July 2010 Archives

After two years of medical malpractice premium rate freezes, New York physicians will see their premiums increase an average of 5% this year. These increases, which took effect on July 1, vary for doctors depending on their specialty and geographic location.

New York State Insurance Superintendent James J. Wrynn, who approved the rates, said the increase "will help hold the line on costs for physicians while giving the insurance companies the resources to pay claims as they come due."

The 5% base rate increase was approved for the two largest carriers in the state, as well as two smaller specialty carriers. However, members of the Medical Malpractice Insurance Pool--the state's insurer of last resort, providing insurance for those not able to obtain coverage in the voluntary market--received an average increase of 9.9%.

Wrynn added that even though this increase should bring some relief to both doctors and insurers, there needs to be long-term solutions as the state cannot afford to lose doctors because of high medical malpractice insurance rates, and patients need to be properly protected.

When patients are not properly protected and malpractice is committed, they should seek the services of an attorney who knows the healthcare arena. Dr. Bruce G. Fagel is an attorney who only handles medical malpractice cases, and he is a licensed physician. Call him at 800/541-9376, or visit his website at www.medicalmalpracticedoctorlawyer.com, for a free consultation.

A bill designed to help attract physicians to volunteer their services in medically underserved areas with free malpractice coverage is facing stiff opposition. The bill, recently passed by the House Energy and Commerce Health subcommittee, would provide malpractice coverage to doctors volunteering at community health centers--private facilities receiving federal funds to treat patients where care is lacking.

Similar bills have passed the House before, but each time they die in the Senate because trial lawyers, major supporters of Democratic campaigns, oppose these measures. It is believed that many retired or semi-retired physicians would like to volunteer at the centers, but do not because of malpractice concerns.

Malpractice does occur, and if you have been victimized by a physician or hospital, you need the services of an attorney who is experienced in the healthcare arena. You need Dr. Bruce G. Fagel, a licensed physician. For a free case evaluation, call him at 800/541-9376. You can also reach him through his website at www.medicalmalpracticedoctorlawyer.com.

As of late last month, physicians in California must inform their patients that they are licensed by the Medical Board of California, and include the Board's contact information. The information must read as follows:

NOTICE TO CONSUMERS

Medical doctors are licensed and regulated by the

Medical Board of California

800/633-2322

www.mbc.ca.gov

The purpose of the new requirement is to inform consumers where to go for information or with a complaint about California medical doctors. This can be done in one of three ways by physicians:

• Prominently posting a sign in an area of their offices conspicuous to patients in a minimum of 48-point type
• Including the notice in a written statement, signed and dated by the patient or the patient's representative, and kept in that patient's file, staing the patient understands the physician is licensed and regulated by the Board
• Including the notice in a statement on letterhead, discharge instructions, or other document given to a patient or the patient's representative, where the notice is placed immediately above the signature line for the patient in at least 14-point type.

These options are designed to serve a multitude of practice settings, including emergency departments, skilled nursing facilities and surgical settings. In every setting where they practice, physicians are responsible for compliance with this regulation, not the facility. In a group setting, only one sign must be posted--should the physicians choose that option--but it must be one that each patient can see. The Board said it expects a good-faith, common-sense interpretation and compliance with this regulation.

Obviously, one of the instances in which a patient would be interested in this notification is when malpractice is committed. If you are interested in filing a medical malpractice claim, you should seek the services of an attorney who understands medicine. Dr. Bruce G. Fagel is an attorney who is a licensed physician. For a free consultation, call him at 800/541-9376, or visit him online at www.fagellaw.com.

In an effort to reduce medical malpractice costs, five New York City hospitals--three in Manhattan, one in Brooklyn and one in the Bronx--have agreed to be part of a pilot program in which they will divulge medical mistakes early, offer settlements quickly and utilize special "health courts." Judges in these courts will help negotiate agreements before cases go to trial. Four of the five hospitals will focus on efforts to reduce errors in obstetrics, while the fifth hospital will focus on preventing surgical errors.

The program is funded by the federal government. Aimed at reducing the $1.4 billion spent annually in New York State on medical malpractice premiums, the program is for three years and costs $3 million. 

