Articles Tagged with “Boston medical malpractice attorneys”

young surgery team in the operating room .As The Boston Globe continues to report on the unsafe practice of concurrent surgeries, we want to remind patients and health care consumers that you have legal rights when you seek medical treatment.

In 2015, The Boston Globe Spotlight Team reported on the practice of concurrent, overlapping surgeries at hospitals in Massachusetts and across the country. Concurrent surgery occurs when a surgeon has one patient still in surgery and starts a procedure on another patient. Patients were not informed of the practice.

This month, the U.S. Senate Finance Committee urged hospitals to clearly prohibit the practice.

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Poor communication between doctors and hospital staff hurts patients and causes many deaths, a new study reports. Electronic medical records should improve communication, but doctors are not always reading results.

Communication failures played a role in 30 percent of the medical malpractice cases examined by CRISCO Strategies of Boston. The study was released Monday.

The study reports on roughly a third of all paid medical malpractice claims nationwide, nearly 24,000 cases from 2009 to 2013. Over 7,000 cases involved communication failures which injured patients, including 1,744 resulting in wrongful death.

“Good communication in the medical record or in verbal reports is the hallmark of good medical care. We have seen many preventable deaths and serious injury cases that were the result of communication breakdowns,” Attorney Marc L. Breakstone said.

When Medical Mistakes May Happen

Electronic medical records may get doctors test results more promptly, but the study shows some are not reading them:

  • One woman’s cancer diagnosis was delayed for a full year. Her primary care doctor never read the lab result in her electronic medical record.
  • A patient was rushed to the emergency room and died after his lungs filled with blood. Less than two weeks earlier, his primary care doctor had referred him to a lung doctor. The two doctors failed to communicate about the lab results on the patient’s electronic medical record, which showed possible early congestive heart failure.

Many mistakes – 80 percent – happen as a result of miscommunication when doctors and medical staff transfer patient cases, according to the Joint Commission Center for Transforming Healthcare.

Across the country, 32 hospitals are trying to improve communication by adopting the I-PASS approach for how doctors and nurses communicate during shift changes, according to the medical publication STAT. One of these hospitals is Brigham and Women’s Hospital in Boston.

What Patients Can Take Away from This Study

Monitor Your Medical Records. If you have the option, monitor your medical records online. You will gain a better understanding of how your doctor and the medical practice approach your care. If you find a mistake, ask for a correction. On the other hand, if you do not have electronic access, remember you have the right to make a written request for medical records at any time.


When Shifts Change. Before the day of a surgery, ask when the surgeons and nurses change shifts. Ask what to expect if your procedure is delayed.


Patient Advocate. Bring someone you trust to your pre-operation appointment and to your procedure. Our article about the Massachusetts Patient’s Bill of Rights may be a helpful resource.


Research Online. Research if your doctor or surgeon has been disciplined or has paid medical malpractice claims in the Massachusetts Board of Registration database. You can also search Medicare’s Hospital Compare database for hospital information, ratings and practices.


Make Your Own Decision. Online databases and electronic medical records are important but make your own decision about your doctor’s communication. Observe their practices firsthand, ask questions and choose another doctor if you are concerned.

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44783989_s.jpgPatient beware: A new report says most of us will leave a doctor’s office with a diagnosis which is either late or wrong at least once in our lives. This can be life-changing for some, leading to serious injury, handicap or even death.

The report, “Improving Diagnosis in Health Care,” was released this week by the Institute of Medicine, which also published the landmark report, “To Err is Human” in 1999. The 1999 report exposed the fact that approximately 44,000 to 98,000 people were dying in U.S. hospitals each year as a result of medical errors.

The current report focuses on how doctors diagnose patients. The report shared the story of Carolyn, who believed she was suffering a heart attack and visited a hospital emergency room. When she asked her doctor questions, a nurse told her the doctor “doesn’t like to be questioned.” Told she was suffering acid influx, she was released a few hours later. But she was not better; she returned to the ER two weeks later. As she suspected, she had suffered a heart attack and needed surgery to unblock her artery.

The authors say they do not know how many Carolyns are out there. But some estimates are at least 12 million people are being incorrectly diagnosed like this year, or roughly 5 percent of adults who seek outpatient care each year.

They predict more bad news for patients too: Errors will likely increase because of the processes behind how patients are diagnosed, and how health care is being delivered today. The Institute of Medicine recommends health care organizations set up systems to identify diagnostic errors, adopt a non-punitive culture and work as a team.

A few highlights from the report:

  • There are many causes to diagnostic errors, including poor collaboration among physicians, patients and their families.
  • Physicians often receive limited feedback when they make a diagnostic error. In some cases, they never even learn about their error.
  • The medical culture continues to discourage transparency and disclosure of errors.
  • Doctors may still be struggling to learn electronic medical record systems which have been implemented to help eliminate medical mistakes. This may actually be contributing to mistakes.

Read more from the report and its recommendations.

Patient Resource:
Our attorneys have also written an article called “Preventing Medical Errors at Hospitals” which discusses how patients can advocate for themselves and explains the Massachusetts Patients’ Bill of Rights.

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Important Questions After New York Man Was Forced to Pay $117,000 for Last-Minute Surgeon He Never Met

20140924_medicalbilling.jpgIt is hard enough to be in pain and need surgery. But it gets much worse if you are unfairly billed huge sums from doctors you never met and never knew would be “helping.”

