Posts Tagged ‘catastrophic injury’

Why early settlement is a win-win for all

Friday, May 20th, 2011

There is an old adage in the law that cases settle on the courthouse steps. There is a reason for that. When the parties are actually walking into court to try their case, they seem to suddenly recognize that there are significant risks to going to trial, and that there is serious money at stake. When you go to trial, only one side can win. The other side goes home a loser. Faced with such a stark outcome, both sides tend to become more reasonable in their assessment of their case and more willing to talk settlement. After all, despite all the years of experience that trial attorneys amass, no one can ever predict what a jury is going to do in any specific case. As one mediator I know likes to tell the litigants, going to court is like going to Vegas:  you roll the dice and you take your chances. So often times, the closer a case gets to the trial date the more motivated the two sides are to talk settlement. But is there a better way?

A couple of recent cases made me start to think about settlements and how they come about. (If you missed it, Brian Nash wrote an excellent piece on the frustrations of mediation and trying to settle cases). I’ve recently handled two cases that illustrate how settlements work and how two cases can go down dramatically different routes to ultimately get to the same place. Both of these cases are subject to confidentiality agreements so I can’t divulge the names of the parties or the settlement amounts, but they were both seven-figure cases with significant injury.

In the first case, the patient alleged that her doctor failed to timely diagnose stomach cancer over a period of several years. By the time the patient was properly evaluated by another physician, the cancer had progressed to the point that there was virtually no chance of a cure, and the young woman was likely going to die in the next few years. In the second case, the patient alleged that he suffered serious neurological complications (motor and nerve dysfunction in his arms and legs) as a result of post-operative complications that were not treated quickly enough. In both cases, a lawsuit was filed in court.  At that point, the two cases diverged.

Case Example #1 – Getting it done early

In the cancer case, before any depositions had taken place, the defense attorney called and asked if we might be able to talk about resolving the case. That’s always a great call to get as a plaintiff’s lawyer because it means there is a good chance that you will be able to get a nice result for your client, which is always the ultimate goal. Within a matter of weeks, we had reached an agreeable number and the case was over.

Case Example #2 – Grinding it out to the courthouse steps

In the second case, there was no early talk of resolution. The case proceeded through the normal course of litigation, which in the District of Columbia usually means about eighteen months of discovery, depositions, expert meetings, etc. Twenty-five experts were hired to review records and testify. Twenty-seven depositions ended up being taken. The case got all the way up to the Thursday before trial was scheduled to start on the following Monday morning. At that point, the parties finally reached agreement on a number and the case was settled.

Why the difference in approach?

So we have two cases, both with significant injury and both with questionable care. One case settled right away, and one dragged on for almost two years before settling. Is there a simple reason why? Not that I’ve been able to figure out. After years of doing this, I, like every other attorney, get a gut feeling as to what cases are worth, which ones will likely settle, which ones will go to trial. But it’s still a gut feeling; there’s no science involved.

It’s usually a combination of factors – the quality of the medical care, the severity of the injury, the likeability of the plaintiff and the defendant (more important than most people realize), the specific jurisdiction you’re in, etc. On top of these factors you have a myriad of psychological reactions that pop-up in lawsuits and there is no predicting those. Sometimes people get entrenched in fighting for no other reason than to fight. Some people get a number in their head for what a case is worth and don’t want to budge. So even though I can’t sit here and explain why certain cases settle early and some settle late, I do want to talk about the value of early settlements to all sides.

Common Sense and good economics say “get it done early”

It is easy to see why early resolution of cases benefits everyone, and it comes down to the costs of litigation. In today’s world, it can easily cost $75,000 to $100,000 (if not more in many instances) just in expenses to take a case to trial; it can easily be much higher in complex cases. (I know of one attorney who spent $300,000 on a case that he took to trial; he lost the case). These expenses consist primarily of expert fees paid to doctors to review records and testify. Expert doctors routinely charge at least $400 per hour and oftentimes more for their time. For trial testimony, doctors usually charge around $5,000 per day (some substantially more). If it runs into two days, that’s $10,000 just for one witness. It’s not unusual to spend tens of thousands of dollars for expert fees alone.

