General Surgery

Apr 25, 2018
A Complication Involving Laparoscopic Lysis of Adhesions
David B. Troxel, MD, Medical Director, Board of Governors
A medical malpractice case about laparoscopic lysis of adhesions involved negligent performance of surgery and mismanagement of postoperative care.

Dec 07, 2017
Teamwork Saves Lives in Bronx-Lebanon Hospital Shooting
Shelley Rizzo, MSN, CPHRM, Patient Safety Risk Manager, The Doctors Company, and Steven J. Weintraub, MD, Chief of Risk Management, North American Partners in Anesthesia
Teams pull together to save lives and provide support during a deadly hospital shooting.
From The Doctor’s Advocate

Jun 06, 2017
Prescribing Opioids Safely
Howard Marcus, MD, FACP
Dr. Howard Marcus discusses guidelines and recommendations for preventing opioid misuse and addiction in patients with acute or chronic pain.
From The Doctor’s Advocate

Apr 17, 2017
Prescribing Opioids Safely: How to Have Difficult Patient Conversations
Roneet Lev, MD, Chief of Scripps Mercy Emergency Department, Chair of Prescription Drug Abuse Medical Task Force, and President of Independent Emergency Physicians Consortium
Drug overdose is the leading cause of accidental death in the U.S., and opioids account for over 60 percent of those deaths. Building a strong doctor-patient rapport can help facilitate tough conversations with patients about opioid prescriptions and reduce risks that could lead to malpractice suits.

Mar 16, 2017
San Diego Death Diaries
Roneet Lev, MD
Dr. Roneet Lev provides insights into the prescription opioid abuse epidemic.
From The Doctor’s Advocate

Mar 16, 2017
Analysis of Medication-Related Claims from The Doctors Company
David B. Troxel, MD, Medical Director, Board of Governors
Dr. David Troxel reviews 1,770 closed by The Doctors Company in which patient harm involved medication factors.
From The Doctor’s Advocate

Feb 23, 2017
Caring for the Hospitalized Obese Patient
Paul Nagle, ARM, CPHRM, Director of Physician Patient Safety, and Shelley Rizzo, MSN, CPHRM, Patient Safety Risk Manager II.
Hospitalists and facilities can reduce potential liability when caring for obese patients by taking risk management steps, such as additional monitoring for patients with OSA.

Jan 05, 2017
Patient Safety in Anesthesiology
Donald Wood, CRNA, CPHRM, Patient Safety Risk Manager II.
Anesthesiologists can reduce potential liability by taking risk management steps, such as obtaining separate informed consent for anesthesia care.

Oct 26, 2016
Optimize the EHR: Better Workflow Means Better Work-Life Balance
Chad Anguilm, Director of Professional Services, Medical Advantage Group. Medical Advantage Group is a wholly owned subsidiary of The Doctors Company.
There are tools that can streamline patient care and payment workflows in the electronic health record (EHR). By dedicating time and effort up front to optimize the EHR, physicians can get relief from administrative tasks, reduce duplicate entry of data, and save time by not having to search for records in multiple places.

Sep 20, 2016
Money Talks: Discussing Cost with Patients Before Treatment Is a Win-Win
Ralph A. Gambarella, MD, Chairman and President of Kerlan-Jobe Orthopaedic Clinic, and a member of The Doctors Company's Orthopedic Advisory Board.
The physician needs to be involved in making sure that the patient is informed and educated about the financial burden of surgical and medical treatments. Doing this before proceeding with treatment can help lower the risk of a malpractice claim even when the medical outcome doesn’t meet the patient’s expectations.

Feb 18, 2016
Are Decisions Shared?
Robin Diamond, JD, RN, Senior Vice President, Department of Patient Safety and Risk Management
There is a growing emphasis on patient-centered care and shared decision making in healthcare.
From The Doctor’s Advocate

Oct 26, 2015
Reducing the Risk of Retained Foreign Objects During Surgery
Ernest E. Allen, CSP, ARM, Patient Safety/Risk Management Account Executive, The Doctors Company.
Medical RFI (radio frequency identification) chip technology is now available to track sponges and surgical towels used during a procedure.

Sep 03, 2015
Minimizing Surgical Errors
Jonathan Jones, MD
From The Doctor’s Advocate

Sep 03, 2015
Teamwork in the OR
Susan Shepard, MSN, RN, Director, Patient Safety Education, The Doctors Company
From The Doctor’s Advocate

Jun 08, 2015
MAC/Sedation Fires Increasing
Susan K. Palmer, MD, The Doctors Company Anesthesia Advisory Board Member
Dr. Susan Palmer offers strategies for preventing MAC/sedation fires. Author: Susan K. Palmer, MD
From The Doctor’s Advocate

Apr 20, 2015
Mid-level Practitioner Liability—Preventive Action and Loss Reduction Plan
This booklet can help practitioners avoid liability risks when hiring or working with mid-level practitioners.