The New York Times recently shared the story of a New York City man who received an unexpected $117,000 bill after a neck surgery. The story did not have a fair ending; the man had to pay the bill, though the reimbursement came from his health insurance company.

Peter Drier had done careful research on the costs before his surgery at a Manhattan hospital and thought he knew what to expect. But the bank technology manager was blindsided when he received a $117,000 bill for an assistant surgeon he had never met or knew was involved in his care. Before surgery, Drier’s primary surgeon, Dr. Nathaniel L. Tindel, had agreed to accept a negotiated fee determined by his insurance company, about $6,200. Drier had to pay $3,000 toward this as part of his health insurance deductible. But Drier was never informed about the assistant surgeon, Dr. Harrison T. Mu, who was outside of his insurance company’s network of covered providers, until after he was home and received the bill.

The primary surgeon’s office said he did not share in the billing and the assistant surgeon never responded to The New York Times. Drier questioned the charge, and at the same time argued with his insurance company to make the payment. They resisted the “out of network” charge, but eventually paid it, even though by now the patient was protesting the entire unfairness of the situation.

“I thought I understood the risks,” Mr. Drier told The New York Times. “But this was just so wrong — I had no choice and no negotiating power.”

The New York Times recently reported on the growing practice of consumers being charged for out of network doctors in many instances, even hospital emergency rooms, and later receiving unexpected bills. This is significant because an out of network physician can charge 20 to 40 times as much as an in network doctor and costs are not covered by health insurance. For example, an out of network doctor charges an average of $115,625 for a spinal fusion in the U.S., while an in network physician charges an average of $5,983, according to figures cited by the newspaper.

How Massachusetts Consumers Can Protect Themselves From Unexpected Charges
New York will implement a new law next March, which in part will require more advance disclosure of medical costs and seek to protect patients from unforeseen out of network fees. Hospitals and insurers will be directed to mediate and negotiate cases from there.

Massachusetts is also making changes. In 2012, the state passed a health care cost containment law, which called for patients to have access to medical costs before a procedure or care is delivered.

  • As of October 2013, health insurers have been required to provide information on cost estimates for office visits to physicians and specific tests and procedures. For the first year, insurers had two working days to provide the information. Starting October 1, 2014, they will be required to provide the information instantaneously. Consumers are expected to be able to search pricing online themselves.
  • As of January 1, 2014, hospitals and physicians also have to provide cost estimates.

What to request:

  • Under the law, your doctor or health care provider must disclose the “allowed amount” or charge of admission, procedure or service, including the amount of any “facility fees.” The allowed amount is the contractually agreed amount paid by a carrier to your health care insurer. The most important thing is to make sure you understand what your insurance company must pay and what you must pay for a deductible. If that is not written down for you clearly, ask questions – and keep asking questions until you have something in writing you understand.
  • They should provide you with CPT codes, or the billing codes.
  • As for out of network costs, the law also compels providers who participate in networks to provide sufficient information about the proposed procedure or service to allow a patient to use the network’s toll-free number and website to disclose the costs.

The key is that patients must request this information. Start by making sure you understand exactly what your medical treatment will include. Doctors may order panels of test for which expenses add up quickly; you may wish to control the extent of treatment being offered depending on its cost.

We suggest you take time over the next few months and become comfortable with the system before you have a medical crisis. Start by contacting your health insurer and asking for an estimate for your next medical appointment. Contact your physician’s office or hospital as well and compare the findings. Also, ask your health insurer what pricing information is available online too but do not rely on it until you learn about the system.

Be a wise consumer! Do not step into a doctor’s office until you have reached agreement on the price, what your health insurer will pay, and how much you will pay for your deductible.

Related:
After Surgery, Surprise $117,000 Medical Bill from Doctor He Didn’t Know, The New York Times.

Medical Price Transparency Law Rolls Out: Physicians Must Help Patients Estimate Costs, Massachusetts Medical Society Blog

Massachusetts Office of Consumer Affairs and Business Regulation Infographic

Many unaware of new rules on health care costs, The Boston Globe.

Breakstone, White & Gluck consumer safety articles
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We commend The Boston Globe for highlighting one of the state’s most pressing problems in health care: too many Massachusetts hospitals and physicians are still using paper medical records.

In a May 7th editorial, the Globe rightly pointed out that electronic medical records, “will prevent errors, improve diagnostic work, avoid duplication of tests and procedures, and simplify clinical studies.” The newspaper called on the 63 Massachusetts hospitals not using any computerized systems to make the change now.

“Electronic medical records would be the best medicine for taking care of medical errors,” Massachusetts medical malpractice lawyer Marc Breakstone said in response to the editorial.

A 2008 study by the Massachusetts Technology Collaborative and the New England Healthcare Institute found just 10 of the state’s 73 hospitals used a computerized system for doctors’ orders. More alarming was the study found 1 in every 10 patients at six community hospitals in the state suffered from serious medication mistakes.

According to the Institute of Medicine, 50,000 to 100,000 patients nationwide die annually of preventable medical errors.

In addition to offering stimulus-bill help, the federal government is threatening to reduce Medicare payments for doctors who fail to implement electronic medical records by 2015. A 2009 national survey by the New England Journal of Medicine showed that only 1.5 percent of hospitals and 4 percent of doctors’ practices have adopted comprehensive electronic systems.

At Breakstone, White & Gluck, we know firsthand electronic medical records will save lives. Massachusetts hospitals are doing the public they should be serving a great injustice every day they continue to make excuses for not going electronic.

For more information, read The Boston Globe’s editorial.
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