C-Sections and Malpractice during Childbirth

May 14, 2015

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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How to Pursue A Psychiatric Malpractice Claim

May 4, 2015

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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Chicago Hospital Owner Guilty of Schemes to Harm Patients

April 23, 2015

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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House Bill Proposes Malpractice Suit Guidelines

April 2, 2015

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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MDVIP Hit with $8.5 Million Malpractice Verdict

March 30, 2015

the-stethoscope-31.jpgThe country's largest concierge medicine firm, MDVIP, was recently hit with an $8.5 million jury verdict in a medical malpractice case. This verdict is the first against any concierge management firm, a relatively new phenomenon in healthcare. Medical malpractice lawyers at Pintas & Mullins explain this case and how similar firms could be found liable for negligence.

There are several models of concierge healthcare, from basic to comprehensive<:

1. Travel medical assistance, which connects consumers to operators if they are hurt or sickened abroad.

2. Private health advisories, which helps with complex disease management, electronic medical records, comprehensive physical exams, and access to second opinions.

3. Private physician practices, which provides consumers with a 24-hour physician with higher levels of personal interaction.

4. Total care platform, which includes all the above-mentioned services in addition to other services, like immediate telediagnosis and treatment.

These concierge firms were created for consumers with a little more money to spend to bypass public healthcare systems. Doctors often prefer these firms because they give them greater control over their practices and because they can benefit financially.

Doctors are not directly employed by concierge firms; instead, doctors pay the firm a per-patient stipend (for things like marketing, legal and branding) and are paid by patient membership fees and insurance revenue.

MDVIP was founded 15 years ago by Procter & Gamble and charges members $1,500 to $1,800 per year for "exceptional care and fast access to all types of physicians." The firm contracts nearly 800 doctors in more than 40 states. All doctors with MDVIP are limited to serving 600 patients - compared to 2,000 - 3,000 for doctors in traditional healthcare systems - and they must be available 24/7 for their patients.

The lawsuit was filed against both MDVIP and the individual doctor, Charles Metzger, by the widower of the deceased Joan Beber. Beber sought medical attention for leg pain and was repeatedly misdiagnosed by Metzger and other MDVIP staff. She was referred to several orthopedists, who were not told that her symptoms were worsening and did not receive her medical records from MDVIP.

Had the orthopedists received her medical records and progression information, they likely would have discovered that she had a very serious circulation problem. No one caught the problem until it was too late, however, forcing Beber to have her leg amputated above the knee in 2008. She died four years after the amputation, from leukemia.

Metzger settled with Beber's family out of court before the case went to trial. Ultimately, the Florida jury found MDVIP liable for the doctor's negligence and misdiagnosis. The jury also found that MDVIP was falsely advertising its services and healthcare as exceptional.

This case is important because it was the first confirmation that concierge firms may be found liable for the care provided by contracted doctors. It also confirms that concierge companies must be more cautious about how they advertise their services and market their doctors.

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Most Patients Overestimate Benefits, Underestimate Harms of Medical Care

March 5, 2015

8674734838_ac23a222ba_c.jpgA new study - the first of its kind - reviewed the medical literature on patient's expectations of the benefits and harms of medical treatments, with surprising results. Medical malpractice lawyers discuss this study and how it reflects patient safety in the United States.

The study, Patients' Expectations of the Benefits and Harms of Treatments, Screening, and Tests was published in one of the most esteemed peer-reviewed journals in the world, JAMA Internal Medicine. Researchers analyzed more than 30 studies wherein patients were asked whether or not they understood the pros and cons of certain treatments.

Most of the time, patients had no idea what the benefits and risks of their treatments were: on average, 65% of patient overestimated any given treatment's potential gain.

For example, one of the studies involved women who had undergone a double mastectomy. Researchers asked these women to estimate how much the surgery reduced their risk of breast cancer. On average, the women estimated it would reduce their risk by about 65% - a gross overestimation.

