Justia Lawyer Rating for Robert D. Kreisman

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As patients, we put our faith in doctors to identify our medical problems and properly treat our ailments. However, in order to achieve a successful doctor-patient relationship, oftentimes doctors need compliance from their patients. Whether by accurately describing our symptoms, or by following up on all of our doctors’ recommendations, as patients we need to be active participants in our own medical treatment. And in medical malpractice cases, juries are reluctant to hold doctors liable for any negligence if the doctors can prove that the patient/plaintiff did not hold up their end of the bargain.

The Illinois wrongful death lawsuit of Estate of Rogers Givens, deceased v. Clarendon Hills Family Practice LLC, et al., 09 L 113, is a perfect example of the importance of actively participating in your own medical care. The decedent, Rogers Givens, began seeing Dr. Hutto, a family practice doctor, for complaints of hypertension, asthma, and eczema. Dr. Hutto prescribed Givens medication to control his hypertension and asthma; however, subjective notes in the medical records indicated that Givens did not always take his medications. His lack of compliance with his medications presumably is why his high blood pressure was never properly controlled.

Almost a year after being placed on the blood pressure and asthma medications, Givens presented to Dr. Hutto with the new complaints of shortness of breath and tightness in his chest when moving. Dr. Hutto attributed these new symptoms to bronchitis and an acute asthma attack and began prescribing treatment for these diagnoses. Following the course of treatment, Givens reported feeling better and testing supported the diagnosis of resolving pneumonia.

However, as a precaution, Dr. Hutto had also recommended on two separate occasions that Givens obtain an echocardiogram. Givens ignored these recommendations and never scheduled these tests. By choosing not to follow his doctor’s instructions, Givens not only put his medical health at risk, but compromised Dr. Hutto’s ability to properly diagnose and treat his medical conditions.

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It is common knowledge that the earlier cancer is diagnosed, the greater the chance of survival. However, we continually see medical malpractice lawsuits where a treating physician failed to recognize the signs and symptoms of cancer in a timely manner. The Cook County medical malpractice lawsuit of Carmela Sahagun v. Allan Aven, M.D., et al., Case No. 08 L 5346, is yet another example of a failing to diagnose cancer in its early stages.

Forty-six year-old Carmela Sahagun presented to Dr. Aven, her primary care physician, complaining of a lump in her left breast as well as a hardness near her breast bone. In order to pinpoint the problem, Dr. Aven referred Sahagun for a CT scan of her chest. The diagnostic test returned signs of a 1.9 cm mass in her left lung; the radiologist further indicated in his report that he suspected the mass might be malignant.

Upon receiving the CT scan results, Dr. Aven appropriated consulted with a Dr. Loren, a surgeon, who recommended a breast biopsy to rule out breast cancer. In addition, Dr. Loren indicated that if the breast biopsy was negative for malignancy, then he would recommend a lung biopsy to rule out lung cancer. Dr. Loren then performed the breast biopsy on Ms. Sahagun, the results of which were negative. However, rather than preforming a lung biopsy, Dr. Loren dismissed Ms. Sahagun from his care and never saw her again.

Ms. Sahagun returned to Dr. Aven for further care and treatment. Over the course of the following year, Ms. Sahagun presented to Dr. Aven’s office on several occasions, complaining of a cough and chest pain at each visit. However, despite these complaints and despite Dr. Loren’s recommendation, almost a whole year passed before Dr. Aven finally ordered a lung biopsy. By this time, the lung biopsy revealed that Ms. Sahagun had Stage IV lung cancer.

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The right to a trial by jury is a central tenant to American law. As a result, courts tend to be reluctant to overturn a jury’s verdict. However, there are some exceptions to this rule. For example, if a jury’s verdict is found to be in conflict with current laws, a court might overrule the verdict. Also, if a jury award contradicts the jury’s own statements and opinions, then a judge or court might be inclined to vacate the jury verdict.

The Illinois wrongful death case of Philemont Garcia, etc. v. Seneca Nursing Home, etc., 2011 Ill.App. (1st) 103085, demonstrates what happens when an jury contradicts itself. The Cook County jury awarded the decedent’s estate $1 million as compensation for Roberto Garcia’s fall to his death after he climbed out of a fifth story window while staying at Seneca Nursing Home. In theory, the jury award meant that the jury had found the defendant nursing home negligent for contributing to the decedent’s death. Yet in a response to a special interrogatory, the same jury had stated that the nursing home could not have foreseen the circumstances leading to the resident’s death.

The case facts of the Illinois wrongful death lawsuit centered around Roberto Garcia, a resident at Seneca Nursing Home. Garcia suffered from paranoid schizophrenia, along with blindness, abnormal muscle tone, and chronic restlessness. He suffered from delusional behavior and occasional hallucinations. In addition, Garcia had difficulty walking on his own and was essentially wheelchair dependent. Yet despite his physical limitations, Garcia was found wandering away and hiding at times and had made more than one attempt to try and climb out his bedroom window.

