Justia Lawyer Rating for Robert D. Kreisman

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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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Sometimes we have to wonder: Would we get the best care possible if we were to be transported to a hospital emergency room? Our local hospital has a good reputation, but it is managed by humans, correct? And humans are known to make mistakes.

The quality of care was debated in the case of a young woman who died in a Brooklyn hospital five years ago. She was an aspiring novelist named Sabrina Seelig.Only 22 at the time of her death, Seelig might have received inadequate care. At least, that is what her family believes.

Convinced she was the victim of errors and misjudgment in the emergency room at her local hospital, they filed a medical malpractice suit. The case went to trial this spring, and the trial lasted four weeks. A jury decided that neither the hospital nor an emergency room doctor or nurse had been negligent.

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A new study by the Institute of Medicine has found that over treatment is costing the nation’s health care system $210 billion each year. More important, too many treatments — x-rays, CAT scans, blood checks and procedures — are harming patients.

“What people are not realizing is that sometimes the test poses harm,” said Shannon Brownlee, acting director of the health policy program at the New America Foundation and the author of “Overtreated: Why Too Much Medicine Is Making Us Sicker and Poorer.”

In her book, Brownlee writes that the nation’s medical system delivers an enormous amount of care that does nothing to improve people’s health. Between 20 and 30 cents on every health care dollar we spend goes toward useless treatment and hospitalization, she says.

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Radiation has been a great boon to medicine, helping doctors reveal hidden problems, including broken bones, lung lesions, heart defects and tumors. It can be used to treat and sometimes cure certain cancers.

Now researchers are pointing to its potentially serious side effects: the ability to damage DNA and, 10 to 20 years later, to cause cancer. CT scans alone, which deliver 100 to 500 times the radiation associated with an ordinary X-ray and now provide three-fourths of Americans’ radiation exposure, are believed to account for 1.5 percent of all cancers that occur in the United States.

Numerous experts, including some radiologists, are now calling for more careful consideration before ordering tests that involve radiation.

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A new study shows that white children are more likely than black or Hispanic children to receive CT scans following minor head injuries, exposing them to the dangers of excess radiation.

The study was conducted by Dr. Prashant Mahajan of the Children’s Medical Center of Michigan and other researchers.

The Archives of Pediatrics & Adolescent Medicine reported the results of the study in an article titled, “Cranial computed tomography use among children with minor blunt head trauma: Association with race/ethnicity.”

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A hospital’s neonatal intensive care unit is the triumph of modern medicine’s investment in technology, pharmacy and know-how, says Dr. Rahul K. Parikh, a pediatrician in Walnut Creek, Calif. Dr. Parikh wrote an essay published in a recent edition of the New York Times.

Dr. Parikh points out that babies born somewhere between 23 and 26 weeks of gestation, or what’s called the limit of viability, are placed in the NICU. In the 1960s, when the first NICUs opened, premature infants had a 95 percent chance of dying. Today, they have a 95 percent chance of survival.

Now we face a difficult choice, Dr. Parikh says, one not unlike that facing physicians who take care of adults near the end of their life: whom to fight for and whom to let go. The decision says volumes about how we have come to regard the tiniest, frailest of patients.

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