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Wayne Parsons
Wayne Parsons
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Texas medical injuries mount as malpractice laws protect negligent doctors and hospitals.

22 comments

Today I report the sad saga of Parkland Memorial Hospital in Dallas, Texas.

As reported by Jamie Stengle of the Associated Press in Forbes, Feds: Parkland conditions a ‘threat’ to patients a Texas hospital has now made the news when federal government agency The Centers for Medicare & Medicaid Services sent a letter to Parkland Memorial Hospital in Dallas pointing such serious threats to patient safety that unless immediate corrective action was taken, Parkland would be taken out of the Medicare system by September 2nd.

After a patient died in February the federal agency became concerned about safety and a recent two week inspection by the feds confirmed that Parkland must be placed on "immediate jeopardy" status, the worst finding for a hospital. The areas of immediate concern included infection control.

The Dallas Morning News has reported that George Cornell, a 49-year-old schizophrenic with a heart condition, died after being placed in restrained. He was not monitored by nursing staff and the hospital employees who restrained him lacked training according to the news story.

A number of stories recently have shown the true effects of Texas tort reform in the area of medical malpractice.

Exposing the Perils of Texas Tort Reform, August 11, 2011, By Mark Bello

Does Texas medical malpractice "reform" attract bad doctors?, By Wayne Parsons

Texas Law Capping Medical Malpractice Awards Hasn’t Cut Health Care Costs, July 27, 2011, By Andrew Cochran

Tort Reform and the Risky Perils of Texas Hospitals, August 11, 2011

The latter article is from The Center For Justice & Democracy (CJ&D) and their website on tort law, called The Pop Tort. The head of CJ&D is Joanne Doroshow a fearless advocate for safety and prevention and now a movie star after her role in the new movie sensation HOT COFFEE. The CJ&D story on Texas Hospitals asks the question of when will the public wake up to the perils of tort reform:

Maybe this will finally jolt people into understanding what happens when a state severely reduces a hospital’s accountability for negligence.

Looking at Parkland’s situation we know that 40 percent of Parkland’s funding comes from taxpayers, 16 percent from Medicare and 32 percent from Medicaid. The waste of taxpayer money only increases when treatment leads to injury or death thus costing more taxpayer money. Tort reform will continue to escalate spending on health. The only benefit of Texas medical malpractice reform is to reduce accountability for avoidable medical errors. There are 98,000 deaths each year due to avoidable medical errors and Texas is doing its part to keep those grim statistics at current or higher levels. Parkland is regional center for burns and trauma, and the teaching hospital for the University of Texas Southwestern Medical Center.

Patients should be able to hold doctors and hospitals fully accountable when avoidable medical errors cause injuries or deaths. Taxpayers should insist that the wrongdoers pay, not the taxpayers. Texas tort reform should be repealed. As a medical malpractice attorney in Hawaii, I hope to never see these laws come to the Islands. A good place to start is for all of the legislators in every state to see the movie HOT COFFEE!

22 Comments

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  1. sage says:
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    it would be magnificent if an edified, intelligent person, capable of junior high level grammar and syntax, would approach a sensitive subject with tact and evidence, and objectively present a case with humanist concern. instead, we are left with the ignorant and unfounded ramblings of one who has poached into a subject where he smells profit. from across miles and oceans you offer negativity, misunderstanding the integrity and decency of a hospital offering haves to the have-nots. continue to mine for profits, continue to harass for personal gain…you are a disappointing end of a spectrum of humanity, thanks for fulfilling a philosophical archetype of wanton selfishness that allows us to truly appreciate selflessness.

  2. sage says:
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    it would be magnificent if an edified, intelligent person, capable of junior high level grammar and syntax, would approach a sensitive subject with tact and evidence, and objectively present a case with humanist concern. instead, we are left with the ignorant and unfounded ramblings of one who has poached into a subject where he smells profit. from across miles and oceans you offer negativity, misunderstanding the integrity and decency of a hospital offering haves to the have-nots. continue to mine for profits, continue to harass for personal gain…you are a disappointing end of a spectrum of humanity, thanks for fulfilling a philosophical archetype of wanton selfishness that allows us to truly appreciate selflessness.

