Indiana Injury Law Blog

The National Highway Traffic Safety Administration has long been criticized by product liability lawyers in Indiana and around the country for its failure to come down stronger on automakers who refuse to admit to auto defects. This criticism has become stronger as hearings into Toyota’s failures continue in Washington DC this week.

The hearing saw family members of victims who died in crashes involving Toyota vehicles, as well as Toyota chief Akio Toyoda testifying before a House committee set up to look into the recent massive recalls announced by the company. What the crisis has also done is increase scrutiny of the NHTSA. One victim’s family member criticized the agency openly for its failure to keep Toyota in check. As we know now, the agency had plenty of opportunity to investigate the complaints of unintended acceleration involving Toyota vehicles when they first began to surface several years ago. Complaints had been trickling in since 2002. An investigation by the NHTSA did not reveal defects that were substantial enough to announce a recall, and the NHTSA let the matter lie.

The agency was shaken out of its complacency in August of 2009 after a crash in California involving a Toyota Lexus, killed four people. The crash was traced to defective or incompatible floor mats in the Lexus, which Toyota said, caused the accelerator pedal to jam. The company reacted quickly with a massive recall, and a public apology by Akio Toyoda.

If Toyoda believed the apology and the recall would end matters right there, he was wrong. Since the San Diego crash brought the unintended acceleration problem sharply into the international limelight, other Toyota owners who have experienced the problem themselves, have been coming out with their stories.

Meanwhile, the automaker has said that repairs its engineers had developed to deal with the acceleration problem, may not be the permanent solution that Toyota owners and Indiana product liability lawyers were hoping for.

As medical malpractice lawyers representing victims of negligence in Indiana, minimizing hospital infection rates has been high on our wish list. It therefore disturbs us that there is a growing trend in the healthcare industry to reuse single-use medical products like catheters, scissors and compression sleeves.

The healthcare industry is facing mounting pressure from the green brigade to cut down on the amount of waste it generates every year. Part of these efforts includes cutting down on the number of medical products that are used in hospitals every year. This has led to more and more hospitals choosing to reuse compression sleeves, surgical scissors and ultrasound catheters. These are meant to be single use products that must be discarded after the first use. However, as many as a quarter of all hospitals in the United States currently engage in reusing such products.

These measures have widespread support from environmental groups, because they reduce consumption and help minimize waste. Hospitals also encourage these moves because they translate into more cost savings. As usual, it falls back on medical malpractice attorneys in Indiana and around the country to object to practices that place patients at a high risk of contracting infections.

The pro-reuse lobby insists that if proper practices of sterilization and reuse are followed, these products can be used again with zero risk of infection. Unfortunately, as Indiana medical malpractice lawyers, we often see that inculcating safety and hygiene practices among hospital staff is a long and intensive process. Hand washing rates among doctors continue to be low in spite of sustained efforts by watchdog groups and health experts. In a situation like this, training staff to use the right sterilization and reuse processes is going to take a really long time.

Cutting costs must not come at the expense of patient safety. There are other ways to cut costs and minimize waste, and the healthcare industry must be investing in efforts to develop and refine these.

Every year, more than 98,000 people are killed because of medical errors. Those numbers have not decreased significantly, although there has been a dip from the use of checklists before surgeries. Patient safety practices can be enhanced if we invest in a new generation of doctors who are as committed to patient safety.

The New York Times published a report last month which discussed how more and more medical schools are introducing patient safety subjects in their medical curriculum. In 2008, a study by the Liaison Committee on Medical Education reported that appropriately 2/3rd of medical schools reported including patient safety as part of the curriculum for their students. However, another study conducted by the Institute for Healthcare Improvement found that 4 out of 5 students felt that their exposure to patient safety had been “fair” at best.

There is much that medical schools can do to inculcate better patient safety practices in order to prevent medical errors and minimize error rates. However, for many medical schools, patient safety has been low on the priority. One of the reasons for this is that a medical course includes large amounts of material that have to be covered before the program ends. Concepts of patient safety seem to lose out to seemingly more important medical topics.

There are indications that this attitude is changing. One medical school now invites parents of victims of medical errors to speak to students about their experiences. Another school allows students to participate in debriefing sessions with doctors whose job is to respond quickly to emergencies. Also very encouraging is the fact that more and more medical school students, who see the national discussion over medical errors, are willing to speak up and broach this hitherto forbidden subject.

Developing a stronger awareness of the hundreds of things can go wrong before, during and after a procedure, and establishing means to prevent these, must begin right in medical school. We hope more schools realize this, and make time for patient safety discussions in their programs.

