Monday, May 23, 2016


Patients' Bill of Rights

 
There are few times that we are more vulnerable than when we, or our loved ones, are admitted to a hospital.  New York State mandates a specific list of rights with such basic items as the right to receive treatment without discrimination, and the right to considerate and respectful care. In the context of illness, it is difficult know what our rights are, let alone assert them.  We are at the mercy of hospital staff who, we can only hope, take the title “caregiver” seriously.  We sign multiple pages on admission as they are placed in front of us, at the time when all we want, is to feel better.  Among those pages is that “Patient bill of Rights.”  It is hardly a time that we are going to stop and analyze what those rights are.  In any event New York Public Health law mandates the following rights for every patient.

 

As a patient in a hospital in New York State, you have the right, consistent with law, to:

  1. Understand and use these rights. If for any reason you do not understand or you need help, the hospital MUST provide assistance, including an interpreter.
  2. Receive treatment without discrimination as to race, color, religion, sex, national origin, disability, sexual orientation, source of payment, or age.
  3. Receive considerate and respectful care in a clean and safe environment free of unnecessary restraints.
  4. Receive emergency care if you need it.
  5. Be informed of the name and position of the doctor who will be in charge of your care in the hospital.
  6. Know the names, positions and functions of any hospital staff involved in your care and refuse their treatment, examination or observation.
  7. A no smoking room.
  8. Receive complete information about your diagnosis, treatment and prognosis.
  9. Receive all the information that you need to give informed consent for any proposed procedure or treatment. This information shall include the possible risks and benefits of the procedure or treatment.
  10. Receive all the information you need to give informed consent for an order not to resuscitate. You also have the right to designate an individual to give this consent for you if you are too ill to do so. If you would like additional information, please ask for a copy of the pamphlet "Deciding About Health Care — A Guide for Patients and Families."
  11. Refuse treatment and be told what effect this may have on your health.
  12. Refuse to take part in research. In deciding whether or not to participate, you have the right to a full explanation.
  13. Privacy while in the hospital and confidentiality of all information and records regarding your care.
  14. Participate in all decisions about your treatment and discharge from the hospital. The hospital must provide you with a written discharge plan and written description of how you can appeal your discharge.
  15. Review your medical record without charge. Obtain a copy of your medical record for which the hospital can charge a reasonable fee. You cannot be denied a copy solely because you cannot afford to pay.
  16. Receive an itemized bill and explanation of all charges.
  17. Complain without fear of reprisals about the care and services you are receiving and to have the hospital respond to you and if you request it, a written response. If you are not satisfied with the hospital's response, you can complain to the New York State Health Department. The hospital must provide you with the State Health Department telephone number.
  18. Authorize those family members and other adults who will be given priority to visit consistent with your ability to receive visitors.
  19. Make known your wishes in regard to anatomical gifts. You may document your wishes in your health care proxy or on a donor card, available from the hospital.

 

But at a basic level, your rights go far beyond those enumerated one liners.  There are national standards that require doctors, nurses and other staff to maintain minimum levels of care.  These standards apply to all patients.  Those rights include:

 

