Posted on July 06, 2015 in Medical Malpractice

A recent article in Maryland’s legal newspaper, The Daily Record, titled "Md. hospitals take aim at costly, deadly sepsis," correctly points out that hospitals must have the proper procedures in place to both detect and treat sepsis quickly. The article can be found here.

Sepsis is a complication of an infection and occurs when chemicals released into the bloodstream to fight the infection trigger inflammatory responses throughout the body that can damage organs, causing devastating organ failure. If sepsis progresses to septic shock, the patient’s blood pressure will drop dramatically, often resulting in the patient’s death. In a patient suffering from sepsis, every second counts as a delay of as little as an hour "could mean the difference between life and death."

Some of the classic symptoms of early onset of sepsis include fever, elevated heart rate, elevated respiratory rate, rash, vomiting, diarrhea and confusion. Doctors encountering patients with these types of symptoms should immediately recognize sepsis and begin treating with antibiotics and intravenous fluids until a blood test either confirms or rules out the presence and progression of sepsis. In medical malpractice cases involving the failure to timely diagnose and treat the onset of sepsis, the defense often argues that the delay was not unreasonable. Proving that the delay caused unnecessary injury to the patient can be very complicated. Therefore, medical malpractice cases involving sepsis and septic shock should be assessed by an experienced medical malpractice attorney.

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 Posted on July 02, 2015 in Medical Malpractice

Severe back or pain is one of the more debilitating conditions facing many Americans today. Lower back 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 June 24, 2015 in Medical Malpractice

Some of the most obvious medical mistakes are those in which the doctor operates on the wrong part of the patient’s body. This type of negligence can occur in a variety of situations. The doctor may be careless in his or her reading of the medical chart or the doctor may fail to accurately identify the correct anatomy prior to operating on a structure.

For example, we recently handled a case in which a young woman presented for removal of an ovary that was stricken with an ovarian cyst. During the surgery, the surgeon negligently removed the wrong ovary, which had been healthy. As a result of this careless mistake, a woman with many child-bearing years remaining could be unable to have any more children. She will require an additional, otherwise unnecessary surgery and if the cyst cannot be removed without removing the ovary, removal of the entire ovary will cause her to become permanently infertile and require hormone therapy for life.

These types of medical mistakes can have devastating effects on the patient’s health and, as in the situation described above, can seriously change the plans that a patient has for his or her own life. Notwithstanding how clear these mistakes may appear to be, a competent defense lawyer is often able to create issues that can call in to question whether the doctor was at fault. Therefore, even clear cases of medical malpractice such as these should be reviewed and pursued only by experienced medical malpractice lawyers.

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 Posted on June 19, 2015 in Medical Malpractice

Physicians have known for decades that persons with decreased renal (kidney) function or kidney failure have a reduced ability to process and metabolize certain drugs such as opiate pain medications. If due to decreased kidney function, the body is unable to metabolize and pass these drugs, the patient can overdose and die. These risks are increased in patients who, in addition to suffering from diminished kidney function, also suffer from liver dysfunction.

When a patient with decreased kidney function or kidney failure presents to a hospital in pain, that pain should be treated as conservatively as possible. Moreover, if the doctor decides that opiate pain medication is appropriate, that doctor must carefully monitor the patient for signs of drug toxicity, including confusion, disorientation, hallucinations and a deterioration of vital signs.

Our firm has evaluated and successfully pursued multiple medical malpractice cases involving the negligent administration of prescription pain medications to patients with decreased ability to metabolize them due to kidney dysfunction. Due to their complexity, it is important that such cases be evaluated by a skilled and qualified medical malpractice attorney.

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 Posted on June 12, 2015 in Medical Malpractice

Expert witnesses are necessary in virtually every medical malpractice case filed in Maryland and the District of Columbia. Knowing which types of experts to use and not to use can make or break a case. Therefore, it is important to choose a lawyer who has extensive experience choosing, retaining and using experts.

In each of our cases, we identify the type of experts we need to prove our case. Some of the experts may focus on whether the defendant did anything wrong, such as a surgical expert or internal medicine expert who can testify as to whether the defendant violated the standard of care. Other experts we use may focus on whether a defendant’s conduct caused any injury, such as a neurologist who may testify that a violation of the standard of care during surgery caused paralysis. Finally, we use damage experts, such as life care planners and economists who testify about the cost of future medical care.

After we identify the categories of experts, we frequently consult with experts in those categories we have used before in other cases, since we have experience with such persons. Sometimes, we need to find a new expert in a field, which we do by researching which experts have published medical literature in the field of medicine that relates to our case, and consulting with other attorneys who have used similar experts previously.