The Indiana medical malpractice lawyers at Theodoros & Rooth represent persons injured because of surgical errors, emergency room errors, failure to diagnose , misdiagnoses, and other forms of medical negligence.

The New York Times is reporting on fearsome and deadly new bacterial infections that are highly resistant to drugs and antibiotics. While most talk of hospital infections centers around the dreaded MRSA methicillin-resistant Staphylococcus aureus, new drug-resistant varieties are quickly emerging, posing a serious threat to patients and a challenge to doctors.

Every year, MRSA infections leave thousands of patients seriously ill, and kill several others. As dangerous as these infections are, these organisms do respond to antibiotic therapy. What's worrying doctors across the country is the development of new strains of bacteria that are even more deadly because they're resistant to the antibiotics currently being used. According to the figures, the numbers of people being killed by these drug-resistant bacterial infections possibly runs into the tens of thousands of patients annually.

One such organism is Acinetobacter baumannii. Acinetobacter baumannii and other such drug-resistant bacteria belong to a group called Gram Negative bacteria. The name comes from their negative reaction to the Gram stain test. Yet another Gram negative organism is Klebsiella pneumoniae. This organism seems to thrive especially well in the crowded hospitals of New York.

These so-called super germs are now spreading across the world. Studies into injury and fatality rates from Gram-negative bacterial infections are not sophisticated enough for us to know how many people are killed from these infections every year. To be honest, MRSA kills more people than any other kind of orgasm. MRSA also continues to be more dangerous because it can spread even outside the hospital. In contrast, gram-negative bacteria attack people who have a weakened immune system, and only thrive in a hospital setting. These germs breed on surfaces in a hospital, and are introduced into the body through open cuts and contaminated medical products, like catheters.

Because treatment is so difficult and available antibiotics have a high risk of leaving patients with kidney damage, the best cure for these infections is prevention. This makes it all the more necessary that hospitals take up their infection control programs on a war footing.

The Indiana medical malpractice lawyers at Theodoros & Rooth represent persons injured because of surgical errors, emergency room errors, failure to diagnose , misdiagnoses, and other forms of medical negligence.

A new study estimates that approximately 48,000 people are killed every year from hospital infections. Most of these deaths occur from two of the most common and deadliest hospital infections - pneumonia and sepsis.

The researchers in the study looked at discharge records between 1998 and 2006 across 40 states. They found that pneumonia and sepsis accounted for most of the fatalities, and that these infections resulted in treatment costs of $8.1 billion. This means that treatment costs for hospital-acquired infections amounts to approximately 1% of the total expenditure on health care in the country.

That isn't good news for patients waiting to get admitted into a hospital, but it also doesn't mean that you have absolutely no control over your health during and after your hospital visit. Experts advise that you arm yourself with information and knowledge in order to reduce your risks of contracting dangerous bloodstream infections like sepsis, or deadly respiratory infections like pneumonia during your hospital stay.

• Ask your doctors what kind of infection control and prevention strategies they use.
• Ask your doctors if it would help if you were screened for MRSA.
• Ask if you will be given antibiotic therapy before your surgical procedure to prevent infections.
• Insist that doctors and nurses wash their hands where you can see them before they proceed to examine you.
• Ask your doctors if they follow a surgical checklist that has been proved to dramatically reduce the risk of contracting a bloodstream infection. The checklist was developed by Dr. Peter Pronovost of John Hopkins, and has been found to cut infection rates by more than 60%.

Asking questions like these informs your doctors, nurses and other healthcare professionals that you are aware of patient safety protocols, and reminds them of their duties and responsibilities. Informed patients can bolster infection prevention efforts.

The Indiana medical malpractice lawyers at Theodoros & Rooth represent persons injured because of surgical errors, emergency room errors, failure to diagnose , misdiagnoses, and other forms of medical negligence.

Traumatic brain injury, or TBI often occurs in severe automobile and truck accidents, workplace disasters and other accidents. The degree of impact on a victim's life is defined by the severity of the injury. A minor TBI for instance, would include a concussion, while severe injuries can result in a person being dependent on care even for his basic needs.

As Indiana personal injury lawyers representing victims of accidents across the state, we frequently come across persons who have suffered a severe brain injury. Unfortunately, there has been little advancement made in treatment for TBI, and no new treatment program has been approved for at least the past three decades. That could change soon, as researchers begin clinical trials into the benefits of progesterone therapy on TBI.

