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November 28, 2011

Medical Malpractice, Alarm Fatigue Get Attention

patientalarms_web.jpgAs the problem of alarm fatigue comes under increased scrutiny, Massachusetts General Hospital has implemented steps to improve the medical staff's response to patient alarms and avoid unnecessary deaths.

Alarm fatigue at hospitals has received much attention in the past year as it has led to several patient deaths and illnesses throughout Massachusetts. Alarm fatigue is a type of medical malpractice caused when nurses and medical staff work among numerous alarms, many false, and grow desensitized to the many sounds and fail to respond to patients.

At Mass. General Hospital, an 89-year-old man died in January 2010 as he recovered from surgery and awaited implantation of a cardiac pacemaker. State and federal investigators reported 10 nurses on duty said they failed to hear alarms beeping at the central nurses' station. The nurses also said they never saw ticker signs indicating the patient's dropping heart rate on three hallway signs.

In April, Mass. General Hospital settled a medical malpractice claim made by the patient's family for $850,000. After an internal investigation, the Boston hospital also implemented several improvements to reduce this form of medical malpractice, including disabling the off switches of 1,100 cardiac monitors, educating nurses about alarms and installing speakers so alarms are heard more clearly. The medical malpractice settlement was reported today by The Boston Globe on Nov. 28, 2011.

Another medical malpractice lawsuit is pending against Mass. General Hospital after a 47-year-old woman died in the hospital in January 2009. The state Department of Public Health found the patient's cardiac monitor was not setting off alarms.

Other hospitals experiencing problems with alarm fatigue include UMass Memorial Medical Center in Worcester. In September 2011, The Boston Globe reported the hospital had two wrongful deaths over the past four years due to failure to respond to patient alarms. In one case, nurses failed to respond to alarms for almost an hour. The hospital is now taking steps such as holding monthly drills for medical staff and arranging voluntary seminars and webinars for the hospitals 2,100 nurses.

The hospital has also started sending low-battery warnings to nurses' cell phones and pagers for life-threatening changes in patients.

Hospitals are not alone in addressing the problem. Last month, the Joint Commission, which accredits hospitals, and the U.S. Food and Drug Administration attended a summit in Washington D.C. In future months, they are expected to make recommendations for the medical community.

Continue reading "Medical Malpractice, Alarm Fatigue Get Attention" »

November 18, 2011

Defective Products: The 10 Most Dangerous Toys of 2011

pull_toy__1321458591_0639.jpgAs the holidays approach, the lawyers at Breakstone, White & Gluck, PC urge you to shop carefully to avoid dangerous toys.

Each year, companies recall thousands of toys that put children at risk for injuries such as strangulation, lacerations, falls and death. According to the Consumer Product Safety Commission, the 34 toy recalls in fiscal 2011 were a marked decrease from 172 in 2008, but toy-related deaths rose slightly last year, with 17 children suffering wrongful deaths from defective toys.

In 2010, about 181,500 children were treated in emergency rooms for toy-related injuries. Non-motorized scooters continue to cause the most injuries, while toys with small parts and unsafe cords are also involved in many recalls.

Each year, a non-profit Boston organization, World Against Toys Causing Harm Inc., (WATCH) releases a list warning parents about the hazards of certain toys. The toys present hazards for burn injuries, strangulation injuries, and other bodily injury. This year's "WATCH's Most Dangerous Toys of 2011," includes:

1) The Incredible Shrinky Dinks Maker

Potential hazard: Possible electric shock and burn injuries.

2) Sword Fighting Jack Sparrow

Potential Hazard: Possible eye and other bodily injuries.

3) 'Gigan' Godzilla Figure

Potential hazard: Possible puncture wounds.

4) Twist 'n Sort
Potential hazard: Small parts cause a choking hazard.

5) Power Rangers Samurai Mega Blade
Potential hazard: Blade can cause injuries.

6) Fold and Go Trampoline
Potential hazard: Can cause injuries to people using it, including to the head and neck.

7) Pulling Animal Duck
Potential hazard: Potential for strangulation injuries.

8) School Bus
Potential hazard: Choking hazard.

9) Z-Curve Bow
Potential hazard: Danger to eyes.

10) Stepper 'Low Rise" Stilts
Potential hazard: Head and other injuries from impact.

Click here to read more about this year's WATCH list.