  • Medical Records: Today, all hospitals should be using electronic records, but that doesn’t change the fact that patients should have access to their record.  Hospitalized patients should be offered their medical record daily and be shown how to make entries into their record and correct any misinformation. Hospital should provide a CD with the record at minimal cost, upon request of the patient or the patient’s representative.
  • Evidence-based care: Diagnosis and treatment shall be according to federal healthcare guidelines or according to peer-reviewed guidelines published by expert organizations for the medical condition of the patient. If the physician determines that a deviation from guidelines is needed, then the patient must be told that her care should deviate from guidelines and given an explanation for the deviation.
  • Therapeutic Drugs: No patient shall be prescribed a medication for off-label purposes without being informed that the drug prescribed has not been approved by the FDA for the patient’s medical condition. The rationale for prescribing the off-label drug and the risk associated with this must be revealed to the patient and documented. The patient shall be told how to report adverse effects of any prescription drug to the FDA.
  • Physician Competency: Patients have the right to be told the competency status of their physician before they are treated. This status shall include completion of state mandated CME, board-certification status, maintenance of board certification, rehabilitation from drug abuse, and any other factors that bear on the physician’s competency.  This also means that patient’s in a teaching hospital have the right to refuse treatment by medical students, and interns who are merely “learning” rather than contributing to the care. 
  • Costs: Patients shall know the ordinary costs of the diagnosis and treatment that they are going to receive before they agree to a diagnostic plan or treatment plan. Treatment found to be against guidelines without the patient’s consent does not have to be paid for.  Patients are entitled to itemized bills detailing all treatment.
  • Adverse Events: If an unanticipated adverse event occurs during diagnosis or treatment, the patient has a right to a full accounting of what happened and how the hospital intends to prevent similar adverse events in the future. If the adverse event was caused by a medical error, then the patient has a right to just compensation. Falsification of medical records after an adverse event constitutes tampering with evidence.
  • Duty to Warn: Patients shall know the hospital’s infection rate and morbidity and mortality associated with planned invasive procedures. The patient shall be warned of any lifestyle activity that threatens their health. They shall be given guidance on management of that activity.
  • Informed Consent: The patient shall give their informed consent for invasive procedures according to guidelines published by the American Medical Association. Fear shall never be used to elicit consent for invasive procedures. Invasion of another person’s body without genuine informed consent is improper and the patient has a right to be compensated.
  • Right to an Advocate: Research (Gittell, High Performance Healthcare) has shown that while in the hospital the main one to integrate the care of a patient is the patient’s advocate. All hospital patients must have the right to an advocate.

 

At The Sanders Firm, we have decades of experience protecting patients. If you or a loved one have been injured due to substandard hospital care call 516-741-5252 or email us at tgoralski@thesandersfirm.com for a free consultation. 

 

Friday, May 20, 2016


Nursing Home Abuse Guide

There is a devastating epidemic which is overwhelming our nation’s senior population. Within our nursing homes and assisted living facilities, nearly 10%, or roughly 150,000 seniors experience elder abuse each year. Many of these cases go unreported, although some of them can be quite serious and even result in the death of a loved one. Nursing home abuse in the United States has turned into an epidemic. Our seniors and loved ones are at risk of elder abuse each and every day.

Nursing home abuse is a difficult issue to face. Elder abuse exists in many forms, many of which may not be evidenced by clear, physical signs. Many victims are frail and vulnerable. As a result, they are often unable to protect themselves or seek needed help. Elder abuse can be difficult to prove once suspicion arises. A sad truth is that many nursing home abuse cases go unreported and unpunished. It is estimated that roughly 1,800 deaths each year occur due to elder abuse.

Types of Nursing Home Abuse

Physical Abuse

Physical abuse occurs when physical force is used to cause harm against a victim. This can include hitting, scratching, shoving, biting, and inappropriate use of restraints. Physical elder abuse typically has the most obvious warning signs. For this reason, it may be more plausible to prove physical abuse than other less obvious forms of elder abuse.

Emotional Abuse

Emotional elder abuse occurs when a caregiver or other individual causes emotional distress within a victim. Emotional abuse may result from ridicule and humiliation, intimidation, terrorizing, or ignoring an elder. Demeaning behavior, scapegoating, and blaming are also considered emotional elder abuse.

Sexual Abuse

Sexual elder abuse takes place when non-consensual sexual contact is made with an elder. In many case, physical and emotional abuse may also play a role. Elders who are sexually abused may be tricked, coerced, manipulated, or forced into sexual contact.

Financial Abuse

Stealing money or personal property are common forms of elder financial abuse. Additionally, financial abuse can occur when a caregiver or other individual tricks or pressures an elder to divulge valuable information, such as bank account and credit card numbers. Financial abuse also occurs when a victim is coerced to modify a deed, will, or trust.

