Man dies from potassium chloride overdose
Man dies from potassium chloride overdose
A 61-year-old man was killed in April when a registered nurse accidentally gave him a large dose of potassium chloride. The concentrated potassium chloride was administered through an intravenous drip, according to Michael Lang, vice president of marketing for Miller-Dwan Medical Center in Duluth, MN. The patient was in the hospital for an undisclosed ailment.
Lang says the hospital is investigating the accident to determine how the fatal medication was administered. The nurse has been taken off the work schedule but has not been dismissed.
In diluted form, potassium chloride is used to slow a rapid heart beat; in concentrated form, it is used by some states for lethal injection. t
Health plans have duty to disclose, court says
The ERISA medical liability shield may be weakened significantly now that a federal appellate court has ruled that health plans have a duty to disclose that they reward physicians who deny referrals to specialists.
The Eighth U.S. Circuit Court of Appeals in Alexandria, MN, ruled recently that the Medica HMO in Minnetonka, MN, breached its fiduciary duty to a 40-year-old patient because it did not tell him that his gatekeeper physician benefitted financially when he denied the man access to a cardiologist. The man died of heart failure after the primary care physician said he did not need to see the specialist.
After his death, the patient’s family sued Medica and the primary care physician. The appellate court ruled that the ERISA law "preempted the health plan from state laws that relate to any employee benefit plan.’" However, the court went on to rule that the HMO’s proprietary capitated deals with doctors violated the part of the ERISA law that requires fiduciaries to disclose "essential information" to beneficiaries.
The financial reward for limiting access to specialists involves "matters of life and death, and an ERISA fiduciary has a duty to speak out if it knows that silence might be harmful," the court noted. "Indeed, in this case, the danger to the plan participant’s well-being was created by the fiduciary itself."
If the patient had known of the financial reward to the gatekeeper, he may not have trusted the doctor’s decision that a cardiologist was unnecessary, the court explained.
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