Medical Malpractice - How to Protect Yourself

According to a recent report from the American Institute of Medicine, medical mistakes kill as many as 98,000 people every year and up to 7,000 patients die from errors in prescribing medicine. This far exceeds the annual number of people killed as a result of traffic accidents (43,450), breast cancer (42,300), or AIDS (16,400).

Even if a medical mistake is not fatal, it can cause severe, permanent damage, such as brain injury, paralysis, amputation, disability, or disfigurement. Medical malpractice is about far more than dollars or statistics. The errors take a terrible toll on the lives of innocent victims.

Medical malpractice occurs when a doctor fails to act with a reasonable standard of care. When someone who is not a doctor makes a mistake, he or she is often said to have acted negligently. Malpractice is simply negligence applied to health care professionals. Tragically, a doctor's mistake can have severe -- or even deadly -- consequences for a patient.

Despite the problems in the medical system, the vast majority of physicians are very competent and dedicated to protecting your health and well-being.

Of course, the best possible situation is avoiding medical mistakes entirely. You can take several steps to help your doctors improve the quality of your medical treatment. What follows is a list of some important steps you can take, and questions you can ask. We hope these guidelines provide a starting point for you to approach decisions about your medical treatment:

• Participate in your care. Do not be afraid to ask your doctor questions. Ask what alternative treatments are available. Remember: You have a right to get answers -- in terms that you can understand.

• Do not be afraid to ask for a second opinion.

• Let your doctor know about any allergies you have to medications or other substances.

• Let your doctor know all the medicines you current take or took in the past. This may prevent harmful interactions. You should provide this same information to your pharmacist.

• When a doctor writes a prescription, do not be afraid to make sure that his or her handwriting is clear and easy for your pharmacist to read.

• Ask what side effects to expect from a medicine or a procedure. Also, ask what side effects are serious and require you to seek further medical care.

• When undergoing a procedure that requires hospitalization, ask around for the best health care facility that provides the care you need. Check the track record of the facility with the state government regulatory agency.

• Do not be afraid to ask your physician or others in a hospital if they have washed their hands. Many dangerous infections are spread by a lack of sanitation.

• If you are having surgery, make certain that your surgeon and your family physician are in agreement regarding the course of treatment.

• In addition, do not assume that the surgeon who checks you before a procedure will be the one who actually performs it. Ask for the name of the surgeon who will be doing the procedure and find out whether he or she has satisfactory credentials.

• If you undergo a medical test and do not find out the results, do not be afraid to ask your doctor just what the test showed.

• Do not be afraid to speak up if you feel that something is wrong. Always voice your concerns about treatment.

• Get regular check-ups and follow the guidance of your family physician.

Protect your rights. If you or a loved one is the victim of medical malpractice, talk with an experienced medical malpractice lawyer.

Medical Malpractice - Heart Attack Misdiagnosis

In the United States, leading cause of death is coronary artery disease, or narrowing of arteries supplying blood to the heart. This condition often results in a heart attack. In fact, about 1.1 million Americans suffer heart attacks every year, and about 460,000 of these attacks are fatal. In some cases, a heart attack kills almost instantly. Nothing could be done to save the victim.

However, in other cases, timely diagnosis could make the difference between life and death. Some heart attack victims who get proper treatment right away may have an opportunity to avoid serious heart damage and resume a normal life. Too often, medical mistakes deprive an individual of this opportunity. Medical staff at the doctor's office or emergency room ignores complaints of chest pains and other key symptoms, makes the individual wait to see a doctor, or sends the person away without complete testing and proper treatment.

In that situation, the prospects for the victim are grim. Even if the individual survives, future treatment may not reverse the heart damage, or other consequences of the blocked artery, like paralysis or brain damage.

