Des Moines Personal Injury Lawyer - Medical

"Kill All The Lawyers!" Oops!, Who Maddoff with our 401K money?

Steve Lombardi — Tue, 10 Nov 2009 10:01:00 GMT

With all the talk of tort reform one might begin to believe that attorneys really are the cause of climbing costs in healthcare along with every other economic ill special interests can blame them for. What are some of the reasons for spiraling health care costs? What isn't being talked about is the enormous amount of insurance fraud (including government programs Medicare and Medicaid).

Douglas Dvorak, a Cedar Rapids chiropractor, was convicted on April 22^nd 2009 on 22 counts of mail fraud, 11 counts of aggravated identity theft and 6 counts of money laundering for filing fraudulent Medicaid claims from late 2005 to early 2007. He has been sentenced to seven years in prison and ordered to pay more than $71,000 in restitution. This is just a small piece of the fraud that is committed daily against the health care system and if pursued aggressively one has to wonder, how much would healthcare costs drop if we could stop it?

Instead of allowing ourselves to be distracted with talking about whether an injured patient is compensated we should be asking our public officials and the special interest groups that promote reforms what they are doing about health care and pension plan fraud. Politicians love to talk about anything that doesn't hold them accountable for what they let happen on their watch while sitting in Congress or holding public office. It's time we start to hold them accountable.

Originally posted at InjuryBoard by Steve Lombardi

Rhode Island Hospital Again Does a Wrong-site Surgery

Steve Lombardi — Mon, 26 Oct 2009 08:41:00 GMT

This is the 5^th time since 2007. This time the surgical site was the patient’s hand. Apparently, and the reports differ, it was the correct hand, the right finger but the wrong joint. I have to give the hospital credit for publicizing the mistake. It can’t be easy for the hospital’s president Timothy Babineau. Even though the mistake won’t help to make patients comfortable his honesty with the public is refreshing.

So how can patients increase the chances of avoiding a wrong-site surgery? It’s actually pretty simple. By having the doctor mark the surgical site with a surgical marker and reviewing the procedure, the identity of the patient and the body part/location that is to be operated on, mistakes would rarely occur. Here are two questions that would help. 1. Have you read the chart? 2. If so, then describe the procedure to be undertaken and to what part of the body. You might think this is an embarrassing discussion to have with the surgeon, but it’s your body so get over it. Here are three articles discussing the Rhode Island Hospital case. http://www.youtube.com/watch?v=cUMgyoVIqNE

Originally posted at InjuryBoard by Steve Lombardi

Liposuction puts Woman in a Coma at Florida Day Spa

Steve Lombardi — Wed, 21 Oct 2009 11:03:00 GMT

In Weston, Florida, on Friday September 25^th, Rohie Kah-Orukotan, age 37, went into a coma after a “routine liposuction” procedure at Weston Medspa, according to the Miami Hearald news source. Kah-Orukotan was a nurse, mother of three, and a regular customer of this Medspa for five years. The doctor who performed the surgery was Dr. Omar J. Brito, a licensed doctor, and his attorney Brian Biber commented for Brito sited by Belleville News sources:

"She went in for a routine liposuction ... performed by Dr. Brito without any complications until the very end, at which time Dr. Brito immediately administered emergency care and called 911," Bieber said. "Paramedics arrived; they noted all emergency procedures put into place were proper."

Though Brito is a licensed doctor he “is not board-certified or trained in plastic surgery; his background is in occupational medicine, records show.” He received his medical degree in Bogota, Colombia.

An interesting fact for consumers to note is the privately owned Weston Medspa according to Florida officials “is not licensed to perform liposuctions under general anesthesia, but could do a scaled-down version using a local anesthetic that keeps the patient awake. Bieber said he did not know which type of liposuction was performed.”

Bieber also said, "The obtaining of the appropriate licensing is the responsibility of the owner. (Brito) did not know (it wasn't licensed for office surgery)."

Consumers purchasing these types of services need to ask questions about licensing and to dig deeper than just assuming they wouldn't be doing it if it weren't legal for them to do this procedure.

History of Dr. Brito reported by Belleville News is that “In 2006, the medical board fined him $5,000 and ordered him to perform community service for his role in an insurance fraud scheme, state records show.”

Kah-Orukotan went in for what a medical consultant believed to have been a “light liposuction” treatment which, while awake the anesthetic lidocaine is administered, then a laser is placed under the skin to “to liquefy fat tissue, which is then removed.” The use of lidocaine, Dr. Brett Coldiron, a Cincinnati dermatologist who has studied cosmetic surgeries said it, can result in seizures if an excessive amount is used, and also a patient could have an allergic reaction to it. The woman’s attorney, Michael Freedland, “said Kah-Orukotan has bruises on her back from seizures, and `a lot of damage to a lot of her body.''”

