Recently in Wrongful Death Category

Changes to Come to California Malpractice Laws

March 31, 2014

witkin-ninth-edition-ca-law_l.jpgIn 1975, the California government established a maximum money amount injured patients could receive for noneconomic damages in malpractice lawsuits. Nearly four decades later, the $250,000 cap has yet to adjust to keep up with inflation. Medical malpractice lawyers at Pintas & Mullins explore how and why California advocates are now pushing to raise the cap.

Consumer Watchdog, a nonprofit public advocacy group, is organizing the campaign to raise the damage cap among other changes, which its president believes will significantly impact patient safety for the better. In addition to raising the cap, proponents are also aiming to require doctors to undergo routine drug and alcohol testing.

If the initiative qualifies, this law change will be put to California voters in November 2014. The drug testing aspect of the law change is actually a major move - nationally, physicians are much less scrutinized for this type of impairment than other high-risk professions, like firefighters or police officers. We recently wrote a post on some particularly horrendous cases of surgical malpractice in Texas, which was likely caused by the physicians' addictions to alcohol and prescription drugs.

Why Malpractice Caps at All?

Currently, 35 states have some kind of law placing a maximum on the amount of noneconomic damages patients can recover in malpractice suits. California's cap, at $250,000, is toward the lower end, and prevents many patients from ever bringing claims against hospitals or doctors who injured them at all. The costs of expert testimony and continued litigation can add up quickly, and in many cases, the costs are far too great to make a lawsuit seem worth it, so the injury case is never pursued, and the patient is left without justification or compensation for their pain and suffering.

Earlier this month, the Florida Supreme Court ruled that these types of noneconomic damage caps were unconstitutional. In its decision, the court argued that the caps only protected doctors and hospitals from facing responsibility for medical negligence. They said damage caps are arbitrary, unfair, and hurt the most vulnerable patients. The justices concluded that noneconomic damage caps offended the "fundamental notion of equal justice under the law."

The initiative in California would raise the damage cap to $1.1 million and will make sure that number will be able to adjust to inflation. The law would also require doctors and nurses to check patients' prescription drug histories using a state database. This is meant to identify and monitor people who "doctor shop," looking to get different prescription medications to abuse.

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Dangerous Doctors, Patient Deaths Reveal Failing Texas Healthcare System

March 11, 2014

299122118_1e0a8cdc8e.jpgDr. Christopher Duntsch arrived in Texas in 2010 to start a neurosurgery practice. By 2013, he had killed two patients from malpractice, paralyzed four others, and had his medical license revoked. Our team of medical malpractice lawyers examines this horrifying story and the problems within the Texas legislature that allowed it to happen.

Throughout the three years he was practicing in Texas, physicians, patients, and malpractice lawyers repeatedly tried to have his license suspended. Their efforts were unsuccessful for so long because of a series of conservative reforms in the Texas court and medical systems. Over the past ten years, these reforms have severely limited the resources and options available to patients injured by negligent physicians.

The medical system in Texas used to be overseen by a connected network between the state medical board, hospital management, and the courts, which prevented and punished cases of medical malpractice. This changed around 2003, when the Republican Texas Legislature set maximum dollar amounts for malpractice lawsuits at $250,000. This is problematic for many reasons that are beyond the scope of this article, but in essence the damage cap does not adequately protect patients who suffer permanent injuries from doctors like Duntsch and deters malpractice lawsuits from being filed.

Other laws were introduced that protected hospitals from being sued for the actions of their doctors. Currently, Texas law states that hospitals may only be held liable for damages if the plaintiff can prove that hospital management knew that the doctor posed an extreme risk to patients and hired them anyway. Compounding this, hospitals in Texas are allowed to keep all their information regarding doctor hiring practices completely private, so neither patients nor plaintiffs can access them.

So, with hospitals deregulated and the court system substantially curtailed, the Texas Medical Board was all that remained to police physicians and protect patients. The board, however, was established to monitor physician licenses and oversee professional standards, not in any way protect the public. The board's intention is to protect physician's rights, and does not revoke medical licenses unless there is overwhelming, inarguable evidence such as a felony conviction or dolling out opioids to addicts.

Dr. Duntsch and His Wake of Destruction

In 2010, Duntsch started a practice, the Texas Neurological Institute and worked at Baylor Regional Medical Center in Plano. Another surgeon at Baylor told the Texas Observer that Duntsch was, by far, the worst surgeon he had seen, even when performing relatively minor procedures.

Reports of serious harm done to patients by Duntsch are long and illustrate consistently dangerous and unconscionable medical care. After the first few botched surgeries Baylor had to bring in senior surgeons to correct the damage done to patients, though most of it was irreparable. Duntsch even operated on a childhood friend, severely damaged his spinal cord, and delayed follow-up tests so long that his friend permanently lost the use of his arms and legs.

Duntsch was suspended for 30 days, after which he was supposed to be supervised during every surgery. This never happened; soon after the first paralysis, a woman named Kellie Martin went to Duntsch to treat back pain. Duntsch recommended a microlaminectomy, a minor surgery which removes part of the spine to relieve pain from nerve pressure.

Duntsch performed the surgery, which was supposed to take 45 minutes, unsupervised. Two hours after she went in the OR, her husband asked to speak with Duntsch, who said there had been some complications and she would have to stay the night. Another few hours later, she was rushed to the intensive care unit. Ultimately, after an excruciating wait, he and his daughters were told Kellie had died.

