Michigan Nursing Home Law

In addition to federal government oversight, the State of Michigan regulates the quality of care in nursing homes. The Patient’s Bill of Rights in the Michigan Public Health Code, MCL 333.20201, includes the following protections:

• A Michigan patient or resident is entitled to be free from mental and physical abuse and, except as authorized by a physician, or as necessitated by an emergency to protect the patient, free from physical and chemical restraints.
• A Michigan patient or resident shall not be denied appropriate care based on race, religion, national origin, sex, age, handicap, marital status, sexual preference, or source of payment.
• An individual may obtain a copy of, or inspect his/her medical records, and a third party shall not be given a copy without authorization of the patient except as required by law and third party contract.
• A Michigan patient or resident is entitled to privacy, to the extent feasible, in treatment and caring for personal needs with consideration, respect, and full recognition of his/her dignity and individuality.
• A Michigan patient or resident is entitled to receive adequate and appropriate care and information about his/her medical condition, proposed treatment and prospects for recovery, unless medically contraindicated by the physician in the medical record.
• A Michigan patient or resident is entitled to receive and examine an explanation of his/her bill. He/she also is entitled to know who is responsible for, and who is providing, his/her care.
• A Michigan patient or resident is entitled to associate and have private communication with his/her physician, attorney or any other person, and to send and receive personal mail unopened, unless medically contraindicated.
• A Michigan patient's civil and religious liberties shall not be infringed. The nursing home shall encourage and assist in the exercise of these rights.
• A Michigan patient or resident is entitled to retain and use personal clothing and possessions as space permits. At the request of a patient, a nursing home shall provide for safekeeping of personal property and funds, except that a nursing home shall not be required to provide for the safekeeping of property, which would impose an unreasonable burden on the nursing home.
• Each Michigan nursing home patient shall be provided with meals that meet the recommended dietary allowances for the patient's age and sex and that conform to the individual’s special dietary needs.
• A Michigan nursing home, its owner, administrator, employee, or representative shall not discharge, harass, retaliate, or discriminate against a patient because a patient has exercised rights protected by law.
  

If you think that a loved one was the victim of nursing home abuse or neglect, you owe it to that individual and your family to try to find out what happened. It is important to talk with a Michigan Attorney experienced in nursing home cases and Michigan regulations of nursing homes.

Ohio Medical Malpractice Law Overview

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).

Under Ohio law, you often have only 1 year from the date of negligence to file a claim. If the victim of medical malpractice is a minor, then additional time is allowed.

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 healthcare professionals. Tragically, a doctor's mistake can have severe -- or even deadly -- consequences for a trusting patient.

What is Medical Malpractice?
Some forms of medical malpractice are unmistakable, like performing surgery on the wrong body part or the wrong patient, or administering the wrong medication.

Other types of medical malpractice may not be obvious. For example, if an individual was not warned about the serious risk of a particular treatment or if treatment unexpectedly causes a horrible injury, malpractice may have occurred.

In general, an individual may have a medical malpractice claim when a doctor or other medical professional failed to provide proper treatment and the incorrect treatment caused the patient to suffer a new injury. The law requires evidence of new injury, because it would be unreasonable to hold the healthcare professional responsible for the original medical problem.

Some examples of medical malpractice include:

• Failure to diagnose a medical condition
• Misdiagnosis of a medical condition
• Failure to treat a patient's medical condition properly
• Failure to administer anesthesia safely
• Failure to manage a pregnancy or deliver a baby in a safe manner
• Failure of a nurse or other staff member to keep a treating physician informed of a patient's condition
• Failure to administer medications properly
• Failure to protect a patient from a fall or other injury on hospital property

The Rights of Ohio Medical Malpractice Victims
Sadly, many Americans die each year from medical mistakes. One of the best ways to help correct this crisis in medicine is to hold the negligent hospitals and physicians accountable for their mistakes.

In Ohio, a patient has the right to file a lawsuit against any physician or hospital, which may have committed malpractice. However, the filing requirements for a malpractice lawsuit are lengthy and complicated.

The laws governing malpractice suits may be the most complex of all Ohio personal injury laws. Failure to meet the Ohio legal requirements for an Ohio medical malpractice claim means that the victim loses all rights to file a lawsuit against the medical professional or hospital which negligently caused severe injury -- or even death.

