“All human beings are born free and equal in dignity and rights. They are endowed with reason and conscience and should act towards one another in a spirit of brotherhood.”

 Universal Declaration of Human Rights

Article 1

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"Every idea is an incitement. It offers itself for belief, and if believed it is acted on unless some other belief outweighs it or some failure of energy stifles the movement at its birth. The only difference between the expression of an opinion and an incitementis the speaker’s enthusiasm for the result."

 

Justice Oliver Wendell Holmes, Jr., also known as "The Great Dissenter"

Source: Gitlow v United States, 1922

Canary Blog

Lingering Questions in the Murder of Dr. Vajinder Toor

Posted May 9, 2010

Dr. Lishan Wang is charged with homicide of another doctor, Vajinder Toor. Lishan Wang is now facing charges of homicide in Superior Court New Haven, CT  in the U.S.A.    Dr. Lishan Wang filed a law suit alleging that he was retaliated against for being a whistleblower and then lost his job. He feared that he would not regain employment and then would no longer be able to support his family. Like many doctors in the USA he faced an unresponsive peer review system that was not transparent nor equitable.  It is a terrible tragedy that it appears that he has chosen to take the life of another.  In the hours after police say he shot and killed Dr. Toor, Lishan Wang  is said to have expressed regret for what he'd done as he spoke with the Branford police.


I do not want to diminish the gravity of the offense of which Dr. Lishan Wang is charged and to which he apparently confessed to police.  If he is guilty he should certainly bear the weight of the justice system for his crime.  Homicide is never justified and this was a terrible loss for the Toor family.  Toor leaves behind his wife, who was 14 weeks pregnant with the couple's second child and a toddler son.  We extend great sympathy and condolences for this grieving family.


I believe we learn to prevent further tragedies by recognizing the truth behind these events.  This is one reason why Medical Whistleblower provided information to the Office of the High Commissioner for Human Rights in Geneva information about the lack of protections for those who are defenders of human rights.  In this UPR report Medical Whistleblower outlined the many ways in which justice is not served in the medical quality review and peer review system and why medical professionals in particular are threatened frequently with bad faith peer review. Bad Faith Peer Review is the lack of due process, transparency and justice in the administrative system controlling doctor's licensing.  It is important the public recognize the inherent problems in the system that lead up to this tragic death so that the Toor family and others can understand what may have driven this man to such a desperate act.


TIMELINE OF EVENTS



July 2006 - May 2008: Wang is a resident at Kingsbrook Jewish Medical Center.

Nov. 2006: Toor joins the staff at Kingsbrook.

May 25, 2008: Heated argument between Wang and Toor where Toor accuses him of using "hostile body language."

July 6, 2008: Wang files EEOC complaint against hospital.

July 25, 2008: Wang terminated by Kingsbrook.

Nov. 2008: Wang resigns from a job at AE & LY Medical Associates of Flushing, N.Y., and moves back to Texas.

Feb 2009 – Feb 2010  Dr. Wang does postdoctoral work at Morehouse School of Medicine in Atlanta

May 8, 2009: EEOC gives Wang permission to sue hospital.

July 28, 2009: Wang files federal discrimination lawsuit against Hospital. In the federal discrimination lawsuit filed by Wang in 2009, Toor is referenced at least four times, and is accused of racial discrimination. In one incident documented in the suit, Wang said Toor humiliated him in front of other medical residents during a morning conference.

August 2009: Toor moves his family to Meadows condominium complex in Branford in preparation for a fellowship at Yale School of Medicine.

March 10, 2010: Federal judge orders Wang to comply with subpoena from hospital attorney's seeking his IRS returns, medication history and employment records.

April 13, 2010: Federal judge postpones conference call on status of federal discrimination case until May 6, 2010.

April 26, 2010  Police said Dr. Vajinder Pal Toor, 34, was walking to his car outside his Branford condo on Blueberry Lane just after 8 a.m. Monday when he was shot at least three times. Police said Toor's pregnant wife heard the commotion and confronted the gunman, later identified as 44-year-old Lishan Wang, of Georgia. Police said Wang turned and fired at her, but missed. Toor was pronounced dead at the scene.  Police said Wang then fled in a red minivan.  The names of two additional people directly involved with Wang's termination from the residency program were also located inside the van, according to court documents.  These additional people were apparently unhurt.  Using a description of the vehicle provided by witnesses, police were able to locate the Wang and take him into police custody. Police said two large-caliber handguns were found in a tote bag in the minivan's back seat.  Branford police released a report from an officer who interviewed Wang.  In the report, Wang told officers that he was sorry for what happened.

