Category: Daily News

After a three-day trial that gripped nurses across the country, former nurse, 38 year old RaDonda Vaught, was convicted in Tennessee of two felonies, gross neglect of an impaired adult and negligent homicide, and is facing eight years in prison for a fatal medication mistake. She was scheduled to be sentenced on May 13.

She was arrested in 2019 in connection with the killing of Charlene Murphey, who died at Vanderbilt University Medical Center in late December 2017. Murphey was prescribed a sedative, Versed, to calm her before being scanned in a large, MRI-like machine. Vaught was tasked to retrieve Versed from a computerized medication cabinet but instead grabbed a powerful paralyzer, vecuronium.

Vaught overlooked several warning signs as she withdrew the wrong drug – including that Versed is a liquid but vecuronium is a powder – and then injected Murphey and left her to be scanned. By the time the error was discovered, Murphey was brain-dead.

Court House News reports that she was sentenced to three years of probation Friday as hundreds of health care workers rallied outside the courthouse, warning that criminalizing such mistakes will lead to more deaths in hospitals.

A state judge imposed the sentence on RaDonda Vaught after she apologized to relatives of the victim, Charlene Murphey, and said she’ll be forever haunted by her mistake. Vaught was found guilty in March of criminally negligent homicide and gross neglect of an impaired adult after she accidentally administered the wrong medication.

Nashville Criminal Court Judge Jennifer Smith said Vaught would receive judicial diversion, a way for first-time offenders to have their charges dropped and their records expunged after successfully completing probation. Prosecutors had argued against diversion, although they were not opposed to probation.

The crowd of nurses outside protesting cheered, cried and hugged after hearing the sentence. The relief came after the health care workers spent hours in the sun and clung to every word of the judge’s lengthy sentencing explanation, some linked in a chain with hands locked.

The fact that Vaught, 38, faced any criminal penalties at all has become a rallying point for many nurses who were already fed up with poor working conditions exacerbated by the pandemic. The crowd outside listened to the hearing through loudspeakers and cheered when some of the victim’s relatives said they wouldn’t want jail time for Vaught.

In weighing whether to grant Vaught judicial diversion, Judge Smith cited Vaught’s remorse as well as her honesty about the medication error.

After Vaught was found guilty in March, health care workers began posting to social media that there were leaving bedside nursing for administrative positions, or even quitting the profession altogether. They said the risk of going to prison for a mistake has made nursing intolerable.

On Friday, Vaught’s supporters wore purple T-shirts reading “#IAmRaDonda” and “Seeking Justice for Nurses and Patients in a BROKEN system,” as they listened to speeches from other nurses and supporters. They also held a moment of silence to remember Charlene Murphey.

Vaught reported her error as soon as she realized what she had done wrong – injected the paralyzing drug vecuronium instead of the sedative Versed into 75-year-old Charlene Murphey on Dec. 26, 2017.

Vaught admitted making several errors that led to the fatal injection, but her defense attorney argued that systemic problems at Vanderbilt University Medical Center were at least partly to blame.

Gus Kowal claimed two injuries while employed as a roofer by the County of Los Angeles. But, on August 5, 2019, the employer sent to applicant a Notice of Denial of Claim for Workers’ Compensation Benefit citing “02/28/2012” as the “DOI.”

In response, on October 11, 2019, Kowal requested and obtained a QME panel in orthopedic surgery for the 2012 cumulative trauma claim. On October 16, 2019, the employer sent Kowal a letter objecting to the CT panel, and also striking Dr. Robert Kolesnik from the panel as a precaution.

On October 29, 2019, Kowal sent a fax to defendant with his strike of Dr. Hananni from the panel. About one year later, Kowal sent a letter on October 8, 2020 to the employer advising that an appointment had been scheduled for December 8, 2020 with the same doctor he struck from the panel, Dr. Hananni, to conduct the QME evaluation.

The employer then sent him a letter objecting to the evaluation with Dr. Hananni since he had previously struck this physician from the panel.

The matter proceeded to trial on the issue: “Can applicant set a panel exam with a doctor they untimely struck when, after defendants timely struck, the remaining doctor was not able to see applicant within the statutory time period?” The WCJ concluded that Kowal could not.  Reconsideration was granted, and the WCAB panel allowed him to proceed with the QME evaluation in the case of Kowal v County of Los Angeles, ADJ12372302 (May 2022).

The QME panel in the CT case issued on October 11, 2019. The employer made a timely strike from the panel on October 16, 2019. However, Kowal sent a letter striking Dr. Hannani from the panel on October 29, 2019. Even accounting for additional time for mailing, applicant’s strike from the panel was untimely and invalid. Thus, both remaining doctors on the panel remained viable choices as the QME.

