Sources: David A. Hyman, MD, JD ; and Charles Silver, JD; CHEST 2013; 143(1):222–227
Take it with a grain of salt as it comes from a physician-lawyer and a lawyer, but strongly consider a well-researched article published in a peer reviewed medical journal which seeks to dispel the 5 Major myths that are consistently brought up by advocates for tort reform.
Myth 1: Malpractice Crises Are Caused by Spikes in Malpractice Litigation (ie, Sudden Rises in Payouts or Claim Frequency)
So-called “runaway” jury verdicts are rare and payment on them rarer still. Using data from State and Federal databases, including the National Practioner Databank, the authors determined that the frequency of medical malpractice claims and medical malpractice payments on malpractice claims were either stable or declining in the years preceding the “medical malpractice crisis” 1999 to 2000. The vast majority of patients who have bad medical outcomes do not retain a lawyer and do not ever file a medical malpractice lawsuit.
Myth 2: The Tort System Delivers Jackpot Justice
Again, most medical malpractice cases are settled with less than 5% of medical malpractice cases going to trial. And the doctors tend to win, at least 75% of the time. The big verdicts get publicity because, well they are big verdicts. But the fact is that big verdicts aren’t typically paid verdicts. Appeals almost always follow and such cases, if not retried, are settled for substantially less money than the original reported verdict. Settlements are almost always on the condition of non-disclosure agreements and therefore these do not get published with the detail and names that the original sensational news item will.
Myth 3: Physicians Are One Malpractice Verdict Away From Bankruptcy
Any verdict, blockbuster or otherwise, that exceeds the limits of a provider’s insurance coverage (typically $500,000 to $1 million) is very unlikely to be paid. It certainly would be difficult if not impossible in some circumstances to collect a verdict directly from a doctor. Out-of-pocket payments by physicians are extraordinarily rare. In sum, physicians have effectively no personal exposure on malpractice claims (other than the obvious and unavoidable side effects of litigation, eg, the emotional and time-related costs of being deposed and the surcharges from their insurance company).
Myth 4: Physicians Move in Large Numbers to States That Adopt Damages Caps
The “we’re losing our doctors” cry has fallen on deaf ears. Your doctors are still here, for the most part. It is true that doctors are electing not to go into higher risk professions (obstetrics, surgery) and that this may be a response to medical malpractice claims but babies continue to be delivered at hospitals both with and without incident. According to the authors’ extensive research, those patients who suffered grave and permanent injuries (including death) received a mean payout of only $1.25 million and a median payout of about $1 million. Not the kind of thing that causes doctors to leave en mas
Myth 5: Tort Reform Will Lower Health-care Spending Dramatically
The direct costs of medical malpractice claims (including the cost of malpractice awards and settlements and all costs associated with defending against such claims, including the administrative costs of medical malpractice insurers is relatively modest. There is broad agreement that the direct costs of the malpractice system are on the order of 2% of health-care spending. Studies, commissioned by the Federal Government suggest that a cap on non-economic damages would reduce Medicare spending by a statistically insigniﬁcant 1.6%.
Damages caps do little to improve the malpractice system. Although they can dramatically reduce claims frequency, payouts per claim, and insurance premiums, they do not make health-care safer, reduce health-care spending, compensate those who are negligently injured, or make the liability system work better. The best reforms are patient safety initiatives that reduce the frequency and severity of medical mistakes. Those tend to come from medical malpractice lawsuits.
The Lewis Law Firm handles cases of medical malpractice in Philadelphia and New Jersey. Call for FREE consultation today. Have you or a loved one been the victim of medical maplractice? Contact the Lewis Law Firm for a free consultation.
Among their conclusions were that, “Handoffs can create important information gaps, omissions and errors in patient care.”
The study’s authors recommend computerization of handoffs as a way to prevent errors that may constitute nursing malpractice and which may result in harm to a patient. Verbal handoffs (where nurses communicate with one another regarding patients when transferring shifts) serve important functions beyond information transfer and should be retained. A Greater consideration was felt to be needed on analysing handoffs from a patient-centered perspective (oddly, we assumed this was always the perspective nurses took when attending to patients). The study suggested that handoff methods should be highly tailored to nurses and their contextual needs. The current preference for bedside handoffs (where a nurse changing shift discusses the patient at bedside, in front of the patient) is not supported.
