A patient’s wife claims the couple was treated outrageously after her husband suffered a fatal ski accident. David Morse of Nova Scotia died after a ski accident on vacation in Maine. Investigators are looking into both the care Morse received and how his loved ones were treated during the incident.

According to Morse’s family, he was on vacation with his wife, Dana, their children and other family members. An experienced skier, he lost control and slammed into a tree. Dana Morse, a nurse practitioner who has spent a decade working in intensive care, was present at the time of the accident and said Morse suffered severe chest trauma and internal trauma. Morse was awake and responsive immediately after the accident, but in significant pain.

Morse’s wife said that paramedics did an initial assessment of Morse at the base of the hill, but didn’t take his blood pressure, start an IV or take other key basic steps. Then they started to put him in the ambulance, but he went into cardiac arrest.

What went wrong?

As the ambulance raced to the hospital with Dana Morse in the front seat, she said she sensed her husband was dying and asked to sit in the back so she could hold his hand. Instead, the paramedics got annoyed with her requests, stopped the ambulance and left her out on the side of the road.

Dana Morse said she had to flag down a passing car to get a ride back to the ski resort so she could get her car and drive herself to the local hospital, Franklin Memorial Hospital in Farmington. Morse died en route to the hospital.

For reasons that aren’t yet clear, the ambulance returned with Morse’s body to the ski resort’s medical clinic. When Dana Morse arrived at the hospital, staff had no idea where her husband was, or what his condition was.

Administrators at Franklin Memorial have launched an investigation into both the care he received and the allegations about how his family was treated. Among the questions are whether he should have received more aggressive treatment earlier and if he should’ve been flown to another hospital as another skier was that same weekend.

Hospitals’ incident reporting systems are only registering about 14% of patient injuries, according to a new study. 

That’s the conclusion of a new statement from the Office of the Inspector General. According to the report, hospitals investigate the patient harm events that are most likely to help them make safety or quality improvements and they made relatively few policy changes based on the events that were reported.

As for the other 86% of incidents, hospitals said 61% were events that the staff didn’t perceive as a reportable event. The rest were normally reported but not reported in that specific instance.

OIG noted that all the hospitals reviewed had incident reporting systems in place and that hospital managers say they rely on the systems to monitor quality of care and catch potential problems.

Because incident reporting is so vital to hospitals, OIG recommended that CMS take the following steps:

• collaborate with the Agency for Healthcare Research and Quality (AHRQ) to create a list of potentially reportable incidents that hospitals could use
• provide guidance to accreditors regarding their assessments of hospital efforts to track and analyze events
• suggest that surveyors evaluate the information collected by hospitals using AHRQ’s Common Formats, and
• scrutinize survey standards for assessing hospital compliance with the requirement to track and analyze events and reinforce assessment of incident reporting systems as a key tool to improve event tracking.

To see the full report as a downloadable PDF click here.

Will those steps actually improve incident reporting and make it easier for hospitals to improve overall patient care? Share your thoughts in the comments.

Social media has real business benefits within health care — and serious negatives that can be hard to protect against — whether or not you even use the sites.

The open nature of social media sites like Facebook and LinkedIn means that no matter how carefully you manage your own profile — or even if you choose not to use them — there are some things you simply can’t protect yourself from.

Take the case of Jerry Penner, the CEO of Murray-Calloway County Hospital in Murray, Kentucky.

Shortly after coming to the hospital, a hospital VP made a joke about Penner having sent a friend request to all of the VP’s staffers, but not the VP himself. The only problem? Penner hadn’t sent any of the requests.

A little sleuthing turned up a fake profile of Penner that used a photo of him from a hospital web page, and his basic biographical info such as his educational and work history, which were correct aside from a few mistaken dates. There were few posts made on the page, and aside from some poor grammar and spelling, none of the information posted was damaging or harassing to Penner — but he was understandably disturbed.

Penner said his privacy settings on the site are relatively high and he uses the page mostly to communicate with business connections and promote the hospital.

Activity on the fake profile died down until recently, when a flurry of Penner’s real-life friends and colleagues received friend requests from the fake profile. Most upsetting to Penner: One hospital employee received a friend request with an “I love you” note attached.

In that instance, the person was already connected to Penner on Facebook and knew there was an impostor afoot. But Penner has no ideas who else may have received such inappropriate messages, and if those people realize they aren’t coming from him.

Penner said he had received little assistance from Facebook about the fake account — while he can no longer see the page when he logs on, he said other friends of his can.

