August 6, 2012
New York Times writer, Anemona Horticollis has written yet another telling story. The Short Life and Lonely Death of Sabrina Seelig describes why entering a hospital could be hazardous to your health.
Sabrina Seelig was a writer, a student and came from a family of artists. Both of her parents previously taught at the University of Art in Philadelphia and then moved to an artists’ colony in Maine. Sabrina eventually moved to my hometown of Brooklyn, New York in a neighborhood that was changing. Like many New York neighborhoods, Bushwick has experienced significant transformation and revitalization, thus attracting young professionals, students and artists. Unfortunately, the neighboring hospital remained unchanged and had been cited for mismanagement, was under investigation by the Brooklyn District Attorney and didn’t carry medical malpractice insurance. Had Sabrina had known those facts; they might have saved her life.
According to The New York Times, Sabrina took Ephedra (a stimulant) to stay awake all night so that she could write her Latin paper for school. She also took an herb called Valerian. Feeling sick, she contacted the public health Poison Control Center after calling an ambulance that never came. The Poison Control Center wasn’t that helpful and basically told her to wait for the ambulance. It’s not clear how Sabrina arrived at Wyckoff Hospital but a cascade of unfortunate events sent her to the grave:
- She was given a sedative that made her sleepy although she had taken Valerian
- Her wrists were bound in restraints
- She was never given oxygen
- She lie on a small hospital cot unresponsive for over 12 hours
- She never received a breathing mask or tube
- She was never transferred to the ICU
- There were few notes written in her medical chart
- She did not have vital signs recorded for over 3 hours despite the fact that she was unconscious
- Her parents had her transferred to another hospital but by that time she was brain dead
- The nurse involved stated “writing vital signs were unnecessary because she was watching the cardiac monitor. “
- Her family had a challenging time finding an attorney who would take the case
- A jury found the hospital not guilty and made snide comments about Sabrina’s alleged drug use
As a physician and parent, I am outraged about the death of Sabrina. Wyckoff Hospital should be shut down immediately.
There are two lessons to be learned from this case. (1) Know your hospital. There is a chapter in The Smart Mother’s Guide that addresses this issue. If a hospital does not carry medical malpractice insurance, RUN in the opposite direction; and (2) to quote Sabrina’s dad, “Never enter a hospital alone.”
March 7, 2012
March 4 – 10 is Patient Safety Awareness Week, a subject near and dear to my heart. The subject reached the radar screen after a 1999 report from the Institute of Medicine (IOM) reported that over 100,000 people in the U.S. die each year from preventable medical mistakes. Many of these mistakes were due to medication errors, hospital infections and “systems errors” which is a polite way of saying the left hand didn’t know what the right hand was doing.
The Smart Mother’s Guide to a Better Pregnancy was written as a guide to improve pregnancy outcomes. I wanted to help women take home a healthy baby by avoiding all of the preventable mistakes that are regretfully made in labor rooms and clinics. No one wants to witness or be a victim of “mistakes” that could have been avoided if people were paying attention. Imperfection is a way of life yet in healthcare it is unforgiving.
As a result of the IOM’s report, hospitals and healthcare organizations have made patient safety a national and international priority. Checklists, medication bar codes and infection control committees have emerged in many hospitals, but patients must also get involved. The federal government has a started a campaign entitled “Questions Are the Answer” that encourages patients to ask their physicians or healthcare providers questions about their healthcare. Pregnant women over 35, African Americans and Medicaid recipients face the greatest risk for medical mistakes and complications. However, there are things one can do to minimize risks.
- If your blood type is Rh Negative, make sure you are given all test results, including an antibody screen
- Ask what your vital signs are at each prenatal visit to rule out high blood pressure
- Ask for a high-risk consult with a specialist if you have diabetes, high blood pressure or asthma
- Pay attention to fetal movement
- Ask about all lab results, especially your diabetes test
- Ask whether your midwife or obstetrician knows how to manage a shoulder dystocia
- If you’re hospitalized for pre-eclampsia and someone wants to send you home before having your baby, ask for a second opinion, preferably with a high risk physician
Please be pro-active regarding your prenatal care. Remember, a healthy pregnancy doesn’t just happen. It takes a smart mother who knows what to do.