The specific handoff structure for all units may be less important than having a structure for contextually based handoffs. Research on pertinent information content for contextually based handoffs is an urgent need. Without it, handoff computerization is not likely to be successful. Researchers need to use more sophisticated experimental research designs, control for individual and unit differences and improve sampling frames.
The Lewis Law Firm handles cases of nursing malpractice and hospital malpractice in Philadelphia and New Jersey. Call for FREE consultation today. Have you or a loved one been the victim of nursing or hospital malpractice? Contact the Lewis Law Firm for a free consultation.
Sources: Current Litigation; US Food & Drug Administration
Breast Cancer can be detected early in many women who undergo routine mammography. Unfortunately, simply having a mammogram isn’t always a guarantee that you or your doctor will receive your results. The Lewis Law Firm urges all women who have a mammogram to follow up with their referring doctors. Under Federal Law in the US, you are supposed to receive a letter from the center performing the mammography within 30 days advising you, in simple terms, of the results. But does that mean you will?
Mammography is a business and like all businesses, mammography centers aren’t always successful. We are aware of no less than 3 mammography centers in Northern New Jersey which went bankrupt in 2009 and 2010 -literally closing their doors with patients still in radiology rooms.
Did you have a breast cancer screening mammogram scheduled and performed at any of the following New Jersey Mammography Centers?
Bergen Open MRI & Diagnostics, located at 1 W. Ridgewood Ave., Paramus, NJ;
Englewood Imaging Center, P.A., located at 177 N. Dean Street, Suite 102, Englewood, NJ; or
Imaging Center of Oradell, LLC, located at 680 Kindremack Road, Oradell, NJ.
Each of these facilities has gone through bankruptcy proceedings. Their records (YOUR films and reports) may not have been sent to your referring doctor! What does that mean for you? It means that you may experience difficulty and or a significant delay in trying to obtain the results of your diagnostic studies. This can have serious consquences to your health. If you have breast cancer which is shown on any prior mammography then any delay in the diagnosis of your breast cancer can mean a missed opportunity for treatment and may eliminate or reduce the possibility of a cure.
Facilities performing breast mammography have reporting requirements which are established by Federal Law. The failure to timely and properly interpret and report the results of a mammogram which reveals breast cancer is not only a violation of Federal Law, it is in our opinion, malpractice.
We are already aware of at least one patient who will likely not survive her breast cancer because these mammography centers did not send her mammogram results to the patient or to her doctors! The delay in her diagnosis caused her breast cancer to progress from a lesser stage to a metastatic (spread) stage.
If you had a mammogram at any of the above mammography centers, or if you had a prior mammogram for which you never received a report, or if you believe that a mammogram was misread then contact the Lewis Law Firm. The Lewis Law Firm has a history of representing women who are diagnosed with advanced breast cancer. If you are in Philadelphia or New Jersey and you or a loved one have been diagnosed with breast cancer contact the Lewis Law firm today for a FREE consultation.
Source: US Dept. of Health & Human Services, Agency for Healthcare Research and Quality Press Release
Hospital infections persist, according to the recently issued National Healthcare Quality Report and National Healthcare Disparities Report by the U.S. Department of Health & Human Services’ Agency for Healthcare Research and Quality to the conclusion that improvements in patient safety continue to lag.
Very little progress has been made on eliminating hospital infections (hospital-associated-infections) or (HAIs), according to a new section added to the quality report. For example, of the five types of hospital infections in adult patients who are tracked in the reports:
- Rates of postoperative sepsis, or bloodstream infections, increased by 8 percent.
- Postoperative catheter-associated urinary tract infections increased by 3.6 percent.
- Rates of selected infections due to medical care increased by 1.6 percent.
- There was no change in the number of bloodstream infections associated with central venous catheter placements, which are tubes placed in a large vein in the patient’s neck, chest, or groin to give medication or fluids or to collect blood samples.
- However, rates of postoperative pneumonia improved by 12 percent.
In addition, although rate of hospital infections could improve incrementally, blacks, Hispanics, Asians, and American Indians are less likely than whites to receive preventive antibiotics before surgery in a timely manner.
