Justia Lawyer Rating for Robert D. Kreisman

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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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Most elderly people will tell you they’d rather remain in their homes as they age rather than going to live in a care facility. Now a new study shows that those who live at home are MORE likely to die in a hospital. That’s because the elderly who live in their homes often do not receive the care of a nursing professional, resulting in a trip to the emergency room, and, eventually, death in a hospital bed.

The study was carried out by researchers from the Cicely Saunders Institute at King’s College in London. It was funded by the National Institute for Health Research Health Services & Delivery Research (NIHR HS&DR) Program. But even though it was conducted in the United Kingdom, its findings are applicable in the United States.

The study found that 42 per cent of patients with advanced non-malignant conditions reported a preference for home death, yet only 12 per cent of deaths from respiratory and neurological conditions occur at home, and only 6 per cent for dementia.

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When we undergo surgery, we cannot think, breathe, make decisions and advocate for ourselves. We depend on the experts — doctors and nurses — who oversee the surgery to do what’s best for us.

Trouble is, that does not always happen. Take the case of Sophia Savage. One night she felt a crushing pain in her abdomen, and she started vomiting. She went to a local emergency room and was admitted to a hospital. Her doctor discovered a medical sponge left over from the surgery when she had a hysterectomy. And how long had the sponge been in her body? Four years.

She sued the hospital in which the hysterectomy had taken place, and in 2009 she won $2.5 million in damages. But the award has been appealed. Meanwhile, she suffers from severe bowel problems and has been unable to work. She reports bouts of from anxiety and depression.

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Most of us can remember a time when our doctors scribbled notes on paper inside a folder while talking to us. Now most of us see only our doctor’s back while he or she types information into a computer whenever we visit. The change is due to the introduction of electronic health records.

A new study has found that doctors who use these electronic health records are less likely to get sued than their colleagues who stick with traditional paper records.

Electronic health records were first introduced 30 years ago in the United States to streamline patient care. They allow different doctors treating a single patient to access each other’s notes and see what medications the patient has been prescribed. Some researchers have worried that doctors could make more mistakes using electronic medical records because they are using a new and unfamiliar system and could write notes and prescribe drugs in the wrong patient’s record.

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One of the biggest problems among patients who live in nursing homes is the development of bed sores or pressure ulcers. The medical profession identifies these as decubitus ulcers. These ulcers commonly occur on the feet, backs and buttocks of ill or elderly patients who spend many hours lying in bed.

Family members can help identify problems at nursing homes by noting the position of the patient they are visiting. Is the patient always in the same position? If so, this could result in a bed sore. If the patient is diabetic or has a skin wound of some type, the danger of a bed sore is even greater. Patients should be rotated in bed every two hours at a minimum. Massage can also increase blood flow and help reduce the danger of a bed sore.

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Attorneys know that experts are frequently important in the courtroom to assist them during trial. A doctor, for example, can introduce expertise and experience that an attorney cannot possibly duplicate. The doctor’s testimony can influence the jury in exactly the way the attorney desires.

It is important, however, to make sure that the expert testimony is credible and supportive. This was proved in a recent case that came before the Maryland Court of Appeals in Dixon v. Ford Motor Co., et al., 2012 WL 2483315. In this case, the plaintiff brought a suit against certain automobile and brake manufacturers alleging that Joan Dixon’s household exposure to asbestos caused her to develop and die from pleural mesothelioma. The complaint alleged that Dixon was exposed to asbestos dust on her husband’s work clothes. He worked with asbestos-containing auto parts.

At trial, the plaintiff’s attorneys introduced Dr. Laura Welch. The attorneys identified her as an expert in asbestos epidemiology.

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