Is your hospital safe?

Not all hospitals are the same. In fact, one recent study showed patients who undergo common surgeries are safer at busy hospitals that perform the procedures regularly.

Hospital surgical volume matters

A medical team performing an operationAn article published in U.S. News and World report has shed the light on a little-known surgical risk: inexperience. Extrapolating data from Medicare statistics, the study revealed that hospitals performing only a small number of common surgical procedures place patients at a far greater risk than high-volume hospitals.

How big of a problem is it? “You can save your life by picking the right place,” says Leah Binder, director of the Leapfrog Group, a nonprofit organization that measures hospital safety and performance.

Dr. John Birkmeyer, Professor of Surgery at Dartmouth–Hitchcock Medical Center has estimated that as many as 11,000 deaths could have been prevented nationally if patients who went low-volume hospitals opted to for the highest volume hospitals instead. For example, at one low-volume Colorado hospital, patients were three times more likely to die during hip replacement surgery and 24 times more likely to die during a knee replacement.

Increased risks with low-volume hospitals

According to the study, hip replacement patients who had their surgery in the lowest-volume hospitals were about 50 percent more likely to die than patients treated at surgical centers in the top 20 percent. Knee replacement patients took a larger gamble using low-volume hospitals, with a nearly 70 percent higher risk of death. Patients with congestive heart failure and chronic obstructive pulmonary disease fared somewhat better; however, they still had a 20 percent increased risk of dying.

While these numbers are dramatic, it’s important to remember that volume is only one indicator patients should consider when selecting a healthcare facility. In fact, some low-volume hospitals provide excellent care. Conversely, some high-volume centers may perform unnecessary surgeries.

Choosing a hospital

One of the best ways to make a decision is to ask questions. Here are a few examples:

  1. What procedures do you recommend for my case, and why?
  2. Do I need this surgery? What other options are there?
  3. How many times have you performed this procedure in the past year?
  4. What is your complication rate?
  5. How do you follow a patient post-surgery?
  6. What will my follow-up care look like?
  7. Tell me about your medical team – nurses, physical therapists, and others who can help guide me pre and post-surgery.

There are also rating systems available online, including U.S. News Best Hospitals and Hospital Safety Score. So how do you know which hospital or surgeon is right for you? There is no magic formula, but most experts agree patients should take the time to educate themselves about the doctors and medical facilities they choose.



“Risks Are High at Low-Volume Hospitals” by Steve Sternberg and Geoff Dougherty, U.S. News & World Report, May 18, 2015.

“Hospitals Move to Limit Low-Volume Surgeries” by Steve Sternberg, U.S. News & World Report, May 19, 2015.

Drive Sober or Get Pulled Over kickoff event

The Portage County Safe Communities Coalition kicked off their annual “Drive Sober or Get Pulled Over” event on Monday, August 17, 2015 at Robinson Memorial Hospital. The event featured local speakers who have endured personal losses due to alcohol-related crashes, local law enforcement and government officials.


Drive Sober or Get Pulled Over is a partnership with the National Highway Traffic Safety Administration (NHTSA) to curb impaired driving and save lives. August 21-September 7 (Labor Day), law enforcement partners nationwide will show zero tolerance for drunk driving. Increased state and national messaging about the dangers of driving drunk, coupled with checkpoints and increased officers on the road, aim to drastically reduce the toll of drunk driving.

“Portage County Safe Communities’ goal is to not only prepare the public for the national Drive Sober or Get Pulled Over Campaign, but also to remind everyone their choice to drink and drive creates a danger for all of us on the roadways,” says Lynette Blasiman, the Director of Portage County Safe Communities Coalition.

