Archive for the ‘Health’ Category

FIVE TIPS TO GETTING READY FOR YOUR FIRST CONSULTATION WITH A MEDICAL MALPRACTICE ATTORNEY

Monday, July 18th, 2011

No one ever wishes to be injured as a result of medical negligence. Nonetheless, the lives of thousands are affected every year as direct result of medical errors. How would you handle such a situation? Where would you go for answers?  How do you cope? And most of all, how do you move on with your life when your life, as you know it, has changed because of a medical mistake?  For some people, consulting with a medical malpractice attorney is a prudent choice. If you have come to this conclusion, you might want to call an attorney. Let’s say you already have a scheduled appointment. How do you prepare for this meeting? What do you need to consider before you even step foot into a lawyer’s office?  The purpose of this blog is to give you some guidance.  Here are five (5) tips to get you ready for your initial consultation:

Consider your purpose.  First and foremost, make sure that you know why you are considering an action against a health care provider. Perhaps, this determination is the most important one you will have to make in the entire litigation process.  Invariably, the reason why a person decides to sue will dictate the nature of the litigation process and even its eventual outcome. Medical malpractice cases should only involve medical negligence that results in injury.  Ask yourself: Do I have a good faith basis for contacting a lawyer?  If the answer is “yes,” you are on the right track.  You don’t have to be a medical expert or an attorney to have a gut feeling about the case.   The important thing here is to avoid litigation for the purpose of revenge or annoyance. Such cases are doomed to fail.

Do you have an injury? As you prepare for your initial meeting with a lawyer, consider if the case has some cognizable injury.  Remember – it isn’t enough that a health care provider did something wrong, the negligent act must result in injury.  All medical malpractice actions are fundamentally cases of negligence. Generally speaking, in order to prevail on a negligence claim, the plaintiff must prove that 1) the health care provider breached an applicable standard of care (i.e., a wrongful act took place), 2) the breach of the applicable standard of care directly and proximately (lawyers are still fighting about the meaning of “proximate”) caused injury to plaintiff, and 3) the plaintiff sustained a discernible and identifiable damage(s).

So, ask yourself: Do I have an injury that was caused by the action or inaction of a health care provider? If the answer is “yes,” you are on the right track. Remember, absent an injury, a Plaintiff will not be able to prevail against a health care provider even if the health care provider breached an applicable standard of care.  Here is an example, let’s say that you or a loved one needed a CT scan to confirm a ruptured appendix, which the physician failed to order. But, around the same time, another physician ordered the CT scan, which revealed the ruptured appendix. Assume further that the first physician’s failure to order the CT scan did not result in any meaningful delay in treatment. Under such circumstances, one could hardly argue that the first physician’s conduct, even if negligent, caused any injury. The lesson here is to simply make sure that you have an injury as you contemplate bringing a lawsuit against a health care provider.

Examine your damages.  Once you have determined that a tangible injury exists, be prepared to discuss the full extent of your injury(s) during the initial consultation.  Your initial consultation is not a time to be shy about your experience, your injuries, and your suffering.  I know; it is counter-intuitive. After all, there are better things to brag about than your suffering. I recommend that you come up with a complete list of all injuries suffered as a result of the medical error. As you brainstorm, keep in mind that your injuries can be both economic and non-economic. Economic damages are financial damages sustained in the past, present, and future. Such damages will generally include the cost of any medical treatment for injuries related to the alleged negligence (even if your insurance is covering these expenses). They may include further medical costs as well as other costs arising from your injuries (e.g., if you have developed a disability, you may need house modifications, a new car, nursing assistance, and assistance with household activities, among other things).  Economic damages can also include lost earnings (both past and future), loss of retirement benefits, and even loss of earning capacity among many other things. Non-economic damages will generally include damages for pain and suffering caused by the negligent conduct of the health care provider.  Make sure that you consider all of your damages thoroughly before meeting with an attorney.

What is your gut feeling? Oftentimes, your gut feeling about what went wrong, is in fact what went wrong. Medical malpractice cases will often involve very complex medical issues, spanning multiple specialties.  It can be a daunting task to get to the bottom of things in medical malpractice cases. Sometimes, it takes months of medical reviews before the negligent conduct and causation are determined. As such, clients are sometimes understandably reluctant to share what they think constituted the act(s) of negligence.   Still, even after months of investigation, the lawyer’s theory of liability will invariably  end up being the same or similar to that of the client. For this reason, it is again important to be complete and willing to share as much information as possible during your first interview. It may help the lawyer narrow down the issues in order to expedite the review and investigation of your case.  If you already have some or all of your medical records, it is a good idea to bring them with you. Any other documentation, which reflects the events surrounding your care, may be very helpful as well. Also, make sure to provide the lawyer with a chronology of any and all care rendered to you around the time of your injury and subsequently.