Another study asked patients to estimate the pros of bowl and breast cancer screening. 90% of patients overestimated the benefits of breast cancer screening, and 94% overestimated the benefits of bowl cancer screening.

This pattern repeats over and over, from studies on the benefits of drugs to treat cardiovascular disease to hip fractures. The same was found when looking at studies that measured how much harm was being done to patients. One of these asked patients to estimate the risks of a CT scan. More than 40% underestimated how much radiation is involved, and 60% underestimated the risk of cancer from CT scans.

For the record, a single CT scan exposes patients to the same amount of radiation as 300 x-rays, and carries a 1 in 2,000 risk of inducing a fatal cancer.

The crux of the issue is that patients are severely under-informed about the risks they are taking during medical care. The fault partially lies in a lack of doctor communication, but also in the lobbying of drug and medical device companies. Watch any drug commercial and you will hear the benefits overstated, without any real data backing it up, and the risks swept under the rug.

If patients knew about the actual risks and gains of medical care, they would choose to have less of it. This threatens doctors, medical companies, and Big Pharma, which all have extraordinary lobbying power. Keeping patients in the dark about treatments adds to healthcare spending without effectively treating people. It's time we do something to change that.

Doctors and Big Pharma Working Together at Cost of Patient Safety

One of the leading voices in patient safety, Dr. Chuck Denham, recently agreed to pay $1 million in a settlement with the Justice Department. Denham is accused of taking illegal kickbacks from a drug company to promote its products in national health quality guidelines. Unfortunately, these types of doctor kickbacks are incredibly common.

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Suspended Psychiatrist Charged with Writing Prescriptions

February 9, 2015

rosy-glasses-crimson-pills.jpgA psychiatrist in Pennsylvania was recently charged with writing prescriptions and taking patients while his medical license was suspended. Medical malpractice lawyers at Pintas & Mullins are currently investigating cases of injury or death from negligence physicians and dangerous drugs.

The psychiatrist, Jospindar Harika, will be prosecuted for Medicaid fraud and theft and be subject to a federal investigation. Dr. Harika was a contractor at three mental health clinics in Berks and Philadelphia counties, and saw hundreds of patients while his license was suspended in 2012.

He wrote over 450 prescriptions during that time, billing Medicaid about $60,000. The grand jury in his case stated that his psychiatric notes were illegible, did not provide adequate treatment for patients with substance abuse or traumatic histories, and overlapped session times in his Medicaid billings.

In 1997, Harika plead guilty to billing more than $84,000 to the Somerset State Hospital for services he never performed. He was convicted of the felony, serving four years of probation and fines. Then, in 2012, Harika was charged with failing to pay child support in a divorce and custody case, resulting in about one month of medical license suspension. It was during that time, in March 2012, that he illegally saw and prescribed psychiatric patients.

Psychiatric Medical Malpractice

Psychiatrists are responsible for prescribing and monitoring pharmaceuticals that are often incredibly powerful and quite dangerous. Because they are responsible for diagnosing and treating serious mental disorders, malpractice and negligence can be difficult to pinpoint.

Medical malpractice lawsuits, regardless of the discipline, must involve serious harm done to the patient, not just a feeling of being wronged or unfairly treated. Generally, successful malpractice claims must have four elements:

1. There was a confirmed doctor-patient relationship.

2. The doctor failed to provide reasonable care to the patient. All doctors have a duty to provide the best, most practice medical care they are able.

3. Serious harm must have occurred. This can include physical injuries such as fractured bones or developed health conditions, or devastating emotional injury.

4. A link between the doctor's negligence and the patient's injury. In legal terms this is called "proximate cause," and is often the most difficult to prove. Particularly in complex psychiatric cases, there may be many intervening factors that would influence the injury or doctor's duty of reasonable care. Cases of suicide, for example, can be difficult to prove on these grounds.

Since cases of medical malpractice are so unique and depend entirely on specific circumstances, it is best to get in contact with a malpractice attorney as soon as you are able. A large amount of psychiatric malpractice cases center on the negligent prescription or improper monitoring of prescription medications.

