A recent BMJ (British Medical Journal) study listed medical errors as the third leading cause of death in the United States. The BMJ recommends that healthcare providers make prevention of patient harm the top healthcare priority and institute policy and procedure changes directed toward that objective.

The study points out that the medical cause of an injury or death on the death certificate doesn’t reflect that “communication breakdowns, diagnostic errors, poor judgment, and inadequate skill can directly result in patient harm and death.”


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A Professor of Surgery at Johns Hopkins University School of Medicine, Martin Makary, M.D., M.P.H., has published his research into various categories of treatment of patients in hospitals. These categories ranged from more simplistic “bad doctors” to “more systemic issues such as communication breakdowns when patients are handed off from one department to another.”

Dr. Makary explained that “when a plane crashes, we don’t say this is confidential proprietary information the airline company owns… we consider it part of public safety. Hospitals should be held to the same standards.” The study and research was done to illuminate problems which are normally swept under the rug by hospitals and healthcare facilities. Often, these facilities will go out of their way to avoid discussing any issues or risks, and frankly bend over backwards to keep such information confidential, arguing it is “privileged.”


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New Jersey Statute 45:9-19.17 requires physicians to maintain insurance and specifically states:

A physician who maintains a professional medical practice in this State and has responsibility for patient care is required to be covered by medical malpractice liability insurance issued by a carrier authorized to write medical malpractice liability insurance policies in this State, in the sum of $1,000,000 per occurrence and $3,000,000 per policy year and unless renewal coverage includes the premium retroactive date, the policy shall provide for extended reporting endorsement coverage for claims made policies, also known as “tail coverage,” or, if such liability coverage is not available, by a letter of credit for at least $500,000.


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In a recent New York Times article, Dhruv Khullar, M.D., a medical resident in a large Boston teaching hospital, wrote about what often happens when a patient, especially an elderly patient, is discharged from the hospital. All too frequently, there is a high chance of readmission for many of these patients. Dr. Khullar notes that one-fifth of Medicare recipients are readmitted to a hospital within 30 days of discharge, and one-third are readmitted within 90 days.

One study found that 20% of patients have a complication within 3 weeks of leaving the hospital and that half of those complications could have been prevented or mitigated. Although many of these complications are minor, some are serious and life-threatening. Medicare spends $26 billion annually on readmissions, and more than half of that amount on readmissions that are considered preventable.


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By way of a decision by the Superior Court of New Jersey, Appellate Division in October 2015, a case was remanded for a new trial following the Trial Court’s granting of Motions under N.J.R.E. 702 and determining that the Emergency Medicine expert was “not qualified to render opinions as to the standards of care applicable to either defendant nurse.”

This arises out of the matter of Lauckhardt v. Jeges, 2015 N.J. Super. Unpub. LEXIS 2393. Plaintiff’s emergency medicine expert, Dr. James Bagnell, was offered to provide testimony as to the emergency room doctors and nurses. Even after Dr. Bagnell had substantially completed his testimony, both as to the doctor and the nurses, there was a Motion to bar his testimony as to the accepted standards of emergency nursing care. The Court granted the Motion pursuant to 702 based on the determination that plaintiff’s expert was “not qualified to render opinions of standards of care applicable to either defendant nurse.” The Court did not just strike the expert’s testimony regarding the nursing care, instead provided an instruction that read in substance:

Dr. Bagnell was qualified as an expert in the field of Emergency Medicine and in that regard he can render and did render opinions as to the deviations from the standards of care with regard to Dr. Jeges, but he cannot as a matter of law do that for either of the nurses…


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For those unaware, a “hospitalist” is a physician who works exclusively in a hospital setting and specializes in Hospital Medicine. Most commonly, hospitalists undergo residency training in Internal Medicine or Family Medicine and, therefore, have education and training similar to doctors practicing as primary care physicians or family doctors.

However, some hospitalists have training in other medical specialties, and some hospitalists do undergo hospital-focused post-residency training, such as a fellowship in Hospital Medicine. Because they work in hospital settings, hospitalists frequently have to manage acutely ill and hospitalized patients. Often their role involves coordinating the treatment of the various physician specialists involved in a patient’s care while they are hospitalized. A hospitalist, in a sense, can serve as a patient’s primary care physician while the patient is in the hospital.


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For those of us who practice in the world of medical negligence, it is almost routine to receive Preliminary Objections from the defense moving to strike all allegations that contain references to unidentified agents, servants, employees, attending physicians, nursing staff, and other support staff. Despite what seems to be clarity in the law, the preliminary objections are filed time and time again.

Just several months ago the Superior Court of Pennsylvania once again clearly stated that such preliminary objections are not proper and should be overruled. This additional clarification came through the matter of the Estate of Arthur Denmark, by and through his Administrator Anthony W. Hurst, Sr. v. Mercy Health System and Mercy Philadelphia Hospital, et al., 2015 PA Super. 101, Filed April 28, 2015. In that matter, there were several issues raised on preliminary objections and the Court sustained preliminary objections on punitive damages and all references to unidentified agents, servants, employees, etc.

There was an appeal on a rather convoluted procedural history since the case had been marked, in part, nolle pros as opposed to non pros, and non pros was inapplicable because there was no failure to file a complaint, failure to file a certificate of merit, failure to be ready at the start of trial, or any discovery sanction. The Superior Court looked at this procedurally as if the case had been dismissed by way of summary judgment.


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The Journal of Patient Safety discussed recent studies which have shown that preventable medical errors are responsible for between 200,000 and 400,000 patient deaths per year in U.S. hospitals. These errors include facility acquired infections, medication errors, omissions in treatment, communication errors between health care providers, nerve or vessel injuries, wrong operations, injuries to organs