During the event, members of the Coalition recognized Troopers for a Safer Ohio and David Elk of the Elk & Elk law firm for their commitment to reducing drunk and distracted driving. Earlier this year, Elk & Elk was the Presenting Sponsor of the 2015 None 4 Under 21 and Choices Beyond event, which focuses on the long-term consequences of everyday choices and seeks to reduce preventable teen crashes due to drunk and distracted driving. “Unfortunately, as personal injury lawyers, we see the devastating effects of drunk and distracted driving every day,” says Elk. “It is our privilege to provide financial support and other contributions, enabling more than 2,000 Northeast Ohio high school students to attend this life-saving event each year.”

School Bus Driver Liability for Injuries

Earlier this year, the Ohio Supreme Court heard arguments about liability for injuries to children involving school buses. The issue in the case was whether school bus drivers are liable for injuries and fatalities when students do not go straight home after leaving the bus.  Although the court dismissed the case, the general issues are worthy of consideration.

_MG_7919-2The case in question involves a first-grader who left her school bus and ran down the street toward a friend’s house and was struck and seriously injured by a car – after the bus had continued on its route.  The incident occurred in the Village of Cleves, near Cincinnati. Ohio law says that drivers must wait until the student reaches a safe place before moving on. At issue is how long a driver must wait and what is meant by a “safe” place. Although many, including some justices on the lower court, agreed that the law was poorly written, it is the only law available for now.

The Ohio Supreme Court decided that it had “improvidently” accepted this case and dismissed it, sustaining the ruling of the Hamilton County Court of Appeals that the school district was not liable.  Nevertheless, the larger issues about school busses and liability are not new nor are they limited to Ohio.

Do you think school bus drivers should be liable for students after they leave the bus? Share your school bus safety concerns in the comment section below.

School districts across the United States are generally immune from liability in such matters, unless it can be demonstrated that the driver was negligent. Is the driver required to actually supervise a child once he or she is no longer on the bus? Is not providing such supervision a form of negligence?  Is the driver required to escort the child to a safe place, leaving the other children unsupervised on the bus?

Supervision of Students

And what is meant by supervision? In North Carolina, for example, the state Board of Education is considering a requirement that drivers signal students when it is safe to cross the street. What if the driver signals, the students start to cross, and a car speeds around a corner and strikes a student? Is the bus driver liable?

Criminal Negligence vs. Civil Negligence

Like Ohio, the state of Washington requires that school bus drivers be found negligent before they can be held liable for student injuries or deaths. They can be criminally negligent, which means they have broken a law, such as failing to stop at a traffic signal or speeding. A driver could also be proven negligent in a civil case, which requires a lower standard of proof than criminal negligence. This could mean that the driver should have responded to a situation in a way a reasonable person would have and is a tough standard to apply. For example, if a driver suspected that the brakes on the bus were bad, should he or she have kept on driving?

Are Drivers Supposed to Intervene When a Child Is Being Bullied?

What about a child who is bullied on a school bus? Parents in Missouri sued their school district because it allegedly failed to stop their son from being bullied on the school bus, resulting in the boy’s suicide. The parents received a $300,000 settlement from the school district.

Bus Fights

In St. Johns County, Florida, bus drivers are expected to break up fights – IF doing so does not compromise their safety. In other Florida counties, however, drivers are not permitted to touch students in any way, making it difficult to intervene in many situations.

Driver Texting

A Nashville case was pretty straightforward; a driver was found to have been sending and receiving texts while transporting students. The driver has since died, so families cannot file lawsuits against the driver. However, the school district could still be held liable.

Liability for Administering Medication

How far will we go to ensure the safety of students on school buses? Some districts issue EpiPens to drivers so they can administer medication to students experiencing allergic reactions. However, many drivers are afraid they will be found liable if a student dies as a result of an allergic reaction, despite being given the injection. A lawmaker in Pennsylvania introduced a bill that would give drivers immunity from civil lawsuits involving the use of EpiPens.

Other Questions About School Bus Driver Liability

What if drivers are not school district employees? What if the buses are not school district equipment? Who is liable if school transportation is provided by a contractor rather than a school employee? The questions seem endless. This makes it very important for drivers to know the rules of their districts and states regarding operation of buses and their liability for injuries and deaths.