Justia Lawyer Rating for Robert D. Kreisman

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Continuity of care is paramount in patient healthcare. The goal is always to give the patient the best medical care while at the same time reduce medical errors. For the last 20 years hospitals and physicians have been using electronic health records (EHR).

Although the intent was noble, EHR has caused serious and even catastrophic injury and harm to patients because of poorly written software programs for healthcare providers. Sometimes the medical recording software does not allow for certain medical conditions, treatments and tests. In those cases, the medical providers simply use the drop down or other shortcut to comply with the entry requirements.

It used to be that narrative nursing notes would be important in providing details of patient care. But in most hospital settings, nurses simply use default screens on a computer to make their entries. Physicians often are not able to read the nurses’ remarks or notes. 

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On July 8, 2013, the U.S. District Court in Charleston, W.Va., started the first bellwether jury trial in the C.R. Bard, Inc. Multidistrict Litigation (MDL). Bard manufactures transvaginal mesh products. Not long after the beginning of the trial, the trial judge declared a mistrial. After opening statements and the testimony of at least one witness, a physician then testified inadvertently that the manufacturer (Bard) was no longer selling this type of mesh product, which was at issue in the case.

The court declared the mistrial because the testimony violated a pretrial order that prohibited evidence of a subsequent remedial measure. The case was restarted again in mid-August, but this time the jury returned a $2 million verdict for the injuries suffered by Donna Cisson, a public-health nurse from Georgia. She received the Bard Avaulta Plus implant in 2009. Jurors deliberated for 12 hours over two days before reaching their verdict. The vaginal mesh implant is made by Bard. Bard’s attorneys have said on the record that the company intends to appeal the verdict ($250,000 in compensatory damages and $1.75 million in punitive damages), which they say was wrong because Cisson’s injuries were not caused by Bard’s product.    

The transvaginal mesh products are used in surgical procedures to repair conditions in women that have pelvic organ prolapse and stress urinary incontinence. Bard has removed its Avaulta Plus implant product off the market in 2012 after the FDA ordered that all makers of these implant products review reports of organ damage, infection and pain during sex.

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The Illinois Supreme Court has reversed an Illinois Appellate Court ruling concluding that Section 3.150(a) of the Emergency Medical Services Systems Act immunizes an ambulance driver in a non-emergency transfer of a patient. 

According to the Act, Section 3.150(a), “Any person . . . certified, licensed or authorized pursuant to this act or rules thereunder, who in good faith provides emergency or non emergency medical services . . . in the normal course of conducting their duties, or in an emergency, shall not be civilly liable as a result of their acts or omissions in providing such services unless such acts or omissions . . . constitute willful and wanton misconduct.”

In this case, the plaintiff, Karen Wilkins, sued Rhonda Williams for the injuries she sustained in Oak Lawn, Ill., when she was in an ambulance that crashed into her car. The ambulance was proceeding during a routine, nonemergency transfer of a patient from a hospital to a nursing home. The lawsuit alleged that the driver, Rhonda Williams, and her employer, Superior Air Ground Ambulance Service, were negligent. The defendants moved for summary judgment based on the Emergency Medical Services System Act.

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On June 22, 2006, Raymone Bowe, a 10-year-old boy, was brought by his mother to the emergency department at Norwegian American Hospital in Chicago with a sore throat, headache and a history of fever and vomiting. Raymone was seen in the ER by the defendant, Dr. Joseph Mejia, an occupational medicine/ophthalmology physician. 

Dr. Mejia diagnosed flu and headache and discharged Raymone with instructions to follow up if his symptoms continued or got worse. Two days later, at 12:19 a.m. on June 24, 2006, Raymone’s mother brought him to the emergency department at John H. Stroger Jr. Hospital of Cook County. She reported that Raymone had  3 days of diarrhea, vomiting and fever. The complete blood count showed Raymone had an elevated white blood count, but he was still discharged with a diagnosis of a viral syndrome. Later that  day, Raymone was taken to Children’s Memorial Hospital, where he was diagnosed with Streptococcus pneumoniae meningitis. Raymone was admitted to the pediatric intensive care unit. 

Because of the delay in treating the meningitis, Raymone sustained complete and permanent hearing loss in both ears resulting in surgeries to insert bilateral cochlear implants. 

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Jungie Kim underwent surgery to repair an abdominal aortic aneurysm at Rush Northshore Medical Center on Sept. 24, 2003.  Kim was a 55-year-old housewife.  The surgery was done by a vascular surgeon, Dr. Douglas Norman, a contracted employee at Rush Northshore. 

Following the surgery, Ms. Kim experienced severe ischemia in her right foot. Several more surgical procedures were performed.  There was the development of compartment syndrome pressure in a muscle compartment, which can cause muscle and nerve damages because of decreased blood flow.

In spite of the right foot surgeries, Ms. Kim’s foot became gangrenous, which eventually led to an amputation of the forefoot in April 2004.