The medical examiner had to examine her twice because he was so shocked by the state her body was in. It was clear Duntsch severed one of her spinal arteries during surgery (as he had with his childhood friend a month prior), and failed to notice it in time to save her life. She eventually bled to death.

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Bariatric Surgery and Children: When Weight Loss Kills

February 17, 2014

childhood-obesity-1_l.jpgThe number of overweight and obese children is rising substantially throughout the United States and the world. This, of course, is a problem in and of itself, however additional concerns are being raised about the prevalence and dangers of pediatric bariatric surgery. Medical malpractice lawyers at Pintas & Mullins take a closer look at this troubling trend and how it could impact our children.

The childhood obesity problem is most prevalent in developed countries, and rates are expected to rise even more over the next decade in affluent Middle Eastern countries. A recent article in the Wall Street Journal profiles one little boy, aged three, who currently weighs in at 61 pounds, more than twice the average for his age. He was just one year old when his parents began noticing health issues associated with his weight, including dangerously slow circulation due to pressure on his airways.

Due to his extraordinary size, his parents recently decided to have him undergo bariatric surgery. The procedure will remove part of his stomach, ideally so he will be unable to eat as much and feel satiated with lesser amounts of food. They hope that this surgery will prevent a lifetime of additional obesity-related health problems, such as diabetes, heart disease, and severe sleep apnea.

Obesity in children is caused by a sedentary lifestyle (excess video games and television time, lack of physical activity) and overindulgence in unhealthy foods lacking in real nutrients. It is now a serious health problem not only in Western countries but other places, such as Saudi Arabia, where over 9% of school-aged youths are obese (about 18% of American school aged children are obese).

Weight-Loss Surgery and Children

U.S. doctors are willing to perform bariatric surgery on teenagers, however such procedures on children under the age of 13 are generally not done. In order to qualify for bariatric surgery, youths must have a BMI of 35 or higher in addition to a serious weight-related health problem. This may include diabetes, sleep apnea, increased pressure inside the skull (pseudotumo cerebri), high cholesterol/blood pressure, or severe liver inflammation.

There is a plethora of other factors doctors should consider before deciding to perform bariatric surgery on a child. Among these include:

• whether or not they have been able to lose weight on their own through diet and exercise

• whether they are finished growing

• understanding that they must be willing to follow lifestyle changes post-surgery

• use of alcohol or drugs within 12 months before surgery

If any of the above-mentioned factors were not considered before surgery, the child may suffer severe, even life-threatening complications from the procedure. Unfortunately, more and more rogue physicians are looking to cash in on this trending market by performing surgeries on children who do not qualify. Parents need to inform themselves on the general safety guidelines for bariatric surgery to avoid a devastating malpractice event.

There is now a global debate over the appropriate age for bariatric surgery. In the U.S., the youngest is typically about 14; abroad, as stated, children as young as three are undergoing the procedure. The World Health Organization points to a total lack of data on the long-term health effects of such surgeries on children, and that surgeons should err conservatively on the age spectrum.

Currently, the issue of highest concern is not the procedure itself but on how the abrupt change in nutritional consumption would affect long-term brain and sexual development. The brain critically needs the proper types and amounts of nutrients to mature properly, which also affects hormones associated with sexual maturation and cognitive functioning. There is currently no data proving weight-loss surgeries do not affect this development.

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Congress to Tighten Leash on VA after Disastrous Medical Errors

February 10, 2014

6989660347_405bf398c4.jpgIn the wake of the our efforts in Iraq and Afghanistan, the Department of Veteran's Affairs (VA) has been innundated with a new generation of injured troops entirely different than in wars past. The changes in veteran demographic, mixed with the pre-existing American healthcare problems and an array of other factors, is causing disarray in the VA. Medical malpractice attorneys at Pintas & Mullins take a closer look into the disorder and how Congress plans to fix it.

You know something has gone terribly wrong when the least-productive Congress in U.S. history is calling foul on another government agency. Bipartisan members of Congress are launching investigations and working on remedial efforts after reports of serious and devastating problems at VA hospitals throughout the country. To have bipartisan members of Congress frustrated with the agency is extremely telling of its fundamental, deep-rooted problems.

The issues are wide-spread and affect all 1,700 VA facilities in the U.S. Among the problems, legislators are blaming lack of accountability, management errors, and restrictions on performance-based pay for the abundance of medical errors, which are devastating veterans. Congressional members are now considering and will more than likely approve penalties for the VA.

The House Veterans Affairs Committee chairman told the Wall Street Journal that he plans to introduce legislation that will make it easier for poorly performing hospital staff to be demoted or fired. Currently, VA executives receive bonuses based almost exclusively on tenure rather than performance or contribution.

Needless Deaths of our Veterans

Much of the Congressional uproar is in response to an influx of media coverage of the dire, often fatal conditions at VA hospitals in Pennsylvania, Georgia, and South Carolina to name just three. CNN recently published a story on several patient deaths at the Dorn VA Medical Center in South Carolina and the Charlie Norwood Medical Facility in Georgia. CNN reporters investigated the facilities after it became clear that dozens of patients were dying of cancer due to delayed or flat-out denied care.

