Monday, January 27, 2014

Ten Patient Stories: When Attorneys Refused My Medical Malpractice Case

After surgery on her ankle, Jeanine Thomas suffered a potentially deadly bacterial infection that required seven more operations to save her leg and nearly five years of recovery.

Thomas found a medical malpractice attorney to file a lawsuit on her behalf. But then he withdrew, she said, because he wouldn’t make much money if they won. Thomas had just started a consulting business and didn’t make much. Because economic damages in lawsuits are largely based on lost income, she was told the potential rewards weren’t high enough, she said.

Thomas moved on. Now, she fights for better infection prevention standards in health care through her advocacy organization, the MRSA Survivors Network. She was one of dozens of readers who shared similar experiences in the comments section for ProPublica’s recent story, “Patient Harm: When An Attorney Won’t Take Your Case.”

Their stories cut across many dimensions of the problem, so we decided to highlight a few. The excerpts below were edited for clarity, and some writers did not provide their names.

As we reported, the medical malpractice system often discriminates against certain patients, particularly those with low incomes. Those who can’t get representation ­— often women, children or the elderly — are sometimes called the “hidden victims” of medical malpractice. Studies show that the problem isn’t limited to states that have strict limits on malpractice awards.

In addition to commenting on the story, many readers responded by filling out the ProPublica Patient Harm Questionnaire or by posting to ProPublica’s Patient Harm Facebook group. Both are part of our ongoing reporting about patient safety, and we invite you to check them out.

1. "He was too old"

When my father passed from MRSA acquired after open heart surgery (acquired either in the hospital or rehab center) I called 40 attorneys and was told the exact same thing as the article states: He was too old, had lost his viability (translate earning potential) and had no wife (she had died). Most of them would not tell me why they would not take the case, but one did. It's not only hard to hear that your elderly parent has no value legally, but this is exactly why doctors and hospitals and other medical facilities continue their poor attempts at keeping hospitals as clean as possible. They answer to no one.

— Carol Dye

2. “What was done to me was clearly negligence

This is really so painful to re-live. All of the attorneys I discussed my case with said that what was done to me was clearly negligence and that the case had merit indeed. However, the potential award would have fallen below the $250,000 mark, and to fight it would have been a gamble because jurors – for whatever reason – see physicians in a “can do no wrong” light and may decide in favor of the negligent doctor. I wanted to fight it out of principle more than anything else.

— Gloria Shen

3. Rejection Letter

Our son's case was a good example. There were many instances of error, but because he was single we couldn't bring case because there was no “pain or suffering” allowed for parents of adult children over the age of 25. I did call many attorneys and mostly was asked how old he was and if he was married. Then I got a rejection letter. The solution is very simple. Be honest when errors take place, and compensate victims fairly, then peace will come a lot sooner for everyone, including doctors.

— John

4. "It was business"

I had the same issue after my daughter passed from medical harm. I did at one point have a signed contract with an attorney. He had a friend in the medical field that he felt could review her 2,500 pages of medical records. However, when his friend explained that because she was an infant who went in for heart surgery, you'd require two specialists to review my daughter’s chart and testify. I was told it would cost roughly $50,000 to $75,000 per specialist. This doesn't include normal costs for the attorney. It didn't take long for the attorney to send me a letter stating he couldn't help me. I added that letter to the other dozen all stating we had a good case, but the financial limits made it impossible for them to take it. It was business.

Although it was heartbreaking, I do understand the attorneys cannot lose that kind of money on a case. I even asked if it were possible for me to sign an agreement stating the attorney gets everything above expenses. I didn't want the money. I just wanted the hospital to have to own the mistakes.

As you read this, don't assume she passed because of her heart. The surgery was successful, as expected. It was the aftercare that killed her: Avoidable infections, overdose of heparin, lines becoming dislodged, a doctor collapsing her lung while removing a drain tube. It seemed endless but was only 95 days. One heart surgery with a 99.9 percent success rate and a week of recovery in the hospital turned into three heart surgeries, an exploratory abdominal surgery and seven hospital associated infections and 95 days later, her death. I wish there were a medical court (of sorts) that patients could go to without an attorney. They could file a complaint and sit in a room with the doctor, nurses, specialists and a panel of “judges” and plead their case. Ask their questions. No attorneys. No “specialists.” Just a place to get answers, and, if needed, monetary compensation. Personally, I just wanted answers.

— kratliff73

5. “Dad’s life was worth nothing”

My Dad was an elderly, and he was killed by the misuse of an off-label medication that was contraindicative for his medical conditions. The harm was totally preventable. After Dad’s death, we talked to 20+ attorneys. 99 percent of them said there was malpractice and the doctor was negligent. But because of my Dad’s age and the lack of future earning, no attorney was willing to take my Dad’s case on contingency.