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Amputee Awarded $3.1 Million in Malpractice Case

February 5, 2015

wheelchair-access-1.jpgA former Illinois police lieutenant was awarded $3.15 million in his case against the doctor who negligently amputated his leg. The incident occurred at Rockford Memorial Hospital in 2010, when the victim was admitted for dizziness and suspected stomach bleeding. Medical malpractice lawyers at Pintas & Mullins further explain this case.

The former Loves Park lieutenant, Donald Johnson, was 65 years old when he was admitted to the hospital. He had a history of vascular disease in his lower extremities, and showed signs of injury on his lower left leg. Dr. Mark Zarnke was the physicians on his case, who applied a special gauze bandage known as the Unna Boot to Johnson's leg for five days.

Previous testing showed that Johnson had just 41% blood flow to the leg, and the Unna Boot is designed to decrease the blood flow to the lower leg. After the boot was removed five days later, Johnson's leg showed signs of tissue death requiring amputation below the knee.

Dr. Zarnke is a general surgeon, however he failed to offer any surgical options to restore the blood flow to the victims leg and never consulted a vascular surgeon to treat him. Johnson and his family consequently filed a medical negligence claim against Zarnke and his employer, Surgical Associates of Northern Illinois.

In his suit, Johnson states that he should not have been given the Unna Boot because the blood flow to his leg was already decreasing. The trial lasted two weeks and the jury took less than five hours to make their decision. The jury awarded Johnson $3.157 million for current and future medical bills, pain and suffering, permanent disfigurement, and other damages.

Birth Injuries and Medical Malpractice

The largest medical malpractice in Winnebago County was $10.23 million, awarded in 1996 to a woman who suffered injuries at the same hospital as Johnson. The victim in that case was admitted to Rockford Memorial Hospital while pregnant, and was discharged despite leaking amniotic fluid (the liquid surrounding the fetus).

The day after leaving the hospital, the woman delivered a daughter with brain damage and cerebral palsy. She filed suit against the hospital, claiming her daughter's condition was caused by inadequate medical care before birth.

Unfortunately, birth injuries like cerebral or erb's palsy are quite often the result of medical negligence or malpractice. Gynecologists and obstetricians have among the highest malpractice premiums of all types of specialists (premiums refer to a function of the expected cost to insure a doctor against malpractice lawsuits). Premiums are highest for doctors with the highest risks of having suits filed against them.

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Doctor Arrested for Unnecessary Surgeries and Patient Deaths

December 10, 2014

5342749335_f92b5d34c1_o.jpgA doctor in Michigan is currently facing 100 years in prison on federal charges for deceiving patients, fraudulent billing, and even the death of a patient. Medical malpractice attorneys at Pintas & Mullins report on this case and others like it throughout the country.

The neurosurgeon, Aria Sabit, surrendered his medical license in California in 2013 after a series of accusations very similar to those he is now charged with in Michigan. He performed 200 unnecessary surgeries in California, resulting in dozens of lawsuits, infections, permanent injuries, and at least one patient death.

After injuring patients in California Sabit moved his practice to the Detroit-area, continuing to botch surgeries and bill Medicare for millions of dollars of services promised but not provided to patients. One of these victims, Tonocca Scott, was recently profiled by the Washington Times.

In the profile, Scott details his encounter with Dr. Sabit, describing him as having "swagger off the charts." Scott suffered from bulging discs in his spine and agreed to undergo surgery by Sabit. About a year after that surgery, Scott is now in worse shape than ever, wearing a back brace and taking painkillers constantly.

Scott was promised a spinal fusion surgery, which would have healed his bulging discs and relieved his pain. Looking at his medical records and x-ray images of his back, doctors have found that this surgery was never performed. There are four other patients in Michigan who have come forward with similar stories, but the FBI believes there are many, many more.

