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hospitalFour years ago, Medicare started penalizing hospitals for patients that returned within a month of discharge, also known as readmissions. The Hospital Readmissions Reduction Program is meant to encourage hospitals to consider how patients fare after they leave the hospital. Our team of medical malpractice lawyers examines the Illinois hospitals facing the most penalties for readmissions.

The more Medicare patient are readmitted, the more the hospital is penalized by receiving lower Medicare reimbursements for each patient, whether they are readmitted or not. In Illinois, 113 hospitals will receive lower Medicare reimbursements starting in October, accounting for 62% of the state’s hospitals.

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gavelOn July 1, 2015, an appeals court in Florida ruled that damage caps in medical malpractice injury cases were unconstitutional. Our team of malpractice lawyers is excited to report on this major ruling and how it will affect Florida plaintiffs.

The decision came from the medical malpractice personal injury case North Broward Hospital District v. Kalitan. The plaintiff in this case underwent outpatient carpel tunnel syndrome surgery to her wrist. As she received anesthesia, one of the tubes nicked Kalitan’s esophagus unbeknownst to the anesthesiologist. When she awoke from surgery Kalitan complained of excruciating back and chest pain.

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pregnancyAlthough rare, birth injuries that occur from medical malpractice are among the most devastating and sensitive cases we handle. These claims involve complex legal and medical issues, with laws and statutes vastly differing between states. In the most severe cases, malpractice can occur by failing to prevent a medical issue that causes the death of the infant. Our team of birth injury lawyers details one such case below.

At 38 weeks, Kelly Ferraro Bloch was perfectly healthy as was her unborn daughter. Less than one month before her due date, however, she was told her daughter was stillborn, that an undetected umbilical cord abnormality had cut off her nutrient supply. The abnormality, marginal insertion of the cord, was present from the beginning of her pregnancy and could have been properly managed if it had been detected.

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the-stethoscope-31Our team of medical malpractice lawyers has been working with patients injured by negligence for 30 years. We understand the importance of establishing trust with your healthcare team and the devastating consequences of breaking that trust. In this blog, we explore what types of cases merit legal action and how the legal process affects patients and doctors alike.

One recent study by researchers at the University of Florida surveyed about 700 patients and families who had been injured by medical errors throughout the country. This survey was intended to record patient and family perspectives. Unsurprisingly, responders felt a lack of accountability, poor communication, and felt disrespected from their healthcare providers.

Responders noted their medical errors led to severe financial losses, permanent disability, forced additional treatment, and death, among other outcomes. The patients and families who felt their providers were untrustworthy or were attempting to hide the errors were much more likely to file a medical malpractice lawsuit.

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gavelA man in Virginia went in for a colonoscopy with a plan: he would use his smartphone to record the doctor’s instructions, so he would be able to follow them exactly after his procedure. He accidentally recorded the entire examination, however, including everything that happened while he was sedated. This recording became the subject of a medical malpractice and defamation lawsuit against two doctors and their practices. Our team of malpractice lawyers details this unique case below.

The medical team in this case consisted of an anesthesiologist, a medical assistant, and a gastroenterologist who performed the colonoscopy. The gastroenterologist was dismissed from the case on the opening day of the trial.

The anesthesiologist, 42-yaer-old Tiffany Ingham, was recorded saying by far the most malicious comments about the patient. Among her unethical actions, she instructed the medical assistant to lie to the patient, wrote a false diagnosis of hemorrhoids on his medical chart, and called him horrible names while he was sedated. Upon hearing the recording on his phone, the patient filed suit.

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newbornPediatric heart surgery is a delicate, complex area of medicine that requires a sophisticated and specialized team. Heart surgery in children is done to repair defects and diseases of the heart and its surrounding tissue, but it is extremely difficult and risky. Medical malpractice lawyers at Pintas & Mullins highlight what constitutes negligence during these types of surgeries and a certain Florida hospital under fire for its program.

The pediatric heart surgery program at St. Mary’s Medical Center in West Palm Beach, Florida was established in 2011. By 2013, the mortality rate for babies having heart surgery through its program was three times the national average; something the hospital does not tell families considering surgery there.

