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The new needlestick law is now valid but will not be enforced until July 18, 2001. All will need to keep a log of all injuries caused by contaminated sharps. The law also requires the consideration of the new safe needles which OSHA states is the best strategy for worker protection. Top
San Francisco Supervisor Ammiano has urged state Attorney General Lockyer to block the merger of St. Luke's Hospital and Sutter. Ammiano stated that the merger would decrease the city's unfunded charity care performed by St. Luke's. Lockyer's office stated that the decision will not come for months. One can only hope that Lockyer realizes that without the merger there will be no St. Luke's and a 100% decrease in charity care. Also, he must look at the source of the request.
The same San Francisco members have voted to allow tax money to be used for sex change surgery for five-year employees. See prior months story. Top
President Bush has allowed the FTC to continue its investigation to determine whether or not drug companies conspired to not release cheaper generic drugs. About 90 drug companies will be subpoenaed. Top
In a sentinel event that will need a root cause analysis Washoe Medical Center in Reno had a baby abduction but did not call the police for over an hour after the discovery of the incident. A woman posing as a nurse abducted the baby and was found soon after in another hospital. She had pretended for ten months to be pregnant. The mother thought the woman was a hospital nurse and the nurses assumed she was a family member. The hospital has implemented measures to prevent future problems. They have a person checking all visitors as they arrive. They have added security cameras, already in the rest of the hospital, in the maternal wing. They had in place an alarm system that was to go off if the child went beyond a certain point. It did not go off and the arm band was found in a stairwell. Yes, it is rare but it can happen at your facility, so take care.
In another root cause investigation Denver's St. Joseph Hospital is being investigated for reusing instruments on six patients after doing surgery on a patient with Creutzfeldt-Jacob Disease. The hospital did not know what was wrong with her when they operated. The hospital has a policy of not using the same instruments again until they are sure the patient does not have CJD. If the patient does have CJD the instruments are destroyed. This did not happen.
In an interesting merger the JCAHO, AMA and the NCQA have
combined to publish a coordinated performance measurement for the management of
diabetes. The measures are HbA1c, lipids, urine protein, eye exams, foot
exams, influenza immunization, blood pressure and frequency of office
visits. The measurements may be seen at
www.ama-assn.org/ama/upload/mm/370/diabetes.pdf Top
The recently enacted HIPAA regulations may or may not allow access to peer review records. It will probably take a court challenge for the determination. If peer review records state patient identifying information they will probably be fair game since the individual has the right under Section 164.524(a) and 164.501 to copy any information that relates to the care of the identifiable individual. On the other hand peer review records are not used to make treatment decisions and therefore may not be a part of the "designated record set." It is advisable for all meetings including tumor board, department and case review not use patient names or other patient identifying information. Top
A LA Times editorial chastises the CMA for backing AB 1600. According to the Times the bill would allow doctors antitrust exemptions for arbitration on rate-setting. The Times feels this would increase the cost of medicine. The editorial goes on to state that the only organization that could handle the arbitration is the Department of Managed Care since "rent-a-judge" arbiters have no experience in the medical rate setting arena. The editorial is correct about costing more since California has the lowest capitation rates in the nation and the most IPA bankruptcies. More money is needed. Top
The Bush administration has proposed an Internet databank of medical errors. The bank would have no identifying features on any reports. Congress has been asked for $12 million to set up the bank. Top
PacifiCare has been release from Texas state oversight on late and underpayments. They had someone from the state looking over their shoulder for the past several months. To correct their problems they purchased a computer upgrade for $135 million. PacifiCare still has problems in California where it was fined $250,000 for late payments and the Feds are investigating possible overcharges under the False Claim Act.
In more from Fresno, there has been allowed a special open enrollment period for those government employees who were switched by PacifiCare from Matrix to another medical group. Top
MDs Want More Regulation
Some physicians are lobbying for a requirement that all patients be asked whether they own a gun. If the answer is yes they are to warn the patient of the dangers of handguns. I can see the plaintiff's attorney now going after the physician who did not document asking. 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.