New Mexico Injury Attorney Blog

Medication errors are a serious problem, and many of them involve preventable drug interactions. The Academy of Managed Care Pharmacy (AMCP) describes a specific preventable error as one that is "due to the lack of both adequate documentation and drug utilization review." In other words, physicians and pharmacists should be taking a close look at the drugs that patients are currently using to determine whether a dangerous drug combination might occur. If they don't, their failure to properly screen and monitor for harmful interactions could constitute medical malpractice exposing them to liability for the injuries and damages that result to the patient.

What is a Drug Interaction?

The Federal Drug Administration (FDA) defines a drug interaction as one of the following: an occurrence that can make other drugs less effective, can cause unexpected side effects, or can increase the action of a specific drug. The FDA explains that there are three kinds of drug interactions.

• Drug-Drug interactions happen when two or more drugs react with one another to cause an unexpected side effect. These interactions can occur with two prescription medications, over-the-counter and illegal drugs, or a mix of the two. For example, the FDA explains that taking a sedative with an antihistamine can cause a drug combination that leads to delayed motor responses. One recently growing proble is the issue of dangerous inteactions between other drugs (specificially opiates) and alcohol.


• Drug-Food/Beverage interactions happen when drugs react with food or beverages. For example, the FDA says that taking alcohol with certain drugs can dramatically slow your reaction time.


• Drug-Condition interactions happen when you have an existing medical condition that makes "certain drugs potentially harmful." For example, having high blood pressure can make certain medications very dangerous to you (and these are drugs that wouldn't otherwise be harmful to someone without high blood pressure).

Screening and Monitoring to Prevent Harmful Drug Combinations

One important method that health care professionals can use to monitor patients' potential drug interactions is an electronic health record (EHR) system. These systems do exactly what they sound like--they maintain a database for each patient's health record, and they perform other internal functions, too. According to HealthI, these systems can "track medication use, identify drug interactions, and provide better healthcare to patients."

Who uses these EHR systems? The American College of Physicians (ACP) explains that there are a number of types of EHR systems that medical facilities can choose from. Most importantly though, the ACP makes clear that the government is working to make sure that all health care providers are using EHR systems. In fact, "the government has imposed incentives and deadlines to implement EHR systems or face penalties." These incentives are available to medical professionals who "adopt, implement, upgrade or demonstrate meaningful use of certified EHR technology," according to the Centers for Medicare and Medicaid Services.

What are the Patient's Responsbilities?

According to the AMCP, healthcare professionals have a duty to make sure they've provided their patients with adequate education about potential drug interactions and warnings associated with certain prescriptions.

At the same time, some of the onus to prevent dangerous drug combinations is on the patient. When they're prescribed a medication, patients must be honest with their physicians and pharmacists about other drugs they're currently using to avoid harmful interactions. The AMCP explains that patients can act as "the final check system." In addition to being informed about potential drug interactions (and informing their health care providers), patients can also carry an up-to-date list of medications with them in case of an emergency.

But of course, errors still occur. In cases where medical professionals fail to monitor or to otherwise prevent a harmful drug interaction, they can be held accountable for this negligence. The Clinical Manual of Drug Interaction Principles for Medical Practice makes clear that physicians are responsible for a "failure to monitor drug levels with medications known to exhibit considerable drug-drug or drug-dietary interactions." And in some cases, even nurses and pharmacists have been named as co-defendants in medical malpractice claims.

Do Not Delay!

If you or a loved one have been harmed as a result of a drug interaction and you believe medical negligence is to blame, it is important to contact a medical malpractice attorney right away. There are important and strict deadlines in medical malpractice claims that when missed will bar your claims completely.

Related Reading:
Failure of Medical Provider to Properly Screen for Medications
Growing Dangers of Prescription Drug Abuse
Hospital Medication Errors More Common Than One Might Think

Collins & Collins, P.C.
Albuquerque Attorneys

Parrish Collins
Collins & Collins, P.C.
Phone: (505) 242-5958
Fax: (505) 242-5968

"Never Events" are a specific set of incidents that occur in a medical setting as a result of preventable errors or substandard care. These specific incidents are named in reference to the fact that they almost by definition the result of medical negligence. Following proper procedures, standards and protocols can eliminate them entirely.

Unfortunately, even though there is widespread acknowledgement that these mistakes should never occur, many investigations have found that these "never events" occur thousands of times each year.

Responding to the challenge of preventing never events, the American Association of Critical-Care Nurses (AACN) has developed "Practice Alerts" that provide evidence-based guidelines designed to sharply reduce specific never events. These Practice Alerts are best practices that should be implemented in the clinical setting to protect patients. The AACN also notes that, by protecting patients, nurses also will be protected from the trauma that may result from being involved in an avoidable medical error.

For example, following proper standards can prevent the never event known as ventilator-associated pneumonia (VAP). VAP refers to a lung infection which develops in a patient who is using a ventilator. This usually occurs when the tube used becomes infected with germs that enter the patient's lungs.

Ventilator-associated pneumonia is deadly, resulting in death in 20-40% of cases. For each 1000 ventilator days, there are between 10 and 35 VAP cases. The ACCN Practice Alert for ventilator-associated pneumonia identifies three key steps that critical care nurses should follow to prevent VAP. Each of these are supported by multiple clinical studies in a variety of patient populations and settings:

• Elevate the head of the bed by 30-45 degree. This simple, no-cost technique can make a dramatic difference in gastric reflux as well as VAP. Yet studies and literature show there is poor compliance with this recommendation.


• Use an endotracheal tube so that secretions can be continuously drained.


• Change ventilator circuits routinely based on duration of use.

The ACCN has also issued a Practice Alert for Oral Care in critically ill patients to prevent VAP. The goal is to prevent infections by improving oral care in patients at high risk of VAP by:

• Brushing teeth, gums, and tongue at least twice daily with a soft toothbrush.


• Providing oral moisture to the mouth and lips every two to four hours.


• Using a medical rinse twice daily during hospitalization, from admission to discharge.

It is always critical to have an individual assessment of situations where medical malpractice might have occurred leading to serious injury or wrongful death of a patient. However, when a never event occurs, like ventilator-associated pneumonia, there is a very significant chance that medical negligence was the cause. Failure to follow these clinical guidelines is likely evidence of malpractice.

