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According to, a study published by The Project on Government Oversight suggests that Syracuse’s Veterans Administration Medical Center, also known as the Syracuse VA, has very few medical malpractice claims filed against it.

There may be a number of reasons for the low volume and size of claims against the Syracuse VA for medical malpractice. One explanation is that many veterans are not inclined to file a lawsuit against an entity that is providing ‘free’ medical care to them. Second, many veterans do not know that they have been injured by malpractice because they are advanced in age and/or are suffering from a constellation of disabilities stemming from their military service. Finally, claims against the Syracuse VA for medical malpractice are complicated because they are governed by the Federal Tort Claims Act (FTCA). Many personal injury lawyers do not prosecute FTCA cases because they are not familiar with the administrative claims process or the technical requirements of a lawsuit in federal district court.

“We like the complexity of FTCA cases,” said Michael A. Bottar, a Syracuse-based attorney handling a number of VA medical malpractice lawsuits, as well as claims against the the Department of Health and Human Services. “In addition, many agencies, including the VA, do a pretty good job of resolving claims during the administrative review process. Sometimes a lawsuit is unnecessary.” This, of course, assumes that the attorney handling the FTCA claim knows what information must be submitted to the agency, how to submit it, where it should go, and when. “The FTCA can be a mine field for the uninitiated, as there are short deadlines,” Bottar added.

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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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Do you know you statistical risk for a heart attack?

The American Heart Association wants you to know so that you can control your risk factors and avoid or delay the onset of heart disease and complications like a myocardial infarction (MI). The AHA heart attack risk calculator can be found here.

Computer-based risk calculators take a number of variables into consideration, such as a person’s age, gender, cholesterol levels, lifestyle, activity level, body habitus, blood pressure, and history of heart disease and diabetes. With this information, a heart attack risk calculator can estimate your chances of a problem over the next 5-10 years. “If calculators like these are available to doctors throughout the State of New York, we may see a decrease in the number of missed opportunities to intervene and save a life,” said Syracuse medical malpractice lawyer Michael A. Bottar, of Bottar Law, PLLC.

When patients report to their physician or an emergency room with complaints of chest pain, shortness of breath, jaw pain, sweating, and/or left arm pain, the heath care provider should analyze these variables and arrive at a differential diagnosis that includes the possibility of a heart attack. When doctors fail to consider and/or rule out a heart attack as a potential cause of a patient’s complaints and, instead, make a diagnosis of, e.g., shoulder strain or heart burn, and the failure to diagnose a heart attack causes damage to the heart muscle (i.e., diminished ejection fraction), the patient may have a cause of action against the doctor for medical malpractice. If the patient dies following premature discharge from a hospital, the patient’s family may have a cause of action for wrongful death.
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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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Preeclampsia, also known as toxemia, is a condition that complicates as many as 10% of pregnancies. Typical symptoms during pregnancy and the immediate post-partum period include high blood pressure, protein in the urine (i.e., proteinuria), foot, leg and hand swelling (i.e., edema), nausea, severe headaches and abdominal pain.

A dangerous variant of preeclampsia is known as H.E.L.L.P. syndrome. A woman with H.E.L.L.P. syndrome may have a low platelet count and elevated liver enzymes. Women who suffer from H.E.L.L.P. syndrome may not exhibit the primary indicators for preeclampsia, such as high blood pressure and proteinuria. Because a pregnant woman with H.E.L.L.P. may not have symptoms that doctors typically look for, a woman suffering from preeclampsia may be misdiagnosed with the flu and treatment may be delayed.

Preeclampsia affects pregnant women everywhere, including in central New York. According to, in the weeks before she gave birth by cesarean section on August 1, 2011, Cato resident Kristie Rubino experienced several preeclampsia symptoms. She presented to St. Joseph’s Hospital Health Center on July 28, 2011, but was discharged. Days later, she underwent an abdominal delivery performed under general anesthesia. Shortly thereafter, her blood pressure escalated and she passed away.

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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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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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As discussed in our prior post titled “Premature Birth Injury Topic Of New York Cerebral Palsy Conferences In Syracuse, Binghamton and Watertown,” premature birth is a potentially dangerous pregnancy complication. “Babies born early at are risk for lifelong disabilities like respiratory distress syndrome, persistent pulmonary hypertension of the newborn and cerebral palsy,” said New York birth injury lawyer Michael A. Bottar, Esq.

According to a recent study published in PLoS Medicine, pregnant women who receive the flu vaccine during pregnancy may be as much as 40% less likely to have a premature birth. Pregnant flu vaccine recipients were also as much as 70% less likely to deliver a low birth weight or “small for gestational age” baby. The results were associated with deliveries during peak flu season.

Researchers suggest that the flu vaccine may prevent respiratory infections during pregnancy — infections which can lead to delivering a small baby, or a preterm baby. Pregnant women are particularly susceptible to the influenza, which can lead to serious injury and death. Generally, this is because a woman’s lung capacity decreases toward the end of pregnancy. In turn, the heart must work harder to circulate oxygenated blood to support the fetus. This extra effort drains a pregnant mother’s body and can make it more difficult for her immune system to fight off the flu.

Other pregnancy, labor and delivery complications include pregnancy-related obesity, which is associated with cesarean delivery, preeclampsia, macrosomia, shoulder dystocia and Erb’s palsy, as well as gestational diabetes and, while rare, pregnancy-related death (typically from post-partum hemorrhaging).
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“Hospital errors result in the death of nearly 200,000 Americans every year,” said New York wrongful death lawyer Michael A. Bottar, Esq. In an effort to improve patient care, and to attract more doctors, upgrade its information/technology systems and stabilize its finances, Community Memorial Hospital, located at 150 Broad Street in Hamilton, New York, just minutes from Colgate University, will soon link to Syracuse’s Crouse Hospital.

CMH is a 40-bed hospital where approximately 5,000 procedures were performed in 2009 and 2010. Most of those procedures (more than 4,000) were diagnostic or therapeutic in nature. Since 2005, CMH has been investigated twelves times by the New York State Department of Health. According to the NYSDOH website, eight investigations resulted in no citations. However, four investigations resulted in a total of 33 citations including statement(s) of deficiency for, e.g., infection control, anesthesia services, pharmaceutical services, quality of care, supervision of nursing care, nursing services, medical staff and incident reporting.

Hospital officials noted that the Crouse-CMH affiliation is not a merger or asset acquisition like the recent transaction between Syracuse’s Community General Hospital and Upstate Medical University. According to, Dr. Paul Kronenberg, Crouse’s president and CEO, noted that “the affiliation with Community Memorial is part of Crouse’s strategy to develop an integrated delivery network and expand its geographic reach.”

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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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