The Journal of Emergency Medicine recently reminded its readers that fever and white count are not foolproof. In fact, the article pointed out that more than half of the patients studied had a normal white count despite having an infection. Seventeen percent of infected patients had both a normal white count and no fever.
There are many reasons why temperature and white count can be normal in a patient with an infection. For example, when these may not appear until later in an infection, particularly in elderly populations. Temperature can be masked in patients who are on fever-relieving medications or who receive chilled intravenous fluids that reduce the body's temperature. White counts are likewise subject to a number of factors.
In Ohio, when physicians fail to follow accepted standards of medical practice and cause injury to a patient. they are liable for harm caused to the patient by such medical errors. When the treatment of an infection is delayed, and it progresses from an early treatable infection to an advanced septic shock or organ failure such that the patient dies or sustains other avoidable injuries, it may be worthwhile to speak to an experienced medical negligence attorney.
]]>Surgical fires occur when gases used during surgery, such as oxygen or nitrous oxide, are ignited with heat generating tools, such as electrocautery tools, lasers or fiber-optic lights. According to the FDA, "[s]urgeries of the head, neck and upper chest pose a greater risk of fire, especially if the patient is receiving extra oxygen through a breathing mask or nasal tubing."
The problem occurs often enough that the FDA organized a coalition of surgical teams, hospitals, healthcare engineering companies and patient safety organizations to prevent this medical error. The FDA's Preventing Surgical Fires Initiative (www.fda.gov/preventingsurgicalfires) was formed to encourage caregivers to adopt safe surgical practices to prevent fires in the operating room (O.R.).
Avoidable surgical errors often carry devastating consequences. Patients are most vulnerable when they are sedated. Many things, including fires, can go wrong if due care is not employed to protect the defenseless in this setting.
]]>Since the procedure is considered experimental, health care providers who perform it must carefully and thoroughly explain its experimental nature, the lack of data supporting clear benefits and the significant risks. For consumers considering this procedure, full disclosure is critical to informed consent.
Risks of the procedure include death, stroke, detachment and migration of the stents, damage to the treated vein, blood clots, cranial nerve damage and abdominal bleeding associated with the procedure. The treating physician should also disclose that the balloon angioplasty devices and stents used in the procidure have not been approved by the FDA for use in treating CCSVI. Only one clinic in Ohio currently performs the procedure, so its use has not become widespread locally. But like many lucrative procedures, it is probably only a matter of time before more physicians offer the treatment to their desperate patients.
]]>Dangerous drugs, including contaminated drugs, that cause injury may properly be the subject of a product liability claim or a medical claim, depending on the circumstances of the case. In Ohio, time limits for filing a lawsuit are different for product liability claims and medical claims. Therefore, prompt consultation with an attorney is advisable.
]]>1. Average Life expectancy was 78.1 years. This is an average and includes all comers, including healthy people, people with multiple diseases and illnesses and all races. The trend shows that people continue to live longer.
2. The leading causes of death are heart disease, cancer, chronic lower respiratory diseases, stroke and accidents. Heart disease and cancer continue to trend lower as a cause of death.
3. The leading causes of infant deaths are congenital malformations, disorders related to short gestation and low birthweight,sudden infant death syndrome, and newborn deaths caused by maternal complications.
4. The age-adjusted death rate was 1.2x greater for black's and 2.3x greater for black's for infant deaths.
For more information on National Vital Statistics visit http://www.cdc.gov/nchs/products/nvsr.htm
If a loved one has died due to negligence we can help you.For information on wrongful death claims visit us at Mishkind Law Firm Co. L.P.A.
]]>Other distinguishing factors to inquire about involve experience, results and peer recognition. Due to the complexity and high-stakes associated with medical negligence litigation, few inexperienced lawyers can provide competent representation, unless they are closely supervised by a more experienced attorney. At Mishkind Law, we have a combined 56 years of experience handling medical negligence claims. Results are another consideration. Mishkind Law lawyers are members of the Million Dollar Advocates Forum and have recovered over $100,000,000.00 on behalf of clients. Finally, peer recognition is an important consideration. The Mishkind Law Firm lawyers have achieved the highest rating by the Martindale-Hubbell rating service and have been named Super Lawyers in Ohio.
Every medical negligence case is unique, though many share similarities. We have handled cases involving virtually every specialty of medicine. While we may not have handled your specific fact pattern, our global experience with medical negligence litigation and specific experience within the specialty of medicine involved in your case, qualifies us to handle your claim.
]]>When caught early and treated properly, the prognosis for malignant melanoma is excellent. However, delays in diagnosis can lead to progression of the disease from an early, treatable stage to an advanced, incurable stage. As with most other cancers, early detection saves lives, while a delay in diagnosis of cancer can cost lives. Delays in diagnosis and treatment may occur for a number of reasons that are attributable to medical negligence: (1) failure to screen or failure to refer to a dermatologist for screening; (2) failure to remove and send pigmented lesions (e.g, moles) for evaluation by a properly trained pathologist; or (3) misinterpretation of pathology slides.
