More Good News for Patients -No, Not Really.
Source: The New York Times, June 2009
A survey led by an associate professor at Weill Cornell Medical College of records of some 5,434 patients at 19 independent primary care and 4 academic medical centers has produced some startling results.
Now before you jump all over the Plaintiff attorney, the Director of Clinical Informatics and Brigham and Women’s Hospital in Boston, a fine institution in its own right, says the study was “high quality” and utilized “good methodology.”
So what were the results? Glad you asked. More than 7% of abnormal tests results were NEVER reported to the patient. Missed notifications included blood work and imaging studies. Curiously the offices in the survey volunteered to participate, indicating they were fairly confident they would get it right. The implication certainly is that one should not go by the old adage of no news. . .
Bottom line: If you haven’t heard back from your physician on a lab result or study, you might want to call and ask about it. Just a suggestion.
posted by David Marc Schwadron, Esq.
Pesticide Exposure and Parkinson's?
You have to be the right age group for this one and it may be a regional thing but . . Apparently running behind the mosquito truck was NOT a good idea.
Epidemiologists (people who study outbreaks of diseases) are beginning to link cases of Parkinson’s Disease to individuals occupationally (at work) exposed to pesticides. Specifically, the study focused upon French farm workers (a potential oxymoron) who used and were close to the use of organochlorine based insecticides, including DDT which has been long banned in the United States.
The Paris-based researchers have reported early results suggesting an increased risk for Parkinson’s Disease among that group. While the study drew no conclusions for common backyard gardeners, if the results relative to professional farm workers are supported, it might be a good idea to just put down the spray can and find more environmentally, and people-healthy ways of ridding yourself of those bugs eating your tomatoes.
posted by David Marc Schwadron, Esq.
Meat, Eggs, Dairy –Apparently do NOT Increase Risk of Breast Cancer
Okay, were I a woman, I’d be pissed. As a fan of women, I’m pissed on your behalf. Not only have you been told to refrain from red meat, eggs and dairy products (milk and cheeses) depriving your collective selves of wonderful and yummy animal proteins rich in amino acids, iron and calcium (something most women don’t get enough of) there apparently has been no valid reason for doing so.
A study of 319,826 women ranging in ages from 20-70 in Denmark, France, Germany, Greece, Italy, Norway, Spain the Netherlands (that’s the Dutch) and the UK failed to document any consistent link between intakes of meat, eggs and dairy products and any increased risk for the development of breast cancer in women.
I won’t get into the specifics of the study of the exclusionary criteria. Suffice it to say that the study published online in the American Journal of Clinical Nutrition, June 2009, was funded by a large number of international research foundations and it tails a 2007 World Cancer Research Fund study which similarly found no clear link between animal protein intake and breast cancer.
Now, put down the tofu. Step away from the tofu. I suggest that instead you have a nice filet with maytag blue cheese and a ceasar salad. No. Seriously.
posted by David Marc Schwadron, Esq.
Prostate Cancer and PSA Testing
Source: The American Urological Society
The American Urological and American Cancer Societies and the American College of Physicians, recommend prostate cancer screening at age 50 for even healthy males. For African-American males and those with a strong family history of prostate cancer, at age 40.
PSA (Prostate Specific Antigen) is an enzyme that naturally occurs in seminal fluid. However it should not be present in high quantities in the blood stream.
PSA levels of 4 to 10 ng/ml indicate a 20-30% risk for prostate cancer. 10 to 20 ng/ml indicate a 50-75% risk for prostate cancer and levels of PSA above 20 ng/ml represent a 90% risk.
There are other conditions, such as urinary tract infections, inflammation and BPH (Benign Prostatic Hypertrophy) which can also account for higher than normal PSA levels. However, you should not be falsely re-assured. The Lewis Law Firm is presently handling at least one case for a Veteran receiving treatment at a VA Hospital who was told that it was essentially “normal” for PSA levels to fluctuate above normal. If found early and treated properly (Another issue) Prostate Cancer is very survivable, depending on age of onset and aggressiveness.
