Fatalities At Railroad Crossings Are On the Rise

According to Bloomberg News (2/6, Levin, 2.94M), deaths at rail crossings are beginning to rise “after years of decline, possibly due to an improving economy that has increased traffic on both roads and rails.” The article adds that over the past decade, the number of people killed at rail crossings has “dropped by more than one-third…and since the 1960s has fallen at a faster pace than highway deaths.” Unfortunately, in 2014, fatalities at “rail crossings were on a pace to reach the highest level since 2010, according to” FRA data “through November.”


Wal-Mart Settles With Family Of Comedian Killed In New Jersey Truck Wreck

The AP (1/22, Porter) is reporting that the family of James McNair, the comedian who was killed in a New Jersey Turnpike crash last summer that seriously injured Tracy Morgan, has “settled a wrongful-death claim with Wal-Mart.” According to the story, the “out-of-court settlement” is the “first stemming from the June 7 crash, in which a Wal-Mart truck slammed into a limo van” carrying Morgan and McNair. The AP notes that a preliminary investigation by the NTSB estimated that the truck driver, Kevin Roper, was “driving 65 mph in the 60 seconds before he slammed into the limo van.” The speed limit on that section of the highway is 55 mph and was lowered to 45 mph on the day of the accident due to construction. ABC News (1/22, Katersky, 3.41M) reports that the amount of the settlement is confidential.


NHTSA Scrutinizes Ford Recall

In an article appearing on the front page of its “Business Day” section, the New York Times (1/21, B1, Jensen, Ivory, Subscription Publication, 9.97M) reports that a week after NHTSA Administrator Mark R. Rosekind said he planned on being “more vigilant on safety,” the NHTSA has “taken the unusual move of revisiting the 2013 recall of Ford’s biggest pickup trucks.” The initial recall, which was issued to repair a stalling problem, was limited to nearly 3,000 trucks that were used as ambulances. However, citing several complaints from drivers, the NHTSA notified Ford that “it is now investigating whether that recall should be” expanded, to include almost “197,000 additional pickups that have similar engines but are not used as ambulances,” according to the report. The Times goes on to note that recall queries, such as the investigation into the Ford recall, are “unusual,” noting that there were only four recall queries in 2014.


NHTSA Investigates Jeep Cherokee Vehicles After Reports Of Fires

Bloomberg News (1/17, Plungis, 2.94M) reports that NHTSA has begun “a defect investigation into the latest model of the Jeep Cherokee sport-utility vehicle after an owner reported 20-foot flames shot out of its engine compartment after being parked,” which spreads across 50,415 vehicles built for the 2015 model year. The article states that NHTSA routinely starts investigations “based on a single complaint” when the agency “believes the alleged defect is especially dangerous.”
Reuters (1/17) reports that Fiat Chrysler spokesperson Eric Mayne stated the company plans to cooperate to the fullest with NHTSA.
The Auto World News (1/16, 1K) reported that NHTSA Deputy Administrator David Friedman told the press back in November that Jeep has “to get their act in gear,” adding that “They’ve got to make sure that they are getting those parts in the hands of consumers.”


Dietary Supplements Manufacturer Shuts Down After Federal Lawsuit

The Los Angeles Times (1/17, Panzar, 3.49M) reported that a pharmaceuticals manufacturer in Los Angeles “agreed to close its operations and to recall and destroy all the dietary supplements it has sold since 2011 as part of an agreement with” the FDA. According to a lawsuit filed by the DOJ and FDA, the manufacturer “distributed unapproved supplements that claimed to treat diabetes, allergies and cancer. “ The AP (1/16) and Medical Daily (1/18, Olson, 85K) also reported on the story.


Auto Parts Suppliers Step Up Quality Control

The Wall Street Journal (1/14, Kubota, Subscription Publication, 5.62M) reports that parts suppliers for automakers are working to improve their quality control process following the record recalls in 2014, including the issues with Takata’s exploding air bags and Delphi Automotive’s faulty ignition switches in GM vehicles.