Rely on your loved ones. You don’t have to come to the initial interview alone.  Injuries resulting from medical negligence can be quite severe and life changing. Sometimes, it is simply easier to try to forget the events surrounding the injury. Other times, because of the medical condition (e.g., coma), the patient has little or no relevant information to convey. However, it is not uncommon to have family members or friends who may have direct or indirect familiarity with the medical care or the events surrounding your injury. Such friends and family members are an invaluable source of information. Ask them to talk to your attorney as well. Additionally, it is not easy to relive a traumatic experience alone. If you can, why not rely on someone who loves and cares about you?

I hope that these tips are helpful.  I  invite all of our lawyer friends to contribute to this discussion. What else can a perspective client do to prepare for an initial meeting with an attorney? If you are a patient, what do you expect from the attorney at the time of your initial consultation?

Acquired Brain Injuries: Hypertensive Brain Hemorrhages

Friday, July 15th, 2011

So what if my blood pressure is high, right? I’m under a lot of stress. I’ll cut back on my caffeine.  I don’t use that much salt.  It’s hot outside.  All reasons to ignore an abnormal blood pressure reading, right?  NOT!

View Image

On the heels of Rachel Leyko’s blog about heat stroke, and in keeping with some topics I’ve been blogging about on acquired brain injuries, hypertensive brain hemorrhages seemed to be a good topic du jour!

Hypertensive brain hemorrhage is just one of the many complications of uncontrolled high blood pressure.  We are currently seeing an epidemic of hypertension, much of it caused by lifestyle and the current epidemic of obesity in the U.S. And, yes, childhood and early adulthood hypertension is on the rise!  In a recent post by MedPage Today, as many as 1 in 5 young adults may have hypertension! The article goes on to cite studies measuring and monitoring patient blood pressures over several years. It is interesting to note that most of the hypertensive individuals did not know that they had high blood pressure! In 2009, DukeHealth.org posted doctor’s advice on managing childhood hypertension, recognizing that the incidence of the condition is on the rise.

Organ Systems Affected by Hypertension

The Mayo Clinic provides an excellent overview of the effects of hypertension on the various organ systems required for bodily functions.  Uncontrolled blood pressure causes damage to the following organs and results in the following conditions:

-Arteries/blood vessels: “hardening of the arteries” and cholesterol-plaque formation leading to stroke, kidney failure, heart attacks, “poor circulation”; aneurysm formation and rupture

-Heart: coronary artery disease (heart attacks); left ventricular hypertrophy and dilated cardiomyopathy; congestive heart failure

-Brain: TIA (transient ischemic attack); stroke (hemorrhagic & ischemic); dementia; mild cognitive dysfunction

-Kidneys: renal failure; renal scarring (leading to failure); renal artery stenosis or aneurysms

I have to admit that one of my “scare tactics” for encouraging patients to treat their hypertension was elaborating on the horrors of hemodialysis; hypertension and diabetes are the two main culprits for patients requiring hemodialysis.  Imagine having to spend 3 days every week hooked up to a dialysis machine (either by a large needle in one’s arm or via a “permanent” catheter tunneled under one’s skin), having to monitor fluid intake, being at increased risk for various infections, and requiring all kinds of specialized drugs to do what the kidneys would normally do! Not fun for anyone! For some reason, this had more effect that the risk of a stroke!

Hypertensive Brain Hemorrhages

I’m going to focus on these types of strokes as opposed to ischemic strokes, knowing that uncontrolled hypertension causes both types.

According to a MedScape Reference Article,

Intracerebral hemorrhage accounts for 8-13% of all strokes and results from a wide spectrum of disorders. Intracerebral hemorrhage is more likely to result in death or major disability than ischemic stroke or subarachnoid hemorrhage. Intracerebral hemorrhage and accompanying edema may disrupt or compress adjacent brain tissue, leading to neurological dysfunction. Substantial displacement of brain parenchyma may cause elevation of intracranial pressure (ICP) and potentially fatal herniation syndromes.

Apparently, over time, the high blood pressures in the arteries and arterioles of the brain causes damage to the inner lining of the walls, making them stiff, weak and less compliant to that pulsation we feel everytime our heart pumps blood throughout the body.  As the pressures inside the vessels exceed the compliance of the vessel walls, ruptures occur, leading to bleeding or hemorrhage into the brain tissue.  The blood can extend into the brain ventricles or into the subarachnoid space, or it can localize and clot within the brain tissue. Not only is the blood flow to brain cells disrupted, but there is now this increased pressure being exerted by the blood collection onto adjacent brain tissue causing even more damage. That brain tissue responds by leaking fluid, causing more brain swelling and increased pressures. It is a bad cascade of events that leads to serious brain injury, permanent neurologic problems and even death.

Watch the following You Tube Animation for both ischemic and hemorrhagic strokes:

httpv://www.youtube.com/watch?v=M_fo6ytlmD0

Some Epidemiologic Statistics

According to the same MedScape article, 350 per every 100,000 elderly individuals sustain hypertensive brain hemorrhages every year in the U.S. The overall mortality rate for general intracerebral hemorrhages is very high, with 20,000 people dying annually in the U.S., 44% of which die within 30 days, and 75% of those with pontine or brainstem hemorrhages dying within 24 hours!

