Articles Posted in Medical Malpractice

A newspaper’s detailed account of a teenage girl who suffered brain damage and eventually died because of negligence during what should have been a routine outpatient procedure was presented to Congress last week by patients rights advocates, according to an account in the Sacramento Bee.

The girl suffered brain damage during what should have been a routine procedure at a Los Angeles area hospital operated by UCLA. She never regained consciousness and died shortly after her parents authorized the removal of her respirator. What is truly shocking about this case, however, is the lengthy battle the girl’s parents had to go through just to get the hospital to level with them about what happened – and the difficulties they experienced in finding a medical malpractice attorney willing to take the case because of statutory limits on medical malpractice damages.

Hospitals and doctors claim such limits are necessary to curb frivolous lawsuits. In many states, however, the effect has been to shield the medical industry from accountability for negligence, particularly negligence leading to wrongful deaths here in Oregon and elsewhere around the country. Relatively low damage limits, in particular, can create an incentive for hospitals to stall families and their wrongful death attorneys with the goal of making the case too expensive for a personal injury or medical malpractice lawyer to pursue.

A medical journal study released this month offers alarming evidence about the long-term prospects for stroke victims and raises broader questions about the way hospitals treat them. The study, originally published in the medical journal Stroke, and reported on by a number of mainstream media outlets, found that, as summarized by Bloomberg Businessweek: “within a year of having a stroke, almost two-thirds of Medicare patients die or wind up back in the hospital.”

According to Businessweek, the study looked at data covering over 91,000 Medicare patients at 625 hospitals nationwide. It covered the years 2003 to 2006 and found no change in the rates of rehospitalization or death over that period. One caveat, noted by outside experts interviewed by the magazine, is that a study like this – one focusing on older patients – can have a difficult time controlling for other medical issues the patients may be experiencing.

The study uncovered a death rate of 14.1 percent within the first 30 days after a stroke and 31.1 percent within a year. More alarmingly, “61.9 percent of stroke patients were readmitted to hospital or died within a year of their stroke,” Businessweek notes.

In looking at ways to contain the ever-rising cost of health care in America tort reform – a fancy way of saying ‘making it harder to sue bad doctors’ – is often cited as a quick fix. A recent article in the New York Times, however, underlines in the most harrowing ways possible the consequences that can arise when a legislature lets the urge to cut doctors costs outrun its concern for patients rights.

As the article details, in 2003 Texas changed its tort laws with the goal of making it “more difficult for patients to win damages in any health care setting, but especially emergency rooms.” The state’s big idea was to cap damage awards with the goal of bringing down doctors’ insurance rates: noneconomic damages in Texas are now limited to $250,000 from each health care provider and $750,000 overall.

The legislature also, however, sought to provide extra protection to emergency room doctors, on the grounds that they must often make split-second life-or-death decisions and, thus, should be insulated from frivolous lawsuits. It is a laudable goal in theory: reform that makes life easier for the hardest-pressed doctors and, in the process, lowers their insurance rates. To achieve this, however, the legislature used sweeping language, declaring that emergency room doctors cannot be sued at all unless a victim can show the doctor acted with “willful and wanton negligence”. In practice, as the Times notes, that standard has proven virtually impossible to meet.

With recent statistical reports demonstrating that elder abuse is a rising problem here in the United States, media reports here in Oregon indicate that officials at the state Department of Human Services fear our state may have become part of this disturbing trend.

According to a recent article published in The Daily Astorian, “national studies estimate 3 to 5 million seniors, aged 65 and older, have experienced abuse – but only 1 in 5 cases are reported.” Adult Protective Services agents are asking family members to keep an eye out for signs of trouble, particularly as we enter the holiday season.

Elder Abuse can take many forms, and need not be physical in nature. As an information page at the Oregon Department of Human Services’ website (see link below) outlines, Oregon elder abuse can take many forms. These may involve Oregon medical malpractice or nursing home neglect, but can also include financial exploitation or psychological and emotional trauma.

Recent reporting by the Seattle Post-Intelligencer highlights important differences in how Washington and Oregon treat the reporting of medical errors. The article focuses on Washington, where hospitals are required to report their medical errors to state officials. It notes, however, that there are many holes in the system – notably concerning definitional questions. It also adds that such problems can be even worse in the 23 states where the reporting of hospital errors is not required by law.

Oregon, unfortunately, is one of those states. As the Oregon Patient Safety Commission’s website notes, its mission is to “establish a confidential, voluntary serious adverse event reporting system in Oregon.” Because reporting is voluntary, it is difficult to tell whether the 32 deaths from “preventable errors” in 2009 reported by The Oregonian earlier this year represent the sum total of deadly Oregon medical errors, or whether the problem is more serious than indicated by the available data.

In this regard the example of Washington is sobering. According to the Post-Intelligencer, even in a state where the reporting of serious hospital incidents is mandatory loopholes can allow obvious errors to slip through the system. The article I link to below tells the story of a Yakima man who went into the hospital for routine shoulder surgery, suffered brain damage due to nursing errors and died two days later. The newspaper reports that because the victim did not die within 24 hours of the surgery, however, the events were not considered to be related for incident reporting purposes. It took a complaint by the victim’s family for the incident to be formally logged and the hospital to become subject to disciplinary action.

The New York Times reported last week that Massachusetts has reached a settlement with the Stryker Corporation in a lawsuit alleging that the hip and knee manufacturer “marketed items without regulatory approval and misled health care providers about the use of its products.” The case focused specifically on Stryker’s OP-1 implant and OP-1 putty, according to the Times.