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The U.S. Department of Labor reports that in 2008 only 12% of doctors were self-employed. With the implementation of the Affordable Care Act (ACA) and other healthcare reforms, the future of employment by physicians in hospitals will be overtaking the past trends. Hospital employment of doctors is expected to increase between 10 and 25% over the next five years. 

At the same time that employment of doctors is increasing in hospitals, the numbers of physicians practicing on their own is declining. This data comes from the Physician Compensation and Production Survey from the Medical Group Management Association (2003-2009) report. According to that report, physician-owned practices declined from 70% in 2002 to just under 50% by the year 2008.  In contrast, by 2008, hospital ownership of physician practices exceeded the percentage of physician practice sowned by physicians.  Hospital ownership of physician practices in 2002 was only slightly more than 20%.

Back in the 1990s, hospitals and health systems were employing primary care physicians more so than medical specialists because it was thought that the healthcare model of the future would ensure that primary care physicians would be gatekeepers to health care. Because of reform and the ACA, that trend has changed.  The rate of increase in employment of primary care physicians by hospitals and specialists is about equal now.  That is because the ACA does not promote a primary care gatekeeper model. The lowest cost resource at the earliest point of medical care means that specialists will be directed to the patient instead of through the primary care physician.

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Jennifer, a 25-year-old student, began experiencing severe headaches and visual disturbances. Several days later she went to a hospital emergency room. She told the ER staff  she was not prone to headaches and that she was currently taking oral contraception. Jennifer was diagnosed with a complex migraine headache.

Several hours later however, she developed slurred speech, tingling and paralysis in her arm along with low blood pressure. An attending physician ordered a CT scan of Jennifer’s head, which was interpreted by a radiologist showing no evidence of acute hemorrhage. Jennifer’s condition continued to deteriorate, and she began experiencing seizures. 

Finally, she was transferred to another hospital, where a second CT scan showed bilateral intracranial hemorrhages caused by thrombosis or a stroke. The doctors ordered brain surgery, which required a long and extensive rehabilitation program. She now has right-sided weakness and speech problems and requires lifetime medications.

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Bozena Smith filed a medical negligence complaint against two doctors who were residents in 2006 when she claims she was injured in postsurgical treatment.

After the fact discovery was done by each of the parties, and the trial judge entered a deadline of Sept. 13, 2010 for the plaintiff to disclose any experts and opinions. Bozena disclosed one expert she had hired to render an opinion. In the Rule 213(f)(3) disclosures, the plaintiff stated that the doctor retained as an expert would provide expert opinions that both the residents, Drs. Murphy and McFadden, deviated from the standard of care in treating Smith, which caused her injuries. 

However, on Nov. 8, 2010, when the plaintiff’s expert doctor appeared for his deposition, he testified that he was withdrawing his adverse opinions against the residents and then testified that he held no opinions that implicated the residents in any substandard medical care of the plaintiff. In fact, the plaintiff’s expert testified as follows:

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Joseph Farias, age 29, began treatment with the defendant internist, Yolanda Co, M.D., in February 2002. He came to the doctor with complaints of constipation for three years and rectal bleeding. Dr. Co performed a rectal exam and ordered a colonoscopy, which came back negative. There was no cause determined as to why Farias had rectal bleeding.

In October 2003, Farias returned to Dr. Co with new complaints of rectal bleeding. That visit was a cause of what became a medical malpractice lawsuit. This time Dr. Co did a digital rectal exam and diagnosed internal hemorrhoids. In Farias’s Cook County complaint, it was alleged that the internal hemorrhoids could not be diagnosed through digital examination unless the internal hemorrhoids were visualized outside the anus. The standard of care as contended required Dr. Co to perform an anoscopy to properly visualize the hemorrhoids. It was also asserted that should Dr. Co not have the facility to do the anoscopy,  she should have referred Farias to another physician such as a gastroenterologist. 

Dr. Co defended the case by saying that she did observe prolapsing internal hemorrhoids (protruding out of the rectum), even though her chart  stated only internal hemorrhoids. Dr. Co testified that the standard of care required a treating internist such as herself to grade and chart the severity of an internal hemorrhoid, but she admittedly didn’t do that in October 2003.

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In November 2006, the defendant surgeon, Dr. Hodgett, performed a laparoscopic biopsy on a 72-year-old woman, Mary Backes.  The purpose was to diagnose a suspected lymphoma in her retroperitoneal area, which is behind the abdomen. The biopsy was done at Provena Nursing Medical Center in Aurora, Ill. 

Another defendant, Dr. Sayeed, was the patient’s primary care physician. Following the biopsy, Backes experienced blood pressure drops, low urine output and rapid respiration. 

Her family maintained in the lawsuit that Dr. Hodges and Dr. Sayeed chose not to recognize that Backes’s duodenum had been perforated during the biopsy procedure and failed to realize that her post-op symptoms were indicative of developing sepsis. It was also claimed that the doctors chose not to timely return Backes to surgery for exploration and repair of the perforation to attempt to save her life.

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