The national rate of mortality in pediatric heart surgery is 3.3% – at St. Mary’s, the rate is 12.5%. This information is not made available online, however. St. Mary’s does not provide this type of data, 12.5% death rate was calculated by a team at CNN, who gathered the information through a Freedom of Information Act inquiry.

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sala-de-parto-03-845205-m.jpgIt’s no secret that medical costs in the United States are among the highest in the world, yet our healthcare system is far from the highest quality. Lesser known is the crisis in childbirth: that our maternal mortality rate is actually steadily increasing. Medical malpractice attorneys at Pintas & Mullins explore this quiet crisis and why it is particularly affecting southern states.

A woman giving birth in the United States is three times more likely to suffer fatal complications than in the United Kingdom, and twice more likely than in Saudi Arabia. The U.S. is actually the only advanced country in the world with a rising maternal death rate – more than 18 women died for every 100,000 births in 2013. In Mississippi, 40 of every 100,000 women die in childbirth.

The most frequent causes of maternal mortality are high blood pressure, obstructed labor, heavy bleeding, and other preventable causes. Far too many women lack access to regular check-ups or do not have health insurance. More than 100,000 people in Mississippi do not even have access to insurance after the state decided not to expand Medicaid.

Some experts believe racial discrimination plays an important role in poor healthcare for expectant mothers in the south. This point is reinforced by a troubling statistic: in Mississippi, nearly 55 black women die in childbirth for every 100,000 births, compared to just 30 white women.

Although the quality of care women receive is decreasing, the cost of care is sharply increasing. The average cost of delivery in the U.S. has tripled since 1996, costing more than $50 billion per year. Childbirth is the single largest category for hospital payouts in almost every state.

Trying to Reduce C-Sections

Insurance companies are aware of the rising costs of maternal care, informing hospitals that action must be taken to curb costs. One of these hospitals, Hoag Memorial Hospital Presbyterian in Orange County, California, was warned that its maternity costs were too high and was at risk of being cut from its insurance network. Driving the high costs was the increasing frequency of Caesarian sections.

In 2012, about 38% of all births performed at Hoag Memorial were C-sections (compared to the state average of 33%). Over the next three years, the hospital dropped its C-section rates to about 33% overall, and to 25% for low-risk births. Hoag also increased the percentage of natural births among women who previously had C-sections.

Increasing the number of natural births and decreasing C-sections results not only in lower costs, but better health outcomes for mothers and babies as well. Of course, in many cases C-sections are necessary and in the best interest of the mother and child, such as when the baby is in breech position. Over the past few decades, however, the sharp rise in C-sections has not been driven my medical necessity, but by other factors – namely, doctor time constraints.

Government agencies like the CDC and Medicaid are pushing to reduce C-sections that are not medically necessary. Non-profits, such as the March of Dimes, have launched educational programs that encourage women to wait for natural labor, and physician groups have proposed several ways to reduce C-section rates.

Hoag told The Atlantic that changing the mindset of doctors was the focus of the change. The hospital took records of each doctors’ C-section rate and shared this data with all doctors in the department. Names were not withheld, so it was evident to all who was operating far above or below average. OB-GYNs at Hoag said that knowing the hospital was monitoring C-section rates changed how they thought about their practice and discouraged them from using C-sections as a crutch.
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priority-mental-health-329644-m.jpgIn recognition of Mental Health Awareness Month, the medical malpractice attorneys at Pintas & Mullins explore how psychiatric negligence and abuse cases work. This is a unique form of medical malpractice, as patients often see their complaints dismissed or never even reported. We are here to help patients and their families struggling with psychiatric malpractice.

Psychiatric treatment is a delicate practice between doctor and patient, guided by strict guidelines. Malpractice is as common in this field as any other area of medicine, though the consequences are often much more complex. Psychiatric malpractice legal claims often include:

• Improper diagnosis and/or treatment.