“Despite promising improvements in a few areas of health care, we are not achieving the more substantial strides that are needed to address persistent gaps in quality and access,” said AHRQ Director Carolyn M. Clancy, M.D. “Targeted AHRQ-funded research in Michigan has shown that infection rates of HAIs can be radically reduced. We are now working to make sure that happens in all hospitals.”
Over 100 participating hospital intensive care units in Michigan have been able to keep the rates of central line-associated bloodstream infections to near zero, 3 years after adopting standardized procedures. The project, conducted by the Michigan Health and Hospital Association Keystone Center, involved the use of a comprehensive unit-based safety program to reduce these potentially lethal infections. Last year, AHRQ announced new funding that has expanded the project to all 50 states, Puerto Rico, and the District of Columbia.
AHRQ’s annual quality and disparities reports, which are mandated by Congress, were first published in 2003. The reports show trends by measuring health care quality for the nation using a group of credible core measures. The data are based on more than 200 health care measures categorized in four areas of quality: effectiveness, patient safety, timeliness, and patient-centeredness.
The reports indicate that the lack of health insurance slows improvement in health care quality and reduction of disparities. For many services, not having insurance is the single strongest predictor of poor quality care, exceeding the effects of race, ethnicity, income or education.
Americans with no insurance are much less likely than those with private insurance to obtain recommended care, especially preventive services and management for diabetes. While differences between blacks and whites in the rates of lack of insurance have narrowed in the past decade, disparities related to ethnicity, income and education remain large.
The Lewis Law Firm handles cases of hospital infection and hospital malpractice in Philadelphia and New Jersey . Call for FREE consultation today. Have you or a loved one been the victim of hospital maplractice? Contact the Lewis Law Firm for a free consultation.
Sources: U.S. Center for Disease Control and Prevention; National Institutes of Health
Childhood Disease Rates have been kept low with the advent of vaccination programs. Childhood disease is common in the early months and years of life. Some upper respiratory viral or bacterial infections—colds, bronchitis, or croup—are quite common. Also common are ear infections, sinusitis, impetigo (skin infection), and conjunctivitis (pinkeye). However, there are diseases which used to kill large numbers of children before they reached adulthood. Vaccines have been incredibly effective in preventing childhood diseases and improving child mortality rates.
Childhood diseases such as Diphtheria lead to breathing problems. Pertussis is another name for whooping cough, and it hinders breathing and eating. Tetanus is a serious bacterial infection that can be fatal if not prevented or treated. Vaccinating your child against diphtheria, tetanus, and pertussis can be done in a single dose (DTP Vaccine). Thanks to a vaccine, the United States is one of the only places in the world where polio is completely eradicated. One shot is all it takes to prevent this paralyzing condition. Getting a flu shot and a pneumonia vaccine are also recommended for infants six months or over. A certain strain of pneumonia can lead to blood infections and meningitis, which is covered in the vaccine. Similarly, the MMR vaccine protects against measles, mumps, and rubella, viral infections that cause serious symptoms. Measles and mumps often can lead to chronic conditions, such as deafness, brain damage, and reproductive problems. Rubella (also known as the German measles) and causes a high fever.
The childhood diseases of Pertussis and Measles have been seen more frequently than expected in the United States as parents “opt out” of vaccination programs because of misplaced fears regarding the safety of vaccines. More than 41,000 cases of pertussis were reported to CDC during 2012. 18 pertussis-related deaths during 2012 were been reported to CDC as of January 5, 2013. The majority of deaths continue to occur among infants younger than 3 months of age. The incidence rate of pertussis among infants exceeds that of all other age groups. The second highest rates of disease are observed among children 7 through 10 years old. Rates are also increased in adolescents 13 and 14 years of age.
The CDC reports several important milestones already have been reached in controlling vaccine-preventable diseases among infants and adults worldwide. Vaccines have drastically reduced infant death and disability caused by preventable diseases in the United States. In addition:
- Through immunization, we can now protect infants and children from 14 vaccine-preventable diseases before age two.
- In the 1950s, nearly every child developed measles, and unfortunately, some even died from this serious disease. Today, few physicians just out of medical school will ever see a case of measles during their careers.
- In March 2005, CDC announced that rubella is no longer a major health threat to expectant mothers and their unborn children, thanks to a safe and effective vaccine, high vaccine coverage.
- In September 2010, CDC announced that childhood immunization rates for vaccines routinely recommended for children remain at or near record highs.
