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A New Tool for Pediatric Inpatients

Kid Checked by a DoctorWhen children become ill, it is always a somewhat more precarious situation than it is for an adult. A child's immune system is not as well developed as an adult's, which can lead to illnesses and consequences not seen as often in adult patients. This can give rise to malpractice suits, given that the margin for physician error can be much smaller. However, a new tool developed by a cadre of doctors from all across the country, via a study published in Pediatrics, may significantly reduce preventable pediatric errors, and thus reduce potential malpractice claims.

The PACHMT and "Preventable Harm"

While preventable harms may sometimes be difficult to detect vis-a-vis non-preventable harms, sometimes they are clear-cut indeed. If a young patient appears healthy, is given a medication that may cause arrhythmia in those with a heart condition, and then experiences an arrhythmia, that is a non-preventable harm--the heart condition was unknown. If the condition is known and the medication is administered anyway, the resulting arrhythmia is a preventable harm. The study sought to distinguish the occurrence of preventable harms from that of non-preventable harms.

The study examined 600 charts of child inpatients from 6 different U.S. hospitals, and was able to distinguish a pattern of preventable harms. On 240 of those charts (approximately 45 percent of the study sample), recognizable harms were identifiable. The Pediatric All-Cause Harm Measurement Tool (PACHMT) was developed by the authors of this study in order to more accurately pinpoint the cause of harm in child inpatients. The tool searches medical records for “triggers”, or the tests and procedures most often performed when harm has befallen a patient - for example, breathing treatments being administered to an asthma patient. In theory, if preventable harms can be distinguished on medical records, hospital procedures may improve, and it may also make it easier to separate malpractice from simple mistake

Is It Reliable?

In terms of accurately identifying current triggers, the PACHMT is reasonably reliable, but cannot accurately identify conditions and effects that might otherwise be more subtle. For example, it identified preventable infections as triggers approximately 86 percent of the time, but only identified elevated pain levels as a trigger seven percent of the time. This is not acceptable, as very often, elevated pain levels both cause harm and provide a wealth of information to the attending medical professionals. The study also had some limitations, most notably a smaller sample size than is generally recommended (an appropriate sample size for a test of this sort would be between 700 and 1,000 charts).

Despite these faults, patients victimized by malpractice can still use these statistics as appropriate. It can give patients a better sense of what may constitute the “prevailing standard of care” in their community (which is important, because a doctor has a duty to provide care consistent with the ‘prevailing standard’ for a doctor of similar age, experience and talent). If, for example, a rural hospital has older equipment than a city center hospital, tests and procedures may take longer, or run a slightly higher risk of mistake. If a patient is reasonably informed of this, they may be able to plan accordingly.

Seek Experienced Assistance in San Jose

It remains to be seen whether the PACHMT will be updated and improved enough to become a mainstay in identifying preventable pediatric harms. The passionate San Jose medical malpractice attorneys at Corsiglia, McMahon & Allard, L.L.P. do our best to keep up with all the relevant news, because it could one day make or break a case for one of our clients. If you need representation, contact us at our office to set up a free initial consultation. We serve San Jose, the Bay Area, and the counties of Alameda, Monterey, San Benito, Santa Clara and San Mateo.

Client Reviews
My experience with Attorney Brad Corsiglia during my recent medical malpractice case was nothing short of amazing given the very stressful circumstances. I was fortunate to find Brad highly recommended from a mutual contact and from the very beginning of the process, Brad was truly engaged and knowledgeable in understanding my case and providing input on what avenues were available to me. Michelle M.