From a race perspective, African Americans have a higher incidence of these brain bleeds due to the higher incidence of hypertension within the population.

Women have a higher incidence of brain aneurysms while men have an overall increased incidence of intracranial hemorrhage (general term includes trauma).

With respect to age,

Incidence of intracerebral hemorrhage increases in individuals older than 55 years and doubles with each decade until age 80 years.

Although the overall incidence of hypertensive brain hemorrhages has decreased between 1950 and 2005 with improved diagnosis and management of hypertension, this trend could change with the increasing incidence of hypertension in the young and lack of diagnosis and treatment; hypertension has historically been a disease of the “middle age” patient.

Medical Diagnosis & Treatment

Time is brain tissue when it comes to any kind of stroke, much like the American Heart Association’s motto regarding Acute Coronary Syndrome, “Time is heart muscle.” In each event, the time from onset of symptoms to diagnosis and treatment is absolutely critical.  In some cases, the severity of the injury might not be amenable to any medical interventions, but then again, a lesser injury can sometimes be treated and managed medically or surgically with a fairly good outcome.  Know the signs and symptoms of stroke (similar for ischemic & hemorrhagic) and do NOT delay in contacting “911″ for rapid transport and medical attention!

SOME RELATED POSTS:

Acquired Brain Injuries: Causes and Impact

Acquired Brain Injuries: Subdural Hematomas

Stroke Warnings:Most People Who Experience Minor Strokes Do Not Recognize Its Symptoms\

Image courtesy of “Baxters Blog”.

 

 

 

 

 

Dog Days of Summer Bring Pool Parties and Cookouts but Increase Your Risk for Heat-Related Injury

Monday, July 11th, 2011

The dog days of summer are upon us and with that heat and humidity comes an increased risk for injury.

Recently I ran a 7 miler race through the streets of downtown Baltimore on a hot and humid morning.  During that race, I saw at least one person suffering from what appeared to be heat exhaustion.  Luckily for that runner there was race support nearby and EMS on its way.  Had there not been race support there to cool the runner down with bottles of water he may not have survived.  Running is not the only outdoor summer activity that can result in heat exhaustion or heat stroke.  Any outdoor event in this heat can lead to an emergency situation.  It is important to know how to prevent such heat-related injury from happening but it’s also imperative to know what to do should someone suffer from heat exhaustion or heat stroke because if not properly treated death can occur.

What is Heat Exhaustion?

Heat Exhaustion usually develops after several days of exposure to high temperatures and inadequate intake of fluids. The elderly and people with high blood pressure are prone to heat exhaustion as well as people working or exercising in the heat. Heat exhaustion symptoms include heavy sweating, paleness, muscle cramps, tiredness, weakness, dizziness, headache, nausea, vomiting, and/or fainting. With heat exhaustion, a person’s skin may feel cool and moist.  Cooling off is the main treatment for heat exhaustion. Drinking cool, non-alcoholic liquids may help as well as taking a cool shower, bath, or sponge bath. Getting into an air-conditioned environment will also help. If the conditions worsen or have not subsided within an hour, seek medical attention. If heat exhaustion is not treated, it may lead to heatstroke which needs immediate emergency medical attention. Call 9-1-1.

What is Heat Stroke?

Heat Stroke is the most severe of the heat-related problems. Like heat exhaustion, it often results from exercise or heavy work in hot environments combined with inadequate fluid intake. Children, older adults, obese people, and people who do not sweat properly are at high risk of heatstroke. Other factors that increase the risk of heat stroke include dehydration, alcohol use, cardiovascular disease and certain medications. Heatstroke is life threatening because the body loses its ability to deal with heat stress. It can’t sweat or control the body’s temperature. Symptoms of heatstroke include rapid heartbeat, rapid and shallow breathing, elevated or lowered blood pressure, lack of sweating, irritability, confusion or unconsciousness, feeling dizzy or lightheaded, headache, nausea, and/or fainting.  If you suspect heatstroke, call 9-1-1 immediately. Then try to move the person out of the sun and into a shady or air-conditioned space. Cool the person down by spraying them with cool water or wrapping them in cool damp sheets. Fan the person, and if possible, get the person to drink cool water.

Tips for Prevention

An article on the Active.com website highlights 10 tips to prevent a heat-related injuries:

1.  Acclimatize – It takes your body time to adjust hot and humid weather.  Just because you can run a 10-miler at an 8-minute pace, doesn’t mean you can do the same when the dog days of summer approach.  The same goes for any outdoor exercise! The American Running and Fitness Association recommends that on your first run in the heat, you should cut your intensity by 65 to 75 percent. Then over the next 10 days, slowly build back to your previous level.

2.  Check the Index – Before you leave the comfort of your air conditioner, check the heat index and air quality index.  The Air Quality Index (AQI) is an index for reporting daily air quality. It tells you how clean or polluted your air is, and what associated health effects might be a concern for you. The Heat Index tells you what the temperature feels like when combining the air temperature and the relative humidity.  Both indexes should be checked before heading outdoors.  Your health depends on it!

