Articles Posted in Medical Malpractice

Medical errors kill enough people to fill four jumbo jets a week. A surgeon with five simple ways to make health care safer.

From The Wall Street Journal By Dr. MARTY MAKARY;

“When there is a plane crash in the U.S., even a minor one, it makes headlines. There is a thorough federal investigation, and the tragedy often yields important lessons for the aviation industry. Pilots and airlines thus learn how to do their jobs more safely.

By: Anthony H. Gair, Esq.

This New York malpractice case involved a fifty-three year old man who was diagnosed with squamous cell carcinoma of the mouth encompassing the soft palate, the uvula, the tonsil and the base of the tongue. He underwent extensive radiation therapy and fortunately the cancer was irradicated. The patient developed osteoradionecrosis of the mandible following a wisdom tooth extraction by his dentist who was well aware that he had undergone radiation therapy.

As a result, he had to have three major surgeries involving removal of part of the mandible and extensive bone grafting and reconstructive surgery.

The definition of osteoradionecrosis is bone death due to radiation. Teeth removed in irradiated jaws often initiate Osteoradionecrosis.¹

In patients who have undergone radiation therapy for cancer of the mouth, the tissues in the mouth become hypoxic. Further, the vascular supply to the tissues is impaired and blood vessels are destroyed as a result of the radiation. The tissues also become hypocellular. These effects on the tissues of the mouth are permanent.

The important issues in the development of Osteoradionecrosis are endothelium, bone, periosteum and fibrous connective tissue of the mucosa and skin. The effects of radiation on the tissue level are endothelial necrosis, hyalinization, and thrombosis of vessels. The periosteum becomes fibrotic and bone osteoblasts and osteocytes undergo death with fibrosis of the marrow spaces. Mucosa and skin also undergo fibrosis, with decline in the cellularity and vascularity of the connective tissue. The result is a composite tissue which is hypovascular and hypocellular and has proved to be hypoxic compared with non-irradiated tissue. Once any wound is created, it would be unrealistic to expect effective healing, given the hypovascular, hypocellular and hypoxic nature of the affected tissue.²

It was the plaintiff’s contention that when a tooth is extracted a wound is always created at the site of extraction and that as a result of the radiation induced hypoxia, hypovascularity and hypocellularity of the tissues there will be problems with the healing process which may often lead to infection spreading to the bone and leading to osteoradionecrosis. This is even more so in patients with periodontal disease, which is often the case in those facing tooth extraction.
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In December 2006, Krissy Myatt went to the emergency room at Poudre Valley Hospital in Fort Collins with an intense headache and “dangerously” high blood pressure. She had been receiving treatment for multiple sclerosis, including strong doses of steroids, which can cause high blood pressure.

The doctor misdiagnosed her brain bleed as a migraine, gave her pain medicine and sent her home. She woke up the next morning paralyzed. The hemorrhagic stroke she had suffered devastated her family and led to the largest jury-verdict award in Larimer County history: $3.9 million.

In patients with Hemorrhagic stroke (intrcerebral bleed) bleeding within the brain occurs leading to an elevation of intracranial pressure which if not relieved will lead to, as here, severe brain damage. In some cases brain herniation may occur leading to patient death. A sudden severe headache is a classic sign if an intracerabral bleed. The cause of the bleed is not given. The appropriate treatment depends on the specific cause. At the very least a CT Scan should have been taken which would have been diagnostic of the bleed. It is an emergent situation requiring a lowering of intracerebral pressure. Depending on the cause surgery may be required. In other cases an intraventricular peritoneal shunt may be needed to drain fluid from the brain.

Ben B. Rubinowitz Gair Gair Conason Steigman Mackauf Bloom & Rubinowitz

Our Partner Ben Rubinowitz will be a featured speaker at the Suffolk County Bar Association‘s Program “THE TRIAL OF A MEDICAL MALPRACTICE CASE.” This is a three part program which will include trial demonstrations from top notch trial attorneys who have tried numerous medical malpractice cases. Mr. Rubinowitz, a member of the Prestigious Inner Circle of Advocates and a lawyer who has obtained multiple million dollar verdicts for his clients, will demonstrate the opening statement for the plaintiff. This part of the program will take place May 1, 2012. Joining Mr. Rubinowitz will be the Hon. Peter Mayer, William Spratt, Michael Colavecchio, and Michael Ronemus. The program will then continue on Tuesday May 8th and Wednesday May 16th 2012 and will feature Direct and cross examination of the Plaintiff’s expert as well as Direct and cross of the defendant doctor. The Hon. Jerry Garguilo, David Golomb, James Duffy, Bruce Brady, Clifford Bartlett, Kevin Fox and Doctor David Mayer will participate in this demonstration. The program will then continue on Wednesday, May 16th. The Jury Charge Conference and Closing Arguments will be conducted by Hon. Peter Mayer, John Bonina, William Spratt, Marvin Salenger, and Fred Johs. “I consider it an honor to be asked to speak at this program” said Mr. Rubinowitz. “It is always a treat to be joined by such eminent members of the Judiciary and such fine trial lawyers. This program is sure to produce some heated exchange and talented advocacy.”

This medical malpractice trial commenced on April 4, 2012 in Penobscot County Superior Court, Maine. On April 12, 2012, the jury returned a verdict for $1,912,934 in damages against a physcian for overprescribing methadone. According to a story in the Bangor News the initial dose was 40mg. It was alleged that the plaintiff stopped breathing and thereafter experienced 20 to 30 minutes of slow, shallow breathing which caused brain damage that affected her ability to multitask and perform relatively simple jobs and tasks.

It is well known that Methadone may cause slowed breathing and irregular heartbeat, which may be life-threatening. Further, the risk that one will experience serious or life-threatening side effects of methadone is greatest when methadone is first prescribed. When first prescribing Methadone the lowest possible dosage sufficient to alleviate pain should be given. The usual dosage of oral Methadone for pain is 2.5 to 10 mg every 3 to 12 hours.

This medical malpractice trial commenced on April 4, 2012 in Penobscot County Superior Court, Maine. The details are set forth in an article in The Bangor News. Although essential facts are not included in the article it appears that the defendant physician prescribed methadone for pain resulting from prolotherapy for the first time on August 26, 2006. Approximately 48 hours later the plaintiff stopped breathing and was revived by her fiance but allegedly suffered brain damage resulting in permanent injury. The dosage of Methadone given is not stated.

It is well known that Methadone may cause slowed breathing and irregular heartbeat, which may be life-threatening. Further, the risk that one will experience serious or life-threatening side effects of methadone is greatest when methadone is first prescribed. When first prescribing Methadone the lowest possible dosage sufficient to alleviate pain should be given. The usual dosage of oral Methadone for pain is 2.5 to 10 mg every 3 to 12 hours.

Our partner Jeffery Bloom settled this complex and difficult liability New York Medical Malpractice case in New York Supreme Court, Nassau County following two mediations. The case arose as a result of the alleged negligent care by the defendant doctors’ of the plaintiffs’ daughter a then 10-year old girl. It was claimed that the defendants failed to timely diagnose and treat a benign brain tumor, a craniopharyngioma, for years, until the tumor grew to the size of a golf ball and invaded both optic nerves, hypothalamus, the anterior and posterior cerebral arteries, the carotid artery, and the third ventricle of her brain.

As a result it was alleged she suffered injury, including blindness, Unable to deal emotionally with her blindness and other medical issues, it was claimed she suffered from clinical depression.

The attorneys at Gair, Gair, Conason, Rubinowitz, Bloom, Hershenhorn, Steigman & Mackauf have years of experience representing patients who have been injured or have died as the result of medical malpractice.