Posted on January 01, 2017 in Medical Malpractice

Article posted on: 10/24/2007

According to a 2003 study by Emory University and the Centers for Disease Control and Prevention, sepsis killed 120,491 hospitalized people in 2000. The same study found cases of sepsis in the U.S. have risen dramatically in recent decades, nearly tripling from 82.7 cases out of every 100,000 Americans in 1979 to 240.4 cases per 100,000 in 2000. Shockingly, Muppets creator Jim Henson died of the disease in 1990 at age 53.

Sepsis – the body’s ultimate response to a bacterial infection — is characterized by severe reaction of the body’s organs to the foreign bacteria and/or death. Sepsis is also referred to as systemic inflammatory response syndrome (SIRS). Although sepsis often results from the widespread invasion of bacteria into a patient’s bloodstream, this invasion is not essential for the development of severe sepsis since local infection/inflammation can also cause distant organ dysfunction and blood pressure irregularities. Some of the common places in the body where an infection might start include the skin (celluitis), the lungs (bacterial pneumonia), liver, gall bladder, lining of the brain (meningitis), the bloodstream, the bones, the bowel, or the kidneys. For hospitalized patients, common sources of infections include bedsores (decubitus ulcers), surgical drains, intravenous lines, or surgical wounds. Unfortunately, bacteria live and breed in hospitalized settings, and thus, many healthy people who have suffered an injury requiring a drain, or IV lines or open ports into their blood stream often contract an infection that turns into sepsis.

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 Posted on January 01, 2017 in Medical Malpractice

The labor and delivery process associated with the birth of a child is simultaneously exhilarating and fraught with considerable danger to the baby in certain circumstances. Too often, obstetricians and high risk pregnancy specialists, called maternal fetal medicine doctors, are, through their own negligence asked to make split second decisions that could potentially impact the lives of these babies and their parents for the rest of their lives. The most devastating injuries to a newborn baby are those affect the brain. In most instances, injuries to the baby’s brain are caused by a lack/deprivation of oxygen to the brain for a prolonged period of time during the labor and delivery process. For example, the baby might be in an unusual position that results in the umbilical cord (the lifeblood for the baby) being compressed or squeezed, thereby reducing the flow of oxygen to the baby’s brain. In other circumstances, sometimes the labor itself is too long (hours or even days), causing stress on the baby, and resulting in a shortage of oxygen to the brain. In still other circumstances, the baby’s red blood cells, the cells that carry oxygen to the brain are compromised, thereby reducing the amount of oxygen that reaches the baby’s brain. If these potentially catastrophic circumstances, and other similar ones, are not timely recognized, the outcome is often life-changing for the baby.

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 Posted on January 01, 2017 in Medical Malpractice

Severe back or pain is one of the more debilitating conditions facing many Americans today. Lower back pain pain, which starts below the ribcage, is called lumbar back pain. Mid-back pain, centrally located, is called thoracic back pain. Neck pain is often referred to as cervical pain. Sometimes this pain comes on suddenly (acutely) following an injury from an athletic activity or fall. In other cases, the pain comes on slowly and lasts for months and months, if not years. In many of these instances, the pain is caused either by degeneration of the spinal cord discs. Spinal cord discs are gel-like spacers that occupy the spaces between the spinal cord vertebrae. These discs are prone to wear and tear from injuries or from mere aging. As these discs weaken, the discs can bulge out of the normal disc space, or even rupture, which in turn, puts pressure on the spinal nerve roots that run through the back region. Discs that extend slightly outside that normal disc space are often called “bulging” or “herniated” discs. Intense pain often results when these herniated/bulging discs put pressure on the surrounding nerve roots. In many instances, the pain can radiate into a person’s buttocks or down into their legs. In severe cases, the herniation can result in loss of bowel or bladder control, leg weakness or even paralysis.