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    Thank you for your comment but is the only thing you have to say is that I am bad person? What do you think about the Parkland situation? Is the federal government wrong? Is it okay with you that the patients died? What is your solution to a level of treatment that leads to someone dying by substandard medical care? And what about laws that protect doctors whose work is below the standard of care? Who are you and what view of this system do you have? I wish someone who wants to continue to protect negligent doctors would explain why I am wrong. You won’t get very far by simply attack me as a person. If you care about what you say, then what are your facts and arguments? I want to protect patients and save lives. What is your goal?

  4. Cilla Mitchell says:
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    Sage,

    Opinions are like assholes, everyone has one. You are entitled to your opinion.

  5. Cilla Mitchell says:
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    Sage:

    I normally would jump at the opportunity to debate a comment like yours, but after reading your reply to Mr. Parson’s I realize I don’t have much time on earth to waste.

  6. Cilla Mitchell says:
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    Sage:

    If you want credibility to your comments the rules are:

    1. Stick with the subject matter

    2. Avoid personal confrontation

    3. Back your opinions with facts, if at all possible

    4. Use your real name to show you have balls to stand up for what you believe in. Anonymity gives people false courage.

  7. Former says:
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    My suspicion is that there are still several skeletons left to be discovered if surveyors were to dig a little deeper…

  8. up arrow

    Thanks Former. The 98,000 deaths each year is a minimum number because when the Harvard School of Public Health reviewed closed case files they rejected any file where it was close. You sound like someone who cares. What do you think can be done to reduce the injuries from avoidable medical errors? We need to do something about the problem.

  9. Cilla Mitchell says:
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    My suggestion to reduce avoidable medical errors would be, get rid of superfluous documentation. Superfluous documentation bury medical personal beyond belief and take time away from patient care.

    An example: In some facilities when you take a diabetic’s blood sugar, you have to chart it in three different places. There have been studies that the more charting, the more likely a lawyer can find errors in the charting.

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    Thanks Cilla. Your comments are always relevant and geared toward solving problems. Thanks. This good. I want to get some more on ways to cut down on the paperwork.

  11. Former says:
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    My first suggestion is ramping up the electronic recoding process. It is nearing the new norm in most facilities; however, better interface between the multiple systems would reduce a great deal of the repetition. I certainly do not come from an IT background, but to me, that would be a start.

    Reduction of the above would free up a great deal of the care giver’s time to be able to more closely monitor their patients. It’s certainly sad when one can receive a more catered to service in a hotel, than when you’re in a hospital bed, when you need it most.

    Unfortunately, finances do drive many decisions hospital must make. A national healthcare plan is not the answer (my opinion only)as an increased risk of situations such as this one at Parkland will likely increase. There would still be a system of “have’s and have not’s”.

    As with any career, there are folks working in these facilities that just simply do not care. I’ve observed it myself, having been tied to multiple hospitals around the country, including Parkland.

    HAI’s would be my biggest concern if I were a patient going into a hospital. Things to watch for or observe if one becomes a patient: care givers thoroughly washing hands when coming into the room before touching anything in the room, validation that you are the right patient, are proper isolation procedures being followed (do folks go in and out without proper gowning and de-gowning, do those folks touch items when the exit the room before thoroughly washing their hands, is housekeeping doing a thorough job while cleaning the room (wiping all surfaces with disinfectant allowing for proper dwell/kill time per manufacturer’s specifications), employee education (unfortunately in many hospitals employees have employees on their staff in service areas that can’t read/write English – how exactly are they properly educated?). There are some great ways to measure folks efficiency of cleaning, hand washing, etc in the hospital environment, but unfortunately some of it is held back for fear of offending folks culturally

    The other item that is a concern is the level of apathy I’ve often observed with staff. This is just a job, I’ll do my eight/twelve hours, get paid and get out of here.

    All that being said, there are other folks in these hospital that are complete opposite of the ones I’ve describe above, so don’t get me wrong, going into a hospital isn’t an automatic “death sentence”. It may be more likened to a game of “Russian Roulette” with a little better odds.