While patients and families will be encouraged to solve their disputes with hospitals through this system, they will still have the option to seek a jury trial. Nicholas Timko, president of the New York State Trial Lawyers Association is hopeful about this new system, but expressed his concerns: "We favor initiatives that promote patient safety, but are concerned that the disclosure and early settlement program may allow negligent providers to escape responsibility for their actions and exploit patients unrepresented by counsel."

If you have a medical malpractice case and seek an attorney who is also a licensed doctor, you should contact Dr. Bruce G. Fagel. His track record of success is due to his knowing the legal and medical fields so well. Call him at 800/541-9376 for a free consultation, or visit his website at www.fagellaw.com.  

Last week, the American College of Obstetricians and Gynecologists (ACOG) issued new guidelines stating that attempting a vaginal birth after cesarean (VBAC) is a safe and appropriate choice for most women who have had a prior cesarean delivery, as well as for some women who have had two previous cesareans.

The cesarean delivery rate in the U.S. increased dramatically over the past four decades--from 5% in 1970 to over 30% in 2007. Before 1970, the standard practice was to perform a repeat cesarean after a prior cesarean birth. During the 1970's, as women had successful VBACs, it was considered a viable option. The VBAC rate increased from just over 5% in 1985 to 28% by 1996, but then began a steady decline. By 2006, the VBAC rate fell to 8.5%, reflecting restrictions hospitals and insurers placed on the trial of labor after cesarean (TOLAC) as well as decisions by patients when presented with the risks and benefits.

In keeping with past recommendations, ACOG says most women with one previous cesarean delivery with a low-transverse incision are candidates for and should be counseled about VBAC and offered a TOLAC. Approximately 60-80% of appropriate candidates who attempt VBAC will be successful. A VBAC avoids major abdominal surgery, lowers a woman's risk of hemorrhage and infection, and shortens postpartum recovery. It may also help women avoid the possible future risks of having multiple cesareans such as hysterectomy, bowel and bladder injury, transfusion, infection and abnormal placenta conditions.

Both repeat cesarean and a TOLAC carry risks including maternal hemorrhage, infection, blood clots, hysterectomy and death. Most maternal injury that occurs during a TOLAC happens when a repeat cesarean becomes necessary after the TOLAC fails. A successful VBAC has fewer complications than an elective repeat cesarean, while a failed TOLAC has more complications than an elective repeat cesarean.

The risk of uterine rupture during a TOLAC is less than 1%, but if it occurs it is an emergency situation that can cause serious injury to a mother and baby. ACOG maintains that a TOLAC is most safely undertaken where staff can immediately provide an emergency cesarean.

Lastly, ACOG says that restrictive VBAC policies should not be used to force women to undergo a repeat cesarean delivery against their will if, for example, a woman in labor presents for care and declines a repeat cesarean delivery at a center that does not support TOLAC. If, during prenatal care, a physician is uncomfortable with a patient's desire to undergo VBAC, it is appropriate to refer her to another physician or center.

The fact is that much can wrong during childbirth, and often it is the result of medical malpractice. When that is the case, you should seek the services of Dr. Bruce G. Fagel, one of the nation's preeminent birth injury plaintiff attorneys. Call him at 800/541-9376 or go to his website at www.birthinjurydoctorlawyer.com.

Last week a Virginia judge reduced a $3 million medical malpractice jury verdict against a local gynecologist to $1.9 million because of a state law capping such awards.

A woman was injured when her hysterectomy went awry. During the operation, the doctor allegedly placed sutures that lacerated the patient's rectum. The patient realized that something was wrong in the days after the surgery when she began to experience rectal bleeding. She needed several additional surgeries to correct the problem, including a colostomy procedure.

The patient incurred losses of $125,000 in medical costs and lost wages because of the surgical error. The jury announced a $3 million verdict after a three-day trial. Her attorneys knew the amount would likely be reduced because of the state's medical malpractice cap. The attorneys filed a brief arguing that the cap was unconstitutional, but the judge rejected their argument.

Many states have imposed caps on medical malpractice awards, but if you have a case that should not dissuade you from filing a suit. And if you want the services of an attorney who is a licensed physician, you should contact Dr. Bruce G. Fagel. Call him at 800/541-9376 for a free consultation. Visit him online at www.fagellaw.com.