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 Posted on January 01, 2017 in Medical Malpractice

In the early 1990s, health care providers pioneered an innovative surgical technique for patients requiring the removal of their gallbladder (“cholecystectomy”). In the years leading up to 1990, gallbladder surgeries were performed solely in what was known as an “open” manner whereby a patient’s abdomen was surgically opened in order to gain access to the gallbladder for the purposes of removing it. Beginning in 1991, the laparoscopic cholecystectomy replaced the open cholecystectomy as the first choice of treatment for gallstones and/or the inflammation of the gallbladder. A laparoscopic cholecystectomy only requires several small incisions in the abdomen to allow the insertion of operating ports (small tubes 5-10 mm in diameter), through which surgical instruments and a video camera are placed into the abdominal cavity. The camera operates to illuminate the surgical field and send a magnified image to a video monitor giving the surgeon an up-close view of the organs and surrounding tissues. After a patient is sedated, typically the surgeon will inflate the abdomen with carbon dioxide to create a suitable working space. The camera is then inserted and additional ports are created at other sites on the abdomen to permit the surgeon the ability to manipulate the surgical instruments in which ever direction is needed. The surgeon next works to identify the gallbladder and open what is known as the Triangle of Calot, a region created by the location of the cystic artery (the artery that connects the liver to the gallbladder), the cystic duct (through which bile flows out of the gallbladder) and the common hepatic duct. At that point, the cystic artery and cystic duct are clipped and cut, permitting the removal of the gallbladder. Although the surgery is very complicated and requires precise maneuvering by the surgeon, it can generally be accomplished within an hour or so.

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 Posted on January 01, 2017 in Medical Malpractice

Earlier this month, in the case of Smith v. United States of America, the Utah Supreme Court struck down legislation that capped/limited certain damages for medical malpractice injuries resulting in death. That legislation, known as the Utah Health Care Malpractice Act, had been on the books since 1986. According to the Utah Supreme Court, the legislation violated the state’s constitution by unfairly limiting the amount of recoverable damages for injuries resulting in death. Following this ruling, Plaintiffs in Utah who bring a medical malpractice case for medical mistakes resulting in the death of a loved one may not have their awards reduced or limited by the former non-economic damages cap.

So what are non-economic damages? Non-economic damages are they type of compensation awarded to plaintiffs for the losses caused by the medical negligence of others. Non-economic damages typically are referred to as compensation for the pain, suffering and emotional distress associated with the loss of a loved one. In a wrongful death case, these injuries are claimed by the surviving beneficiaries, as defined by each state’s laws. In Maryland, wrongful death beneficiaries include the decedent’s spouse, parents (if living), and children. In addition, the decedent’s Estate is entitled to bring a claim for non-economic damages as well. The decedent’s personal representative typically brings this claim by essentially standing in the shoes of the decedent and arguing that prior to his/her death, the decedent experienced pain, suffering and emotional distress that he/she should not have experienced. Non-economic damages can be contrasted with economic damages (things like past medical bills, future medical bills, out-of-pocket medical costs, funeral expenses, past lost wages, future lost wages).

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 Posted on January 01, 2017 in Medical Malpractice

9/18/15: Community acquired or hospital acquired bacterial infections are among the most deadly conditions patients face each year. Because of the high morbidity and mortality associated with bacteremia, prompt evaluation and appropriate antibiotic treatment are of paramount importance when a physician suspects that a patient has acquired a bacterial infection. As many of you are likely aware, when a bacterial infection is suspected, the first step in treating the infection is to fully identify the type of bacteria that is present. This is accomplished by drawing a sample of the patient’s blood (called cultures) and testing it in a laboratory. Laboratory technicians often employ a method of testing known as “gram staining”. This method involves utilizing a chemical stain known as “crystal violate” to a slide containing the blood specimen. The slide is then rinsed with water and placed in iodine and then either acetone or alcohol (this is called decolorization). This process, in general, permits the laboratory technicians to categorize the observed micro-organisms in a patient’s blood (under the microscope) into two major groups, gram positive bacteria or gram negative bacteria. Gram positive bacteria retains the crystal violent stain and appears purple under the microscope while gram-negative bacteria does not retain the crystal violet and appears pink in color. Although there are, admittedly, some bacterial species that cannot be visualized by the gram stain technique, the major groups of bacteria generally fall into one of these two categories. In addition to “positive” or “negative”, gram-stained bacteria are also described according to how the bacteria are shaped; i.e., cocci (spherical), bacilli (rod-shaped), how they are arranged; i.e., in chains or in clusters, and their size.

