Delaware Business Lawyer Blog

As a Delaware medical malpractice lawyer, I've become more and more involved with clients who acquired MRSA in the hospital. Now comes a report that a 77 year old woman who was in the Abington Memorial Hospital was a victim of contracting MRSA while in the hospital. This poor woman had to undergo 20 surgeries as a result, and she ended up dying due to the infection. The hospital's chief of staff has been quoted as saying that this infection was brought into this woman's room on the hands of someone in the hospital.

For more information, check out:
MRSA Is Preventable
Infections In Hospitals
MRSA- Too Many People Get Sick In Hospitals
HA-MRSA Is A Growing Danger

As a Delaware medical malpractice lawyer, I have strong feelings when relatively healthy clients of mine go into the hospital for routine surgery, and get real sick because of a lapse in infection control. This is a series of articles dealing with hospital acquired MRSA.

For more information, check out:
MRSA Is Preventable
Infections In Hospitals
MRSA- Too Many People Get Sick In Hospitals

As a Delaware medical malpractice attorney, I can never get used to the words "sometimes, bad things happen in hospitals." The reason these words bother me so much is that I only hear them when the bad thing that happened was preventable. One of these preventable bad things is infection.

Researchers at Duke University Medical Center recently announced the results of a large study about infections from surgery. According to the lead author of the study:

"We found that patients with surgical site infections due to MRSA were 35 times more likely to be readmitted and seven times more likely to die within 90 days compared to uninfected surgical patients."

"These patients also required more than three weeks of additional hospitalization and accrued more than $60,000 in additional charges."

MRSA infection is caused by Staphylococcus aureus bacteria, often called "staph." MRSA infections that occur in hospitals or other health care settings such as nursing homes and dialysis centers is commonly known as HA-MRSA, which stands for health care-associated MRSA.

MRSA usually starts as small red bumps that looks like pimples, boils or spider bites. These can quickly turn into deep, painful abscesses that require surgical draining. In some cases, the bacteria remain confined to the skin, but in other cases they can penetrate into the body, causing potentially life-threatening infections in bones, joints, surgical wounds, the bloodstream, heart valves and lungs.

As a Delaware medical malpractice lawyer, I'm currently representing a woman who contracted MRSA while she was in a local hospital. This preventable infection is all too common. According to the U.S. Centers for Disease Control and Prevention, more than 2 million hospital infections occur each year, and about 90,000 people die each year from infections they got while in the hospital.

This topic was the subject of an interesting book review that appeared in the NY Times.

According to this review, in order to prevent a patient from getting an infection when a catheter is inserted in the vein, there are five things that doctors should:
(1) wash hands with soap
(2) clean the patient’s skin with antiseptic
(3) cover the patient’s entire body with sterile drapes
(4) wear a mask, hat, sterile gown and gloves
(5) put a sterile dressing over the insertion site after the line is in

Incredibly, in some hospitals, doctors skip one of these steps. The failure to follow any one of these steps is a departure from the standard of care, and constitutes medical malpractice.

As a Delaware medical malpractice attorney, I find that patients are becoming more and more angry when they go into the hospital with one problem, and come down with a new problem during their hospital stay. I recently wrote about hospital acquired MRSA. Well, another serious condition that patients get while they’re in the hospital is bedsores, also called pressure sores, decubitus ulcers, and pressure ulcers. And just like MRSA, pressure sores are preventable.

The problem has been getting worse, not better. In fact, an article published in the New York Times in December of 2008 called hospital acquired bedsores an epidemic. This article, entitled “Hospitals Face a New Epidemic: Bedsores,” reported that the number of hospital patients with bedsores has risen dramatically over a 14-year period, leading to longer, more expensive hospital stays.

What causes pressure sores? They occur when the blood supply to the skin is cut off for more than two to three hours. When the blood supply is cut off, the skin dies. A bedsore starts out as a red, painful area, and eventually turns purple. If it’s not treated, a bedsore can lead to serious infection and other life-threatening complications, such as blood poisoning.

So what causes the blood supply to the skin to get cut off? It’s from staying in one position for too long. There are areas in your body where the bone is close to your skin, such as your ankles, back, buttocks, elbows, heels and hips. If you’re lying in bed or sitting in a wheelchair for a long time, or if for some other reason you’re unable to change your position, this puts pressure on the skin, and the blood supply is cut off.

Bedsores can be prevented by inspecting the skin for areas of redness. Other ways of preventing bed sores include: (1) changing position, (2) using pillows and other soft padding in wheelchairs and beds to reduce pressure and (3) keeping the skin clean and dry.

