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Articles Tagged with medical malpractice

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renal mass

renal mass in a 3 year olds child

Failure to timely diagnose Denys-Drash syndrome can be medical malpractice that can lead to renal failure and ultimately death. Denys-Drash syndrom is a very rare congenital disorder that affects young children. There are only 150 known cases in the world therefore very little information is available for doctors to diagnose and treat this disorder.

What is known so far is that  90% of the children with this disorder develop a rare pediatric kidney cancer known as Wilms tumor. Undescended testes and severe proximal hypospadias are also associated with this disorder. The Journal of the American Academy of Physician Assistants (JAAPA) recently released an article describing the case of a 3 year old patient affected by this syndrome. The authors Shawn C. Smith,  Barry Chang and Laura Beth Fleming are all from the Cardon Children Medical Center in Mesa, AZ where the patient was admitted.  The article describe how the authors of the article diagnosed the disorder and which treatments were used to treat the patient. The complete article can be found here 

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Distribution of the maxillary and mandibular nerves, and the submaxillary ganglion. Source: Wikipedia

Facial nerves, Source: Wikipedia

Failure to diagnose a rare disease called trigeminal neuralgia (TN) can be medical malpractice. The disorder can cause pain so extreme to a patient that it has been nicknamed “the suicide disease”.

In a recent article in the Washington Post, Sandra G. Boodman describes the story of a 59 year old man who almost died after a cohort of doctors he visited were unable to make a proper diagnosis.

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Medical malpractice is on the rise in hospices. Once a place handled by nuns and caring volunteers, hospice care has become a multi-million dollar business handled by not so caring CEO’s who are often putting profits ahead of patient needs.

Recently the FBI busted Brad Harris the 30 year old owner and CEO of a Texas Hospice for instructing nurses to overdose patients.  The Daily Beast  writes that during the course of the investigation Harris texted one of the nurses “You need to make this patient go bye-bye”. Harris who has no medical education also texted another nurse to increase by four times the patient’s medication. In another conversation Harris said “if only this F*** would die”.

Because hospices are paid by the government through Medicaid and Medicare  they receive a cap amount of $27,820.75  per patient. Therefore a patient who stays alive too long is not profitable for a hospice. The incentive is to have more patients with shorter stays. The FBI said Harris spoke about “finding patients who would die within 24hrs”.

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NursingMedical malpractice is often preventable. According to statistics from the Journal of the American Medical Association, 80% of adverse events in the health care system are the result of human errors. Medical malpractice is not only committed by doctors but also by nurses and other health care professionals. In a recent article in Minority Nurse, Nicole Thomas, a legal nurse consultant shares some very interesting statistics about medical malpractice. She also gives the following tips to nurses to avoid being sued for medical malpractice:

  1. Nurses should make sure they always proprely document their work. When a nurse writes a clear and precise description of what happens to a patient when he is under her care it  not only helps her and the staff make sure the patient is proprely being taken care but it also protects the nurse in case of a potential lawsuit. A nurse who defends herself  by saying “I did it but I forgot to document it”  will have trouble convincing the jury in a medical malpractice trial.
  2. Not only nurses should document everything but they should make sure their notes are easy to read. Even though a nurse may have been doing the right thing, unreadable notes open the door for a patient to question the nurse’s actions in considering filing a medical malpractice lawsuit.
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Urgent Care Centers have been opening all around New York City and the US these recent years  but are they really safe? Here are the most common acute care medical malpractice risks:

  • Patient is being send home with a very abnormal vital sign without a re-evaluation of that abnormal sign
  • Poor risk factor evaluation happens when  practitioners forget to ask important questions about the medical history of the patient
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Multiple cases of medical malpractice committed by several doctors including 3 neurosurgeons almost killed a patient according to a recent article written by Sandra Boodman in the Washington Post. Brad Chesivior from Maryland almost died after several doctors failed to diagnose a brain bleed. When a neurosurgeon finally made the proper diagnosis, the acute subdural hematoma that he was suffering from was as large as the size of an adult’s palm and was threatening to kill him. According to the neurosurgeon who made the proper diagnosis, Bard had probably no more than 24 hours to live and needed immediate surgery.

In the article the author describes how multiple doctors misdiagnosed the 60 year old man to the point that he almost died. The first significant symptoms appeared just after Thanksgiving 2013. Chesivoir suddenly became very weak and unable to walk. He was transported by ambulance to a Maryland emergency room. As he arrived at the ER he felt better and was able to walk again. The ER staff performed CT and MRI brain scans as well as multiple blood tests.  Doctors thought that he was the victim of a heart attack or a stroke but tests didn not show any of these. They completely missed evidence of multiple bleeds and sent Chesivior home with a diagnosis of headache.  They told him he should consult with his internist.  Chesivior went to see his internist who recommended he sees a neurosurgeon. The neurosurgeon looked at the previous scans made at the ER and missed the bleeds too. Instead she ordered additional tests and scheduled a follow up appointment almost two months later. In between, Chesivior’s headaches got worse. When they got even worse, he consulted with another neurosurgeon as his neurosurgeon was out of town. The second neurosurgeon told him that his problem was a typical migraine and prescribed amitryptiline. A few days later he developed double vision. The neurosurgeon told him it was an adverse effect from the medication and reduced his dose. The problem got worse. Two days later, he went to consult with a ophthalmologist who told his wife to drive him immediately to the ER where a fourth neurosurgeon finally proprely diagnosed the problem and saved him from death by operating on him the following day.

