Is Noise Affecting the Safety of Health Care?

 A recent position paper calls out surgical practitioners and technology for contributing to distractions in surgical settings.

Distraction is a part of modern medical care.  Nursing staff are routinely overwhelmed with thousands of alarms per shift.  During a surgical procedure, noise and distraction increase the likelihood that a surgical error or never event could occur.

In the position paper published in the Aorn Journal, a publication on Perioperative Nursing, the authors describe what could be going on in the operating room where you are hoping your surgical team is paying the utmost attention to your surgery.  It might be something like this:

• Routine noise is emitted by monitors, necessary equipment, and alarms relative to patient care
• Members of the surgical team could be inattentive due to cell phone calls, texting, pagers, and communication from staff outside of the operating room
• The paper reports approximately 55 percent of perfusionists who responded (specialists who operate heart-lung bypass machines during cardiac surgery) reported using cell phones during a procedure, while almost 50 percent noted they had sent a text message during a surgical event
• Other types of electronic activities that occur within the OR setting include social media messaging, Internet searches, and gaming

It is not a stretch to assume that the distraction of a surgical team member creates a gap in the process intended to secure a healthy outcome for the patient on the table.  In addition to impacting the ability of a surgical team to communicate, distractions and noise increase the possibility of wrong site surgery and the likelihood of complications.

The paper does not suggest surgical teams are irresponsible, but proposes respect for the amount of noise and interruptive activities in a normal surgical setting.  The perioperative setting, when surgery takes place, is one of critical care, requiring focused attention and precise skills.  Add unnecessary electronic devices and personal activities to a setting wherein the long-term health or survival of a patient is at stake and the possibility of an error increases.

At a minimum, the authors suggest defining the phases of surgery where minimal interruption and maximum attention are required.  Referred to as a “zone of silence,” “sterile cockpit,” or “red zone,” these phases require the full attention of the surgical team member.  These could occur during time-outs, surgical counts, procedures around anesthesia, and at other times.

Unfortunately, the patient is not always the focus of full attention in surgical settings.  If you, or a loved one, is injured during a surgical procedure—speak with an experienced injury attorney at our office.

Experienced medical malpractice attorneys serving Washington, DC and Maryland

With more than 35 years of successfully taking on physicians and healthcare institutions on behalf of injured patients, our legal team at Schochor, Federico and Staton, P.A. provides unsurpassed legal representation and advice. Contact us today or call us at 410-234-1000 to schedule a free consultation to discuss your case.

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Amid Challenges, Number of Primary Care Physicians May Decline

 A recent survey reveals the impact of the COVID-19 crises on Primary Care physicians.  As a result, their patients may neglect their health or lose accessible healthcare altogether.

The COVID-19 pandemic has reset how we live, who we interact with, and the products and services to which we have access.  Of those, medical care has been a continued hotspot in the US—how to get needed care for symptoms of the novel coronavirus, how to maintain health when chronically ill with other diseases, and how to get basic health care during times of community viral spread.

Primary Care physicians (PCPs) are an historically valuable component of any healthy community.  Primary Care practices often provide a mix of Family Medicine (across age ranges) and Internal Medicine.  From the days of the Family doctor arriving in a horse and buggy to today, when patients can often take advantage of a full-service contemporary medical practice serving inter-generational needs, PCPs occupy an important niche in health care.

According to a survey from the Primary Care Collaborative in partnership with the Larry A. Green Center, the overall fitness of Primary Care practices has suffered at a time when communities need more robust health care than ever before.

The survey represents the responses of 636 practitioners in 47 states from settings including office practices in city and rural settings, schools, community health centers, and patient-centered care facilities.  Some key points of the survey include:

• The survey fielded responses from August 1, 2020 to August 24, 2020. In that time, two percent of responding practices closed, two percent were considering bankruptcy and an additional ten percent were unable to project their business solvency past the next month. These practitioners see an increase in need for primary care and a decrease in support and guidance from policy makers regarding financial and economic hardship due to the pandemic.
• Practices across the country are seeing an increase in food, financial, and housing insecurity in their patients. These anxieties translate to increased disease including weight gain, emotional and mental exhaustion, increase in substance abuse and decrease in self-care among patient populations. Despite diminishing resources, some medical practices are trying to help patients as they are able with food, housing, and financial insecurity. Some are strengthening relationships with social and public health services in order to help their patients with the strain.
• At the same time, a number of practices facing resource and financial shortfalls have had to cut back staff hours, preventative health and educational services, and struggled with staffing as personnel are exposed, in quarantine, or ill.