3.  Hydrate! Hydrate! Hydrate! – Always remember to rehydrate after outdoor exercise! But it’s even more important to be well-hydrated BEFORE you exercise or spend time outdoors.  Hydration during your run depends on the temperature and the length of your run.  Don’t wait until you feel thirsty to drink. If you’re thirsty, that means you’re already low on fluids. Also, as you age, your thirst mechanism isn’t as efficient and your body may in the early stages of dehydration and you may not even feel thirsty. After 60 minutes of outdoor exercise, you will need to start using a sports drink or supplementing with a sports gel or a salty food such as pretzels. After 60 minutes, you begin to deplete vital electrolytes (i.e., sodium, potassium, etc.). Sodium is needed in order for your body to absorb the fluids you are ingesting and depleted potassium levels can increase your chances of experiencing muscle cramps.  Also, packing an extra bottle of water during outdoor exercise to pour over your head can help increase the evaporation-cooling effect.  Lastly, when you finished exercising, you need to replace the water you’ve lost.

4. Know the Warning Signs – Dehydration occurs when your body loses too much fluid. This can happen when you stop drinking water or lose large amounts of fluid through diarrhea, vomiting, sweating, or exercise. Not drinking enough fluids can cause muscle cramps. When you’re dehydrated, you may feel faint, experience nausea and/or vomiting, have heart palpitations, and/or experience lightheadedness. Runners also need to be aware of the signs of severe dehydration such as heat exhaustion and heatstroke, not only for yourself, but so you’ll be able to identify the symptoms if a fellow runner is experiencing heat-related problems.

5.  Buddy-Up – In the severe heat, be sure to work-out with a buddy. That way you can keep tabs on each other. Sometimes it’s hard to tell if you’re starting to suffer the effects of the heat, but a buddy may be able to spot the signs before its too late.  Plus, working out is always more fun with someone else!

6.  Work-Out Early – If at all possible, get your work outs done in the early morning.  The hottest part of the day is typically around 5p.m.  So, if you can’t work-out until after work, wait until later in the evening.

7.  Go Technical – Wearing light-colored tops and shorts made of technical fabrics will keep you cool and allow moisture to evaporate more quickly.  Staying dry will also help prevent chafing.  Clothing made of Lycra, Nylon, CoolMax and Dry-Fit are some examples of technical fabrics. Be sure to hang dry your technical fabric clothes.  The fabric softener in dryer sheets can actually block up the fabric decreasing its moisture0wicking abilities.

8.  Change Your Route – If your normal running route or work-out spot is treeless, find one that provides more shade.  If this isn’t possible and you have access to a treadmill or gym, head indoors on really hot days.

9.  Lather It On – Be sure to wear sunscreen!! Use a sports sunscreen that is waterproof with an SPF of 15 or higher.  Also, be sure to wear a hat or visor.  This will help keep the sun out of your eyes as well as the sweat out of your eyes.

10.  Have a Plan – Let your family and friends know your running route or work-out location.  If you’re gone too long, they will know where to look for you.  If you are in a rural area or doing a trail work-out, you may even want to pack your cell phone.  Don’t change your plans at the last minute without letting someone know.  It’s better to be safe then sorry!

For additional information on heat related injury and illness, see the National Weather Services heat advisory information page – Heat Kills

Week in Review: (July 2 – July 9, 2011) Eye Opener Health, Law and Medicine Blog

Saturday, July 9th, 2011

Eye Opener’s Week in Review

From the guest editor:         Good morning! I was hoping that you would take a break from making your “to do” list to stop by and check in with us. As usual, we have been busy blogging. And practicing law. And getting ready for trial. And in trial! Needless to say, we have been pushing it to the limits. In truth, we wouldn’t have it any other way. Before we get back to trial preparation, lets take a step back and look at the past week.

–Jason Penn, guest editor

Litigating for the Sake of Litigating: A Temptation to Be Resisted

By Jon Stefanuca

What do you do when your opposing counsel forgets that the practice of law is a profession and not a blood sport? What do you do when the phase “zealous representation” gets confused with “obnoxious obstructionist behavior?” When faced with similar frustrations, Jon Stefanuca broke out his keyboard and explained what we litigators deal with on a day to day basis. Being a lawyer is a very rewarding profession, but like any other, it has its share of frustrations. Don’t take my word for it, read more

Can Copper Surfaces and Duct Tape Reduce Hospital Infections and Deaths?

By Sara Keogh

Germs are in your kitchen.  They are in your bathroom and your bedroom.  They are on your fingertips and even on your tongue.  And everyone knows that there are going to be germs in hospitals. Even the best hospitals have to work to keep the patients, rooms and visitors clean and safe.  Sara Keogh reported on news that may make keeping hospitals and other health care environments less germy in the future. Two simple solutions, copper and duct tape, might have a major impact on infection control.  Read more

Sneak Peak of the Week Ahead:

The Eye Opener and its writers are excited about the week ahead too!  Here’s a sneak peak of what’s in store for you:

  • Service dogs for children:  more than just a pet
  • Legal Boot Camp is back in session and Part IV of our Cerebral Palsy tutorial.
  • And more!