  12. Buddy Steves says:
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    Whatever the issues with the Parkland, you can’t blame the situation on Tort Reform. Parkland, as I understand it, is a County or District Hospital which is protected by governmental immunity which has been waived by statute up to a limit of $100,000 per person and $300,000 per accident.

    You might argue with governmental or sovereign immunity but it has exited for time immemorial. When we got rid of the king after the Revolutionary War, we did not get rid of the concept that the king can do no wrong.

    Most of the academic investitigations suggest that imposing legal liability in medical malpractice cases is, at best, a inconsequential factor in mitigating patient injuries. In fact, the fear caused by the treat of lawsuits has probably inhibited collaborations that might improve safety and increase medical costs by some amount, general estimated in the single digits.

    Iatrogenic injuries have been studied for a good part of the last century. Factors that make a difference are check lists, hand washing, culture good management practices and financial incentives or disincentives. CMS’ threat to remove Parkland from the Medicare and Medicaid programs, in this respect, is much more likely to get the attention of the hospital and the medical staff than fear of legal liability.

    Litigation, as one of my attorney friends is fond of saying, is the second most wasteful practices in the world, save only war.

    If you want to lower injury rates, you might just have to let CMS and related oversight organizations, a freer hand in encouraging (and requiring) evidenced based healthcare practices by using their enormous purchasing power (50% of national health care speeding) to drive quality and reduce waste.

    As one healthcare CEO said of the Healthcare Reform, you can’t mandate values. But you can begin to allow science to dominiate decision making in healthcare. Litigation takes money out of the system to the benefit of a few. Evidenced based medicine puts money back into the system (and could dramatically reduce costs, the state and federal health related expenditures and make the United States more competitive in the global economy).

    Maybe we should move beyond the coversation on Texas tort reform and focus attention on improving quality by encouraging all healthcare providers and the general population to embrace evidenced based healthcare.

  13. Buddy Steves says:
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    Whatever the issues with the Parkland, you can’t blame the situation on Tort Reform. Parkland, as I understand it, is a County or District Hospital which is protected by governmental immunity which has been waived by statute up to a limit of $100,000 per person and $300,000 per accident.

    You might argue with governmental or sovereign immunity but it has exited for time immemorial. When we got rid of the king after the Revolutionary War, we did not get rid of the concept that the king can do no wrong.

    Most of the academic investitigations suggest that imposing legal liability in medical malpractice cases is, at best, a inconsequential factor in mitigating patient injuries. In fact, the fear caused by the treat of lawsuits has probably inhibited collaborations that might improve safety and increase medical costs by some amount, general estimated in the single digits.

    Iatrogenic injuries have been studied for a good part of the last century. Factors that make a difference are check lists, hand washing, culture good management practices and financial incentives or disincentives. CMS’ threat to remove Parkland from the Medicare and Medicaid programs, in this respect, is much more likely to get the attention of the hospital and the medical staff than fear of legal liability.

    Litigation, as one of my attorney friends is fond of saying, is the second most wasteful practices in the world, save only war.

    If you want to lower injury rates, you might just have to let CMS and related oversight organizations, a freer hand in encouraging (and requiring) evidenced based healthcare practices by using their enormous purchasing power (50% of national health care speeding) to drive quality and reduce waste.

    As one healthcare CEO said of the Healthcare Reform, you can’t mandate values. But you can begin to allow science to dominiate decision making in healthcare. Litigation takes money out of the system to the benefit of a few. Evidenced based medicine puts money back into the system (and could dramatically reduce costs, the state and federal health related expenditures and make the United States more competitive in the global economy).

    Maybe we should move beyond the coversation on Texas tort reform and focus attention on improving quality by encouraging all healthcare providers and the general population to embrace evidenced based healthcare.

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    Former: I appreciate your thoughtful and detailed suggestions. That is how we as a community can improve safety and prevent injury in health care reform. I agree also about the fact that there are many great, caring, competent nurses and doctors. Dr. William C. Chapman at Washington University in St. Louis, MO is one such doctor. He is a famous transplant surgeon and he cares. He talks to his patients and their families and he takes on tough diseases like cholangiocarcinoma – a deadly killer where everyone dies. He has a new transplant protocol that is a cure. He is a hero of mine. Anyway, thanks for sharing your ideas. You obviously have a great deal of knowledge. We need to keep the dialogue going. I hope that one day I see no more patients who come to me after being injured by an avoidable medical error.

