Med Board Reprimands Waterbury Obstetrician, Disciplines Two Other Docs

The state Medical Examining Board disciplined three doctors this week, including reprimanding a Waterbury obstetrician for failing to perform a timely Caesarean section in a case in which the infant died. Dr. John Kaczmarek also failed to assess the infant’s category III fetal heart monitors results on Aug. 10, 2014 at Waterbury Hospital, a consent order he signed with the board states. Category III results are considered abnormal and may indicate that the fetus is at risk of being deprived of oxygen. Kaczmarek also did not appropriately document his evaluation of the monitor results or his plan of care, the order said. The consent order does not detail what happened to the baby, but Christopher Stan, a spokesman for the state Department of Public Health (DPH), said Thursday that despite resuscitation efforts and a transfer to Yale New Haven Hospital, the baby died a day after delivery.

15 Hospitals Penalized For High Infection Rates, Injuries

About half of Connecticut hospitals—15 out of 31—will lose part of their Medicare payments in 2018 as a penalty for having relatively high rates of patients who acquired preventable injuries and infections while hospitalized. The hospitals are among 751 nationwide that will lose 1 percent of their Medicare reimbursements in this fiscal year. The penalties are part of the Centers for Medicare and Medicaid Services’ (CMS) Hospital-Acquired Condition Reduction Program, which is part of the Affordable Care Act. The program penalizes hospitals with the highest rates of patients who got infections from hysterectomies, colon surgeries, urinary tract catheters and central line tubes. It also tallies those who suffered from blood clots, bed sores or falls while hospitalized.

Heavy Drinking Among Women At All-Time High, Despite Health Consequences

An ever-increasing number of women in the state are drinking to excess, state and federal data show. Statewide, female admissions to acute hospital emergency departments for alcohol-related reasons rose by 4.8 percent between fiscal years 2012 and 2016, according to the Connecticut Hospital Association. The female-only Eden Hill Recovery Retreat in Canaan fills an average of 10 to 12 beds per month; earlier in the center’s eight-year history, rarely were there more than eight beds occupied at a time. Researchers at the Yale School of Medicine note an increase in the number of women enrolling in studies that examine the effectiveness of a medication to curb one’s desire to drink alcohol. The uptick in problem drinking among women in Connecticut mirrors a national trend.

Yale: Opioid Addiction Treatment In ED Is Cost-Effective

As the opioid epidemic deepens, Yale researchers say starting treatment with medication is the most cost-effective way to treat patients in hospital emergency departments. People with opioid addiction often seek treatment in EDs for overdoses and other ailments. Those who receive buprenorphine, a medication that reduces drug cravings, in the ED incur lower health care costs over the following month than those who get a referral to treatment services or receive a brief intervention with a facilitated referral, according to a new analysis of a randomized clinical trial. The analysis, published today in the journal “Addiction,” compared the estimated health care costs for patients over the 30 days following their ED visit. Those costs included ED care, addiction treatment, inpatient and outpatient costs and medications.

Med Board Fines Yale Doctor $10,000, Cites Five Others

The state Medical Examining Board Tuesday fined a Yale New Haven Hospital doctor $10,000 for abandoning a patient who was detoxing and reached an agreement with a Norwalk doctor to stop practicing medicine because his lapse in care contributed to the death of a patient. Dr. Martin Perlin of Norwalk admitted no wrongdoing but agreed to stop practicing medicine on Aug. 31. The consent order the board approved Tuesday also reprimands him and places his license on probation. It said that Perlin’s lapses in care contributed to a patient death and serious injury to another patient.

State Ranks High In Opioid-Related Visits To Hospitals

In less than eight hours last June, Yale New Haven’s emergency department treated 12 patients who had overdosed on opioids. Three died; nine were saved. With opioids in wide circulation, Dr. Gail D’Onofrio, chief of emergency medicine at the hospital and chair of emergency medicine at Yale School of Medicine, isn’t sure that one-day spike will stand as a record. “To be honest, no, I don’t expect the numbers to get better,” D’Onofrio said. “We’re going to have more treatment options in Connecticut, I think, more safe prescribing — but I don’t know that we’ll see improvements in the numbers of people using.”

D’Onofrio’s concerns are borne out in a recent report by the Agency for Healthcare Research and Quality (AHRQ) that ranks Connecticut the 5th highest among 30 states in the rate of opioid-related emergency department (ED) visits — 254.6 per 100,000 population in 2014, well above national rate of 177.7.

Pediatric Psychiatric Cases Continue Climbing, Swamping ERs

The state’s efforts to direct children in mental health crisis away from emergency rooms, to other services, have fallen short, with major hospitals reporting staggering increases in patient visits since 2013: Up 32 percent at Connecticut Children’s Medical Center, and 81 percent at Yale New Haven Hospital. The children’s hospital (CCMC) reported nearly 3,300 visits last year – 275 a month, on average — with the average length of stay increasing to 15 hours from less than 12 in 2013. “I wish I could say we had made a lot of progress, but we haven’t,” said Dr. Steve Rogers, medical director of the emergency department’s (ED’s) behavioral health unit. “Unfortunately, I think it’s only going to keep trending this way.”

Similarly, Yale saw ED visits by children ages 15 and younger rise from fewer than 750 in 2013 to more than 1,350 in 2016 — and the numbers are running even higher this year, said Dr. Claudia Moreno, medical director for psychiatric emergencies in Yale’s children’s emergency department. At times, she said, all ED beds are full, and children wait on hallway gurneys.

Menopause Puts Women At Higher Risk Of Fall-Related Injuries

A growing number of women are getting hurt by falling, and they are much more likely to suffer fall-related injuries than men, data show. From 2011 to 2014, 51 women per 1,000 population were hurt in falls, up from 47 per 1,000 from 2005 to 2008, according to recent data from the National Center for Health Statistics and the Centers for Disease Control and Prevention (CDC). Falls were the most common cause of nonfatal injuries to women, the report found, and significantly outpaced injuries from overexertion, the second leading cause of injury that afflicted just 14 per 1,000.  

Hormone-related changes associated with menopause are the main reasons women are so prone to falling, especially as they age, said Dr. Karen Sutton, an orthopaedic surgeon, director of Women’s Sports Medicine at Yale New Haven Hospital, and associate professor of orthopaedics and rehabilitation at the Yale School of Medicine. “Their muscles are weaker, their bones are weaker,” she said, since hormone changes lead to reduced bone mass and the onset of osteoporosis in many women.

14 Hospitals Penalized For Infection Rates, Injuries

Nearly half of Connecticut hospitals – 14 out of 31 – will lose a portion of their Medicare payments in 2017 as a penalty for having too many patients who acquired preventable infections and injuries while hospitalized. The hospitals are among 769 nationwide that will lose one percent of their Medicare reimbursements this year as part of the Centers for Medicare and Medicaid Services’ (CMS) Hospital-Acquired Condition Reduction Program. The CMS program, now in its third year, penalizes the lowest-performing hospitals where a relatively high number of patients got infections from hysterectomies, colon surgeries, urinary tract catheters and central line tubes. It also takes into account patients who suffered from blood clots, bed sores or falls while hospitalized. New this year, CMS also factored in the incidents where antibiotic-resistant bacteria – namely, methicillin-resistant staphylococcus aureus (MRSA) and Clostridium difficile (C.