On top of that there is the cost of court reporters for each deposition, copying charges, obtaining medical records, long-distance calls, travel expenses, etc. Going through litigation is an expensive undertaking, and the longer the case goes on the more expensive it is. On the plaintiff side, all of those expenses are usually advanced by the attorney (in jurisdictions where this is permitted), but they all get paid back by the client at the end of the case (assuming the plaintiff wins; if there is no recovery, the plaintiff’s attorney “eats” those costs). So every dollar spent on litigation comes straight out of the client’s portion of the recovery.

On the defense side, insurers and self-insured institutions (like hospitals) have those same expenses, but on top of that, they also have to pay legal fees to their attorneys. Defense attorneys charge by the hour for everything they do on a file from reviewing records to meeting with clients to talking to experts to taking depositions. The complexity of medical negligence cases means long hours of work on each file, generating substantial legal fees. Those fees get paid to the defense lawyer whether the case is won, lost or settled at the last minute. The longer the litigation lasts, the higher the legal fees.

Of course it always costs money to investigate a case. There is no avoiding that.  Records need to be obtained and reviewed. Experts need to be retained for an initial opinion. But instead of spending $75,000 or $100,000 (or more) on a case, it may cost only several thousand dollars to work-up a case to get it ready to file – that is, to be in a position where early resolution can be discussed with the defendant. If a case can be settled early on, all of those thousands of dollars that would have gone to litigation costs go straight to the client. That is a huge benefit to the client.

The defendant benefits too. No hospital or insurance company wants to spend money needlessly. Early resolution means that the defendant doesn’t have to spend tens of thousands of dollars in expenses and tens of thousands more in legal fees. The only way it makes sense to spend that money is if, at the end of the day, the “defendant” (read insurer/hospital) believes it can either win the case or settle it for less down the road. But here’s the thing – a case can usually settle early on for less than the case would be worth had the case gotten closer to trial. This isn’t always true, of course, but as a general rule, a good case does not become less valuable over time.

Plaintiffs’ attorneys don’t undersell their cases to get an early settlement, but in practical terms, attorneys and clients are usually willing to consider some discount because they know that an early settlement is to their mutual benefit.The plaintiff gets a guaranteed financial payment now rather than waiting eighteen months for a trial and then a possible appeal that may drag the case out another two years. In that circumstance, the plaintiff is usually willing to take a little less money now because it is certain. It’s the age-old question: would you rather have X amount of money now, or wait eighteen months for the chance of getting more? For most plaintiffs, it’s an easy answer. Also the defense can pay less on a case than it would have ended up paying anyway and save thousands in expenses and legal fees by doing so. It’s a win-win for all parties.

Just do the math!

The big secret with early settlements (and which can sometimes be difficult to explain to a client) is that even though an early settlement might be for less than what a jury might award, the client can actually put more money in his or her pocket with a lower settlement amount. Again, we’re back to the issue of litigation costs. If a firm spends $10,000 to investigate a case and get it ready to file rather than $100,000 to take a case to trial, that is an extra $90,000 that goes straight to the client. Also, some law firms will have a contingent fee agreement in which the fee is higher (usually from 1/3 to 40%) when the case goes to trial, which serves to compensate for the additional time,  risk and expense of going to trial. When you consider the higher legal fees and the increased costs of litigation that have to be paid back, it can actually take a substantially larger jury verdict to put the same amount of money in the client’s pocket as he or she would get with a smaller early resolution.

Some cases may just need to be tried

I don’t mean to imply that every case that gets filed should be settled early. Far from it. Some lawyers undoubtedly file cases that are simply without merit and should be defended vigorously. Other cases – while they may be defensible – fall into a middle category where the care may not be the best but the plaintiff has problems with his/her case too. Some cases can be difficult to evaluate without further investigation and discovery to gauge the strength of the case. In those cases, it is entirely appropriate to proceed with litigation – even on a somewhat limited scale through discovery. No doubt there are instances where insurance companies do need to protect the interest of their doctors, and sometimes that means vigorously defending a case all the way through trial.

Some cases, however, – the cases where the medical care is truly egregious and the damages are clear – need to be looked at early on to see if the two sides can be reasonable and find some middle ground. If a case is going to ultimately settle (and believe me, experienced attorneys and claims adjusters can usually identify those cases early on), it makes sense to talk sooner rather than later. It requires compromise on everyone’s part, but the value to both sides is so great that it makes sense to talk early and get it done.

What has been your experience?