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 Posted on June 11, 2015 in Medical Malpractice

Our Baltimore law firm routinely investigates potential medical malpractice cases in which a person has died as the result of a pulmonary embolism after what should have been a routine surgery.

Orthopedic surgery and subsequent immobility from such surgery puts patients at an increased risk of developing blood clots in the veins of their legs following surgery. These blood clots, called “deep vein thrombosis,” can cause swelling in the leg where the clots exist. As the clots continue to grow, small portions of the blood clot can break off and travel to the lungs, at which point they are called “pulmonary emboli.” Because of this risk, patients with deep vein thrombosis and pulmonary emboli are often given blood thinners which prevent the clot from growing large enough to break off and travel to the lungs, killing the patient.

Two classic warning signs of a blood clot in the legs that can break off and travel to the lungs are cast tightness and shortness of breath. A patient who complains of these symptoms following surgery should immediately undergo an ultrasound and be given blood thinners which are used to stop the growth of the clot and minimize the chance that it will grow large enough to break off and travel to the lungs or elsewhere.

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 Posted on June 08, 2015 in Medical Malpractice

Each year, our law firm receives several requests to review medical malpractice cases involving the removal of the gallbladder to treat gallstones. We typically pursue one to two of these cases per year.

The procedure allows for bile to bypass the gallbladder on its way out of the liver. Bile is a substance created in the liver and used for digestion of food in the small intestine. Bile normally flows from the liver down the right and left "hepatic ducts" into the "common hepatic duct" and is stored in the gallbladder until it is needed for digestion. When gallstones form in the gallbladder – a condition known as "cholelithiasis," – they can interfere with the normal flow of bile and disrupt the digestion process. This can be a very painful and debilitating condition.

To treat and remove the gallstones, doctors often recommend that the patient undergo a "laparoscopic cholecystectomy," which is the removal of the gallbladder through minimally invasive surgery. During a laparoscopic cholecystectomy, the gallbladder is removed and then the bile flows directly from the liver through the right and left hepatic ducts and then into the small intestine.

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 Posted on June 04, 2015 in Criminal Defense

As an Aggressive and Experienced Criminal Defense Attorney and former Assistant State’s Attorney, I have prosecuted and defended well over a thousand First and Second Degree Assault Cases. These serious cases can carry substantial penalties to include lengthy jail sentences upon conviction – particularly when a serious injury is involved. The maximum penalties are 25 years and 10 years respectively. Many people are shocked to learn that second degree assault carries such a long jail sentence in spite of it being a misdemeanor.

I recently secured an acquittal for a Maryland school teacher who was charged in such as case. The incident, which I will describe below, resulted in the alleged victim sustaining a traumatic brain injury and was charged as a First Degree Assault. Needless to say, given the serious injury to the victim, the State was aggressively prosecuting the case. He are the facts:

My client is a school teacher who lives in Baltimore County but teaches in another jurisdiction. He lives in a relatively rural part of the county on which the houses occupy lots of 2 acres or more. One Saturday this past summer, my client and his wife hosted a first birthday party for one of their children. This child had been diagnosed at birth with a life threatening and chronic health issue so the celebration was particularly heartfelt for him and his family.

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 Posted on June 03, 2015 in Criminal Defense

Sex Offenses including Second Degree Rape charges are among the most serious criminal offenses that are handled in the criminal just system. Anyone who is charged with Rape or any other Sex Offense requires the assistance of an Aggressive and Experienced Criminal Attorney who has substantial experience handling these types of cases. In the twenty years that I have been practicing exclusively criminal law, I have handled scores if not hundreds of Rape and Sex Offense cases both as a prosecutor and as a criminal defense attorney.

I have written many times in this space about the importance of hiring an experienced criminal specialist when charged with any criminal offense. When dealing with Rape of Sex Offense charges, it is not just important, it is an imperative. I just finished successfully defending a 19 year old charged with Second Degree Rape in St. Mary’s County that was a shocking example of what can happen if this imperative is not observed. I was brought into the case 8 months after the charges were filed and just after the client’s current lawyer told him that he should plead guilty to Second Degree Rape and accept a 12 year prison sentence. His parents then reached out to me for a second opinion. Here are the facts:

My client (I will refer to him as "Joe") was 18 years old at the time of the incident which occurred late last year. The incident occurred at a house party hosted by a sister and brother who Joe went to high school with. The party was attended by upwards of 100 people and copious amounts of alcohol was consumed by most everyone who attended. Many of the party goers, including Joe, also smoked marijuana throughout the night. Several witnesses, included the host of the party who was called by the State, testified that Joe was "highly intoxicated". In fact, in his initial interview with the police, the host of the party volunteered his opinion that Joe was very drunk without even being directly asked that question.