One attorney wrote to us that my Dad’s age was above the average life expectancy, and therefore it “seriously reduces the damages likely to be awarded for loss of future life earnings. Certainly this does not excuse the poor care he received but this makes the case economically untenable as the expenses will likely eat up the majority of likely recoverable damages. We do not have punitive damages in Washington (state) that an outraged jury could award to punish the Dr. and Hospital for their callousness. For these reasons our firm does not wish to undertake this case.”

So we learned quickly that, in our current legal system, Dad's life was worth nothing because he was old.

— Yanling

6. "I’ve never sued anybody"

I attempted to get recompense for my elderly mother after medical neglect that resulted in her losing her ability to walk, additional surgeries, and months of pain. I had no idea WHY the lawyers I contacted didn't even want to listen to the details. Now I know, and am disheartened to learn the reason for their disinterest. I've never sued anybody, am not one of those people who would sue when I dump coffee in my lap. But when one has a legitimate reason and legitimate damages, it's horrendous that our legal system provides no avenue of recompense for actual damage that is life altering.

— Kathleen

7. "I am, however, alive"

I was an RN and suffered serious and permanent harm from my cancer surgery. There were many errors, including my waking up during surgery, life-threatening infection, internal sutures that did not dissolve, renal failure, a collapsed lung after hospital discharge, abscesses and wound dehiscence. Years later, I am homebound and unable to work. I would be making $80-100,000/year now or more but am stuck barely above poverty on Social Security Disability. Since I and the various insurances have spent over $2 million for my care, and I do not have enough money to obtain all the care and medications I need, I am very unhappy. I have a potential new abscess now. It is a living horror, and the cancer may return. I am always in pain. No attorney would take my case. Even the failure to diagnose the cancer for years, with facts right there for every doctor I went to with my symptoms, isn't actionable. I am however, alive.

— Nightmare-daily

8. "Perverse incentive"

We got dropped the moment our attorney heard mom had died. It creates a very perverse incentive when a hospital realizes that they have committed a serious harm. The best thing it can do is kill you, which is precisely what we think the hospital did.
— Debra Van Putten

9. "It was not cost effective anymore" When I went back to work my lawyers dropped my case. It was NOT cost effective anymore.

— Ron Giovagnoli

10. "It would cost too much"

My younger brother died almost 2 years ago. He coded (his heart stopped beating) a couple days after a colostomy procedure. The doctors rushed him into surgery as he was clearly bleeding internally. They didn't find the source of the bleed, but after looking for a while, gave up and closed the surgery anyway. He continued to bleed, which led to two more surgeries, more complications and his eventual death.

We have had multiple lawyers look at the case. All of them have told us that while they believe mistakes were made, it would cost too much to prosecute the case to be worth it. Since he was 25, single and childless, there are no financial losses; no one who was depending on his paycheck. All we really want is answers and assurances that something has been done within the hospital to prevent similar mistakes from occurring again.

— Jessamare


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Source: ProPublica (Allen-Pierce, 1/09)

Monday, January 20, 2014

Acetaminophen doses over 325 mg might lead to liver damage

You're in pain after surgery, and your doctor prescribes you Vicodin, or maybe Percocet. But when you get home, the pain hasn't subsided and you decide to pop some Extra Strength Tylenol.

Unknowingly, you may have just taken more of the drug acetaminophen than is safe.

Don't combine aspirin and ...

Acetaminophen is often used in pain medications with opioids such as oxycodone (Percocet), hydrocodone (Vicodin) and codeine (Tylenol with Codeine).

These are called combination drugs, and the Food and Drug Administration is asking doctors to stop prescribing those that have more than 325 mg of acetaminophen per dose.

FDA warns of acetaminophen liver damage FDA: Pain meds may cause liver damage

The FDA says no data show that taking more than that amount provides enough benefit to outweigh the risk of liver damage.

"Many consumers are often unaware that many products (both prescription and OTC) contain acetaminophen, making it easy to accidentally take too much," the FDA said in a statement Tuesday.

The warning does not apply to over-the-counter drugs such as Tylenol, which contains acetaminophen. The FDA said it will address over-the-counter products in another regulatory action.

In 2011, the FDA asked manufacturers to limit the amount of acetaminophen in prescription combination drugs to 325 mg per capsule or tablet by January 2014. While more than half of the manufacturers agreed, some combination drugs with higher amounts of acetaminophen remain on the market. The federal agency says it plans to start the process of withdrawing approval of prescription combination drugs from manufacturers that have not complied.

Health risks

"Acetaminophen overdose is one of the most common poisonings worldwide," according to the National Institutes of Health.

