Virginia Medical Malpractice Blog - Williamson & Lavecchia, L.C.

Treating the Medical Hit and Run

Tips for Preventing Medication Errors

Doctors Push "Gag Contracts" on Patients

The Medical Justice Corporation, a Greensboro, N.C. entity headed by Dr. Jeffrey Segal, has been advising its members to use a standard one-page “contract” with all patients before they treat them. The document specifies “you agree to refrain from directly or indirectly publishing or airing commentary” about your doctor or your medical records. 

This practice, begun in 2007 and in use by over 1000 physicians nationwide, is in response to various doctor-rating websites that have become popular, such as RateMD.com. Medical Justice Corporation began as an organization devoted to preventing patients from successfully recovering for their malpractice injuries, and files lawsuits against expert witnesses who agree to testify against doctors.

This type of agreement clearly violates the public policy favoring open discussion of medical treatment. Of course, good physicians have nothing to fear from such discussion. The “contracts” attempt to force patients to choose between health care and their First Amendment rights, and many are simply choosing another doctor instead of signing them.

Patients in Virginia have the right to discuss their medical treatment with whomever they wish, and giving up that right to see a doctor who requires one of these agreements is not a fair trade.

Preventing Medication Errors

States Weigh the Merits of Medical Malpractice Caps

Too many lawsuits or too much malpractice?

Watching the news and listening to politicians you would assume there are far too many frivolous lawsuits that are driving doctors out of business.  Is there any truth to those claims?  Well the facts show that the frivolous lawsuit theory is nothing more than a myth according to a recent article published in the Canadian Medical Journal.  Click here to read the article.

Medical Malpractice Myths

Medical Malpractice Cap on Damages

Virginia has had a medical malpractice cap for approximately 30 years.  What that means is there is an arbitrary limit to the amount a victim of medical malpractice may recover regardless of how badly the victim was injured or the amount of medical bills or lost wages.  Currently the cap is $2,000,000. 

$2,000,000 is sufficient in most cases, but there are no exceptions to the cap.  In many cases the cap creates an incredible injustice.  Take the hypothetical example of a doctor or nurse who negligently overdoses a 40 year old patient on medications which cause a brain injury.  The patient remains hospitalized for 1-2 months and incurs medical expenses over $500,000.  He can no longer work at his job paying $50,000/year.  He will require in home care or permanent placement in a nursing home at a cost of over $50,000/year.  Therefore even without compensating him for his tremendous pain and loss of enjoyment of life, his medical bills and lost income exceed the maximum recovery under the Virginia:

$500,000 past medical expenses + $1,250,000 in lost income until age 65 + $1,750,000 in future medical bills (based on average life expectancy)

Total medical bills and lost income = $3.5 million

The victim under Virginia law can only collect $2,000,000 leaving him with $1.5 million in uncompensated medical bills and lost income.  Again we are not even taking into account his tremendous loss of enjoyment of life, dignity, pain, and suffering.

We believe that every person and every company should take responsibility for the consequences of their negligence including  doctors, nursing homes, hospitals, assisted living facilities, pharmacists, lawyers, truck drivers, contractosr, etc.

If you believe that you or a loved one is a victim of medical malpractice, you are welcome to contact us by phone at (804) 288-1661 or click here to contact us by email to discuss your legal rights.  We represent victims of malpractice and other types of wrongful conduct throughout Virginia including Richmond, Petersburg, Fredericksburg, Charlottesville, Hampton Roads, and northern Virginia.

Regards,

Josh Silverman

Will Someone Take Responsibility for Medication Errors?

Thousands of times a day a patient is injured due to a medication error.  In many cases the patient tragically dies.  We have seen this happen with blood thinners (Coumadin, Lovenox & Heparin), antibiotics (Gentamicin, Vancomycin, etc.) and numerous other medications.  Instead of taking responsibility, doctors, nurses, hospitals and pharmacists start playing the blame game. 