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Among the various types of medical malpractice suffered by hospital patients, misdiagnosis accounts for approximately 10% of patient deaths. In a recent Opinion Page from the New York Times, Sandeep Jauhar, a Long Island cardiologist, wants to Bring Back the Autopsy as a weapon to fight misdiagnosis.

With the evolution of medicine and the proliferation of medical tests, autopsy doesn’t seem as essential these days as it was in the past to determine the cause of death of a patient. Before 1971, community hospitals were required to perform autopsies on 20% of their dead patients to earn their accreditation from the Joint Commission. This requirement was dropped after that date. Furthermore in 1986, Medicare considered autopsies financially draining and stopped paying for them. Now an autopsy is mostly considered by doctors as an educational tool.

Recent studies however have demonstrated that despite the medical technological advances autopsy can be a very effective manner to reduce the rate of hospital misdiagnosis.  In his opinion Sandeep Jauhar suggests that Medicare and private insurers pay for them again so that financial considerations doesn’t limit their use.

 

 

 

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Should primary care doctors be liable for medical malpractice if they fail to discuss the HPV vaccine with parents of teenagers? HPV (human papillomavirus) is a sexually transmitted virus that can cause cervical cancer.  Because it is related to teenage sexual activity many doctors don’t discuss it with parents to avoid uncomfortable conversations with them.

A recent study published in Pediatrics shows that the HPV vaccine introduced 10 years ago is extremely effective in combating the virus and therefore in fighting cervical cancer. The study indicates that a comparison of the HPV rate between the pre vaccine period and the post vaccine period shows a decrease of two-thirds of HPV cases among girls aged 14 to 17. The decrease  occurred despite a very low immunization rate of 40% among 14 to 17 year old girls and 20% for boys of the same age. The rate of HPV cases among women between 20 and 24 years old also decreased by 34%. Among women older than 25 years the rate of HPV didn’t change.

Every year 14 million people in the US are diagnosed with HPV. According to the CDC there are approximately 100 strains of this type of virus. Around 40 of them can lead to an infection of the genital areas. Most of these 40 strains will turn into benign infections but a few of them can lead to serious conditions. Some HPV  strains such as types 16 and 18 can develop into oncogenic high-risk infections.  These specific infections cause most cervical, penile, vulvar, vaginal, anal, and oropharyngeal cancers and precancers. Other HPV strains such as types 6 and 11 cause genital warts and recurrent respiratory papillomatosis.

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Diane HoffmanCan medical malpractice lawsuits help reduce opioid addiction?  In a recent opinion in the New York Times Diane Hoffman  a law professor and the director of the Law and Health Care program at the University of Maryland’s Francis King Carey School of Law is warning about the consequences of erroneous criminal prosecutions of doctors who treat chronic pain patients. While she agrees that bad actors who are over prescribing drugs for profit should be punished, she worries that good doctors may under threat their patients for fear of being investigated and prosecuted.  While she recognizes that opioid addiction and abuse is a major issue that should be addressed by law enforcement, she also believes that the 100 million American patients who are suffering from serious pain condition shouldn’t be under treated. We agree that doctors who specialize in treating patients for chronic pain should not be subject to criminal prosecution. However, those doctors who run so called prescription mills and write narcotic prescriptions for anyone who walks in the door should be criminally prosecuted. Doctors who have no training in the field of pain medication and over prescribe narcotics resulting in fatal overdoses may be liable for medical malpractice. The fact is that lawyers who specialize in medical malpractice will not bring these cases unless the prescribing doctor blatantly over prescribed without any medical basis. Ms. Lane’s statement that doctors who under prescribe pain medication may be subject to medical malpractice law suits is based on one 15 year old case in which a doctor was found liable for elder abuse for under prescribing pain medication to an elderly man dying of cancer. In reality these types of cases are rarely brought.

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In a recent article, Sandra G. Boodman from the Washington Post writes about the case of a man whose doctors failed to diagnose Familial Mediterranean Fever (FMF) for months until he consulted with a well traveled gastroenterologist who suspected FMF. FMF is a disorder caused by a gene mutation. this disorder is known to affect Sephardic Jews, whose ancestry is Middle Eastern, as well as non-Jews from the Middle East, Italy and Armenia.

43 year old Jeffrey Sank suffered from recurrent abdominal pain for nearly a year. At the beginning attacks were intermittent but after several months the pain increased in severity and intensity. Jeffrey visited with multiple doctors including two gastroenterologists, a kidney specialist and an infectious-disease physician.  The infectious-disease specialist suspected he had FMF but but did not pursue it after Sank told him he wasn’t of Middle Eastern descent. The last gastroenterologist he saw also suspected it was FMF and even though Sank again denied any Middle Eastern descent again, he decided to prescribe him colchicine, a mainstay therapy for FMF. The drug worked immediately and the abdominal attacks almost stopped. Later on genetic tests demonstrated that Sank had indeed inherited mutated genes from both his parents.

 

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