice putting on and taking off the equipment safely, and that hospitals have a trained monitor to observe both procedures.

“There’s no alternative to hands-on training,” Frieden said, adding that “it’s an important message for healthcare workers that these are three comprehensive aspects.”

The CDC now says personal protective equipment should consist of:

  • Double gloves
  • Boot covers that are waterproof and go to at least mid-calf or leg covers
  • Single-use, fluid-resistant or impermeable gowns that extend to at least mid-calf or a coverall without integrated hood
  • Either N95 respirators or powered air purifying respirators
  • Disposable single-use full-face shield
  • Surgical hoods to ensure complete coverage of the head and neck
  • A waterproof apron that covers the torso to the level of the mid-calf in the event Ebola patients have vomiting or diarrhea

The guidance no longer recommends goggles, arguing they might leave skin exposed, are not disposable, and might fog up, tempting healthcare workers to manipulate them with gloved — and possibly contaminated — hands.

Screening and Triage

While a great deal of attention has been paid to protective equipment, it’s “just one aspect of infection control,” Frieden said, and such things as screening and triage are also “critically important.”

“Every healthcare worker needs to learn how to screen a patient who may have Ebola,” he said, including making sure to ask about a travel history.

For Full Article, see Medpage Today.

AHA Includes Depression as Risk Factor for Cardiac Disease

April 14, 2014

Depression is common after acute coronary syndrome (ACS), according to a brief review by the authors featured as part of the current American Heart Association (AHA) Scientific Statement. It is encountered in approximately 20% of patients hospitalized for ACS, compared with a prevalence of approximately 4% in the general population. Depression not only reduces quality of life among these patients but also might increase the risk for recurrent cardiac disease. Potential mechanisms by which depression can increase cardiovascular risk include neuroendocrine dysfunction, enhanced platelet activity, and endothelial dysfunction, as well as lifestyle factors (sedentary behavior, smoking, etc) noted to be worse in the presence of depression.

Depression should join the ranks of obesity, diabetes, hypertension, and smoking as an official heart disease risk factor, according to an expert panel convened by the AHA (American Heart Association).

The recommendation is based on an extensive literature review examining the risks for depression conducted by the panel, which included Robert M. Carney, PhD, professor of psychiatry at the Washington University School of Medicine in St. Louis, Missouri.

The AHA Scientific Statement notes that the combined findings support the call to formally “elevate depression to the status of a risk factor” for adverse outcomes, such as all-cause and cardiac mortality, in patients who have ACS.

“It was very gratifying to see this recommendation at this time and know that the potential risks are appreciated,” Dr. Carney, who is also a member of the AHA Statistics Committee of the Council on Epidemiology and Prevention and the Council on Cardiovascular and Stroke Nursing, told Medscape Medical News.

“We’re hoping that eventually we’ll be able to show that treating depression will improve survival and heart health. Although that story remains to be done, I’m happy we’ve come this far,” Dr. Carney added.

The Scientific Statement was published online February 24 in Circulation.

Lowe’s and Walmart: Surgery’s On Us

January 11, 2014

Outpatient Surgery/Daniel Cook/Published October 15, 2013

The retail giants offer employees and their families free joint replacements.

Lowe’s and Walmart have partnered with 4 hospital systems to offer complimentary hip and knee replacements to employees and their families. 

The retail giants combined forces with the San Francisco, Calif.-based Pacific Business Group on Health Negotiating Alliance to launch a national Employers Centers of Excellence Network, which aims to provide workers of large employers with quality, affordable health care. 

Individuals who opt for the free surgery must travel to one of the following partner facilities to have it done:

-Johns Hopkins Bayview Medical Center in Baltimore, Md.

-Kaiser Permanente Orange County Irvine Medical Center in Irvine, Calif.

-Mercy Hospital in Springfield, Mo.

-Virginia Mason Medical Center in Seattle, Wash.

Safety: 4 Ways to Stop DVT in Its Tracks

November 15, 2013

September 2013/Cheryl Marsh, BS, RN, CNOR/Outpatient Surgery

The stakes are high when it comes to preventing deep vein thrombosis and pulmonary emboli. Between 300,000 and 600,000 people suffer DVT and PE each year, with 60,000 to 100,000 ultimately dying from the complications. When it’s not fatal, DVT can cause post-op morbidity, prolonged hospitalization and increased healthcare costs. An essential part of caring for surgical patients is to understand your role and responsibilities in preventing clots from forming. 

1. Know the facts. 

DVT commonly occurs when blood flow changes, which could cause clots to form in deep veins, often in the calf or thigh and less commonly in the chest or arm. Pulmonary emboli develop when clots break free from veins and travel to the lungs. The condition can prove fatal within minutes or hours.

Who’s at risk? Anyone who undergoes surgery, because injuries to vessels when surgeons operate and changes in blood chemistry caused by dehydration or general anesthetics increase the likelihood of clots forming. That said, the more invasive procedures in the abdomen or lower extremities put patients at increased risk. 

Other factors that heighten DVT possibilities include advanced age, obesity, recent physical trauma, varicose veins, personal or family history of circulation problems, surgeries lasting longer than 45 minutes and hip or knee replacement surgery. 

2. Pick the prophylaxis.

Muscles in prone, anesthetized patients aren’t working as they normally would; even sleeping individuals move slightly every few minutes to keep blood flowing properly. 

Two effective preventative measures against DVT:

  • Sequential compression devices. SCDs combat venous stasis and coagulation changes by squeezing legs to stimulate muscles and move blood through the veins.
  • Anti-embolism stockings. Stockings protect against venous stasis and vessel wall damage by keeping leg muscles tight and firm, which reduces pooling of blood in the veins.

Using both in combination therefore protects patients against all 3 risk factors of DVT. The stimulation and constriction combine to regulate the blood’s chemistry and break down any blood clots that might form. 

 


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