Holding those responsible for medication errors often falls on the shoulders of attorneys.  As attorneys much of our work occurs even before we file a lawsuit.  In the investigation we search all of the relevant medical records including physician notes, nursing notes, and pharmacy records.  We retain experts in these fields to advise us how the medication errors could have been prevented.  Finding qualified experts is a challenge in itself.  Our senior trial lawyer, Tom Williamson, has published several articles on expert witnesses that are available in our online library.  

Our goal is to file the lawsuit early enough that we will have time under the statute of limitations to add new defendants if one health care provider starts pointing fingers at another.  

The following are common types of medication errors:

• Doctor writing the incorrect dose on the prescription,
• Doctor prescribing medication that the patient is allergic to,
• Nurse administering the wrong prescription to the patient.  Often the prescription is intended for another patient,
• Nurse administering the medication incorrectly (ex. vein as opposed to muscle),
• Pharmacist misfilling the prescription (wrong dose or wrong medication),

Medication errors occur in hospitals, nursing homes, and doctors' offices.  Because they occur so frequently we have devoted a practice page to medication errors.  Please visit our medication error practice page for more information or contact us at (804) 288-1661 or by email if you or a loved one is a victim of a medication error.

Regards,

Joshua Silverman

Trial of a Medical Malpractice Case

Half of Pediatricians Would Refuse to Admit Medical Mistakes

A recent study reports two very alarming malpractice statistics:

1. Approximately 7% of all hospitalized children are victims of medical malpractice often due to medication errors.
2. Only 50% of pediatricians would admit to the mistake.

"Pediatricians would admit error only half of the time." U.S. News and World Report, October 6, 2008.


Many of the pediatricians would admit the mistake, but only if it were obvious.  In other words, they would admit their mistake only if the parents would find out on their own.  The distinction between obvious malpractice and hidden malpractice is unethical according this article.  Amongst the most common errors are accidental overdose and adverse reactions to medication.  This issue became prominent when Dennis Quaid's newborn children were given massive overdoses of a blood thinner.  As I've discussed on recent blog posts, overdoses of blood thinners like Coumadin, Lovenox, and Heparin can be lethal and Dennis Quaid's children are fortunate to be alive.  That is why there is a "black box" warning on the physician information sheets for these blood thinners.

As parents we have to trust our children's pediatricians to provide quality care and we expect them to be upfront about their mistakes so we are fully informed about the health of our children and equally importantly so the pediatrician ensures that no other children are harmed.

One of the most common statements we hear from clients as medical malpractice attorneys is that they want to make sure no one else is a victim of medical malpractice.  That point is important.  From my experience, a small percentage of physicians commit much of the medical malpractice.  By holding physicians including pediatricians accountable through medical malpractice claims, you send a strong message that malpractice can not be tolerated and you help to protect other patients from needless suffering.

At Williamson & Lavecchia, L.C. we have represented clients throughout Virginia who range in ages from infants to those in their 90s living in nursing homes and assisted living facilities.  If you or a family member has been a victim of medical malpractice, please call us at (804) 288-1661 or click here to contact us by email. 

Josh Silverman

Coumadin: Serious Side Effects and Patient Education

Majority of ER Patients Leave Hospital Confused about Treatment and Medications

Reporting Medication Errors

Are you a victim of a medication error?  If so, the attached link may interest you.  The dangers of medication errors are so serious that the FDA has asked consumers and health care professionals to report medication errors.  The attached link will take you to a form that can be entered online and submitted to the FDA. 

As I have discussed on a number of prior blog posts, medication errors are preventable in almost all cases.  They come from pharmacists misfilling a prescription, nurses administering the wrong medication or an incorrect dosage, pharmaceuticals giving different medications similar names, and physicians who write prescriptions at an incorrect dosage or prescriptions that are inappropriate for the patient. 

Our experience with victims of medication errors reflects that these errors can be fatal.  If you or a loved one is a victim of medical malpractice due to a medication error, you are invited to contact us to discuss your situation. 