• Failure to prevent patient suicide
• Failure to warn about threats to others
All psychiatrists must conduct suicide risk assessments for patients that may be suicide risks. Factors taken into consideration include age, patient history, living standards, sexual orientation, and employment, among other things. If a doctor fails to conduct one of these assessments for an at-risk patient, and that patient harms themselves purposefully, the psychiatrist may be liable.

Similarly, if the psychiatrist conducts the assessment and determines the patient is at risk of suicide, the doctor must take all steps necessary to stop this from happening. Any failure to take appropriate steps may be considered negligence.

Courts have ruled that if a patient makes remarks about harming another person to their doctor, the doctor must warn this person of the potential threat. This is a difficult situation, of course, but if someone is seriously hurt or killed by a patient who expressed premeditated thoughts, the doctor may be held liable.

Psychiatric Drug Side Effects

These cases become somewhat more complex when dangerous drugs are prescribed to patients. Many drugs meant to treat mental conditions have very severe side effects. If a patient is hurt or killed from one of these side effects, their lawsuit can be filed either against the drug manufacturer, or the prescribing physician, depending on the circumstances.

Take for example the 2014 lawsuit against the manufacturer of Paxil. A lawyer in Chicago was prescribed the antidepressant Paxil by his psychiatrist to help curb his anxiety and depression. He took the pills as prescribed for six days. On the sixth day, he committed suicide.

His widow consequently filed suit against GlaxoSmithKline, Paxil’s manufacturer, and a generic drug manufacturer. She argues that Paxil’s labelling was inadequate and misleading, and that the drug companies knew about the risk of suicide and chose to hide it from doctors and patients.

Paxil’s labels have a Black Box warning stating that the risk of suicide does not extend beyond the age of 24. The widows argued that if she and her husband had been aware that the risk of suicide extended to older patients and knew about the warning signs, they would have taken immediate action to stop taking the medication.

In some cases, however, the psychiatrist can be sued for a patient’s suicide. A high school coach in Syracuse, New York recently committed suicide after three years of taking antidepressants. His widow filed a lawsuit against his prescribing psychiatrist for negligent and low-quality care. The New York Supreme Court found his doctors negligent and held one liable for his death, awarding his widow $1.524 million.

More information on psychiatrist malpractice lawsuits can be found here.
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3684779068_384db5d411_b.jpgThree executives of the now-defunct Sacred Heart Hospital have been found guilty of a massive fraud scheme that led to serious patient harm and deaths. The executives were convicted of bribing doctors to send Medicare and Medicaid patients to the substandard, filthy hospital.

In July 2013 our medical malpractice attorneys posted on this blog that the West hospital abruptly closed following an FBI raid. Six employees were arrested at that time on charges ranging from purposefully overmedicating patients to a scheme to defraud federal health systems. Ed Novak, the hospital’s owner and mastermind behind the scheme, is now facing prison time. Two hospital executives, the former finance chief and chief operating officer, also face prison time.

The men have been convicted of bribing doctors to send patients on federal assistance to Sacred Heart, where they received grossly inadequate care at the cost of taxpayers. These patients would be driven by ambulance across Chicago, past higher quality hospitals to get to Sacred Heart.

The bribes to doctors were disguised as staffing fees, rental payments and teaching costs. In secretly recorded conversations played during trial, Novak is heard telling his staff to “cover our asses” before federal and state investigators came in.

Patient Deaths from Unnecessary Surgeries

Among the most disturbing allegations against Novak and his hospital staff includes orders to perform tracheotomies on patients that were not medically needed. Novak would urge doctors to dose patients with dangerous medications so they were unable to breathe on their own, then use this as justification to perform the tracheotomy. A tracheotomy is a surgical procedure that creates a hole through the front of the neck into the windpipe.

Some patients died from the unnecessary procedure. Novak urged doctors to do this so he could bill Medicare and Medicaid for the surgery and collect high reimbursements.
Federal prosecutors were not able to use these specific allegations during trial, but they may be able to refer to them at Novak’s sentencing hearing, which is scheduled for July 2015. He has been convicted of 27 counts of fraud and is facing five years in prison.

