Archive for the ‘nursing’ Category

Actor Dennis Quaid sues drug maker

May 27, 2010

Last month, we reported in a blog through our website, how actor Dennis Quaid is involved as a patient advocate, after his newborn twins nearly lost their lives back in 2007, from a medical error that could have very easily been prevented.  Put simply, the precious twins were given two doses of Heparin instead of Hep-lock (an anti-coagulant medication widely used for children).  Why is this significant?  Heparin is a drug one thousand times stronger than what the twins were supposed to have received.

Earlier this week, it was reported in the Contra Costa Times, that Mr. Quaid has filed a lawsuit on behalf of his children.  As far as the extent of his children’s injuries, the article states “The children suffered internal injuries and shock, but the extent of what happened to them will probably not be known for years, according to the suit.”  The lawsuit alleges that vials of the 10,000 unit Heparin should have been recalled previous to what happened to his children, because other infants had already died from similar medication errors.  The suit also claims that the company responsible for making the drug, Baxter Healthcare, “was obligated to warn healthcare providers of the previous medication mistakes.”

We wish the best for the Quaid family, and hope that the discovery in this case shines a light on not only finding out exactly what happened in this case, but also makes information available that may be able to save the lives of other children from future similar medical errors.  We will continue to monitor the course of this case.

Expanding The Role Of Nurse Practitioners: Licence To Practice Medicine Without A License

February 27, 2010

An article published by NPR comments on the nationwide movement to expand the role of nurse practitioners in light of the growing deficit of primary care physicians. According to the article:

Nursing leaders say large numbers of [nurse practitioners] …will be needed to fill gaps in primary care left by an increasing shortage of doctors, a problem that would intensify if Congress extends health insurance to millions more Americans. Advocates say nurse practitioners have the extra education and training needed to perform a variety of services, including physical exams, diagnosis and treatment of common ailments and prescribing drugs.

A study published by the Center for Workforce Studies projects that, by 2025, there will be a nationwide shortage of about 124,000 physicians. Researchers note:

Under any set of plausible assumptions, the United States is likely to face a growing shortage of physicians. Due to population growth, aging and other factors, demand will outpace supply through at least 2025. Simply educating and training more physicians will not be enough to address these shortages. Complex changes such as improving efficiency, reconfiguring the way some services are delivered and making better use of our physicians will also be needed.

Based on this rationale, a number nursing organizations, state level legislators, regulatory bodies, and various other national organizations and policy thinktanks advocate for an expanded role, particularly in the field of primary care, for nurse practitioners. According to the article, a number of states have already implemented or are presently considering legislation to expand the role of nurse practitioners. For example, a Colorado bill would enable nurse practitioners to issue orders in the same way as a physician. Practically speaking, this would mean that a nurse practitioner, in addition to being able to order medications, would also be able to issue orders directing the treatment of the patient (e.g., orders to admit the patient, CT/MRI orders, consultation orders, etc.)

While these proposed reforms may be practical and serve a utilitarian purpose, one can’t help but wonder if the quality of health care rendered to millions of Americans is going to be compromised as a consequence. The easy answer is not always the right answer. It may be true that there are more nurse practitioners in the U.S. than there are physicians (there are about 125,000 more nurse practitioners). If allowed, nurse practitioners could certainly fill the void. But, the critical inquiry remains: are nurse practitioners sufficiently qualified to serve as substitutes for physicians? For example,

The American Medical Association (AMA) and doctors’ groups at the state level have been urging state legislators and licensing authorities to move cautiously, arguing that patient care could be compromised.

The AMA issued a report in which it questioned whether nurse practitioners are sufficiently qualified to render medical care in areas currently restricted to physicians.

“To back up its claims, the report cites recent studies that question the prescription methods of some nurse practitioners, as well as a survey that reported only 10 percent of nurse practitioners questioned felt well prepared to practice primary care.”

The idea that nurse practitioners are qualified to serve as substitutes for physicians it truly worrisome. There is a reason why nurse practitioners are not physicians – they don’t have the same level of training and expertise. Surely, there are patients with fairly simple medical complaints, which probably could be addressed by nurse practitioners; however, what about the inevitable complex patient? Are nurse practitioners sufficiently trained to simultaneously recognize the interplay of multiple medical conditions, as well as determine the interplay of necessary medications, radiographic studies and necessary follow up care? I for one will make sure to be seen by a physician.

Contributing author: Jon Stefanuca

Anne Mitchell, Whistle-Blowing Nurse, Is Acquitted in Texas – NYTimes.com

February 11, 2010

Just a few days ago – somewhat as a Johnny-come-lately it appears, I wrote about a nurse in Texas charged with a crime for reporting a doctor (anonymously) to a medical licensing board.   The nurse, Anne Mitchell, was acquitted today after a 4 day trial.  After digging out from under our second huge snow storm  for most of the day, I finally had a chance to check the news  and here it was – Anne Mitchell, Whistle-Blowing Nurse, Is Acquitted in Texas – NYTimes.com.  And GOOD NEWS it is.  The good people of Texas were able ot come to the right decision in less than an hour.

