Hospitals Need to Report Infectious Outbreaks

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 “Sunlight is said to be the best of disinfectants…”

    – Louis Brandeis

The CDC estimates that there are approximately 1.7 million hospital-acquired infections each year, resulting in almost 100,000 wrongful deaths.

According to the Committee to Reduce Infection Deaths (RID), the most dangerous hospital-acquired infection is MRSA, a superbug that has become resistant to antibiotics. Hospital infections that are closely behind are vancomycin-resistant Enterococcus (VRE) and Clostridium Dificil (C-Diff).

In many states, health officials require hospitals to disclose information regarding infectious outbreaks. While some willingly comply, there is no incentive for hospitals to report because in most cases there are no regulatory or financial penalties for hospitals that don’t release such vital information.

There have been cases when records of infections have been released months or even years after known outbreaks, preventing patients from making informed decisions about which hospitals they choose to trust for their care.

Advocates for easily accessible infection information believe that when hospitals do not release outbreak information, they cannot truly improve the quality of care they provide to patients.

Often, lethal outbreaks have only been disclosed in public medical journals written by the doctors who treated infected patients. Concealing vital information which should be publicly disclosed places countless lives in danger.

As of October 2011, state legislation on healthcare-associated infections included 30 states that had laws requiring infectious diseases to be reported publicly. Five states, including Arizona, still give hospitals the option to voluntarily disclose infectious outbreaks or non-publicly report them to the Division of Health of the State Department of Health and Human Services. The remainder of the states have pending healthcare-associated infection legislations or no laws at all on reporting infectious outbreak information.

What is it going to take to end the silence?

States need to take immediate action to force hospitals to publicly disclose vital information about infection rates to patients. Reporting requirements should be amended to include strict regulatory and financial penalties for non-compliance.

The most vulnerable populations–the young, the elderly, and those with delicate immune systems–are the ones at most risk to contract an infection in a hospital. Through appropriate penalty-based reporting systems, hospitals can be held accountable and hopefully incentivized to take proactive steps to curtail hospital-acquired infection rates.

Medical Errors: Patients Deserve Safety

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Last summer, a Senate sub-committee on patient safety heard testimony that preventable medical errors in hospitals were the third leading cause of death in the U.S. The committee had called a hearing after a study appeared in the Journal of Patient Safety that found that more than 400,000 patients die each year from preventable injuries suffered in hospitals.

Tragically, patients are suffering medical malpractice not just in hospitals—medical injuries can often result from a delayed or wrong diagnosis at a doctor’s office, from receiving the wrong medication, from medical error or acquiring an infection during a procedure, or from inadequate care at a skilled nursing facility or nursing home.

With the goal of improving patient safety and increasing medical provider accountability, two organizations launched grass-roots efforts to collect patient stories and lobby for change and transparency.

Safe Patient Project

In 2003, Consumer’s Union, which publishes Consumer’s Reports, launched an initiative to reduce hospital infection rates, which eventually became the Safe Patient Project. Their efforts helped pass patient safety laws in 27 states that require public reporting of infection rates.

The Safe Patient Project has now expanded to much more than preventing medically transmitted infections. If a patient has been harmed by medical errors, the Safe Patient Project is ready to collect their story, which they will use to lobby for improved patient safety. Their website is easy to navigate and stories are collected in the following areas:

  • Healthcare-Acquired Infections
  • Medical Errors
  • Doctor Accountability
  • Hip and Knee Replacement

The Safe Patient Project website also has an active blog that offers patient safety information, such as, “3 Questions to Ask Your Doctors About Your Medications,” “6 Questions to Ask Before Getting a CT Scan or X-Ray,” and “A Surprising Way to Avoid Medical Errors in the Hospital.”

According to the Safe Patient Project, if you are planning a hospital stay, ask a friend or relative to monitor your care, insist that nurses and doctors wash their hands, and ask about medications that are unfamiliar. Also make sure hospital staff checks your wristband when delivering medication and make sure that any surgical site is marked.

Patient Voice Institute

Like the Safe Patient Project, the Patient Voice Institute is a non-profit patient advocacy organization that collects patient stories and lobbies for positive change in patient safety and dignity.

The Patient Voice Institute also has a blog on their website with patient stories about their experiences and how patients and their families were motivated to effect change. One story talks about the late architect Michael Graves, who was paralyzed by a rare virus and had a dehumanizing hospital experience. Another story is written by a mother who tragically lost her 22-year-old son due to medical error during brain surgery. She later helped pass a patient protection law in Colorado.

The more informed you are as a patient, the less likely you are to become a medical error statistic. The more patient groups shine a light on the vast numbers of such errors, the more likely medical institutions are to effectuate positive changes for patient safety.

National Dog Bite Prevention Week May 17-23, 2015

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What You Should Know About Man’s Best Friend

Mary was at a park walking Buster, her friendly Golden Retriever, when they came upon a couple walking their dog. Being extra-cautious, Mary asked the couple if their dog was friendly around other dogs. The couple assured her their dog would be fine around Buster. But as soon as Mary and her dog were close to the couple, their dog attacked Buster. As she was still holding onto his leash, Mary tried to pull Buster away but the other dog bit her in the leg. After the couple calmed their dog, they assured Mary he had all his vaccinations and quickly left the scene. Mary had to make a trip to urgent care to have her wounds treated.

Dog bites can happen quickly and unexpectedly. According to the American Veterinary Medical Association, each year over 4.5 million people are bitten by dogs in the U.S. Children make up half of the roughly 800,000 people who require medical attention after a dog bite.