Nursing Home Neglect

Elder neglect, or nursing home negligence, most commonly occurs when a resident does not receive proper medical, physical, or emotional attention. As a result, neglect can pose serious risk of harm to victims. In certain cases, neglect may escalate to physical or emotional abuse.

Taking Action against Elder Abuse


While it may be difficult, taking action against elder abuse may be the only way to stop the mistreatment and prevent others from becoming victims. If the victim is in immediate danger, he or she should be removed from the nursing home facility as soon as possible. After the elderly patient is safe, legal action should be taken against the facility.

Reporting Nursing Home Abuse

Reporting nursing home abuse to the proper state hotline will always be one of your first steps once you feel your loved one may have been abused. In New York you can file a complaint on line with the Department of Health using a form found at: https://apps.health.ny.gov/nursing_homes/complaint_form/complain.action    
If you are unable to submit your complaint by using the Nursing Home Complaint Form , then you may contact the Nursing Home Complaint hotline (1-888-201-4563) which can be called 24 hours per day, seven days per week. The hotline is manned by Nursing Homes and ICF/IID Surveillance staff from 8:30 a.m. to 4:45 p.m. Monday through Friday. A voicemail message may be left during non-business hours.
 
 
Be sure to always ask your senior how they are feeling and how they are being treated in a facility. Contacting a nursing home abuse attorney with experience and a proven track record of case settlements and verdicts, will only ensure your family that they get the compensation they deserve.

Filing a Nursing Home Abuse Lawsuit

If you or a loved one were the victim of nursing home abuse, an experienced nursing home abuse lawyer can help. A nursing home abuse lawyer will help to navigate the complex legal process needed to pursue a nursing home abuse lawsuit. Additionally, an elder abuse lawyer can help provide support and peace of mind during a difficult time.

 

At The Sanders Firm, we have decades of experience dealing with negligent nursing homes. If you or a loved one have been subject to abuse or neglect in a a nursing home call 516-741-5252 or email us at tgoralski@thesandersfirm.com for a free consultation. 

 

Tuesday, May 17, 2016

How to be a Patient Advocate


How to be a Patient Advocate


 
I shared these thoughts a few weeks ago, on my firm's site. That was before starting up this blog.  Since then, my Dad was in the hospital and I needed to put my own advice into practice.

Here are some guidelines for helping someone to get the best care possible from a hospital.

When a loved one is sick it is time to put other things aside and work hard for the care that they are entitled to.  A hospital should be a place of safety but all too often, patients are in danger of injury from negligent medical care.  Medical malpractice is the third leading cause of death in America behind heart disease and cancer.  A patient’s friends and family are the first line of defense.  Here’s what you can do.

 

1.       Make a daily list of questions to ask the doctor and find out how to reach him or her by phone. Ask questions about procedures, medications, diet, recovery time, and so on. Without a list, you may have trouble remembering all of your concerns. Be sure to leave space in your list not only for the answers given to your questions but for new information you'll receive since those answers will inevitably lead to more questions.

2.       Ask for copies of test results like lab tests, pathology reports, scans, x-rays etc., and keep them in chronological order in a folder. These will also prove helpful when it comes to deciphering medical bills and Explanations of Benefits from the insurance company which sometimes only reference the "Date of Service".

3.       Be in the hospital room when the doctor arrives. This is very difficult since doctors arrive at odd times like 7:15 a.m. or right when you've stepped out to lunch or to make a phone call. Unless you have specific questions ready, the doctor will only stay about three minutes to quickly check the patient's condition.

4.       Keep track of ALL the personnel (their names and positions)that may be attending the patient and with whom you have occasion to speak from the specialists on down to the volunteers. Use their names when you speak to them and make sure they know your name and the patient's name.

5.       Ask the attending nurse to page the doctor if you miss him or her so you can ask your questions. If this doesn't work, ask the patient to have the doctor give you a call.

6.       Help the patient receive what he or she needs and deserves. It is important however, to remember that hospitals can be dangerous places. So, if the treatment or service the patient needs can be more safely provided on an outpatient basis you should promote that alternative. Make sure the patient always has the phone, call button, and all supplies within reach. Make sure the nurse checks in periodically.