Rule 31.3 provides the procedures for parties to schedule an appointment with the QME. A represented worker has the right to schedule the appointment for the first 10 days. After that, either party may schedule an appointment with the QME.

In an en banc decision, the Appeals Board noted in a footnote that if the employee fails to schedule an appointment with the QME within ten business days, “the clock stops running and either party has an indefinite time to schedule the appointment.” (Cervantes v. El Aguila Food Products, Inc. (2009) 74 Cal.Comp.Cases 1336, 1348, fn. 11.

Therefore, after that initial 10-day period, the employee may still schedule the appointment, or the appointment may be scheduled by the claims administrator or the claims administrator’s attorney pursuant to AD Rule 31.3(d).

The WCAB noted that “this is a unique set of facts since applicant scheduled an appointment with the physician he attempted to strike from the panel. His strike was untimely per the discussion above. Both parties had the right to schedule an appointment with the two remaining physicians on the panel and applicant chose to exercise that right by accepting an appointment with Dr. Hannani within 90 days of his appointment request.”

Therefore, the WCAB panel rescinded the F&O and issued a new decision finding that Kowal was permitted to schedule an examination with the doctor that he untimely struck. The parties were ordered to proceed with using the existing panel.

A new study, published Wednesday in the journal Science Translational Medicine claims that the treatments often used to soothe pain in the lower back might cause it to last longer.

According to the study authors, chronic pain inflicts huge societal costs, in terms of management, loss of work productivity, and effects on quality of life. And chronic low back pain (LBP) is the most frequently reported chronic pain condition. LBP ranks the highest of all chronic conditions in terms of years lived with disability, with its prevalence and burden increasing with age.

Current treatments for LBP often target the immune system and include nonsteroidal anti-inflammatory drugs (NSAIDs), acetaminophen, and corticosteroids, although all of these drug classes are minimally effective at best.

The transition from acute to chronic pain is critically important but not well understood. Despite advances in the understanding of social, psychological, and genetic factors, as well as brain processes associated with chronic LBP, scientists understand very little of the molecular mechanisms underlying the acute-to-chronic pain transition that might lead to more efficacious analgesic strategies.

Therefore the researchers investigated the pathophysiological mechanisms underlying the transition from acute to chronic low back pain (LBP) and performed transcriptome-wide analysis in peripheral immune cells of 98 participants with acute LBP, followed for 3 months.

Transcriptomic changes were compared between patients whose LBP was resolved at 3 months with those whose LBP persisted.

Clinical data showed that the use of anti-inflammatory drugs was associated with increased risk of persistent pain, suggesting that anti-inflammatory treatments might have negative effects on pain duration. Analysis of pain trajectories of human subjects reporting acute back pain in the UK Biobank identified elevated risk of pain persistence for subjects taking NSAIDs.

Thus, despite analgesic efficacy at early time points, the management of acute inflammation may be counterproductive for long-term outcomes of LBP sufferers.

Researchers then replicated their findings using a prospective cohort of similar design. The replication cohort comprised subjects with another musculoskeletal pain condition, temporomandibular disorders (TMD). Although the pathophysiology of TMD is likely not identical to LBP, they hypothesized that the active contribution of the immune system in the transition to chronic pain could be shared.

The authors say that these conclusions may have a substantial impact on medical treatment of the most common presenting complaints to health care professionals. Specifically, the data suggest that the long-term effects of anti-inflammatory drugs should be further investigated in the treatment of acute LBP and likely other pain conditions.

The National Council on Compensation Insurance (NCCI) released its performance metrics for the US workers compensation system for 2021. NCCI’s annual State of the Line presentation provides an exclusive review of trends, cost drivers, and significant developments shaping the workers compensation industry.

Private carrier plus state fund net written premium increased about 1% to $43 billion in 2021 (private carrier premium alone was $38B). Private carriers again posted a profitable Calendar Year 2021 combined ratio of 87. It is the fifth consecutive year with a combined ratio below 90 for the workers compensation insurance market and the eighth consecutive year of underwriting profitability.

“The strength and resilience of the workers compensation system is a point of pride for all stakeholders,” said Bill Donnell, President and CEO of NCCI. “As the workforce and workplaces are changing, the industry must step up again to fulfill its noble responsibility: helping injured workers.”

“Strong employment and significant wage growth are fueling workers compensation payroll increases,” NCCI Chief Actuary Donna Glenn added. “We have a remarkably strong and healthy system right now.”

