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Landmark “Doctors in Training” Case Leads to Nationwide Safety Improvement

It is not exactly unique to hear plaintiffs or medical malpractice lawyers mention that a key goal of a lawsuit is to ensure that things are made better for future patients. These claims are not idle talk. Time and again medical facilities and other care center enact real meaningful changes in the aftermath of a medical error for which they ended up being held civilly liable.

Medical Malpractice Lawsuit–They Really Do Make a Difference
Earlier this month the New York Times published a story on just such a case that set a precedent and ultimately forced nation-wide changes that likely preventing many future patients from suffering the consequences of poor medical care.

The case, Zion v. New York Hospital, involved the care received by an 18-year old college freshman in 1984. The young woman had a high fever and bizarre “jerking” movements. She had a history of depression and was on an antidepressant at the time. A group of resident doctors (doctors in training) decided on a treatment plan that include use of an opiate drug, hydration, and observation. Eventually she was given another drug and tied to the bed with restraints, after which her resident doctor stopped normal observations to take a nap (common at the time).

When she was finally checked on again, nurses noticed that the woman had an incredibly high temperature which eventually threw her into cardiac arrests. She ultimately died.

All of these eventually led to medical malpractice lawsuit being filed. The main issues in the case–and the surrounding publicity of the case–involved the work schedule of those providing care. Understandably, the teen’s parents were shocked to learn that their daughter was seen only by doctors in training and that those doctors often worked 36 hours shifts.

The actual legal case ended up with some liability found for the hospital. Yet, the real legacy was the huge debate it stirred on the safety of current work protocols for resident doctors. In fact a grand jury was ultimately convened which considered murder charges against the resident doctors. Charges were not filed, but the grand jury report pilloried the hospital for its practices.

Eventually changes were enacted nationwide for work schedule or resident doctors. For example, in 1987 there were recommendations for an 80-hour work week and no more than 24 hours of work in a row. Those requirements were finally made mandatory in 2003 by the Accreditation Council for Graduate Medical Education. Last year the Institute of Medicine urged even stricter standards.

The teen’s father who started the crusade is still at it–working to ensure the proposed standards are actually implemented. He pithily notes that “I don’t know anyone who still works 24 straight hours in any other business. And these are people with lives in their hands.”

Beyond this specific issue, the case Zion v. New York Hospital is a reminder of the critical role the civil justice system plays in enacting changes which prevent future instances of medical malpractice. It’s one of many reasons that if you have concerns about inadequate care at a medical institutions to contact an attorney to learn about your rights.

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