Severe bedsores are absolutely preventable, and a hospital or nursing home that allows a patient to develop bedsores should be held accountable.

As a Delaware medical malpractice attorney, I believe it's only a matter of time before a patient in Delaware sues a hospital because he came down with a MRSA infection. These cases are showing up around the country. For example, a Dallas jury has awarded $17.5 million in damages to a man who had to have both of his arms and both of his legs amputated because of a hospital-acquired MRSA infection. The sad thing is that MRSA infections are preventable if proper care is taken. Even worse is the fact that most MRSA infections occur in hospitals or other health care settings, such as nursing homes and dialysis centers. Here’s an excerpt from a Wall Street Journal article which appeared least month:

“Too many patients get sick in the very places that are supposed to heal them. The facts are frightening: As many as one in 10 patients hospitalized in the U.S. will come down with an infection - often due to the very care that is supposed to be restoring health. These infections afflict nearly two million patients a year, cause close to 100,000 deaths and cost up to $6.5 billion.”

Actually, in the U.S., more people die each year from MRSA than from AIDS.

MRSA symptoms can range from mild infections on the skin which cause pimples or boils, to more serious skin infections and infections of surgical wounds, the bloodstream, the lungs, or the urinary tract. It's tougher to treat than most strains of staph because it's resistant to commonly used antibiotics.

If you or a family member came down with a MRSA infection as a result of a hospital stay, you should contact a Delaware attorney to find out whether you are entitled to receive money damages to pay for such things as medical bills, nursing care, loss of income, and pain and suffering.

As a Delaware medical malpractice lawyer, I stay up to date on malpractice trials around the country. Earlier this month in Illinois, the family of a 42 year old woman who died from blood clots after having outpatient knee surgery was recently awarded more than $6 million by a jury. The woman had been having knee pain, but because it was getting worse, her family doctor referred her to an orthopedic surgeon for an evaluation. At first, the surgeon gave her an injection for the pain, and some physical therapy. The surgeon then ordered an MRI, after which he decided to perform arthroscopic surgery which took less than an hour. She was taken home by her daughter,, but the next day she was found dead on her on the bathroom floor.

Her death was caused a pulmonary embolism that occurred when deep venous thromboids that had formed at the site of the surgery traveled to her lung. The jury found that the surgeon ignored several risk factors that should have indicated that blood clotting could be a problem: the patient was somewhat obese and was taking birth control pills; she also had a personal history of asthma and hypertension and a family history of heart disease and stroke.

Had the surgeon considered these risk factors, he could have taken precautions after the surgery that should have prevented the blood clots from forming.

Interestingly, the family's lawyer had demanded $2 million to settle the case, but the insurnace company refused to settle.

Blood clots in the large veins (deep venous thrombosis) is common after othopedic surgery. When a patient is considered at risk for blood clots, all the surgeon has to do is put the patient on blood thinning medication.

As a Delaware medical malpractice lawyer, the saddest cases I handle are severe birth injuries that could have been avoided. Usually, this involves a delay in the delivery during which time damage to the baby’s brain occurs because of a lack of oxygen. Unfortunately, this happens much too often. Take a look at the following example.

A Maryland jury recently awarded $13 million to a mother who was not told by her doctor that a C-section was an option. The mother had gone to the hospital at 28 weeks gestation with bleeding. After she was stabilized, they kept her in the hospital for the next 6 weeks for monitoring and observation. Although her OBGYN discovered several complications with the mother’s pregnancy, he didn’t tell her about this and never gave her the option of an earlier delivery by C-section. During this time, the mother had what’s known as a complete placental abruption, and this caused her son to have severe permanent and irreversible neurologic injuries.

The Court decided that the doctrine of informed consent required the mother’s doctor to divulge all information that would be material to her decision about whether to continue with the conservative treatment and wait until 36 weeks gestation, or to deliver earlier by C-section.

So what is informed consent? In Delaware, informed consent is the patient’s consent to medical treatment after the patient has been told the nature of the proposed treatment and the risks and alternatives to that treatment which a reasonable person would consider important to the decision whether or not to undergo the treatment. The important thing about informed consent is that it’s more than just signing a written consent form. Instead, informed consent involves communication between the doctor and the patient.

In my next article about informed consent, I’ll discuss what this communication process should include.

As a Delaware malpractice lawyer, I believe that there would be fewer medical errors if patients took a more active role in their care. Let's talk about infections in hospitals. The Centers for Disease Control and Prevention (CDC) is a part of the Department of Health and Human Services. According to the CDC, 2 million people come down with infections in the hospital every year, and 90,000 of these people die as a result. There are lots of reasons why this occurs, but there’s something you can do to help avoid becoming infected.

