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Consumer group ranks harshness of state medical boards
Thirty-three lawsuits over gastric surgery cloud California town
GAO report links ED crowding to lack of inpatient transfers

Patient Safety Monitor Alert, April 1, 2003

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CONSUMER GROUP RANKS HARSHNESS OF STATE MEDICAL BOARDS

Wyoming, North Dakota, Alaska, Kentucky, Oklahoma, Arizona, Ohio, Colorado, Montana, and Utah: What do these 10 states have in common?

For malpracticing doctors, they're the worst places to work, according to information from Public Citizen, a national nonprofit consumer advocacy organization. Public Citizen ranked state medical boards on the basis of how many serious disciplinary actions they took against doctors in 2002. The 10 listed above were had the most harsh disciplinary records, according to a press release from the watchdog organization.

The states that took the fewest disciplinary actions were Hawaii, Delaware, Wisconsin, Tennessee, South Carolina, Maryland, North Carolina, Florida, Pennsylvania, and Minnesota. State boards across the nation took a total of 2,864 actions against doctors for offenses such as incompetence, negligence, sexual misconduct, and breaking criminal laws. Disciplinary actions included license revocations, surrenders, suspensions, or restrictions.

"This information raises serious questions about the extent to which patients in states with poorer records of serious doctor discipline are being protected from physicians who might well be barred from practice in states with boards that are doing a better job of disciplining physicians," said Sidney Wolfe, MD, director of Public Citizen's Health Research Group in the release. Go to www.citizen.org/publications/release to read a copy of the report.

THIRTY-THREE LAWSUITS OVER GASTRIC BYPASS SURGERY CLOUD CALIFORNIA TOWN

If doctors in your facility have plans to perform gastric bypass surgery, they may want to take a look at Fresno, CA, first. Thirty-three lawsuits related to the procedure have been filed in that town-at least 25 of them since last year, according to the Fresno Bee.

More than 27 people in the Fresno area died between 1999 and 2001 following their operations, according to the newspaper. One patient, for instance, died after her liver's main artery was accidentally stapled during surgery. Another died after poisonous gastrointestinal juices leaked out from his surgical connections.

The California Medical Board is investigating two surgeons who carried out some of the operations. Nineteen of the lawsuits name 56-year-old surgeon Dr. Herbert Gladen, a faculty doctor at the University of California at San Francisco (UCSF), the Bee reports. Though he was placed on leave for a time while the hospital reviewed deaths that resulted from gastric bypass surgeries he had performed, Gladen has now returned to work as a general surgeon. The Board is also investigating another UCSF faculty doctor, Dr. Christopher Kinter.

GAO REPORT LINKS ED CROWDING TO LACK OF INPATIENT TRANSFERS

Noticing a jam in your emergency department (ED)? The most common factor associated with overcrowding in that department is the inability to transfer patients from the ED to inpatient beds, according to a recent report from the General Accounting Office (GAO). Those awaiting transfer from the ED pull staff and resources away from other incoming patients.

Some of the actions hospitals take to address overcrowding include
- expanding the ED
- developing ways to transfer ED patients to inpatient beds more quickly

The number of patients visiting EDs each year has increased from about 95 million in 1997 to about 108 million in 2000, according to the report.

In addition, the GAO found that EDs in certain hospitals—such as those located in communities with a recent high population growth or a large percentage of people without health insurance—are more likely than others to experience overcrowding. Go to www.gao.gov to read the full report.

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