January 9, 2014

Medical Malpractice Brain Aneurysm - Failure to Timely Diagnose and Treat

A family, whose daughter died as a result of an untreated brain aneurysm, recently has settled their wrongful death lawsuit against a medical group comprised of more than 400 doctors, prior to the case going to trial.
More details of the case can be found here.

For years, the woman suffered from frequent migraine headaches and had been receiving treatment from a particular medical group. In December 2006, the woman visited another medical center complaining of an unusually severe headache. She received a pain shot and was sent home from the medical center shortly after. Over the next several days, the woman visited doctors at both the medical group and the medical center and was treated with medication for a sinus infection and given additional pain shots. At no time during these visits did she receive any radiographic studies or undergo any further tests to determine if a more serious condition may have been involved. Several days later, the woman was rushed to the hospital where she was diagnosed with an untreated aneurysm. Tragically, six days later, she died as a result of bleeding in her brain.

The woman’s lawsuit alleged that she did not receive the medical care she needed and deserved from the treating physicians and staff. As a result, the woman lost the opportunity to receive the necessary medical treatment due to the misdiagnosis. The medical malpractice wrongful death suit recently settled for $3.25 million.

While certainly no one intended to miss the aneurysm and ultimately this tragedy to happen, physicians and hospital staff are held to a certain standard of care for all of their patients. This level of care must be maintained, since a mistake of any kind or any bit of negligence on behalf of the hospital or a physician may result in unfortunate consequences, such as causing a patient’s injury to be worse than what they came in with, or sometimes even death. Certainly, no amount of money can take the place of a healthy family member, or make up for a family’s terrible loss, but the individuals who made these negligent mistakes must be held accountable for their actions, and the families affected deserve some type of financial compensation for their loss.
In tragic cases such as these, where a person is injured or killed as a result of someone else’s medical negligence, the family of the victim may be able to file a medical malpractice claim or lawsuit for wrongful death on behalf of their family member affected by the physician’s negligent act. Wrongful death actions allow the family to hold the person accountable for their negligent actions, even though the party bringing the suit was not the one injured by the physician’s negligent act.

If you have a loved one that was injured or killed as a result of a physician’s negligent actions, please contact one of our medical malpractice attorneys to discuss what legal options may be available to you and your family. Our experienced medical malpractice attorneys have helped many families hold negligent physicians and hospital staff liable for their wrongful actions that resulted in death or injury of a loved one.

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December 20, 2013

Medical Malpractice Settlement For Failure to Diagnose and Treat Diabetes

It should go without saying that a person who enters a hospital has certain expectations of the level of care they will receive and how the medical staff will behave. Hospitals can be frightening and intimidating, and patients rely on their physicians to ease their apprehensions and concerns. Above all, patients expect to receive the highest level of care, both quickly and meticulously. In this same vein, doctors are expected, and even trained, to make the proper decisions when the time comes to make a diagnosis or recommend the appropriate treatment.

Unfortunately, this standard of care sometimes is taken for granted. Across the country, surgical errors, misdiagnoses and hospital negligence happen all too often. The consequences of such mistakes vary widely – from no injury to the patient to sometimes permanent injuries. When a doctor misses important information, or ignores crucial signs, the result can be a serious misdiagnosis, often leaving a patient in a worse condition. No matter how small the error or resulting injury may be, these medical mistakes cannot be overlooked.

Misdiagnosis is a common error among physician’s that puts a patient’s health and safety at risk. For these reasons, many patients file medical malpractice lawsuits against physicians who negligently misdiagnose an injury or illness. This was the case for a woman in Iowa, who recently was awarded a large settlement in connection with her physician’s serious failure to diagnose an illness. A copy of the article regarding the settlement can be found here.

A State Appeal Board recently approved a $1.5 million medical malpractice award against a hospital for a lawsuit filed by a woman who alleged doctors failed to diagnose her condition correctly. The woman had to have all of her toes amputated due to diabetes, which she alleged the hospital failed to diagnose and properly treat. The woman visited the hospital in July 2010, seeking a diagnosis for her symptoms. She later claimed that the care she received at the hospital was substandard. This level of care, she alleged, resulted in no diagnosis, and the woman’s diabetes went untreated. Unfortunately, this led to the amputation of her toes sometime later.

The woman sued the Iowa medical facility for medical malpractice, alleging that the doctors failed to provide the proper standard of care during her visit. Ultimately, the hospital settled the case for $1.5 million. This past week, that award was approved by the State Appeal Board, ensuring that the woman receives adequate compensation for her physical and emotional pain and suffering as a result of the physician’s failure to diagnose her diabetes.

Patients who feel their health and well-being have been compromised by a physician’s negligence, including a failure to diagnose, may be able to bring a medical malpractice suit. These medical malpractice suits often are complex and require specific attention to detail. Our experienced medical malpractice attorneys successfully have represented dozens of patients who have suffered injury or loss as a result of a physician’s medical negligence. Please contact one of our medical malpractice attorneys if you believe you may be a victim of physician negligence.

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October 9, 2013

Jury Awards More Than $950,000 in Medical Malpractice, Wrongful Death Lawsuit

Recently, in a medical malpractice wrongful death case in Harford County, Maryland, a jury awarded more than $958,000 to the family of a woman who died after receiving “excessive amounts” of pain medication during a hospital stay. According to the lawsuit, the woman’s death resulted from the hospital providing hospice care rather than standard treatment for her infected ulcers.

In February 2010, the decedent, Beverly Ann Gargiulo, was admitted to Upper Chesapeake Health Center seeking treatment for ulcers that reportedly had become infected. The hospital allegedly told Mrs. Gargiulo she would need hospice care but never communicated that information to her family. During her treatment, Mrs. Gargiulo reportedly received large amounts of narcotics, including morphine and oxycodone, in increasing amounts and with increasing frequency. The family claimed in their medical malpractice and wrongful lawsuit that this pain relief medication was more appropriate for a patient about to die than for a person who was expected to be discharged from the hospital. Gargiulo’s family filed suit against the hospital asserting multiple causes of action for medical malpractice. In August, a jury awarded the family $958,258 after it found that the hospital committed medical negligence in its treatment of Gargiulo, and that this negligence resulted in a wrongful death. A copy of an article regarding the case can be found here.

I have handled many cases involving overmedication causing serious injuries and even death. These cases require a detailed understanding of medications and dosage levels, which only a medical malpractice lawyer has.