I’d be curious to know the experience of our readers. Has anyone been involved in a lawsuit that settled? Did it resolve early on or did it stretch out for years? Do you think the time involved had any impact on the amount of the settlement? Any tips or tricks you might suggest? Let’s hear from you – maybe we can all learn how to get these cases resolved earlier and stop wasting time, resources and money.

You may also want to read these related posts:

Frequently Asked Questions (FAQ’s)

A View from the Shady Side – The Defense Perspective

Every bad outcome does NOT a malpractice case make! Some practical advice

 

Should you sue a healthcare provider? Some guidelines to help you decide.

Thursday, April 14th, 2011

Recently, a CNN article titled “Harmed in the Hospital? Should You Sue?” described the story of a two-year-old baby with a septic infection who waited about five hours in the emergency department before being seen by a physician. The child ultimately needed several amputations as a result of the delay in medical treatment.

Using this tragic story as a point of reference, the article suggests a number of criteria to help patients decide when to sue and when not to sue a health care provider. For example, the article correctly suggests that a patient who has not sustained injury should not sue a health care provider even if the health care provider’s conduct might have been negligent. In medical malpractice cases, a plaintiff seeks monetary compensation for injuries. If there are no identifiable injuries, there simply isn’t a case for medical malpractice.

However, most of the remaining recommendations in the article seem to suggest that a patient can make an educated determination about pursing a medical malpractice case without the advice and counsel of a skilled medical malpractice attorney. While this may possible in some cases, a well-considered determination about the merits of a medical malpractice case is difficult, if not impossible, to make without the guidance of a skilled attorney.

The decision to sue is never an easy one. Engaging in litigation is costly, time-consuming, stressful, and emotionally draining. This is particularly true in medical malpractice cases where a plaintiff’s own physical injuries or the death of a loved one is the subject of litigation. As a consequence, the decision to sue a health care provider must always be well-considered because of the impact the lawsuit might have on the patient, the patient’s family and the defendant health care provider.

Is deciding if you really have a case a “do it yourself” project?

In this vein, the article suggests that a patient should always consider whether her injuries are the result of the alleged negligence or some other unrelated factors. This consideration is particularly important when the patient’s pre-existing medical conditions cause or contribute to the alleged injury. In such instances, however, unless the patient has sufficient medical knowledge and, perhaps some legal knowledge, it may be difficult, if not impossible, to determine the actual cause of the injury.  In most instances, these determinations should be made by a skilled health care provider in the relevant medical specialty in consultation with a skilled medical malpractice attorney. By extension, to suggest that a patient should be able to make this determination on her own is frankly impracticable in most instances.

What’s the process for determining if you have a real case

Therefore, whether or not a patient ultimately decides to pursue a lawsuit, it is prudent to seek counsel from a skilled medical malpractice attorney. Many attorneys offer free initial consultations. More importantly, most attorneys will  (or should) undertake  a thorough investigation of a potential medical malpractice case before a decision to file suit is made. This process involves an internal review of the medical records. Often times, this is done with the assistance of an in-house medical expert. If  an investigation passes the threshold in-house review, the records are then reviewed by outside experts whose sole purpose is to determine the quality of care rendered and whether any of the alleged injuries are related to the care that is being criticized.

This multi-layered review can amass a tremendous amount of information, which in turn can help a patient decide if it is worth pursuing a lawsuit. All of this detail and information is provided to a patient at no cost where contingency fee agreements are in place (generally speaking, under a contingency fee agreement, the client is not responsible for any costs, unless the attorney is able to recover a monetary sum. If recovery is made, the costs are deducted from any such recovery.).

The article further recommends that a patient consider if the injuries are of a type which would be considered within the acceptable risk for a given medical procedure. Yet, another recommendation encourages patients to evaluate if the care rendered was within the standard of care. All such recommendations, although very appropriate, are vague and ambiguous absent context. A mother whose baby was not timely delivered should not be expected to know how to interpret fetal monitoring strips. A patient who undergoes a hip replacement surgery should not be expected to know the proper surgical technique. A patient whose cancer remained undiagnosed should not be expected to know how to interpret blood tests or to read MRIs or other diagnostic tests.

