The New York State Department's Health Code, Section 405 , also known as Libby Zion Law , is a regulation that limits the number of resident doctors in a New York State hospital. about 80 hours per week. The law was named Libby Zion, who died at the age of 18 under the care of what his father believed to be an overworked physician and intern physician. In July 2003, the Board of Accreditation for Post-Graduate Medical Education adopted a similar regulation for all accredited medical training institutions in the United States.
Although civil arrangements and processes find conflicting evidence of Zion's death, today his death is widely believed to have been caused by serotonin syndrome from drug interactions between phenelzines he took before hospital visits, and pethidine administered by resident doctors. Lawsuits and regulatory inquiries following his death, and their implications for working conditions and supervision of apprentices and residents are widely publicized in both the laity and medical journals.
Video Libby Zion Law
Kematian Libby Zion
Libby Zion (November 1965 - March 5, 1984) is a freshman at Bennington College in Bennington, Vermont. She took antidepressants, phenelzines, every day. Hospital autopsies reveal traces of cocaine, but subsequent tests show no trace. She is the daughter of Sidney Zion, a lawyer who was a writer for The New York Times, and Elsa, a former publishing executive. He has two brothers, Adam and Jed. The news of his death at The New York Times, written a day after his death, stated that he had been ill with "flu-like illness" over the past few days. The article stated that after being treated at New York Hospital, he died of a heart attack, the cause is unknown.
Libby Zion was admitted to hospital by an emergency room doctor on the night of March 4th. Raymond Sherman, the Zion family doctor, agreed with their plan to hydrate and examine it. Sion was assigned to two inhabitants, Luise Weinstein and Gregg Stone, both of whom evaluated it. Weinstein, a first-year resident doctor (also referred to as an apprentice or PGY-1), and Stone, a resident of PGY-2, were unable to determine the cause of Zion's disease, although Stone suggested that his condition may be a simple overreaction to a normal ailment. After consulting Dr. Sherman, two specified petidins (meperidine) to control the "strange jerking movement" that Zion had shown when he was being treated.
Weinstein and Stone are responsible for covering dozens of other patients. After evaluating Sion, they leave. Weinstein went to cover up other patients, and Stone slept in the call room in the adjacent building. Zion, however, does not improve, and continues to be more agitated. After being contacted by the nurse by phone, Weinstein ordered medical restrictions placed in Zion. He also prescribed haloperidol over the phone to control agitation.
Sion finally managed to fall asleep, but at 6:30, the temperature reached 107Ã, Â ° F (42Ã, Â ° C). Once again Weinstein was called, and the steps were taken quickly to try to reduce his body temperature. However, before this can be done, Sion has a heart attack and can not be resuscitated. Weinstein told Zion's parents over the phone.
Several years have passed before a general agreement is reached on the cause of Zion's death. Zion has taken antidepressants, phenelzine, before he is taken to the hospital. The combination of it and the pethidine given to it by Stone and Weinstein contribute to the development of serotonin syndrome, a condition that causes increased agitation. This causes Sion to pull his intravenous tube, causing Weinstein to order physical restraint, which Zion also fights. By the time she finally fell asleep, her fever had reached dangerous levels, and she died soon after a heart attack.
Maps Libby Zion Law
Publicity and testing
Grieving over the loss of their child, Zion's parents became convinced that their daughter's death was caused by inadequate staff at an educational hospital. Sidney Sion questioned staff competence for two reasons. The first is the provision of pethidine, which can cause fatal interactions with phenelzines, antidepressants taken by Sion; This interaction was known by several physicians at the time, though because the case is now widely known. The second problem is the use of emergency psychiatric restraints and treatment. The sad words of Sidney are: "They give him a drug destined to kill him, then ignore him except to tie him up like a dog." To the trouble of the doctors, Sidney called his daughter's death a "murder". Sidney also questioned the long hours that the population worked on at the time. In an op-ed New York Times article he writes: "You do not need a kindergarten to know that a resident who works 36-hour shift is not in a condition to make any judgments" - for about life and death. "The case ended up being a protracted high profile legal battle, with some sudden reversals; case reports about it appearing in major medical journals.
