Hackers Attack Surgery Center

CYBER ATTACK A Nebraska surgery center was the victim of a ransomware attack.

Two Nebraska medical facilities are warning patients after they suffered a ransomware attack that encrypted files and made some patient information vulnerable.

The attack occurred on Oct. 7, according to a statement from Eye Physicians, P.C., one of the two facilities that suffered the breach. The other facility, Columbus Surgery Center, shares a building and computer server with Eye Physicians. It was that server that was breached, said Billi Jo Benson, RN, BSN, of the Columbus Surgery Center.

Ms. Benson said the surgery center realized it had been a victim of an attack when employees tried to use their computers and found their systems were not working. They contacted their IT department, which recognized a ransom note on the server, she said.

The attack encrypted files on the server, making patient information including names and birthdates vulnerable, according to both Ms. Benson and the Eye Physicians statement. No financial records, payment records or social security numbers were put at risk by the breach, said Ms. Benson and the statement. There's no evidence that the hackers were able to access or view the information, said Ms. Benson.

The facilities restored their servers with information saved during a recent backup and said they're notifying any patients who could be affected by the attack. They've also used independent experts in computer forensics to investigate what caused the breach.

Ms. Benson said the surgery center is releasing information sheets to patients, detailing how they can further protect their personal information. A representative for Eye Physicians, P.C. did not immediately return a call for comment Monday.

In a November story, Outpatient Surgery Magazine wrote about the effects of cyber attacks and various ways that surgical facilities can prevent them.

Anna Merriman

Lawsuit: Gentamicin Injection Blinds Man After Cataract Surgery

ROUTE OF ADMINISTRATION A patient was blinded during cataract surgery when an ophthalmologist injected gentamicin meant to be administered intravenously or intramuscularly into his right eye.

A cataract surgeon's highly unusual practice of prophylaxis of endophthalmitis — injecting gentamicin into the patient's eye post-cataract surgery — blinded an 80-year-old man in his right eye because the gentamicin the surgeon injected was meant to be administered intravenously or intramuscularly, court records show.

A Florida civil court awarded $13 million in damages to Miguel Diaz, 80, who filed a medical malpractice lawsuit against ophthalmologist Jonathan Leon-Rosen, MD, claiming the surgeon injected a highly toxic, concentrated form of gentamicin into his eye after his surgery at the Coral Gables (Fla.) Surgery Center. More lawsuits are coming, says attorney Gary Alan Friedman, who represents Mr. Diaz and 13 other patients who claim gentamicin injections caused swelling, inflammation and edema of the cornea. In all, 19 of Dr. Leon-Rosen's patients have filed suits claiming they suffer from toxic anterior segment syndrome (TASS), visual loss and blindness.

Mr. Freidman details the lawsuit in this short video produced by the Miami Herald.

While more and more surgeons are using antibiotic injection over topical drops to prevent endophthalmitis, few administer subconjunctival injections of gentamicin, says ophthalmologist T. Hunter Newsom, MD, of Newsom Eye & Laser Center in Tampa, Fla., in large part because gentamicin's spectrum of coverage is not good against gram-positive bacteria, which is often found in endophthalmitis.

"And problems can arise if you inject the wrong dose or concentration of gentamicin" says Dr. Newsom.

According to the complaint, the gentamicin Dr. Leon-Rosen injected into Mr. Diaz's eye was "defective, unsafe and unfit for human consumption."

Mr. Diaz filed his suit against Leon Medical Centers in Miami, Fla., and Dr. Leon-Rosen (no relation), the ophthalmology practice group, South Florida Eye Associates, and the Coral Gables ASC. In an interesting twist to this case, Leon Medical Centers tried to avoid liability by claiming Dr. Leon-Rosen acted as an independent contractor. The jury, however, found him to be an apparent agent of the healthcare group and thus held it liable as well.

Leon Medical Centers plans to appeal the verdict. In a written statement released to the Miami Herald, the company says: "While we are pleased that the jury correctly concluded that there was no negligence on the part of Leon Medical Centers, we are disappointed that the effect of their decision is to hold Leon Medical Centers liable for the actions of an independently contracted ophthalmologist group. Furthermore, Leon Medical Centers is committed to facilitating its patients' access to its independent healthcare specialists and in doing so, it is in no way misleading its patients."

Dr. Leon-Rosen's attorney declined to comment. Mr. Diaz's attorney was unavailable for comment.

Joe Madsen

Depression Could Cause Nurses to Make More Medical Errors

SELF-CARE A new study shows that by not taking care of their own health, nurses could be putting patients at greater risk.

Depression and illness could cause nurses to make more medical errors than those who have optimal health, according to a study published in the Journal of Occupational and Environmental Medicine. The study surveyed 1,790 nurses across the United States with an average age of 44. Nurses were asked to answer 53 questions pertaining to their physical and mental health.

Of those surveyed, 54% reported poor physical and mental health, and another one-third said they had some degree of depression, anxiety or stress. The study found that nurses who reported poorer health had a 26 to 71% higher chance of reporting medical errors than nurses who reported being healthy. Depression was an especially key predictor of medical errors.

"When you're not in optimal health, you're not going to be on top of your game," said lead study author Bernadette Melnyk, PhD, RN, dean of The Ohio State University's College of Nursing, in a press release from the university. "Nurses do a great job of caring for other people, but they often don't prioritize their own self-care."

The study also found that nurses who perceived their workplace as being more conducive to wellness had a higher likelihood of reporting good health. Based on that finding, Dr. Melnyk recommends that health care facilities take steps to improve the wellness of their staff. Among her suggestions? Try to limit long shifts and provide easy access to resources for physical and mental health, including depression screenings. By improving your staff's health, you ultimately could improve your patient outcomes.

Brielle Gregory

InstaPoll: Do You Serve Patients Hot Beverages in PACU?

Many patients ask for a cup of hot coffee after surgery, but there's always the risk that they'll spill the hot beverage on themselves. We want to know in this week's InstaPoll if you serve both hot and cold beverages in PACU.

Nearly 2 of 3 surgical facility leaders has been sexually harassed on the job. Two-thirds (65%) of the 496 respondents have been a victim of unwanted come-ons, inappropriate touching, dirty jokes or sexual comments. The results:

Have you ever been a victim of sexual harassment?

  • yes 63%
  • no 37%

Dan O'Connor

News & Notes

  • Gastric bypass weight loss shows success after 7 years A study aimed to examine the effects of Roux-en-Y gastric bypass surgery showed that mean weight loss 7 years after the surgery was 28.4% of the studied patients' baseline weights. The study compared that result to laparoscopic adjustable gastric banding, which resulted in a mean weight loss of 14.9% in the 7 years after surgery.
  • Black box recorder evaluates surgeons' skills while they perform robotic operations In a study of robotic surgical procedures, namely radical prostatectomy, researchers at Keck Medicine of USC have developed a recording tool that, when attached to a robotic system, can evaluate the practicing surgeon's skills and experience based on timing and movement. Data from the study will be published in the January 2018 edition of The Journal of Urology, and the hope is to build a consistent method of gauging physician proficiency in order to ensure patient safety.
  • Desflurane increases carbon footprint Reducing the use of desflurane in operating rooms could help reduce the carbon footprint of surgery, according to a study published in The Lancet. That's because desflurane has a global warming potential (GWP) that's about 5 to 18 times higher than that of other anesthetic gases like isoflurane and sevoflurane.