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A7GEAW_2378638bNovember is National Diabetes Awareness Month, so a recent report published in JAMA Pediatrics, revealing that pregnant woman with elevated blood sugar levels are more likely to have babies with congenital cardiovascular defects, even if their blood sugar is below the cut off for diabetes, could not come at a more appropriate time.

The study was conducted over four years out of the Stanford University Medical Center, where researchers examined blood samples taken from 277 California women during their second-trimester of pregnancy. Out of the 277 women, 180 were carrying infants without congenital heart disease, and the others had infants affected by one of two serious heart defects. Specifically, 55 had tetralogy of fallot, where a baby is getting too little oxygen, and 42 had dextrotransposition of the great arteries, where the position of the two main arteries leading form the hart are swamped, preventing oxygenated blood from the lungs to circulate throughout the body.

The women’s levels of glucose and insulin were measured and used to test the association between those levels and the odds of having a baby with a heart defect. The results revealed that women who had fetuses with tetralogy of fallot had higher average blood glucose levels, but there was no significant finding in the relationship between dextrotranspostition of the great arteries and glucose levels.

In sum, women who have elevated glucose values during pregnancy, but do not meet the current diagnostic criteria for diabetes, still face an increased risk of having children with congenital heart disease, and more research should be done to further evaluate this correlation.

The trial lawyers at Bottar Leone, PLLC, have decades of experience investigating, prosecuting and trying to verdict all types of medical malpractice and birth injury cases, including those arising out of a failure to treat and/or diagnose a risk to a fetus. To speak with us about a potential medical malpractice or birth injury claim, please contact the Firm by telephone, email, or by submitting an online contact form.

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According to a recent lawsuit filed in the U.S. District Court of Tennessee, defendant health care providers failed to properly handle the delivery of the minor plaintiff, resulting in extended fetal oxygen deprivation and brain injury at birth. Specifically, the complaint alleges that during the mother’s labor and delivery, medical personnel failed recognize and respond to clear signs of declining fetal response, indicating the need for an emergency C-section.

The mother plaintiff gave birth to her first child via Cesarean section, and shortly thereafter she became pregnant again. According to the lawsuit, despite her risk factors, including short stature; previously unsuccessful attempt at vaginal birth; and a brief time between the two pregnancies; the mother plaintiff was advised that she was a good candidate for a vaginal birth after C-section (VBAC).

The mother plaintiff went into labor early, and within the first half hour the EFM strip indicated minimal variability and loss of accelerations (two signs of fetal compromise). According to the lawsuit, rather than being admitted to the Labor & Delivery ward, the fetal monitoring was stopped and the mother plaintiff was advised to walk around the hospital for an hour or so. About two hours later, she was admitted whereupon labor progression was slow and the fetal monitoring continued to show repetitive late decelerations. After several hours, a C-section delivery was ordered.

According to the lawsuit, upon delivery, the infant plaintiff was limp, with bluish-tinged skin and no pulse. He wasn’t breathing and had a high blood acid level indicative of acidosis. The infant plaintiff was sent to the NICU ward, where he spent nearly a month and during which time brain cooling was utilized in attempts to mitigate the damage to the baby’s cells, to no avail. The infant plaintiff was diagnosed with hypoxic ischemic encephalopathy caused by intrapartum asphyxia. He has since been diagnosed with spastic quadriplegic cerebral palsy and suffers serious developmental delays.

The trial lawyers at Bottar Leone, PLLC, have decades of experience investigating, prosecuting and trying to verdict all types of medical malpractice cases including babies injured following a complicated labor and delivery. If your child has been diagnosed with a disability, you and/or your family may be entitled to compensation. To discuss your case or concerns with an experienced Central New York medical malpractice lawyer, contact Bottar Leone, PLLC.

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imageAccording to a recent study published in The Lancet, there needs to be a revision of current clinical guidelines for patients who are already at high risk of having a heart attack or stroke. Specifically, the study revealed that several major clinical guidelines on managing high blood pressure have actually raised blood pressure targets from 130/85mmHg to 140/90mmHg for high-risk patients.

Instead, treating blood pressure to a lower level than the currently recommended targets (which, until now, have been widely regarded as acceptable), will result in better health outcomes for patients. Indeed, a more intensive management of high blood pressure achieved lower systolic blood pressure and reduced the risk of heart attack by nearly 14% and stroke by roughly a quarter.

