Syracuse Medical Malpractice Lawyer Blog

More than 140,000 people die every year from a stroke. As strokes are the number three cause of death in the United States, health care providers should consider a stroke when a patient presents to an emergency room with complaints of a severe headache, face droop, arm drift, and/or slurred speech.

"As many as 800,000 people suffer a stroke each year," said Syracuse medical malpractice lawyer Michael A. Bottar, of Bottar Leone, PLLC, a law firm representing injured patients throughout the State of New York. "Unfortunately, strokes are frequently misdiagnosed in the emergency room and patients are sent home without appropriate therapy." Stroke therapy may include the administration of antiplatelets, anticogaulants, statins, and/or blood pressure medications. t-PA may also be administered. Depending upon the type of stoke, surgery may be necessary.

Recently, medicine took a major step forward toward treating acute ischemic strokes. On trial now in Florida is a device called Trevo. Trevo is a minimally invasive catheter system that can retrieve clots in order to return blood flow to the affected portions of the brain before there is brain death. Trevo is a hybrid of current catheter-guided thrombolysis technology. "If the Florida trial goes well we may see Trevo in New York and, in turn, stroke-related permament disabilities may decline," said Bottar.

Continue reading "Syracuse Stroke Misdiagnosis Lawyer Welcomes Trevo Clot Therapy To New York" »

According to the American Heart Association, patients with stroke symptoms who are admitted to a hospital over a weekend have a higher risk of death than those admitted on a weekday. The risk is more than 17% higher. "This known as the weekend effect," said Syracuse medical malpractice lawyer Michael A. Bottar, Esq., of Bottar Leone, PLLC, a law firm prosecuting New York stroke misdiagnosis lawsuits.

"Generally, there is decreased staffing at hospitals over weekends and, in turn, the quality of care can decrease." However, the "weekend effect" appears not to occur at comprehensive stroke centers where brain imaging and acute stroke teams are available around-the-clock.

Designated stroke centers in central New York include Crouse Hospital and Upstate University Hospital. A list of the 116 other designated New York stroke centers can be found here.

Rather than focus on improving the quality of medical care as a way to reduce health care costs throughout the United States, the self-dubbed "Gang of Six" has included in their budget proposal plans to save "an unspecified amount through medical malpractice reform." Even conservative republicans, who traditionally support tort reform because they are financially backed by powerful insurance companies and wealthy hospitals and doctors, believe that federal reform like this is unconstitutional.

"The federal government should not be telling the states whether or how their citizens can use the courts to seek legal redress for their injuries," said Michael A. Bottar, an upstate New York birth injury lawyer. "Who knows what 'reform' means. Typically, 'reform' means a cap on recovery for pain and suffering." Where caps on pain and suffering have passed around the country -- usually in the amount of $250,000.00 or $500,000.00 -- medical malpractice premiums have not decreased and physicians continue to order the same number of purportedly "defensive" tests. This means that medical malpractice is NOT the reason for rising health care costs.

"A well kept secret is the fact that your orthopedic surgeon probably owns the x-ray or MRI machine where s/he referred you for a study. Likewise, that doctor may also own the outpatient surgery center where s/he sent you for a knee replacement. And your gastroenterologist probably owns the machine and surgical suite used to scope you. This means the doctor is paid up front to treat you in the office, and a second time when you use his/her equipment or facilities."

"Another well-kept secret is how egregious medical malpractice can be," Bottar said. "No one knows because almost all New York medical malpractice lawyers and their clients are required to sign a confidentiality agreement when a case settles. Consider this case. An orthopedic spine surgeon practicing in Hawaii (only because he failed to disclose that he had lost his license in other states) was operating on a patient and, after discovering that the titanium rods he needed to implant in the patient's spine were not in the operating room (and would not arrive for 45 minutes), he cut up steel screwdriver and used pieces of the rod to perform the procedure. The rods which were not manufactured for use in the human body broke two days later and the patient was rendered a paraplegic." The insurance companies insist on confidentiality because they do not want the public to know about cases like this.