Additional key insights in NCCI’s State of the Line Report include:

– – The workers compensation line is strong and healthy.
– – WC results continue to reflect a strong financial position.
– – Lost-time claim frequency data suggests the long-term decline has continued, despite a rise in frequency in 2021. Since 2019, frequency declined slightly.
– – The 2021 changes in indemnity and medical claim severity are expected to be flat.
– – The number of COVID-19 claims declined in 2021 relative to the prior year.
– – Workers compensation reserves grew to $16 billion redundant as of year-end 2021.
– – The system saw its eighth consecutive year of underwriting profitability with a calendar year combined ratio of 87, outperforming other property-casualty lines.
– – The 2018 to 2021 loss ratios have been the lowest observed in at least 30 years
– – Net written premiums rose about 1% in 2021.
– – Between 2020 and 2021, countrywide private carrier direct written premium increased 1.9%.
– – State funds saw a larger increase in premium compared with private carriers.
– – Lost-time claim frequency data suggests the long-term decline continues, despite a rise in frequency in 2021. Since 2019, frequency has declined slightly.
– – There is no change expected in medical and indemnity claims severity in 2021.
– – There are potential challenges ahead as medical costs could experience inflationary pressure.
– – Workers compensation reserves are robust. Reserves grew to $16 billion redundant as of year-end 2021.
– -Total property and casualty net written premium for private carriers increased by approximately 9% to more than $700 billion in 2021.

Glenn issued the State of the Line Report at NCCI’s Annual Insights Symposium on May 10 in Orlando, FL.  The State of the Line Report and State of the Line Guide are available online.

Each year the California Chamber of Commerce releases a list of job killer bills to identify legislation that it says will decimate economic and job growth in California. The CalChamber tracks the bills throughout the rest of the legislative session and works to educate legislators about the serious consequences these bills will have on the state.

Following the April 29 deadline for legislation to be referred to fiscal committees, several bills identified by the California Chamber of Commerce as job killers will not be advancing this year. The 2022 list now consists of 12 bills, including two carry-over proposals from 2021. CalChamber monitors changes in legislation and will add bills to the list as appropriate.

The good news is that the proposal for a 32 hour work week in California seems to no longer be a problem.  AB 2932 (Low; D-Campbell) significantly increases labor costs by imposing an overtime pay requirement after 32 hours and other requirements that are impossible to comply with, exposing employers to litigation under the Private Attorneys General Act (PAGA). In Assembly Labor and Employment Committee. Failed deadline to move from policy committee to fiscal committee, April 29, 2022.

One bill remains on the Workers’ Compensation section of the list. SB 213 (Cortese; D-San Jose) significantly increases workers’ compensation costs for public and private hospitals by presuming certain diseases and injuries are caused by the workplace and establishes an extremely concerning precedent for expanding presumptions into the private sector. 2021 carry-over bill.

And there are several employment law related proposals that remain on the Job Killer list.

AB 2095 (Kalra; D-San Jose) places new onerous administrative burdens on employers by requiring annual reporting of wage and hour data and employee benefits on an employer’s entire United States workforce that will unfairly criticize employers for lawful conduct by publishing that data on the Labor and Workforce Development Agency’s website and using such data to rank employers and deny them state opportunities, and will subject employers to frivolous litigation and settlement demands.

AB 2182 (Wicks; D-Oakland) imposes new burdens on employers to accommodate any employee with family responsibilities, which will essentially include a new, uncapped protected leave for employees to request time off and exposes employers to costly litigation under the Fair Employment and Housing Act by asserting that any adverse employment action was in relation to the employee’s family responsibilities, rather than a violation of employment policies.

AB 2188 (Quirk; D-Hayward) risks workplace safety by promoting marijuana use to a protected class under California’s discrimination law, on par with national origin or religion. Also effectively prohibits pre-employment drug testing, harming employers’ ability to keep their workplace safe and drug free. In addition, would prohibit use of traditional marijuana tests, such as urine and hair testing, and compel employers to utilize saliva-based testing.

SB 1044 (Durazo; D-Los Angeles) allows employees to leave work or refuse to show up to work if employee subjectively feels unsafe regardless of existing health and safety standards or whether employer has provided health and safety protections and subjects employers to costly Private Attorneys General Act (PAGA) lawsuits if they dispute the employee’s decision or need to have another employee take over any job duties.

AB 2289/ ACA 8 (Lee; D-San Jose) seeks to impose a massive tax increase upon all forms of personal property or wealth despite California already having the highest income tax in the country. This tax increase will drive high-income earners and job creators out of the State as well as the revenue they contribute to the General Fund.