  15. Cilla Mitchell says:
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    Mr. Steves:

    I disagree with you on your statement “If you want to lower injury rates, you might just have to let CMS and related oversight organizations a freer hand …….”

    In my opinion, it is comparable to giving the inmates the keys to the asylum.

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    Thanks Buddy: Your comment is better than my article. I will watch for you in the network of people who are talking about safety and prevention in the medical profession. The public is poorly informed about the threat to their health by insurance and corporate conspiracies to close the courtroom doors. I follow Andrew Cochran at The 7th Amendment Advocate who is a conservative Republican who points out that accountability saves taxpayer money and, at it’s heart, is a conservative issue. Read “More FACTS About Texas Law Limiting Medical Malpractice Lawsuits” at http://7thamendmentadvocate.org/ to see what Andrew has to say. Thanks for your great Comment.

  17. Cilla Mitchell says:
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    Since I was in disagreement with Mr. Steves’ comment about “letting CMS and related oversight organizations a freer hand….”, I failed to state why I disagreed with his statement . (The rest of his comments were excellent).

    Rather than have large entities govern medical institutions with more regulations which are entirely too many, much like the tax codes, decreasing medical errors should come from the very place they originated from.

    For instance, the very basic tool used in patient care across the board is communication.

    If a doctor’s handwriting is difficult to read, rather than fear offending him/her, call the doctor up and inform him the order is difficult to read. If a doctor is called a few times, they will take the time to go over the orders with the nurse or whoever is taking off the orders. Some nurses are guilty of this issue too.

    When taking verbal orders over the phone, repeat the orders back to the doctor after he/she is through and make sure the background noise is down.

    When there is a change of shift and report is exchanged, there should not be any interruptions or back ground noise because important information may be missed. Years ago, nurses used to have a report room where report was exchanged in a quiet environment. Now, the reports are given at nurses stations with interruptions being the norm.

    Every potential problem needs to be reported to prevent an occurrence, but unfortunately many problems are not because people fear retaliation or displeasing management. Any error found needs to be addressed immediately and resolved, without fear of retaliation. Many errors are covered up because there is retaliation from management, and because of these fears, medical errors are swept under the carpet.

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    Cilla, you know. Thanks for adding substance to this discussion. A very senior nurse told me recently that doctors don’t look at patients anymore and don’t touch them. She said you can learn a lot by looking and touching, particularly with babies. Anyway, I appreciate you Cilla!

  19. Cilla Mitchell says:
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    I appreciate you allowing me to visit and post on your blog and I thank you for it. Your generosity in allowing me to unload the frustrations of nursing shared by many nurses, gives me hope that as long as people are willing to exchange dialogue and learn from each other, the medical community just might be a better place.

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    Cilla you are making a real difference. We all have to look at what causes injury and find ways to reduce or eliminate those causes. I know that I am attorney who is trained to file lawsuits but what I like about this Blog and the members of THe Injury Board is that we care more about preventing injuries than we do about getting cases. Your voice is important Cilla. Rock on!

    Aloha, wayne

  21. Cilla Mitchell says:
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    Have decided to share with you and your readers the result of what Tort Reform will be doing to people who are deprived of the civil rights for a trial to get accountability. If politicians think that the laws will prevent people from getting accountability, they are sadley mistaken.

    This new video will put a face on one of many doctors who drop the ball.

    http://www.youtube.com/watch?v=OXEexlDZL_0

    Or, just Google WHY DID YOU DROP THE BALL DR ANDRADE?

    Anyone know a good attorney that specializes in slander? I have a feeling I might need one.

    Thank you for your time,

    Cilla

  22. Cilla Mitchell says:
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    I wanted to send the link of the video to the doctor’s office so he could get a look at it because I believe in being up front about everything I do.

    However, when I asked him the first time in April via his clinic email site “why did you drop the ball?, he had his manager, head of the clinic write me an email stating he would sue me for slander. (Like that would stop me), so I can not send this to his clinic because they had my email address rejected from their web site.

    Oh well.

    Cilla