Liability Claims Reduced by Hospitals in National Program

December 6, 2012 – Claims Journal
Initial results from a national perinatal improvement initiatives suggest hospitals can reduce harm to babies and mothers, and lower associated liability claims and pay-outs, through the use of high-reliability perinatal teams.
Results from Phase 1 (2008-2010) of the Premier Perinatal Safety Initiative (PPSI), a Premier healthcare alliance project, show that the 14 participating hospitals have reduced harm and liability since the program’s baseline period (2006-2007).
In relation to harm, PPSI hospitals have reduced, on average:
• Birth hypoxia and asphyxia, which can cause infant brain damage, by 25 percent.
• Neonatal birth trauma, which can range from minor bruising to nerve or brain damage, by 22 percent. In addition, all hospitals were below the 2008 AHRQ Provider Rate, a national comparative rate measuring perinatal harm.
• Complications from administrating anesthesia during labor/delivery, which include cardiac arrest and other cardiac complications, by 15 percent.
• Postpartum hemorrhage, the most common cause of perinatal maternal death in the developed world, by 5.4 percent.
• The adverse outcome index rate, which measures the number of patients with one or more of the identified adverse events as a proportion of total deliveries, by 7.5 percent.
Because of these improvements, approximately 110 fewer mothers and babies experienced these harms.
Reduced liability claims
In addition, participants decreased the number of annual liability claims filed per delivery by 39 percent vs. 10 percent at non-participating hospitals. PPSI hospitals averaged a total of 18 claims per year and project wide during the baseline period, that number dropped to 10 in 2009 and is trending to be at 8 in 2010.
Findings on liability claims and losses are current through November 2012. Because it typically takes two years or longer for a claim to be filed after an injury, final liability claims and losses will not be closed for some time. These results, however, provide clear insight into the trend in claims and losses.
Launched in 2008 by Premier and affiliate liability insurer American Excess Insurance Exchange, RRG (AEIX), PPSI participants are large and small, teaching and non-teaching, system-based and stand-alone, with employed and non-employed physicians. They represent 12 states, in which approximately 250,000 babies will be delivered over the collaborative’s five years (2008-2012).
“There’s no other area in a hospital where providers routinely treat two distinctly different patients at the same time,” said Susan DeVore, Premier president and CEO. “Even though childbirth is so complex and unique, serious adverse events during labor and delivery are rare. But they do occur – sometimes they’re preventable, but they’re always devastating for babies, mothers, families and care providers.”
“The PPSI seeks to better define preventable perinatal harm and identify care practices that can result in improved outcomes,” continued DeVore. “Our results to date suggest that doing so can lower the incidence of certain infrequent, though serious, birth injuries and their associated liability claims. And the diversity of the participating hospitals also lends well to possible replication of the project and its results nationwide.”
Leveraging knowledge gained from previous initiatives, including an Institute for Healthcare Improvement (IHI)/Ascension Health/Premier collaboration, PPSI hospitals use two powerful methods to create high-reliability healthcare teams: increased adherence to evidence-based care bundles and enhanced communication and teamwork.
Increased adherence to evidence-based care bundles
Research shows that grouping essential processes together in care bundles helps clinical staff remember to take all of the necessary steps to provide optimal care to every patient, every time. Although many hospitals have long followed some or all of these individual care practices to improve perinatal outcomes, the key is consistently using all of them in concert.
Care bundle adherence is scored in an “all-or-none” fashion; the care team must provide all elements of care in the bundle to be given credit for its use. For example, one care bundle is focused on reducing the risks associated with augmenting labor, particularly in using oxytocin, a drug that accelerates a slow labor. This bundle has four elements that must be practiced consistently. If a team neglects to estimate the fetal weight before administering the medication, it would not receive credit for the work, even if team members successfully implemented the three other elements of the bundle.
PPSI hospitals have significantly improved compliance with care bundles over the course of Phase I. These improvements led to 106,000 additional mothers receiving evidence-based care bundles.
“Over the past several years, our team has established a number of quality interventions designed to increase safety for moms and babies and reduce the incidence of already very rare perinatal injuries,” said Tiffany Kenny, RN, MSN, C-EFM, OB informatics administrator at Summa Akron City Hospital in Akron, Ohio. “By following evidence-based care models, we’ve improved the quality of our Elective Inductions, lowered the C-section rate for low-risk first time mothers and improved overall safety.”
Enhanced communications and teamwork
PPSI hospitals have implemented the following proven strategies for certain high-risk protocols:
• TeamSTEPPS: Developed by the U.S. Department of Defense and the Agency for Healthcare Research and Quality (AHRQ), TeamSTEPPS produces highly effective medical teams that optimize the use of information, people and resources to achieve the best clinical outcomes.
• Situation Background Assessment Recommendation (SBAR): An effective situational briefing strategy, used by the U.S. Navy, to communicate relevant case facts in a respectful, focused and effective manner.
• Simulation drills: Exercises featuring actresses and mannequins reacting as real patients during the birthing process.
“These principles and strategies provide a foundation of clear communications tools and close to real life scenarios for use by obstetric, NICU, anesthesia, blood bank and lab teams,” said Becky Gams, RN, MS, APNL, University of Minnesota Medical Center, Fairview, and University of Minnesota Amplatz Children’s Hospital.
The PPSI’s Baseline Phase consisted of the retrospective collection of harm outcome data from 2006 and 2007 to establish a baseline of performance. During Phase I, healthcare teams implemented interventions and actively worked on performance and perinatal safety improvement across approximately 145,000 births.
Phase II began in January 2011 and will be completed in December 2012. In June 2010, AHRQ awarded a three-year demonstration grant to PPSI participant Fairview Health Services to extend the initiative. The grant allowed for the Phase II extension, which is examining hospital bundle compliance and associated outcomes, and the role of hospital culture in perinatal performance improvement to further reduce harm and liability. The University of Minnesota School of Public Health and the National Perinatal Information Center will continue providing specialized data and analytic services during the grant phase. Premier will begin analysis of Phase II results when the PPSI concludes. Results from the entire initiative will be made public in the summer or fall of 2013.