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 Posted on June 02, 2015 in Driving Under the Influence

The client did possess a commercial driver’s license but when he was pulled over for exceeding the speed limit by 15 miles per hour, he was operating his personal vehicle. When the Trooper approached the defendant he smelled of alcohol, had a flushed face and had slurred speech. The Trooper asked him to step out of the vehicle to perform field sobriety tests. In the opinion of the officer, his performance on the field sobriety tests indicated that he was impaired by alcohol. He was taken into custody and once back at the barracks, agreed to take the breathalyzer. The test result was .11 grams of alcohol per 210 milliliters of breath. The case against the defendant was strong to be sure. The Trooper clearly had probable cause to pull him over as he was exceeding the speed limit by 15 miles per hour. Based on the smell of alcohol, his performance on the field sobriety tests and the Trooper’s other observations, it was also quite clear that the Trooper had probable cause to take him into custody and request that he take a breathalyzer. He blew a .11 which is above the legal limit of .08. The attorney pled his client guilty to the DUI "per se" charge under 21-902A2 of the Motor Vehicle Code. In mitigation, he explained his client’s circumstances to include that he was the father of 3 and the sole breadwinner for the family. He advised that he was a truck driver with a commercial driver’s license. The attorney then requested probation before judgment so that his client "would be able to maintain his CDL and his employment". The judge granted the request, stuck the guilty verdict and entered probation before judgment. Both the client and the attorney walked out of the courtroom with looks of relief and satisfaction. But did the attorney really do a good job for his client? The answer is no because, presumably due to his lack of experience, he didn’t understand the law. What the inexperienced apparently didn’t understand is that under Maryland Vehicle Law 16-803, even a probation before judgment on 21-902A violation, Driving Under the Influence of Alcohol, violation results in the mandatory revocation of a person’s commercial driver’s license for a year for the first offense and a permanent revocation for a second or subsequent offense. The fact that he received probation before judgment does not prevent the MVA from suspending his commercial driver’s license as the attorney apparently believed. The appropriate way to handle a case like this would have been to either try to convince the prosecutor to allow the client to plead to the lesser offense of 21-902(B). Under this subsection the defendant would not be subject to having his commercial license revoked. I have convinced prosecutors to do this in these types of cases many times simply because it is more often than not the right thing to do. If the State’s Attorney were unwilling to accommodate, as they usually are in these types of cases, then the case must be taken to trial. The attorney should have moved to suppress the test result and argued to the court that the evidence was sufficient only for the 21902B violation, but not the 21902A violation. These arguments are successfully made on a variety of grounds every day in the district courts of this state. Because this was not done, this client is going to have a rude awakening when he is notified by the MVA that his commercial license and therefore his livelihood will be taken away for a year. Had this client taken the time to do a little research and hired a DUI/DWI specialist, it is highly unlikely that this would have occurred.As an Aggressive and Experienced DUI Attorney, I have represented dozens of Defendants in DUI cases who have commercial driver’s license. These cases pose a unique set of challenges and considerations for Maryland DUI Attorneys as the administrative sanctions associated with commercial driver’s licenses are far different than the sanctions associated with standard Class C driver’s licenses. I have blogged often about the importance of selecting an attorney who specializes in DUI/DWI Defense when charged with this serious offense and this advice is even more applicable to cases involving commercial driver’s licenses. Unfortunately, all too often we see attorneys with little or no experience with these types of cases appearing in court to represent clients. Because of their lack of experience, these attorneys often make mistakes that can have serious consequences for their clients.
Often these attorneys make simple mistakes that no experienced DUI/DWI attorney would ever make. I was representing a client in the District Court of Baltimore County a few days ago. While waiting for my case to be called I witnessed an attorney whom I know not to be a Criminal/DUI Specialist representing a client in a DUI case involving a defendant with a commercial driver’s license. I found out later that this attorney was a so called "general practitioner who spends the majority of his time handle divorce and personal injury matters. In other words, he was NOT a DUI/DWI specialist. Here are the facts.

The client did possess a commercial driver’s license but when he was pulled over for exceeding the speed limit by 15 miles per hour, he was operating his personal vehicle. When the Trooper approached the defendant he smelled of alcohol, had a flushed face and had slurred speech. The Trooper asked him to step out of the vehicle to perform field sobriety tests. In the opinion of the officer, his performance on the field sobriety tests indicated that he was impaired by alcohol. He was taken into custody and once back at the barracks, agreed to take the breathalyzer. The test result was .11 grams of alcohol per 210 milliliters of breath.

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