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Syracuse radiologist, Stephen Montgomery, M.D., who is also the medical director for Crouse Hospital Breast Health Center, believes that recent Task Force recommendations about mammograms — imaging studies used to detect breast cancer — are “complicated.”

Earlier this week, the U.S. Preventive Service Task Force recommended that women over age 50 undergo mammograms every-other-year. It also recommended against breast self-examinations. Both recommendations could lead to a rise in the number of undiagnosed breast cancer cases. The Task Force’s findings conflict with the American Cancer Society’s recommendations that women learn breast self-examination at or about age 20, and that they undergo mammograms yearly beginning at age 40.

The Task Force recommendations may discourage many women from receiving timely imaging studies that could detect breast cancer early. The recommendations may also confuse physicians, and could lead to an increase in medical malpractice due to a failure to diagnose breast cancer.

According to Dr. Montgomery, “[b]reast cancers are going to show up later, at a higher stage.” That means “a higher mortality.”
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Residents of Syracuse, a city located within Onondaga County in Central New York, and the doctors who care for them, should pay close attention vitamin D levels. A recent study showed a connection between vitamin D, strokes, and heart disease. This is an important development, because the failure to diagnose a stroke, and the failure to diagnose heart disease can have serious consequences, including death.

According to the study, people over age 50 with low vitamin D levels were 45% more likely to develop coronary artery disease, which can cause a heart attack or other heart failure. They were also 78% more likely to have a stroke, and were 77% more like to die early than those with normal levels.
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Many people under age 50 who present to a hospital emergency room with stroke symptoms are misdiagnosed and do not receive timely treatment. This is because most stroke victims are over age 55. In turn, doctors and other medical professionals may fail to diagnose a stroke because they attribute stroke signs and symptoms such as slurred speech and stumbling, to intoxication or a migraine.

According to the American Stroke Association’s International Stroke Conference, 8 of 57 patients between the ages of 16 and 50, who enrolled in the study, were misdiagnosed when they were suffering from stroke. Most patients suffering from a stroke were improperly sent home.

Examples of stroke misdiagnosis include an 18 year old man with left side numbness who was diagnosed as intoxicated, a 37 year old man with slurred speech who was diagnosed with a seizure, and a 48 year old woman with blurred vision and lack of coordination who was diagnosed with an inner ear infection.

Depending upon the type of stroke, a drug known as tPA can be given to prevent or limit damage to the brain.
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Anthony S. Bottar, senior partner of Bottar Leone, PLLC, a law firm based in Syracuse, New York, was re-elected by his peers to the 2010 edition of Super Lawyers – Upstate Edition.

Mr. Bottar was 1 of 45 upstate New York attorneys recognized for representing those injured due to medical malpractice (1 of only 4 attorneys recognized in Syracuse). Mr. Bottar was 1 of 25 upstate New York attorneys recognized for representing those injured by dangerous and defective products (1 of only 3 attorneys recognized in Syracuse). Mr. Bottar was also recognized for general plaintiff’s personal injury.

Mr. Bottar has enjoyed continuous listing in Super Lawyers since 2007, the first year that Super Lawyers began honoring upstate New York attorneys. Super Lawyers website can be found at www.superlawyers.com.
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Loretto announced today that it is closing two Syracuse-area nursing homes over the next two years. The involved homes are Loretto-Oswego and Rosewood Heights. Loretto’s press release did not discuss the motives for the closures including whether or not the decision was driven by costs, patient population, medical malpractice, and/or quality of care concerns.
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Many years ago, thrombolytic therapy was approved for the acute treatment of a stroke. Despite this therapy, very few patients are receiving treatment in time to prevent stroke sequela. There are several explanations for the failure to diagnose a stroke and the failure to timely treat a stroke.

First, many patients wait too long to go to the hospital after experiencing stroke symptoms. On average, patients alone at symptom onset waited more than three and one-half (3.5) hours to go to the hospital (as compared to roughly 2 hours for those not alone). Awakening from a sleep with symptoms increases delay. Transport to the hospital by emergency medical services decreases delay.

Second, many hospitals wait too long after a patient arrives in the emergency department to obtain a CT scan, the results of which may result in a stroke diagnosis and prompt thrombolytic therapy. On average, hospitals take just over 1 hour to perform the diagnostic study. A hospital may depart from accepted standards of care, an be liable for hospital negligence or medical malpractice, for exceeding time standards set by the a National Institute of Neurological Disorders and Stroke advisory committee.

In sum, delay in presenting to the hospital, when joined with hospital delay, can lead to a failure to timely diagnose a stroke and, in turn, a poor outcome such as brain damage.
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St. Joseph’s Hospital Health Center, Syracuse, New York, recently obtained certification as the only accredited chest pain center in Central New York. The certification was issued by the Society of Chest Pain Centers.

As an accredited chest pain center, St. Joseph’s Hospital promises immediate treatment for patients who come to the hospital complaining of chest pain and shortness of breath. The new protocol for immediate treatment may decrease medical malpractice claims for delays in treatment that lead to heart damage. Early treatment is critical during a heart attack.

According to Richard Caputo, M.D., a Syracuse-area cardiologist, “[t]he average patient arrives in the Emergency Department more than two hours after the onset of symptoms, but what they don’t know is that the sooner a heart attack is treated, the less damage to the heart and the better the outcome.”

In addition to its recent accreditation as a chest pain center, St. Joseph’s Hospital is the only Syracuse-area hospital that is designated by the American Heart Association as a Missing Lifeline STEMI hospital, for the treatment of heart attacks.
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The New York State Department of Health Office of Professional Medical Conduct (“OPMC”) has suspended for thirty days the license of a Syracuse doctor specializing in obstetrics and gynecology. According to OPMC, Dr. Richard Caputo, who operated a practice known as The Good Life Centre for Women, “improperly used forceps to deliver babies and exposed patients to unnecessary risks.”
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According to materials examined by Hearst reporters and graduate students at the Toni Stabile Center for Investigative Journalism, medical professionals are not always truthful on death certificates. Especially so where the true cause of death may trigger a medical malpractice or wrongful death lawsuit, or where the true cause of death may lead to scrutiny from the New York State Department and/or Center for Disease Control.

In most cases, relevant information about a patient’s death was left off of the death certificate. An example includes the death of Norine Zazzara, 81, who died at St. Joseph’s Hospital Health Center in Syracuse, New York. According to her death certificate, she died of pneumonia. However, her medical records revealed that she had contracted MRSA while admitted for leg swelling, which led to pneumonia, ventilator respiration and eventually death. MRSA was omitted from Ms. Zazzara’s death certificate.
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According to Peter Rosi, M.D., a Chicago-area obstetrician who has been sued more than ten times, and criminally prosecuted, for medical mistakes including errors made during home births, and pediatric care leading to infant brain damage, “[e]ighty percent of complications in childbirth are psychological.” Dr. Rosi contends that “[b]abies can be killed by a mother’s attitude.”

In Illinois, Dr. Rosi advised pregnant women whose home births ran into problems to drive long distances to hospitals where he had privileges. For example, Dr. Rosi has testified that he instructed a woman in labor to crouch on all fours in the back seat of her car while her family drove her 75 miles to a hospital where he had medical privileges. Dr. Rosi followed the laboring mother in his car. While there were 7 closer hospitals which could have performed a c-section, Dr. Rosi did not advise the family to go there for emergent medical care. According to court records, the baby was born dead, following inhalation of his own waste. When questioned about his handling of this case, Dr. Rosi testified that “[b]abies die.”

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