- Yet, the CDC reports, “without diligent efforts to maintain immunization programs in the United States and to strengthen them worldwide, vaccine-preventable diseases will remain a threat to children. As illustrations, it’s only necessary to consider the 2010 California outbreak of whooping cough where over 8,000 cases were reported in the state and where there were 10 infant deaths, or measles, which takes the lives of more than 100,000 children globally each year.”
- Over the last two years, Pennsylvania has had one of the highest rates of pertussis outbreaks in the US.
For more information search for “childhood immunization” or “shots” on medlineplus.gov. Or visit the Centers for Disease Control and Prevention at www.cdc.gov/vaccines for more about vaccination schedules.
The Lewis Law Firm has a long history of representing children, and their families in Philadelphia and New Jersey. If your child has been diagnosed with preventable childhood disease, contact the Lewis Law Firm for a FREE consultation and review of your case, today.
Sources: National Cancer Institute; Journal of Clinical Oncology; Lancet
NEOADJUVANT therapy is treatment given before primary therapy. For example, a woman may receive neoadjuvant chemotherapy for breast cancer to shrink a tumor that is inoperable or a woman whose breast tumor can be removed by mastectomy may receive neoadjuvant therapy to shrink the tumor enough to allow breast-conserving surgery.
Adjuvant therapy, or additional treatment (ie. chemotherapy, radition) has long been advocated for women with breast cancer. This takes place after the primary treatment, be it surgical, chemical or radiological. Neoadjuvant chemotherapy is given in the same manner as adjuvant chemotherapy. If a tumor does not respond (shrink) or continues to grow or even spread (metastasize) during neoadjuvant chemotherapy, the doctor may stop treatment and try another type of chemotherapy or perform surgery instead, depending on the stage of the cancer.
Clinical trials are examining whether hormonal thereapies or traditional chemotherapy agents, such as Tamoxifen, are benefecial to women diagnosed with breast cancer and even to women -very young women (under age 40) in particular, who have not yet been diagnosed with breast cancer but have a strong family history or genes of significance. “It is extremely encouraging to know there is a very simple technique that can make a really big difference in terms of coming out the other end with no disease,” said Lori Redmer, former executive director of the Triple Negative Breast Cancer Foundation.
The majority of breast cancers are driven by one of three causes – the hormone estrogen, another hormone called progesterone, or a gene called human epidermal growth factor receptor 2 (HER2). Triple negative isn’t caused by any of these – and it isn’t helped by the many targeted drug treatments that have been developed to fight the other three causes. Triple-negative cancer is more likely to strike young women, they aren’t checking for cancer the way older women are, they aren’t getting regular mammograms, and they often don’t find the tumors until they are large and have spread.
Breast cancer is the second-leading cancer killer of women, after lung cancer. The American Cancer Society projects that 226,870 women will be diagnosed with breast cancer this year and that 39,510 will die of it. In the United States, 93 percent of women with Stage 1 breast cancer survive for at least five years, but this falls to 15 percent for women with stage 4 – the type that has metastasized (spread).
The Lewis Law Firm has a history of representing women who are diagnosed late with breast cancer. If you are in Philadelphia or New Jersey and you or a loved one have been diagnosed with breast cancer contact the Lewis Law firm today for a FREE consultation.
Sources: AARP, The Magazine, Story by Beth Howard; the Leapfrog Group
By Gayle R. Lewis, Esquire:
Hospital malpractice continues to be a major health concern. The Leapfrog Group is an independent, national not-for-profit organization “founded more than a decade ago by the nation’s leading employers and private healthcare experts.” According to their website, “The Leapfrog Group Hospital Safety Score program grades hospitals on their overall performance in keeping patients safe from preventable harm and medical errors. The grades are derived from expert analysis of publicly available data using 26 evidence-based, national measures of hospital safety.”
Hospitals are given a Safety Score of A, B, C, D or F, depending upon their performance measures. More than 180,000 deaths from hospital errors resulting in injuries ocurr in US Hospital every year! Included are so-called “never events” such as bedsores and surgeries on the wrong part of the body as well as hospital acquired infections, medication mix-ups and other errors, some potentially fatal.