Therefore, the suggestion that a patient should carefully evaluate the merits of his/her case should not be interpreted to mean that a patient should do so without the guidance of a skilled medical malpractice attorney. There is an important distinction between investigating a case and pursing a case.  Just because you decide to employ a lawyer to investigate a medical malpractice claim on your behalf does not mean that you or the lawyer have committed to filing a lawsuit. With this in mind, it is important to realize that medical a malpractice attorney can be a great resource even if the client ultimately decides not to pursue the case. If you are unsure about whether you have a case or you are uncertain about the strenght of your case, take advantage of the resources and counsel of a skilled medical malpractice attorney.

How to tell if a lawyer is really a specialist

Throughout this post, I have emphasized skilled medical malpractice lawyer. Admittedly, sometimes it’s simply not that easy to tell from advertising or websites which attorneys are really specialists in medical malpractice investigations and litigation. If you have doubts, ask questions! Most people are pretty savvy and should be able to tell if the lawyer they are considering has a real grasp of the medicine and the law – both of which are required to be a skilled medical malpractice lawyer. Remember, you are entrusting your case to someone you really don’t know.

You ask questions in your daily life’s affairs and form judgments on whether or not you would entrust your childcare to some, which mechanic you’ll let fix your car, which home repair specialist you’ll permit to enter your home and do needed repairs. You get a sixth sense feeling sometimes as to whether or not the one your talking to (i.e. interviewing) will be a good fit for the task at hand. Why should it be any different with a lawyer, who claims he or she is a medical malpractice specialist. Just as we constantly preach about choosing a doctor, make informed decisions after asking the right questions.

If you need some guidance on what questions to ask, take a look at the White Paper we posted on our website – “Choosing a Lawyer – a Primer.” Hopefully, this will help you make an informed decision before you sign that fee agreement.

Related Posts:

The Reality of Medical Malpractice Lawsuits: Demystifying and Dismantling the Medical Profession’s Arguments

Every bad outcome and injury does not a malpractice case make! Some practical advice.

 

Science Confirms What Women Have Known for Years – We Really Are the Stronger Sex!

Saturday, October 23rd, 2010

Guess the "study" is right!

A new study from Johns Hopkins University led by assistant professor of surgery, Dr. Adil Haider has shown that women have an increased ability and tenacity to survive trauma when compared to men who have suffered a traumatic injury.

Haider and collegues collected data on over 48,000 patients who had suffered a severe traumatic injury.  Only patients whose blood pressure was extremely low – which is considered a sign of traumatic injury - were included in the study.  Male and female participants were placed in three groups – under 12, between 13 and 64 and those over 65.  After taking into account such variables as age, severity of injury, type of injury and manner of injury, women demonstrated a 14% higher rate of survival of traumatic injury than men.  While other variables may have caused the increased rate of survival, Haider suggests that female sex hormones like estrogen are a likely factor in women’s survival.  In some cases, female sex hormones enhance the immune system.  However, it is unclear whether the improved odds of survival are a result of the prescence of female sex hormones or the result of a decrease in the amount of male sex hormones like testosterone that serves as a protector.

Whatever the cause of the improved odds its nice to have science show us who is really capable of survival!

Editorial Comment: Geez…this is what I have to deal with….! (Brian Nash)

The Hidden Dangers of Button Batteries

Wednesday, July 14th, 2010

Sunday evening, immediately after putting our two year old to bed, my wife and I watched 60 Minutes and settled in to begin to enjoy what we thought would be a ‘relaxing’ evening.  Unfortunately, one of the lead stories that the program featured involved the dangers of ‘button batteries’.  These batteries are especially dangerous to small children, because, as I learned from the show, the electrical current of the battery, once stuck in the esophagus, literally burns through the tissue surrounding it, causing holes in the esophagus.  They are also, unfortunately, very easy to get stuck in a child’s throat.

My mind starting racing; “OK, what products do we have in the house that are powered by button batteries?”  My concern was well-justified, as the vast majority of these tragic incidents occur to children under the age of four.  Scouring the internet this morning, I found several articles warning the parents of small children about dangers they should heed.  Sadly, I also saw blogs from the parents, in which they recount how they lost their child because of such a tragedy.  These products are not the subject of recalls, mind you.  These are batteries found in everyday products that you may have in your home.  The damage can be permanent and may effect your child’s ability to eat and drink permanently.