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 Posted on January 01, 2017 in Medical Malpractice

Surgical scissors. Surgical clamps. Gauze pads. A sponge. A needle. Left behind in your body after surgery. Without a doubt, one of the more frequent, and often times puzzling, types of medical malpractice cases occurs when a surgeon or his/her surgical team finishes a procedure and fails to remove all of the surgical instruments or equipment used on the patient during surgery. The medical watchdog group known as the Joint Commission recently was quoted as stating that the “leaving of a foreign object after surgery is a well-known problem, but one that can be prevented.” The Joint Commission, like most malpractice attorneys, recognize that this all-too common problem is one that leave severe damage to patients or even cause death. Between 2006 and 2013, the Joint Commission was made aware of over 770 reports of retained foreign objects in patients that resulted in 16 deaths. The Joint Commission believes, however, that this 770 cases only represented a fraction of the true number of cases involving retained foreign objects, with a more realistic number being closer to 1,500-2,000 incidents per YEAR. In 95% of these cases, the patients were required to stay additional days in the hospital and undergo additional surgical procedures to remove these foreign objects. The retention of these foreign objects can obviously cause patients severe pain, result in significant infections and organ damage.

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 Posted on January 01, 2017 in Medical Malpractice

10.2.15 Millions of Americans are afflicted with heart rhythm disorders requiring the insertion of pacemakers or implanted defibrillators. These devices utilize leads, a wire that runs from a pacemaker or implantable defibrillator into the heart’s chambers. The lead wire attaches to the heart muscle and “assists” the heart maintain rhythm through the emission of electrical signals from the device as the patient requires it. Like anything device that is implanted in the human body, over time, scar tissue forms around the leads making their removal, at the appropriate time, more difficult. Typically, during a removal procedure, an electrophysiologist (a doctor who specializes in heart rhythm disorder) uses a laser to burn through the scar tissue encapsulating the lead wires. However, in order to accomplish this, the laser must go through the major vein leading to the heart and into the chamber of the heart where the lead is attached. No matter what the doctor’s level of experience and skill is in performing this procedure, the tearing of the vein (or tearing of the heart) is an unavoidable risk that results in internal bleeding. If the bleeding is not effectively repaired immediately, that blood loss can be fatal.

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 Posted on January 01, 2017 in Medical Malpractice

One of the more common types of cases that our office handles is the circumstance in which a surgeon injures a patient during the course of a surgical procedure, perhaps even not negligently, but fails to either recognize the injury or fails to timely repair the injury prior to the patient suffering additional injuries. In most surgeries, physicians are operating in areas in which anatomical structures are often times separated by centimeters or millimeters. In other instances, critical structures such as veins and arteries can be fused together with ducts and organs, requiring the surgeon to painstakingly separate these structures in order to perform the procedure or remove an organ. In some of these instances, it is recognized that an accepted risk of the procedure is the unintentional injury to an adjacent structure, whether it be a laceration, puncture or even transection. When this occurs, the surgeon is generally not regarded as having negligently injured these structures, but rather, it is what the surgeon does next that determines whether his actions constitute negligence or not. When our office reviews these kinds of cases, we always generate a timeline of events, down to the minute in order to evaluate the surgeon’s actions.

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 Posted on January 01, 2017 in Medical Malpractice

The Patient Protection and Affordable Care Act (ACA) was passed in 2010. As many of you know, although the ACA did not establish universal health insurance coverage, it did contain a requirement, known as the individual mandate, that all non-exempt U.S. residents maintain medical insurance. Seizing upon this mandate, defense attorneys across the United States have attempted to use the ACA as the latest tort reform vehicle by filing motions in limine to limit what plaintiffs can present to juries on future medical expenses — essentially arguing to Courts that the requirement of continuing medical insurance coverage will provide reimbursement for the claimed future medical expenses, thereby nullifying plaintiffs’ ability to claim these expenses. Put another way, the defendants essentially argue that the plaintiff should only be permitted claim their out-of-pocket costs for medical care, a sum that has a maximum cap under the ACA, and the current cost of purchasing their medical insurance.

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