Articles Posted in Medical News

Annually in the U.S., at least 3.5 million people are treated for traumatic brain injuries (TBI). A recent article published in the Journal of the American Medical Association’s neurology section reports that the development of therapies for TBI has been limited by the absence of diagnostic and prognostic biomarkers. The microtubule-associated protein Tau is an axonal phosphoprotein. Up to now, the presence of the protein in plasma from patients with acute TBI and chronic TBI has not been investigated.

Traumatic brain injury (TBI) is considered an event and/or a disease. Traumatic brain injuries may lead to chronic functional, neurocognitive and neuropsychiatric deficits. The three classifications of a TBI are measured by severity, which can be mild, moderate or severe.

There were more than 3.5 million emergency department visits for TBI and more than 280,000 patients are hospitalized annually with TBI; most of these are classified as mild TBI. It is presumed that there are many more individuals who have mild TBI, but do not seek medical attention. Between 2000 and 2014, more than 300,000 members of the military sustained TBI during combat and training. Approximately half of the patients with TBI in the U.S. have at least some short-term disability related to that injury or illness. TBI is associated with an increased risk of neurodegenerative disorder such as Alzheimer’s disease, which can occur in individuals years after the injury.
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On July 25, 2017, Kreisman Law Office’s Robert Kreisman was one of the principal speakers at the Professional Negligence Section’s full-day session. Mr. Kreisman was one of several speakers on the topic of maternal deaths and the causes related to medical malpractice. The seminar was part of the American Association for Justice‘s (AAJ) annual convention that was held in Boston, July 22-26, 2017. Robert Kreisman is the immediate past chair of the Professional Negligence Section of AAJ.

Mr. Kreisman has often been a speaker at both annual and mid-year meetings of AAJ. In addition, Mr. Kreisman has been a faculty member for many professional negligence seminars sponsored by AAJ over many years. Several years ago, he was honored with the “diplomat” status for his participation as a speaker and teacher of trial technique and strategies with the organization.

At the July 25, 2017 program, Mr. Kreisman spoke on the subject of proving cause in maternal deaths due to influenza. It is unfortunate that the United States statistically has a dismal record in maternal deaths. In fact, the number of maternal deaths in the U.S. has been rising alarmingly over the last decade.
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It is no secret that thousands of American patients die or are permanently and seriously injured by medical providers. More than 250,000 Americans die in hospitals every year due to medical errors. That staggering number makes deaths in hospitals, clinics, nursing homes, assisted living facilities and long-term care centers the third most common cause of death in the United States. The number of Americans who die because of the negligent errors made by medical providers is higher than those who die because of respiratory disease, accidents, stroke and Alzheimer’s disease.

According to the study by Johns Hopkins University School of Medicine, the causes of the deaths are not isolated to one common medical practice area.

The Johns Hopkins research involves a comprehensive analysis of four large studies. According to a report a year ago by the Washington Post, the Johns Hopkins report took into account studies from the U.S. Health and Human Services Department’s Office of the Inspector General and the Agency for Healthcare Research and Quality between 2000 to 2008. The calculation of 251,000 deaths in a year amounts to nearly 700 deaths a day — about 9.5 percent of all deaths annually in the United States.
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“Leaders must commit to creating and maintaining a culture of safety.” National Patient Safety Foundation. Free From Harm: Accelerating patient safety improvement for 15 years after To Err is Human.  2015 (accessed Dec. 8, 2016). This is just a part of the Sentinel Event Alert publication of The Joint Commission Issue 57, March 1, 2017.

The core of the publication is that leadership in hospitals and medicine generally have a priority to be “accountable for effective care while protecting the safety of patients, employees, and visitors. Competent and thoughtful leaders contribute to improvements in safety and organizational culture.”

This alert acknowledges that hospitals, doctors, nurses and health care professionals must do a better job of protecting their patients from harm. The article states that “The Joint Commission’s Sentinel Event Database reveals that leadership’s failure to create an effective safety culture is a contributing factor to many types of adverse events-from wrong site surgery to delays in treatment.” Smetzer, J, et al. Shaping systems for better behavioral choices: lessons learned from a fatal medication error. Joint Commission Journal on Quality and Patient Safety. 2010; 36: 152-164.
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In the recent Illinois Appellate Court decision of McChristian v. Brink, it was held that the defendant’s attorney, representing a podiatrist and the podiatry clinic, was not prohibited from calling a controlled expert (Ill. S. Ct. Rule 213 (f)(3)) podiatrist to testify at trial when this expert was also one of the injured plaintiff’s treating podiatrists and a member of defendant’s podiatry clinic.

