Concurrent Surgeries & The Orthopedic Surgery Expert Witness

A Boston jury has determined that a spine surgeon, did not cause his patient’s quadriplegia following surgery in 2012. The surgeon, Chief of orthopedic spine service, performed two complicated surgeries during the same time frame. The patient sued the surgeon for malpractice following an eleven hour surgery that left him paralyzed. The jury concluded that the doctor’s divided attention did not cause the patient’s quadriplegia.

Concerns over concurrent and overlapping surgeries have come to the attention of hospitals and the public. The Senate Finance Committee released a report in December 2016 that calls for a ban on concurrent surgeries and more regulations on overlapping surgeries. The Senate Finance Committee has jurisdiction over the Medicare and Medicaid programs and part of its oversight responsibility is to improve patient safety and transparency. In December 2015, Committee staff became aware of overlapping, concurrent, and simultaneous surgeries reported in a Boston Globe article. The American College of Surgeons Statements on Principles, revised April 12, 2016, found that “A primary attending surgeon’s involvement in concurrent or simultaneous surgeries on two different patients in two different rooms is not appropriate.”

In the case Boston case, the jury found that while the spine surgeon failed to inform the patient that he planned to operate on two patients at once, the jury decided that the doctor’s divided attention did not cause his quadriplegia. Judge Edward Leibensperger instructed jurors that they could only consider whether the medical treatment the patient received “deviated from established standards of care and caused his injury” (Boston Globe, 1/30/2017). Judge Leibensperger is a member of the Business Litigation Session of the Superior Court of Massachusetts.

When the attending surgeon is managing more than one case at the same time, he or she may be away from one of those patients for an extended period of time.  If complications arise, the patient may question whether “double-booking” was an appropriate medical procedure and bring allegations of medical negligence.

A 2019 study published in the Journal of the American Medical Association showed nearly 12 percent of the 66,000 operations studied had some overlap with another case. For the majority of overlapping surgeries, we found no increase in deaths or overall complications compared to surgeries that did not overlap.  A subset of complications — major complications such as stroke and heart attack — were slightly higher.

The study found small increases in deaths and complications for overlapping surgeries involving coronary artery bypass grafting and high-risk patients. In both of these groups, small errors in surgical care could have harmful effects.

 

HealthCare Partners Charged With Pediatric Medicine Negligence

Long Beach, CA, mother Samantha Knox is charging HealthCare Partners with medical malpractice in their care of her son EJ. Knox visited HealthCare Partners pediatricians and urgent care providers five times. They diagnosed the 8 month old with a viral infection. A month after symptoms first appeared, Knox took her son to the ER at Long Beach Memorial Medical Center. An X-ray revealed he had a penny stuck in his esophagus that was impeding his breathing. He was immediately taken to Miller Children’s Hospital where the penny was removed. A specialist told Knox that the penny had been there for 37 days based on the corrosion. The penny had caused her son’s 103 degree fever, rash, and listlessness as well as two ulcers.

Knox filed a complaint with the Medical Board of California which is pursuing the case against providers at HealthCare Partners. The medical group is composed of more than 65 medical offices and employs more than 600 primary care and specialty physicians in Southern California.

Pediatricians diagnose and treat conditions among children including injuries, organ dysfunctions and diseases, critical care medicine, neonatal medicine, and more. They treat patient in private offices, urgent care facilities and hospitals. The pediatric urgent care center is designed to treat minor injuries and illnesses such as minor head injuries, allergic reactions without breathing problems, rashes, etc. and is open during the hours that primary care physician’s offices are closed. Emergency rooms treat children with serious injuries such as bleeding that won’t stop, trouble breathing, head injuries with loss of consciousness, etc., and are open 24 hours a day, seven days a week.

Medical malpractice litigation in pediatrics may involve allegations of missed or delayed diagnoses of life threatening conditions, as in the lawsuit Samantha Knox filed against HealthCare Partners. Pediatric emergency medicine expert witnesses are critical in medical malpractice cases.  They bring in-depth understanding of pediatric issues and present their impartial opinions to the court. Contact ELITE Medical Experts  to find the board certified and best qualified pediatric emergency medicine expert witness you need for your case.

Did The Interventional Cardiologist Cause Medical Harm?