If you or a loved one is the victim of medical malpractice, talk with a dedicated Ohio medical malpractice lawyer.

Challenging the FDA and Drug Industry

Many in today's society are quickly realizing that just because the Federal Drug Administration approved a drug, doesn't mean that it's safe. An example of this is actor Dennis Quaid, who nearly lost his newborn twins when they were given an excessive dosage of Heparin. While the labels of the two bottles look nearly identical, the dosage that the Quaid twins received was 1,000 times larger than the amount they should have consumed. Although the company warned hospitals and requested label changes, they didn't take the drug off of the market.

According to Healthgrades, almost 250,000 patients studied between 2003 and 2005 died from potentially preventable problem dealing with improper medication use. The Institute of Medicine approximates that 1.5 million patients suffer the consequences of medication mistakes.

Despite these dangerous errors, the Bush Administration has attempted to pass a bill of goods to the courts, under the grounds that states don't have the right to hold a company accountable for selling a product that has been approved by the federal government. This, many medical experts agree, would be a grave mistake and ultimately would harm drug safety.

An important case to cite is that of Vioxx. In this example, Vioxx was approved by the FDA in 1998, even though it could potentially cause heart attack, stroke, or other severe cardiovascular problems. This is a great example of why the court system is so important. Medical experts remind us that it is absolutely paramount that a drug be constantly monitored during the post-marketing period, as it is possible that new serious safety issues may arise only after a drug has entered the market.

Mistakes in the practice of medicine, especially dealing with medication, are often life-changing and sometimes irreversible. As we handle a considerable number of medical malpractice cases each year, the Law Offices of Samuel I. Bernstein urges you to find an experienced lawyer who will fight on your behalf.

Cancer Misdiagnosis

Importance of Early Diagnosis
Sometimes, physicians fail to properly diagnose cancer in their patients. In fact, the leading cause of all medical error or medical malpractice lawsuits is the misdiagnosis of cancer.

Timely detection of cancer is a matter of life and death.
For example, breast cancer has a 95% survival rate when caught at its earliest stage. When breast cancer advances to "stage 4,” an individual only has a 7% chance of survival. Indeed, the key to successful treatment of most types of cancer is early diagnosis.

Other types of common cancers for which early treatment is crucial are cancer of the prostate, cervix, colon, lung, kidney, ovaries, skin, and testicles. It is important for your family physician to check for cancers that may pose a greater risk to you, due to your family history, gender, or age. Most cancer tests are painless. Regular cancer screening and early diagnosis can greatly increase your prospects for a long and quality life.

Some of the mistakes that a doctor may make in screening for cancer include:

• Failure to understand or notice the nature of a patient's complaints.
• Failure to order the proper test, such as a mammogram or PSA test.
• Failure to properly read or interpret test results.
• Failure to refer a patient to a specialist for further testing.
• Failure to note that a patient’s family history increases the risk of a particular type of cancer.
• Failure to notice a mass or mistaking a malignant mass for one that is benign.
• Failure to run routine tests, such as a prostrate screening for males over age fifty.
• Failure to test someone who is at risk, because of age or ethnicity. For example, African-American males are at increased risk of prostrate cancer and need screening tests from the age of forty.
• Failure to follow-up with a patient if cancer should be suspected.
  

Sometimes, the reason for delayed cancer diagnosis is not the fault of a physician. You need to take care of your own health and get medical check-ups.

If you have discomfort, pain, an unusual lump or mass, or other health concerns, be sure to tell your doctor. Also, let your physician know about any family or personal history of cancer. If you believe that you are not being adequately screened for cancer risks, then you should express this concern to your physician. Never be afraid to seek a second opinion, if you think one is required.

There are many reasons why you should talk with a medical malpractice lawyer about your legal rights after an instance of cancer misdiagnosis. After you or a loved one suffers from a cancer misdiagnosis, it is important to talk with a personal injury attorney with experience in medical malpractice law for several compelling reasons.


Put a Fighter In Your Corner
Insurance companies will vigorously fight against paying damages to an medical malpractice victim -- especially cases involving cancer misdiagnosis. You need a law firm that will vigorously represent your interests in these proceedings and counsel you as your claim progresses.