The report noted that thousands of veterans at these two facilities alone were being forced to wait several months even for routine screening tests such as colonoscopies - within some waiting lists going back as far as 2010. To say this is unacceptable is a dire understatement. Making matters worse, those in charge of these facilities were wholly unable to report remedy and disciplinary action for the backlogs.

VA facilities function differently than traditional privatized hospitals and healthcare clinics. As with any other government agency, the environment within the facilities is extremely enclosed and nepotistic. Inadequate employees are rarely fired; the worst that happens is a transfer to another VA facility, where the cycle of negligence merely continues without discipline or consequence. Additionally, many do not realize that the VA in its entirety is paid for by the American public through taxes.

Among its aims, Congress will explicitly examine each VA executive's history of contribution, action and capabilities. The VA system cares for about 8.75 million patients - from WWII vets to teenagers coming back from Afghanistan - with an annual budget of over $145 billion. There are no current discussions surrounding cuts to this massive budget, only of the VA's performance and lack thereof.

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What Fuels Medical Mistakes

January 8, 2014

4727573126_7418a98c6f.jpgAs a law firm specializing in medical malpractice and mistakes, we see firsthand the traumatic and often catastrophic results of malpractice, and its effects on victims' families. Our passion for this field translates into great interest into how and why these mistakes are made in the first place, and what malpractice attorneys and plaintiffs as a community can do to prevent them.

Though much ink has been spilled on this topic, we recently came across an article in the esteemed British Medical Journal (BMJ), in which the author asserts that evidenced-based medicine is damaged. Evidence-based medicine is heralded in the U.S. as the solution to medical malpractice reform. In theory, it sounds ideal: in order to minimize medical errors, physicians should apply therapeutic principals rooted in scientific and medical research when diagnosing and treating patients.

The reality, of course, is much more complex, varied, and as many argue, broken. The BMJ author declares that drug manufacturers have figured out how to manipulate this evidence-based system to their advantage, conducting research trials as opportunities to tout unnecessary drugs. Once these trials produce "evidence," that certain drugs help certain patients at certain times, physicians are forced to comply, often to the rapid demise of their patients' health.

Overdiagnosis, Overtreatment

Truth be told, the drug industry funds (and therefore controls) the majority of medical research, which leads to massive overdiagnosing and overmedicating. This, many doctors believe, is what is truly fueling medical mistakes in American health centers. Our societal dependence on prescription drugs is immense and steadily increasing. According to the Center for Disease Control and Prevention (CDC), nine out of ten adults in the U.S. report using at least one prescription drug in the past month.

That clinical research is corrupted by the drug industry doesn't make national headlines like egregious medical malpractice lawsuits do, but it is the driving force behind such cases. In order to remedy this, we have to first understand and accept that it is happening, and direct energy toward changing what is broken.

Medical researchers need to focus on what desperately needs to be studied - natural history of diseases, diagnostic criteria, long-term efficacy and safety of drugs. Conversely, we also need to urge researchers, philanthropic organizations, and government officials to tighten regulation of competing interests, predetermined agendas, and Big Pharma influence.

Complex Patient, Understaffed Hospitals

Another major problem affecting every subset of our healthcare system is overworked, underpaid nurses and medical assistants. An article recently published on ProPublica, written by a Harvard Medical School graduate and internal medicine resident, illuminates how difficult it is to keep patients with complex conditions safe in hospitals. The author's mother died of breast cancer after six months in a nationally-ranked hospital, during which time she witnessed a slew of medical mistakes and incidents that hastened her mother's death.

She asserts that, most often, injuries from medical mistakes are not the result of negligence, but of critical information falling through the cracks. Things like medication errors, nutritional regimens, and falls are often caused by seemingly minor incidences, like handoffs between nursing shifts, nearly identical labeling and drug names, and lack of fail-safe systems.

In a word, the author believes complexity is the problem plaguing our health system. As medical advances save and improve lives, it is also creating an influx of new medical devices, pharmaceuticals, and treatments; there are just too many layers to manage, and overbooking physicians is only exacerbating the problem.

How to Help

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Uterine Growth Removal Procedure under Scrutiny for Cancer Risk

December 30, 2013

8759177830_2ecb0f9160.jpgThree U.S. teaching hospitals are now examining the safety of a popular surgery to remove uterine growths after reports that the procedure could spread cancer in high rates. Two esteemed hospitals in Boston, along with the Cleveland Clinic, plan to better inform patients of this risk. Medical negligence attorneys at Pintas & Mullins remind women undergoing these types of procedures that they must always be adequately informed of all risks before they consent to a surgery.

The procedure, known as uterine fibroid surgery, is recommended for patients diagnosed with noncancerous growths in the uterus. It is estimated that about three out of four women will experience these types of growths (fibroids) in their lifetime, some without ever realizing it. By themselves, uterine fibroids do not cause cancer and are easily manageable. In a specific subset of patients, however, the symptoms (pain, bleeding) interfere with health to such an extent that surgery is necessary.

Uterine growth procedures are minimally invasive, typically performed laparoscopicly. The number of these types of surgeries has skyrocketed over the past decade, often with positive results. For some women, however, the procedures have turned disastrous and even fatal, because it significantly increases the risk of cancer spreading into the abdomen.