This court held that the Petrillo doctrine does not preclude ex parte communications with individuals who serve as the “corporate heads and are the decision makers of the defendant corporation.” Petrillo v. Syntex Laboratories, Inc., 148 Ill. App. 3d 581, 601 (1st Dist. 1986). The Petrillo decision and the many cases following that basic principle is that defense attorneys are not allowed to retain an expert who works for the same professional organization where the plaintiff received medical care.

In the McChristian case, the court ruled that the defendant medical group and doctor could utilize an expert witness at trial who worked for the same clinic as the defendant. Recent cases have expanded the Petrillo decision stating that a treating physician’s status can now be imputed to expert witnesses in the same professional association, even if they practice in different fields of medicine.
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Not-for-profit hospitals are tax exempt. Seven of the ten most profitable U.S. hospitals are nonprofit, according to new research. One hospital, located in Urbana, Ill., is involved in a contentious court battle. The decision could determine whether medical facilities are paying their fair share of taxes.

According to this study, delivery of patient care was a money-loser for 55% of hospitals in 2013, which was the year the study was done. About one-third of these hospitals made some money, up to $1,000 per patient. About 12% of those in the sample research group made more than $1,000 per discharged patient. The highly profitable hospitals were mostly for-profit corporations. In this group were Medical City Dallas Hospital in Texas and Swedish Medical Center in Englewood, Colo.

The not-for-profit hospital Carle Foundation Hospital in Illinois claimed tax exemption, but state appeals court in January 2016 ruled Illinois law allowing hospitals to avoid taxes is unconstitutional.

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In this case before the U.S. District Court for the Northern District of Illinois, the Federal Rules of Civil Procedure were examined closely with respect to a subpoenaed nonparty deposition. The court stated that nonparties will be protected by undue burden and that, in weighing requests to depose nonparties, courts will consider four factors:

  1. The person’s nonparty status;
  2. Relevance of discovery sought;
  3. Need for discovery; and
  4. Breadths of the request.

In this case, the plaintiff Prabhjot Uppal graduated as a physician from Rosalind Franklin University of Medicine and Science in 2005.  He obtained a residency at Lutheran General Hospital in Park Ridge, Ill.

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A city of St. Louis Circuit Court jury found that Johnson & Johnson’s well-known white powder, Baby Powder and Shower to Shower and other products containing talcum, were the cause of the ovarian cancer and death of an Alabama woman. The Shower to Shower product line was sold by Johnson & Johnson in 2012. For decades, these products have been depicted in advertisements as beneficial for women and children.

The civil lawsuit was brought by Jackie Fox of Birmingham, Ala., which was part of a larger claim involving 60 other injured individuals. Fox’s claim was brought by her son who took over the case after his mother passed away in October 2015 at the age of 62. She died 2 years after her diagnosis of ovarian cancer. Fox underwent painful chemotherapy and radiation therapies in the effort to control her cancer.

It was alleged and proved in the lawsuit that Fox used the talcum powder as a bathroom staple for years. The jury deliberated for five hours after a 3-week trial. It was the first such case among more than 1,200 nationally that are still pending against Johnson & Johnson.

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Unfortunately, there are too many medical or hospital related errors that have injured or killed patients in the United States. According to a recent study by the Institute of Medicine, “Most people will experience at least one wrong or delayed diagnosis at some point in their lives, a blind spot in modern medicine that can have devastating consequences.” The institute’s report calls for urgent changes in many areas of health care. According to the report, the most significant change is that patients become central to a solution, said Dr. John Ball of the American College of Physicians. He chaired the Institute of Medicine committee.

The report indicates that medical providers must take patients’ complaints more seriously and make sure that the patient receives copies of test results and other records to encourage patients to ask, “Could it be something else?”

In other words, patients should be seeking other opinions from physicians to diagnose their ailments. This is a cultural shift. It could be the norm to finally get the right diagnosis or that the second opinion doctor calls the treating doctors to say it turned out to be this and not that. One of the most famous diagnostic errors occurred in 2014 when a Liberian man who was sick with Ebola initially was misdiagnosed in a Dallas emergency room as having sinusitis. The man returned two days later and eventually died.

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Eric Topol, M.D., is the director of Scripps Translational Science Institute, which is believed to be one of medicine’s most innovative programs about the digital future in medicine. The book written by Dr. Topol, “The Patient Will See You Now” was reviewed in the New York Times Book Review section on Sunday, Feb. 15, 2015.

Commenting on the future of medicine and how it will be administered, he writes, “We are about to see a medical revolution with little mobile devices. Smartphones will play a role well beyond a passive conduit.”

Dr. Topol’s book says smartphones will be used to accomplish what doctors in their offices and at hospitals have been doing for many decades. The author says smartphones will be able to perform blood tests, medical scans and even parts of the physical examination. This is what Dr. Topol calls “bottom-up medicine.”

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