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The family of a 48 year old woman who died after being given Sotalol by her cardiologists for atrial fibrilation (“afib”) was awarded $1.6 Million by a Delaware Jury on Monday, June 16, 2008. In 2003, Sandra Koch had been a dialysis patient for less than a year when she developed afib. On her third episode of afib (a very common irregular heart rhythm), Mrs. Koch was admitted to the hospital where her treating cardiologist started her on Sotalol. Evidence at trial revealed that Mrs. Koch was not told at the time the drug was prescribed that the Physician’s Desk Reference, the hospital’s drug formulary and the package insert written by the manufacturer of Sotalol all warned against using Sotalol in dialysis patients. Trial testimony further established that although patients are to be kept in the hospital and closely monitored until Sotalol is fully effective in the body (a process that takes on average 3 days in a patient who is not on dialysis and longer for dialysis patients), Mrs. Koch was discharged less than 2 days after starting Sotalol. Mrs. Koch died without warning just 6 days after her cardiologists started her on the drug.

At trial, the cardiologists did not present any expert testimony from other physicians that their use of Sotalol in Mrs. Koch while she was on dialysis was acceptable medical practice. Mrs. Koch’s family (her husband and now grown children, who were 17 and 21 at the time of her death) presented the testimony of 2 medical experts (a cardiologist and a nephrologist, or kidney specialist) that the use of Sotalol was unacceptable in her case. The defendant cardiolgoists did present expert testimony that Sotalol was not the cause of Mrs. Koch’s death, instead attempting to blame it on a variety of other medical conditions from which Mrs. Koch suffered or had suffered previously (but admitting at the same time that Sotalol was a “possible” cause of her death). The medical experts testifying on behalf of the Koch family testified that they could exclude all other causes of death because she was being successfully treated for these conditions, none of which would cause sudden death. Further, the cardiology expert who testified for the Kochs explained to the jury that Mrs. Koch had evidence of a deadly heart rhythm known as Toursades de Pointes (or “turning of the screw”) on the heart monitor strips taken by the paramedics just prior to her death. He explained that this arrhythmia occurs in patients having an adverse reaction to Sotalol.

After 5 1/2 days of trial, the jury deliberated for 2 1/2 hours before returning a verdict of $1.6 Million for Mrs. Koch’s husband and 2 children.

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A 13 1/2 hour delay in the delivery of a baby girl who was stuck in the birth canal resulted in brain injuries from both the delay in delivery and from the mother’s uterus repeatedly contracting on the baby’s head because of medications given to the mother to encourage labor. Testimony during the 5 week trial demonstrated that the treating OB/GYN knew prior to delivery that the mother had a narrow pelvic arch and that the baby was approximately 9 pounds. Notwithstanding these two contradictory facts, the doctor allowed the mother to attempt a vaginal delivery when a cesarean section was indicated. The doctor not only attempted a vaginal birth, but then allowed it to continue for 13 1/2 hours, during which the mother was having contractions every 1-2 minutes for many hours.

Because the baby’s head was squeezed so many times during the long delivery by the frequent contractions, the now-10 year old suffered brain damage that resulted in permanent injuries. She has been diagnosed as spastic guadriplegic, which means she has only limited use of her arms and legs. She is limited to walking short distances and only with the use of a walker, she can ee but because the part of her brain that processes what she sees was damaged, she can’t interpret what she is seeing, she is mildly retarded and she has difficulty utilizing her hands.

After hearing all the testimony, the jury in this Ohio case awarded almost $8M for future medical care, over $7M for the inability to perform normal activities, and $3M for pain and suffering. Grow v. Yang, Hamilton County, Ohio.