Images courtesy of:

www.lifehack.org

www.mountainpulse.blogspot.org

 

Can Copper Surfaces and Duct Tape Reduce Hospital Infections and Deaths?

Thursday, July 7th, 2011

Image from medgadget.com

How many times have you heard about someone entering the hospital healthy, or relatively so, and developing a dangerous infection while hospitalized? What about the number of times that you may have visited your own doctor’s office or your child’s pediatrician’s office and wondered whether the cold you got a few days later was coincidence or the result of having been in the waiting and exam rooms following other sick patients? Have you ever considered what cleaning procedures are done in hospital rooms when one patient is discharged before another takes their place?

In the past, Brian Nash and the other legal bloggers here at Eye Opener have written posts and made mention of the importance of hospital cleanliness and sterility, see the related posts below. We have been involved in cases involving the devastating results of infections. However, everyone knows that there are going to be germs in hospitals. Even the best hospitals have to work to keep the patients, rooms and visitors clean and safe.

Well, there is news that may make keeping hospitals and other health care environments less germy in the future. Two recent articles have focused on seemingly simple solutions, copper and duct tape, that may have major impacts on infection control.

Copper Surfaces Dramatically Reduce Infections by Killing Bacteria

A Reuters’ article reports that a recent study “presented at the World Health Organization’s 1st International Conference on Prevention and Infection Control (ICPIC) in Geneva, Switzerland” shows that “replacing the most heavily contaminated touch surfaces in ICUs with antimicrobial copper will control bacteria growth and cut down on infection rates.” According to the Reuters’ article:

[a]ntimicrobial copper surfaces in intensive care units (ICU) kill 97 percent of bacteria that can cause hospital-acquired infections, according to preliminary results of a multisite clinical trial in the United States. The results also showed a 40 percent reduction in the risk of acquiring an infection.

This news could have a profound impact on health-care costs, disease spread, and most importantly lives lost. If hospitals are able to replace some of their current surfaces with copper surfaces, at least in the parts of the hospital that are most frequently the source of infections, there could be a dramatic improvement in hospital-acquired infections.

Hospital-acquired infections (HAIs) are the fourth leading cause of death in the United States behind heart disease, strokes and cancer.

According to estimates provided by the Centers of Disease Control and Prevention, nearly one in every 20 hospitalized U.S. patients acquires an HAI, resulting in 100,000 lives lost each year.

From Reuters

Perhaps even more infections could be prevented if these changes could be made outside of just ICUs. For instance, perhaps copper surfaces could replace highly touched surfaces on sink handles, the doors to hospital rooms, hospital bed rails, or in out-patient surgery centers and long-term care facilities that are not housed within hospitals.

Duct Tape Warnings Keep Others Far Enough Away from Infected Patients

Image from ducttapesales.com

An article from Medicalnewstoday reports that some hospitals are using plain duct tape – just colored red – to achieve a reduction in infection rates from highly infectious patients without having to deal with the hassle and expense of all visitors or hospital personnel who enter the room having to rescrub and use new gowns every time they enter the room of an infected patient. The study looked at highly infectious diseases like C. diff that require isolation of patients and very careful hand washing to avoid spreading the infection. So how does duct tape help?

The Association for Professionals in Infection Control and Epidemiology (APIC) commissioned a study to corner off a three foot perimeter around the bed of patients in isolation. Medical personnel could enter the room unprotected if they stayed outside the perimeter. Direct patient contact or presence inside the perimeter meant a redo of the cleansing process. The concept, called “Red Box” employs red duct tape, a color used as it provides a strong visual reminder to those who enter the room to be aware.

The study found that 33% of all who entered the rooms could do so without the addition of gowns and gloves, saving the environment, hospital and patient costs, and time without compromising the patient or the medical personnel.

From Medicalnewstoday

How Else Can We Reduce Infections?

What ideas do you have for the use of copper surfaces? Do you think that copper surfaces or duct tape could make a dramatic difference in the safety of hospital admission? What about the cost? Do you think that hospitals would pay the upfront costs of replacing surfaces with copper to be able to dramatically cut infection rates? What about other low cost solutions like duct-tape around the perimeter of the bed? Can you think of other low-cost solutions that could minimize infections and maximize safety?

Related Posts:

New federal study finds ‘lax infection control’ at same-day surgery centers

FDA warning to healthcare professionals: use sterile prep pads!

Litigating for the Sake of Litigating: A Temptation to Be Resisted

Tuesday, July 5th, 2011

It really grinds my gears when attorneys start litigating for the sake of litigating without context or purpose. That’s right; I bet if you are a litigator, you know exactly what I am referring to.  I am litigator, and I am absolutely convinced that we would all be better lawyers and happier individuals if we just learned how to do our job with dignity and professionalism, while avoiding absurd tactics and unnecessary drama.

