Philadelphia Medical Malpractice Lawyer Blog

Published on: September 30, 2007

Anesthesia Death

Anesthesia medical errors and inadequate monitoring are a frequent area of medical malpractice and wrongful death lawsuits in Pennsylvania and around the country. Recently, the family of a 56 year old woman who died from an overdose of the drug lidocaine with epinephrine during a routine facelift procedure settled the wrongful death case for $3.1 million. In addition to the lidocaine overdose, the plaintiffs alleged that there was inadequate anesthesia monitoring during the procedure because the volume on alarms were turnned down so low that when the patient’s blood oxygen levels dropped (hypoxia), the alarms could not be heard. Malitz v. Manhattan Eye, Ear & Throat et al., No. 0411083C (N.Y.Sup.Ct., New York County May 24, 2007). This unfortunate patient sufferred tachycardia (fast heartrate) and subsequent cardiac arrest (heart stops) from the medication overdose. The case was of particular note becuase it involved a reknowned plastic surgeon who had operated on movie stars, politicians and other public figures.

During the litigation, it was revealed that the New York State Health Department had investigated the incident and concluded that the initial dose of lidocaine that was given “significantly exceded the maximum recommended amount.” Additionally, the autopsy found a needle hole in the patient’s larynx, which indicated that the lidocaine was injected into the wrong portion of the patient’s neck during the surical proceedure.

This case demonstrates not only that anesthesia errors and medical monitoring are among the frequent areas of medical malpractice, but it also illustrates how critical medical evidence can be in winning a case. First, it is not uncommon for a few medical errors to combine to result in a tragic outcome. In this case, there was a drug overdose, injection into the wrong site and inadequate monitoring, all of which combined to result in an untimely death. Such complexity in a case requires a knowledgeable and experienced attorney, who is able to understand the relationship between these types of errors and how their combination can result in serious complications and even death. Second, because these cases may involve multiple medical errors, several medical experts may be needed from areas such as anesthesiology, cardiology and pathology. Finally, the attorney must work with the medical experts to identify and present the key medical evidence, including medical records, pathology reports and radiology studies, to build a winning case. These issues all evidence why the attorney’s knowledge and experience are critical to the case’s ultimate success.

Published on: September 26, 2007

Chiropractors in New Jersey Can Only Adjust Spine

by Leon Aussprung

A New Jersey appeals court found that the New Jersey Chiropractic Board Act and the New Jersey Administrative Code limits chiropracters to maneuvers designed to treat only the spine. In a recent case, Bedford v. Riello, 2007 WL 135521 (N.J. Super. Ct. App. Div.), two New Jersey chiropractors adjusted a woman’s painful knee and, according to the patient’s medical malpractice claims, caused a torn meniscus that required arthroscopic surgery. The patient’s medical malpractice claims were based partly upon the patient’s argument that the Chiropractic Board Act and the New Jersey Administrative Code prohibit chiropractors from adjusting a knee. The Trial Court did not agree with the patient’s theories and refused to allow the patient’s expert medical witnesses offer opinions that the chiropractors’ manipulation of the patient’s knee were outside the boundaries of allowable chiropractic activites in New Jersey. The experts testifying for the patient were allowed to testify that the chiropractors failed to look for a subluxation (joint abnormality) before doing the adjustment and perfomed the adjustment so “vigorously” so as to tear a ligament in the patient’s knee. The jury found against the plaintiff and she appealed the Trial Court’s rejection of her argument that all chiropractors are prohibited from adjusting a knee.

The patient won her appeal and is now permitted a new trial. The appeals court held that the Trial Court erred in its interpretation of the law. The appeals court ruled that in the patient’s new trial, the jury would be instructed that an adjustment of a knee by a chiropractor is beyond the boundaries of permissable chiropractic practice in New Jersey such that doing a knee manipulation could be viewed as evidence of negligence. In reaching its decision, the appeals court recognized that chiropractors in New Jersey are permitted to move a patient’s arm or leg to help in adjusting the spine, but since the manipulation in this case was of the leg to address a complaint in the leg, rather than the spine, the adjustment of the knee in this case was beyond the bounds of the chiropractors’ scope of practice.

This case is an example of two important principles in handling a medical malpractice case: (1) legal rulings made prior to trial are often crucial to the outcome of a case and (2) medical malpractice cases require a willingness by the patient’s lawyer to “fight to the end. When I represent patients, I prepare cases thoroughly and with attention to detail and I stand behind my client’s rights and fight for them from start to finish.

Published on: September 25, 2007

Medical Malpractice Basics

by Leon Aussprung

People who suffer serious injuries, including permanent disabilities, cancer, nerve damage, brain damage, cerebral palsy, surgical complications or death from medical errors should consider having their situation reviewed by an experienced medical malpractice attorney. Before speaking to an attorney, it is helpful to understand some basic information concerning the law and the legal issues involved in bringing medical malpractice cases.

Every medical malpractice case, including those in Pennsylvania, requires that an injured person (the plaintiff) prove four basic criteria. First, the plaintiff must demonstrate that the physician, nurse or other health care provider had a “duty” to the plaintiff. That means that the plaintiff was under the care of the health care provider. This criterion is rarely disputed and is generally easy to prove. Second, the plaintiff must prove, through expert medical testimony, that the health care provider “deviated from the proper standard of care” in his or her treatment. Third, the injured person must prove that the health care provider’s deviation form the standard of care was a “cause” of the plaintiff’s injuries. Finally, the plaintiff must be able to demonstrate that he or she actually suffered injury.

Although the plaintiff has the burden to prove each of the four criteria discussed above, this legal burden is only to a standard of “more likely than not,” which is substantially less than the criminal standard of “beyond a reasonable doubt.” Nevertheless, the plaintiff’s burden of proof means that he or she must hire medical experts who are willing to stard up during trial and publicly testify against their colleagues. These medical experts are expensive and must be hired long before the case ever sees the inside of a court room.

Published on: September 23, 2007

New Jersey Neurologist is Qualified Standard of Care Expert

by Leon Aussprung

In New Jersey, as in many states including Pennsylvania, medical experts in medical malpractice cases must be qualified in a defendant doctor’s area of medicine to give an opinion that the doctor deviated from the standard of care. In a case involving thoracic cord compression, necrotic disc injury, permanent nerve damage and diabetic neuropathy, an appeals court in New Jersey held that a Neurologist was qualified to offer an expert opinion against an internal medicine physician, a physiatrist (rehabilitation physician), an emergency room doctor and an orthopedic surgean concerning treatment of these spinal cord and nerve disorders. Bull et al. v. Zeidman et al., 2007 WL 1008887 (N.J. Super. Ct. App. Div.).

As in Pennsylvania, the court concluded that the Neurologist’s credibility was to be decided by the jury, which could weigh his testimony, education and experience. Although the Neurologist was not board-certified in any of the defendant physicians’ specialties, because he had 25 years of experience as a Neurologist and had experience treating patients with the plaintiff’s spinal cord and nerve disorders, he was qualified to offer his opinion to the jury.

In Pennsylvania, although the Medical Care Availability and Reduction of Error Act (“MCARE Act”) does generally require same specialty match in order for a medical expert to be qualified to offer standard of care opinions, there are some exceptions. For example, orthopedic surgeons have been found qualified to offer standard of care opinions against defendant podiatrists. This is contrasted with Delaware, which now requires strict specialty matching as a minimun qualification for medical experts.