Medical Malpractice “Never” Events Like Sepsis and Repeat Surgery

Andrew NeuwirthAsk Andy Podcast

This episode addresses my views as a medical malpractice attorney dealing with “never” events.


[00:00:07] Good morning, you’re welcome to Ask Andy. This is a daily podcast about personal injury practice in Philadelphia, Pennsylvania. I’m Andrew Neuwirth. You can reach me at So I wanted to once again talk to you for this week about medical malpractice. The numbers about the existence of medical malpractice as a cause of death of Americans are frankly astonishing. The most recent figures I’ve seen is that medical errors are the cause, the third leading cause of death of Americans behind like smoking and heart disease. All right. So we’re a big, fat country and we smoke too much sometimes. But at Med Mal, you know, we’re supposed to be the leading light, the best place to get health care in the world and we are killing our own people with errors. Now I say this take this with some sort of a grain of salt. My wife is a physician. I believe that most physicians are good at what they do and caring and all that stuff they are, you know, among the last sort of respected members of society. So however, there’s just a lot. It just seems like there’s a lot of bad out there and there’s, you know, explanations for it. Sometimes they’re just bad providers who commit malpractice over and over again. That’s been demonstrated in a bunch of studies in the Northeast. Sometimes transitions from one specialist to another, like if you go from the E.R. to the floors or you’re discharged and then you come back. Some of those transitions are problematic, and there’s a lot of nursing home neglect that, in my view, you know, is the result, you know, not of a physician doing something wrong, but rather, you know, a hedge fund or some other large corporation trying to make money off of your mom or dad.

[00:02:15] And if you try and make money, what’s the first thing you need to do? You need to cut employees. And if you cut employees, if you can’t cut any more employees, what do you need to do? You cut the amount they’re being paid. So then what’s the nursing home doing? They’re finding the cheapest people they can pay and have the fewest of them and overwork them to the point where, you know, it’s not surprising when someone gets crappy care, someone gets dropped and breaks a hip or breaks a knee and or someone dies from dehydration or other diseases that you know are thoroughly preventable. So, you know, there’s a fair amount of nursing home negligence that probably bumps up the deaths from medical malpractice numbers now. I think it’s kind of disturbing to hear that it might make you afraid of going for health care in America, but I don’t think that’s a reasonable conclusion. I just think that there’s, you know, needs to be a consciousness among people that you’ve got to be diligent about, you know, your loved one’s health care. If they’re getting treated, you know, you don’t want to be a pain in the ass, maybe. But at the same time, like you’ve got to be aware of what’s going on and what your medical history is.

[00:03:39] And, you know, be responsible. If a doctor tells you to go to physical therapy, you’ve got to go. If the doctor tells you to stop taking your blood thinner, you’ve got to do that, you know, with that being said. You know, my wife treats a lot of very sick people who are diagnosed with cancer or, you know, being treated for cancer. And there are a lot of people who, you know, modern medicine just can’t, just can’t save. And that’s not a failing of medicine. That’s not malpractice. It’s just, you know, everyone’s going to die of something. And there are just a lot of diseases that we don’t really have a good handle on. We’ve made a lot of developments, you know, in treating cancer particularly. But you know, right now we’re in the middle of sort of multiple flu epidemics and coronavirus. This and you know, is there stuff to worry about? Yes. Are you going to get good care at most hospitals and most Doctors’ offices? Absolutely. But you know what is? What’s there to do? There are certain things that should never happen. So one of them is, you know, for the most part, you should not bounce back in the lingo. You should not have to return to an ER after you’ve been discharged for the same condition. So let’s say you go to the ER, you’ve got terrible back pain. They discharge you saying you’ve got terrible back pain. Go see your doctor. And then all of a sudden, you know you’ve got numbness in your feet or you can’t go to the bathroom.

[00:05:10] Now, would that be significant to you? Might or might not. It should be. But whether it’s significant to your non doctor or your non-lawyer, I don’t know. But that’s certainly a sign that you better get your ass back to the doctor, to the ER right away. Forget about the doctor. That’s one of these. Don’t stop go things because it means that you’ve got pressure on your spine that is affecting your nerves and may be leading to paralysis. So that’s one of those things like if you’re discharged from the ER and you have to go back within, let’s say, 24 hours, it means the ER screwed up. Now maybe they can fix everything and you’ll walk out the door and be fine and happy. But if not, it’s a red flag. It’s a sign that something’s wrong. What other ones? Well, air embolism. What’s an air embolism? It means if you’re getting dialysis or your sister’s getting dialysis or your mom is getting dialysis and the machine pumps air into your body, your body’s blood stream is not supposed to have air in it. It acts like a clot. It causes strokes and death. All right. So if you have a death shortly after dialysis or at some point after dialysis, you’ve got to look at that. Medicare, who are the ultimate payers for people on dialysis, say this should never happen. What else is? You know, what else are never events? You know, Medicare says they’re never going to pay for IV infiltration.

[00:06:38] That’s not going to be a medical malpractice case for the most part, except in one sort of semi unique circumstance. What’s an IV infiltrate? An I.V. infiltrate is when the hospital usually leaves your IV in too long. An IV is, you know, just a catheter. It’s like a, you know, tube into your blood vessel. It provides medication, it’s antibiotics or fluid. But if they don’t change them regularly, they get infected. So they’re supposed to rotate them from arm to arm, from leg to leg, et cetera. But you’re supposed to do it every six hours or eight hours. I don’t know the exact numbers, but if you don’t do it and they get infected, what happens? Well, you’ve got a line right into your vein at that point. So if you’ve got an IV infiltrate and you’re not the healthiest of bears, let’s say you’re 65 year old person with diabetes. You know, the hospital basically without you realizing it just caused you to have a blood borne infection. Now, blood borne infection is much more dangerous than your topical. Oh, I’ve got a scratch and it gets red, OK, scratch and red. You can fix that pretty quickly. Blood borne infection often is called bacteremia means you have bacteria in your bloodstream. It causes, you know, your white blood cell count to go through the roof and in older people or in compromised people, or sometimes even in younger people who’ve had surgery and aren’t moving a lot. What do you get? You get something called sepsis.

[00:08:07] Sepsis is a serious blood borne infection that can cause death and often does. And modern medicine, you know, has spent a lot of time researching trying to figure out drugs to to treat sepsis. But once you got sepsis, you’re, you know, in a lot of you’re in a lot of trouble and you’re in serious medical condition. So that’s why we worry about small things like I.V. infiltrates that might not seem like a big deal, but Medicare has said this should never happen in the absence of negligence. So, all right, so you got I.V. infiltrates, you got air embolisms, you’ve got bouncing back to the E.R. Most surgeons will not take you back or not take a patient back to the operating room, you know, within 24 hours, much less within 30 days, because they get dinged on their hospital record. You know for that because it basically is an admission that they screwed up the surgery or something went wrong during the surgery. Does that mean you died as a result? No. But at the same time, you know, it’s it’s an indicia or indicator that something is wrong. So that’s enough on medical malpractice for today. Those are some examples of, you know, cases that might develop into an actual lawsuit. That being said, you know, once again, most doctors are good. Most doctors believe that they are doing the right thing, and most of them are doing great work. So that’s enough for today. I’m Ask Andy, I hold people accountable. Have a great weekend.