Later On

A blog written for those whose interests more or less match mine.

Medical malpractice

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According to many doctors, medical malpractice is a phony problem pushed onto the public by trial lawyers and liberals, and in fact if the medical profession could only stop lawsuits by putting ridiculously low caps on awards, there would be no more medical malpractice—because, you see, it could not possibly be the case that doctors are at fault. No, it’s the lawyers!! (Look over there, where I’m pointing, and stop looking at me, say the doctors.)

A counter-example reported in the NY Times by Walt Bogdanich and Kristina Rebelo:

It was well after midnight when Dr. Salvatore J. A. Sclafani finally hit the “send” button.

Soon, colleagues would awake to his e-mail, expressing his anguish and shame over the discovery that the tiniest, most vulnerable of all patients — premature babies — had been over-radiated in the department he ran at State University of New York Downstate Medical Center in Brooklyn.

A day earlier, Dr. Sclafani noticed that a newborn had been irradiated from head to toe — with no gonadal shielding — even though only a simple chest X-ray had been ordered.

“I was mortified,” he wrote on July 27, 2007. Worse, technologists had given the same baby about 10 of these whole-body X-rays. “Full, unabashed, total irradiation of a neonate,” Dr. Sclafani said, adding, “This poor, defenseless baby.”

And the problems did not end there. Dr. John Amodio, the hospital’s new pediatric radiologist, found that full-body X-rays of premature babies had occurred often, that radiation levels on powerful CT scanners had been set too high for infants, and that babies had been poorly positioned, making it hard for doctors to interpret the images.

The hospital had done the full-body X-rays, known as “babygrams,” even though they had been largely discredited because of concerns about the potential harm of radiation on the young. Dr. Sclafani and Dr. Amodio quickly stopped the babygrams and instituted tight controls on how and when radiation was used on babies, according to doctors who work there. But the hospital never reported the problems in the unit to state health officials as required.

A little over a week ago, after The New York Times asked about the situation at Downstate, the state health commissioner, Dr. Nirav R. Shah, ordered two offices of the department to investigate.

“Our investigators will pull films, they will examine the medical records and they will interview relevant staff,” said Claudia Hutton, the department’s director of public affairs. “Our authority to investigate goes basically as far as we need it to go.”

The errors at Downstate raise broader questions about the competence, training and oversight of technologists who operate radiological equipment that is becoming increasingly complex and powerful. If technologists could not properly take a simple chest X-ray, how can they be expected to safely operate CT scanners or linear accelerators?

With technologists in many states lightly regulated, or not at all, . . .

Continue reading.

Written by LeisureGuy

28 February 2011 at 8:59 am

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