tag:blogger.com,1999:blog-2760353953251845523.post9167275442926104041..comments2024-02-10T02:14:39.898-05:00Comments on Buckeye Surgeon: Malpractice or Criminal?Jeffrey Parks MD FACShttp://www.blogger.com/profile/15650563299849196122noreply@blogger.comBlogger10125tag:blogger.com,1999:blog-2760353953251845523.post-43984563840216683132009-09-10T11:22:03.921-04:002009-09-10T11:22:03.921-04:00Anybody who doesn't see this as a terrible for...Anybody who doesn't see this as a terrible forecast of potential things to come needs to get out of the profession.<br /><br /><br />Criminal act? Are you kidding? He made a mistake. We all do....everyday.<br /><br />Human error within a system which has process hiccups....absolutely.<br /><br /><br />The judge is terribly ignorant. Shame on him.<br /><br />But the Ohio Board of Pharmacy knows all too well about JCAHO, system processes, error prevention, system improvement, etc. SHAME ON THEM for revoking his license.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-2760353953251845523.post-8380389049200658312009-06-18T22:30:10.216-04:002009-06-18T22:30:10.216-04:00Back in the early 90s, before 19-year-old girl &qu...Back in the early 90s, before 19-year-old girl "pharmacy technicians" were the norm, and most medications were prepared by actual licensed pharmacists, we had a serious mixup with a medicine involving my younger brother. <br /><br />He was still a baby then, about six years old, and was taking antibiotics (in liquid form). Just in time, we realized the label was papering over the REAL label, which identified it as a powerful anti-seizure sedative that likely would have killed my brother. <br /><br />Mislabeling kills people. My mom went down to the pharmacy and hit the roof. <br /><br />Turns out that pharmacist was crazy overworked for weeks and fatigued to the max. Why? the pharmacist shortage, the one that would soon force them to delegate much of the work to 19-year-old girls. <br /><br />That pharmacist was put on forced leave for several weeks.Nick Dupreehttp://nickscrusade.orgnoreply@blogger.comtag:blogger.com,1999:blog-2760353953251845523.post-23623779088242546242009-06-07T12:28:11.522-04:002009-06-07T12:28:11.522-04:00The death of the child was preventable, the pharm...The death of the child was preventable, the pharmacist's negligence caused the death. <br />But that's not the whole of it. The prosecutor felt his conduct rose to the level of CRIMINAL negligence, which would imply there was more than mere mistake, or falling short of standards of care. <br /><br />In this case a key fact was probably the testimony that that the pharmacist was actively INFORMED by his underling that there was something wrong with the chemotherapy preparation. <br /><br />In spite of being * informed*that the solution was improperly prepared, he was indifferent to the consequences to human life, despite the fact that his expert knowlege, and his special duty to recipients of medication, would have informed him of potentially fatal risks and required him not to release a potentially deadly solution for use by patients. <br /><br />In other words, he knew the bad solution might injure directly (by causing harm) or indirectly (by not being the proper therapeutic dose, leaving the patient's underlying condition improperly treated)<br />And HE DIDN"T CARE. <br /><br />Now, that may not be the case here, but it would form a reasonable basis to presume a callous disrequard for human life resulting in death, that is, a criminally negligent homicide.<br /><br />A pattern of similar mistakes in the past or other troubles might make a prosecutor take a hard line regarding this fatal incident - I don't know the whole context. But this situation can be distinguished from mere malpractice, for instance, he failed to check the solution, relying on the competence of his underling, but was never informed of any problem.... or he prepared the solution himself and made a mistake because of illegible handwriting or confusing labeling of products, or made a dosing error of his own but was unaware of it before sending it out.<br /><br />Here he was informed the solution was defective.<br />The conseguences were fatal. He was an expert with not only a duty to ensure the correct solution was provided, but with full knowlege of the potential consequences of a defective batch - conscious that death or injury might result from the error he was TOLD was made. He took his chances. That chance he took may rise to the level of criminal neglignence.SarahWhttps://www.blogger.com/profile/04557172584578880603noreply@blogger.comtag:blogger.com,1999:blog-2760353953251845523.post-56585630190160750472009-06-03T11:20:45.443-04:002009-06-03T11:20:45.443-04:00I have to go with criminal negligence here. It see...I have to go with criminal negligence here. It seems to my, admittedly untrained, eye to be a classic example. Not unlike a parent's lack of supervision for a teenager's party at his home ending in a drunk driving death or injury from one of the partygoers.<br /><br />Pharmacists and physicians benefit financially by having lower level care providers under their supervision. In exchange they are expected to actually supervise and check on the work of these individuals. To not do so is gross negligence and in this tragic example ended in death. Too often there is a cursory (and often not even that) review of a lower or mid-level's work. This is completely inappropriate.