Earlier this week. the Wisconsin Supreme Court ruled that the state must repay a medical malpractice fund more than $200 million it took to balance the budget three years ago. In a 5-2 decision, the court agreed with the Wisconsin Medical Society that taking the money from the fund used to help pay malpractice claims was unconstitutional. It sent the case back to a lower court with directions to pay back the money with interest and lost earnings.

A medical society spokesperson said the ruling was a "big win" for Wisconsin citizens as they can be assured that there is adequate financial resources to pay medical malpractice claims. About 13,000 healthcare providers participate in the fund, which was created in 1975. The fund has been credited with keeping malpractice insurance rates low as it pays for claims that are more than a provider's primary malpractice insurance coverage--generally $1 million per claim.

If you have a medical malpractice case, and want the services of an attorney who is also a licensed physician, call Dr. Bruce G. Fagel. He has a nearly 30-year track record of success with medical malpractice cases. Call him at 800/541-9376 or visit his website at www.medicalmalpracticedoctorlawyer.com.

A Florida Appeals Court agreed with a lower court's ruling that a patient does not have a medical malpractice case against a physician who revealed her medical condition in front of her daughters. They were visiting their mother who was hospitalized for a bladder infection, The defendant-physician walked in and asked the patient whether she was continuing with her HIV medications.

The patient sued the physician for medical malpractice, alleging that his query caused mental anguish and emotional distress. The court held that normally in order to be victorious in a medical malpractice case a plaintiff must demonstrate that a doctor owed the plaintiff a duty of care, the doctor breached the duty of care, and the breach caused injuries and damages are owed.

In this case the court held that since the plaintiff could not show that her daughters had heard the physician's question, no actual disclosure took place, and therefore the plaintiff could not show damages.

If you are uncertain but think you have been victimized by medical malpractice, call The Law Offices of Dr. Bruce G. Fagel and Associates for a free case evaluation. Call 800/541-9376 today, or visit online at www.medicalmalpracticedoctorlawyer.com.  

A new study hopes to determine whether waiting two minutes to clamp a newborn's umbilical cord after delivery could improve how well he or she recovers from corrective heart surgery. Typically, physicians clamp and cut the imbilical cord immediately following delivery. Some physicians believe that delaying the clamping of the cord would increase the flow of blood from the placenta to the child.

The practice of delayed umbilical cord clamping has been shown to improve hematocrit levels, leading to an increased number of oxygen-carrying red blood cells throughout the body. Hematocrit levels are an important factor during surgery, and blood transfusions are often required to replace blood lost during complicated procedures.

Dr.Carl Backes Jr., a neonatology fellow, has received a $125,000 two-year grant from the American Heart Association. He will use the grant to study whether delayed umbilical cord clamping could have a positive impact on surgical outcomes. When a baby being cared for prenatally at Ohio State University Medical Center is identified in the womb as having a prenatal heart lesion, doctors will determine whether the baby has critical congenital heart disease likely to require surgery within the first month of life. If so, Dr. Backes will work collaboratively with medical center obstetricians to coordinate the timing of the umbilical cord clamping.

Each baby's umbilical cord will either be clamped right away or the clamping will be delayed for 120 seconds post-delivery. The research team will then monitor the children's progress for two years, comparing differences between the groups. Dr. Backes said he suspects that delayed clamping has additional benefits other than improving hematocrit levels.

Medical advances are being made all the time. When a doctor is unaware of new techniques and doesn't use them, it could be medical malpractice. If you or a family member has been victimized by malpractice, call Dr. Bruce G. Fagel, a practicing attorney and licensed physician. Contact him at 800/541-9376 or www.fagellaw.com.

Last month a federal jury found a Kansas doctor and his wife guilty of conspiring to profit from illegally prescribing painkillers to dozens of patients who later died. Dr. Stephen Schneider and his wife Linda were charged in a 34-count indictment with unlawful dispensing of drugs, healthcare fraud and money laundering. Jurors convicted them of a money-making conspiracy that was linked to 68 overdose deaths. They were directly charged in 21 of those deaths.

The government accused Dr. Schneider of being little more than a drug dealer who did not carefully monitor cases, prescribed excessive dosages and wrote prescriptions so freely he became known among his patients as the "Candy Man." Prosecutors said the couple did not alter their practices even after getting notices their patients were turning up in emergency rooms and at the morgue following overdoses.