I found a warning on-line from the Consumer Product Safety Commission (CPSC), going all the way back to March of 1983, almost 30 years ago:

Technologic advances in electronic miniaturization have increased the availability of miniature (button) batteries in homes..in watches, calculators, cameras, hearing aids, and games. Although the vast majority of these button batteries, when accidentally swallowed, will pass through the person without any problem, occasional severe complications and even fatalities have been reported. Batteries may become lodged in the esophagus or intestine, slowly leaking alkaline electrolytes and causing an internal chemical burn.

Battery ingestions are preventable. Important prevention and treatment information is available based on preliminary results of a National Button Battery Ingestion Study conducted by Dr. Toby Litovitz, director of the National Capital Poison Center, of 62 button battery ingestions reported to the National Capital Poison Center in the past 9 months, 59% involved batteries that were left out loose rather than properly discarded or stored; 39% of the batteries were in the product they were intended for, and removed from the product. Half of these batteries were in hearing aids.

Fast forward to the present, and the warnings are all over the place.  In a recent article from examiner.com out of Baltimore, the urgency of getting the button battery out of the child as soon as possible is emphasized, due to how quickly damage can occur to the child’s throat:

The research also found there is only a two hour window to get the batteries out when lodged in the esophagus, which is less time than previously reported. Delayed removal can result in serious injuries such as tissue tears, burning, and internal bleeding .

Where can these batteries be found, and what can we do to help safeguard our children? A recent Reuters article provides us with some guidance:

They warn parents to keep not only loose batteries out of children’s reach, but also the household products that contain the batteries. In about 62 percent of cases where a young child swallowed a button battery, the child fished the battery out of a household item.

For an additional barrier, the researchers advise parents to place strong tape over the battery compartment of all household products.

They urge extra caution with any 20-mm lithium cell batteries, which can be recognized by their imprint codes — usually CR2032, CR2025 or CR2016.

On a final note, another danger is that doctors sometimes misdiagnose the injury, as the symptoms can be non-specific at times:

The current study found that in the majority of fatal or severe injuries, no one had seen the child swallow the battery. And because the symptoms of poisoning are non-specific — such as fever, vomiting, poor appetite and lethargy — doctors often initially misdiagnosed the problem.

Of course, the key is not to let your child get a hold of these ‘button batteries’ to begin with.  We strongly urge you to check your homes for these products and to take the appropriate steps to safeguard your family.  We are also again providing the link for the CPSC, as we have previously done so many times in our website‘s blog, for additional follow-up information.



New National ‘Pool Safely’ Campaign Initiated to Save Children’s Lives

Tuesday, July 6th, 2010

Approximately a month ago, we featured a blog on our website that dealt with child safety; specifically, safety in and around a pool.  Now, with record high temperatures hitting most of our local areas, we thought it worthwhile to further detail these safety issues and concerns, as more and more of us and our children head for comfort in the area local pools.  The Consumer Product Safety Commission (CPSC) has actually done that for us, through a national campaign that they have recently started, entitled ‘Pool Safely’:

The U.S. Consumer Product Safety Commission (CPSC) today kicks-off the Pool Safely campaign (www.poolsafely.gov), a first-of-its-kind national public education effort to reduce child drownings and non-fatal submersions, and entrapments in swimming pools and spas. At a press conference at the Fort Lauderdale Aquatic Complex today, Olympic swimmers Jason Lezak and Janet Evans joined Inez Tenenbaum, Chairman of the CPSC; U.S. Rep. Debbie Wasserman Schultz (D-FL); and Nancy Baker, mother of Virginia Graeme Baker, to officially launch Pool Safely and release the CPSC’s annual submersion and entrapment reports.

Please note that the campaign is NOT just about pool drownings and submersions; it also focuses on “entrapments”.  Entrapments should not be overlooked because sadly and tragically entrapments occur more frequently than one may think.  An entrapment occurs when a child is literally stuck to the pool floor at or near a drain site, where the suction force is so great, that the child is unable to break free from the suction, thereby causing the child to drown.  The statistics speak for themselves within this year’s memorandum drafted by the CPSC.

The campaign also details preventative measures for parents to take note of and remember, in addition to providing the tragic statistics regarding accidental child drownings:

The Pool Safely campaign will deliver an important and simple message: just adding an extra safety step in and around the water can make all the difference. Your greatest water safety assurance comes from adopting and practicing as many water safety measures as possible, including: barriers that completely surround the pool with self-closing, self-latching gates; staying close, being alert, and watching children at the pool; learning and practicing water safety skills (knowing how to swim and perform CPR); and having the appropriate equipment (compliant drain covers, alarms, barriers and sensors).