How to Prevent a Dog Bite

To protect yourself and your children from a dog, always remember that even a nice dog is capable of biting. Some things to remember include:

  • Don’t look a dog in the eye as it may provoke him;
  • Use caution when entering an enclosed area where there’s a dog—he may become aggressive if he’s protecting his territory;
  • Don’t walk up to an unfamiliar dog to try to pet him, or try to reach through a fence to pet a dog;
  • Don’t try to pet a dog that’s eating or sleeping;
  • If a strange dog comes up to you stay still and don’t make sudden movements.

Which Dog Breed is More Prone to Bite?

Can you predict if a dog will bite based on his breed? Pit Bull terriers are at the top of the list for causing the most fatalities due to bites. But a study from the University of Pennsylvania found that of 33 breeds studied, the most aggressive dog turned out to be the Dachsund, with Chihuahuas and Jack Russell terriers in second and third place. A bite from a big dog may cause serious, catastrophic injury to its victim, but this study shows that small breeds can also be aggressive. People should be equally cautious when approaching a dog, no matter its size.

What to do After a Dog Bite

If, like Mary, you or a loved one suffers a dog bite injury, your first priority should be to seek medical attention.

Because Mary was in a public place and she was not provoking the dog or trespassing on the couple’s property at the time of the attack, under Arizona law the couple is liable for any injury or damage caused by their dog.

But the issue of provocation may be left to a jury to decide. The couple could say that Mary was trying to separate the dogs and that’s why she was bitten. But because the attack was so quick and Mary was holding onto Buster’s leash trying to pull him way from danger when she was bitten, a jury may conclude she did not provoke the dog and hold the couple responsible.

Before the couple left the scene with their dog, Mary should have asked them for their names and phone number. If they refused to provide such information, she could have dialed 911. If there happened to be any witnesses, Mary should have asked for their contact information as well.

Mary should have also reported the dog to the local animal control, which would investigate the dog bite and quarantine the animal if necessary.

National Dog Bite Prevention Week

May 17-23, 2015, is National Dog Bite Prevention Week. It’s a good time to familiarize yourself and your family with dog behavior and learn what you can do to prevent your dog from biting someone.

According to AVMA, a baby or small child should never be left alone with a dog. Teach children to be careful around pets and strange animals. They should learn never to approach a strange dog, and to ask permission from an owner before petting a dog.

Dogs can make wonderful pets and bring joy and comfort to its owners. But dogs can also react unexpectedly and aggressively under what may seem like a normal situation. By treating dogs with respect and caution you’ll make sure you, your children and other family members are not on the receiving end of a dog bite.

Facts About Dog Bites

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People own dogs for many reasons–for the unconditional love and companionship they provide; to assist with medical conditions such as depression, diabetes, seizures or Alzheimer’s; or to help reduce stress and provide comfort in institutional settings like hospitals and nursing homes. Dogs can enrich the lives of their owners and provide emotional support for the entire household.

But owning a dog comes with responsibilities—they need to be properly cared for, taken for walks or runs, and their vaccinations must be kept up-to-date. By providing proper care and attention, pet owners can make sure their dogs grow up to be healthy and well socialized, which can make a difference between raising a happy, socially adaptable animal or one that grows up to be aggressive and dangerous.

Arizona law about dog bites

If you’re a dog owner in Arizona, you should be aware of a few facts about dog bites:

  1. You, or the person responsible for the dog at the time the damages were inflicted, are strictly responsible for any injury or damage caused by your dog;
  2. You may be strictly liable if your dog bites someone, even if the dog is known to be harmless and has never before been aggressive or bitten anyone;
  3. If your dog bites someone, you may have a defense if you can prove the person who was bitten had been provoking the dog or was trespassing on your private property.

Laws pertaining to dogs can get complicated fast

Consider this example. You own a dog that’s friendly, docile, and has never bitten anyone. Your brother goes over for a visit, and when he leaves, he takes your dog with him. Arriving home, he takes your dog for a walk. The dog gets loose and attacks a dog belonging to a neighbor. As your brother and his neighbor attempt to separate the dogs, your dog bites the neighbor.

Are you, the owner of the dog, liable for the dog bite injury or does it fall on your brother? Supposing your dog is known to be perfectly friendly and has never before bitten anyone, is that a defense? Under Arizona law, you can be held responsible anyway.

Arizona dog bite law clearly states: “Injury to any person or damage to any property by a dog while at large shall be the full responsibility of the dog owner or person or persons responsible for the dog when such damages were inflicted.” (Arizona Revised Statutes 11-1020)

Notice the all-inclusive part that says “the dog owner or person or persons responsible for the dog when such damages were inflicted.” So both you and your brother could be held liable unless you did not give him permission to take your dog–then all liability would fall on him.

However, because the injury to the neighbor happened while he was in the process of trying the separate the dogs, a jury could decide that in doing so, the neighbor was provoking the dog. Provocation is one of only three possible defenses in an Arizona dog bite case. Arizona law says “Proof of provocation of the attack by the person injured shall be a defense to the action for damages. The issue of provocation shall be determined by whether a reasonable person would expect that the conduct or circumstances would be likely to provoke a dog.” (Arizona Revised Statues 11-1027)

Two other possible defenses to a dog bite could prevail:

1. If the dog was a military or police dog

2. If the person was bitten while trespassing on private property.

Any dog is capable of biting 

Even if your dog has never shown a trace of hostility and has never before bitten anyone, that is not a defense. Arizona is not one of the states that provides for “one free bite,” where you might be exempt from liability the first time your dog bites someone.

For more information about Arizona laws pertaining to dog bites take a look at the Arizona Revised Statutes Section 11-1001 through 11-1029, or contact our office to talk to one of our experienced dog bite attorneys.