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October 7, 2013

Medical Malpractice and Wrongful Death in Hospitals - An Alarming Trend

In 1999, the Institute of Medicine estimated that each year 98,000 Americans die as a result of medical malpractice. A recent study published in the Journal of Patient Safety says that number now is estimated to be between 210,000 and 440,000 patients. The new estimates, developed by John T. James, a toxicologist at NASA’s space center in Houston and leader of an advocacy organization called Patient Safety America, were based on the findings of four recent studies which examined records of more than 4,200 patients hospitalized between 2002 and 2008. A copy of the article can be found here.

What makes those numbers particularly appalling is that the causes of wrongful death were preventable medical mistakes, such as errors of commission and omission, errors of communication and context, and diagnostic errors. And, even more disheartening, this number would make medical malpractice errors the third-leading cause of death in America, behind heart disease and cancer, respectively.

The recent study found the increase was due to multiple causes. Systematically, hospitals struggle with staffing issues, making suitable technology available for patient care, and executing effective handoffs between shifts and inpatient and outpatient care. Further, increased production demands, coupled with a lack of transparency and accountability, also may increase the risk of preventable adverse events. James advocates for a national patient bill of rights for hospitalized patients that would empower them to be thoroughly integrated into their care so that they can take the lead in reducing their risk of serious harm from medical malpractice and wrongful death.

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July 2, 2013

Medical Malpractice Involving Failure to Diagnose

Unfortunately, some of the most common medical malpractice lawsuits involve a doctor of hospital’s failure to diagnose a patient properly. When a patient seeks medical help, he or she trusts that their doctor or hospital will perform the necessary steps to diagnose what is causing their symptoms ultimately provide the proper treatment.

A missed or wrong diagnosis can lead a patient down the wrong treatment plan, or without any treatment plan at all. A missed diagnosis or a failure to diagnose occurs when a doctor or hospital does not diagnose a medical condition in a timely matter. Failing to properly diagnose a patient prevents doctors and medical staff from providing the proper treatment, which often can lead to further injury or sometimes even death.

Such was the situation in a recent case study involving a twenty-nine-year-old patient who delivered a child by cesarean section. One month after her delivery, the mother went to the hospital complaining of a painful migraine, blurred vision, nausea, and vomiting. The results from her CT scan were interpreted as normal, and the patient was discharged from the hospital with no medication or treatment provided. Two days later, she returned to the hospital with slurred speech, drooling and weakness in her upper and lower limbs. An additional CT scan was ordered immediately, which revealed an intracranial hemorrhage. Ultimately, she died of an intraparenchymal hemorrhage in her left cerebral hemisphere.

This case illustrates the serious risks involved if a doctor fails to diagnose the symptoms of a stroke. The faster a stroke is detected, the sooner treatment can begin and the better the chances the patient will have a full recovery. When a medical professional misdiagnoses a medical condition or fails to diagnose a medical condition and a patient ends up seriously injured as a result, the patient may have a medical malpractice case. Our medical malpractice attorneys have successfully represented victims of misdiagnoses and missed diagnoses and have the experience and resources needed to handle these complex matters.

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June 11, 2013

Negligence Involving Bed Rails

There are many hidden and unknown dangers in the very places we expect to heal; for example, hospital beds. Many of these hospital beds have rails, typically made of metal, that run along the side of the sleeping space. These bed rails operate to prevent someone from rolling off accidentally.

Several months ago the Consumer Product Safety Commission released a review of bedrail deaths and injuries of adults. Using data from hospitals, the report cited 155 deaths involving bed rails from January 2003 to September 2012. In that same period, almost 37,000 people were injured in bed rail accidents and treated at hospital emergency rooms. According to this report, the deaths and injuries most commonly occurred when the victim became stuck in the bed rails, mainly with his or her head or neck getting caught. These alarming numbers triggered the CPSC to move forward in addressing bed rail safety.

Last week, the CPSC “merged” two petitions related to bed rail safety. Combined, the two petitions offer the CPSC an array of options: it can decide to do nothing, ban the use of bed rails entirely, or choose any various steps in between. Safety advocates are insistent that no intermediary step will eliminate all harm, suggesting that a ban likely is the best and safest option. The prevalence of these beds and bed rails in residences, nursing homes, and hospitals suggests that it is likely this petition will gain deep collective interest among a number of organizations.

Although these bed rails are intended to improve safety, they may lead to serious harm or even death. No one should be injured by a product that is supposed to keep them safe and content. But, when something does go wrong, it may be due to improper design or use. For those affected, there are many avenues for legal recourse. To learn more, please contact our experienced attorneys who have handled negligence cases involving hospital beds.

A copy of the petition can be found here.

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May 21, 2013

Malpractice litigation helps reduce medical error

The New York Times recently ran a fascinating op ed by Joanna Schwartz, a professor at UCLA. The subject was a study that Professor Schwartz did on the value of medical malpractice litigation in reducing medical errors. Professor Schwartz’s conclusion was that medical malpractice claims and lawsuits actually don’t result in doctors and other health professionals hiding problems and, in fact, such suits actually encourage improved practices.

In order to reach her conclusions, Professor Schwartz surveyed more than 400 people who are responsible for hospital risk management, claims management and quality improvement in hospitals in the U.S. She found that, although hospitals used to handle medical errors and lawsuits by taking an adversarial and secret approach, hospitals have begun changing that approach. Now, she reports, hospitals are more open with patients. In fact, she found that over 80 percent of hospitals that she surveyed now actually have a policy of apologizing to patients who are victims of errors. Most importantly, she found that most hospitals are willing to discuss and learn from errors with staff. This is a dramatic shift form the old days when health care providers kept from patients the fact of medical injury. A copy of the op ed piece can be found here.

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February 22, 2013

Dr. Nikita Levy - A Race To The Courthouse

A number of news organizations are reporting today that lawyers in Baltimore are racing to the courthouse to file lawsuits against Dr. Nikita Levy and Johns Hopkins Hospital. When I heard that, I sadly chuckled. The only thing that these lawyers know now is what the media is reporting. There is no other information available from Dr. Levy’s family, Johns Hopkins, the Baltimore County Police who executed the search warrant, the Baltimore City Police who are leading the investigation or the FBI which is assisting the Baltimore City Police with the forensic evaluation of the electronic evidence.

My firm and I are taking a different approach than rushing to the courthouse; we believe that it is better to conduct a thorough and detailed investigation rather than run the courthouse simply to be the first to file a civil lawsuit. Accordingly, I issued a pre-lawsuit deposition notice and subpoena to Johns Hopkins today seeking to determine what it knows and where documents and other evidence are located. A copy of the Deposition Notice can be found here. While I believe that ultimately a lawsuit is likely in these cases, such a lawsuit should be based upon a through analysis of the facts and not media reports.