Related Entries

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November 1, 2011

Change Your Smoke Alarm Batteries for Daylight Saving Time

smokedetector_blog.jpgOn Sunday, Nov. 6, we turn clocks back an hour as Daylight Saving Time ends. The change from Daylight Saving Time is an important reminder to protect our family and homes by checking and changing the batteries in our smoke alarms and carbon monoxide detectors.

Fire and carbon monoxide poisoning are great concerns as the cold weather arrives and residents make their home heating decisions. Each year, more than 150 people in the United States die from accidental non-fire related carbon monoxide (CO) poisoning. This poisoning is associated with consumer products, such as furnaces, stoves and water heaters.

Even more people die each year in fires. In 2010, 3,120 people were killed while another 17,720 suffered fire-related injuries, according to the National Fire Protection Association. Four out of five civilian fire deaths occurred in the home. These statistics make your work to prepare your home for the winter especially important.

Smoke Alarms: Massachusetts requires a smoke alarm be installed on every habitable level of a residence as well as the basement floor.

There are two types of smoke alarms, photoelectric and ionization. Effective April 5, 2010, only photoelectric smoke detectors are to be installed within 20 feet of kitchens and bathrooms with showers. These alarms are less sensitive and the goal is to reduce nuisance alarms that cause people to disable devices. Both photoelectric and ionization alarms are required in all other areas.

Carbon Monoxide Detectors: Since March 31, 2006, residences have been required to have working carbon monoxide alarms on every habitable level of the home or dwelling unit. Carbon monoxide is a colorless and odorless gas that results from incomplete burning of fuels. The first symptoms of poisoning are similar to the flu and include headache, fatigue and dizziness.

The requirements for meeting the smoke alarm and carbon monoxide detector laws can be met with separate units or with smoke alarms that have carbon monoxide detectors.

Continue reading "Change Your Smoke Alarm Batteries for Daylight Saving Time" »

September 28, 2011

Food Recalls Put Focus on Safe Preparation and Inspection

cantaloupe_web.jpgRecent food recalls involving cantaloupe, ground beef and ground turkey have put a renewed emphasis on food safety.

The cantaloupe recall ranks as the worst in a decade, causing 13 deaths and sickening more than 70 people. In 1998, Listeria contamination in hot dogs and deli meats killed 21 people, according to the Centers for Disease Control and Prevention.

On September 14, Jensen Farms of Holly, Colorado voluntarily recalled their shipments of Rocky Ford whole cantaloupe because of the potential for Listeria monocytogenes contamination. The food recall impacted shipments to 17 states, including in Colorado, Texas, Pennsylvania, New York and New Jersey. Massachusetts did not receive shipments of the contaminated cantaloupe.

The cantaloupe recall has subsequently been expanded, with Carol's Cuts LLC, a Kansas food processor, recalling 594 pounds of fresh-cut cantaloupe. Eight wrongful deaths and 55 cases of foodborne illness have been linked to the contaminated cantaloupe. Listeria can cause serious and sometimes fatal food poisoning. Complications range from nausea and high fever among the general public to miscarriage and stillbirths for pregnant women.

In other recall notices, on September 28 Tyson Fresh Meats of Kansas recalled 131 pounds of ground beef products that may be contaminated with E. coli, a bacterium that can cause a wide range of symptoms, including dehydration, kidney failure and death. The contaminated ground beef products were shipped to 14 states.

The recall was issued after an Ohio man became ill from food poisoning and authorities tested leftover ground beef collected from his home. The beef was contaminated with the virulent strain of E. coli known as O157:H7.

On September 11, Cargill Meat Solutions Corporation of Springdale, Arkansas recalled 185,000 pounds of ground turkey products for Salmonella contamination on September 11. No injuries have been reported in that food recall.

It is important to carefully inspect your food during preparation. The U.S. Department of Agriculture's Food Safety and Inspection Service offers tips for safe food handling and inspection in its guide called, Check Your Steps: Food Safe Families.

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September 21, 2011

Unsecured Truck Load Accidents Are Growing Problem in Massachusetts, Nationwide

tractortrailer_web.jpgUnsecured truck loads are a growing problem endangering drivers across the country. Massachusetts has seen two of these fatal car accidents in the past two months.

In 2004, the AAA Foundation for Traffic Safety reported 25,000 motor vehicle accidents are caused each year by unsecured materials on highways.