For medical professionals who are already leery of social media’s privacy pitfalls, this may seem like one more reason not to use it. But not having the ability to monitor what other people say about you (or say as you) on social networking sites can be even more damaging in the long run.

From hard-to-believe HIPAA violations to dogs performing medical tests, here are the top 10 most popular stories on HealthExecNews from 2011:

10. 5 things doctors wish more of the patients would do

9. Outrageous! Visitor hurt, nurse says: ‘Call 911′

8. Doctor sues patient’s family — and everybody loses

7. Want the most depressing job? Work in health care

6. Doc convicted of murder for lipo gone wrong

5. Patient says ‘leaked’ medical info ruined her life

4. The scary truth about two common drugs

3. Paging Dr. Pooch: Dogs almost as accurate as colonoscopies

2. Doc disciplined, fined over Facebook posts

1. One dumb move nets first civil HIPAA fine

A pathologist was awarded $7.6 million from a federal jury in her suit alleging racial and gender discrimination by her employer.

Dr. Vivian Renta was a senior attending physician with the Cook County (Illinois) pathology department in early 2003 when she filed a charge of discrimination with the Equal Employment Opportunity Commission. In the complaint, she claimed that she had suffered harassment and been paid less than her professional peers. Renta claimed the cause for the treatment was that she was a woman and Puerto Rican.

Three months after she filed the complaint, she was suspended from her job, and in September 2004 she was terminated. She had worked for the county for nine years.

Among other things, Renta claimed she was retaliated against because she tried to expose various incidents of misdiagnosis, negligence and other wrong-doing that put patient care and safety at risk. For its part, the hospital argued that Renta herself had misdiagnosed several patients and had demonstrated a pattern of not following protocols. Renta’s lawyer provided proof that her error rate was actually better than the national average.

The federal jury hearing the case agreed with Renta, and awarded her $4 million for pain and suffering and $3.2 million in lost wages and benefits. The jury specifically requested that the pathology chairman be ordered to pay Renta an additional $400,000. Note: The jury verdict isn’t final. The judge can reduce the award for pain and suffering to just $300,000.

What kind of discipline do doctors face when they commit serious violations of patient safety? In many cases, nothing at all.

That’s what Public Citizen discovered after analyzing records from the National Practitioner Data Bank Public Use File for 1990-2009. The research found that of more than 10,000 physicians in the file who had at least one revocation or restriction of their clinical privileges, 45% also had one or more state licensing actions — which means 55% of the docs didn’t.

In one of the states least likely to take disciplinary action, California, the group found that the state medical board had failed to discipline about half of the doctors who had been disciplined by their own hospitals or health organizations between September 1990 and December 2009. That’s more than 700 doctors — most disturbingly, 102 of those doctors had been deemed by their peers as an “immediate threat” to patient health or safety.

Typical actions that landed physicians in the database were alcohol and substance abuse, providing substandard care, wrong diagnoses and leaving equipment in surgical patients.

Yet the state medical board didn’t act.

Since the initial report this spring, the state medical board hasn’t picked up the pace, and Public Citizen sent a letter to the governor outlining both the slow action against potentially dangerous docs and the state’s alarming recent decline in enforcing medical standards.

While these complaints are specific to California, it’s hardly the only state where malpractice is dealt with something less than haste. The real question is why some states seem to make it a practice to do little more than wink at physicians’ serious missteps.

Do physicians get a free pass when it comes to unprofessional behavior? Or is it merely that the process moves slowly? Share your thoughts in the comments.

Attention all germophobes: Latex gloves may actually worsen the hand hygiene of health care workers who wear them. That’s the finding of a recent study published in the journal Infection Control and Hospital Epidemiology.

The researchers found that health care workers who wear latex gloves are less likely to wash their hands in between patients.

That’s a problem because latex gloves are far from foolproof when it comes to protecting patients and health workers from each others’ germs.

Germs can travel through the latex material, or get sprayed through the air when the gloves are removed. Since gloves are most commonly worn when providers are dealing with the sickest of patients or procedures that are most likely to involve bodily fluids, it means even greater exposure to germs through health care workers’ germ-tainted hands.

For the study, researchers reviewed more than 7,000 contacts between doctors and patients, at 15 different hospitals throughout England. They found that the overall hand-washing rate among physicians was just under 48%. But when doctors wore latex gloves — for about 25% of patient interactions — the hand-washing rate dropped to a dismal 41%.

