Mount Sinai Rehab slapped with lawsuit for wrongful death, recklessness

[MSKmonky]

you're points are valid. We do have autonomy on the consult service (which is only 2 blocks out of the three years we train). As far as teaching however, Elmhurst can be considered a Gold-standard for Teaching and that is entirely due to the "brain trust" i mentioned above. We get extra didactics (EMG lectures, journal club discussions) as well as one-on-one time with the physiatrists daily.

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[docere11]

Wow, after seeing the abc vid it's just so unfortunate and downright inexcusible that the mistakes from the earlier death last year we're not taken seriously to avoid the second death. This just seems like a systemic problem with the culture of the residency programs and the hospital as a whole. It's not a knock on all residents, but just the laissez-faire atttitude by some residents and attendings (I'm not even talking about the insurance fraud here, that's beyond my point).

This can happen at any hospital, sure, but for it two occur twice in almost the same year? Unbelievable. It doesn't matter how you cut it, it was just downright incomprehensible.

Just to echo the sentiments from a recent response - if an attending doesn't see the patients and signs off on them (consult service or not), you are committing medical fruad, pure and simple. You can round in a meeting and intellectualize all you want with coffee and donuts, but in the end of the day if something gets missed, no matter how much of a "brain trust" you have, something will go wrong eventually.

We all can defend our residency program as much as we want, which is expected, but the facts cannot be overlooked. It's hard to change a medical culture, so let's hope this was the final straw.

 

[WaterAvatar]

everytime I see a post by a "new member" .. I get suspicious....

 

[Rehab26]

everytime I see a post by a "new member" .. I get suspicious....

I agree. I find it pretty suspicious that this "medical student" allegedly rotated here last year and didn't join SDN until last month, well into interview season. As far as Sinai is concerned, it's an awesome program. I could not be happier. It's the perfect combination of working hard enough where you actually learn your stuff & having plenty of free time for your friends an family. It's pretty obvious that there are certain people out there that are just trying to bring down Sinai's reputation. Sinai has & always will be a great place to train. You will graduate this program and be a great physiatrist. There are some really great attendings here that you will learn a lot from. All this crap about overbilling procedures & residents being forced to do anything is complete bullsh**. No one is ever asked to do anything they are uncomfortable doing, not to mention, no one at Sinai would ever ask or do anything that is unlawful. So if you really want to know what Sinai is really like, I strongly suggest you contact one of the current residents via the program coordinator or even come for a second look. Trust me, you will not regret coming to Sinai for residency. It's a great place to train.

 

[rehabdocmd]

For those of you in private practice now paying for your own malpractice insurance, what happens if youre hit with punitive damages when solo, if its not covered by malpractice insurance? I understand that the actions have to be reckless and grossly negligent to amount to punitive damages, and hopefully that never happens in an outpatient private practice setting, but I am assuming punitive awards are in the order of millions. So would they come after your assets if its not covered by malpractice insurance?

The abc video mentions that New York Dept of Health investigated and found the hospital negligent. Do they impose additional fines?

Lots of money involved here, just wondering how someone solo would deal with this.

 

[RUOkie]

For those of you in private practice now paying for your own malpractice insurance, what happens if youre hit with punitive damages when solo, if its not covered by malpractice insurance? I understand that the actions have to be reckless and grossly negligent to amount to punitive damages, and hopefully that never happens in an outpatient private practice setting, but I am assuming punitive awards are in the order of millions. So would they come after your assets if its not covered by malpractice insurance?

The abc video mentions that New York State Dept of Health investigated and found the hospital negligent. Do they impose additional fines?

Lots of money involved here, just wondering how someone solo would deal with this.

This type of situation is extremely rare in private practice. Since most docs do not have the big pockets of hospitals, it would be unlikely to get put in that situation. But it is still smart to have NO money. Get financial planning advice with a trust/estate attorney. Put property in a spouses name. By performing asset protection, you sheild yourself from frivolous lawsuits.

 

[SSdoc33]

Put property in a spouses name. By performing asset protection, you sheild yourself from frivolous lawsuits.

but you dont shield yourself from frivolous wives, unfortunately.....

 

[RUOkie]

but you dont shield yourself from frivolous wives, unfortunately.....

true, true, true.

I forgot to say, treat you wife well.

 

[ampaphb]

Putting your assets in your wife's name is routinely disallowed by courts as an obvious attempt to subvert the system.

Assets earned during a marriage are typically viewed as joint assets, regardless of whose name they are in.

A trusts and estates attorney is the right person to talk to re the ins and outs of asset protection.

 

[surftheiop]

Quick general question related to PM&R residencies

from article

"
Dr. Rebecca Brown was the resident on call from 7:00 p.m. on April 6, 2007, until 7:00 a.m. on April 7, 2007 .....

It is important to note that immediately prior to beginning her shift at the rehabilitation clinic onthe evening of April 7, 2007, Dr. Brown worked a 12 hour shift in the outpatient clinic at Mt. Sinai.

"

In general how many times per week/month are PM&R residents working 24+ hour "days" ?

