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In a co-authored investigative report by ProPublica and The Atlantic, journalist David Epstein outlines the epidemic being played out in hospitals, clinics, and doctor’s offices around the country. Despite evidence to the contrary, physicians frequently are prescribing medicines and treatments that are not necessarily the safest choice for patients. Epstein describes how factors such as not keeping up with current research, relying on popular but unfounded research findings, profits, and bending to demanding patients has led to over invasive treatments and tests, useless medication therapies, and even severe injuries and death.

A Tale of Two Stents

The report begins with the stories of two patients who both were recommended for stent placement. One, a high-stress middle-aged man with chest pains and high blood pressure, used Google to second guess his doctor’s stent recommendation. He avoided the procedure entirely by seeking a second opinion and remains healthy and stent-free. The second man was a 51 year old stage IV lymphoma survivor who, after rounds of chemo and radiation, was suffering from lung scarring. He went to the hospital with chest pains from the scarring and despite his prior cancer history was given a stent, along with medication that would prevent blood clots arising from the implantation site of the stent. Months later, the man’s scarring had progressed to the point where a lung transplant was needed. The anticoagulant medications from the stent had to clear his system before a transplant surgery could take place, or else the man could bleed to death. While waiting for the blood thinners to wear off, the man suffocated to death due to the scar tissue that had invaded his lungs. Using the stent stories of two men with two drastically different outcomes leads to the main point of the report: Widely-known and frequently used procedures are not always the right choice. American College of Cardiology recommendations have been altered to clarify which situations merit stent placement and this has reduced the number of needlessly placed devices. However, in the stents that are implanted, a recent study revealed that half of them are unnecessary. It is important to note here that stents are recommended and have been proven to be beneficial in patients who have suffered a heart attack.

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Levin & Perconti has just settled a medical malpractice lawsuit against Mt. Sinai Hospital, recovering $3.6 million for the estate of Alberto Mendez, who died after improperly administered anesthesia after a cascade of medical oversights. Mr. Mendez’s estate was represented by Founding Partner Steven Levin, Partner Margaret Battersby-Black and Associate Jaime Koziol.

“A Perfect Storm”

In 2012, Mr. Mendez visited the emergency department at Mt. Sinai hospital with obvious symptoms of rhabdomyolysis, a disease that arises from muscle injury and causes muscle fibers to release their contents into the bloodstream. Leaked contents such as potassium can cause serious complications if left untreated, including kidney failure and even death. However, if timely interventions are implemented, rhabdomyolysis is treatable. What happens next has been described by Ms. Margaret Battersby-Black as a “little bit of a perfect storm.” Despite presenting with obvious symptoms that easily led to his diagnosis, Mr. Mendez’s potassium levels rose unnoticed by staff, allowing his overall condition to worsen and cause compartment syndrome in his thigh. Compartment syndrome occurs when a muscle injury causes pressure to build up in a part of the body, ultimately causing muscle death and requiring surgery. Doctors determined Mendez needed a consult on his condition. 2 hours after that determination, surgical residents evaluated Mendez and reached the conclusion that he needed a pressure-needle test to measure the pressure buildup in the affected thigh. 3 hours after calling for the test, it was finally administered, showing that his pressure level was at 80 millimeters of mercury. 5 mmHg is considered safe. 30 mmHg requires emergency surgery. While Mr. Mendez was prepped for surgery, his anesthesiologist, Dr. Constanta Alexandreanu, referred to a 12 hour old potassium level test and administered a drug that is specifically not recommended for patients with elevated potassium levels. The paralytic anesthetic, succinylcholine, caused Mr. Mendez to go into cardiac arrest 30 minutes after it was administered. He passed away 28 hours after his admission to Mt. Sinai.

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A report by the Institute of Medicine has brought attention to the frequency of diagnostic errors in healthcare and the outcomes of such mistakes. The report analyzed data from several studies, relying heavily on one particular study led by an accomplished physician from Johns Hopkins.

What is a Diagnostic Error?

An error is more than just assigning an incorrect underlying cause to a set of symptoms. Diagnostic errors are classified as one of three types: misdiagnosis (attributing symptoms to the wrong disease or condition), delayed diagnosis (failure to identify a diagnosis until a later time when symptoms and the underlying condition have become more progressed), and missed diagnosis (failure to attribute symptoms to any condition or disease). The study estimates that the rate of diagnostic errors is between 5-15%, with a much higher rate associated with certain types of cancers and disease. In many cases, a delayed, missed or misdiagnosis can result in serious injury and even death.

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Late last month, Dallas surgeon Christopher Duntsch received life in prison for surgical errors that directly caused the death of 2 patients and serious injuries to many others. The neurosurgeon, often described as overly confident, has left behind a bloody trail of victims in his wake. In a November 2016 article in Dallas Magazine author Matt Goodman describes just some of the carnage caused by Duntsch: ‘There was Kellie Martin, who died from massive blood loss after a surgery at Baylor Plano. There was Floella Brown, whose sliced vertebral artery triggered the stroke that killed her at Dallas Medical Center. There was Duntsch’s childhood friend, Jerry Summers, who woke up from a procedure unable to move his arms and legs. There was a dissection of one patient’s esophagus, and screws that an indictment labeled “far too long” that caused significant blood loss in another patient. One surgeon described these as “never events.” They shouldn’t ever happen in someone’s entire career. And yet they occurred in Duntsch’s operating rooms over a period of just two years.’

With all the horror the article describes, one can only wonder why none of these patients had tried to sue Duntsch and why the hospital hadn’t caught on to his pattern of death and destruction and terminated his employment.