Investigation country
In May 1986, Manhattan District Attorney Robert Morgenthau agreed to let a jury consider murder charges, an unusual decision for a medical malpractice case. Although the jury refused to sue the killings, in 1987 the intern and residents were charged with 38 counts of gross negligence and/or disability. The grand jury considers that a series of errors contribute to Zion's death, including inappropriate prescription drugs and failure to perform adequate diagnostic tests. Under New York law, the investigative body for this allegation is the State Council's Hearing Committee for Professional Medical Behavior. Between April 1987 and January 1989, the committee conducted 30 trials in which 33 witnesses gave testimony, including expert witnesses in toxicology, emergency medicine, and the head of the internal medicine department at six leading medical schools, some of whom stated under oath they had never heard. of the interaction between meperidine and phenelzine prior to this case. At the end of this process, the committee unanimously decided that none of the 38 prosecutions against the two citizens were supported by evidence. His findings were received by the full board, and by state health commissioner David Axelrod.
However, under New York law, the final decision on this matter lies with another body, the Bupati Council, which is not obliged to consider recommendations from the Commission or the Hearing Committee. The Bupati Council, which at that time had only one doctor among its 16 members, chose to "denounce and reprimand" the resident physician for the act of gross negligence. This decision does not affect their right to practice. The verdict against two residents was considered very surprising in the medical community. In other cases, the Bupati's Council did not rule out the Commissioners' recommendation. The hospital also admitted to providing inadequate care and paying a $ 13,000 fine to the state. But in 1991, the state appeals court completely cleared the records of both doctors' findings that they had provided inadequate care for Sion.
Civil trial
Along with state investigations, Sidney Zion also filed separate civil cases against doctors and hospitals. The civil trial ended in 1995 when a Manhattan jury found that both residents and primary care physicians supported his death by prescribing the wrong drugs, and ordered them to pay a total of $ 375,000 to the Zion family for their pain and suffering. The jury also found that Raymond Sherman, the primary care physician, had lied in the witness stand in denying that he knew that Libby Zion would be given pethidine. Although the jury found the three physicians negligent, none of them were found guilty of "naughty" negligence, which was to demonstrate total disregard for the patient, as opposed to a simple mistake. Payments for naughty negligence will not be covered by physician malpractice insurance.
The emergency room doctor, Maurice Leonard, as well as the hospital (as a legal persona) was found not responsible for Zion's death in a civil trial. The jury decided that the hospital was negligent because it left Weinstein alone responsible for 40 patients that night, but they also concluded that this omission did not directly contribute to Zion's death. The trial was displayed on Court TV .
Legal and regulatory
After the grand jury indictment of two residents, New York State Health Commissioner David Axelrod decided to address the systemic problems in residency by forming a panel of blue-ribbon experts led by Bertrand M. Bell, a primary care physician at Albert Einstein. College of Medicine in the Bronx. Bell is famous for his critical attitude about the lack of doctor-in-training supervision. Formally known as the Ad Hoc Advisory Committee on Emergency Services, and better known as the Bell Commission, the committee evaluates training and supervision of doctors in the state, and develops a series of recommendations that address some of the issues of patient care, including restraint of use, treatment systems, and hours work of the population.
"In 1989, the state of New York adopted the Bell Commission's recommendation that residents can not work more than 80 hours a week or more than 24 consecutive hours" and that physicians present "need to be physically present at the hospital at all times. institutionalizing so-called night buoys, doctors who worked overnight to spell their colleagues, enabling them to comply with the new rules. "Continuing regular audits have prompted the New York State Department of Health to crack down on hospital offenses. A similar boundary has been adopted in many other countries. In July 2003, the Board of Accreditation for Post-Graduate Education (ACGME) adopted a similar regulation for all accredited medical training institutions in the United States.
See also
- "Recipe for Death," first episode Legal & amp; Messages , based on the Sion case
- New York Law
References
Source of the article : Wikipedia
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