Studies conducted 25 years ago seem to indicate that progesterone, a hormone that is typically used to treat menstruation problems, can actually have a protective effect on damaged brain tissue. It may prevent inflammation, and could check further damage. The new trials will include more than 1,000 patients who will be injected with the progesterone hormone a few hours after the injury. For the treatment to work, the hormone must be injected within a period of four hours after the person suffers a TBI. The treatment must then be continued over the next four days. The study promises to result in possibly new treatments for TBI that can limit the impact that an injury can have, and prevent death.

Medical experts, doctors and brain injury lawyers in Indiana will be watching the trials closely. We hope that the trials lead to a new treatment program that uses progesterone to limit the extent of TBI.

As medical malpractice lawyers in Indiana, we regularly track patient safety issues that affect our clients and readers. Consumer Reports magazine has published a comprehensive report on the deadly bloodstream infections that kill close to 30 percent of the 99,000 people who fall victim every year to hospital infections. The report outlines how hospitals around the country are seeing substantial success in minimizing their infection rates just by following simple safety steps included in a checklist.

Bloodstream infections, also known as central line infections, are contracted when bacteria contaminate the central lines that are used to deliver food and drugs to patients in intensive care. The central lines are far more convenient, and allow for faster delivery than IV lines, but this also means that any infection contracted through the central line spreads rapidly. Body stream infections can result in a conduction called sepsis, whose symptoms are a lot like flu (fevers, chills etc.) but much, much worse. These infections are very often fatal.

However, as the Consumers Report piece shows us, these rates can be brought under control. All it takes is for doctors, nurses and other professionals in charge of handling the central line to take some basic steps to prevent infections. A checklist developed by Peter Pronovost of John Hopkins, if followed stringently, can help prevent these infections.

The checklist isn’t exactly rocket science. It recommends
1. Washing hands well before handling the central line
2. Disinfecting the skin before touching it
3. Using all precautions while handling the patient. This includes wearing a mask, cap and sterile gloves and covering the patient’s body with a sterile sheet.
4. Removing any non-essential catheters
5. If possible, trying to avoid placing catheters in the groin region where they may be at a greater risk of infections

Preventing central line infections is not impossible. If fact, by following the checklist, many hospitals around the country have been able to bring down their infection rates by more than 66 percent.

If a loved one is in intensive care, you can increase his/her chances of avoiding a bloodstream infection by asking the doctors and nurses to follow the steps in the checklist.

The Indiana medical malpractice lawyers at Theodoros and Rooth represent victims of surgical errors, misdiagnoses, emergency room errors, and other forms of negligence by doctors, nurses and other healthcare personnel.

Assessing the risks of surgery is much more precise than it used to be. For years, doctors have found it a challenge to calculate and discuss the risks of various surgical procedures with their patients. Now, there are ways to calculate the risks of a surgery more accurately, and doctors are using these more and more often to assess potential complications and counsel patients about these risks.

Risk calculators are not a new means of risk assessment. For years now, these have been used for heart surgeries, but now these are being used in other medical specialties too. For instance, the American College of Surgeons has developed risk calculators for colon and pancreas surgery too. The ACS is also in the process of developing several other such calculators for hernia repair and gastric bypass. With a calculator, a doctor can enter a patient’s specific variables like his medical condition and age, and receive a report about the kind of complications likely.

Hearing about the risk of complications or even death from your surgeon is not a pleasant thought, but patients find that the information they receive from these risk calculators can help them make an informed choice about the surgery. The data can also help them prepare themselves for the procedure, and may make them more confident about the decision to have the procedure. Earlier, patients would be wheeled into surgeries after signing a piece of paper that many of them would likely have not even bothered to read. Having all the risks explained to you beforehand can give you the tools to make the right decision.

The Indiana medical malpractice lawyers at Theodoros and Rooth represent victims of surgical errors, misdiagnoses, emergency room errors, and other forms of negligence by doctors, nurses and other healthcare personnel.

Dyer couple awarded $3.5 million in damages

Jury finds doctor responsible for 2-year-old boy's death

Posted: Friday, July 2, 2004

CROWN POINT -- A Lake Superior Court jury awarded Pat and Cyndi Sawaska, of Dyer, $3.5 million Thursday for the wrongful death of their 2-year-old son more than four years ago.

Merrillville attorney Barry Rooth said the couple's son Kyle died May 19, 2000, after going into shock at St. Margaret Mercy Healthcare Center in Hammond. He was admitted to the pediatric intensive care unit the same day for treatment of vomiting and dehydration.

