Kroger | Burrus is pleased to announce that Lauren M. Nelson, JD has been selected as a 2014 Texas Rising Star. Ms. Nelson was previously selected in 2012 and 2013. Lawyers who are 40 years old or younger are eligible for peer nomination. The selection process includes a review of credentials and experience. Ultimately, less than 2.5% of the state’s lawyers are recognized for this award.
Ms. Nelson is a graduate of Baylor University and South Texas College of Law. She practices in the areas of medical malpractice defense and health law, representing health care providers across Texas. In January of this year, she became a partner of our firm.
McAllen Hospitals v. Texas Health and Human Services Commission
Hospitals denied Medicaid reimbursements challenged the state’s administrative ruling that the services were unnecessary and could have been performed on an outpatient basis. The trial court granted the state’s plea to the jurisdiction, concluding that the hospitals had not established a constitutional takings claim necessary to confer it jurisdiction. The Austin appellate court agreed that the hospitals interest in the payments at issue were not yet vested and could not support a takings claim. It also concluded that the administrative decision did not involve a “contested case” subject to judicial review. It found the trial court may have jurisdiction to consider the hospitals’ request for mandamus relief that would compel the state to consider appeals involving cases denied due to insufficient documentation.
Stethoscopes More Contaminated Than Doctors’ Hands
Researchers in Switzerland found that stethoscopes tend to be more contaminated with bacteria than the hands of the doctors using them, with the exception of the physicians’ fingertips. The study’s authors noted there are no official guidelines that detail how frequently stethoscopes should be cleaned.
CBO: Republican Health Law ‘Fix’ Would Cost Billions
A proposal by Congressional Republicans to fix the federal health law would cost as much as $74 billion and cause one million people to lose work-based insurance, according to Congressional Budget Office projections. The proposed fix would change the definition of a full-time employee from someone working 30 hours per week to someone working 40 hours.
President’s Budget Recommends Billions for Physician Training
President Barack Obama’s proposed budget recommends a $14.6 billion expansion of health-care and medical-training programs for fiscal year 2015. The funding would be used to increase the number of medical residents and encourage health care providers to provide services in rural areas with limited access to health care.
Study: Medical Homes Haven’t Saved Money or Substantially Improved Care
A pilot program intended to improve health care quality and reduce costs has not yielded substantial results. Patient-centered ‘medical homes’ involve team-based practices in which providers actively manage patients’ chronic conditions. An early study of the largest medical-home pilots found that after three years, patients’ health improved in only 1 of 11 measures.
Study: Primary Care Physicians More Likely to Misdiagnose Cardiac Disease in Women
Primary care physicians are more likely to misdiagnose cardiac disease in women and are sued more frequently than physicians practicing in other fields, according to a recent analysis of 41 lawsuits in California. Primary care doctors were defendants in 50% of the lawsuits evaluated, 22% were cardiologists, 17% were emergency medicine physicians, and 6% were orthopedists.
Health Law’s Small Co-Ops Experience Mixed Success
Nonprofit health cooperatives intended to drive down insurance prices in areas with little competition have experienced mixed success so far, with critics predicting that many will ultimately default on the federal loans they received. About 300,000 of the 4 million people who signed up for health care coverage in state and federal exchanges so far joined a health co-op, and in some areas supporters report the co-ops have succeeded in lowering prices.
Dallas Buyers Club, which is based on a true story, stars actor Matthew McConaughey, who has won several acting awards for his portrayal of the movie’s main character, Ron Woodruff. Mr. Woodruff was diagnosed with AIDS at a time when it could result in death in a matter of months. Mr. Woodruff believed the side effects of the FDA-recommended dosage of AZT were harming his health (his white blood cell count decreased significantly). The movie suggests the FDA knew its recommended dosage of AZT was harmful but refused to change its recommendation. Through Mr. Woodruff’s own research, he learned of alternative drugs available in other countries with less harmful side effects and potentially better efficacy in treatment. He then illegally imported those drugs to the U.S. to sell to other HIV and AIDS patients.
Dallas Buyers Club raises bioethical questions about drug trials for those with terminal illnesses. To evaluate those issues, consider the bioethical principle of autonomy: a patient’s right to make decisions independently after disclosure of the risks and benefits. The following questions are a starting point in considering some issues related to the FDA’s approach to treatment for terminal illnesses:
- If a patient suffers a drug’s side effects which could be hastening death or putting him at risk for other significant illnesses, should resources be provided for alternative treatments, even if those alternatives involve unproven drugs or unconventional treatment (e.g., Eastern medicine, etc.)?
- In the case of a terminally ill patient, should drug testing on humans be allowed before animal (or other) testing evaluates its efficacy or side effects?
- How should the FDA choose which drugs to fast track for terminal illnesses when their efficacy and side effects are still being researched and / or are unknown?
If you do not have time (or the desire) to see Dallas Buyers Club at the movie theater, consider renting Lorenzo’s Oil, which addresses orphan drugs and involves similar bioethical issues. In this movie, a young boy develops ALD, a severe central nervous system disorder, which was so rare, almost no research was being conducted on its cause or treatment. After learning of this lack of research, the boy’s parents essentially taught themselves medicine, and then badgered scientists and physicians to develop a drug to treat ALD.