Source: Premier healthcare alliance


Liberty Mutual’s Top 10 Causes of Work Place Injuries

By Denise Johnson | January 14, 2015 Claims Journal

Overexertion and falls account for more than $25 billion in workers compensation costs in the U.S., according to Liberty Mutual Research Institute for Safety’s 2014 Workplace Safety Index.
In its 15th year, the annual ranking of top 10 causes of serious, nonfatal workplace injuries is based on the company’s workers’ compensation claims data and data from the Bureau of Labor Statistics and the National Academy of Social Insurance.
The research institute examined 2012 claims data (the most recent available) for injuries lasting six or more days and ranked the injuries by total workers compensation costs.
10 Leading Causes and Direct Costs of Workplace Injuries in 2012:
1. Overexertion $15.1B 25.3%
2. Falls on same level $9.19B 15.4%
3. Struck by object or equipment $5.3B 8.9%
4. Falls to lower level $5.12B 8.6%
5. Other exertions or bodily reactions $4.27B 7.2%
6. Roadway incidents involving motorized land vehicle $3.18B 5.3%
7. Slip or trip without fall $2.17B 3.6%
8. Caught in/compressed by equipment or objects $2.1B 3.5%
9. Repetitive motions involving micro-tasks $1.84B 3.1%
10. Struck against object or equipment $1.76B 2.9%
The leading cause of injury on the list, overexertion, was typically related to lifting, pushing, pulling, holding, carrying or throwing. Other exertions, which came in at number five, includes injuries due to bending, crawling, reaching, twisting, climbing, stepping, kneeling, sitting, standing or walking.
According to statistics compiled by the City of Denver, 311 overexertion claims were reported by employees in 2013. Injuries most often occurred as a result of holding, carrying or lifting.
Recently, Accident Fund Insurance Company of America and United Heartland reported that close to a third of all Midwestern workers’ comp claims with lost time were due to slip and falls on ice and snow.
According to the insurers, winter-related slip and fall claims doubled between 2013 and 2014.
The top five states were:
1. Indiana – 37 percent
2. Wisconsin – 33 percent
3. Michigan – 32 percent
4. Illinois – 32 percent
5. Minnesota – 29 percent
Road deaths
According to the BLS, there were 105 worker deaths at road construction sites in 2013. Texas, Florida, Illinois, Pennsylvania and California were the top ranking states for roadway worker deaths. The top cause (69 percent) were pedestrian workers killed by motor vehicles.
In 2013, 63 percent of occupational fatalities in work zones were to the following occupations: construction laborers, highway maintenance workers, heavy and tractor trailer truck drivers, first-line supervisors of construction an extraction workers and construction equipment operators.
Private sector construction – primarily heavy/civil engineering construction and specialty trades contractors – accounted for 60 percent of worker fatal injuries in work zones.
Service producing industries in the private sector, such as the transportation and warehousing industry and the administrative and support services industry, accounted for an additional 27 percent of worker deaths in work zones. Ten percent of workers fatally injured in work zones were in the government sector.
According to the Occupational Safety and Health Administration, worker deaths in America are down. In 1970, there were on average 38 worker deaths a day and in 2012, the figure was down to 12 deaths a day. OSHA reports workplace fatalities have been reduced by more than 65 percent and occupational injury and illness rates have declined by 67 percent. At the same time, U.S. employment has almost doubled.