This woman was put in a coma because of this treatment, and then kept alive by life-support. The family had to decide whether to keep her on life-support and her husband, Joseph Orukotan, “declined to comment on his impending decision” reported the Miami Herald. Who can blame him, this is a tough decision to make and why would anyone want to discuss it publicly.

This incident has re-sparked the discussion over Medspas that have caused concern over many years. The Belleville News De reported that stricter rules at clinics are being discussed because, “Medspas are largely unregulated and often expand their services beyond what some consider safe, said Fort Lauderdale surgeon Robert Cline, chairman of a surgical quality committee for the Florida Board of Medicine.” Cline said ‘"They have a lot of nonphysicians doing services doctors should do. Obviously this case is going to cause a lot of concern. We will be investigating it and trying to come up with some regulations.’”

This case will initiate plenty of questions concerning these cosmetic clinics, and hopefully new regulations which help create a safe and legitimate environment for their patients. Patients should be aware that efforts to pass "tort reform" measures will certainly increase this type of problem and reduce any monetary recourse available to those who suffer an injury.

http://www.youtube.com/watch?v=G5NzZzLjRA4&feature=fvw

Originally posted at InjuryBoard by Steve Lombardi

Tort Reformers Ask: "What? You asked for an X-ray!" Bah! Humbug!

Steve Lombardi — Mon, 19 Oct 2009 10:14:00 GMT

Our lesson for today concerns news print reporting of medical malpractice reform measures. The lesson is that reporters should avoid heavy medication before editorializing about something they know nothing about.

To me it’s so typical. Another editorial pandering to the few advertisers newspapers have left, saying what the advertisers want to hear; regardless of the affect on society. In this case it says let’s all save money by making the injured patients pay for medical mistakes instead of those responsible for creating the injury or killing the patient. Today’s editorial is in the Coventry News and is written by Patrick Durusau. All I can say is shame on you Patrick. If anyone wishes to read the entire fairy tale that masquerades as an editorial follow the link. Here is part of what he writes.

The current adversarial system between physicians and their patients benefits only three groups: medical malpractice insurers, medical malpractice defense and plaintiff lawyers. Abolishing medical malpractice is an important step in repairing the physician patient relationship. Getting physicians and patients on the same side will result in better medical care and, coincidentally, the demise of medical malpractice insurers and their familiars. That doesn’t bother me. How about you? Patrick Durusau, Coventry News

I think he forgot the main beneficiaries of the medical litigation process: The injured patient, the surviving dependents or those patients not injured because of fear of being sued when you do something wrong that hurts the patient.

Don’t they count? Or are they the riffraff of Mr. Potter's world?

Either this reporter has a naïve view of life or he's pandering to his news organization’s paying advertise-customers. Perhaps he's just naive from never having interviewed a grieving widow raising hungry children alone after watching her husband die as a result of a failure to diagnose cancer or some other fatal disease? Get real Patrick; I suggest you visit the morgue and then interview the widows and widowers in major cities where health care can be downright factory like and prone to mistakes.

I rarely practice in this area so hold your tongue about me being just another lawyer trying to make a buck. I do consider myself a “plaintiff’s lawyer” because my practice is one where I represent people, not big insurance. I’m pretty typical for most small city or rural based lawyers. We don’t seek out medical malpractice cases; in fact we try to avoid them. They are way to expensive to litigate and wrought with landmines to make mistakes. Like many I have friends, colleagues and relatives who are practicing physicians. In Iowa we have just a handful of lawyers who practice full time in this area as specialists. We don’t have a problem, like I’m sure New York, California and Florida does. We have just a few cities, we have good doctors and yes a few that have made professional mistakes. Frankly we don’t need injured patients paying for someone else’s mistakes. We like our system of tort law; it’s served us well. We still have moral fiber that tells us those who make mistakes pay for their mistake.

I grew up in Rhode Island and know only too well the consequences of medical malpractice and a dead bread winner. My father died when I was 12, he left behind a 37 year-old wife and five children all under the age of 13. We never sued, even though the doctor diagnosed a pulled muscle instead of the lung cancer. I’m sure the doctor didn’t want to take an x-ray since it was as tort reformers say, “unnecessary and expensive.” That’s the defensive medicine I grew up with; it’s the same one that Mr. Durusau is advocating for the rest of us. That’s the kind of defensive medicine that you’ll say isn’t needed, is thought to be too expensive and a waste of time and money. That’s the kind of loyal patient and doctor friendly medicine that I grew up with. It’s the same kind of medicine that buried my father, put no food on our table, took away the one man who was going to send us to college and wasn’t there for my sister’s wedding, birthdays, deliveries, anniversaries or grocery shopping day. Oh it’s friendly alright. It’s friendly to big insurance company executives, but does nothing for the widows and orphans it leaves behind.