Sincerely yours,

Joshua Silverman

CBS 60 Minutes Story on Medication Errors

Last night CBS broadcast a shocking report on medication errors.  It did not happen at a rural hospital or to the underprivileged.  It happened at Cedar-Sinai, the hospital of the stars in Los Angeles, to actor Dennis Quaid's children.  His infant twins were prescribed Heparin which is a common blood thinner.  Instead of being given pediatric doses, they were administered full adult strength Heparin which was 1000 times stronger than prescribed.  These children began to bleed out of their bandages, out of their belly buttons and even had blood "squirting" out of their bodies.  Fortunately the children survived and hopefully they are not permanently injured.  Right now their prognosis is promising.  To say they are lucky is probably an understatement.  We have successfully pursued wrongful death cases where the victim died from overdoses of blood thinners. 

Medical malpractice is unbelievably common.  According to CBS: "Chances are you probably know someone who has died, or nearly died, because of medical mistakes in a hospital. It's much more common than most people realize, and if it can happen to the children of movie star, at one of the finest hospitals in the country, it can happen to anyone."  In fact, every year 100,000 Americans die from medical malpractice.  It would take 100s of commercial airplane crashes to equal the preventable deaths by medical malpractice.  So where is the uproar?  That's a question I can not answer. 

We believe that holding hospitals accountable for medical malpractice is not just morally sound, it creates a financial incentive for them to provide better care.  In other words, it is cheaper to institute safeguards to prevent medical malpractice than to defend medical malpractice claims and to pay settlements and judgments. 

If you or a loved one is a victim of a medication error, please contact us to discuss your legal rights.

Sincerely yours,

Josh Silverman

Medication Error Website

Below is a link to the FDA's website on medication errors.  Yes, it is so common that the FDA has devoted a portion of its website to address medication errors.  Medication errors are defined as "any preventable event that may cause or lead to inappropriate medication use or patient harm while the medication is in the control of the health care professional, patient, or consumer. Such events may be related to professional practice, health care products, procedures, and systems, including prescribing; order communication; product labeling, packaging, and nomenclature; compounding; dispensing; distribution; administration; education; monitoring; and use." The National Coordinating Council for Medication Error Reporting and Prevention.  

The key word in that definition is preventable.  Medication errors are almost always preventable when health care providers (doctors, nurses, and pharmacists) use reasonable care.  In our experience, medication errors most often occur when a pharmacist puts the wrong medication in the patient pill bottle, a nurse gives a patient the wrong medicine, or a doctor fails to carefully and legibly prescribe medications.  Other preventable medication errors come from confusing and similarly sounding medications. For example, Serzone and Seroquel.

Medication errors can cause anywhere from no harm to death.  For example, giving a patient Tylenol instead of aspirin may be harmless, yet overdosing on medications like Coumadin (blood thinner) or Methotrexate can be fatal.  On our website we have further information about medical malpractice, the statute of limitations, and publications by our lawyers on legal rights. 

If you or a loved one is a victim of a medication error, please safely keep the medication as it may be crucial evidence in your case.   Then click here to contact us to discuss your legal rights.

Regards,

Josh Silverman

Too many medical malpractice lawsuits?

That is a claim that everyone has heard multiple times.  It is usually coupled with the argument that medical malpractice lawsuits are driving up the cost of healthcare and running good doctors out of business.  But is there any truth to these claims?

Law Professor Max Mehlman of my alma mater, Case Western, conducted an exhaustive study of these questions and found very little truth to many of these claims.  He found that the current system filters out meritless claims.  In fact, many victims of medical malpractice never hire a lawyer or file a claim because they do not know they are victims.  For example, if you are hit by a drunk driver you immediately know that you have a claim against the drunk driver.  Alternatively, if a relative dies on the operating room table the family often assumes that their relative died of natural causes as opposed to medical malpractice.  Obviously that assumption is true much of the time, but the point is that many times malpractice occurs and neither the patient nor the family is aware that they are victims of medical malpractice.

As to whether lawsuits are driving up the cost of healthcare, studies have shown that less than 1/2 of 1 percent of medical costs go towards medical malpractice insurance or claims.  With high healthcare inflation it is obvious that medical malpractice does not play any meaningful role in the cost of healthcare.