Government Releases Hospital Compare Fact Sheet

The Centers for Medicare and Medicaid Services has a website for public use called Hospital Compare, which provides information on quality of care. This information is collected by a standardized 32-question survey and other data collection techniques that measure patient’s own perspectives of their hospital care.

The website includes hospital ratings and comparisons to other facilities and to national or state averages. Hospitals are rated on a five-star system, with 12 different categories for each hospital. This is similar to the rating system used on the government’s Nursing Home Compare and Physician Compare sites.

This star rating system – though far from complete – gives the public a quick summary of each hospital’s quality based on patients’ experiences. It is updated each quarter, and includes categories such as: cleanliness of hospital environment, responsiveness of staff, communication with doctors and nurses, pain management, and communication about medicines.

“Satisfaction” Does not Equal Quality Care

The Atlantic recently published an interesting take on this new healthcare rating system, titled The Problem with Satisfied Patients, which outlines the problems with this new government ratings program. Not only is the government publishing results on these surveys online, but it is also basing 30% of hospital Medicare reimbursements on these survey scores.

Experts believe this will cause hospitals to steer focus away from patient health and toward patient “satisfaction.” Patients can be dissatisfied because the hospital does not carry Splenda, or because their sandwich did not have enough meat on it, translating to poorer scores for nursing care. Nurses often have to sacrifice patient satisfaction for the greater good: their life.

A national study found that patients who said they were the most satisfied on surveys were actually more likely to be hospitalized and more likely to die within four years than patients who said they were less satisfied. It’s an issue of giving patients what they need instead of what they want.
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371357299_2ab7d501a4_o.jpgA bill was recently introduced in Congress that proposes to create a safe legal harbor against malpractice suits for physicians. Medical malpractice lawyers at Pintas & Mullins express skepticism that any type of regulation could truly provide physicians a “safe harbor” from the consequences of negligent practice.

The bill – HR 1406 The Saving lives, Saving Costs Act – would allow physicians who can “prove they followed the recommended best practices” to remove their malpractice claims to federal court or other alternative dispute resolutions. According to the New York Times, the bill has overwhelming bipartisan support.

Quality of care standards are currently set by federal programs such as: Medicaid, Medicare, and the Affordable Care Act. Doctors, hospitals and their insurance companies complain that these quality standards are not accurate and should not be used to prove negligence in malpractice cases. This bill would require that quality of care and performance be measured on a scale of zero to 100. This rating would then be used in malpractice claims, instead of the federal guidelines.

The Affordable Care Act mandated quality metrics that doctors and hospitals fear open them up to more malpractice liability. Quality metrics include requiring doctors to report data that assess the quality of care they provide, such as questions about how they counsel patients to quit smoking or how many of their patients develop infections after surgery.

Health care providers fear that these new metrics will be used in court to prove negligence or sway jurors. It is unsurprising, then, that nearly all hospitals, insurance companies, and physicians passionately support the bill.

Many experts believe, however, that prohibiting lawsuit claims based on federal malpractice guidelines does not make sense. These standards are there for very good reason: to indicate what reasonable medical care is. Jurors, patients and doctors should want to take these standards into consideration.

Consequences for Nursing Home Residents

Consumer advocates are also expressing concern about the bill. A lawyer for the AARP called the bill “troubling,” and The National Consumer Voice for Quality Long-Term Care said the bill would make it more difficult for nursing home residents to prove a facility violated federal standards.

The repercussions of this bill could be devastating for elderly Americans. The nursing home industry is in dire need of reform, and at present, one of the only ways for abused, neglected and mistreated nursing home residents to gain justice is through lawsuits. The majority of nursing homes are run by for-profit corporations, which under-staff facilities just to boost profits, among other dangerous cost-cutting measures. Like any other big business, they respond only to cash incentives- i.e. large settlements and verdicts – to reform. This is the best, most effective, most efficient way to protect residents from further harm.

State and federal inspection reports are a crucial aspect of these cases. Violations of federal standards are major indications that something is wrong in a nursing home and illuminate why and how residents are being injured. If the injured are not able to cite these violations in court, it could undermine the most important system there is to protect our most vulnerable citizens.
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