Maybe I am alone on this one (and part of me really wishes that I am), but I just don’t understand why some lawyers think it is beneficial to have one gear and one gear only during the litigation process –  to object and obstruct no matter what. Is it really necessary, for example, to resist any and all discovery requests by dreaming up objections that have no merit?  In the end, is impeding the flow of information during discovery really in the client’s best interest, and frankly, is it consistent with our ethical obligations as professionals?  It is my humble impression that this kind of obstructive behavior happens more than one might expect. So, we end up writing unnecessary motions and nasty letters and emails, we go to depositions to argue some more with the opposing attorney instead of focusing on the witness, and we create so much “bad blood” that the case becomes one about lawyers and not their clients. Is this consistent with our professional obligations? I certainly think not.

Isn’t it in the client’s best interest to share as much information as possible about the merits of the case so that the opposing party can make informed decisions about settling the case early instead of dragging the parties through litigation for years? Why would a plaintiff’s lawyer not want a defendant to know the nature of his claims, the extent of his damages, and the identity and subject matter of his experts’ testimony?  Sharing this type of information is exactly the reason why a Plaintiff is in litigation in the first place.

Similarly, doesn’t it help a defense lawyer to be a straight shooter early on in the discovery process so that the plaintiff will not go on to note 100 depositions and use every discovery tool just to make sure that defense counsel isn’t hiding something? If the defense to a case is weak, isn’t better for all parties to be on the same page (yes, even when a corporate defendant is not in the mood to hear bad news) so that a case that must be settled can be settled early without making defendant incur unnecessary defense costs? Pardon my cynicism, but since I am on my soapbox, let me say this as well: the interest in having billing time should never be a substitute for the client’s best interest.  One byproduct of being evasive in discovery is that the defendant client (especially a corporate client) might end up being misinformed about the merits of the case – not a good position to be in when the lawyer finally comes to his/her senses and recommends settlement, but the client is not on the same page.

We have got to stop taking positions that have no good faith basis.  If there is no evidence of contributory negligence, don’t claim contributory negligence.  If experts are retained to testify at trial before the expert designation deadline, don’t object to their disclosure during written discovery simply because the expert designation is not due for another three months. If you can’t resist speaking objections, there are better places than a deposition to hear yourself talk.  If you have to file a motion, file one because you have to, not because you got a new crop of summer associates or first year associates doing nothing but writing motions for the sake of writing motions. I can go on, and I am sure that, if you’re a litigator, you can contribute to this list.

Life is too short and our occupations too stressful to engage in the meaningless waste of spirit. Time spent on useless litigation could be time spend with our families. What do you think? Don’t be shy, hop on the soapbox….

Related Posts:

Why early settlement is a win-win for all

Mediation of Lawsuits: The Top 5 Things that Tick Me Off!

 

 

 

Week in Review: (June 27 – July 1, 2011) Eye Opener Health, Law and Medicine Blog

Monday, July 4th, 2011

Eye Opener’s Week in Review

From the (guest) editor:  Good morning!  With the morning workout complete, I thought now would be a good time to take a look back.  We had a sneaking suspicion that with the excellent weather forecast you might spend some time outdoors.  Before you do, make sure you read our Summer Series.  This week we gave you what you need to know before you (and your little ones) head to that family BBQ.  Enjoy your Independence Day, drink a tall glass of fresh squeezed lemonade and enjoy!

–Jason Penn, guest editor

Cancer: HIV/AIDS Patients At Increased Risk

By Jon Stefanuca

As if life with HIV/AIDS is not difficult enough, researchers have also found that HIV/AIDS patients are also more prone to developing various malignancies when compared with the non-infected population. In fact, cancer is one of the leading causes ofmortality in the HIV/AIDS  population. It is estimated that 30%-40% of HIV patients will develop some type of cancer during their life time.  Read more

Skin Cancer: Types, Causes and How to Protect Yourself

By Sara Keogh

We can all agree that “skin cancer” is bad.  When we refer to skin cancer, what do we mean?  Most often we are referring to squamous cell, basilar cell or malignant melanoma.  On Tuesday, Sara described the different types of skin cancer and the  associated rates and survival statistics.  Read more

Skin Cancer Prevention: Will new FDA Rules Help?

By Sara Keogh

So Sara’s piece on Tuesday convinced you that sunscreen is necessary?  But how do you pick one?  Last week, the FDA announced new regulations of sunscreen. If sunscreens meet the new legal standards, they can use certain marketing phrases so that consumers know what level of protection will be provided by the product.  Read more

Diseases of Summer: Ticks and Lyme Disease

By Theresa Neumann

Summer is heating up, and there are lots of outdoor activities in which to participate. Along with the thermostat, however, there is also a rise in the deer tick population! This equates to an increase in Lyme disease, the most commonly reported vector-borne illness in America! Maryland, Virginia, Pennsylvania, Delaware and New Jersey all all“hotbeds” for this disease, comprising 5 of the top  12 states comprising 95% of all Lyme disease cases nationwide. Before you leave for the family picnic, you should read more

