Arroyo v. Plosay (Cal. Ct. App. - April 2, 2014)
California Appellate Report
Thoughts on recent Ninth Circuit and California appellate cases from Professor Shaun Martin at the University of San Diego School of Law.
April 02, 2014
Maria Arroyo dies, and when the mortuary comes to pick up her body, her face is all bashed in, which the mortuary can't fix. Since Arroyo simply died of a heart attack -- not something that usually bashes a face -- everyone assumes that someone in the hospital must have futzed with (or mutilated) the body. So in 2011, Arroyo's survivors sue the hospital for disfiguring the body, which is indeed a tort.
But plaintiffs end up dismissing the case without prejudice after the trial court grants various summary judgment motions. Oh well. That's the way the cookie crumbles sometimes.
But then Arroyo's survivors figure out what really went down. How did Maria's face get bashed in? Well, after she was pronounced dead by the medical staff at the hospital, she was taken to the morgue and put in a compartment in the hospital's freezer. Presumably one of those drawer-like things that you see on television.
But when the mortuary workers found her, Arroyo was face down. With her nose broken and with lacerations and contusions all over her face.
How'd she get that way? You guessed it. The survivors' expert says that Maria was still alive when the hospital declared her dead and put her in the freezer. And that, later, she woke up, bashed her face and head against the compartment in a vain attempt to escape, and ultimately just froze to death.
YIKES!!
There's a whole big statute of limitations problem. Which, as the Court of Appeal holds, is more fatal to one cause of action than some of the others.
But boy. I would not want to be defending this one. Because unless you've got a good way to explain to a jury how Maria ended up face down with her nose broken, the alternative -- that she was put in the morgue alive only to freeze to death -- is . . . well, chilling. To say the least...
The decision states, "The separate judgments
of dismissal are reversed as to the causes of
action for medical negligence and wrongful
death against the Hospital and Dr. Plosay
, and affirmed as to the cause of action for
negligence.
The parties shall
bear their own costs on appeal.
Showing posts with label evaluating hospitals. Show all posts
Showing posts with label evaluating hospitals. Show all posts
Tuesday, April 8, 2014
Wednesday, October 23, 2013
Kaiser wants the public to know the truth about Kaiser quality. So do I.
Here it is straight from the horse's mouth: Kaiser wants the public to have more information about the quality of medical care provided by Kaiser.
I'm happy to help with this blog. Of course, I agree that Covered California should post ratings of insurers. I'd also like to suggest that the California exchange public Kaiser's treatment guidelines and those of other insurers.
The desire for openness is a big change in attitude for Kaiser, a company that usually wants to keep secrets.
Kaiser faults California’s exchange for lack of quality ratings
Chad Terhune
Los Angeles Times
Oct. 22, 2013
Healthcare giant Kaiser Permanente and two other insurers say California’s insurance exchange is withholding crucial information from consumers by not posting quality ratings alongside health plan rates.
The insurance companies said “there has never been a compelling reason to deny this information to consumers…. On this issue, Covered California has surrendered its ‘pace car’ status.”
Sharp Health Plan in San Diego and Western Health Advantage in Sacramento joined Kaiser in criticizing the state’s position in a letter sent Monday to Covered California, the state health exchange. Some consumer advocates have also urged the state to reconsider, saying any delay rewards lower-performing insurers.
Thousands of people have been shopping for coverage at the state’s website at www.coveredca.com since enrollment opened Oct. 1 under the Affordable Care Act, also known as Obamacare.
Covered California ignited this debate in August when it backed off earlier plans to include insurance company ratings in its online enrollment system.
This came as a surprise because state officials had touted the idea of consumers choosing coverage based on the overall value, combining price and quality measures.
At the time, the exchange said it reversed course because the latest state rankings examine performance from 2011, and they don’t reflect many of the new health plans and provider networks being offered for the first time under the federal healthcare law.
Major insurers such as Blue Shield of California and Health Net Inc. have offered narrower networks for some exchange policies to help lower premiums. In contrast, Kaiser and its full provider network are often more expensive.
State officials have discussed including ratings for some health plans, such as Kaiser, that are using their current network and labeling newer products as “not yet rated.” Covered California’s five-member board is expected to consider the matter at a regularly scheduled meeting Thursday.
In their letter, the three insurers also point out that other state-run exchanges, such as those in Colorado, Maryland and Oregon, are displaying quality data prominently on their websites. Colorado’s website even sorts a consumer’s options by quality, rather than just price.
“The leadership of these three state exchanges faced a choice, as California’s does now – and they chose to put consumers first,” the insurers said.
I'm happy to help with this blog. Of course, I agree that Covered California should post ratings of insurers. I'd also like to suggest that the California exchange public Kaiser's treatment guidelines and those of other insurers.