The problem is most prevalent in California, which had 32 million registered vehicles in 2007 - more than twice the number of any other state, according to the New York Times. The California state transportation department reported that over a two-year period between 2005 and 2007, 155 people were killed as the result of debris from unsecured truck loads.

In some of these fatal trucking accidents, authorities file criminal charges against drivers and other employees. When these motor vehicle accidents result from negligence, drivers and companies may also face wrongful death lawsuits in civil court.

Some states have strengthened the penalty for accidents involving tractor-trailers carrying unsecured loads such as construction equipment, building supplies, wood and furniture. Several years ago, Washington state passed Maria's Law, named for Maria Federici, a young woman in her 20s who was blinded and disfigured when a piece of furniture flew off a trailer and smashed her windshield.

Maria's Law made hauling an unsecured load causing injury a gross misdemeanor, carrying maximum penalty of one year in jail and a $5,000 fine.

In Massachusetts, a 27-year-old Lynn man died Sept. 19 when a 400-pound tire being hauled by a truck broke loose on Interstate 93 in Somerville. The truck was owned by Ryder Truck in Braintree and leased to Sullivan Tire. The tires spilled across the median and smashed the windshield of the Lynn man's car, throwing his car toward a retaining wall.

The 2005 Freightliner M2 flatbed truck was carrying tires containing a tire fill. This material made them heavier than standard tires filled with air.

On Aug. 12, a backhoe fell off a National Grid truck traveling on Interstate 495 in Southborough. The backhoe struck a van, killing an elderly passenger and causing serious personal injuries to others in the vehicle.

Click here to read a 2007 New York Times article about unsecured truck loads.

Continue reading "Unsecured Truck Load Accidents Are Growing Problem in Massachusetts, Nationwide" »

September 19, 2011

Child Passenger Safety Week Highlights Need to Protect Children

childseat_web.jpgTo parents, there is nothing more important than their children's safety. In the car, safety starts with child passenger safety seats.

This week, the National Highway Traffic Safety Administration is observing Child Passenger Safety Week. This weekend is National Seat Check Saturday, an opportunity for parents to have their child's safety seat inspected free of charge.

Motor vehicle accidents are the leading cause of death among children in the United States, according to the Centers for Disease Control and Prevention (CDC). Child passenger safety seats have been shown to reduce these deaths. For infants, child safety seats result in a 71 percent reduction in motor vehicle accident deaths.

All 50 states have child passenger protection laws. Violations are a primary offense in Massachusetts and 47 other states, meaning police can stop drivers solely for non-compliance. In Colorado and Nevada, child passenger safety violations are a secondary offense.

In Massachusetts, children must travel in a federally approved child passenger safety seat restraint until they are 8 years old or over 4'9" tall.

Parents often use child safety seats incorrectly. In one study observing nearly 3,500 child safety seats, 72 percent were misused, according to the CDC. This increases the chance for motor vehicle accident injuries and deaths.

Massachusetts parents can ensure their child safety seat is properly fastened on Saturday, when police departments and not-for-profit organizations will provide free checks.

If you are a parent of a young child, click here to find an inspection station near you.

Click here for information on the Enhanced Child Passenger Safety Law in Massachusetts.

Continue reading "Child Passenger Safety Week Highlights Need to Protect Children" »

August 29, 2011

Massachusetts Safety Tips After Tropical Storm Irene

treedamage.jpgNow that Tropical Storm Irene has passed, residents and businesses throughout Massachusetts have started the extensive clean-up. Many remain without power.

An estimated 4.5 million homes and businesses along the East Coast lost power, including 700,000 in Massachusetts, officials reported. Utility and state officials estimate it may take several days to restore power in some communities.

The storm caused 26 deaths across the country. In Massachusetts, a public works employee on his way to join recovery efforts was electrocuted Monday by a downed power line outside his Southbridge home.

From Storrow Drive in Boston to Interstate 91 in western Massachusetts, many roads were shut down by flooding. Residents in several communities were evacuated from their homes, including in several western Massachusetts towns, Southboro and New Bedford,

Whether you are cleaning up your yard, driving or waiting for power to be restored, it is essential to think safety for you, your family and property. Here are safety tips from the Boston personal injury lawyers at Breakstone, White & Gluck:

  • Be prepared for intersections without working traffic lights or police officers to direct cars.

