Your Hospital Can be Hazardous to Your Health

The landscape of the modern medical system at first can seem quite picturesque. American hospitals are capable of great feats: saving lives, curing disease, and inventing new procedures. These successes rise like mountains in the sky, focusing attention on the positive peaks in our hospital system. But that pretty picture also has deep dark valleys. These valleys are made up of preventable mistakes that cause almost 100,000 American hospital deaths each year.

Preventable hospital mistakes range from U.S. surgeons operating on the wrong person or body part, happening as much as 40 times per week, to a hospital staff member's failure to properly disinfect a room or wash his hands. Modern medicine is becoming increasingly complex with thousands of diagnosis and drugs, but the simplest precautions to ensure the safety of patients are being overlooked. Recently some hospitals have greatly reduced infections and injuries by using simple tools such as checklists and training, yet others keep using a failing system that remains unchecked.

Amid the growing concerns about hospital infections and the continuing concerns about the rise in drug-resistant bacteria, health care worker's clothing are getting more attention. While there is extensive research on the benefits of hand washing and equipment sterilization in hospitals, little is known about the role that ties, white coats, long sleeves and soiled scrubs play in the spread of bacteria. In 2008 the British National Health Service imposed a "bare below the elbows" rule barring doctors from wearing ties and long sleeves, both of which are known to accumulate germs as doctors move from patient to patient. Currently, there are no such rules in US hospitals. Regarding scrubs, most hospitals in the US encourage medical workers to change out of soiled scrubs before leaving, but enforcement can be lax. It is not uncommon to see medical professionals and aids traveling on public transportation to and from their hospitals in scrubs where they become a magnet for bacteria. A study at a Connecticut hospital sought to gauge the role that clothing plays in the spread of methicillin-resistant Staphylococcus aureus (MRSA). The study found that if a worker entered a room where the patient had MRSA, the bacteria would end up on the clothing 70% of the time, even if the worker had not touched the patient.

Recent studies suggest that the real risks for hospitalized patients may be a well kept secret. A January report on Medicare patients found that 86 percent of injuries to patients are not even reported by hospital staff. If errors are not disclosed then there is little hope that they can be corrected. This same study showed that one in seven Medicare patients died or suffered serious or long term injuries resulting from poor hospital care. Nearly 44 percent of these problems were found to be preventable.

These mistakes are not only costing lives but tipping the scales in an already shaky economic balancing act. The total national costs of the lost income, lost household production, disability and healthcare costs of preventable hospital mistakes are estimated to be between seventeen and twenty nine billion dollars.

Shedding light onto the problem of preventable hospital errors may be the quickest solution to a growing problem. Twenty nine states now require public reporting of hospital infection rates. At least twenty eight states are requiring reporting on medical errors. Since 1998 NY has in place a system for reporting and tracking adverse medical events in hospitals. An adverse result is considered to be an "unintended adverse and undesirable development in an individual patient's condition that was not caused by the natural course of illness, disease or proper treatment." However, it is essentially a voluntary reporting program with little consistence among reporting facilities. Medicare now restricts payments to hospitals for costs associated with ten hospital acquired ailments and plans to give extra funding to hospitals scoring highest on a set of standards linked to better patient results.

New York hospitals also have farther to go in reducing hospital-acquired infections. The U.S. Agency for Healthcare Research and Quality Reports nearly 1.7 million hospital-acquired infections occur annually, leading to approximately 99,000 deaths a year. At any one point in time one in every 20 hospital patients in the United States has a hospital-acquired infection.

According to the 2010 Agency for Healthcare Research and Quality (AHRQ) hospital quality performance report, New York did "worse than average" on two infection indicators, "postoperative sepsis per 1,000 elective surgery discharges" and "selected infections due to medical care per 1,000 discharges." The Consumer Reports hospital patient safety rankings released in 2012 also found that New York's hospitals do poorly on infection prevention. New York was 16% worse than the nation in cardiac surgery infections and 21% less in bloodstream infections. According to Consumer Reports, after bloodstream infections, surgical site infections are the common hospital-acquired infection.

