A catastrophic brain injury resulting from a severe hypoxic or ischemic event is the type of medical malpractice case that represents the greatest cost to hospitals, society and the families of injured victims. A hypoxic brain injury occurs when the brain is deprived of sufficient oxygen for a prolonged period. An ischemic brain injury happens when there is an insufficient blood flow to the brain or a specific area of the brain, such as when a blood clot occurs in an adult or the blood supply to the baby is restricted from the placenta or umbilical cord. Many of these injuries are preventable. For example, a hypoxic brain injury in an adult that is preventable usually occurs because of the patient's underlying condition that they went into the hospital to have treated. This condition then worsens, causing cardiac or respiratory arrest. A hypoxic brain injury in a newborn child that is preventable often occurs because the condition of the baby in the uterus deteriorates and causes injury before the delivery, and the medical staff fails to recognize the problem and take action in time.
Several causes are responsible for preventable severe hypoxic or ischemic brain injuries:
- Inadequate communication
- Improper assumptions
- Mentality of healthcare providers
Inadequate communication is the greatest problem regarding preventable severe injuries that occur in hospitals. This occurs with the failure of the medical staff, including doctors and nurses, to properly communicate with each other. This often happens during a shift change as well. Also, the communication problems often involve more than one medical staff member. Therefore if multiple staff members are miscommunicating, the problem becomes more difficult to trace, and the ability for the hospital to trace the root cause and prevent the problem from happening again is very difficult.
Improper assumptions of responsibilities are another critical problem with preventable brain injuries. Many staff members just assume other members of the staff have performed various tasks related to the patient's medical care or assume other members of the staff have not conducted these tasks. This could result in a patient getting an overdose of medication for example. If a hospital has a high turnover rate or the medical staff is not familiar with each other, they are likely to make more mistakes because they fail to understand how each staff member functions or what areas of responsibility each staff member will handle in various situations. Doctors may believe nurses are handling certain areas of the patient's care or if multiple doctors are working with a patient, may incorrectly assume another doctor is handling certain areas of the patient's care, when in fact this may not be the case.
Mentality of healthcare providers is an overlooked area of medical malpractice. Often with cases involving medical negligence, doctors or nurses who are negligent are lacking the specific skill or knowledge in a specific area related to the condition of the patient. Instead of asking for help from a more qualified doctor or nurse, one who has a better knowledge-base in that specific area, their pride stands in the way and they attempt to solve the problem themselves, until they realize they are in over their heads. Another problem is the medical staff failing to recognize the warning signs the medical equipment is providing them. For example, if a baby is hooked up to an electronic fetal monitoring device and the machine is showing a problem with the patient, the medical staff may incorrectly believe the machine is malfunctioning, wasting precious time trying to correct the problem or find another machine, rather than attending to the needs of the infant.
Most doctors and nurses have great difficulty understanding why legal liability flows from the nature of the injury or death, rather than from the recklessness of their actions. As a result of this medical-legal disconnect, and the fact that doctors and nurses cannot maintain a constant state of high alert, preventable catastrophic injuries will continue to occur in hospitals and even though such injuries may be completely out of proportion to the actions of the doctors or nurses, the financial impact to the doctors and hospitals will be based on the outcome of those actions.