Peace of Mind
You owe it to yourself and your family to seek experienced legal counsel. To protect all your legal rights, you need a law firm that is well versed in the complicated laws that govern medical malpractice law.

The Financial Impact of Injuries
The cost of a cancer misdiagnosis can be catastrophic. This is an extreme hardship when the injuries make work impossible and rent, gas, and medical bills start to accumulate. You need a law firm that will help you recover these costs from the insurance company or the at-fault party. A study recently indicated that injured parties represented by legal counsel obtain far greater recoveries than those individuals who attempt to represent their own interests.

Birth Injuries

Types of Birth Injuries

One of the many types birth injuries that can result from a mistake during delivery is known as shoulder dystocia or Erb's palsy. Shoulder dystocia or Erb's palsy may occur when an inexperienced or improperly trained physician damages a newborn's brachial plexus, a delicate part of the shoulder. The improper use of forceps or other negligent actions during delivery may cause this injury. Brachial plexus injury results in pain, a limited ability to move a hand and/or arm, or an inability to lift an arm above shoulder level.

Causes of Birth Injuries

Another cause of debilitating birth injury results from lack of oxygen to the brain during delivery. The lack of oxygen at this critical time can result from either an anoxic injury or a mechanical injury. An anoxic injury is caused by a reduced oxygen supply, respiratory obstruction, or inadequate respiratory movements during delivery.

Similar brain damage also can result from a mechanical injury or physical trauma during birth. A skull fracture is just one devastating consequence of this kind of trauma. The improper use of forceps, suction, or force to the baby's head can all result in this, or other types of mechanical injury.

Signs of Birth Injury

The signs that a fetus has a higher risk of birth injury include:

• A difficult and long labor
• Improper use of medication or other substances by the pregnant mother
• An abnormally large fetus
• Breech birth (buttocks first)

The risk increases if there is an unreasonably long delay in performing an emergency cesarean section. A pregnant woman with gestational diabetes also has an increased chance of complications at birth.

While estimates vary, it appears that between two to seven babies, out of every thousand births, will suffer birth injuries. Therefore, it is important to take every precaution to have a healthy delivery, by seeking out a competent obstetrician or pre-natal physician and carefully following his or her advice and instructions.

Why You Need a Lawyer

There are many reasons why you should consult with an attorney about your legal rights.

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

The Lifelong Cost of Caring for Your Child
The cost of caring for a child who suffers from birth injuries can be financially catastrophic. A family can expect significant expenses throughout the child's lifetime, because the condition may not improve over time. This is an extreme hardship for most families, who are already struggling with the emotional circumstances created by the responsibility of caring for a severely injured child. If the 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.

Professional Legal Evaluation of Your Claim

Proving any type of medical malpractice case is a complicated process, and this is certainly true of a claim on behalf of a child with birth injury. It may take an attorney hundreds of hours to gather all of the documentation, make a determination, and file the appropriate claim on your child's behalf. You need a lawyer who is well versed in the complicated laws that govern these actions.

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.

Nursing Home Abuse and Neglect

Nursing home neglect and abuse is a national disgrace. In fact, this is a widespread -- and increasing -- problem in the United States. An analysis of the death certificates of persons who died in California nursing homes between 1986 and 1993 revealed that over 7%, or 1 in 15, of the deaths of seniors in nursing homes, resulted at least in part, to utter neglect, lack of food or water, untreated bedsores, or other generally preventable ailments. Since that study, this nation's nursing home population has risen sharply. If the 1.6 million Americans now in nursing homes are dying of questionable causes at the same rate, then every year about 35,000 elderly citizens die prematurely or in unnecessary pain, or both. According to a survey published in the Journal of the American Geriatrics Society, 30% of those polled said they would rather perish than live in a nursing home.

The U.S. Congress and state legislatures have taken steps to make nursing homes accountable. The federal Nursing Home Reform Act states that a nursing home must provide "services and activities to attain or maintain the highest practicable physical, mental, and psycho-social well-being of each resident in accordance with a written plan of care." However, you still need to be alert to your own loved one's needs, and if necessary, demand that the nursing home respect all of his or her legal rights. Listed below are examples of positive steps you can take to prevent problems and ensure proper treatment in a nursing home for your relative or friend.