In some women, undetectable cancer cells proliferate in these uterine growths and can spread into the abdomen during or after laparoscopic surgery. This is due to the nature of the surgery, which requires surgeons to "grind" the growths down into small pieces so they are more easily removed. Thus, the cancer cells release into the abdomen and uterus, making the potential for full-blown cancer more likely.

Making matters worse, physicians are currently unable to test the fibroids to determine if the growths are cancerous before the procedure and the American Congress of Obstetricians and Gynecologists explicitly notes that there are not guidelines for how physicians should inform patients of this risk.

Why Women aren't Being Warned

In a study involving 30,000 patients, researchers determined that about one in every 415 women who undergo this procedure have undetected cancerous fibroids. Prior to these findings, which will be published in the New England Journal of Medicine, physicians believed the risk to be much lower - about one in 10,000 - and were therefore understating the actual risks to patients.

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One of Six American Deaths Caused by Preventable Hospital Error

December 16, 2013

4726929163_1dc2a8fd75.jpgHealth experts estimate that an alarming number of patients in the U.S. - about 440,000 per year, to be exact - die from medical errors in the hospital. That amounts to about one-sixth of all deaths nationally, and the third leading cause of death overall. Our team of medical malpractice attorneys examines how this could be so in a country so touted for medical advancement.

According to a recent article by the New York Times, the number of patients seriously injured (but not killed) by medical negligence is 10 to 20 times higher than 440,000. The author of that article suggests that the most surefire way to heighten hospital safety is to make information and records more transparent. She affirms that hospitals began tracking safety errors in 2000, and in 2003 the Centers for Medicare and Medicaid Services started collecting hospital safety information.

The website Hospital Compare lists much of this information, and most states run similar websites. Other websites and advocate groups that rank or publish hospital safety information include the U.S. News Best Hospitals, Consumer Reports, and Leapfrog Group.

Among the information that can be mined from these sites include rates of surgical site infection, drug-resistant bacteria infection (such as C.diff), and bedsore and blood clot rates. There is also, however, a significant dearth of information, which is worrisome to say the least, and confirms that hospitals are not comprehensively reporting their data on preventable errors and medical mistake.

The American healthcare system is hotly contested in all its factions, as it affects the lives of everyone in this country: young and old, sick and healthy, rich and poor. The politics in this issue are omnipresent and intrinsic in understanding how and why the reporting system is so colluded. Enter: the National Quality Forum, a federal organization established in 1999 that is influenced by hospital lobbyists just as Congress is. Consumer representatives of National Forum committees told the Times that they are rolled over by lobbyists and hospital administrators "constantly" in deciding core reporting requirements and other issues.

For example, Hospital Compare no longer provides information on surgical instruments left in patients after procedures, or frequencies of air embolism. About 27 states now require public report of hospital-acquired infection rates, however, this is the only government-mandated safety information required, leaving much buried beneath the surface.

Proving Fault in Hospital Error Lawsuits

When medical negligence directly causes serious patient injury or death, a lawsuit is the most efficient and effective way to ensure the hospital corrects the inadequacies that led to the error. Lawsuits may only be filed, however, if it can be proven that the physicians or hospital staff failed to meet the standard level of care in your treatment.

To prove negligence it must be demonstrated that the physician/hospital's conduct fell substantially below the general medical standard of care. This medical standard can be established through testimony by a medical expert practicing in the same field (for example, if the lawsuit is being brought against an OB/GYN, the testimony of another obstetrician or gynecologist from a different hospital would be acceptable).

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Veterans Affairs Spends $845 Million on Malpractice Claims over Past Decade

November 15, 2013

6348524704_1572a02c0e.jpgA recently-released analysis by the U.S. Department of Veteran's Affairs (VA) showed that the agency paid about $845 million in medical malpractice payments since 2003. This amount of money was paid to over 4,400 veterans who were injured through medical negligence. Medical malpractice attorneys at Pintas & Mullins frequently work on behalf of injured veterans, and know just how damaging the effects of malpractice can be, and that no amount of money can make the victim whole again.

In 2012 alone, the VA settled over 450 cases, totaling more than $98 million. This number is causing Congress, medical experts and public watchdog groups to question whether the VA is learning from its mistakes and improving its practices accordingly. Over the past decade the VA has not enacted or even proposed a major reform program within its hospital systems.

Stories of Fatal Neglect

Dayton Daily News dug deeper into the issue, speaking to families of injured veterans and reporting on their stories (the article may be found here). Among their stories include a 20-year-old who was admitted to a VA hospital for a routine tooth extraction and left in a wheelchair, paralyzed and unable to speak. Another family watched their loved one, a Vietnam War veteran, die of cancer after VA doctors missed the diagnosis several times over three years.

The VA hospital network is one of the largest in the nation - in 2012, it treated about 6.3 million veterans. When malpractice claims are made, the VA settles financially with about a quarter of them (private U.S. hospitals pay out about 20% of claims).

One of the highest recent VA payouts was awarded to the family of a retired Air Force captain, who flew B-52s in the Vietnam War. He was admitted to the Atlanta VA to undergo treatment for a heart arrhythmia (irregular heartbeat). During laser surgery, doctors accidentally punctured his heart, though fortunately he survived and was released shortly after.

In the ensuing months he was hospitalized several times due to dizziness and was prescribed numerous medications. During his last ER visit it became clear his organs were failing, and his heart continued to lead blood, requiring emergency surgery. His wife asked for an autopsy and requested the hospital launch an internal investigation. After the investigation and subsequent lawsuits, the hospital admitted he died from neglect, and settled with his family for $300,000.

