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Medical groups that perform heart bypass surgery are now being rated alongside cars and toaster ovens in Consumer Reports.

In most parts of the country, data-based ratings of doctors are not available to patients. Only a few states, including New York, provide them.

The magazine published ratings of 221 surgical groups from 42 states online on Tuesday and will print them in its October issue. Groups are rated, not individual doctors. The groups receive one, two or three stars, for below average, average or above average. The scores were based on complication and survival rates, whether the groups used the best surgical technique and whether patients were being sent home with certain medicines that research has shown to be beneficial after this type of surgery.

Read More: The New York Times

Thirty-five weeks pregnant, Robin Rodgers was vomiting and losing weight, so her doctor hospitalized her and ordered that she be fed through a tube until the birth of her daughter.

But in a mistake that stemmed from years of lax federal oversight of medical devices, the hospital mixed up the tubes. Instead of snaking a tube through Ms. Rodgers’s nose and into her stomach, the nurse instead coupled the liquid-food bag to a tube that entered a vein.

Putting such food directly into the bloodstream is like pouring concrete down a drain. Ms. Rodgers was soon in agony.

“When I walked into her hospital room, she said, ‘Mom, I’m so scared,’ ” her mother, Glenda Rodgers, recalled. They soon learned that the baby had died.

“And she said, ‘Oh, Mom, she’s dead.’ And I said, ‘I know, but now we have to take care of you,’ ” the mother recalled. And then Robin Rodgers — 24 years old and already the mother of a 3-year-old boy — died on July 18, 2006, as well. (She lived in a small Kansas town, but because of a legal settlement with the hospital, her mother would not identify it.)

Their deaths were among hundreds of deaths or serious injuries that researchers have traced to tube mix-ups. But no one knows the real toll, because this kind of mistake, like medication errors in general, is rarely reported. A 2006 survey of hospitals found that 16 percent had experienced a feeding tube mix-up.

Experts and standards groups have advocated since 1996 that tubes for different functions be made incompatible — just as different nozzles at gas stations prevent drivers from using the wrong fuel.

But action has been delayed by resistance from the medical-device industry and an approval process at the Food and Drug Administration that can discourage safety-related changes.

Read More: The New York Times

John Peter Smith Hospital officials will review the medical response to a man who collapsed and died Tuesday in the hospital pharmacy after witnesses complained that help was slow to arrive and that emergency equipment did not appear to work properly.

Jeff Dickerson, who was picking up a prescription at the pharmacy, said it took medical workers nearly 10 minutes to get there. Once there, he said that two defibrillators the workers tried to use did not appear to work.

“I thought this was all so ridiculous because you’re in a hospital and the equipment doesn’t work right,” Dickerson said, adding that he was in a group of witnesses who agreed after the incident that they should contact the media about their concerns.

Read More: Fort Worth Star-Telegram

The antibiotic-resistant microbe MRSA may be slowing its pace after rampaging through hospitals for years, researchers from the U.S. Centers for Disease Control and Prevention said Tuesday.

From 2005 to 2008, surveillance data from nine metropolitan areas showed an overall decline of 28 percent in severe infections with MRSA (methicillin-resistant Staphylococcus aureus) contracted in healthcare settings.

“We are encouraged by the findings,” said CDC’s Dr. Alexander Kallen, whose study is published in the Journal of the American Medical Association.

Although the data aren’t nationally representative, he said they bolster earlier studies and are “very good evidence that invasive MRSA infections are decreasing.”

[...]

“But before we get too self-congratulatory about reducing MRSA rates, we need to remember MRSA is only one type of Staph,” said Diekema, who wrote an editorial about the new findings. He noted that MRSA accounts for less than one in 10 hospital infections.

At this point, nobody knows why the rates are falling. One possibility is that infection prevention efforts are paying off, said Diekema.

Over the past decade, hospitals have introduced several measures aimed at preventing the spread of infectious disease, such as requiring staff to wash their hands with soap before inserting a catheter into a patient.

CDC’s Kallen said this was probably one of the most important points, and he recommended patients always make sure that nurses and doctors wash their hands prior to providing care.

Read More: Reuters

Two nurses agreed Tuesday to split a $750,000 payment from Winkler County, Tex., to settle the lawsuit they filed after being fired and criminally prosecuted for reporting allegations of improper medical treatment by a doctor at the county hospital, their lawyer said.

One of the nurses, Anne Mitchell, was acquitted in February of misuse of official information, a felony, for anonymously reporting Dr. Rolando G. Arafiles Jr. to the state medical board in 2009. Charges against the second nurse, Vickilyn Galle, were dropped shortly before the trial.

Experts on whistle-blower protection laws said the prosecution seemed unprecedented, and the nurses’ cause was taken up by state and national nursing associations that warned of a chilling effect on the reporting of medical misconduct.

Ms. Mitchell, 53, said in an interview that she was glad to put the case behind her. “We’ll be able to move on with our lives,” she said. “We never thought we’d be in this situation at this stage, when we should be settling down and looking toward retirement.”

Ms. Mitchell and Ms. Galle, both of whom live in Jal, N.M., have not been able to find work in the field since their dismissals as nursing administrators last year, said Brian Carney, one of their lawyers.