In a state with a pain and suffering cap of $250,000.00, the patient would receive $17.00 a day for the loss of use of his legs. According to the Medical Group Management Association, the median salary for a spine surgeon in 2009 was $669,073.00, with the 90th percentile earning $1,086.528.00. "That's $1,833.00 to $2,976.00 per day. Sound constitutional to you?"

"Hospital errors result in the death of nearly 200,000 Americans every year," said New York wrongful death lawyer Michael A. Bottar, Esq. In an effort to improve patient care, and to attract more doctors, upgrade its information/technology systems and stabilize its finances, Community Memorial Hospital, located at 150 Broad Street in Hamilton, New York, just minutes from Colgate University, will soon link to Syracuse's Crouse Hospital.

CMH is a 40-bed hospital where approximately 5,000 procedures were performed in 2009 and 2010. Most of those procedures (more than 4,000) were diagnostic or therapeutic in nature. Since 2005, CMH has been investigated twelves times by the New York State Department of Health. According to the NYSDOH website, eight investigations resulted in no citations. However, four investigations resulted in a total of 33 citations including statement(s) of deficiency for, e.g., infection control, anesthesia services, pharmaceutical services, quality of care, supervision of nursing care, nursing services, medical staff and incident reporting.

Hospital officials noted that the Crouse-CMH affiliation is not a merger or asset acquisition like the recent transaction between Syracuse's Community General Hospital and Upstate Medical University. According to Syracuse.com, Dr. Paul Kronenberg, Crouse's president and CEO, noted that "the affiliation with Community Memorial is part of Crouse's strategy to develop an integrated delivery network and expand its geographic reach."

Hospital affiliations, or a link between a small hospital and a large hospital, are one way to decrease hospital negligence leading to New York medical malpractice lawsuits for personal injury and wrongful death. Where these arrangements function correctly, the smaller hospital is able to draw upon the knowledge and resources of the larger institution and prevent harm to patients from, e.g., surgical errors, prescription medication errors, emergency room mistakes and misdiagnosis or the failure to diagnose.

"Even though stroke is the third leading cause of death in the United States, the signs and symptoms are often overlooked in the emergency room," said Syracuse medical malpractice lawyer Michael A. Bottar, Esq., of Bottar Leone, PLLC.

"We are currently representing a man who actually asked emergency room staff is he was having a stroke. He was, but was diagnosed with a 'headache" and some over-the-counter Tylenol. The neurological damage progressed and one side of his body no longer functions." The failure to diagnose a stroke occurs when emergency room personnel, especially in small towns, are not familiar with what to look for in a patient. A headache with other symptoms like loss of coordination and slurred speech should prompt a thorough investigation, including diagnostic imaging.

A new smart phone application may make diagnosis easier -- by enabling doctors to diagnose a stroke remotely. The application is called Resolution MD. The program allows physicians to view high-resolution three dimensional images of the brain on an iPhone, iPad or Android phone. According to a study of the software, it was 94-100% accurate.

Prompt diagnosis of a stroke is critical because damage increases with time. Depending upon the type of stroke, medication called tPA may be administered to relieve symptoms. Information about tPA can be found in our prior post entitled "What Is tPA And Is It Available In Central New York Emergency Rooms?" Most emergency rooms, especially New York certified stroke centers, should have tPA on hand.

Continue reading "New York Stroke Misdagnosis To Decline In Syracuse When Smartphone Technology Arrives" »

According to the Boston Globe, between 2005 and 2010, more than 200 hospital patients died nationally from an improper response to "patient monitors." Patient monitors are those machines that keep track of heart function, respiratory rate and other vital signs. Typically, nurses are responsible for watching monitors.