Due to the many challenges and unique and critical deadlines associated with medical malpractice claims, where there is suspected medical negligence that has caused serious personal injury or wrongful death, it is important to contact an attorney experienced in medical malpractice claims as soon as possible.

Related Reading:
Misplaced Feeding Tubes - A "Never Event" in Medical Treatment
Hospital Medication Errors More Common Than One Might Think
Patient Advice of Risks and Consent Will Not Bar New Mexico Medical Malpractice Claims

Collins & Collins, P.C.
Albuquerque Attorneys

Medication errors occur more often than most of us would like to imagine, and many of them are preventable. In many cases, physicians and other health care professionals who closely monitor patients' medications can help to prevent those errors by ensuring that harmful drug interactions don't occur.

The term "drug interactions" can refer to many different types of interactions. These include:

• Drug-drug interactions, which occur when two or more drugs interact and cause unexpected side effects

• Drug-food/beverage interactions, which occur when drugs interact negatively with food or beverages

• Drug-condition interactions, which occur when a drug interacts negatively with an underlying health condition

Perhaps more significant than monitoring patients to prevent these harmful drug interactions, health care professionals can ensure that adverse drug reactions don't occur by screening patients for medications prior to prescribing additional medications.

If physicians and other health care professionals fail to screen patients for potential drug interactions, they could be liable for any damages sustained as a result. Sadly, it is not uncommon that these dangerous drug interactions lead to very serious injury or death.

What Does Proper Drug Screening Entail?

Proper drug screening is dependent on the circumstances and the patient. There may be issues and circumstances suggesting higher levels of drug screening. At a minimum, drug screening requires proper intake questionnaires and protocols to identify possible drug interaction risks.

Screening can range from a urine test or other drug abuse screening to a physician's/medical provider's duty to conduct an accurate medical history report for the patient. In certain patients, where the issue is clearly present or should be apparent, a drug abuse screening should be conducted for the detection of the presence of harmful drugs that could lead to harmful interactions with other prescription medications. One such situation is the growing issue of the dangerous interactions between benzodiazepines and opiates, alcohol or other drugs.

For example, the University of Iowa Health Care System provides a manual for its laboratory pathology department that explains how drug abuse screenings can prevent dangerous drug interactions. These screenings should test for the presence of amphetamines, benzodiazepines, cocaine, opiates, and oxycodone among others.

These tests can be very valuable because they can alert health care professionals to a number of drug abuse or misuse dangers including off-label use occurs. Off-label use refers to the use of prescription drugs in ways that haven't been approved by the Federal Drug Administration (FDA). These screenings can also detect illegal use of many of these prescription drugs.

It's important to know what drugs a patient is using. The concurrent use of opiates and benzodiazepines can have very serious and sometimes fatal consequences. Likewise, benzo use and alcohol is very dangerous. What this means at a minimum is that benzos should not be prescribed to a known alcoholic or opiate addict.

In addition to drug abuse screening, physicians should also be careful when constructing patients' medical history records. A report from the National Institute of Health indicates that there is typically a 20 percent error rate in patients' medical records. This means that future monitoring of patients' health and medical records, no matter how precise and thorough, can't prevent all errors. In this case, the careful construction of a patient medical record from the beginning of a physician-patient relationship is extremely important.

Careful screening can prevent a health care professional from unknowingly prescribing medications with known drug interactions. There are many such dangerous interactions and medical providers should be aware them and take necessary precautions to prevent them. The failure to do so with resulting serious injury or death to a patient may well constitute medical malpractice.

Related Reading:
The Many Dangers of Benzodiazepines
Hospital Medication Errors More Common Than One Might Think
Growing Dangers of Prescription Drug Abuse

Collins & Collins, P.C.
Albuquerque Attorneys

Benzodiazepines (often referred to simply as benzos) fall into the category of central nervous system depressants. They're typically used to treat anxiety and sleep disorders, but they can also be prescribed as sedatives and as anticonvulsants (to treat epilepsy), and as muscle relaxants. You've probably heard of some of the brand-name benzodiazepines. They include: Ativan (lorazepam), Klonopin (clonazepam), Xanax (alprazolam), and Valium (diazepam).

They're typically used to treat anxiety and sleep disorders, but they can also be prescribed as sedatives and as anticonvulsants (to treat epilepsy), and as muscle relaxants. Sometimes they are prescribed for off label uses. They are often abused. They are often used in dangerous combinations with alcohol or other drugs. They can be quite dangerous even when used as authorized by prescription. When abused or taken in unsafe manners, they are extremely dangerous.

The Controversial History of Benzodiazepines

In recent years, researchers have been cataloguing the dangers of benzodiazepines. One study reported in Psychology Today described efforts to get feedback from benzodiazepine users in America and Britain. This report came just after a 2010 warning from the Medical Research Council that Valium and Xanax can cause permanent brain damage. Surprisingly, this warning actually dates back to the 1970s, when the rise of benzodiazepine prescriptions began.

Have researchers known about links between brain damage and benzodiazepines for almost forty years? Beginning in the 1970s, "vast numbers of people" started taking benzodiazepines to treat stress and anxiety. Even at this time, certain physicians and researchers worried about the dangers of these drugs. In 1975, a physician from the University of Tennessee indicated that benzodiazepines might be responsible for memory loss, saying, "I am very convinced that Valium, Librium, and other drugs of that class cause damage to the brain . . . and I am beginning to wonder if that damage is permanent." Others echoed this finding, while also raising concerns about the addictive quality of the drugs along with other dangers.

Nonetheless, benzodiazepines were very popular for that decade and into the 1980s, until the use of "benzos," as they're called for short, waned in popularity with the rise of selective serotonin reuptake inhibitor (SSRI) antidepressants.

From the 1980s and into the 1990s, SSRI antidepressants such as Prozac, Zoloft, and Paxil gain prominence. During this time, several studies noted the dangers of benzodiazepines in comparison to the SSRI antidepressants, "including pronounced behavioral abnormalities and a serious risk of addiction." Despite these findings, the drug class had resurgence in the early 2000s.