According to trial evidence, there was no record of Garcia ever being identified as presenting a risk for self-harm, suicide, or escape. As a result, no clear plan was ever developed to prevent him from climbing out of his window. The lack of preventive measures was partly explained through testimony by Garcia’s psychologist and psychiatrist, both of whom testified that they did not think that the fifth floor windows in Garcia’s room even opened. They further stated that if they had known that they did, they would have been more proactive in formulating a preventive care plan to limit Garcia from escaping through the window.

At the end of the trial, the defense submitted a special interrogatory to the jurors. A special interrogatory is a question a party submits to the jurors, typically aimed at deciding a major legal component of the case. In Garcia, the defense submitted a special interrogatory that asked whether the jurors believed it was “reasonably foreseeable” that Garcia would kill himself or act self-destructively. The Cook County jury answered in the negative, but then went on to enter a $1 million jury verdict in favor of the nursing home’s negligence.

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To many women, pregnancy and childbirth is a magical time that ends with the arrival of a new family member. However, for many women pregnancy and labor are anything but easy. Some women suffer difficult pregnancies and are placed on high risk status, or put on bed rest. Other women undergo difficult and complicated labor and deliveries, sometimes resulting in birth injuries to the baby. However, a recent article in The New York Times highlighted another potential complication of the birthing process – stillbirths.

Despite America’s status as a wealthy nation that offers high quality prenatal care, stillbirths continue to be a problem for many pregnant women. A group of papers put together by The Lancet, a British medical journal, stated that about 1 in 300 babies continue to be stillborn in high-income countries. And while about 98 percent of the global stillbirths occur in low- or middle-income countries, the report calls into question what doctors and families can be doing to decrease the incidences of stillbirths in the U.S.
Some of the risk factors for stilbirths include maternal obesity, maternal age over 35, smoking during pregnancy, and multiple pregnancies, e.g., twins or triplets. Reports suggest that obesity is the cause of 18 percent of stillbirths in higher-income nations, a statistic that is not surprising considering other medical reports citing the increase in adult obesity in the U.S. However, while the negative effect of obesity on one’s heart and general health are well-known, perhaps the effect of obesity on one’s fetus is not as well-known. Educating American women about the link between maternal obesity and stillbirth could at least make more women aware about this problem and perhaps work towards lowering the cases of maternal obesity, just as educating women about the risks of smoking during pregnancy has lowered the rate of smoking-related stillbirths.

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The field of medicine is generally associated with healing – we go to our doctors when we don’t feel well and expect them to treat us. Yet a large part of medicine is also prevention. Women undergo yearly mammograms to try and catch breast cancer early on, while people with high blood pressure take medication to try and prevent heart attacks or strokes.

Doctors and nurses are responsible for identifying the risk of future medical problems and developing a treatment plan to avoid that risk. For example, some patients with decreased mobility and strength might be at risk for falling during a hospital admission or rehab stay. Therefore, nurses need to evaluate patients to determine whether or not their conditions puts them at an increased risk for falling. Once the degree of risk is determined, the medical staff can work together to create a prevention plan to insure the patient’s safety. It is when these risks are not properly evaluated and prevented that nursing malpractice and medical negligence can occur.

The Illinois wrongful death lawsuit of Sorce v. Shorehaven Health and Rehab. Ctr., 09 CV 3083 (Waukesha County), illustrates what can happen if there are not adequate fall prevention measures in place. The 76 year-old Sorce had been admitted to the Shorehaven Health and Rehabilitation Center as part of his recovery from brain surgery. During his admission, Sorce was using a walker to get around and was generally given assistance with getting up and around.

However, one day towards the end of his stay, Sorce was sitting in his recliner chair when he realized he needed to use the restroom. As was his practice, Sorce pressed his call button to request nursing assistance to the bathroom. However, as more time passed and his call continued to go unanswered, Sorce elected to try and reach his walker and the bathroom by himself. Sorce raised himself out of his recliner, took a few steps across the room, but then fell on the floor and hit his head.

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Privilege is a legal term that infers an exception from a particular rule or requirement. For example, attorney-client privilege refers to the fact that attorneys are not required to disclose information gained from communication with their clients. However, the concept of privilege is not limited to the law alone. Doctor-patient privilege protects information gained during the course of medical treatment from being used in court without the patient’s permission.

The purpose of these forms of privilege is to encourage people to be candid with their lawyers and doctors in order to help those professionals perform their jobs. The idea is that if a person fears legal ramifications as a result of their communications with their attorneys and physicians, that he would be less candid and potentially withhold important information. In this way privilege is meant to protect clients and patients.

