Massive Fraud Uncovered at New York City Hospitals

I don't think I'm overstating matters in the headline. The City of New York operates 11 hospitals via the Health and Hospitals Corporation [ed: see the comments for clarification on relationship between NYC and the HHC]. They are: Bellevue, Coney Island, Elmhurst, Harlem, Jacobi, Kings County, Lincoln, Metropolitan, North Central Bronx, Queens and Woodhull.

Each and every one of those hospitals was found faking records, including coverups of medical malpractice and inadequate care.

A months-long probe found coverups at all 11 Health & Hospitals Corp. hospitals — the only option for millions of New Yorkers who cannot afford private medical centers.

From 2004 through September 2008, the state cited city hospitals 68 times for violating laws that require immediate reporting of "adverse events," records show.

Each hospital — Bellevue, Coney Island, Elmhurst, Harlem, Jacobi, Kings County, Lincoln, Metropolitan, North Central Bronx, Queens and Woodhull — had at least one citation.

The law requires all New York hospitals to quickly report all serious medical mishaps to the state.

"There's a tremendous lack of confidence in the reporting," said Arthur Levin, director of the Center for Medical Consumers. "It matters because it is a way to understand where the safety problems are. . . . This identifies what goes wrong and where."

Hidden incidents uncovered by The News — corroborated by dozens of interviews with doctors, patients, lawyers and families of victims — bordered on the Medieval.

Some incidents were simply not reported, while others were reported long after the fact, making investigation impossible. Some records were incomplete or even fictional.

* A stroke victim's leg had to be amputated after gangrene was left untreated. No report.
* An ill infant died after sitting, unexamined by a doctor in an ER for 24 hours. Confronted for not having enough doctors on duty, they produce a "corrected" report saying there was – a month after the fact.
* A mental patient hanged himself and, after several days, died. Though hospitals must report suicides, they report this one as an "unexpected death."
* Records were altered after medical students made mistakes and an infant died.
* Logs for a respirator were changed after staff failed to notice it wasn't turned on. The patient died.

The findings come a year after employees of Kings County Hospital tried to hide the death of 49-year-old Esmin Green. Hospital staff wrote in records that she was fine; a shocking video showed Green dead on the floor.

New York City has some of the best hospitals in the world, but these 11 aren't among them. The best hospitals are the private institutions such as Hospital for Special Surgery, Memorial Sloan Kettering, New York–Presbyterian Hospital, Weill Cornell, and Mount Sinai Medical Center.

This is the Obama health care in action. It's what the care will be in microcosm. Inadequate care, but access is provided.

Enforcement of existing regulations shows that several of the hospitals received no citations, despite racking up hundreds of violations. The oversight is completely lacking:

Since 1999, all New York hospitals have been required to self-report a long list of medical incidents to NYPORTS, which in turn analyzes the incidents and implements patient safety reform.

Sunday NYPORTS barely functions. The Statewide Council that oversees it hasn't met in more than two years. Though NYPORTS is supposed to release "annual" reports, the last one filed is dated 2004.

Levin, a consumer member of the NYPORTS Council, says he's watched the system "sort of gradually slide into total dysfunction."

While all hospitals have been underreporting bad outcomes for years on end, the HHC hospitals have underreported to a much greater degree: 34.8 incidents versus 45.5 for every 10,000 patients discharged.

The HHC will obfuscate that the HHC hospitals handle millions of admissions every year, 400,000 of which are uninsured, but that ignores the fundamental issue that they provide inadequate care to all those who come through their door. Insurance isn't the issue - the quality of care and the subsequent coverup of how inadequate that care is.

Unconscionable: Veterans Administration Hospital Botches 92 of 116 Prostate Cancer Treatments

Not only did the hospital botch the procedures, but regulators not only overlooked the errors, but made attempts to allow the doctor to revise his treatment plan for some of those patients to make the errors "go away".

Most of the seeds, 40 in all, landed in the patient’s healthy bladder, not the prostate.

It was a serious mistake, and under federal rules, regulators investigated. But Dr. Kao, with their consent, made his mistake all but disappear.