Posted in General
Tagged as vajinder toor, murder, and lishan wang

Exhausted Medical Residents Make Medical Errors

Posted May 9, 2010

The November 1999 report of the Institute of Medicine (IOM), entitled To Err Is Human: Building A Safer Health System, focused a great deal of attention on  as many as 44,000 to 98,000 people die in hospitals each year as the result of medical errors.  Medical Errors are the eighth leading cause of death.  More people die each year due to medical error than die due to work related injuries and even more than die in automobile accidents.  These medical errors can occur outside the hospital in other medical settings and even at home as there are medical errors in the writing and filling of prescriptions. The Massachusetts State Board of Registration in Pharmacy estimated that 2.4 million prescriptions are filled improperly each year in the State. See the IOM reporton Medical Errors was issued in February 2000 .

What are medical errors?  Well it can be a botched surgery, amputation of the wrong limb,  an wrong medication dose given, ordering the wrong diagnostic test or forgetting to order a diagnostic test, poor infection control leading to nosocomial or post-surgical wound infections,  giving the wrong blood unit to a patient,  improperly adjusting IV fluid flow, misinterpretation of a test and failure to act on abnormal results.  

So how do you feel about the idea that a resident/intern in charge of decisions that affect you or your loved one has been sleep deprived and is exhausted?  It is clear all rational decision makers that a doctor who is unable to get adequate rest will probably start making mistakes.  In the hospital environment this can lead to medical error and even patient death.  Rather than hiding the truth of medical errors we need to address this problem head on and need to address the abusive system of on call duty and lack of sleep time for resident/interns.  

There is a new study out call  Resident Duty Hours: Enhancing Sleep, Supervision, and Safety,  the most comprehensive study of resident work hours conducted to date.  According to this recent Institute of Medicine study there are many abuses of scheduling of the more than 100,000 resident physicians in teaching hospitals across the country.  Often in the U.S.A. these interns and residents are routinely scheduled to work shifts of 24-30 consecutive hours, with little or no sleep.  They work in operating rooms and ER’s on the wards and in clinics.    According to the study, the residents/interns when they are done their 12 hour or longer shifts, they potentially face back to back “on-call shifts” that can be 30 hours long.  This brutal schedule leaves them sleep deprived and deeply fatigued interns and residents make mistakes thus impacting quality of medical care and safety.  The rising level of medical errors in the USA is a testament to this real problem of quality of patient care and safety. Marathon work hours are linked to significant increase in failures of attention, performance deficits and medical errors.  Driving back to their homes after an exhausting day at work leads to increased car accidents. The study reviews the robust evidence base linking fatigue with decreased performance in both research laboratory and clinical settings and makes a number of important recommendations for changes in the current system of training physicians. These include new limits on resident physician work hours and work load, increased supervision, training in structured hand-overs and quality improvement systems, more rigorous oversight and the identification of expanded funding sources necessary to successfully implement the recommended reforms.

There is a human cost  to medical error in injury, increased sick time, days off work, and even death due to medical errors.  This is a huge problem for our health care system, one which costs about $37.6 billion each year; about $17 billion of those costs are associated with preventable errors. Imagine how much more efficient and economical our medical system would be if we could prevent the expenses related to medical error which account for direct health care costs.

Medical error is often not attributable to individual negligence or misconduct. The key to reducing medical errors is to focus on improving the systems of delivering care and not to blame individuals. Health care professionals are simply human and, like everyone else, they make mistakes.

For more information on medical errors

For more information on medical errors

See also the landmark research conducted by Lucian Leape, M.D., and David Bates, M.D., and supported by the Agency for Health Care Policy and Research, now the Agency for Healthcare Research and Quality (AHRQ).

Medical Errors: The Scope of the Problem. Fact sheet, Publication No. AHRQ 00-P037. Agency for Healthcare Research and Quality, Rockville, MD.  The prestigious Institute of Medicine (IOM) in December 2008 released its landmark report,  Additional information on Resident Duty Hours: Enhancing Sleep, Supervision, and Safety report  at  the report are available from the National Academies Press; tel. 202-334-3312      or 1-800-624-6242 or on the Internet at http://www.nap.edu 

 or

http://www.nap.edu .  In addition, a podcast of the public briefing held to release this report is available at National Podcast

 

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Posted in Health
Tagged as medical training, health, education, medical error, residency, and internship

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"Never impose on others what you would not choose for yourself."  Confucius

"It is not the critic who counts; not the man who points out how the strong man stumbles, or where the doer of deeds could have done them better. The credit belongs to the man who is actually in the arena, whose face is marred by dust and sweat and blood; who strives valiantly; who errs, who comes short again and again, because there is no effort without error and shortcoming; but who does actually strive to do the deeds; who knows great enthusiasms, the great devotions; who spends himself in a worthy cause; who at the best knows in the end the triumph of high achievement, and who at the worst, if he fails, at least fails while daring greatly, so that his place shall never be with those cold and timid souls who neither know victory nor defeat."

Theodore Roosevelt- Excerpt from the speech "Citizenship In A Republic", delivered at the Sorbonne, in Paris, France on 23 April, 1910