In addition, medical negligence may arise by a failure to properly treat malignant melanoma once detected by a pathologist. The primary treatment found to be effective in preventing the spread of malignant melanoma is surgical removal. Unlike other cancers, malignant melanoma is not amenable to chemotherapy or radiation therapy. Several experimental treatments are available, including intereferon therapy, but none has been shown to be curative.
In order for surgical excision to be effective, the surgeon must obtain "clean margins." This means that the tumor is completely removed and the pathologist finds that there is no tumor that connects to the skin left behind after surgery. Absent clean margins, the tumor may grow back (called a "local recurrence") and spread to other parts of the body through the lymphatic system and bloodstream, including to lymph nodes, the liver and the brain.
In order to obtain clear margins, certain standards of care have developed to assure a surgeon that an adequate periphery of noncancerous tissue has been established around the tumor site. A recent study published in the Journal of the American Academy of Dermatology showed that, to clear melanomas, 6-mm margins were sufficient in 86% of cases, 9-mm margins cleared 98.9%, 1.2 cm cleared 99.4%, 1.5 cm cleared 99.6%, and 100% of lesions were cleared with 3-cm margins.
]]>Once the parties have exchanged written discovery responses, depositions will take place. A deposition is a question-and-answer session wherein the opposing party's attorneys question various parties and witnesses about facts relevant to the case. You will typically be asked to sit for a deposition. We meet with all of our clients in advance of these depositions in order to familiarize them with the process, prepare them for the types of questions that they may be asked and to answer any questions that they have regarding the deposition process.
Finally, you will be involved in the resolution of the case, whether through settlement or trial. Settlements typically occur during the course of mediation, which is a formalized settlement conference. You will need to be present during the course of mediation. Mediations usually last about one day, but can take several days. If the case is not resolved by settlement at mediation, the case proceeds to trial. The length of the trial will vary depending on the nature of the case and the court's scheduling conflicts. Most cases can be tried in one to two weeks. You will be required to be present during each day of the trial, except in cases where the client is excused due to age, infirmity or disability.
]]>When the administration of clot busting medications is delayed, the window of opportunity for using these medications closes and they can no longer be used. The American Stroke Association has already established that "time is brain," meaning that the sooner blood flow is restored to the brain after a stroke, the less permanent brain damage the stroke will cause. Clot busters are an important tool for opening clogged arteries and restoring blood flow.
There are, of course, certain limits on the use of clot busters, as with any medication. Not only must they be used within the applicable window, but they can only be used to reverse symptoms of a stroke caused by blood clots. They cannot be used to restore blood flow when there is a hemorrhagic stroke (also called a "brain bleed").
]]>Our fee percentage, as set forth in our contingent fee agreement, is consistent with industry standards. Further, our contingent fee agreement complies with all ethical rules that apply to Ohio lawyers.
]]> In addition to fees, there are expenses. The expenses associated with some injury litigation can be monumental. For example, in medical negligence cases, case expenses, including expert fees, court costs, deposition fees, travel expenses, costs for trial exhibits and the like, can exceed $100,000.00. As part of the contingent fee agreement, Mishkind Law will typically advance payment for expenses incurred during the course of litigation. If and only if a recovery is made, the attorneys will be reimbursed for these case expenses after attorney fees are paid. If there is no recovery, the client does not owe for the case expenses.Critics argue that contingent fees make it too easy for clients to sue. The other side of this coin is that without contingent fees, courts would be reserved only for the wealthiest members of society. Average citizens would have no recourse even when seriously injured by another's negligence. It should also be understood that there are many checks and balances in place to prevent frivolous lawsuits. Lawyers are subject to sanctions for frivolous lawsuits. Judges are vested with the authority to dismiss nonmeritorious cases. Finally, juries can reject cases with which they disagree, even after the judge has determined that the dispute between the parties is legitimate.
]]>Cerebral palsy is an umbrella term used to describe a multitude of symptoms that affects the cerebral area of the brain, the side of the brain responsible for motor skills and movement. Some cases of cerebral palsy can be traced to a lack of development in utero, and other cases can be attributed to damage to the brain before, during or after birth.
Of the 100,000 children who are diagnosed with cerebral palsy each year, about 10 percent are found to be due to a birth injury. Deprivation of oxygen during the birth process and difficult deliveries are believed to contribute to the diagnosis.
]]> Treatment of Cerebral PalsyCurrent regimes for treating the disorder include physical therapy, surgical intervention and drug therapies. Although these treatments may help reduce the symptoms, currently there is no treatment available to reverse the damage. It is permanent.
Earlier this month, however, a team of researchers from the Eunice Kennedy Shriver National Institute for Child Health and Human Development announced that they had had some success with the use of a new drug in reversing the symptoms of cerebral palsy in rabbits. The particular type of cerebral palsy was caused by an infection the birth mother had prior to delivery. After treatment with the trial drug, researchers found that rabbits showed reversal of cerebral palsy motor symptoms within five days.