I know this is extremely common in some specialties, but is much less common in others like psych, I was curious where PMR fitted in?​

 

[rehabdocmd]

If you notice in the article there is a time gap-

Dr. Rebecca Brown was the resident on call from 7:00 p.m. on April 6, 2007, until 7:00 a.m. on April 7, 2007.
​

Dr. Nutini, a second year resident was on duty from 9:00 a.m. on April 7, 2007, until 9:00 a.m. on April 8, 2007.

So either there was a 2 hour gap where there was actually no resident or no attending on duty (from 7am-9am) which obviously would be a big no-no and the plaintiffs would have also made an issue of this, or the resident actually worked from 7am Fri- 9am Sat (26 hours), also a violation. Either way, something is missing from the deposition and there is probably an underlying hours violation.

Hours violations for rehab for the most part are rare. Overnight shifts, which are not supposed to be more than 24 hours before relief comes in, however, are not. Some programs have overnight in house call, while others have at-home call.​

Quick general question related to PM&R residencies

from article

"
Dr. Rebecca Brown was the resident on call from 7:00 p.m. on April 6, 2007, until 7:00 a.m. on April 7, 2007 .....

It is important to note that immediately prior to beginning her shift at the rehabilitation clinic onthe evening of April 7, 2007, Dr. Brown worked a 12 hour shift in the outpatient clinic at Mt. Sinai.​

"​

In general how many times per week/month are PM&R residents working 24+ hour "days" ? ​

I know this is extremely common in some specialties, but is much less common in others like psych, I was curious where PMR fitted in?​

 

[MSKmonky]

I'm a current resident at Sinai and I've never worked over 24 hours. We are relieved from call by the next call resident or the day team. There is always a resident there at all times. no 2 hour gaps... you get signout directly from the previous resident oncall. .. like any program

 

[jjwallace]

I would give less fault to the resident here. Yes she probably should have followed up on the xray, and notified her attendings, but you also have to keep me in mind that residents are much more overworked relative to attendings (at most places) and in my opinion, the attending is ultimately responsible. If she was working from 7am-9am, this is a violation, and fatigue and sleep deprivation may have played a factor.

There were failures in the administration and in the system and I think that is what ultimately warranted the reckless indifference.

Another malpractice question for ampaphb. If a resident has a malpractice suit on their record, and is in this database, what exactly are the ramifications? Do you report it to state licensing boards? Does it make your malpractice insurance go up? Is this database available to the general public, if so what is the link? I cant remember ever filling out a form that asked such a question, except for maybe licensing forms, so I am just wondering what exactly are the consequences of one or more malpractice suits on your record.

I believe the resident is partly at fault for knowing that she/he had a sick patient and not following up on him for 24h. for not following up on the cxr. i am sure he/she was overwhelmed with so many patients but it looks badly.

 

[ampaphb]

I would give less fault to the resident here. Yes she probably should have followed up on the xray, and notified her attendings, but you also have to keep me in mind that residents are much more overworked relative to attendings (at most places) and in my opinion, the attending is ultimately responsible. If she was working from 7am-9am, this is a violation, and fatigue and sleep deprivation may have played a factor.

There were failures in the administration and in the system and I think that is what ultimately warranted the reckless indifference.

Another malpractice question for ampaphb. If a resident has a malpractice suit on their record, and is in this database, what exactly are the ramifications? Do you report it to state licensing boards? Does it make your malpractice insurance go up? Is this database available to the general public, if so what is the link? I cant remember ever filling out a form that asked such a question, except for maybe licensing forms, so I am just wondering what exactly are the consequences of one or more malpractice suits on your record.

The relevant website to review is http://www.npdb-hipdb.hrsa.gov/

 

[rehabdocmd]

I dont think the databank is open to the public or I could not figure it out. I think public court records are public but I dont think that databank is.

Rehab 26, I could see how you can get defensive and protect your program. Your colleague from Mt Sinai has posted on other threads that certain attendings has been asked or forced to leave Mt Sinai. There is probably a reason for that. Other prominent attendings have also left your program. The posts here are from reputable sources (abc, new york law journal, state health dept) and judges who have criticized the standard of care at Mt Sinai.

I am glad your program is making changes but there is probably reasons why the changes are being made. No matter who the comments are from, its important for medical students to visit programs, and rotate at programs to get a true sense of what would be a good fit for them.

The relevant website to review is http://www.npdb-hipdb.hrsa.gov/

 

[ampaphb]

http://www.npdb-hipdb.hrsa.gov/pubs/Data_Banks_at_a_Glance.pdf

 

[jjwallace]

Thanks for the interesting link.

It looks like Mt Sinai recently underwent an ACGME review and got the worst accreditation cycle you can get- one year. It's worse than NRH's 2 year probationary cycle. I wonder if it had anything to do with these lawsuits?

 

[Gainer]

Thanks for the interesting link.

It looks like Mt Sinai recently underwent an ACGME review and got the worst accreditation cycle you can get- one year. It's worse than NRH's 2 year probationary cycle. I wonder if it had anything to do with these lawsuits?

ACGME won't give a probationary accreditation because of lawsuits. They must have found some severe violations of the ACGME rules that need to be corrected. Usually they give the program a 3 year accreditation for problems. 2 if they are not corrected promptly, and a 1 only if the program has been warned before.