Some of the medical mistakes that a doctor may make in responding to a heart attack victim include:

• Failure to take seriously a patient's complaints
• Failure to notice or understand the nature of a patient's symptoms
• Failure to order the proper tests
• Failure to properly read or interpret test results
• Failure to refer a patient to a specialist for further testing or treatment

As soon as a potential heart attack victim arrives at the hospital, medical staff should provide essential emergency care. Doctors also may conduct tests to make a complete diagnosis and determine the proper treatment. These tests include:

• Electrocardiogram (ECG or EKG). This is a graphic record of the electrical activity of the heart as it contracts and relaxes. The EKG can detect abnormal heartbeats, some areas of damage, inadequate blood flow, and heart enlargement.
• Blood test. A blood test will be done routinely to check for enzymes or other substances that are released when cells begin to die. These are "markers" of the amount of damage to the heart.
• Nuclear scan. This test shows areas of the heart that lack blood flow and are damaged. It also can reveal problems with the heart's pumping action. A small amount of radioactive material is injected into a vein, usually in the arm. A scanning camera positioned over the heart records whether the nuclear material is taken up by the heart muscle (healthy areas) or not (damaged areas). The camera also can evaluate how well the heart muscle pumps blood. This test can be done during both rest and exercise, to enhance the usefulness of its results.
• Coronary angiography (or arteriography). This test is used to check blockages and narrowed areas inside coronary arteries. A fine tube (catheter) is threaded through an artery of an arm or leg up into the heart. A dye that shows up on X ray is then injected into the blood vessel, and the vessels and heart are filmed as the heart pumps. The picture is called an angiogram or arteriogram.

Based on the test results, doctors should determine and then provide the appropriate course of medical treatment.

Watch for signs of a possible heart attack.

Sometimes, a heart attack goes untreated through no fault of a physician. To protect yourself, you need to take care of your own health and get regular medical check-ups.

Moreover, you need to watch out for the signs of a possible heart attack, which include:

• Chest discomfort. Most heart attacks involve discomfort in the center of the chest that lasts for more than a few minutes, or goes away and comes back. The discomfort may feel like uncomfortable pressure, squeezing, fullness, or pain.

• Discomfort in other areas of the upper body. This may include pain or discomfort in one or both arms, the back, neck, jaw, or stomach.

• Shortness of breath. This often comes along with chest discomfort, but also can occur before chest discomfort.

• Other symptoms. These may include breaking out in a cold sweat, nausea, or light-headedness.

Unfortunately, many people who experience heart attack symptoms delay getting medical attention. They try to find other reasons for feeling badly, like have a hard day at work or eating a heavy meal, decide to rest, and wait for the symptoms to go away. Do not make this mistake -- it could be deadly. To be most effective, treatments for a heart attack are needed right away, within 1 hour of the start of the symptoms. If you or a family member has signs of a heart attack, call 9-1-1. Get the person to a hospital immediately.

Medical Malpractice - Birth Injuries

Tragically, severe injuries can occur during pregnancy, labor, or shortly after birth.

Many parents face the challenge of providing for a child with special needs and seeking to secure the child's future care and treatment. If medical error caused the child's injury, a medical malpractice claim may be possible, to help ensure financial security for potentially staggering medical and financial costs. While most injuries or illnesses are usually not caused by medical treatment errors, others are linked closely with medical negligence or medical mistakes. Thus, it is necessary to take a close look, to determine whether a birth injury was caused by a physician or hospital mistake, or if the birth injury was something that simply could not be avoided.

Cerebral palsy is one major group of illnesses, which may result from avoidable medical mistakes.

Medical History of Cerebral Palsy

In the 1860s, an English surgeon named William Little wrote the first medical descriptions of a puzzling disorder that struck children in the first years of life, causing stiff, spastic muscles in their legs and, to a lesser degree, in their arms. These children had difficulty grasping objects, crawling, and walking. As they grew up, they did not get better, but they did not get worse. Their condition, which was called Little's disease for many years, is now known as spastic diplegia. It is just one of several disorders that affect control of movement and are grouped under the term cerebral palsy.