Signs of Nursing Home Abuse

It is important to watch for signs that your loved one may be a victim of abuse or neglect. Most nursing home residents must depend on the staff for most or all of their daily needs, including food, water, medicine, toileting, grooming, stimulation and turning.

Although most facilities provide good care, some cause needless suffering and death. Sadly, many nursing home residents are starved, dehydrated, over-medicated, and suffer painful pressure sores. In addition, they may be isolated, ignored, and deprived of social contact and stimulation.

The following is a list of some forms of nursing home abuse:

• Assault and battery
• Sexual assault and battery
• Rape
• Unreasonable physical constraint
• Prolonged deprivation of food or water
• Use of physical restraints, like straps or belts
• Use of chemical restraints, like sedatives or sleeping medications
• Use of psychotropic or other medications for any purpose not authorized by a physician
• Excessive dosages of medication
• Withholding needed medication
• Confinement to a room or fixed location

Nursing home abuse victimizes the most vulnerable individuals. Although many residents can report mistreatment, some cannot even describe what happened. If your relative or friend is a nursing home resident, you can help by watching out for signs of abuse, including:

• Unexplained injuries
• Inability of nursing home staff to give an adequate explanation of a resident's condition
• Open wounds, cuts, bruises, welts, or bedsores
• Slapping, pushing, shaking or beating
• Non-verbal signs from the nursing home resident that something is wrong, such as:
• Unusual emotional outbursts or agitation
• Extreme withdrawal or lack of communication
• Unusual behavior, like sucking, biting, rocking, etc.
• Humiliating, insulting, frightening, threatening or ignoring behavior towards family and friends
• Desire to be isolated from other people

Signs of Nursing Home Neglect

Neglect means the negligent failure by any person with care or custody of an elderly or a dependent adult to exercise that degree of care that a reasonable person in a similar position would exercise.

Neglect includes, but is not limited to:

• Failure to provide food, clothing, shelter, or help with personal hygiene
• Failure to provide medical care for physical and mental health needs
• Failure to protect from health and safety hazards
• Failure to prevent malnutrition or dehydration
• Failure to provide the necessities of daily living
• Failure to prevent bed sores
• Failure to provide sanitary conditions
• Failure to prevent infections

Specific Examples of Common Nursing Home Abuse or Neglect Injuries

Bedsores

Bedsores are also known as pressure ulcers, pressure sores, and decubitus ulcers. The primary cause of bedsores is unrelieved pressure to a particular part of the body. They also may result from friction, like rubbing against something like a bed sheet, cast, brace, etc., or from prolonged exposure to cold.

Any area of skin tissue directly over a bone is a potential site for a bedsore. These areas include the spine, coccyx or "tailbone," hips, heels, and elbows. The factors that contribute to formation of a bedsore include poor nutrition, poor hygiene, weight loss, diabetes, and dehydration. The least serious kind of bedsore looks like skin discoloration, and may disappear within a few hours after relieving pressure on that area. However, more severe bedsores are profound wounds, which can extend through skin tissue into internal organs or bones.

Medical professionals have identified similarities between bedsores and burns. Like a first-degree burn, a mild bedsore may involve mild redness of the skin and/or blisters. A third-degree or fourth-degree burn, or severe bedsore, may have a deep open wound with a lot of blackened tissue, which is called "eschar." The primary treatment for bedsores starts with removing all pressure from the affected area, to prevent further tissue decay and promote healing. The victim must be turned or repositioned frequently and get enriched nutrition. The affected area must be kept clean, and dead or necrotic tissue should be removed to minimize the risk of infection. The worst bedsores often require a surgical procedure, known as debridement of dead tissue.

If you suspect that a relative or friend is suffering from a bedsore, you need to get immediate medical attention for that individual. In addition, help your loved one get legal assistance. Very frequently, severe bedsores result from abuse and neglect. Federal regulations confirm that there rarely is a valid medical reason for a bedsore to develop into a massive deep wound, which is known as the stage 4 level.

Suffocation and Strangulation

A frail nursing home resident can suffocate or strangle to death in a hospital bed, if ignored or neglected by nursing home staff. Between 1993 and 1996, there were 74 of these cases reported, and probably many more went unreported.