The desire for openness is a big change in attitude for Kaiser, a company that usually wants to keep secrets.
Kaiser faults California’s exchange for lack of quality ratings
Chad Terhune
Los Angeles Times
Oct. 22, 2013
Healthcare giant Kaiser Permanente and two other insurers say California’s insurance exchange is withholding crucial information from consumers by not posting quality ratings alongside health plan rates.
The insurance companies said “there has never been a compelling reason to deny this information to consumers…. On this issue, Covered California has surrendered its ‘pace car’ status.”
Sharp Health Plan in San Diego and Western Health Advantage in Sacramento joined Kaiser in criticizing the state’s position in a letter sent Monday to Covered California, the state health exchange. Some consumer advocates have also urged the state to reconsider, saying any delay rewards lower-performing insurers.
Thousands of people have been shopping for coverage at the state’s website at www.coveredca.com since enrollment opened Oct. 1 under the Affordable Care Act, also known as Obamacare.
Covered California ignited this debate in August when it backed off earlier plans to include insurance company ratings in its online enrollment system.
This came as a surprise because state officials had touted the idea of consumers choosing coverage based on the overall value, combining price and quality measures.
At the time, the exchange said it reversed course because the latest state rankings examine performance from 2011, and they don’t reflect many of the new health plans and provider networks being offered for the first time under the federal healthcare law.
Major insurers such as Blue Shield of California and Health Net Inc. have offered narrower networks for some exchange policies to help lower premiums. In contrast, Kaiser and its full provider network are often more expensive.
State officials have discussed including ratings for some health plans, such as Kaiser, that are using their current network and labeling newer products as “not yet rated.” Covered California’s five-member board is expected to consider the matter at a regularly scheduled meeting Thursday.
In their letter, the three insurers also point out that other state-run exchanges, such as those in Colorado, Maryland and Oregon, are displaying quality data prominently on their websites. Colorado’s website even sorts a consumer’s options by quality, rather than just price.
“The leadership of these three state exchanges faced a choice, as California’s does now – and they chose to put consumers first,” the insurers said.
Wednesday, September 18, 2013
Tri-City Medical Center in the top 100? Really? Or did someone do some fixing? Also: Larry Anderson placed on administrative leave
Larry Anderson, well-traveled hospital CEO
Click HERE for new video from the San Diego Union Tribune on Tri-City Healthcare's Larry Anderson.
Becker's Hospital Review, which came up with its own ratings, is a good pal of Larry Anderson. They paid him, for some reason, to visit Chicago and stay at a $569 per night hotel. But Anderson didn't report the gift until SDUT asked him about it.
US News and World Report wasn't quite as impressed with Larry Anderson and his hospital. In fact, Tri-City got a ranking of 1.1 out of a possible 100 in cardiology, with survival "much worse than expected. Tri-City's overall score was 20.5 out of 100.
Quite a discrepancy, wouldn't you say?
On the other hand, Scripps La Jolla received a ranking of 63.4 in cardiology with survival "much better than expected."
I've started preparing a comparison of local hospitals HERE.
Becker's also ranked Larry Anderson himself in the top 100 of hospital administrators, but it now reports that Mr. Anderson has been placed on leave:
Tri-City Medical Center CEO Larry Anderson Put on Administrative Leave
Written by Anuja Vaidya
Becker's Hospital Review
September 06, 2013
Larry Anderson, CEO of Tri-City Medical Center in Oceanside, Calif., has been put on paid administrative leave, according to a U-T San Diego report.
Hospital board chair Larry Schallock told U-T San Diego that Mr. Anderson was put on leave in relation to a personal matter and declined to comment further. He also said that Casey Fatch, the hospital's COO, will serve as interim CEO.
Saturday, May 25, 2013
US not sure how to evaluate hospital performance; don't know if they will cause more deaths if they punish high readmission rates
Hospital deaths and readmissions not linked: study
By Andrew M. Seaman
Feb 12, 2013
(Reuters Health)
A measure used by Medicare to penalize hospitals for poor performance is not linked to how many patients die after being admitted, suggests a new study.
The study, published in the Journal of the American Medical Association on Tuesday, suggests that hospitals can keep the number of patients who come back for more treatment low without having more of them die.
"The concern was that their performance in one area is going to compromise their performance in another," said Dr. Harlan Krumholz, the study's lead author from the Yale University School of Medicine in New Haven, Connecticut.
Currently, the U.S. Centers for Medicare and Medicaid Services (CMS), which oversees the federal government's insurance programs for the elderly, disabled and poor, uses those measures to judge a hospital's quality.