Today, we also joined with a leading Maryland victims service organization, The Maryland Crime Victims Resource Center, Inc., to advocate for victims of this travesty. A copy of the letter can be found here.

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February 19, 2013

Johns Hopkins Physician Dr. Nikita Levy

Over the last few days, news reports have surfaced that a gynecologist / obstetrician who worked for Johns Hopkins, Dr. Nikita Levy, was improperly taking photographs and videos of patients. The Baltimore Sun's report can be found here. WBAL's report, which includes an interview I gave, can be found here. Apparently, a co-worked reported Dr. Levy to a supervisor at Hopkins on 2/4/13 which resulted in Dr. Levy being fired by Hopkins on 2/8/13 and Hopkins notifying the police.

The police subsequently searched Dr. Levy's home and found a large amount of "evidence." Presumably, this means that they found many photos and videos of his patients. After retaining a local lawyer, Dr. Levy committed suicide.

Surprisingly, patients are finding out about Dr. Levy's misconduct through the news media instead of through Hopkins itself. Even the now disgraced St. Joseph Medical Center advised patients when its cardiologist Dr. Midei was found to have unnecessary implanted cardiac stents in hundreds of patients over years.

One major issue is who is responsible for Dr. Levy's misconduct. He is certainly liable, but his malpractice insurance may exclude coverage for such misconduct and the extent of his assets are unknown. Hopkins, on the other hand, may be liable for the conduct of their employee.

As an attorney who handles major medical malpractice cases, I already have been contacted by several patients of Dr. Levy. These people are angry that Hopkins did not contact them, they want to know whether they are victims and whether the photos / videos have been distributed.

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October 12, 2012

Johns Hopkins study find misdiagnosis to be a significant contributor to instances of medical malpractice in intensive care units

Johns Hopkins Hospital researchers recently uncovered a startling figure regarding hospital medical malpractice: 40,500 intensive Care Unit (ICU) patients die each year as a result of misdiagnosis, as opposed to life threatening conditions that cannot be treated. A copy of an article regarding the study can be found here.

The study, released September 26, 2012, found that patients in the ICU are fifty percent more likely to be misdiagnosed than patients in other parts of a hospital. Further, according to the study, the most common misdiagnosis involves the vascular system, often resulting in heart attack or stroke.

This is an important study because it shows that there is malpractice at many of Maryland's hospitals. It also shows that even some of the best hospitals in the state, such as Johns Hopkins Hospital or the University of Maryland Medical Center, are still striving to improve quality of care and reduce the incidence of medical malpractice and wrongful death.

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September 13, 2012

Johns Hopkins Hospital Among Maryland Hospital’s Testing Patients for Hepatitis C

Numerous Maryland hospitals are currently in the process of testing almost 2,000 patients who may have been exposed to hepatitis C, a viral disease that typically affects the liver. A copy of an article can be found here.

David Kwiatkowski, an employee at as many as eleven hospitals nationwide, was arrested in July 2012 after authorities learned he had been injecting himself with syringes filled with stolen narcotics at the hospitals where he worked, and then leaving the contaminated needles to be used on other patients. Investigators believe Kwiatkowski may have had hepatitis C since at least June 2010, increasing the likelihood that he infected patients who came in contact with these syringes.

In Maryland, Kwiatkowski is known to have worked at four hospitals including Johns Hopkins Hospital, Maryland General Hospital, Baltimore VA Medical Center and Southern Maryland Hospital. At Johns Hopkins Hospital, three people have tested positive for a hepatitis C strain the same or similar to Kwiatkowski which indicates their cases may be related.
While no patients have yet filed a lawsuit against Johns Hopkins Hospital or one of the other Maryland hospitals where Kwiatkowski worked, a Kansas resident filed suit against a Columbia-based staffing agency for failing to report Kwiatkowski even though they knew he had stolen narcotics.

As an experienced Baltimore, Maryland medical malpractice lawyer, I have successfully handled a number of medical malpractice cases against hospitals for the negligence of their employees or agents. To see some of the cases I have handled, click here.

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August 24, 2012

Could placing patients’ pictures in their charts reduce medical errors? One study says yes.

After pushing hospitals to replace paper records with electronic ones, many policymakers now believe the next step in improving the quality of medical care is to reduce the number of errors made by doctors. One study recently found that putting a child’s photo in their electronic hospital chart reduced one type of medical error – a patient getting a test or treatment intended for someone else due to a doctor’s misplaced orders. An article about the study can be found here.

The Children's Hospital of Colorado found that misplaced orders were the second-most common reason that patients received care not meant for them in a quality improvement program conducted in 2009. The hospital reacted to this result by changing its computer system so that each order for a test or treatment required an affirmative “verification” that the order was aligned with the correct patient which included a photo of the child.
The results reflected the success of this policy change: in 2010, the hospital had twelve incidents in which a child received care intended for another patient because of misplaced orders, but after implementing the photo policy, that number fell to three.

Using digital cameras to take patient’s photos when they are admitted would make is feasible for other hospitals to add photos to their electronic records as it is relatively inexpensive.
Although policies such as this reduce the number of medical errors at hospitals, patients should still understand the general treatment plan so they can speak up if they believe they are getting incorrect or inappropriate treatment and/or tests.

As an experienced Baltimore, Maryland medical malpractice lawyer, I have been involved in a number of medical malpractice, medical negligence and medical error cases in Baltimore and other counties in Maryland involving misplaced orders. To see some of the cases I have handled, click here.

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February 10, 2012

Johns Hopkins Study Finds Hospital Websites Exaggerate Success

Research conducted by Johns Hopkins doctors has found that an estimated forty percent of hospital websites advertise the use of robotic surgery as superior to conventional surgery. However, there is a no evidence to suggest these statements are true. In particular, hospitals often exaggerate the benefits associated with robotic surgery while ignoring the risks.

A copy of the article about the study can be found here.

Johns Hopkins researchers warn that the lack of candor in promotional materials is potentially dangerous for various reasons. Much of the positive advertisement is provided by the surgical robots' manufacturers, as opposed to independent analysis by doctors or hospitals. This is a concern because the general public relies on hospitals, including their websites, to provide honest and complete information. Essentially, many would consider the material on a hospital's website to be as if it was coming directly from a physician.

