Governor John Kasich State Medical Board of Ohio to take the MD licenses of women physicians with no patient complaints after medical mistakes have been made on them to allow the statute of limitations to expire & make sure that the woman MD does no Columbus, Ohio

The first question in the MKSAP 15 (Medical Knowledge Self-Assessment Program) for Internists is about how to handle medical mistakes and reads

ITEM 1: An 83-year old man is hospitalized for cholecystitis.  He is prescribed subcutaneous unfractionated heparin, 5000 units every 8 hours, for prevention of venous thromboembolism.  By accident, the nurse uses a vial with a more concentrated heparin and administers 50,000 units to the patient.  She immediately tells her supervisor.  An incident report is filed and an immediate PTT is requested.  When or under which circumstances should the error be reported to the patient?  (A) As soon as possible; (B) If additional therapy is required; (C) If the PTT is greater than 100 sec; (D) If there is clinical bleeding.  And the answer is A, and the purpose of the question for the certifying of internists is to understand disclosures relating to medical errors = something that the State Medical Board of Ohio does not understand.  Does anyone on the State Medical Board recertify?  

Medical errors happen every day; drug, surgical, orthopedic, gynecological, pediatric, obstetric, etc., and the only thing that sets physicians apart is how they handle these errors - the checklist for medical mistakes.  But when the State Medical Board of Ohio, instead of admitting care errors, wants the physician-patient punished that she brought this problem to their attention - to get therapy for this 'personality disorder' of being honest that there are problems - there is a compounding of medical errors resulting in a ruined health career to show for the situation.  Disclosure of medical error is not a psychiatric diagnosis - some errors can be looked the other way for - but that doesn't mean that the mistake won't happen again.  Even a discussion of clinical near-misses might prevent a 'miss.'   

State Medical Boards are supposed to have a policy for physicians, hospitals, medical facilities, nurses, etc. on medical error in 2012 - and not be punishing anyone that brings these situations to their attention.  Medical 'whistleblowers' just want to get the care corrected - it's not a personal thing or even for damages - just for the patient to live or recover.  No one wants to 'tell' on a colleague, but letting someone die or suffer medical complications is unethical if not stupid.

The charts need to be sent before 2 years or 20.  Medical errors happen in Ohio, they happen in Pennsylvania - but Pennsylvania has medical mistake laws and a lawyer Governor.

In general, and State Medical Boards need to help physicians with this, physicians should disclose to patients information about procedural or judgment errors, and unanticipated results happening in the course of patient care - if it can avert, prevent, or modify an adverse event that might occur, or has occurred, and will be made worse if the staff tries to cover up the mistake.  Errors that are material to, or make a difference in, the patient's well-being need to be disclosed. 

This means casts not applied before terrible swelling and deformity (excrescence) develops from trying to use a fractured extremity (physician shopping for polo ponies), casts applied wrongly or without x-ray confirmation (physician partying), lab work not done or lost (physician's office goofed), lab work not ordered but indicated (no differential diagnosis), physical therapy not ordered, and labs or x-rays misread.  Anything that starts an error sequence, needs to be reported to stop, undo, or lessen the bad care outcome - to get the consults, or the drug to reverse the effects of the overdose.  Lies never make anything better. 

But in Ohio, because of the State Medical Board, errors are lied about and then compound because the next care of the patient, or physician-patient, never fixes the problem that is the 'elephant in the room' and can't be admitted.  And physician-patients are the worst off in this scenario, as medical licenses are then taken for 'making too much of bad care' - to let the statute of limitations expire for the error - so that Anita Steinbergh DO doesn't have to hear about it again. 

Most patients, or physician-patients, don't want to go to court with the mistake, as they feel guilty that they went to the wrong physician or didn't try hard enough to get referred (didn't see that the physician was not capable or able to solve the problem), but they do want the mistake admitted and TAKEN CARE OF AS MUCH AS POSSIBLE before 2 weeks, 2 years, or 19 years.  Being 'had' is painful, but not being able to 'take that Marilyn Monroe tattoo off' is even more painful.  Killing someone with silence is not the answer; letting the 83-year old bleed out before admitting what happened is not the answer.  Yes he was 83, but that doesn't mean that he didn't 'deserve' proper care.

After 19 years, an untreated metabolic bone condition is much worse than what it was 19 years ago when a physician at St. Louis University wanted to treat it - but the State Medical Board of Ohio disagreed that it was just 'psychiatric' - to cover for the 'friend' physician who goofed.  And now the Cleveland Clinic is blaming the State Medical Board in their notes, but not fixing the problem afraid that the Medical Board will go after one of them.  Blame games don't solve problems.   

After a decade, an autoimmune thyroid problem is much worse, has destroyed a part or most of the thyroid gland, and might have gone to cancer or lymphoma - and it's important for a woman physician that those outcomes NOT HAPPEN.  And her life, health, and career have been ruined - she did not get to have even one child even though they would have had to monitor her thyroid during the pregnancy, they didn't while she had a medical license - no need to check that.  

And with the 83-year old, he might have clinical bleeding.  But if the nursing supervisor or physician is immediately told, then protamine sulfate or heparinase can be administered to reverse the effect of 50,000 units before any clinical bleeding occurs.  But in Ohio, the nurse will be afraid to tell her supervisor or the physician - delays will cause clinical bleeding - and the family will eventually know but after the damage is done - which can be a GI bleed, a subdural/intracranial bleed, or some benign bruising - depends on the clinical condition of the patient in many regards.    

The thinking is in Ohio, for physicians & nurses, to LIE, accuse the patient of being difficult and senile, and make every excuse except to admit that a mistake happened; the patient is just crazy and doesn't deserve care.  The thinking in Ohio is that if a patient is crazy, then they didn't deserve care, and it was ok to make a mistake = DR. NICE quote.  This happens every day; the surgical technologist doesn't realize that part of the surgical tray, or OR equipment, was not sterilized until too late in the procedure.  The physician doesn't find out until the patient spikes a fever post-op, and four days have gone by without adequate antibiotic prophylaxis of the error

The Medical Board hears & decides a case, then 19 years later realizes that the lab work was omitted, and the physicians lied about the care - took them long enough, but still asap the patient should know - and there needs to be an administrative procedure for handling medical mistakes and the wrong judgments on those mistakes at the Ohio State Medical Board.  Physician need to improve medical care, and lying about errors needs to be somehow stopped.  Really it's not the mistakes that need the discipline.  Most errors have no intent to harm; it's the lying about the mistakes that are intentionally harmful -  while the patient crashes or has a complication and everyone looks 'dumb.' 

The State Medical Board of Ohio - like 40+ other states - needs to have some form of medical mistake laws to protect patients and physician-patients; so that the women physician doesn't lose her license for making too much of bad care after miraculously surviving the boys being boys admittedly bad care. 

Medical 'near misses' are just as painful, the recoveries are very long, and the emotional damages are real - but won't be solved by a new right Ohio psychiatrist for the State Medical Board.  A 'sorry' goes a long way, an acknowledgement of the error, and helping the person get back to health or practice - every day that the person is back to work they regain a part of themselves.  A discussion of the 'elephant in the room' helps prevent this error again, and gives 'how to handle this' care paradigms to other health professionals.  Governor Kasich needs to consider the implementation of medical mistake laws.