  • When driving, travel farther behind the vehicle in front of you than normal. Road detours and single-lane roads may not be visible until just before you reach them.

  • Give even more room when traveling behind tractor trailers carrying heavy loads of branches and storm debris.

  • If your home is still without power, make sure you have enough flashlights and plenty of extra batteries. Avoid using candles.

  • Natural gas or propane valves that have been under water should be replaced. Smell and listen for leaky gas connections that may trigger an explosion.

  • If you believe there has been a gas leak, there is risk for a home explosion. Immediately leave the house, leave the doors open and contact a gas system professional before you return.

  • Take measures to avoid food poisoning. Throw away any refrigerated foods that are held at above 40 degrees for more than two hours. Food can generally keep for up to 4 hours in a refrigerator that is not opened and between 24 to 48 hours in a freezer.

  • Watch news reports to see if your local health department has cleared tap water for safe consumption. If you are without power and cannot watch television or access the Internet, call your town or city hall to ask.

  • Watch out for and stay away from downed power lines.

  • Do not enter and avoid walking near damaged buildings.

  • Be careful walking under trees as there may be loose branches.

Continue reading "Massachusetts Safety Tips After Tropical Storm Irene" »

August 26, 2011

Medical Malpractice Appeal Leads to New Trial in Massachusetts Superior Court

courtcolumns.jpgAn appeal by a plaintiff in a medical malpractice case involving a failure to diagnose cancer has led to a new trial. The Appeals Court reversed the directed verdict, entered by Superior Court Judge Patrick Brady, after finding that the judge had improperly allowed the defendant's motion for a directed verdict.

The case arose from the treatment of a patient who was having complaints of hoarseness and acid reflux. After several months of delay, a CT scan on the neck was finally performed, which revealed the presence of tumor near the esophagus and in the lung; the tumor was affecting the nerves which controlled the vocal cords. A biopsy revealed a non-small cell cancer which was staged at Stage 3B. Treatment was unsuccessful, and the patient died a year and a half later.

Claims were brought for medical malpractice resulting in conscious pain and suffering, wrongful death, and negligent infliction of emotional distress, among others. At trial, the plaintiff's expert was prepared to testify that if it had been diagnosed in a timely manner, the cancer would have been at Stage 2 or possibly Stage 1. Judge Brady would not permit the testimony of "possibly Stage 1" and eventually foreclosed any meaningful expert testimony on his opinion about the stage of the cancer. Those rulings set the stage for the judge's allowance of the defendant's motion for a directed verdict.

On appeal, the Massachusetts Appeals Court found that the testimony about the tumor being "possible Stage 1" was properly excluded, but that the testimony about the tumor being likely Stage 2 was improperly excluded. Accordingly, the judge's ruling was reversed, and the plaintiff will now have a second chance at trial.

The Appeals Court also recapitulated the necessary evidence for cases involving the loss of a chance when a physician fails to diagnose cancer. Loss of a chance cases require opinion evidence on the stage of the cancer at the time the diagnosis should have been made. The evidence does not require exact staging; a range of stages is permissible. Also required is evidence on the likelihood of survival after a timely diagnosis. The evidence must include an opinion about the difference in likelihood which more probably than not resulted from the delay. Citing Matsuyama v. Birnbaum, 452 Mass. 1 (2008), the Court noted:

Under a loss of chance theory, a "plaintiff must prove by a preponderance of the evidence that the physician's negligence caused the plaintiff's injury, where the injury consists of the diminished likelihood of achieving a more favorable medical outcome." Id. at 17. The court explained: "[P]robability of survival is part of the patient's condition. When a physician's negligence diminishes or destroys a patient's chance of survival, the patient has suffered real injury. The patient has lost something of great value: a chance to survive, to be cured, or otherwise to achieve a more favorable medical outcome.... Thus we recognize loss of chance not as a theory of causation, but as a theory of injury." Id. at 16.

The case decided was Carreri v. Isihara, Mass.App.Ct. No. 10-P-109 (August 25, 2011).

Continue reading "Medical Malpractice Appeal Leads to New Trial in Massachusetts Superior Court" »

August 15, 2011

Drive Safe in August as Motor Vehicle Accidents Rise

carcrash.jpgYou may think winter snowfall makes for treacherous driving. But government figures show August is actually the most dangerous month on the roads, making it an important time to take precautions.