High blood pressure is commonly known as the “silent killer” – and poor management can lead to a heart attack or stroke. Bottar Leone, PLLC has decades of experience investigating and pursuing claims for cardiovascular deaths. If you have questions about care that you, or a loved one received, do not hesitate to contact us.

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A jury in New Haven Connecticut recently awarded a 58-year-old man $4.2 million for an injury incurred during a surgical procedure that was the result of a doctor’s misdiagnosis.

In December 2008, plaintiff visited the doctor for treatment of a swollen lymph node on the side of his neck. According to the suit, the doctor misdiagnosed what was really a mild Bartonellosis bacterial infection, also known as “cat scratch disease,” and instead recommended surgery to remove the lymph node. Then, during the procedure, the doctor damaged plaintiff’s spinal accessory nerve, causing permanent catastrophic injuries to plaintiff’s left shoulder.

Besides misdiagnosing plaintiff’s case entirely, the surgeon botched the surgery. According to the suit, plaintiff now has nerve palsy, permanent disfigurement of his left shoulder, an inability to extend that arm or raise it above his head, permanent numbness and pain, and he can no longer work at his job without considerable difficulty.

The trial lawyers at Bottar Leone, PLLC, have decades of experience investigating, prosecuting, and trying to verdict all types of medical malpractice cases, including those involving misdiagnosis and surgical errors. To speak with our experienced legal team about your medical care, please contact the Firm by telephone, email, or by submitting an online contact form.

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Syracuse New York Hospital Mistake LawyersAccording to a recent study, medication errors or adverse drug events occurred in about half of all surgeries done at one of the nation’s most preeminent hospitals.  Specifically, over the course of an eight-month period in 2013-2014, researchers observed randomly selected operations at Boston’s Massachusetts General Hospital (“MGH”), and documented every drug given immediately before, during, and after the surgery.

“We knew that medication errors were common,” said Syracuse medical malpractice attorney Michael A. Bottar, “but the results of the study were startling.” During 124 of the 277 observed operations (i.e., 45%), researchers noted at least one medication error or drug-related incident that harmed a patient.  More than one-third of the observed errors injured patients, including three life-threatening mistakes.  Two of the life-threatening mistakes were caught by the operating room staff and one was intercepted by researchers.

The most frequently observed errors were:

  • mistakes in the labeling of syringes,
  • incorrect dosages,
  • neglecting to treat a problem indicated by the patient’s vital signs,
  • medications that should have been given but were not, and
  • documentation errors.

Dr. Karen Nanji, an anesthesiologist at MGH and lead author of the study, has since suggested that it is very likely that this issue could be at least as high at many other hospitals.

The trial lawyers at Bottar Leone, PLLC, have decades of experience investigating, prosecuting, and trying to verdict all types of medical malpractice cases, including those involving surgical errors.  To speak with our experienced legal team about your medical care, contact us at 1-800-336-5297, by email at info@bottarleone, or by completing an online contact form.

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According to a study published this week in the Journal of Pediatrics titled “Prescription Opioid Epidemic and Infant Outcomes,” the use of prescription narcotic painkillers during pregnancy increases the risk that a baby will be born small or early, as well as the risk of drug withdrawal known as neonatal abstinence syndrome.

The study included the analysis of medical records for more than 112,000 women in the Tennessee Medicaid program between 2009 and 2011. Of those women, approximately 28% filled a prescription for at least one narcotic painkiller — mostly short acting medications such as hydrocodone or oxycodone.  According to the authors, prescription narcotic painkillers are “commonly prescribed in pregnancy.”

Babies born small or early are at greater risk for labor and delivery complications, as well as neonatal complications, including:

  • respiratory distress,
  • infection,
  • jaundice,
  • intraventricular hemorrhage,
  • inability to maintain body heat,
  • gastrointestinal issues,
  • anemia,
  • patent ductus arteriosus,
  • retinopathy of prematurity, and
  • sepsis.

The study provides healthcare providers, including obstetricians, with important information about the dangers associated with the prescription of narcotics to women for pregnancy-related conditions such as pubic symphysis diastasis. “Studies like this are important to patient safety, because the warnings issued help inform and shape the standard of care,” said Michael A. Bottar, a Syracuse medical malpractice lawyer.

Bottar Leone, PLLC has decades of experience investigating and pursuing claims for injured patients, workers, motorists, and consumers.  To speak with us about a potential medical malpractice or birth injury claim, please contact the Firm by telephone, email, or click here to submit an online contact form.