Rooth said the pediatrician attending Kyle consulted with Dr. Gloria Buentello, a pediatric gastroenterologist, on his treatment. According to Rooth, Buentello testified during the trial that although she was concerned Kyle had received several enemas that could have caused an electrolyte disturbance, she failed to order new tests to determine if that was the case. Instead, she relied on tests from the previous day. Rooth argued if Buentello hadn't failed to order new tests, the problem with Kyle's potassium would have been diagnosed and easily corrected.

The jury found the Sawaskas suffered damages totaling $5 million and Buentello was 70 percent responsible for Kyle's death.

http://nwitimes.com/news/state-and-regional/article_5eaeb298-6a39-56fe-87e8-1ee5e6b6d3ef.html

GUEST COMMENTARY: Malpractice lawsuits perform a role of justice:

By Barry D. Rooth | Posted: Tuesday, December 29, 2009:

The recent apprehension of Dr. Mark Weinberger has generated enormous local and national attention, with the media revisiting the intriguing circumstances of his disappearance and reporting on the details of his accidental capture in a tent at the foot of an Italian glacier.

These headlines appear at a time when there is an ongoing national debate about reforms to fix the problems inherent in our health care system.

Of course, no discussion of health care can occur without the opponents of reform focusing on the evils of a tort system that allows patients and their lawyers to sue doctors for medical negligence.

The "tort-reformers" argue that it's these lawsuits that add billions of dollars to the nation's medical costs as doctors perform otherwise unnecessary tests to defend against potential malpractice claims.

We are also told that frivolous lawsuits filed by greedy plaintiff's lawyers threaten the doctors' ability to practice on account of the exorbitant costs of lottery-type verdicts and increased malpractice insurance premiums.

I think few Hoosiers understand the extensive limitations already imposed upon Indiana patients and malpractice actions.

In the 1970s, under the leadership of Gov. Otis Bowen, a doctor, our Legislature passed the Indiana Medical Malpractice Act, a comprehensive overhaul of the medical malpractice system that imposed extensive and unprecedented restrictions upon the filing and prosecution of a medical malpractice claim.

The statute provides, among other things, that every case under the act must be submitted to a panel composed of doctors charged with reviewing the conduct of their peers. Only about 19 percent of the panels find in favor of the patient. Attorney's fees are limited by the act, a doctor will never be required to pay the injured patient more than $250,000 (before 1999, the limit was $100,000), and the patient's recovery is capped.

While Indiana already has the most restrictive medical malpractice laws in the country, we now hear that the new health care reforms will further limit a patient's recovery of noneconomic damages to $250,000. If passed, the law will now make it possible for the owner of a prized racehorse to collect more for the horse's death than the parents of a child killed by medical negligence.

What neither the Indiana act nor the proposed reforms do, however, is find a way to effectively identify and protect the public against doctors who practice well beyond acceptable boundaries. If one subscribes to the "80/20 Rule," in which 20 percent of physicians are said to be responsible for 80 percent of the medical negligence claims, then identifying methods for improving quality of care for the 20 percent will go a long way to cutting back on malpractice claims and even putting attorneys like me out of business.

There should be no doubt that medical errors are a real societal problem. According to a July 26, 2000, article from the Journal of the American Medical Association, "44,000 and perhaps as many as 98,000 hospitalized Americans die every year from medical errors." While these are significant numbers, they do not account for non-hospital deaths from medical errors.

I cite these studies not to impugn the overwhelming majority of competent, caring and often brilliant physicians practicing in our community. I do it as a reminder that the medical community can do more to police itself.

All of which brings us to the famous Dr. Weinberger and the lessons that can be learned from his spectacular downfall. While he meticulously crafted a practice that minimized his interaction with his peers, he was not entirely sequestered. Many in the medical community knew of his alleged aberrant and negligent practices, but very few saw fit to take steps to bring his actions to light.

In January 2004, our office represented two patients in lawsuits filed against Dr. Weinberger. By the summer of 2004, a couple of months before he fled the country, our law firm was investigating 18 additional lawsuits.

I say this to remind those critical of the tort system that medical negligence claims do have utility beyond enraging physicians and the political right. In addition to providing justice for those harmed by negligence, they often expose medical practices and behavior that no reasonable person can defend, thus making our communities safer for those in need of medical care.

Barry D. Rooth is a lawyer with Merrillville-based Theodoros & Rooth, P.C.

http://nwitimes.com/news/opinion/guest-commentary/article_a8f0de6a-3d4a-52dc-b56a-79ae7c981fec.html