Ob-Gyn Group Addresses Patient Safety

Medical errors made during pregnancy, labor and delivery, and post-natal care can cause brain damage to the infant and lifelong conditions like cerebral palsy. However, the medical community has been slow to make changes toward reducing the potential for mistakes. But at a recent meeting of the American College of Obstetricians and Gynecologists (ACOG), the emphasis was on making the difficult but necessary changes.

Patient safety expert Dr. Robert M. Wachter, who addressed those in attendance, used the emergency landing of a US Airways plane in the Hudson River as an example of how standardization and training can help doctors prepare for the unexpected.

Dr. Wachter argued that the captain of that plane, Chelsey “Sully” Sullenberger, was able to remain calm during the crisis because he had trained for emergency situations using simulators and also because he immediately made it clear to his co-pilot who was in charge.

In healthcare settings, simulation and team training for unexpected emergencies is not standard but it should be, according to Dr. Wachter. Checklists, computers and standardization are all tools ob-gyns and other doctors should be using to reduce the incidence of medical errors.



 

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Brachial Plexus Injury Awareness Week

The United Brachial Plexus Network, Inc. (UBPN) and its Awareness Committee have announced that the 9th annual Brachial Plexus Injury Awareness Week will be celebrated from October 19th through October 26th, 2008.  The goal of the week long activity is to increase general awareness regarding brachial plexus injuries: traumatic injuries that can result in full to partial paralysis of one or both arms.

The brachial plexus is an arrangement of nerve fibres, running from the spine proceeding through the neck, the axilla (armpit region) and into the arm.  Injury to these nerves can result in a paralysis of the arm called Erb's Palsy which is almost always caused during birth. 

The most common cause of Erb's Palsy is dystocia which is an abnormal or difficult childbirth or labor.  The nerve injury  happens when too much force is used in the delivery trying to free a baby that is stuck in the birth canal.   When the baby's shoulder gets stuck behind the mother's pubic bone it is called shoulder dystocia.  However, there are several maneuvers and techniques that can be safely used to free the baby's shoulder thus avoiding damage to the brachial plexus nerves.

If the delivery is not handled correctly, the resulting nerve damage may result in varying degrees of weakness or paralysis of the shoulder, arm and hand.  The amount of paralysis will depend on which nerves in the plexus( network ) are injured.  In some cases the resulting paralysis could be permanent and in others the weakness or paralysis may be minor enough to resolve itself over time. 

This is where we see malpractice cases arise. It is often when communication in the delivery room breaks down, warning signs are missed or people aren't familiar enough with the maneuvers.
 

 

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Medical Errors: Children Are the Most Vulnerable

A recent New York Times article sheds light on the dangers of medical errors, particularly in infants and children since they are more vulnerable due to their small size. They are also still developing, and the effects of a medical error during this crucial time can have permanent or potentially life threatening consequences.

According to the article, the most common medical mistakes in children are:

  • Hospital infections
  • Medication errors
  • Catheter injuries
  • Misdiagnosis

In many instances, such errors are preventable but they happen nevertheless. Nearly a decade ago, the Institute of Medicine released a report on the prevalence of medical mistakes in the United States. At the time, the agency estimated that about 98,000 death a year were caused by preventable medical mistakes.

Some hospitals have taken measures to reduce the incidence of preventable errors, but more needs to be done, especially where children are involved.  In the meantime, parents can act as advocates for their children by asking questions, paying attention, and speaking up when necessary.

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