Mar 14, 2015
Analyzing Bowel Perforation Claims
Darrell Ranum, JD, CPHRM, Vice President, Patient Safety and Risk Management
Darrell Ranum outlines findings from a recent analysis of bowel perforation claims. Author: Darrell Ranum, JD, CPHRM
From The Doctor’s Advocate

Feb 01, 2015
Patient Selection for Elective Procedures
Susan Shepard, MSN. RN, Director, Patient Safety Education.
The patient selection process is a valuable tool for loss control, because many claims occur with patients who are not appropriate candidates for a procedure.

Dec 10, 2014
Editorial Comment on Maintenance of Certification
David B. Troxel, MD, Medical Director, Board of Governors
Dr. Troxel suggests ways to restructure the MoC examination process to adapt it to changes in the healthcare delivery system.
From The Doctor’s Advocate

Dec 02, 2014
Diagnostic Error in Medical Practice by Specialty
David B. Troxel, MD, Medical Director, Board of Governors
This closed claim review focuses on the variance between specialties in the incidence of diagnosis-related error.
From The Doctor’s Advocate

Sep 05, 2014
Conflicting Guidelines on Mammograms Can Pose Risks
David B. Troxel, MD, Medical Director, The Doctors Company.
Breast cancer screening guidelines issued by national organizations and medical specialties have inconsistent recommendations about mammogram screening ages and intervals, which can create potential liability for delayed or missed diagnoses. Learn how to reduce these mammography risks.

Dec 20, 2013
Interactive Guide to Patient Safety for Office Practices
This interactive guide is designed to help you uncover areas of potential malpractice exposure in your practice.

Nov 21, 2013
Medical Clearance Does Not Clear the Patient or Physician of Risks
"Medical clearance" is when a surgeon requests clearance before performing surgery on a patient. The goals of the assessment are to determine the level of risk and to identify opportunities to mitigate risk, with an exchange of information between the surgeon and the assessing physician.

Oct 03, 2013
Medical Clearance
Susan L. Marr, MSA, CPHRM, Patient Safety/Risk Management Account Executive, The Doctors Company.
Medical clearance should involve an exchange of information between the surgeon and the assessing physician to mitigate risk to the surgical patient.

Sep 20, 2013
Avoid Missed or Delayed Diagnosis by Being Aware of Risks for BRCA-Based Breast Cancer
Physicians should be aware of the risk factors for BRCA gene-based cancer in order to identify those who need testing and to avoid delayed or missed diagnosis.

Jul 20, 2011
Keys to Patient Safety for Dermatology
Susan L. Marr, MSA, CPHRM, Patient Safety/Risk Management Account Executive.
Doctors can reduce potential liability in dermatology by taking risk management steps, such as avoiding verbal prescription orders.

Dec 21, 2010
Fire Safety in the Surgical Suite
Susan K. Palmer, MD, Oregon Anesthesiology Group, and Ernest E. Allen, Account Executive, Patient Safety Department, The Doctors Company.
Besides conducting annual fire drills that include what to do if a fire occurs on a patient, it is also wise to review fire risks in high-risk procedures prior to the start of the surgical procedure.

Jun 22, 2010
Dilaudid-Related Morbidity and Mortality from Respiratory Depression
Howard Marcus, MD, FACP, a general internist in Austin, Texas, and chairman of The Doctors Company Physician Advisory Board in Texas.
Patient safety organizations and the FDA are focusing on ways to reduce patient harm from opioids.

Jun 01, 2006
Scar—The Trigger to the Claim
Mark Gorney, MD, FACS (1924–2014), Governor Emeritus
A discussion with the patient about scarring is an important part of the preoperative disclosure process that helps prevent claims.

Feb 01, 2004
Surgery: Foreign Object Retention
John K. Cherry, M.D., F.A.C.S., a retired general surgeon, is a former chief of staff and chairman of the Department of Surgery at Scripps Memorial Hospital in La Jolla, California.
The retention of a foreign object within a patient's body cavity or incision after an operation is a source of avoidable litigation for surgeons and facilities.

May 01, 2000
Removing a Pigmented Skin Lesion
David Charles, M.D., is a practicing plastic surgeon in Denver, and is co-owner of the Plastic Surgery Clinic. Dr. Charles is a member of The Doctors Company Board of Governors.
When considering treatment for any pigmented skin lesion, there is no substitute for accurate microscopic pathological confirmation prior to definitive treatment. The range of error in clinical as opposed to microscopic diagnosis can be as high as 50 percent.