CMS also punishes hospitals with high readmission rates by reducing their payments. In 2013, CMS estimates hospitals will lose - on average - 0.3 percent of their funding, about $270 million overall (see Reuters Health story of January 22, 2013 here: reut.rs/Xwm984).
For the new study, Krumholz and his colleagues looked at whether there was a link between the number of people who died within 30 days of being admitted to hospitals and the number of people who came back for more treatment within 30 days after they were discharged.
They analyzed data on older Americans on Medicare who were admitted to U.S. hospitals between July 2005 and June 2008 with a heart attack, heart failure and pneumonia - the conditions CMS tracks.
They found about 20 percent of heart attack patients, 24 percent of heart failure patients and 18 percent of pneumonia patients came back to the hospital for more care. That compared to about 17 percent of heart attack patients and 11 percent of heart failure and pneumonia patients who died.
Overall, they found no relationship between the number of heart attack and pneumonia patients who were readmitted and those who died.
The researchers also found that between 5 percent and 9 percent of hospitals were able to have both low readmission and death rates, which Krumholz said should calm concerns that doing well in one area means doing poorly in the other.
"I think our goal should be to learn from the hospitals excelling in both areas and spread those ideas," said Krumholz, whose team created the measures CMS uses to judge hospital quality.
He added that the findings also suggest that readmission and death rates measure two different events, and one is not dependant on the other.
‘NO EASY PATH'
But Nancy Foster, vice president for quality and patient safety policy at the American Hospital Association, said the new study does not close the door on questions about readmission and death rates.
"This question that has been raised around the link between readmission and mortality is beginning to be investigated. There is no easy path to know what the relationship is because it's a very complicated problem," said Foster, who was not involved with the new study.
Foster told Reuters Health that she believes the new study has flaws, including that the researchers adjusted the rates for smaller hospitals, which led to the findings. She added that there could be other reasons why hospitals performed well on both measures.
"I'd love to say that it's only to the hospitals' credit that they've done so well (to) have low levels of mortality and readmission. But in all fairness, we recognize that community and other factors have an important role," she said.
By Andrew M. Seaman
Feb 12, 2013
(Reuters Health)
A measure used by Medicare to penalize hospitals for poor performance is not linked to how many patients die after being admitted, suggests a new study.
The study, published in the Journal of the American Medical Association on Tuesday, suggests that hospitals can keep the number of patients who come back for more treatment low without having more of them die.
"The concern was that their performance in one area is going to compromise their performance in another," said Dr. Harlan Krumholz, the study's lead author from the Yale University School of Medicine in New Haven, Connecticut.
Currently, the U.S. Centers for Medicare and Medicaid Services (CMS), which oversees the federal government's insurance programs for the elderly, disabled and poor, uses those measures to judge a hospital's quality.
CMS also punishes hospitals with high readmission rates by reducing their payments. In 2013, CMS estimates hospitals will lose - on average - 0.3 percent of their funding, about $270 million overall (see Reuters Health story of January 22, 2013 here: reut.rs/Xwm984).
For the new study, Krumholz and his colleagues looked at whether there was a link between the number of people who died within 30 days of being admitted to hospitals and the number of people who came back for more treatment within 30 days after they were discharged.
They analyzed data on older Americans on Medicare who were admitted to U.S. hospitals between July 2005 and June 2008 with a heart attack, heart failure and pneumonia - the conditions CMS tracks.
They found about 20 percent of heart attack patients, 24 percent of heart failure patients and 18 percent of pneumonia patients came back to the hospital for more care. That compared to about 17 percent of heart attack patients and 11 percent of heart failure and pneumonia patients who died.
Overall, they found no relationship between the number of heart attack and pneumonia patients who were readmitted and those who died.
The researchers also found that between 5 percent and 9 percent of hospitals were able to have both low readmission and death rates, which Krumholz said should calm concerns that doing well in one area means doing poorly in the other.
"I think our goal should be to learn from the hospitals excelling in both areas and spread those ideas," said Krumholz, whose team created the measures CMS uses to judge hospital quality.
He added that the findings also suggest that readmission and death rates measure two different events, and one is not dependant on the other.
‘NO EASY PATH'
But Nancy Foster, vice president for quality and patient safety policy at the American Hospital Association, said the new study does not close the door on questions about readmission and death rates.
"This question that has been raised around the link between readmission and mortality is beginning to be investigated. There is no easy path to know what the relationship is because it's a very complicated problem," said Foster, who was not involved with the new study.
Foster told Reuters Health that she believes the new study has flaws, including that the researchers adjusted the rates for smaller hospitals, which led to the findings. She added that there could be other reasons why hospitals performed well on both measures.
"I'd love to say that it's only to the hospitals' credit that they've done so well (to) have low levels of mortality and readmission. But in all fairness, we recognize that community and other factors have an important role," she said.
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