Articles Posted in Medication Errors

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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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According 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 Law, 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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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 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:

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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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“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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We frequently blog about labor and delivery complications, including precipitate delivery, gestational diabetes and preeclampsia, and placenta accrete. Each can lead to serious injury to a baby, such as cerebral palsy.

Some Syracuse labor and delivery complications can be avoided if a baby is delivered by cesarean section (c-section), rather than a vaginal delivery. A recent study on 230,000 deliveries in 19 hospitals around the country revealed that about 1/3 of the babies were born by c-section. Rates are expected to continue rising because most women experience repeat c-section, rather than a vaginal birth after cesarean section (VBAC).

According to Syracuse birth injury lawyers Bottar Law, PLLC, the medical industry was quick to blame the rise in abdominal deliveries on obstetrical medical malpractice claims and doctors practicing “defensive medicine.” However, the study did not cite legal concerns as the basis for the statistical increase. Rather, it cited “chemically-induced” labors as the primary reason for c-sections. Indeed, women whose labor was induced were twice (2x) a likely to have a c-section. The chemical commonly used to induce labor is Pitocin or “pit.”

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Michael A. Bottar, Esq., a Syracuse medical malpractice lawyer with Bottar Law, PLLC, recently secured $700,000.00 in compensation from a group of medical defendants. The New York medical malpractice lawsuit alleged that the defendants’ improperly prescribed birth control pills to the plaintiff for mid-cycle pain, causing a stroke that led to mild foot drop, mild speech and memory deficits, a (controlled) seizure disorder and the need for lifetime Coumadin.

In sum, the 19 year old plaintiff presented to her obstetrician with complaints about mid-cycle pain. She was prescribed birth control pills to relieve the pain. The which were contraindicated because the plaintiff had a genetic blood disorder which the defendants knew about, or should have known about. Months later, the plaintiff suffered a stroke. The stroke prevented blood from reaching the plaintiff’s brain, causing mild, yet permanent brain damage.

The $700,000.00 recovery was for past and future pain and suffering, and future lost wages.

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Stevens Johnson Syndrome (“SJS”) is a rare disorder in which the skin and mucous membranes react adversely to a medication. According to Syracuse wrongful death lawyer Michael A. Bottar, SJS “commonly starts with flu-like symptoms. A painful red or purple rash follows, with blistering, and skin death and shedding, also known as sloughing.” In some cases, as much as 100% of the skin can be lost. Other unsafe medication complications include infections and blindness.

A New York dangerous medication lawyer recently settled a product liability lawsuit against Pfizer for the sum on $3.780,000.00. The lawsuit alleged that a nine year old girl was given Dilantin, an anti-seizure medication, together with Flagyl, an anti-fungal medication. Less than one month later, the young girl developed toxic epidermal necrolysis (“TEN”) and, before her death, lost almost all of her skin.

According to the New York Stevens Johnson Syndrome lawyers at Bottar Law, PLLC, as many as 20% of patients in a recent study were diagnosed with toxic epidermal necrolysis while taking Dilantin. While Pfizer warns patients in Canada of the increased risk of Dilantin Hypersensitivity Syndrome (which may include TEN) in certain patient populations, similar warnings are not issued in the United States.

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Stevens Johnson Syndrome (SJS) is a rare disorder that involves a skin reaction to medication. Medications with a known link to SJS include non-steroid anti-inflammatory drugs (NSAIDs), such as Phenytoin, Carbamazepine, as well as anticoonvulsants and sulfa antibiotics.

According to Michael A. Bottar, a Syracuse toxic epidermal necrolysis lawyer with the law firm of Bottar Law, PLLC, SJS or TEN commonly starts with non-specific symptoms such as a headache, cough, or fever. These symptoms may be followed by a whole-body rash and then blisters forming in and around the eyes, mouth and genitals. In some cases, the damaged skin then peels in sheets, and hair and nails may fall out. As people suffering from severe cases of SJS often lose much of their skin, they are commonly treated like burn patients in specialized health care facilities. Risk of infection is high.

In Syracuse, most SJS patients are treated at the SUNY Health Science Center – Burn Unit, located at 750 East Adams Street, Syracuse, New York. Other area facilities include St. Joseph’s Hospital in Elmira, New York, and Strong Memorial Hospital in Rochester, New York. Treatment usually includes immediate termination of the drug that is the suspected cause of the reaction followed by the administration of intravenous fluids and aggressive infection treatment and management.

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