"Alarm fatigue," a phenomenon where nurses become desensitized to frequent monitor beeping and constant false alarms, may contribute to instances of nursing negligence. A study at Johns Hopkins Hospital in Baltimore revealed 942 critical alarms on one floor, in one day. "That's one alarm every 91 seconds," said New York hospital negligence lawyer Michael A. Bottar, Esq., of Bottar Leone, PLLC, a Syracuse based law firm representing patients injured due to hospital mistakes and errors.

"The alarms become background noise," Bottar said. In one case, a patient who was wheeled into an intensive care unit and connected to a cardiac heart monitor. The leads slipped off and the machine sounded an alarm, but nursing staff did not respond. The patient stopped breathing and died without anyone noticing. At a different hospital, a patient's heart monitor displayed a flat line for more than two hours because the battery was low. Even though they were checking on the patient, the nurses did not change the battery. The patient suffered a heart attack without anyone knowing, and died.

Nurses work in a loud, busy and often over-stimulating environment. As there are only so many nurses to care for the patient population, when machines are simultaneously emitting a "low-priority alarm (e.g., a low battery) and a "high-priority alarm" (e.g., a cardiac arrest), the high-priority alarms receive greater attention. The low-priority alarms get attention when there is time. But low-priority alarms, such as those indicating low battery power, need attention too. Bottar added, "there is no way to monitor for a heart attack, or low blood sugar, or low oxygen saturation, if the monitor is off."

At the forefront of the current New York State budget debate is whether or not non-economic damages in New York medical malpractice lawsuits should be capped at $250,000.00. Non-economic damages are those damages awarded by a jury for pain and suffering and loss of enjoyment of life.

According to hospitals and doctors around the State, medical malpractice lawsuits are universally "frivolous." In response, we ask New York doctors to comment on what just happened to 2 year old Malyia Jeffers. Specifically, we welcome their thoughts on whether this is a case of emergency room malpractice.

A short time ago, Malyia woke up with a fever. When the fever began to rise and Malyia began to show bruising on her cheeks, her parents rushed her to Sacramento's Methodist Hospital emergency room. According to a CNN report entitled "Harmed In The Hospital? Should You Sue?", Malyia sat in the emergency room for nearly five (5) hours before she was examined by a physician. By the time emergency room personnel diagnosed her with sepsis (i.e., a blood infection), it was too late. The infection was advanced and, to save her life, doctors had to amputate her left hand, most of her right hand, and both of her legs. Sepsis is typically treated with intravenous antibiotics. "And time matters," said Michael A. Bottar, of Bottar Leone, PLLC. "It is well known that for every hour of delay in the administration of antibiotic therapy for sepsis, there is an associated 7% rise in mortality."

Bottar, a Syracuse medical malpractice lawyer, continued "if this happened in New York, and there were a $250,000.00 cap on pain and suffering, Malyia would receive, essentially, $8.00/day for her loss. The average salary for an emergency room physician is $267,000.00 per year, or $731.00/day. Sound fair to you?"

"A sponge was left inside our client for nearly one year," said Syracuse medical malpractice lawyer Michael A. Bottar, Esq., an attorney representing the patient and his family. "We believe it was a laparotomy sponge measuring nearly 12 inches by 18 inches. That's the size of a kitchen dish towel. And it had a radio-opaque strip woven into the fabric so it should have been identified on a post-operative xray -- had a study been ordered. The surgical team forgot that too. This was a complete comedy of errors."

A retained surgical sponge is an avoidable mistake. To leave a sponge behind is either the result of surgical malpractice or nursing negligence. This is because surgeons and operating room nurses are supposed to know exactly how many sponges are used during a procedure and should not close until the sponge count is correct. "Ten in, ten out," Bottar added.

Surgeons have an independent duty to check the abdominal cavity for sponges, even if advised by the nursing staff that that all sponges have been counted. This is because sponges and pads are known to stick together so a nurse, thinking that one sponge has been handed to a surgeon has actually handed over two. When one sponge is counted at the end of the procedure, it appears that the count is correct.