The study conducted by Johns Hopkins researches yielded startling results. Of the sample of hospital websites studied, forty-one percent described the availability of robotic surgery. Of those, eighty-nine percent (89%) indicated that robotic surgery is clinically superior over conventional surgery. Specifically, eighty-five percent (85%) said there would be less pain, eighty-six percent (86%) said there would be a shorter recovery, eighty percent (80%) said there would be less scarring and seventy-eight percent (78%) said there would be less blood loss. Shockingly, none of the websites mentioned any risks associated with robotic surgery at all.

The researchers at Johns Hopkins warn that the continuation of this type of behavior by hospitals could ultimately result in medical malpractice suits. When hospitals rely on device manufacturer's to provide patients with information, and the information is not substantiated, hospitals are providing content that is dishonest and misleading. While the use of surgical robots to perform minimally-invasive common procedures has grown at a rapid pace, claims of smaller incisions, more precise results, less pain and shorter recovery time remain unsubstantiated. However, as more and more hospitals buy this expensive equipment, they continue advertising these results to patients. In actuality, studies have shown that robotic surgeries present numerous risks because they take more time and keep patients under anesthesia for longer, in addition to the fact that they are more costly; but none of these concerns are usually provided by hospitals promoting its use.

The biggest problem with a hospital’s use of manufacturer-provided information is the inherent conflict of interest. Hospitals hold a trusted role as medical advisors and must make all effort not to misinform patients. To use the information provided by manufacturers of the robotic devices without verifying the accuracy and truthfulness of that information is a violation of public trust, according to Johns Hopkins researchers.

This is an important study because it shows that there is possibly significant malpractice at many of Maryland's hospitals as a result of the failure to adequately inform patients regarding their care.

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December 1, 2011

Family Wins Medical Malpractice Case Against Johns Hopkins Hospital

In early 2010, the family of a 17-year-old girl with a rare genetic disorder brought a medical malpractice suit against the Johns Hopkins Hospital alleging that the Johns Hopkins doctors and nurses provided inappropriate treatment to the disabled girl.

The Baltimore City jury that heard the medical malpractice suit found the staff at Johns Hopkins negligent in restraining the girl in a manner that caused extensive bruising. The girl, a long-time patient at Johns Hopkins Hospital, was extremely frail as a result of her condition and required special treatment. The girl’s father alleged that following an overnight stay at Johns Hopkins Hospital on March 12, 2007, he noticed "numerous bruises" on the girl’s body in addition to a "large lump on her forehead." Johns Hopkins Hospital staff provided no explanation for the bruises other than "spontaneous bruising" caused by her disorder. The girl’s father was not satisfied with this response, and brought the medical malpractice suit against Johns Hopkins Hospital. A copy of the article regarding the lawsuit can be found here. Ultimately, the jury found that Johns Hopkins Hospital was negligent and committed malpractice for the bruises awarded the girl $250,000.00.

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October 20, 2011

Medical Mistake Regarding Organ Transplant Leads to Medical Malpractice Lawsuits

A couple in Pennsylvania has filed two medical malpractice lawsuits following, what should have been, a routine organ transplant.

The couple alleges that the organ transplant went awry when, despite test results indicating the donor-spouse had hepatitis C, the hospital transplanted her kidney into her husband. Hepatitis C is an incurable infectious disease that attacks the liver causing a wide range of problems including damage, cirrhosis, cancer or failure. A copy of the article regarding the case can be found here

The first lawsuit was filed against the hospital and various staff members. The suit, filed by the donee and the donor, alleges negligence. The couple states that the donor’s blood results were available months before the organ transplant, but that the hospital and physicians missed them. The organ transplant, which took place in April, was preceded by a blood test on January 26 which indicated that the donor had hepatitis C. The hospital never notified the donor of these results or disqualified her as an organ donor. Another test, which occurred weeks after the organ transplant, also indicated the presence of the infection. It was not until a month after the kidney transplant had taken place when the donor was notified of these results.

The second lawsuit claims that physicians provided the donor with the option of keeping her infection a secret from her long-time boyfriend, despite the transplant of the hepatitis C kidney. The suit also alleges that the physicians made several accusations against the donor, including her having cheating on her boyfriend and having used cocaine. The Pennsylvania couple has been together for 21 years and they have an 18-year-old son.
The hospital has stated that the transplant was a “medical mistake” and an investigation was completed; the results found that human error was to blame. This mistake comes after guidelines were recently issued by the CDC to reduce the risk of transmitting disease during organ transplants, specifically focused on donor screening.

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September 1, 2011

$2.5 Million Malpractice Award to Maryland Family

A Maryland jury awarded the wife and two children of a 59-year-old man $2.5 million in damages following his untimely death from medical malpractice at Montgomery General Hospital in 2007. The lawsuit alleged that the doctor attending to the man at Montgomery General failed was negligent in failing to recognize and diagnose that he was suffering from "hemorrhagic shock" and treat the same. A copy of the article regarding the settlement can be found here.

The man’s death occurred two days after he fell and fractured his pelvis. The family alleged that the primary care physician, who was the sole defendant in the medical malpractice case, did not realize that the man was suffering from internal bleeding. The family believes that had the doctor treated this condition when he first examined him, he could have saved the man’s life. Instead, the man ultimately died from multiple organ failure due to the internal bleeding.
While the primary care physician argued that the man died as a result of a side effect to medication that restricted his intake of oxygen, this theory was discredited because no mention was made of any such complication on the death certificate.

Further, the family’s attorney was able to present numerous signs that the doctor should have alerted the doctor to the problem. For example, the man had both low blood pressure and a rapid heartbeat. Another example is that, within a 24-hour period, the man had not produced urine. Each of these circumstances, in addition to others, were clues that the patient was experiencing blood loss.

The $2.5 million in damages consisted of $1 million each to the man’s estate and his wife, and $250,000 was awarded to each of Dixon's children.

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August 15, 2011

Peninsula Regional Medical Center Settles Stent Medical Malpractice Cases

Peninsula Regional Medical Center, located in Salisbury, Maryland is the latest Maryland hospital involved in medical malpractice suits arising from unnecessary stent procedures.

Last month, cardiologist John R. McLean, M.D. was convicted of health care fraud offenses after implanting cardiac stents in more than 100 patients who did not need them. McLean was found to have performed unnecessary tests and made false entries in medical records when he submitted insurance claims for the stent procedures.