The healthcare network in the US is strained to breaking in portions of the country.  Reduced access to care means critical treatment is missed and conditions that could be caught through diagnostic testing may be delayed.  Physicians operating under stress in the surgical suite or during an office visit may make a mistake or miss a symptom.

Leadership and economic support are important for physicians and their patients to come through this crisis. Without it, Primary Care physicians may be absorbed into hospital specialty groups or simply give up their practices—leaving patients without the care they need.

Skilled legal help with medical malpractice in Baltimore, Washington, D.C., and throughout the country

Representing clients injured by error and negligence, Schochor, Federico and Staton, P.A. is a leading medical malpractice law firm with a strong track record of winning complex cases against physicians and healthcare facilities.  Contact us today or call 410-234-1000 to schedule a free consultation to discuss your case.

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Migraines During Pregnancy Can be More than ‘Just a Headache’

 Pregnant women who experience migraines may be at a higher risk of stroke, according to recent research.

Along with the aches, pains, hunger, and nausea that sometimes accompany pregnancy, many women experience severe headaches or migraines.  Because of the hormonal fluctuations of pregnancy, women who usually get migraine headaches may be afflicted less—or more—until and after they give birth. Sometimes these conditions are passed off by healthcare providers as a common side effect of pregnancy.

A study published in JAMA Neurology suggests that migraine during pregnancy may increase maternal risk of both ischemic and hemorrhagic stroke.  An ischemic stroke occurs when a clot or embolism blocks or slows blood supply to the brain.  A hemorrhagic stroke results from the bursting of a weak blood vessel that breaks within or on the surface of the brain.  Both are dangerous medical conditions that require emergency treatment.

The increased risk of stroke appears to be related to hypertensive disorders sometimes experienced during pregnancy. “Hypertensive disorder” is a broad term that captures conditions related to high blood pressure disorders of pregnancy, including preeclampsia, gestational hypertension, and associated conditions.

In this study, researchers evaluated data from three million singleton births that occurred between January 2007 and December 2012.  The aim of the research was to explore the involvement of hypertensive disorder in the relationship between migraines and maternal stroke.

The study found that hypertensive disorders put women who suffer migraines at higher risk of stroke.  Here are some points of the study:

• Within the study data, 26,440 women were diagnosed with migraines (or 914 of 100,000 births).
• 843 women (29 of each 100,000 births) suffered a stroke. Of these, 58% were ischemic strokes.
• Analysis reveals hypertensive disorders were associated with 21 percent of stroke risk during pregnancy, and 27 percent of stroke risk in the postpartum period.

Study authors note, “Approximately one-fourth of the excess cases of maternal stroke associated with migraine were attributable to hypertensive disorders. This suggests that other pathways exist between migraine and stroke during the perinatal period, potentially through pathophysiologic changes, such as increased blood volume and cerebral circulation.”

While headache is common during pregnancy, migraine may give rise to more serious complications during and after pregnancy.  If you or a family member is pregnant and experiences migraine, be sure to speak with your physician about concerns and monitoring for hypertensive disorder, because sometimes a headache is not just a headache.

Knowledgeable malpractice attorneys fight for compensation on your behalf

Whether from misdiagnosis, failure to diagnose, or medical mistake, Schochor, Federico and Staton, P.A. delivers experienced, skilled legal service to individuals and families hurt by poor standards of healthcare. Contact us today or call 410-234-1000.

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Nine Schochor, Federico and Staton, P.A. Attorneys Recognized as 2021 Super Lawyers®

 The skilled and knowledgeable attorneys of Schochor, Federico and Staton, P.A. are deeply committed to providing medical malpractice plaintiffs with the highest quality of legal representation. Since our opening day in 1984, we have recovered more than one billion dollars for our clients. Our award-winning attorneys have earned a wide range of distinctions from prestigious organizations such as Best Lawyers, Martindale-Hubbell, and – once again – the national attorney rating agency, Super Lawyers®.