This is the basis of many allegations against Sabit. According to federal reports, Sabit submitted $32 million in Medicare and Medicaid claims throughout his Michigan tenure, enjoying $1.8 million in profits. Like Scott, most patients never received the promised medical devices, though Sabit billed the government for them.

We recently reported on a bankrupted company that manufactured fake screws that were implanted in for several years, causing devastating injuries. The company, Spinal Solutions, manufactured mixed in their own hardware with medical-grade screws to be sold to surgeons like Sabit. Unknowingly, doctors who ordered medical hardware from Spinal Solutions incidentally implanted toxic knockoffs in patients, many of whom suffered serious consequences.

For the most part, these practices that jeopardized patients' health were done to increase the profits of one or two people. This type of greed is not only illegal, but puts everyone at risk of serious, life-changing consequences. Healthcare fraud is exorbitantly common and most often caught by private citizens who notice unsavory practices and report it.

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Injuries from Medical Mistakes and the Need for Reform

November 25, 2014

surgeons-1.jpgHundreds of thousands of patients in United States hospitals die from medical mistakes every year. There are no indications that injuries or deaths from malpractice are declining, either. Medical malpractice lawyers at Pintas & Mullins illuminate recent studies from the country's top medical experts who are trying to enact fundamental change to protect patients.

Researchers at Johns Hopkins University School of Medicine recently published a report finding that patients who suffer medical mistakes rarely get an apology or even an acknowledgement from their doctors. They also found that, when officials did acknowledge the harm done to patients, it was often only because they were forced to.

About 30% of injured patients paid medical bills resulting from malpractice, with an average cost of over $14,000. Researchers guessed that, although doctors would like to be more open with their patients, they lack the moral courage to do so. The authors recommended that medical schools and training programs start introducing skills on how to best inform patients when mistakes are made.

Others in the field recommend similar alternative approaches to help curb medical injuries. In the past, medical malpractice issues have been left largely up to legislative bodies, with tort reform laws and limits on the amount of damages patients can collect. Since there is no evidence that injuries and deaths from malpractice are declining, alternative are obviously needed.

Perfect Time for Reform

A new analysis in the Journal of the American Medical Association found that now may be the perfect time for alternative malpractice reform. Among these include communication and resolution programs, apology laws, judge-directed negotiations, and administrative compensation systems.

The goal is to have serious medical errors trigger a process that effectively allowed healing and learning for both doctors and patients. Unfortunately, the current process does not typically allow patients or doctors to grow positively from a malpractice event. Doctors resent the legal framework that forces them to practice defensive - instead of preventative - medicine. Meanwhile, patients continue to be injured in ever-increasing numbers, without any type of acknowledgement or apology afterwards. Often, all they want is an "I'm sorry."

The malpractice system must address two core issues: compensating patients wrongly injured, and deterring substandard medical care. The current system is mediocre at best, and relies almost exclusively on tort reform, which creates barriers to bringing malpractice lawsuits, limits the amount injured patients can recover, and changes how damages are paid.

About 30 states have passed laws placing a cap on the maximum amount patients can recover in malpractice lawsuits. This not only does not solve the problem, but further harms those patients who have already been injured. There are about seven types of nontraditional malpractice reforms in the works:

1. Communication and resolution programs - after an error is made, doctors discuss the problem directly with patients, seek resolution, offer apologies, and potentially offer compensation.

2. Administrative compensation systems - malpractice claims route to a system that uses experts, evidence-based guidelines, and compensation standards to offer patients resolution.

3. Safe harbors - laws that protect doctors who can prove they followed best-practices guidelines for the injured patient.

4. Mandatory pre-suit notification laws - injured patients would be required to give medical officials advanced notice that they intend to sue.

5. Judge-directed negotiations - patients and doctors meet with a judge who will guide them toward settlement with assistance from nonpartisan legal advisors.

6. Apology laws - any apology or admission of fault by a doctor or hospital would not be permissible to use in malpractice lawsuits.

