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.

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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.

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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.

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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.

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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.

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Trouble at VA Hospitals Nationwide

May 15, 2014

5451372776_cb3fcbee8d_b.jpgFederal authorities are conducting a nationwide review of all VA facilities, though the Hines VA Hospital in Chicago is being singled-out after a whistleblower exposed fraudulent activity resulting in harm to patients. Medical malpractice lawyers at Pintas & Mullins dig deeper into this story and how patients have been affected.

The whistleblower was a social worker at Hines and alleged that a hospital executive - a man who is already under a cloud of suspicion - implemented a "secret waiting list" similar to schemes in other VA hospitals in the country. This waiting list kept names of veterans who were to be denied treatment in a scheme to hit fast treatment goals and collect bonuses.

This prevented hundreds, even thousands of veterans who were seriously ill or dying from getting the treatment they desperately needed. Veterans waiting for physical or mental treatment were forced to wait for weeks and even months, so executives could reap in bonuses.

Local Chicago veterans are devastated by this news, which demonstrates the utter lack of respect in hospitals designated to serve those who once risked their lives for our country. U.S. Attorney General Eric Holder, in response to this federal scandal, stated that the allegations, if true, are unacceptable and being taken very seriously by federal auditors. One local veteran stated that he typically has to wait one to four months for an appointment.

Illinois Senator Mark Kirk stated that the Inspector General, who is already conducting investigations in other VA hospitals accused of keeping similar lists, should immediately investigate Hines VA and provide a report as soon as possible. There will be Senate hearings on secret VA lists beginning Thursday, May 15, 2014, in Washington D.C.

Hines Hospital serves over 50,000 veterans every year. This scandal is not contained to Chicago - VA officials in Texas are concerned that some veterans passed away while waiting for treatments. Similar accusations are directed at the VA hospital in Phoenix, where about 40 veterans have died awaiting treatment and three executives are on administrative leave. Scandal is also stirring at the VA clinic in Fort Collins, Colorado.

Whistleblower Exposes Fraud

The Chicago whistleblower told reporters that employees were coming to her from almost all departments of this hospital, including surgery, inpatient, radiology, and outpatient, regarding the lists. When veterans called for an appointment, instead of logging their names into the computer system for the next available time, the patients were put on secret waiting lists, only formally booking them when an appointment came up within the VA's goal time of 14 days.

This was done because the VA grants bonuses to executives and doctors partly based on short wait times. Thus, patients were secretly waiting on these unofficial lists, to conceal delays in care to make Hines' numbers look better, and to collect cash rewards. This incentive program for 14 day wait times was implemented in 2011.

Many believe this practice is more widespread than just a handful of VA hospitals. The VA Secretary, Eric Shinseki, will be the first to testify during the Senate hearings this morning. Lawmakers are well aware that the VA is operated as a bureaucracy that often moves much too slowly, to the demise of its veteran patients. Shinseki recently ordered in-person audits of the scheduling systems at all VA medical centers in the country.

Continue reading "Trouble at VA Hospitals Nationwide" »

New Study Confirms 440,000 Deaths from Medical Negligence Every Year

May 12, 2014

the-stethoscope-31.jpgFor many years, the federal government asserted a very conservative 98,000 Americans were killed each year by preventable medical errors. New studies are finding what many experts know to be true - the number is actually much, much higher. In fact, around 440,000 Americans are killed annually by physician, hospital or nurse errors. Medical malpractice lawyers at Pintas & Mullins dive deeper into these studies and why so many are killed my negligence.

The study was recently published in the Journal of Patient Safety and was conducted to update decades-old data and official opinion on patient deaths caused by error. The Institute of Medicine and medical professionals constantly state that less than 100,000 Americans die annually from medical errors, however, that estimate is based on data from 1984.

