Recently in Surgical Errors Category

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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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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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.

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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.

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How Spine Implants Cause More Harm than Good

April 16, 2014

6087539168_6117cd51b0_b.jpgStimulation therapy is a growing treatment intended to relieve chronic pain in the spinal cord by sending electrical pulses through an implant. In some patients, the procedure works well and pain is well-managed. In others, the operation turns dire, causing permanent paralysis. Medical device attorneys at Pintas & Mullins look into these implants and who is to blame when a patient is paralyzed.

Spinal stimulator devices are manufactured by a variety of companies, including Medtronic, Boston Scientific, and St. Jude Medical. The devices are implanted into patients near the spinal cord, where a pulse generator sends low currents of electricity into extension wires, which are placed on the spine. The leads then transmit an electrical current onto the spine that distracts the brain from recognizing - and therefore feeling - pain signals.

Patients are typically admitted to hospitals for overnight stays, and can return home shortly after implantation with, ideally, a pain-free life. For dozens of patients, the procedure goes too far, causing partial or permanent paralysis or motor weakness.

In most of these cases, the injury occurs after the spinal cord is punctured or compressed by the electrical conductors, which are inserted into a narrow cavity called the epidural space in the lower spine (this is where an epidural anesthesia is administered during childbirth).

According to the FDA's database, nearly 60 patients were paralyzed by spinal stimulators in 2013 - up from nearly 50 the year before. It is worth noting that the FDA's database is far from complete, and many assert that injuries are vastly underreported.

Who is to Blame?

Doctors highlight a potential cause of the problem - insufficient awareness by doctors on the true risks of operating around the spinal cord, and proper techniques for avoiding the most dangerous areas. Much of the blame, they assert, rests on insufficient training and lack of surgical guidelines that leave physicians unprepared.

Part of the reason for this is that spinal stimulation procedures are conducted by various types of doctors: orthopedic spine surgeons, neurosurgeons, or anesthesiologists. Thus, no one medical society (which are typically responsible for developing training standards and practice guidelines) is held responsible for issuing such standards and performance tracking.

It may sound trite to say that surgical outcomes largely rely on the experience and skills of the doctor - but in spinal stimulation implantations this is particularly true. A physician at the Dartmouth-Hitchcock Medical Center stated that the surgery initially seems straightforward and simple, which attracts doctors who are not familiar with how risky a spine procedure actually is.

Medical device manufacturers like Medtronic claim they monitor adverse event reports and update the product labelling to reflect new or increased risks. Among these include the possibility that scar tissue can form around the device electrodes and cause nerve damage (which is also the site of paralysis). Companies like Medtronic offer weekend-long training sessions, however, experts agree that these courses are not sufficient.

Stimulators can cost between $20,000 and $60,000 each, but about a third of patients experience complications because of the device within a year of implantation. Nearly one in four patients have to undergo additional surgeries to fix the adverse side effects.

Continue reading "How Spine Implants Cause More Harm than Good" »

Another da Vinci Robotic System Approved for Market

April 3, 2014

fort-belvoir-community-hospital-astounds-with-groundbreaking-technology-and-devotion-to-patient-care.jpgIntuitive Surgical, the company that makes the da Vinci Robotic Surgery System, recently announced that it gained approval for a new robotic system, called the da Vinci Xi. Our team of da Vinci surgery injury lawyers takes a closer look at this new system and how it could affect patient care.

Robotic surgical systems are aggressively marketed to hospitals throughout the country as the "new, latest, most advanced" technology. In fact, there are no conclusive studies that show that such robotic systems provide better care for patients - quite the opposite. Hospitals are agreeing to pay millions of dollars (an average of $1.85 million) for these systems only to stay up on the competition.

The new Xi features thinner arms than the traditional da Vinci, and is intended to perform more complex surgeries. It also includes a fluorescent imaging system, nicknamed Firefly, which the company believes will improve patient safety by improving surgeon's seeing ability. Other upgrades include new joints for greater range of motion and improved visual definition.

To use the robots, surgeons sit behind a console and operate the device using a control panel, which includes a screen, pedals and joysticks. The system has raised much controversy since its initial 2009 release, and several lawsuits have been filed against Intuitive by patients seriously, some fatally, injured by the robots.

Adding fuel to the fire, the FDA approved the Xi robotic system through a special process (called the 510(k) approval) that requires minimal testing. What makes this so disconcerting is that Intuitive has been reprimanded by federal authorities for withholding information on how many patients have actually been injured by the robots. All injuries and deaths associated with a certain type of medical device are reported by the hospital directly to the manufacturer. The manufacturer is then required to inform the FDA within 30 days of receiving the report, and is also required to investigate the injury or device malfunction, sending the FDA a report of this investigation once it is completed.