We encourage our readers to review all of the links within this article. We sincerely want you to be better aware and prepared as we go through a summer of intense heat.  It looks as if the heat is here to stay for awhile, and pools can be a great source of fun relief, if the proper safety precautions are followed.

With the Fourth of July comes Fireworks. Be Smart!

Thursday, July 1st, 2010

Many people enjoy watching the beautiful fireworks displays that accompany the July 4th Holiday.  Others decide to set-off the fireworks themselves.  Some people do both.  An article posted earlier this week at Springfield, Missouri’s News-Leader.com reminds us how dangerous lighting fireworks can be:

Those fireworks injuries include burns and injuries to hands, fingers and even eyes at this time of year.

Some burns caused by fireworks are minor; others are serious third-degree burns.

Fireworks burns may be small, but they can go deep, said physician Ted McMurry, medical director of St. John’s Emergency Trauma Center.

A Roman candle, for instance, “shoots a little fireball” that can penetrate clothing and skin.

Care providers have also seen eyes burned or injured by foreign bodies from fireworks, or they’ve had to remove fingers or hands ravaged by explosions.

“Typically, they come in with partially amputated fingers or a hand and the surgeons have to amputate (the rest),” said Debbie Mikkelson, nursing director at St. John’s Burn Center.

What causes this to happen?  Just plain carelessness for one. Recklessness or becoming injured when attempting to re-light fireworks are other reasons.  Another factor is alcohol. Kind of common sense, isn’t it? alcohol combined with fireworks can quickly turn a fun-filled family event into tragedy:

Booze may fuel such behavior, even in adults.

“I think as much as anything it’s risky behavior, but quite honestly the other thing that sometimes drives risky behavior is alcohol,” McMurry said. “Alcohol impairs our judgment so people will do things they might not otherwise do.”

It also slows reflexes, he added, so that drinkers lighting fireworks might not be able to move away from fuses as quickly as normal.

Accordingly, the Consumer Product Safety Commission (CPSC) has listed fireworks safety recommendations. It has also put a chilling video on YouTube that brings it home quite vividly.  We wish you a happy AND safe Fourth of July Weekend.

Deaths of Infants in Cars Increasing with Summer Heat; Important Safety Reminders!

Monday, June 28th, 2010

The Associated Press (AP) has just posted a troubling article, one that should grab the attention of every parent who has a child that uses a car seat.

Unfortunately, with the summer comes the heat.  Already this season, we are seeing high temperatures that are matching or breaking records in the Mid-Atlantic Region.  It is with this in mind that we share excerpts from the AP article that we want you to remember, especially when transporting the ‘precious cargo’ that sometimes falls asleep in the back seat of a car:

Safety groups such as Kids and Cars and Safe Kids USA urge parents to check the back seat every time they exit the vehicle and to create a reminder system for themselves.

Some parents leave their cell phone or purse on the floor near the car seat to ensure they retrieve it along with the child. Others remind themselves by placing a stuffed animal in the car seat when the child isn’t using the seat and putting the toy in the front seat when the child is tucked in the car seat.

Unfortunately, not all parents are using these and other simple measures, to remember to never leave a child unattended in a vehicle.  Accidents happen, yes; unfortunately, these accidents can turn deadly when a child is trapped in a car in the intense heat.  As the following tragic scenario illustrates, the temperature in the car in this devastating loss was not survivable:

In Portageville, Mo., 2-year-old twins Allannah and Alliya Larry were found dead in their grandmother’s car on June 16 as temperatures pushed into the mid-90s. New Madrid County Sheriff Terry Stevens said the children apparently got into the unlocked car on their own and were locked inside the vehicle for two hours.

When investigators arrived, he said, the temperatures inside the car had surpassed 140 degrees.

The number of heat-related deaths of children in cars is dramatically increasing, so much so that “the government’s highway safety agency issued a consumer advisory this week that included a warning for parents not to leave children unattended in or near a vehicle.”

We leave you with these sobering statistics, including research done by Jan Null, an adjunct professor of meteorology at San Francisco State University:

The spate of deaths in June has caught the attention of safety advocates because July tends to be the most deadly month for children trapped in hot cars. With a week left in June, the number of deaths has already surpassed the previous record of 17 fatalities from January to June 2009, according to Null’s data.

