Justia Lawyer Rating for Robert D. Kreisman

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The Missouri Supreme Court has found that the statute that limits noneconomic damages in medical malpractice cases to $350,000 unlawfully infringes on a jury’s constitutional right to determine the amount of damage that a person has sustained from medical negligence.

In this Missouri case, Deborah Watts filed suit for medical negligence against the hospital and others alleging that her son suffered catastrophic brain injuries because of hospital and medical providers’ negligence. Ms. Watts went to Cox Medical Center at 39 weeks of pregnancy after she felt cramping and decreased fetal movement. No diagnostic tests were completed, and she was sent home. When she returned two days later, she was this time placed on a fetal heart tracing monitor. More than an hour later, her son Naython was delivered by Caeserean section. Unfortunately, Naython suffered catastrophic brain injuries.

The jury awarded $1.45 million in noneconomic damages and $3.371 million in future medical damages. However, because of the Missouri statute capping noneconomic damages, the trial judge reduced the noneconomic award to $350,000. Ms. Watts appealed, arguing that the statute violates the right to trial by jury and other violations of the state constitution.

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On June 12, 2006, 35-year-old Tracy Ariss underwent an echo-cardiogram stress test at LaGrange Memorial Hospital after a workup for carpal tunnel pain in her arms was found to be inconclusive. Less than 3 minutes into the stress test, Tracy suffered a myocardial infarction — a heart attack. She was immediately taken off the treadmill and treated with nitroglycerin, aspirin and other medicine.

The defendant Rod Serry, M.D., an interventional cardiologist, was called from the cath lab. Even though Tracy did not believe that she was pregnant, Dr. Serry ordered a pregnancy test. Tracy was about 2 ½ weeks pregnant. Her pregnancy complicated her medical treatment in that Dr. Serry did not know any other cardiologists who had performed a cardiac intervention on a pregnant woman after suffering a heart attack.
Dr. Serry called an obstetrician seeking help as to the proper course of treatment. The obstetrician told Dr. Serry that he should make medical choices for the mother as the primary concern. At the trial, Dr. Serry testified that the OB also stressed to him not to prescribe anticoagulants or other medicine long-term during pregnancy. However, this was not noted in the medical chart.

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It has become much more common to find that the known name for a nursing home is not related to its true nursing home ownership. Often, owners of nursing homes are carefully hiding the identity in a maze of ownership.

A plaintiff’s lawyers who handle nursing home cases are cautious about researching ownership. Today more than ever, nursing home operators find that elderly residents are filling these facilities at higher occupancy levels.

There is more and more demand for elder care in independent living or assisted living in nursing homes. Because of the demand, ownership of nursing homes is on the private investment company favored list of acquisitions. Private equity enterprises and larger publicly traded companies are operating more nursing homes today than ever before.

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A new Finnish study suggests that high blood levels of lycopene may significantly reduce the risk of stroke. Vegetables, especially tomatoes, are a significant source of lycopene.

The analysis was published in the journal Neurology, prospectively followed 1,031 men ages 46 to 55, measuring their blood levels of five antioxidants and recording incidents of stroke.

According to the journal, serum concentrations of carotenoids retinol and α-tocopherol were measured by high-performance liquid chromatography. The association between the serum concentrations of lycopene α-carotene, β-carotene, α-tocopherol, and retinol and the risk of strokes was studied by using Cox proportional hazards models.

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Most of us are urged by our doctors to take a multiple vitamin everyday or some other supplement, such as a B vitamin or a calcium pill. There hasn’t been a lot of evidence, however, that a multiple vitamin has a beneficial effect on our health.

That may be changing for multivitamins. A new report indicates that taking a standard multivitamin pill every day for more than a decade reduces the odds of developing cancer. The finding comes from the Physicians’ Health Study II, a Harvard-based trial that was launched in 1997. In the study, nearly 15,000 male physicians aged 50 years and older took a daily pill containing 31 vitamins and minerals or a placebo.