If sponges are identified and removed quickly, there is usually little harm other than a second surgical procedure. However, in this case, the sponge was allowed to fester. It led to a very serious infection, a bowel obstruction, the removal of more than one foot of his intestine and a ventral hernia. "On doctor's orders, our client has been out of work for nearly one year. Once a manual laborer, he can no longer lift more than 5-10 pounds and, because of his permanent physical disability, just recently lost his job."

"Stroke is the number three cause of death in the United States," said NY medical malpractice attorney Michael A. Bottar, of Bottar Leone, PLLC, a Syracuse-based law firm prosecuting New York stroke misdiagnosis lawsuits.

On top of the 'usual' stroke risk is the increased risk of a cerebral vein thrombosis (CVT) during pregnancy. A CVT is the occlusion, or blockage, of a venous sinus which may extend to veins draining into the sinus. It can lead to regional ischemia and infarction in the cerebral cortex.

In a recent report titled Diagnosis and Management of Cerebral Vein Thrombosis: A Statement for Healthcare Professionals from the American Heart Association / American Stroke Association, the AHA articulated a number of evidence-based standards for the timely diagnosis of a CVT and recommendations for treatment during pregnancy and the post-partum period.

Unlike a conventional arterial stroke, the signs and symptoms of a CVT are more variable and typically take weeks to develop. This increases the risk of CVT misdiagnosis. Most patients suffer from a headache, paresis, seizure (generalized or focal) and mental status disorders.

Research behind the AHA study revealed that women a highest risk for a CVT are those who are pregnant, or taking oral contraceptives, and people under age 45. 73% of CVTs strike during the post-partum period (the +/- 4 weeks after giving birth). Recommendations for clinical diagnosis include: a comprehensive history for risk factors, blood testing, and magnetic resonance imaging (MRI). Treatment modalities include anticoagulant medications and, in some cases, endovascular treatment or surgery.

Continue reading "CVT Stroke Risk High During Pregnancy and Postpartum Period" »

"Because of confidentiality agreements that insurance companies insist upon following a New York medical malpractice settlement, the public does not know about the number and severity of medical errors. They are common and can be deadly," said Syracuse hospital negligence lawyer Michael A. Bottar, Esq., of Bottar Leone, PLLC.

The statistics are alarming. According to a study recently released by the Office of the Inspector General (OIG), 1 in 7 Medicare patients were harmed by the medical care they received while hospitalized. "14% ?!" Bottar remarked. "We often file claims on behalf of families who suffer a loss due to New York hospital negligence, but we had no idea mistakes were this prevalent."

The OIG study reported that as many as 180,000 patients are harmed annually, with a price tag of $4,400,000,000.00. The study was based on doctors sampling and reviewing medical records of just under 1,000 Medicare patients in 2008. For advice about how to stay safe during a hospital stay, patients should review the Consumer Reports on Health's Staying Safe in the Hospital.

The most common hospital errors include prescription medication dosing errors (receiving too much or too little medication), improperly combining medications, infections, bed sores, equipment malfunction, falls and poor wound care. Wrong site and wrong side surgical errors also occur. Statistics suggest that nearly 50% of hospital mistakes were/are preventable.

Continue reading "New York Hospital Errors Causing Injury and Wrongful Death Are Commonplace" »

According to a 2010 study, more than 225,000 Americans die every year due to medical mistakes. "Medical malpractice is not a myth," said Syracuse medical mistake lawyer Michael A. Bottar, Esq., of Bottar Leone, PLLC. "That being said, most medical negligence is confined to a very small number of physicians. The majority of physicians will practice for 20-30 years without being the subject of a medical malpractice lawsuit. Of course, they won't say that publicly because it does not help advance tort reform to prevent negligence lawsuits altogether."

