[ccm-l] Never 27 Law Watch

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Wait a minute.......
 
I just got around to reading the attached document, and let me offer a
devil's advocate defense. I agree with Dr Mattox that we (the medical
profession) should have done this, and it is a shame that it needs to be
addressed legislatively, but does that make it bad?  We failed to address
the issue of patient safety and the state stepped in. It is not the CMA's
fault.
 
The reporting of sentinel events such as wrong-site surgery to the JCAHO on
a voluntary basis has been a dismal failure. If one looks at the record of
disciplinary action by state boards of medicine one would think that bad
medicine is never practiced. 
 
Look at the list of 27 items. Certainly, one could argue that some should
not make the list, but would anyone argue that the Department of Health
shouldn't track wrong-site surgery (1A), wrong patient surgery (1B),
retained foreign body (1D),  death from a contaminated drug or device (2A),
discharge of an infant to the wrong person (3A), patient suicide (3C), death
from medication error (4A) etc, etc? The DOH is in the business of licensing
health care facilities. I don't find it unreasonable that we must report to
them and they conduct investigation of events considered potentially
egregious deviations from standards. Certainly this seems more reasonable
than requirements elswhere, such as in PA, requiring reporting of surgical
wound infections. 
 
Parts of the document are vague (e.g. what is the defintion of "serious
injury"), and some of the reporting is gratuitous (e.g. stage 3 and 4
decubiti) but on the whole, I don't see this as harassment. Do you think
that a hospital should be left to deal with a patient abduction (6B) without
oversight?
 

Jeffrey Hammond MD, MPH
Chief, Trauma/Surgical Critical Care
Robert Wood Johnson Medical School
New Brunswick, NJ
ph: 732-235-7920
e-mail: hammond at umdnj.edu
  

 

  _____  

From: ccm-l-bounces at ccm-l.org [mailto:ccm-l-bounces at ccm-l.org] On Behalf Of
KMATTOX at aol.com
Sent: Wednesday, February 28, 2007 9:22 PM
To: Heidi.Hotz at cshs.org; trauma-list at trauma.org; ccm-l at ccm-l.org
Subject: [ccm-l] Never 27 Law Watch


Heidi Hotz of Los Angeles has shared with us the attached California
Statute.   It creates a list of 28 ADVERSE EVENTS occurring in a hospital
setting, which must be reported to the STATE HEALTH DEPARTMENT and then a
required on site (?Manditory) review and judgment evaluation by a regulatory
and reimbursement team.    
 
Regulatory harressment from the Regulatory Industrial Complex.   Society,
patients, families, hospitals, and health workers will NOT be better served
by this bill for a long list of reasons.  However, consumerism in health
care is now with us, and we must accept that this is only one of many such
regulations to come.   
 
Such laws are being passed because we did not police ourselves internally,
as did the airline industry.  We needed to have an attitude of ZERO
tolerance.   How many of our hospitals have patients who develop nosocomial
bed sores (not present on admission) ?   How many doses of medication are
given with the wrong drug, wrong dose, wrong time, wrong patient, etc.
One only has to be a patient or have a family member that is a patient to
recognize that the system is BROKEN.  
 
However, it is not just lack of attention to detail by the doctors and
nurses, it is our SYSTEM which is at fault, including the restrictive and
demeaning regulations, paper work, work hour restrictions, etc.     Nurses
cannot be nurses anymore because they are busy just keeping compliance
records and assuring numbers for the regulators and JCAHO.    Then there are
laws about nurse patient ratios which are impossible to fulfill because of
the number of total nurses available and the low number in the que.    
 
I am very saddened by this California Law and would hope that the California
Medical Association, California Hospital Association, California Trial
Lawyers Association, etc. could join together to repeal this law.   It is
not in the best interest of quality patient care.     
 
But.........look for the name of your hospital and your name on the front
page of the Los Angeles Times.   
 
Thank you ACLU for helping pass this law.  



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