Despite its attempt last year to be dismissed from the case involving McLean, which was denied by the U.S. District Court for the District of Maryland, Peninsula Regional Medical Center agreed to pay $1.8 million to settle the case in early August. The allegations set forth in the suits against Peninsula Regional Medical Center were that it failed to act to prevent the unnecessary procedures even though it were aware of McLean’s behavior. There were fifty-two parties named as plaintiffs. Additionally, under the settlement, the hospital must also repay the money it received from federal health benefit programs while the unnecessary medical procedures amounting to fraud were going on.

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August 10, 2011

Baltimore Washington Medical Center Must Pay A $14,000 Fine

Baltimore Washington Medical Center, located in Anne Arundel County Maryland, was recently fined by the Maryland Department of Environment (MDE) a result of medical malpractice. The settlement agreement reached between the MDE and Baltimore Washington Medical Center stemmed from an error in which the hospital administered an improper dose of radiation. The MDE became involved because radiation doses are supposed to be limited to levels as low as reasonably achievable, pursuant to the Maryland Radiation Act. A copy the article can be found here. .

As a result of the self-reporting system, the hospital notified officials, as well as the patient, about the error in which the patient was exposed to radiation inconsistent with the treatment plan. While it’s likely that the medical mistake will not result in any negative effect on the patient, radiation doses that are too high can kill cells while those that are too low can damage or alter the DNA within the cells.

As a result of this mistake, and in addition to the $14,000 fine, hospital officials will have a radiological health official present at each of their next four radiation safety meetings to make sure the hospital is in compliance and to provide guidance if necessary.

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June 20, 2011

Punitive Damages and Vicarious Liability in a Maryland Medical Malpractice Case

In a Maryland medical malpractice case in which the plaintiff seeks punitive damages against a doctor for conducting an unnecessary procedure, is the employer hospital vicariously liable for punitive damages?

In general, Maryland has uniformly applied a broad rule for punitive damages and held an employer vicariously liable for punitive damages for its employee’s tortious acts. Embrey v. Holly, 293 Md. 128, 137-38, 442 A.2d 966, 971 (1982). The nature of punitive damages is such that a punitive damage award may be apportioned between multiple wrongdoers depending upon the degree of culpability and the pecuniary status of each. Embrey, 293 Md. at 141, 442 A.2d at 973. In Embrey, which was a defamation case, the Court held that it was entirely proper to permit a jury to apportion punitive damages among multiple defendants, the speaker of the defamatory language and his employer radio station. Id. at 143, 442 A.2d at 974.

Continue reading "Punitive Damages and Vicarious Liability in a Maryland Medical Malpractice Case" »

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June 17, 2011

In 2002, ten years after being born with among other things, cerebral palsy, mental retardation, and developmental delay, a newborn, through her guardian, filed a medical malpractice lawsuit against University of Maryland Medical System’s University of Maryland hospital. The newborn, through her guardian, alleged that hospital was negligent because it made the mother wait before conducting an emergency c-section, which resulted in severe injury to newborn. A jury in the Circuit Court for Baltimore City initially entered a verdict in favor of hospital. On appeal, the Maryland Court of Appeals reversed and remanded the case to the Circuit Court. A copy the judicial opinion regarding the case can be found here.

The underlying issue in this medical malpractice case was a factual dispute regarding culpability on the part of the University of Maryland Hospital for the newborn’s injuries. The mother stated that after arriving at the University of Maryland hospital, she waited for approximately five hours, without any treatment, before the c-section was performed. The University of Maryland hospital, on the other hand, denied that it was negligent and stated that the woman did not arrive at the hospital until minutes before the emergency c-section was performed.

The c-section only took three minutes to perform but when the newborn was delivered, she was without a heartbeat, she was having difficulty breathing, and she had low Apgar scores. Apparently, a placental abruption had caused the need for the emergency c-section, and the newborn’s disabilities. The doctors at the University of Maryland hospital inserted a breathing tube and placed the child on a ventilation machine, after which she was admitted to the Neonatal Intensive Care Unit.

The Circuit Court, in ruling on various evidentiary issues, had excluded hospital medical records that corroborated the mother’s version of events. The Court of Appeals ultimately reversed the decision of the Circuit Court and remanded it for further proceedings because it believed the medical records had been improperly excluded.

I have handled many cases where the entire case turns on a just a few medical records. These cases can be won or lost on the medical records, which is why it is important in a medical malpractice case to use an experienced medical malpractice attorney who is very familiar with what should be in medical records and what should not be in medical records.

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June 10, 2011

Maryland Hospital Patient Safety Report

Earlier this month the Maryland Department of Health and Mental Hygiene Office of Health Care Quality published a report regarding medical malpractice in Maryland hospitals. The report is a review of the safety and care provided to patients in Maryland hospitals. The report compiles information collected by the OHCQ in 2010 relating to serious adverse events that affected patients or their families. A copy of the report can be found here.

The adverse events that hospitals are required to report include a rather long list of mistakes that are possible because of hospital error, medical malpractice (negligence), or inattention. Patient falls are the most frequently reported event. In 2010, there were 88 reported cases resulting in serious disability or death. Of these 88 reported cases, 10 resulted in loss of limb or function of limb, 52 required surgical interventions, 20 required medical intervention and 6 resulted in death of the patient.

Hospital-acquired pressure sores / ulcers, which are associated with high morbidity (medical complications) and mortality (death) once they reach Stage 3 and 4, were reported 59 times in 2010 making it the second most frequently reported event. However, none of the reported cases in 2010 resulted in death.

The third most frequently reported event was delay in providing needed treatment leading to a patient suffering death or serious disability. There were 20 of these reported in 2010. Delays in treatment that result in an adverse event often cause hospital protocols to be revised and changes in hospital policies and procedures to take place. In 2010, there were 17 cases where a delay in treatment resulted in death.

Adverse events related to the failure of doctors to maintain a patient’s airway or to supply an adequate level of oxygenation increased in 2010. A basic medical intervention is a procedure to keep a patient’s airway open. However, there were still 9 reported “airway misadventures” in 2010; 8 were fatal and the other left the patient in a persistent vegetative state.

Delays in treatment and failure to maintain a patient’s airway are the medical errors that most frequently fatal. Over the past six years, 83 of 102 patients whose medical treatment was delayed died, and 51 of the 58 patients whose airway was not maintained.

Surprisingly, adverse events related to foreign bodies being retained within a patient following surgical procedures continue to occur on a regular basis. In 2010, there were 15 reports which is a 250% increase over any previous year. However, the number of reports of wrong patient surgeries, wrong side surgeries, and wrong surgical procedures is low; there were only 4 reported cases in 2010. When these errors are made, the root cause is often the consent or pre-operative forms prepared in doctor’s offices.

