Articles Posted in Medical Malpractice

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According to the Centers for Disease Control and Prevention, the number of women dying because of pregnancy and childbirth is going up. More than 25 years ago (1987), there were 7.2 deaths of mothers per 100,000 live births; in 2011, that number more than doubled to 17.8 deaths per 100,000 births.

According to experts reporting on this subject, there is not any one factor to explain the increase, but a number of issues, including obesity related complications, record-keeping changes, age and delayed childbearing, health disparities, and an increase in the number of cesarean section births. One of the causes not mentioned, however, is medical malpractice.

Recently, a family of a 32-year-old woman who died from complications during pregnancy while being treated at the Cooley Dickinson Hospital, filed a lawsuit against the hospital for negligence. According to the complaint, the hospital staff missed signs of pre-eclampsia – a potentially fatal complication of pregnancy – and then failed to timely treat it. The complaint further alleges that after the woman was unresponsive for over 10 hours and had given birth by cesarean section, staff realized she had suffered a massive cerebral hemorrhage and would not recover.

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November 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.

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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.

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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.

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According 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:

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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 en.worldcpday.org, 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 a study conducted by Dr. Ramon Jimenez entitled “Do Poor People Sue Doctors More Frequently?“, poor patients are less likely to sue their doctors for medical malpractice. The study has been published in the February 25, 2012 edition of Clinical Orthopaedics and Related Research.

The results of this study run counter to the notion, or misconception, that poor patients are more likely to pursue medical negligence lawsuits to obtain the proverbial “payday.” It appears, instead, that poor patients file claims less because they have less access to legal counsel and often lack the finances necessary to prosecute a case.

The study also touched on an “unconscious bias” held by some physicians who refuse to treat low income patients — that bias being that the doctor will not be paid for rendering services. The decision not to treat patients who may be hard to collect payment from may be eased, or justified, by accepting the assumption that poor patients are more likely to sue.

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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 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.
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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.”

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