<br /><br />I agree, however, that some sort of reporting system of errors with immunity from criminal prosecution (but still allowing for compensation for the victim) is a prudent course to pursue. Shining the light of day on error has the amazing ability to reduce it.<br /><br />If the general population is expected to trust healthcare then healthcare must prove itself trustworthy. The time has passed when blanket trust can or should be expected.<br /><br />Trust has been lost and it is incumbent upon healthcare to earn it back. Admitting mistakes is a beginning. It allows the system that permitted the error to be adjusted to assist in preventing its recurrence.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-2760353953251845523.post-11285516393057239032009-06-03T01:23:43.307-04:002009-06-03T01:23:43.307-04:00The pharmacy association aren't sitting back o...The pharmacy association aren't sitting back on this. Both the Ohio pharmacy association and other groups are planning to push for an FAA-like immunity system that would encourage pharmacists to report errors (they do a poor job now) in exchange for immunity from prosecution. <br /><br />I wrote about reaction to the <a href="http://www.medcitynews.com/index.php/2009/05/a-2-year-old-a-death-a-pharmacist-facing-jail-what-will-spur-lasting-change/" rel="nofollow">Eric Cropp case here</a>.Chrishttp://www.medcitynews.comnoreply@blogger.comtag:blogger.com,1999:blog-2760353953251845523.post-19039947092729122212009-06-02T18:39:35.462-04:002009-06-02T18:39:35.462-04:00i thought the four dreaded d's are
duty
diligence...i thought the four dreaded d's are<br /><br />duty<br />diligence<br />damage<br />direct (as in your lack of diligence directly caused the damage)Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-2760353953251845523.post-35419186108508262262009-06-02T10:53:20.148-04:002009-06-02T10:53:20.148-04:00I'm uneasy with the concept of criminalizing what ...I'm uneasy with the concept of criminalizing what essentially amounts to carelessness/negligence.<br /><br />But it does happen in other arenas, and quite frequently. It's not at all unusual for someone to be criminally prosecuted for careless or reckless behavior that leads to someone else's death. You've probably heard of involuntary manslaughter.<br /><br />Except in the most wanton and egregious cases (which admittedly are very rare), health care professionals have always gotten a free pass. You can't really say this for any other group in our society. Is this really fair? Is it fair to the victims? Heck, the health care industry has a long and ugly tradition of covering up its errors and being less than honest with patients and families. Maybe it's time to level the playing field.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-2760353953251845523.post-48683692055073140382009-06-02T09:39:26.473-04:002009-06-02T09:39:26.473-04:00I agree with you on all points. This is scary stuf...I agree with you on all points. This is scary stuff. <br /><br />I do have one note to make. You commented on "injury sustained" and possibly alluded (or I inferred) that this correlates one-to-one with negligence. In you example the injury sustained is not necessarily negligence. By definition: <br /><br /><I>NEGLIGENCE - The failure to use reasonable care. The doing of something which a reasonably prudent person would not do, or the failure to do something which a reasonably prudent person would do under like circumstances. A departure from what an ordinary reasonable member of the community would do in the same community.</I>Bile duct injury certainly can be caused by negligence, but I suspect that often times it is not. I probably read too much into your good example... but I wanted to make this point of clarification.<br /><br />Finally.. I enjoyed this post because it dove tails a bit with Dr. Wachter's post yesterday about <A HREF="http://community.the-hospitalist.org/blogs/wachters_world/archive/2009/06/01/is-hospital-peer-review-a-sham-well-mostly-yes.aspx" REL="nofollow"> Hospital Peer Review</A>JFSJoseph Sucher, MD FACShttps://www.blogger.com/profile/09187702675709935451noreply@blogger.comtag:blogger.com,1999:blog-2760353953251845523.post-76191499895374261422009-06-02T08:15:48.440-04:002009-06-02T08:15:48.440-04:00As tragic as it is that the child died due to Crop...As tragic as it is that the child died due to Cropp's "inattentive and lazy and careless"; I agree with you that the real fear (for me) comes in the prosecutor's "arbitrary judgment call" in deciding whether it is a malpractice or criminal case. This should scare all medical providers.rlbateshttps://www.blogger.com/profile/15236331355857884458noreply@blogger.comtag:blogger.com,1999:blog-2760353953251845523.post-54534412885568517162009-06-02T05:54:05.946-04:002009-06-02T05:54:05.946-04:00Your Paper's really called "The Plain Dealer"??? T...Your Paper's really called "The Plain Dealer"??? There was a Navy Heart Surgeon Court Martialed for Manslaughter back in the 80's, convicted, was doin hard time till his case was overturned on appeal. From the evidence, didn't sound like he was a very competent surgeon, but clearly didn't meet the requirements for manslaughter. The Prosecution made a big deal that he was "Legally Blind WITHOUT his glasses" a meaningless statement since "Legally Blind" is defined as20/400 or worse WITH correction. Navy had to give him back pay, and a discharge for PR reasons, still ruined the guy's life. Google "Dr. Billig" if you want more...<br /><br />FrankAnonymousnoreply@blogger.com