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February 11, 2010
Nurse acquitted for reporting doctor, but watchdog group predicts chilling effect
A jury in West Texas acquitted a nurse on trial for reporting that a doctor had improperly encouraged patients to buy herbal medicines and wanted to use hospital supplies to perform a procedure at a patient’s home, according to the Associated Press.
Winkler County prosecutors accused the nurse, Anne Mitchell, of being motivated by personal, not professional concerns when she complained to the Texas Medical Board about Dr. Rolando Arafiles. She was indicted in June on “misuse of official information” after Arafiles filed a harassment complaint with the Winkler County Sheriff’s Department, according to the AP.
The prosecutor dropped a complaint against a second nurse alleged to be involved in the case.
Both nurses were fired from their jobs where they worked wtih Arafiles at Winkler County Memorial Hospital in Kermit.
We’ve run several columns on this by Austin nurse Toni Inglis, including this one.
Alex Winslow, executive director of the consumer group Texas Watch, said that regardless of the acquittal, the case would have a chilling effect on nurses who want to report wrongdoing by doctors and patient safety.
“Texas has become the Wild West when it comes to medicine,” said Winslow in a news release on the acquittal. “Our courthouses are closed and patients have no public advocates. Now, our only line of defense to protect patients from dangerous, careless or unqualified doctors, the Texas Medical Board, is hamstrung because of this prosecution.”
Mari Robinson, executive director of the medical board, said in a letter to prosecutors that, “the willingness of persons to come forward and file complaints with the Board is critical to the Board’s success in regulating the practice of medicine as required by Texas law. Causing persons to fear criminal felony prosecution if they do so undermines the Board’s ability to do its job.”
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February 5, 2010
Patient safety campaign targets brutal work schedules of doctors-in-training
A new campaign aimed at reducing medical errors is targeting the grueling schedules required of medical residents (doctors-in-training) and interns who often work shifts up to 30 hours at a time.
Research shows that lack of sleep can lead to impaired decision-making and mistakes. In a hospital, such mistakes can mean life or death.
A coalition of more than 40 health care, patient safety and other advocates is behind the campaign called Safe Work Hours, Safe Patients. They are asking the public to share stories about fatigued physician care and sign a petition to the organization overseeing residency training programs in the U.S., the Accreditation Council for Graduate Medical Education.
The coalition wants the council to limit the amount of time residents go without sleep to no more than 16 hours and increase supervision of the residents. The coalition hopes to influence the council’s board, which is meeting Sunday through Tuesday, according to a news release about the campaign.
“Few, if any, people would fly on a plane whose pilot had been awake and working for 25 to 30 hours. In fact, that long a shift is prohibited,” Dr. Sidney Wolfe, director of Public Citizen’s Health Research Group, said in the release. “But patients routinely get medical care from resident physicians who have been working that long. They become fatigued, making them more susceptible to making errors that greatly harm patients. It is likely that there are more deaths in U.S. hospitals each year caused by sleep-deprived doctors than the total annual deaths from plane crashes and train accidents.”
Helen Haskell, the founder and president of Mothers Against Medical Error, one of the coalition groups, became involved in patient safety after her 15-year-old son Lewis Blackman died in a South Carolina hospital from an elective procedure in 2000. He died “from ‘failure to rescue,’ or failure to recognize and act upon the signs of serious decline in a patient,” according to Haskell.
“I know that fatigue must have played a role in my son Lewis’s intern’s judgment and in her inability to buck the system for the sake of a patient,” she said in the news release. “There is no way I can ever know how large a role it played, but I do know that in those hours of crisis, the last thing we needed was to have an exhausted, unsupervised young trainee as my dying child’s only lifeline.”
Lisa McGiffert of Austin, who is leading the Stop Hospital Infections project for Consumers Union, said her organization is a backer of the campaign and has long been concerned about medical errors.
“This is the first time consumer organizations have come together on the issue,” she said yesterday, when the campaign was announced.
No one knows how many medical errors occur each year, she said, “possibly as many as 200,000 but we estimated over 100,000. We know there are almost 100,000 deaths from hospital-acquired infections.”
A report her organization wrote said that behind the numbers are real lives, like that of Haskell’s son, Lewis.
“The lack of a reliable measurement of medical harm is a major challenge that must be addressed,” the report concluded. “But don’t confuse the magnitude with the impact. We know the impact of the problem today. Just ask Lewis Blackman’s family.”
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