Malik v. Bhargava
A woman filed suit against a physician alleging that his failure to diagnose a pulmonary embolism resulted in her former spouse’s death. The defendant physician moved for summary judgment, arguing that the woman lacked standing to bring a wrongful death claim because she was not married to the decedent. Although the woman alleged the divorce was purely for financial reasons and the couple had an informal marriage, the Dallas appellate court affirmed the trial court’s summary judgment, noting that the woman had testified in her deposition that the couple did not plan to remarry until after resolving their unresolved financial problems.
Cervantes v. McKellar
A woman whose child was born with encephalopathy filed suit against the medical center where the child was delivered, alleging that the staff’s failure to monitor a fetal heart monitor caused the child’s injury. The medical center, a governmental entity, filed a plea to the jurisdiction asserting sovereign immunity. The Texarkana appellate court affirmed the trial court’s granting of the plea to the jurisdiction, holding the claims did not involve the use of tangible property, as required to establish immunity had been waived, but rather the misuse of information.
University of Texas Health Science Center v. Dickerson
The mother of an infant that died from a streptococcus infection filed suit alleging that the results of a blood culture that tested positive were never communicated to her by hospital staff, depriving her of the chance to purse life-saving treatment for her daughter. The defendant hospital filed a plea to the jurisdiction, asserting that as a governmental entity it was covered by sovereign immunity. The mother alleged that immunity was waived through the misuse of tangible equipment, including a telephone and computer, that she argued should have been used to communicate the results of the blood test to her. The Houston appellate court reversed the trial court’s denial of the plea to the jurisdiction, holding that the claims involved the failure to communicate information, rather than the use of tangible property.
Woman Develops Process to Run 30 Lab Tests on Single Blood Drop
A California woman has developed a blood-testing service that requires only a single blood drop to perform blood tests cheaper and faster than with conventional methods. Her company, which introduced its services at a Palo Alto, California Walgreen’s last year, estimates that the technology could someday save Medicare and Medicaid billions of dollars.
25 Charged in $500 Million Pain-Pill Ring
Twenty-five people have been charged with being involved in the operation of an alleged pill mill that officials say provided more than 5 million oxycodone pills to pharmacies in New York and throughout the country.
Feds Propose Medicare Advantage Payment Cuts
The Obama administration has proposed spending cuts that would reduce Medicare Advantage spending by 3.55%. Last year, Medicare officials had proposed reducing the Medicare Advantage payments by 2.2%, but changed course in response to a strong industry lobbying campaign and instead raised the rate by 3.3%. Critics of the proposed cuts caution that seniors in the program could lose benefits and may face higher premiums.
Medicare Releases ACO Quality Measure Data
Medicare has released data from 2012 on five of the 33 quality measures being used to track how well accountable care organizations are caring for patients. The data reflect that the average ACO reached the Medicare goals for 65% to 75% of their patients. Four of the quality measures evaluated how well the ACOs had helped patients with diabetes, while the fifth measure examined how many patients with arterial plaque were receiving appropriate medication.
ACOG Urges Members to Reduce Number of C-sections
The American College of Obstetricians and Gynecologists recently released new guidelines encouraging its members to allow women with low-risk pregnancies to spend more time in labor prior to recommending a caesarean section. The recommendation follows recent studies that suggest that an increase in caesarean sections over the past decade has not led to better outcomes for women or infants.
Flu Hitting Young Harder
The flu is hitting younger individuals harder this year than in previous years, according to the Center for Disease Control. People between the ages of 18 and 64 represent 61% of all flu-related hospitalizations this season, compared to 35% in previous years.
Study Finds Patients Find Online Physician Ratings Useful
Among individuals who used an online physician review in the last year, 93% reported that the ratings were either somewhat useful or very useful in making a decision about a doctor. However, another recent study focused on online ratings for urologists found on average there were only 2.4 reviews per physician, suggesting that ratings are vulnerable to being skewed by a single positive or negative review.
Report Finds Hospital Networks, Equipment Frequently Under Cyber Attack
Last month, over the course of one month more than 50,000 unique cyber-attacks occurred across more than 700 devices, according to a recent report on cyber security in the health care industry. The attacks were committed against a broad spectrum of targets, including billing systems, as well as radiology equipment and dialysis machines.
Researchers Call for Interdisciplinary Approach to Infection Prevention
Nurses cannot prevent hospital-acquired infections by themselves, according to the authors of a recent study who recommend an interdisciplinary approach to infection prevention. Researchers from the Columbia School of Nursing recommend that nurse leaders take the lead on making sure that an interdisciplinary team is adhering to existing infection prevention policies and recommending new policies that should be in place.
Chadha v. Rothert
A patient filed suit against the physician who treated her for hand, hip, and neck pain and a hospital, alleging she lost her vision due to a missed diagnosis of temporal arteritis. The Austin appellate court affirmed the trial court’s denial of the hospital’s motion to dismiss, finding that the patient’s expert adequately described his opinion that the treating physician should have recognized that an elevated erythrocyte sedimentation rate was a major abnormality indicating temporal arteritis.
Northeast Methodist Hospital v. Dewey
A hospital visitor alleging he was injured by a sliding electric door filed a premises liability claim without filing a Chapter 74 expert report. The San Antonio appellate court joined recent appellate court decisions in Beaumont, Corpus Christi, Texarkana, and Dallas, distinguishing the Texas Supreme Court’s decision in Texas West Oaks and ruling that because the claim was not even indirectly related to health care it was not a health care liability claim subject to Chapter 74’s provisions.
