Maryland Medical Malpractice Attorney Blog

No Fault Medical Malpractice

Fri, 03 Feb 2012 09:27:21 -0500

Vermont is considering switching to a no-fault medical malpractice system. The theory? It is what they do in New Zealand. The thinking is that we should replicate New Zealand's law since, you know, we do that with just about everything else.

I'm oversimplifying it trying to be funny. The theory is that less fear of lawsuits means doctors practice less “defensive medicine” which makes up an estimated 99.99% of medical costs (source: AMA).

Antidepressants Causing Nursing Home Falls?

Fri, 27 Jan 2012 11:17:48 -0500

There appears to be a correlation between antidepressant drugs (selective serotonin reuptake inhibitors or SSSIs) and falling injuries in nursing home patients who have dementia. The British Journal of Clinical Pharmacology released the results of a study that should make people take pause when approving certain medication for their loved ones who have dementia.

SSRIs are mostly used to treat clinical depression. There is a lot of debate over whether they are even effective—some studies show them to be no more reliable than placebos. (I think they probably work for some, but probably a minority, of patients.) SSRI antidepressants include:

Paxil
Luvox
Zoloft
Prozac
Lexapro

The study showed that nursing home residents with dementia who take SSRIs are three times as likely to suffer falls. What’s more, the fall risk increases as the SSRI dosage increases. The data used is impressive—the study’s authors examined 248 nursing homes for two years, which resulted in 85,074 person-days.

Though the data does not strictly show cause-and-effect, it does raise some interesting concerns. Nursing homes in particular need to pay attention—if there is a cause-and-effect relationship, even if it can’t be proven legally, their best interest is in finding alternatives to SSRI’s for depression. Not all nursing home falls lead to lawsuits but some do. Why not make sure we are creating an environment that is as safe as possible?

Man Awarded $178 Million in Medical Malpractice Lawsuit

Tue, 24 Jan 2012 09:01:15 -0500

Tragic story here about a lieutenant from a Sheriff's Department who was severely incapacitated after he underwent bariatric surgery in 2007. The details of his care and treatment are appalling.

After being told that a weight-loss surgery would be "less risky" than continuing to live in his physical state (he was 6'1" and 375 lbs), a once active and contributing member of society now remains confined to a wheelchair, brain damaged and blind, but completely aware of what he once was and what he is now.

How could this happen you might ask? Well, when your surgeon is unaccredited and has performed less than half of the required number of surgeries to become accredited, you find yourself with a major case of malpractice. Furthermore, the surgeon was required to have at least twenty hours of bariatric education courses, yet he had only taken one.

None of this stopped the hospital from holding themselves out as having an accredited "Bariatric Surgery Center," which amounted to fraud. The victim's attorney said that the hospital sold the illusion that they had a "team" of doctors and nurses, committed to bariatrics. On the day of surgery, the man found this to be untrue when, in the middle of about ten pages of documents, he found a paragraph stating that "we are all independent and nobody's a team."

The day after having undergone a gastric bypass surgery, the lieutenant collapsed in respiratory failure and was placed into critical care. For eight days, he showed signs of complication, where fluids from the bowels leaked into his abdomen. The hospital's own experts later stated that most bariatric doctors would have taken a patient back into surgery as soon as the patient showed symptoms, and no later than on the sixth day after surgery. But yet, he wasn't taken in for eight days.

At one point during the ordeal, his blood pressure dropped to the point where he suffered a "low-flow" stroke, and went comatose for over two weeks. During this time, he was on a respirator, though no lubricate eye drops were given to him, which burned his retina and caused permanent loss of eyesight. The lieutenant can no longer speak intelligently and he cannot walk, feed, or clean and bathe himself.

Malpractice Suit Filed Stemming from Failure to Diagnose

Wed, 18 Jan 2012 16:17:46 -0500

Suit was recently filed in the Superior Court in Hartford, Connecticut, alleging that a pediatrician failed to diagnose bacterial meningitis, leading the loss of a young boy's eyesight.

The details here are so sad. The lawsuit claims that the doctor dismissed the boy's severe headache, instead of sending him to the emergency room where a spinal tap would have been done and the meningitis would have been diagnosed. Tragically, the boy fell into a month-long coma, suffering severe brain damage along with the blindness, the suit claims.

These kinds of failure to diagnose claims are so sad because the illness could have been so easily prevented had the proper diagnostic tests been done. Instead, the boy's complaints were disregarded and quickly brushed off. Too often, the severity of injury in meningitis cases is the result of medical malpractice. These claims usually involve an infection from a delay in diagnosis or failure to properly treat the meningitis to stop the infection. Too many doctors chalk up meningitis as simply a headache or a simple fever. Misdiagnosis or delay in diagnosis of bacterial meningitis is of great concern as early diagnosis of bacterial meningitis and treatment is key to prevent permanent damage such as brain damage, hearing loss, seizures, intracranial pressure, decreased intelligence, kidney damage, amputation, or death.