New Jersey ranks 15th out of the 51 states with 23 Hospitals scoring an “A” in the state. This only represents 33% of the state’s total hospitals, however. Pennsylvania ranks 20th out of the 51 states with only 37 of Hospitals in the state scoring “A”. This representes only 29% of all Hospitals in Pennsylvania. In New Jersey, the Cooper and Kennedy Health Systems and Jersey Shore Memorial Hospital come in with C’s while Our Lady of Lourdes brings in a D grade on the survey. In Philadelphia, the Temple and Thomas Jefferson Health Systems also score C’s. Temple University Hospital’s score reflects 131 deaths from “serious treatable complications after surgery.” Lourdes had 156 deaths in the same category.
While the survey organization has a lot of qualifiers to the use of its data, this is another free consumer tool out there to assist patients in determining where or whether they should go to a particular hospital in Philadelphia or New Jersey.
The Lewis Law Firm handles cases of hospital malpractice in Philadelphia and New Jersey . Call for FREE consultation today. Have you or a loved one been the victim of hospital or physician maplractice? Contact the Lewis Law Firm for a free consultation.
Sources: Nature Medicine Published online
According to the authors of the study, approximately 100,000 individuals in the United States currently await kidney transplantation, and 400,000 individuals live with end-stage kidney disease requiring hemodialysis. It is hoped that the creation of a transplantable graft to permanently replace kidney function would address donor organ shortage and the morbidity associated with immunosuppression. The difficulties of course are that a bioengineered graft must have the kidney’s architecture and function and permit perfusion, filtration, secretion, absorption and drainage of urine -just like the owner’s original kidney would.
The kidney, actually succeded in producing urine, albeit at a rate 23% of natural ones. And while the organ’s effectiveness decreased to 5% when transplanted into another rat, it functioned. According to lead researcher, Dr Harald Ott, “If you’re on haemodialysis then kidney function of 10% to 15% would already make you independent of haemodialysis. It’s not that we have to go all the way.”
Nearly 1 million patients in the United States live with end-stage renal disease (ESRD), with over 100,000 new diagnoses every year. Although hemodialysis has increased the survival of patients with ESRD, transplantation remains the only available curative treatment. About 18,000 kidney transplants are performed per year in the United States, yet approximately 100,000 Americans currently await a donor kidney. Waiting times for donors have increased to over 3 years and those dying while waiting have increased by 5–10%. Even if a donor is found, 20% of recipients will experience an episode of acute rejection within 5 years of transplantation, and approximately 40% of recipients will die or lose graft function within 10 years after transplantation. The creation of a bioengineered kidney could theoretically solve all of these these problems by providing an autologous graft on demand.
The Lewis Law Firm has a long history of representing patients and their families in Philadelphia and New Jersey. Contact the Lewis Law Firm for a FREE consultation and review of your case, today.
Posted by: Gayle R. Lewis, Esquire
Sources: National Cancer Institute; US Centers for Disease Control & Prevention (CDC)
ON AVERAGE 1 to 2 out of every 10,000 children in the United States are diagnosed with some form of cancer. Cancer is the leading cause of death by disease among U.S. children 1 to 14 years of age. Over the past 20 years, there has been some increase in the incidence of children diagnosed with all forms of invasive cancer, from 11.5 cases per 100,000 children in 1975 to 14.8 per 100,000 children by 2004. In 2007, approximately 10,400 children under age 15 were diagnosed with cancer and about 1,545 children were expected to die from the disease. Although this makes , cancer is still relatively rare in this age group. On the positive side, the 5-year survival rates for all childhood cancers combined increased from 58.1 percent in 1975–77 to 79.6 percent in 1996–2003.
Long-term trends in incidence for leukemias and brain tumors, the most common childhood cancers, show patterns that are somewhat different from the others. Incidence of childhood leukemias appeared to rise in the early 1980s, with rates increasing from 3.3 cases per 100,000 in 1975 to 4.6 cases per 100,000 in 1985. Rates in the succeeding years have shown no consistent upward or downward trend and have ranged from 3.7 to 4.9 cases per 100,000. For childhood brain tumors, the overall incidence rose from 1975 through 2004, from 2.3 to 3.2 cases per 100,000.