CHRISTUS Santa Rosa Health Care Corporation v. Vasquez
A patient’s family filed suit against a hospital and issued a Chapter 74 expert report prior to the 120 day deadline. The hospital filed objections and a motion to dismiss on the basis that the expert and his report were inadequate. The San Antonio appellate court affirmed the trial court’s denial of the motion to dismiss, noting that although the hospital had to file its objections within 21 days, the trial court could not grant or deny a motion to dismiss until the 120 day deadline to file an expert report had passed.
Study Suggests Some Interventions for Prolonged Childbirths Unnecessary
A recent study suggests that epidural anesthesia can lengthen the second stage of labor longer that generally recognized, and some women may be subject to unnecessary interventions by physicians concerned that labor has become prolonged. The findings indicate clinicians may need to wait longer before intervening with oxytocin, forceps, vacuum, or a cesarean.
Severe Flu Season May be Responsible for Saline Shortage
Hospitals across the nation are facing a shortage of intravenous saline, which may be attributable to a spike in flue cases in recent weeks. Frustration over the shortage has prompted at least one hospital to ask the government to release saline from its emergency stockpiles.
Medical Identity Theft on the Rise
Medical-related identity theft accounted for 43% of all identity thefts reported in the United States in 2013. Victims have reported having their identity’s stolen by thieves seeking medical treatment and prescription drugs, and in one instance by a psychiatrist who created false diagnoses of drug addiction and depression to submit fraudulent medical insurance claims.
Legislators Reach Deal on Medicare Payment Overhaul
Lawmakers in Washington have reached a bipartisan agreement that would replace the current Medicare system for paying physicians that would increase payments by 0.5% each year over the next five years. Legislators must still agree on a method to pay for the proposed fix, which could cost as much as $150 billion.
Insurers Report Losses, But Gain Younger Members Under 40
Humana has reported that it lost money in the fourth quarter of 2013 and a drop in membership, but has also had younger than expected enrollees sign up for insurance after federal health law reforms took effect. Cigna has also reported a fourth-quarter profit dip. Aetna has announced it expects to lose money on its business in the health-law marketplace this year, with the demographics of enrollees skewing more than expected toward people likely to generate higher costs.
Study Finds Home Births Tied to Higher Infant Death Rate
The potential for neonatal death was about four times higher for children delivered at home by a midwife compared to children delivered by a midwife at a hospital, according to a recent study. According to experts, home births lack the advantage of readily available access to critical care for when complications arise. Between 2004 and 2009, the number of home births in the United States has increased by 29%.
Older Nurses Favored Over Recent Graduates
Nurses licensed in 2010 or 2011 were less likely to work in hospitals than nurses licensed in 2004 or 2005, according to a survey of 34 states. Nurses who were expected to retire and open up positions at hospitals have not done so, likely because of the economy, according to the study’s authors.
TV Series ‘House’ Helps Solve Real Medical Mystery
A German physician recently diagnosed a case of cobalt poisoning caused by a patient’s artificial hip after recognizing that his symptoms mirrored those of a patient in an episode of the medical drama ‘House.’
Columbia North Hills Hospital v. Bowen
A patient sued a hand surgeon and hospital, alleging caused an injury to his left ulnar nerve during elbow surgery. The hospital challenged the patient’s Chapter 74 expert’s qualifications to opine on the standard of care for nurses and hospitals, and argued his report was inadequate as to causation. The Fort Worth appellate court affirmed the trial court’s refusal to dismiss, noting that the patient’s expert was familiar with the standards of care for nurses and hospitals. It found that the expert adequately described his opinions that the hospital should have questioned the rush to perform non-emergent surgery, and that if its nurses had documented the intraoperative injury an unnecessary exploratory surgery could have been avoided.
Plum Creek Healthcare Center v. Kirkland
A man undergoing rehabilitation for a broken leg filed suit alleging a nurse negligently applied antibiotic cream to his injuries that caused an allergic reaction resulting in skin necrosis and an above the knee amputation. The healthcare center appealed an adverse verdict, arguing that expert testimony linking the medicated cream to skin necrosis was purely conclusory. The Amarillo appellate court found the plaintiff’s expert sufficiently reliable, noting that he considered factors such as the pattern of necrosis, witness accounts that the plaintiff experienced significant pain after the cream was applied, and supportive medical literature regarding allergic reaction to the medication at issue.
Memorial Hermann Southwest Hospital v. Galvan
A hospital visitor who slipped and fell filed a premises liability claim. The hospital sought dismissal after the visitor failed to file an expert report, arguing that per the Texas Supreme Court’s holding in Texas West Oaks, claims involving safety qualify as health care liability claims, even if not directly related to health care. The Houston appellate court agreed, reversing the trial court’s refusal to dismiss the case.
Wait Times Down, But May Increase Under Health Law
At 45.4 days, the average wait time to see a physician in Boston is more than double of reported wait times across 15 metropolitan areas recently surveyed. The average wait time throughout the cities surveyed was down from 20.4 days in 2009, the year before the Affordable Care Act was enacted. The report found that the drop in wait times may be due to fewer people having sought care during the recession, as well greater efficiency associated with mid-level practitioners. The study’s authors speculate Massachusetts’ 2006 health law initiative may be responsible for the lengthy wait times reported in Boston. They anticipate the Affordable Care Act could have a similar impact nationwide.
More Republicans Favor ‘Fixing’, Rather Than Repealing Health Law
A shift in tone among some influential conservatives suggests the Republican party may be shifting toward pursuing ways to alter the Affordable Care Act, rather than attempting to have it repealed outright.