7. State-facilitated dispute resolution laws - patients and doctors would voluntarily work with a state-appointed agency that would help resolve conflict, which may not be used in trial.

Continue reading "Injuries from Medical Mistakes and the Need for Reform " »

California Voters to Decide on Long-Awaited Medical Malpractice Bill

November 4, 2014

your-vote-counts.jpgIn today's election, voters in California will be asked to approve or deny a proposition that will affect every person and family in the state. Anyone - rich or poor, male or female, young or old - can be the victim of medical mistakes, and hundreds of thousands of Americans die every year from medical negligence. It is time for Californians to pass this measure, to protect their rights and safety. The medical malpractice lawyers at Pintas & Mullins respect the opinions of all our clients and readers; we merely wish to illuminate an issue blurred by special interest groups.

Proposition 46 will require mandatory drug and alcohol testing for doctors who work in hospitals, create a state database to track painkiller prescriptions, and, after decades of stagnation, raise the medical malpractice payout cap for pain and suffering. This last measure is the most critical piece of legislation.

Like many other states, California places a cap on the amount victims can receive in non-economic damages from malpractice lawsuits. Currently, this cap is set at $250,000, which was established in 1975, and has never risen to account for inflation. Non-economic damages are awarded to injured victims to compensate them for things that cannot easily be measured by dollar amounts, such as psychological impact of disfigurement, loss of enjoyment of life, emotional effects of losing a family member, and the pain and suffering inflicted upon them by medical negligence.

To better understand how the affects real California families, take for example the family profiled in one of our posts from this blog, the Jeffers family. Four years ago, Malyia Jeffers suffered an infection that spread throughout her body, ultimately requiring amputation of her legs and hands. The infection spread so severely because doctors at the Sacramento clinic her family took Malyia to did not make time to see her, delaying for hours until it was too late to save her limbs. She was just two years old at the time.

Malyia now requires 24-hour care, and will need continued care for the rest of her live. Like the majority of families, the Jeffers had no way of paying for this immense cost, and filed a lawsuit against the hospital for their malpractice and negligence. The Jeffers were only able to receive $250,000 because of the medical malpractice cap, which will do very little to help them pay for an entire lifetime of care.

Opposition Campaigns

Several organizations have come out with extraordinarily well-funded opposition campaigns against Prop 46. Critics assert that increasing the non-economic damage cap would cause healthcare providers to pay more in insurance premiums, transferring costs to patients, or causing doctors to leave the state. These are merely scare tactics, and are not upheld by evidence.

This is a common assertion among opponents of victims' rights, and in no case does it turn out to be true. Many states have raised their malpractice caps in recent years, and doctors remain. Any physician in good standing, who does their best to practice in good faith, would not want negligent doctors creating liability and endangering the public, including their friends and family. It is that simple.

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Hospitals to Release Medical Mistake Data

September 10, 2014

12134671045_b3dbbf9f31_c.jpgEarlier this year the Centers for Medicare and Medicaid Services (CMS) stopped publically releasing mistakes made in hospitals, despite saying it would not do so. After public outcry CMS relented, stating it would again release the information by the end of 2014. Medical malpractice lawyers at Pintas & Mullins cannot overstate how important it is to have this information available to the public, both for patient safety and to keep hospitals and doctors accountable.

Among the information retracted related to eight types of hospital-acquired infections, which affect at least one of every 25 patients, and kill more than 75,000 people every year. Some of the most deadly infections spreading in hospital are:

• Clostridium difficile, or c.diff
• Bloodstream infections, such as sepsis
• Surgical site infections
• Catheter-associated urinary tract infections

CMS also stopped reporting how often doctors leave foreign objects in patients during surgery, when patients are given the wrong blood type, and other egregious medical mistakes that should never occur. These rare events that should never happen in hospital are referred to as 'never events' and rare as they are, they are critically important for consumers to know about when choosing a hospital or physician.

Why is Hospital Transparency so Critical?