In a Nationwide study published by Consumer Reports in its August 2012 edition many of the major hospitals were rated based upon four criteria:

  1. Infections: reflecting the hospital's success in avoiding infections from central-line catheters used in ICU and/or infections after cesarean section, hernia repair, hi or knee replacement, hysterectomy, spinal fusion, coronary bypass, colon, or gall bladder surgery.
  2. Re-admissions: the chance that a patient who has had a heart attack, heart failure or pneumonia will have to be readmitted within 30 days of his discharge.
  3. Communications: how clearly staff explains new medications and discharge planning to patients.
  4. Scanning: reflecting the percentage of chest and/or abdominal CT scans that are ordered twice for the same patient, once with contrast and the once without contrast.

Here are how some of the hospitals in New York City did on the study (perfect score being 100):

1. NYU Langone Medical Center with a better than average mortality rate 56

2. Peninsula Hospital in Far Rockaway with a worse than average mortality rate 52

3. Richmond University Medical Center on Staten Island 50

4. Staten Island University Hospital 44

5. Maimonides Medical Center 43

6. Jamaica Hospital Medical Center 42

7. St. Barnabas Hospital in the Bronx 42

8. Lutheran Medical Center in Brooklyn 42

9. SUNY Downstate Medical Center in Brooklyn 42

10. New York Hospital Queens with a worse than average mortality rate 41

11. New York Westchester Square Medical Center in the Bronx with a worse than average mortality rate 40

12. Bellevue Hospital 40

13. Brooklyn Hospital Center 40

14. St Lukes Roosevelt Hospital Center 39

15. Lincoln Hospital in the Bronx 39

16. Queens Hospital Center in Jamaica 38

17. NY Downtown Hospital with a worse than average mortality rate 37

18. Lenox Hill Hospital with complications worse than average 36

19. Montefiore Medical Center Bronx with a worse than average mortality rate 36

20. New York Methodist Hospital Brooklyn with a worse than average mortality rate 36

21. Flushing Hospital with a worse than average mortality rate 36

22. St John's Episcopal Far Rockaway with a worse than average mortality rate 35

23. NY Community Hospital Brooklyn with a worse than average mortality rate 34

24. Kingsbrook Jewish Medical Center 34

25. Beth Israel Medical Center 32

26. NY-Presbyterian Hospital 32

27. Forest Hills Hospital with a worse than average mortality rate 32

28. Wyckoff Heights Hospital with a worse than average mortality rate 31

29. Brookdale Hospital Brooklyn with a worse than average mortality rate 31

30. Woodhull Medical Center 30

31. Coney Island Hospital 30

32. Mt Sinai Hospital with a complication and mortality rate worse than average 30

33. Jacobi Medical Center Bronx 27

34. Bronx Lebanon 26

35. Kings County Hospital 22

36. Harlem Hospital Center 20

Veterans and children's hospitals were not included in the survey as government regulations do not require that they participate in a survey of patients that Consumer Reports used to determine the ratings for the communication category. Specialized hospitals like Hospital for Special Surgery in Manhattan were not included as they did not treat patients with the conditions used in the readmission criteria used in this study.

In short, the most highly rated hospital in New York City, NYU Langone Medical Center only scored a 56%. Not a happy thought. Worse yet is that the Hospitals owned by the City's Health and Hospital Corporation which services the poorest residents scored the lowest ratings, with Harlem hospital scoring the second lowest in all of the hospitals surveyed in 11 states.

Until the landscape of medical care is changed, patients must take steps to protect themselves. Bringing a friend or relative to keep a watchful eye and being diligent in communicating all medications and concerns to the hospital staff are simple ways to prevent harmful mistakes.

If you or someone you love has been injured or harmed by medical negligence, contact an experienced New York medical malpractice attorney. A lawyer knowledgeable on medical malpractice claims can provide you with the information necessary to protect your rights.

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