He simply rewrote his surgical plan to match the number of seeds in the prostate, investigators said.

The revision may have made Dr. Kao look better, but it did nothing for the patient, who had to undergo a second implant. It failed, too, resulting in an unintended dose to the rectum. Regulators knew nothing of this second mistake because no one reported it.

Two years later, in 2005, Dr. Kao rewrote another surgical plan after putting half the seeds in the wrong organ. Once again, regulators did not object.

Had the government responded more aggressively, it might have uncovered a rogue cancer unit at the hospital, one that operated with virtually no outside scrutiny and botched 92 of 116 cancer treatments over a span of more than six years — and then kept quiet about it, according to interviews with investigators, government officials and public records.

This is medical malpractice coupled with government failures. Not only did the doctors work for the Veterans Administration, but the VA failed to provide proper oversight or notice anything wrong with the treatment being offered in the cancer unit.

How many men suffered needless complications from this one doctor's malpractice?

One of the men didn't realize it was medical malpractice until he went to another hospital outside the VA to treat his condition and they informed him of the errors made by the prior doctors at the VA.

The problem at the Philadelphia hospital isn't alone. Several other cancer units at VA hospitals in Jackson, Miss., and Cincinnati, Ohio, were also closed, although the problems weren't nearly as widespread as the Philadelphia case.

In fact, none of the errors at this hospital might have been uncovered but for a clerical error where seeds of lower dosage were reported. That resulted in closer scrutiny by the NRC, which governs radiation usage, and the discovery of dozens of cases of improper placement of the seeds used in brachytherapy.

So, while the doctors in this program were contractors operating at the behest of the hospital, the doctrine of respondeat superior is going to hold the hospital liable because of the failure to oversee the program.

Kings County Hospital Psych Unit Cited By DOJ

The City of New York operates Kings County hospital and the psychiatric unit, which was the scene of multiple instances of abuse and failure to care for patients, including the infamous case of Esmin Green:

After a yearlong investigation, the Department of Justice portrayed the unit at Kings County Hospital Center as a nightmarish place where patients were not treated for suicidal behavior, were routinely subdued with physical restraints and drugs instead of receiving individualized psychiatric treatment, and were frequently abused by other patients.

The details are laid out in a 58-page report to Mayor Michael R. Bloomberg that was made public on Thursday.

The investigators found that the psychiatric service operated like a prison. The report said that instead of meaningful treatment and diagnosis, the patients received frequent visual checks by the staff, and that even when patients were supposedly under watch, violence and attempted suicides occurred.

Among the most serious incidents the report documented were an October brawl among six patients that left one needing surgery, and an autistic patient being forced to perform oral sex in November. The report also included allegations that a woman was raped and that a 14-year-old was forced to engage in oral sex by a 16-year-old.

All four incidents occurred after the highly publicized death of Esmin Green, a Jamaican immigrant with a history of depression, who collapsed on the floor of the emergency waiting room after waiting nearly 24 hours to be seen. A surveillance video showed Ms. Green, 49, lying on the floor for nearly an hour; during that time, a guard came in to check on her by wheeling his chair along, and another staff member prodded her with a foot.

The Esmin Green death is far more egregious than just that; there are allegations that hospital workers falsified records to cover up their horrible treatment.

This is government health care in a nutshell for those who think that our current private health care system is broken.

Questions Continue Swirling Over Esmin Green's Death

Esmin Green, the woman seen on the horrifying video at Kings County Hospital in her last moments as hospital workers ignore her condition and do not take action as they see her sprawled on the floor was lovingly and fondly remembered yesterday at her funeral as a hard working and loving mother who had suffered from mental problems in the past and may have had depression following the loss of a job and her apartment.

Esmin Green may have died alone and ignored on the floor of a busy Brooklyn hospital waiting room.

But her funeral Sunday at Jesus Is Lord Church in Canarsie, where she taught Sunday school, was packed to the rafters.

"She looks great. She looks beautiful," said church elder Compton Cuffy as he looked at Green, laid out in a white dress and white lace gloves in a blue casket.