If you are or a loved one is a victim of medical malpractice, contact our team of lawyers to discuss your case. If you have any questions for our Maryland malpractice attorneys, you can reach us at 800-553-8082 or get a free, on-line no obligation medical misdiagnosis consultation.

Certificates of Merit: Should They Be Required?

Wed, 11 Jan 2012 13:51:35 -0500

The Pop Tort rages about the certificate of merit requirement that many states have in medical malpractice cases, citing a particularly onerous Connecticut merit requirement. The Pop Tort cites a news article of an awful injustice done to a woman who had her medical malpractice lawsuit dismissed.

After a long ride to the end of the article, we find out what the grave injustice was. The plaintiff sued her doctors for alleged breach of contract and infliction of emotional distress — not malpractice - and the court decided she need a certificate of merit.

Personally, I'm fine with this. I think certificates of merit are actually a good thing. There is a knee jerk reaction: the certificate of merit makes it hard for plaintiffs and their lawyers to bring lawsuits. But not all things that are made harder are bad thing. I know that there are some meritorious cases that don't make the cut because discovery is needed to get the information for the cerftificate of merit in the first place. But good lawyering can find a way around that problem, at least in Maryland.

The upside for medical malpractice victims is that there are less cases filed by a pro se plaintiff who is just mad at their doctor and does not have real evidence that could ever support a verdict. In states where there is no certificate of merit, the local paper with nothing else to write about always fires out a story about the poor doctor who got hit with a frivolous lawsuit. The absence of these stories provides an indirect but meaningful benefit to malpractice plaintiffs: less polluted juries and less stupid, irrelevant anecdotes to march in front of the Maryland General Assembly.

Please note: I could be completely wrong about this. Maybe certificate of merits keep out too many good cases than the PR upshot we get. But I think I'm right and I think the knee jerk "if it is hard for plaintiffs, it must be bad" colors the opinion of plaintiffs' lawyers more often than it should.

Sample certificate of merit
An overview of the certificate of merit requirement
The application of the 20% rule

Appendicitis Misdiagnosis

Tue, 10 Jan 2012 12:47:27 -0500

One frequent emergency room complaint is abdominal pain of unknown origin. The challenge for the ER doctor is to diagnose the source of the problem, or at least narrow the problem, and rule out life threatening aliments. Three big potentials for problems are appendicitis, volvulus, and ruptured abdominal aortic aneurysm and intussusception - all can lead to misdiagnosis and wrongful death malpractice lawsuits. Today, we will look at appendicitis misdiagnosis claims.

Failure to diagnose an appendicitis is a common failure. It is critical to immediately remove an inflamed appendix before it ruptures. If a patient walks in with an inflamed appendix and walks out before getting the proper treatment – usually removal – they are put at risk of death. Particularly at risk for an appendicitis and a missed diagnosis is our youngest and oldest. The classical appendicitis presentation includes patients with low grade fevers with crampy, intermittent abdominal pain that gets worse with movement that migrates to the right lower quadrant of the stomach within 12–24 hours of the onset of symptoms.

Some emergency room doctors miss even the obvious diagnosis in patients most at risk. There are medical malpractice cases where the patient could just have well come in the emergency room with an “I have an inflamed appendix” shirt and the ER doctor still blows it. But the standard of care also requires ER doctors to catch more than just the fly balls. For moderate risk patients that have some, but not all of the classic appendicitis symptoms, doctors really do need to order more follow-up diagnostic testing. Call it defensive medicine, call it whatever you want, but if it looks like it could be an appendix problem, it's worth getting a CT scan.

Medical Malpractice News

Mon, 26 Dec 2011 07:54:01 -0500

"Tort reform" has nothing to do with insurance rates.
Can statutory caps actually hurt defendants?
Kennerly's got an interesting post about problems with anesthesia.
The decline in number of autopsies performed could mean we're missing big mistakes on the part of hospitals.
A member of the state's committee to address unnecessary stents has now himself been accused of placing unnecessary stents.

