Category: Opioid Safety

6-Month Return on Investment of Continuous Electronic Monitoring: An Interview with Eyal Zimlichman, MD

Eyal Zimlichman, M.D., MSc., holds dual appointments as Deputy Director General and Chief Quality Officer at Sheba Medical Center in Israel and at the Center for Patient Safety Research and Practice at Brigham and Women’s Hospital and Harvard Medical School.

In an in-depth discussion with the Physician-Patient Alliance for Health & Safety (PPAHS), Dr. Zimlichman discusses his research, experience, and thoughts on continuous electronic monitoring. He says that his research of a continuous electronic monitoring system has shown a 6-month break-even point for acquisition and implementation, and thereafter cost savings. To listen to the interview with Dr. Zimlichman on YouTube, please click here.

Continue reading “6-Month Return on Investment of Continuous Electronic Monitoring: An Interview with Eyal Zimlichman, MD” →

3 Things to Remember in the Fight Against Opioid Misuse, Abuse, and Overdose

According to the Centers for Disease Control and Prevention (CDC), the misuse, abuse, and overdose of opioids has reached epidemic proportions:

More people died from drug overdoses in 2014 than in any year on record. The majority of drug overdose deaths (more than six out of ten) involve an opioid. And since 1999, the rate of overdose deaths involving opioids (including prescription opioid pain relievers and heroin) nearly quadrupled. From 2000 to 2014 nearly half a million people died from drug overdoses. 78 Americans die every day from an opioid overdose.

To address this epidemic, recent regulatory and legislative efforts have targeted misuse, abuse, or overdose of opioids: Continue reading “3 Things to Remember in the Fight Against Opioid Misuse, Abuse, and Overdose” →

Dentistry and Death: More Laws or More Education?

By Michael Wong, JD (Executive Director, Physician-Patient Alliance for Health & Safety)

Editor’s Note: Last week, we asked whether the use of birth control is a patient safety risk because of possible development of blood clots. In this post, the question is – do we need more laws or more education to help prevent anesthesia-related deaths in dental procedures and oral surgery.

Most people would not associate dentistry with death – discomfort perhaps – but not death.

However, the death of Caleb Sears forces us to consider the possibility of death in dentistry – or, more accurately, oral surgery:

Caleb Sears was a healthy six-year-old living in the Bay Area. He was in his first year of elementary school and just starting to read and write. He loved playing with his little sister, climbing trees, singing Les Miserables, and making up funny stories about llamas and time machines. Continue reading “Dentistry and Death: More Laws or More Education?” →

Patients Need to Be Better Assessed for Respiratory Compromise

Editor’s Note: What might better assessment for respiratory compromise mean to a patient’s outcome? We ask this question in light of yesterday’s post on an assessment tool and the death of 17-year old Logan.

Yesterday, we posted on research by Hiroshi Morimatsu, M.D.,Ph.D (Okayama University Hospital, Okayama, Japan) and his colleagues on whether a patient pulmonary index could be a predictor of respiratory adverse events.

On July 23, 2007, 17-year old Logan died after successfully undergoing routine surgery to correct his sleep apnea. Continue reading “Patients Need to Be Better Assessed for Respiratory Compromise” →

Opioid Pain Medication & Assessing the Risk of Respiratory Compromise: Pamela Parker, RN on the Death of Her 17 Year Old Son

In this Podcast with PPAHS, Pamela Parker, BSN, RN, CAPA describes her son, Logan, as “a red haired, fair skinned, seventeen year old fun big kid … [who] was very silly and … even embraced the term ‘goofy’.”

Logan had obstructive sleep apnea (OSA) with elements of central sleep apnea. He underwent surgery to have “his tonsils and his uvula removed, septum and his turbinate repaired. Basically, opening up the airway by removing the tissue in the back of his airway.” Continue reading “Opioid Pain Medication & Assessing the Risk of Respiratory Compromise: Pamela Parker, RN on the Death of Her 17 Year Old Son” →

The Epidemic of Opioid OverPrescribing Suggests the Need for Caution and Careful Monitoring

Recent research has found that opioids are being overprescribed to patients.

A study at the Johns Hopkins University School of Medicine has found that opioids are being overprescribed to children.

Myron Yaster, MD (Richard J. Traystman Distinguished Professor, Departments of Anesthesiology, Critical Care Medicine and Pediatrics, Johns Hopkins University School of Medicine) and his colleagues interviewed the patients of pediatric patients who had been given opioids upon discharge from hospital. They were looking to determine: Continue reading “The Epidemic of Opioid OverPrescribing Suggests the Need for Caution and Careful Monitoring” →

Was Gary Bougie’s Post-op Gallbladder Surgery Death Preventable?

Fox 9 News recently reported on the death of Gary Bougie following routine gall bladder surgery:

Gary Bougie was two months shy of his 36th birthday when he died nearly two years ago. His family suspects he died from a condition called opioid-induced respiratory depression after going to the hospital for gallbladder surgery and they want to warn other families about how to possibly avoid a tragedy like this …

Bougie had just opened his new restaurant when he went to United Hospital for surgery to remove his gallbladder back in April of 2014. He stayed overnight for observation, but his parents say learning the next morning he’d passed away from complications during the night was surreal.

While the medical examiner ruled there was no anatomical cause for Bougie’s death, his family believes the mix of pain meds he was on caused him to fall into such a deep sleep, he stopped breathing. They are suing the hospital. Their attorney says even though nurses checked on Bougie once an hour, they should have used a fingertip sensor that would have alerted them when the level of oxygen in his blood went too low. Continue reading “Was Gary Bougie’s Post-op Gallbladder Surgery Death Preventable?” →

Tools and Recommendations for Assessing the Risk of Over-Sedation and Respiratory Depression

Although there are benefits to the use of opioids for the management of pain, particularly with patients post-operatively, there are risks of over-sedation and respiratory depression, as The Joint Commission cautions in its Sentinel Event Alert “Safe use of opioids in hospitals”:

While opioid use is generally safe for most patients, opioid analgesics may be associated with adverse effects, the most serious effect being respiratory depression, which is generally preceded by sedation.

Assessing which patients are at risk of developing opioid-induced respiratory depression (OIRD) would be of benefit, as treatments could be altered or tailored to the particular patient to reduce the risk of opioid-related adverse events.

The Michigan Opioid Safety Score (MOSS) was “developed to incorporate patient risk, respiratory rate, and sedation into one bedside score that could be used to improve patient safety during inpatient opioid therapy. Scoring is based on a summation of risk data with objective bedside measures of over-sedation trumping a patient’s subjective reports of pain.” Continue reading “Tools and Recommendations for Assessing the Risk of Over-Sedation and Respiratory Depression” →

What do Joan Rivers and Katherine O’Donnell Have in Common?

Joan Rivers and Katherine O’Donnell underwent medical procedures. They and their loved ones expected these procedures to be routine – and, yet, they tragically died during their medical procedures prompting their families to commence lawsuits.

As reported by CNN, Joan Rivers died during throat surgery: Continue reading “What do Joan Rivers and Katherine O’Donnell Have in Common?” →