September 26, 2011
Three young mothers under the age of 40 are dead because they wanted to be beautiful. Kellee Lee-Howard wanted a slimmer body. Ditto Maria Shortall and Rohie Kah-Orukatan. Shortall worked as a housekeeper; Lee-Howard was the mother of six kids and Kah-Orukotan died at the same place where she received manicures. What do these women have in common besides being minorities? They had liposuction procedures performed by men who offered a discounted price for an elective surgical procedure. These men professed to be competent in performing the procedures but never had accredited training.
I knew this day was coming. I saw the storm long before the clouds emerged. As the insurance payments for professional medical services decreased and declined, physicians began to look for alternative ways to earn money. But was it ethical? Gynecologists began to do liposuctions. General surgeons did breast augmentations. Some primary care physicians abandoned seeing patients altogether and opted to do chemical peels and weight loss treatments. Medical spas were added to traditional medical practices. Everyone wanted to cash in on a woman’s desire to be beautiful. Physicians were now business owners and entrepreneurs. However, could they attend a weekend seminar and returns to their offices on Monday ready to do the procedures? Were they really as competent as a plastic surgeon who had five years of training?
Jayne O’Donnell recently published an expose about these doctors in USA Today entitled Lack of Training in Cosmetic Surgery Can Be Deadly. It reads like a litany of horror. The physician who performed Kah-Orukotan’s liposuction was an Occupational Health physician. He didn’t have the proper equipment in his office nor was the procedure approved for office surgery. Shortall and Lee-Howard’s physician did an internship in pediatrics, another internship and residency in general surgery but never got board certified in the 27 years that he has practiced medicine. Had these ladies accessed the Florida Board of Medicine website and looked up their physician, they would have noted the $350,000 settlement in 2004. They would have also noted the absence of board certification, the absence of plastic surgical training and the absence of privileges to admit to a hospital.
All three women died from complications of anesthesia. They had received too much lidocaine which is a numbing medicine given by injection prior to a surgical procedure. Too much lidocaine can also stop the heart. These deaths should have never happened.
In Part 2 of this blog, you will learn what can be done to avoid becoming a victim of a preventable medical mistake. The life you save could be your own.
May 31, 2010
My institute of residency training is in hot water again, and I groan in despair (see Heart Tests at Harlem Hospital Went Unread). The New York Times reported that Harlem Hospital had performed nearly 4,000 cardiac echo exams in a two year period and none of them had been read by a physician. The Times alleges that the responsibility of reviewing these labs reports had been given to the cardiac techs and now the consequences of that decision was coming back to haunt the entire hospital.
This scandal reminds me of another that occurred over 25 years ago. Hundreds of New York City women entrusted their PAP smears to city hospitals that were never read by a gynecologists. By the time the debacle was discovered years later, some of these women developed cancer. With a failing economy and budget constraints, I’m sure someone had the misguided perception that they could save money and resources if the technicians read the lab reports and reported the “abnormals” back to the physicians. The same principals apply to nursing. Medical assistants are now expected to perform duties traditionally done by nurses as a means of “saving” money. These “cost-saving” strategies have a chilling effect.
Harlem Hospital is an historical haven for the poor. Despite limited resources, its dedicated staff saves lives on a daily basis. However, please don’t push the envelope. The quality of medical care greatly diminishes as the volume of patients increases. Delegating a physician’s duties to a technician will NOT remedy this problem.
A team of 15 to 20 physicians from other city hospitals were assembled to review the cardiac records and miraculously no abnormalities were found. There were also disciplinary actions that resulted in the termination of a clinical director and the demotion of a physician. The take-home message for ALL patients regarding this debacle is to obtain the results of all of your medical tests. Do not assume “no news is good news.” And if someone wants to give you an injection, please verify that they’re truly a nurse.
Our present healthcare system is on automatic pilot. It’s up to you to grab hold of the wheel.