There has been much media coverage recently on the safety and price comparisons between hospitals - specifically, how significantly they can range. Hospital pricing is extraordinarily convoluted and the largest driver of medical care inflation. This isn't news. The New York Times ran an 8-part series starting in June 2013 titled "Paying Till It Hurts: A Case Study in High Costs." The series covers eight different types of patients, from pregnancy to E.R. visits, attempting to uncover why the U.S. spends more money on healthcare than any other country in the world by far.

Nowhere is this more obvious and outlandish than in the pharmaceutical industry. Due to the never-ending aggression of the pharmaceutical lobby, the average price for a cholesterol drug like Lipitor in the U.S. is about $124. In nearly all other developed countries, the price of Lipitor averages around $6. Several studies conclude that, despite the large difference in pricing, Americans do not receive better medical care than patients in other developed countries.

That is another blog for another time. What this is meant to prove is why it is so incredibly important for patients to have access to medical data. In an opaque market with even more opaque pricing practices, patients need to research the hospitals they are considering for surgeries, births, and even vaccinations. This rings particularly true for elective surgeries, such as hip replacements, for which the average U.S. price is more than $40,000.

In a system where patients do not see prices (and are often told to "not worry about the money,") until after the service is provided, data on past pricing and quality is invaluable. Between doctors, hospitals, medical companies and insurance providers, very rarely is anyone looking out for the best value for the patient; in fact, all of these entities have incentives to drive up prices. This means that patients must look out for themselves, and the only way they can do that is if medical care data is publically available.

"Never Events" Actually A Daily Occurrence

Another so-called never event, leaving foreign objects in patients, actually occurs about a dozen times every day in the U.S. This can occur during any type of surgery, and most often involve the cotton sponges doctors use to soak up blood. The sponge may be small, but it can cause a host of serious health issues, from permanent loss of intestines to death. The average amount of a hospitalization caused by a lost sponge averages over $60,000.

One victim was recently interviewed by USA TODAY: Erica Parks underwent a cesarean section in 2010 and left the hospital with a queasy feeling in her stomach. One month later, she was swollen and her bowels shut down entirely. She was sent to the ER, where X-rays showed a large infected sponge left in her abdomen requiring a six-hour surgery to remove followed by three weeks in the hospital.

Making matters worse, there is no federal requirement for hospitals to report such mistakes, despite reports that foreign objects left in patients was in the most serious category of medical mistakes. This type of mistake is completely preventable, yet it continues to consistently occur every single day. While there are numerous technologies that exist to cut the likelihood of this type of mistake, few hospitals (less than 15%) actually employee them.

Continue reading "Hospitals to Release Medical Mistake Data " »

Oral Cancer and Medical Malpractice

August 15, 2014

4747536941_b5435b1df0_b.jpgThroughout the country, patients are being diagnosed with oral cancers that should have been detected by their dentists. Overall, these patients are diagnosed at a young age, and suffer poor outcomes in their cancer treatment. Medical malpractice lawyers at Pintas & Mullins dive deeper into this issue and how unsuspecting Americans are being victimized.

Many different types of cancer can fall under the category of 'oral' including tongue, tonsil, throat, esophageal, and mouth. More than 43,000 Americans are diagnosed with oral cancer every year, and this number is only increasing. Most oral cancers are caused by one of three factors:

1. Excessive or long-term tobacco or alcohol use
2. Exposure to the HPV-16 virus (also the cause of cervical cancer in women)
3. Exposure to asbestos

About 7% of those diagnosed, however, have no identifiable cause other than genetic predisposition. Unfortunately, oral cancers are extremely hard to treat and therefore extraordinarily fatal when not caught early - about 43% of late-stage patients pass away within five years of diagnosis.

This is why early detection is so important, and such a critical responsibility for dentists and other medical practitioners. Dental professionals are the first line of defense against detecting and confirming oral cancer. Most Americans see a dentist every year, if dentists performed cancer screenings for their existing patients, it would allow thousands of cancer cases to be caught early.

