Articles Posted in Failure to Monitor Change in Condition

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The family of a man who died after complications following knee replacement surgery was awarded more than $8 million. After a 10-day trial the jury deliberated for just over two hours before coming back with a verdict. In the case the man, a husband and father, died after what was supposed to be routine knee surgery. He suffered a heart attack following surgery that reportedly went improperly treated. The lawsuit stated that the medical professionals did not order the correct tests that would have prevented the situation from occurring. They failed to diagnose and treat reduced blood flow that led to his death from myocardial infarction.

Medical Malpractice
Medical malpractice occurs when a doctor or other medical professional is negligent in the treatment of a patient. Doctors are required to provide proper care. If they perform a treatment improperly or, as in this case, fail to perform treatment, the result can cause serious injury or death. The man suffered confusion and disorientation after a heart attack. According to the lawsuit the doctors failed to order a simple and inexpensive non-evasive test that could have provided critical information in preventing the man’s death. Medical personnel did not recognize the signs of a heart attack until it was too late. The jury agreed that this was indeed a case of medical malpractice.
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In an historic verdict for Williamson County, Illinois, a jury capped off 2013 by awarding more than $2.4 million in the case of a nurse who was negligently treated at local Carbondale Memorial Hospital. The verdict is reported to be the second largest in county history. The highest medical malpractice award in Williamson history is $1.05 billion in the case of Avery v. State Farm. The $2.4 million figure accounts for all actual damages assessed by the Williamson jury. Illinois law does not allow for punitive damages. While the verdict came almost six years after Ms. Yates passed away, it took the jury a mere two hours to come back with its award for in the favor of Ms. Yates’ family.

In this most recent, sad case, Ramona Yates died in March 2007 after emergency room doctors failed to properly diagnose the symptoms Ms. Yates experienced. Ms. Yates, who died at 47 years old, was herself a nurse. She went to the hospital one night with horrible pain in her abdomen and back, which is believed to be a byproduct of gastric bypass surgery, which Ms. Yates underwent a couple of years before her death. Such pains are known to strike recipients of gastric bypass. In this particular case, Ms. Yates’ pain was due to a bowel obstruction which went unnoticed until it was too late. Tragically, an emergency room doctor “did not order more tests, seek other medical consultation or have [the patient] transported to another hospital. Instead, he sent her to the observation ward to be treated for back spasms,” as reported by The Madison-St. Clair Record.

This case is a sobering reminder of the risks associated with medical care, and serves as an example of the type of medical malpractice case where a provider makes a misdiagnosis, a fails to properly diagnose a condition, or delays in making the correct diagnosis. In the latter scenario, it will often be too late to correct the mistake, and someone could be permanently injured or not survive their condition or injuries. What adds to the pain of injury or losing a loved one is the fact that this tragic result was in all likelihood avoidable and preventable if the doctor had operated at the level of the standard of care required of a medical provider in that situation.

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Medical malpractice cases are some of the most specialized in the entire personal injury field. That is because the specific negligence in question is of a professional nature–not necessarily apparent to the general community member. Doctors spend years in post-graduate study understanding the specifics of their field, and so it is illogical to expect jurors to be able to understand what does or does not constitute proper care in any given situation.

Making matters even more complex is the fact that in instances of medical malpractice, patients are already sick with some injury or ailment. This adds confusion, because in virtually all cases the defense alleges that any adverse event–such as the patient’s death–was caused by the underlying ailment that brought them to the doctor originally–and not anything related the professional negligence.

All of this is why expert witnesses are so critical in these cases, explaining what happened in a particular situation, outlining the proper standards of care, and arguing whether the doctor’s conduct in any specific case did or did not meet those standards.

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Last week we touched on a somewhat nuanced legal issue that has been discussed repeatedly across the blogosphere over the last few days. The issue is known as the Lost chance” or “loss of chance” doctrine. It most often applies to cases of missed diagnosis or delayed diagnosis. Considering that diagnostic errors are the most common mistakes leading to medical malpractice judgments and settlements, it it worthwhile to re-emphasize more of the general principles underlying the debate around this issues.

Lost Chance of Survival in Illinois

Illinois is among a number of states that have adopted the “lost chance” doctrine. Simply put, lost chance is the harm resulting to a patient when negligent medical treatment has allegedly decreased the patient’s chance of survival or recovery. In 1997 the Illinois Supreme Court heard Holton v. Memorial Hospital and ultimately recognized the right of patients in certain cases to seek recovery, even if the patient’s risk of survival or recovery was less than 50%. With this ruling, Illinois joined a majority of states in recognizing the lost chance doctrine. Undoubtedly, patients in Illinois prospered with this ruling, both from a fairness and financial standpoint. After all, a delayed diagnosis can be lethal in some circumstances.

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Patients assume that doctors know what they are doing at all times. There is a tendency to trust doctor decisions without question, simply doing as one is told and expecting the outcome that the doctor says is likely.