Silencing Some Hospital Alarms Could Improve Outcome
At a hospital in Boston, researchers found more than 12,000 alarms were sounding daily, desensitizing staff and contributing to “alarm fatigue.” After determining that some low-level “warning” alarms do not need to make an audible signal to be effective, the hospital turned many off. Staff and patients have responded favorably, noting that it is easier to hear and respond to critical alarms and patients’ call signals.
ICU Infection Control Practices Not Adequate at Many Hospitals
ICU units throughout the country showed uneven compliance with infection prevention policies, according to a recent study in The American Journal of Infection Control. The study found adherence to prevention policies ranged from 37% 5o 71% for central line-associated bloodstream infections, 45% to 55% for ventilator-associated pneumonia, and 6% to 27% for catheter-associated urinary tract infections (CAUTI). The authors encouraged more focus on CAUTI, noting that it is the most frequent healthcare-acquired infection, yet only 27% to 68% of ICUs had CAUTI prevention policies in place.
Uninsured Patients, Women Less Likely to be Transferred Between Hospitals
Contrary to popular perception, women and uninsured patients are less likely to be transferred among hospitals than others, according to a study by the University of Pittsburgh School of Medicine. These results may mean uninsured patients and women are not being transferred as often as other patients to facilities that offer more advanced treatments, according to the study’s lead author. The trend may also mean that men and insured patients are at greater risk of exposure to more costly procedures and excessive treatments than women and the uninsured.
Veterans Dying Due to Delays in Diagnosis
At least 19 veterans have died due to delayed diagnoses that could have been made through simple screenings such as colonoscopies or endoscopies, according to an internal document from the US Department of Veterans Affairs. Recently, as many as 7,000 veterans were on a backlog waiting for these procedures at VA facilities in Washington D.C., South Carolina, and Georgia. The VA has since resolved the delay issues at those facilities and reports it is working to prevent similar delays in the future.
Wikipedia Top Source of Health Care Info For Patients and Doctors
Wikipedia is the leading source of medical information for patients and healthcare professionals, with 50% of the latter reporting that they have consulted the online encyclopedia for information on health conditions, according to a study by the IMS Institute for Healthcare Informatics.
In Tenet v. Rivera, an obstetrics medical malpractice case, the Texas Supreme Court will decide whether the ten-year statute of repose in the Texas Medical Liability Act (TMLA) violates the Open Courts provision of the Texas Constitution when applied to claims by children injured before the age of eight. TMLA was enacted in 2003 to “make affordable medical and health care more accessible and available to the citizens of Texas.” Act of June 2, 2003, 78th Leg., R.S., ch. 204, § 10.11(b)(5), 2003 Tex. Gen. Laws 847, 884–85.
Will the Court’s decision in Rivera have any impact on the practice of obstetrics in the State of Texas? Oral arguments in the case will be heard on Tuesday, February 4, 2014. Live streaming of the arguments can be found here.
NUMBER OF OB-GYNS IN TEXAS BY YEAR
Between 2000 and 2010, the population of Texas increased by 20.6 percent, but there was only a seven percent increase in the number of doctors practicing obstetrics in Texas. In contrast, there was a 29.7 percent increase in the overall number of doctors providing direct patient care.
Rivera v. Compton
The Texas Supreme Court will hear oral arguments soon in a case challenging the state’s 10 year statute of repose for medical malpractice claims. Last year, the El Paso appellate court held that the statute, which sets a hard deadline for malpractice cases, violated the Open Courts provision of the Texas Constitution for minors under 8-years-old. The appellants have argued that public policy favors having a definitive cut-off for claims. The plaintiff has argued that because minors do not have the legal capacity to sue, the statute of repose deprives them from seeking redress for their injuries if they do not turn 18 within 10 years of the incident at issue.
Obama Administration Responds to Nuns’ Lawsuit Over Birth Control Rule
The Obama administration has urged the Supreme Court to reject a lawsuit filed by an order of Roman Catholic nuns challenging a mandate requiring employers to provide health insurance that covers birth control. The administration has argued that the requirement does not burden the nuns’ right to practice their religion because they can opt out from the requirement by certifying they have a religions objection.
Many Newly Insured Face Challenge Finding Physician
Many of the estimated 36 million Americans expected to obtain coverage under the Affordable Care Act may have difficulty finding a physician, or face long wait times when they do, according to the director of the Association of American Medical Colleges. Several of the newly insured will be covered through Medicaid, which many primary care doctors and dentists do not accept. More than 20% of Americans live in an area with an insufficient number of physicians, although the shortage could be alleviated in the long run as more mid-level providers begin offering routine treatment.
CHRISTUS St. Catherine to Transition to Post-Acute Care Hospital
CHRISTUS St. Catherine Hospital will transition into the Katy area’s first long-term rehabilitative center over the next year. Houston Methodist, which is acquiring a majority interest in the CHRISTUS St. Catherine, is expanding Houston Methodist West Hospital, where it will offer the majority of emergency care and surgical procedures
Task Force Announces Lung Cancer Screening Guidelines
Adults aged 55 to 80 who smoked a pack or more per day over the past 30 years should undergo annual low-dose CT scans to screen for lung cancer, according to the U.S. Preventative Service Task Force. The task force estimates that between 8,000 and 22,000 lung cancer deaths could be prevented each year if its recommendations are followed.
Study Suggests Expanding Health Coverage Increases ER Use
Expanding the number of individuals with health insurance could result in a significant increase in costly emergency room visits, according to a new study. An 18-month study that followed 25,000 low-income Oregonians who recently obtained Medicaid coverage found that ER visits increased by 40% among the newly insured.