Known Dangers of Benzodiazepines

As benzodiazepines gained renewed popularity in America and in the U.K. in the 2000s, researchers voiced continued concern about the drugs in relation to addiction. In a 2002 Discovery Channel documentary, a researcher from the London Institute of Psychiatry explained that, while physicians had a pretty good idea in the 1970s that benzodiazepines posed a danger of addiction, they didn't have sufficient findings to curb the drug's use.

At that time, they had assumed that "only addictive personalities could become dependent, and that true addiction was unusual." However, by the early 2000s, it was clear that "even people taking therapeutic doses" of benzodiazepines were at risk for addiction. With rising levels of addiction, other dangers became clear. Most notably, it is clear now that withdrawal from benzo use is highly dangerous, even more so that opiates such as heroin.

In addition, benzos pose a serious risk of overdose. Overdose can occur even with prescribed use. The risks of overdose increase dramatically when used in combination with alcohol or other drugs such as opiates. Unfortunately, this is far too common and often leads to severe injuries or death.

Possible Medical Negligence

The issue of medical negligence associated with benzo use most commonly come up in the context of withdrawal and overdose. In the case of withdrawal, a medical provider that fails to properly account for the dangers of withdrawal from benzos with resulting serious injury or death is almost by definition guilty of medical malpractice.

The same would hold true for doctors that prescribe benzos to patients known (or who the medical provider should have known) were likely to use the drugs in combination with alcohol or other dangerous drug combinations. Remarkably, there are mental health professionals who prescribe benzos knowing full well that their patient has alcohol and/or drug addiction issues. In fact, it may be that the patient is being treated for those very issues when he or she is prescribed benzos. Without proper precautions to protect the patient, this is inexcusable.

If you or a loved one has suffered serious injury or wrongful death in one of these contexts, then it is important to contact an experienced personal injury attorney right away.

Related Reading:
Criminal Penalties for Off-Label Drug Marketing: Will They Make a Difference?
Hospital Medication Errors More Common Than One Might Think
Growing Dangers of Prescription Drug Abuse

Collins & Collins, P.C.
Albuquerque Attorneys

"Never Events" are adverse medical incidents which are by definition caused by medical negligence. Included among these are misplaced feeding tubes. It is important for patients and their families to understand that when they are seriously injured by one of these never events, they likely have a medical malpractice claim against the medical provider(s).

There are many challenges to medical malpractice claims. There are also unique and critical deadlines on medical malpractice claims. As such, if you or a loved one has suffered serious personal injury or wrongful death as a result of one these events, it is important to contact a medical malpractice attorney right away.

Many different patient advocacy groups have sprung up in recent years to address the persistent problem of never events. For example, the American Association of Critical-Care Nurses (AACN) compiled a list of guidelines based on a wide-range of available evidence to help guide medical care professionals in eliminating these errors. Quite simply, these guidelines, known as "Practice Alerts," represent steps that should be followed 100% of the time in order to keep patients safe.

Consider one of the most common types of never events: misplaced feeding tubes. Many patients need to receive nutrients into their stomach via these tubes. For instance, some patients such as those with cancer or anyone having problems affecting the throat or mouth might requiring a feeding tube. When not inserted correctly, these tubes can cause serious problems.

When nurses are negligent in inserting the tube it may feed nutrients directly into the bloodstream. At other times the tube incorrectly may send material to the lungs, potentially leading to pneumonia. Tubes can also perforate the gastric system or even dislodge, causing leakage that leads to asphyxiation.

The problems arise much more frequently than is acceptable considering the rather routine nature of these procedures. One study reviewed more than 2,000 feeding tube insertions and found misplacements in 1.3 to 3.2 % of the insertions, and 28% of those misplacement resulted in pneumonia or pneumothorax.

Feeding tube errors can be prevented with adherence to proper safety protocols outlined by the AACN. The ACCN has issued a Practice Alert for verification of feeding tube placement. The Practice Alert prescribes a variety of bedside methods to be followed, such as observing for signs of respiratory distress. It also requires obtaining an x-ray to confirm that the tube was correctly placed before it is used. The guidelines calls for checking tube location every 4 hours after feedings begin.

Additionally, the Practice Alerts provide for staff training so that nurses and other professional staff follow the practices identified in the alerts consistently. The evidence shows that inter-professional teams, including nurses, doctors, and other professionals, are most effective in implementing the alerts. Hospitals and their administrators need to understand the importance of this training to keep patients safe.

Again, if you or a loved one has been negatively affected by a hospital-acquired health care problem, such as a misplaced feeding tube, you should contact an attorney right away for a review of your case. When a never event occurs, almost by definition, medical negligence will be to blame.

Related Reading:
Are Guns Safer than Hospitals?
Simple Surgical Checklist Can Save Patient Lives!
Hospital Medication Errors More Common Than One Might Think

Collins & Collins, P.C.
Albuquerque Attorneys

According to the White House's Office of National Drug Control Policy (ONDCP), prescription drug abuse has become an epidemic in America.

What is prescription drug abuse? The National Institute on Drug Abuse defines prescription drug abuse as "the use of a medication without a prescription, in a way other than prescribed, or for the experience or feelings elicited."

While the Centers for Disease Control (CDC) has noted an increase in the use of some illegal drugs such as cocaine, the majority of first-time drug users actually begin "by using a prescription drug non-medically." In fact, statistics show that treatment admissions, emergency room visits, and overdose deaths related to prescription painkillers have increased steadily across the past decade surpassing that of illegal drugs.

Who is Most Susceptible to Prescription Drug Abuse?

Specific data from the National Survey on Drug Use and Health (NSDUH) shows that teens are particularly susceptible to prescription drug abuse. They tend to believe that prescriptions drugs are safer to use than "illicit drugs," such as marijuana or cocaine, since they've been "prescribed by a healthcare professional" and "dispensed by a pharmacist."

But teens aren't the only ones who begin abusing prescription drugs. Older adults who take prescription drugs to relieve chronic pain can also abuse these substances. Frequently, these users never intended to become addicted to prescription painkillers, but after years of use, it can be hard to stop.

This "largely unrecognized epidemic" leads to more than 26,000 fatal overdoses per year, according to a report from the CDC. In fact, Robert DuPont, the former director of the National Institute on Drug Abuse, described prescription drug abuse as "the biggest and fastest-growing part of America's drug problem." While illegal narcotics such as heroin and cocaine used to have the highest rates of overdose and death, the fatalities associated with prescription painkillers have exceeded those of both heroin and cocaine.