The design of the side rails on a nursing home bed may contribute to the danger. Often side rails have slats that are spaced six or more inches apart. That space may trap an elderly person's head, causing him or her to strangle, or allow a thin individual to squeeze between the rails and fall to the floor. If the mattress on a nursing home bed does not fit properly in the bed frame, a patient may be trapped and strangle in a gap between the mattress and side-rails.

Broken Bones or Fractures

For the elderly, falling is the most frequent cause of fractures. Nursing home staff must regularly evaluate each patient; determine his or her risk for falling, and provide safety devices and services that each individual needs to minimize the risk of injury. Some of the risk factors for harmful falls include:

• Previous falls
• Cardiac arrhythmias (irregular heartbeat)
• Stroke
• Central nervous system disorders, such as Alzheimer's disease, Parkinson's disease, or dementia
• Problems with mobility and gait
• Low blood pressure (orthostatic hypotension) when trying to stand up
• Bowel or bladder incontinence
• Dizziness
• Dehydration
• Visual impairment (i.e. macular degeneration, cataracts, etc.)
• Use of restraints
• Medication side effects
• Slipping or tripping hazards, like torn or loose rugs or mats

The Cost of Nursing Home Abuse or Neglect

The cost can be quite high for the treatment of a victim of nursing home abuse or neglect. Often the resulting injuries are permanent, and may require hospitalization or a higher level of medical treatment and nursing care than your loved one previously needed. This can be an extreme hardship for the victim and his or her family. If the injuries are the fault of a nursing home, then it should have insurance to pay for those substantial bills, other expenses, and damages for pain and suffering. Proving a nursing home abuse or neglect case is a complex process. To succeed, you need a lawyer who is well versed in the complicated laws that govern these legal actions.

How to Find the Best Nursing Home

Even at a well-known, fully licensed nursing home, there is the possibility of abuse or neglect. That is why you need to make sure that a facility will provide your loved one with quality care.

Touring a facility is only the first step, because a scheduled visit is unlikely to reveal everything that is happening beneath the surface or when no one is visiting. Certainly, your goal is to assure quality care for your loved one, as well as peace of mind for your family. To accomplish this, it's helpful for you to take the following steps before selecting a nursing home:

• Talk with other residents at the nursing home that you are considering. You can simply walk the corridors of the facility, and speak with residents, including those who are bedridden.

• In addition, your own physical observations are extremely important. Do the residents appear well groomed? Do any of them have visible wounds or sores? How is their oral care? If you find several residents who seem confused and disoriented, you may be witnessing signs of neglect.

• Federal regulations require that all nursing homes have the latest state survey of the facility readily available for review. Ask the management for this survey, read it carefully, and ask questions. Be on the lookout for signs of any problems with basic care.

• Ask questions about the staff at the facility. What is the size of the staff during the different hours of the day and night? How many staff members are nurses? How many are nursing assistants? Are there social workers and clergy on the staff? Consider how the staffing of that facility compares to other nursing homes with a similar number of patients.

• Speak with the relatives of other residents at the facility. Have they observed any problems? Do they have any issues with the management or staff at the facility? You may wish to find out whether any of the residents' families use of web cameras (sometimes called "granny cams"). Although this cyber visitation is a new practice, some families who cannot visit their loved ones every day are placing special internet cameras in relatives' rooms to allow them to see what is happening at any time. If you see a "granny cam" at a facility, ask to speak with the family of that resident, to learn what they have observed. If possible, inquire if the facility would mind if you used this kind of device.

• When walking the halls of the facility, use your senses. One of the most effective methods of inspecting a facility may be your sense of smell. A nursing home should not smell of urine or feces. If it does smell, residents may not be receiving adequate toileting care. Often, this basic care is essential to preventing life-threatening illnesses, like urinary tract infections or bedsores.

• Watch as residents are being fed. Do many residents look underweight? How much of the food are they eating? Is staff helping residents who have problems feeding themselves? Do the aides who assist with the food seem overwhelmed? Are the aides spending enough time working with each resident during mealtime?