This distinguished annual award is bestowed on only five percent of attorneys nationwide in 2021. We are pleased to announce that six of our highly respected partners and three of our accomplished associates have been included on this prominent list in 2021:

• Jonathan Schochor, a founder and senior managing partner of our firm, was recently recognized as one of the Top 100 Litigation Lawyers in the State of Maryland by the American Society of Legal Advocates. He has also achieved recognition from many other prestigious organizations, including being named Trial Lawyer of the Year by the Maryland Association of Justice as well as the 2016 Lawyer of the Year for plaintiffs’ medical malpractice by Best Lawyers in America®. Mr. Schochor also led the Class Action litigation involving Nikita Levy, M.D., a gynecologist who sexually abused his patients. The case resulted in a $190 million settlement purported to be the largest single perpetrator, sexual assault settlement in U.S. history at that time.
• Philip C. Federico, a senior partner with Schochor, Federico and Staton, P.A., is one of our distinguished founders. Among his numerous awards and recognitions, he has been named a Maryland Super Lawyer™ Top 100 Lawyers every year since 2012, and was designated as one of the Top 100 Attorneys in Maryland™ in 2010 and 2011.
• Kerry D. Staton is a founding partner of Schochor, Federico and Staton, P.A. whose unyielding dedication to medical malpractice plaintiffs has resulted in numerous recognitions.  In addition to receiving the Maryland Super Lawyers® Top 100 Lawyers award every year since 2012, he has also been elected as a Fellow of the American College of Trial Lawyers, an honor that is only bestowed upon the top 1% of lawyers in each state. Mr. Staton has been recognized as Lawyer of the Year® for plaintiffs’ medical malpractice in Baltimore twice, in 2013 and 2018 by Best Lawyers In America®, an organization which has recognized him annually since 2008.
• James D. Cardea, a partner with Schochor, Federico and Staton, P.A., has been selected for inclusion in the Best Lawyers in America™ since 2011. Mr. Cardea has also been recognized as one of the Top 100 Trial Lawyers in Maryland™ by The American Trial Lawyers Association and a Top 100 Litigation Lawyer in the State of Maryland by the American Society of Legal Advocates. In 2018 and 2019, Mr. Cardea was included as one of the 10 Best Attorneys for Maryland by the American Institute of Personal Injury Attorneys.
• Scott P. Kurlander, a partner with Schochor, Federico and Staton, P.A., is widely respected for his knowledge of medical malpractice. His numerous accolades include being named to the Best Lawyers in America™ since 2011. He has been a Maryland Super Lawyer every year since 2009 and has been a member of the invitation only Million Dollar Advocates Forum and the MultiMillion Dollar Advocates Forum. He is a member of the Board of Governors of the Maryland Association of Justice. Mr. Kurlander is frequently asked to deliver presentations to a variety of audiences, including lawyers, paralegals, medical students and various physician groups. He recently taught a class on medical malpractice for all judges in the State of Maryland at the Judicial College of Maryland. Mr. Kurlander volunteers his time in numerous professional organizations and committees, including Peer Review for the Attorney Grievance Commission of Maryland, the Judicial Evaluation Committee for the Baltimore City Bar Association and the MAJ Legislative Committee amongst others.
• Jonathan E. Goldberg is a Schochor, Federico and Staton, P.A. partner who has served as the co-chair of the Medical Malpractice Subcommittee of the Health Law Section of the American Bar Association. He has given several lectures and presentations in the areas of medical malpractice issues throughout the state of Maryland. Prior to representing clients injured due to medical negligence, Mr. Goldberg spent approximately 14 years defending health care providers in medical malpractice lawsuits.
• Aubrey Wray Fitch, IV is an Associate who was designated a Rising Star by Super Lawyers®, a distinction that only 2.5 percent of Maryland attorneys achieve every year. Mr. Fitch earned his Juris Doctor from The George Washington University Law School in 2011 with high honors. He is an experienced litigator who has also presented oral argument before the Court of Special Appeals of Maryland.
• Brent Ceryes is a valuable part of our team at Schochor, Federico and Staton. In his role as an Associate, Mr. Ceryes represents clients in a variety of mass tort and class action matters, including the representation of individuals exposed to potential bloodborne pathogens in an ambulatory surgery center, the representation of individuals affected by groundwater contamination and air pollution from industrial agriculture operations, and the representation of dozens of counties and municipalities in litigation against the manufacturers and distributors of opioid pain medication.
• Jonathan Huddleston, an Associate with Schochor, Federico and Staton, has been selected as a Rising Star by Super Lawyers®. Mr. Huddleston graduated from Vanderbilt University in 2008 and earned his Juris Doctor from the University of Maryland School of Law in 2011. He co-chaired the education committee for the Young Lawyers Section during the 2018-2019 bar year and received the Maryland State Bar Association Young Lawyers’ Section award for “best committee.” This year, Mr. Huddleston was inducted into the Maryland Bar Foundation, as a Fellow. Fellowship in the Maryland Bar Foundation is by invitation only and is restricted to outstanding Maryland attorneys and judges not exceeding two and one-half percent (2.5%) of membership of the MSBA. He now utilizes his education and experience in his role as an exceptional litigator with our firm.