What Kinds of Drugs Are Most Commonly Abused?

The National Institute on Drug Abuse, which seeks to provide "the science of drug abuse and addiction," provides a fact sheet for some of the most commonly abused prescription drugs. These include:

• Opioids, which are typically prescribed to treat pain


• Central nervous system depressant, typically used for treating anxiety and sleep disorders


• Stimulants, most often used to treat attention deficit hyperactivity disorder (ADHD)

Is Medical Negligence to Blame?

Many experts blame the rise in prescription drug abuse on medical professionals and pharmaceutical sales. According to the chair of anesthesiology at the University of North Carolina Hospital, there are ample supplies of prescription drugs available, and "they're relatively easy to get."

An addiction specialist at the same hospital indicated that physicians are more willing to prescribe the prescription painkillers described above than they were in previous decades. The same appears to hold true for the over-prescription of ADHD drugs.

There can be a fine line between legitimate and responsible prescription of medications to patients for pain, ADHD, sleep disorders and the like. However, there are some practices that are simply unacceptable and dangerous.

It will not always be easy to tell the difference. After all, doctors cannot be held responsible for every negligent or reckless act of their patients. On the other hand, when these propensities for abuse are or should be obvious to the doctor, then failure to take appropriate precautions to protect the patient is unacceptable and may give rise to a medical malpractice claim.

Do Not Delay!

If you or a loved one has been harmed by prescription drug abuse, it is important to speak to an attorney right away to help determine if medical negligence was to blame. Keep in mind that there are strict deadlines associated with medical malpractice claims. Missing a deadline will bar your claims completely.

Related Reading:
The High Costs of Medical Errors on the Healthcare System
Hospital Medication Errors More Common Than One Might Think
Medical Malpractice Claims Raise Unique Statute of Limitations Issues

Collins & Collins, P.C.
Albuquerque Attorneys

Many of us have loved ones in nursing homes. In addition to providing daily care, these facilities administer many different medications to their patients. Medication administration is a little different in nursing homes than in other settings since these facilities deal with live-in residents. In many ways, this makes it easier to ensure that patients aren't subjected to medication problems, but medication errors occur nonetheless.

Often, these mistakes pertain to inadequacies in medication monitoring, and according to the Medication Error Quality Initiative (MEQI), they're often preventable. When preventable medication errors do occur and a loved one suffers serious personal injuries or wrongful death, you should consult with an attorney to determine if you have a possible claim for nursing home negligence and/or medical malpractice.

How Do Medication Errors Affect Nursing Home Patients?

According to the MEQI, most of the errors that occur in nursing homes fall into two "less serious categories." In many cases, the medication errors did not reach the patient--in other words, the patient never took the medication. In other cases, the medication error did not harm the patient--in other words, the patient took the medication, but the error was not significant enough to cause an injury. In most nursing home cases, these two types of errors typically account for more than 90% of all medication mistakes.

However, some medication errors can cause serious injuries and even death, and it's important to know what leads to these kinds of mistakes.

What Causes These Errors?

For the majority of medication errors, the MEQI attributes them to human factors. These include basic human error, simple mistakes, forgetting, overlooking orders, carelessness, and lack of oversight. In these situations, the medication errors were preventable.

Similar to a hospital setting, a nursing home has medical personnel in various departments. These include physicians, nurses, pharmacists, and pharmacy technicians. In nursing homes, errors across these areas deal primarily with dose omission. This includes overdoses, under doses, forgotten doses, wrong doses, and extra doses. In fact, 75% of all reported nursing home medication errors related to dose omission.

According to the nonprofit group Nursing Home Families, the majority of fatal and serious medication errors from dosage omission concern "adverse consequences." This refers to situations in which a detail about the patient's medical condition, medical and prescription history along with other concurrent medications lead to an adverse reaction with a medication that they've been prescribed. An important factor to keep in mind is that many nursing home residents are more susceptible to adverse consequences from medication errors, since many of these elderly patients are already taking a number of other long-term medications.

How Can Medication Errors be Prevented?

While errors can occur in any of the medical departments associated with nursing homes, all areas are specifically tasked with the important act of monitoring. Monitoring includes continuous observation of patients to: 1) ascertain their responses to treatment, 2) detect complications or adverse consequences, and 3) support their decisions concerning modifying or discontinuing specific medication use.

The pharmacy department has a specific task, which is called a "medication regimen review." This should consist of a pharmacist's "thorough evaluation" of a patient's medication regimen in order to prevent, identify, report, and resolve any medication errors or other irregularities in the patient's treatment.

Since nursing home residents live at the facility where they receive medications and other care, there's a special burden on health-care providers to closely monitor each patient's medication record. When medication records are adequately monitored, studies show that dose omission and related adverse consequences significantly decrease.

Do Not Delay if a Loved One has Been Harmed by Nursing Home Medication Errors!

These cases can be complex and there are unique requirements and deadlines associated with these claims. If you or a loved one has been negatively affected by a nursing home medication error, it is advisable to immediately seek the assistance of an attorney experienced in nursing home negligence and medical malpractice claims to make sure that your rights are protected.

Related Reading:
Hospital Medication Errors More Common Than One Might Think
Are Guns Safer than Hospitals?
Nursing Home Abuse and Medication Issues

Collins & Collins, P.C.
Albuquerque Attorneys

Every year, over 30 million Americans are admitted to hospitals. While in the hospital, they are almost always prescribed medications intended to treat their condition. Unfortunately, due to medication errors, these medications will often do more harm than good due to medication errors.

However, medication errors in the hospital setting are rampant. It has been estimated that there is on average one medication error per patient per day. In fact, some reports have argued that nearly three out of four patients at some hospitals go home with either the wrong prescriptions or a very limited knowledge about the medications they're taking, which often leads to readmission and adverse drug reactions.

When medications errors occur in hospitals, they not compromise our confidence in the health-care system and increase our health-care costs. Most importantly, they jeopardize patient safety. In those cases where a medication error has led to serious injury or wrongful death, it is important to determine whether medical negligence was to blame.

Ripe Circumstances for Medication Error in Hospitals?