Despite advances in detection, the causes of childhood cancers remain largely unknown. Some genetic conditions, such as Down syndrome and ionizing radiation exposure, explain a small percentage of cases. A number of studies are examining suspected or possible risk factors for childhood cancers, including early-life exposures to infectious agents; parental, fetal, or childhood exposures to environmental toxins such as pesticides, solvents, or other household chemicals; parental occupational exposures to radiation or chemicals; parental medical conditions during pregnancy or before conception; maternal diet during pregnancy; early postnatal feeding patterns and diet; and maternal reproductive history. Researchers are also studying the risks associated with maternal exposures to oral contraceptives, fertility drugs, and other medications; familial and genetic susceptibility; and risk associated with exposure to the human immunodeficiency virus (HIV).
Current treatments for pediatric cancers continue to lag. Most children’s cancers are treated primarily with chemotherapy over the course of one to several years. Some cancers also require radiation therapy, surgery, and/or bone-marrow transplants. Chemotherapy is a group of highly toxic chemical drugs that were developed to kill fast-replicating cells. These drugs are non-specific -they don’t distinguish between diseased and healthy tissuess and result in severe reactions such as hair loss, nausea, significant weight loss and weakness associated with thier toxicity. As if that weren’t enough, most pediatric cancer protocols suggest combination chemotherapy which involves the infusion of several different toxic drugs over the course of time to kill cells at differing levels of development. Radiation therapy, while it can be targeted, is also an indiscriminate killer of healthy tissue and organs. Even if a cure or remission is obtained, children can develop long-term medical problems, including the development of secondary cancers from the chemotherapy or radition itself.
The Lewis Law Firm has a long history of representing children with cancers, and their families in Phildelphia, PA and New Jersey. If you or a loved one have been diagnosed with liver cancer, contact the Lewis Law Firm for a FREE consultation and review of your case, today.
Sources: NPR (National Public Radio); US Centers for Disease Control and Prevention (CDC)
WE’VE blogged about MRSA (methicillin-resistant Staphylococcus aureus), VRE (cancomycin Resistant Enterococcus) and C-Diff (Clostridium difficile). Get ready to add another nasty super bug to the list -CRE (carbapenem-resistant Enterobacteriaceae).
Federal officials warn that the newest kid on the block has become a significant health problem in hospitals throughout the United States. These germs, known as carbapenem-resistant Enterobacteriaceae, or CRE, have become much more common in the last decade, according to the Centers for Disease Control and Prevention. And the risk they pose to health is becoming evident. “What’s called CRE are nightmare bacteria,” says Dr. Thomas Frieden, director of the CDC, “They’re basically a triple threat.” First of all, they are resistant to virtually all antibiotics, including the ones doctors use as a last-ditch option. Second, these bugs can transfer their invincibility to other bacteria. “The mechanism of resistance to antibiotics not only works for one bacteria, but can be spread to others,” Frieden says. Third, the bacteria can be deadly. Infection with the bacteria “have a fatality rate as high as 50 percent,” Frieden says.
While resistant bacteria potentially pose a risk to anyone, people whose immune systems are weaker, such as elderly people, children and people who have other health problems, tend to be most susceptible to infection.
CDC data show the proportion of bacteria that have this resistance to many drugs has quadrupled in the last decade or so. CRE cases were reported by 4 percent of hospitals in 2012, up from about 1 percent from about a decade earlier, according to the report. In long-term care hospitals the situation is even worse — about 18 percent have reported cases, the CDC says. In addition, the proportion of Enterobacteriaceae bacteria that were resistant increased from 1.2 percent in 2001 to 4.2 percent in 2011, the CDC reported.
The big fear is that they’ll start to move out of hospitals and into the communities around them. “If CRE spreads out of hospitals and into communities, that’s when the ship is totally underwater and we all drown,” Infectious disease specialist Dr. Brad Spellberg, of the Los Angeles Biomedical Research Institute at the Harbor-UCLA Medical Center, says. To prevent that from happening, the CDC and others are calling on hospitals to contain CRE. The first thing hospitals need to do is test patients to see if they have these bugs. That includes common-sense things like keeping them away from other patients and sterilizing everything they come into contact with. And doctors have to use antibiotics more carefully to prevent more germs from developing into more dangerous superbugs.
The Lewis Law Firm represents patients and their families who are victims of hospital and physician malpractice in Philadelphia and New Jersey resulting in serious injury and death. If you or a loved one were the victim of hospital or physician malpractice, contact the Lewis Law Firm for a FREE consultation and case review today.