My mother kept a single can of shrimp in the pantry to let us know we weren’t poor. I guess it also meant we wouldn’t starve. At least I hoped that’s what it meant. We ate Mrs. Paul’s fish sticks and frozen French fries every Friday that we didn’t have corn chowder. God I hated both. The fish sticks tasted like burnt cardboard and were always overcooked while the fries were mushy and undercooked. Dr. Sandstone never did see what he’d created for this family of six trying to get by on Mom’s sewing money and a monthly Social Security check. Not exactly the kind of life my father had hoped for his wife and children. I often wonder what the outcome would have been like had he ordered that expensive and unnecessary $5 x-ray.

This editorializing reporter must have had a good life without any medical mistakes interrupting his education and family vacations. I say that because he’s got a naïve and foolish point of view that draws conclusions that border on being downright cruel. Before you join his world I invite you to look at his methodology for improving health care and delivering better medicine.

If we follow that logic all car collisions caused by distracted drivers would result in the digitally drunk and distracted teen driver getting a smile from the other drivers; well… at least those who aren’t dead or brain injured and the teens will somehow miraculously learn how to drive safer. How does not making those who make professional mistakes take responsibility make the system more responsible? I’m left wondering just how old our reporter is and what time of day he wrote this little ditty. Maybe he needs to stop drinking the Guinness so early in the day.

“If we abolish medical malpractice as we know it, physicians (not the government) would have to develop better ways to discover why "mistakes" happen and ways to prevent them from happening again. That is to change from a blame assignment/avoidance system to one that tries to improve the quality of care delivered to everyone. Wouldn’t that be a more useful part of a health care system?”

“The current adversarial system between physicians and their patients benefits only three groups: medical malpractice insurers, medical malpractice defense and plaintiff lawyers. Abolishing medical malpractice is an important step in repairing the physician patient relationship. Getting physicians and patients on the same side will result in better medical care and, coincidentally, the demise of medical malpractice insurers and their familiars. That doesn’t bother me. How about you?” Patrick Durusau, Coventry News

LET’S TAKE A TRIP to POTTER'S FIELD or DICKENS’ WORLD

http://www.youtube.com/watch?v=B3sZy7IVRiw

Mr. Durusa there’s a little cemetery in a small quaint New England town with a brownish headstone bearing the name Lombardi. The stone has a polished face, a rough finish on thick edges with pink, white and red flowers that surround it. On the back side this gravestone has the name Charles A. Lombardi inscribed on it. Visit St. Mary’s Cemetery where Charlie lies and you’ll notice the surrounding grass is strong and healthy. That grass grows tall from the tears that have watered it for the past 41 years. Like Charlie, the doctor too is dead but I can say that during his lifetime I never saw him visit that grave to support the widow who stood strong for her five hungry children. The widow and her five children today live far from where Charlie lays waiting. I guess you can say we lived your friendlier medicine because we didn’t sue. That was 40+ years ago and I’m still waiting for the doctors to deliver better medicine. Are you sure of your theory? Because today as a 54 year-old-man whose had a front row seat to the “better medicine" you’ve described I’m not seeing the benefits... or a bigger can of shrimp.

The Durusau World of Friendly Medicine and Medical Tort Reform

http://www.youtube.com/watch?v=kr4WxEQHiCE

Originally posted at InjuryBoard by Steve Lombardi

Would tort reform put back the healthy kidney?

Steve Lombardi — Thu, 10 Sep 2009 12:18:00 GMT

A 70-year-old retired assembly worker was admitted into the Parkview Community Hospital Medical Center in Riverside, California to have his diseased left kidney removed. Following surgery he learned the doctor removed his healthy right kidney in what they call a “never event” or a wrong-site surgery.

Is it called a "never event" because we get to make-believe it never happened?

The hospital is reported to be denying responsibility and the doctor apologized. We can’t be sure if the apology was genuine or a “patient-ha-ha you can't sue me apology” because the lawyers aren't saying one way or the other. Remember it's impossible anymore to tell if they really mean it when they say they are sorry because of the apology shield law makes all apologies phony. The apology shield law is designed to make all apologies a "never-event" when it comes to evidence the jury will hear. It's thought to be a good law because in the past patients who received an apology were less likely to sue. So now to encourage doctors to say "I'm so sorry." apologies are an evidentiary figment of our imagination. An evidentiary mirage, there really is no oasis in the evidentiary desert. A jury will never hear that the doctor said he or she were sorry. The article doesn’t elaborate on whether the hospital lawyers ordered the doctor to apologize or if he thought of it on his own and really meant to apologize. From the article we also can't tell if the hospital lawyers told the hospital staff to apologize.

How do we know when the hospital lawyer ordered apology is genuine and when they are fake apologies?

So what happened that caused the healthy right kidney to be confused with the diseased kidney? We can’t be sure because everything is so clearly muddled. How about your help me sort through the evidence. Remember I'm just a dumb-ol' plaintiff attorney.

'Chart was Clear'

"The chart was absolutely clear," Watkins said. "This was his left kidney."

