Many hospitals have adopted new safety measures in order to curb hospital infection rates, and the decline in MRSA rates indicates those measures have been effective.The Centers for Disease Control and Prevention (CDC) says there is still more work to be done but that the results are encouraging. The CDC reported earlier that there were some 90,000 cases of MRSA across the nation in 2005.

For more information, see this article in USA Today.

This was not the first ruling against Mogen. Mogen still owes $7.5 million as a result of a 2007 Massachusetts judgment. Mogen, it seems, has gone out of business, so it is doubtful any of the money will be collected.

The New York case was filed by anti-circumcision attorney David Llewellyn of Atlanta. Llewellyn has successfully won a number of circumcision cases. For more information, see this article from the Atlanta Journal-Constitution.

Singh managed to survive but the road to recovery has been long and painful and incomplete. After three days in critical care, Singh moved to the University of Washington Medical Center, where he waited 11 weeks for a heart transplant. During that time machinery kept him alive. The heart transplant was successful, but Singh must take several dozen pills every day, and he has battled numerous medical setbacks. Singh will never be able to return to his former life.

Singh and Providence sued the device manufacturer, and in May 2008 Singh was awarded $41.1 million.

Providence chose to use part of their settlement proceeds to establish a $2.18 million fund devoted to improving patient safety. It was named Singh Family Fund for Patient Safety and Quality in Singh’s honor. The aim of the fund is to provide training and programs to reduce medical errors and promote safety.

See this article for more on Singh’s story.

The class-action lawsuit represented about 32,000 patients who received substandard care between 2003 and 2009. A California law requires each patient receive 3.2 nursing hours per day, a mandate Skilled Healthcare allegedly violated. Based in southern California, Skilled Healthcare has facilities in seven states totaling some 78 nursing homes, including five in Humboldt County.

Additional punitive damages will be determined by the jury next week. For more information, see this article.

This is the second law rejected by the state’s Supreme Court. A law that required patients to obtain a certificate of merit from an expert before filing a medical malpractice lawsuit was found unconstitutional.

This week the hospital’s human resources department formally reprimanded five employees involved in the case. But reading the details of these reprimands just leads to more questions. Three of those given letters of reprimand are nurses. Two were found negligent in making sure staff followed protocol and in supporting their staff. One nurse was reprimanded because he failed to provide the required monthly written reports on the patient for nearly five months. The remaining two to receive reprimands are aides. One aide was cited for doing nothing when the patient failed to appear for his afternoon medications. The aide was supposed to alert a nurse and to record the fact that the patient didn’t take his medications. He indicated that he was busy preparing for the evening meal and thus was unable to check on the patient. The other aide failed to complete required weekly paperwork on the patient’s status. He asserts that with the number of patients under his care, he could not always adequately monitor each patient and had to make decisions based on urgency and patient needs.

I don’t really know what is going on at Oregon State Hospital. Either the hospital has a lot of incompetent employees, or the conditions are such that the employees are overworked and simply unable to manage their jobs efficiently. Perhaps it’s a combination of both. Whatever the case may be, it seems the patients are the ones who are suffering the most and who have the least power to do much about it. I hope conditions improve at the hospital for everyone’s sake.

While some studies report the July effect is pretty much false, others have found evidence the July effect may be true. The University of California at San Diego and University of California at Los Angeles investigated the occurrence of fatal medication errors. The supposition was that medical residents would have a say in a patient’s medication. The researchers studied death certificates from 1979-2006, which numbered more than 244,000, and found a 10 percent increase in fatal medication errors in teaching hospitals in July. The study was published in the Journal of General Internal Medicine.

The study did not include information on non-fatal medication errors nor did it discover an increase in other deaths, but it does provide some food for thought. What do you think? Will you stay away from hospitals in July?

The rates provide valuable information, but they shouldn’t be taken completely at face value. A small hospital with few infections might get an above-average rate based on the numbers. Also, some facilities specialize in patients with more critical cases, and those patients might be more susceptible to infections and other issues. Also, the data is reported by the hospitals themselves, so there is no third party to verify the accuracy of the rates.

At any rate, no pun intended, the figures are interesting and often telling. For instance, Adventist Medical Center in Portland joined a safety campaign designed to decrease the rate of central-line infections in the intensive care unit in 2006. Since undertaking the campaign, which involves some basic safety measures, the hospital has had zero central-line infections. Before, the hospital had up to six patients per year suffer from such infections. Good Samaritan Regional Medical Center in Corvallis also fared well in terms of central line infections.

The worst culprits in terms of central line infections were Oregon Health Sciences University Hospital in Portland, McKenzie-Willamette Medical Center in Springfield, and Tuality Healthcare in Hillsboro. All three had three times the state average of central line infections.

See this article in the Oregonian for additional information, including rates on knee-replacement surgical site infections and heart bypass surgical site infections.

The Veterans Affairs Department so far has named five hospitals that will be limited to performing less-complicated surgeries. They are located in Alexandria, LA; Beckley, WV; Fayetteville, NC; Danville, IL; and Spokane, WA. One hospital in Marion, IL, is not allowed to perform any inpatient surgeries at all. This suspension has been in place since 2007 after investigators discovered a troubling number of surgical deaths and poor care.

On the surface the case seems to be about miscommunication or possibly a medical error, but the story gets stranger, and it’s hard to tell what is what. It seems Irby’s testicular pain began with a drunk driving car accident in which he was involved in a rollover crash. He then went to the University Medical Center and began to experience pain. An ultrasound was ordered, but Irby left the hospital before getting the results. He later received a call from the hospital informing him that the ultrasound turned up a mass, and he needed a biopsy. Irby is adamant that the doctor told him the testicle would only be removed with the confirmation of cancer, but the hospital records contradict this–they indicate Irby would undergo an excisional biopsy, a biopsy of the testicle after removal. Irby seems quite distraught over the removal of his testicle. He claims it has negatively affected his social life and his self-esteem.