How VA Lawsuits Differ

Malpractice lawsuits against the VA hospitals differ in many ways from lawsuits against private hospitals in several ways because the VA is a federal department. In more traditional suits against private hospitals, plaintiffs can hold individual physicians, nurses or other administrators liable for negligence. At the VA that is not possible. Plaintiffs must sue the entire hospital or not at all; individual employees cannot be sued.

At the same time, VA hospital personnel are consistently given pay raises and transfers even if their conduct has resulted in serious injury or malpractice claims. A federal report confirmed that, in 2011, the VA awarded performance bonuses and awards in the amount of $160 million to staffs without properly associating the bonuses with esteemed performance. Many of the bonuses even went to administrators who oversaw massive adverse events at their respective hospitals, including fatal outbreaks of Legionnaires disease, veteran suicides, and sterilization oversights.

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Wrongful Death Suit filed after Fatal Reaction to CT Scan Dye

October 25, 2013

ct-scan-1_l.jpgWrongful death attorneys at Pintas & Mullins report on a lawsuit recently revived against the federal government, after a man died at a federal clinic in Kentucky. He was seeking treatment for persistent pneumonia and passed away from a severe allergic reaction from CT contrast scan dye.

The man was admitted to the federal clinic, Mountain Comprehensive Health Corporation in Whitesburg, Kentucky, in January 2009, and died the same day. His medical chart specifically noted his allergy information, flagging a similar reaction to CT scan dye one month earlier. At the time of his death, his attending physician informed his wife that he died of natural causes from aspirating (suctioning out) a blood clot.

When a coroner arrived, however, emergency personnel told a completely different story, and an autopsy was ordered. The autopsy revealed the true cause of her husband's death: severe allergic reaction. She presented her claim to the U.S. Department of Health and Human Services (as the medical clinic is federal agency) in 2011, however, the HHS denied her claim because it arrived four days too late. The statute of limitations in Kentucky is two years, and because her husband died in January 2009, the statute would have expired in January 2011.

Since, however, the wife did not receive her husband's autopsy report until April 2009, she subsequently filed a lawsuit against HHS, and an appeals court decided her claim did not expire until the date she received the autopsy. The Supreme Court has previously ruled that medical malpractice statute claims only begin when the plaintiff knows both the existence and cause of injury.

The appeals court confirmed that the statute of her claim depended on the date she was alerted of the possibility that the medical center caused her husband's harm and consequent death. Since the physician initially informed her that her husband's death was due to a blood clot, the appropriate date was actually when she received the autopsy.

Medical malpractice lawsuits arise from an array of complex situations. A similar suit was recently filed in Beaumont, Texas, after a woman was treated with a drug she was allergic to. The woman, Laura Laday, sought treatment at Fannett Medical Center for lower back pain, body aches, and swollen feet when she was administered Bactrim D.S., a sulfa drug.

Laday suffered a severe allergic reaction to Bactrim causing physical impairment, disfigurement, and deterioration of her physical and mental conditions. Additionally, according to her complaint, the injuries she suffered adversely affected her capacity to earn money.

Like the man in Kentucky, Laday's allergen to Bactrim and all sulfa drugs was well-documented in her medical charts. Despite this clear indication, physicians at Fannett Medical prescribed and administered her a sulfa. When patients enter a medical center they assume their medical charts and information are up-to-date and available for review. They assume, rightly, that nurses and physicians do not administer drugs without first checking that an allergic reaction would occur, and when this trust is broken, the results can be catastrophic.

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Cardiac Stents One of Most Overused Medical Procedures

October 24, 2013

polygon-medical-animation-angioplasty-procedure_l.jpgMalpractice lawyers at Pintas & Mullins report on several recent studies and news articles highlighting the massive overuse of cardiac stents in the United States. Over seven million Americans have been implanted with stents in the past decade, costing them and the healthcare system more than $110 billion.

Stents are implanted around the heart to prop open heart attack patients' arteries and restore blood flow. About half of those implanted with stents use them for this purpose, which is incredibly effective and usually very necessary. The other half, however, are electing to have the procedure done based on their doctors' recommendations, despite being in overall stable health.

There have been several widely-publicized scandals regarding the overuse of stents, largely focusing on catastrophic premature deaths and certain doctors performing stent surgeries in astronomical numbers. The medical devices are not inherently bad; they are partly responsible for the drastic decrease in cardiovascular disease deaths over the last forty years or so, and, nationwide, stents are required to be implanted in heart attack patients within 90 minutes of their ER arrival.

The benefit of stents in cardiac arrest patients is irrefutable. Their benefits in stable patients with chronic heart disease, however, are far less known. Unfortunately, this has not stopped physicians from prescribing them over less dangerous treatments, such as aspirin, beta blockers and other medications, which are just as effective.

Health care reformers and the public are now voicing their concern about stent overuse and the motives behind it. A heart specialist in Louisiana recently put a face on the issue when he was convicted of 51 counts of billing for medically unnecessary surgeries and sentenced to ten years in prison.

Though one stent can save a life, several stents do not equate to better results. One patient, Bruce Peterson, went to see a cardiologist for chest pain and subsequently implanted with 21 coronary stents, one of which tore a blood vessel. His physician put five stents in a single artery, which weakened his heart and exposed him to severe complications that ultimately took his life.