In fact, cerebral palsy is an umbrella-like description for several chronic disorders impairing control of movement, which appear in the first few years of life and generally do not worsen over time. The term cerebral refers to the brain's two halves, or hemispheres, and palsy means any disorder that impairs control of body movement. Thus, problems in muscles or nerves do not cause these disorders. Instead, faulty development or damage to motor areas in the brain, disrupt the brain's ability to control movement and posture adequately.

Symptoms of cerebral palsy range in severity. An individual with cerebral palsy may have difficulty with fine motor tasks, such as writing or cutting with scissors; experience trouble maintaining balance and walking; or have involuntary movements, such as uncontrollable writhing motion of the hands. The symptoms differ from one person to the next, and may even change over time in the individual. Other medical disorders, like seizures or mental impairment, may affect some people with cerebral palsy.

Contrary to common belief, cerebral palsy does not always cause profound disability. While a child with severe cerebral palsy might be unable to walk and need extensive, lifelong care, a child with mild cerebral palsy might require limited special assistance. Cerebral palsy is not contagious and not usually inherited from one generation to the next. At this time, there is no cure, although scientific research continues to yield improved treatments and methods of prevention.

The United Cerebral Palsy Association estimates that more than 500,000 Americans have cerebral palsy. Despite advances in preventing and treating certain causes of cerebral palsy, the number of children and adults it affects has remained essentially stable, or may have risen slightly over the past 30 years. This is partly because more critically premature and frail infants are able to survive with improved neonatal intensive care. Unfortunately, many of these infants have developmental problems of the nervous system or suffer neurological damage. Medical research is under way to improve care for these infants.

Early Signs

The signs of cerebral palsy usually appear before 3 years of age, so that parents often are the first to suspect that their infant is not developing normal motor skills. Frequently, infants with cerebral palsy are slow to reach developmental milestones, such as learning to roll over, sit, crawl, smile, or walk. Sometimes this is called developmental delay.

Some affected children have abnormal muscle tone. Decreased muscle tone is called hypotonia and caused a baby to seem flaccid and relaxed, even floppy. Increased muscle tone is called hypertonia and causes the child to seem stiff or rigid. In some cases, a newborn baby has an early period of hypotonia that progresses to hypertonia after 2 to 3 months. Affected children also may have unusual posture or favor one side of the body.

Parents who are concerned about their baby's development for any reason should contact their physician, who can help distinguish normal variations in development from a developmental disorder.

Clinical Diagnosis

Doctors diagnose cerebral palsy by testing an infant's motor skills and looking carefully at the infant's medical history. In addition to checking for the symptoms described above -- slow development, abnormal muscle tone, and unusual posture -- a physician also tests the infant's reflexes and looks for early development of hand preference.

Reflexes

Reflexes are movements that the body makes automatically in response to a specific cue. For example, if a newborn baby is held on its back and tilted so the legs are above its head, the baby will automatically extend its arms in a gesture, called the Moro reflex, that looks like an embrace. Babies normally lose this reflex after the age of 6 months. However, those with cerebral palsy may retain it for much longer. This is just one of several reflexes that a physician may check.

Hand Preference

Doctors also look for hand preference -- a tendency to use either the right or left hand more often. When the doctor holds an object in front and to the side of the infant, a child with hand preference will use the favored hand to reach for the object, even when the object is closer to the opposite hand. During the first 12 months of life, babies do not usually show hand preference. But infants with spastic hemiplegia, may develop a preference much earlier, because the hand on the unaffected side of the body is stronger and more useful.

Movement Problems

The next step in diagnosing cerebral palsy is ruling out the other disorders that may cause movement problems. Most importantly, doctors must determine that the child's condition is not getting worse. Although its symptoms may change over time, cerebral palsy by definition is not progressive. If a child is continuously losing motor skills, the problem is more likely to spring from other problems, like genetic diseases, muscle diseases, metabolism disorders, or tumors in the nervous system. The child's medical history, special diagnostic tests, and, in some cases, repeated check-ups can help a physician determine whether or not disorders are at fault.