The $1.35 million settlement with Stryker’s biotech unit consists of a $325,000 civil penalty and $875,000 in funds to combat illegal marketing by other health-care related companies. The remainder is taken up by “legal fees and investigative costs.”

After the Massachusetts attorney general announced the settlement the company issued a statement emphasizing that under the terms of the agreement it has admitted no liability. It is hard, however, not to miss the product liability issues this may raise for Stryker in other states. Clearly, any Oregon patient suffering from the symptoms that were raised in the Massachusetts case would be well advised to consult with a Portland medical malpractice lawyer to consider best way to proceed.

The 2008 death of a 25-year-old woman who was kept waiting at an Oregon hospital for more than six hours has prompted an Oregon wrongful death lawsuit directed against Springfield’s Sacred Heart Medical Center, according to the Associated Press.

The suit was filed by the woman’s parents, a couple from Eugene, who contend that the hospital’s failure to see and treat their daughter in a timely manner contributed to her death two days before Christmas 2008.

According to the AP, the woman, Martha Barr, arrived at the hospital around midday and was initially assessed by hospital staff as suffering from “shortness of breath, anxiety, fatigue, abnormally fast heart and respiration rates and low oxygen saturation.” It was, however, more than six hours before a doctor actually examined her. The doctor reportedly ordered a series of tests, but Barr went into “respiratory and cardiac arrest” before they could be performed and died just over two hours later. AP reports that in the Springfield wrongful death court papers the Eugene parents “contend that a long wait to see an emergency room doctor proved fatal for their daughter.”

If you arrive in a hospital emergency room unconscious and suffering from an Oregon traumatic brain injury can the doctors use you for a medical experiment without your consent? You might have thought the answer to that question was pretty obvious: absolutely not. According to a recent article in the Portland Tribune, however, you would be wrong.

The Tribune reports that researchers at Oregon Health & Science University, beginning this week, are using a loophole in federal regulations governing medical studies on humans to move ahead with an Oregon brain injury study. Under the so-called “community-wide study exception” the hospital has staged about 20 community meetings to explain its proposed brain injury study and may now presume that any unconscious person brought into the emergency room with an Oregon traumatic brain injury has consented to involvement in the study unless they are wearing a bracelet that declares otherwise, or family members arrive at the ER within one hour of the patient’s admission and refuse to consent to the injured person’s enrollment in the program.

The study in question involves use of progesterone, a hormone that may help severely injured patients recover from brain injuries. It raises, however, a broader question of what ‘informed consent’ ought to mean in the real world. Can an entire community legitimately be said to have agreed to be involved in a study on the basis of a series of public meetings, some of which, according to the paper, were attended by only a handful of people? What about people from elsewhere in Oregon or from out of state who are unlucky enough to be involved in a Portland auto accident and just happen to be taken to OHSU?

As a recent report in The Oregonian details, Adventist Medical Center has witnessed a dramatic drop in Portland hospital deaths from bloodstream infections in the three-plus years since it instituted a new set of simple, but effective, safety procedures. The development is obviously good for patients, but it also has implications for Oregon wrongful death and medical malpractice claims related to our state’s hospitals.

The paper explains that in 2006 Adventist began implementing a set of relatively simple procedures developed at Maryland’s Johns Hopkins University. These involve medical professionals carefully checking each other to ensure thorough hand-washing before care-givers have contact with patients, greater attention to the use of antiseptics to clean patients skin and more extensive use of “full surgical regalia”.

As the paper reports, data collected by the state shows a dramatic drop in mortality and infection rates once the new procedures went into effect – especially when compared with other Portland area hospitals that do not follow the Johns Hopkins guidelines. The newspaper, citing Adventist’s director of quality resources, reports that there have been no ICU infections at the hospital since the spring of 2007.

A state appeals court has upheld a $1.4 million Oregon medical malpractice judgment against the Oregon Health & Science University’s hospital and one of its doctors. The court rejected arguments by the university and doctor that state law capped Oregon medical malpractice liability at $200,000, according to local media reports. The Portland Business Journal reports that the hospital plans to appeal the ruling.

The focus of the case is former Portland TV host Ken Ackerman. According to The Oregonian, Ackerman contends that a botched 2003 operation to repair a bulging spinal disk has left him in near constant pain, reduced his dexterity in one hand and reduced his sensitivity to hot and cold on one side of his body. Ackerman sued for $5 million and was awarded $1.4 million after a 2006 Portland medical malpractice trial. His suit also challenged a law limiting damages against state employees performing their official duties to $200,000. The question of whether the law protected the doctor and hospital from damages above that figure was effectively resolved when the State Supreme court overturned the limits in a separate 2007 case.

Ackerman’s latest victory is good news for anyone who has been the victim of Oregon medical malpractice and is seeking compensation for his or her injuries. A Portland medical malpractice attorney can advise clients on the best ways to approach a case, based on the victim’s own particular experiences. In addition to medical bills and lost wages or salary, compensation can include awards for pain and suffering, and for lost potential income. The state’s moves to revise the old caps on liability awards is an important acknowledgement that in this age of ever-rising medical costs the value of damages associated with Oregon medical malpractice claims should also rise accordingly.

50 SW Pine St 3rd Floor Portland, OR 97204 Telephone: (503) 226-3844 Fax: (503) 943-6670 Email: matthew@mdkaplanlaw.com
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