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Month: May 2016

Tear during childbirth results in complications

Posted on by Burton Bentley II, M.D FAAEM

FOCUS

A woman during vaginal childbirth experiences a tear and complications from a failed repair.  A medical negligence case requiring Obstetrics and Gynecology medical expert witness review.

 

BACKGROUND

Vaginal tearing during childbirth is an extremely common injury. The repair can be simple or complex, depending on the severity and location.

 

CASE

A 40-year old woman underwent a routine vaginal delivery and experienced a tear. The obstetrician repaired the wound, but the patient alleges that the repair was performed improperly and that it failed to adequately correct an underlying muscular injury. She has since experienced a range of complications.

 

ELITE’S ROLE

ELITE’s physician-led team was asked to secure a top-tier professor of OBSTETRICS AND GYNECOLOGY to act as a medical expert witness and to determine if the treating obstetrician deviated from any applicable standard of care that were causative to the patient’s outcome.  A pending statute of limitation placed time constraints on the case, and a review and oral opinion had to be completed less than 72 hours after the assignment was given to ELITE.

 

THE MEDICAL EXPERTS

ELITE rapidly secured a top-tier professor of OBSTETRICS at a major west coast US Medical School to review the records and opine on any deviations from the standard of care.  The OB/GYN physician was considered a leading expert in the field of childbirth, lecturing nationally on operative management of childbirth.  ELITE coordinated with the expert to complete the review within the given deadlines, and the expert provided an oral opinion to the legal team within 48 hours.

 

OUTCOME

After receiving a favorable review and an affidavit of merit from a top OBSTETRICS expert, the case was confidently filed by the legal team before the statute of limitations expired.  Subsequently, the OB/GYN expert provided a full written report on the case, and the legal team successfully negotiated a strong settlement for their client.

 

E-CASE STUDIES are brief clinical vignettes based upon actual cases handled by ELITE. Identifying information has been redacted or altered to protect case confidentiality.

Pediatric Forensic Pathology Expert Witness: Infant death at daycare

Posted on by Burton Bentley II, M.D FAAEM

FOCUS

Infant death at daycare: SIDS or strangulation?  A case requiring PEDIATRIC FORENSIC PATHOLOGY expert witness review.

BACKGROUND

Sudden Infant Death Syndrome (SIDS) is a leading cause of death in infants aged less than 1 year. There is little know about the cause of SIDS, though it does frequently occur when the infant is sleeping. In an autopsy, the cause of death is only identified to be SIDS when all other possible diagnoses are ruled out using medical history, history of accidents, abuse, or neglect, and any previously undiagnosed conditions.

CASE

A 6-month old girl is taken to a daycare center where she is left unobserved for a period of time, whereupon she was found to be apneic. Despite full resuscitative efforts, she was pronounced dead. The autopsy identified Tardieu’s spots, an observation found in tissues of persons who have been strangled, or otherwise asphyxiated. The cause of death was listed as “Unexpected Infant Death” (SIDS). The family of the child alleges neglect against the daycare center.

ELITE’S ROLE

ELITE’s physician-led team was asked to secure a top-tier PEDIATRIC FORENSIC PATHOLOGIST expert witness to independently review the case and to determine if the objective data supports death due to neglect, rather than SIDS.

THE MEDICAL EXPERTS

ELITE MEDICAL EXPERTS secured a top-tier professor of PEDIATRIC FORENSIC PATHOLOGY at a major east coast US medical school with experience identifying SIDS and negligent death, having both extensively researched and published on the topic, as well as serving as a medical expert witness in prior cases regarding SIDS.

OUTCOME

The PEDIATRIC FORENSIC PATHOLOGIST expert witness opined that the autopsy and objective findings supported the plaintiff’s theory, necessitating a further investigation into the specific events at the daycare surrounding the infants death.

E-CASE STUDIES are brief clinical vignettes based upon actual cases handled by ELITE. Identifying information has been redacted or altered to protect case confidentiality.

$55M Johnson & Johnson Talc Powder Award

Posted on by Burton Bentley II, M.D FAAEM

In the latest talcum powder lawsuit, Johnson & Johnson was ordered by a St. Louis, MO, jury to pay $55M to Gloria Ristesund.  The plaintiff believes her ovarian cancer is the result of years of talcum powder use. The award designated $5M in compensatory damages and $50M in punitive damages.  Earlier this year gynecology expert witness Daniel Cramer, MD, ScD, testified in the Johnson & Johnson trial regarding the link between talc powder and ovarian cancer in the death of Jackie Fox. Her family was awarded $72M after finding Johnson & Johnson guilty of failing to warn the public and keeping information about the possible link between their product and ovarian cancer from the public.