There were only 9 reported cases of physician errors resulting in the wrong medication being administered to a patient that resulted in death or serious disability. This includes patients who have adverse drug reactions.

Misdiagnosis was only responsible for 2 reported cases of death or serious disability, whereas failure to act accounted for 3 cases.

We handle cases like these all of the time in my practice. It’s nice to see a government agency reporting on these things. Hopefully, this report will encourage hospital administrators and doctors to take action to try and prevent these things in the future.

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March 4, 2011

Malpractice / Negligence Involving Ulcer Treatment

The surviving family of a 37 year old Alabama man has won a $3 million jury verdict from a local hospital. The man died a few days after surgery for a duodenal ulcer. The family claimed that the man bled to death after negligent surgery, and negligent follow-up care after discharge. Specifically, the family alleged that the man’s ulcer, a perforation in the first section of the small intestine, was large and not treatable by the standard surgical procedures. The family also alleged that the man was sent home after surgery with a very low blood count and was not adequately examined by his doctor before being discharged. A copy of an article regarding the case can be found here.

I have handled many negligent surgery cases. The key to success in such cases is obtaining all of the relevant medical records, reviewing them carefully, getting a good expert witness and backing the case up with medical literature where appropriate. Also important in such a case is reviewing the medical records to make sure the post-operative care is within the standard of care and not negligent. Usually, this is done by checking the patient’s vital signs (heart rate, breathing rate, blood pressure and temperature), and drainage.

I once handled a case a somewhat similar case of a woman who came into a hospital emergency room with a bleeding ulcer and bleed to death (called exsanguination) within hours. She kept bleeding in the hospital as evidenced by her blood test results which indicated that she was experiencing severe internal bleeding (her hematocrit level kept dropping), but the doctors failed to stop the bleeding. Eventually, her blood pressure crashed and they gave her many units of blood, but by then it was too late to do surgery and she died. That should not happen where there is enough time to operate and stop the bleeding.

As an experienced Baltimore, Maryland medical malpractice lawyer, I have handled a number of medical malpractice cases involving negligent surgery, negligent emergency room or other hospital care and negligent discharge from a hospital. They are extremely complicated and require expertise that most general personal injury attorneys do not have. To see some of the cases I have handled, click here.

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March 2, 2011

Maryland Hospitals Penalized for Preventable Complications

Nine Maryland hospitals face financial penalties for having far too many patients contracting preventable medical conditions such as infections, pneumonia and bed sores. Those hospitals commtting medical malpractice are Prince George's Hospital Center, Doctors Community Hospital, Laurel Regional Hospital, Union Hospital in Cecil County, Montgomery General Hospital, Civista Medical Center in Southern Maryland, Shady Grove Adventist Hospital, Washington Adventist Hospital and University of Maryland Medical Center. The penalties were handed down by the Maryland Health Services Cost Review Commission, which sets rates that hospitals can charge. The evaluation and penalties are designed to improve patient safety and lower health care costs by linking hospital performance with their payments. A copy of an article regarding the penalties can be found here.

This is an important study because it shows that there is significant malpractice at many of Maryland's hosptials. It also shows that even some of the best hospitals in the state, such as the University of Maryland Medical Center, still have far to go to improve quality of care and reduce the incidence of medical malpractice and wrongful death. In fact, it is interesting to note that, at the same time that this study came out, members of Congress were trying to further limit the rights of victims of medical malpractice by trying to limit damages to $25,000.

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August 4, 2010

Malpractice Causing Injury To Blood Vessel and Nerve During Biopsy

An Ohio jury has awarded $1.5 million dollars to a in a medical malpractice case against two doctors. The jury found that a doctor committed malpractice during a bone marrow biopsy in which a nerve was nicked and an artery was damaged. Apparently, the problem went undiscovered for five days and doctors had to remove two large hematomas from the hip and pelvis. The other doctor was called two days after the procedure but declined to examine the patient. The negligence caused the man to lose he use of his right leg below the knee, and resulted in chronic pain. A copy of an article regarding the case can be found here.

As an experienced Baltimore, Maryland medical malpractice lawyer, I have handled a number of medical malpractice cases involving vascular injuries and nerve injuries. These can be difficult cases because the defense is that the procedure is done relatively blindly and injury to a blood vessels and nerves and this can happen, but there are procedures to minimize the risk of such injuries and they clearly were not followed in this case. Moreover, the failure of the subsequent treating doctor to see the patient was clear malpractice.

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February 11, 2010

Post-Operative Monitoring Medical Malpractice

A Connecticut medical malpractice case has been settled for $5.25 million in favor of a woman whose left leg had to be amputated as a result of complications from spinal surgery performed at a local hospital. The lawsuit alleged that a doctor performed an elective "anterior transabdominal approach to the lumbosacral spine," and then her doctor and the hospital staff failed to properly take care of her in the intensive care unit, causing the loss of the leg. While in the ICU, the woman suffered intra-abdominal hemorrhaging, post-operative bleeding, abdominal wounds, and other severe complications that the hospital staff did not appropriately diagnose or treat, resulting in a gangrenous lower leg that resulted in an above-the-knee amputation. A copy of the article regarding the case can be found here.

As an experienced Baltimore, Maryland medical malpractice lawyer, I have handled a number of medical malpractice cases involving failed back surgery. Usually, they are caused by improper technique during the surgery, but sometimes it is the post-operative monitoring that is deficient. During the post-operative period, the surgeon and the nurses at the hospital must be alert for changes in the patient’s condition that require further testing and procedures. Usually, simply monitoring the patient’s oxygenation rate, pulse, breathing, responsiveness and blood work is sufficient. These functions usually tell how well a patient is doing. Any abnormalities must be promptly investigated. To see some of the cases I have handled, click here.

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February 11, 2010

Post-Operative Monitoring Medical Malpractice

A Connecticut medical malpractice case has been settled for $5.25 million in favor of a woman whose left leg had to be amputated as a result of complications from spinal surgery performed at a local hospital. The lawsuit alleged that a doctor performed an elective "anterior transabdominal approach to the lumbosacral spine," and then her doctor and the hospital staff failed to properly take care of her in the intensive care unit, causing the loss of the leg. While in the ICU, the woman suffered intra-abdominal hemorrhaging, post-operative bleeding, abdominal wounds, and other severe complications that the hospital staff did not appropriately diagnose or treat, resulting in a gangrenous lower leg that resulted in an above-the-knee amputation. A copy of the article regarding the case can be found here.

