Doctor Harvey S. Levin of the Baylor College of Medicine is alluding to a common perception that toddlers and adolescents who sustain head injuries generally recover more quickly than do adults with similar injuries. Additionally, there is widespread belief that kids are not as vulnerable to the negative and long-lasting effects of TBI episodes.
]]> Two studies carried out at the same children's hospital in Australia do not bear this out. They show, rather, a discernible impairment in cognitive ability in children who have sustained severe head injuries that persists and can worsen as they get older.The key factor, unsurprisingly, is the severity involved. A persistent view held by many is that children generally bounce back quickly from most head injuries, without lasting effects. In one of the studies carried out in Australia, data confirmed that most kids do recover appreciably over years from even severe brain injuries, but that there is often a corresponding and lasting mental gap vis a vis their peers later in life.
In other words and, again unsurprisingly, the deficit is commensurate with the TBI severity.
Researchers point out that children are at an unduly high level of risk for head injuries because of their propensity to fall during a time when they have not yet gained full balancing abilities.
Source: CNN Health, "Severe traumatic brain injury affects development in young children" Jan. 23, 2012
]]>In an interesting twist on doctors' failing to properly diagnose illnesses, a recent story from the Chicago Tribune reveals that some younger doctors and nurses not only fail to note the symptoms of and indentify certain illnesses and diseases, but also lack even rudimentary knowledge of them.
]]> Take measles, for instance. The newspaper reports that it recently took an entire day for a young boy with the disease to be properly diagnosed at a hospital in Texas. An older doctor made the right call, and he was one of only a few people at the facility who had ever seen a case of measles."They weren't thinking measles," said an infectious disease specialist, who, along with others, notes how certain diseases that were once common have become rare through vaccination and now pose problems in identification and treatment for many younger practitioners who lack experience with them.
Whooping cough is in that category, as are mumps, chickenpox, diphtheria and tetanus.
The problem: These scourges can and do occasionally emerge and, when they do, medical professionals who have never personally seen a case and have knowledge of the illness only through lecture and a textbook are often unprepared to deal with them.
That happened last year in Indiana, following the return from Indonesia of a person unvaccinated for measles. The disease was initially misdiagnosed and not figured out until 17 days later, after more than 800 people had been exposed.
Older doctors who have personal experience with horrible diseases that are now largely eradicated routinely stress the importance of vaccinations in order to completely stamp them out. They often think that younger doctors lack the same strong views regarding routine and comprehensive vaccinations.
Inoculation in all recommended cases is essential, they say, to fight diseases and to prevent their return and spread owing to many younger professionals who don't even recognize them.
Source: Chicago Tribune, "Once-common diseases slipping past younger doctors" Lisa Pevtzow, Jan. 18, 2012
]]>The medication is first ordered. It must then be transcribed, following which it is dispensed. In a patient setting, the medication must then be delivered and administered to the patient.
]]> There is the opportunity for medical error to creep in at any of these points. The wrong drug might be ordered or dispensed. It could be delivered to the wrong patient. It could be given at an inappropriate dose level.The point sought to be made by Kevin Pho, a primary care doctor and writer on such matters, is that many acts of malpractice and medical error owe to systemic glitches -- "system-wide procedural failures" -- and not necessarily to a discrete act or omission on the part of a single physician.
When that happens, doctors -- representing the face and focal point of treatment -- need to step forward and explain that to patients.
Moreover, they need to apologize.
Pho argues that doing so can actually lead to fewer mistakes and a vastly improved environment for physician-patient exchange and communication.
When things go wrong, Pho notes, doctors and hospitals often clam up, run to their insurers and teams of attorneys and fail to communicate at all with the party who has been harmed.
That has never been right, Pho says. Better communication, he maintains, always leads to better results.
"If errors are made," he says, "doctors should apologize and work with the patient and, when necessary, their lawyer, to find a compromise."
Source: USA TODAY, "Column: How doctors can reduce medical errors, lawsuits" Jan. 18, 2012
]]>A new study involving more than 100 hospitals across the globe spells the next-generation effort in discovering why that might be true, and researchers are guardedly optimistic over the outcome.
]]> "Although we have to be cautious, the rewards of this trial could be phenomenal," says Tony Belli, the study's chief investigator. Belli adds that the results could have "the potential to significantly improve the outcome for patients with traumatic brain injuries."The new study is funded by BHR Pharma, an American research and development company. The hope is that research will be carried out at all the participating institutions in trials involving between 10 and 15 patients at each center. Collectively, it is hoped that about 1,200 patients will be enrolled worldwide.
Those patients will have significant head trauma and need to receive an infusion of progesterone within eight hours of sustaining their injuries.