Read More: The New York Times

Findings from a new study released today estimate that measurable medical errors cost the U.S. economy $19.5 billion in 2008. Commissioned by the Society of Actuaries (SOA) and completed by consultants with Milliman, Inc., the report used claims data to provide an actuarially sound measurement of costs for avoidable medical injuries. Of the approximately $80 billion in costs associated with medical injuries, around 25 percent were the result of avoidable medical errors.

“This report highlights a singular opportunity for both improving the overall quality of care and reducing healthcare costs in this country,” says Jim Toole, FSA, CERA, MAAA and managing director of MBA Actuaries, Inc. “Of the $19.5 billion in total costs, approximately $17 billion was the result of providing inpatient, outpatient and prescription drug services to individuals who were affected by medical errors. While this cost is staggering, it also highlights the need to reduce errors and improve quality and efficiency in American healthcare.”

Medical errors are a significant source of lost healthcare funds every year. For example, the study found that $1.1 billion was from lost productivity due to related short-term disability claims, and $1.4 billion was lost from increased death rates among individuals who experienced medical errors. According to a recent SOA survey, which identified ways to bend the national healthcare cost curve, 87 percent of actuaries believe that reducing medical errors is an effective way to control healthcare cost trends for the commercial population, and 88 percent believe this to be true for the Medicare population.

Read More: Society of Actuaries

Dr. Juan Salazar used to scribble onto a notepad or dictate into a recorder what he wanted to report from his patient’s visits.

The information the physician gathered eventually ended up in his chart room, where his staff files the paper medical records that are sometimes as thick as books.

A shift to an electronic medical records system at Salazar’s clinic on East Nolana won’t result in a paperless environment that empties out his chart room. But Salazar, who practices internal medicine, said the system promises greater safety and lower costs for his patients in both the clinic and hospital settings.

Doctors Hospital at Renaissance, where Salazar often sends his patients, is asking its physicians to switch to electronic medical records as the federal government adopts guidelines to put all of the nation’s health care providers on computerized records by 2015.

Read More: The McAllen Monitor

It was a Monday morning quarterback session of sorts, as faculty surgeons from UT Southwestern Medical Center met to review cases of medical mistakes.

In one instance, resident doctors-in-training had failed to properly secure an artery during an appendectomy at Parkland Memorial Hospital, the school’s main teaching facility. The patient had to be rushed back into surgery the next day because of internal bleeding.

The faculty surgeon who was supposed to supervise the residents said they did not notify him that they were taking the patient to surgery. He learned of it, he said, only after the operation was under way and while he was working on a trauma victim in Parkland’s emergency room.

That was standard operating procedure at Dallas County’s charity hospital, where “the resident gets to decide” on patient care, Dr. Raminder Nirula told The Dallas Morning News.

Procedures were different at the two hospitals owned by UT Southwestern, where faculty physicians see their privately insured patients, said Nirula and other former doctors who shared his concerns.

“Even though these hospitals are under the same roof, there’s two different levels of care,” said Nirula, a former surgery supervisor who quit UT Southwestern in protest in 2007 after a year.

Read More: The Dallas Morning News

Nurse Craig Peske was fired from a hospital in Wausau, Wis., in 2007 after stealing the powerful painkiller Dilaudid “whenever the opportunity arose,” state records say. In one three-month period, he signed out 245 syringes full of the drug — nine times the average of his fellow nurses.

Hospital officials reported him to Wisconsin nursing regulators and alerted police.

Six months later, Peske was charged with six felony counts of narcotics possession. But by that time, he had used a special “multistate” license to get a job as a traveling nurse at a hospital 1,200 miles away in New Bern, N.C.

“When I went to go for the job in North Carolina, I looked at the status of my license, and it was still active,” says Peske, 36, who was later convicted of two felony drug charges. “That kind of surprised me, so I figured I would take it.”

The ease of Peske’s move illustrates significant gaps in regulatory efforts nationwide to keep nurses from avoiding the consequences of misconduct by hopping across state lines.

The two states in which Peske worked are part of a 24-state compact created to help get good nurses to areas where they are needed most. Under the decade-old partnership, a license obtained in a nurse’s home state allows access to work in the other compact states.

But an investigation by the non-profit news organization ProPublica found that the pact also has allowed nurses with records of misconduct to put patients in jeopardy. In some cases, nurses have retained clean multistate licenses after at least one compact state had banned them. They have ignored their patients’ needs, stolen their pain medication, forgotten crucial tests or missed changes in their condition, records show.

Critics say the compact may actually multiply the risk to patients. There is no central licensing for the compact, so policing nurses is left to the vigilance of member states.

Outside the compact, each state licenses and disciplines its own nurses. But within it, states effectively agree to allow in nurses they have never reviewed.

Read More: USA Today

The federal government issued new rules Tuesday that will reward doctors and hospitals for the “meaningful use” of electronic health records, a top goal of President Obama.

The rules significantly scale back proposed requirements that the health care industry had denounced as unrealistic.

The Department of Health and Human Services said doctors and hospitals could receive as much as $27 billion over the next 10 years to buy equipment to computerize patients’ medical records. A doctor can receive up to $44,000 under Medicare and $63,750 under Medicaid, while a hospital can receive millions of dollars, depending on its size.

Starting in 2015, hospitals and doctors will be subject to financial penalties under Medicare if they are not using electronic health records.

Dr. Donald M. Berwick, who was sworn in Monday as administrator of the Centers for Medicare and Medicaid Services, said electronic health records would lead to “better, smoother care, more reliable care.”

Read More: The New York Times