Over the course of the trial, 1,379 men in the placebo group developed some form of cancer (18.3 cancers per 1,000 men per year), compared to 1,290 men in the multivitamin group (17.0 cancers per 1,000 men per year). That represents an 8 percent reduction in cancer. Rates of prostate cancer were the same in both the multivitamin and placebo groups, however. Deaths were also similar in both groups. The findings were presented at the annual American Association for Cancer Research Frontiers in Cancer Prevention Research meeting in Anaheim, Calif., and published online by the Journal of the American Medical Association.

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Stroke is the fourth leading cause of death among Americans. Hospitalization and medical care immediately following a stroke are very costly, as is the rehabilitative care. So the question is how best to prevent a stoke or to help patients recover following a stroke.

The National Institutes of Health is conducting ongoing studies to determine ways of preventing strokes. Some of the most recent studies include:

— The use of dilation and stenting techniques similar to those used to unclog and open heart arteries has been proposed as a less invasive alternative to carotid surgery to remove the buildup of plaque within the carotid artery, which supplies blood to the head and neck. According to the NIH, carotid endarterectomy is considered the best treatment for preventing stroke and other vascular events. Stenting is a newer, less invasive procedure in which an expandable metal stent is inserted into the carotid artery to keep it open after it has been widened with balloon dilation. But the new NIH study found that the safety and effectiveness of the two procedures was largely the same. Following this study, doctors will have more options to tailor treatments for people considered at risk for stroke.

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Thirty-two-year-old Regina Ruff came to the emergency room at Advocate South Suburban Hospital in the morning on July 14, 2007 complaining of shortness of breath. Ruff had a history of congestive heart failure, hypertension, diabetes and non-compliance with the taking of some of her medicine.
At about 11:45 a.m., the emergency department doctor, defendant Sharon Smith, M.D., examined Ruff and ordered tests. That included lab, chest x-ray and EKG.

The chest x-ray that was done at 12:15 p.m. was interpreted by a radiologist at 12:30 p.m., suggesting bilateral pneumonia. Dr. Smith’s review of the chest x-ray films was indicative of both pneumonia and congestive heart failure. The lab results showed an elevated white blood count consistent with infection like pneumonia and elevated BNP (B-type Natriuretic Peptide), which is a substance secreted from ventricles or lower chambers of the heart that show pressure increases. These occur when a person has heart failure.

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The American Medical Association reports that a growing number of physicians are choosing to be “hospitalists.” These doctors work in the hospital full time, while their colleagues provide care in local offices.

The advantage for the patient is that care is not disrupted when the doctor has to rush off to the hospital to attend to another patient there. Meanwhile, doctors don’t have to drive to hospitals, search through parking lots for a place to put their cars, then rush into a hospital to find a patient to provide care.

The hospitalist program seems to be an advantage to everyone involved. But hospitalists say physicians in each community need to be involved closely in determining how hospitalist programs are structured. They say physicians should decide how information will be communicated between settings, who will do what, how reimbursement will be handled and the protocols for certain procedures.

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A new study shows that shoulder dislocation in older patients is more likely to be overlooked or misdiagnosed than among younger patients. The study warned that older patients whose shoulder injuries are not treated can face years of persistent pain and disability.

Published in the October 2012 issue of the Journal of the American Academy of Orthopaedic Surgeons, the study examines the differences in dislocation injuries between older and younger patients. It also suggests an approach to evaluate older patients that could help improve diagnosis and management of related injuries.

The study’s lead author is Dr. Anand Murthi. He says understanding the very different ways shoulder dislocation can affect patients over 40 years of age is the first step in making an accurate diagnosis of dislocation-related injuries. Older patients are more likely to experience injury to the rotator cuff, which is the group of tendons, ligaments and other structures that help give the shoulder its range of motion, Dr. Murthi explained. He said this happens because the rotator cuff tissue becomes weaker and more brittle with aging and tears more easily.

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The Obama administration wants consumers to be able to report medical mistakes and unsafe practices by doctors, hospitals, pharmacists and others who provide treatment.

Some hospital spokesmen say they are receptive to the idea, although they have concerns about malpractice liability,
Federal officials say medical mistakes often go unreported, and that patients have potentially relevant information. The information often entails drug mix-ups, surgery on the wrong body part, surgical instruments left in patients’ bodies following surgery, radiation overdoses and other problems.

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