CT Scan

The doctor may also order special tests to learn more about the possible cause of cerebral palsy in an individual child. One test is computed tomography, or CT, which is a sophisticated imaging technique that uses x-rays and a computer to create an anatomical picture of the brain tissues and structures. A CT scan may reveal brain areas that are underdeveloped, abnormal cysts (sacs often filled with liquid) in the brain, or other physical problems. With the information from CT scans, doctors may be better equipped to judge the long-term outlook for an affected child.

MRI Scan

Magnetic resonance imaging, or MRI, is a brain imaging technique used to identify brain disorders. This technique uses a magnetic field and radio waves, rather than x-rays. An MRI gives better pictures of structures or abnormal areas located near bone than a CT scan.

Ultrasonography

Another test that exposes problems in brain tissue is ultrasonography, or ultrasound. This technique bounces sound waves off the brain and uses the pattern of echoes to form a picture, or sonogram, of its structures. Ultrasonography can be used with infants before the bones of the skull harden and close. Although it is less precise than CT and MRI scans, this test can detect cysts and structures in the brain, is less expensive, and does not require long periods of immobility.

EEG

If the doctor suspects a seizure disorder, he or she may order an electroencephalogram, or EEG. During this test, special patches called electrodes are placed on the scalp and will record the natural electrical currents inside the brain. The recording can help the doctor see patterns in the brain's electrical activity which suggest a seizure disorder.

The Intelligence Test Issue

Intelligence tests are often used to determine if a child with cerebral palsy is mentally impaired. However, some children's intelligence may be underestimated because problems with movement, sensation, or speech due to cerebral palsy make it difficult for them to perform well on these tests.

Medical Problems Related to Cerebral Palsy

Physicians will look for other conditions linked to cerebral palsy, including seizure disorders, mental impairment, and vision or hearing problems. For potential vision problems, the doctor may recommend an examination by an ophthalmologist. If the treating physician suspects hearing impairment, he or she may refer the patient to an otologist. Identifying these accompanying conditions is important and is becoming more accurate as ongoing research yields advances that make diagnosis easier. Specific treatments may address many of these conditions, to improve the long-term outlook for those with cerebral palsy.

What Causes Cerebral Palsy?

Often, parents of children with cerebral palsy are led to believe that their child suffers from a birth defect that was unavoidable. Rarely are they told that medical errors caused their child's disability. Many parents feel that there is no way to know what caused cerebral palsy and are unaware of the ways to search for answers. The reality is that cerebral palsy is sometimes the result of a medical mistake that deprived a child of oxygen during pregnancy, often while the mother was in labor.

Doctors have an obligation to provide adequate care during all stages of a woman's pregnancy, including labor and the period immediately after birth. Unfortunately, doctors are capable of error or negligence.

Physician mistakes that may cause cerebral palsy include:

• Failing to perform a cesarean section when the fetus is in distress or getting too little oxygen.
• Inadequately monitoring the mother during pregnancy and throughout the labor process.
• Misinterpreting test results during pregnancy, or outright failure to conduct necessary tests.
• Failing to monitor closely when the mother has a condition like diabetes, heart disease, hypertension, asthma, renal disease, lupus, or thyroid disease.

Peace of Mind

If your child has cerebral palsy, it may have been caused by medical malpractice. You owe it to your child and your family to see if the cause of your child's condition can be determined. A good malpractice attorney will obtain all relevant medical records, review all documentation, and consult with leading medical experts to determine definitively whether a medical professionals negligence caused your child's condition.

The Lifelong Cost of Caring for Your Child

The cost of caring for children who suffer from cerebral palsy can be financially catastrophic. You must expect significant expenses throughout your child's lifetime, because the condition will not improve over time. However, if your child's condition is determined to be the fault of a hospital or physician, then there should be medical malpractice insurance in place to provide financial compensation for these costs.

If your child or grandchild has been diagnosed with cerebral palsy that you believe may have been caused by a doctor or hospital's mistake, talk with a lawyer experienced in cerebral palsy law.