According to the American Society of Health-System Pharmacists (ASHP), in-patient hospital care is unique because of the "special collaborative processes" that occur in hospitals. Unlike other areas, hospitals see pharmacy and therapeutics committees working in conjunction with health-care providers. This "multidisciplinary" approach means that hospital medication errors can be committed by a variety of staff members, including pharmacists, nurses, pharmacy technicians, medical students, ward clerks, administrators, pharmaceutical manufacturers, and even patient caregivers.

Hospital medications are also unique in that they often take a variety of forms, including both oral and injectable products, radiopharmaceuticals, anesthetic gases, dialysis fluids, investigative drugs, drug samples, and even medicines that patients have brought into the hospital with them.

This means that errors may be committed in the prescription, administration and application of medication at every stage and level of the patient care process.

Common Medication Errors Occur in Hospitals

Due to the multifaceted nature of the hospital setting, the types of medication errors often are varied. They can include: prescribing errors, dispensing errors, medication administration errors, and patient compliance errors. When errors are "detected and corrected through intervention" from another healthcare provider before they can have adverse effects on patients, they're called "potential errors." These errors occur before they reach patients, so they don't lead to medical harm.

Hospital Medication Errors are Preventable

The ASHP favors a behind-the-scenes system for people who work in hospitals and deal with patient medications. It recommends that hospitals institute specific organizational systems for "ordering, dispensing, and administering medications" to limit any medication errors. Such a system would require that different hospital factions work together. They should be designed to reach across the many departments that exist in hospitals to encourage communication among pharmacists, health-care practitioners, and health-care administrators.

In addition there is a need to better educate patients. Often, patients only get a "quick drug rundown" from their nurse before being discharged, and as a result they don't understand how to effectively take the medication they've been prescribed. If a major problem with medication errors is "non-intentional non-adherence" on a patient's end, then hospital personnel need to educate patients about the medications they're taking, how to take them properly, and whether those medications can have any adverse reactions to other medications or lifestyles.

Know Your Rights

It's important to keep in mind that hospital medication errors are distinct because they involve many different professional departments, extending from physicians and nurses at the hospital, out to pharmaceutical manufacturers who provide samples for various forms of medications for in-patient use.

If you have been a victim of a hospital medication error, it is important to speak with an attorney experienced in medical malpractice to determine if and against whom you might have claim for medical malpractice.

Related Reading:
The Myth of the Frivolous Medical Malpractice Lawsuit
Are Guns Safer than Hospitals?
The High Costs of Medical Errors on the Healthcare System

Collins & Collins, P.C.
Albuquerque Attorneys

In New Mexico, a doctor may be liable in a medical malpractice lawsuit if the doctor failed to follow standard medical practices in discovering and treating a medical condition. Medical malpractice is the failure of a doctor to act within the normal standards of care for a doctor with the same medical experience and training. In other words, the doctor must act in the same manner as another doctor would act if provided with the same information about the patient.

Failure to Treat or Treat Adequately

A medical malpractice claim against a doctor for the failure to treat a medical condition, illness or injury can occur in many different scenarios. For example, if the patient has an infection or develops an infection while staying in the hospital and the doctor fails to treat the infection, serious harm can result.

There are a couple of possibilities. First, the doctor may have been aware of the infection (or other illness) or the risk of such illness and simply failed to treat. Second, the doctor may have failed to treat adequately. Finally, the doctor may simply overlook the symptoms and send the patient home or otherwise fail to treat the patient. This last possibility is more akin to a failure to diagnose. In any event, an untreated infection or other serious medical condition can cause severe damage and sometimes death.

Failure to Treat Not Always Malpractice

A failure to treat is not always malpractice. If the treating doctor acted in the same way that another doctor would act in her same situation and the treatment did not work, there is no medical negligence under the law and therefore no medical malpractice claim. There are many cases where the doctor or medical provider did everything reasonable under the circumstances and simply did not discover the condition.

However, doctors are required to keep up with advances in their respective fields. This means that they should if possible adhere to the current standards of care, not some obsolete version or practice. The failure of doctors to keep up with advances and treatment protocols is far too common sometimes with devastating consequences. The doctor cannot simply ignore medical advances in his or her field. To do so puts patients at unnecessary risks as is the very definition of medical negligence.

Expert Review Required

Generally, to win a medical malpractice claim, the injured patient must show that the doctor acted below the "standard of care" in the profession. In order to do this, the patient must hire an expert in the particular area of medicine to review the medical records associated with the care and provide an opinion that the doctor did not meet the standard of care.

The expert doctor must have comparable education and expertise in the same area of practice as the alleged negligent doctor. For example, if the doctor is a cardiologist, then the expert witness must also be a cardiologist. It is important to note that it is best to get an objective medical expert for the opinion. Medical malpractice claims are challenging and expensive so it is best to have a no nonsense evaluation up front rather than to learn it at trial.

As such, most experienced medical malpractice attorneys will get a rather thorough evaluation of the claim before accepting the case. Most of these evaluations come back negative meaning the expert does not believe there was an act of malpractice. Once the expert gives the opinion, in the absence of an indication that a second opinion is needed, the experienced medical malpractice lawyer contrary to popular myth will usually decline to pursue the case.

Do Not Delay!

Medical malpractice is a complicated area of law. There are a number of important deadlines and requirements associated with medical malpractice claims that are not required in other personal injury cases. As such, if you have suffered serious injuries and you believe they were caused by medical negligence, it is important to contact an attorney experienced in medical malpractice as soon as possible. Missing a deadline can bar your claim completely.

Related Reading:
Oxygen Deprivation at Birth: Cooling Blankets Becoming Standard Treatment
Failure to Diagnose Not Uncommon: Patients Must Protect Themselves!
Failure to Diagnose Medical Malpractice Claims: Not as Easy as One Might Think

Collins & Collins, P.C.
Albuquerque Attorneys

When a person is injured, he or she has a certain time limit for filing a lawsuit. This is referred to as the statute of limitations. In New Mexico, the length of the statute of limitations varies depending upon the type and circumstances of the case. For example, in New Mexico, the statute of limitation in most medical malpractice matters is three years.