A lot of doctors wrongly assume that patients understand the discharge instructions that they go over quickly. When you’re being discharged from the hospital, ask your doctor to explain the treatment plan you should use at home. This includes learning about your medicines and finding out when you can get back to your regular activities. This is another time when having an advocate there with you can be very helpful.

As a Delaware malpractice lawyer, I've seen all kinds of medical mistakes that could have been avoided. Here are just a few:

So what can you as the patient do to help protect yourself from becoming a victim of medical malpractice? The most important thing you can do is to take an active role in your care. So how do you do this? Let's take a look at medication errors.
You're at the drug store to pick up your medication.

1. Open the bag . Make sure they gave you what you're supposed to get.
2. Don't sign too quickly. The cashier asks you to sign a paper or an electronic screen that says you agree that you've received the information you need. Most of us sign it without even thinking about it. Don't sign it without checking first.
3. Read every word on the label. Check for the name of the drug, and if the name isn't the name your doctor told you he was prescribing, don't assume they're giving you the generic substitute. Ask the pharmacist.
4. If the pharmacist or the cashier asks if you need counseling on the medication, say "yes."
5. When you're at the doctor's office, write down the medicine that's being prescribed. Take your notes to the pharmacy and compare the name you wrote down with the name on the bottle.

As a Delaware medical malpractice lawyer, I talk with clients all the time who ask about suing their doctor or a hospital. These people were seriously injured, and they feel that the doctor or the hospital should pay. In my last article, I explained that medical negligence occurs when a doctor runs through a medical red light (deviates from the standard of care). The purpose of this article is to discuss the question of causation.

Medical malpractice cases are expensive to bring, and most of these cases are decided in the doctor’s favor. In my next article, I’ll talk about the results of these cases in Delaware.

As a Delaware lawyer who represents victims of medical malpractice, I find that many people don’t have a real good understanding of the basics of bringing a medical malpractice lawsuit. This is the first in a series of articles describing the ins and outs of medical malpractice lawsuits in Delaware.

MEDICAL EXPERT WITNESS REQUIRED
When we file a medical malpractice lawsuit here in Delaware, we’re required to also file what’s called an “affidavit of merit” signed by our medical expert doctor. This affidavit must say that in the opinion of this expert, there are reasonable grounds to believe that there’s been medical malpractice, and that the malpractice was the cause of your injuries.

WHAT IS MEDICAL MALPRACTICE?
Medical malpractice occurs when a doctor runs through a medical red light. A medical red light is more commonly referred to as a “standard of care,” and a doctor runs through this red light when he deviates, or fails to adhere to the standard of care.

STANDARDS OF CARE
Standards of care are like the rules of the road. We all know that a driver has to pay attention, stop at stop signs, and yield the right of way under certain circumstances. And of course there are many more rules that drivers have to follow.

Well, doctors have rules of the road (standards of care) that they have to follow. Here’s a standard of care that applies when a CT scan reveals the presence of two ovarian cysts in the patient’s body – the standard of care requires the doctor to (1) inform the patient of the presence of the cysts, (2) refer the patient for a sonogram, and (3) refer the patient for an OB/GYN consultation.

Let’s look at standards of care for back pain.
•A doctor should conduct a focused history and physical examination to help place patients with low back pain into 1 of 3 broad categories: nonspecific low back pain, back pain potentially associated with radiculopathy or spinal stenosis, or back pain potentially associated with another specific spinal cause. The history should include assessment of psychosocial risk factors, which predict risk for chronic disabling back pain.
•A doctor should perform diagnostic imaging and testing for patients with low back pain when severe or progressive neurologic deficits are present or when serious underlying conditions are suspected on the basis of history and physical examination
•A doctor should provide patients with evidence-based information on low back pain with regard to their expected course, advise patients to remain active, and provide information about effective self-care options.
•A doctor should consider the use of medications with proven benefits in conjunction with back care information and self-care.
•A doctor should assess severity of baseline pain and functional deficits, potential benefits, risks, and relative lack of long-term efficacy and safety data before initiating therapy. For most patients, first-line medication options are acetaminophen or nonsteroidal anti-inflammatory drugs.
•For patients who do not improve with self-care options, a doctor should consider the addition of nonpharmacologic therapy with proven benefits for acute low back pain, spinal manipulation; for chronic or subacute low back pain, intensive interdisciplinary rehabilitation, exercise therapy, acupuncture, massage therapy, spinal manipulation, yoga, cognitive-behavioral therapy, or progressive relaxation

In my next article, I’ll talk about the concept of causation.