GM Recalls Will Not Hurt Its Profitability

The Detroit Free Press (1/14, Gardner, 974K) reports that GM CEO Mary Barra told analysts said that the company expects higher profitability in every region during 2015. The article reports that GM CFO Chuck Stevens said that while the company may announce more recalls over the next few years, “the cost per recall should fall, partly because the company can respond faster.” The Free Press reports that the company will spend between $400 million and $600 million on the compensation fund related to the faulty ignition switches, but the exact figures will not be released until later in the year.
Bloomberg (1/15, 2.95M) reports that Barra spoke on the changes the company made to its recall process, saying that the faulty ignition switch defect was ignored because “people had a different view of stalling,” treating it as a “customer satisfaction issue” instead of a safety issue. She noted, “a series of mistakes were made.”



Congress rolled back safety rules aimed at ensuring truck drivers get enough rest. U.S. Transportation Secretary Anthony Foxx and other safety advocates strongly opposed the plan.

The bill that passed suspended rules the Transportation Department implemented last year, which required drivers, after working 70 hours over eight days, to rest for 34 hours before beginning another work week. The rules had also required that the rest period include two consecutive nights from 1 a.m. to 5 a.m. The amendment suspends these rules until Oct. 1, 2015.

My firm handles personal injury cases involving large trucks. Trucker fatigue is a tremendous safety problem all across the U.S. This issue gained a lot of attention when the Wal-Mart Store’s tractor-trailer hit a limousine carrying comedian Tracy Morgan. The trucker in that incident had been awake for at least 24 hours, according to a police report. He was nearing the end of a 14-hour work shift. Secretary Foxx had tried to convince Congress to do the right thing by sending a letter to senior members of the Senate and House appropriations committees who were considering the year-end spending plan. The letter said:

The evidence clearly shows that truck drivers are better rested and more alert after two nights of sleep than one night, and that unending 80-hour work weeks lead to driver fatigue and compromise highway safety.

Secretary Foxx was not successful in trying to convince Congress to reject language in the Amendment that suspends regulations that require two overnight rest periods between trucker work weeks. The regulations also curtail practices that allowed up to 82 hours of work a week. The following is an examination of what the Senate amendment has done:

Rising Rate

The provision to delay elements of the agency’s rule was in a Senate version of the annual spending bill for transportation programs and was then added to the year-end omnibus bill being worked out by House and Senate appropriators by the Amendment, sponsored by Senator Collins.

Truck crashes caused 3,912 deaths in 2012, and the fatal-crash rate increased each year from 2009 through 2012, reversing a five-year trend. The hours-of-service regulation was expected to prevent 1,400 truck crashes a year, saving 19 lives and avoiding 560 injuries.

Public Citizen reports that every year, 4,000 people are killed and more than 100,000 are injured in crashes involving trucks. Truck crashes cost the American people and our economy S99 billion annually. Nearly half of all truck drivers admitted to falling asleep behind the wheel at least once in the previous year, according to a 2006 study.

Long Weeks

The trucking rules are needed because the industry has been abusing previous regulations to force truckers to drive as much as 82 hours a week. My long-time friend Joan Claybrook, president emeritus of Public Citizen, the Washington-based watchdog group, had this to say:

No one can drive 82 hours in a seven or eight-day period and not be tired. Truckers don’t get enough rest. These provisions ensure they get a little more.

Nighttime Rest

Senator Collins’ provision suspends a mandatory second nighttime rest period while the agency studies whether the regulation has forced more drivers to operate during daytime hours, when there is more traffic congestion and crash risk. It doesn’t take a study to find out that which common sense and available data from highway crashes already tell us and that is a fatigued truck driver is a safety hazard.

Sadly, Congress yielded to the intense pressure from the trucking industry instead of doing the right thing and protecting folks on our highways. Increasing safety on our highways should be a top priority in Congress. It makes absolutely no sense from a safety perspective to do something that would put innocent folks on our highway at risk of death or serious injury. But that’s exactly what members of the House and Senate have done.