However, if left unchecked, improperly reported or unrecognized, elevations in PSA could continue for months and even years during which time cancer can spread beyond the prostate (metastasize) and through the body resulting in limited chance of a cure. This is truly nothing to turn your head and cough about. If you are a male over age 50, or high risk by family history or by virtue of being an African-American Male, insist on a PSA check and ask to know the numbers.
posted by David Marc Schwadron, Esq.
Philadelphia Veterans and Botched Prostate Cancer Treatment!
In a case of truly adding insult to injury, physicians at the Philadelphia Veterans’ Hospital made significant errors in treating veterans with prostate cancer.
A common treatment is the implantation of radioactive “seeds” locally in the prostate to attack cancer cells forming tumors. However, in at least 92 of 116 such procedures, the team’s aim was “a little off” resulting in the implantation of the radioactive “seeds” into healthy bladders. Absent cancerous cells or a tumor, radiation will attack healthy tissue and organs resulting in irreparable damage including perforation and loss of bladder control.
Federal investigators have determined that Dr. Kao simply re-wrote medical notes to match the number of seeds where they should have been. For reasons which are unclear, the normal governmental checks went unwatched resulting in treatment without any review over a span of approximately six (6) years.
If you are a patient who underwent such treatment at the Philadelphia Veterans’ Hospital between 2003 and 2006, you should immediately contact your physician to determine whether there were similar errors made in your treatment for prostate cancer.
The Lewis Law Firm is presently handling cases of apparent medical errors in the diagnosis and treatment of prostate cancer.
posted by David Marc Schwadron, Esq.
Legislating Medicine: Access to Lab Testing
The Patient Access to Critical Lab Tests Act was introduced on 6/10/2009 by Senators Arlen Specter (PA) and Ron Wyden (OR). The Act is designed to improve patient access to potentially life-saving laboratory testing through allowing independent labs to bill Medicare directly.
With reimbursement streamlined, the hope is that physicians will not be discouraged to order additional laboratory testing for their patients. Currently labs are required to bill hospitals who, in turn, bill medicare. Presumably this system is inefficient and results in less testing being performed.
Whether the bill will become law or get lost or mired somewhere in the process remains to be seen. Kind of ironic, that. Will follow.
posted by David Marc Schwadron, Esq.
From the Looking Pretty Files -Dermal Fillers for Everyone!
Source: Various, including Dermik, makers of, you guessed it…
Okay, maybe not for everyone. For those of us aging (You know who you are) there are now more options than ever to not look like ourselves. Those of us intimidated by the prospect of surgery for facial rejuvination (Making your face look younger. Presumably the rest of you can go to hell in a handbasket), have the option of using dermal fillers! Dermal what-ers?
A history lesson. Since the dawn of time, or at least the dawn of purely cosmetic surgery in the 1980′s, doctors have been injecting substances under the skin to make it look fuller and more youthful and to get rid of lines and wrinkles. Not botox, which is poison –botulism, and works by paralyzing muscles with toxins, but other interesting substances. The first was bovine collagen (Yes, from cows!). More recently Hylauronic acids, which degrade over time requiring re-addition every 6-9 months and substances that stimulate the body to make it’s own collagen. Oh and returning to the animal kingdom, porcine collagen (From pigs, not porcupines) is said to be even more promising.
Perhaps not coincidentally, none of these treatments appear to last for more than 6-9 months and some considerably less. Draw your own conclusions there. So, if your lips aren’t full enough to resemble that of a famous Hollywood actress who has literally become a characature of herself or those stubborn cheeks of yours are still a little saggy or hollow and you don’t want to go under the knife, maybe injectable dermal fillers are the right thing for you.
The people at Dermik, Sanofi-Aventis and Johnson & Johnson sure would like you to think so.
posted by David Marc Schwadron, Esq.
On the Horizon: a Vaccine for Melanoma?