His doctor was fined just $10,000 for Peterson's death, along with two years of oversight. While it is important not to demonize outright all cardiologists who recommend more than one stent, it is equally important for patients to ask physicians why exactly they believe what they're doing is right. There are some doctors who over-treat patients in pursuit of profits - the Louisiana cardiologist, for one, enjoyed a $6 million income in 2003 thanks to the stent procedures. He now earns $5 dollars per month as a supervisor of his prison's cleaning crew.

As a result of his malpractice, some of his patients require regular blood transfusions; others have needed remedial surgeries, or suffered heart attacks and strokes. Several died, after which their families sued him and the two Lafayette hospitals where he worked, obtaining a $15.1 million class-action settlement. The man himself was getting about $2,600 per stent, and used to boast that he could implant ten a day. At any one time he would have between 6,000 and 7,000 patients under his care. He would schedule 40 appointments in a two-hour period, sometimes recommending they undergo stent surgery, literally, on his way out the door.

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Widow Wins $4.2 Million Verdict after Doctor Misdiagnosis

October 16, 2013

7440364264_d4e8b671d0.jpgMedical malpractice attorneys at Pintas & Mullins report on a recent malpractice lawsuit concerning North Cypress Medical Center located near Houston, Texas. The jury awarded the widow $4.2 million after her husband was misdiagnosed by a North Cypress physician and ultimately died as a result.

The man was only 46-years-old when he passed away from severe buildup of spinal fluid in the brain (hydrocephalus). Evidence produced at trial showed that emergency room physicians initially properly diagnosed his condition, which is treated with a drainage tube implanted in the brain. Another doctor, Victor Kareh, rejected that diagnosis and refused to provide the man with the treatment he needed.

Further illuminating the malpractice, the man, Lancer Windrum, underwent an MRI and CT scan at the medical center which unambiguously showed the fluid buildup. Windrum also showed multiple symptoms of such a condition, with slurred speech, headaches, and confusion.

Instead of treating him, Dr. Kareh decided to monitor Windrum for 24 hours before making a precise diagnosis, despite Windrum suffering from three previous episodes of the same type within the few months prior. After the 24-hour delay, Kareh decided the patient was not suffering from spinal fluid buildup and sent him home to his wife and three children.

Windrum first visited Dr. Kareh in early February 2010, and visited him several times after that with the same exact symptoms consistent with those for hydrocephalus. Dr. Kareh, however, ordered tests unrelated to his suspected condition, failed to treat him appropriately and repeatedly sent him home without aid. Finally, on May 2, 2010, Windrum passed away in his home.

Throughout trial it became clear that Kareh significantly deviated from the standard level of care for Windrum, ignoring the opinions of his fellow physicians and failing to adequately read his MRI and CT scans. Windrum's symptoms were classic signs of hydrocephalus, and treatments for this condition are straight-forward and would have saved his life. The doctor's negligence in this case was clear, resulting in a substantial verdict for his family.

A recent article in the Washington Post highlights the troubling prevalence of misdiagnoses in the United States. Most people, even patients with ambiguous ailments, do not consider the serious repercussions of a misdiagnosis until they hear or experience a situation similar to Windrum's. Some instances of misdiagnosis are relatively minor. Others can be devastating and result in permanent disability or loss of life.

Itzhak Brook, a pediatric infectious disease specialist, was experiencing chronic throat pain in 2006, which his doctors told him was simple acid reflux. After seven months of complaining, a particularly astute resident located a tumor in Brooks' throat which turned out to be cancerous. The tumor was the size of a peach pit, and was found using simple procedures that his head and neck physicians never thought to attempt.

Because of the seven-month lag in diagnosis, Brooks had to undergo extensive surgery to remove his voice box which left him speaking in a permanent whisper. He believes that this procedure would not have been necessary had his cancer been detected earlier. Patient safety experts affirm that Brooks' situation is actually extremely common: missed, incorrect, or delayed diagnoses affect between 10 and 20% of all medical cases.

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Family Receives $15 Million after Fatal Doses of Radiation

September 19, 2013

8202674444_177b7ec1c9.jpgMedical malpractice attorneys at Pintas & Mullins report on a recent settlement by the family of a lung cancer patient who suffered severe injuries after being exposed to overdoses of radiation. The family settled with the medical services company, Varian Medical Systems, in the amount of $15 million.

The man, Zacarias Chichioco Jr., died in May 2011 after received about 2.5 times the appropriate amount of radiation during 21 of 35 treatments. The error was reportedly caused by a glitch in the software. After his death his family filed suit against the medical center where he was receiving radiation treatments, Pacific Center Institute in Hawaii, as well as Varian Medical Systems, which developed the defective software.

Chichioco was diagnosed with lung cancer in February 2008, over three years before his death. His oncologists developed a treatment plan based around Varian Systems' Eclipse medical device, which delivers radiation through a linear accelerator. His doctor started him on a regimen of 35 radiation treatments, however, after the first few sessions Chichioco quickly suffered severe side effects, such as hallucinations, hearing loss, and partial face paralysis.

Chichioco underwent several skin graft operations to relieve the side effects, to no avail. His family's lawsuit points to a software update by Varian in May 2007 - less than a year before Chichioco began radiation treatments - informing them of the programming error. The glitch was in the treatment planning software, however, Varian did not include any notes to Pacific Center on how to avoid the programming error.

