 | |
| |
| |
| |
| |
| |
| |
| |
| |
|
SB 149 by Figueroa (the physician's friend) stated "that if a peer review body knew or should have known that it was required to file an 805 report that involved circumstances in which a patient was injured, fails to file the required 805 report and a physician and surgeon who should have been the subject of the report causes harm to a subsequent patient as a consequence of acts substantially similar to acts that occurred previously that should have required the filing of an 805 report, the peer review body shall be liable for the injuries and damages caused by that physician and surgeon of the subsequent patient." (underline added). The underlined section was removed thanks to pressure by the Union of American Physicians and organized medicine. If it had passed if a doctor had an bad result, was peer reviewed and no action was necessary or taken then the physician causes harm to another, the original peer review committee in retrospect may have been judged liable and need to pay damages. Remember hospitals can and do sue physicians for damages if they believe the peer review committee subjected them to fines or litigation due to the hospital's perception of inadequate peer review. Figueroa's last missive SB150 has been defused, but not killed. Those of you in her district, do something. Top
The Commission has released a report to the hospitals
regarding a potential significant problem, neonatal kernicterus. The JCAHO
stated that hospitals need to be careful not to send infants home too early,
especially those who are born several weeks premature. Their recommendations are
to evaluate all newborns for jaundice, education of parents and medical
follow-ups within two days after they are sent home. These common sense
recommendations are good but one should realize there is only a tiny fraction of babies that
have significant jaundice. A home visit by a nurse competent in perinatal
nursing should be all that is necessary.
The Commission realizes it is over burdensome to institutions and is in the
process of rewrite many of the rules. They are hampered by the requirement
of a deemed status of HCFA in what they can or cannot do. They also will not
change or rework any of the recent rules on restraint, safety or pain.
They are looking to reduce the amount of documents one must show that they have
complied with standards. It is a shame they will not re-look at the
patient safety standard which is wrongly written requiring a medical staff to
make a governing board put things in their bylaws and imposing the hospital in
the individual physician patient relationship. I still recommend that
physicians not follow the JCAHO recommendation of telling patients if there has
been substandard care. I have no idea what the wording means and neither
does the hospital or JCAHO. Top
Reusing One Time Use Items, FDA Stance
The FDA has sent a letter to all hospital administrators and
risk managers stating that if they reuse items they need to meet the same
regulatory requirements as the original manufacturer. There are seven
requirements including registration with the FDA and listing of all reprocessed
devices. The web site is www.fda.gov/cdrh/reuse/042301_reuse.html
Top
In Bakersfield, California the County Board of supervisors requested local health officials to end distribution of emergency contraception in the county clinics. The California Family Health Council, that distributes the money, stated that the Board has not stated any good reasons why a waiver to the federal rule requiring emergency contraception should be granted. In all of 2000 only 643 pills were distributed and very few to teens. If the Council eventually formally rejects the waiver the controversy may go the HHS and serve as a springboard to limit family planning. Top
Massachusetts is considering joining Mississippi in a rule to inform all women getting information on abortion to be informed of a greater than normal risk of developing breast cancer. This is in spite of the fact that the American Cancer Society and the National Cancer Institute have not agreed that there is any relationship between the two conditions. The studies to date have at the most shown a small percentage increase in risk while others have shown no increase in either induced or spontaneous abortion. Two equally liberal states thinking alike. Top
The FDA has issued a warning regarding the use of two endovascular stents. The Guidant Ancure System stent may have severe vessel damage on deployment. The Medtronic AneuRx System may cause aneurysm rupture and other adverse events. They recommend that those using the stents stay informed of all manufacturer warnings and instructions and that all patients are carefully followed with imaging. If patients are not likely to follow-up they may not be candidates for the graft placement. Top
The Office of the Inspector General (OIG) has issued a private advisory opinion authorizing a physician recruitment. The opinion may be found on the OIG site and is document 01-4. In the facts a underserved area hospital is paying a physician a loan at prime plus 1% during the five years of an ENT residency. The physician would agree to practice in the underserved area after the residency program. The loan would be forgiven over a three year period. The opinion is only for the one hospital and physician but may give ideas to others attempting to lure physicians to their underserved area. Top
I have recently joined a HIPAA LISTSERV dealing with all aspects of the legislation. I am not a techie so I will not comment of the firewalls etc. I will comment on the Privacy aspects. I hope that all you watch closely your people in charge of writing these institutional rules. From what I've seen they are very focused on the technical aspects and are forgetting about the care of the patient. If you have clinics outside the main institution and the records are kept in the main institution some are saying no records go to the clinic. This is dangerous and may amount to malpractice if an error is made because of lack of the medical record. Also, if you utilize patient reminders for appointments they are saying they might be problem. They may be right for open postcards but letters may be a more expensive way to make sure patient care is not compromised. Physicians have a duty in some cases to make sure care is continuous. Please be aware of what is happening in your institution and how it may impact the quality of care. I will be doing an article on the privacy aspect as it currently exists in the near future. Top
Alabama is the latest state to pass and have the Governor sign a prompt pay law. The law states that insurers have 30 days to tell electronic filers and 45 days for paper claims that their claim is not clean. Top
DISCLAIMER: Although this article is updated periodically, it reflects the author's point of view at the time of publication. Nothing in this article constitutes legal advice. Readers should consult with their own legal counsel before acting on any of the information presented.