According to lawsuits against Intuitive, the company was systemically underreporting the complications caused by da Vinci robots, along with knowingly misclassifying serious injuries and deaths as "other." The FDA was then never informed of the true injury risks from the da Vinci, and the public was never informed. The company also concealed three separate voluntary recalls from the FDA, which involved defective da Vinci parts. Due to their lack of reporting, dozens of patients were injured - specifically, burned - by malfunctioning parts.

According to reports, patients who are obese or who suffer from other serious medication conditions are significantly more likely to suffer an adverse event from the da Vinci. Other studies note that robotic surgery is not at all superior to traditional methods.
The original system was approved for minimally-invasive laparoscopic surgeries on the gallbladder and for gynecologic procedures. It was later approved for more complex procedures, such as chest, cardiac, and urologic surgeries.

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Dangerous Doctors, Patient Deaths Reveal Failing Texas Healthcare System

March 11, 2014

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

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

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

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

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

Dr. Duntsch and His Wake of Destruction

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

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

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

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

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

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Popular Hysterectomy Surgery Causing Cancer Spread

February 27, 2014

6025359063_81a0b67b4c.jpgDoctors across the country are calling to change standards for a common gynecological procedure, morcellation, which can spread dangerous types of uterine cancer. Many studies have confirmed this risk, forcing the medical community to reevaluate how and when the procedure is done. Medical malpractice lawyers at Pintas & Mullins take a closer look at this procedure and who is most at risk.

Morcellation is a hysterectomy procedure that involves grinding the uterus so tissue can be more easily removed through small incisions. In women with cancerous or pre-cancerous uterine cells, however, the procedure breaks up the cancerous tissue and scatters them into the abdomen or other organs.

What makes the issue particularly dangerous is the inability to test for cancerous uterine cells before the surgery. These cancerous cells can also often appear non-cancerous or non-threatening in initial tests, so the risk is amplified.

Personal Tragedy leads to Public Change

Among the most vocal physicians fighting to curb the use of morcellation is a Harvard-affiliated cardiothoracic surgeon, whose wife suffered the serious consequences of the procedure. He has written dozens of letters to medical journals and media outlets saying that the surgery endangers women, referring to it as a major public health crisis. The surgeon's wife, who is also a physician, underwent a morcellation procedure to treat what her medical team believed were benign (or non-cancerous) masses in her uterus.

The procedure went smoothly, however during follow-up testing showed that the "benign" cells actually contained a rare and extremely aggressive cancer known as uterine leiomysarcoma. The cancerous tissue was spread throughout her abdomen and lungs during the morcellation surgery, inflicting her with stage four cancer.

She is now going through chemotherapy and additional surgeries to remove cancerous tissue, with the support of her husband and six children. She asserts that neither her gynecologist nor her surgeon informed her of the risk of cancer spread before she agreed to a morcellation procedure. At present, the hospital she underwent her procedure, Brigham and Women's Hospital (where her husband also works), has imposed limits on morcellation procedures, including strengthening the informed consent process and adding restrictions for eligibility.

The couple is now criticizing doctors, hospitals, and medical society that they believe underplayed the risks of morcellation. The issue is quickly becoming a hot topic of debate in the field of gynecology, and many other physicians have joined in on the call to curb the procedure. Already, two esteemed medical journals have published critical articles on morcellation.

Very recently, on February 26, 2014, the FDA announced it would begin investigating information and data on morcellation procedures. FDA spokespeople stated that the agency is extremely concerned about the potential of cancer spread in at-risk women.

Since the couple started campaigning against morcellation, many other wives and their spouses, have come forward to say they suffered similar devastating cancer spread from the surgery. They are calling the procedure flawed and are asking researchers to conduct analyses of morcellation studies and the rate of cancer spread.

Risk Factors Include...

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Bariatric Surgery and Children: When Weight Loss Kills

February 17, 2014

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

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

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

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

Weight-Loss Surgery and Children

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

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

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

• whether they are finished growing

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

• use of alcohol or drugs within 12 months before surgery

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

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

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

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What Fuels Medical Mistakes

January 8, 2014

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

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

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

Overdiagnosis, Overtreatment

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

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

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

Complex Patient, Understaffed Hospitals

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

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

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

How to Help

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Uterine Growth Removal Procedure under Scrutiny for Cancer Risk

December 30, 2013

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

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

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

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

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

Why Women aren't Being Warned

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

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One of Six American Deaths Caused by Preventable Hospital Error

December 16, 2013

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

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

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

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

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

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

Proving Fault in Hospital Error Lawsuits

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

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

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How a Doctor's Apology can Affect your Medical Malpractice Suit

December 6, 2013

7142786591_2f7065d001.jpgWhen a medical mistake or negligent act result in severe injury or harm to a patient, physicians must decide whether they will apologize directly to the patient or their family. The decision is often more complex than it seems - many doctors are coached not to admit they made a mistake, as this confession may later be used in a lawsuit to prove that malpractice was committed. Medical malpractice lawyers at Pintas & Mullins bring to light a few basic laws and tips for how to best handle a medical mistake.