Based on records dating back to 1994, the National Highway Traffic Safety Administration (NHTSA) reports more Americans die in car crashes in August than at any other time of the year. In August 2009, that number totaled 2,864 deaths.

September had the next highest rate of traffic fatalities, followed by July. Weekends are the deadliest time on the roads throughout the year. Nationwide in 2009, there were an average of 123 deaths each day on Saturdays and 107 deaths on Sunday.

Experts say motor vehicle deaths rise in August because more people are on the road traveling for vacation, taking day trips and attending summer events.

Because of these factors, it is paramount to practice safe driving. Here, our Massachusetts personal injury lawyers offer safety tips to protect you and your family:

  • Do not drink and drive.
  • Travel slowly at night and make sure you are familiar with your route.
  • Reduce distractions by putting away your cell phone and GPS.
  • When traveling with children, explain you must concentrate on the road.
  • On the highway, make sure children have distractions such as books and games.
  • Never leave a child unattended in a vehicle.
  • Wear your seat belt.
  • Do not speed.
  • Talk to teenagers about taking safety precautions such as limiting passengers and avoiding night driving.

Continue reading "Drive Safe in August as Motor Vehicle Accidents Rise" »

June 29, 2011

New Crib Safety Standards Ban Sales of Drop-Sides

cribrules.jpgThe Consumer Product Safety Commission (CPSC) has implemented comprehensive new safety standards for baby cribs. The standards ban the sale of dangerous drop-side cribs and improve safety testing to prevent infant strangulation deaths.

The regulations took effect this week after the recall of over 11 million unsafe cribs since 2007. Over the past decade, at least 32 infants have suffered suffocation and strangulation deaths in defective baby cribs.

The CPSC is calling the new regulations the "most stringent crib safety standards in the world." The standards are important for parents to learn because the CPSC reports that even cribs without drop-sides are unlikely to meet the new standards.

The standards work to prevent infant deaths in several ways. In addition to banning the manufacturing or sale of drop-side cribs, the standards strengthen mattress supports and crib slats, make testing more rigorous and require crib hardware to have anti-loosening devices.

All importers, distributors, manufacturers and retailers must comply with the regulation immediately. Many large retailers such as Target and Walmart say they have already stopped selling drop-side cribs.

Certain businesses using cribs have a grace period for compliance: in-home child care services, child care facilities, rental companies and public accommodations such as hotels.

The CPSC said parents who want to keep using drop-side cribs can contact their manufacturer and ask if they offer an immobilizer. These devices secure drop-sides to prevent the crib from separating and causing an infant injury.

Parents with other types of cribs are urged to check their cribs as well. One of the reasons other cribs are unlikely to comply is the new standards require stronger wood and other materials. Parents who continue to use their existing cribs are urged to monitor recalls on the CPSC website at www.cpsc.gov.

Continue reading "New Crib Safety Standards Ban Sales of Drop-Sides" »

April 27, 2011

Workers' Memorial Day in Massachusetts Remembers Workplace Victims

Every year, Massachusetts families and organizations come together to honor the men and women who are killed and injured while on the job. This year, on April 28, the Massachusetts Coalition for Occupational Safety and Health (MassCOSH), the Massachusetts AFL-CIO, and the Greater Boston Labor Council are co-sponsoring Workers' Memorial Day and are publishing the 2011 report: Dying for Work in Massachusetts: Loss of Life and Limb in Massachusetts Workplaces.

"It is critical that Massachusetts employers improve the safety of their workplaces to protect their workers. The high rate of death and injury on the jobsite is still taking a horrible toll on Massachusetts workers and their families. It is also unfortunate that enforcement continues to suffer budget cuts," said Boston personal injury lawyer David White.

As stated in this sobering report, its purpose is to "highlight the fact that work continues to kill and maim workers in epidemic and alarming numbers. The saddest aspect to this loss in lives and limbs is that work-related injuries and illness are preventable."

The report describes in clear detail the tragedy facing Massachusetts workers and their families. In 2010 alone, 47 Massachusetts workers lost their lives while on the job. (Breakstone, White and Gluck has the privilege and honor of representing the family of one of these deceased workers in their claim for his pain and suffering and wrongful death while on the job.)

The top three causes of fatalities among Massachusetts workers in 2010 were transportation (12 deaths: drivers or workers on roads involved in motor vehicle accidents and plane/helicopter crashes), falls (9 deaths: half being construction site accidents), and commercial fishing (4 deaths).

