Articles Posted in Misdiagnosis

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stethoscope-hand-moneyAccording 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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DrAccording 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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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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“Stroke is the number three cause of death in the United States,” said NY medical malpractice attorney Michael A. Bottar, of Bottar Leone, 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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“Even though an appendicitis is a clinical emergency, it is commonly misdiagnosed,” said Syracuse pediatric malpractice lawyer Michael A. Bottar, Esq., of Bottar Leone, PLLC. As many as 1 out of every 5 cases of appendicitis is not diagnosed before the appendix perforates (i.e., ruptures), which can lead to serious health problems including a periappendiceal abscess, peritonitis, an intestinal blockage, sepsis and death.

An appendicitis, or inflammation of the appendix, is caused by an obstruction of the appendiceal lumen. Signs and symptoms of an appendicitis, which typically strikes between the ages of 2 and 30, include (1) diffuse abdominal pain developing over 4-48 hours, (2) nausea, (3) vomiting, and (4) loss of appetite. When acute (i.e., inflamed), it is a “surgical” disease, meaning that it is treated by surgery as opposed to antibiotics. Surgery to remove the appendix is known as an appendectomy.

New York has one of the highest densities of pediatricians in the United States, with more than 150 pediatricians for every 100,000 children (second only to Massachusetts). This is a reassuring statistic because, according to a recent Reuters Health article titled Fewer Pediatricians, More Ruptured Appendixes, children who live in areas adequately staffed with pediatricians are more like to be timely diagnosed with an appendicitis and, in turn, are at 12% lower risk for rupture. According to the study underlying the Reuters article, a child’s proximity to a hospital, emergency room doctor and/or surgeon did not decrease risk. Statistically, access to pediatricians seems to make all of the difference in avoiding complications from an appendicitis.
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While it is well-known that birth control pills may increase the risk of a stroke, a new dangerous side-effect is receiving the attention of the medical field. According to a physician who spoke at the “50 Years of the Pill” conference last week in Washington, D.C., there is a strong link between the pill and an increased risk of breast cancer, as well as cervical cancer and liver cancer.

“The ‘pill’ was developed in the 1950s. Data suggests an astounding 660% increase in non-invasive breast cancer since 1973,” said Michael A. Bottar, Esq., a New York medical malpractice lawyer with Bottar Leone, PLLC, a Syracuse-based law firm with decades of experience handling cases involving avoidable metastastic cancer. “Doctors should be aware of the potential association between the pill and cancer so that they can help their patients avoid the consequences of a failure to diagnose breast cancer, cervical cancer misdiagnosis, or late diagnosis of liver cancer.”

Breast cancer, in particular, presents a very real risk for women, especially following a confusing U.S Preventive Service Task Force recommendation against yearly mammograms and breast self-examinations which we blogged previously in a post titled “Failures To Diagnose Breast Cancer May Increase Following Task Force Recommendations.” Risk factors for breast cancer in women include increasing age, a prior breast cancer diagnosis, a family history of breast cancer, high breast tissue density, high-dose chest radiation, no children (or first child after age 30), and a long menstrual history.
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Syracuse University Hospital mistakes were the focus of a 68 page report generated by the New York State Department of Health (“DOH”). The DOH is an agency charged with oversight of medical care in the State of New York, including events that may give rise to claims for medical malpractice, failure to diagnose, birth injury, infection and wrongful death. The full report is available here.

According to Syracuse hospital mistake lawyer Michael A. Bottar, Esq., the report cited University Hospital for several violations of state regulations — one of which was an incident where a student doctor known as a “medical resident”, overseen by an unqualified attending physician, performed a complex operation on a patient’s spine because the neurosurgeon was busy in another operating room.

Syracuse surgery mistake lawyer Anthony S. Bottar, Esq., noted that the DOH, in its Statement of Deficiencies and Plan of Correction, found shortcomings in doctor performance, patient safety, quality of care and infection control practices.

In another aspect of the report, University Hospital was cited for the apparent absence of a “time out” during a surgical procedure, which is a process where surgical staff stop and verify that they have the correct patient in the operating room and are about to operate on the correct body part. The “time out” process is intended to prevent surgical errors, such as wrong-site surgery – like in 2004 – when a Syracuse surgeon about to remove a blood clot made an incision on the wrong side of an infant’s head, as well as wrong-side surgery – like in 2006 – when a Syracuse surgeon operated on the wrong side of a patient having a tumor removed from an adrenal gland. During the latter procedure, the surgeon failed to review radiological films.

Poor medical controls and oversight may also cause or contribute to a medical misdiagnosis, which we blogged about here.
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Syracuse medical malpractice lawyer Anthony S. Bottar, managing partner of Bottar Leone, PLLC, one of Upstate New York’s oldest law firms with a practice limited to medical malpractice, wrongful death, birth injuries, work injuries, brain injuries, and product/premises liability, was elected president of the New York State Academy of Trial Lawyers, an organization dedicated to protecting, preserving and enhancing the civil justice system.

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.

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To err is human. Doctors, nurses and hospitals are no exception. According to a study published by the Journal of the American Medical Association, as many as 10-15% of medical diagnoses are wrong. That data, taken from patient autopsies, paints a fairly accurate picture about Syracuse medical malpractice lawsuits for mistakes made by local practitioners and at area hospitals, like Crouse Hospital, St. Joseph’s Hospital Health Center, University Hospital and Community General Hospital. That is, most patients receive proper medical care, but nearly 2 in 10 will not.

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.
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With Spring comes more sunshine and more time outdoors for Central New York residents, including children living in Syracuse, Ithaca, Oswego, Utica, Rome, Herkimer, Watertown and Binghamton. At the same time, more time outdoors means more exposure to Lyme Disease. Syracuse New York Lyme Disease lawyers Bottar Leone, PLLC, warn residents to check their arms and legs for ticks!

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).
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