Gair, Gair, Conason, Rubinowitz, Bloom, Hershenhorn, Steigman & Mackauf is a New York Plaintiff's personal injury law firm specializing in automobile accidents, construction accidents, medical malpractice, products liability, police misconduct and all types of New York personal injury litigation.

Articles Posted in Medical Malpractice

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A doctor who prescribes opioids to a patient with a history of abuse, fails to closely follow up with a patient who exhibits addictive behavior or disregards family concerns or warnings from other professionals such as pharmacists or primary physicians could face medical malpractice  and/or wrongful death litigation, criminal prosecution, and a disciplinary proceeding by the State Medical Board.

In New York City, deaths related to opioid analgesics have increased 256% from 2000 to 2013 in Manhattan, Staten Island and the Bronx are the most affected of the 5 Boroughs. To fight this epidemic, the New York Sate Department of Health is launching a Bronx detailing campaign during which representatives will visit more than 1000 doctors to educate them about about safe and judicious opioid analgesic prescribing. A similar campaign in Saten Island in 2013 lead to a reduction of 29% of overdose deaths from opioid analgesics.

Read the press release from the New York Health Department

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Operation Provide HopeWhen medical malpractice or medical error occurs at an American hospital or clinic, the victim of the malpractice or his or her family has the right to legally challenge the facility and obtain explanations and compensation.  The story is very different for the 1.3 million active-duty service members of our nation. Not only are they captive of the military medical system and can’t get care elsewhere without special approval but also if medical malpractice is committed they have no legal right to bring a medical malpractice suit. In a recent article in the New York Times, Sharon LaFraniere investigates this issue and describes the nightmares that many military families are enduring.

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blood bagIn the US red blood cell units can be stored for up to 42 days after they are collected.  Previous studies have questioned this medical practice and  have implied that the storage duration may impact the quality of the blood cell units. These studies which were based on observations showed a correlation between the transfusion of blood stored for a longer duration and increased morbidity and mortality. However according to National Institutes of Health the clinical significance of these findings was  difficult to determine due to study-design limitations.

In order to get a better opinion on whether red blood cell storage duration impacts a patient’s clinical outcome after transfusion  the NIH  funded the Red Cell Storage Duration Study (RECESS) that was also supported by the National Heart, Lung, and Blood Institute (NHLBI).

RECESS was conducted at 27 hospitals in the US including Weill Cornell Medical College, Cornell University and Columbia University Medical Center in New York. The study evaluated 1,098 cardiac surgery patients who were randomized to receive red blood cell units stored for short (up to 10 days) or long periods (21 or more days).  The study was conducted from January 2010 to January 2014.

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Wallcure simulation ssalineTwo patients were seriously injured in a New York urgent care facility after they were inadvertently administered non sterile simulation intravenous fluids. They both experienced a febrile illness during administration and had to be hospitalized. One of them developed sepsis. Both of them survived.

The cases were reported to the New York State Department of Health (NYSDOH)last year. The NYSDOH  began a collaborative investigation with the CDC in December.  The investigation found that four other New York outpatient facilities had received Wallcur simulation saline. All facilities said they had ordered the real product and weren’t aware that they had received a simulation product until they were were notified by the NYSDOH. Fortunately none of the facilities had used the product yet.

Wallcur recalled all its saline simulation products from the market at the beginning of the year (see previous blog). Investigation was pursued by the CDC at a national level. So far nationally 9 adverse events have been reported for 25 people including 11 hospitalizations. Two deaths occurred even though it wasn’t clear that they were related to the administration of the product.  All clinical facilities that received the products confirmed that they were not aware at time of purchase that the product was intended for simulation only. Read more on the CDC website

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TestosteroneIn recent years the off-label use of testosterone has been exploding as doctors prescribed testosterone to their aging patient to improve their libido and make them feel more vigorous and younger. However, the FDA warned that recent studies indicate that the off label use of testosterone as the ultimate anti-aging therapy may  increase cardiovascular risks.  Testosterone was only approved by the FDA to treat hypoginadism, a condition of the sex glands that can be genetic or result from damages of chemotherapy or infection.   Therefore the FDA is now requiring all manufacturers of approved prescription testosterone to change their labeling to clarify the approved used of the medication and warn about  the possible increased risk of heart attacks and strokes associated with testosterone use. Read more in Medical Law Perspectives

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Patient SafetyMedical errors and adverse events are among the leading causes of death and personal injury in the U.S. According to a recent study in the Journal of Patient Safety  the number of premature deaths associated with preventable harm to patients is estimated at more than 400,000 per year. Serious harm seems to be 10- to 20-fold more common than lethal harm.