Research shows that early intervention seems to be critical to success. This need for quick diagnosis may prove to be problematic for medical professionals. Currently, children are typically not diagnosed until they are two or three when most children begin to walk.
While the new medicine is in the early development phases it offers some hope for the families of children struggling with cerebral palsy.
Source: Fox News, "Cerebral palsy drug may offer hope for treatment," Rachael Rettner, Apr. 19, 2012.
]]>Once prolactinoma is suspected, imaging is typically done. However, imaging cannot conclusively determine whether a mass is a prolactinoma, another pituitary tumor or some other type of tumor.
]]> A critical part of the testing for prolactinoma is a blood test for elevated prolactin levels, a hormone produced by the pituitary gland. Interestingly, these blood tests must be performed on more than one occasion because hormone levels can be adversely affected by a variety of factors, including the time of day that the test is performed, diet and even lunar cycles.Currently, the blood test for prolactinoma is effective for diagnosing smaller prolactinomas. However, larger tumors produce so much prolactin that the serum prolactin level may actually appear normal, low or only slightly elevated. This phenomenon is called the "hook effect." Hook effects are relatively common and well-known among endocrinology experts. A special laboratory test must be ordered to account for the hook effect when a large prolactinoma is suspected.
When a large prolactinoma is misdiagnosed as another type of tumor, devastating consequences can ensue. Most prolactinomas can be treated with medicines that shrink the tumor and relieve its symptoms. However, when there is a misdiagnosis, surgery may be ordered. Unnecessary surgery to remove a prolactinoma carries many otherwise avoidable risks, such a brain injury, nerve damage, blindness, infection, stroke and death.
Medical malpractice claims arise under Ohio law when a physician fails to follow accepted standards of medical care. When it comes to misdiagnosing a large prolactinoma, there are two potential types of medical negligence: (1) a surgeon failing to consult an endocrinologist; and (2) an endocrinologist failing to order specific lab testing to account for a potential false negative due to the hook effect.
]]>Prior to filing a medical negligence claim, your attorney must obtain an "affidavit of merit." This affidavit certifies that the allegations in the complaint have been reviewed by a qualified medical expert and appear meritorious based on the contents of the medical records. Since it takes time to obtain an affidavit of merit, it is best that you consult an attorney as soon as possible after you suspect that you have been a victim of medical negligence.
]]>Often, medical negligence cases are subject to mediation. Mediation is a formal settlement conference presided over by an independent mediator who attempts to facilitate settlement. Prior to any mediation, we will meet and prepare by reviewing the mediation process and discussing our evaluation of the claim at that point in the litigation.
When a case cannot be settled through mediation, the case proceeds to trial. Settlement discussions typically continue during the course of trial. At the conclusion of the trial, we will suggest to the jury what would be fair compensation for the injuries that are at issue. The amount of the dollar amount that we suggest depends on the various valuation factors discussed above. Ultimately, if the case is not settled, a jury is vested with sole discretion to set the value of the case through its verdict. However, the jury's decision is subject to two important limitations: (1) the trial court has the duty to impose certain pre-set caps on damages; and (2) the trial court has the duty to reduce the damage award if it is deemed excessive or order a new trial.
]]>In additiion, contractual duties may impose liability. Professional services agreements often require staff physicians to obtain insurance coverage. Patients are third-party beneficiaries of such a contract. Under Ohio law, when a promisee intends for a contract to benefit a third party, the promisee assumes a duty toward the third party. Laurent v. Flood Data Serv., Inc. (2001), 146 Ohio App.3d 392 3. In breaching such a duty, the hospital is liable for damages caused.
Common law duties may also arise when a hospital undertakes the duty of requiring insurance coverage to protect its patients. "A voluntary act, gratuitously undertaken, must be ... performed with the exercise of due care under the circumstances." Briere v. Lathrop (1970), 22 Ohio St.2d 166, 172. This assumed duty may be breached by virtue of the fact that the hospital did not require an "occurrence"-type policy or "tail" coverage upon termination of staff privileges to cover a claim occurring during the pendency of the staff privileges.
Finally, Ohio hospitals owe their patients a fiduciary duty due to their special relationship. Douglass v. Salem Community Hospital (2003), 153 Ohio App.3d 350. A fiduciary has "a duty, created by his undertaking, to act primarily for the benefit of another in matters connected with his undertaking." Strock v. Pressnell (1988), 38 Ohio St.3d 207, 216. By failing to ensure that its staff physician was covered for a patient's claim before granting him staff privileges, the hospital arguably breached its fiduciary duty to the patient.
For attorneys who would like briefs or pleadings that pertain to this discussion, feel free to contact the lawyers at Mishkind Law. As dedicated advocates for healthcare consumers, we would be pleased to assist you.
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