Then, one day before surgery, a hospital nurse and Wahlstrom both wrote notes in Torres' chart, indicating that his right kidney was to be removed, according to medical records supplied by Watkins.

"The 'L' turned into an 'R,' " Watkins said. "Everything before that says 'left.' I cannot accept that the hospital is not responsible. What kind of safeguards are in place to make sure that doesn't happen?"

It's unclear whether the hospital practices a pre-surgery protocol and whether the medical staff followed it before Torres' surgery, Watkins said.

Wow, that cleared it all up. Thank you hospital lawyers. Is this the kind or health care reform the hospital industry is offering us? Well golly-gee Private Gomer, I feel better already.

Mr. Torres should be thankful he’s not a Texan. In Texas under the leadership of Governor Perry they've come up with a tough love approach to medical mistakes where they let the patient take responsibility in all cases of catastrophic injury, such as this one. Here listen to Governor Perry turn his back on the injured patient and cheer on early retirement for those responsible for medical mistakes. If you’re looking for the injured patients in this crowd look behind the Governor; I know they should be there because he’s turned his back on them.

http://www.youtube.com/watch?v=RV_PiY5H_go

And if you’re wondering how you explain wrong-side or wrong-site surgery follow this explanation by Tom Shilllue. I wish a judge would let me use this as a closing argument.

http://www.youtube.com/watch?v=SxDx2DlL0UY

In other news of new and innovative legislation characterized as unfair to the medical profession, please note that New Jersey is now “forcing” hospitals to tell the truth and to disclose medical errors. When I was a little boy my mother called this a character builder. In Texas they call it unfair.

I'm guessing that if I asked my mother about the phony apology law she'd summon up that high school education of hers to ask the good Governor a question. "What are you stupid?"

Originally posted at InjuryBoard by Steve Lombardi

Is there something wrong with the Bacolfen Pump, Model No. 863740 causing overdoses in patients?

Steve Lombardi — Tue, 11 Aug 2009 12:03:00 GMT

When we are ill or have a medical condition, we generally trust our doctors and medical system to prescribe us treatments which will help us to feel better. However, sometimes, there are dangers in our treatments which may not be readily apparent.

Is there something quirky about the programming mechanism of the Baclofen Pump or is it just a case of the fat finger syndrome?

The drug Baclofen is used as an antispastic agent and also as a muscle relaxer and is often used to treat people with spinal injuries or multiple sclerosis. For some patients, the drug is administered to the patient via an implanted pump.

This pump is designed and programmed to distribute six months worth of medicine in carefully measured doses. However, there have been instances where patients have been overdosed and under-dosed on the Baclofen through their pumps. Baclofen toxicity is very serious and can potentially be life threatening. Acute under-dosing can also be a serious life-threatening condition. A patient suffering from Baclofen toxicity may experience mild symptoms such as nausea or lightheadedness, but some patients have suffered from respiratory distress and in at least one instance, coma. See Tuanli, Intrathecal Baclofen Toxicity and Deep Coma in Minutes, et al. 2006 American Paraplegia Society and What Are the Advantages of the Bacolfen Pump System? Published on MedicineNet.com.

This toxicity occurs when a patient receives too much Baclofen. A malfunctioning pump can cause this to occur. However, there have also been instances reported where the pump has malfunctioned and has not delivered any medicine at all and patients have suffered from severe withdrawal syndrome Mohammed and Hussain, Intrathecal baclofen withdrawal syndrome- a life-threatening complication of baclofen pump: A case report. 2004, BMC Clin. Pharmocol. This withdrawal syndrome can also be life threatening. Why is this happening? Is there something about the Baclofen pump that is causing it to malfunction or is it simply the result of preventable human error in the doctors and surgeons implanting and programming the pumps? In the instance above the cause was noted to be a programming error.

Case Presentation

"A 24-year-old man with a past medical history of cerebral palsy and spastic quadriparesis developed hyperthermia, disseminated intravascular coagulation, rhabdomyolysis, acute renal failure and multisystem organ failure leading to a full-blown intrathecal baclofen withdrawal syndrome. Intrathecal baclofen pump analysis revealed that it was stopped due to some programming error. He was treated effectively with supportive care, high-dose benzodiazepines and reinstitution of baclofen pump."

The FDA has taken note and has concerns that there may in fact be a fatal flaw in the pump itself. In 2002, the FDA changed its warnings of Baclofen pumps and injections to warn about the risk from the withdrawal syndrome; at that time, the FDA had notice of six deaths which were linked to the pumps’ failure and subsequent withdrawal syndrome of the patient. Lioresal Intrathecal (Baclofen Injection): Overview.

In June of this year as reported by the Wall Street Journal, the FDA sent warning letters to Medtronic, the manufacturer of the pumps which are used for the administration of Baclofen. In the letters, the FDA expressed its concern with what it considered to be a lack of reporting with regard to problems the company knew existed with the pumps; the FDA also was concerned about Medtronic’s response to the reported problems as it took them two years to finally recall the products with the reported problems (http://online.wsj.com/article/SB124585661696447913.html).