The researchers have high hopes that progesterone -- a sex hormone that regulates the female menstrual cycle and plays a role in pregnancy, yet also is present in low levels in males -- will have a protective effect on the brain by reducing swelling and allowing adequate levels of blood to continue flowing to the brain.
Trial results may be available within a couple of years. Similar studies in rats have shown a "remarkable" improvement in outcomes and recovery.
One brain injury expert calls the study "exciting news" and notes that, while the medical field must remain cautious pending the results, the research is "warmly welcomed."
Source: Daily Mail, "Can female sex hormones beat brain damage? Doctors believe progesterone may have protective effect" Rachel Ellis, "Jan. 16, 2012
]]>Traumatic brain injury experts note that the soldier's experiences are not unique. Thousands of veterans returning from service in the Middle East, including Ohio service members, are experiencing similar post-traumatic issues. These struggles while driving are being diagnosed as a symptom of a traumatic brain injury or post-traumatic stress disorder.
]]> The result is higher accident rates among veteran drivers, so much so that insurance companies are adjusting their rates as a result. A review of veteran driving records found that the number of at-fault accidents caused by veterans increased by 13 percent after they returned from their deployments. Accident rates were highest in the first six months after returning from overseas service.Consequently, increased research and safety measures are being taken to combat the increased accident rates. The Army reports that accident rates have declined recently as increased educational efforts have prepared soldiers for difficulties they might face when returning home.
Army records indicate, though, that the number of soldier deaths caused by off-duty vehicle accidents was the highest it has been in the past three years.
Many doctors and therapists are now working with soldiers to help manage their anxiety and make it possible to operate a motor vehicle without the risks created from nervousness or unsafe driving tendencies.
Source: New York Times, "Back from war, fear and danger fill driver's seat" James Dao, Jan. 10, 2012
]]>Birth injuries in Ohio and everywhere else are obviously stressful and dramatic, and sometimes life-altering in the extreme. Sometimes what happened couldn't have been avoided. On other occasions, though, medical error alone is responsible for the harm that visits an infant during birth.
]]> "There are a number of things that can cause birth injuries, ranging from the improper use of forceps or drugs to a failure to conduct a timely C-section," says a spokesperson for one legal information website.Thankfully, not all birth injuries are severe or lasting. In fact, they can be minor in nature, such as a bruise or scratch on a baby.
However, they can also be devastating to a child or family. Common birth injuries that can have materially dire outcomes include the following:
Money can never replace what has been taken from a family when an act of medical malpractice or hospital negligence results in a birth injury to an infant.
A medical malpractice recovery, though, serves several important purposes. It assigns responsibility and hopefully prevents a reoccurrence of medical harm in the future. Additionally, it can give a family valuable peace of mind through their knowing that the financial needs of their loved one -- for care, medical equipment, education and other costs -- will be provided for.
Source: KJRH, "How medical malpractice leads to birth injuries" Jan. 11, 2012
]]>The report, issued last week, was published under the aegis of the Department of Health and Human Services (DHHS). It cites a litany of medical malpractice woes in hospitals across the country, including patients suffering from facility-acquired infections, being prescribed medications inappropriately and in the wrong doses, and suffering from a number of other wide-ranging adverse events.
]]> The inspector general of the DHHS, Daniel R. Levinson, says that hospital bad faith is not a factor in most cases at the employee level, although the government's report states that hospital administrators often know that their staff members are not reporting adverse events.Levinson states that hospital workers are simply unaware in many instances "what constitutes patient harm." They might not see a harm or injury as being part of a larger pattern that needs to be addressed, or they might believe that another worker will report an incident and take follow-up action concerning it.
A New York Times report states that only one out of seven medical errors harming Medicare patients is ever reported, which makes improvement difficult.
One health expert says the central issue in underreporting is that, "You have to learn from mistakes -- and there are still many doctors and hospitals that do not do that."
Source: Fox News, "Report: Most hospital errors go unreported" Jan. 6, 2012
]]>The study, published in the August 2011 issue of the Journal of Medical Internet Research, stated that the devices are raising concerns for patient safety with doctors and patients nationwide, including Ohio. Physicians are interrupted about five times per hour by emails, phone calls or other distractions.
]]> The study focused on a 2010 survey of more than 400 perfusionists. The majority routinely used cell phones during cardiopulmonary bypasses. Of the group, 21 percent checked email, 15 percent used the Internet and three percent posted to social sites.Physicians have long relied on pagers during clinical use, but smart phones are being used for referencing drugs, treatments, accessing patient information, and communication. Many doctors say turning off the device is not a realistic option for them.