Defense attorneys contended it was impossible to know whether patients died from overdoses or other serious cardiac problems because the local medical examiner did not do internal examinations whenever a toxicology report showed high drug levels.

If you have been wronged by a doctor, you might have a medical malpractice case. The Law Offices of Dr. Bruce G. Fagel and Associates have successfully fought against medical malpractice for nearly 30 years. If you need our services, call us at 800/541-9376 or go to www.medicalmalpracticedoctorlawyer.com.

The Journal of the American Medical Association published a survey this week stating that many American physicians fail to report troubled colleagues to authorities. The consensus is that either someone else will take care of it, nothing will happen as a result of making a report, or they could be targeted for retribution. The findings are based on a survey of 1,890 physicians.

Nearly one in five physicians surveyed had direct, personal knowledege of an impaired or incompetent physician in their workplaces. One-third of those doctors had not reported the matter to authorities such as hospital officials or state medical boards. Programs exist for retraining doctors with weak skills and getting addicted ones into treatment. However, the survey results suggest doctors are not confident in the system.

The American Medical Association and other professional groups say doctors have an obligation to report on their colleagues. Many states require physicians to tell authorities about colleagues who endanger patients because of alcoholism, drug abuse or mental illness. The survey did not specify the type or severity of the impairment or incompetence. Respondents were asked: "In the last three years, have you had direct, personal knowledge of a physician who was impaired or incompetent to practice medicine in your hospital, group or practice?"

Impaired doctors are a botched surgery or wrongful death waiting to happen. When you put your trust and life in a doctor's hands, he or she must act in a professional, responsible manner. Otherwise, medical malpractice can occur. If you are victimized by malpractice, you need the services of a successful attorney who understands medicine. You need to call Dr. Bruce G. Fagel, a licensed attorney and physician. Call him today at 800/541-9376 for a free consultation. On the web, visit him at www.fagellaw.com.

The International Stem Cell Institute (ISCI) has announced the launch of stem cell therapy treatments aimed at helping those with cerebral palsy. The procedure--safely and comfortably administering placental stem cells into several key parts of the body--is a leading-edge alternative CP treatment proving highly effective for infants and even older children with CP.

ISCI Executive Director Rita Alexander acknowledges that while the condition can't be completely cured, the stem cell treatment is dramatically improving the quality of life for many children, often exceeding their parents' expectations.

Additionally, the stem cell treatments are being viewed as a potent medical tool in treating the seizures, difficulty with vision, hearing and speech, incontinence, and recurring lung infections that children can often experience with CP. One million children in the U.S. have CP, and that number is expected to rise with increases in the number of multiple births and survival rates of premature infants.

Cerebral palsy often is the result of medical malpractice prior to or at the time of a baby's birth. The Law Offices of Dr. Bruce G. Fagel and Associates has an excellent success rate in cerebral palsy cases. Call us at 800/541-9376, or visit us online at www.brucefagellaw.com, for a free consultation. 

Doctors at some Illinois and Florida hospitals are coming under scrutiny after a report questioned the use of double CT scans that subjected patients to higher radiation levels. A possible increase in cancer could be a result. These hospitals have launched investigations, and physicians are beginning to focus on curbing the use of the scans.

Nearly 5,000 hospitals across the nation submit information to the federal government, which posts this information on a website called Hospital Compare.

Computed tomography scans are increasing dramatically. About 70 million were performed in 2007 as opposed to 3 million in 1980. That increase has led to greater scrutiny from several government agencies and medical groups concerned about patients' exposure to radiation. In February, the Food and Drug Administration announced it was implementing measures to increase regulation of all CT scans.

If increased radiation causes cancer, it could be medical malpractice. If you or a loved one is a victim of medical malpractice, you need the services of an attorney who understands what should and shouldn't happen in a hospital. Dr. Bruce G. Fagel, an attorney who is also a licensed physician, is who you need working on your behalf. Call him at 800/541-9376, or visit on line at www.medicalmalpracticedoctorlawyer.com, for a free consultation.

The Accreditation Council for Graduate Medical Education has proposed a change whereby resident doctors would work shorter shifts and receive more supervision. This change responds to concerns about medical errors made by tired and overworked residents.Currently, many residents work shifts that can stretch longer than a day with little rest. Studies show this often results in errors being made.