Skin Cancer Prevention: The Dangers of Tanning Beds

By Sara Keogh

It is popular to “pre-bake” before hitting the beach.  A tanning bed is often the The use of tanning beds or “indoor tanning” greatly increases a person’s risk of developing skin cancer. It is a completely voluntary exposure to UV radiation, and yet many people choose to expose themselves despite all of the risks.  Before you opt to “fake and bake,” you should read more

Sneak Peak of the Week Ahead:

The Eye Opener and its writers are excited about the week ahead too!  Here’s a sneak peak of what’s in store for you:

  • Service dogs for children:  more than just a pet
  • Legal Boot Camp is back in session and Part IV of our Cerebral Palsy tutorial.
  • And more!

 

Images courtesy of:

www.news.getaroom.com

www.topnews.net.nz

www.dsf.chesco.org

www.magazine.ayurvediccure.com

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Skin Cancer Prevention: The Dangers of Tanning Beds

Friday, July 1st, 2011

 

Image from hometanningbed.com

In my last two posts, I have examined the various types of skin cancer, their prevalence and survivability rates, and some prevention methods. Today, I will focus on another major risk factor for skin cancer. The use of tanning beds or “indoor tanning” greatly increases a person’s risk of developing skin cancer. It is a completely voluntary exposure to UV radiation, and yet many people choose to expose themselves despite all of the risks.

Known Dangers of Tanning Beds

Here are just a few statistics about indoor tanning from the Skin Cancer Foundation:

  • “Ultraviolet radiation (UVR) is a proven human carcinogen. Currently tanning beds are regulated by the FDA as Class I medical devices, the same designation given elastic bandages and tongue depressors.
  • The International Agency for Research on Cancer, an affiliate of the World Health Organization, includes ultraviolet (UV) tanning devices in its Group 1, a list of the most dangerous cancer-causing substances. Group 1 also includes agents such as plutonium, cigarettes, and solar UV radiation.
  • Frequent tanners using new high-pressure sunlamps may receive as much as 12 times the annual UVA dose compared to the dose they receive from sun exposure.
  • Ten minutes in a sunbed matches the cancer-causing effects of 10 minutes in the Mediterranean summer sun.
  • Nearly 30 million people tan indoors in the U.S. every year; 2.3 million of them are teens.
  • On an average day, more than one million Americans use tanning salons.
  • Seventy-one percent of tanning salon patrons are girls and women aged 16-29.
  • Indoor ultraviolet (UV) tanners are 74 percent more likely to develop melanoma than those who have never tanned indoors.
  • People who use tanning beds are 2.5 times more likely to develop squamous cell carcinoma and 1.5 times more likely to develop basal cell carcinoma.
  • The indoor tanning industry has an annual estimated revenue of $5 billion.”

Internal references omitted

 

Horrifically, it is mainly young people choosing to use these devices despite the greatly increased risk of melanoma and other skin cancers. Given the enormous financial incentive to service young people – the industry cannot be expected to regulate itself. If they can make $5 billion dollars a year in revenue with a largely young female population, why would they stop? (Aside from morality of course…)

How to Protect the Skin – Even if You Don’t Want To

From a social perspective, there need to be some changes to the value our society places on certain skin color and beauty. This is outside of the realm of this post – but what a shame that in this century, men and woman would still rather expose themselves to harmful radiation than live life with their natural coloring (or lack thereof).

From an education perspective, I think that public awareness and an increased focus on education must continue to be one prong to battle this problem. However, clearly warnings alone are not enough. This is exemplified by a recent news story about a now 23-year-old woman who visited tanning salons three to five times a week starting when she was 16 years old.  This young woman, who despite knowing the risks of tanning continued to use tanning beds until 2009, had to endure surgeries, drug therapies and over a year of painful treatment at the age of twenty-one for the advanced melanoma that had spread to her lymph nodes. Luckily, she is now cancer-free, but living with a greatly increased risk of developing another cancer. This is a cautionary tale, but it is also an example of the invincibility thinking of many young people that makes the risks seem lower than they really are to using tanning beds.

Legal Options – Regulation

So what remains? The tanning salon industry has a financial disincentive towards preventing skin cancers, the young patrons of these establishments may not understand the risks and consequences, yet the individuals and society are going to pay the price of devastating illness, high cost medical treatments and people’s lives if the current use of tanning beds continues. That is where the legal side of this post enters. There are a number of states that have started to regulate the use of these tanning beds – at least for minors. Most states do not regulate these very heavily. The National Conference of State Legislatures has compiled regulations from many states on their website. There are a combination of approaches which generally include either banning the use of tanning beds by very young children and teens (typically under 14 or 16 – but few states have an outright ban) and/or requiring parental consent for the use by children below a certain age (typically 18, occasionally 16). Some of these consent statutes require the parent to be present (in person) to provide consent. Others allow written consent or require the parent to be present only one time in the year. Do you think that these statutes are sufficient? Should the requirements involve vivid pictural warnings like the new requirements for cigarrettes?