On the other hand medical malpractice lawsuits not only bring justice to victims, but they also encourage responsible medical care.  One of the purposes of medical malpractice lawsuits is to deter poor quality medicine.  For example, medical malpractice lawsuits against hospitals have led hospitals to take significant steps to improve patient care. In a recent case, the adjustor of a hospital told me that the hospital has taken new steps to prevent patients from developing pressure ulcers as a result of our case.  In other words my client may have helped save lives by holding the hospital accountable for his injuries.

Please return to our blog for more discussion on these issues or click here to send me an email with your comments and questions.

Regards,

Josh Silverman, Esq.

Arbitrary Cap on Medical Malpractice Damages in Virginia

As of July 1, 2008, the maximum amount a victim of medical malpractice can recover is $2 million in Virginia.  At first glance, that sounds like a lot of money, but is it really fair?  Consider a patient who suffers a brain injury due to medical malpractice. Her lifetime medical care could exceed $5 million.  So if the doctor's insurance company only pays $2 million, who pays the rest?  The doctor continues with his career, but the patient is left without money for basic medical care, much less compensation for lost income, pain and suffering, and a catastrophic deterioration in her quality of life. 

At Williamson & Lavecchia, L.C. we have actively lobbied against unfair medical malpractice caps.  Our position is based on a principle that everyone must take responsibility for his or her own actions regardless of whether you are a truck driver, a manufacturer, a lawyer, or a doctor.  Medical malpractice caps uniquely protect doctors from being held accountable for their carelessness. 

Medication Errors Lead to 18 Million Emergency Room Visits

"A recent study estimated that in one year, incorrect use of medications resulted in more than 9 million hospital admissions and more than 18 million emergency room visits." 

That quote is not coming from a lawyer, but from the non-profit Institute for Safe Medication Practices.  The Institute for Safe Medication Practices seeks to assist doctors, nurses, and pharmacists in reducing medication errors.  Even if you are not a health care provider, its information can help you protect yourself from the serious and potentially deadly consequences of medication errors.  The website contains a very valuable brochure to assist patients in being proactive to prevent medication errors.

Their website lays out the seriousness of the problem.  For example, doctors and nurses often use abbreviations to save time.  Too often the abbreviations are confusing and can lead to dangerous medication errors: "HS" means half-strength which can easily be confused with "hs" meaning at bedtime.  Likewise, "q1d" means daily, while "q.i.d." means four times per day.    The simple solution: write out the word "daily" instead of q1d.  That only requires 2 more characters, but it could save a life.

If you or a loved one has been injured as a consequence of a medication error by a pharmacist, doctor, or nurse, please contact us to discuss your legal rights.

Regards,

Josh Silverman

Using Technology to Prevent Medication Errors

Medication errors range from the benign to the catastrophic.  They occur due to mistakes by the prescribing physician, the pharmacist filling the prescription, the nurse administering the prescription and sometimes by the patient.  Examples include:

• Physicians writing illegible prescriptions
• Physicians prescribing medicine even though the patient is known to be allergic to one or more ingredients in the medication
• Pharmacists placing the wrong medication in the prescription bottle or syringe
• Pharmacists filling the prescription at the wrong dose
• Nurses administering the wrong medication to the patient
• Physicians and nurses failing to monitor the affect of the medication

When a patient is administered an incorrect medication or the wrong dose the harm ranges from losing the therapeutic value of the intended medication to life threatening side effects.  We have represented patients who suffered heart attacks due to medications dropping their blood pressure to patients who have tragically bled to death due blood thinning medications like Coumadin or Lovenox.

In almost all cases, these injuries can be prevented.  Studies have shown that when doctors, nurses, and pharmacists use readily available technology the error rate can drop by 80%.  For example, there is no risk of misconstruing a doctor's handwriting when the prescription is typed.  Additionally many hospitals are now using bar code systems to make sure the correct patient receives the correct medication.  Basically, each patient is given a wrist band with a bar code.  Likewwise each prescription contains a bar code.  Before a nurse administers a medication he or she should scan both the medication and the patient wrist band to ensure that the medication is given to the correct patient.

If you or a loved one has been injured due to a medication error it may have been avoidable.  Please contact us for legal guidance.