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Brandon, a 10 year old boy who suffers from cerebral palsy, severe brain damage and blindness as a result of an obstetrician delaying in the diagnosis of his mother’s pregnancy complications in 1997 was awarded $19M by a Monmouth County Jury after 2 days of deliberations. The jury heard evidence that Brandon’s mother, Bonnie, was 30 weeks pregnant when she began complaining of abdominal pain. Bonnie called her OB/GYN after the pain started and was instructed to go to Riverview Medical Center in Red Bank, where her OB/GYN concluded she was likely suffering from appendicitis. The OB/GYN requested that a general surgeon remove the appendix before the OB/GYN ran tests to determine the cause of her abdominal pain and despite readings on a fetal monitor attached to Bonnie that showed the baby was in distress.

More disturbing, the jury heard testimony that a nurse on duty at the time the appendix removal surgery was being planned and performed warned the OB/GYN that the monitoring strips showed a problem with the baby. Further, the nurse felt so strongly that the baby was in danger that when the doctor refused to listen to her concerns, she went to to her charge nurse and then to the hospital’s nursing supervisor seeking to have an emergency Cesarean section performed on Bonnie to save the baby. Instead of listening to the nurse, the OB/GYN and the general surgeon removed the appendix, only to find that it was normal, but Bonnie’s abdomen was filled with 3.5 liters of blood, which is half the amount of blood an average woman has in her entire body.

Ultimately, a c-section was performed to deliver Brandon more than one and a half hours after the appendix surgery began. At birth, Brandon had no muscle tone and required extensive medical intervention to live, including a four month hospitalization in the neonatal intensive care unit. An expert medical witness testified to the jury that if Brnadon had been delivered even half an hour sooner, he would have been medically normal. The OB/GYN continues to assert that his care was appropriate and that Bonnie’s complication was “incredibly rare” and is seeking a new trial and possibly an appeal.

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Delaware has become the third state in the nation that will not bill patients or their insurance companies for certain medical errors. Delaware hospitals identified 9 serious mistakes for which they will no longer bill:

(1) performing surgery on the wrong body part;

(2) performing surgery on the wrong patient;

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A Philadelphia jury unanimously found in favor of a woman who alleged that 2 doctors at 2 hospitals failed to timely diagnose breast cancer and awarded her $12 Million as compensation. Sutherlin v. Magilner. At trial, the jury heard testimony that 2 doctors at 2 different hospitals – Fox Chase Cancer Center and Albert Einstein Medical Center – missed suspicious findings on mammograms that required follow-up evaluation and would have diagnosed Stage 1 breast cancer that could have been cured with a mastectomy. The jury heard that because of the errors, the woman was not diagnosed until she had Stage 4 cancer that had spread to her bones and organs.

The woman received a screening mamogram in June 2003 from a Fox Chase mobile mammography unit that was read as showing a dilated duct unchanged from a 2001 mammogram. The jury heard testimony that the woman’s 2001 mammogram did not show a dilated duct, which meant that the 2003 mammogram should have been reported as showing a suspicious change that required further evaluation. The woman then had a 2004 mammogram at the Albert Einstein Medical Center and the physician who read that report noted several small nodular densities that were stable when compared to prior mammograms. Again, the jury heard evidence that the doctor mis-read the mammogram because the woman’s prior mammograms had not reported nodular densities. The woman’s lawyers argued that doctors again missed a chance to instruct the woman to obtain follow-up medical care that would have diagnosed the cancer. Ultimately, the woman was found to have Stage 4 metastatic breast cancer in the location where the 2003 mammogram showed a dilated duct.

Prior to trial, the Albert Einstein Medical Center and the doctor who read the 2004 mammogram settled with the woman for a confidential amount of money. Fox Chase and its physician had refused offers to settle along with Albert Einstein for a total of $2 Million (which was the maximum amount available under the doctors’ insurance coverage), offering only $125,000. The woman’s lawyer had warned Fox Chase that if a jury ultimately awarded more than $2 Million, the woman would be eligible to pursue bad faith claims for failing to settle.

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A new study published in The Journal of the American Medical Association reveals that the likelihood of patient survival after cardiac arrest (when the heart stops) in a hospital is significantly impacted by the time of day the attack occurs. This study follows earlier studies that demonstrated that patients fare worse during weekend care than they do during care received during the workweek for the same health problems.

