According to Syracuse birth injury lawyer Michael A. Bottar, the passage of the Midwife Modernization Act may contribute to a rise in preventable birth injuries, such as cerebral palsy and Erb's palsy, from at-home births that appear "low-risk" but evolve into complicated deliveries due to, e.g., umbilical cord compression, shoulder dystocia, fetal distress and/or maternal hemorrhaging. Simply stated, a "low-risk" birth can become a "high-risk" birth in a matter of seconds and, where a laboring mother and fetus attended to by a midwife (who is not qualified to perform a cesarean section), a mother and baby may suffer harm before there is time to relocate to a hospital for surgical or therapeutic intervention. This is why, according to American Medical Association Resolution 205 (2008), "the safest setting for labor, delivery and the immediate post-partum period is in a hospital or birthing center within a hospital."

At the present time, there are approximately 1,000 licensed midwives practicing in the State of New York, with more than one-half practicing in and around New York City. The balance are spread around the State, with roughly 50 practicing in and around Syracuse, Binghamton, Utica, Herkimer, Oneida, Oswego and Watertown.

The New York State Academy of Trial Lawyers boasts a membership of more than 1400 judges, law clerks, law firms, lawyers, paralegals and law students, including: Syracuse medical malpractice lawyers handling cases concerning stroke misdiagnosis, failure to diagnose cancer and failure to prevent a heart attack; Syracuse work injury lawyers handling cases concerning construction site accidents, scaffolding accidents and injuries caused by a fall from a height; Syracuse birth injury lawyers handling cases concerning fetal hypoxia and ischemia, cerebral palsy and Erb's palsy; Utica brain injury lawyers handling cases concerning concussions, post-concussion symdrome and TBI; Watertown medical malpractice lawyers handling cases concerning Samaritan Medical Center negligence and Fort Drum physician mistakes; and Watertown injury lawyers handling New York State Thruway accidents.

Should I call a Syracuse medical malpractice lawyer to find out if I have a case? The short answer is yes. As your time to file a lawsuit is limited, you should call sooner, rather than later. In an effort to provide some guidance to the victims of medical malpractice, we will attempt to identify five warning signs of medical negligence:

ONE: Be concerned if, despite treatment for your illness, you do not get better (be very concerned if you in fact get worse). After settling on a diagnosis, whether or not it's the correct one, many health care professionals choose not to look further. No one wants to admit that they were wrong. Seek a second opinion, as the diagnosis you carry may be incorrect!

TWO: Be concerned if your diagnosis does not seem to match your symptoms. We all have access to the internet. Search the web to see if your symptoms are consistent with the diagnosed condition. If not, you may have been misdiagnosed. Good sources of information about your symptoms and your condition include WebMD (www.webmd.com) and YourDiagnosis (www.yourdiagnosis.com), as well as WD (www.wrongdiagnosis.com). Take this information to the doctor who diagnosed you, or to a new doctor, and ask questions. Help your doctor help you!

THREE: Be wary of a diagnosis based solely upon a single lab test. Labs can be wrong. Make sure that your doctor questions the lab results and, if a very serious condition, request that a second lab perform an analysis.

FOUR: Be concerned if your doctor attributes common complaints to an uncommon diagnosis. Often, a headache without more is, well, just a headache.

FIVE: Challenge a diagnosis that can be confirmed or ruled-out with a test that you have not received. If there is a test that will paint a complete picture for your doctor, you should receive it. If it has not been recommended, ask for it (see sign TWO, supra - do research)! The failure to diagnose a condition is often due to the decision not to order a test when the test was indicated.

While a medical malpractice lawsuit cannot fix the physical damage caused by a misdiagnosis or a failure to diagnose, but it can help to secure funds so that you and your family can attempt to live a normal life despite your losses, which may include permanent disability due to a surgical error, wrongful death due to nursing negligence, limb loss due to infection, or brain damage due to medication errors. A lawsuit may also recover future medical costs and restore economic losses, such as lost wages and benefits.