Regards,

Josh Silverman

Over 238,000 Preventable Hospital Deaths

A recent study has found that between 2004-2006 there were over 238,000 preventable hospital deaths in the United States.  Patient safety incidents cost the Medicare program over $8.8 billion!  Approximately 1,100,000 Medicare patients suffered a preventable injury or died of a preventable cause during their hospital admission. 

While hospitals argue that these injuries and deaths are not preventable, the study found huge differences in the rate of injuries and deaths between the lower tiered hospitals and hospitals recognized for excellence.   

Here is the irony in these statistics: Since Medicare is paying hospitals to treat preventable injuries, hospitals often profit from their mistakes! 

The following is a partial list of the type of preventable injuries and deaths:

• Pressure ulcers (also called bed sores or decubitus ulcers)
• Hip fractures
• Foreign body left in during surgical procedure
• Post-operative infections
• Complications of anesthesia

One way to stop hospitals from profiting from their errors is to file a medical malpractice action.  In a medical malpractice action, the hospital can be held accountable for medical bills, lost wages, pain and suffering, and any other harm it caused.  Equally important, you are giving the hospitals a financial incentive to improve care for future patients.

Regards,

Josh Silverman

30,000 Americans Wake Up During Surgery Each Year

Can you imagine waking up in the middle of surgery?  It is estimated that 30,000 patients wake up during surgery, yet they are unable to move, talk, or cry out for help.  This is thought to happen to 1 or 2 of every 1,000 surgical patients.  It is more likely to happen to children than adults.  One victim in an MSNBC story describes it like being entombed.  “While you’re laying there on the table,” she recalled, “you are thinking, praying, cursing, plotting, pleading, trying to crawl off the gurney, trying to kick, scream, move any part of your body to let them know you’re awake. In effect, you are entombed in a corpse.”

Most likely, patients wake up during surgery due to insufficient anesthesia.  During most surgeries an anesthesiologist or a nurse anesthesiologist monitors the patients vital signs and level of anesthesia.  A balance must be maintained so the patient remains unconscious but at the same time too much anesthesia can be dangerous.  While there are new technologies for measuring the patient's level of consciousness, some experts believe the best method is for the doctor to carefully follow protocols for monitoring patients' depth of sleep.

Medication Errors Injure 1.5 Million Americans

A report by The National Academies, finds that at least 1.5 million Americans are injured or killed each year due to medication errors. The extra cost of treating these injuries is estimated at $3.5 billion dollars per year excluding lost time from work and more importantly the needless suffering of victims of preventable medication errors.

Medication errors account for approximately 400,000 injuries in hospitals, 800,000 injuries in long term care facilities (nursing homes), and over 500,000 injuries in out patient clinics. 

The report recommends specific steps to reduce the frequency of medication errors.  The report recommends improved communication between physicians and patients as well as improved communication between insurance companies and patients.  You may find it surprising, but patients and their families often are never informed when medication errors occur even when the medication errors cause serious injuries or death.  The report further suggests that patients become more proactive in asking their doctors questions about how to take the medication, side effects, and providing accurate information to their doctors about all the medications they take.

Click here to read the full report.

Most problems relate to carelessness.  At home we all know that we need to be very careful with our medicines so our children do not get their hands on them.  Hospitals need to be equally diligent.  The starting point is the prescription written by the patient's physician.  Illegible handwriting is a common cause of medication errors.  Electronic prescriptions would significantly reduce these errors.  Pharmaceutical companies have complicated the job of nurses and pharmacists by giving multiple prescription medications similar names.  Then comes the problem of giving the correct medication to the correct patient.  In one prior case, our client suffered a heart attack after being given the wrong medicine.  The nurse must verify the identity of the patient, the prescription, the dose, and the correct medicine before administering the medication.

Until these medication errors are reduced, patients will continue to suffer serious and even catastrophic injuries.  If you or a loved one has been injured due to a medication error, please contact us immediately.  Your rights are subject to a strict statute of limitations. 

Sincerely yours,

Josh Silverman

Should physicians who commit medical malpractice be protected by charitable immunity?

Patient Injuries and Death Due to Medication Errors