In the recently-published study, almost 87,000 patients who suffered from cardiac arrest were studied at 507 hospitals during 7 years. Typically, when a patient’s heart stops, a team of medical professionals is called urgently to the patient’s bedside to begin rendering care from a “crash cart” that contains equipment such as a defibrillator and various drugs. As a practical matter, patients who suffer from a cardiac arrest are usually very sick and even at the best of times the rate of survival is fairly low (among the studied patients, approximately 20% of those who suffered a cardiac arrest during the day shift survived to the point of hospital discharge), but something about the night shift seems to make the chances of survival even worse. In the study, only 15% of those patients who suffered a cardiac arrest during the 11 p.m. – 7 a.m. shift survived long enough to be discharged from the hospital.

This study would suggest that the level of patient care received a night is subpar – either because the night shift workers are too tired to react as efficiently as the day shift workers or because there is less staff during the night hours such that they can’t check patients as often and react to problems as quickly or because the experience and skill level of night shift workers is lower than that of day shift workers. Whatever the explanation, it is reasonable to conclude that differences in care are not limited to cardiac arrest situations.

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Evidence showed that poor nursing care at Pennsylvania Hospital of the University of Pennsylvania Health System, including failure to contact a physician as ordered when the patient’s blood pressure dropped below 100 and the absence of documented nursing care for a 16.5 hour period after surgery, resulted in the death of a 55 year old woman following a routine hernia operation. At trial, medical records presented to the jury showed that after surgery, a resident examined the patient and noted in her chart that nurses should call a physician if the patient’s blood pressure dropped below 100. The same records showed that later the same day, at 5:15 p.m., a nurse recorded a blood pressure of 90/60, but did not call a doctor. This was the last nursing note written in the chart for the patient until 9:45 the next morning, reflecting a gap in documented care of 16 and 1/2 hours. The 9:45 a.m. chart noted that the patient was “extremely sedated, requiring painful stimuli for arousal and with a blood pressure of 90/58.”

Following the 9:45 a.m. note, the patient’s morphine pump was stopped and she was transferred to the intensive care unit, where she died two and a half days later. Attorneys for the woman’s family argued that the nurses violated the standard of care by not calling for a doctor when the patient’s blood pressure dropped below 100. Although attorneys for the hospital disputed that the nurses’ care was negligent, a nursing supervisor employed by the hospital testified that a doctor should have been called when the patient’s blood pressure dropped below 100.

In addition to the allegations that the nurses were negligent for failing to call for a doctor, the plaintiff’s attorneys argued that the patient was over-medicated with morphine. Evidence presented at trial showed that people with compromised livers, which this patient had because of a chronic alcoholism condition, process morphine 50% slower than patients with a healthy liver. Attorneys for the hospital essentially argued that the patient was caused by her alcoholism and related medical problems such as liver disease and high blood pressure.

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In 2002, baby Ira Faustino died after having heart surgery performed by Dr. William I. Norwood at duPont Hospital for Children. In 2005 Ira’s parents filed a medical malpractice suit after learning for the first time that Ira suffered brain damage as the result of allegedly negligent conduct by Dr. Norwood during the surgery. The Faustinos claim that it was not until Dr. Norwood was fired from duPont in 2005 amidst heavy media coverage that they learned that Dr. Norwood had allegedly been performing experimental surgeries on critically ill children in an attempt to develop a new surgical procedure for heart problems. Only after the media coverage revealed apparent problems with Dr. Norwood’s techniques did the Faustinos learn that Dr. Norwood had used an unconventional cooling method on Ira to prepare him for surgery and then fraudulently concealed that fact from his parents after he died. It is alleged that Dr. Norwood used an untested cooling method that cooled the body more quickly than standard methods, but resulted in seizures and brain damage in some patients. Because Dr. Norwood allegedly did not tell the hospital or parents of patients that he was not cooling patients in a traditional manner, it was never suggested to the Faustinos that this aspect of the surgery could have been the cause of Ira’s death. The Faustinos allege that if they had known at the time that Ira died that Dr. Norwood had used the unconventional cooling technique and that Ira suffered brain damage thereafter, they would have filed suit sooner and not allowed the 2 year statute of limitations to expire.