Under the proposed changes the maximum length of work for a first-year resident would be cut from 24 hours to 16 hours. However, second-year residents would still be allowed to work 24-hour shifts.

These changes are being hailed by physicians and patient advocates as a step in the right direction, even though it is likely to pose logistical and financial challenges for teaching hospitals.

Errors that are made by overworked and tired residents can have devastating results. If you are injured due to medical malpractice, we can assist you. Call The Law Offices of Dr. Bruce G. Fagel and Associates at 800/541-9376 for a free case evaluation. You can also visit us online at www.fagellaw.com.  

A lack of skilled attendants at birth accounts for 2 million preventable maternal deaths, stillbirths and newborn deaths each year, according to a recently released study entitled Countdown to 2015 Decade Report. The report shows that nearly 50% in the 68 countries tracked--most of which are in Africa and Asia--still give birth without the aid of a trained midwife, nurse, doctor or other skilled birth attendant. Only 10 of the 68 countries have increased the rate of skilled care at childbirth by at least 10% since 1990.

In two years since the publication of the previous Countdown report, 19 million women and children under 5 have died because of preventable or treatable conditions. Pneumonia, diarrhea and malaria continue to kill more than 3 million children every year.

The new report includes good news and bad news. The good news is that the under-5 child mortality rate has declined by 28%, from an estimated 90 deaths per 1,000 live births in 1990 to 65 deaths per 1,000 in 2008, accounting for a reduction of nearly 4 million child deaths per year. That news is balanced by the finding that most Countdown countries are not progressing fast enough, and many may not meet the 2015 deadline on reducing child deaths.

Even with our advanced medical technology, the United States has a high number of birth injuries and death. Many times this is the result of an error made by someone prior to or during the birthing process. If this unfortunate incident happens to you or your family, call The Law Offices of Dr. Bruce G. Fagel and Associates. As an attorney who is also a licensed physician, Dr. Fagel knows what should and shouldn't happen in the hospital. Call him at 800/541-9376 or visit online at www.birthinjurydoctorlawyer.com.

According to a recent survey published by the Archives of Internal Medicine, 90% of the physician respondents said they overtest and overtreat to protect themselves from malpractice lawsuits. These findings echo a recent Associated Press story in which many emergency room doctors said lawsuit fears are the primary reason for overtreating in the ER. The survey of more than 1,200 physicians nationwide included ER doctors and other specialists, surgeons and primary care physicians.

The survey asked two questions: "Do physicians order more tests and procedures than patients need to protect themselves from malpractice suits?" and "Are protections against unwarranted malpractice lawsuits needed to decrease the unnecessary use of diagnostic tests?" Overall, 91% of doctors surveyed affirmatively to both questions.

Overall, almost 93% of male physicians said doctors order unnecessary tests because of malpractice concerns, versus 87% of female physicians. Equal numbers of men and women said protection from unwarranted lawsuits is needed to decrease overtesting. The survey didn't ask doctors if they personally ordered needless tests because of malpractice concerns.

Even with overtesting and overtreating, medical malpractice does occur on a regular basis. If you need the services of one of the nation's most successful malpractice attorneys, contact Dr. Bruce G. Fagel, an attorney who is also a licensed physician. Call 800/541-9376 for a free consultation.

The Hartford Courant (www.courant.com) reported last week that a Connecticut Superior Court jury awarded $1.35 million in a medical malpractice lawsuit that tested whether an unmarried same-sex partner could recover for loss of consortium.

In January 2006, Margaret Mueller sued her oncologists because she claims they treated her for years for the wrong form of cancer--which ultimately led to the surgical removal of part of her intestines and colon. Mueller died three years later, and a Stamford jury found damages of $2.45 million. Before trial, one defendant settled for an undisclosed sum, and a second defendant was found 55% liable in the amount of $1.35 million.

The suit also included a claim of loss of consortium on behalf of Mueller's long-time partner, Charlotte Stacey, whom Mueller joined in a civil union in November 2005, a month after the state's civil union law went into effect. In 2008, a judge threw out Stacey's claims, ruling that while Mueller and Stacey had been partners for more than 20 years, they were not legally married at the time of the malpractice. Stacey's attorney said they are deciding whether they will challenge the rejected loss of consortium claim. The attorney said that while the law does not permit a party to marry into a cause of action, Mueller and Stacey were prevented from marrying only on the basis of what was later deemed an unconstitutional law.