As an experienced Baltimore, Maryland medical malpractice lawyer, I have handled a number of medical malpractice cases involving failed back surgery. Usually, they are caused by improper technique during the surgery, but sometimes it is the post-operative monitoring that is deficient. During the post-operative period, the surgeon and the nurses at the hospital must be alert for changes in the patient’s condition that require further testing and procedures. Usually, simply monitoring the patient’s oxygenation rate, pulse, breathing, responsiveness and blood work is sufficient. These functions usually tell how well a patient is doing. Any abnormalities must be promptly investigated. To see some of the cases I have handled, click here.

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February 10, 2010

Acute Long-Term Care Malpractice

The New York Times has just published a very interesting article on Long-term acute care hospitals and the medical malpractice / substandard care that goes on in many of them. According to the Times, these hospitals, have been springing up across the country since the 1980s, and specialize in the long-term care of seriously ill patients. Most of these hospitals are for-profit, which means that there is a strong incentive to provide minimal care. Once long term acute care hospital chain drew increased scrutiny, Select Medical Corporation, which reportedly had a rate about four times that of regular hospitals for serious violations of Medicare rules. According to the Times, Medicare inspection reports of many of these hospitals showed preventable patient injuries and deaths and inadequate staff numbers with high turnover. A copy of the article can be found here.

As an experienced Baltimore, Maryland medical malpractice lawyer, I have successfully handled a number of medical malpractice cases involving care of the chronically ill. These patients are at risk for severe bed sores, major infections, falls and death. These people usually are almost totally dependent on others for their care. That makes it even more outrageous when they are not properly care for due to the profit motive.

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February 9, 2010

Malpractice Causing Dehydration and Brain Damage

A Florida jury has awarded the family of a 9-year-old boy $11.1 million in a medical malpractice case arising out of negligent medical care at a local hospital. The family claimed that the child was not properly treated in the emergency room. The child, then 3 months old, had been sick for days with vomiting and diarrhea, so he was taken to the hospital. After a few hours, he was discharged, however, the hospital had failed to check the child for dehydration. By the next morning he could barely breathe, and had to be rushed back to the hospital. By that time, he suffered from an irreversible brain injury. A copy of the article regarding the case can be found here.

As an experienced Baltimore, Maryland medical malpractice lawyer, I have successfully handled a number of medical malpractice cases involving sick children. I also have handled several dehydration cases. When people get sick, especially when they vomit or have diarrhea, they can become dehydrated quickly, which creates a serious imbalance in their fluid and electrolyte levels. When these levels become out of sync, they can cause severe sickness, organ damage and even death. In these cases, it is critical for the doctor or hospital to perform a a complete blood count and a simple metabolic panel. To see some of the cases I have handled, click here.

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February 3, 2010

Failure to Respond To Abnormal Blood Test Results

A Pittsburgh jury has awarded $2.3 million to a woman in a medical malpractice case against a hospital which arose from a complete abdominal hysterectomy she underwent there. The woman went to the hospital to deliver a child and was improperly discharged with a high white blood count that gave her a serious infection requiring a hysterectomy one week later. The woman’s doctor claimed that he never received notice of the abnormal blood work, but the hospital claimed he had. While the blood work results were i the chart, no one appears to have paid attention to them before the woman was discharged. The verdict was for the woman’s pain and suffering.

As an experienced Baltimore, Maryland medical malpractice lawyer, I have successfully handled a number of medical malpractice cases involving abnormal blood work that was never communicated to the right person or acted upon properly. In one case, a woman who was being transferred from a hospital had a severely low electrolyte level but no one acted on it before she was transferred and she died. In another case, a child had a very low white blood count with what is called a left shift, indicating a severe infection. But the hospital sent him home where he went into arrest and died. Cases like these, where abnormal lab reports are in the medical records but no one responds, are inexcusable cases of medical malpractice. To see some of the cases I have handled, click here.

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August 3, 2009

Spinal Abscess Causing Paralysis - Medical Malpractice

A New York man has been awarded $19.2 million in a medical negligence case against a hospital in New York City. The man was admitted to the hospitalcomplaining of severe back pain. The hospital’s staff negligently failed to diagnose a spinal abscess, which is an infection on the spinal cord, which quickly led to his permanent paralysis. Apparently, the hospital did not conduct an MRI or CAT scan until two weeks after thje man was admitted, when the damage had already been done. A neurosurgeon tried to reverse some of that damage, but it was too late. The man has been paralyzed from his chest down ever since.

As an experienced Baltimore, Maryland medical malpractice lawyer, I frequently handle medical malpractice cases in Baltimore, Maryland and other places involving paralysis. To see some of the cases I have handled, click here .

In a case like this, it is important to prove violations of the standard of care and that the violation caused the person’s paralysis. In such cases, we frequently use neurosurgery experts, neuroradiology experts, infectious disease experts, etc. One of the most frequent reasons for people to sue in such a situation is to obtain compensation that allows them to obtain better medical care than they or their health insurer otherwise would provide, and to gain independence. That is exactly what happened in this case. A copy of the article regarding the case can be found here.

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December 5, 2008

Hospital Malpractice - Medical Malpractice

Los Angeles County has finally acknowledged for the first time in a medical malpractice case that a woman who died shortly after writhing in pain for nearly an hour on the waiting room floor of a county hospital been saved if she had been properly treated. The woman was captured on security videotape as a janitor mopped around her and a triage nurse dismissed her complaints early one morning in May 2007. The woman’s death helped precipitate the closure of the hospital's emergency room and inpatient care after federal regulators determined that staffers had failed to deliver a minimum standard of care.

The woman’s boyfriend, who had accompanied her to the emergency room and called 911 from a nearby pay phone after no one would help, recently was offered a $250,000 settlement by county supervisors. A separate lawsuit against the county filed by her adult children could potentially prove far more costly and is considered more likely to go to trial. The children have asked for $1 million for each minute she was denied treatment -- $45 million in all.

The indifference shown to the woman’s suffering made national news and outraged county supervisors and national health authorities as well as area residents. A federal report issued last year concluded that six staff members, including a nurse and two nursing assistants, saw or walked past the woman but did nothing. She died from a perforated bowel shortly after she was arrested on an outstanding warrant instead of being treated.

The potential county payouts in the case would mark the latest in a long history of settlements and judgments against the now-shuttered hospital for poor patient care. A copy of an article regarding the case can be found here.