Taking too much of this pain reliever can lead to liver failure or death.

The FDA has set the recommended maximum for adults at 4,000 milligrams per day. It's easier to reach this limit than you might think; one gel tablet of Extra Strength Tylenol, for example, contains 500 mg.

New Tylenol cap will have warning label

Consumers should not take more than the prescribed dose of any medication that contains acetaminophen, according to the FDA, and should avoid taking more than one acetaminophen product at a time. Drinking alcohol while taking acetaminophen also puts you at risk.

To find out if your medications contain acetaminophen, read the drug label or the list of ingredients in the patient information leaflet that came with your prescription. Look for the word "acetaminophen" or the letters "APAP," an abbreviation sometimes used for the drug. If you are still unsure, contact your doctor or pharmacist.

Acetaminophen may also cause serious skin reactions in some people. According to the FDA, the skin reactions are rare but can be deadly. These conditions can cause blisters, serious rashes, reddening of the skin and the detachment of the upper surface of the skin, the epidermis.

Anyone who develops these types of conditions after using acetaminophen should stop taking the product immediately and visit a doctor or emergency room. FDA issues warning about acetaminophen and skin reactions

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Source: CNN (Yan, 1/16)

Monday, January 13, 2014

Friends, family remember Vista Ridge students killed

CEDAR PARK, Texas -- Two Vista Ridge High School teenagers died after a crash in Cedar Park last night.
Police say 17-year-old Taylar Lesser and 18-year-old Nathaniel Gomez were traveling north on Parmer lane when they crossed over the median and into oncoming traffic. A Volkswagen hit their car. The teenagers died at the scene.
Crowds of people visited the crash site Saturday evening to set up a memorial with balloons, crosses and pictures.
"We found out this morning at 4:00 when we got a knock on the door," said Gomez' mother Michelle Gonzales.
Gonzales described her son as a hard worker. Gomez would have graduated this year.

"I knew it couldn't have been my Nathaniel, but it was," she explained.

Friends know Lesser as the girl with a kind heart.

"She left a mark on Vista and I wanted to make sure that even people who didn't know who she was, knew she was a good person," said her friend Ashley Cooper.

But also friends knew the students together.

"They were the high school couple. Everyone knew them," Cooper said.

They had been dating since 2012. Friends said they rarely saw the couple apart.

"You didn't know them as 'Taylar and Nathaniel,' you knew them as 'Taylar AND Nathaniel,'" Cooper said.

"She was like our daughter. Any get-together we had she was invited, she came. She was part of the family," Gonzales said.

Friends said right now it still doesn't seem real. They won't see their classmates in school on Monday.

"I just was like 'No, it's not happening, not real. I'm going to see her.' And like, I know she's not," Cooper said.

By the end of the night friends sat closer to one another, huddled together around the memorial sharing stories and memories of Taylar and Nathaniel.

"It's extremely comforting and we're glad that he is surrounded by people like this," Gonzales explained.

"I want people to know, she was a great friend," Cooper said.

Friends say they've ordered bracelets to remember the students by. The school principal sent a letter to students and parents saying counselors will be available on campus this week.
Source: KVUE News, "Friends, family remember Vista Ridge students killed," Shannon Murray, January 11, 2013

Friday, January 10, 2014

All lanes of I-30 at Dalrock open after pileup over Lake Ray Hubbard

ROWLETT –– Dallas police say a 23-year-old man was arrested for intoxication assault in connection with a 13-vehicle pileup that shuttered Interstate 30 in both directions over Lake Ray Hubbard before dawn Friday.

Christopher Anthony Sosa was arrested and charged Friday morning, according to a police spokesperson. He was booked into the Dallas County Jail. It's not clear whether Sosa caused the accident –– heavy fog is also suspected to have played a role.

At about 7:50 p.m., more than 16 hours after the crash, all lanes at Dalrock Road were reopened.

While the accident spurred traffic woes for drivers, it also created a problem for some area businesses.

"Everybody nowadays is in a hurry to get somewhere," said Brian Vosburg, an employee at Parkway Car Care, which is located along Highway 66. "And when you get stuck in something like that there are no words to describe it."

Vosburg said on average he works on 12 to 18 vehicles a day. Friday, he worked on three.

The owner of the business said their supplier of vehicle parts was stuck in traffic, which put the business two days behind.

"If I'm not turning wrenches working on cars, I'm not making a whole lot of money," Vosburg said.

TxDOT sent crews to help control traffic on either side of Lake Ray Hubbard and repair the 500 feet of concrete median barrier that was damaged in the wreck, said Tony Hartzle, department spokesman.