Delayed diagnosis of cancer is an example of medical malpractice. If you or someone you know has been victimized by medical malpractice, contact The Law Offices of Dr. Bruce G. Fagel and Associates. Medical malpractice is all we do. Call or click today. Call 800/541-9376 or click www.medicalmalpracticedoctorlawyer.com.

For the past week, I've stated reasons why medical malpractice will always exist. With this post, I conclude this series, and ironically it is the most correctable of all the reasons detailed previously. It is the pervasive attitude among doctors, nurses and hospital risk managers that encourages a complete lack of candor and acceptance of responsibility for actions that cause injury or death to patients. Any time there is an incident in a hospital where negligence may be the cause of a serious injury or death, the immediate response by almost all involved is a complete and total shutdown of any discussion with the patient or their family. The legal privilege and immunity granted to hospital mortality and morbidity investigations have created an atmosphere where any discussion outside of such a committee meeting is discouraged, if not completely forbidden.

Thus, when a patient or family asks the totally appropriate question, "What happened?," the most common response in the setting of a hospital or doctor's office is "I don't know." While many healthcare providers can convince themselves that such an answer is honest and not evasive, this response is far more likely to result in a consultation with an attorney in an attempt to get answers that patients and families feel they are entitled to receive. In many cases the only way to obtain such answers is through the legal system. And when healthcare providers are subject to cross-examination either before or during trial, it becomes obvious that in most cases there is an intentional effort to obfuscate, confuse, and ultimately avoid responsibility for their actions. This attitude by most doctors and nurses, which is often encouraged by defense attorneys who instruct their witnesses to not answer many reasonable questions at depositions, is what most juries utilize to finally decide the facts in medical malpractice cases.

While negligence is defined as a failure to fulfill a duty owed to a patient and does not require any intentional act or motivation, many jurors are ultimately convinced of the negligence of a doctor or nurse by the intentional evasion that many such healthcare providers utilize when they must explain their actions. Often, it is not the original act that provokes the public's anger, rather it is the cover-up that people resent. People are usually quite forgiving, especially when doctors and nurses are involved. However, since a cover-up is always intentional, such an action shows the true character of a defendant. The public rarely forgives a cover-up. Many medical malpractice cases, therefore, focus not on the medical facts and issues, but rather on the cover-up of those facts, which always starts almost immediately after the event. Most doctors and nurses believe they are required to forget anything untoward that has happened in relation to a patient's care, but in reality it is not human nature to forget such events.

 The real value of our jury system in medical malpractice cases has nothing to do with the juror's ability to understand the medical facts and issues that are placed before them (it is widely accepted that very little of the medical information presented to a jury is understood by them), rather it is the ability of the jury to understand when a witness is telling the truth that allows our system to function.

Yes, medical malpractice will always exist. If you are victimized by medical malpractice, I can help you. Call The Law Offices of Dr. Bruce G. Fagel and Associates at 800/541-9376 today for a free consultation. We have a track record of success in getting large amounts for our clients. Visit us at www.fagellaw.com.

Last week I detailed five reasons I believe medical malpractice will always exist. Today is part six, and tomorrow will be the seventh and final installment in this series.

The sixth reason is related to the changing economics of medical care. The widening gap between income and expenses for both doctors and hospitals requires numerous efforts to save money. However, in an increasingly complex scientific environment, often it is the redundancy of personnel that provides the safety net required in modern healthcare.

Entering a doctor's office or hospital is often a risk enterprise, and it is often the intercession of a nurse or a second physician that prevents more catastrophes from occurring. The number of medication errors that are caught by a second look or review, as well as the everyday reminders from conversations between physicians or between nurses and physicians that result in the discovery of a potential problem before it occurs, are examples of how the healthcare profession requires more redundancy, not less. Yet the economics of healthcare are forcing the opposite effect of eliminating the checks and balances that protect patients. In something as basic as the administration of medications, where the number and nature of pharmaceutical interactions has been increasing almost geometrically, few hospitals can afford the computerization necessary to reduce the risk of such medication errors. The increasing use of part-time or per-diem nurses, which avoids the costs of benefits paid by the hospital, only increases the problems of inexperienced nurses and miscommunications with physicians.