On Workers' Memorial Day, we honor the fallen by demanding stronger workplace health and safety protections under the Occupational Health & Safety Administration, because it is every person's right to be safe in their own work environment.

Join us on Thursday April 28, 2011 from 12:15 to 1:15 p.m. outside the Massachusetts State House as we mourn for the dead and fight for the living.

Breakstone, White & Gluck is a proud sponsorof MassCOSH, an organization with a great reputation for protecting workers and improving workplace safety. 

Continue reading "Workers' Memorial Day in Massachusetts Remembers Workplace Victims" »

April 25, 2011

Massachusetts Escalator Accident Follows Years of State's Failure to Inspect

escalator.jpgA recent public records request made by the Boston Globe shows the state has failed to regularly inspect approximately 75 percent of the escalators in Massachusetts malls.

From 2008 to 2010, only 44 of the state's 188 mall escalators received annual inspections as required by law. Inspectors missed one or two inspections during those three years on 144 escalators.

When mall escalators were inspected, they needed repairs in more than half the cases. Mall escalators were shut down 22 times.

The newspaper made the public records request following the wrongful death of 4-year-old Mark DiBona last month in an escalator accident in a Sears department store at the Auburn Mall near Worcester. The child fell through a 6-inch-wide gap between the handrail and the glass barrier.

The state Department of Public Safety suspended the two inspectors who approved the defective escalator for use.

The state's failure to inspect its escalators dates back at least 15 years. In 1995, the Globe reported that nearly 40 percent of the state's escalators and elevators had expired inspections.

The state currently has 34,000 elevators and 900 escalators for 51 inspectors to examine. Two dozen of those positions were created in 2010, the same year an audit found that nearly a third of the state's elevators and escalators had expired inspections. Fifty one inspectors is the most the state has had in years, though some specialists say they still carry a heavy workload.

Beyond staffing, some specialists in the field say that inspectors spend more time on elevators and are less experienced with escalators, which may contribute to escalator accidents in Massachusetts.

Boston personal injury lawyer David White on the findings: "It is encouraging that the state is now catching up on the backlog of inspections. What is discouraging, however, is how many violations they are finding. This is a strong indication that property owners and their own service companies may be putting the public at severe risk."

To read the Boston Globe article reporting this data, click here.

Continue reading "Massachusetts Escalator Accident Follows Years of State's Failure to Inspect" »

April 25, 2011

Window Blind Design Reconsidered After Numerous Infant Deaths

venetian-window-blind.jpg

The Consumer Product Safety Commission (CPSC) has asked manufacturers to re-design window blinds so as to eliminate the risk of infant wrongful death from strangulation.

Window blind manufacturers have known about the problem for decades, starting with a federal study in the 1980s that tied 41 child strangulation deaths to drapery and blind cords.  Since then, manufacturers have dragged their feet when it comes to improving safety.

And infants are still dying. The NY Times reports that in August 2009, Kathleen Leeson put her 2-year-old son down for a nap.  A short time later, Ms. Leeson discovered her son hanging, lifeless, an inch off the floor with the window blind cord wrapped around his neck.  Further, in 2002 1-year-old Cheyenne Kaiser was found by her mother strangled sitting up in her crib, which was next to the window, with the inner window blind cord wrapped around her neck.

The CPSC has released a safety alert for concerned parents explaining the risk of personal injury and wrongful death to children from the various types of window blind cords.  In its safety alert, the CPSC makes four recommendations to help prevent these tragic strangulation injuries:

  • Use only cordless window blinds in all homes where children live or visit;
  • Do not place cribs, beds, or furniture close to windows where children can climb and gain access to the cords;
  • Make all loose cords inaccessible; and
  • In windows with looped bead chains or nylon cords, use tension devices to keep the cord taut.

Moreover, in response to the industry's unenthusiastic attempts at improving product safety, a task force of regulators, consumer advocates, and industry leaders have come together to find a solution by the fall of 2011.

The CPSC has also warned the window blind industry that, if it cannot reach a solution soon to minimize these life-threatening dangers, it may face mandatory safety regulations.

Continue reading "Window Blind Design Reconsidered After Numerous Infant Deaths" »

March 30, 2011

Salmonella Outbreak in Rhode Island Now Linked to Death

A salmonella outbreak in Rhode Island now includes at least twenty-one people with severe illness, and one death, according to reports from public health officials in that state. Health officials are investigating another eighteen illnesses to see if they are tied to the salmonella outbreak.