The patient safety awareness week is an annual campaign led by the National Patient Safety Foundation to create awareness about patient safety among healthcare providers and their patients. The campaign is running this week and the subject is “United in safety” . The emphasis is on better communication between healthcare providers and patients to reduce adverse events or medical errors.

Tomorrow Wednesday March 11th at 8:30 pm ET anyone interested can join a twitter chat on patient and family engagement using  #PSAWunited to participate. People interested can also join a free webcast on patient safety on Thursday March 12th.

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Janet Hickey, a resident of City Island in the Bronx, NYC, was recovering from  brain surgery at New York Presbyterian Hospital and was transferred by ambulance to Phelps Memorial Hospital, for  rehabilitation. During the trip between the two facilities, the ambulance that was transporting her crashed into a pole in Westchester County. During the accident, the 60 year old woman suffered serious head and neck injuries that left her brain dead. According to doctors who tried to save her after the accident, the woman wasn’t proprely strapped to her stretcher by the Senior Care Emergency Services ambulance staff. Read more in the New York Daily News

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Pigment_stone_extractionAfter two patients died and many other suffered personal injury from a recent “superbug”outbreak involving duodenoscopes, the safety of these medical devices (see previous blog) and the method used by hospitals to reprocess them are being questioned. In a recent Hazard Report, the ECRI Institute is recommending culturing Duodenoscopes as a key step to reducing carbapenem-resistant Enterobacteriaceae (CRE).  The Institute believes that duodenoscope procedures are vital when treating and diagnosing conditions of the gall bladder and pancreas with Endoscopic Retrograde Cholangiopancreatography (ERCP) procedures and the risk of infection can be mitigated if hospitals upgrade their reprocessing methods by also scope culturing.The Institute recommemds that hospitals not only check with the duodenoscope manufacturer as to whether they are using the appropriate reprocessing method but also add a baseline culture of all duodenoscpoes.  Read the complete ECRI High Priority Hazard Report 
Picture Duodenoscopy image of two pigment stones extracted from common bile duct courtesy of Wikipedia

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Sharing diabetes pens among patients is a gross medical malpractice that can lead to transmission of infections and viruses such as HIV and hepatitis viruses.  According to the FDA, since 2008 thousands of patients may have been exposed  to blood-borne pathogens from the sharing of multi-dose pen devices for insulin and other injectable diabetes medicines. In 2009 the FDA was informed that 2,114 patients  from a U.S. army facility had been injected with pens that had been used on other patients. Then in 2011, 2,345 patients from the Dean Clinic in Wisconsin were notified that pen and needles had been shared among patients. More recently in 2013, 716 patients from the Veteran Health Administration were notified of potential exposure to infections through the sharing of diabetes pen. Last March in New York, the South Nassau Community Hospital in Long Island contacted 4000 patients to be screened for HIV and Hepatitis after a nurse said she was using the same insulin pen for multiple patients (see previous blog).

Insulin pens and pens for other injectable diabetes medicines should never be shared among patients, even if the needle is changed. To promote safe use, the FDA is requiring that pens and packaging containing multiple doses of insulin and other injectable diabetes medicines display a warning label stating “For single patient use only.” Read the safety announcement from the FDA

multi-dose-insulin-pen

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Since 2009, the FDA has been aware that duodenoscopes manufactured by Japanese companies Olympus, Pentax and Fujifilm have been at the origin of the spread of sometimes fatal spread of pathogens but did nothing to change the situation. Hospitals that faced such outbreaks began sterilizing the devices more rigorously and the transmission of dangerous disease stopped. Therefore, the suspicion was that the superbug outbreak happened because of medical malpractice during which the hospital staff didn’t respect the sterilization procedure. However for the first time on Thursday the FDA said that even hospitals that fully respected the sterilization process could have their devices infected by the superbug. However the FDA didn’t propose to improve the sterilization procedures. They only issued a “safety communication” warning healthcare providers that duodenoscopes’ “complex design” may impede effective sterilization.  The problematic part is a movable “elevator” mechanism at the tip of the duodenoscope: Its moving parts have microscopic crevices where bodily fluids can remain after standard cleaning.  The FDA and the manufacturers are aware of this deadly manufacturing flaw but the FDA didn’t require the manufacturers to improve their device either. Read more on Reuters

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