A recent case study in a patient safety journal, AHRQ WebM&M, tells of a 56-year-old patient set for an endoscopic gastrostomy. Although his doctor issued a stop order for the drug Warfarin, the resident responsible for charting the order stopped to answer her smart phone and never completed the doctor's order. The mistake was discovered when the patient had to undergo open heart surgery because of complications caused by Warfarin overdose.
Although some physicians argue that mobile technology works more efficiently, concerns are increasing. Health experts suggest prioritizing device settings to distinguish emergencies from social calls.
Source: American Medical News, "Doctors have to manage smartphone distractions" Kevin B. O'Reilly, Jan. 2, 2012
]]>Now he is a Harvard university professor focused on doing the same thing in hospital emergency rooms in the United States.
Litvak and others like him are in high demand, given the frenetic nature and flow of ER daily realities. In a word, ERs are busy.
And that makes for both inefficiencies and mistakes. The latter include medication errors, surgical mishaps and other problem results that flow directly from patient overcrowding and inefficiently staffed caregivers who are often under extreme pressures.
]]> Litvak has just received a $7 million grant from the New Jersey Hospital Association to take a hard look at what's going on in that state's emergency rooms and to offer recommendations for improving the situation. He says he is confident that he can make changes that will save New Jersey hospital as much as $6 billion in a single year.That will likely start with "process engineering" focusing on frank discussions with ER surgeons, who customarily schedule all their surgeries for a week on a single day, or perhaps two. That clogs the ER inordinately on those days, and also introduces a major element of staff inefficiency and problems with scheduling. An ER might be a fairly quiet and orderly medical department three or four days a week. On surgery days, it is anything but that.
Resistance is expected, but experts throughout the system say that, owing to greater patient loads and fewer emergency rooms overall than existed just a few years ago, change simply must occur.
"If surgeons are not riding this bus," says one emergency department director, "it's going to run them over."
Source: Philadelphia Inquirer, "Engineering a cure for hospital inefficiencies" Mark Taylor, Dec. 30, 2011
]]>Two days later, he died. Traumatic brain injury experts point out that the incident is a reminder of the risks associated with playing aggressive contact sports like football. Concussions and other head injuries are unfortunate hazards that come with playing the game, and incidents that aren't handled property can have life-ending consequences.
]]> The mother of the boy noted that confusion at the scene of the accident resulted in a delay in getting the boy to the hospital. Although it is unknown whether faster delivery to the hospital could have saved the boy's life, the complications underscore the importance of high schools having detailed emergency plans in place to handle such situations.Head injuries and other sports-related injuries affect thousands of high school athletes every year. According to the National Athletic Trainer's Association, 50 high school athletes died from sports-caused injuries in 2010.
But only 42 percent of high school athletic programs have access to a certified athletic trainer. Providing better medical and sports medicine services can reduce the severity of injuries and improve safety and health among high school athletes.
Changes to sports legislation could also reduce the effects of severe injuries. Thirty-one states have already adopted laws governing procedures when an athlete suffers a concussion. An Ohio bill that introducing a youth concussion law is currently pending,
Source: US News & World Report, "Parents speak out on catastrophic youth sports injuries" Lisa Esposito, Dec. 29, 2011
]]>According to a recent national study, there is a long way to go.
]]> The annual state-by-state health rankings recently released by the United Health Foundation list Ohio as the 36th healthiest state in the country, with researchers citing a wide range of factors that contribute to that showing.The quality of medical care is certainly in the mix of any health assessment, but researchers point to additional factors that they say are particularly troublesome for Ohio and have directly contributed to its slide in the rankings (down from 33rd in 2010).
An inordinately low level of public-health funding, for example, leads to fewer educational efforts aimed at things like smoking and obesity. Ohio spends only about $45 yearly per person in this area.
As a result, there is a trend in the state toward more -- not less -- smoking, with close to a quarter of adult Ohioans lighting up.
Obesity, too, is on the rise, being called "a major challenge" by Dr. Teresa Long, Columbus' health commissioner. Long says that the state "absolutely needs to increase the public-health funding" to combat the uptick.
Obesity has a close nexus with diabetes, and that, too, is a problem in Ohio, which ranks 39th in the country. More than 10 percent of all state residents have been diagnosed with the condition.
One state health expert calls the report findings "a reflection of our failure to invest in evidence-based public-health strategies."
Source: The Columbus Dispatch, "Obesity, smoking, kids in poverty -- all on rise in Ohio" Wesley Lowery, Dec. 6, 2011
]]>Utecht wanted to be a singer. After his NFL football career -- during which he played a season in Ohio with the Cincinnati Bengals and also won a Super Bowl ring with the Indianapolis Colts in Super Bowl XLI -- was cut short by multiple concussions, Utecht quickly found success in the performing arts. But even now, the 6-foot-6-inch former tight end is experiencing the aftermath of the brain damage suffered in his football playing days.