Last Week In Medical Malpractice News

Mon, 05 Dec 2011 09:47:31 -0500

The family of a man who died at Massachusetts General Hospital has settled its case against the hospital for $850,000. The man died after nurses failed to respond to alarms on his cardiac monitor. This death has shed national attention on the dangers of “alarm fatigue’’ among hospital staff.
A few New York courts are taking a new approach to handling the 4,000 medical malpractice suits filed each year. The approach...settling cases early. The pilot program will be using a $3 million grant to train more judges in medical issues, and has been shown to cut court backlogs and save money, while also proving to be a cost savings to hospitals and directly impacting the indemnity insurance of doctors. One of the new rules approved for the medical malpractice cases, in order to expedite things - scheduling Settlement Conferences 45 days after court papers are filed.
The Tennessee Court of Appeals issued an opinion on its relatively new certificate of merit rule in Crawford v. Kavanaugh. Maryland has a similar rule and this opinion is a cautionary tale for both Tennessee and Maryland malpractice lawyers. The lesson: don't take a malpractice case unless you know how to handle it.
It is being said that confidential settlements make it harder for future plaintiffs to get evidence and information they need to bring out all of the facts about the defendant's conduct. I agree, there is little doubt that confidential settlements make it harder for the next plaintiff, as well as making the insurance less accountable. But, the problem is that people who have been badly injured have a hard time focusing on the global interests of plaintiffs everywhere when they are fighting and scrapping to be compensated for their own injuries.
Some experts are predicting that the increasing numbers of physicians using electronic health record systems (EHR) may trigger an increase in medical malpractice lawsuits. Regardless of the concern, the federal government is pushing physicians to implement and use EHR systems, as required under the 2009 American Recovery and Reinvestment Act, and are directing hospitals to implement the EHRs by 2012.

Details Matter in Filing Malpractice Case: New Appellate Opinion

Tue, 29 Nov 2011 13:20:53 -0500

The Tennessee Court of Appeals issued an opinion on its relatively new certificate of merit rule in Crawford v. Kavanaugh. Maryland has a similar rule and this opinion is a cautionary tale for both Tennessee and Maryland malpractice lawyers. The lesson: don't take a malpractice case unless you know how to handle it.

In Crawford, the defendant doctor performed a cystoscopy, retrograde pyelogram, and a brush biopsy on a woman's ureter. The purpose of this procedure is typically to diagnose transitional cell carcinoma, a cancer of the urinary system. The doctor believed the woman had atypical urothelial cells. To combat this, the doctor performed a uretectomy and ureteroneocystostomy. The woman had an infection and other complications. Another doctor treating the woman noticed she had a bowel obstruction. The woman had to undergo another surgery.

Clearly, this is an awful thing in human terms but not a major injury in the medical malpractice milieu. The woman needed “many additional weeks” in the hospital and “many months of recuperation and rehabilitation.” Again, I don't want to minimize her suffering. This is a tragedy if it happens to someone I care about. But that does not mean it is a good malpractice case. What is my point? This is the kind of case taken by maybe an otherwise good lawyer who does not regularly handle malpractice cases. Typically, experienced malpractice lawyers don't take a case like this and won't make these mistakes.

Medical Malpractice News on Cyber Monday

Mon, 28 Nov 2011 08:18:56 -0500

There are already major safety issues with medical devices, so what do the venture capitalists who invest in device companies want to do? Make it easier to get devices approved.
The Delaware Supreme Court holds that a referring physician is not liable for malpractice committed by the doctor to whom he or she refers a patient.
Here's a point in the case for choosing a female doctor.
Rick Perry's medical malpractice "reform" in Texas did not solve the state's serious shortage of doctors in some areas.
A federal judge in Illinois is letting a man proceed with his claim against emergency responders who forced "care" upon him after he refused medical treatment. His suit claims that paramedics "put their patient in a headlock, rammed his head 20 times into an ambulance wall and taped him up 'like a mummy.'"
"A $9 million medical malpractice verdict in the case of an oil-field worker with a broken neck is thought to be the largest in Wyoming history."

Nursing Home Death Leads to Lawsuit

Tue, 15 Nov 2011 10:20:43 -0500

A wrongful death lawsuit has been filed in Texas after a nursing home resident fell from her bed and suffered severe and eventually fatal neurological injuries.

The facts are awful. A woman was found on the floor, next to her bed, yelling for help. She was neurologically alert and coherent, but bleeding from head trauma, and in severe pain. According to the lawsuit, the woman was placed back in bed, where she was later discovered nonresponsive, taken to the hospital, and died from her injuries.

Plaintiff's lawsuit alleges that contrary to the doctor's orders, the woman's bed was not in a low position, and floor mats and a bed alarm were not being used. Though she was a high fall risk resident, a care plan and nursing interventions (to prevent a fall) weren't followed. The lawsuit further claims that the nursing home's nurses were not adequately trained or apprised of the resident's care plan.

If the article I read is to be believed (reporters do screw these things up, sometimes), the discovery battle is beyond odd. The doctors have refused to produce the decedent's health care medical chart, on the basis that its lawyer had the chart... and they refuse to provide the lawyer's identity and contact information. As a result, the plaintiffs' malpractice lawyers have had to ask for a temporary restraining order against the center, preventing them from destroying or altering the chart. A hearing is scheduled for this week on the restraining order.