7.       Be persistent in the nicest way possible. An occasional minor tantrum might help, but generally it's better to just keep asking and asking until someone helps you.

 

Though you may feel like screaming at the hospital personnel at times, try to remain calm, but firm, about your needs. Be persistent. Remember that the person you are advocating for already feels life is out of control so you don't want to contribute further to that feeling.  Also remember that If your efforts fail and an injury occurs, the patient still has rights.  Ultimately, the patient may be entitled to compensation.  At The Sanders Firm, we have decades of experience protecting patients. If you or a loved one have been injured due to substandard hospital care call 516-741-5252 or email us at tgoralski@thesandersfirm.com for a free consultation. 

Friday, May 13, 2016

How to Avoid Risky Doctors


As a Medical Malpractice attorney, friends and family are always asking me if their doctors are "good."  Internet sites that commonly come up on Google searches aren't much help.   Sites like Yelp, which include reviews of doctors, don't do a good job of calling attention to doctors' documented misconduct. Doctors who've admitted to sexually assaulting their patients, or botching procedures due to negligence, still score high on online review boards.

The truth is that most doctors are quite good.  A VERY SMALL PERCENTAGE OF DOCTORS have accounted for most of the country's medical malpractice payouts over the last quarter century. That's according to an analysis done for Consumer Reports of the National Practitioner Data Bank, a federal repository that has collected disciplinary actions and medical malpractice payouts since 1990.

Malpractice suits aren't necessarily an indication of  poor skills. Cases often settle before trial and without documented findings of wrongdoing. And even the best doctors and surgeons can sometimes face lawsuits. But when doctors have multiple large settlements against them, it can be a warning sign ... suggesting that if licensing boards and hospital peer reviewers were willing to either get these doctors to stop practicing or get retraining, we'd all be better off.

Certainly you can protect yourself and your loved ones by simply choosing another doctor if your current physician has multiple lawsuits, or disciplinary actions.

You can get information about your doctor from your State Government.  In New York go to New York State Physician Profile at http://www.nydoctorprofile.com/.  Although not as informative, you can search license status of other professionals at http://www.op.nysed.gov/opsearches.htm#nme.

Consumer Reports ranks the New York Physician profile site second in the country. You can see the rankings at  http://consumersunion.org/wp-content/uploads/2016/03/Chart-website-review-CR-blobs-all-states-FINAL-4.pdf.

If you are unfortunate enough to fall victim to substandard care, we can help. Call the Sanders firm for a free consultation at 516-741-5252 or email us at tgoralski@thesandersfirm.com.

Thursday, May 12, 2016

Health providers use malpractice suits to improve safety


Health providers use malpractice suits to improve safety

 

The Wall Street Journal is reporting that there is a potential public health benefit to medical malpractice lawsuits: Better healthcare and improved patient safety.

Doctors, hospitals and other medical providers reportedly are using data and lessons from thousands of past malpractice suits to learn the most common reasons they're getting slapped with such claims — and then making changes to better care for patients, and to lower the chances of getting sued in the future.


The report noted that a leading physician-owned malpractice insurer,  has in recent years conducted dozens of studies of more than 10,000 medical malpractice lawsuits. The data dug up from those cases has been provided to doctors and hospitals for use in detecting "emerging concerns and [to] share tips for avoiding common pitfalls."

The article points out that a common dangerous emergency can arise during vaginal deliveries, especially with larger babies. After the baby’s head emerges, the shoulders can get stuck inside the mother’s body. Known as shoulder dystocia, it can cause damage to the brachial plexus, the nerves around the baby’s shoulder, and was one of the most common injuries alleged in 882 obstetrics claims from 2007 to 2014.


 

At The Sanders Firm, we decades of experience representing injured patients in these kinds of cases and more.  If you or a loved one have been injured in the course of medical care contact us today by phone, (516) 741-5252 or email at tgoralski@thesandersfirm.com  for a free consultation.