But, as the hundreds of thousands of patient who suffer at the hands of medical errors know–doctors are not perfect. In the heat of a workday they may misread a test, fail to wash their hands, prescribe the wrong dosage of a medication, or otherwise take steps that will cause patients more harm. Understanding the prevalence of preventable errors, many advocates encourage patients be proactive in their healthcare. There are things that patients can do on a consistent basis which may allow an error to be caught before it causes harm.

For example, well-known TV doctors Oz and Roizen recently shared information on way to help your doctor avoid a misdiagnosis. The tips provided in the story are worth reading, as misdiagnosis remains one of the most common forms of medical malpractice. The article reminds that “39 percent of U.S. malpractice payments are for nondiagnosis or an incorrect or delayed one.” Even more, “of all medical mistakes, diagnostic errors appear to be the most common, most costly, and most dangerous.”

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We have often discussed the issue of medical malpractice in the military. Most of the discussion centered on the Feres doctrine–a legal bar to recovery for active duty military members for medical malpractice. There have been recent challenges seeking to more precisely define where the bar applies. There have also been attempts to overturn the ban altogether–though the Supreme Court has been cool to any attempt to change its rule from the original Feres case from 1950.

It is amid this backdrop regarding the limits on legal recovery, that news is coming out regarding the potential widespread malpractice that exists in military settings. For example, IVN News recently shared an article which argues that military medical malpractice is continually swept under the rug. The examples pointed out in the story pull at the heartstrings.

For example, one female sergeant went into labor while in the service in 2007. She gave birth via C-section while at an air force hospital base. Fortunately, the baby was born without complication, but the mother was not so lucky. The medical team accidentally cut the mother’s uterine artery. This led to massive blood loss which doctors could not stop in time. She died about twelve hours after delivering her child.

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Diagnostic Imaging, a publication geared toward radiologists, published an interesting story discussing trends in the most common medical malpractice cases where radiologists are named as defendants. Of course, being a defense-oriented report, the story frames the details in certain ways, but the underlying statistics are useful to understand common examples of medical errors in the field.

The article summarizes a report published in the journal Radiology which found that failing to diagnose breast cancer was the single most common medical mistake among radiologists. The data in this research project found that about three to four patients out of every 1,000 fell victim to a misdiagnosis of breast cancer. In virtually all of those cases the signs of the cancer should have been caught by the medical professionals but were missed. The patients are usually diagnosed later, with the delay in treatment having varying effects on the long-term harm and ability to fully recover.

Beyond that, misdiagnosis in all forms was far and away the most common mistake which led to a malpractice lawsuit for radiologists. Besides breast cancer, failure to catch non-spinal fractures was the second-most common missed reading. That was followed by spinal fractures, lung cancer, and vascular disease. When all misdiagnosis mistakes are combined, anywhere from 14 to 15 patients per 1,000 are affected. This is not an insignificant number, meaning that thousands are harmed by this problem every year.

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According to the Sacramento Bee, a man recently filed a new medical malpractice lawsuit after having several amputations caused by a spreading infection. The complaint in the suit suggests that a misdiagnosis and failure to timely treat the man’s condition allowed the ailment to progress to the point that the amputations were necessary. Had he receive care up to reasonable standards, he claims, then he would not have lost his limbs.

These sorts of cases are classic examples of the extreme consequences that are often directly related to mistakes made by medical providers.

According to the article the man suffered from a serious (but treable infection) known as MSSA. Medical professionals explain that when caught in time, antibiotics are usually able to deal with the infection and prevent long-term harm. The key, of course, is the timing. When a patient has the infection it is absolutely critical that the doctors identify the problem and ensure antibiotics are given as soon as possible.

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The Post-Gazette reported this week on another case of potential medical test reading gone awry. One of the most harmful mistakes that a medical professional can make is giving false assurances about one’s well-being, leading to a delay in proper diagnosis and treatment. Timing matters immensely in so many medical situations, making it important for doctors and nurses to react efficiently and appropriately based on the information in front of them.

Sadly, sometimes that doesn’t happen.

Delayed Diagnosis

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Not all medical malpractice cases are straight-forward instances of medical professionals making obvious errors. Sometimes there are far more subtle and unique legal issues at play, often involving the intersection of personal responsibility and prudent medical decision-making. The emotions are always high in these cases.

Take, for example, the tragic story of one recent medical malpractice lawsuit filed following a suicide. The Pilot Online recently published an article on the tragic situation. According to the report, one woman was extremely worried about the health and well-being of her identical twin sister. Her sister, a Navy veteran, had battled depression and mental health issues for some time. Tragically, two years ago on Veterans Day the woman took her own life by taking an enormous quantity of Seroqual–a widely-used antipsychotic drug.

But the story is not as simple as that. The victim’s grieving sister was outraged at the situation, because the woman had tried to take her own life three times before in the previous eight months. She had tried to overdose on the exact same medication on each of those occasions but was unsuccessful. Yet, despite those past three attempts, her doctor at the defendant-VA hospital still gave her a 120-day supply of the drug. That large prescription allowed her to consume enough of the pills at once to kill herself.