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Wrightsville Beach Medical Malpractice Law Blog

Lack of oxygen a top cause of birth injuries in premature babies

It is not always possible to control when a baby is born. According to the March of Dimes, nearly 10% of babies are born prematurely in North Carolina--a rate that is higher than many states'. And with how common premature babies are, it might make sense that doctors and hospitals nationwide understand how to keep both mother and child safe.

However, a high percentage of premature babies sustain severe birth injuries. And a new report connects long-term brain injuries to a significant lack of oxygen during and after birth.

Kentucky Medical Malpractice Review Panels Ruled Unconstitutional

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Kentucky enacted a Medical Review Panels Act in 2017 that required medical malpractice claimants, including in nursing home negligence cases, to submit their case to a panel of health care providers and an attorney for review before filing a lawsuit. In some cases this caused up to as much as a nine month wait for claimants before an injury or death victim could file suit.

In November of 2018, however, these medical review panels were ruled as unconstitutional by the Kentucky Supreme Court. The requirement that medical malpractice claimants (including in nursing home cases) get "approval" from these panels directly contradicted Kentucky's own constitution (Section 14), which states that every person has access to the courts "without... delay." People in Kentucky are supposed to have a right to "immediate access to courts," yet the law created a mandatory delay. It did allow claimants to bypass the review panel, but only if the defendants agreed to binding arbitration or bypassing the review panel process.

Nursing home fines drop significantly

Fines against nursing homes that were found to injure or endanger their residents were significantly reduced after the Trump administration changed its policy on the issue. Average fines dropped from $41,260 in 2016 under the Obama administration to $28,405 under Trump. The reason why fines decreased so much is due to a policy that changed the way nursing homes in North Carolina and other states were fined. It changed from the number of days they were out of compliance to a single fine for each reported violation.

This shift in policy was welcomed by the nursing home industry, but many health officials say that it could make life more dangerous for seniors. Since taking office, the Trump administration has heeded a wide range of suggestions made by nursing home lobbyists who believed that enforcement of regulations was overzealous. This included an 18-month moratorium on penalties related to several new health and safety regulations implemented by the Obama administration.

Induction of Labor and "High-Alert" Drug Pitocin/Oxytocin

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Oxytocin is a naturally-produced hormone that plays a role in social bonding, sexual reproduction, childbirth, and the period after childbirth. The synthetic version of oxytocin (brand name "Pitocin") is often used for the induction of labor, and in the labor and delivery process to cause or strengthen labor contractions.Using Pitocin interrupts the natural process of birth, and does not allow for spontaneous labor. Spontaneous labor is generally healthier for both the mother and the baby.

Despite its common use, oxytocin is considered a "high-alert" medication, which means that it has a higher risk of causing significant patient harm when used in error. When harm does occur with high-alert medications, the effects are more devastating to patients.

Quality of Care Regulations in Nursing Homes

Virtually all skilled nursing facilities accept taxpayer dollars via Medicare. As a condition of being able to get paid Medicare dollars, Medicare has regulations that set minimum standards for the quality of nursing care provided in nursing homes. The purpose of these regulations is in part to ensure proper care is given in order to avoid neglect, injury, and even death to nursing home patients. These regulations, 42 CFR 483.25, address some of the more common types of problems we see in nursing home cases, problems that can lead to injury, or even death.

Diversicare Nursing Homes in Kentucky

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According to the Nashville Post, as of December 1, 2018, Diversicare sold three long-term care facilities in Kentucky, bringing down their number of nursing homes in Kentucky to ten facilities. Diversicare of Fulton, Diversicare of Glasgow, and Diversicare of Clinton were collectively sold for $18.7 million. The article goes on to state that all net proceeds were used to pay off associated indebtedness, with almost $6.5 million set aside as a contingency expense related to a U.S. Department of Justice investigation that was started four years ago. The investigation involves alleged false claims, the company's rehabilitation practices and policies, and pre-admission procedures. This article suggests that executives of Diversicare would like to settle with the government, but there is no guarantee that the money set aside will cover the settlement. Diversicare apparently suffered a net loss of $7.4 million due to this ongoing investigation, and sold the three facilities in Kentucky as a way to address that issue.

Genesis HealthCare Nursing Homes in Kentucky

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Genesis HealthCare Corp. is the nation's largest nursing home chain in America, with around 400 nursing homes and other facilities. It is a large, publicly-traded company. Genesis operates in approximately 30 states, including Kentucky. We previously wrote about the Medicare Five-Star Rating System, and even more detail can be found here at the American Health Care Association's website. A one-star rating is the lowest star rating a nursing home can get, and as of very recently, Genesis had six one-star nursing homes in Kentucky.

Nursing Homes in North Carolina: Special Focus Facilities

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North Carolina has two facilities that have been designated by the Centers for Medicare and Medicaid (CMS) as Special Focus Facilities (SFF). CMS started the SFF Initiative as a way to stimulate sustainable improvement in some of the country's worst nursing homes. Each nursing home undergoes periodic inspections throughout the year in order to ensure that residents are being cared for properly and are safe from harm. When a facility has deficiencies, they must come up with a "plan of improvement" to immediately address these issues. Some nursing facilities, however, institute just enough improvement that they are in compliance on one survey. Soon after, though, significant problems would resurface. These types of facilities had a reputation for having a "yo-yo" compliance history, according to CMS, and would rarely actually address the underlying systemic issues that caused these serious deficiencies. Thus, the CMS Special Focus Facility Initiative was created to address those problems.

Fetal macrosomia and medical malpractice

Fetal macrosomia is the medical term for a newborn who weighs more than the average baby. A baby weighing more than 9 pounds 15 ounces may experience serious health complications. Fetal macrosomia may cause problems during a vaginal delivery, and may cause the baby to incur injuries during the birth process. Additionally, fetal macrosomia may cause a baby to experience other health issues later on.

Errors in infant resuscitation

North Carolina expectant parents may be aware that infant resuscitation is sometimes needed after birth. Placental problems, maternal infections, and sudden bleeding during pregnancy can all raise the risk of this being necessary. That risk may also increase with premature labor, an umbilical cord prolapse, an unusually large baby, or the use of forceps, vacuums, and other birth-assisting tools.

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