Traumatic brain injury experts note that concussions can have serious long-term effects on an individual's mental health. Multiple concussions can be even more dangerous, but it can take years for the full effects of the brain damage to kick in.
]]> Experts point out that individuals with three or more concussions in their past can begin experiencing accelerated memory impairment within mere years of those episodes. Memory loss typically seen in 50- and 60-year-olds is now being identified by age 30 in some people.Utecht, who played six seasons in the NFL but was injured for two, said he might have retired earlier if he had understood the full effects of his concussions. He suffered five of them. Already he finds himself unable to remember certain life events, such as the wedding of a close friend. He says he has prepared himself for the possibility of developing early-onset dementia or behavioral changes as his brain function worsens in his 50s.
In the meantime, he's enjoying his time with his young daughters and his second career, which is taking him on a national performance tour.
Source: USA Today, "Ex-NFL player Utecht battling memory loss" Erik Brady, Dec. 21, 2011
]]>The case, which is from Nebraska, has caught the attention of birth injury experts in Ohio and elsewhere across the country. The child, who is now three years old, has almost no function in her right arm after doctor-introduced errors in the birthing process caused several nerves and other connective tissues to be torn. The permanent damage has stunted the growth of the arm and eliminated almost all of its motor function.
]]> Representatives for the young girl and her family argued that the doctor overseeing the birth resorted to dangerous, unadvised methods of birthing the child when alternative and safer methods would have been more effective and saved the young girl from paralysis.Problems in the birthing process arose when the baby's shoulder became stuck behind the mother's pelvic bone. The doctor pushed the head downward to attempt to free the shoulder, but this dangerous practice -- which is not advised by other doctors -- produced the severe shoulder and arm damage.
Attorneys for the doctor argued that the obstetrician was forced into a panic over concerns that the baby's dropping oxygen levels could lead to permanent damage or even death. But plaintiffs noted that all of the hospitals monitoring devices indicated that oxygen levels were normal and no emergency situation was present.
The monetary award is considered substantial for a non-fatal malpractice injury, particularly one that did not produce any brain damage. The jury was reportedly influenced materially by evidence pointing to future emotional trauma the young child might face owing to the substandard treatment she received during delivery.
Source: Omaha World-Herald, "1.8M awarded in birth injury" Todd Cooper, Nov. 24, 2011
]]>Kevin Pearce, now 24 years old, was injured December 31, 2009, when his head struck a halfpipe during a complex trick. At the time, Pearce was 22 years old and a top candidate to make the 2010 Winter Olympics in Vancouver.
]]> Wearing a helmet saved Pearce's life. Even so, the head injury put Pearce in a coma for several days. When the Olympic hopeful came out of the coma, he found his basic motor functioning -- including walking and even seeing straight, much less riding a snowboard -- had to be re-learned.Pearce's Olympic goals were quickly replaced by an overriding desire to simply walk and function again in the simplest ways. As he engaged in a difficult rehabilitation process that took nearly two years to complete, Pearce slowly began to regain his basic functioning, and he remained committed to making it back onto a snowboard.
The athlete's return to the slopes in Colorado was watched in person by a few hundred people, who cheered for him as he took gentle runs through the powdery snow. Although he no longer dreams of being an Olympic athlete, Pearce plans to continue to snowboard recreationally and to cheer on his fellow snowboarders as they pursue their own Olympic dreams.
Source: MSNBC, "Snowboarder who nearly died returns to slopes for first time" Eddie Pells, Dec. 14, 2011
]]>Just such a medical malpractice case was settled yesterday when an Ohio U.S. Army veteran was awarded $275,000 after surgeons left a pair of towels inside him following kidney surgery. The surgery was to remove cancerous cells, and instead left the man with an incredible health risk. More than three months after the surgery, the man was readmitted to the hospital with stomach pains and scans discovered what was wrong. A second surgery was performed to remove the towels.
]]> However, a third surgery was needed to fix a hernia the man suffered shortly after the towels were removed. His attorney said it is common for multiple abdominal operations to cause a hernia and as a result of all the surgeries the man missed a year of work.The federal government agreed to the settlement for the medical malpractice suit, admitting that the standard of care was breached by hospital staff. A report filed by surgeons following the surgery said that all equipment was accounted for upon the procedure's completion.
As a result of the case, the hospital has installed a new tracking system for medical tools and equipment, a decision that highlights the dangers and complications presented by surgical procedures.
Source: Cleveland Plain Dealer, "Veteran gets $275,000 after doctors at Louis Stokes VA Medical Center leave 2 towels inside him during surgery," Mark Gillispie, Dec. 14, 2011
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