First Study of ED Falls Conducted
The number of falls at a Colorado hospital decreased by over 16% after completion of the nation’s first study of fall risks specific to emergency department patients. Nationwide fall risk studies have not separated emergency departments, where the population skews younger, from other units. The study found that the average age of patients who fell was 46 and 44% of those who fell were intoxicated.
Study Shows Link Between Fatigue, Clinical Decision Regret
Fatigued nurses are more likely to express concern that they made a wrong decision, according to a study published in the American Journal of Critical Care. The study’s authors recommend that employers use relief staff to provide completely relieved work breaks and allow for strategically planned nap times.
Pregnant Nurse Claims She Was Fired For Refusing Flu Vaccine
A Pennsylvania nurse says she was fired for refusing to take a flu vaccine while pregnant, noting she had concerns over the limited studies of the vaccine’s effects on pregnant women. The nurse acknowledged that the CDC recommends pregnant women obtain a flu shot, but believes her request to wear a face-mask as an alternative should have been approved.
Concerns Over New Medical Billing Code Rollout Raised
The troubled launch of HealthCare.Gov has some concerned that the planned October 2014 start date for a new medical billing code system could also prove challenging. The new set of codes, which are used by Medicare, Medicaid and private insurers, will allow for greater detail in describing illnesses, injuries and treatment procedures. Some are concerned that hospitals already grappling with adapting to electronic health records and the Affordable Care Act could be overwhelmed and are pushing for more testing or a delay in implementation.
United States of America v. McKenzie
The owner of a medical supply company convicted of Medicare fraud appealed a court order requiring him to pay $3 million in restitution. An expert for the defendant had testified that it was not possible to determine how much the restitution figure should be reduced to reflect payment adjustments by Medicare. The 5th Circuit affirmed the restitution amount, noting that the defendant had the burden of introducing evidence regarding any offsets. The court reversed the order requiring an immediate lump sum payment, finding that the defendant did not have the financial resources to pay restitution immediately.
Hospitals, Unions Clash Over Flu Shot Mandates
A growing number of hospitals are requiring health care workers to get vaccinated against the flu and other infectious diseases to protect patients. Unions in several states have opposed these requirements and in some instances have obtained injunctions to prevent employees who refuse to be vaccinated from being terminated.
Study Casts New Light On Blood Pressure Levels
According to new guidelines, patients who are 60 or older can have their blood pressure reach 150/90 before medication is necessary rather than 140/90. However, doctors caution that these new guidelines do not apply across the board and are not applicable to some patients with comorbidities such as diabetes or heart disease.
Pharmacy Owners Agree To Settlement Over Meningitis Outbreak
The owners of a compounding pharmacy linked to a deadly fungal meningitis outbreak have agreed to a preliminary settlement that would create a $100 million fund for victims. More than 700 illnesses and 64 deaths have been attributed to injections prepared at the pharmacy.
Feds Approve St. Luke’s, Baylor Partnership
The Federal Trade Commission has approved a joint venture between Baylor College of Medicine and St. Luke’s Health System. The institutions signed a letter of intent in October to enter into negotiations to create a clinical partnership.
Survey Suggests Patients Prefer Physicians For Medical Care
A recent survey by the American Academy of Family Physicians reflects that almost 75% of respondents would prefer to take a loved one to a physician over a nurse practitioner. The poll contradicts findings by the American Association of Nurse Practitioners, which reported last month that there is widespread, national support among the general public for legislation and policy proposals increasing access to nurse practitioner care and services.
Few Residency Programs Teach Cost-Conscious Care
Fewer than 15% of residency programs teach new physicians to practice cost-conscious care, according to a new research letter published by the Journal of American Medical Association. The American College of Physicians has called for high-value, cost-conscious care to become a critical competency for physicians and about 85% of medical programs surveyed have agreed that medical education has a responsibility to help curtail the rising costs of health care.
US Ranks Near Bottom on Efficiency of Health Care Spending
The United States ranks near the bottom among industrialized nations in the efficiency of its health care spending, according to a new study by researchers at the UCLA Fielding School of Public Health. Researchers noted that every additional $100 spent on health care in the United States translates to less than half a month of increased life expectancy, compared to an additional four months of increased life expectancy in Germany.
Castillo v. Brownsville-Valley Regional Medical Center
After an ICU charge nurse was disciplined for refusing to accompany a med-surg patient and instead resumed her ICU duties after a code, several other nurses refused to assume the responsibility of charge nurse. The nurses’ union filed suit under the National Labor Relations Act and state whistleblower laws, alleging they had been terminated for engaging in protected, concerted activity. The trial court granted the hospital’s plea to the jurisdiction, holding that the union’s claims were pre-empted by federal labor law. The Corpus Christi appellate court affirmed, concluding the whistleblower claims involved the same operative facts as the labor allegations and were thus pre-empted by federal law.
Garza v. Deleon
The parents of a child who sustained injuries during a circumcision filed suit against the physician who performed the procedure. The physician objected to the plaintiffs’ expert report, arguing that it did not explain what she was supposed to have done to avoid injuring the child’s urethra. The Corpus Christi appellate court affirmed the trial court’s refusal to dismiss, finding that the report adequately opined that the physician should have avoided cutting into the urethra with a scalpel or electrocautery tool, crushing it with a circumcision clamp, or puncturing it with a suture.