I have been involved in a number of medical malpractice / medical negligence / medical error cases in Baltimore and other counties in Maryland involving care that was so below the standard of care that the state medical board or nursing board investigated and filed charges. In one case, a nurse was even prosecuted criminally for failing to render proper medical care, causing the death of the woman. It’s always helpful when the state gets involved to investigate. Many times, the state’s report can be a helpful tool to prove what happened before the lawsuit is ever filed.

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September 3, 2008

Failure to Follow Orders - Medical Malpractice

A South Carolina hospital and doctor have agreed to pay more than $1.2 million to settle a medical malpractice wrongful death lawsuit filed by the family of a woman who died after she failed to receive a physician-ordered blood test. Apparently, the woman had surgery and was later discharged. Two days after the discharge, she went to the emergency room of the defendant hospital complaining of numbness in her left leg. The medical negligence lawsuit claimed that a doctor ordered a blood test that was not done. The woman subsequently went into a coma and died. A copy of the article regarding the case can be found here.

I have successfully handled a number of medical malpractice and wrongful death cases in Baltimore and other counties in Maryland involving a failure to follow-through with a doctor’s orders. One of the cases I handled involved a failure to timely give blood that was ordered by a doctor. As a result, the patient bled out and died. These cases are always tragic because the problem was recognized by the doctor, but the staff just did not follow the order.

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August 11, 2008

Premature Discharge Medical Malpractice

A California jury has awarded $8.5 million to the widow of a man who died on the day a surgeon was going to discharge him from the hospital. Because of limits on medical malpractice cases, the woman probably will receive only $1.6 million of that amount.

The 49-year-old man broke six ribs in a motorcycle accident in 2002. At the trial, his wife’s attorneys argued that a doctor should have more closely monitored him after x-rays showed he had one gallon of liquid backed up in his stomach four hours before he died, and he had previously been resuscitated. The man died after choking on his own vomit.

I have successfully handled a number of medical malpractice / medical negligence / medical error cases in Baltimore and other counties in Maryland involving premature hospital discharge / improper discharge from a hospital. These cases have ranged from failure to properly diagnose and treat infections / sepsis, failure to diagnose and treat pulmonary embolisms, failure to properly diagnose and treat surgical complications, failure to diagnose and treat heart attacks, failure to diagnose and properly treat brain injuries, etc. Sometimes these cases arise soon before discharge or right after. These cases are always tragic because the patient and family trust the doctor and hospital to do the right thing and, as a result, they are usually given a false sense of security in the planning of the discharge or the actual discharge itself. Many times, the patient and/or family’s concerns are dismissed and they are reassured that everything will be fine and the patient will get better. A death within days of a planned or actual discharge should always be carefully investigated.

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July 23, 2008

Hospital Malpractice Involving Brain Abscess

A Pittsburgh jury has found that the University of Pittsburgh Medical Center at Shadyside was negligent in a patient's death and awarded $2.5 million for wrongful death. The case alleged that a young man died after a brain abscess was not treated in time by the staff at the hospital. The jury actually issued a statement saying, "It is our belief that UPMC Shadyside's policies, culture, and lack of competent supervision resulted in the death of Michael Rettger." The young man, who was an accountant, was in West Virginia in November 2003 to perform an audit of another hospital when he began vomiting and reporting a headache. The man then was admitted to that hospital, and a CT scan and MRI revealed a large, swelling mass in his brain. The man was transferred to UPMC Shadyside in order to be closer to home. A copy of the article regarding the case can be found here.

I have successfully handled a number of medical malpractice / medical negligence / medical error cases in Baltimore and other counties in Maryland, and in Washington, D.C., involving the failure of hospitals to timely diagnose and treat patients with brain and other conditions. Of course, one has to obtain the medical records and retain proper experts in these cases, such as neurosurgeons and radiologists, to determine what really happened. But what is also critical in these type of cases is to obtain the hospital’s written standards to determine how the hospital expected its people to act, and to then take the depositions of the people most involved with the care and treatment of the patient, to understand what they did and whether they complied with hospital policies.

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June 30, 2008

Hospital Failure To Care For Transerred Patient - Malpractice

A Florida jury has awarded $12 million for the death of a premature baby caused by medical malpractice. The parents contended in their suit that the hospital negligently accepted a transfer of the baby from another hospital, but did not have the appropriate specialists on its staff to deal with their baby’s infection. A copy of the article regarding the case can be found here.

In Maryland and the District of Columbia, most hospitals can be classified as academic medical centers (like the Johns Hopkins Hospital, the University of Maryland Medical Center, George Washington University Medical Center or Georgetown University Hospital, etc.) or community hospitals (like Sinai Hospital, Harbor Hospital, Shady Grove Adventist, etc.). Maryland and District of Columbia hospitals also are labeled according to what type of trauma center they are.

The concept of a trauma center was developed at the University of Maryland Medical Center in the 1960s and 1970s by heart surgeon and shock researcher R Adams Cowley, who founded what became the Shock Trauma Center. Trauma centers in the United States are ranked by the American College of Surgeons (ACS), from level I (comprehensive service) to level III (limited-care). The different levels refer to the type of resources available in a trauma center and the number of patients admitted yearly.

A level I trauma center provides the highest level of surgical care to trauma patients. It has a full range of specialists and equipment available 24 hours a day and admits a minimum required annual volume of severely injured patients. A level I trauma center is required to have a certain number of surgeons and anesthesiologists on duty 24 hours a day at the hospital, an education program, preventive and outreach programs. Other required elements include 24-hour in-house coverage by general surgeons and prompt availability of care in varying specialties such as orthopedic surgery, neurosurgery, anesthesiology, emergency medicine, radiology, internal medicine, oral and maxillofacial surgery, and critical care, which are needed to adequately respond and care for various forms of trauma that a patient may suffer. Additionally, a Level I center has a program of research, is a leader in trauma education and injury prevention, and is a referral resource for communities in nearby regions.

A level II trauma center works in collaboration with a Level I center. It provides comprehensive trauma care and supplements the clinical expertise of a level I institution. It provides 24-hour availability of all essential specialties, personnel, and equipment. Minimum volume requirements may depend on local conditions. These institutions are not required to have an ongoing program of research or a surgical residency program.

A level III trauma center does not have the full availability of specialists, but does have resources for emergency resuscitation, surgery, and intensive care of most trauma patients. A level III center has transfer agreements with level I or level II trauma centers that provide back-up resources for the care of exceptionally severe injuries.

Obviously, a Maryland or District of Columbia hospital can be liable for medical malpractice / medical negligence for failing to have the required specialist on the premises, or readily available as required by the ACS, if it causes an injury or damage.

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