“Both directions are going to be shut down for multiple hours; motorists need to find an alternate route around this area just to stay away,” Hartzle said in the midst of the cleanup. “The detours are going to be fairly substantial for the next couple of hours.”

As dawn broke over the lake, Dallas police Sgt. David Conley said the wreck involved six 18-wheelers and seven cars. A total of eight people were taken to Baylor Medical Center with non-life threatening injuries, said Dallas Fire-Rescue spokesman Jason Evans.

One of the 18-wheelers visibly jack-knifed into the median before coming to a stop. A trail of debris was scattered about the four-lane highway behind it. Fog was a likely culprit in the collision, Hartzle said. Not long before the crash, The National Weather Service issued a Dense Fog Advisory that expired at 9 a.m. as visibility in some areas dipped to below a quarter of a mile. The NWS advises drivers to slow down and use their low-beam headlights when driving through fog.

Eastbound drivers were forced to take the Zion Road exit while those headed west took the Ridge Road exit. Both were significantly backed up at 6 a.m., as reported by News 8's Brian Glenn.

Evans said units were called at 3:30 a.m. to help. Hazardous materials crews were on-scene cleaning up vehicle fluids. No one had to be extricated from a vehicle by Dallas Fire-Rescue, Evans said.

A Rockwall Police Department dispatcher says a few units assisted with blocking off the Dalrock Road exit but had no additional information. The Texas Department of Public Safety and the Garland Police Department are also helping investigate.

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Source: WFAA (Goodman, 1/10)

Thursday, January 2, 2014

Indictments handed down in fatal crash

A motorist, who crossed onto the wrong side of a highway, resulting in the death of two people in a fiery crash in Bandera County on July 4, has been arrested. Lab reports indicated that Troy Allen Timmins, 38, was apparently driving under the influence at the time of the head-on crash.

On Monday, Dec. 23, deputies with the Bexar County Sheriff's Office arrested Timmins at his mother's house in Bexar County on an outstanding warrant related to a previous narcotics charge, according to Bandera County Sheriff's Office Chief Deputy Matt King. "He's set to be arraigned in Bandera County on Monday, Jan. 6, but that will probably be reset," King said, adding that a felony bench warrant would most likely be issued to ensure Timmins' return to Bandera County.

On Monday, Dec. 2, a Bandera County Grand Jury indicted Timmins on two counts of manslaughter, enhanced.

Because Timmins was allegedly driving under the influence of drugs at the time of the crash, the charges could be elevated to a first-degree felony.

The two-vehicle crash occurred at approximately 8:30 pm, Thursday, July 4, on Highway 16 South, about a half mile south of Timber Creek Road. Carolyn Buck died at the scene and her husband died after suffering a stroke during an operation directly related to the crash.

According to a Texas Department of Public Safety accident report, Timmins was driving north on the inside of the southbound lane coming out of a curve on Highway 16 when he struck the Buck's vehicle traveling southbound.

At that time, it was unknown what caused Timmins to swerve directly into the path of a Ford Expedition driven by Carolyn Buck, 63, of Helotes. However, the DPS accident report also noted that subsequent toxicology results revealed that Timmins had multiple drugs in his system at the time of the crash, including benzodiazepine and amphetamine.

Buck died at the scene and her husband, Ron "Butch" Buck, who was in the passenger seat, was airlifted to the burn unit at the San Antonio Military Medical Center. After several surgeries, he succumbed to massive injuries on July 22.

Timmins was airlifted to University Hospital with unspecified, but non-life-threatening, injuries.

Tragically, the Bucks, who were returning from an Independence Day picnic, were reportedly just minutes from their home when the head-on occurred.

Bandera County Fire Marshal John Stith happened on the grisly scene about "30 seconds after (the accident) happened," according to his estimation. When he arrived, he reported the Expedition was on its side and engulfed in flames with the Bucks trapped inside.

"Attempts made to pull the occupants out were unsuccessful," Stith said. "But, we were able to keep the fire away from them until the firefighters arrived with extrication equipment, the 'jaws of life'." The Pipe Creek Volunteer Fire Department responded to the accident.

Stith and several firefighters were taken to Boerne Methodist and treated for smoke inhalation and minor burns. Buck was pronounced dead at the scene. "It was pretty intense," Stith said of the incident. He later lauded civilians who assisted at the scene.

"The bystanders were able to do the things needed to give people the best chance of survival," he said on Thursday, Dec. 26. "The assistance from the public was incredible."

Stith also singled out for praise Dale Martin with the PC VFD, who also is a firefighter in San Antonio. "It was a tough scene," Stith added.

Texas Department of Public Safety Trooper Chip Aragones handled the initial investigation of the fatal crash.

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Source: Bandera County Courier (Pannebaker, 1/02)