The high cost of hospital care has also led to a dramatic increase in the number and nature of medical and surgical procedures being performed in physicians' offices or outpatient surgical centers. In addition, the use of nurse anesthetists and other healthcare personnel who can provide care at a lower cost, increases the risk of patient injuries from a variety of problems.

Although the vast majority of patients can receive care outside of a high-cost hospital setting without any problem or injury, even if 1% of such patients suffer an injury or death, the facts underlying the malpractice in such cases often indicate an economic motivation through the use of lower-cost facilities and personnel. Many times these cases involve elective procedures on otherwise healthy patients where there are few, if any, reasons for the injury or death, other than specific communication errors or other basic problems. The very fact that such patients are perceived as healthy often results in incorrect assumptions about problems that may develop in a post-operative setting and a delay in providing proper and required treatment.

Even when there is malpractice, it can be difficult to prove in the hands of an unskilled attorney. As a licensed attorney and physician, I have a track record of success in these types of cases. Call The Law Offices of Dr. Bruce G. Fagel and Associates at 800/541-9376 for a free consultation. Also, we are online at www.medicalmalpracticedoctorlawyer.com.

Reason number five for the perpetuation of medical malpractice: nursing shortages. Because of the shortage many hospitals are forced to use foreign-trained nurses and part-time or temporary personnel. At the same time many of the better nurses are becoming nurse practitioners, nurse-midwives, physician assistants or administrators, further diminishing the availability of experienced nurses at the staff level.

Most physicians increasingly rely on nurses to care for their patients, monitor their condition, and report on the need for physician involvement. Many staff nurses view this trend as recognition of the important role that nurses play in medical/hospital care of patients, and some tend to assume a greater role in such care based on their own custom and practice, which often may have little or no scientific basis other than the nurse's own experience.

When staff turnover or increasing use of nurses who are part-time or nurses who float from one area to another in a hospital occurs, then the potential for assumptions leading to inadequate communication between physicians and nurses increase. When foreign-trained nurses--who bring with them both language and cultural issues--are involved, the potential for miscommunications and inaccurate assumptions about the proper role and responsibility of the nurse versus the physcian increases dramatically.

Medical malpractice often is the result of miscommunication and/or innaccurate assumptions. If you think you have a malpractice case, call me at 800/541-9376 for a free case evaluation. You can also visit our website at www.medicalmalpracticedoctorlawyer.com. 

Previously this week I've stated three reasons I believe there will always be medical malpractice. A fourth reason I think it will continue is the fact that the scientific basis of medicine is far more complex today than it was when most physicians were trained, and this trend is likely to continue in the future. Much of the scientific basis for the current practice of medicine did not exist at the time when many physicians obtained their basic medical training. While many of the American specialty boards now require recertification, many do not. For example, the American Board of Obstetricians and Gynecologists requires recertification only for physicians who became board-certified after 1985. Older physicians who obtained their training before 1985 remain board-certified forever.

The attempts by some of the specialty organizations to promote evidence-based outcome data as the basis for care recommendations represents a recognition that scientifically based objective data should be the basis of medical care. However, even when there is reasonably clear data to substantiate specific medical care, the specialty organizations are reluctant to recommend a course of treatment or action that could be defined as a standard of care.

The medical profession refuses to provide sufficiently clear policies or procedures for fear that such specifics could be used to prove that a different course of action would be defined as below the standard of care. As a result of these trends, there are many physicians who cannot adequately explain or understand the scientific basis of their actions and are forced to rely on a custom and practice that may be supportable only because of the absence of any clear data to the contrary.

As the interactions between different specialties and between different healthcare providers increase--especially in relation to patients with complicated medical or surgical problems--the inability of many physicians to understand the science involved in their practice will only increase the potential for misunderstandings and miscommunications between various healthcare providers.

If you have been victimized by medical malpractice, I can help. As an attorney who is a licensed physician, I understand what should and shouldn't happen in the emergency room and in the hospital. Call me for a free consultation at 800/541-9376, or visit our firm's website at www.fagellaw.com.