In short, a person wishing to bring a lawsuit for medical malpractice has three years from the date of the injury to file a lawsuit. In some cases, the 3 year statute of limitations may not begin to run until the injury is discovered. For qualified healthcare providers, an injured plaintiff or his estate must first bring a claim before the New Mexico Medical Review Commission (MRC).

Bringing the claim with the MRC will toll (stop) the running of the statute of limitations. The question arises whether naming the wrong doctor in the MRC claim will toll the statute of limitations for the claims against the appropriate doctor. The short answer to this question is NO!

The New Mexico Court of Appeals, in Meza v. Topalovski, reviewed just this question (i.e. whether providing the wrong health care provider in an application to the New Mexico Review Commission would allow a plaintiff to apply that filing date to another health care provider for the purposes of the statute of limitations).

In Meza, an ultrasound revealed a spot on the plaintiff's left kidney. As a result, the plaintiff's surgeon recommended surgery to remove the growth. The plaintiff agreed to the surgery and the surgeon removed the mass of tissue from the plaintiff's kidney. The removed growth was sent to the defendant for a "frozen section" evaluation. The defendant diagnosed the tissue specimen as cancerous, resulting in the plaintiff electing to have her entire left kidney removed. Several weeks later, on February 27, 2006, the plaintiff's treating physician informed the plaintiff that the original mass of tissue taken from her kidney was benign.

After finding out about the non-cancerous diagnosis from the original mass, the plaintiff filed an application for review with the Medical Review Commission on December 11, 2008, alleging a malpractice claim against the wrong doctor. The application did not allege a malpractice claim against the defendant. On March 23, 2009, more than 3 years since the erroneous specimen test by the defendant, the plaintiff filed an amended application for review with the Medical Review Commission alleging a malpractice claim against the defendant.

The Medical Review Commission issued its final decision on July 28, 2009, and the plaintiff filed a complaint against the defendant in district court shortly afterwards. The defendant filed a motion for summary judgment to dismiss the plaintiff's claim because she did not file her lawsuit within the three year statute of limitations for medical malpractice cases.

The plaintiff's complaint was filed more than three years after she discovered the alleged medical malpractice on February 27, 2006. While she did file her initial claim with the Commission within the three-year statute of limitations, she did not name the correct doctor.

The Commission does allow plaintiffs to add or delete parties with proper notice; however, those changes may only occur if they are consistent with New Mexico law, including the three-year statute of limitations. In this case, the plaintiff did not comply with the three-year statute of limitations, and at the time she sought to add the defendant the deadline had already passed.

Even if the plaintiff did not realize that the defendant was the physician performing the initial diagnosis on her kidney tissue, it was her duty, as the party filing the medical malpractice claim, to investigate and evaluate her claim including obtaining her medical records. As a result, the plaintiff could not claim that her statute of limitations period began when she discovered that the defendant performed the diagnosis. Consequently, her case was dismissed on summary judgment.

In short, her claim was barred from moving forward. Interesting to note, it appears from the Court of Appeals case caption that all the plaintiff's claims were filed pro se without an attorney. This illustrates another important point about medical malpractice claims. Medical malpractice claims are very complicated. It is highly advisable to seek the guidance of an experienced personal injury attorney.

Related Reading:
Medical Malpractice Claims Raise Unique Statute of Limitations Issues
New Mexico Statute of Limitations & Exceptions -- Time is Always of the Essence!
Tolling of Statute of Limitations is Rare

Collins & Collins, P.C.
Albuquerque Attorneys

The issue of independent intervening cause can cause significant confusion in a personal injury claim. However, in New Mexico at least, what might seem to be an independent intervening cause may not necessarily relieve the initial negligent party from liability.

A helpful place to start is with the New Mexico Jury Instruction 13-306 on Independent intervening cause: "An independent intervening cause interrupts and turns aside a course of events and produces that which was not foreseeable as a result of an earlier act or omission."

An independent intervening cause interrupts a train of events thereby causing an outcome that was not a foreseeable result of the earlier act or omission. This issue comes up on occasion in serious personal injury and wrongful death cases. Among the most common scenarios involves negligent medical care that leads to additional harm to the already injured plaintiff.

It is often contended wrongly by a defendant or his or her insurance in these situations that there was an independent intervening cause that breaks the chain of causation. They argue this of course to also deny liability. After all, if there is no causation, there is no liability.

Despite the vigor with which insurance companies in particular might argue independent intervening cause in these cases, it simply does not fly in New Mexico. There is in fact case-law directly on point to address this situation.

The issue comes down to foreseeability of harm. For independent intervening causation, the intervening event must be unforeseeable. Certainly, if someone is injured, it is foreseeable that they will require medical attention. And it is equally foreseeable that in obtaining that medical care, they may also fall victim to medical negligence.

It is important to distinguish between foreseeability and certainty. Of course, it is not a certainly that the person will suffer medical negligence. However, it is foreseeable. In fact, one need not look long to find that medical negligence and medical errors are rampant. In a 2010 study from the Office of the Inspector General of the Department of Health and Human Services, it was estimated that as many as 180,000 Americans die each year from medical errors. The study concluded that as 1 in 7 patients suffer injury as a result of medical errors.

So is it foreseeable? Of course, it is foreseeable and in light of those figures it may be even more than foreseeable though not yet quite certain. In fact, the medical treatment may cause far greater harm than the original accident.

Naturally, many (though certainly not all) insurance companies are deaf to such arguments. When they are, quote them the language from our New Mexico Courts in Lujan v. Healthsouth: "When a person causes an injury to another which requires medical treatment, it is foreseeable that the treatment, whether provided properly or negligently, will cause additional harm." Quoted in Lujan is Dean Keeton who perhaps put it best when he stated, "It would be an undue compliment to the medical profession to say that bad surgery is no part of the risk of a broken leg."

Those insurance companies prone to stick to their guns are the same companies that will find any reason to deny a claim and when there is no reason, they may make one up or simply just deny it without basis.

Ironically, the insurance company may plead for fairness arguing that you should and must sue the doctor for the harm caused by medical negligence. And though you may very well have a separate medical malpractice claim, the insurance company is still on the hook for its coverage.

If you are faced with a situation like this, it highly advisable to seek the advice of a personal injury attorney. This is particularly necessary here due to the possibility of multiple claims for personal injury and medical malpractice.

