California investigators have called for changes in the emergency departments at UC San Diego's two hospitals, after one elderly patient hanged herself at Thornton Hospital and another suffered cardiac arrest after being forceably removed from UCSD Medical Center. The state Department of Public Health, which also investigates on behalf of the federal Centers for Medicare and Medicaid Services, issued a 62-page "Statement of Deficiencies" to UCSD. The university submitted a correction plan late Thursday. State and federal officials will review the plan and decide whether it's adequate. The probe has delayed the launch of UCSD's $227 million Sulpizio Family Cardiovascular Center next to Thornton Hospital in La Jolla. UCSD had planned to open that facility April 4 but state health officials said they won't approve any new services at UCSD until the emergency departments are fixed.
The most common hospital-contracted malady among older patients in Houston is systemic vascular infections, a problem often caused by unsanitary or improper procedures during their hospital stay, a new study of Medicare claims shows. Among 46 hospitals within a 50-mile radius of the city of Houston, half reported vascular infections in Medicare patients through catheters, the tubing used for various procedures. A total of 472 "hospital-acquired conditions" were reported from the 234,200 Medicare discharges from October 2008 through June 2010. That's two incidents per 1,000 Medicare discharges in Houston.
Allowing the public to see information about mishaps and errors that occur during a patient's hospital stay has been a contentious issue for hospital personnel, who believe the public could misread it. To date, there's no universal ranking system for the public to determine the safety of the nation's hospitals.
Several medical experts have disputed the basis for a Las Vegas hospital's claim that patients benefited when cardiologists there switched to heart devices made by a company that paid it consulting fees, saying data to support that claim did not exist. This month, University Medical Center of Southern Nevada said in a statement, "results to date show significantly improved outcomes for our cardiac patients" who got heart implants made by a little-known company, Biotronik. The statement was attributed to Kathleen Silver, the CEO of the hospital. Silver issued that statement after an article in The New York Times reported that cardiologists there switched in 2008 to using Biotronik devices after that company started paying them thousands of dollars in consulting fees. A hospital spokeswoman later said in response to a reporter's question that Silver's comments were based on data drawn from a national registry of heart patients who received an implanted defibrillator. University Medical Center also provided The Times with limited data from that registry that it said backed its contention.
Military personnel who suffer traumatic brain injury need to be fed adequately and immediately to reduce the severity of trauma and improve their chance of survival, according to a report by the Institute of Medicine, a finding that also has implications for people sustaining head injuries in other situations, such as sports and traffic accidents. The report, commissioned by the U.S. Defense Department and released Wednesday, recommends that in the first 24 hours after head trauma, patients need to receive at least 50% of their typical calorie intake, including a higher-than-normal amount of protein, in order to reduce inflammation and swelling of the brain and provide enough energy to help the brain repair itself. The intensive nutrition regimen should be continued for at least two weeks, the report says.
Early last year, four Delaware patients needed emergency heart-related procedures only days after Blue Cross Blue Shield of Delaware refused to pay for a nuclear cardiac stress test to measure blood flow to the heart, according to results of a state investigation. But the final outcome is known for only one of those patients—Michael Fields, the 46-year-old Maryland man whose story of successful emergency bypass surgery reported in The News Journal in March 2010 triggered state and federal investigations of preauthorization denials by insurers. A legislator in Dover is now pressing to know what happened to the other three patients. "There's a part of this report that's missing," said Rep. Danny Short, R-Seaford. "Did the patients get the treatment they needed? Did they survive? Are they back at work? Let's get personal on this and find out truly what the outcome was." Citing patient privacy, BCBSD would not comment on the outcomes of the four patients who ended up hospitalized after a preauthorization for the critical test was denied.
Patients with Do Not Resuscitate orders are more than twice as likely to die within 30 days of surgery as those without the orders, according to a new study at Yale. The study, led by Hadiza Kazaure, an associate professor of surgery at Yale University School of Medicine, compared the surgical outcomes of 4,128 adult patients with Do Not Resuscitate orders and 4,128 without DNR orders. The two groups were matched for age and types of surgical procedures. The data were collected from more than 120 hospitals between 2005 and 2008. The average age of the subjects was 79. Most were white women. Of the patients with Do Not Resuscitate orders, 23.1% died within 30 days of surgery, compared with 8.4% of the patients without the orders.