"A 24-year-old man was admitted to our intensive care unit (ICU) with a possible diagnosis of seizure disorder and sepsis. He had a past medical history of cerebral palsy and spastic quadriparesis. Three years ago, he had an ITB pump implanted for spasticity refractory to the high doses of oral baclofen. He had a significant improvement in spasticity, social and functional capacity in the past three years. Later, he developed some disorientation and increased spasticity. He was taken to a local physician who prescribed oral baclofen (120 mg daily in four divided doses) for his increased spasticity. He also advised him to have his ITB pump checked immediately. The following day, his spasticity increased even after taking oral baclofen. He developed multiple seizures and respiratory distress in the next 24-hour period. Subsequently, he was admitted in a local hospital where he was orally intubated and transferred to our ICU for aggressive management. ....

Next day, his spasticity improved and an ITB specialist investigated his baclofen pump. His baclofen pump analysis revealed that it was stopped due to some programming error, which was restarted at a previously prescribed baclofen rate (260 μg/day)."

What this seems to show us is that it is not doctors who are to blame in most of the cases of Baclofen pump problems but rather it is the pump itself. In our legal system, a company has a legal duty to ensure that the products it is placing on the market do not suffer from any sort of design or manufacturing flaw or defect and that their warnings about the shortcomings of the products are adequate. The Medtronic pump’s warning label was changed once in 2002 in response to the reports of the withdrawal syndrome but to our knowledge no subsequent warnings have been placed or mandated be placed on the packaging. Doctors are advised that they must constantly and vigilantly monitor any patient that has a pump to ensure its continued functionality and proper dosing.

However, if the problem is with the pump, then it is possible that a consumer who has been injured or suffered as a result of the pump’s malfunction may have a claim in a class action if enough others have been hurt as well. Doctors incorrectly charged with malpractice may also be able to join a class suit. As of yet, there is no class litigation pending but as more people come forward with their stories about malfunctioning Baclofen pumps, litigation may be forthcoming.

"The precise mechanism of action of baclofen as a muscle relaxant and anti-spasticity agent is not fully understood. Baclofen inhibits both monosynaptic and polysynaptic reflexes at the spinal cord level [6], possibly by decreasing excitatory neurotransmitter release from primary afferent terminals, although actions at supraspinal sites may also contribute to its clinical effects. Baclofen also causes enhancement of vagal tone and inhibition of mesolimbic and nigrostriatal dopamine neurons (directly or via inhibiting substance P) [7]. Baclofen is a structural analog of the inhibitory neurotransmitter GABA, and may exert its effects by stimulation of the GABA_Breceptor to cause muscle relaxation. Baclofen reduces increased muscle tone, Babinski sign, tendon reflexes, ankle clonus and sometimes decreases muscle force."

If you or a loved one have been proscribed a Baclofen pump, remain alert. Watch for signs of withdrawal or toxicity which could be warning signs of the pump’s malfunction. Do not be afraid to speak with your doctor if you feel your pump is not working the way it ought. If you or a loved one does begin to experience symptoms of withdrawal or overdose toxicity, get immediate emergency medical treatment and inform the treating emergency room doctor that the patient has a Baclofen pump so that proper procedures can be used. If you or your loved one have been injured or have experienced problems with either withdrawal, toxicity or any other result of a malfunctioning pump, you may have a case against Medtronic. Contact an attorney who specializes in medical malpractice or class action litigation; as with any potential case, always be sure to take notes of what happened and when so that you have a clear record of your experiences. The Lombardi Law Firm has been serving the Iowa community for almost three decades and would welcome a chance to discuss any concerns you may have regarding your malfunctioning pump.

"ITB withdrawal syndrome has been fatal in some cases. Six patients have died out of 27 cases reported to FDA [13]. Most reported episodes of ITB withdrawal were caused by preventable human errors or oversights. However, catheter dislodgement, catheter migration and kinks, and other catheter-related issues might be more common than pump-related malfunctions [1,14]. Close attention to pump refilling and programming procedures may reduce the incidence of ITB withdrawal syndrome."

You are the patient and should not have to worry that the device installed to treat your pain or your symptoms may malfunction and become a risk to your life.

Originally posted at InjuryBoard by Steve Lombardi

The Apology Shield - Pandering to Lies and Deception over Truth and Consequences

Steve Lombardi — Fri, 24 Jul 2009 10:23:00 GMT

Get your beer goggles on because you’re going to need them to see straight after reading this one.