Following the NPR series titled "Doctors Behaving Badly," our team of medical negligence attorneys formulated the following list of ways that New York could better protect patients seeking medical care in this State:

Number One: Before licensing a physician in New York, the State should communicate with the licensing bodies of other states. There is no reason for New York not to know why a physician lost his or her license in Florida. It should not be up to physicians seeking licensure in New York to interpret and self-report the actions of another state's administrative agency.

Number Two: Search the National Practitioner Data Bank to determine whether a doctor seeking licensure in New York has a disciplinary history and, if so, the details of the history. According to reports, states seldom query the registry. Why not?

Number Three: Interact with local and state agencies to be in a position to learn about publicly available information, such as when a physician is arrested. It should not be up to physicians to self-report their indiscretions.

Number Four: While much of medicine is an art not a science, there are aspects of medicine that have absolute standards of care. Why not codify the standards and force physicians to follow them or face civil liability?

Number Five: Create a process whereby the worst physicians cannot continue to practice, similar to three-strikes-and-you're-out. After a specific number of mistakes, or perhaps after a single egregious error, a physician's license to practice medicine should be in jeopardy. Many successful physicians are not concerned about medical malpractice lawsuits because they can afford to pay insurance premiums and, beyond that, it is almost impossible for them to lose their license.

Number Six: Doctors in need of help, such as rehabilitation or therapy, should have access to necessary services. Inpatient and outpatient treatment should be readily available to ensure that good doctors sidelined by personal issues are not exiled and can return to the field quickly once rehabilitated.

Number Seven: Physician disciplinary histories should be word-searchable and easy to find. It should be easy for patients and boards to find out about a doctor by way of a Google search.

Number Eight: A doctor's track record should be publicly available forever so that a board and/or potential patient can decide if a transgression in the doctor's past is something to be concerned with. There is no reason for disciplinary records to be purged after, e.g., 5 or 7 years. A mistake 8 or 9 years ago may be relevant to someone's decision making process.

Number Nine: If there is too much information to mine and process, then help should be recruited.

Number Ten: Patients should be provided a centralized venue to share their views about a doctor, subject to review by a moderator to prevent abuse. Often, patients have the best information about whether a doctor is a great healthcare provider or otherwise. All doctors to reply to patient comments. The dialogue should make its way into board decision-making.

Continue reading "10 Ways To Cut Down On Medical Malpractice In Syracuse New York" »

Severe sepsis affects more than 750,000 people every year. "Our New York medical malpractice lawyers often file lawsuits alleging that a doctor or hospital failed to diagnose sepsis before it was too late," said Syracuse wrongful death lawyer Michael A. Bottar, Esq., an attorney presently prosecuting several sepsis-based lawsuits.

The failure to diagnose sepsis is a common error. Unfortunately, sepsis, which is also known as blood poisoning, can result in a wrongful death. More than 200,000 every year. "It is the leading cause of death in the non-coronary ICU," Bottar added.

Fortunately, help may be on the way. A new credit-card sized device being tested in Germany may aid physicians in quickly diagnosis sepsis. The tool, called MinoLab, may enable a doctor to diagnose sepsis in as little as 1 hour. Presently, analysis can take as long as 48 hours.

Signs and symptoms of sepsis include a fever, chills, severe shaking, tachycardia (i.e., high heart rate), low blood pressure, confusion, a decrease in urine output, and painful joints. If sepsis is timely diagnosed, it can be treated with intravenous antibiotics, vasopressors and corticosteroids, as well as intravenous fluids and surgery if the source of the infection can be identified and removed. Sepsis is a medical emergency. One out of of every 3 patients who develop "severe" sepsis will die within 30 days.

Continue reading "New York Failure To Diagnose Sepsis Lawsuits To Decline With MinoLab Test" »

"Even though an appendicitis is a clinical emergency, it is commonly misdiagnosed," said Syracuse pediatric malpractice lawyer Michael A. Bottar, Esq., of Bottar Leone, PLLC. As many as 1 out of every 5 cases of appendicitis is not diagnosed before the appendix perforates (i.e., ruptures), which can lead to serious health problems including a periappendiceal abscess, peritonitis, an intestinal blockage, sepsis and death.

