FIRST DO NO HARM 8 Ja nua ry 2008 A Pa tie nt I nve stig a tio n - PDF document

11/6/2014 WHAT HAPPE NE D T O ME ? FIRST DO NO HARM 8 Ja nua ry 2008 A Pa tie nt’ I nve stig a tio n into Ne g a tive Surg ic a l Outc o me s DAVI D ANT OON T his pr e se ntation is the e xpr e ss opinion of David Antoon VICT IM HAR M  L e g a l Atte mpts  Pe rma ne nt Physic a l  Vic tim c re dib ility is Disa b ling Ha rm a tta c ke d  Disa b ling  “E xpe c te d De pre ssio n/ PT SD Outc o me ”  L  T o ss o f o rt Re fo rm  L Re la tio nships/ I ntima c y e g a l E xpe nse s  No Disc lo sure -  L o ss o f E mplo yme nt  “Wha t Ha ppe ne d to  L o ss o f Me dic a l Be ne fits Me ? ”  Divo rc e  No Clo sure  Suic ide Me dic ine vs Aviation Me dic ine vs Aviation  Airc ra ft Ac c ide nts - Ne xus o f F a ilure s o Huma n F a c to rs  F a tig ue  Ne g a tive Outc o me (Me dic a l o r Avia tio n)  F a ilure to tra ining o Ba d L uc k? de sc rib e d b y Do c to r  F a ilure to e va lua te o Or Ca usa l F a c to rs?  Stre ss  Alc o ho l/ Drug s/ Me dic a tio n  Ma na g e me nt/ Ove rsig ht o We a the r o E q uipme nt (Airc ra ft o r g ro und) 1

11/6/2014 Me dic ine vs Aviation Me dic ine vs Aviation  Airc ra ft Ac c ide nt I nve stig a tio n  Me dic a l Ne g a tive Outc o me I nve stig a tio n o I nde pe nde nt I nve stig a tio n o Pe e r Re vie w (Unlike ly) o Multidisc iplina ry Bo a rd Me mb e rs o No t I nde pe nde nt o De te rmine Ac tua l a nd Pro b a b le Ca use s o Co nfide ntia l o Pub lic Re le a se o f All I nfo rma tio n o No T ra nspa re nc y o No Co nfide ntia lity o No Co nc e a lme nt o T o ta l T ra nspa re nc y  Ag e nc ie s Co nta c te d Ove r vie w Ove r vie w  Omb udsma n (Co nfide ntial)  Ho spital CE O re q ue sting Pe e r Re vie w (No Re spo nse )  Pa tie nt Pre pa ra tio n/ Re se rva tio n Afte r Dia g no sis  Me dic a l Bo a rds (Ohio , Uta h, I ndia na , I o wa ) (Co nfide ntia l)  Blue Cro ss (E  Ne g a tive Surg ic a l Outc o me / Ob se rva tio ns mplo ye r) a nd He a lth Ne t F e de ra l Se rvic e s (Go vt) (No Re spo nse )  CAQH (T o p Se c re t !)  I nve stig a tio n (Airc ra ft Ac c ide nt Me tho do lo g y)  Ohio De pa rtme nt o f I nsura nc e (Co nfide ntial)  Me dic a l Re c o rds Se a rc h  Ohio De pa rtme nt o f He a lth  CMS (Ce nte rs o f Me dic a re / Me dic aid Se rvic e s)  Cre de ntia ls E xa mina tio n  Jo int Co mmissio n (COI , Co nfide ntial)  Othe r Vic tims  HHS/ OI G, CMS/ OI G (L a c k o f Re so urc e s)  Co nflic t o f I nte re st  HHS/ Offic e o f Civil Rig hts (HI PAA)  F DA (Co nfide ntia l – Wa rning L e tte r)  Ohio I nspe c to r Ge ne ra l (Ove rsig ht o f Me dic a l Bo a rds)  Ohio Atto rne y Ge ne ra l (Only I nve stig ate s Me dic a l F ra ud)  Ne ws Me dia (Co nflic ts o f I nte re st, Ce nso ring o f Co mme nts) PAT IE NT DE CISIONPR E PAR AT ION  R e ad Patr ic k Walsh’s Book - SUR VIVING PR OST AT E CANCE R  Vo lume Ce nte r  Re c o rd o f Po sitive Surg ic a l Outc o me s  Surg e o n with Hig h Vo lume E xpe rie nc e  Surg e o n who is Bo ard Ce rtifie d  Surg e o n with Po sitive Surg ic a l Outc o me s  Assure that o nly this surg e o n will pe rfo rm the pro c e dure 2

11/6/2014 R e pr e se nte d by R e pr e se nte d by Sur ge ons Doc tor On Hospital We bsite R e pr e se nte d by Doc tor 3

11/6/2014  “Ne a rly fo ur ye a rs a g o , g o ve rnme nt inspe c to rs inve stig a ting a c o mpla int b y re tire d Air F o rc e Co l. Da vid Anto o n thre a te ne d to c ut o ff Cle ve land Clinic fro m re c e iving Me dic a re pa yme nts a fte r b e ing sto ne wa lle d b y ho spita l o ffic ia ls. T he Vie tna m c o mb a t ve te ra n ha d a c c use d the ho spita l o f fa iling to fully inve stig a te his c ha rg e tha t so me o ne o the r tha n his a utho rize d surg e o n ha d pe rfo rme d pro sta te c a nc e r surg e ry a nd le ft him g ra ve ly injure d..”  “All o f the vio la tio ns we re re po rte d to the ho spita l's  “A thre e -mo nth Mo de rn He a lthc a re a na lysis o f hundre ds b o a rd o f g o ve rno rs a nd to Co sg ro ve , who in a t le a st o f pa g e s o f fe de ra l inspe c tio n re po rts re ve a ls the 1,268- o ne c a se wa s pe rso na lly c ite d fo r syste mic b e d ho spita l spe nt 19 mo nths o n “te rmina tio n tra c k” with ma na g e me nt fa ilure . T he y c ite d him fo r fa iling to Me dic a re b e twe e n 2010 a nd 2013 a s a re sult o f mo re e nfo rc e a n a de q ua te info rme d-c o nse nt syste m a fte r he tha n a do ze n inspe c tio ns a nd fo llo w-up visits trig g e re d a dmitte d so me pa tie nts we re no t to ld a ro b o t wo uld b e b y pa tie nt c o mpla ints..” use d in the ir pro c e dure ..” 4

11/6/2014  “… Ohio ho spita l inspe c to rs a g a in thre a te ne d to  “T he b usine ss-b a c ke d L e a pfro g Gro up, fo r insta nc e , suspe nd Cle ve la nd Clinic 's pa rtic ipa tio n in Me dic a re g a ve the Cle ve la nd Clinic a D whe n it e xpa nde d its a fte r ho spita l o ffic ia ls to ld a pa tie nt the y ha d no sa fe ty g ra de s in 2012 to inc lude fa iling g ra de s. T he e vide nc e tha t a surg e o n ne g le c te d to re mo ve a suture g ra de impro ve d to C la st ye a r.” ne e dle a fte r surg e ry. I t wa s o nly unde r q ue stio ning b y a g o ve rnme nt inspe c to r tha t a ho spita l o mb udsma n la te r a dmitte d ha ving a n X-ra y o n file sho wing the le ft-in ne e dle , a c c o rding to inspe c tio n re po rts o n file with the CMS..” A R obotic Sur ge r y Disaste r 5