In 2005, when Null counted a record 47 child hyperthermia fatalities, only 12 of the deaths occurred through the end of June.

Since 1998, Null has documented 463 child deaths involving heat exhaustion inside cars and trucks. Safety advocates said the deaths have been more prevalent since the mid-1990s when parent-drivers were required to put their children in the back seat, where they are safer in transit but more likely to be forgotten.

Please take precautions to make sure that you do not leave any child in your vehicle unattended for any length of time.

Child Safety Tips: As mercury goes up, so do safety risks for kids!

Wednesday, June 2nd, 2010

By picpoke.com

Yes, it is really getting hot out there this week!!!  Coming from Florida to DC last year, I thought “OK, so it will not get nearly as hot up here, or at least not as early in the summer.”  Yes, I was wrong.  This thought brought me to thinking about some of the fun things to do in the summer, but also the dangers for our little ones during this time if we are not extra careful.  Lo and behold, I found this article today, courtesy of the Dallas Morning News and reprinted by the Kansas City Star:

Emergency-room professionals have their own name for the long, lovely, lazy days that kids look forward to in summer: trauma season. Because that’s when hospitals see a spike in drownings and heat-related accidents.

The article discusses several myths and related facts associated with those myths.  Here are a few samples from the article:

MYTH: Pool parties are safe as long as adults are around.

FACT: Many drownings happen when adults are close by. The problem is too much commotion. The key is to have a designated adult watching the water because that is where the danger is. The pool should be free of excess toys that can block the view of the water.

MYTH: Floaties keep little ones safe in the water.

FACT: Floaties are designed for fun, not safety. They give a false sense of security, can deflate and can slip off.

MYTH: The kids will be fine in the pool for the short time it takes to answer the phone or get a cold drink.

FACT: In a minute, a child can go under water. In two or three minutes, the child can lose consciousness. In four or five, the child could suffer irreversible brain damage or die. According to the Centers for Disease Control and Prevention, drowning is the second-leading cause of unintentional, injury-related death for children 1 to 14 years old, second only to car and transportation-related accidents.

The article states several other myths and facts, which include the hazards of leaving children unattended in cars and car seats, as well as sun exposure and dehydration.  We encourage you to read the article in its entirety.  Let’s all have a safe summer out there, please!!

Florida's doctor discipline system not tough enough, critics say

Sunday, May 30th, 2010

As a Florida-licensed attorney who spent 15 years working in consumer justice law firms in the ‘Sunshine State,’ I keep a watchful eye on trends and developments within various personal injury practice areas in Florida.  There is currently a real, legitimate concern regarding the system that is responsible for disciplining doctors who are licensed to practice medicine in Florida.  The Orlando Sentinel recently published an article how some believe there is much to be desired when it comes to how the  Florida Department of Health handles these matters.  

Consumer group Public Citizen last month ranked Florida the eighth most-lenient in the nation for disciplining doctors. The ranking stems from the number of serious actions per 1,000 doctors last year, when the state revoked the licenses of 94 and suspended 18 others. The toughest state disciplined doctors at rates three times as high. The trend has been true for a decade, the group said.

Critics contend the state does not act fast enough or toughly enough against the small share of practitioners accused of substandard care, negligence, crimes or improper behavior. Too often, they say, the state lets professionals such as Lan continue practicing while officials probe allegations of crimes or serious violations and injuries.

Regulators dismiss 90 percent of complaints that patients or others file against practitioners, more than 95 percent of those against doctors. When action is taken, the state rarely imposes serious punishments, such as revoking or suspending licenses.

There is ‘the other side’ of the story.  According to the article, some of the advocates for the way the system works take the following position:

State officials and some attorneys defend the system and say the criticisms are overstated. They say any system can be improved, but contend the state focuses on protecting the public from professionals who commit the most serious wrongs, and demands remedial training for professionals who make errors.

“I don’t see the evidence to support [the criticism]. We believe we are doing a good job,” said Lucy Gee, the health department’s director of medical quality assurance.

Gee said the process moves deliberately so it can be thorough. Cases remain secret because laws aim to keep baseless complaints from becoming public and unfairly tarnishing professionals, she said.

