It’s been almost two years since COVID-19 infected the everyday lives of people around the world. There are still over 30,000 cases being reported every day in the United States. Hospitals have routinely run out of beds and supplies to treat patients. Nurses and doctors have been overworked. It’s an outbreak that has impacted how hospitals and healthcare workers respond to changing guidelines and staff shortages – which can cause delayed treatment and a lower standard of care for patients.
The Impact on the Average Hospital Patient
As healthcare workers on the frontlines work tirelessly to address the changing aspects of the pandemic, the stress on the healthcare system showed us how disease outbreaks could impact those who need standard treatments. From putting off surgeries, to avoiding medical facilities despite needing care, the average would-be-patient has had their lives and health negatively affected even if they were never infected.
Even more concerning is the fact that COVID-19 prompted significant changes to malpractice laws and regulations at state and federal levels. Such radical changes are usually never to the benefit of the average person.
Staffing Shortages and Patient Safety Conditions
Even before COVID-19, there was a warning from health care leaders about nursing shortages. With hospital conditions worsening, nurses are retiring early or quitting the workforce entirely. The demand for nurses is so high that some hospitals are responding with large sign-on bonuses and pay increases, leaving hospitals without the same financial resources severely understaffed. Disease outbreaks themselves can worsen the staffing shortages as doctors and nurses fall sick or have to quarantine after being exposed to an infected patient.
Staffing shortages across the country complicate the effort to treat hospitalized coronavirus patients. When hospitals lack nurses to treat those who need less intensive care, emergency rooms and I.C.U.’s get backed up, limiting the ability to admit new patients. According to an analysis by the New York Times, one in five I.C.U.’s are at 95% capacity. This level of capacity makes it difficult to maintain the standard level of care. I.C.U. capacity can also lead to excess deaths. (More information on this below).
Nurses’ attention at the bedside is essential to their ability to ensure patient safety. Therefore when nurses receive an increasing number of patients it eventually comprises their ability to provide safe care. Several studies have linked higher patient-to-nurse ratios with an increased risk of patient safety events, even mortality.
Patient Safety Events Caused by Disease Outbreaks
As hospitals shift focus to respond to disease outbreaks like COVID-19, it can have a negative impact on patient safety. A disease outbreak can overwhelm health systems and cause patient safety events such as:
- Missed or Delayed Diagnosis: An overwhelmed health system with staffing shortages can lead to an increased risk of diagnostic errors. A Harvard Medical Practice Study revealed that diagnostic errors account for 17% of preventable errors in hospitalized patients. A diagnostic error may be a missed or delayed diagnosis of a non-COVID-19 condition because of the presumption that they contracted coronavirus. It can also be providers overlooking other potential diagnoses, treating with anecdotal information rather than evidence-based study, as in the first few months of the outbreak.
- Human Factors: These are errors that result from human conditions such as stress and exhaustion. Higher patient-to-staff ratios on top of a pandemic that has taken such a physical and emotional toll on health workers can lead to these errors.
- Infection prevention and control: Frontline staff with inadequate training can greatly increase the risk of infection transmission when caring for a patient with an infectious disease. Infection prevention is critical during a disease outbreak like COVID-19, especially to staff and patients. Staff may struggle to keep up with these prevention methods as complicated guidelines may be ambiguous and change frequently.
Hospital Strain Leading to Excess Deaths and Malpractice
During the past two years, hospitals have had to make room for more patients. As the outbreak worsened hospitals ran out of I.C.U. beds. Hospital bed capacity has a link to the number of excess deaths that occur. An excess death is defined as the difference between the observed and expected number of deaths during specific periods.
The Cybersecurity & Infrastructure Security Agency (CISA), examined the relationship between hospital strain and excess deaths to see what the impact of a disease outbreak has on hospital system operations. They found that when I.C.U. beds are at 75% capacity across the nation, 12,000 additional deaths would occur over the following two weeks. And when I.C.U. bed capacity reached 100%, that number of additional deaths reached 80,000.
As excess deaths rise and patients receive delayed or misdiagnosis, this leaves the healthcare system at risk for medical malpractice lawsuits.
The Standard of Care on Hospital Malpractice Claims
When disease outbreaks occur the standard of care changes. With resource limitations, such as available hospital space, beds, staffing, and supplies it leads healthcare systems to adapt to a crisis standard of care. It changes the focus from getting the best outcomes for individual patients to addressing the immediate care for larger groups of patients.
As hospitals deviate from conventional standards of care, many preventive and elective procedures get suspended. This leads to the progression of serious conditions of people who would have benefitted from earlier diagnosis and treatment.
Hospitals and doctors might be liable for medical malpractice if the delay in treatment or diagnosis causes harm. There has to be a doctor-patient relationship already and the doctor had to breach the standard of care by not diagnosing sooner.
Can I Make A Medical Malpractice Case Involving a Disease Outbreak?
Nursing Home Related Infections
Among the elderly infections have always been deadly. Even flu or pneumonia outbreaks can lead to higher patient deaths in nursing homes. Normally, a family would have the grounds to sue if they can provide evidence that their loved one died due to inadequacies in treatment that caused a fatal infection.
Proving a coronavirus case will be much more difficult due to executive orders that protect nursing homes from legal action unless gross negligence is proven. Hospital malpractice claims regarding nursing home-related infections are predicted to rise after the order expires.
The order that protects nursing homes also protected hospitals and healthcare services. However, patients may have the right to sue depending on their reason for being in the hospital. If they were being treated for a condition not COVID-19 related and their treatment was not disrupted by the facility’s response to COVID-19 they may be eligible to claim negligence.
Are There More Hospital Malpractice Claims Due To Disease Outbreaks?
When Covid first struck, many states put a freeze on elective surgeries to slow non-essential hospital visits. This, along with people generally avoiding hospitals, caused medical malpractice cases to decline throughout 2020 and 2021. There’s currently not enough data to determine if this decline is in line with the total number of non-covid patients treated in hospitals.
Even so, it’s hard to imagine that the state of our hospital during the pandemic didn’t lead to some level of decreased standard of care for patients.
Will Patients Be Able to Sue for Covid-19 Treatments
Since Covid-19 was a novel virus and no standard of care existed for treatment, medical malpractice claims directly related to the treatment of covid are not likely to be viable in any state. Additionally, the federal government’s emergency use authorization would shield healthcare providers who followed any government-issued treatment or drug guidelines.
However, if non-covid patients were injured due to negligent acts of overworked doctors and staff, they would still be liable for malpractice.
If you or a loved one were injured due to the negligence of a doctor, hospital, or medical staff, you should contact an experienced medical malpractice attorney who can help you determine your rights.