Researchers involved in this study compiled medical records and studies published from 2008 to 2011, ultimately finding that the true number of premature deaths associated with preventable harm to patients was over 440,000 per year. The amount of serious harm, but not death, done to patients was about 10 to 20 times more than this.

Those involved in this study called the prevalence of preventable medical errors an epidemic, and we hasten to agree. The reality of medical negligence needs to be taken much more seriously and publicly known if it is going to be reduced or curtailed in any way.

There are several interventions hospitals, patients and medical professionals can take to help lessen the frequency of medical errors. Among these include fully engaging patients and their families during hospital care, transparent and full accountability when mistakes do occur, systemically engaging with patients to identify precise injuries, and purposefully correcting the root of harm.

Medical errors cost our country tens of billions of dollars every year, yet federal and state legislatures limit accountability of doctors and place maximum amounts patients can receive from malpractice lawsuits. Not all states place damage caps on malpractice suits, but the ones that do (most notably California) leave patients at risk for more injuries from negligent care.

One in Three Hospital Patients Experience Medical Errors

One study published in the Archives of Surgery estimates that serious surgical mistakes occur about 40 times per week in U.S. hospitals. Serious surgical mistakes involve procedures performed on the wrong patient, on the wrong body part, or incorrect surgeries performed. These are also often referred to as "never events," because they should never occur in medical practice.

Medical care in the U.S. is extremely complex at all levels, and individual physicians generally do their best to optimize patient care. Guidelines and clinical research on how to apply optimal patient care quickly becomes out-of-date and is often biased, and the continuing education system for doctors is lacking. These among other factors are contributors to the knowledge and performance deficiencies in hospitals.

Patients can suffer injuries from medical errors immediately, or delayed for months or even years. For example, a patient may be injected with a drug using a needle contaminated by a harmful virus, like Hepatitis C, which may not be discovered until much later.

Continue reading "New Study Confirms 440,000 Deaths from Medical Negligence Every Year" »

Deadly New Orleans Outbreak leads to Questions on Hospital Safety

April 29, 2014

pediatric-polysomnogram.jpgSeveral children have died at the Children's Hospital in New Orleans after a horrifying outbreak of a flesh-eating fungus. The infectious fungus was spread by bed linens, towels and gowns, and new reports are raising serious questions about how the infections originated and why nothing was done to stop it for nearly a year. Medical malpractice lawyers at Pintas & Mullins look into the serious and dire issue of hospital-acquired infections.

The details of the deaths at Children's Hospital are gruesome. The first victim was a premature infant in the ICU who suffered an open wound from his groin to his abdomen. The most recent victim was a ten-year-old, who died with her face wasted away almost completely.

Other patients were forced to undergo dozens of surgeries to try to save their small bodies from the flesh-eating infection known as mucormycosis. The invasive fungal infection has an extraordinarily high fatality rate and primarily affects patients with compromise immune systems.

It took ten months after the death of the first victim for doctors to connect the dots between fatalities. Medical researchers identified the hospital's bed linens as the source that carried mucormycosis throughout the facility, where it came into contact with vulnerable patients and killed them between August 2008 and July 2009.

According to investigations, the infections went undetected for so long because of defects in the hospital's infection controls and negligent handling of contaminated linens. Hospital workers would clean all linens on the same dock where medical waste was removed, would transport both clean and dirty linens on the same carts, and store linens in hallways covered in debris from construction.

Hospital officials did not notify the families of the five victims until after a report was published on the issue. Even the head of the hospital's infection control committee told the New York Times that he was not aware of the first infant's mucomycosis at the time.

Hospital-Acquired Infections throughout the Country

About 75,000 patients die every year from infections acquired from health care facilities - and the number of deadly fungal infections is on the rise. In response, the CDC recently started a program to help hospitals communicate with the public about infections and hospital errors. Hospitals taking initiative in this effort are enjoying significant gains in public trust.

Surprisingly, mucomycosis is not on the list of diseases that hospitals must report to the government. The infection can start as a small irritation or small black spot, which later spreads into nearby areas of the body, ravaging the skin and internal tissue.