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According to a study published in the journal Rheumatology titled “Non-Steroidal Anti-Inflammatory Drugs and Risk of Venous Thromboembolism: A Systematic Review and Meta-Analysis,” there is an increased risk of venous thromboembolism (VTE) among users of non-steroidal anti-inflammatory drugs (NSAIDs). NSAIDs include drugs such as aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), and celecoxib (Celebrex).

VTE is a disease that includes deep vein thrombosis (DVT) and pulmonary embolism (PE). It is the third most common cardiovascular illness, after coronary syndrome and stroke, and can result in permanent disability or death if untimely diagnosed by a healthcare provider.

Data from the Ungprasert study, which compared NSAID users to non-users, provides that NSAID users demonstrated a 1.80-fold increase in risk for VTE. Until now, evidence supporting a between between NSAIDs and VTW was scant. The study has broad public health implications given the prevalence of NSAID use in the general population. As the report warns physicians to be aware of the association between VTE and NSAIDs, especially in patients already at a higher risk of VTE, this report may influence the standard of care with regard to NSAID use in various patients.
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World Cerebral Palsy Day is a global innovation project created to improve quality of life for people living with cerebral families, and their families. The project is led by a group of non-profit cerebral palsy charities, and supported by organizations in over 45 countries.

Cerebral palsy is a neurological disorder caused by abnormalities in parts of the brain that control muscle movements, hearing, vision and cognition. It is the most common physical disability in childhood. The majority of children with cerebral palsy were born with it, although the diagnosis may not be made until a child reaches three years of age. According to, at least two thirds of children with cerebral palsy will have movement difficulties affecting one or both arms, 1 in 4 children with cerebral palsy cannot talk, 1 in 3 cannot walk, 1 in 2 have an intellectual disability, and 1 in 4 have epilepsy. In the most severe cases, children born with cerebral palsy will live their lives dependent upon others for every aspect of daily living.

Causes of cerebral palsy include hypoxia or ischemia during childbirth, genetic disorders, stroke, infection and trauma. Where cerebral palsy is caused by a preventable medical error during labor and delivery, the child and his or her family may have a claim for medical malpractice.
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According to the Centers for Medicare and Medicaid Services (“CMS”), between October of 2008 and June of 2010, more than 11,000 Medicare-eligible patients received care and treatment at Crouse Hospital in Syracuse, New York.

During that time period, at least two patients experienced a 100% preventable surgical complication known as a gossypiboma or textiloma, which is when an object like a sponge, pad, or gauze are accidentally left inside a patient after the incision is closed. For this adverse incident category, Crouse’s rate per discharge of 0.609 was more than six times the national rate per discharge of 0.09.

“CMS’ report is significant because it lifts the veil of secrecy surrounding medical mistakes at area hospitals,” said Syracuse medical malpractice lawyer Michael A. Bottar, of Bottar Leone, LLC. “These statistics do not include errors affecting non-Medicare-eligible patients.”

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According to, a study published by The Project on Government Oversight suggests that Syracuse’s Veterans Administration Medical Center, also known as the Syracuse VA, has very few medical malpractice claims filed against it.

There may be a number of reasons for the low volume and size of claims against the Syracuse VA for medical malpractice. One explanation is that many veterans are not inclined to file a lawsuit against an entity that is providing ‘free’ medical care to them. Second, many veterans do not know that they have been injured by malpractice because they are advanced in age and/or are suffering from a constellation of disabilities stemming from their military service. Finally, claims against the Syracuse VA for medical malpractice are complicated because they are governed by the Federal Tort Claims Act (FTCA). Many personal injury lawyers do not prosecute FTCA cases because they are not familiar with the administrative claims process or the technical requirements of a lawsuit in federal district court.

“We like the complexity of FTCA cases,” said Michael A. Bottar, a Syracuse-based attorney handling a number of VA medical malpractice lawsuits, as well as claims against the the Department of Health and Human Services. “In addition, many agencies, including the VA, do a pretty good job of resolving claims during the administrative review process. Sometimes a lawsuit is unnecessary.” This, of course, assumes that the attorney handling the FTCA claim knows what information must be submitted to the agency, how to submit it, where it should go, and when. “The FTCA can be a mine field for the uninitiated, as there are short deadlines,” Bottar added.

Contact us for a copy of “A Desktop Guide To Federal Tort Claims Within the United States Court of Appeals for the Second Circuit,” or to learn more about claims against the federal government for negligence, malpractice and wrongful death.

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