An interventional cardiologist has specialized training in order to diagnose and treat coronary artery disease. These medical specialists use catheterization and other procedures to clear blocked arteries, correct congenital heart abnormalities and repair heart valves. Procedures include:

Cardiac catheterization – used to determine the severity and extent of cardiovascular problems

Coronary angioplasty – used to open arteries that have been narrowed by atherosclerosis

Percutaneous valve repair –  repairs the valve without removing the old, damaged valve

Balloon valvuloplasty – widens a heart valve that is narrowed

Atherectomy – removing atherosclerosis from blood vessels within the body

When an IC doctor is charged with a medical negligence claim, an interventional cardiology expert witness is often required to address causation. Dr. Burton Bentley writes:

In additional to opining on standard of care, causation arguments may arise when an interventional cardiologist is alleged to have acted negligently. In other words, did the alleged malpractice result in harm? Interventional cardiology experts also evaluate causation when a patient suffers a deprivation of care by not being referred to an interventional cardiologist in a timely manner. For example, allegations may arise when a primary care provider fails to refer a patient with chest pain, or when an emergency medicine specialist delays admission to the cardiac catheterization lab. Such situations mandate meticulous analysis, and only a credible and independent interventional cardiology expert witness can connect the dots.

Since interventional cardiology experts are also cardiologists, IC experts are also called upon to determine the existence, nature, extent, and prognosis of cardiac harm. For example, when a patient suffers a myocardial infarction (i.e. heart attack), what is the extent of the injury and how will it impact the patient’s health? Investigating the status and degree of cardiac harm is an essential strategic element is many cases…

In a cardiac negligence case, a skilled and impartial interventional cardiology expert witness will be key in your case’s success.

Colorado Medical Practice Act Violation Lawsuit

Neurologists specialize in disorders of the central nervous system such as stroke, dementia, multiple sclerosis, and Parkinson’s disease, as well a number of other pain-related conditions. Neurology expert witnesses are called upon to consult and provide testimony in cases involving neurologists who do not follow the medical standard of care and/or violate the Medical Practice Act in their state. These statutes govern the practice of medicine as well as the requirements and methods of licensure. Medical Practice Acts were adopted to protect the public from unqualified doctors and fraudulent medical procedures.

The Colorado Medical Board suspended a Fort Collins neurologist’s license pending charges that he violated the Colorado Medical Practice Act. Dr. Timothy Jay Allen instructed medical students to fill prescriptions in their names and then return the drugs to him for his personal use. Neurology expert witnesses are hired in this type of case to review medical records and opine on the standard of care provided by the defendant. These experts are able to testify in neurology medical malpractice lawsuits as well as cases involving violations of applicable state statutes.

Colorado Medical Board Rules may be found here.  More information on the history of medical practice acts: The Early Development of Medical Licensing Laws in the United States, 1875-1900.

Cardiology Medical Malpractice

Cardiologist Dr. Arvind Gandhi and his associates at Cardiology Associates of Northwest Indiana, P.C., are under investigation for allegedly performing unnecessary surgeries. Over 300 patients have accused the medical practice of implanting pacemakers, defibrillators, and stents they didn’t need. Plaintiff attorney David Cutshaw had a doctor review 12 defibrillators implanted by Gandhi. Seven of the procedures were found to have been medically unnecessary.  The cardiology group is facing charges of medical malpractice, violations of the False Claims Act, and Medicare fraud.

In December 2015, a Lake Superior Court jury awarded Shannon Greer $450K in the wrongful death lawsuit against Ghandi. Her late husband died after the doctor treated him for an infected pacemaker. In the hospital, Gandhi took out the device, washed it off with antibiotics and reinserted it. Two weeks later, Greer returned to the hospital to have the pacemaker removed because it was still infected. Returning home, the 65 year old patient collapsed and later died in the ER.

The American Heart Association states:

Complete removal of all hardware, regardless of location (subcutaneous, transvenous, or epicardial), is the recommended treatment for patients with established CIED (cardiovascular implantable electronic device) infection. This includes cases in which a localized pocket infection occurs in the absence of signs of systemic infection. Complete removal of hardware is needed because infection relapse rates due to retained hardware are high. Erosion of any part of the CIED should imply contamination of the entire system, including the intravascular portion of leads, and complete device removal should be performed.

Cardiologists and hospitals are under scrutiny by regulators for performing unnecessary medical procedures. The Indiana Lawyer reports that Cardiology Associates of Northwest Indiana “routinely performed unneeded procedures, sometimes scheduling patients for invasive procedures such as angiograms every six months.” Medical malpractice litigation against a cardiologist may involve improper or delayed treatment of coronary artery disease.  Cardiology expert witnesses are qualified to assess the standard of care provided by a cardiologist or hospital charged with performing unnecessary surgeries. These experts are trained to be an invaluable part of the discovery team and present medical records to the court with full transparency.