In the past, physicians have avoided apologizing for accidents during the course of treatment due in no small part to the fear that the apology could be used in a malpractice lawsuit. Dozens of states recognized this ethical dilemma and established "apology laws" to ease the legal consequences of apologizing and admitting an error. To date, 36 states and the District of Columbia have provisions allowing medical professionals to apologize without liability.

If a malpractice case arises from the error, these laws allow defendants (the individual doctor or hospital) to exclude apologetic statements from evidence. In 1999, the Institute of Medicine released a report detailing how prevalent medical mistakes really are: at least 44,000 (and as many as 98,000) people die every year in U.S. hospitals from preventable medical errors. The highest error rates occur in operating rooms, intensive care units, and emergency departments.

Despite this increase in transparency and legislative effort for disclosure encouragement, medical mistakes are still shrouded in silence. Physicians remain fearful of admitting their misdeeds not only to their patients, but to their peers as well.

How an Admission of Guilt can Influence your Case

In order for a medical malpractice suit to be argued successfully, plaintiffs must demonstrate four key factors:

1. There was a set and applicable standard of care expected
2. That standard of care was breached or unmet
3. An injury or ailment occurred
4. Evidence that the breach of medical duty caused the injury

As stated, most state's apology laws prevent an apology made by the physician after-the-fact from being submitted into evidence. If your case is brought in a state with more lax, or nonexistent apology laws, an apology can be used to prove the standard of care was in fact breached and caused your injury.

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

November 15, 2013

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

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

Stories of Fatal Neglect

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

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

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

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

How VA Lawsuits Differ

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

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

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FDA, Plaintiffs Warn Against Unapproved IUDs

November 4, 2013

3756923820_4406f711bf.jpgMirena attorneys at Pintas & Mullins remind women implanted with an IUD contraceptive or thinking of having one implanted of the still-present problems over unapproved, or "black market" IUDs. This issue was first raised in 2010, when the FDA issued letters to health professionals stating that using unapproved IUDs could constitute fraud and counterfeiting lawsuits.

Inevitably, that is exactly what happened. In September 2010 the Rhode Island Department of Health opened an investigation after a class action lawsuit was filed on behalf of women who received unapproved IUDs. The lawsuit named over 50 health care providers as defendants, all of whom worked for group practices targeted by FDA investigations - Bayside OB/GYN, Center for Obstetrics and Gynecology, and OB/GYN Associates.

Black Market Mirena and Paraguard

According to an article in Pediatric News, most of the claims submitted in the class action involved unapproved Mirena implantation. One health provider was using both Mirena and Paraguard illegally, however it was not immediately clear if any other devices were used. The womens' lawsuit argues that defendants implied that the IUDs were approved by the FDA to be used in the United States when that was not the case.

Instead, the IUDs were purchased for discounted prices through Canadian websites. Since the substitutes were not approved by the FDA, their integrity, purity, source, handling and identity could not be verified. For a product that is inserted into a patient's internal organs, this type of substitution is egregiously unacceptable.

Plaintiffs argue that they received a device to which they did not consent, alleging offensive contact and battery among their grievances, and requesting a jury trial. The women claim they were intentionally placed in harm's way by the defendants, suffering immense embarrassment, emotional distress, and inconvenience, among other injuries.

In a Press Release, the Rhode Island Department of Health estimated that between 400 and 500 women received the counterfeit IUDs, which were implanted beginning in January 2009. All patients who may have been implanted with a non-FDA approved IUD should have been notified in the summer of 2010.

Putting Patients at Risk - Know Your Rights

With the exception of rare circumstances, any use of a medical device or drug not approved by the FDA is against the law. Likewise, using a drug or medical device for uses not explicitly listed on its labels may also be grounds for a lawsuit. Healthcare providers are well aware that both federal and state law requires them to use only drugs and devices purchased through FDA-approved sources, and ambiguous suppliers out of Canada is clearly not one. Legitimate online pharmacies display a seal from the National Association of Boards of Pharmacy (known as a VIPPS seal). A comprehensive list of approved, legal internet pharmacies may be found here.

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