Malpractice Caps in Texas Caused Horrific ‘Domino Effect’

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In our continuing fight to protect patients’ rights and to combat H.R. 1215, a proposal that would cap a patient’s right to fair compensation for medical errors and negligence, we would like to take the opportunity to share more evidence to contradict the myth that medical costs are skyrocketing due to malpractice costs.

Fact vs. Fiction: Medical Malpractice

Below, please see some of the most commonly cited arguments in defense of limiting medical malpractice payouts and review the truth about these so called facts.

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This is one of the most urgent issues we have ever had to feature on our blog. Within the next two weeks, H.R. 1215, also known as the Protecting Access to Care Act, will be voted on in the House. If it passes, it moves to the Senate for a vote and then onto President Trump for approval before becoming law. Although the name of the act sounds promising, the summary is this: H.R. 1215 will limit your ability to receive anything in excess of $250,000 in non economic damages. This means that if a serious preventable medical error or a complete lapse of care in a nursing home occurred, you would not be able to recover more than $250,000 to compensate you or your loved ones for the loss of many liberties you may have once enjoyed, including your life. All it takes is a look at some of our verdicts and settlements to see just a handful of the atrocities that have taken place against ordinary American citizens.

Before we go any further, we’d like to ask you to spend 30 seconds notifying congress that you do not support HR 1215. Please click here to enter your zip and/or full address to have an email auto generated to your senators.

Restricting Legal Settlements Does NOT Lead to Better or Cheaper Health Care

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As we wait for tomorrow’s vote on the confirmation of Tom Price for Secretary of Health & Human Services, one cannot help but notice many erroneous ‘facts’ and figures being touted in the media by medical malpractice naysayers. One such untruth is that healthcare costs have significantly increased in recent years due to an influx in medical malpractice lawsuits. Despite evidence to the contrary, this myth persists and there seems to be no end in sight.

You Can’t Argue the Facts

Nationwide, state-filed medical malpractice lawsuits fell 23% between 2001 and 2010. In Illinois alone, medical malpractice suits have fallen 39% since 2003. Across the United States, civil lawsuits, under which medical malpractice is classified, are mostly comprised of contract disputes. In fact, 64% of all civil lawsuits are related to contracts, while malpractice cases account for only .2% of all civil lawsuits. This information was obtained through the Illinois Courts’ own website.

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Rick Santorum, the former Pennsylvania Republican senator who is best known for his unsuccessful 2012 and 2016 presidential campaigns, is guilty of saying one thing and doing another.  In 1999, Santorum’s wife, Karen, sued her chiropractor for $500,000 after his treatment of her sore back caused further injury that required surgery. Former Senator Santorum testified in the case that his wife’s quality of life had been diminished, with the injury having harmed her active lifestyle and her ability to keep up with household tasks. Mrs. Santorum was awarded $350,000 (she ultimately received $175,000).

Hypocrisy

Just 5 years prior to his wife’s lawsuit, Santorum fought to implement legislation that would place a $250,000 cap on damages for pain and suffering, the very injustices that he testified his wife had to face after receiving poor care. Not surprisingly, when pushed by the media on the issue during his 2012 presidential bid, Santorum said that his wife did not sue for pain and suffering.  Instead, he argued that his wife fought to be compensated for lost income and costs stemming from the injury (medical costs associated with her injury and surgery were shown to total less than $20,000). The judge who initially presided over the trial later reduced her award to $175,000, citing Mrs. Santorum’s own words that the operation gave her “immediate relief” and that she required no further treatment after the surgery.

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A study has been making headlines this week with results showing that the number of black women dying from cervical cancer is higher than white women and even greater than was reported in recent years. The study evaluated previously calculated numbers, but changed a key study parameter to come up with more accurate statistics on the cervical cancer death rate.  The study authors eliminated those who had received hysterectomies from the population tally of women, as they have no chance of developing cervical cancer and therefore should not be a consideration. The new data reveals that 10.1 out of 100,000 black women will die from cervical cancer, while 4.7 out of 100,000 white women will succumb to the disease. The difference before data was reexamined showed a slightly smaller disparity of 2.5% between black women and white women.

Cutting Affordable Care Act May Further Widen the Gap
Sadly, despite the Affordable Care Act covering cervical cancer screenings (through annual pap smears) and the fact that if caught early, cervical cancer is curable and even preventable, the rate of cervical cancer deaths among women of all races is still increasing. While the causes of higher cervical cancer death rates among black women were not examined, many medical experts have concluded that less access to quality healthcare is to blame. If the Affordable Care Act were to eliminate insurance coverage of annual pap smears, the predicted outcome by health experts would be more cases of cervical cancer being missed and ultimately more deaths from the disease.

 

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This morning at 10 am ET, Republican Congressman and Trump’s nominee for Secretary of Health & Human Services (HHS), Tom Price, M.D., began his second confirmation hearing, this time with the Senate Finance Committee. Last Tuesday, Price was grilled by the Senate Health Committee. Today’s panel is the only one of the two committees with the power to vote on his nomination. Once today’s committee has wrapped up their questioning, they will vote on his nomination. If affirmed, the Senate Finance Committee moves the vote to the full Senate who will then affirm or deny Tom Price as Secretary of HHS.

Price Aims to Limit Medical Malpractice Payouts 
To recap, Tom Price is a staunch advocate of legal reform as it pertains to healthcare. Price is a proponent of caps on damages, revamping Medicare/Medicaid and has also said he will push for national health guidelines that physicians must follow when diagnosing a patient and recommending treatment. We encourage you to read Levin and Perconti’s recent review of Tom Price’s proposed changes to the U.S. healthcare system.