duPont and Dr. Norwood are asking the Court to punish the Faustinos’ attorney for filing the lawsuit, arguing that she knew it was frivolous because the statute of limitations had clearly expired before it was filed. In support of their argument, duPont and Dr. Norwood allege that the Faustinos knew immediately after Ira’s death that he died from fluid in the lungs, which is a common complication of the surgery he had. Further, duPont and Dr. Norwood argue that the Faustinos were told that Ira died from “complications of surgery,” which they assert demonstrates there was no overt act of fraudulent concealment as required by Pennsylvania law to extend the statute of limitations. The Faustinos, on the other hand, argue that duPont and Dr. Norwood’s failure to advise them that an unconventional cooling method was used on Ira during surgery was an overt act of fraudulent concealment.

This case demonstrates that complex issues, both legal and medical, that can arise in medical malpractice cases. The assistance of an experienced attorney who is willing to explore all available legal theories is crucial to success in this complicated area of the law.

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In a case in the Eastern District of Pennsylvania, a New Jersey man’s Estate is suing the Philadelphia Hospital of the University of Pennsylvania because cancerous lungs were improperly transplanted into his body. Tony Grier died after he was transplanted with lungs from an individual with a 16 year history of smoking. The transplanted lungs were filled with cancer. The transplant was needed because Mr. Grier sufferred from severe sarcoidosis, which had badly damaged his own lungs.

The transplant occurred on January 7, 2005 after the hospital obtained informed consent tfor the transplant. However, the obtaining of consent was based on the hospital’s representations that the lungs to be transplanted were from an 18 year old in good health. Only four months after the transplant, the lungs were found to be filled with cancerous tumors. Subsequently, Mr. Grier died only a couple of months later.

Mr. Grier’s Estate has filed suit alleging that the Hospital of the University of Pennsylvania falsely represented that the lungs were from a young and healthy person. Recently, a motion was filed to allow the Estate to add additional defendants and new allegations, including lack of informed consent, battery, negligence and intentional infliction of emotional distress, based on new information discovered concerning the origin of the smoker’s lungs. The Estate of Mr. Grier seeks to sue the hospital and doctor responsible for removing the bad lungs and the donor program that was responsible for suppling incorrect information concerning the bad organs.

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Donna Cameron, of Ashton Pennsylvania, who was the former Director of Nursing at St. James Retirement & Rehabiliation in Chester, Pennsylvania, pled no contest to charges that she criminally neglected patients, falsified records and perjured herself. The nurse neglected a 72 year old patient’s head wound and allowed it to become infected with maggots. Although doctor’s recommended the patient see a dermatologist for the lesion on her head and for nurses to apply an antibiotic ointment, the nursing director failed to do so. Even worse, the nurse then falsified medical records and lied to invesigating authorities to hide the improper care. Two other employees of the nursing home are also facing criminal charges.

Public news accounts of the incident report that the patient was cared for at a hospital prior to being transferred to the nursing and rehabilitation facility. At the nursing home in Delaware county, the physician’s orders concerning wound care were never followed. The wound worsened and became infested with maggots. Eventually, the patient was transferred back to the hospital’s emergency room, where a hospital staff member noticed blood coming from the bandaged wound. When the bandage was removed, it was immediately noted that there were over 50 live maggots in the wound. Upon arrival at the hospital, the patient was also described as very unkempt with soiled clothing.

Prosecutors claimed that the Cameron, who was the patient’s sole nurse, failed to care for the wound over a four month period of time. Then, when being investigated, the nurse falsified the medical records to have them show that proper new dressings had been previously applied to the wound. Under the plea, the nurse will not contest the charges record tampering, criminal neglect and perjury.