Articles Posted in Emergency Room Errors

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A recent case out of Illinois alleges that a husband’s disabling injury was caused by a neck injection. According to the complaint, on March 20, 2015, Bill Blechinger came under the care of a doctor for an undisclosed ailment. A day later, the plaintiff entered the emergency department at St. Joseph’s Hospital – again for an undisclosed ailment – during which time an injection was administered to his neck.

According to court documents, the injection was negligently and carelessly administered in the absence of a sterile environment, causing an infection. Among other claims, the plaintiff asserts that he has become been crippled, permanently disabled, and suffers great pain, mental anguish and disfigurement. Plaintiff further asserts that he has been permanently prevented from attending his usual duties, and has lost wages, income, and has incurred large amounts of medical expenses.

The trial lawyers at Bottar Law, PLLC, have decades of experience investigating, prosecuting and trying to verdict all types of medical malpractice cases. Victims of medical complications due to the negligence error of the administering physician could be entitled to monetary compensation. Do not hesitate to contact us to speak with someone about a potential malpractice claim.

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According to a recent article out of the New York Times, shorter hospital stays are not because hospitalized patients are becoming younger and healthier.  In fact, by and large, today’s patients are actually older and sicker. Rather, shorter hospital stays may be attributed to hospital financing.

According to the New York Times, in 1980 the average hospital stay in the United States was 7.3 days, while today it is closer to 4.5 days. One reason attributed to this change came in the early 1980s when Medicare stopped paying hospitals for their claimed costs and phased in a payment system. This “prospective payment system” pays a predetermined rate tied to each patient’s diagnosis and shifts the financial burden of a patient’s hospitalization from Medicare to the hospitals. As a result, hospitals are economizing and one way to do this is to get patients out of their hospitals, sooner.

Almost as soon as this “prospective payment system” started, experts raised concerns that it would lead to a higher rate of readmission. Meaning, patients discharged too quickly may be prone to complications, necessitating their return to the hospital. According to the New York Times, evidence backs this logic.  And, with recent programs created by the federal government aimed to penalize hospitals for readmission rates, e.g., Medicare’s Hospital Readmissions Reduction Program, where hospitals lose up to 3 percent of their total Medicare payments for patients readmitted within 30 days of discharge, questions remain as to whether patients are getting the care they need.

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Crouse Hospital and St. Joseph’s Hospital Health Center are being penalized by the federal government for having high rates of avoidable patient complications. They are among 758 U.S. hospitals – 46 in New York – having their payments from Medicare reduced by 1 percent over the course of the federal fiscal year, which runs through September 2016.

The fines are based on the government’s assessment of the hospital-acquired condition (HAC) score. HACs are conditions such as infections, sepsis, broken hips, and other problems patients did not have upon arrival at the hospital, but developed during their stay. Each hospital was given a score of 1 to 10, 1 being the best and 10 being the worst. The following are the HAC scores for Central New York hospitals:

  • Crouse: 9
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According to a paper published in the new issue of the Journal of the American Medical Association, more than one in four doctors in the early stages of their careers have signs of depression, and their patients – now and in the future – may suffer because of it.

The findings come from an investigation of 50 years’ worth of studies, published between January 1963 and September 2015, that looked for depression symptoms in more than 17,500 medical residents. Their analysis revealed that the percentage of residents with possible depression ranged from 20 to 43 percent, resulting in an average of 29% physicians-in-training with depression or depressive symptoms.  By way of comparison, in 2013 the National Institute of Mental Health reported that about 6.7% of all U.S. adults had at least one major depressive episode during the previous year.

According to Srijan Sen, M.D., Ph.D., senior author of the study and a member of the University of Michigan’s Depression Center, depression obviously negatively impacts the doctors-in-training themselves, but it also affects patient care, as mental health issues are linked to medical errors. Indeed, it could interfere with attention and focus, the development of the doctor-patient relationship, and result in a resident physician less engaged or interested in a patient’s care – inevitably resulting in errors. The prevalence of depressive symptomatology and disease in physicians-in-training is a significant and important indication of a system in need of change.

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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 Law, 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.
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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 Law, 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.

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“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 Law, 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.
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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 Law, 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.”

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“Stroke is the number three cause of death in the United States,” said NY medical malpractice attorney Michael A. Bottar, of Bottar Law, 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.
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“Baby boomers are spending more and more time in hospital emergency rooms because of the medications that they take,” said New York medication error lawyer Michael A. Bottar, Esq., an attorney with Syracuse-based Bottar Law, PLLC, a team of lawyers handling New York emergency room lawsuits. “Unfortunately,” Bottar added, “many of the medications that seniors take do more harm than good.”

According to Dr. Carolyn Clancy, the Director of the Agency of Healthcare Research and Quality, Americans take a record number of medications to maintain their health. This is because many medical problems can now be treated with drugs that were not available years ago. However, a constellation of drugs used to treat virtually all ailments have been linked to three troublesome conditions, including: (1) drug-induced delirium, (2) drug overdose, and (3) drug withdrawal.

Often, when seniors present to emergency rooms with complaints, they are prescribed drugs that are not compatible (i.e., contraindicated) with their current medication regimen. For example, seniors on blood thinners should not receive tPA, a stroke drug we blogged about previously in a post titled “What Is tPA and Is It Available In Central New York Emergency Rooms.” Likewise, prescriptions are frequently discontinued in the emergency room setting even through the patient should not stop taking a drug. “Either scenario can have devastating consequences,” said Bottar, whose office is currently prosecuting several medication error lawsuits involving severe personal injury and permanent disability, including stroke and blindness.
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