However, there are times when these forms of privileged can be waived, allowing other parties access to this formerly confidential information. For example, an Illinois judge recently reviewed the circumstances under which doctor-patient privilege is waived; Flowers v. Owens, No. 09 C 2716. In examining the case facts, the judge needed to ensure that the plaintiff-patient’s rights were protected, while also considering whether maintaining the privilege put the defense at an unfair advantage.

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In recent years there has been a lot of debate over the effectiveness of the Food and Drug Administrations’ medical device review system, i.e., the 501(k) process. Its critics say that the review system is not comprehensive enough and allows for the approval of unsafe medical devices. However, its advocates argue that a quick and easy approval process is necessary to ensure American patients can take advantage of the most advanced medical products available; a more involved review system would only mean more red tape for medical device companies.

In an attempt to find ways to improve its much-debated medical device review system, the FDA sought the advice of a panel of doctors and researchers from the Institute of Medicine (IOM). Over the years, the IOM has made numerous recommendations for improving government programs. However, in the case of the 501(k) process, the IOM’s recommendations were perhaps more severe than the FDA had anticipated. Rather than suggesting various ways the program could be changed, the IOM instead recommended that it be abandoned all together.

In support of its recommendation, the IOM panel stated that the 501(k) approval process was “flawed” and “does not really assess safety and effectiveness.” In order to obtain approval under the 501(k) process>, a medical device manufacturer must show that its medical device is similar to a device that is already on the market. The approval process was created in the 1970s to allow the FDA to quickly grant approval to those products shown to be similar to those already on the market. However, while it was meant as a temporary method to help grandfather in devices that were already in widespread use, the 501(k) process has become the standard for medical device approval.

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A Loyola University Medical Center patient suffered brain damage after undergoing two separate surgeries during the same hospital admission. The second surgery was required to fix surgical errors made during her initial surgery. The woman’s surviving family sued the Chicago hospital for its surgical negligence and received a $2.5 million settlement.

The forty-five year-old decedent presented to Loyola University Medical Center to undergo a laparoscopic procedure to remove dense adhesions in her pelvic region. Everything appeared to go well during the surgery and the decedent was taken to the post-op care area and then transferred to the floor for additional post-operative care and monitoring.

However, she continued to complain of severe abdominal pain, above and beyond what one would expect following this type of surgery. Her pain continued despite the high levels of post-operative pain medications she was given. In addition, the decedent developed shortness of breath and began to have an increased heart rate. Together, these various symptoms indicated that perhaps something was wrong.

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There’s an old saying that there are two sides to every story – in civil litigation, the plaintiff’s attorney present one side of the story to the jury while the defendant’s attorney presents the other. In order to ensure that the facts are fair and that neither party presents information to the jury that would unfairly prejudice it towards the other side, the trial judge rules on motions in limine prior to the trial.

Each side prepares its own motions in limine, which set out various evidence and testimony that it feels should be excluded from the trial. Each motion includes not only a recitation of which evidence the party seeks to exclude, but also an argument as to why that specific evidence should be excluded from the civil trial. The judge then makes the final ruling on each motion in limine. If the judge rules to exclude the evidence, then neither side may bring it up during trial. However, if the judge denies a motion in limine, then that evidence is free game.

The Illinois attorneys involved in Guski v. Raja, No. 1-10-0108 (May 10, 2011), went through this motion in limine process prior to the Illinois medical malpractice trial. The judge granted some motions, but denied others, including one of plaintiff’s motions regarding the decedent’s marijuana use. After the jury found in favor of the defendant doctor, the plaintiff sought a retrial based on the the trial court’s erroneous motion in limine rulings and the defense’s unfair closing argument.

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An elderly man required an above the knee amputation with a flesh-eating bacteria after his heel ulcer became infected . He brought an Illinois nursing negligence lawsuit against the home health service that was supposed to be monitoring his pressure ulcer. The Cook County jury awarded the plaintiff $793,644 for his suffering and disability as a result of the healthcare service’s negligence in Rudolph v. Northwestern Memorial Home Healthcare.

The medical negligence can be traced to the plaintiff’s right hip replacement in December 2000. During his recovery at the Rehabilitation Institute of Chicago, the 79 year-old William Rudolph developed a blister on his right heel that quickly progressed to a Stage III pressure ulcer. Pressure ulcers typically develop in bedridden or wheelchair-bound patients whose limbs stay in one position for extended periods, which limits the blood supply to that area. They are typically identified by stages of severity, with Stage I being the least severe and Stage IV being the most severe.

After Rudolph’s release from his inpatient rehab stay, Northwestern Memorial Home Healthcare was assigned to treat the plaintiff’s pressure ulcer. The healthcare service would make in-home nursing visits to Rudolph in order to maintain the integrity of the area around the wound, clean and treat the pressure ulcer, and prevent the ulcer from progressing to a Stage IV ulcer. In order to do so, the nursing service visited Rudolph three times per week during December 2000 and January 2001, during which time the heel wound remained a Stage III ulcer.

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