In Maryland, Howard County is a leader in regulating this industry. In Howard County, minors under 18 years of age are not permitted to use tanning devices without a doctor’s note stating a medical reason and allowed frequency.  These rules are not subject to a parent’s consent. Many states legislators have proposed tougher legislation in the past few years to increase the regulations on this industry across the country, but few have been successful.

Your Thoughts?

What do you think should happen with the tanning industry? Do you think that there should be an outright ban for any minors using these devises? What about adults? There are still lots of tanning customers who are young adults who are over 18. What can be done to protect them from the increased risks of skin cancer? Is public education sufficient? Could it be done better?

Related Posts:

Skin Cancer: Types, Causes and How to Protect Yourself

Skin Cancer Prevention: Will New FDA Rules Help?

Skin Cancer Videos

 

Diseases of Summer: Ticks and Lyme Disease

Thursday, June 30th, 2011

family-time2

Summer is heating up, and there are lots of outdoor activities in which to participate. Along with the thermostat, however, there is also a rise in the deer tick population! This equates to an increase in Lyme disease, the most commonly reported vector-borne illness in America! Maryland, Virginia, Pennsylvania, Delaware and New Jersey all all “hotbeds” for this disease, comprising 5 of the top  12 states comprising 95% of all Lyme disease cases nationwide.

According to a recent post by Roberta Seldon in Boomer Health and Lifestyle, the deer tick population is a “bumper crop” this year, partly due to the wet winter in the Midatlantic and Northeast United States. Tick activity peaks in June and July, and this correlates to rates of illness as reported by the Centers for Disease Control (CDC). The CDC also reported 2009 as the second-highest incidence of disease cases, following 2007; with the estimated increase in the deer tick population, 2011 might go down in the record books as the highest year ever since the beginning of recording/reporting lyme disease (1995). The Maryland Department of Health and Mental Hygiene (DHMH) breaks down the jurisdictions even further into cases per County, with the top two counties being Baltimore and Anne Arundel, with Howard, Harford and Carroll counties being right in the mix.

What is a deer tick and what does it look like?

The deer tick, as it is commonly called, is really the black-legged tick or Ixodes scapularis. This is NOT the same as the dog tick; it is a much-smaller version with different coloration. The Canadian Lyme Disease site provides an excellent pictoral description and differentiation of the various types of ticks and relative sizes. The deer tick, especially in the nymph stage, is so very tiny and nearly impossible to see, and it is this very pinpoint little bug that causes most of the infections.

The CDC website (one of my favorites for all kinds of information related to infectious diseases and other public health topics) details the disease transmission process and prevention, diagnosis and treatment information. The site discusses many myths about the tick, its removal, the disease, its symptoms and long-term sequellae.

Did you know that the tick itself does not cause the disease? The tick carries a bacteria called Borrelia burgdorferi that has to be transmitted through the saliva during feeding. It takes at least 24 hours, if not 36 to 48  hours, of tick attachment and feeding in order to transmit the bacteria. Thus, besides various prevention techniques with appropriate clothing and wearing bug spray with DEET, it is critical to perform (or have someone else perform) a “tick-check” after being in wooded areas or areas known to have deer activity. The best way to remove this little critter is by using tweezers and grasping the head while applying gentle traction in the opposite direction of attachment. Even if you are not the environmental type but you have a dog, be sure to apply tick-prevention remedies to your pet since they can bring these critters into your home.

What are some common symptoms of Lyme disease?

The most common symptom, and the one classically associated with Lyme disease, is the bulls-eye type rash (called erythema migrans) that develops at the site of the infection/tick bite.

There is a central area of redness, and over several days, the red ring starts to migrate peripherally, followed by an area of clearing; it clearly resembles a bulls-eye target. According to the CDC, approximately 68% of those infected report this rash. The next most common symptom is joint pain that can involve one or more joints and typically migrates to various joints. Other more serious presentations include paralysis of the facial nerve (Bell’s palsy), meningitis or encephalitis, and even heart block or problems with the electrical conduction system of the heart leading to irregular heart rhythms.

The Maryland DHMH just released a video on Lyme Disease in Maryland. Dr. Katherine Feldman describes the disease.  It is a 7-minute and 23-second video with lots of good information. Please, click the link to watch and learn!

Other tick-borne illnesses:

Lyme disease is not the only disease transmitted by ticks. Ticks live on the blood of the hosts on which they feed. They can transmit a variety of pathogens via their bite and/or saliva that have been acquired from other hosts. Some of these infections include anaplasmosis, babesiosis, ehrlichiosis and Rocky Mountain Spotted Fever (RMSF). As an aside, don’t let the Rocky Mountain part fool you! North Carolina has one of the highest incidence rates of RMSF nationwide!

QUESTION: Do you know someone who has had Lyme Disease? Were there any unusual circumstances surrounding the diagnosis? Share your story so others can be more aware!

Images courtesy of:

(c) L. Gerlach on Blisstree.com