A review later conducted by Pacific Center revealed that Chichioco received 2.5 the appropriate dose of radiation during his first 21 treatment rounds. He ultimately died from his lung cancer, however, his family asserts that it was the toxic doses of radiation that weakened his immune system, directly leading to his death. He had survived three years with the cancer before starting radiation.

Near the end of his life Chichioco refused to see any more doctors, citing a complete loss of trust for the medical system. He also refused any type of treatment for his cancer, which ultimately killed him. His family settled with Varian and Pacific Center for $15 million - $13.5 million of which will be paid by Varian.

In related news, a recently study by Duke University Medical Center found that doctors were much more likely to order unnecessary knee imaging when they had a financial stake in the equipment. As illustrated above, unnecessary MR images can result in an array of side effects from radiation exposure, particularly if the equipment or software is in any way defective.

Researchers found that MRI scans were read as negative significantly more often in patients who were referred by a doctor with ownership interest in the imaging equipment (33% negative) than those without any financial incentive (25% negative). The results were recently published in the medical journal Radiology.

The retrospective review could not prove that physicians were ordering knee MRIs in pursuit of profit, however, the numbers speak pretty clearly. Researchers highlighted the poignancy of this study, as it is published in the midst of great national debate over the rising cost of health care. They affirm that the inherent conflict of interest in doctors ordering and performing MR imaging examinations and then collecting fees on their acquisitions is an important factor.

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Veteran's Malpractice Payouts Reach 12-Year High

September 13, 2013

Medical malpractice lawyers at Pintas & Mullins report that veterans' medical malpractice payouts are steadily rising as more soldiers require care. The U.S. government made more than 400 payments in 2012 to resolve malpractice suits against Veteran's Affairs hospitals, costing it nearly $92 million.

2920376476_b4befd25b7.jpg One of these cases, filed by Christopher Ellison, recently resulted in a $17.5 million judgment for him and his family. He went to the Philadelphia veteran's medical center in 2007 to have eight teeth removed, however, what should have been a routine visit left him physically incapacitated for the rest of his life.

Other cases against the VA resulting in permanent disability have been the result of delays in or missed diagnoses, and surgeries performed on wrong body parts. Though these types of medical mistakes are often found in the general public's healthcare system, the significant rise in VA malpractice claims illuminates deep flaws in the system's practices.

A Representative from Florida told Bloomberg that these rapid malpractice judgments reflect the pattern of preventable deaths of soldiers at VA hospitals. He asserted that what the VA is most lacking, is not money or resources, but accountability. The Representative, Jeff Miller, is also Chairman of the Committee on Veteran's Affairs.

On September 9, 2013, Representative Miller and the House Committee on Veteran's Affairs held a hearing to examine the most recent preventable mistakes at VA medical centers nationwide, including an outbreak of Legionnaires' disease a few years ago that killed at least five veterans. The inspector general of the VA is currently conducting a criminal investigation into that incident, which was caused by bacterial infections spread through the water supply, and which we reported on in March of this year.

At least one family, that of John Ciarolla, filed a wrongful death lawsuit against the Pittsburg VA. They were not even aware of the outbreak until over a year and a half after Ciarolla's passing. Families of the other veterans who died of Legionnaires' were very outspoken about the length of time it took the VA to contact families about the outbreak, prompting the investigation.

One son whose father died from the outbreak said that his father was permitted to shower, wash and drink hospital water for sixteen days without any warning of a potential health problem. He died from the bacterial exposure. His son also plans to file a claim against the VA.

There are currently about 1.2 million American soldiers that are due to become veterans before 2017, more and more of whom are being diagnosed with complex diseases, such as post-traumatic stress disorder, that frankly, physicians do not know a lot about yet. Others suffer from injuries that would have been fatal in Vietnam or World War II. The median age of these new veterans is between 25 to 34 years old - comparatively, the median age for Vietnam, World War II and Korean War eras was 65 and older.

The VA system must learn to change and adapt to the new generation of veterans, who suffer from vastly different ailments, conditions and require alternative treatments, including psychological care. Relatedly, medical malpractice payouts are now larger because the life expectancy of injured veterans is now decades longer.

In clearer terms, if a VA surgeon accidentally cuts off the wrong leg of a 70-year-old Vietnam War vet, whose life-expectancy is around 75, that patient is entitled to five years of damages. If that same surgeon accidentally cuts off the wrong leg of someone whose just come back from Afghanistan, who is perhaps 25, the payout will be much larger because he or she is entitled to at least 50 years of damages.

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$5.5 Million Award to Family of Bypass Surgery Victim

September 11, 2013

Medical malpractice lawyers at Pintas & Mullins report on a recent unanimous jury verdict out of Maryland that awarded the plaintiff $5.55 million for medical negligence during and after an open-heart coronary bypass surgery. The patient died shortly after surgery, and the malpractice suit was brought by her daughter.

6300225700_e4f86d19e1.jpg The deceased patient, Velda Faye Richardson, underwent open-heart surgery in February 2011. Just before the surgery was completed surgeons placed pacing wires on her heart, and she recovered as expected, scheduled to be released from the hospital the following week.