In sum, the 51 year old plaintiff presented to the emergency room on day 1 with complaints of a headache and lower extremity weakness. She was discharged with a diagnosis of back pain. She returned on day 23 with ongoing complaints of lower extremity weakness and decreased muscle control. She was again discharged with a diagnosis of back pain. She returned on day 24 with complaints of jumbled thoughts, blurred vision, lower extremity weakness, decreased lower extremity sensation, and was observed dragging her foot while walking. She was discharged with no diagnosis. On day 25, the plaintiff suffered a stroke. The stroke prevented blood from reaching her brain, causing brain damage.

As the plaintiff was permanently totally disabled before the stroke, for reasons unrelated to the lawsuit, she did not have a claim for lost wages. The $900,000.00 recovery was for her past and future pain and suffering.

Unlike the typical personal injury case, a medical malpractice case requires a very specific skill set. Not every Syracuse personal injury lawyer has the skill, experience and resources to handle a medical malpractice case that costs $50,000.00 to prosecute and, while many lawyers accept medical malpractice cases, very few in Central New York have a nearly 30 year track record of success.

When selecting a Syracuse medical malpractice lawyer make sure you pick a lawyer that knows his/her medicine. While your lawyer need not be a doctor to win your case, he/she certainly needs to understand anatomy, or be willing to learn through research and consultation with experts. Make sure you also check to see if your lawyer, like the attorneys at Bottar Leone, PLLC, has been selected for membership in peer review organizations such as The Best Lawyers In America, SuperLawyers, the Million Dollar Advocates Forum, the Multi-Million Dollar Advocates Forum, Lawdragon, etc. Inquire about whether your lawyer has, like Anthony S. Bottar, Esq., ever been named Syracuse personal injury lawyer of the year. Ask your lawyer how long he/she has been advocating for patients and their families. Experience counts.

Bottar Leone, PLLC, is one of Syracuse's oldest and largest medical malpractice law firms. We have experience with virtually every type of medical malpractice case, including claims for a Syracuse birth injury leading to cerebral palsy or Erb's palsy. If your child was injured during child birth in Syracuse, call us. Our most recent birth injury case, involving a child diagnosed with cerebral palsy, settled for $3,250,000.00. If a loved one had a stroke after being discharged from the emergency room, call us. Our most recent case involving a failure to diagnose a stroke settled for $900,000.00. If you were injured during surgery, call us. Our most recent case involving a surgical error causing incontinence settled for $1,000,000.00.

Bottar Leone, PLLC. In and for the community. Since 1983.

According to Syracuse New York nurse practitioner error lawyers Bottar Leone, PLLC, nurse practitioners are increasingly becoming the focus of malpractice cases because of the growing role they play in dispensing medical care. According to the HealthPro/NSO report, the highest number of claims against nurse practitioners arose out of care provided in the medical care office. Nurse practitioner specialties with the most claims against them included adult/geriatric NPs, family NPs, and pediatric/neonatal NPs. The most severe claims -- meaning those with the most significant injury to the claimant -- conerned care that was or should have been provided by a pediatric/neonatal nurse practitioner. The largest settled claims involved a pediatric/neonatal NP's failure to diagnose.

In 1980, the NIH released a similar report, in which it encouraged doctors to permit vaginal deliveries after a prior cesarean section incision has weakened a pregnant mother's uterus, exposing her to increased risk for rupture and hemorrhaging. VBACs rose through the 1990s from 3% to 23%, but have decreased in frequency since 1996, to 8.5% in 2006. In 1999, the American College of Obstetricians and Gynecologists (ACOG) revised its guidelines to practitioners from "encouraging" VBACs to pregnant mothers, to "offering" VBACs as an "option." Shortly thereafter, as many as 30% of hospitals prohibited VBAC deliveries.