Contact ELITE today to find a cardiology expert witness for your medical malpractice case.

NY Medical Malpractice Law

New York legislation to change the state’s medical malpractice law did not pass before the end of the current session. Lavern’s Law is named after Lavern Wilkinson, a 41-year-old mother who died in 2013 of a curable form of lung cancer. By the time she filed a malpractice complaint, the statute of limitations had run out.  Another cancer patient, Elissa McMahon was treated for what doctors told her were benign uterine fibroids in 2012.  Two years later, her new doctors told her that she had advanced uterine cancer that had spread to her liver and spine and that the disease should have been caught in 2012. As in Wilkinson’s case, it was too late to file a malpractice suit.

Statutes of limitations are dependent upon the cause of action and vary from state to state. The passage of Lavern’s Law in New York would have changed the statute of limitations to begin when an error is discovered, not when the medical mistake occurred. Sponsored by Helene E. Weinstein, A00285 “amends the civil practice law and rules, in relation to accrual of causes of action for medical, dental and podiatric malpractice.”

Oncology lawsuits often allege failure to diagnose and/or failure to treat.  Oncology experts consult and testify in medical negligence cases such as McMahon’s.  They are knowledgeable on applicable laws and skilled in evaluating alleged misdiagnosis and/or mistreatment. These experts can be counted on to present an unbiased and professional assessment to the court as to whether doctors met the medical standard of care for oncology.

 

Pelvic Surgery Complications

Maria D. Ramirez has filed a medical malpractice complaint in Cook County Circuit Court against Presence Chicago Hospitals Network.  She was admitted to the hospital in 2014 for removal of an ovarian cyst and suffered bowel perforation during the procedure. Ramirez experienced pain and incurred medical costs which she is seeking to recover. A bowel perforation is a surgical emergency, requiring immediate treatment to prevent further complications such as infection or death. The plaintiff states the hospital staff failed to obtain a surgical consultation in a timely manner or properly diagnose the bowel perforation.  Patients with this condition often need surgery to repair the perforation and remove any waste material that has leaked from the intestine into the abdominal cavity.

Gynecology expert witnesses are needed to consult on both standard of care and causation in complex medical malpractice cases such as this.  These experts are trained to write reports and testify regarding allegations of negligence following gynecologic surgery.  Pelvic surgery has the potential for unforeseen complications which may involve ureteral, bladder, or bowel injury. The expert witness analysis on how the medical team handled the surgical complication is essential in a malpractice case such as Ramirez v. Presence Chicago Hospitals Network, et al.

New York Medical Malpractice Statute Of Limitations Legislation

There is a limited amount of time within which a patient can make a medical malpractice claim against a medical professional.  These statutes vary by state. The New York Senate is considering legislation to change the statute of limitations for medical malpractice claims. The New York bill would amend the statute of limitations to start the fifteen month clock from when a patient first realizes they were possibly misdiagnosed or harmed by a medical professional instead of fifteen months from the original incident.

The Medical Society of New York opposes A00285A.

This bill would amend the statute of limitations for medical, dental or podiatric malpractice to include a discovery of injury rule, allowing the current two and half year statute of limitations to run from the date an injured patient discovers, or should have discovered, that their injury was caused by malpractice. The bill would prohibit a malpractice action to be filed more than ten years after the date of the alleged malpractice. As this measure would potentially lead to enormous increases in the cost of liability insurance for physicians and hospitals at a time when no increases can be tolerated due to the enormous changes occurring in health care delivery, the Medical Society of the State of New York strongly opposes this measure and urges its defeat.

Florida Supreme Court To Hear Medical Malpractice Disclosure Arguments

In a case is being closely watched by medical professionals and the legal community,  the Florida Supreme Court will hear arguments regarding access to medical malpractice case documents. Initial litigation was filed by the family of Marie Charles alleging she suffered neurological injuries while a patient at two Baptist Medical Center facilities. The hospitals released some documents but refused to provide others.

In a Jacksonville case, the First District Court of Appeal then ruled that a federal statute overrides the state disclosure requirements. According to the Department of Health and Human Services, the Patient Safety and Quality Improvement Act of 2005,  42 CFR Part 3,  was designed to improve quality and safety by reducing the incidence of events that adversely affect patients by establishing:

…A framework by which hospitals, doctors, and other health care providers may voluntarily report information to Patient Safety Organizations on a privileged and confidential basis, for the aggregation and analysis of patient safety events.

The AMA, Florida Medical Association, Florida Justice Association and AARP have filed amicus curiae briefs in the October 2016 case.