My friend and colleague David Mittleman recently posted "I'm Sorry" Policy Works for University of Michigan Health System, discussing a most disingenuous legislative invention being employed in Michigan. But, Michigan isn’t alone; they join the ranks of some 33 or more states that have made doing what’s right not something a jury would be able to hear. That’s right, a professional makes a mistake, they apologize and no one knows it in court. It’s the apology shield; an evidentiary apology gag-order tool used to deceive a jury by protecting them from the truth. It works like this: A school yard bully is taken to the principal’s office for picking on the little kid where he’s made to apologize; the bully then heads right back out to the play yard announcing to everyone within ear shot that the little guy got detention for slandering the bully. Because of the principal’s apology shield the little guy can’t say a word about what went on in the principal’s office. If the little guy says anything he is further picked on not only by the bully but by every kid on the school yard.

Patients already victimized by a medical mistake (a surgical staff that hasn’t read the chart and operates on the wrong side for example.), then gets to listen to how the patient was at fault and can’t mention a peep about how the surgeon and staff apologized after making a series of critical mistakes. The jury never hears the truth of what was said. Yes, you understand what I’m saying; it’s legislative and judicially sanctioned reality deception. It’s the new reality show except now it’s in the Courtroom sanctioned by the legislature. Like reality TV you get paid to lie, cheat and be deceitful. The most deceitful person wins the entire show, I mean trial. I’m ashamed of the legislatures in all 33 states. You’re all pandering to lies and deception over truth and consequences. You’re mothers would be ashamed of all of you who voted for this garbage.

Maybe this is the new math that I missed in school. Are three shielded apologies worth more than one genuine apology?

A professional with any decency says they are sorry no matter how it affects them legally. I wrote a post on May 8, 2009 titled, Tort Reform Protocol: Oops! Sorry! The Apology, a new Gold Standard of Practice. I meant it and I still mean it. Just recently a potential client told me the doctor apologized, almost snickering, not once or twice, but three times. Maybe this is the new math that I missed in school. Are three shielded apologies worth more than one genuine apology? While a shielded apology is all the rage the way it's being used is cynical and classic deception by a villain of the worst kind. It’s like your wife cheating on you and then apologizing and saying you should never cheat because it would be immoral. There’s something incredibly shallow and cynical about the entire apology shield. It’s really a sign that society no longer understands the concept of shame. Aren’t apologies supposed to be genuine? Don’t we teach our children to apologize irrespective of the consequences to follow?

Does anyone think a professional who apologizes behind an apology shield really means it? Give me a break. Even those that do mean it, we can no longer believe. My guess is those professionals with any conscience will no longer apologize because it doesn’t feel right to do so. If you make a mistake, do as your parents taught you and offer a meaningful and truthful apology, irrespective of what the lawyers say.

Take a look at the comedian, Tom Shillue's monologue about wrong-side surgery apologies. Think about what he’s saying, "I'm sorry I operated on your wrong side and took out the healthy kidney. I'm really sorry, but you can’t use this against me; ever! You can’t tell a soul I admitted I made a huge mistake. And never can you mention a word to my next surgical patient – even if they are on your jury." When in fact it should be, "Sorry, I was in a hurry, hung over, didn't take the time to read your chart, neither did any of the other operating room staff and we've screwed up your life. Will you accept an apology and a half-million dollars?" Get real Michigan.

The monologue is well-defined sick humor and demonstrates how silly an apology-shield looks to the rest of the world. After the staff doesn't do their job reading the chart they simply apologize so you won’t sue them. You can thank to the Michigan legislature for dumbing-down professional responsibility and making the innocent patient pay for professional mistakes. Why not give the same shield to lawyers, accountants, stock brokers, architects, engineers, civil engineers and the rest. I can hear them in Minnesota, “Sorry that bridge collapsed. Hey let’s do coffee next week after the funerals.” And on Wall Street Madoff would have been in seventh heaven, “Sorry I stole your $50 Billion. Ah shucks can I interest you in some bonds?” The pharmaceutical companies and Big Tobacco would like to be included. “Sorry we killed your husband, can we still be friends? Here let me give you a free pack of cigarettes; and take a couple more packs for the kids. Yeah, yeah don’t worry, it will be fine. I won't get in trouble.”

See also, Nick Avgerinos, Slice of Humble Pie: Doctors may get Cash Bonus for an Apology

Avgerinos probably had it right back on May 27, 2008 when he posted about humble pie and cash bonuses. I hate to sound cynical but please don’t wonder why kids seem confused about the world in which we’re creating. With doctors being offered money to do what is right when they do something wrong, we can hardly complain about the behavior of young adults. Talk about a confusing world in which we live. This is preposterous to say the least.

What young adults hear: Do as I say not as I do.

See also Jeff Rasansky from Dallas, Texas with The Power of Apology, cataloguing 33 states with apology protection legislation.

And they accuse me of being cynical.

http://www.youtube.com/watch?v=SxDx2DlL0UY

Originally posted at InjuryBoard by Steve Lombardi

Pork Reforms not mentioned by the American “More Pork” Reform Association, why do hospital's advertise?