 

The Super Lawyer® selection process

The annual Super Lawyers® list results from months of peer reviews and extensive independent research. The selection process begins with nominations from peers and other legal professionals. The Super Lawyers® research team then evaluates each nominee using 12 indicators of professional achievement. To qualify as a Rising Star, a candidate must be 40 years old or younger, or in practice for ten years or less.

Once the pool of nominees is narrowed, a blue-ribbon peer review is conducted to determine who will be chosen as Super Lawyers®. Only about five percent of all attorneys ever receive this reputable designation, and we are proud that they are with our firm.

Fighting for medical malpractice plaintiffs across Washington DC, Maryland and Baltimore

The award-winning attorneys of Schochor, Federico and Staton, P.A., advocate for people injured by medical malpractice. We are proud that our peers have chosen to acknowledge the efforts of our partners. We appreciate the knowledge and skill of these nine attorneys and congratulate each of them for this prestigious recognition.

For more information about Schochor, Federico and Staton, P.A. or the Super Lawyers® selection process, call our office at 410-234-1000.

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Study Suggests Longer Hourly Shifts May Not Translate to More Medical Errors

 Fear of overtired medical residents may be misplaced.  A new study found that residents working 24-hour shifts don’t necessarily make more errors than colleagues working shifts of 16 hours or less.

A study and opinion piece in the New England Journal of Medicine looks at the schedules given to medical residents and the impact of schedules on patient safety.

Medical error is rampant in the practice of medicine in America today.  Occurring at all levels of care, medical malpractice happens every day, oftentimes unnoticed, but sometimes with deadly serious consequences for patients and their families.

Resident physicians and their often-grueling work schedules are a prominent example used when discussing fatigue that leads to a host of medical errors.  In recent years, scheduling policies for first-year residents have gone back and forth in response to the public conversation about medical fatigue and medical error.

The new NEJM study looked at the length of shifts and the likelihood of medical error in shorter and longer shifts.  Over six facilities, researchers evaluated the impact of scheduling on pediatric resident physicians working in intensive care units. Results were obtained by direct observation, close surveillance, and chart review. Here is what they found:

• Residents who worked controlled shifts of less than 24-hours had higher rates of preventable adverse events, made more medical errors, and had more near misses
• Residents working 24-hour or more shifts made fewer medical mistakes despite working longer hours than those who worked less

Digging into the data, study authors found that the three sites with the highest number of errors also had the highest number of patients.  Although patient volume was not the focus of the study, it may not be the hour of the night that impacts medical error for residents, but how many patients a physician is driven to see that increases or decreases the number of medical mistakes made on any shift.

While these findings turned over enough data to find that higher patient volume may lead to increased medical error, it will always be true that fatigue and distraction contribute to mistakes and confusion.

Research continues into the ways and means to reduce medical mistakes made by physicians, and other healthcare providers, nursing staff, and institutions.  If you suffer medical negligence, speak with our legal team today.

Providing unsurpassed legal service to Maryland patients injured by medical malpractice

Schochor, Federico and Staton, P.A. has more than 35 years of successful experience representing clients and their families injured through medical negligence.  When you suffer serious injury due to the fault of others in Baltimore, Washington, DC, or elsewhere in the US, we can help. Contact us or call 410-234-1000 to schedule a free consultation today.

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More Surgical Checklists, Fewer Errors?

 Recent research suggests using two surgical checklists together may result in fewer medical errors and less harm to patients.

Checklists are an important part of patient safety.  In a surgical setting, careful attention to checklists can reduce serious mistakes, like wrong-site or wrong person surgeries.  We recently talked about the importance of the surgical time-out that is part of the checklist process. Overall, checklists draw attention to surgical detail and aim to improve surgical team function and culture.

In 2013, the rate of medical error in the United States was placed at approximately 400,000 deaths per year—and that was seven years ago. The rate continues to rise as do efforts to stem the very human mistakes that lead to injury and death caused by medical negligence.  Checklists are part of that effort. Two widely used surgical checklists include the World Health Organization surgical safety checklist (WHO SSC) and the Surgical Patient Safety System checklist (SURPASS).