Related Reading:
Reexamined Duty of Care in New Mexico Personal Injury Lawsuits
Patient Advice of Risks and Consent Will Not Bar New Mexico Medical Malpractice Claims
The Myth of the Frivolous Medical Malpractice Lawsuit

Collins & Collins, P.C.
Albuquerque Attorneys

When a patient goes in for a medical procedure, he or she is handed numerous documents that must be signed prior to the procedure. These include a variety of disclaimers and warnings of risks related to the procedure. The risks and possible bad outcomes are often numerous and terrifying.

Indeed, upon reading some of these forms, one might reasonably ask how in the world some of the risks are inherent to the procedure. In fact, many of them are not but are added as boilerplate catchall provisions to try to cover not only inherent risks but many other bad outcomes as well. Yet the procedure is necessary so the patient signs.

Throughout the stack of disclaimers and warnings will be various acknowledgements and acceptance of the risks. All of this culminates with the signing by the patient of consent forms consenting to the procedure.

It is not unusual that the worst does occur. Sometimes the bad outcome is an inherent risk of the procedure. Clearly, there are many high risk procedures. And clearly, medicine is not perfect. However, that is not the issue in the case of most medical errors and medical negligence. In fact, it is not an issue of being perfect; it is an issue of competence, of meeting the standards of the medical profession.

Despite the widely accepted myth of the frivolous medical malpractice lawsuit, there is vast medical negligence. In a 1999 study from the Institute of Health, it was estimated that as many as 98,000 patients a year die from medical negligence making it the 6th leading cause of death at the time.

That's bad! What's worse is that since 1999, the problem has actually grown worse. In 2010, the Office of the Inspector General of the Department of Health and Human Services estimated the number of deaths from medical negligence at 180,000. The Inspector General found also that as many as 1 in 7 patients suffer injury as a result of medical error.

Knowing this will make those consent forms pretty frightening. However, rest assured that in New Mexico, all these disclaimers, warnings and consents will not excuse negligent medical care. In fact, there is a jury instruction that says exactly that.

New Mexico Uniform Jury Instruction 13-1105A entitled Consent No Excuse for Negligent Treatment states:

"The fact that a doctor communicates the inherent and potential hazards of a proposed [procedure] [treatment] does not necessarily mean that those hazards, should they arise, are not the result of negligence in performing the proposed [procedure] [treatment].

The fact that a patient expressly or impliedly consents to a proposed [procedure] [treatment] does not mean that the patient consents to the negligent performance of that [procedure] [treatment] and therefore does not prevent you from considering whether the [procedure] [treatment] was negligently performed.

The fact that a patient consents to an adequately performed [procedure] [treatment] does not excuse the doctor from negligence in choosing an unnecessary or contraindicated [procedure] [treatment]."

In short, an advice of risks and consent to medical treatment is not a waiver of a patient's right to competent medical care. It is not a free pass for the medical provider. The fact that the patient signed the consent forms will not prevent the patient (or his or her estate) from recovering for the personal injuries or wrongful death associated with medical negligence.

If you believe that you or a loved one has been harmed by medical negligence, it is important to seek the counsel of an experienced personal injury attorney right away. Medical malpractice claims in particular have many unique requirements and deadlines that must be met to protect a patient's rights to recovery.

Related Reading:
The Myth of the Frivolous Medical Malpractice Lawsuit
Are Guns Safer than Hospitals?
Medical Malpractice Claims Raise Unique Statute of Limitations Issues

Collins & Collins, P.C.
Albuquerque Attorneys

In New Mexico, there are caps on both medical malpractice claims and claims against the government. These caps are highly detrimental to injured plaintiffs and they undermine the right to a jury guaranteed under the 7th Amendment of the U.S. Constitution. However, the caps are routinely upheld in New Mexico and beyond.

Most recently, in Lajeuenesse v. Board of Regents of the University of New Mexico, the New Mexico Supreme Court addressed the maximum liability of a government entity in a wrongful death action when there is one deceased victim and several beneficiaries.

Lajeuenesse was a wrongful death action brought by a man's estate based on negligent medical care by the University of New Mexico Hospital. The jury awarded the plaintiff's estate damages of $750,000. The defendants made a motion to reduce the damages, which the trial court granted, and the damages were reduced to $400,000 plus medical costs of $13,032. The trial court relied upon the language of the New Mexico Tort Claims Act, limiting recovery to $400,000.

The New Mexico Wrongful Death Act allows a family member, or other person close to the victim, to bring a lawsuit for a wrongful or negligent act that result in the death of the victim. In this case, the victim's spouse had already passed, so the Wrongful Death Act states that the monetary judgment should be distributed to the victim's children.

The New Mexico Tort Claims Act provides exceptions to the government's immunity from lawsuits. Pertinent to this case, the Tort Claims Act waives immunity for wrongful death caused by the negligence of public employees acting within the scope of their duties. However, the Tort Claims Act limits the liability of a government agency to $400,000 for any number of claims arising out of a single occurrence for all damages other than property damage and medical expenses, and $750,000 for all claims other than medical expenses arising out of a single occurrence.

The court first examined the interaction between Wrongful Death Act and the Tort Claims Act, to determine if this matter is a single claim or multiple claims, which would determine whether the damages were limited to $400,000 or $750,000.

The court first noted that the Tort Claims Act provides an exception to the government's liability for wrongful death cases. It then explained that the Wrongful Death Act provides for a personal representative to bring the lawsuit against the wrongful party. Then the Wrongful Death Act states that the damages award should be distributed to the deceased person's beneficiaries. The personal representative is distinct from the statutory beneficiaries. Here, the personal representative is the only person making a claim against the government.

The court found that the person addressed in the Tort Claims Act limitations is the personal representative, because they are the only one able to file the claim. The statutory beneficiaries are not bringing a claim.

The court did not believe that the New Mexico Legislature intended the damage limitations to depend on the number of beneficiaries that a deceased victim had. In a wrongful death action, according to the court, there is only one deceased person, so the number of beneficiaries is immaterial.

Medical malpractice claims are complex. Those involving governmental medical provider come with additional issues. There are several deadlines and requirements that are unique to medical malpractice claims and claims against the government. It is important to seek the guidance of an experienced personal injury attorney as soon as possible to insure that you do no miss any critical deadline or other requirements.