Officials are focused on zeppole and other pastries which were made by Defusco's bakery in Johnston, Rhode Island. According to news reports, investigators found pastry shells stored in boxes contaminated with raw eggs, and also found that custard used as filling was not being properly chilled.

Investigators have identified the particular strain of salmonella, known as Salmonella heidelberg, as the suspected organism responsible for the illnesses. They are now trying to determine whether the death of the elderly Rhode Island resident was caused by that particular strain.

The investigation into the food poisoning outbreak began on March 25, 2011, after nearly a dozen elderly residents of a Warwick nursing home became sick after eating pastries from Defusco's bakery. Since March 12, two dozen victims have required hospitalization for severe illness.

Salmonellosis, the disease caused by salmonella infection or salmonella toxins, leads to diarrhea, fever, vomiting and abdominal cramps. Most people recover without treatment, but in the elderly, in infants, or people with compromised immune systems, the disease can be very severe, requiring hospital admission for rehydration and antibiotic treatment to prevent the spread of infection. Severe infections can lead to reactive arthritis and death.

Prevention of salmonella illnesses is straightforward. Food which may contain the bacteria, such as chicken or pork, must be prepared properly to kill the organism and destroy any salmonella toxin. Eggs and milk, and their products, must be properly prepared, handled, and refrigerated. Infections can also occur from contact with reptiles, pet rodents, and tainted fruits and vegetables. Proper hygiene--washing hands before and after handling food--is also a common sense method of reducing the likelihood of food poisoning.

Each year over 140,000 people suffer from salmonella poisoning in the U.S. and dozens die from the illness.

Continue reading "Salmonella Outbreak in Rhode Island Now Linked to Death" »

February 18, 2011

Surgical Checklists, Reducing Malpractice and Saving Patient Lives


It is hard to imagine that experienced surgeons, anesthesiologists and nurses would need a checklist to avoid obvious mistakes in surgical procedures, but the hard evidence is that simple checklists make an enormous difference in patient outcomes. Complications and medical malpractice rates are cut dramatically. The evolution of the checklist is chronicled in a recent book by Boston surgeon Atul Gawande. books[1].jpg

In his book, The Checklist Manifesto (Metropoliltan Books 2009), Dr. Gawande, who practices at the Brigham & Women's Hospital in Boston, points out that the average American has seven operations in his or her lifetime; that there are fifty million operations performed every year; and that there are "upwards of 150,000 deaths following surgery every year--more than three times the number of road fatalities." And, research has shown, "at least half our deaths and complications are avoidable." 

Inspiration for the procedural checklists for surgery came from the airline industry, which has always used checklists for routine and emergency procedures. Thousands of hours are spent honing the lists so they are not overwhelmingly detailed and difficult to follow. And they work.

Working with the World Health Organization, Dr. Gawande and the research team studied complication rates in a variety of hospitals around the world, some teaching institutions in wealthy countries, some from the most impoverished countries, and some in between. Complications and deaths were assessed. The checklist was implemented and changes were studied. Within months, major complications had dropped by 35% and deaths had dropped by 47%. 

The 19-point checklists now in use include some remarkably simple steps: The operating room personnel introduce themselves and state their roles; they discuss any known risk factors; they make sure they have the right patient, the right procedure, and the right part of the body. The list also includes more details such as confirming medication allergies, reviewing the anesthesia plan, discussing concerns about blood loss, identifying pathology specimens, confirming sponge and needle counts, and sending important information to the recovery room. 

These simple procedures have saved lives, reduced complications, and saved probably hundreds of millions of dollars and immeasurable pain and suffering. A checklist that costs almost nothing to perform (just a few minutes of everybody's time) is easily saving far more than any possible medical malpractice "reform" that is being considered in the halls of Congress or state houses around the country.  Further fine-tuning of medical practices, not punishing the injured, is the correct path to malpractice reform. 

Advice to Consumers: If you are planning for a surgical procedure, make sure your surgical team is using a checklist to avoid complications in your case. According to Dr. Gawande, over 94% of medical professionals say they would want a checklist for themselves.
 

Continue reading "Surgical Checklists, Reducing Malpractice and Saving Patient Lives" »