While encouraging more VBACs, the NIH panel conceded there was "moderate evidence" of a "clear increased risk of uterine rupture in trial of labor compared to an elective repeat cesarean delivery" and noted that uterine rupture "can be catastrophic and remains the most dreaded short-term complication of a trial of labor."

In terms of risks to an unborn baby, the NIH panel found "moderate evidence" of "increased perinatal mortality and low-grade evidence of increased fetal mortality." It concluded that there was "insufficient data on the incidence of hypoxic ischemic encephalopathy in cases of VBAC versus repeat cesarean sections." Hypoxia and ischemia can lead to cerebral palsy.

Lyme Disease is a largely tick-borne disease that is passed to humans through a bug bite, which is usually followed by a rash and/or bulls eye shaped red mark. Additional signs and symptoms include a flu-like feeling, fever, chest congestion, headache, nausea, and joint pain. Unfortunately, a Lyme Disease rash is often misdiagnosed as poison ivy or ringworm. Other symptoms are commonly confused with the flu or a musculoskeletal injury.

The failure to diagnose Lyme Disease can have devastating consequences, including brain damage due to meningitis, heart damage due to infective endocarditis, Lyme arthritis and Bells' Palsy. Generally, Lyme Disease is diagnosed by a blood test and, if positive, is treated with either oral or intravenous amoxicillin (depending upon the stage of the disease).

After birth, a baby needs to breathe. In babies with PPHN, the ductus arteriosis does not close on day one of life, leaving blood directed away from the lungs and low blood oxygen levels. While many babies suffer from PPHN due to a birth injury, according to Binghamton New York birth injury lawyers Bottar Leone, PLLC, a recent study also links PPHN to maternal consumption of selective serotonin reuptake inhibitors (SSRIs), such as Prozac, Zoloft, Paxil, Symbyaxm Celexa, Cymbalta, Effexor and Lexapro.

The study reported a shocking statistic. That is, that women who took SSRIs during their third trimester were six times more like to deliver a baby diagnosed with PPHN after birth (usually within 12 hours, if not sooner). A failure to diagnose persistent pulmonary hypertension of the newborn can result in damage to a baby's brain, kidneys and liver. Many babies with PPHN are diagnosed with cerebral palsy secondary to PPHN oxygen deprivation.

According to Syracuse New York gestational diabetes lawyers Bottar Leone, PLLC, well-known blood sugar level benchmarks may soon be revised in order to better diagnose and treat women diagnosed with diabetes during pregnancy. Soon to be released revised guidelines will result in more women carrying the diagnosis of gestational diabetes, as well as better care for blood glucose levels which may pose a threat the health and safety of a mother and her unborn fetus.

Historically, a fasting blood sugar level of 92 mg/dL was considered "safe," as was a one-hour level of 180 mg/dL and a two-hour level of 153 mg/dL. New standards will set the bar much lower. Medical intervention at lower maternal blood glucose levels should reduce the number of premature deliveries, shoulder dystocias due to big babies, and a high blood pressure condition called preeclampsia. A failure to diagnose preeclampsia can cause maternal heart failure, and death.

The failure to diagnose gestational diabetes can have serious consequences, including maternal or fetal death, maternal or fetal heart damage, Erb's palsy, cerebral palsy, polycythemia, jaundice and hypocalcemia.

Danish researchers recently published the results of a study of births from 1989 through 2006. Of the 730 babies born to women who underwent IVF or ICSI, 8% were born premature and 1.5% were born very premature, compared to 5% and 0.06%, respectively, for women who conceived "naturally."

There are many health risks for premature babies. Some premies are born with respiratory distress syndrome (RDS) and need to be on a mechanical ventilator for the first few weeks of life. Other premature baby diagnoses include intraventricular hemorrhaging (bleeding in a baby's brain following birth), periventricular leukolamacia (baby brain damage), cerebral palsy, bronchopulmonary dysplasia (when a baby needs oxygen after 36 weeks), or retinopathy of prematurity (due to abnormal blood vessels in the eyes). In addition to any of the above problems, premature babies are also predisposed to learning disabilities, problems with their hearing and vision, blindness, deafness, and mental retardation. More often than not, however, premature babies grow up with no problems whatsoever.