SJ Medical Center v. Estahbanati
A hospital named in a negligence suit filed a plea to the jurisdiction, arguing that it was immune to suit because it should be considered a hospital district management contractor. The Houston appellate court affirmed the trial court’s denial of the plea, concluding that although the hospital was treated as a partnership for tax purposes, it was organized as a limited liability company and as such could not qualify as a hospital district management contractor. The court noted that only partnerships, nonprofit corporations, and sole proprietorships can qualify as hospital district management contractors that qualify for governmental immunity.
Texas Law Prohibits Father From Taking Pregnant Wife Off Life Support
A Texas man whose 18-week pregnant wife has been on a ventilator for weeks has stated that she told him she would not want to be on life support. However, under state law, life-sustaining procedures cannot be removed from a pregnant woman even if she has an advance health care directive stating she does not want to be kept alive on a machine.
Student Sentenced for Trying to Hack MCAT Score
A student who paid hackers $6,000 to try to change his MCAT score has been sentenced to three months in prison. The student, who took the exam seven times between 2009 and 2012, also reportedly was preparing to submit fake graduate transcripts to employers.
Doctors’ Views on Hospice Care Influence Patients
Doctors who would choose hospice care for themselves are more likely to discuss such options with patients, according to a new study. A majority of physicians surveyed said they would choose hospice care if they were terminally ill. About half said they would wait until a patient had no more treatment options available before discussing hospice care.
Physician Accused of Unethical Study Has License Suspension Lifted
A New Jersey physician accused of administering high levels of Vitamin D supplements to disabled patients without their guardian’s consent has had a suspension on his license lifted. The state’s Division of Criminal Justice investigated the allegations, but did not file charges.
Family Fights to Keep Daughter on Life Support
The family of a 13-year-old girl declared brain dead following a tonsillectomy has obtained a temporary restraining order to keep her on life support.
Congress Prepared to Fix Medicare Payment Glitch
Congress is poised to permanently fix a flaw in the Sustainable Growth Rate that determines how much health care providers are reimbursed under Medicare. Since 2002, Congress has had to repeatedly pass legislation to temporarily prevent physician payments from being drastically cut automatically under the payment formula. Congress is expected to replace the flawed system with one that would provide reimbursement based on quality measures.
Backlash Over Opioid Threatens Sickle Cell Care
Concerns about opioids being over-prescribed have resulted in many sickle cell patients with chronic pain experiencing difficulty in obtaining needed treatment. According to a recent study, many sickle cell patients delay seeking treatment until their pain nears 9 on the 10 point pain scale and are often wrongly suspected of exaggerating their pain or abusing drugs.
Foreign-Educated Nurses Report Unequal Treatment In US Workplace
About 40% of foreign-educated nurses working in US hospitals report they receive inferior wages, benefits, or shift assignments compared to their American peers. One-third of respondents also reported they did not receive adequate orientation to life in the US or cultural differences they encounter at work.
Schronck v. Laerdal Medical Company
The family of a woman who died after EMTs were unable to resuscitate her with a defibrillator filed suit alleging her death was attributable to the device not being fully charged. The trial court granted summary judgment after granting the defendants’ motion to exclude the testimony of an expert who opined that the defibrillator was defectively designed. The Waco appellate court affirmed, finding that the expert’s opinion that the woman had a greater than 51% chance of survival if the device had functioned properly was conclusory and contradicted accepted literature that suggested her odds of survival were under 40%.
Laredo Medical Center v. Melendez
A patient who underwent a thermal ablation procedure filed suit against a clinic and the physician who performed the procedure, alleging a catheter was left in her leg. The defendants sought dismissal on the basis that the patient had not served curricula vitae for her Chapter 74 experts. The patient argued in response that the curricula vitae were included in her experts’ reports. The trial court denied the motion to dismiss. The Laredo appellate court affirmed, holding that an expert’s curricula vitae need not be included in a separate document.
Borowski v. Ayers
A patient’s family filed suit alleging that his physicians failed to recognize and treat an aortic dissection. The physicians moved for summary judgment on the basis that the case was filed after the statute of limitations had expired because health authorizations that did not list the patient’s prior providers were not effective to toll the statute of limitations. The family countered that the forms were substantially compliant with the applicable statute and in the alternative that the defendants were estopped from objecting to the health authorizations because they had been used to obtain health records. The trial court denied the motion for summary judgment, without specifying the grounds, and authorized an interlocutory appeal. The appellate court found that it lacked jurisdiction because the trial court had not first ruled on a substantive issue of controlling law.
East Texas Medical Center Regional Health System v. Reddic
A woman who slipped on a wet mat near the front desk of a hospital filed suit alleging a premises liability claim. The hospital moved for dismissal on the basis that she had not submitted an expert report. The Tyler appellate court reversed the trial court’s denial of the motion, finding that the claim qualified as a health care liability claim regardless of whether the plaintiff was a visitor or a patient.
Congress Moves Closer To Changing How Medicare Pays Doctors
Key congressional committees have approved legislation aimed at repealing the Sustainable Growth Rate, the formula that determines how physicians are compensated for treating Medicare patients. The new payment system is expected to compensate physicians for meeting certain quality metrics.
Burnout Among Inpatient, Outpatient Physicians Equal
An analysis of 54 studies of physician burnout has concluded that physicians practicing in an inpatient setting experience an equal amount of burnout as those who practice in hospitals.
Study Finds Medicare Beneficiaries Have Good Access to Doctors
More than 90% of Medicare beneficiaries report having access to a doctor’s office or clinic and are able to schedule timely appointments. Only about 2% of Medicare beneficiaries report having problems finding a new physician, a rate comparable to privately insured adults aged 50 to 64.