What about the doctors and individuals within the medical profession that repeatedly cause harm to patients or are charged with serious crimes (felonies) but are permitted to continue practicing medicine?  What about these same individuals within the profession, who do not receive ANY form of discipline whatsoever, or are allowed to continue practicing, while the investigation against them is pending. Here are just a few examples of such real world cases:

Dr. Stuart F. Tillman, a Tallahassee anesthesiologist arrested in July and charged with soliciting sex online from a police officer posing as a girl of 14.

Dr. Joseph M. Hernandez, formerly of Fort Lauderdale, who was arrested in Lake City in February and charged with trafficking narcotic pain pills and prescribing drugs for monetary gain. In 2006, records show the state banned him from doing surgery and temporarily suspended his license because his vision was severely impaired. In 2007, he was fined $5,000 for leaving part of an IV tube in a patient’s chest.

Dr. John N. Mubang, an internist in the Tampa suburb of Seffner who was arrested and charged in July 2008 with drug trafficking and prescribing controlled substances for monetary gain.

All three have pleaded not guilty, with trials pending. Hernandez and Mubang are practicing, according to their offices. Hernandez declined to comment. Mubang and Tillman could not be reached for comment, despite calls or messages left at their offices.

What does this say about the system that disciplines doctors in Florida?  Sure, there are many great doctors in Florida, but for the ones who put their patients’ lives at risk (through negligent treatment or otherwise) or are charged with serious crimes that may have an impact on their practice/medical license, the question remains: Would YOU want to have a surgical procedure performed by a doctor that has a criminal investigation pending against him or her that may land them in jail? I suspect you would prefer your doctor to be completely focused on your surgical procedure and not thinking about other ‘outside distractions.’  Shouldn’t there be additional aggressive safeguards in place that will IMMEDIATELY prevent the medical provider from committing more harm?

We leave you with this: Yes, emergency suspensions were put into effect 248 times in 2009.  However, compare that with the approximate 24,000 complaints that were filed against doctors and other members of the medical profession the same year, by both individuals and other agencies.  Are we really to believe that only 248 of those 24,000 cases required emergency suspension of one’s practice…??

IV infiltration leads to $1.5 million verdict when patient loses thumb.

Saturday, May 29th, 2010

Recent news from Georgia (where the state’s cap on non-economic damages was recently overturned): A patient, Johnnie Jackson, age 47, was awarded $1.5 million for pain and suffering in addition to recovery of his medical expenses, for injuries he sustained when delay in treating an infiltration of his IV ultimately led to the loss  of his thumb.

Mr Jackson presented to Coffee Regional Medical Center for complications resulting from a pancreatic condition on April 30, 2005. Mr. Jackson had a known history of diabetes and chronic pancreatitis.

Upon presentation, a nurse administered Phenergan and Demerol through an IV, which had been inserted into Mr. Jackson’s right wrist. At approximately 3:00 a.mm on the morning of May1, Mr. Jackson complained of swelling and pain at the site of the IV causing it to be removed 45 minutes later.

After nine hours of complaints, Mr. Jackson was examined by his physician, who found that the medications had leaked into the surrounding tissues. Mr. Jackson’s physician elevated the arm in a failed attempt to reduce the swelling. On the afternoon of May 2, Mr. Jackson was transported to the South Georgia Medical Center for advanced treatment.

A pretrial order revealed that Mr. Jackson was transported to  the medical center for the treatment of a blood clot that was found near his thumb.  During Mr. Jackson’s 24 day admission at the medical center, he underwent a multiple surgeries by an orthopedic surgeon, who was unable to salvage Mr. Jackson’s thumb.

Mr. Jackson’s attorney, Laura Shamp, filed suit against Coffee Regional and five treating nurses in 2007 alleging that Mr. Jackson was unable to work due to frequent hospitalizations caused by diabetes and pancreatitis, but that:

…the hospital gave him a ‘job’ of living without his thumb for the rest of his life, so he should be paid for it.

“Their defense was that the IV did not infiltrate and that even if it did, that was not what caused the loss of his thumb,” said Shamp. “They said it was simply that strange things happen and this was a coincidental blood clot that ended up contributing clotting at the same time.”

With the plaintiff’s permission, the named nurses were dismissed with the hospital remaining as the sole defendant. The Coffee County jury awarded Mr. Jackson $53,026 for medical expenses and $1.5 million for pain and suffering.