A sign by Green's body said she was now "in God's care."

It was a poignant reminder of the care she did not receive during her last day on Earth.

Green, 49, a mother of six who moved to New York from Jamaica eight years ago, died June 19 after waiting more than 24 hours for help in the psychiatric ward of Kings County Hospital.

Security video showed her finally falling off her waiting room chair in convulsions.

While six people have been fired or suspended for failing to act, I'm more interested in knowing how and why records were falsified claiming that she was being properly cared for.

I think that investigators will find a horror show as they dig into the records. They may uncover rampant problems with records - that proper patient care was not a prerequisite, and that the mental health facilities at Kings County was anything but an environment where patients could receive care for their conditions. The NYCLU has been going after the hospital for failing to provide proper care for years, and this deadly incident may be the trigger to getting real reform implemented at the hospital.

New York Civil Liberties Union said last week that the hospital staff falsified Green's records to cover up the time Green went without assistance.

A federal investigation of the hospital was under way when the incident involving Green happened. The probe was sparked by abuse allegations at Kings County detailed in a May 2007 lawsuit filed by the NYCLU and the Mental Hygiene Legal Service, which alleged conditions at the facility are filthy.

Patients are often forced to sleep in plastic chairs or on floors covered in urine, feces and blood while waiting for beds, and often go without basic hygiene such as showers, clean linens and clean clothes, the suit states.

How Rich: NYC To Pay Funeral Expenses For Woman Left To Die

Well, isn't that rich of them. New York City will pay the funeral expenses for Esmin Green, the woman who died at Kings County Hospital on video showing hospital staff acting indifferent or ignoring the fact that she was lying on the floor.

Mayor Bloomberg announced yesterday that the city would pick up the funeral expenses of the 49-year-old Brooklynite, who was left to die on the waiting-room floor of Kings County Hospital's psychiatric emergency room on June 19.

The mayor also said developer Forest City Ratner had agreed to pay to fly Green's relatives here from Jamaica and back, and to fly the body there.

Why is the developer Forest City Ratner involved? Why isn't the City picking up all these expenses? Considering that the City should expect to lose a multi million dollar lawsuit, I guess they found a way for them to avoid breaking the budget?

The real problem, however, is that Kings County Hospital is a budget buster. More lawsuits have been filed and the City has paid out more settlements on Kings County malpractice suits than any of its other hospitals. In fact, Kings County has been responsible for 1/3 of all malpractice suits against the 11 hospitals in the NYC Health and Hospitals Corporation.

The hospital is facing another budget buster from a family who is suing on behalf of their son who died after being misdiagnosed and mistreated. They gave him allergy medication instead of providing treatment for MRSA.

Something needs to be done, and it's highly unfortunate that it took the death of this woman to do something about the dire situation at Kings County. There was criminal neglect, and while six people have already been fired, it is insufficient to change how the hospital operates. Criminal charges are being mulled, and I'd say that they're completely warranted.

They Look Real and Fabulous, But It's Still Malpractice

If you go to have plastic surgery to remove wrinkles and excess skin after you lose a whole bunch of weight, you'd think that you're going to get a tummy tuck and other similar procedures. Well, that's not what happened to one patient in Germany. They gave the 33 year-old woman breast implants - increasing her size from a C cup to a D cup.

A German woman is suing doctors after she checked in to have wrinkles removed - and woke up with a new pair of breasts.

Ingrid Bruelling, 33, had the operation in the German city of Kassel.

She wanted to give herself firmer skin and remove the wrinkles after losing 16 stone on a crash diet.

But when she woke up after the operation she found doctors had put two silicone implants into her breasts, increasing their size from a C cup to a D.

Doctors said the woman should not complain as the best way to tighten the skin and remove the wrinkles was to make her breasts bigger.

I still smell a medical malpractice suit coming on because they didn't do what she had authorized them to do. Her implants might look real and fabulous, but that doesn't mean that the doctors still aren't on the hook for malpractice. (HT: NJDhockeyfan at LGF)