I would love to see the doctors' motions in that case. What could they possibly argue?

If you think you have been a victim of nursing home medical malpractice in Maryland, call 800-553-8082 or get a free online consultation.

Elderly Nursing Home Residents May Suffer More Surgical Complications

Mon, 14 Nov 2011 15:22:49 -0500

Why aren't nursing home residents recovering?

A new study, published in the Annals of Surgery, has determined that elderly nursing home residents may suffer more complications from major operations than other people their age.

Based on more than 70,000 nursing home residents, and 1 million non-institutionalized Medicare enrollees 65 years and older, it is being reported that the elderly "are frail and often have advanced medical problems, which puts them at higher risk of dying after surgery." An example cited states that 12 out of 100 nursing home residents who had their appendix removed died within a month of the procedure, as compared to 2 out of 100 elderly people living on their own.

The study revealed that the death rates were consistently higher among people in nursing homes. Why is this? Researchers have said that we may be too aggressive with surgery in nursing home residents, that they are frail and often have advanced medical problems. This puts them at a higher risk of dying after surgery.

Do Electronic Records Lead to More Medical Malpractice?

Mon, 14 Nov 2011 08:46:36 -0500

Do electronic records decrease malpractice?

Electronic medical records are all the rage. The potential benefits are not hard to see. Doctors can access a patient's entire medical history from one chart. Allergic reaction to penacilin in 2003? Got it. Equally helpful, the system has built-in alerts of the potential dangers of drugs interactions.

It is a bipartisan idea in Washington, D.C., a town where bipartisan ideas are as common as Indianapolis Colts wins without Peyton Manning. President George Bush first championed Health Information Technology as a national priority for the U.S. in 2004. President Obama then threw $36 billion in stimulus money from the American Recovery and Reinvestment Act (ARRA) – earmarked to facilitate implementation of electronic health records (EHRs) – just what the doctor ordered to speed things up. Since then, the EHR implementation machine has churned away in an effort to improve efficiency in patient care. By broadening access to patient information, creating a consistent system for reminders and alerts, offering important safety features such as clinical decision-making support, and automating prescription filling and re-filling, EHRs have the potential to change the landscape of medicine in the U.S. and across the world.

In addition to their direct patient and physician benefits, EMRs are also touted as a means of reducing medical malpractice claims against doctors. Recently, however, a number of malpractice claims have been filed against providers using EHRs; claims directly and indirectly related to the use of EHRs in patient care. Either medical malpractice lawyers will sue over just about anyone or there is real cause for concern that we all should be thinking about. I suspect it is the latter. Medical malpractice insurers apparently agree and are considering increasing medical malpractice insurance premiums in order to offset the potential risks associated with the use of EHRs.

Orthopedic Surgeon Faces a Possible 100 Malpractice Cases

Thu, 10 Nov 2011 09:30:47 -0500

Stunning malpractice claims

You suffer an injury and need surgery. You have to rely on your surgeon to play it straight with you. Besides a second opinion, never a bad idea, what else can you do? Far down on your list of fears: not getting the surgery the doctor tells you that you are getting.

But, in massive numbers, that seems to have happened in New York. There are currently dozens of new lawsuits, alleging medical malpractice, pending against a New York based orthopedic surgeon, with about another 100 cases being discussed.

Ten of the current lawsuits filed allege that the doctor performed surgery, but intentionally did not treat, or improperly treated, his patients' injuries. While those complaints stem from a surgery performed, there are yet other complaints that allege a surgery was never performed. In one particular case, a patient went to the surgeon because of shoulder problems. A "shoulder reconstruction" was performed, but when the patient's pain and problems continued, she sought a second opinion from another doctor. After a battery of x-rays, it was determined that there was no evidence whatsoever that the surgeon performed a shoulder reconstruction, such as screws, anchors, or a fixation device. That patient further claims that the doctor injured her nerves during the surgery, and as a result, she now has permanent hand numbness, and problems grasping things.

Why Maryland Nursing Home Suits Improve Care

Fri, 04 Nov 2011 09:13:26 -0500

Are Maryland nursing home lawsuits a part of the solution or a part of the problem?

Over 36 million Americans are currently over the age of 65. By 2050, that number is expected to raise to 86.7 million. We have an estimated 1.4 million residents living in 16,000 nursing homes in the United States. Incredible statistics.

This problem did not sneak up on us. We all knew that our population was aging. It is a great thing. People are living longer and more productive lives. Today, 80 is the new 60. But there are byproducts of civilization's leap forward. We keep saying we realize there is a problem with nursing home abuse and neglect. But the problem is getting better, not worse.