State Judge Dismisses Some Bair Hugger Lawsuits
HOT AIR No generally accepted scientific evidence links infection risk to forced-air warming, according to the ruling.

A district court judge has dismissed dozens of lawsuits filed by Minnesota residents who allege that the Bair Hugger forced-air warmer caused their deep joint infections during joint replacement surgery by blowing contaminants off of the floor and into their open wounds — essentially the same claim that more than 4,000 orthopedic surgery patients from across the country have made in their pending federal lawsuits.

"There is no generally accepted scientific evidence — and plaintiffs offer none — that the risk of infection associated with forced-air warming systems is greater than that associated with patients who are not warmed during surgery," wrote the judge in granting 3M's motion for summary judgment last week.

While the state court ruling won't directly impact the federal cases, it's worth noting that federal prosecutors are expected to call many of the same expert witnesses and rely on many of the same studies as their colleagues in district court did.

The first "bellwether" federal lawsuit is scheduled for trial in the spring.

Prosecutors argued that the Bair Hugger alters the normal downward push of an OR's laminar flow that's designed to keep bacteria-carrying particles on the floor and that the device's blower might harbor bacteria. The lawsuits were backed by computer models, expert testimony and studies that show airborne contamination could happen. Lawyers for 3M, the maker of the Bair Hugger, countered that numerous experts and studies support the safety of the device and argued that no surgical site infection has been linked to its use.

A spokeswoman for 3M says the judge's decision backs the company's position that its devices do not cause SSIs. The patients who filed the lawsuits reportedly plan to appeal the judge's decision.

Daniel Cook

What Are Your Patients Doing With Their Unused Pain Pills?
OUT OF CIRCULATION Providing easy-to-read brochures encourages patients to properly dispose of unused medications.

Patients are twice as likely to properly dispose of their unneeded pain medications when given an informational brochure at discharge, a study published on the Journal of American College Surgeons website.

The opioid epidemic has been linked to over-prescription of painkillers after surgery combined with a lack of information on how to properly dispose of the unused medications. While it's difficult to determine the appropriate number of post-op pain meds patients need, it's relatively inexpensive to provide patients with specific instructions on how to dispose of their medications — and prevent diversion, say researchers.

A team of surgeons, nurses and administrators at the Washington University School of Medicine and Barnes Jewish Hospital in St. Louis created a brochure for new patients that briefly describes the opioid epidemic and how it is fueled by improper disposal of medications. The brochure then provides links to websites that list drug take-back locations as well as step-by-step instructions on how to properly dispose of medications based on guidelines from the Food and Drug Administration and published medical reports. The self-disposal instructions recommend combining the unused medications with household items such as kitty litter or liquid dish detergent to discourage inappropriate use.

The researchers gave the brochure to 170 patients who had surgery performed at the upper extremity/peripheral nerve clinic between February and September 2017. The patients were enrolled in a survey along with 164 patients that did not receive the brochure. The survey showed 22% of patients that received the brochure disposed of their medications compared to 11% of patients that did not receive a brochure.

These findings suggest that by providing patients with the information to dispose of their medications, surgical facilities can play an active role in keeping opioids out of the community, say researchers.

JoEllen McBride

Surgeon Admits to Branding Patients' Livers
BRANDED Simon Bramhall has to complete 120 hours of community service but will avoid jail time.

A well-respected UK surgeon was ordered to pay a nearly $14,000 fine and complete community service after he admitted to using an argon beam to brand his initials into patients' livers during surgery.

Simon Bramhall, MD, FRCS, MB ChB, 53, was found guilty of 2 counts of battery last week in Birmingham Crown Court and was sentenced to a 12-month community order, which includes 120 hours of unpaid work and the fine, but no jail time, according to a statement from the Crown Prosecution Service (CPS).

The sentence was important, "to maintain the confidence of patients who put their complete trust in surgeons," says Frank Ferguson, head of special crime at CPS.

Dr. Bramhall, who was a consultant surgeon in the liver unit at Queen Elizabeth Hospital, Birmingham, UK, starting in 2002, allegedly used an argon plasma beam coagulator to mark a patient's organ with his initials, ‘SB.'

Another surgeon discovered the initials when he operated on the patient for a follow-up procedure. Since then, Dr. Bramhall has been accused of branding the liver of a second patient.

Dr. Bramhall admitted to the 2 incidents during a hearing in December.

Anna Merriman

InstaPoll: Has a Patient Ever Died on Your Table?

Tell us in this week's InstaPoll if a patient has ever died while undergoing elective outpatient surgery.

Trying to wedge add-on cases into an already packed schedule can bring inefficiency to your operations and inconvenience to you and your staff. Add-on cases are a "major" or "significant" problem for one-third (33%) of the 300 respondents to last week's poll. The results:

How big of a problem are add-on cases at your facility?

  • major problem 12%
  • significant problem 21%
  • moderate problem 25%
  • slight problem 27%
  • no problem at all 15%

Dan O'Connor

News & Notes
  • Sizing up ASC market In 2016, revenues for ambulatory surgery center services reached $26 billion, according to the 2017 Ambulatory Surgery Center Market Report, which also says that 57% of the 6,150 ASCs are independent/physician-owned, 21% are hospital owned/nonprofit and 22% are corporate/for-profit. The report also says that ASCs are expected to treat 60% of outpatient surgical cases by 2020.
  • Did infertility specialist make patient infertile? A woman has sued an infertility specialist, claiming the Gore-Tex plastic barrier he placed inside of her during surgery to remove uterine fibroids in 2007 worked like an IUD and has made it impossible for her to get pregnant. Mehmet Tamer Yalcinkaya, MD, a former doctor at Wake Forest (N.C.) Baptist Medical Center, is seeking to dismiss a lawsuit from former patient Kimberly Bryant, saying that his patient has a condition that causes severe scar tissue.
  • Obese patients likely to become dependent after joint surgery Obese patients who get joint surgery for arthritis are more likely to struggle with such day-to-day tasks as getting out of bed or bathing following surgery, according to a study published in the British Journal of Anaesthesia. Researchers found that these patients have a 35% higher risk of dependence following joint surgery in one or more activities of daily living after surgery.