The public can relate this to the importance of getting regular PAP smears, prostate exams, and mammograms, and how this has positively impacted early detection rates in the U.S. Current studies show that less than 15% of dental patients report having an oral cancer screening at their last checkup.

Medical Malpractice Lawsuits by Cancer Patients

One particular study by the University of Nebraska Medical center analyzed medical malpractice litigation in the U.S. Researchers looked at patients diagnosed with oral cancer who consequently filed malpractice lawsuits as a result of their diagnosis and treatment. They used data from jury reviews between 1984 and 2000, choosing about 50 cases to analyze.

Among the cases, researchers noticed that the average age of plaintiffs was relatively young (45 years), and nearly half died from the disease. Generally, the younger plaintiffs had better outcomes and won higher awards compared to older plaintiffs. The average jury award for younger plaintiffs was just over $755,000, while older plaintiffs averaged just shy of $500,000.

In 43 of the 50 analyzed cases, dentists, general practitioners or otolaryngologist (ear, nose and throat doctor) were accused of failing to diagnose the cancer. Other common allegations were failing to perform biopsies and failing to refer patients to oncologists. Ultimately, researchers recommended that medical professionals should set risk management goals to prevent delays in diagnosis.

In addition to early detection, public awareness is arguably the most important aspect of early detection. Speaking for hypochondriacs everywhere, it is easy to misdiagnose every lesion and abnormality as "cancer," however, oral cancer is actually quite difficult to detect. Most people have some type of oral conditions, such as cold sores, wounds and sores that can mimic pre-cancerous tissue.

It is important to remember to watch these areas over time. Any type of abnormality - whether it be a sore, irritation, swollen tissue, discoloration, or hoarseness - that does not resolve within two weeks should be examined further. Patients should notify their dentist, who should conduct a thorough cancer screening.

Continue reading "Oral Cancer and Medical Malpractice" »

The Problem with Children's Emergency Care

July 21, 2014

my-brave-boy.jpgAmerican parents expect the treatment their children receive - whether it's at school, day care or at the hospital - to be the best, most compassionate care. Unfortunately, the majority of doctors working in emergency care units have had only minimal experience, an average of four months, working with children. Medical malpractice attorneys at Pintas & Mullins further explain this problem and how American children are suffering the consequences.

Children are three times more likely to suffer a serious medication error than adults. Clinically, children are not just 'little adults.' Their metabolic rates are completely different, so medications dissolve at faster rates. Children often have undiagnosed allergies, and doses need to be adjusted for weight and other factors.

To help combat this, some hospitals are hiring staffs of full-time pharmacists in the ER to reduce medication errors and adverse events. Medication errors contribute to approximately 7,000 deaths in the country every year, and are particularly dangerous in children. The Children's Medical Center in Dallas, for example, was recently profiled on NPR for hiring ten new 24-hour pharmacists who specialize in emergency medicine.

The overriding issue, however, is that emergency room doctors are often young with little experience. Millions of children visit the ER each year, however, only one in ten children are able to see doctors with any real experience in pediatrics. The remaining 90% of kids are treated in general ERs, such as at community hospitals, where just four months of training in pediatrics is required.

Statistically, about 30% of ER patients are children; however, the education doctors receive in pediatrics represents less than 10% of their training. In 2006, the Institute of Medicine released a report titled "Emergency Care for Children: Growing Pains." In this report, the Institute describes the unique challenges facing emergency departments in their treatment of children.

Researchers involved in this project found that many general ER physicians feel much more stress and anxiety when caring for pediatric patients compared to adults. Too often, this causes doctors to under-treat and fail to stabilize children who are critically ill. Unlike adult patients, there are no established patterns for treating children in the ER, which leads to a wide array of treatments that may not always work.