Fungi can thrive in any moist environment, including a washroom or near water sources. TLC Linen Services, which provided and maintained linens for the hospital, is located just a few blocks from a large lake in New Orleans and includes a 40,000-square-foot washing warehouse. Moldy environments or those with inadequate ventilation systems can also cause fungi to thrive and spread.

Three families of the mucomycosis victims have filed lawsuits against the hospital so far, one of which was recently settled in an undisclosed amount. Hospital linens must always be wrapped in bags or cellophane while being transported; if not, fungi and other infections can spread rapidly.

Continue reading "Deadly New Orleans Outbreak leads to Questions on Hospital Safety" »

Gynecologic Procedure now Banned by Four Top Hospitals

April 28, 2014

6842256759_0613c09bf9_b.jpgOur team of medical mistake attorneys recently reported that doctors throughout the country were calling for a ban on one popular gynecological procedure, known as morcellation. In the wake of public outcry, at least three of the nation's top hospitals have banned the procedure. Importantly, the FDA has also released a statement discouraging surgeons from using morcellation procedures.

Morcellation was generally used during hysterectomy or myomectomy procedures to treat uterine fibroids in women. The practice involved using a laparoscopic power morcellator (a medical device) to divide the uterine tissue into smaller pieces or fragments.

Now, it has become clear that about one in every 350 women who undergo this type of procedure will be diagnosed with uterine sarcoma, which is a type of uterine cancer. This is possible because uterine sarcoma hides in the fibroids that morcellation procedures are designed to break up. If such cancer cells are already present in fibroids when a morcellator divides them, the cancer cells spread into the abdomen and pelvis, significantly worsening the patient's likelihood of survival.

What makes this issue particularly frightening is that there is no reliable method for predicting whether a woman's fibroids contain cancerous cells. Because of this, the FDA is now discouraging the use of morcellators during hysterectomies and myomectomies for uterine fibroids.

This issue was brought to the forefront of public and medical attention when a prominent doctor at Beth Israel Daconess Medical Center was diagnosed with uterine sarcoma after undergoing the procedure. Her husband is a Harvard-affiliated surgeon who went public with the dire news, calling on hospitals and doctors to stop practicing morcellation.

This couple has become the driving force behind the call to ban the procedure. Two hospitals affiliated with Harvard Medical School - Brigham and Women's Hospital and Massachusetts General Hospital - were the first to cease using morcellation procedures. Two more of the nation's most esteemed hospitals, the Cleveland Clinic and the University of Pennsylvania Health System, are the latest to suspend the use of morcellators. Temple University Hospital has also sharply limited power morcellator.

Public Safety Number One Priority

Officials at these four hospitals have gone on record saying that the public called on them to act immediately, so they did. A chairman at the Cleveland Clinic stated that the hospital will decide whether or not it will permanently ban the procedure in the upcoming months.

The FDA also plans to hold a hearing on morcellators in the coming months, which hospitals throughout the country will surely look to for guidance. Over the past ten years power morcellators have become extremely popular because they are used in less-invasive forms of hysterectomies and myomectomies. Known as laparoscopic procedures, these operations use only tiny incisions to break up fibroids instead of previous practices that left large scars and longer recoveries.

Women undergoing hysterectomies or myomectomies need to be completely aware of the risks of the procedure. Once the patient has been counselled on how the surgery will be performed, she reserves the right to request a different method or choose a different surgeon altogether. This is known as an informed-consent process.

It is important to note that there are still other ways to perform surgery on uterine fibroids using minimally-invasive techniques. Among these include vaginal hysterectomies and mini-laparotomy procedures, which do not require abdominal incisions. Temple University Hospital already designates the mini-laparotomy as its preferred uterine fibroid technique.

Continue reading "Gynecologic Procedure now Banned by Four Top Hospitals " »