While you might think two checklists are a bit much, they do not primarily overlap.  Here are some differences:

• SURPASS: The SURPASS list ensures that admission concerns leading up to surgery including radiology, lab work, blood products, and medications are accounted for by individuals responsible for that work.

This list picks up in the Recovery room, the intensive care unit, or wherever the patient bed is located.  Instructions about medications, post-surgical care, and follow-up are maintained until the patient is discharged.  At that time, the SURPASS checklist aids caregivers in discharging the patient appropriately with needed medications and instruction.

• WHO SSC: The WHO list carefully lists procedures that should occur prior to anesthesia, prior to incision and after the procedure, before the patient is taken from the operating room. The WHO SC list brings focus to the role and responsibility of individual team members throughout the surgical experience.

Surprisingly, the two checklists are not used jointly.  Not surprisingly, a recent study published in JAMA surgery found significant benefits to the use of the two checklists together.  Looking at data from approximately 9,000 surgical procedures in three hospitals, the primary benefits of using both checklists include:

• Fewer surgical complications
• Drop in the number of surgeries repeated
• Reduced rate in hospital readmissions

To answer the question posed by the headline—more surgical checklists, fewer errors?  When used correctly, the answer from this research appears to be “yes.”

Speak with knowledgeable malpractice attorneys if you suffer an injury during medical care 

If you suffer injury as a result of medical care, our legal team delivers aggressive legal representation to obtain compensation on your behalf.  Talk with an attorney who will listen to what happened and answer your questions about seeking compensation. Schochor, Federico and Staton, P.A. delivers experienced, skilled legal services to individuals and families hurt by medical mistake. Contact us today or call 410-234-1000.

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Executive Order Makes Telehealth Services Permanent through CMS in Some Areas

 A recent Executive Order is aimed at expanding telehealth options in rural areas.

Just months ago, telehealth was a sideline of many medical practice groups. With the onset of the COVID-19 pandemic, telehealth services took center stage as in-person care became dangerous for patient and provider.  Recent statistics show 0.1 percent of Medicare primary care visits were conducted by telehealth in February, 2020.  By April, 43 percent of Medicare primary care visits were conducted remotely.

As hospital and care centers closed shop on elective and non-emergency procedures, many practices and their patients turned to remote care for advice and assessment.  In August of this year, President Trump signed an Executive Orderfocused on healthcare consumers who live in rural areas.

Points addressed by the Order include:

• Approximately 57 million people live in rural areas that are under-served by medical facilities, primary care physicians, and specialists. Because of these limitations, those living in rural area lack access to quality care and are more likely to suffer from heart disease, chronic respiratory illnesses, and cancer.
• Across the country, telehealth visits jumped as the country locked down as a result of the pandemic. With staged reopenings across the country, telehealth visits have remained high, even as physicians’ offices have resumed scheduling visits.  The ongoing high rate of remote healthcare could be an indicator that telehealth is here to stay.
• To improve access to healthcare and acknowledge the continued use of telehealth, the Order directs the Department of Health and Human Services (HHS) to develop new payment models and reduce regulatory restrictions that make telehealth either unaffordable or unavailable in rural settings.
• The Order directs agencies involved in the delivery of care to develop plans to build out communications infrastructure, as well as provide direction on addressing maternal health care and improving mental health services.

In a short period of time, telehealth has come become a primary mode of delivery in many healthcare practices. Bundled with healthcare portals, and electronic health records, telehealth offers improved access and convenience for more than just rural populations.

Yet beneath the rush to offer desperately needed healthcare during a pandemic remain questions about the types of healthcare services that can be offered remotely and those that cannot.  Serious concerns remain about illnesses and conditions that could be misdiagnosed via telehealth and what types of medical errors will inevitably occur as this new delivery mode becomes more prevalent across the country.

With or without this Executive Order, it is unlikely that the United States will turn back from telehealth. If you or a family member suffer serious medical injury or error due to remote or other type of healthcare service, speak with our experienced legal team about your circumstances.

Experienced injury lawyers fight for compensation on your behalf in Baltimore and Washington, DC

Serving injured patients around the country from offices in Baltimore, Maryland, and Washington, D.C., Schochor, Federico and Staton, P.A. is a highly reputable medical malpractice law firm working on behalf of clients injured by mistake or negligence. Call 410-234-1000 or contact us today to schedule a free consultation to discuss your injury.

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