About five days later, however, a nurse went to remove her pacing wires, and a few minutes after the removal Richardson became short of breath and began bleeding severely from her chest. Pacing wires are normally clipped off at skin level and left in internally or surgically removed. Just a few short minutes after nurses removed the wires Richardson started losing consciousness, told the nurses she thought she was dying, and ultimately became unresponsive.

During trial evidence showed that, when the wires were pulled from Richardson one or more lacerated or cut her newly-implanted vein graft. This laceration caused the profuse bleeding and prevented the heart from receiving blood, resulting in her death. Her surgeon testified that he did not remember precisely where the wires were placed on Richardson during the initial procedure or how many wires were used.

Not one member of the surgical team could even remember who placed the pacing wires in Richardson, neither were there records indicating such information. Her daughter successfully argued that this lack of information and record keeping showed that her mother suffered from inadequate care at the hospital and at the hands of the medical team, directly leading to her death.

In a similar case which concluded last year, a former police lieutenant was awarded $178 million after suffering from devastating medical negligence at Memorial Hospital Jacksonville. The man, Clay Chandler, underwent laparoscopic gastric bypass surgery in 2007. The day after his surgery, Chandler, who was once heralded as the next County Sheriff, suddenly collapsed from respiratory failure and rushed to critical care.

Chandler remained in critical care for eight days, during which time fluids leaked from his bowels into his abdomen. The leak was ultimately fixed with surgery, however, the more than week-long delay caused irreversible, devastating damage in Chandler's body. By the end of the eight days his blood pressure dropped so low he had a "low-flow stroke," and slipped into a coma for over two weeks.

While he was in the coma no one ever put lubricate drops in Chandler's eyes, which is required, causing him to suffer a burned retina; he is now permanently blind as a result. Medical experts testifying in this case stated that these oversights were the result of inexperienced, extraordinarily poor care - that most doctors, adhering to standard levels of care, would have taken Chandler back into surgery as soon as he started showing symptoms of bowel leakage, not eight days after.

Today, Chandler cannot feed, clean or bathe himself, nor can he walk or speak intelligently. At the time of the procedures, his physician, Dr. DePeri, had performed only 21 bariatric (weight-loss) surgeries and had taken only one class. He continues to perform bariatric surgeries at Memorial Hospital Jacksonville.

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Physician Case Load Linked to Death during Dialysis

August 13, 2013

444961895_395142547a.jpgMedical malpractice lawyers at Pintas & Mullins highlight a recent observational study which found that higher caseloads for nephrologists lead to higher death rates in their hemodialysis patients. Patient mortality was about 2% higher for each additional 50 cases a physician took on.

The study was conducted at the University of California, Irvine, and published in the Journal of the American Society of Nephrology. Researchers also found that physicians with lower patient mortality also demonstrated better dialysis characteristics, such as longer sessions and increased dialysis doses.

End-stage renal disease care is extremely expensive and dangerous; sudden cardiac arrest is the most fatal complication that can occur while on dialysis, a risk that is heightened if a patient's attending physician does not have sufficient time to monitor them. Each individual patient requires a unique dose and time allotment during dialysis, and if not enough attention is paid to these factors, the effects can be deadly.

Conversely, other studies have linked high case volumes for physicians to advantages in surgical and invasive procedures. Such examples include AIDS, sepsis, and acute myocardial infarction (heart attack) procedures, where experience and repetition is critical to a successful outcome. Care for end-stage renal disease, however, differs because the potential for complications is so individualized.

Of course, acquiring experience and knowledge is important for physicians, however hemodialysis requires a substantial amount of individualized management and communication with other team members, along with complex medical decisions that require more time to consider. Nephrologists with high caseloads may simply not have enough time to consider all these factors carefully for each patient.

The UC Irvine study used data from the U.S. Renal Data System to examine outcomes for over 4,000 hemodialysis patients in the Los Angeles metropolitan area. Specifically, researchers analyzed patients at DaVita dialysis clinics, and physicians with caseloads between 50 and 200 patients.

In total, more than 40 nephrologists were included in the retrospective study and ranked by patient mortality rate between the years 2001 and 2007. Physicians with the highest rates of patient mortality had average case loads of about 103, while those with lowest patient mortality had caseloads around 65. In fact, mortality risk consistently rose as caseloads increased above 50, plateauing around 140.

Other characteristics that put hemodialysis patients at an increased risk of death included being African American or Caucasian (Hispanics had the best survival rates), having diabetes, heart conditions or hypertension, being insured through Medicaid, and greater inflammation demonstrated by lower white blood cell counts.

These associations, however, may not be completely straightforward. For example, shorter dialysis sessions were linked to higher mortality rates and increased physician caseloads, which may be influenced by overcrowding or patient non-adherence to process, rather than physician aptitude. Other limitations include severity of illness and influence of socioeconomic status beyond insurance carrier (Medicaid vs private insurance). The study also did not differentiate between specific causes of death, number of provider visits per month, presence of nurse practitioners, or associations with academic centers.

It is worth noting that the study also did not detail the types of drugs administered during dialysis treatments. It has been proven that dialysis patients administered the products GranuFlo and NaturaLyte have significantly increased risks of mortality, due to the defective design and manufacture of these drugs. GranuFlo is given to balance acid and base in patients' blood streams, however, the product often causes the blood to become too acidic, leading to heart problems and cardiac arrests.

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