Source: American Society of Clinical Oncology Annual Meeting 2009, Orlando
An experimental vaccine study has shown recent promise in the treatment of melanoma, an often aggressive cancer of the skin. Melanoma is the deadliest form of skin cancer with a projected annual rate of death estimated at 8,650 patients this year alone.
The study combines the vaccine with interleukin-2 (IL-2), the standard in treatment of melanoma. The idea is to stimulate the immune system to attack cancer cells, much like a typical vaccine would for a common virus. How cool is that?
Okay, there’s always a “but.” In this case a large one. (mature blogger, I know). The study was of only 185 patients. Tumors actually shrank in only 22% of patient’s given the vaccine plus IL-2. IL-2 alone had a 10%. The vaccine was also said to delay cancer growth from 1 and 1/2 months with just IL-2 to almost 3 months with the vaccine combo.
Not exactly earth shattering but then, not exactly worth ignoring either. Perhaps in the future we will have cancer curing vaccines. Yes, before those flying cars and domestic robots we were all supposed to have by now.
posted by David Marc Schwadron, Esq.
Pro Tip: The Law Suit Process -A Primer
“Pro Tip” attributed to Lee.
We are often asked what one may expect when one suspects (say that 5x fast) that there was a mistake made with regard to medical care provided to a wife, husband, mother, father, child or loved one. In my former medical malpractice defense life I often provided physicians and nurses who were unfamiliar with a ‘road map’ to the process. From recent telephone conversations with potential clients, it occurred to me that patients and their family members might need one too. So here goes. The following is not meant to be exhaustive and certainly does not constitute “Legal Advice.”
What to expect from a Law Suit: Ours is a small office. Intentionally so. We limit the amount of cases which we accept to assure that: 1.) We are only taking cases with merit; and 2.) We can provide an outstanding level of service to our clients. So what happens when you think that there is a problem with the medical care received?
The First Step is to gather information. In this case, obtaining medical records. While lawyers can issue formal requests for records, once we get involved the process is slowed and by then costs you money. So the best thing to do is obtain all of the medical records you can before you contact us or shortly thereafter. Most documents and just about all MRI/CT/X-ray studies are conveniently available in CD/DVD formats.
The Second Step is our review. Our office, and certainly most, will not charge you for our initial review and opinion of whether a law suit makes sense. A bad outcome does not necessarily mean that you have a medical malpractice case. (Repeat as often as necessary). We must first determine whether there is arguable malpractice, or negligence, in the medical care. The next thing we must determine is whether the malpractice resulted in the harm or whether it could have occurred anyway. The third thing we must determine is what the harm is. Significantly, whether the amount of harm sustained is worth your time and effort, and yes, ours too. If we feel it’s not, game over. You are free to get a second opinion but trust us. So we have your records and we feel you may have a case. What next? Well as important as we feel our opinion on that is, the important opinions for your case are not out own.
Third Step, our medical experts. In both PA and NJ we are legally required to obtain the opinion of a properly qualified medical expert that you have a case before we can file a law suit on your behalf. What next? We file a law suit, which is Step Four and then you wait. Law suits can take a lot of time. (Repeat as often as necessary). In reality there are a number of things going on, formal responses to legal documents —called pleadings and formal requests for medical and other information –called discovery. You may be asked to sign authorizations for discovery and verify the statements in pleadings as well, but you will not really do much until the time of depositions.
Step Five is preparing for and providing a deposition. A process which could take up a book or two. For our purposes it is the time for you to answer questions asked by the attorney’s for the people sued and for you to truthfully tell your story. Then you wait, again. This is the longest wait from your perspective. It takes approximately 18 months, in theory, for your case to go from filing to a trial date. In reality that will be delayed. There will be delays in discovery, Motions, trial date delays. In short, expect delays. We do.
The final steps are Trial –Step Six or Settlement –Step Seven. Settlement is listed as seven only because it often takes the fact of a trial and sometimes the start of a trial for Settlement to be offered by the parties being sued. Hopefully, followed by Step Eight which is recovery.
Simple, right? Well, mostly anyway. The more you know. . .
posted by David Marc Schwadron, Esq.