Related Reading:
Caps on Medical Malpractice Damages Do Not Lower Insurance Premiums or Healthcare Costs
Medical Malpractice Caps and Public Costs, Who Really Pays?
Medical Malpractice Reform Harms Patients and the Taxpaying Public

Collins & Collins, P.C.
Albuquerque Attorneys

Shoulder dystocia refers to the condition that occurs when a baby's head is delivered but the shoulders get stuck inside the mother's body. The word "dystocia" actually means slow or difficult labor or delivery. In most cases, once the baby's head is delivered the rest of the baby's body follows easily.

In some instances where the baby's shoulders and chest are larger than the baby's head, the shoulder may become lodged behind the mother's pelvic bone. It is estimated that shoulder dystocia occurs in anywhere from 1 to 8 out of every 1000 births.

In most cases where shoulder dystocia is handled appropriately by the healthcare providers the baby and the mother do not sustain any permanent birth injuries. However, if the healthcare providers responsible for the labor and delivery of the baby do not react quickly and appropriately shoulder dystocia can lead to serious and permanent injury to the baby.

These injuries include 1) damage to the sensitive nerves in the baby's neck, commonly referred to as a brachial plexus injury, 2) low oxygen levels leading to brain damage and cerebral palsy, and 3) bone fractures caused by the force used to dislodge the shoulder.

While there are risk factors for shoulder dystocia, healthcare providers generally cannot predict or prevent shoulder dystocia from happening.

Some risk factors include the following:

1. A very large baby.
2. A mother with diabetes.
3. Being pregnant with more than one baby.
4. Obesity in the mother.
5. Delivery of the baby after the baby's due date.
6. A previous history of delivering a baby with shoulder dystocia.

Yet it should be remembered that shoulder dystocia can occur when there are no risk factors at all.

Prevention
Doctors can take steps to prevent injuries caused by shoulder dystocia. This often includes repositioning the mother and/or the baby during delivery to allow the baby to pass while using gentle pushing and pulling techniques. More serious procedures may include breaking the mother's pelvic bone or the baby's collar bone or performing an emergency cesarean section.

Medical Negligence
If the doctors and/or nurses responsible for the delivery of the baby fail to recognize signs of shoulder dystocia or fail to respond in an appropriate manner they may constitute medical negligence. When the healthcare providers are found to be negligent they can be held responsible for any injuries caused to the baby as a result of their unreasonable conduct.

Medical malpractice claims are quite complex. It is to contact an experienced personal injury attorney to conduct a careful review of the medical records and determine whether the baby's injuries were caused by the negligence of the medical providers.

There are numerous unique deadlines and other requirements that must be considered. So it important to make these determinations as soon as possible if you suspect medical negligence. Delay can result in a missed deadline which may bar your claim completely.

Related Reading:
High Burden of Proof in New Mexico Birth Injury Lawsuits
Cesarean Sections: An Essential Tool in Prevention of Cerebral Palsy
Cerebral Palsy Birth Injuries: Devastating, Costly and Sometimes Avoidable!

Collins & Collins, P.C.
Albuquerque Attorneys

Prisoners, now more than ever, are at a great risk for medical mistreatment. The problem of medical treatment in prisons has been increased by the use of contractors and sub-contractors to run the prisons and provide medical care. By their very nature they are shielded from public view, with very limited rights and little power to redress wrongs against them. The medical negligence is not limited to physical problems, but includes mental and emotional issues as well. Studies have shown that a disproportionate number of prisoners in the American penal system suffer from mental health issues which is often severely neglected.

The United States Supreme Court has consistently stated that prisons have an obligation to provide adequate medical care to prisoners, because not doing so would constitute "cruel and unusual punishment." Typically, medical malpractice suits require the plaintiff to prove that the medical provider's actions were below the standard of care ordinarily expected in the local community. This standard holds true for personal injury lawsuits against the medical providers in a prison or jail.

For a civil rights claim, a prisoner may also allege "deliberate indifference," where he or she must prove a serious medical need, that the persons or entities being sued knew of that need, and that they intentionally or deliberately failed to provide the required treatment. If the prison personnel are not aware of the prisoner's medical condition, then they will not be held liable for any alleged inadequate care.

For example, in January 2012, a federal jury in New Mexico awarded $22 million to a man for medical mistreatment. Stephen Slevin was arrested for driving while intoxicated. The prison personnel believed Slevin was suicidal and he was first placed in a padded cell for three days, before being transferred into solitary confinement.

At one point, Slevin was forced to pull his own tooth because he was denied dental treatment. His toenails began to curl around his foot, and he developed fungal infections. Despite the initial concerns about Slevin's mental health, prison officials failed to provide any mental health treatment. Since his release, Slevin was diagnosed with post-traumatic stress disorder, which will likely mean taking medication for the rest of his life.

Prisoners may also make a claim for delayed medical treatment, even where the treatment is provided in the end. In this type of case, the prisoner must show that a negative result was caused by the delay in treatment. However, even when the medical incident is severe, like a heart attack, the prison will not be liable if there is no proof that the delay in treatment caused the prisoner additional problems.

Deliberate indifference cases by prisoners are often brought in federal court. The federal court rules also allow the prisoner to then bring medical malpractice claims under New Mexico law as well. By bringing both sets of claims, the chances of accountability are increased.

It is important to note that, like many types of cases involving injury, the statute of limitations begins to run when you discover the problem. In many cases, this is very straightforward, but sometimes it isn't.

In the case of suits against prisons and jails for medical malpractice, there are a number of important deadlines. These include all the unique deadlines associated with medical malpractice claims as well as those under the New Mexico Tort Claims Act and the Section 1983 of the Civil Rights Act.

Medical malpractice cases are quite complex. They are made even more so in the prison or jail environment. It is important to contact an experienced attorney as soon as possible following an incident of medical malpractice in jail or prison. The deadlines are real and they are serious. Missing one can bar your claims completely.

Related Reading:
New Mexico Statute of Limitations & Exceptions -- Time is Always of the Essence!
Medical Malpractice Claims Raise Unique Statute of Limitations Issues
MedMal Cap Protection in New Mexico Protects both Doctors and Medical Corporations

Collins & Collins, P.C.
Albuquerque Attorneys