Psychiatrists Least Likely to Accept Insurance
Psychiatrists are less likely than other physicians to accept insurance, with only about half reporting that they accepted private insurance between 2009 and 2010, compared to about 93% of other physicians.
CHRISTUS Santa Rosa New Braunfels Hospital Named Accredited Chest Pain Center
CHRISTUS Santa Rosa New Braunfels Hospital has been named an accredited chest pain center by the Society of Cardiovascular Patient Care.
CHRISTUS, Houston Methodist Finalize Partnership
CHRISTUS St. Catherine Hospital and Houston Methodist have finalized a partnership in which Houston Methodist will take a majority ownership of the facility, one other hospital in the Katy area, and a network of clinics in Katy and Nassau Bay.
Texas Children’s Opens First Preventative Cardiology Center
Texas Children’s Heart Center has opened a multidisciplinary center offering specialized care for children at risk for heart disease. The center will manage the risks of children who have a family history of cardiac disease, as well as treat children with Kawasaki disease, a rare condition involving the inflammation of blood vessels.
Texas Biggest Loser in Missed Federal Medicaid Funding
Texas is expected to lose out on the most federal funding among the 20 states foregoing Medicaid expansion under the Affordable Care Act, according to a recent study. The study’s authors estimate that if every state expanded Medicaid, as many as 21.3 million Americans would gain coverage by 2022.
Hospital Prices Biggest Drive of Medical Inflation
Hospital prices represent the largest share of the nation’s annual health care bill, about one-third of the $2.7 trillion spent annually, and are also the largest contributor to medical inflation, according to a new study in the Journal of the American Medical Association.
ACLU Files Suit Alleging Hospitals Place Women at Risk
The ACLU has filed suit in federal court in Michigan, alleging that the United States Conference of Catholic Bishops is placing women at risk by enforcing religious directives it argues discourage hospitals from performing therapeutic abortions at times when the mother’s life is at risk.
Medical Data Sharing Remains Challenge for Health Care Providers
Although many health care providers have made the transition to using electronic health records, it may still take another decade before these records can be easily shared among different health care systems, according to a report from the Workgroup for Electronic Data Interchange.
Parents Claim Child Denied Heart Transplant Because of Disability
The parents of a child born with a genetic disorder have challenged doctors’ decisions not to perform a heart transplant. They allege that claimed concerns about their child’s immune system are a pretext for discrimination against him because of his disability, which may result in intellectual impairments later in life.
Doctors Fear Lower Pay From Exchange Plans
Doctors in Texas and several other states have shared their fears with medical associations that they will receive less pay to treat patients who purchased coverage through the federal health law’s new insurance marketplaces. Insurance officials have acknowledged they have had to reduce rates in some plans, but anticipate physicians will make up for lower pay by seeing more patients.
Edward J. Kroger, MD, JD, managing partner of Kroger | Burrus, has been selected as a 2013 Texas Super Lawyer. Dr. Kroger was previously selected in 2008, 2009, 2010, 2011 and 2012. He practices in the areas of health law and medical malpractice defense. His clients include health care facilities and medical professionals across Texas.
LasikPlus v. Mattioli
A laser eye surgery clinic filed suit alleging an ophthalmologist violated a non-compete agreement. The trial court denied the clinic’s motion for a temporary injunction. The Houston appellate court held the trial court did not abuse its discretion because the clinic did not establish it was likely to succeed on the merits. The court noted that non-compete agreements involving physicians must contain a buy-out provision and rejected the clinic’s argument that the trial court could reform the agreement to include a buy-out provision.
Gynecologists Discouraged From Treating Male Patients
The American Board of Obstetrics and Gynecology has informed its members that they are not permitted to provide treatment to men, including anoscopies, a technique adapted from cervical cancer screening. Researchers fear the decision will stymie a national study on anal cancer prevention by prohibiting some of the most qualified physicians from participating.
Lawsuit Alleges Nurse ‘Worked to Death’
An Ohio man has filed suit against the hospital where his wife worked, alleging she fell asleep while driving due to fatigue associated with being overworked to compensate for inadequate staffing levels.
Study: Bedside Nurse Shift Handovers Improve Outcomes
Nurses can reduce errors and improve patient satisfaction by performing shift handovers at bedside rather than at a nursing station, according to recently published research.
Study Finds High Density Mattresses Help Prevent Pressure Ulcers
A randomized study of nursing home residents at risk for pressure ulcers found that there was no difference in the incidence of pressure ulcers for residents turned at intervals of two, three or four hours. Researchers concluded that high-density foam mattresses expose residents to less pressure than conventional spring coil mattresses, reducing the risk for pressure ulcer formation.
Surgeon Convicted of Manslaughter for Delaying Operation
A colorectal surgeon in London has been convicted of manslaughter and sentenced to 2.5 years for delaying surgery for a man with a perforated intestine. According to the judge, the physician suspected a bowel perforation but did not order a CT scan until the following morning and did not pursue findings of what proved to be free intra-abdominal air on the CT scan or request a reading from a radiologist.
Obstetrician and Gynecological Associates v. Hardin
A man filed a Deceptive Trade Practices Action against a fertility clinic alleging the clinic released his cryopreserved sperm without authorization and used it to inseminate his then-girlfriend. The clinic sought dismissal on the basis that the claim was a health care liability claim and no expert report was served. The Houston appellate court affirmed the trial court’s denial of the clinic’s motion to dismiss. The court found that the clinic offered no evidence that it was a licensed health care provider, and as such, could not establish that the claim was a health care liability claim.
