Preventable “never events” cost patients and hospitals

| Jan 29, 2016 | Social Security Disability

According to the National Quality Forum (NQF), “never events” are errors in medical care that are clearly identifiable, preventable, and serious in their consequences for patients, and that indicate a real problem in the safety and credibility of a health care facility. Never events,” like surgery on the wrong body part or mismatched blood transfusion, cause serious injury or death, and result in increased healthcare costs t to treat the consequences of the error. These errors are called “never events” because they are serious and costly errors in the provision of health care services that should never happen.

National Quality Forum’s Health Care list the following as “Never Events”

Surgical events

  • Surgery or other invasive procedure performed on the wrong body part
  • Surgery or other invasive procedure performed on the wrong patient
  • Wrong surgical or other invasive procedure performed on a patient
  • Unintended retention of a foreign object in a patient after surgery or other procedure
  • Intraoperative or immediately postoperative/postprocedure death in an American Society of Anesthesiologists Class I patient

Product or device events

  • Patient death or serious injury associated with the use of contaminated drugs, devices, or biologics provided by the health care setting
  • Patient death or serious injury associated with the use or function of a device in patient care, in which the device is used for functions other than as intended
  • Patient death or serious injury associated with intravascular air embolism that occurs while being cared for in a health care setting
  • Patient protection events
  • Discharge or release of a patient/resident of any age, who is unable to make decisions, to other than an authorized person
  • Patient death or serious disability associated with patient elopement (disappearance)
  • Patient suicide, attempted suicide, or self-harm resulting in serious disability, while being cared for in a health care facility

Care management events

  • Patient death or serious injury associated with a medication error (e.g., errors involving the wrong drug, wrong dose, wrong patient, wrong time, wrong rate, wrong preparation, or wrong route of administration)
  • Patient death or serious injury associated with unsafe administration of blood products
  • Maternal death or serious injury associated with labor or delivery in a low-risk pregnancy while being cared for in a health care setting
  • Death or serious injury of a neonate associated with labor or delivery in a low-risk pregnancy
  • Artificial insemination with the wrong donor sperm or wrong egg
  • Patient death or serious injury associated with a fall while being cared for in a health care setting
  • Any stage 3, stage 4, or unstageable pressure ulcers acquired after admission/presentation to a health care facility
  • Patient death or serious disability resulting from the irretrievable loss of an irreplaceable biological specimen
  • Patient death or serious injury resulting from failure to follow up or communicate laboratory, pathology, or radiology test results

Environmental events

  • Patient or staff death or serious disability associated with an electric shock in the course of a patient care process in a health care setting
  • Any incident in which a line designated for oxygen or other gas to be delivered to a patient contains no gas, the wrong gas, or is contaminated by toxic substances
  • Patient or staff death or serious injury associated with a burn incurred from any source in the course of a patient care process in a health care setting
  • Patient death or serious injury associated with the use of restraints or bedrails while being cared for in a health care setting

Radiologic events

  • Death or serious injury of a patient or staff associated with introduction of a metallic object into the MRI area

Criminal events

  • Any instance of care ordered by or provided by someone impersonating a physician, nurse, pharmacist, or other licensed health care provider
  • Abduction of a patient/resident of any age
  • Sexual abuse/assault on a patient within or on the grounds of a health care setting
  • Death or significant injury of a patient or staff member resulting from a physical assault (i.e., battery) that occurs within or on the grounds of a health care setting

Medicare, Medicaid and private insurance are beginning not to pay for “never events”

The Journal of the American Medical Association reported on a 2010 study of 12 major hospital systems that of 34,256 surgical discharges, 1820 patients (5.3%) experienced 1 or more postsurgical complications. According to the study, preventable complications cost an additional $39,000 per patient for those covered under private insurance and $1749 for those covered under Medicare. In 2008, Medicare stopped reimbursing hospitals for treating conditions, infections, or illnesses that were acquired in the hospital, and for any readmissions associated with treating those hospital-acquired conditions. As part of the Affordable Care Act, Medicaid will now stop paying for these “never events” as well. Many private insurance companies have followed Medicare’s lead and are not paying for “never events” and some other preventable healthcare acquired conditions.

Patients should never have to suffer for preventable complications

What does this mean? These numbers mean that if someone goes into the hospital for surgery, they have a 5.3% chance of some type of post surgical complication. The insurance industry is beginning to refuse to pay for these medical mishaps. Patients also need to take precautions. If you or a family member have suffered on of these “never events” it is important to seek legal advice regarding your options. The insurance companies understand that withhold money will make hospitals safer by forcing them to review their practices, training and procedures. A patient shouldn’t have to suffer from a preventable medical event. Each case is unique. If you have questions about a medical mistake or any other questions about your legal rights, please contact Venus Poe today at 864-963-0310 or click here to fill out an online case evaluation form. We have offices in Greenville, South Carolina and Fountain Inn, South Carolina to better serve you anywhere in South Carolina. There is no obligation or charge for our initial consultation to see if we can help you.

The information you obtain in this article is not, nor is it intended to be, legal advice.You should not read this article to propose specific action or address specific circumstances, but only to give you a sense of general principles of law. Application of these general principles to particular circumstances must be done by a lawyer who has spoken with you in confidence, learned all relevant information, and explored various options. Before acting on these general principles, you should hire a lawyer licensed to practice law in the jurisdiction in which you may have a case.

Journal of the American Medical Association,

Relationship Between Occurrence of Surgical Complications and Hospital Finances, April 17, 2013, Vol 309, No. 15

http://jama.jamanetwork.com/article.aspx?articleid=1679400