According to North Country medical malpractice lawyers Bottar Leone, PLLC, patients who took just one more pill (a week) decreased their risk of stroke by nearly 10%, and their risk of death by around 7%. Most of the nearly 50,000 patients in the study were on two blood pressure medications; however, some were taking as many as six. Roughly 60% of the patients did not fill their prescriptions 80% of the time. These patients, known as non-adherent patients, were .5% more like to die over a five-year period.

There are many different types of blood pressure medications. Diuretics, such as Amiloride, Bumetanide, Chlorothiazide, Chlorthalidone, Furosemide, Indapamide and Spironolactone, decrease blood pressure by causing the body to purge excess fluids and sodium. Angiotensin Converting Enzymes (ACE) inhibitors, such as Benazepril, Captopril, Enalapril, Fosinopril, Lisinopril and Moexipril, decrease blood pressure by allowing blood to flow more freely, which makes the heart's job easier. Beta blockers, such as Acebutolol, Atenolol, Betaxolol, Bisoprolol, Carteolol, Metaprolol, Nadolol and Sotaolol, decrease blood pressure by decreasing heart rate and cardiac output.

According to Central New York medical malpractice lawyers Bottar Leone, PLLC, most unnecessary medical procedures are performed without incident. However, where a patient experiences a complication as a result of a contraindicated medical procedure, the physician who ordered the procedure may be liable for medical negligence.

Typically, interventional cardiologists perform cardiac catheterizations by threading a thin tube into a vein or artery in the groin and maneuvering the tube to the coronary arteries or heart. In most cases, the patient is awake and feels no pain. Soreness is to be expected in the blood vessel where the catheter was inserted. Known risks and complications associated with cardiac catheterization include: infection, damage to involved blood vessels, arrhythmias, low blood pressure (hypotension), blood clots, heart attack, congestive heart failure and allergic reactions to dye causing kidney damage.

When OBGYNs or labor and delivery nurses correctly diagnose an impending preterm birth, a recent study suggests that magnesium sulfate should be prescribed to protect against cerebral palsy. According to Syracuse birth injury lawyers Bottar Leone, PLLC, magnesium sulfate may strengthen fetal blood vessels and, in turn, increase oxygen transport despite swelling and inflammation associated with an early delivery.

While scientists have not identified exactly how magnesium sulfate may aid in protecting a premature baby from brain injury, and despite the fact that the therapy has not been approved by the FDA, many OBGYNS are recommending the chemical compound (which also goes by the name Epson salt) to pregnant mothers.

According to John Thorpe, co-author of one of the largest studies of cerebral palsy and magnesium sulfate, "[v]irtually every delivery room in the United States is already stocked with magnesium sulfate solutions that are given to pregnant women during childbirth for other reasons. [W]hat we have learned from this study is that we have a cheap, widely available treatment already in hand that cuts in half the risk of babies being born with an extremely disabling disorder. That is a tremendously exciting development."

According to Syracuse, New York infection lawyers Bottar Leone, PLLC, one of the most significant signs of an ongoing disease process in children is a fever. Most infant visits to an emergency room are for fever. As many as 20% of fevers have no identifiable cause. While a fever may be a symptom of something as minor as a cold or the flu, a fever may also be a sign of a very serious infection, such as meningitis, bacteremia, pneumonia or urinary tract infection. The failure to diagnose meningitis can result in brain damage or death.

As many as 12% of "well-appearing" children in the emergency room are very ill. Emergency room doctors should not rely solely upon whether a child has a fever to determine whether a baby is sick, especially in children under the age of 3 months. In turn, most order a battery of tests, including analysis of blood, urine and spinal fluid. Performing a procalcitonin test may allow emergency room personnel to quickly identify whether a child is at low-risk for a serious bacterial infection.