CHRISTUS Santa Rosa v. Botello
A patient who non-suited her claim against a hospital re-filed after sending an expert report to the hospital’s attorney. The hospital sought dismissal on the basis that the deadline for an expert report had expired by the time the second lawsuit was filed. The San Antonio appellate court upheld the trial court’s dismissal, holding that a non-suited defendant is no longer a party and delivery of an expert report to the hospital’s attorney did not satisfy Chapter 74’s expert report requirements.
Alonzo v. Lampkin
A hysterectomy patient who filed suit against her surgeon appealed the summary judgment of her claim, arguing that the trial court’s ruling striking her untimely designated expert amounted to an inappropriate sanction. The Amarillo appellate court affirmed, holding that the scheduling order the parties agreed to qualified as a Rule 11 agreement and the trial court had a ministerial duty to enforce the deadline for designating experts.
CHRISTUS St. Elizabeth v. Guillory
A visitor who slipped on water in a hospital hallway filed a premises liability suit and the hospital sought dismissal on the basis that no expert report was filed. The Beaumont appellate court affirmed the trial court’s denial of the motion to dismiss, concluding that the visitor’s claim did not implicate any standards of health care and as such did not qualify as a health care liability claim.
Shoemaker v. Lorenz
The family of a patient alleging a wrongful death claim against a physician and hospital appealed the summary judgment dismissal of their claim arguing that the statute of limitations did not apply because the hospital did not comply with their request for medical records. The Corpus Christi appellate court affirmed, finding that the plaintiffs offered no affidavit or other evidence to support a fraudulent concealment defense to the statute of limitations.
University of Texas Southwestern Medical Center v. Klingslick
The family of a lung transplant recipient filed suit against the medical center that performed the operation alleging that it had stored the lung in preservation fluid that had a dangerously elevated pH level. The medical center sought dismissal on the basis that the family’s expert report was inadequate. The Dallas appellate court held the expert adequately described his opinions that the medical center breached the standard of care by not verifying that preservation fluid with an appropriate pH level was used, and that damage from the fluid contributed to the patient’s death.
Lahiq v. Rosemond
A sepsis patient who experienced debilitating contractures filed suit against a physician he alleged should have recognized the development of the contractures and ordered range-of-motion therapy during his hospitalization. The Houston appellate court reversed the trial court’s denial of a motion to dismiss. It found that the patient’s expert report was conclusory, noting that contractures were not noted in the patient’s medical record until 28 months after his hospitalization and the expert’s opinion that the condition could have been detected earlier was speculative.
Medicare Penalizes Almost 1,500 Hospitals
Almost 1,500 hospitals were assessed penalties by Medicare pursuant to the quality of care system established under recent federal health law. About 1,200 hospitals will receive increased reimbursements based on two-dozen quality measurements, including patient satisfaction and death rates.
Nurse Education, Experience Impact PICU Mortality
A study of 38 children’s hospitals found that nursing education and experience significantly impact the outcome for patients who underwent cardiac surgery. The researchers recommend that there be no more than 20% of nurses with less than two years of clinical experience in pediatric ICUs to decrease mortality rates and noted that nurse education preparation at the baccalaureate level or higher improved mortality rates.
Nurse Home Visits Decrease Infant Emergency Care
Home visits from nurses decrease the number of emergency care episodes, according to a study published in Pediatrics. The study focused on a program in which nurses visit new parents to check on the health of the mother and newborn, offer advice on breast-feeding and child care, and screen for post-partum depression. Families who received home visits experienced 50% fewer emergency care episodes over the course of a year compared to a control group.
Hospital Inpatient Days Expected to Increase 19% by 2025
Researchers using a computer model predict hospital inpatient days will increase by 19% by 2025, largely as a result of an increase in the number of patients with chronic diseases associated with aging.
Women Admitted for Pregnancy Face High Clot Risk
Pregnant women admitted to the hospital for reasons other than delivery face a substantially increased risk of serious blood clots, according to a study published in BMJ.
Physician Demand to Increase by a Third by 2025
Increased access to health insurance and an aging population are expected to increase physician demand by up to a third by 2025. However, the anticipated physician shortage may not be as bad as feared. The expanded role nurse practitioners and physicians assistants are playing in health care may reduce the expected physician shortage by as much as 50%, according to a recent study.
NY Medical Residents Receive Most Support
New York medical residents receive 20% of Medicare’s graduate medical funding, while 29 other states receive less than 1% even though some are experiencing severe physician shortages. Researchers attribute the disparity to a rigid funding formula that needs to be revised.
CHRISTUS, Cantex to Develop Nursing Home in South Texas Medical Center
CHRISTUS Santa Rosa and Cantex Continuing Care Network have partnered to develop a new skilled nursing facility that will be located next to CHRISTUS Santa Rosa Hospital — Medical Center. The 66,000 square-foot post-acute transitional care and rehabilitation center will provide advanced therapy and medical care to patients.
Study: Sleepy Surgeons Still Perform Well
A study of 10,000 gall bladder operations performed in Ontario found that sleep deprived surgeons did not perform poorly verses when they had received a full night’s rest. Surgeons who had performed an emergency operation the night before a planned procedure were not found to have made an increased number of mistakes.
Feds Boost Mental Health Access
Federal officials have announced new rules intended to improve access to mental health treatment. The rules will require insurance companies to charge similar co-payments regardless of whether treatment is for physical or mental health.