Steve Lombardi — Tue, 14 Jul 2009 10:08:00 GMT

Consider the policy of medical service providers wanting tort reform measures to save money. The policy is to make severely injured patients pay for the cost of medical mistakes that they had no fault in committing. The health care workers make the mistakes and the patient gets to pay. Manufacturers want the same gravy train from financial responsibility. They make or import crappy products from third world factories and you, the consumer pays. It's just more pork for those already taking multi-million dollar bonuses while running the source of our pay checks right into the ground.

Does this make sense or is this illogical? Let's consider the evidence on hospital's advertising. Today let's focus on how hospitals could save money but choose otherwise. Let's examine how our health care dollars are being spent and you can ask yourself if it's a wise investment towards better more affordable health care.

I often wonder why hospitals advertise. With all this talk of tort reforms to save money an explanation is necessary as to why it’s necessary that they advertise. Do the hospital CEO’s think we need to be told that if we’re having a heart attack that the hospital has an emergency room? I’ve never taken a poll but my guess is that most adults that can read the English language already know the hospital has an emergency room.

I opened up my latest version of Newton Magazine, a very nice local monthly publication edited by Jonathan Brickman that is targeted to one particular suburb of Boston. The ad on the inside cover is about an orthopaedic service offered by Newton Wellesley Hospital in collaboration with Massachusetts General Hospital. Page four has a full-page ad about diabetes from the Joslin Diabetes center. Page seven has a full page ad about heartburn and other digestive disease treatments at BIDMC. Then, of course, there are the smaller ads sprinkled through the magazine from practitioners in cosmetic dentistry, ophthalmic services, varicose veins, plastic surgery, concierge primary care, in-vitro fertilization, acupuncture, psychology, home care, assisted living, and cord blood banking. But for this post, let me focus on the hospital ads.

ON ADVERTISING, Running A Hospital Blog

I’m going to go out on a limb. If I had to guess hospitals advertising on billboards, in magazines and on television have to pay. What do you think? What do you believe; is it cheap or expensive to advertise? Is this a good use of tax and insurance dollars?

Who do you think pays for hospitals to advertise?

Nonprofit Hospitals Get Wealthy Fast, but Don't Share Much, BNET Healthcare, April 12, 2008

Last week, a page-one WSJ story revealed the dirty little secret of some nonprofit hospitals — they have grown very very wealthy, very very quickly. (The article itself, titled “Nonprofit Hospitals, Once For the Poor, Strike It Rich,” is visible via this Google News link, but otherwise behind a paywall.) The 50 top nonprofit hospitals racked up net income of $4.6 billion in 2006 (no, that’s not a typo), versus a little more than $500 million in 2001.

http://www.youtube.com/watch?v=1xPp2FYB2J0

Once again consider the policy of medical service providers wanting tort reform measures to save money. The policy is to make severely injured patients pay for the cost of medical mistakes while Fox is reaping the benefits of hospital advertising dollars. This policy doesn’t seem to make a lot of sense to me. Essentially we are asking those catastrophically injured to pay for hospitals to advertise. Is that the policy we wish to advance or is it simply a matter of a CEO's ego driving public policy?

Have you ever considered the competition between hospitals trying to encourage the same sick or injured patients to pick one hospital over another? They advertise with veiled innuendos about whey their hospital is the better one. Allow me to write the ad copy for what I consider to be a really good hospital ad under this current public policy.

The Top Ten Hospital Ads

1. “Pick us! Pick us! We have sharper needles!”

2. “When you’re in the ambulance and it’s time to choose where to go, pick Our Hospital because we don’t kill as many patients.”

3. “Have you ever seen the infection rates at Other Hospitals in town?”

4. “Only the devil would choose XYX Hospital. We treat only saints.”

5. “Our doctors can read and spell! Think of how nice your chart will look!”

6. “If you die in our hospital you’ll be closer to the funeral home.”

7. “Our ambulances have air-conditioning and new shocks!”

8. “Our ambulances hardly ever break down!”

9. “Our hospital requires all ambulance drivers to have a license to drive!”

10. “Most of our patients leave the hospital alive!”

Let’s not forget hospitals and health insurance carriers go hand in hand to the ad agency.

http://www.youtube.com/watch?v=JkcgJwirhoU

http://www.youtube.com/watch?v=ohpiB4_ezPg

http://www.youtube.com/watch?v=fPibcB1Rego

http://www.youtube.com/watch?v=a189xAYBRv8

http://www.youtube.com/watch?v=R41MtBhKrbE

Here is how I feel about my tax dollars being used to pay Fox, CBS, NBC and all the others for hospital ads.

http://www.youtube.com/watch?v=zFSEpm6_-dI

Here are some of the ads I’d create.

http://www.youtube.com/watch?v=GkyP6LEIvlY

http://www.youtube.com/watch?v=IPlqhw8AoQI

The UK spends $50 million on hospital chaplains.