Essentially, when dealing with the sickest and most infectious patients, doctors are least likely to wash their hands. The researchers suspect doctors and other health care workers are lapsing on hand-washing out of the mistaken belief that latex gloves are impervious to germs and therefore, wearing them leaves their hands clean. In fact, latex gloves lower the risk of germ transmission — they don’t prevent it.

It may have seemed like a good idea to mock obese patients in print, but one surgeon-turned-comedian discovered the joke was on him.

John D. Kelly IV is an orthopedic surgeon at the University of Pennsylvania. He also writes a humor column for Outpatient Surgery Magazine, in addition to do doing stand-up comedy in his free time. He even has a web page devoted to the issue of “healing through laughter.”

Recently, those two worlds got a little too close for comfort.

Under deadline pressure, Kelly says he quickly assembled a bunch of one-liners for his August humor column. Many of the jokes were retreads from Rodney Dangerfield and other well-known comedians. Kelly referred to obese patients as “behemoths.” And under the premise of warning doctors that performing surgery on obese patients might be dangerous, Kelly used such comedy “classics” as: “You should worry about performing surgery on the super-sized if … there is a comma in your patient’s body weight… a patient wears his wristwatch on his finger…[or] has more chins than a Chinese phone book.”

Hysterical!

Also: Cruel and unprofessional!

In a totally unsurprising turn of events, Kelly and the magazine received criticism from sources far and wide, including patients, patient and health advocates, bloggers and the subscribers to the magazine. (The article was eventually pulled from the magazine’s web site.)

Kelly has since issued an apology in the magazine and has been in touch with bloggers who reported on the dust-up. “I blew it. I was not respecting the dignity of my patients. I didn’t recognize that this is a different audience than the comedy clubs. Of course, I will revamp my comedy routines now that I know the potential hurt some jokes can inflict,” was part of the apology he sent to a blogger at FormerFatDudes, a blog about gastric bypass surgery and related topics.

Officials at Penn also issued a statement saying Kelly’s statements don’t reflect the consensus view of the health system.

For his efforts uncovering a Medicaid fraud that the government couldn’t, the veteran pocketed a $15 million whistle blower payout.

Richard West, a 63-year-old Vietnam vet living in New Jersey knew something was wrong when medical services he needed were being cut back because he had supposedly reached the spending limit. West has muscular dystrophy, is confined to a wheelchair and needs oxygen — but he’s nobody’s fool and knew the numbers didn’t add up.

A little digging into his records showed that Maxim Healthcare had overbilled for hundreds of hours of care he never received, from nurses he’d never met.

West contacted numerous federal agencies who all declined to help him. So he hired his own lawyer and went to court.

When all was said and done, Maxim had agreed to pay the highest financial settlement in history for home healthcare fraud: $121.5 million in reimbursements and penalties, $8.4 million to the Veterans Administration and a fine of $20 million. Under the whistle-blower laws, West gets to keep a cool $15 million of that. He said he plans to use the funds to buy a new van, make some improvements to his home and donate to charities for the disabled. He will however, lose his Medicaid eligibility as his lawyer noted.

What motivated him to keep up the fight? West told a reporter for the New York Post: “The more I uncovered, the more pissed off I got that someone was making money on my disability… From my wheelchair, on a ventilator and oxygen, I have spent the last seven years in this fight. Sometimes the good guy wins.”

After two cases of patients dying in part due to nurses ignoring their alarms, a Boston-area hospital is taking action.  A 60-year-old man died at UMass Memorial Medical Center after the alarms indicating his heart rate had sped up and his breathing was irregular went unheard and/or ignored for almost an hour. The patient died in August 2010, but the circumstances of his death were only reported to authorities a few months ago. This is the second such case at the hospital since 2007.

Officials with the state Department of Public Health indicated so-called “alarm fatigue,” when overwhelmed staff tune out alarms — which are often false alarms — may have played a role in the deaths.

A subsequent investigation showed the patient was restless and frequently removed his monitors in his sleep, which led to his monitors making false alarms for a large part of the day. He also received a too-large dose of a medication meant to relieve anxiety. It’s unclear how much of a role the medication error played in his death.

In the earlier case, nurses didn’t respond to an alarm indicating that the battery on a monitor needed to be replaced. Eventually, the patient went into cardiac arrest, the monitor failed to sound the alarm, and the patient died.

After the ’07 case, hospital officials enacted new procedures to reduce instances of alarm fatigue, but as with most other hospitals, it’s clearly still an issue.

Hospital officials didn’t release a statement about this most recent case, but did reiterate to state officials that it’s working to improve patient care and staff attentiveness to alarms.