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Medical Malpractice on Hospital "Graveyard Shifts" Can Be Fatal

Posted on May 28, 2007

In the Reader’s Digest (RD) June cover story, “Fatal Hospital Mistakes You Can Avoid,” the most important lessons learned are: 1) schedule your surgery early in the morning, 2) have a friend stay in your hospital room overnight and 3) ask specifically what drug and milligram amount you are given and know the side effects.

Frightening are where blunders are take place. It’s not necessarily small communities but in metropolitan area hospitals and practicing medical schools. Even if you’d been treated by a board-certified doctor, it’s not always he or she administering your care.

On the hospital ‘graveyard shift,” you are totally dependent on a nurse or nurse’s aide. And if they’ve worked an extended shift by the time they reach your bed, their attention span could be limited. This is not ideal medical care one prefers when intravenous needles, morphine pumps and catheters are inserted into your body.

Check Medication Side Effects

First is the harrowing story of Lewis Blackman. RD’s Max Alexander tells the story of a 15-year-old boy who was having corrective surgery for pectus excavatum, commonly known as sunken chest. Since this condition can lead to respiratory problems, his parents had their son undergo surgery at the local University of South Carolina Children’s Hospital in Charleston.

Three days after surgery, the boy developed severe pain in his abdomen. A doctor said it was gas and prescribed a suppository to relieve the constipation, common after surgery. Later that night, the boy’s heart rate climbed to 142 and his body temperature dropped to 95. His skin become pale and he sweated profusely. The doctor who performed the surgery was not at the hospital. ”There was no one around,” said Lewis’ mother, Helen Haskell. “It was like we were laboratory rats.”

At 8:30 the next morning, nurses could not get a blood pressure reading from Lewis. For two hours, they administered procedures but still no BP reading. Approaching noon, Lewis spoke his final words to his mother, “It’s going black,” he said. Helen yelled for help but her son went into cardiopulmonary arrest. Eleven doctors came to Lewis’ aid but none could save the boy. At 1:30, Lewis died.

The autopsy showed Lewis bled to death internally from a perforated ulcer, likely caused by the painkiller Toradol Near the end, much of the boy’s blood had drained into the peritoneal cavity, the autopsy showed.

RD’s Alexander reports that a more experienced physician and one familiar with the dangerous side effects of Toradol might have recognized the symptoms early enough to save Lewis’ life.

The University settled with the family out of court for $950,000. Helen founded an advocacy group, Mothers Against Medical Error, which later helped pass of The Lewis Blackman Hospital Patient Safety Act. This requires doctors in South Carolina to wear IDs describing their rank. In addition, if a patient asks a hospital staffer to call an attending doctor, they must do so.

Have Someone Stay Overnight With You

In another case, RD’s Alexander writes about Melinda Henneberger, who was in the UCLA Medical Center intensive care unit in Los Angeles, recovering after a 12-hour breast cancer operation.

Nauseated from the morphine drip, she could not stop vomiting and at times, felt like she was choking. Although thirsty, she couldn’t keep fluids down. A friend of hers’ stayed at her bedside overnight and fed Melinda ice chips. When Melinda felt like she was choking, her friend would hold her in an upright position. When Melinda pushed the call button, nurses either came late or not at all. “If I had been on my own and choking, I’m not sure how I would have made it through the night,” Melinda said.

Henneberger thought the staff was undersized. during the night, she heard patients yelling from their beds, their calls seemingly unheeded.

Alexander cited a HealthGrades study that showed 248,000 patient deaths in hospitals over a 3-year period were preventable. The author said skeleton crews dominate the night shift at hospitals. At the same time, top surgeons and other specialists have long since gone when nighttime approaches. Staffers with seniority, or experience, are apt to work the day shift. New employees or those with little experience usually begin their hospital tenure on the night shift.

Among hospital staffs, administered care depends on which nurse answers the call alarm. Like in any profession, it’s about individual work ethic.

A patient who underwent spinal fusion surgery earlier in the day not only spilled a container of water on himself, but wet through his hospital gown and bed sheets at a Northern Virginia hospital in February 2006. After thumbing the call button at 2 in the morning, a nurse appeared. When the patient said he needed a clean gown and sheets, the nurse nodded and said she’d be back.

Upon returning, she dropped the linens on the foot of the bed saying, “Here they are” and walked out the door, never pausing to offer assistance. It took one more patient call on the alarm to get her to return. While she dressed the patient and changed the linens, she never spoke to the patient, who stood against the bed, gripping the IV table, barely able to keep his balance.

Research Hospitals Online

RD’s Alexander offered this tip when planning a hospital visit: compare hospitals in your state at the U.S. Department of Health and Human Services website hospitalcompare.hhs.gov or research hospital services at healthgrades.com.

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