Never Event Blog
A “Never Event”* is a clearly identifiable and measurable, serious, and usually preventable medical error or event. “Never Events” fall into a variety of categories and consists of medical errors such as bedsores, wrong-site surgery and medication errors. If you suspect you or a loved one are victims of medical malpractice, negligence or nursing home abuse, please contact us today to speak to an attorney. Our goal is to make sure that your patient rights are protected and that medical professionals and facilities are held accountable for their actions.
The term “Never Event” was first introduced in 2001 by Ken Kizer, MD, former CEO of the National Quality Forum (NQF), in reference to particularly shocking medical errors that should never occur. Over time, the list has been expanded and grouped into six categorical events: surgical, product or device, patient protection, care management, environmental, and criminal. Source: http://www.psnet.ahrq.gov/primer.aspx?primerID=3
Adverse Events in Hospitals
In November 2010, the Department of Health and Human Services Office of the Inspector General did a report on Adverse Events in Hospitals - National Incidence Among Medicare Beneficiaries. Some of the findings included:
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An estimated 13.5 percent of hospitalized Medicare beneficiaries experienced adverse events during their hospital stays
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An additional 13.5 percent of Medicare beneficiaries experienced events during their hospital stays that resulted in temporary harm.
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Physician reviewers determined that 44 percent of adverse and temporary harm events were clearly or likely preventable.
CDC Media Release on Patient Safety
April 15, 2011
CDC Supports National Initiative to Improve Patient Safety
On Tuesday, April 12, Health and Human Services Secretary Kathleen Sebelius announced an initiative, the Partnership for Patients: Better Care, Lower Costs, aimed at protecting patients in America's health care facilities through the prevention of health care-acquired conditions. CDC is one of several federal agencies participating in the initiative. Medical advances have brought lifesaving care to patients in need, but many of these advances come with a risk of health care-acquired conditions, including infections, falls, pressure ulcers (or bed sores), and blood clots (known as deep vein thrombosis). "Americans expect and deserve safe health care," said CDC director Thomas R. Frieden, M.D., M.P.H. who has made patient safety a top priority at CDC. "CDC has an established track record of improving the quality of health care delivery. This new initiative will help protect patients and ensure that they live healthier, longer, and more productive lives while reducing healthcare costs." Health care-acquired conditions represent a significant burden on the health care system. At any given time, about 1 in 20 patients has an.... Read more...Update on Memorial Cases:Motion for Punitive Damages filed in Chandler case
A motion was filed in the matter of George Clay Chandler v. Memorial Hospital Jacksonville, et. al. seeking punitive damages on Mr. Chandler’s behalf. The Motion presented the following facts: Clay Chandler entered Memorial Hospital in March of 2007 for bariatric surgery. Clay’s suit claims that following his surgery, he suffered from complications which were ignored and resulted in sepsis, a respiratory arrest, followed by a cardiac arrest and ultimately severe brain damage. In the aftermath, he was held in Memorial Hospital’s Critical Care Unit as a total care patient for weeks. During his stay in the critical care unit, he suffered severe injuries to his eyes, contractures (frozen joints), and bedsores. His claim for punitive damages seeks to prove this all happened due to a lack of the most basic human care. The motion presents evidence that Memorial Hospital nurses failed to perform basic managerial review of Clay’s medical records which should have caught and corrected these problems. Recently (December 14, 2010), Clay’s attorneys took the deposition of Memorial Hospital’s wound care nurse. The wound care nurse testified that in the year following Clay Chandler’s problems, she resigned from Memorial Hospital in protest over Memorial Hospital’s administration and management refusing to.... Read more...Hospital ER’s negligence leads to nurse’s disfigurement
A local 39-year-old mother of two lost both legs, all of her fingers on both hands and suffered disfiguring injuries to her face. Jean Law can no longer live any part of the life she had before she sought treatment this past February from the ER at Baptist Hospital South. She suffered a high fever, chills, nausea, pain and difficulty in walking, common symtoms of sepsis that went undiagnosised.
Jean Law knew her symptoms were serious – she had been a nurse with Baptist Hospitals for 17 years and on duty at Baptist South for the past five years. Her temperature, was at the dangerously high level of 104.6. This and her other symptoms are consistent with serious bacterial infection. Although the ER treating Doctor ordered blood and urine tests, after approximately five hours, he diagnosed a viral flu, prescribed Motrin and discharged Law to go home. Doctor's notes from this interaction state, “…serious causes have been ruled out, and there is no indication that she needs antibiotics.” Because of his diagnosis, Law was neither admitted to the hospital nor treated with any type of antibiotic treatment.
Law and her husband Jonathan were surprised and confused. As a nurse, she had expected.... Read more...
BCBS & Never Events
The Blue Cross and Blue Shield Association (BCBSA) announced on February 26, 2010 that all 39 independent Blue Cross and Blue Shield companies established a payment policy that prohibits reimbursement to contracted acute care hospitals for hospital acquired conditions or "never events" – serious events or medical errors that are clearly identifiable and preventable.
The Blues policy, which went into effect on Jan. 1, 2010, include 12 preventable events as recommended by the Centers for Medicare and Medicaid Services (CMS). In addition, Blue Cross and Blue Shield companies will not reimburse for surgery performed on the wrong patient, a wrong body part or for a wrong procedure. Blue companies also will assure that acute care hospitals in Blue networks must hold the member harmless for any charges associated with never events. Click Here to read the rest of the BCBS Press Release.
If you or your loved one is the victim of medical malpractice, contact one of our attorneys today for a free case evaluation.