Why does the ATRA and the Chamber of Commerce pick not on the waste in the system that can easily be eliminated, but on those injured by professional mistakes? From my standpoint this is disgracefully intended to line the pockets of CEO's who already are taking multi-million dollar unearned bonuses and huge pay checks to do very little. While they should be focusing on pork reforms they instead point the finger at those who are not responsible for the mistakes and shout the injured need to take responsibility. It's not the injured that need to take responsibility, it's those in charge. When the team consistently loses it's the coach who gets fired, not the fans. America is ill, we are easily lead to slaughter by the fox. Those paying for these ads are laughing at us for being so easily led astray. They reap huge financial windfalls and you get to pay for their mistakes.

Ask yourself, how gullible are you?

Let’s pick on airports and the TSA next. I'll be in Frankfurt, Germany for a few more days but when I return let's begin to examine why we need 50 TSA employees standing around the airport screening booths. And again ask yourself why does the airport authority advertise? Don't you know where the local airport is located? I don't believe I need someone to tell me they have a runway and airplanes. That's a given.

Originally posted at InjuryBoard by Steve Lombardi

Veteran Health Care Possible Contamination from Florida and Georgia VA Hospital Facilities

Steve Lombardi — Mon, 29 Jun 2009 11:43:00 GMT

If you’ve had a colonoscopy done at the Miami Veterans Affairs Healthcare System, South Florida, then you need to be aware there are concerns the equipment may have been contaminated and you will need to be tested for hepatitis and HIV. About 6,000 to 10,000 veterans may have been exposed to HIV and hepatitis. The problem had to do with the technicians not following the manufacturer’s recommendation concerning replacing certain parts per procedure.

One Vet tested showed positive results for HIV. The Veterans Dept. would not tell CNN where the patient who tested positive was treated where he contracted the virus.

CNN Report on South Florida VA

http://www.youtube.com/watch?v=5-OdkizecUI

There was also a contamination problem at Charlie Norwood VA Medical Center in Augusta, GA. Over 1,000 vets were sent warnings and offered free testing for possible infection issues related to the ears, nose and throat clinic.

A video tape is available on the CNN Video site that may be updated. The YouTube video clip may not be updated by CNN.

VA looking into possible contamination at medical facilities, CNN report from Miami, FL.

Possible contamination at VA facilities sparks call for inquiry, Veterans Today

What is a colon endoscopy examination?

http://www.youtube.com/watch?v=_Uel4SkZEyE

Originally posted at InjuryBoard by Steve Lombardi

Pennsylvania Doctor Laments there just aren't enough Medical Malpractice Cases

Steve Lombardi — Wed, 24 Jun 2009 09:36:00 GMT

In Morning Call, a Pennsylvania’s newspaper reports medical malpractice lawsuit trials are on the decrease as more cases are settled. In a followup article John A. Kibelstis, M.D. openly worries about who with adequate trial experience will in the future defend them.

When the desire to make a legitimate profit turns to greed we get the types of admissions as seen in Pennsylvania.

WASHINGTON, D.C. - The Pennsylvania Medical Society admits it made unsubstantiated claims in its campaign to scare citizens and lawmakers into believing that a medical malpractice crisis justifies changing the state constitution and curtailing the legal rights of injured patients.

The medical society has insisted that malpractice insurance costs have driven as many as 1,700 doctors out of Pennsylvania. But on April 22, the chairman of the medical society finally acknowledged to state legislators that data show the state has gained 800 doctors over the past two years, as reported by the Morning Call of Allentown.

Talking Justice

Wanting to make a profit is fine, but lying to create a false impression of the need for changes that favor your wallet is simply being greedy. Greed is just another from of gluttony; the vice that caused the fall of Rome. This is shameful for an organization of professionals to seek to take away the rights of injured patients simply for the sake of fattening their paychecks; and especially from a profession that takes an oath to do no harm. Supporting reforms that pass on the costs of medical mistakes to the innocent and injured patient is just another form of unbridled greed. Have we no shame? Don't wonder why this next generation seems to have no drive to participate in the establishment. Because we are the establishment. We've become what we marched against in the 1960's.

Does the oath to do no harm exclude lying that harms the patients' financially?

This organized lying is really despicable when you consider the harm caused to patients with inadequate recovery to pay for future medical treatment, to send their kids to college, to buy groceries or other necessities of life. How do they sleep at night?

The doctor's are sounding like farmers sitting around the coffee shop complaining about the weather; too much rain, not enough rain and remembering $4 corn or something to that effect; heck when I last heard that conversation I was a transplanted New Englander in the Midwest as a law student who hadn't a clue what price made corn a good crop to plant. My mother-in-law at that time, a farmer's wife from Newton, Iowa always had a lawyer joke for me. I had one about farmers that today I'll modify for doctors.

Do you know why doctors don’t drive Cadillac’s? The glove box isn’t big enough to hold all the government relief checks.

What does society really need; more tort reform or pork reform?

Originally posted at InjuryBoard by Steve Lombardi