Change is Coming

Fortunately, there are concerted efforts throughout the country aimed at fixing this problem. One of these programs, Improving Pediatric Acute Care Through Simulation (ImPACTS), conducted 200 fake pediatric emergencies in 25 emergency departments, the majority of which were in community hospitals. Their findings were alarming to say the least.

Among treatments for pediatric septic shock, only 13% of general emergency departments were compliant with treatment guidelines for children - compared to over 93% of pediatric EDs that were in full compliance. Community hospitals also showed severed deficiency in delivering life-saving fluids and blood pressure medications to children, and were much less likely to administer correct doses of other drugs or comply with other pediatric guidelines for life-threatening conditions, such as cardiac arrest.

So what can be done? Experts agree that doctors need to receive more education regarding pediatric emergency care in their formal training, including mandatory continued education for emergency medicine residents targeted specifically toward pediatrics. There has also been immense effort put into incorporating functioning partnerships between community hospitals and children's hospitals. Collaborations of this kind will allow constant information exchanges, including educational forums, emergency consultations, and opportunities for continued pediatric emergency medicine.

Continue reading "The Problem with Children's Emergency Care" »

Florida Wrongful Death Compensation Caps Reversed

July 2, 2014

8572607587_fff58574bf_c.jpgFlorida's Supreme Court recently struck down the state law limiting the amount victims of medical malpractice can collect for non-economic damages in cases of wrongful death. The original case was filed by the family of an Air Force pilot who died from complications while giving birth. Wrongful death lawyers at Pintas & Mullins take a closer look at this case, and what it means for Florida plaintiffs.

The pilot, 20-year-old Michelle McCall, was under the care of Air Force family medical personnel when she passed away, leaving her family not only with an immense loss, but significant medical bills and a newborn son without a mother as well. They filed suit against the medical unit, hoping to receive compensation for her wrongful death.

A Florida District Court determined that the family's financial losses amounted to over $980,000, and their non-economic damages (for grief, pain and suffering, and loss of a mother and daughter) totaled $2 million. Based on a Florida Statute, the court then limited the non-economic damages to $1 million, which was the cap for all wrongful death medical malpractice cases, regardless of circumstance.

The family appealed to the state's Supreme Court, which determined that putting a cap on the non-economic damages irrationally impacted situations, like McCalls, where there were multiple claimants. The Court further stated that the damage cap made it unlikely that those who suffered a devastating loss (or in cases where there are multiple survivors), the claimants would be not be fully compensated for their losses at $1 million.

Why Put Limits on Damages At All?

Proponents of placing caps on non-economic damages argue that placing limits on the amount plaintiffs can collect will reduce the amount of doctors' insurance, thus encouraging doctors to practicing in the state (conversely, higher malpractice insurance would deter physicians from working in the state). Despite years of politicians claiming this to be so, historical data tells us that non-economic damages caps in no way influence where a doctor will work.

This point was reaffirmed by the Supreme Court, when it noted that the number of physicians practicing in Florida actually increased during a recent period when juries were awarding large amounts to plaintiffs. The Court stated that the caps arbitrarily reduce the rights of medical malpractice victims.

In a case like McCall's where there are multiple claimants (her son, her parents, and her son's father), the $1 million would have to be split between all of them. This unjustly prevents all claimants from receiving compensation for their losses. What's more, the basis of these damage caps is largely irrational, as the relationship between non-economic awards and medical malpractice insurance is unfounded.

The Supreme Court wrote in its opinion that Florida's damage cap has the effect of saving a modest amount for many (the state's doctors) by imposing devastating costs on a few (those most severely injured). These grievously injured plaintiffs are subjected to division and reduction of their damages not based on the merits of their case, but simply because of the existence of this cap.

This Supreme Court decision was groundbreaking in many ways. First, and most importantly, it struck down statutory caps on non-economic damages in malpractice cases that resulted in a wrongful death. This means that those bringing malpractice lawsuits based on personal injury in general -where no death was involved - will still be subject to damages caps.

Continue reading "Florida Wrongful Death Compensation Caps Reversed " »