An appendicitis, or inflammation of the appendix, is caused by an obstruction of the appendiceal lumen. Signs and symptoms of an appendicitis, which typically strikes between the ages of 2 and 30, include (1) diffuse abdominal pain developing over 4-48 hours, (2) nausea, (3) vomiting, and (4) loss of appetite. When acute (i.e., inflamed), it is a "surgical" disease, meaning that it is treated by surgery as opposed to antibiotics. Surgery to remove the appendix is known as an appendectomy.

New York has one of the highest densities of pediatricians in the United States, with more than 150 pediatricians for every 100,000 children (second only to Massachusetts). This is a reassuring statistic because, according to a recent Reuters Health article titled Fewer Pediatricians, More Ruptured Appendixes, children who live in areas adequately staffed with pediatricians are more like to be timely diagnosed with an appendicitis and, in turn, are at 12% lower risk for rupture. According to the study underlying the Reuters article, a child's proximity to a hospital, emergency room doctor and/or surgeon did not decrease risk. Statistically, access to pediatricians seems to make all of the difference in avoiding complications from an appendicitis.

Continue reading "Failure To Diagnose Appendicitis Low Due To Number Of Pediatricians In New York" »

The kidneys are an essential part of the urinary system. They act as a natural blood filter and, as part of that process, divert waste products to the bladder where they are excreted through urine.

According to New York medical malpractice lawyer Anthony S. Bottar, Esq., a Bottar Leone, PLLC attorney handling Syracuse kidney failure lawsuits, "medical advancements have enabled physicians to diagnose kidney disease and kidney failure sooner and sooner. In turn, kidney dialysis is bring initiated earlier than ever. This may not be a positive development."

Guidelines released by the United States National Kidney Foundation provide that dialysis should not begin until a patient has been diagnosed with stage 5 kidney disease. A study recently published in the Canadian Medical Association Journal reported that the timing of dialysis bears directly on mortality (i.e., death). Approximately 25,000 patients were included in the study. Researchers followed whether each received "early" or "late" dialysis, based upon testing of the glomerular filtration rates. About 30% of the patients started "early," with a GFR greater than 10.5. The balance started "late." Surprisingly, those who started "early" had an 18% increased risk of death.

"It is well-known that the failure to diagnose advanced kidney disease is medical malpractice, this study suggests that a nephrologist may also be liable for the wrongful death of a patient by starting dialysis too soon."

Continue reading "Premature Dialysis Could Lead to New York Wrongful Death Lawsuit" »

"The failure to diagnose cancer is one of the most common types of New York medical malpractice lawsuits," said Syracuse lawyer Michael A. Bottar, Esq., of Bottar Leone, PLLC.

A new blood test developed by several Boston scientists will be brought to the market in the very near future through a partnership with Johnson & Johnson. Unlike currently available tests that can find tumor cells in blood, the new test dubbed a "liquid biopsy" will be able to capture whole cells that doctors can analyze. The new test can find one cancer cell in a billion or more healthy cells by using a microchip covered with 78,000 tiny posts that are coated with antibodies that bind with tumor cells when found. When blood cells are run over the hair-like posts, healthy cells "bounce off" and cancer cells "stick."

"Metastatic disease and death due late diagnosis of cancer should decrease," Bottar added. Historically, doctors administer a drug or therapy and have to wait months to perform imaging (e.g., a CT scan) to determine if the tumor has decreased in size. Many patients do not live long enough for oncologists to find a drug or therapy that works. The new test is promising because doctors will be able to determine, within a day or two, whether a particular cancer treatment is working.

Continue reading "New Blood Test Should Decrease Number of New York Failure To Diagnose Cancer Lawsuits" »