• If at all possible, visit the potential nursing home more than once and plan your visits at different times of the day and week. If you can only visit the nursing home once, go at night or on a weekend afternoon. Staff levels may be lowest during these "off" times.

• Is water easily available to all residents at the facility? If some residents are incapable of helping themselves to a drink, is staff offering assistance at regular intervals?

• When you attempt to look at the facility, are you deliberately steered to certain rooms or residents? If you feel that you are being denied full access to the facility, you should find out if there is a good reason.

• Ask to meet all of the key executive personnel at the facility. Speak with the administrative head, the medical staff administrator, and the nursing staff administrator. Ask how often physicians actually examine residents. Find out about the facility's staff turnover rate, including the average length of employment for nursing assistants and other primary caregivers.

Nursing Home Evaluation Checklist

You should be alert whenever you visit your loved one's nursing home. The following are questions to ask yourself during each visit:

• Do you notice signs that your loved one is suffering from dehydration (lack of water) or malnutrition (lack of food)?
• Have you noticed the resident is less active or less able to move about?
• Have you noticed emotional changes, mood swings, withdrawal, anxiety, or other fears?
• Are residents dressed appropriately for the season and time of day?
• Are the resident's living quarters clean?
• Are the resident's medical conditions being treated in a timely manner?
• Does the resident seem to suffer from chronic viruses and/or infections?
• Are all medications administered in a timely and appropriate fashion?
• Has the nursing home staff delayed reporting an injury or incident to a doctor or to the resident's family or guardian?
• Has the resident suffered frequent falls or broken bones?
• Does there seem to be adequate staff and supervision?
• Are the caregivers ignoring the resident or describing him or her as a burden?
• Does any caregiver react defensively to routine questions about the resident's care?

Nursing homes must provide good nutrition and hydration to residents. Poor diet and lack of water are among the most common forms of nursing home abuse and neglect. Some of the health problems associated with malnutrition and/or dehydration include:

• Increased risk of infections
• Confusion
• Muscle weakness (possible immobility and increased risk of falls)
• Pressure ulcers or bedsores
• Pneumonia
• Increased risk of becoming ill from exposure to bacteria or viruses

The Importance of Proper Nutrition and Hydration

Nursing homes should conduct regular nutritional assessments and provide residents with well-balanced, palatable meals. When you consider a nursing home for a loved one, you may wish to ask to sample a random meal at the facility. Also, ask to speak to the staff dietitian about the factors they use to develop meal plans for the facility. The following is a list of reasons why an individual may suffer from malnutrition and/or dehydration:

Personal causes of malnutrition:

• Illness
• Adverse drug effects such as nausea, vomiting, diarrhea, cognitive disturbances, or sleepiness
• Food and drug interactions that decrease the ability of the body to absorb vitamins and minerals
• Depression
• Swallowing disorders
• Mouth problems such as tooth loss, dentures that do not fit properly, mouth sores, and mouth pain
• Tremors or shakiness, which affect residents' ability to feed themselves

Environmental causes of malnutrition:

• Inadequate staff attention for residents who need help to eat
• Staff who lack training about malnutrition and the proper ways to feed residents who need help
• Reliance on liquid supplements
• Special diets

Signs that a resident is malnourished:

• Clothes fitting more loosely than usual
• Cracks around the mouth
• Pale looking lips or mouth
• Dentures that no longer fit
• Hair thinning or getting sparser
• Wounds that take longer to heal
• Confusion (which is unusual for that individual)
• Skin breaking down
• Sunken eyes
• Weight loss

The following questions may help you pinpoint the reason for a particular person's problems with nutrition or hydration:

• Can the resident feed him/herself?
• What is the resident's favorite meal of the day
• When and where does the resident prefer to have meals serve
• Does it take a long time for the resident to eat?
• Is the resident rushed through meals?
• Is the resident unable to finish meals?
• Does the resident seem to eat more when someone is there to help with the meal?
• Does the resident seem uninterested in food?
• Has the resident lost his/her appetite?
• Does the resident like the food at the facility?
• Can the resident choose from a menu?
• Are snacks readily available to the resident?
• Is the resident on a special diet?
• Has the resident started taking any new medications?
• Is the resident's weight monitored on a regular basis?
• Has the staff informed family members of weight loss?
• Has staff asked family members for assistance?