You may recall the story – Nurse Mitchell filed a complaint with the state medical board after she observed what she believed was unsafe medical practice by a physician at her hospital.  Turns out the doctor had a patient and close friend – the local sheriff.  Next thing Nurse Mitchell knew – she was facing criminal charges.

As we also reported, she and a fellow nurse (who had also been originally charged but against whom charges were dropped prior to trial) have filed a lawsuit against the doctor, the hospital, the prosecutor – anyone and everyone who had anything to do with the absurd prosecution.  That’s apparently going to be the second round- more to come on that one.

The prosecution charged that they had violated the statute by using their positions to obtain and disseminate confidential information, namely patient file numbers, with intent to harm the doctor, Rolando G. Arafiles Jr.

This charge is a third degree felony under Texas law and carries a maximum sentence of 10 years and a $10,000 fine.

Here’ s how the Times reporter, Kevin Sack, presented the arguments of the prosecution and the defense:

The prosecutor, Scott M. Tidwell, the county attorney, argued during the trial that Mrs. Mitchell had waged a vendetta to force Dr. Arafiles from the hospital almost since his arrival in April 2008.

But Mrs. Mitchell’s lawyers presented broad evidence that her concerns about the doctor were well-founded, and that she violated no laws or regulations by alerting the governmental body that licenses and regulates physicians.

The quote by her lawyer after the ‘not guilty’ verdict tells all you need to know if Nurse Mitchell intends to go forward with her civil lawsuit:

“We are glad that this phase of this ordeal has ended and that Anne has been restored to her liberty,” said Mrs. Mitchell’s lawyer, John H. Cook IV. “But there was great damage done in this case, and this does not make them whole.”

Good for her!  If you think going through a criminal prosecution with possible jail time and a fine is not ‘an ordeal’ – try it some time.  We’ll try to keep up on this story to let you know what happens with this civil lawsuit – why do I think I hear the word  “settlement”  – maybe because that’s what those who are liable for this fiasco should do if they have any common sense (which is debatable).

Healthcare providers, who are concerned about patient safety, should not be silenced by the threat of prosecution when they take steps to correct what they perceive to be a lack of quality care.  Nurse Mitchell should have been applauded for her action, not prosecuted.  At least this evening – she can rest comfortably – and get ready for Round Two – hope she knocks them out!

Nurse who reported doctor to disciplinary board faces criminal charges in Texas

February 8, 2010

This just in from a report in the American Bar Association’s Law News NowProsecutors in Texas have charged a nurse, Anne Mitchell, with a third degree felony (which carries a 10 year prison sentence) for ‘misuse of official information’ when she anonymously reported a doctor for various acts, which she deemed dangerous to the patients he was treating.

The prosecution maintains that Mitchell had a history of making “inflammatory” statements about Dr. Rolando G. Arafiles Jr. and that her goal was to damage his reputation when she reported the doctor to the state licensing and disciplinary board.

Mitchell, however, believed she had an obligation to protect patients from what she saw as a pattern of improper prescribing and surgical procedures. Among her complaints was that Arafiles performed a failed skin graft in an emergency room, where he didn’t have surgical privileges, the Times reports. Another complaint—that the doctor sutured a rubber tip to a patient’s crushed finger for protection—was reportedly later deemed inappropriate by the Texas Department of State Health Services.

Bad blood or just bad medicine?  Regardless – does Texas really believe they are serving some public interest by charging this nurse with a felony?   Does this really send the right message to the medical personnel in our health institutions when they observe what they believe to be poor care and violations of patient safety?

This will be a most interesting matter to follow as well as the civil action being brought by Nurse Mitchell and a fellow nurse, Vickilyn Galle, who assisted Nurse Mitchell in writing the letter (charges were dropped against Galle last week), for violations of their rights to free speech and due process.  This civil action by the nurses is being brought against the doctor, the hospital, the sheriff and prosecutors

One other sidebar note: Dr. Arafiles apparently complained about this letter to his friend and patient, the Winkler County sheriff.

The New York Times in reporting on this fiasco, reports:

Until they were fired without explanation on June 1, Mrs. Mitchell and Mrs. Galle had worked a combined 47 years at Winkler County Memorial Hospital here, most recently as its compliance and quality improvement officers.

According to the Times report, nursing associations – both national and state, have risen up in defense of what they called outrageous charges.  These organizations have raised $40,000 for the defense of these charges.

Legal experts argue that in a civil context, Mrs. Mitchell would seem to be protected by Texas whistle-blower laws.

“To me, this is completely over the top,” said Louis A. Clark, president of the Government Accountability Project, a group that promotes the defense of whistle-blowers. “It seems really, really unique.”

See what you get for trying to hold people accountable for what you believe is bad medical care and for placing patient’s health and safety at risk?  Hmmm…. sounds like lawyers representing plaintiffs in medical malpractice cases aren’t the only ones facing criticism (and now criminal charges) these days.

Good luck, Nurse Mitchell.  Give ’em hell!