The International Agency For Research On Cancer writes:

Perineal exposure to cosmetic talc in women is of concern because of its possible association with ovarian cancer. Several studies have been conducted in women to assess potential retrograde movement of particles through the reproductive tract to the ovaries….On balance, the Working Group believed that the evidence for retrograde transport of talc to the ovaries in normal women is weak. In women with impaired clearance function, some evidence of retrograde transport was found.

Cancer.org explains: Talcum powder is made from talc, a mineral made up mainly of the elements magnesium, silicon, and oxygen. As a powder, it absorbs moisture well and helps cut down on friction, making it useful for keeping skin dry and helping to prevent rashes. It is widely used in cosmetic products such as baby powder and adult body and facial powders, as well as in a number of other consumer products….

One study suggested genital talcum powder use may slightly increase the risk of endometrial (uterine) cancer in women who are past menopause. But other studies have not found such a link. Further studies are needed to explore this topic….

Based on limited evidence from human studies of a link to ovarian cancer, IARC classifies the perineal (genital) use of talc-based body powder as “possibly carcinogenic to humans.”

There is more litigation over talcum powder side effects on the horizon for the world’s sixth-largest consumer health company. Over 1,100 women have reportedly sued J&J to date. Oncology expert witnesses as well as gynecology experts will be called upon to consult and testify in cases such as these. Oncology cases are complex and require a thorough analysis by an experienced board certified expert from a top university medical center. These medical professionals are an invaluable resource in evaluating whether consumer products are possibly carcinogenic to humans.

$1.8M OB/GYN Medical Malpractice Award

Posted on by Burton Bentley II, M.D FAAEM

A New London, CT, jury awarded $1.8M to plaintiff Rebecca Simonds in a medical malpractice case against obstetrician-gynecologist Dr. Taylor Hotchkiss.  During Simonds’s appendectomy in May of 2011, Hotchkiss came into the operating room to perform surgery on an abscess on the patient’s right Fallopian tube.  In this case, the wrong Fallopian tube was cut during the procedure resulting in Ms. Simonds becoming infertile and having to undergo additional surgery.

The gynecology expert witness may consult and testify in medical malpractice cases arising from OB/GYN surgery and the complications that may ensue. Gynecology experts are necessary in litigation regarding standard of care and causation in complex medical cases such as Simonds v. Hotchkiss.  Only the most highly trained and credible expert has the knowledge, experience, and judgement to opine on the possible breach of medical duty in a case such as this which may take years to resolve.

Depuy Products Liability $502M Award

Posted on by Burton Bentley II, M.D FAAEM

Orthopedic surgery experts testified in the products liability lawsuit over Johnson & Johnson’s Depuy artificial hip. The medical device manufacturer was ordered to pay $502M to five patients who accused J&J of hiding flaws in the Depuy Pinnacle product. Plaintiffs complained of implant loosening, extreme pain, shedding of metallic debris inside the body, and intense soft tissue damage. Some patients were subjected to revision surgery to remove the implant.

DrugDangers.com writes:

While a number of DePuy products have been successful, the company faces consumer complaints from patients who received ASR and Pinnacle hip replacements. Thousands of patients experienced problems with pain and swelling. Some implants caused severe nerve, muscle, and bone damage. Blood poisoning has also been reported, due to the material from the metal-on-metal implants. Over time, these components can rub together and corrode into the patients’ bodies. This can cause metallosis, osteolysis and other serious health complications.

Orthopedic surgeons diagnose and treat diseases and injuries of the musculoskeletal system. They are experts in the treatment of bones, joints, ligaments, tendons, muscles and nerves with surgery and corrective mechanical devices. Litigation in orthopedic surgery typically stems from medical complications as well as poor surgical outcomes resulting in a loss of function. The highly skilled orthopedic surgery expert witness is critical in product liability cases involving medical devices such as the ASR and Pinnacle hip replacements.

Judge Ed Kinkeade presided over the Northern District of Texas case, IN RE: DePuy Orthopaedics, Inc., Pinnacle Hip Implant Products Liability Litigation 3:11-md-02244.